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Background: The delivery of rehabilitation services for hard-to-reach populations (e.g., refugees) is highly complex. There is a need for evidence-based approaches to deliver physiotherapy (PT) or occupational therapy (OT) services to this underserved group. Objectives: The purpose of this scoping review was to identify PT and OT service delivery models that have been implemented, for populations typically identified as hard-to-reach and their associated health outcomes. Eligibility criteria: Articles were eligible if they described PT and/or OT services for hard-to-reach populations. There were no restrictions on study design. Study selection: Six electronic databases (AMED, CINAHL, MEDLINE, EMBASE, Healthstar, and PsycINFO) were searched from January 2000 to June 2023. Articles were screened in duplicate by two independent reviewers, and conflicts were resolved by consensus. Results: Twenty-one articles with variable sample sizes (min, max n = 3 to 237) were included and detailed PT and/or OT services for immigrants/migrants, refugees, hard-to-reach veterans, people experiencing homelessness, lower incomes, trauma/torture, and those living in rehabilitation-deficient areas. Common rehabilitation needs (e.g., clinician to client connectivity), barriers (e.g., high transportation costs) and facilitators (e.g., encouragement) were identified among the various populations, mainly due to intersecting identities such as those who are both traumatized and refugees. Unique factors pertaining to the PT and OT services were also identified in some groups, including access to child and family services for people experiencing homelessness. Conclusions: Despite common and individual needs, barriers, and facilitators in hard-to-reach groups in the literature, there is a need for studies with larger sample sizes, rigorous methodology and a conscious effort to publish the results of interventions to generate stronger recommendations for practice. [ABSTRACT FROM AUTHOR]

Canadian homelessness is an ongoing issue, especially in the Nipissing District, Ontario, where agencies work to support those in need. However, these efforts were challenged with the sudden onset of the COVID-19 pandemic. Drawing on the Cycle of Homelessness model, this study examines sociodemographic factors associated with homeless experiences during the pandemic. Using data from the 2021 (n = 207) Nipissing District homeless enumeration survey and employing bivariate and multivariate binary logistic analyses, this study examined sociodemographic factors associated with reasons of homelessness, barriers to housing loss and experiences of chronic and episodic homelessness during the pandemic. The results showed a significant sociodemographic variation in the experiences of the homeless population during the COVID-19 pandemic. Those over the age of 35 versus their younger counterparts were more likely (43.7%) found in emergency shelters. Multivariate findings indicated that females experienced housing/financial loss and interpersonal/family issues, directly causing homelessness, 2.2 and 2.5 times more than males, respectively. Welfare recipients were more likely to experience health-related reasons for housing loss (Odds Ratio (OR): 2.8), chronic homelessness (OR: 3.3), addiction (OR: 2.9), and mental health-related barriers to housing (OR: 4.1). Those aged 25–34, 25–44, and 45+ were 7.9, 4.9, and 5.1 times more likely to face chronic homelessness. Conclusions: Welfare recipients are more at-risk of health-related housing loss, addiction, and mental health barriers to housing, and chronic homelessness. This could be attributed to poor public planning and policies that put people in marginal economic and housing circumstances, especially during the pandemic. Therefore, policy reform is required to address the main barriers in eliminating homelessness. [ABSTRACT FROM AUTHOR]

Community health needs assessments (CHNA) involving qualitative techniques help tailor health services to the specific needs of the population groups for whom they are designed. In light of increasing health disparities amongst people experiencing homelessness (PEH)—and to ensure the integration of their voices into a larger CHNA—this study used an ethnographic approach grounded in a social constructivist research paradigm to explore the perspectives of PEH attending a primary care and addiction service in Ireland on their priority health and healthcare needs. Participant observations and informal interviews were conducted with clients experiencing homelessness attending the service for three hours every Monday morning between October 2022 and April 2023. Field note data from active participant observation and informal conversations were collected, anonymised, and analysed using inductive thematic analysis in accordance with the Declaration of Helsinki and the researchers' institutional Research Ethics Committee. Three main themes emerged from the analysis: self-identified priorities, satisfaction with health services, and migrant health. Clients' priority concerns relate to their mental health and personal safety, strengthening ties with children and families, finding a sense of purpose, and feeling better physically. These challenges differ from those of the general population in terms of their severity observed both prior to and during experiences of homelessness, coupled with disproportionately high levels of loss, fear, pain, fatigue, social stigma and other barriers to accessing satisfactory housing. In terms of services, clients are satisfied with their ability to access primary care and harm reduction in a social environment where positive exchanges with friends and providers take place. Conversely, barriers to accessing mental health and addiction services persist including the internalised belief that one is beyond help, lack of access to information on available services and their entry requirements, and lingering stigma within a health system that treats addiction as separate to health. Moving forward, health practitioners may consider holding more regular and open conversations with clients experiencing homelessness about the care they are receiving, its rationale, and whether or not changes are desired that can be safely made. The health needs of migrants and asylum seekers entering homelessness in Ireland are urgent and should be prioritised in future research. [ABSTRACT FROM AUTHOR]

Millions of families with children in the U.S. struggle to afford adequate housing. Housing cost burden places families at risk for homelessness, and prevention efforts are hindered by limited understanding of insecure housing experiences at the margins. The present study investigated variation in housing insecurity experiences in a sample of mothers, as well as which risk profiles were most strongly associated with subsequent homelessness. Latent class analysis identified four distinct subgroups of housing insecurity: "Stable," "Unstable," "Rent-Focused," and "Strategic Bill-Paying." Classes differed on whether they made rent or utility payments on time, experienced utility shutoffs, or were evicted. Mothers who missed rent payments were significantly more likely to experience subsequent homelessness, whereas those who prioritized rent were more likely to have their utilities shut off but remain housed. Policy efforts should emphasize increased wages, rent control, changes to zoning laws and tax codes to prioritize affordable housing, and benefits that help mothers maintain their incomes such as comprehensive healthcare, paid maternity leave, and subsidized childcare. [ABSTRACT FROM AUTHOR]

People experiencing homelessness are more likely to utilize emergency departments than their non-homeless counterparts. However, obtaining a bed in a homeless shelter for patients can be complex. To better understand the challenges of finding a safe discharge plan for homeless patients in the emergency department, our team conducted interviews with emergency department social workers and homeless shelter case managers in the Boston area. We identified and mapped the stages in the processes performed by both parties, identifying challenges with successful placement into a shelter. Furthermore, we assembled a data dictionary of key factors considered when assessing a patient's fit for a homeless shelter. By identifying bottlenecks and areas of opportunity, this study serves as a first step in enabling homeless individuals to receive the post-discharge assistance they require. [ABSTRACT FROM AUTHOR]

The urban heat island effect exacerbates independent climate change‐induced shifts toward longer, stronger, and more frequent heat extremes. Environmental inequity, driven by a history of racially motivated urban planning policies, has led particular demographics to bear the worst impacts of urban heat exposure and thus also climate change. These impacts cause adverse health outcomes in the form of heat emergencies. Through a novel demographic and spatial analysis of heat‐related illness Emergency Medical Services data from Richmond, Virginia, this study investigates the relationships between heat health emergencies and intra‐urban heat islands quantified through three heat exposure metrics. We also evaluate the accessibility of built refuge from urban heat in the form of public transit infrastructure, libraries, and government cooling centers in relation to these emergencies. We found that heat emergencies are inequitably distributed among racial, age, and socioeconomic groups in Richmond, particularly among residents identified as Male, Black or African American, 50+ years old, and experiencing mental health, intoxication, and/or homelessness. We found significant associations between the location of these heat emergencies and urban heat islands as estimated from remotely‐sensed surface and community science‐derived air temperature metrics, but not a co‐estimated heat index. We also found that available refuge facilities are insufficiently located to protect individuals with reduced mobility across areas with the highest number of heat‐related health emergencies. Community involvement in the mitigation and management of extreme heat threats, especially for those disproportionately impacted, is necessary to decrease the number of summertime heat illnesses. Plain Language Summary: In a process called the urban heat island effect, urban areas experience higher average temperatures compared to nearby rural areas, largely due to the lack of cooling provided by trees and the heat‐trapping ability of buildings and paved surfaces. While human‐caused climate change is driving average global temperatures to rise, some communities and neighborhoods in Richmond, Virginia experience hotter temperatures than others. This is largely due to a historical lack of government investment in Black and low‐income neighborhoods. Hotter, less resourced neighborhoods experience more heat‐related health emergencies like heat stroke and heat exhaustion. This study found significant relationships between the location of heat‐related illness Emergency Medical Services data from Richmond, Virginia and areas which are measurably hotter. We also found that Richmond has insufficient publicly accessible places for people with limited mobility to escape the heat, including bus stop shelters, libraries, and government cooling centers. Richmonders bear the brunt of heat emergencies unequally, with a higher proportion of heat emergencies among residents identified as Male, Black or African American, 50+ years old, and experiencing mental health, intoxication, and/or homelessness. Impacted community members should be prioritized as cities like Richmond addresses the everyday impacts of climate change and urban heat. Key Points: Heat‐related health emergencies are inequitably distributed in Richmond, Virginia across demographicsRemotely‐sensed surface temperature, community science‐derived air temperature metrics are strong predictors of heat‐related health impactsBuilt refuge is essential for extreme heat management, inequitable access persists for low mobility and vulnerable residents [ABSTRACT FROM AUTHOR]

Purpose: To identify experiences of boredom and associations with psychosocial well-being during and following homelessness. Methods: Using a convergent, mixed-methods explanatory design, we conducted quantitative interviews with 164 participants) (n = 102 unhoused; n = 62 housed following homelessness) using a 92-item protocol involving demographic components and seven standardized measures of psychosocial well-being. A sub-sample (n = 32) was approached to participate in qualitative interviews. Data were analyzed by group (unhoused; housed). Quantitative data were analyzed using descriptive statistics designed to generate insights into boredom, meaningful activity engagement, and their associations with psychosocial well-being during and following homelessness. Qualitative data were analyzed using thematic analysis. Quantitative and qualitative findings were integrated at the stage of discussion. Results: Quantitative analyses revealed small to moderate correlations between boredom and increased hopelessness (rs =.376, p <.01), increased drug use (rs =.194, p <.05), and lowered mental well-being (rs = -.366, p <.01). There were no statistically significant differences between unhoused and housed participants on any standardized measures. Hierarchical regression analyses revealed that housing status was not a significant predictor of boredom or meaningful activity engagement (p>.05). Qualitative interviews revealed profound boredom during and following homelessness imposing negative influences on mental well-being and driving substance use. Conclusions: Boredom and meaningful activity are important outcomes that require focused attention in services designed to support individuals during and following homelessness. Attention to this construct in future research, practice, and policy has the potential to support the well-being of individuals who experience homelessness, and to contribute to efforts aimed at homelessness prevention. [ABSTRACT FROM AUTHOR]

Young adults experiencing homelessness (YAEH) are faced with instabilities in many areas of their lives, including their living situation, employment, and income. Little is known about how the experience of instability in these different domains might be associated with substance use. Leveraging data collected on 276 YAEH in Los Angeles County, regression analyses examine associations between three distinct types of instability (housing, employment, income) and participants' self-reported alcohol use, alcohol consequences, non-cannabis drug use, and substance use symptoms. Results indicated that recent instability in income, employment, and secure housing for those with access to it (but not housing in general or non-secure housing) were significantly associated with greater alcohol/drug use or substance use symptoms. Depression was also found to moderate the association between employment instability and alcohol use. Our findings suggest that efforts to reduce instability in income, employment, and secure housing may have positive benefits for substance using YAEH, especially those with depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: This paper describes the protocols for a randomized controlled trial using a parallel-group trial design that includes an intervention designed to address social isolation and loneliness among people experiencing homelessness known as Miracle Friends and an intervention that combines Miracles Friends with an economic poverty-reduction intervention known as Miracle Money. Miracle Friends pairs an unhoused person with a volunteer "phone buddy." Miracle Money provides guaranteed basic income of $750 per month for 1 year to Miracle Friends participants. The study will examine whether either intervention reduces social isolation or homelessness compared to a waitlist control group. Methods: Unhoused individuals who expressed interest in the Miracle Friends program were randomized to either receive the intervention or be placed on a waitlist for Miracle Friends. Among those randomized to receive the Miracle Friends intervention, randomization also determined whether they would be offered Miracle Money. The possibility of receiving basic income was only disclosed to study participants if they were randomly selected and participated in the Miracle Friends program. All study participants, regardless of assignment, were surveyed every 3 months for 15 months. Results: Of 760 unhoused individuals enrolled in the study, 256 were randomized to receive Miracle Friends, 267 were randomized to receive Miracle Money, and 237 were randomized to the waitlist control group. In the two intervention groups, 360 of 523 unhoused individuals were initially matched to a phone buddy. Of the 191 study participants in the Miracle Money group who had been initially matched to a volunteer phone buddy, 103 were deemed to be participating in the program and began receiving monthly income. Discussion: This randomized controlled trial will determine whether innovative interventions involving volunteer phone support and basic income reduce social isolation and improve housing outcomes for people experiencing homelessness. Although we enrolled unhoused individuals who initially expressed interest in the Miracle Friends program, the study team could not reach approximately 30% of individuals referred to the study. This may reflect the general lack of stability in the lives of people who are unhoused or limitations in the appeal of such a program to some portion of the unhoused population. Trial registration: ClinicalTrials.gov NCT05408884 (first submitted on May 26, 2022). [ABSTRACT FROM AUTHOR]

Basic foot care is a real need of people experiencing homelessness. To improve access to foot health for this group, three services structured to provide healthcare support for people experiencing homelessness collaborated in metropolitan Melbourne, Australia: an established nurse-led Homeless Persons Program (HPP), a specialty community health podiatry clinic servicing people experiencing homelessness, and a charity supporting disadvantaged communities providing free socks, foot first aid kits and second-hand footwear for distribution by nurses and podiatrists of participating services. This paper outlines the implementation and evaluation of this collaboration. A four stage implementation approach was used, addressing: 1. Who needs to do what differently? 2. What are the barriers and enablers that need to be addressed? 3. Which intervention components could overcome the modifiable barriers and enhance the enablers? 4. How can the changes be measured? The evaluation prospectively collected information about how HPP nurses referred adults to podiatry, and whether the referred individuals accessed the podiatry clinic, the outcomes of the podiatry visit, and how many received footwear, socks and foot first aid kits provided by the non-profit organisation. Over 1st June 2019 and 31st December 2020, 52 individuals were identified as adults who could potentially benefit from podiatry by the HPP nurses, of which 33 accessed podiatry. Those who did not visit the podiatry clinic were more likely to be born outside of Australia, live in more precarious housing (crisis accommodation and rough sleeping), have slightly more predisposing factors for homelessness, but have fewer medical, psychological and cognitive conditions. A structured approach including processes, education, regular, outreach to youth refuges and formal outcome monitoring enabled foot health care access in people experiencing homelessness. Further research is needed to ascertain how to support participants at risk of foot problems to access podiatry before their foot health issue reaches crisis point. [ABSTRACT FROM AUTHOR]

Homelessness is associated with multiple risk factors for neurocognitive impairment. Past research with people experiencing homelessness has described “frontal lobe” dysfunction including behavioral disorders and executive cognitive impairments. In the current study, 72 adults experiencing homelessness were assessed with a standardized assessment of executive function, and interviewed regarding neurological and psychiatric history. When compared to a control sample of 25 never-homeless participants, and controlling for level of education, there was little evidence for executive dysfunction in the sample of people experiencing homelessness. Levels of substance abuse, past head injury, and post-traumatic stress disorder were notably high. However, there were no statistically significant associations between cognitive task performance and clinical or substance abuse variables. Gambling was surprisingly infrequent, but risk-taking behavior among intravenous drug users was common. Though in neither case was it linked to executive function. Overall, there was little evidence for executive impairment in this sample of people experiencing homelessness. I suggest that past research has often used inappropriate criteria for “normal” performance, particularly comparing people experiencing homelessness to control data of relatively high education level. This has led to elements of “frontal lobology,” that is, clinical neuroscience research that tends to overly link non-typical or pathological behavior to frontal lobe impairment. When appropriate comparisons are made, controlling for education level, as in this study, associations between executive function impairments and adult homelessness may be weaker than previously reported. [ABSTRACT FROM AUTHOR]

Medical Respite Programs (MRPs) characterize a care model that has been developed to address the health care and social needs of persons experiencing homelessness by providing post-acute hospital care in a safe environment. Although this model has been shown to reduce hospitalizations, improve health outcomes and increase access to health services, prior studies of MRP programs and outcomes have been limited to individual sites and may not generalize to the population of individuals receiving MRP care. This study protocol describes a mixed method design to collect organizational, provider, and patient-level data from a sample of MRPs. [ABSTRACT FROM AUTHOR]

Scabies is an overlooked tropical illness that yet has significant worldwide effects and lasting health repercussions. The condition is caused by the mite Sarcoptes scabei var. hominis, which is a parasitic organism that dwells on the outer layer of the human skin. Scabies is prevalent in impoverished neighborhoods as a result of the high population density in locations such as nursing homes, correctional facilities, and among homeless and displaced children. Nevertheless, modern nations are also prone to scabies infestations, particularly in cases of institutional outbreaks or mini epidemics occurring after conflict or natural calamities. Scabies diagnosis can be aided by both invasive and noninvasive techniques. This paper reviews assessment diagnosis, and management of scabies in primary health care settings. [ABSTRACT FROM AUTHOR]

In light of evidence that housing-related disparities in mortality are worsening over time, this study aimed to explore the perspectives of experts working in homeless health and addiction services on priority healthcare needs amongst people experiencing homelessness in Dublin, Ireland, a city facing problematic increases in homelessness. As part of a larger qualitative study, a series of semi-structured interviews were carried out with 19 community experts followed by inductive thematic framework analysis to identify emergent themes and sub-themes relating to priority healthcare needs. At the societal level, community experts identified a need to promote a culture that values health equity. At the policy level, accelerating action in addressing health inequalities was recommended with an emphasis on strategic planning, Housing First, social support options, interagency collaboration, improved data linkage and sharing, and auditing. At the health services level, removing barriers to access will require the provision of more and safer mental health, addiction, women-centred, and general practice services; resolved care pathways in relation to crisis points and multi-morbidity; expanded trauma-informed education and training and hospital-led Inclusion Health programmes; and outreach programmes and peer support for chronic disease management. The voices of people experiencing homelessness, including representatives from specific homeless groups such as migrants, youth, and the elderly, must be thoroughly embedded into health and social service design and delivery to facilitate impactful change. [ABSTRACT FROM AUTHOR]

Mobile crisis services for people experiencing distress related to mental health or substance use are expanding rapidly across the US, yet there is little evidence to support these specific models of care. These new programs present a unique opportunity to expand the literature by utilizing implementation science methods to inform the future design of crisis systems. This mixed methods study will examine the effectiveness and acceptability of the Street Crisis Response Team (SCRT), a new 911-dispatched multidisciplinary mobile crisis intervention piloted in San Francisco, California. First, using quantitative data from electronic health records, we will conduct an interrupted time series analysis to quantitatively examine the impacts of the SCRT on people experiencing homelessness who utilized public behavioral health crisis services in San Francisco between November 2019 and August 2022, across four main outcomes within 30 days of the crisis episode: routine care utilization, crisis care reutilization, assessment for housing services, and jail entry. Second, to understand its impact on health equity, we will analyze racial and ethnic disparities in these outcomes prior to and after implementation of the SCRT. For the qualitative component, we will conduct semi-structured interviews with recipients of the SCRT's services to understand their experiences of the intervention and to identify how the SCRT influenced their health-related trajectories after the crisis encounter. Once complete, the quantitative and qualitative findings will be further analyzed in tandem to assist with more nuanced understanding of the effectiveness of the SCRT program. This evaluation of a novel mobile crisis response program will advance the field, while also providing a model for how real-world program implementation can be achieved in crisis service settings. [ABSTRACT FROM AUTHOR]

Introduction: Life skills encompass psychosocial and interpersonal abilities for informed decision-making, problem-solving, effective communication, and balanced living. They are vital for youth facing modern challenges, helping them fulfill roles and build relationships. Developing these skills is crucial for resilience, given the complexities of today's society. The study assesses the attitudes of children and adolescents towards life skills in a Juvenile center in Ahmedabad, India, recognizing the importance of these skills for their well-being and future success. Methodology: This study was conducted in an Ahmedabad juvenile center with ethical clearance from Parul University's ethics committee. It involved 100 participants, selected using a snowball sampling method. A structured questionnaire assessed knowledge and attitudes regarding life skills. The questionnaire, validated by experts, included demographic data, knowledge questions, and attitude statements. The data analysis involved Mann-Whitney tests, Spearman correlation, and descriptive statistics. Findings were statistically significant at a 95% confidence level (p < 0.05). IBM SPSS version 23 was used for data analysis. Results: Gender differences were found in attitudes but not in knowledge among respondents. A moderate positive correlation between attitude and knowledge was statistically significant. Religious affiliation and age didn't significantly affect attitudes or knowledge. Most respondents had poor knowledge (94%) and a negative attitude (93%). Conclusion: Life skills training is vital for homeless children. It equips them with essential knowledge and abilities to navigate life's complexities, fostering resilience, empowerment, and positive attitudes. In their challenging circumstances, these skills become a lifeline, offering hope and the potential for a more stable, self-sufficient future. [ABSTRACT FROM AUTHOR]

Introduction: Life skills encompass a vital set of competencies that empower individuals to make informed decisions, assert their rights, and lead a healthy, productive life, making them agents of change. Adolescence, marked by physical, cognitive, emotional, and social changes, is a critical phase, where the absence of traditional norms and support systems can lead to various mental health challenges. Thus, the present study was undertaken to assess the level of knowledge among the homeless children and adolscents at a juvenile center in Ahmedabad, Gujarat. Methodology: A structured close ended multiple-choice questionnaire was provided to the selected respondents for assessing the baseline knowledge of the children. The sample size for the study was 100. The analysis was carried using IBM SPSS version 23 and chi square test of association was used to analyze the association between the knowledge and age group of the children. Results: Chi-square tests were used to examine age and gender-related differences in responses from children and adolescents. Significantly, age-related variations were found in questions about decision consequences, accident response, and math problem-solving (p ≤ 0.05). Gender differences were significant for decision consequences and math problems (p = 0.04). Other topics showed no significant age or gender variations, suggesting targeted educational interventions can enhance life skills knowledge and attitudes across different age and gender groups. Conclusion: A lower level of knowledge towards life skills among the children and adolescents at the juvenile centre in Ahmedabad suggests that Life skills in juvenile centers is important to empower young offenders with essential abilities for better decision-making and reintegration into society. Life skills training equips individuals with essential abilities for informed decision-making, problem-solving, and well-being, fostering personal growth and adaptability. [ABSTRACT FROM AUTHOR]

Homelessness is a costly and traumatic condition that affects hundreds of thousands of people each year in the U.S. alone. Most homeless programs focus on assisting people experiencing homelessness, but research has shown that predicting and preventing homelessness can be a more cost-effective solution. Of the few studies focused on predicting homelessness, most focus on people already seeking assistance; however, these methods necessarily cannot identify those not actively seeking assistance. Providing aid before conditions become dire may better prevent homelessness. Few methods exist to predict homelessness on the general population, and these methods use health and criminal history information, much of which may not be available or timely. We hypothesize that recent financial health information based on utility payment history is useful in predicting homelessness. In particular, we demonstrate the value of utility customer billing records to predict homelessness using logistic regression models based on this data. The performance of these models is comparable to other studies, suggesting such an approach could be productionalized due to the ubiquity and timeliness of this type of data. Our results suggest that utility billing records would have value for screening a broad section of the general population to identify those at risk of homelessness. [ABSTRACT FROM AUTHOR]

This paper explores the government service interactions for a cohort of formerly homeless youth in Aotearoa New Zealand, using linked administrative data. We report the rates of service interactions pre- and post-housing for a cohort of 69 youth, aged 18–25 years old, who received housing and support from a Housing First provider. 60.9% were women, and 69.6% were Māori. Very high rates of service interactions were seen both before and after they were housed. The evidence shows promising potential improvements in young people's lives when housed. The most significant changes we saw in the one and two years post-housing were in incomes from both wages/salaries and social welfare benefits; there was a significant increase in total income for our cohort. There was also a promising reduction in hospitalisations and emergency deparment admissions. Overall, Housing First shows promising outcomes for youth. [ABSTRACT FROM AUTHOR]

Purpose. The purpose of our research is to reveal the main forms of violation of the rights of minors in the Soviet period. Method. The methodology includes a comprehensive analysis and generalization of theoretical and source material and further formulation of relevant conclusions and recommendations. During the research, the principles of objectivity and systematicity were used, as well as general scientific, special-legal and special-historical methods of scientific knowledge: analysis, synthesis, comparative, functional-legal, system-historical. Results. In our opinion, the key reasons for the development and spread of child homelessness in the first post-war decade in the Ukrainian SSR were: the consequences of the Second World War; specifics of state policy; social instability; difficult financial situation of the population; crisis of the family and the system of family values. In the late 1920s and 1930s, numerous special settlements were created in Siberia. In May 1930 alone, more than 56,000 people were evicted to the Urals. Mortality and injury rates were high among deportees and prisoners, especially among minors. The scale of the violation of the rights of minors increased in the conditions of the Second World War, when both mortality and deportation processes were high. It has been proven that the norm of the Soviet legislation regarding the extension of the norms of criminal law to persons over the age of 12 can be considered a real crime. Scientific novelty. A historical and legal retrospective of the implementation of the Soviet policy in relation to minors, in particular orphans and homeless children, was carried out. Practical significance. The results of the research can be used in further historical and legal studies, preparation of special courses.

Introduction: The objective of this study was to examine the impacts of the coronavirus 2019 (COVID-19) pandemic on various dimensions of wellbeing among 2SLGBTQ+ youth experiencing homelessness over a 12-month period during the COVID-19 pandemic. Methods: 2SLGBTQ+ youth (recruited using a convenience sampling method) participated in three online surveys to assess mental health (depression, anxiety, suicidality), substance and alcohol use, health care access, and violence for 12-months between 2021–2022. Quantitative data analysis included non-parametric one-sample proportion tests, paired t-test and McNemar's test. Longitudinal data collected across all three timepoints were treated as paired data and compared to baseline data using non-parametric exact multinomial tests, and if significant, followed by pairwise post-hoc exact binomial tests. For the purposes of analysis, participants were grouped according to their baseline survey based on pandemic waves and public health restrictions. Results: 2SLGBTQ+ youth experiencing homelessness (n = 87) reported high rates of mental health challenges, including anxiety and depression, over 12-months during the pandemic. Youth participants reported experiencing poor mental health during the early waves of the pandemic, with improvements to their mental health throughout the pandemic; however, results were not statistically significant. Likewise, participants experienced reduced access to mental health care during the early waves of the pandemic but mental health care access increased for youth throughout the pandemic. Conclusion: Study results showed high rates of mental health issues among 2SLGBTQ+ youth, but reduced access to mental health care, due to the COVID-19 pandemic. Findings highlight the need for 2SLGBTQ+ inclusive and affirming mental health care and services to address social and mental health issues that have been exacerbated by the pandemic. [ABSTRACT FROM AUTHOR]

Simple Summary: Companion animals are valued members of many families, providing companionship, affection, and someone to nurture and love. Some situations such as being suddenly hospitalized for mental or physical health or becoming homeless make it difficult for people to keep their animal companions, especially for those who have a limited support network. The RSPCA NSW Emergency Boarding and Homelessness program supports people experiencing a crisis to access boarding and veterinary treatment for their animals, helping to keep the family together in the long term. This study aimed to understand the social value created by the program and to express this value in monetary terms. We interviewed 13 stakeholders including program clients, RSPCA Inspectors, and human service providers to understand what changed for them because of the program and how they valued that change. The main changes were experienced by program clients and their animals. The most valuable changes were being able to keep their companion animal and improved mental health and wellbeing. We estimate that this program results in social value worth AUD 8.21 for each AUD 1 invested into running the program. This study shows the importance of considering companion animals as part of the family unit and supporting people experiencing a crisis to keep their companion animal. Companion animals play a central role in many families and are especially valued by those who are socially isolated. Crisis situations such as acute hospitalizations, homelessness, and natural disasters can make it difficult to preserve the human–animal bond and can result in animals being surrendered or euthanized. Social support programs like the RSPCA NSW Emergency Boarding and Homelessness program support people experiencing crisis situations with emergency pet boarding, access to veterinary treatment and individualized case management. This study aimed to estimate the social return on investment (SROI) for this program using the standard SROI methodology. In-depth interviews were conducted with 13 program stakeholders and questionnaire responses were received from 29 program clients. Outcomes were quantified for four stakeholder groups: program clients, client's animals, RSPCA Inspectors, animal pounds, and shelters. Clients and their animals experienced the bulk of the benefit from the program, estimated to have a combined value of over AUD 5 million for the 2020–2021 financial year. The estimated social return on investment was AUD 8.21 for each AUD 1 invested. The study demonstrates that keeping people together with their companion animals or ensuring they are reunited as soon as possible can reduce stressors and improve outcomes for people and animals. [ABSTRACT FROM AUTHOR]

In Community-Based Participatory Research (CBPR), people with shared lived experiences (co-researchers) identify priority needs and work collaboratively to co-design an action-oriented research advocacy project. For this to occur, academic researchers must build mutually respectful partnerships with co-researchers by establishing trust. In the context of the COVID-19 pandemic, our objective was to virtually assemble a group of co-researchers (people with diverse but relevant experiences of homelessness and diabetes) and academic researchers who engaged in the CBPR process to identify a project that would address the difficulties of diabetes management while experiencing homelessness. Co-researchers were recruited to the committee from community homeless-serving organizations. Six co-researchers, one peer researcher and three academic researchers from Calgary, Alberta met virtually for bi-weekly committee meetings, from June 2021 to May 2022 to explore barriers to diabetes management and to complete a priority-setting exercise to determine the focus of our collective project. After reflecting on our virtual CBPR experience we present lessons learned related to: i) technical challenges and logistical considerations, ii) meeting virtually and building rapport, iii) driving engagement, and iv) challenges of transitioning from virtual to in-person meeting format. Overall, the process of conducting a CBPR project virtually to engage a group of co-researchers during a pandemic presents its challenges. However, a virtual CBPR project is feasible and can lead to meaningful experiences that benefit all group members, both from the community and academia. Plain English summary: In Community-Based Participatory Research (CBPR), we value peoples' lived experiences as knowledge and believe that it can help in the design of research projects. In these projects, people with similar lived experiences work with researchers to design a research advocacy project that will make meaningful changes in their community. Trust and respect between all team members are essential for working well together. Establishing trust and respect can be difficult, especially when done virtually. We virtually convened a committee and completed a CBPR project. Our group consisted of seven people with lived experience of diabetes and homelessness and three academic researchers in Calgary, Alberta. We met every two weeks between June 2021 and May 2022 to explore possible topics for our CBPR project, which we narrowed down to their top priority. As we reflected on our experience of working together, we came up with four categories of lessons learned: i) technical challenges, ii) building rapport, iii) driving engagement, and iv) challenges of transitioning from virtual to in-person meeting format. While our experience presented its challenges, we found working virtually to create a CBPR project is possible and can be meaningful for all group members. [ABSTRACT FROM AUTHOR]

Abstract Background Orphan children living in orphanages are often neglected. These children's physical and mental health status is essential as they are highly prone to malnourishment and psychosocial distress. We aim to evaluate the orphan children's physical and psychosocial status living in orphanages. Methods This study adopted a cross-sectional research design conducted with the children living in the orphanages using a pretested, predesigned schedule. A total of 83 children (aged 5 to 19 years) living in three different orphanages in the Sonitpur District of Assam were randomly selected for the study. Body Mass Index (BMI) for age and height were then determined using WHO standards. Thinness was defined as BMI for age below -2 SD (Standard Deviation) and thinness as height for age below -2 SD. The behavioural and mental status of children aged 10–19 years were evaluated using the Strengths and Difficulties Questionnaire (SDQ-21) with a cut-off value of SDQ score > 15 as the presence of emotional and behavioural distress. Results Almost 50% of orphans were in the age group of 10–14 years, 62.7% were females, and 42.2% had a primary level of education. 52.5% of orphans exhibited severe thinness for

Forced mobility among homeless injection drug users and crack smokers in Montréal: This article focuses on the various actors in the urban setting who contribute to the increase in the forced mobility of homeless injection drug users and crack smokers in Montréal, Canada. The objective is to analyze who these actors are and how they contribute to increasing this forced mobility from the perspective of homeless injection drug users and crack smokers in relation to three needs : basic needs, acquisition of financial resources, and drug use. One hundred and six semi‐structured interviews were conducted among this population. The results indicate that various actors—police officers, community organization, peers, municipal administration, storekeepers, and residents—contribute to the forced mobility of this population in their daily activities. As for their needs, it is when they use drugs, sleep, or loiter that they are more likely to experience events of forced mobility. Police officers are by far the actors who contribute the most to this, often in a repressive way. The role of the municipality is also a determining factor in the daily activities of homeless injection drug users and crack smokers. Messages clés: Plusieurs types d'acteurs (policiers, organismes communautaires, pairs, administration municipale, commerçants et résidents) sont impliqués dans des évènements de mobilité forcée.Les policiers sont les plus impliqués dans les évènements de mobilité forcée.Concernant les besoins, consommer, dormir et occuper l'espace public sont à l'origine du plus grand nombre de déplacements forcés. [ABSTRACT FROM AUTHOR]

Background: Homelessness is associated with high prevalence of psychiatric disorders such as substance use disorders, including alcohol use disorder, and depression. Methods: This case series and feasibility trial evaluated a novel integrated cognitive behavioral treatment (ICBT), which was adapted specifically for homeless individuals and developed to treat substance use and depressive symptoms simultaneously. The ICBT was delivered among four homeless individuals enrolled in the Treatment First program (a social services program where treatment is offered in conjunction with temporary transitional housing), who had access to stable and sober housing milieus. Results: The ICBT was rated high in expectancy of improvement, credibility, and satisfaction, with few treatment-related adverse events, and fairly high treatment retention. At 12 months follow-up, three of four participants were not homeless anymore. Some participants experienced short-term reductions in substance use and/or depressive symptoms. Conclusions: The study provided preliminary support that the ICBT can be a feasible and potentially effective treatment for homeless individuals with substance use and/or depressive symptoms. However, the delivery format within the Treatment First program was not feasible. The ICBT could be offered within the social services Housing First program instead (where permanent housing is offered before treatment), or to non-homeless individuals. Trial registration: The study was registered retrospectively at ClinicalTrials.gov (NCT05329181). [ABSTRACT FROM AUTHOR]

The San Francisco Bay Area has experienced a rapid rise in homelessness over the past decade. There is a critical need for quantitative analysis to help determine how to increase the amount of housing to meet the needs of people experiencing homelessness. Noting that the shortage of housing available through the homelessness response system can be modeled as a queue, we propose a discrete-event simulation to model the long-term flow of people through the homelessness response system. The model takes as input the rate of additional housing and shelter available each year and delivers as output the predicted number of people housed, sheltered, or unsheltered in the system. We worked with a team of stakeholders to analyze the data and processes for Alameda County in California and use this information to build and calibrate two simulation models. One model looks at aggregate need for housing, while the other differentiates the housing needs of the population into eight different types. The model suggests that a large investment in permanent housing and an initial ramp up of shelter is needed to solve unsheltered homelessness and accommodate future inflow to the system. [ABSTRACT FROM AUTHOR]

Background People experiencing homelessness have an increased risk of mortality. The association between being at risk of homelessness and premature mortality is unclear. We aimed to determine all-cause and cause-specific mortality in patients who were homeless, at risk of homelessness (marginally housed), or housed. Methods This retrospective longitudinal cohort study compared mortality patterns in adult patients identified in 2003/04 by linking data from an Australian metropolitan emergency department to national mortality data. We used Cox proportional hazards models to estimate associations between housing status and mortality. To address competing risks, cause-specific hazards were modelled and transformed into stacked cumulative incidence functions. Findings Data from 6290 patients (homeless deceased = 382/1050, marginally housed deceased = 259/518, housed deceased = 1204/4722) found increased risk of mortality in homeless [hazard ratio (HR) = 4.0, 95% confidence interval (CI) = 2.0–3.3) and marginally housed (HR = 2.6, 95% CI = 3.4–4.8) patients. Homeless patients had an excess risk from external causes (HR = 6.1, 95% CI = 4.47–8.35), cardiovascular disease (HR = 4.9, 95% CI = 2.78–8.70) and cancer (HR = 1.5, 95% CI = 1.15–2.09). Marginally housed patients had increased risk from external causes (HR = 3.6, 95% CI = 2.36–5.40) and respiratory diseases (HR = 4.7, 95% CI = 1.82–12.05). Taking account of competing risk, marked inequality was observed, with homeless, marginally housed and housed patients having probabilities of death by 55 years of 0.2, 0.1 and 0.02, respectively. Conclusions Mortality rates were elevated in patients who were homeless or at risk of homelessness. Increasing numbers of people are at risk of homelessness, and the effect of this on mortality is relatively unrecognized. Marginal housing may assuage some risk of premature mortality associated with homelessness; however, it is not equivalent to stable housing. [ABSTRACT FROM AUTHOR]

Urban homeless peoples are always invisible and neglected in public policy, and they are treated as non-citizens in our cities. The paper investigated the living experiences of urban homelessness in the rapidly expanding city of Siliguri- 'the gateway of north-east India'. A case study method using qualitative in-depth interviews and observation techniques has been applied to understand their significant problems and issues. The findings suggest that they have been forced to live in deplorable conditions since they are marginalized and ignored in every fundamental aspect of life. Basic human rights and access to basic amenities are forbidden to them, even they are not permitted and struggle to survive in the vacant space of the city. Surviving on the streets generally entails surviving in a physically and mentally challenging environment, with denial of fundamental human rights, lack of employment, and even no guaranteed nutritious food; they are turning themselves into drug addicts, criminals, and lawbreakers. The study also reveals that some specific homeless groups, including women, children, and elders, are the most vulnerable, and their threats to various menaces are even cumulated during the night. Even though they have equal opportunity and "right to the city," these marginalized individuals have no place to assert their fundamental rights. [ABSTRACT FROM AUTHOR]

Youth homelessness is a significant problem in most United States communities. Health problems are both a contributor to and a consequence of homelessness. Responses to youth homelessness are typically fragmentary. Different agencies deal with various causes and consequences of the problem. Stakeholders in Connecticut sought a more coherent approach. This article describes the development and use of a system dynamics simulation model as a decision-support tool that: (1) brings stakeholders together from diverse service sectors and allows them to see the system as a whole, (2) enables them to explore how delivery systems interact to affect homeless and unstably housed youth, (3) lets them test the impact of different intervention alternatives on reducing the problem, and (4) helps develop insights about coherent approaches to youth homelessness. The model's development is described as a phased process including stakeholder engagement, causal mapping, and creation of the quantitative simulation model. The resulting model is presented along with an interface that enables stakeholders to use the model in a Learning Lab setting. Results of an initial set of Learning Labs are presented, including types of insights gained by participants from using the simulation model. Conclusions include limitations of the model and plans for its future use. [ABSTRACT FROM AUTHOR]

Background : People experiencing homelessness (PEH) have complex health and social care needs and most die in their early 40 s. PEH frequently use community pharmacies; however, evaluation of the delivery of structured, integrated, holistic health and social care intervention has not been previously undertaken in community pharmacies for PEH. PHOENIx (Pharmacy Homeless Outreach Engagement Non-medical Independent prescribing Rx) has been delivered and tested in Glasgow, Scotland, by NHS pharmacist independent prescribers and third sector homelessness support workers offering health and social care intervention in low threshold homeless drop-in venues, emergency accommodation and emergency departments, to PEH. Building on this work, this study aims to test recruitment, retention, intervention adherence and fidelity of community pharmacy-based PHOENIx intervention. Methods: Randomised, multi-centre, open, parallel-group external pilot trial. A total of 100 PEH aged 18 years and over will be recruited from community pharmacies in Glasgow and Birmingham. PHOENIx intervention includes structured assessment in the community pharmacy of health, housing, benefits and activities, in addition to usual care, through weekly visits lasting up to six months. A primary outcome is whether to proceed to a definitive trial based on pre-specified progression criteria. Secondary outcomes include drug/alcohol treatment uptake and treatment retention; overdose rates; mortality and time to death; prison/criminal justice encounters; healthcare utilisation; housing tenure; patient-reported measures and intervention acceptability. Analysis will include descriptive statistics of recruitment and retention rates. Process evaluation will be conducted using Normalisation Process Theory. Health, social care and personal resource use data will be identified, measured and valued. Discussion: If the findings of this pilot study suggest progression to a definitive trial, and if the definitive trial offers positive outcomes, it is intended that PHOENIx will be a publicly funded free-to-access service in community pharmacy for PEH. The study results will be shared with wider stakeholders and patients in addition to dissemination through medical journals and scientific conferences. Trial registration: International Clinical Trial Registration ISRCTN88146807. Approved protocol version 2.0 dated July 19, 2022. [ABSTRACT FROM AUTHOR]

Objective: There is scant research on the effectiveness of permanent supportive housing for homeless women with mental illness. This study examines the effectiveness of Housing First with an unprecedentedly large sample of homeless women from five Canadian cities, and explore baseline risk factors that predict social, health and well-being outcomes over a 24 month-period. Methods: The At Home/Chez Soi multi-site randomized controlled Housing First trial recruited over 600 women between October 2009 and July 2011. This is a post-hoc subgroup exploratory analysis of self-identified women with at least one follow-up interview who were randomized to Housing First (HF) (n = 374) or treatment-as-usual (TAU) (n = 279) and had at least one follow-up interview. Linear mixed models and generalized estimating equations were used after multiple imputation was applied to address missing data. Results: At the end of follow-up, the mean percentage of days spent stably housed was higher for women in the intervention 74.8% (95%CI = 71.7%–77.8%) compared with women in the treatment-as-usual group, 37.9% (95%CI = 34.4%–41.3%), p<0.001. With few exceptions, social and mental health outcomes were similar for both groups at 6-, 12-, 18- and 24-months post-enrollment. Suicidality was a consistent predictor of increased mental health symptoms (beta = 2.85, 95% CI 1.59–4.11, p<0.001), decreased quality of life (beta = -3.99, 95% CI -6.49 to -1.49, p<0.001), decreased community functioning (beta = -1.16, 95% CI -2.10 to -0.22, p = 0.015) and more emergency department visits (rate ratio = 1.44, 95% CI 1.10–1.87, p<0.001) over the study period. Lower education was a predictor of lower community functioning (beta = -1.32, 95% CI -2.27 to -0.37, p = 0.006) and higher substance use problems (rate ratio = 1.27, 95% CI 1.06–1.52, p = 0.009) during the study. Conclusions: Housing First interventions ensured that women experiencing homelessness are quickly and consistently stably housed. However, they did not differentially impact health and social measures compared to treatment as usual. Ensuring positive health and social outcomes may require greater supports at enrolment for subgroups such as those with low educational attainment, and additional attention to severity of baseline mental health challenges, such as suicidality. Trial registration: International Standard Randomized Control Trial Number Register Identifier: ISRCTN42520374. [ABSTRACT FROM AUTHOR]

The number of homeless people has been constantly increasing in Europe over recent years, as well as the proportion of women among the homeless population. Pregnancy can increase the risk of becoming homeless and, on the other hand, homelessness has been widely connected to adverse perinatal outcomes. The objective of this study was to describe the overall perceived impact of homelessness on health during pregnancy and the postpartum period, using a qualitative research approach to prioritize women's perspective. One-time semi structured interviews were conducted with 10 pregnant women and 10 women in the postpartum period experiencing homelessness in the metropolitan area of Nantes, as well as with six people from their social surroundings. A thematic analysis was performed to identify major themes and sub-themes. Homelessness was perceived as having an overall negative impact on all aspects of health (physical health, mental health, and social well-being) during pregnancy and the postpartum period. Stress and anxiety, food insecurity, social isolation, physical suffering, deterioration of chronic diseases, and pregnancy complications, were the main perceived consequences of homelessness on health. On the other hand, social support, and the "welcomeness" of healthcare professionals during pregnancy and the postpartum period were identified as capable of palliating those consequences. Finally, basic needs, such as having access to suitable housing, being independent, and being in good health, were identified by participants in the study as their main priorities. The results of this study, as well as those found by previous research, allowed us to identify possible axes in tackling homelessness and its complex consequences on health during pregnancy and the postpartum period. Housing and income assistance interventions, promoting social support and employment, outreach services enhancing collaborative networks among healthcare service providers, and integrating coordinated multidisciplinary approaches in primary care have shown to provide promising solutions to this issue. [ABSTRACT FROM AUTHOR]

Access to safe housing is considered an essential service as per the United Nation's sustainable development goals. India is currently home to 2.4 billion houses of which 1.6 billion is rural. During 2001–2011, more than half a billion homes were added, and yet there exists acute shortage of quality housing with good public amenities. A report on urban housing shortage prepared by the Technical Group (TG-12) appointed by the Government of India estimated that the total number of households without "decent" housing condition in Indian cities counts to 18.78 million. Lack of sufficient number of houses adds to congestion and shortage. Misappropriation of funds further aggravates housing dilapidation, making the existing homes non-serviceable. Using the framework of TG-12, this study conducts an inter-district analysis of the obsolescence factor, congestion factor and homeless households across the megacity of Delhi for the years 2001 and 2011. Using district as the scale of analysis, housing shortage is measured by the Composite Index, computed for all nine districts for 2001 and 2011. We find that the composite index values are unequally distributed across the megacity's districts. During 2001–2011, the overall shortage of housing had increased in NCT-Delhi, with the highest housing shortage felt in North, Central and New Delhi districts. Out of all nine districts, six showed increase in housing shortage. Also, the percentage of homeless households increased across all nine districts whereas the percentage of rental accommodations increased in seven out of nine districts. [ABSTRACT FROM AUTHOR]

Introduction: The food and nutritional insecurity of the homeless population goes beyond the denial of basic rights, such as housing, and encompasses the uncertainty of what, when, where and how to eat. It is therefore essential to give voice to the vulnerabilities and demands of this population. Objective: To describe and discuss the main issues that permeated the theme of food and eating in articles in the newspaper O Trecheiro, focused on the social realities of the homeless population in Brazil, during a period of the Covid-19 pandemic (March 2020 to February 2021). Methods: This was a generic qualitative research with data production from documentary analysis; the content analysis method was adopted to categorize the documentary corpus and discuss the themes constructed from the data. Results: "Food as a right" emerged as part of the knowledge and struggles of homeless people. The themes and sub-themes that emerged included food as a right that is not guaranteed, linked to the failure to guarantee other needs (land and work); ways of guaranteeing food and other inputs (solidarity, popular struggle); and the senses and meanings that food and the rituals surrounding it have for homeless people. Conclusion: Thinking about the care and feeding of this population requires a comprehensive and multifactorial approach that takes into account the complexity of the group studied, as well as the various aspects that permeate the experiences of these individuals, such as structural and sociopolitical issues and the individual experiences discussed in this article. [ABSTRACT FROM AUTHOR]

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Purpose. The aim of our study is to study the historical experience of preventing homelessness and neglect of orphans, as well as the characteristics of legal norms that guarantee the protection of orphans in wartime. Method. The methodology includes a comprehensive analysis and generalization of theoretical and source material and further formulation of relevant conclusions and recommendations. The study used the principles of objectivity and systematicity, as well as general scientific, special legal and special historical methods of scientific knowledge: analysis, synthesis, comparative, functional-legal, system-historical. Results. The problem of orphans should be considered through the prism of the analysis of the historical experience of the emergence of such a phenomenon and the fight against it; causes of homelessness and neglect of orphans; the procedure for taking into care, adoption and upbringing of orphans; information policy of the state in the field of protection of orphans. Respect for the rights of the child is a fundamental task of the state and civil society. This problem is especially relevant in times of war, when the child is always the least protected. Statistics on the number of children orphaned by the war (since 2014), the number of children forcibly deported to Russia, the internal movement of orphans from areas where hostilities are taking place, indicate the urgency of the problem and the need to consolidate society to address this problems. Scientific novelty. The historical aspects of preventing child homelessness are analyzed, the causes of this phenomenon are determined; the changes that have taken place in the national legislation regarding the procedure of taking into care, adoption and upbringing of orphans are pointed out. Practical significance. The results of the study can be used in further historical and legal research, preparation of special courses.

The main objective of this study was to examine how homelessness and housing instability is captured across data sources in the Veterans Health Administration (VHA). Data from 2021 were extracted from three data repositories, including the Corporate Data Warehouse (CDW), the Homeless Operations Management System (HOMES), and the Homeless Management Information System (HMIS). Using these three data sources, we identified the number of homeless and unstably housed veterans across a variety of indicators. The results showed that the use of diagnostic codes and clinic stop codes identified a large number of homeless and unstably housed veterans, but the use of HOMES and HMIS data identified additional homeless and unstably housed veterans to provide a complete count. A total of 290,431 unique veterans were identified as experiencing homelessness or housing instability in 2021 and there was regional variability in how homelessness and housing stability were captured across data sources, supporting the need for more uniform ways to operationalize these conditions. Together, these findings highlight the and encourage use of all available indicators and data sources to identify homelessness and housing instability in VHA. These methodologies applied to the largest healthcare system in the U.S. demonstrate their utility and possibilities for other healthcare systems. Transparent practices about data sources and indicators used to capture homelessness and housing instability should be shared to increase uniform use. [ABSTRACT FROM AUTHOR]

Background: Orphan children living in orphanages are often neglected. These children's physical and mental health status is essential as they are highly prone to malnourishment and psychosocial distress. We aim to evaluate the orphan children's physical and psychosocial status living in orphanages. Methods: This study adopted a cross-sectional research design conducted with the children living in the orphanages using a pretested, predesigned schedule. A total of 83 children (aged 5 to 19 years) living in three different orphanages in the Sonitpur District of Assam were randomly selected for the study. Body Mass Index (BMI) for age and height were then determined using WHO standards. Thinness was defined as BMI for age below -2 SD (Standard Deviation) and thinness as height for age below -2 SD. The behavioural and mental status of children aged 10–19 years were evaluated using the Strengths and Difficulties Questionnaire (SDQ-21) with a cut-off value of SDQ score > 15 as the presence of emotional and behavioural distress. Results: Almost 50% of orphans were in the age group of 10–14 years, 62.7% were females, and 42.2% had a primary level of education. 52.5% of orphans exhibited severe thinness for < -3 SD. Observed severe thinness more among the 5–9 years and 10–14 years (p-value < 0.05) group and among the male orphans (p-value < 0.05). Of 65 children aged 10–19, 18.5% had behavioural and mental distress. Emotional (32.3%) and poor conduct problems (23%) were observed significantly among male adolescents. Conclusions: Orphaned children, particularly those living in orphanages, are at risk of malnutrition and experience behavioural and psychosocial problems. Frequent assessments of their physical and mental health are advocated for early detection, prevention, and timely intervention. [ABSTRACT FROM AUTHOR]