Cooperative housing under a grant-of-use in Catalonia and health: pre-post analysis.

BACKGROUND: Housing is considered a social determinant of health. In Catalonia and Spain, ensuring affordable housing is challenging and cooperative housing under a grant-of-use emerges as an alternative, challenging traditional housing models. This study aims to quantify its impact on health before and after moving to the cooperative house. METHODS: A longitudinal study of individuals in cooperative housing projects in Catalonia (July 2018-April 2023) was conducted. Data, including sociodemographic, housing information, and health-related details, were collected through baseline and follow-up surveys. RESULTS: Seventy participants (42 women, 28 men) showed positive changes in housing conditions during follow-up. Improved perceptions of health, mental health, and social support were observed. Despite limitations in sample size and short follow-up, initial findings suggest improvements in health. CONCLUSIONS: Cooperative housing under a grant-of-use in Catalonia appears promising for improving health and living conditions. Further research is warranted to explore its full potential as an alternative amid housing challenges in the region.

A scoping review of measures examining the environments of persons with neurodevelopmental disorders in a supported housing setting.

Introduction: Having a neurodevelopmental disorder (NDD) can impact the abilities of an individual in many areas of life, including the ability to live independently. The environment of an individual impacts their day-to-day life throughout their lifespan. To improve supported housing experiences, it is important to map the evidence, especially relating to quality and satisfaction with the environment (as defined by the International Classification of Functioning, Disability and Health (ICF) framework). This has been exacerbated by COVID-19 pandemic restrictions, therefore more insight is needed in measuring this. Objective and methods: This scoping review searched 5 health and social science databases with the objective to identify and examine the outcome measures that integrate aspects of the environment that examine supported housing in individuals with NDD. Results and discussion: Fifteen studies met the inclusion criteria. We found that most measures targeted the satisfaction of individuals about their environment, with the ICF Support and Relationships factor of the environment assessed most. Measures were most often completed by a proxy through an interview. This work enhances our understanding of aspects of the environments of supported housing that are currently measured, laying an essential base for future research to improve the lives of individuals with NDDs.

Using social risks to predict unplanned hospital readmission and emergency care among hospitalized Veterans.

OBJECTIVES: (1) To estimate the association of social risk factors with unplanned readmission and emergency care after a hospital stay. (2) To create a social risk scoring index. DATA SOURCES AND SETTING: We analyzed administrative data from the Department of Veterans Affairs (VA) Corporate Data Warehouse. Settings were VA medical centers that participated in a national social work staffing program. STUDY DESIGN: We grouped socially relevant diagnoses, screenings, assessments, and procedure codes into nine social risk domains. We used logistic regression to examine the extent to which domains predicted unplanned hospital readmission and emergency department (ED) use in 30 days after hospital discharge. Covariates were age, sex, and medical readmission risk score. We used model estimates to create a percentile score signaling Veterans' health-related social risk. DATA EXTRACTION: We included 156,690 Veterans' admissions to a VA hospital with discharged to home from 1 October, 2016 to 30 September, 2022. PRINCIPAL FINDINGS: The 30-day rate of unplanned readmission was 0.074 and of ED use was 0.240. After adjustment, the social risks with greatest probability of readmission were food insecurity (adjusted probability = 0.091 [95% confidence interval: 0.082, 0.101]), legal need (0.090 [0.079, 0.102]), and neighborhood deprivation (0.081 [0.081, 0.108]); versus no social risk (0.052). The greatest adjusted probabilities of ED use were among those who had experienced food insecurity (adjusted probability 0.28 [0.26, 0.30]), legal problems (0.28 [0.26, 0.30]), and violence (0.27 [0.25, 0.29]), versus no social risk (0.21). Veterans with social risk scores in the 95th percentile had greater rates of unplanned care than those with 95th percentile Care Assessment Needs score, a clinical prediction tool used in the VA. CONCLUSIONS: Veterans with social risks may need specialized interventions and targeted resources after a hospital stay. We propose a scoring method to rate social risk for use in clinical practice and future research.

Appraising critical success factors in sustainable housing projects: A comparative study of PPP modalities in Saudi Arabia.

This study examines the critical success factors (CSFs) crucial for the effective deployment of public-private partnership (PPP) models in sustainable housing projects in the Kingdom of Saudi Arabia (KSA), underpinning the nation's Vision 2030. Through a robust methodology that incorporates a profound literature review, structured interviews, and a survey involving key stakeholders, the study prioritizes fourteen significant CSFs integral to PPP efficacy. Employing Analytical Hierarchy Process analysis, key outcomes underscore the paramount importance of technical aspects with an emphasis on sustainability, tailoring risk-sharing and allocation to encompass green technologies and eco-friendly practices, and economic stability in the light of long-term environmental sustainability in fostering successful sustainable housing projects. Notably, the Build-Operate-Transfer (BOT) model is categorized as the most effective PPP modality, attaining a mean importance score of 4.07. This model is contrasted with other modalities such as Design-Build-Operate (DBO) and Build-Own-Lease-Transfer (BOLT), which scored lower in effectiveness. This comprehensive evaluation provides crucial insights for policymakers and practitioners, emphasizing the strategic selection of PPP modalities and the prioritization of CSFs to enhance the sustainability and effectiveness of housing projects in KSA.

Exergames for falls prevention in sheltered homes: a feasibility study.

Introduction: Falls prevention is a global priority given its substantial impact on older adults and cost to healthcare systems. Advances in telerehabilitation technology such as `exergaming' show potential for delivering accessible, engaging exercise programs for older adults. This study aimed to establish the feasibility, acceptability and usability of exergaming in sheltered housing. Methods: A mixed-methods study with participants randomised in 2 sheltered housing facilities to intervention (n = 1 home, 12 participants) and control (n = 1 home 2, 12 participants) provided usual care for all, (physiotherapy prescribed strength and balance exercises and falls prevention advice) and a 6-week supervised exergaming programme (MIRA) offered 3 times per week to the intervention group only. At 6 weeks, feasibility, usability and acceptability outcomes were collected and analysed using descriptive statistics; qualitative focus groups with participants and interviews with staff were also completed and thematically analysed to elicit barriers and facilitators to usability and acceptability. Results: Mean exercise per week increased from 10.6 to 14.1 minutes in the control group and 9.6 to 36.8 minutes in the intervention group. All study processes and measures appeared feasible; 72% of those invited consented to taking part and 92% completed 6-week follow-up. Individual domains for the System Usability Scores (SUS) showed participants felt `very confident' using the system with support (70%), would `like to use exergames frequently' (50%) and found the system `easy to use' (90%). However, they also felt they `needed to learn a lot at the beginning' (40%) and would `need technical support' (70%) for independent use of the exergames. Mean overall SUS was 63 reflecting moderate usability for independent use. Qualitative data indicated exergames were well received and highlighted motivational and social aspects; costs and set up. Staff also felt exergaming complemented traditional care. Discussion: Our study contributes to the evidence guiding the use of exergames to deliver suitable falls prevention interventions for older adults within sheltered housing in community settings.

The Cumulative Impact of Unmet Essential Needs on Indicators of Attrition: Findings from a Public University Population-Based Sample of Students in the Bronx, NY.

In recent decades, a growing proportion of college students have experienced financial stress, resulting in unmet essential needs including food insecurity, housing instability, lack of healthcare access, and inadequate mental health treatment. Given that urban-based public universities constitute a substantial proportion of the US college student population, understanding how unmet needs affect academic achievement in this population is crucial for developing strategies that alleviate college failure and dropout. We examined the cumulative impact of unmet essential needs (scored from 0 to 4) on indicators of college attrition (dropout, leave of absence, risk of academic probation). The sample comprised a college population-representative sample of 1833 students attending one of three urban public colleges in the Bronx, NY. Employing adjusted multinomial and binomial logistic regression models, we assessed how total unmet essential needs predict any indicator of college attrition. Each unit increase in unmet need increased the odds of having any attrition indicator by 29% (p < 0.01). Students with two unmet needs had 43% greater odds (p < 0.01), students with three unmet needs had 57% greater odds (p < 0.01), and students with four unmet needs had 82% greater odds (p < 0.01) of having any attrition indicator compared to those without unmet needs. Findings revealed a modest dose-response relationship between the number of unmet needs and the likelihood of experiencing indicators of attrition, suggesting a cumulative impact of unmet needs on students' ability to persist to graduation. Designing interventions aimed at college students with multiple unmet essential needs, and addressing these needs holistically, may assist student retention and graduation.

Certified Peer Support in the Field of Homelessness: Stories Behind the Work.

Certified peer support specialists (CPSS) are used as a paraprofessional workforce to engage hard-to-reach populations, including people experiencing homelessness. Thematic analysis was used to explore with CPSS (N = 7) what contributed to their effectiveness when working with this population. Participants were recruited at a HUD lead organization in the southeastern United States. Open-ended semi-structured questions were used in online, synchronous interviews. Themes related to three areas, experience, competence, and the organization, contributed to participants being effective. Specifically, interviewees observed that their lived experiences and abilities to speak a common language with clients contributed to their effectiveness. They identified how personal qualities and unique skillsets suited them for the work. Participants also valued the training they received; certification helped them to develop competencies and to balance vulnerability, empathy, and connection. Finally, participants attributed their effectiveness to clarity about their roles within the organization, supervision, attention to self-care, and co-worker support. Findings from this study may have implications for the value of lived and learned knowledge coexisting in organizations serving those who experience homelessness.

Evaluating the effects of supervised consumption sites on housing prices in Montreal, Canada using interrupted time series and hedonic price models.

Background: In 2017, three brick and mortar supervised consumption sites (SCS) opened in Montreal, Canada. Opponents argued the sites would attract people who use drugs and reduce local real estate prices. Methods: We used interrupted time series and hedonic price models to evaluate the effects of Montreal's SCS on local real estate prices. We linked the Quebec Professional Association of Real Estate Brokers' housing sales data provided by Centris Inc. with census tract data and gentrification scores. Homes sold within 200 m of the SCS locations between 1 January 2014 and 31 December 2021 were included. We adjusted for internal (e.g., number of bed/bathrooms, unit size) and external attributes (e.g., neighbourhood demographics), and included a spatio-temporal lag to account for correlation between sales. For sensitivity analysis we used site-specific dummy variables to better account for unmeasured neighbourhood differences, and repeated analyses using 500 m and 1000 m radii. Results: We observed a price shock after the opening of the first two SCS in June 2017 (level effect: -10.5%, 95% CI: -19.1%, -1.1%) but prices rose faster month-to-month (trend effect: 1.1%, 95% CI: 0.7%, 1.6%) after implementation. Following the implementation of the third site in November 2017 there was no immediate impact (level effect: 2.4%, 95% CI: -10.4%, 17.0%) but once more prices roses faster (0.9%, 95% CI: 0.4%, 1.5%) thereafter. When we replaced neighbourhood attributes with a site-specific dummy variable, we observed the same pattern. Sales' prices dropped (level effect: -9.6%, 95% CI: -15.0%, -3.8%) but rose faster month-to-month (trend effect: 0.9%, 95% CI: 0.6%, 1.2%) following June 2017's SCS implementations, with no level effect (4.9%, 95% CI: -7.3%, 18.6%) and a positive trend (0.9%, 95% CI: 0.5%, 1.3%) after November 2017's SCS opening. In most 500 m and 1000 m radii models, there were no immediate shocks following SCS opening, however, positive trend effects persisted in all models. Conclusion: Our models suggest homes sold near SCS may experience a price shock immediately post-implementation, with evidence of market recovery in the months that follow.

Examining Heart Failure Outcomes Amidst Housing Insecurity.

BACKGROUND: How housing insecurity might affect patients with heart failure (HF) is not well characterized. Housing insecurity increases risks related to both communicable and non-communicable diseases. For patients with HF, housing insecurity likely increases the risk for worse outcomes and rehospitalizations. METHODS AND RESULTS: We analyzed U.S. HF hospitalizations using the 2020 National Inpatient Sample (NIS) and Nationwide Readmissions Database (NRD) to evaluate the impacts of housing insecurity on HF outcomes and hospital utilization. Individuals were identified as having housing insecurity using diagnostic ICD-10 codes. Demographics and comorbidities were compared between HF patients with and without housing insecurity. An adjusted logistic regression was performed to evaluate the relationships between housing insecurity and socioeconomic status on in-hospital mortality. Using a Cox proportional hazards model, HF patients with and without housing insecurity were evaluated for the risk of all-cause and HF-specific readmissions over time. Of the 1,003,270 hospitalizations for HF in the U.S. in 2020, 16,150 were identified as having housing insecurity (1.6%) and 987,120 were identified as having no housing insecurity (98.4%). The median age of patients with housing insecurity hospitalized for HF was 57, as compared to 73 in the population with no housing insecurity. A higher proportion of patients in the housing insecurity group were Black (35% vs 20.1%) or Hispanic (11.1% vs 7.3%). Patients with housing insecurity were more likely to carry a diagnosis of alcohol use disorder (15.2% vs 3.3%) or substance use disorder (70.2% vs 17.8%), but were less likely to use tobacco (18.3% vs 28.7%). Patients with housing insecurity were over 4.5 times more likely to have Medicaid (52.4% vs 11.3%). Median length of stay did not differ between patients with housing insecurity versus those without. Patients with housing insecurity were more likely to discharge Against Medical Advice (11.4% vs 2.03%). After adjusting for patient characteristics, housing insecurity was associated with lower in-hospital mortality (OR 0.60, 95% CI 0.39 - 0.92). Housing insecurity was associated with a higher risk of all-cause readmissions at 180 days (HR 1.13, 95% CI 1.12 - 1.14). However, there was no significant difference in the risk of HF-specific readmissions at 180 days (HR 1.07, 95% CI 0.998 - 1.14) CONCLUSIONS: Patients with HF and housing insecurity have distinct demographic characteristics. They are also more likely to be readmitted after their initial hospitalization when compared to those without housing insecurity. Identifying and addressing specific comorbid conditions for patients with housing insecurity who are hospitalized for HF may allow clinicians to provide more focused care, with the goal of preventing morbidity, mortality, and unnecessary readmissions.

Effects of temporary access to environmental enrichment on measures of laboratory mouse welfare.

Laboratory mice are typically housed in "shoebox" cages with limited opportunities to engage in natural behaviour. Temporary access to environments with increased space and complexity (playpens) may improve mouse welfare. Previous work by our group has shown that mice are motivated to access and use these environments, but it is unknown how other aspects of welfare are impacted. Female C57BL/6J, BALB/cJ, and DBA/2J mice (n = 21; 7 mice per strain) were housed in mixed-strain trios and given temporary access to a large playpen with their cage mates three times per week. Control mice (n = 21; 7 mice per strain) remained in their home cages. Home cage behaviour (development of stereotypic behaviour over time, aggression following cage-changing) and anxiety tests were used to assess how playpen access impacted welfare. Contrary to our predictions, we found increased time spent performing stereotypies in playpen mice; this difference may be related to negative emotional states, increased motivation to escape the home cage, or active coping strategies. Playpen access resulted in strain-dependent improvements in aggression and some measures of anxiety. Aggression was lower for C57BL/6J mice in the playpen treatment following cage changing than it was for C57BL/6J control mice, while playpen mice, and particularly the C57BL/6J strain, spent more time in the center of the open field test and produced fewer fecal boli during anxiety testing, supporting other research showing that strain differences play an important role in behaviour and stress resiliency.

Do Health and Housing Attributes Motivate Residential Moves Among Older Chinese Adults? Evidence From an 8­Year Follow­up Study.

Background and Objectives: Despite the widespread belief in aging-in-place as the preferred housing arrangement for older adults, they are increasingly embracing moving. The person-environment fit theory explains that environmental changes due to residential moves can pose health risks, discouraging older people from moving. However, it also suggests that moves may be suitable when living conditions no longer meet their physical needs. The correlation between older people's health, housing, and their subsequent moving or staying actions in China remains underexplored. Research Design and Methods: Using alternative operating variables of key concepts and the China Family Panel Studies 2012-2018 data sets, this study examines the effects of health and housing status on older people's residential moves in China. The study outlines changes in health indicators and housing characteristics during multiple moves, as well as examines the relationship between the health and housing status of older adults and moving over a relatively long period of time using both regression models with lagged explanatory variables and fixed effects binary choice models. Results: The results reveal that: (1) higher rates of subsequent moves were observed among older adults with better self-rated health, positive self-rated health changes, and no ADL impairment, but no significant associations were found between most health variables and moving; and (2) the correlation between older persons' house ownership/type and their residential moves was significant and consistent over time, steady and lasting. Discussion and Implications: Potential mechanisms explaining the association between specific housing types and ownership statuses on moving are discussed. The findings encourage a focus on the positive benefits of moving in later life and how to provide additional housing options for older individuals.

The effect of late-life environmental enrichment on stress and anxiety: The role of sex and age-related differences in coping with aversive stimuli.

Anxiety significantly diminishes the quality of life in older adults, and the drugs used for its treatment often come with risky side effects. Non-pharmacological protocols could be valuable, but more research is needed in this area. Environmental enrichment induces positive effects on anxiety-like behavior in young and adult animals; whether the same happens in aged animals is still elusive. The aged brain undergoes changes that contribute to make it "fragile" and consequently even mild, potentially positive stimuli can trigger dyshomeostasis, worsening rather than ameliorating functioning. Here, by combining behavioral analysis and measurement of serum and brain corticosterone levels, we show that late-life environmental enrichment can induce eustress or distress, depending on sex and hypothalamic-pituitary-adrenal axis function. These findings pave the way for optimizing outcomes and minimizing undesired effects in the clinical setting, underscoring the need to overcome the limits of gender medicine and emphasizing the crucial role of individually tailored therapies.

Calf Management: Individual or Paired Housing Affects Dairy Calf Health and Welfare.

Previous research has indicated that preweaned dairy calves reared in pairs compared with individually have improved performance and indicators of animal welfare. One hundred and thirty Holstein female calves completed the trial, with eighty-five being allocated to paired housing and forty-five calves being allocated to individual housing. Daily live weight gain (DLWG), treatments and mortality were recorded throughout the preweaning period. Salivary cortisol, latency to feed and latency to approach a novel object were assessed at batching. There were no significant differences in DLWG, mortality and disease treatments between the average of the pair and the individually housed calves, although the pair-reared calves were quicker to approach the milk feed after batching and interacted more quickly with a novel object. The heaviest born calves within the pair had the highest DLWG from birth to weaning, with a higher percentage of calves approaching the novel object, compared with the lightest born calf within the pair. This study shows that calves within a pair may have significantly different performance and welfare during the preweaning period, with the heavier calf outperforming and displaying less fear and more exploratory behaviour than the lighter calf within a pair.

Internal Organ Colonization by Salmonella Enteritidis in Layer Pullets Infected at Two Different Ages During Rearing in Cage-Free Housing.

The poultry-housing environment plays a significant role in the transmission and persistence of the egg-associated pathogen Salmonella Enteritidis in laying flocks. The commercial egg industry is in the midst of a transition toward cage-free housing, but the food safety ramifications of this shift are not yet certain. The present study assessed internal organ colonization by Salmonella Enteritidis in layer pullets reared in cage-free housing and infected at two different ages. Groups of 280 pullets were transferred from the rearing facility (at 9 wk of age in one trial and 15 wk in another) to a containment facility with four isolation rooms simulating commercial cage-free barns with perches and nest boxes (70 birds/room). Twenty-four pullets in each room were orally inoculated with Salmonella Enteritidis immediately after placement in the containment facility. At 1-2 wk postinoculation in each trial, samples of liver, spleen, and intestinal tract were collected from all birds in two rooms for bacteriologic culturing to detect Salmonella Enteritidis. At 21-22 wk of age, samples of spleen, ovary, and intestinal tract were similarly collected and tested from all birds in the remaining two rooms. Among samples collected at 1-2 wk postinoculation, Salmonella Enteritidis was isolated significantly more often from groups of pullets infected initially at 15 wk of age than from those infected at 9 wk (61% vs. 38% of livers, 59% vs. 31% of spleens, and 84% vs. 57% of intestines). Among samples collected at 21-22 wk of age, the frequency of recovery of Salmonella Enteritidis was again significantly greater in birds infected at 15 wk of age than in those infected at 9 wk (16% vs. 6% of spleens, 9% vs. 1% of ovaries, and 26% vs. 10% of intestines). These data suggest that Salmonella Enteritidis infections introduced into flocks during the later stages of pullet rearing have greater potential to persist into the early phase of egg production.

Nota de investigación- Colonización de órganos internos por Salmonella Enteritidis en pollitas de postura infectadas en dos edades diferentes durante la crianza en alojamiento sin jaulas. El ambiente en alojamientos avícolas juega un papel importante en la transmisión y persistencia del patógeno asociado a los huevos Salmonella Enteritidis en parvadas postura. La industria comercial del huevo se encuentra en medio de una transición hacia alojamientos sin jaulas, pero las ramificaciones de este cambio en la seguridad alimentaria aún no están determinadas. El presente estudio evaluó la colonización de órganos internos por Salmonella Enteritidis en pollitas de postura criadas en alojamientos sin jaulas e infectadas a dos edades diferentes. Se transfirieron grupos de 280 pollitas desde las instalaciones de cría (a las 9 semanas de edad en un ensayo y a las 15 semanas en un segundo ensayo) a una instalación de contención con cuatro salas de aislamiento que simulaban alojamientos comerciales sin jaulas con perchas y nidos (70 aves/sala). Veinticuatro pollitas en cada sala fueron inoculadas oralmente con Salmonella Enteritidis inmediatamente después de su colocación en la instalación de contención. En cada ensayo, de una a dos semanas después de la inoculación, se recolectaron muestras de hígado, bazo y tracto intestinal para cultivo bacteriológico de todas las aves en dos salas para detectar Salmonella Enteritidis. A las 21-22 semanas de edad, se recolectaron y analizaron de manera similar muestras de bazo, ovario y tracto intestinal de todas las aves en las dos salas restantes. Entre las muestras recolectadas entre una y dos semanas después de la inoculación, Salmonella Enteritidis se aisló significativamente con mayor frecuencia en grupos de pollitas infectadas inicialmente a las 15 semanas de edad que en aquellas infectadas a las 9 semanas (61% contra 38 % en los hígados, 59% contra 31% de bazos y 84 % contra 57% en intestinos). Entre las muestras recolectadas a las 21-22 semanas de edad, la frecuencia de recuperación de Salmonella Enteritidis fue nuevamente significativamente mayor en aves infectadas a las 15 semanas de edad que en aquellas infectadas a las 9 semanas (16% contra 6% de bazos, 9% contra 1% en ovarios y 26% contra 10% de los intestinos). Estos datos sugieren que las infecciones por Salmonella Enteritidis introducidas en las parvadas durante las últimas etapas de la cría de pollitas tienen un mayor potencial para persistir en la fase inicial de la producción de huevos.

Exploring the impact of pharmacist-supported medication reviews in dementia care: experiences of general practitioners and nurses.

BACKGROUND: Dementia is a major global public health challenge, and with the growing elderly population, its prevalence is expected to increase in the coming years. In Sweden, municipalities are responsible for providing special housing for the elderly (SÄBO), which offers services and care for older individuals needing specific support. SÄBO is both the person´s home and a care environment and workplace. Polypharmacy in patients with dementia is common and increases the risk of medication interactions. Involving clinical pharmacists in medication reviews has been shown to enhance medication safety and improve prescribing practices. However, the views of the standard care team involved in medication prescribing, administration, monitoring and documentation on integrating pharmacist services have received less attention. Thus, this study aims to explore how pharmacists' contributions can enhance medication safety, improve patient care efficiency, and potentially alleviate the workload of general practitioners for people with dementia living in special housing. METHODS: This study has a descriptive qualitative study design using semi-structured interviews and qualitative content analysis. The study was conducted in a southern Swedish special housing and included nurses, assistant nurses, general practitioners (GPs), and a pharmacist. Due to the COVID-19 pandemic, interviews were conducted over the phone. The Swedish Ethical Review Authority approved the study. RESULTS: The analysis revealed three main categories, and eleven subcategories.: (1) Integrating multidisciplinary approaches for holistic dementia care, (2) Strengthening dementia care through effective medication management and (3) Advancing dementia care through pharmacist integration and role expansion. Nurses focused on non-pharmacological treatments, while GPs emphasized the importance of medication reviews in assessing the benefits and side-effects of prescribed medication. Pharmacists were valued for their reliable medication expertise, appreciated by GPs for saving time and providing recommendations prior to consultations with individuals with dementia and their next-of-kin. Although medication reviews were considered beneficial, there was skepticism about their ability to solve all medication-related problems associated with dementia care. CONCLUSIONS: This study highlights the critical role pharmacists play in enhancing medication safety and patient care efficiency in special housing for individuals with dementia. Despite the value of their contributions, communication barriers within healthcare teams pose significant challenges. Recognising potential pharmacist role expansion is essential to alleviate the workload of GPs and ensure effective collaborative practices for better patient outcomes.

Addressing racial and ethnic disparities in premature exits from permanent supportive housing among residents with substance use disorders.

Background: Permanent supportive housing (PSH) is an evidence-based practice for reducing homelessness that subsidizes permanent, independent housing and provides case management-including linkages to health services. Substance use disorders (SUDs) are common contributing factors towards premature, unwanted ("negative") PSH exits; little is known about racial/ethnic differences in negative PSH exits among residents with SUDs. Within the nation's largest PSH program at the Department of Veterans Affairs (VA), we examined relationships among SUDs and negative PSH exits (for up to five years post-PSH move-in) across racial/ethnic subgroups. Methods: We used VA administrative data to identify a cohort of homeless-experienced Veterans (HEVs) (n = 2,712) who were housed through VA Greater Los Angeles' PSH program from 2016-2019. We analyzed negative PSH exits by HEVs with and without SUDs across racial/ethnic subgroups (i.e., African American/Black, Non-Hispanic White, Hispanic/Latino, and Other/Mixed [Asian, American Indian or Alaskan Native, and Native Hawaiian or Other Pacific Islander, and multi-race]) in controlled models and accounting for competing risk of death. Results: In competing risk models, HEVs with at least one SUD had 1.3 times the hazard of negative PSH exits compared to those without SUDs (95% CI: 1.00, 1.61). When stratifying by race/ethnicity, Other/Mixed race residents with at least one SUD had 6.4 times the hazard of negative PSH exits compared to their peers without SUDs (95% CI: 1.61-25.50). Hispanic/Latino residents with at least one SUD had 1.9 times the hazard compared to those without SUDs, also indicating a strong relationship with negative PSH exits; however, this association was not statistically significant (95% CI: 0.85-4.37). Black residents with at least one SUD had 1.2 times the hazard compared to those without SUDs (95% CI: 0.85-1.64), indicating no evidence of an association with negative PSH exits. Similarly, Non-Hispanic White residents with at least one SUD had 1.1 times the hazard compared to those without SUDs (95% CI: 0.75-1.66). Conclusions: These findings suggest relationships between SUDs and negative PSH exits differ between race/ethnic groups and suggest there may be value in culturally specific tailoring and implementation of SUD services for these subgroups.

Searching for choice and control: Western Australian service provider experiences of health, housing and migration.

This research aimed to inform approaches to increase access to secure housing and improve mental health outcomes for migrants from culturally and linguistically diverse backgrounds (hereafter migrants) who are generally invisible in health and social policy and service provision in Western Australia. We used semi-structured, in-depth interviews (n = 11) and interpretative phenomenological analysis to explore service provider experiences and perspectives of issues impacting service provision and the needs of migrants in this context. Five superordinate themes reveal complex experiences for both service providers and the migrants with whom they work. Findings reflect tensions between contemporary notions of choice and control and a social service system that is difficult to navigate, reflects systemic racism and appears to rely heavily on the non-government sector. Insights have important and practical implications for health promotion policy, practice and research. Recommendations include improvements to housing access, provision, funding and policies; addressing service barriers via staff training and more accessible community resources; and co-design and community outreach approaches.

Relationship Between Facility Type and Bulk Tank Milk Bacteriology, Udder Health, Udder Hygiene, and Milk Production on Vermont Organic Dairy Farms.

The primary objective of this cross-sectional observational study was to determine whether bulk tank milk quality, udder health, udder hygiene and milk production outcomes were associated with facility type on organic dairies. A secondary objective was to identify other management-related risk factors associated with bulk tank milk quality, udder health, udder hygiene, and milk production on organic dairy herds in Vermont. We aimed to enroll 40 farms, to compare herds using the 2 most common systems (freestalls, tiestalls) for housing organic dairy cattle in the state with those using a bedded pack during the non-grazing season (typically November-May). Two general styles of bedded packs were observed: cultivated bedded packs and untilled deep bedded packs. Due to the limited number of herds using bedded packs to house lactating dairy cattle in Vermont, we combined untilled and cultivated bedded packs to describe udder hygiene, milk quality, and udder health on these loose-housing systems deeply-bedded with organic material. The study was completed on 21 farms (5 bedded packs, 6 freestalls, 10 tiestalls) before interruption due to the COVID-19 pandemic. Data captured from Dairy Herd Improvement Association records from the test closest to the date of the farm visit included average somatic cell score (SCS), standardized 150-d milk (pounds), % cows with current high SCS (SCS ≥ 4.0), % cows with newly elevated SCS (previous SCS < 4.0 to current ≥ 4.0), and % cows with chronically elevated SCS (SCS ≥ 4.0 last 2 tests). Multivariable linear regression models were used to describe outcomes by facility type, but suffered from limited statistical power due to small group sample sizes. Unconditional comparisons failed to find statistically significant differences between farms grouped by facility type in metrics captured from Dairy Herd Improvement Association test data, bulk tank milk somatic cell count (BTSCC) and aerobic culture data, or udder hygiene scores. A secondary analysis was conducted using univariate linear regression to identify associations between herd management factors and outcomes for all 21 farms combined. Although not all differences found were statistically significant in this secondary analysis combining all farms, numeric differences that may be biologically important are reported showing farms with deeper bedding had a lower BTSCC, lower newly elevated SCS, lower chronically elevated SCS, lower elevated current SCS, lower average SCS, and better udder hygiene metrics. Farms with lower mean udder hygiene scores had numerically lower chronically elevated SCS, lower elevated current SCS, and lower average SCS. We could not reject the null hypothesis that milk quality and udder health outcomes did not differ by facility type, and this does not preclude the existence of biological differences in these outcomes between facility types. The current study provides insight on factors affecting bulk tank milk quality, udder health and hygiene measures on organic dairy farms in Vermont. Bedded packs may be a viable option for confinement housing during the winter non-grazing season for pasture-based herds interested in a loose-housing system in the Northeastern US, but more research such as longitudinal studies with a larger sample size is needed to test this hypothesis.

Widespread occurrence of pesticides in low-income housing.

BACKGROUND: Low socioeconomic status (SES) residents living in social housing, which is subsidized by government or government-funded agencies, may have higher exposures to pesticides used in indoor residences since pesticides are applied due to structural deficiencies, poor maintenance, etc. OBJECTIVE: To estimate exposure of residents in low-SES social housing built in the 1970s to legacy and current-use pesticides and to investigate factors related to exposures. METHODS: Twenty-eight particle-phase pesticides were measured in the indoor air of 46 units in seven low-income social housing, multi-unit residential buildings (MURBs) in Toronto, Canada using portable air cleaners deployed for 1 week in 2017. Pesticides analyzed were legacy and current use in the classes: organochlorines, organophosphates, pyrethroids, and strobilurins. RESULTS: At least one pesticide was detected in 89% of the units with detection frequencies (DF) for individual pesticides of up to 50%, including legacy organochlorines and current-use pesticides. Current-use pyrethroids had the highest DF and concentrations, with the highest particle-phase concentration for pyrethrin I at 32,000 pg/m3. Heptachlor, restricted for use in Canada in 1985, had the highest estimated maximum total air (particle plus gas phase) concentration of 443,000 pg/m3. Heptachlor, lindane, endosulfan I, chlorothalonil, allethrin, and permethrin (except in one study) had higher concentrations than those measured in low-income residences reported elsewhere. In addition to the intentional use of pesticides to control pests and their use in building materials and paints, tobacco smoking was significantly correlated with the concentrations of five pesticides used on tobacco crops. The distribution of pesticides with high DF in individual buildings suggested that pest eradication programs by the building management and/or pesticide use by residents were the major sources of measured pesticides. IMPACT: Low-income social housing fills a much-needed demand, but the residences are prone to pest infestation and hence pesticide use. We found exposure to at least 1 of 28 particle-phase pesticides in 89% of all 46 units tested, with the highest DF and concentrations for current-use pyrethroids and long-banned organochlorines (e.g., DDT, heptachlor) due to very high persistence indoors. Also measured were several pesticides not registered for use indoors, e.g., strobilurins used to treat building materials and pesticides used on tobacco crops. These results, which are the first Canadian data for most pesticides indoors, show widespread exposure to numerous pesticides.

Non-invasive methods for analysing pig welfare biomarkers.

At present, the assessment of pig welfare quality has gained significant importance, prompting the exploration of novel biomarkers for this purpose. Traditionally, these biomarkers have been monitored in the blood; however, blood sampling is considered an invasive procedure. Currently, non-invasive methods for collecting samples are emerging as viable alternatives for assessing these biomarkers. This article aims to present the current knowledge regarding the use of non-invasive methods for analysing pig welfare biomarkers, specifically focusing on the saliva, hair, faeces, and urine as matrices to determine these biomarkers. The saliva analysis encompasses various biomarkers, such as cortisol, alpha-amylase, chromogranin A, the total esterase, oxytocin, acute phase proteins, adenosine deaminase, immunoglobulins and parameters of redox homeostasis. Cortisol, a specific biomarker, can be determined in the hair, urine and faeces, while urine samples allow for the analysis of catecholamines as non-invasive markers of pig welfare.