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Background: Homelessness represents a widespread social issue globally, yet the risk of neurodegenerative diseases (NDDs) associated with people experiencing homelessness (PEH) has not received sufficient attention. Therefore, this study aimed to explore the risk of NDDs among PEH and its variation across countries and regions through meta-analysis and systematic review. Methods: Searching from databases such as PubMed and Web of Science, relevant research articles on PEH and NDDs were identified. After multiple screening, eight articles were selected for meta-analysis. Statistical methods and models were used to evaluate the association between PEH and NDDs, stratified by disease type and country. Results: We found that PEH had a 51% higher risk of NDDs (OR = 1.51 (95% CI: 1.21, 1.89)) compared with those with stable housing. Specifically, PEH had a significantly higher risk of developing multiple sclerosis (OR = 4.64 (95% CI: 1.96, 10.98)). Alzheimer's disease and related dementias (ADRD) (OR = 1.93 (95% CI: 1.34, 2.77)), dementia (OR = 1.69 (95% CI: 1.26, 2.27)), and cognitive impairment (OR = 1.07 (95% CI: 0.98, 1.16)) were all at higher risk. Furthermore, country and regional differences were observed, with countries such as Iran (OR = 4.64 (95% CI: 1.96, 10.98)), the Netherlands (OR = 2.14 (95% CI: 1.23, 3.73)), the United States (OR = 1.66 (95% CI: 1.25, 2.22)), and Canada (OR = 1.06 (95% CI: 1.01, 1.10)) showing a higher risk of NDDs among the PEH. Conclusions: The study emphasizes the significant NDD risks among PEH, providing novel perspectives on this issue and shedding light on national disparities influenced by variations in healthcare systems and social environments. This will be beneficial for academia and government to prioritize the health of PEH with NDDs, aiming to mitigate disease incidence and economic burdens while preserving social stability and upholding basic human rights. [ABSTRACT FROM AUTHOR]

The article discusses innovative housing models for older women, emphasizing affordability and community connections to combat poverty and loneliness. It highlights resident-coordinated housing options like co-living and enhanced Naturally Occurring Retirement Communities (NORCs) as effective solutions. These models, rooted in traditional concepts, offer older women opportunities to age comfortably while fostering social connections and empowerment. The commentary calls for further research and community support to develop and sustain these housing models effectively. [Extracted from the article]

Although awareness and understanding of LGBTIQ+ people's experiences of homelessness are rising, their broader housing experiences remain under‐researched. This paper uses qualitative interview data to explore takatāpui and LGBTIQ+ people's experiences of housing instability in Aotearoa New Zealand. In expanding the focus to housing instability, this paper explores how LGBTIQ+ people experience and navigate the housing system, which sheds light on the upstream factors that contribute to the disproportionately high rates of homelessness amongst LGBTIQ+ communities worldwide. A reflexive thematic analysis of the data generated four themes to takatāpui and LGBTIQ+ people's experiences of housing instability; personal experiences are political, survival within inequitable systems is nuanced, instability is relational, and selfhood is mediated through instability. These results highlight the impact of policy and structural failures on LGBTIQ+ communities. [ABSTRACT FROM AUTHOR]

This article shares the micro‐ethical lessons from those researching alongside Aboriginal people experiencing homelessness and Aboriginal Elders in Perth, Western Australia. The article is written from the perspective of the first and second author who are two non‐Aboriginal researchers being mentored in Aboriginal culture. From this positioning, it offers reflections and practical insights into researching “in the right spirit” with Aboriginal communities. More specifically, it shares lessons in negotiating community roles within community‐driven research, the importance in forming relationship with Aboriginal culture as antidote to research fatigue, practical ways to work with Aboriginal communities when they have a history of being exploited in research, navigating fair and ethical payment for involvement, and ways to clearly communicate research with them. It also shares the cultural importance and benefits of working closely with Aboriginal Elders when engaging in research with Aboriginal communities, including their ability to better negotiate project scope with community, and the value in making sense of the research findings alongside them. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic and subsequent implementation of public health policies exacerbated multiple intersecting systemic inequities, including homelessness. Housing is a key social determinant of health that played a significant part in the front-line defence against COVID-19, posing challenges for service providers working with people experiencing homelessness (PEH). Public health practitioners and not-for-profit organizations (NFPs) had to adapt existing COVID-19 policies and implement novel measures to prevent the spread of disease within congregate settings, including shelters. It is essential to share the perspectives of service providers working with PEH and their experiences implementing policies to prepare for future public health emergencies and prevent service disruptions. Methods: In this qualitative case study, we explored how service providers in the non-profit sector interpreted, conceptualized, and implemented COVID-19 public health outbreak control policies in Nova Scotia. We interviewed 11 service providers between September and December 2020. Using thematic analysis, we identified patterns and generated themes. Local, provincial, and national policy documents were useful to situate our findings within the first year of the COVID-19 pandemic and contextualize participants' experiences. Results: Implementing policies in the context of homelessness was difficult for service providers, leading to creative temporary solutions, including pop-up shelters, a dedicated housing isolation phone line, comfort stations, and harm reduction initiatives, among others. There were distinct rural challenges to navigating the pandemic, which stemmed from technology limitations, lack of public transportation, and service closures. This case study illustrates the importance of flexible and context-specific policies required to support PEH and mitigate the personal and professional impact on service providers amid a public health emergency. Innovative services and public health collaboration also exemplified the ability to enhance housing services beyond the pandemic. Conclusions: The results of this project may inform context-specific emergency preparedness and response plans for COVID-19, future public health emergencies, and ongoing housing crises. [ABSTRACT FROM AUTHOR]

Background: The concurrence of homelessness and alcohol use disorder (AUD) has negative consequences in affected individuals. Managed alcohol programs (MAPs), a harm reduction strategy based on providing regular doses of alcohol to individuals with AUD, have emerged as a potential solution to reduce alcohol-related harms.Objectives: This study examined the impact of a MAP implemented in Barcelona on patterns of alcohol and other psychoactive substance use, health, and quality of life among people who use drugs and were experiencing homelessness. The research also incorporated a gender perspective and focused on individuals who had accessed a residential center.Methods: A descriptive qualitative design was used, employing semi-structured interviews with eight participants who were enrolled in the MAP (three women, five men) and four program professionals. Thematic analysis was used to analyze the resulting data.Results: The domains guiding the study appeared as outcome themes: patterns of use of alcohol and other substances, health, quality of life and impact on female-identified participants. Participants reported improved health due to reduced consumption of alcohol and other substances, better anxiety management, and reconnection to health services. The participants reported enhanced quality of life, including feeling safer, and better use of time, which had been spent on meeting their basic needs. Women reported that a key benefit of the program was living in a sexism-free environment.Conclusion: These results appear to demonstrate that harm reduction strategies prioritizing basic needs and adopting a gender-sensitive perspective can positively impact the health and quality of life of people experiencing homelessness with AUD. [ABSTRACT FROM AUTHOR]

Background: Homeless-experienced adults smoke at rates 5 times that of the general adult population, and often have limited access to cessation treatments while homeless. Permanent Supportive Housing (PSH) can be a catalyst for cessation treatment utilization, yet little is known about use of these treatments following PSH entry, or how to tailor and implement cessation care that meets homeless-experienced adults' vulnerabilities. Methods: Using Department of Veterans Affairs (VA) administrative data, we assessed smoking status (ie, current, former, non/never) among a cohort of homeless-experienced Veterans (HEVs) housed in Los Angeles-based PSH. We compared cessation treatment use rates (ie, nicotine replacement therapies, cessation medications, psychosocial counseling) pre- and post-housing using Chi-square tests. Predisposing (ie, demographics), enabling (eg, primary care, benefits), and need characteristics (ie, health, mental health, substance use diagnoses) were examined as correlates of cessation treatment utilization pre- and post-housing in univariable and multivariable logistic regression models. Results: Across HEVs (N = 2933), 48.6% were identified as currently-smoking, 17.7% as formerly-smoking, and 14.0% as non/never smoking. Among currently- and formerly-smoking HEVs (n = 1944), rates of cessation treatment use post-housing were significantly lower, compared to pre-housing, across all treatment types. Health, mental health, and substance use was more prevalent among currently- and formerly-smoking HEVs compared to non/never-smoking HEVs, and most diagnoses were positively associated with utilization univariably. However, in multivariable models, cessation clinic referrals and primary care engagement were the only significant (P <.001) predictors of pre-housing and post-housing cessation treatment utilization. Conclusion: Among HEVs, we found high smoking rates and low cessation treatment utilization pre- and post-PSH entry. Efforts to educate providers about this population's desire to quit smoking, support primary care engagement, and increase cessation clinic referrals may bolster their utilization. For homeless-experienced adults, optimizing cessation treatment accessibility by embedding cessation services within PSH and homeless service settings may reduce utilization impediments. [ABSTRACT FROM AUTHOR]

The author partnered with the Harrison County Library System (HCLS) to create a multilevel program plan for expanding library services to the growing number of homeless people who seek refuge in the library’s facilities. The research for this program plan involved evaluating existing library resources such as collections, programming, and available staff resources; identifying the best practices for providing services to people experiencing homelessness; identifying staff perceptions of working with the homeless; and identifying potential partners for expanded service offerings. The author used document analysis to research data on the library system (IMLS 2021 and reviewed library policy to identify barriers to providing service for the homeless. The author applied qualitative and humanistic research methods involving personal narratives (scenarios) provided through two separate one-on-one interviews with the library director to discuss the library system in general, and one one-on-one interview with six library staff working in the three libraries with the highest use by people experiencing homelessness. This paper discusses the findings from this mixed methods research project and their application to expanding services for chronically homeless patrons who use the HCLS. [ABSTRACT FROM AUTHOR]

Young adults who have endured chronic housing instability have often been failed by settings which have inadequately supported them – such as home and school settings. As such, young people experiencing homelessness and housing instability are seeking supportive settings. Permanent supportive housing (PSH) is a burgeoning supportive intervention in the youth homelessness services landscape. Our study used the geographic interview methodology, a novel qualitative geographic information systems methodology, to understand how young adult residents (N = 15) in PSH experience the physical setting. Residents experienced the common spaces in PSH as contested spaces; meanwhile, they sought choice-centered spaces – where there are choices of what to do, who to spend time with, and how to spend time. PSH settings for young adults may embrace choice-centered principles and practices when building trauma-informed PSH for young adults. Future research should explore these findings across demographic and geographic differences. [ABSTRACT FROM AUTHOR]

This paper is grounded in the context of a severe housing, shelter shortage, and of an increasing number of homeless people in France. It will focus on LGBTQ homelessness in Paris as revealing moments of conflation, overlap and distinction in terms of gender and sexuality. In light of the binary gender framework underpinning the shelter space, there is very little consideration for non-normative gender identities and sexual orientations in the social support shelters provide. This paper will analyse issues of hypervisibility and invisibility amongst homeless LGBTQ people within a French universalist framework. Using interview material from fieldwork focused on the narratives of homeless LGBTQ respondents and drawing from the professional experience of the authors, this paper will highlight how precarious LGBTQ identities and subjectivities are produced by compulsory cisheteronormativity, as well as its consequences on LGBTQ bodies and survival strategies. As LGBTQ homelessness has not been explored much in the French context, these insights will call for the importance of assessing social difference in order to find adequate solutions to ending homelessness. [ABSTRACT FROM AUTHOR]

Objectives. To compare the incidence, case-hospitalization rates, and vaccination rates of COVID-19 between people experiencing sheltered homelessness (PESH) and the broader community in Chicago, Illinois, and describe the impact of a whole community approach to disease mitigation during the public health emergency. Methods. Incidence of COVID-19 among PESH was compared with community-wide incidence using case-based surveillance data from March 1, 2020, to May 11, 2023. Seven-day rolling means of COVID-19 incidence were assessed for the overall study period and for each of 6 distinct waves of COVID-19 transmission. Results. A total of 774 009 cases of COVID-19 were detected: 2579 among PESH and 771 430 in the broader community. Incidence and hospitalization rates per 100 000 in PESH were more than 5 times higher (99.84 vs 13.94 and 16.88 vs 2.14) than the community at large in wave 1 (March 1, 2020–October 3, 2020). This difference decreased through wave 3 (March 7, 2021–June 26, 2021), with PESH having a lower incidence rate per 100 000 than the wider community (8.02 vs 13.03). Incidence and hospitalization of PESH rose again to rates higher than the broader community in waves 4 through 6 but never returned to wave 1 levels. Throughout the study period, COVID-19 incidence among PESH was 2.88 times higher than that of the community (70.90 vs 24.65), and hospitalization was 4.56 times higher among PESH (7.51 vs 1.65). Conclusions. Our findings suggest that whole-community approaches can minimize disparities in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission between vulnerable populations and the broader community, and reinforce the benefits of a shared approach that include multiple partners when addressing public health emergencies in special populations. (Am J Public Health. 2024;114(S7):S590–S598. https://doi.org/10.2105/AJPH.2024.307801) [ABSTRACT FROM AUTHOR]

This study provides a mental health assessment of the homeless of Puerto Rico, compared to a non-homeless sample, in the aftermath of Hurricane Maria. Multi-stage sampling was used to assess risk of anxiety, depression, and PTSD, as well as provide a demographic profile of the homeless and non-homeless of Puerto Rico. The homeless, compared to non-homeless, had a significantly higher risk for all tested mental disorders. Pre-hurricane homeless had significantly higher risk for Major Depressive Disorder and severe mood and anxiety disorders compared to post. This study highlights the need for disaster preparedness strategies specific to this disproportionately affected population. [ABSTRACT FROM AUTHOR]

This article explores the global issue of homelessness, with a focus on the increasing rates in Australia, particularly among women and Indigenous Australians. It discusses the complex factors that contribute to homelessness, such as economic hardship and domestic violence. Homelessness has significant impacts on individuals' physical and mental health, and they face stigma and isolation. The article emphasizes the role of mental health nurses in providing access to services and advocating for safe and affordable housing. It also highlights the importance of trauma-informed care and the need for research and changes in clinical practices to address homelessness and intergenerational trauma. [Extracted from the article]

A pervasive barrier to preventing, reducing, and ending homelessness is the stigmatization of and discrimination towards persons experiencing homelessness (PEH), termed "homeism." To date, there has been no systematic review of the experiences and outcomes of stigmatization and discrimination among PEH or interventions to reduce this discrimination. To fill this gap in the literature, we conducted a scoping review to identify the ways in which PEH have been stigmatized and discriminated against, the results of these experiences, and interventions that have been used to reduce stigma and discrimination. We reviewed results from 12 databases with no date restrictions; 205 studies met our inclusion criteria. Thematic data analyses resulted in the identification of 12 categories. Using community consultation, the scoping review themes were reviewed and validated with 25 PEH or service providers in the homelessness sector and their feedback integrated into our results. Thematic categories included discrimination and stigmatization in healthcare, social services, workplaces and employment, and public spaces by the general public; discrimination and stigmatization from landlords, police and security guards, informal social networks, and by PEH toward PEH; discrimination and stigmatization linked to intersectional domains; PEH feelings about discrimination and stigmatization; outcomes of discrimination and stigmatization for PEH; and interventions to reduce stigma, discrimination, and prejudice towards PEH. Based on findings from this review, we argue that homeism serves as a social determinant of health as PEH confront multiple barriers to housing, income security, and healthcare due to interpersonal, institutional, structural, and intrapersonal stigmatization and discrimination. [ABSTRACT FROM AUTHOR]

Background: Evidence is limited about healthcare cost disparities associated with homelessness, particularly in recent years after major policy and resource changes affecting people experiencing homelessness occurred after the onset of the COVID-19 pandemic. We estimated 1-year healthcare expenditures, overall and by type of service, among a representative sample of people experiencing homelessness in Toronto, Canada, in 2021 and 2022, and compared these to costs among matched housed and low-income housed individuals. Methods: Data from individuals experiencing homelessness participating in the Ku-gaa-gii pimitizi-win cohort study were linked with Ontario health administrative databases. Participants (n = 640) were matched 1:5 by age, sex-assigned-at-birth and index month to presumed housed individuals (n = 3,200) and to low-income presumed housed individuals (n = 3,200). Groups were followed over 1 year to ascertain healthcare expenditures, overall and by healthcare type. Generalized linear models were used to assess unadjusted and adjusted mean cost ratios between groups. Results: Average 1-year costs were $12,209 (95% CI $9,762-$14,656) among participants experiencing homelessness compared to $1,769 ($1,453-$2,085) and $1,912 ($1,510-$2,314) among housed and low-income housed individuals. Participants experiencing homelessness had nearly seven times (6.90 [95% confidence interval [CI] 5.98–7.97]) the unadjusted mean ratio (MR) of costs as compared to housed persons. After adjustment for number of comorbidities and history of healthcare for mental health and substance use disorders, participants experiencing homelessness had nearly six times (adjusted MR 5.79 [95% CI 4.13–8.12]) the expected healthcare costs of housed individuals. The two housed groups had similar costs. Conclusions: Homelessness is associated with substantial excess healthcare costs. Programs to quickly resolve and prevent cases of homelessness are likely to better meet the health and healthcare needs of this population while being a more efficient use of public resources. [ABSTRACT FROM AUTHOR]

Background: People experiencing homelessness have increased prevalence, morbidity, and mortality of cardiovascular disease (CVD), attributable to several traditional and non-traditional risk factors. While this burden is well-known, mainstream CVD management plans and healthcare delivery have not been developed with people experiencing homelessness in mind nor tailored to their unique context. The overall objective of this work was to explore and synthesize what is known about CVD management experiences, programs, interventions, and/or recommendations specifically for people experiencing homelessness. Methods: We conducted a scoping review to combine qualitative and quantitative studies in a single review using the Arksey and O'Malley framework and lived experience participation. We performed a comprehensive search of OVID Medline, Embase, PsychINFO, CINAHL, Web of Science, Social Sciences Index, Cochrane, and the grey literature with key search terms for homelessness, cardiovascular disease, and programs. All dates, geographic locations, and study designs were included. Articles were analyzed using conventional content analysis. Results: We included 37 articles in this review. Most of the work was done in the USA. We synthesized articles' findings into 1) barriers/challenges faced by people experiencing homelessness and their providers with CVD management and care delivery (competing priorities, lifestyle challenges, medication adherence, access to care, and discrimination), 2) seven international programs/interventions that have been developed for people experiencing homelessness and CVD management with learnings, and 3) practical recommendations and possible solutions at the patient encounter level (relationships, appointment priorities, lifestyle, medication), clinic organization level (scheduling, location, equipment, and multi-disciplinary partnership), and systems level (root cause of homelessness, and cultural safety). Conclusions: There is no 'one-size-fits all' approach to CVD management for people experiencing homelessness, and it is met with complexity, diversity, and intersectionality based on various contexts. It is clear, however, we need to move to more practically-implemented, community-driven solutions with lived experience and community partnership at the core. Future work includes tackling the root cause of homelessness with affordable housing, exploring ways to bring cardiac specialist care to the community, and investigating the role of digital technology as an avenue for CVD management in the homeless community. We hope this review is valuable in providing knowledge gaps and future direction for health care providers, health services research teams, and community organizations. [ABSTRACT FROM AUTHOR]

Social isolation and loneliness (SIL) are public health challenges that disproportionally affect individuals who experience structural and socio-economic exclusion. The social and health outcomes of SIL for people with experiences of being unhoused have largely remained unexplored. Yet, there is limited synthesis of literature focused on SIL to appropriately inform policy and targeted social interventions for people with homelessness experience. The aim of this scoping review is to synthesize evidence on SIL among people with lived experience of homelessness and explore how it negatively impacts their wellbeing. We carried out a comprehensive literature search from Medline, Embase, Cochrane Library, PsycINFO, CINAHL, Sociological Abstracts, and Web of Science's Social Sciences Citation Index and Science Citation Index for peer-reviewed studies published between January 1st, 2000 to January 3rd, 2023. Studies went through title, abstract and full-text screening conducted independently by at least two reviewers. Included studies were then analyzed and synthesized to identify the conceptualizations of SIL, measurement tools and approaches, prevalence characterization, and relationship with social and health outcomes. The literature search yielded 5,294 papers after removing duplicate records. Following screening, we retained 27 qualitative studies, 23 quantitative studies and two mixed method studies. SIL was not the primary objective of most of the included articles. The prevalence of SIL among people with homelessness experience varied from 25 to 90% across studies. A range of measurement tools were used to measure SIL making it difficult to compare results across studies. Though the studies reported associations between SIL, health, wellbeing, and substance use, we found substantial gaps in the literature. Most of the quantitative studies were cross-sectional, and only one study used health administrative data to ascertain health outcomes. More studies are needed to better understand SIL among this population and to build evidence for actionable strategies and policies to address its social and health impacts. [ABSTRACT FROM AUTHOR]

This article explores the transformations in European welfare states and social rights, focusing on the regulation of social rights through framework law and the impact of neoliberalism and institutional austerity. It discusses the enforcement of social security legislation and the behavior of front-line officials, as well as the process of asylum adjudication in Sweden and the challenges faced by victims of trafficking and labor exploitation. The text also examines the changing character of the Dutch welfare state and the role of social networks and intermediaries in helping individuals access their rights. Overall, it provides valuable insights into the complexities and challenges of European welfare systems. [Extracted from the article]

Background: Housing insecurity can be understood as experiencing or being at risk of multiple house moves that are not through choice and related to poverty. Many aspects of housing have all been shown to impact children/young people's health and wellbeing. However, the pathways linking housing and childhood health and wellbeing are complex and poorly understood. Methods: We undertook a systematic review synthesising qualitative data on the perspectives of children/young people and those close to them, from the United Kingdom (UK). We searched databases, reference lists, and UK grey literature. We extracted and tabulated key data from the included papers, and appraised study quality. We used best fit framework synthesis combined with thematic synthesis, and generated diagrams to illustrate hypothesised causal pathways. Results: We included 59 studies and identified four populations: those experiencing housing insecurity in general (40 papers); associated with domestic violence (nine papers); associated with migration status (13 papers); and due to demolition-related forced relocation (two papers). Housing insecurity took many forms and resulted from several interrelated situations, including eviction or a forced move, temporary accommodation, exposure to problematic behaviour, overcrowded/poor-condition/unsuitable property, and making multiple moves. Impacts included school-related, psychological, financial and family wellbeing impacts, daily long-distance travel, and poor living conditions, all of which could further exacerbate housing insecurity. People perceived that these experiences led to mental and physical health problems, tiredness and delayed development. The impact of housing insecurity was lessened by friendship and support, staying at the same school, having hope for the future, and parenting practices. The negative impacts of housing insecurity on child/adolescent health and wellbeing may be compounded by specific life circumstances, such as escaping domestic violence, migration status, or demolition-related relocation. Conclusion: Housing insecurity has a profound impact on children and young people. Policies should focus on reducing housing insecurity among families, particularly in relation to reducing eviction; improving, and reducing the need for, temporary accommodation; minimum requirements for property condition; and support to reduce multiple and long-distance moves. Those working with children/young people and families experiencing housing insecurity should prioritise giving them optimal choice and control over situations that affect them. [ABSTRACT FROM AUTHOR]

Pathways into and the impact of homelessness on young people have been extensively explored. There is less emphasis on young people's perspectives of the interventions designed to assist them to avoid or exit homelessness. This study undertook a systematic review of the youth homelessness interventions literature that included the perspectives of young people experiencing these interventions. Our review identified five key approaches as useful in assisting young people to exit or avoid homelessness, namely (1) the centrality of relationships, (2) a youth‐centred approach, (3) integrated and multi‐disciplinary service provision, (4) a beyond housing approach and (5) strength‐based therapeutic models/interventions. The review enhances the capacity of practitioners to provide supportive and contextually situated services to young people experiencing or at risk of homelessness. However, further research is required to understand the bundles of interconnected practices within these approaches that are performed by workers and young people to address homelessness and risk. [ABSTRACT FROM AUTHOR]

This article, titled "Riley's Ashes: On the Occasional Perils of Intellectualizing Emotion," discusses the author's experience of spreading the ashes of a beloved dog named Riley in a park. The author reflects on the challenges of intellectualizing emotions and the role of autoethnography in their life. The article also touches on themes of loss, grief, and the importance of relationships with family and pets. [Extracted from the article]

Amongst women and gender diverse (WGD) populations experiencing homelessness in Canada, one of the most vulnerable and understudied subgroups are those who are pregnant. A key barrier to accessing housing for this population are policies that lead to siloed sector work and complicated and inaccessible services. Frequent relocation and fragmented access to essential prenatal and postnatal support are the result. Experiences of homelessness for WGD people are distinct from that of cisgender men; the former tend to experience 'hidden homelessness' and are more likely to rely on relational, precarious, and sometimes dangerous housing options. The homelessness sector, its policies, and services tend to be cis-male-centric because of the greater visibility of homelessness in cis-men and fail to meet pregnant WGD people's needs. This paper describes the findings from a one-day symposium that was held in Toronto, Canada, in June 2023 that aimed to address the siloed approach to housing provision for pregnant WGD people experiencing homelessness. A key focus was to understand how to incorporate a gendered and intersectional discourse into practice and policy. Adopting a gender-based analysis plus (GBA+) approach within policymaking can help illuminate and address why certain groups of WGD people are disproportionately affected by homelessness, including Indigenous Peoples, recent immigrants, racialized people, and those experiencing intimate partner violence, poverty, and substance use. [ABSTRACT FROM AUTHOR]

The rise of evidence‐based policymaking highlights the importance of evidence and how it is defined and utilized. It also uncovers the gaps in evidence and where lived experience stands to benefit policymaking. The rising level of encampments, homelessness, and housing unaffordability in Canada emphasize the need to consider how and where lived experiences of homelessness are included. This article interrogates the inclusion of lived experiences of homelessness in three specific domains: research, policy, and advocacy. Our findings from systematic reviews of each area reveal an evidence‐policy gap in homelessness policy and governance. Across all three domains, scholars and practitioners alike often fail to explicitly include lived experience to inform their efforts. Enhanced coordination and policy learning across and between the domains can offer a pathway to measurably improve policy effectiveness. [ABSTRACT FROM AUTHOR]

Homelessness is a complex social, economic and psychological issue, and compared with the general population, people experiencing homelessness suffer disproportionately from mental health and substance use issues. Evidence suggests that psychological interventions can improve the quality‐of‐life of people experiencing homelessness. A systematic review and meta‐analysis were conducted on studies identified in five databases. Global studies published before July 2023 were included. A total of 35 studies were identified from 30 independent trials conducted in five countries. Outcomes were divided into six domains: substance use, mental health, psychological wellbeing, health behaviour, antisocial behaviour and social outcomes. A meta‐analysis was performed on data from 22 studies investigating outcomes of substance use, abstinence, anxiety, depression and PTSD. Evidence demonstrates the effectiveness of psychological interventions for a range of outcomes affecting people experiencing homelessness. Cognitive behaviour therapy and motivational interviewing were deemed particularly effective across a range of outcomes and were also considered a cost‐effective option. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

Inspired by critical trauma and embodiment theories, this study aims to illustrate how an arts-based approach such as body mapping assists in exploring the lived experiences of youth, potentially serving as a trauma-informed approach. This qualitative study collaborated with street-involved and homeless youth (SIHY) who have eating struggles while living in situations of food insecurity and other forms of oppression. Eleven participants partook in three individual face-to-face interview sessions and one arts-based body map activity, respectively, at a local SIHY resource centre in a metropolitan city in Canada. Guided by Interpretative Phenomenological Approach (IPA), our findings illustrated how body mapping (1) enabled a deepened understanding of SIHY's eating struggles as both a form of suffering and an embodied means of coping with food insecurity and other systemic and relational trauma(s); (2) provided a transformative experience leading to greater self-compassion and healing; and (3) served as a trauma-informed method that fostered choice and validation. We attest that, as a creative and supportive clinical and research tool, body mapping taps into the unspoken, expressive, embodied, and somatic aspects of eating struggles, food insecurity, poverty, and other forms of oppression deepening knowledge and informing social work research and practice. [ABSTRACT FROM AUTHOR]

This article explores the personalisation of homelessness services in the context of the Homelessness Reduction Act 2017. This ambitious piece of legislative reform introduced requirements on local housing authorities in England to assess an individual's circumstances and develop personalised housing plans for people experiencing homelessness (s.3 HRA 2017, inserting s.189A Housing Act 1996). This article analyses research data (including 26 interviews) collected in 2018–2019 from ethnographic studies completed in two local authorities in the Midlands, across a period of four months in each site. Exploring the implementation of personalised housing plans in practice, this article investigates barriers to the application of the personalisation narrative, finding it operates as a tool of neoliberal governance rather than one of social justice. It asserts that if personalisation has the potential for more satisfactory and sustainable outcomes in preventing and relieving homelessness, then the inability for this narrative to manifest suggests the goal of the HRA 2017 in 'reducing homelessness' is being hampered. [ABSTRACT FROM AUTHOR]

There are two dominant approaches to implementing permanent supportive housing (PSH), namely place-based (PB) and scattered-site (SS). Formal guidance does not distinguish between these two models and only specifies that PSH should be reserved for those who are most vulnerable with complex health needs. To consider both system- and self-selection factors that may affect housing assignment, this study applied the Gelberg-Anderson behavioral model for vulnerable populations to compare predisposing, enabling, and need factors among people experiencing homelessness (PE) by whether they were assigned to PB-PSH (n = 272) or SS-PSH (n = 185) in Los Angeles County during the COVID-19 pandemic. This exploratory, observational study also included those who were approved but did not receive PSH (n = 94). Results show that there are notable differences between (a) those who received PSH versus those who did not, and (b) those in PB-PSH versus SS-PSH. Specifically, PEH who received PSH were more likely to be white, US-born, have any physical health condition, and have lower health activation scores. PEH who received PB- versus SS-PSH were more likely to be older, Black, have any alcohol use disorder, and have higher health activation scores. These findings suggest that homeless service systems may consider PB-PSH more appropriate for PEH with higher needs but also raises important questions about how race may be a factor in the type of PSH that PEH receive and whether PSH is received at all. [ABSTRACT FROM AUTHOR]

This ethnographic exploration of death in the Peruvian context draws on fieldwork among abandoned–both by their families and the state–older adults in a shelter for the homeless in Lima, Peru. I examine the conditions and local forces that shape the ways people at this institution socially and physically die. My argument is that people in this long-term care facility who have lived entire lives on the margins, usually, end up having irrelevant deaths to their families, other residents of the institution, and the Peruvian state. At this shelter, dying in an irrelevant way means dying without companionship from family members and receiving poor and flawed care from the institution that shelters them. [ABSTRACT FROM AUTHOR]

This article examines a temporary accommodation service for homeless people in Finland. By building on institutional ethnography, it aims to map the relations that coordinate the everyday work and to analyse the potential consequences of these relations for clients' vulnerability and autonomy. By applying recognition theory, autonomy is considered to be dependent on mutual relations of recognition. The data are based on 8 group and 5 individual interviews with the workers (N = 20) as well as observations. The results show that 1) everyday activities and recognitional relations are tied to the spatiality of the service, 2) the translocal coordination of work tend to produce a not-worth-the-effort mode of action towards clients, and 3) the aims and recognitional responsibilities are mobilized by an accommodating discourse, which partly limits the workers' professional space. This can potentially leave the clients highly vulnerable in terms of their autonomy. [ABSTRACT FROM AUTHOR]

This article examines the creation and preservation of historical sources about the Mongols, with a focus on Marco Polo's account of East and Central Asia. It discusses how Polo's book differed from other accounts and its influence on European understanding of the Mongols. The article also explores the transmission and preservation of historical information in Mongol Eurasia, using the example of two prophecies related to the Mongol conquest of the Song dynasty. It analyzes the inaccuracies in Polo's account and suggests that historical information compatible with the author's knowledge and the audience's imagination was more likely to be preserved. The text also discusses the use of the white wild goose as a metaphor for the Mongols in Chinese literature during the Yuan dynasty. It explores the symbolism of the wild goose and its association with the Mongol conquest of the Song dynasty. The author argues that historical records should be understood as a reflection of the interaction between information, the author's understanding, and the changing expectations and interests of the audience. [Extracted from the article]

This article presents the narratives of people experiencing homelessness, highlighting the daily violation of their human rights in the city of Seville (Spain). In a process characterised by a search for the meaning of homelessness and the role of Social Work in human rights, their experiences are part of a knowledge production that reclaims the dignity to these individuals using their words and bodies. Methodologically, this goal was achieved by Collective Theatre Creation, combining artistic research with Social Work, theatre pedagogy and aesthetic mediation. This methodology enabled a group of individuals experiencing homelessness to write and perform a play entitled 'The truth that no one wants to see' as a result of a research process applying aesthetic mediation in Social Work. Simultaneously, it leads us to the potentiality of artistic practices in the resizing of group practice in Social Work. [ABSTRACT FROM AUTHOR]

Homelessness is one of the most challenging social problems to solve, and it is the focus of interest not only for individual states and local governments but also for transnational institutions dealing with sustainable development. It affects diverse groups of people, has different causes and consequences, and therefore requires ideally compre- hensive and tailor-made interventions implemented by professionals. This article aims to identify the deficits of the homelessness policy in the Czech Republic and proposals for their solution through “the Framework of problematic areas of homelessness” created by us and to evaluate the comprehensiveness and adequacy of coverage of all potential problem areas of homelessness by these proposals. We assume that only comprehensive and indivi- dualised interventions towards homeless people will alleviate or completely resolve their problems and increase the likelihood of their reintegration into mainstream society. [ABSTRACT FROM AUTHOR]

Living without adequate shelter is a major problem in and of itself. The creation of adequate housing is a structural issue that requires development actors and the government to prioritize and build low-income housing. If the shortage of low-income housing is solved, homelessness will end. However, while homelessness continues to exist, health issues are unavoidable and inherent in the problem. Consequently, addressing the health of homeless persons is important from both a relief and humanitarian perspective. This study describes homeless people's health challenges in Ethiopia. The exploratory design of this study utilizes in-depth interviews and focus group discussions with 34 homeless persons, key informant interviews with three government officials, and multiple rounds of participant observation. Tables show detailed responses as a way of identifying common themes from various data sources. Thematic data analysis shows that persons experiencing homelessness have pitiful hygiene and sanitation practices. They are affected by physical health challenges including diabetes, high blood pressure, epilepsy, respiratory diseases, stomach problems, HIV, skin infections, injury, and foot trauma. Homeless people are susceptible to mental health problems, including insomnia and sleeping disorders, depression, personality disorders, and schizophrenia. Understanding homeless health challenges can inform policymakers, humanitarian programs, and researchers to take action to abate the severity of health issues among the street homeless in Ethiopia. [ABSTRACT FROM AUTHOR]

In recent years, there has been increased interest in completing occupational therapy doctoral capstones with people experiencing homelessness. Given the complexity of practice with this population and its history of discrimination and marginalization, we argue for the development of guidelines for completing capstones in unhoused settings. In this column, we present background and contextual information, justification for the need for guidelines, and preliminary recommendations for consideration by students and faculty. Our aim is to invite reflection within the profession and among academic institutions and to promote dialogue with community agencies that serve this population to ensure that capstones are developed ethically, sustainably, and without unintentionally perpetuating harm. The authors argue for the development of guidelines for completing occupational therapy capstones in unhoused settings. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Occupational Therapy is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: People experiencing homelessness (PEH) are underrepresented in public health and clinical research. Study methods that can improve participation by this group are needed. Methods: In late 2022, the Centers for Disease Control and Prevention conducted an mpox serological survey using venipuncture among PEH in San Francisco, California. Blood collection by a minimally invasive device was offered if venipuncture was not possible or preferred. Participants who had a successful blood draw using the device were asked about device acceptability. Results: Of the 209 successful blood collections, 137 (66%) were among participants who underwent venipuncture and 72 (34%) were among participants who used the device. Use of the device increased overall blood collection participation by 53%. Participants reported high acceptability and preference for the device over venipuncture. Conclusions: Minimally invasive blood collection devices may increase participation and representation of PEH in serosurveys. [ABSTRACT FROM AUTHOR]

The article provides a comprehensive overview of the American College of Veterinary Pathologists (ACVP) from 2009 to 2024. It discusses the college's strategic plans, including initiatives on certification, lifelong learning, partnerships, and communication. The article also highlights changes in the college's governance model and management company, as well as policies on professional citizenship, salary surveys, and membership categories. It emphasizes the college's commitment to diversity and inclusivity, and its initiatives for veterinary students and residents. The article acknowledges the contributions of notable individuals and the college's recognition programs. Additionally, it discusses recent developments such as the introduction of a voluntary accreditation process for veterinary pathology residency training programs worldwide, changes to the certifying examination, advancements in the ACVP's journal, Veterinary Pathology, and the organization's annual scientific meetings, symposia, and community outreach activities. Overall, the article showcases the growth and evolution of the ACVP over its 75-year history. [Extracted from the article]

Copyright of Journal of Planning Education & Research is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Mothers experiencing homelessness are seldom asked about past trauma that may be causal to housing instability and poor health. There are also few validated trauma-focused interventions in family shelters. To address this gap, we tested the feasibility and acceptability of the trauma-focused clinical ethnographic narrative intervention (CENI-TF) in increasing mothers' trauma disclosure, appraisal of its meaning in their lives, and help-seeking behaviors. We also present the qualitative findings to contextualize the intervention. Findings are organized under three major domains and nine subthemes that capture participants' voices and experiences. The CENI-TF has the potential to promote help-seeking behaviors and interrupt recurring cycles of trauma and housing instability in this at-risk population. [ABSTRACT FROM AUTHOR]

Homelessness, particularly unsheltered homelessness is a public health emergency in the U.S. Street outreach programs have demonstrated efficacy in connecting people to housing, initiating or retaining people in primary care, improving access to mental health services, and increasing treatment for substance use disorder. Effective outreach is generally characterized by trained, multidisciplinary teams that visit clients where they are, forming trusting relationships over time. Public health nurses working on outreach teams have opportunities to exercise their full scope and standards of practice and advance street outreach to the benefit of a distinctly marginalized group. [ABSTRACT FROM AUTHOR]

AbstractThe Recovery Toolbox is a curriculum of occupational therapy (OT) groups designed to support individuals experiencing homelessness achieve functional recovery goals. Given that substance use can cause and prolong homelessness, it follows that people without housing are less likely to connect to services that support their recovery goals. The purpose of this article is to describe the curriculum and its application in a shelter setting. Harm reduction principles guide the curriculum as well as the Bridging the Transition from Homeless to Housed framework. A preliminary assessment demonstrated clients improved significantly in their perceived ability to increase their own drug safety. [ABSTRACT FROM AUTHOR]

AbstractSocial capital is recognised as an important resource for people experiencing poverty, yet conceptualisations of its relationship to homelessness are underdeveloped. Some studies show that social capital can protect against the risk of homelessness, whilst others show that reliance on social capital by people already experiencing homelessness rarely enables them to exit homelessness and can in fact render them vulnerable to exploitation and abuse. Building on these insights, we develop a framework for conceptualising the relationship between stable housing and social capital. Drawing on analysis of qualitative interviews with people experiencing homelessness in London, we demonstrate how, in the absence of stable housing, people experiencing homelessness lack key conditions that enable the accumulation and effective use of social capital. These include the ability to practice reciprocity, achieve recognition, and exercise autonomy in social relationships. We conclude that stable housing is a precondition for utilising social capital to ameliorate, rather than exacerbate, vulnerability, lending further evidence to support Housing First policies. [ABSTRACT FROM AUTHOR]

Background: Mobile crisis teams (MCTs) can be important alternatives to emergency medical services or law enforcement for low-acuity 911 calls. MCTs address crises by de-escalating non-violent situations related to mental health or substance use disorders and concurrent social needs, which are common among people experiencing homelessness (PEH). We sought to explore how an MCT in one city served the needs and supported the long- and short-term goals of PEH who had recently received MCT services. Methods: We conducted 20 semi-structured interviews with service recipients of the Street Crisis Response Team, a new 911-dispatched MCT implemented in San Francisco in November 2020. In the weeks after their encounter, we interviewed respondents about their overall MCT experience and comparisons to similar services, including perceived facilitators and barriers to the respondent's self-defined life goals. We analyzed interview transcripts with thematic analysis to capture salient themes emerging from the text and organized within a social-ecological model. Results: Nearly all respondents preferred the MCT model over traditional first responders, highlighting the team's person-centered approach. Respondents described the MCT model as effectively addressing their most immediate needs (e.g., food), short-term relief from the demands of homelessness, acute mental health or substance use symptoms, and immediate emotional support. However, systemwide resource constraints limited the ability of the team to effectively address longer-term factors that drive crises, such as solutions to inadequate quality and capacity of current housing and healthcare systems and social services navigation. Conclusions: In this study, respondents perceived this MCT model as a desirable alternative to law enforcement and other first responders while satisfying immediate survival needs. To improve MCT's effectiveness for PEH, these teams could collaborate with follow-up providers capable of linking clients to resources and services that can meet their long-term needs. However, these teams may not be able to meaningfully impact the longstanding and complex issues that precipitate crises among PEH in the absence of structural changes to upstream drivers of homelessness and fragmentation of care systems. [ABSTRACT FROM AUTHOR]

Objective Data Sources and Study Setting Study Design Data Collection Methods Principal Findings Conclusions To identify organizational service features associated with positive patient ratings of primary care within primary care clinics tailored to accommodate persons with ongoing and recent experiences of homelessness (PEH).PEH receiving primary care in 29 United States Veterans Health Administration homeless‐tailored clinics were surveyed about their primary care experience using the validated Primary Care Quality‐Homeless (PCQ‐H) survey. Characteristics of the clinics were assessed through surveys of clinic staff using a new organizational survey developed through literature review, site visits, statistical analysis, and consensus deliberation.Cross‐sectional examination of patients' ratings of care based on surveys of patients, and of clinic characteristics, analyzed with Classification and Regression Tree (CART) analysis, a form of machine learning.Patient surveys (n = 3394) were obtained from a random sample of enrolled patients by both mail and telephone by an external survey contractor. Staff (n = 52 from 29 clinics) were interviewed by telephone.This analysis identified service features that impact patient experience favorably, including aspects of patient‐centeredness, team identity, strong external leadership support, and service that reach beyond traditional primary care clinic confines. Results varied according to the patient experience scale analyzed. Individual characteristics of PEH, such as degree of social support, general health, and unsheltered status, were also correlated with how they rate care.Organizational characteristics correlate with ratings of primary care from patients with recent and ongoing homelessness. Primary care programs serving homeless individuals can assure better care based on who they hire, how they foster team identity, what services they provide, and the strength of leadership support to protect a homeless‐focused mission. [ABSTRACT FROM AUTHOR]

People experiencing homelessness report increased exposure to traumatic life events and higher rates of depression, anxiety, and post‐traumatic stress disorder as compared with the general population. Heart rate variability‐biofeedback (HRV‐BF) has been shown to decrease symptoms of stress, anxiety, depression, and PTSD. However, HRV‐BF has not been tested with the most vulnerable of populations, homeless adults. The purpose of this randomized controlled trial was to compare the effectiveness of an HRV‐BF intervention versus a Health Promotion (HP) active control intervention focused on improving mental health symptoms among homeless adults. Guided by a community advisory board, homeless adults residing in Skid Row, Los Angeles (n = 40) were randomized to either the HRV‐BF or an active HP control group and received eight weekly, 30‐min sessions over two months, delivered by a nurse‐led community health worker team. Dependent variables of HRV, mental health, anxiety, depression, and PTSD were measured at baseline, the 8‐week session, and/or 2‐month follow‐up. All intervention sessions were completed by 90% (36/40) of participants. Both the HRV‐BF and HP interventions showed significant increases in HRV from baseline to 2‐month follow‐up, with no significant difference between the intervention groups. The HRV‐BF programme revealed a somewhat greater, although non‐significant, improvement in anxiety, depression, and PTSD symptoms than the HP programme. The usefulness of both interventions, focused on emotional and physical health, warrants future studies to examine the value of a combined HRV‐BF and HP intervention. [ABSTRACT FROM AUTHOR]

Background: Homelessness creates a significant social and economic burden in the society. Homelessness and mental illness are two interconnected social issues that poses challenges to individuals and communities across the globe. This systematic review aims to synthesize the existing literature on interventions for the homeless persons with mental illness. Objectives: To systematically review the existing literature on psychosocial interventions for homeless persons with mental illness. Search methods: Five databases including PubMed, ProQuest, Cochrane Library, OVID, and Google Scholar were searched using homelessness, psychosocial interventions, mental ill, residential mental health facility, and case management for experimental studies published from January 2000 to December 2022. Study selection: Abstract review was conducted for the screened studies, and full-text review was done for studies which met inclusion exclusion criteria. Data extraction and analysis: Among the 6,387 studies screened 20 studies were selected which fulfilled inclusion criteria. The full text review yielded data of 12,174 homeless persons with mental illness who undergone intervention. Results: The major psychosocial interventions found including critical time intervention, case management, housing support intervention, assertive community treatment, and life skills training. These interventions were helpful in sustaining housing stability, preventing relapse, reducing hospitalizations, and improving quality of life of the homeless persons with mental illness. Conclusion: Targeted and integrated interventions addressing homelessness and mental illness are required to tackle the social problems of homelessness and mental illness. Further research is required to explore the most effective strategies that address homelessness and mental illness. [ABSTRACT FROM AUTHOR]

Supportive housing (SH), largely consisting of Transitional Living Programs (TLPs) and Permanent Supportive Housing (PSH), is the primarly intervention being applied to the one-in-ten young adults that experience homelessness in the United States each year. To date, efforts to understand the perception of these programs among young adult tenants have focused singularly on TLPs or PSH. The current qualitative study builds upon previous evidence through a comparative analysis of young adult perceptions of TLPs and PSH and examines the the physical, social, and service environments associated with each program. Results suggest six themes, including three themes focused on factors associated with location, common to both TLPs and PSH: desired proximity to friends, family, and amenities; wanted distance from negative influences; and increased ability to assimilate. Three additional themes focused on the environment internal to the housing program that differentiated the models: shared space with roommates, the service environment and relationships with SH staff, and the moving on process. Findings indicate that location is an important but complex element of the housing environment for all young SH tenants with both positive and negative factors. Within the housing environment, more TLP residents had roommates and spoke of utilizing the services associated with their housing, but discussed feeling less prepared for life after SH. [ABSTRACT FROM AUTHOR]

Experiences of family conflict are common in young people's accounts of homelessness, yet in‐depth explorations and conceptualisations of these experiences remain sparse. Drawing on focus group discussions with 29 participants, this article explores the accounts of young people and carers and parents about the dynamics, interactions and characteristics of family conflict. Findings highlight the primacy of verbal insults, criticisms or threats, as well as acts of aggression and violence in young people's and parent's understandings of family conflict. Feelings of mistrust, instability and a lack of safety also pervade family conflict and are considered its most impactful elements. We contend that these impacts are best understood via the concept of ontological (in)security, whereby young people's sense of self, belonging and stability are undermined by family conflict. This provides important insights for developing practice in this space, where working to remove long‐term patterns of family conflict, restoring young people's sense of self and belonging within their family, and supporting the stability and trust within a family may prove beneficial. [ABSTRACT FROM AUTHOR]