Diagnostic patterns in hospital use by an urban homeless population.

Because patterns of disease and health care system usage by the homeless constitute a neglected area of research in the medical literature, we undertook a retrospective analysis of inpatient records on medically indigent adults, controlling for housing status, to add to the growing body of research in the area of homeless health care. Data on all 4,243 indigent patients admitted over 2 fiscal years (1985 and 1986) under the county medical services program of San Diego County, California, revealed 5.3% (226) to be homeless. The commonest major diagnostic category among the homeless discharges was "diseases and disorders of the skin, subcutaneous tissue, and breast," constituting 21.2% as compared with only 8.7% of the discharge diagnoses for housed indigent persons. Within this major diagnostic category, the predominant diagnosis-related group was cellulitis, accounting for 12.8% of diagnoses in the homeless and only 4.0% of discharge diagnoses in other medically indigent persons. A homeless housing status was also correlated with a higher percentage of discharges with the major diagnostic category of "substance use and substance-induced organic mental disorders" but was negatively correlated with that of "diseases and disorders of the circulatory system."     

The Protective Association between Pet Ownership and Depression among Street-involved Youth: A Cross-sectional Study

Street-involved youth represent a particularly vulnerable subsection of the homeless population and are at increased risk of health problems, substance abuse, and depression. Qualitative research has demon- strated that animal companions help homeless youth cope with loneliness, are motivators for positive change, such as decreasing drug or alcohol use, provide unconditional love without judgement, and improve youths’ sense of health. To quantitatively investigate the association between depression and pet ownership among street-involved youth, a cross-sectional study was per- formed with a convenience sample of 189 street-involved youths who were surveyed in four cities in Ontario, Canada, 89 of whom were pet owners and 100 of whom were not. Logistic regression modelling found pet ownership to be negatively associated with depression in the study population (controlling for gender, regular use of drugs, and time since youth left home), with the odds of being depressed three times greater for youths who did not own pets. While pet ownership among street-involved youth has many liabilities, includ- ing impairing youths’ ability to access shelter, services, and housing and employment opportunities, companion animals may offer both physical and psychosocial benefits that youth have difficult attaining. This finding highlights the importance of increased awareness among youth service providers of the potential impacts of pet ownership for street-involved youth.     

Mice in Bion-M 1 Space Mission: Training and Selection

After a 16-year hiatus, Russia has resumed its program of biomedical research in space, with the successful 30-day flight of the Bion-M 1 biosatellite (April 19–May 19, 2013). The principal species for biomedical research in this project was the mouse. This paper presents an overview of the scientific goals, the experimental design and the mouse training/selection program. The aim of mice experiments in the Bion-M 1 project was to elucidate cellular and molecular mechanisms, underlying the adaptation of key physiological systems to long-term exposure in microgravity. The studies with mice combined in vivo measurements, both in flight and post-flight (including continuous blood pressure measurement), with extensive in vitro studies carried out shortly after return of the mice and in the end of recovery study. Male C57/BL6 mice group housed in space habitats were flown aboard the Bion-M 1 biosatellite, or remained on ground in the control experiment that replicated environmental and housing conditions in the spacecraft. Vivarium control groups were used to account for housing effects and possible seasonal differences. Mice training included the co-adaptation in housing groups and mice adaptation to paste food diet. The measures taken to co-adapt aggressive male mice in housing groups and the peculiarities of “space” paste food are described. The training program for mice designated for in vivo studies was broader and included behavioral/functional test battery and continuous behavioral measurements in the home-cage. The results of the preliminary tests were used for the selection of homogenous groups. After the flight, mice were in good condition for biomedical studies and displayed signs of pronounced disadaptation to Earth''s gravity. The outcomes of the training program for the mice welfare are discussed. We conclude that our training program was effective and that male mice can be successfully employed in space biomedical research.     

Happiness and Social Exclusion of Indigenous Peoples in Taiwan - A Social Sustainability Perspective

IntroductionHappiness and social inclusion are important indicators of social sustainability, as recommended in the Sustainable Development Goals; however, little is known about the social sustainable development of ethnic minorities. To fill this knowledge gap, special attention is paid to understanding the issues of social exclusion and happiness in relation to the indigenous peoples in Taiwan.MethodsData used were drawn from a nationwide representativeness survey of the Taiwanese Indigenous People in 2007; it included 2,200 respondents. This study employed binary logistic regression to examine the effects of different domains of social exclusion on the likelihood of perceiving happiness; other exogenous factors, were controlled.ResultsThe results show that among the respondents, mountain indigenous peoples, females, the elderly and those who are healthier, wealthier, highly educated, possessing western beliefs, and are more likely to be happy, compared to their counterparts. As expected, the results reveal that the likelihood of being happy is higher for those who have received medical benefits, as well as those persons without housing problems or financial difficulties, compared to their excluded counterparts. However, no significant association is found between happiness and some social exclusion domains, such as child and youth benefits, and unemployment benefits.ConclusionsThe disengagement of the indigenous peoples in mainstream society, with respect to the accessibility of welfare provisions, is a crucial element in regard to social exclusion and happiness. Several policy implications for the social sustainability of indigenous peoples can be inferred from these findings. For example, providing a mobile clinical tour, on-site health counseling, or homecare service can contribute to the removal of institutional and geographic barriers to medical welfare provisions for the mountain indigenes. Moreover, the government may devote more welfare resources to assist indigenous families and tribal communities to develop their own social safety net, instead of the individual-oriented welfare provisions.     

Assessing Youth Perceptions and Knowledge of Ethics at 4-H Horse Shows in Louisiana

Due to the increased awareness of animal welfare issues and sensitized attitudes throughout society, youth animal projects provide a unique opportunity to assess and impact youth understanding and attitudes regarding animal welfare. Animal ethics training is not an uncommon requirement for participants in 4-H livestock programs. However, participants in 4-H horse projects are not universally held to the same standard. The purpose of this study was to assess youth knowledge, attitudes, and confidence in understanding of equine welfare at the 4-H state horse show, as well as to determine the beliefs and observations of unethical practices, and if differences exist between those parameters in youth competitors. The results suggest that 4-H competitors are interested in ethics and believe that unethical behavior rarely occurs within the state 4-H horse project. However, youth report observing common unethical behaviors at the show, suggesting a disconnect between what they believe is unethical and what they actually observe. Educational opportunities exist within these animal projects and should be enhanced to address the gap in understanding.     

A Variable- and Person-Oriented Investigation of Preschool Competencies and Head Start Children's Transition to Kindergarten and First Grade

There is a widespread belief that youth drop out of youth development programs during the middle school years. Alternative explanations for the smaller number of adolescent program participants have yet to be explored. We examine age trends in program enrollment using data from over 221,000 youth enrolled in the California 4-H Youth Development Program from 1992 to 2002. We include sex, race/ethnicity, rural/urban residence, and project participation as predictors of dropout. Our results indicate that the peak in enrollment in early adolescence that is observable from annual enrollment data can be accounted for by stable and high enrollment turnover before age 11, followed by increased program dropout and fewer new enrollments. These findings have implications for explanations of youth program participation and for youth development program enrollment strategies, both for the 4-H Youth Development program and for youth programs in general.     

Assessing the Welfare of Dairy Cattle

This article suggests that health problems represent some of the main threats to the welfare of dairy cattle. Although disagreement often arises about what constitutes the main welfare problems, there is broad agreement that welfare is reduced by health problems. In recent decades, a marked increase has occurred in the incidence of various production diseases in dairy cattle of which lameness is the most prevalent. This article summarizes the evidence showing that lameness is affected by the genetics of the animal and by housing. High levels of production do not necessarily lead to increased lameness, although genetic correlations between levels of production and the incidence of lameness suggest that continued high selection for milk production will likely exacerbate the problem. Denying access to pasture may increase the incidence of some forms of lameness. Both the design of the stall and the type of walking surface can have a large effect on the incidence of hoof problems for the nonhuman animal kept in free-stall housing. Finally, management and nutritional factors can have a large effect, often obscuring the influence of housing. The behavior of the cow, particularly time spent lying or standing, can influence the likelihood of lameness.     

Innovative HIV/AIDS program launched in Ottawa.

Collaboration among 31 social and health care agencies and the provincial government has resulted in an innovative program for Ottawa-area patients with HIV infection or AIDS. The target group is the homeless and people with "unstable" housing who live in the city''s downtown core, a group at high risk of contracting HIV. The education of family practitioners will be an important part of the program.     

Predictors of Frequent Emergency Room Visits among a Homeless Population

Background

Homelessness, HIV, and substance use are interwoven problems. Furthermore, homeless individuals are frequent users of emergency services. The main purpose of this study was to identify risk factors for frequent emergency room (ER) visits and to examine the effects of housing status and HIV serostatus on ER utilization. The second purpose was to identify risk factors for frequent ER visits in patients with a history of illicit drug use.

Methods

A retrospective analysis was performed on 412 patients enrolled in a Boston-based health care for the homeless program (HCH). This study population was selected as a 2:1 HIV seronegative versus HIV seropositive match based on age, sex, and housing status. A subgroup analysis was performed on 287 patients with history of illicit drug use. Chart data were analyzed to compare demographics, health characteristics, and health service utilization. Results were stratified by housing status. Logistic models using generalized estimating equations were used to predict frequent ER visits.

Results

In homeless patients, hepatitis C was the only predictor of frequent ER visits (OR 4.49, p<0.01). HIV seropositivity was not predictive of frequent ER visits. In patients with history of illicit drug use, mental health (OR 2.53, 95% CI 1.07–5.95) and hepatitis C (OR 2.85, 95% CI 1.37–5.93) were predictors of frequent ER use. HIV seropositivity did not predict ER use (OR 0.45, 95% CI 0.21 – 0.97).

Conclusions

In a HCH population, hepatitis C predicted frequent ER visits in homeless patients. HIV seropositivity did not predict frequent ER visits, likely because HIV seropositive HCH patients are engaged in care. In patients with history of illicit drug use, hepatitis C and mental health disorders predicted frequent ER visits. Supportive housing for patients with mental health disorders and hepatitis C may help prevent unnecessary ER visits in this population.     

The effects of enriching laboratory cages using various physical structures on multiple measures of welfare in singly-housed rats

The single housing of laboratory rats may be recommended in some situations such as hypothesis-driven or test-specific studies, during electroencephalogram recording of phases of sleep and after surgical procedures. However, as single housing of laboratory rats has been shown to be stressful, modification of the housing environment is needed to improve the welfare of these animals. This experiment was carried out to investigate the long-term effects of environmental enrichment on some behavioural, physiological, pathological and psychological measures of welfare. With two batches of animals, 24 rats were housed singly in either enriched cages (EC) (n = 12 cages) or unenriched cages (UC) (n = 12 cages). Behaviour was sampled every week and so was body weight and weight gain over a six-week observation period. Behaviours of the rats in the elevated plus-maze were recorded on the seventh week, whereas organ weights were recorded postmortem. The results revealed that long-term single housing of rats in super-enriched cages increased levels of indicators of good welfare including sleep, exploration, movement and feeding behaviour, body weights, weight gains and the relative weights of the thymus gland and spleen, and decreased levels of indicators of poor welfare such as stationary behaviour and the relative weight of adrenal glands. Thus, enrichment of conventional cages of newly weaned singly-housed laboratory rats with multiple physical structures appeared to improve their ability to control the environment and to promote their species-specific behaviour; changes that can ultimately result in good welfare.     

On-farm assessment of laying hen welfare: a comparison of one environment-based and two animal-based methods

Methods available to assess animal welfare at farm level are based on a range of welfare parameters, which can be divided into two categories, environment-based and animal-based parameters. The first category describes features of the environment and management, which can be considered prerequisites for welfare. The second category records animals’ responses to that particular environment and management more directly. Objective of this study was to validate a mainly environment-based method, the animal needs index (ANI), with animal-based methods: behavioural observations and feather condition scores (FCS). The study was conducted on 20 commercial laying hen farms, 10 farms with battery cages and 10 farms with deep litter systems. During a 1-day visit on each farm, ANI was assessed, FCS was scored, and behavioural observations were performed. Instantaneous scan sampling and continuous focal sampling were used to assess the time spent on different behaviours and the occurrence of event behaviours. Data from behavioural observations and FCS were reduced with principal factor analysis. This resulted in two factors for each method. Significant positive correlations were found between ANI, on the one hand, and ‘movement’ and ‘comfort’, two factors from behavioural observations, on the other hand. A significant negative correlation was found between ANI and ‘wing damage’ (from FCS). The results of this study show that ANI is valid and sensitive enough to show differences in animal welfare between housing systems, whereas differences in welfare within housing systems cannot be shown. In conclusion, ANI is an appropriate method for assessment of laying hen welfare on a large number of farms with different housing systems.     

What happens to homeless mentally ill people? Follow up of residents of Oxford hostels for the homeless.

OBJECTIVES--To follow up severely mentally ill residents of hostels for the homeless to determine their social and psychiatric outcome. DESIGN--Follow up at 18 months of hostel residents previously assessed with psychiatric and behavioural measures. SETTING--Two Oxford hostels for the homeless. SUBJECTS--48 hostel residents previously identified as disabled by mental illness. MAIN OUTCOME MEASURES--Current housing, admissions to psychiatric hospital, violent or antisocial behaviour, and score on standardised behavioural rating. RESULTS--45 of the 48 residents were traced. 27 had remained in the hostels; only 10 had been rehoused, mainly in bedsits or with their families. 16 had a poor outcome as judged by death (four subjects), lengthy hospital readmission (two), marked deterioration in behaviour (six), sleeping rough (one), or disappearance (three). CONCLUSION--More effort is needed to provide suitable housing for homeless mentally ill people.     

Effect of grazing on the cow welfare of dairy herds evaluated by a multidimensional welfare index

Structural development in the prime sector has led to increasing herd sizes and new barn systems, followed by less summer grazing for dairy cows in Denmark. Effects of grazing on single welfare measures in dairy cows – for example, the presence of integument alterations or mortality – have been studied under different conditions. However, the effect of grazing on welfare, conceptualised as the multidimensional physical and mental state of the animal, has not yet been studied in contemporary cubicle loose-housing systems. The aim of our study was to investigate, based on a Welfare Quality® inspired multidimensional dairy cow welfare assessment protocol, the within-herd effect of summer grazing compared with winter barn housing in Danish dairy herds with cubicle free-stall systems for the lactating cows. Our hypothesis was that cow welfare in dairy herds was better during summer grazing than during full-time winter housing. Furthermore, we expected improved welfare with an increase in daily summer grazing hours. In total, 41 herds have been visited once in the winter and once in the summer of 2010 to assess their welfare status with 17 different animal- and resource-based welfare measures. A panel of 20 experts on cattle welfare and husbandry evaluated the relative weight of the 17 welfare measures in a multidimensional assessment scheme. They estimated exact weights for a priori constituted severe compared with moderate scores of welfare impairment concerning each measure, as well as relevance of the measures in relation to each other. A welfare index (WI; possible range 0 to 5400) was calculated for each herd and season with a higher index indicating poorer welfare. The within-herd comparison of summer grazing v. winter housing considered all the 17 measures. The mean WI in summer was significantly lower (better) than in winter (mean 2926 v. 3330; paired t-test P = 0.0001) based on a better state of the integument, claw conformation and better access to water and food. Body condition and faeces consistence were worse in summer. Many daily grazing hours (range average above 3 to 9 h) turned out to be more beneficial than few daily grazing hours (range average above 9 to 21 h) for the welfare of the dairy herds. In conclusion, this study reports a positive within-herd effect of summer grazing on dairy cow welfare, where many daily grazing hours were more beneficial than few daily grazing hours.     

Impact of an integrated service system on client outcomes by gender in a national sample of a mentally ill homeless population

Background: Homeless populations with concurrent mental illness have a complex array of service needs that are often addressed in a haphazard or uncoordinated manner. Information is lacking about the effectiveness of programs and public policy in women who are both homeless and mentally ill.Objective: This study assessed the impact of gender on the outcomes of a multisite public policy intervention that implemented components of an integrated service delivery system to address the needs of mentally ill homeless men and women.Methods: A secondary analysis was performed using longitudinal data obtained from homeless men and women in the Access to Community Care and Effective Services and Supports prospective study, which was conducted at 18 sites across the United States. Outcome data from baseline, 3, 12, and 18 months across 5 annual cohorts were analyzed to determine the impact of gender on 6 clinical outcomes, including days of housing, relationships, victimization, social support, alcohol use, and drug use, in homeless men and women with mental illness. The analysis plan included multilevel modeling of longitudinal data.Results: Data were analyzed from a total of 7229 participants, including 4502 men (62%)) (mean age, 38.2 years) and 2727 women (38%) (mean age, 37.2 years). After 18 months of follow-up, women had significantly better outcomes in terms of family relationships (estimated mean score increased 0.100), victimization (score decreased 0.164), and social support (score increased 0.363) than did men (aall, P < 0.001). Being accompanied by children was significantly associated with less change in drug use among women compared with men (P < 0.01). These outcomes were the same across all 18 program sites.Conclusion: Although the addition of services for the homeless in conjunction with clinical and support services offered by case managers had generally positive effects in this study's population, a gender-specific substance abuse treatment intervention should also be included in a comprehensive program for homeless women with mental illness.     

Trends in Sheltering and Welfare at the Hawaiian Humane Society,Oahu, Hawaii

One of the major goals of an animal welfare organization is to reduce the number of homeless, nonhuman animals in a community. In Hawaii, the Hawaiian Humane Society has provided numerous animal welfare services to work toward this goal, such as offering sterilizations and microchipping at reduced rates and facilitating animal adoptions and education. In addition, the Leash Law and the Cat Identification Program have increased animal welfare through increasing the responsibilities of companion animal caregivers (owners). The goal of this research was to assess if temporal changes in animal sheltering have occurred in Hawaii. The study assessed this by analyzing historical data on dogs (Canis familiaris) and cats (Felis catus) admitted, returned to owner, sterilized, euthanized, and adopted from the Humane Societies of Oahu, Hawaii, from 1993 to 2008. The study also analyzed dog and cat admittance and Honolulu population growth from 1975 to 2008. Sterilizations and pets returned to owners have increased significantly, whereas admittance and euthanasia rates have decreased significantly. Thus, although these data cannot conclusively state that there are fewer homeless animals in Hawaii, the results provide positive indicators of reducing homeless pets, especially when coupled with an increase in both the human population of Honolulu County and dog ownership.     

Trends in sheltering and welfare at the Hawaiian Humane Society, Oahu, Hawaii

One of the major goals of an animal welfare organization is to reduce the number of homeless, nonhuman animals in a community. In Hawaii, the Hawaiian Humane Society has provided numerous animal welfare services to work toward this goal, such as offering sterilizations and microchipping at reduced rates and facilitating animal adoptions and education. In addition, the Leash Law and the Cat Identification Program have increased animal welfare through increasing the responsibilities of companion animal caregivers (owners). The goal of this research was to assess if temporal changes in animal sheltering have occurred in Hawaii. The study assessed this by analyzing historical data on dogs (Canis familiaris) and cats (Felis catus) admitted, returned to owner, sterilized, euthanized, and adopted from the Humane Societies of Oahu, Hawaii, from 1993 to 2008. The study also analyzed dog and cat admittance and Honolulu population growth from 1975 to 2008. Sterilizations and pets returned to owners have increased significantly, whereas admittance and euthanasia rates have decreased significantly. Thus, although these data cannot conclusively state that there are fewer homeless animals in Hawaii, the results provide positive indicators of reducing homeless pets, especially when coupled with an increase in both the human population of Honolulu County and dog ownership.     

Welfare, health, and hygiene of laying hens housed in furnished cages and in alternative housing systems

The aim of this review was to compare welfare, health, and hygienic status of laying hens housed in furnished cages and in alternative systems. In alternative systems (floor housing and aviaries), birds have more freedom of movement and a more complex environment than in furnished cages. However, housing birds in much larger flocks in alternative systems leads to an increased risk of feather-pecking. Furthermore, air quality can be poorer in alternative systems than in furnished cages. This can affect health and hygienic status. There are only limited data on a direct comparison between furnished cages and alternative systems. Therefore, there is a need for an on-farm comparison of welfare, health, and hygienic status in these systems.