Drivers of Being Unhoused and the Prevalence of Health Conditions among Unhoused Individuals in Asheville, NC.

Background: During the COVID-19 pandemic, there was an increase in the number of unhoused individuals in Asheville, North Carolina resulting in more tent encampments.Understanding the physical, mental, and socially determined health characteristics associated with being unhoused can help guide stakeholders with policy development, healthcare program planning, and funding decisions to support unhoused individuals. Methods: In this study, we used an observational cross-section methodology. Using a convenience sample approach, we interviewed 101 participants who were receiving services from 2 emergency hotel shelters, a day center, and a resource center. Data were analyzed using descriptive statistics, and open-ended responses were collected and grouped to provide context. Results: Most participants were White (71%) and identified as male (76%). Over 60% reported having a high school education or advanced degree. Of the participants, 76% reported being unhoused for more than 6 months, and their last permanent housing was in Western North Carolina. Dental disease, chronic pain, and hypertension were common physical conditions. PTSD, depression, and anxiety were common mental health conditions. A lack of transportation was the most noted socially determined challenge. Marijuana, methamphetamine, and alcohol were the most often used substances, where methamphetamine was noted to be particularly problematic for the participants. Conclusion: Understanding the physical, mental, and social issues of the complex unhoused population can assist policymakers, healthcare providers, and other stakeholders in addressing challenges and testing improvement strategies.

"It's a Valuable Service but a Hard Place to Be:" Women's Views About Violence Against Women Shelters.

This mixed-methods secondary analysis examined VAW shelter use by 662 Canadian women abused by partners (50.5% Indigenous, 43.4% White, and 6.1% visible minority). Women who had never resided in shelters (n = 242) had less Severe Combined and Total IPV on the Composite Abuse Scale and fewer PTSD symptoms. More nonresidents worked full time and had higher incomes and no children. The 420 women residents mentioned strengths (70.4%) such as supportive staff and safety, and concerns (29.6%) about unsupportive staff and the shelter rules or facility. Some Indigenous women reported racist attitudes by shelter staff and child apprehensions. Practice implications are presented.

Characteristics and challenges of companion animal rescue organisations in New Zealand.

AIMS: To describe the characteristics of companion animal rescue organisations (CARO) in New Zealand; to describe current capacity, resource limitations and challenges of CARO with a particular focus on cats and dogs; and to explore support for creating a national database of CARO in New Zealand. METHODS: A cross-sectional survey was administered to CARO in New Zealand in May 2022. The survey asked about organisational characteristics, types and numbers of animals cared for, services provided, policies, staffing, funding sources, challenges, and attitudes towards a national database for rescue organisations. Descriptive statistics were provided for all quantitative study variables and free-text comments were analysed for common themes. RESULTS: The survey was completed by 106/208 (51%) known CARO distributed across the country. These CARO provided services to an estimated 59,874 homeless animals annually with 86/106 (81%) providing services to cats and/or dogs. Primary services provided by CARO who cared for cats or dogs included rehoming (72/86; 84%) and housing (70/86; 81%) animals. Intake was managed through a combination of strategies. Donations (72/86; 82%) were the main funding source. The 62 registered charities were more likely to report being funded by grants than the 23 non-charities (39/62 (63%) vs. 1/23 (4%); p < 0.001), and non-charities were more likely to self-fund (18/23 (78%) vs. 20/62 (32%); p < 0.001). Nearly half of the CARO that provided workforce information (35/72; 49%) had a workforce of 10 or fewer including volunteers. A total of 5,699 people worked for 86 CARO that care for cats or dogs of whom 4,847 (85%) were part-time volunteers. Of the 72 cat and dog CARO who provided workforce information, 57/72 (79%) relied solely on volunteers.The majority of all 106 CARO respondents (78/106; 73%) indicated they were likely to register on a national database of CARO, subject to addressing concerns about time required and information security.CARO respondents described challenges of insufficient funding, access to veterinary services, and a shortage of volunteers and foster homes, with additional concerns including a lack of public awareness, supportive legislation, and resources. Financial support (90/106; 85%) and policy change (76/106; 72%) were preferred support options. CONCLUSIONS: This study highlights the significant role played by CARO in New Zealand and the challenges they face, emphasising the need for financial support, legislation, and initiatives extending beyond the rescue sector to reduce the number of animals being surrendered. The findings also suggest a willingness among CARO to participate in a national database.

The Influence of Shelter Type and Coverage on Crayfish (Procambarus clarkii) Predation by Catfish (Silurus asotus): A Controlled Environment Study.

Procambarus clarkii is adept at using natural shelters and caves to evade attacks from predators. However, the concealment abilities and mechanisms of P. clarkii for different types of shelters under predation pressure have not yet been reported. In this study, laboratory experiments were carried out to determine the effects of different coverages (25%, 50%, and 75%) and different combinations (I-VII) of three types of shelters (PVC pipes, water grass, and stone) on the predation rhythm, behavior, and abilities of Silurus asotus on P. clarkii. The results indicated that the predation of S. asotus on P. clarkii exhibited significant rhythmicity under shelter conditions, excluding PVC pipes, 75% stone, and combination VI. Among the three types of shelters, PVC pipes provided the strongest concealment, followed by stone and water grass. With the increase in shelter coverage, the anti-predation ability of P. clarkii continued to increase, and the optimal shade rate for water grass was 50%. In the different shelter combinations, the environmental complexity had little effect on the predation activity of S. asotus on P. clarkii. These findings demonstrated that the type and abundance of shelters in the wild environment can affect the predation rhythm and activities of S. asotus on P. clarkii.

Service restrictions from emergency shelters among people experiencing homelessness: Uncovering pathways into unsheltered homelessness and institutional circuitry.

Service restrictions refer to temporary or permanent bans of individuals from a program or an organization's services, and are widely used in emergency shelter systems. Limited research exists on how service restrictions unfold and their impacts on people experiencing homelessness. This qualitative study used in-depth interviews with timeline mapping to examine the antecedents and consequences of service restrictions from emergency shelters among people experiencing homelessness in two cities in Ontario, Canada. A total of 49 people experiencing homelessness who had been restricted from an emergency shelter program in the past year were recruited and included in the study analysis. A pragmatic and integrative approach was used for data analysis that involved the development of meta-matrices to identify prominent and divergent perspectives and experiences with regard to service restriction antecedents and consequences. Study findings underscored that service restrictions were often the result of violence and aggression, primarily between service users. There were regional differences in other service restriction reasons, including substance use and possession. Service restrictions affected the shelter status of almost all participants, with many subsequently experiencing unsheltered homelessness, and cycling through institutional health, social, and criminal justice services (i.e., institutional circuitry). Other health and social consequences included substance use relapses and hospitalizations; cold-related injuries due to post-restriction unsheltered homelessness; suicidality; food insecurity; diminished contact with support network and connections; and intense feelings of anger, fear, and hopelessness. Overall, the study findings advance our understanding of the role of homeless services in pathways into unsheltered homelessness and institutional circuitry, which raise critical questions about how to mitigate the harms associated with service restrictions, while concurrently facilitating safety and upholding the rights of people experiencing homelessness and emergency shelter staff.

Infectious risk profile and strategies for prevention and control of outbreaks in refugee, asylum seekers and migrant populations in EU/EEA countries: a systematic narrative review of evidence.

Introduction: The recent surge in migration to and within the European Union and European Economic Area has brought the development of migration policy, including health policy, to the forefront of regional priorities. While migrants, in general, do not pose a health threat to the host population, specific subgroups of migrants, including refugees, asylum seekers, and irregular migrants, are particularly vulnerable to infectious diseases. To support public health policies in this area, the Emergency Preparedness and Management' working group of the Italian Society of Hygiene, Preventive Medicine and Public Health has conducted a systematic narrative review with the aim to comprehensively analyze the infectious disease risk within the refugee and asylum seeker populations in EU, EEA, and EU-applicant countries. Methods: Forty-two studies were systematically selected from scientific articles in the MEDLINE/PubMed database from January 1, 2008, to June 1, 2023. The infectious risk associated with each infectious disease among refugees and asylum seekers, as well as the strategies to prevent and control outbreaks, was collected from all available studies. Results: The congregate living conditions in refugee camps, transit centers, and temporary housing facilities make this population particularly vulnerable to infectious diseases. As such, implementing stringent hygiene and preventive measures is critical to safeguarding the health of refugees and reducing the risk of outbreaks that may affect both the refugee population and the host communities. Conclusion: Effective vaccination and preventive strategies for migrants, refugees, and asylum seekers are vital for public health and the well-being of these populations. They should be delivered as part of universal health care. By addressing barriers and implementing tailored programs, we can ensure equitable access to vaccines and protect the health of these vulnerable individuals.

Streptococcus zooepidemicus in dogs: Exploring a canine pathogen through multilocus sequence typing.

Streptococcus equi. subsp. zooepidemicus (S. zooepidemicus) associated diseases in dogs have emerged as a significant concern over recent decades. S. zooepidemicus occurs sporadically in dog populations globally, with increased prevalence in shelters/kennels. This study used multilocus sequence typing (MLST) of 149 independent canine S. zooepidemicus isolates to assess associations between sequence type and breed, country of origin, disease severity, sampling type, year, and behaviour within an outbreak. No clear associations for breed, country, sampling type and year were determined in this study. ST-10 and 123 strains were present within all disease categories, from no clinical signs to severe disease. Assessment of S. zooepidemicus infection in 3 UK outbreaks at the same location found ST-10, 18, 123 strains, and a ST-173 strain in a US outbreak, were associated with haemorrhagic pneumonia and persisted in kennelled populations over time. The ST-173 clonal complex has been noted to have severe virulence capabilities in dogs and other species. S. zooepidemicus seems to thrive in environments with a high risk of transmissibility, overcrowding, stress and naïve populations, particularly for those in shelters/kennels. MLST alone cannot determine the virulence phenotype of S. zooepidemicus in dogs. However, a level of conservancy and diversity within ST allelic loci aids the opportunity to cause severe disease in dogs. Thus, further research into whole genome sequencing and characterising the virulence factors of S. zooepidemicus is warranted in dogs.

Participatory community action research in homeless shelters: Outcomes for shelter residents and service-learning research assistants.

The article reports empirical outcomes of an ongoing transdisciplinary participatory community action research project that implements behavioral activation in homeless shelters. The overall goal of this Project is twofold: (1) to improve psychosocial functioning of shelter residents and enhance their opportunities to overcome homelessness; and (2) to enhance civic development of service-learning students who assist in Project implementation. Two studies are reported, representing these goals. Study 1 found that residents of a men's shelter (n = 892), women's shelter (n = 433), and transitional housing (n = 40) perceived behavioral activation sessions as immediately beneficial (i.e., important, meaningful, worthy of repeating, and enjoyable), and over the course of shelter stay, they perceived behavioral activation as contributing to their hope, empowerment/self-sufficiency, quality of life, purpose/meaning in life, wellbeing, social support, shelter social climate, and relationships with staff. Quantitative findings are supported by qualitative data (comments by residents on forms). Study 2, which replicates and extends past research on civic-development in service-learning students, used a new quasi-experimental design to compare service-learning students (n = 41) in an interdisciplinary course on homelessness versus non-service-learning students (n = 16) in a psychology course. Service-learning students showed pre- to post-semester improvements in community service self-efficacy, decreases in stigmatizing attitudes, and increases in awareness of privilege and oppression, but students not engaged in service-learning did not show these civic-related changes. These quantitative results are supported by qualitative data (written reflections by students). Results and implications are discussed within the context of the concept of psychopolitical validity.

"We Get Our Healing Through Traditional Ways": Canadian Indigenous Women's Use of Violence Against Women Shelters, Mainstream Counseling, and Traditional Healing.

We know little about what services are accessed by Indigenous women abused by intimate partners (IPV). This mixed-methods secondary analysis examines the demographics and narratives of 40 Canadian Indigenous women regarding their use of violence against women (VAW) emergency shelters (55%), second-stage VAW shelters (7.5%), mainstream community counseling (70%), and Indigenous healing practices (42.5%). Five women who identified as LGBTQ or two-spirit accessed community services but not VAW shelters. The women had experienced severe IPV, but scored below clinical cut-offs for depression, psychological distress, and PTSD. They described strengths, concerns, and barriers in accessing services. Implications for counselors are presented.

Challenges to the Provision of Services for Sexual and Intimate Partner Violence in Canada During the COVID-19 Pandemic: Results of a Nationwide Web-Based Survey.

The COVID-19 pandemic increased women's vulnerability to intimate partner and sexual violence (IPV/SV), as well as challenging organizations' ability to respond. This research is based on a 2021 nationwide survey about the impacts of COVID-19 on IPV/SV services across Canada. Nationwide, organizations adopted several measures to reduce the risk of COVID-19 transmission, including scaling back services, reducing or stopping their volunteers, and reducing the number of in-shelter clients. Organizations detailed several financial challenges including increased costs and cancelation of fundraising events. Organizations also reported many staffing challenges, from increased workloads to staff leaves of absence due to childcare responsibilities, mental health reasons, or contracting COVID-19. Policies ensuring adequate financial support to IPV/SV services in nonemergency times could help minimize disruption to service delivery during crisis situations.

A qualitative assessment of cleaning and hand hygiene practices at shelters serving people experiencing homelessness during the COVID-19 pandemic, Atlanta, GA - May-June, 2020.

BACKGROUND: Cleaning practices and hand hygiene are important behaviors to prevent and control the spread of infectious disease, especially in congregate settings. This project explored hygiene- and cleaning-related experiences in shelters serving people experiencing homelessness (PEH) during May-June 2020 of the COVID-19 pandemic. METHODS: We conducted qualitative, in-depth interviews by phone with 22 staff from six shelters in Atlanta, Georgia. The interview guide included questions about cleaning routines, cleaning barriers and facilitators, cleaning promotion, hand hygiene promotion, and hand hygiene barriers and facilitators. We analyzed interview transcripts using thematic analysis. RESULTS: Multiple individuals, such as shelter individuals (clients), volunteers, and staff, played a role in shelter cleaning. Staff reported engaging in frequent hand hygiene and cleaning practices. Barriers to cleaning included staffing shortages and access to cleaning supplies. Staff reported barriers (e.g., differing perceptions of cleanliness) for clients who were often involved in cleaning activities. Barriers to hand hygiene included limited time to wash hands, forgetting, and inconvenient handwashing facilities. Specific guidance about when and how to clean, and what supplies to use, were requested. CONCLUSION: During the early months of the COVID-19 pandemic, shelters serving PEH in the Atlanta-metro area needed resources and support to ensure sufficient staffing and supplies for cleaning activities. As part of future pandemic planning and outbreak prevention efforts, shelters serving PEH could benefit from specific guidance and training materials on cleaning and hand hygiene practices.

A study on siting of emergency shelters for dam failure floods considering population distribution and weather effects.

In recent years, dam failures have occurred frequently because of extreme weather, posing a significant threat to downstream residents. The establishment of emergency shelters is crucial for reducing casualties. The selection of suitable shelters depends on key information such as the number and distribution of affected people, and the effective capacity and accessibility of the shelters. However, previous studies on siting shelters did not fully consider population distribution differences at a finer scale. This limitation hinders the accuracy of estimating the number of affected people. In addition, most studies ignored the impact of extreme rainfall on the effective capacity and accessibility of shelters, leading to a low applicability of the shelter selection results. Therefore, in this study, land-use and land-cover change (LUCC) and nighttime lighting data were used to simulate population distribution and determine the number and distribution of affected people. Qualified candidate shelters were obtained based on screening criteria, and their effective capacity and accessibility information under different weather conditions were quantified. Considering factors such as population transfer efficiency, construction cost and shelter capacity constraints, a multi-objective siting model was established and solved using the non-dominated sorting genetic algorithm II (NSGA- II) to obtain the final siting scheme. The method was applied to the Dafangying Reservoir, and the results showed the following: (1) The overall mean relative error (MRE) of the population in the 35 downstream streets was 11.16 %, with good fitting accuracy. The simulation results truly reflect the population distribution. (2) Normal weather screening generated 352 qualified candidate shelters, whereas extreme rainfall weather screening generated 266 candidate shelters. (3) Based on the population distribution and weather factors, four scenarios were set up, with 63, 106, 73, and 131 shelters selected. These two factors have a significant impact on the selection of shelters and the allocation of evacuees, and should be considered in the event of a dam-failure floods.

Where's the Disconnect? Exploring Pathways to Healthcare Coordinated for Youth Experiencing Homelessness in Toronto, Canada, Using Grounded Theory Methodology.

About 900 youth experiencing homelessness (YEH) reside at an emergency youth shelter (EYS) in Toronto on any given night. Several EYSs offer access to healthcare based on youths' needs, including access to primary care, and mental health and addictions support. However, youth also require healthcare from the broader health system, which is often challenging to navigate and access. Currently, little is known about healthcare coordination efforts between the EYS and health systems for YEH. Using grounded theory methodology, we interviewed 24 stakeholders and concurrently analyzed and compared data to explore pathways to healthcare coordinated for youth who reside at an EYS in Toronto. We also investigated fundamental parts (i.e., norms, resources, regulations, and operations) within the EYS and health systems that influence these pathways to healthcare using thematic analysis. A significant healthcare coordination gap was found between these two systems, typically when youth experience crises, often resulting in a recurring loop of transition and discharge between EYSs and hospitals. Several parts within each system act interdependently in hindering adequate healthcare coordination between the EYS and health systems. Incorporating training for system staff on how to effectively coordinate healthcare and work with homeless populations who have complex health needs, and rethinking information-sharing policies within circles of care are examples of how system parts can be targeted to improve healthcare coordination for YEH. Establishing multidisciplinary healthcare teams specialized to serve the complex needs of YEH may also improve healthcare coordination between systems, and access and quality of healthcare for this population.

Behavior of Inflatable Drop-Stitch Fabric Panels Subjected to Bending and Compression.

In this paper, the mechanics of inflatable drop-stitch panels are investigated, including the impact of large shear deformations, nonlinearity due to wrinkling of the panel skin that occurs under net compressive strain, work done by the confined internal air, and the effect of the drop-stitch yarns on the panel skin stresses. A large deflection finite element (FE) analysis framework is presented that allows for a panel's stability and post-buckling response to be quantified. The FE code is verified through comparison with available analytical solutions, and the impact of critical response drivers is examined. The FE models are then used to explore the capacity of panel walls when used as part of a shelter subject to realistic wind and snow loads and to assess the dependence of the capacity on the important design parameters of inflation pressure and panel depth. The analyses indicate that while the drop-stitch panel capacity is sensitive to the panel depth and inflation pressure, panels with reasonable cross-sectional dimensions are viable for use in structural applications where they must support significant compression and bending. Future work should focus on increasing the structural efficiency and capacity by increasing the panel shear stiffness and operational inflation pressure.

Methadone use for acute opioid withdrawal in Tshwane shelters during the COVID-19 lockdown.

BACKGROUND: Temporary shelters were established for street-based people during the national level 5 coronavirus disease 2019 (COVID-19) lockdown. However, street-based substance users' need to access substances was not addressed, resulting in large numbers of people experiencing withdrawal. The Community Oriented Substance Use Programme (COSUP) in Tshwane provided methadone to manage opioid withdrawal. METHODS: A cross-sectional, descriptive study was conducted using the daily methadone dosing records from shelters in Tshwane between March 2020 and September 2020. RESULTS: The final analysis included 495 participants, of which 64 (12.9%) were initiated on 20 mg - 30 mg of methadone, 397 (80.2%) on 40 mg - 50 mg, and 34 (6.9%) on 60 mg - 70 mg. A total of 194 (39.2%) participants continued their initiation dose for 1-2 months, after which 126 (64.9%) had their doses increased, and 68 (35.1%) had their doses decreased. Approximately 12 (2.4%) participants were weaned off methadone after 1-3 months and 46 (9.3%) after 4-6 months. In all, 100 (20.2%) participants left the shelter prematurely and did not continue with methadone. A total of 126 (25.5%) participants continued to stay in the shelters and received methadone for 6 months, with 125 (25.3%) participants leaving the shelter with continued follow-up at a COSUP site. CONCLUSION: This study demonstrates variability in methadone dosing regimens among shelter residents. As the lockdown measures eased, many chose to leave the shelters, while others remained to receive methadone and other services. The COSUP appears to be effective during periods of increased vulnerability, since a large number of participants were successfully followed up.Contribution: Opioid dependence is a persistent, lifelong disease. It is multifaceted with complex environmental and individual determinants. This study highlighted the use of opioid substitution therapy during a period of increased vulnerability.

Adapting an evidence-based mindfulness-based intervention for sheltered youth experiencing homelessness.

OBJECTIVES: Youth experiencing homelessness (YEH) face challenges that impact their physical, mental, and social wellbeing, emotion regulation, and coping. Mindfulness reduces stress and improves resilience, emotion regulation, and executive functioning. Mindfulness-based interventions (MBI) teach the practice of mindfulness to foster present-moment attention without judgement and enhance self-observation and self-regulation, resulting in greater awareness of thoughts and emotions and improved interpersonal relationships. One such intervention, .b, has been shown to lower stress among youth. While a pilot study of .b among sheltered youth found the intervention to be feasible, the need for modifications was identified to improve its relevance, accessibility, and incorporate a trauma-informed approach. METHODS: We used the ADAPT-ITT (Assessment, Decisions, Administration, Production, Topical experts, Integration, Training staff, and Testing) framework to adapt the .b mindfulness intervention to YEH living in an emergency shelter. Nine focus group discussions (n = 56), key informant interviews (n = 8), and beta testing with five youth working group sessions (n = 10) identified needed modifications. RESULTS: Adaptations to the curriculum and delivery modality were made to approximate the average length of stay in the shelter; integrate trauma-informed care approaches; increase diversity of images by race, ethnicity, age, sexual orientation, and gender identity; and increase the relevance of the audio-visual components. CONCLUSIONS: Youth and the health and social services providers who care for youth generally liked the core concepts and presentation of the curriculum. Using the ADAPT-ITT framework, minor, yet important, changes were made to increase the relevance, acceptability, and feasibility of the intervention. Next steps are to conduct a randomized attention control pilot study to assess feasibility and acceptability.

[Determinants of asylum seekers' health and medical care in Germany]. / Determinanten der Gesundheit und medizinischen Versorgung von Asylsuchenden in Deutschland.

Asylum seekers in Germany are exposed to a variety of health-related stressors, while their access to medical care is impaired. This review explains some of the determinants that structure this situation, for example by elaborating on how the Asylum Seekers' Benefits Act (ASBA), billing via treatment vouchers, and accommodation in refugee shelters affect asylum seekers' health and healthcare utilization. Hereby, it becomes clear that the exclusion of asylum seekers from the welfare system is detrimental to their health, is expensive, and raises ethical and legal questions. In particular, the huge discretionary scope of the social welfare offices in the assumption of costs as well as the different models for billing medical services for asylum seekers are potentially unjust and lead to a plurality of care, which lacks legal and ethical justification.The second part of the article shows that asylum seekers generally suffer from the same health problems as people with statutory health insurance-with the exception of mental illnesses, which are substantially more common among asylum seekers, but are often undiagnosed and frequently inadequately treated.This leads to three practical conclusions: (1) asylum seekers should be integrated into statutory health insurance, (2) from a public health point of view, accommodation in refugee shelters should be avoided in favor of decentralized accommodation, and (3) to ensure diversity-sensitive care for all patients, the healthcare system must make adjustments to its structures and practices.

Feline-Ality™ in Real Life: A Program Evaluation.

Domestic cats are euthanized at high rates in shelters, and appropriate matching between cats and adopters is believed to improve adoption success and reduce euthanasia rates. The ASPCA's Meet Your Match® Feline-ality™ program, designed to match cats with owners based on personality and lifestyle, has been implemented in various shelters. This study is the first systematic evaluation of its implementation process and efficacy. Using a controlled interrupted time series design (CITS), the outcome evaluation examined and compared records for five years (2015-2019) from the Seattle Animal Shelter (SAS) and the Multnomah County Animal Shelter located in Portland, Oregon (USA). The outcome evaluation demonstrated no changes in any outcomes (e.g., cat adoptions, euthanasias, returns, transfers, or length of stay) that could be reliably attributed to Feline-ality™. The process evaluation at SAS identified and quantified eight possible errors in implementation that could affect the success of Feline-ality™; the results indicated a 1.6% overall success rate. Whereas the lack of substantive effect may indicate that MYM® Feline-ality™ does not perform as purported, it is equally as likely (if not more so) that this absence of evidence of any results reasonably attributable to Feline-ality™ has occurred because the error rate in implementation of the program was very high. The fact that a poorly implemented program necessarily impacts the results of an outcome evaluation underscores the need for process evaluation concurrent with implementation.

Prevalence and risk factor investigation for exposure to Brucella species in surrogate stray cattle population reared in cow shelters in Punjab, India.

Bovine brucellosis is endemic in cattle in India, however not much is known on the prevalence of this disease in stray cattle populations of the country. This study aimed to estimate the prevalence and identify risk factors associated with brucellosis in the stray cattle populations reared in cow shelters (gaushalas) of Punjab, India. Blood samples were collected from 587 cattle reared in 23 cow shelters in 23 districts (one per district) of the Punjab and were tested using Rose Bengal plate test (RBPT), standard tube agglutination test (STAT) and Indirect Enzyme Linked Immunosorbent Assay (i-ELISA). Information on the sex and breed of the animal, total cattle population and presence of a separate shed for parturition were collected. An animal was considered exposed to Brucella infection based on a positive RBPT or STAT test and a positive i-ELISA test. Explanatory variables for the animal level disease status outcome variable were sex and breed of the animal and at the shelter level were shelter cattle population size and presence of a separate shed for parturition. Univariable binomial exact logistic regression analysis was conducted to assess the association of each explanatory variable with the binary outcome variable. Sixty-two animals were seropositive on RBPT, with an apparent seroprevalence of 10.56% (95% confidence interval [CI]: 8.33%, 13.31%) and the estimated true seroprevalence of 11.48% (95% CI: 8.9%, 14.64%). Sixty three animals were seropositive using STAT [apparent seroprevalence of 10.73% (95% CI: 8.48%, 13.50%) and the estimated true seroprevalence of 10.69% (95% CI: 8.27%, 13.67%)], and 68 using i-ELISA [an apparent seroprevalence of 11.58% (95% CI: 9.24%, 14.43%) and the estimated true seroprevalence of 13.28% (95% CI: 10.50%, 16.66%)]. Cross bred cattle had a lower risk of being test positive (odds ratio 0.16, p = 0.04) as compared to indigenous cattle. Due to a ban on cow slaughter in the country, roaming stray cattle infected with brucellosis present a permanent risk of introduction of disease to the dairy farms and other vulnerable populations.

"Our services are not the same": the impact of the COVID-19 pandemic on care interactions in women's shelters.

BACKGROUND: Guidelines and regulations in response to the COVID-19 pandemic have significantly impacted the health care sector. We explore these impacts in the gender-based violence (GBV) services sector and, more specifically, in the context of women's shelters. METHODS: Using an interpretive description and integrated knowledge mobilization approach, we interviewed 8 women's shelter clients, 26 staff, and conducted focus groups with 24 Executive Directors. RESULTS: We found that pandemic responses challenged longstanding values that guide work in women's shelters, specifically feminist and anti-oppressive practices. Physical distancing, masking, and closure of communal spaces intended to slow or stop the spread of the novel coronavirus created barriers to the provision of care, made it difficult to maintain or create positive connections with and among women and children, and re-traumatized some women and children. Despite these challenges, staff and leaders were creative in their attempts to provide quality care, though these efforts, including workarounds, were not without their own challenges. CONCLUSIONS: This research highlights the need to tailor crisis response to sector-specific realities that support service values and standards of care.