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This article examines gender differences in psychological distress from the impact of stressors. Stress-related illnesses, in particular suicide attempts/successes, are now of major concern in agriculture and attract increased interest from scholars. Many farmers and farm employees have first-hand experience of fatalities, injuries and ill health where stress and fatigue are major contributors. The study was developed through a questionnaire survey, interviews and farm visits. Results from the hierarchical regression models indicated significant gender differences after severity of stressors were taken into account. Male farmers were experienced the impact of psychological strain, whereas the female farmers reported a slightly higher impact of farm stressors. The demographic variables such as marital status, age group, occupational status and size of the farm were not significant factors for contributing toward stressors-strains relationships. This outcome will encourage practitioners who provide services to confront the impact of stressors directly to reduce psychological strain, which likely enhances satisfaction and performance. This research highlights the need to incorporate the frequency and severity of stressors in the work place to understand fully the stressor-strain relationship on individual differences.

Introduction: Medical schools are the places where students learn the art of allaying people’s sufferings in ill health and of saving their lives. Various studies have shown that medical training and education are stressful and require remedial approaches for benefitting medical students. Objectives: To understand the prevailing life style related health pointers, having potential adverse effect physical, emotional and mental health, among the MBBS students. Methods: A questionnaire-based cross-sectional assessment involving 82 respondents. Results: Average age of the study group was 21.61 years, with a majority (89%) belonging to urban areas, around 44% belonging to business family background. The average BMI for the group was 23.02, with 15.85% having BMI 25 or more (overweight). Only 31.71% respondents considered themselves healthy and fit, 53% were doing regular physical activities in any form. Questions related to inability to concentrate in the classroom, losing interest in hobbies, managing studies, feeling sad, depressed, anxious and worried, getting irritated on minor issues, language barrier, ability to express clearly etc. also revealed some valuable findings. Conclusion: The study findings indicate the need for developing institutional approaches for bringing necessary lifestyle changes to address the issue.

Background Obesity is associated with electrophysiological remodeling, which manifests as detectable changes on the surface electrocardiogram (ECG). Objective To develop neural networks (NN) to predict body mass index (BMI) from ECGs and test the hypothesis that discrepancies between NN-predicted BMI and measured BMI are indicative of underlying adiposity and/or concurrent cardiometabolic ill-health. Methods NN models were developed using 36,856 12-lead resting ECGs from the UK Biobank. Two architectures were developed for continuous and categorical BMI estimation (normal weight [BMI, Graphical abstract

The story of the past 30 years has been the relentless hollowing-out of industrial Britain, the single biggest change to the British economy in the post-war era. During this period, whole communities have become destabilised by mass long-term unemployment resulting in discarded generations that have been excluded socially and economically from the benefits widely available to those in work (Hutton, 1996; Buchanan, 2000). It has been against this backdrop that the youth of the 80s and 90s turned to heroin in an attempt to block out the harsh social and economic realities of their lives (Buchanan and Wyke, 1987). Drawing on semi-structured interviews with twelve opiate-involved users (OIUs), this paper illuminates the harms experienced by those who began their drug taking during the 80s and 90s. Particularly, I argue that the negative consequences brought about by the broad umbrella of drug treatment policy that adopts a framework of risk-based strategies designed to regulate and control drug users has had a cumulative effect contributing to further experiences of stigma, unemployment, physical and mental ill health. La historia de los últimos 40 años ha sido el incesante desmantelamiento de la Gran Bretaña industrial hacia el desempleo de larga duración y las generaciones descartadas que han sido excluidas social y económicamente (Pearson 1987a, 1987b, Buchanan y Young 2000). En un intento de bloquear estas duras realidades sociales y económicas de sus vidas, los jóvenes de los 80 y los 90 recurrieron a la heroína (Buchanan y Wyke 1987). A partir de un abordaje de daño social para el análisis de entrevistas semiestructuradas con doce usuarios de opiáceos, aduzco que los problemas comúnmente asociados al consumo de drogas –experiencias de estigmatización, desempleo, y salud física y mental– podrían entenderse mejor como daños resultantes de un discurso reduccionista que representa erróneamente las drogas y a sus consumidores como una amenaza a la sociedad, y enfoca el tratamiento como una reducción de los daños que suponen los consumidores de opiáceos en lugar de enfocarlo en los recursos sociales que se necesitan para la prosperidad humana. Available from: https://doi.org/10.35295/osls.iisl/0000-0000-0000-1172

In a world with limited resources, allocation of resources to certain individuals and conditions inevitably means fewer resources allocated to other individuals and conditions. Should a patient's personal responsibility be relevant to decisions re- garding allocation? In this project we combine the normative and the descriptive, conducting an empirical bioethical examination of how both Norwegian and British doctors think about principles of responsibility in allocating scarce healthcare re- sources. A large proportion of doctors in both countries supported including re- sponsibility for illness in prioritization decisions. This finding was more prominent in zero‐sum scenarios where allocation to one patient means that another patient is denied treatment. There was most support for incorporating prospective responsi- bility (through patient contracts), and low support for integrating responsibility into co‐payments (i.e. through requiring responsible patients to pay part of the costs of treatment). Finally, some behaviours were considered more appropriate grounds for deprioritization (smoking, alcohol, drug use)—potentially because of the certainty of impact and direct link to ill health. In zero‐sum situations, prognosis also influenced prioritization (but did not outweigh responsibility). Ethical implications are discussed. We argue that the role that responsibility constructs appear to play in doctors' decisions indicates a needs for more nuanced—and clear—policy. Such policy should account for the distinctions we draw between responsibility‐sensitive and prog- nostic justifications for deprioritization.

Undoubtedly, the snake anti-venom is a medication made up of antibodies used to treat itsbites by venomous snakes. Repeated administration of snake venoms from Spitting cobra, ingradual sub-lethal doses into horses has been reported to cause various ill health conditions torecipient animals beside loss in the antibody titer in the plasma harvested from immunizedhorses. It could accordingly, propose some amendment in the immunization schedule usingdifferent adjuvants to choose the best one giving the maximal amount of antibody beside itsmax safety measures. Montanide ISA is an alternative to CFA for hyper-activation of immuneresponse in rabbits beside it is considered as adjuvant with high safety margin.

There9s emerging evidence that weight and health can be uncoupled. Many researchers and doctors—and broader societies—take it as given that obesity means ill health. In fact, some say, the two don9t inevitably go hand in hand. Researchers worldwide are studying genes, animal models, and humans to understand how factors such as the bodily distribution of fat and its nature can blunt or compound any health impacts of extra weight. The researchers are also working to define metabolically healthy obesity and examine how common it is and how long it persists. Beyond the research lies a knotty practical question: what the science means for people with obesity and the doctors they see.

Background While much effort has focused on quantifying disease burden in occupational health, no study has simultaneously assessed disease burden in terms of mortality and morbidity. We aimed to propose a new comprehensive method of quantifying the disease burden in the workplace. Methods The data were obtained from the Japan Epidemiology Collaboration on Occupational Health (J-ECOH) Study, a large-scale prospective study of approximately 80,000 workers. We defined disease burden in the workplace as the number of working years lost among the working population during a 6-year period (April 2012 to March 2018). We calculated the disease burden according to consequences of health problems (ie, mortality, sickness absence [SA], and ill-health retirement) and disease category. We also calculated the age-group- (20-39 and 40-59 years old) and sex-specific disease burden. Results The largest contributors to disease burden in the workplace were mental and behavioural disorders (47.0 person-years lost per 10,000 person-years of working years; ie, per myriad [proportion]), followed by neoplasms (10.8 per myriad) and diseases of the circulatory system (7.1 per myriad). While mental and behavioural disorders made a greater contribution to SA and ill-health retirement compared to mortality, the latter two disorders were the largest contributors to the disease burden in the workplace due to mortality. The number of working years lost was greater among younger versus older female participants, whereas the opposite trend was observed in males. Conclusions Our approach is in contrast to those in previous studies that focused exclusively on mortality or morbidity.

Background: Sick leave due to stress-related mental ill health increases in society. In occupational therapy, occupational balance is considered important for experiencing health and well-being. Thus, knowledge regarding occupational balance and occupational value constitute essential parts of occupational therapists' work with people suffering from occupational ill health. Objective: The aim of this study is to analyse the relationships between sociodemographic factors, occupational value, occupational balance and perceived health in people suffering from occupational ill health. Methods: In a quantitative cross-sectional study data from a total of 218 individuals were included, 192 women, 22 men and 4 individuals who did not specify their gender. Data were collected by means of surveys prior to an occupational therapy intervention. The instruments used included OVal-pd, OBQ, EQ5D and a sociodemographic questionnaire. Data were analysed using regression and decision tree analysis. Results: The results show that individuals who experience an imbalance in their everyday life and who have few or no experiences of daily occupations imprinted by socio-symbolic occupational value experienced lower perceived health. Conclusions: Low level of experiences of balance in daily life and occupational value seems to be the main risk factors for the development of occupational ill health, rather than sociodemographic factors.

OBJECTIVES To identify differences in risk of ill-health retirement (IHR) between groups with different levels of education and examine this difference with respect to working conditions and health-related factors. METHODS This study analysed the longitudinal data of 1691 paid workers aged 45 to 79 years from the Korean Longitudinal Study of Aging. Multivariate Cox regression analyses were conducted to identify the predictors and build a prediction model for IHR according to different final education levels. RESULTS Over the 10-year follow-up, 208 workers exited work because of poor health. Clear educational inequalities in reason of retirement and increased risk of IHR in low, intermediate, and high educational groups were observed. CONCLUSIONS Our results suggest an educational gradient for IHR among Korean male workers and revealed gender differences in the risk of IHR.

Objectives: Globally, breast cancer is the commonest cancer in women. Empirical literature indicate that it is the second cause of cancer-related mortality in high-resource regions, while it is the most common cause of cancer-related deaths among women in poor-resource regions. This study presents the suitability of the health belief model (HBM) as a framework for carrying out a comprehensive assessment of women with late-stage breast cancer in Nigeria. Materials and Methods: This qualitative study employed interpretive description as its methodological approach, while the HBM was the conceptual framework. Two institutional review boards granted approval to conduct the study. Thirty women with advanced breast cancer were recruited for the study using purposeful sampling techniques. Components of the original HBM were identified to carry out the investigation. Data analysis was inductive. Results: Findings indicated that the participants viewed breast cancer as a definite threat- both as a spiritual attack – an arrow shot by the enemy, and as a killer disease. Many of their perceptions appeared to be culturally based, while others were based on their individual experiences. They perceived some benefits to both traditional and medical treatment options. Conclusions: Interventions that address people’s cultural and individual perceptions enables a comprehensive assessment of the patients with breast cancer, which can improve the treatment outcomes and survival rates of disease.

In elite sport, research has highlighted the significant incidence of athletes experiencing mental ill health. The aim of the present study was to make sense of stories that elite athletes tell about experiencing mental ill health through sampling the autobiographies of four male, elite cricketers. In each book, the player spoke in detail about mental ill health and how this impacted on their international career. Horizontal and vertical analyses of the data resulted in six progressive themes being identified, from Early Warning Signs, Fluctuations of Mental Health, Build-up to the Severe Incident, the Severe Incident, the Recovery Process, to Relapsing. The findings are considered in line with how they might be used to meet the call to develop mental health literacy, in aiming to help coaches and other psychology support staff understand more about the process of athletes who experience mental ill health across their career.

In June 2020, the Office for National Statistics (ONS) in England and Wales published the results of an investigation into mortality from COVID-19 by religious group. The analysis revealed a significant "Jewish penalty": coronavirus mortality of Jews was shown to be relatively high compared to the British Christian majority. This paper considers these findings in the light of the literature on Jewish mortality and undertakes a re-analysis of the results alongside the additional data on Jewish deaths provided by the British Jewish communal statistics. It asks two questions: (1) To what extent is elevated British Jewish mortality from COVID-19 a result of the presence of long-standing vulnerability and ill health among Jews? (2) What role do strictly Orthodox Jews play in elevating coronavirus mortality levels among British Jews? The primary contribution of the paper is to explore, via analyses of alternative data sources, the ONS finding of elevated Jewish mortality from coronavirus, to explain why it is surprising, to test whether it is real and to eliminate certain explanations. Such process of elimination in itself will highlight other alternative explanations, but the paper falls short of decisively explaining the phenomenon of the elevated British Jewish mortality from coronavirus. It ends with an outline of future directions of research in this area.

Depression and anxiety are common conditions in adults with intellectual disabilities (ID) and often coexist with behaviour problems. We examined whether behaviour problems can be used to screen for depression and anxiety in ID. Clinical prediction models (CPM) generated from independent databases supported the utility of the depression screen, especially in severe/profound ID. CPM did not support the utility of the anxiety screen at any ID level. Given the paucity of screening tools to improve ascertainment of mental ill-health in ID, the short depression screen would be clinically useful in identifying those who need to undergo a full diagnostic evaluation.

Vitamin B6, a cofactor in many biochemical reactions in the cells of living organisms, is an essential coenzyme for various catabolic and anabolic processes. Although vitamin B6 deficiency in young healthy women with a balanced diet is thought to be unusual, it can be seen with certain medications, health conditions, and dietary deficits, as well as aging. Vitamin B6 deficiency is associated with a variety of ill health effects, and correction of deficiency is considered beneficial. Women particularly are affected by unique health issues that are part of the array of disorders potentially alleviated through vitamin B6 supplementation.

In this article, we examine the operation of shame in the alcohol use habits of pregnant women and the responses of their families and associated institutions. Using a narrative–discursive approach, we interviewed 13 women, living in a low-resource setting in South Africa, who had consumed alcohol while pregnant. Narratives showed how both the act of drinking and “inappropriately” timed pregnancy (early and out of wedlock) were judged to be unacceptable. Women who engaged in these activities were positioned as bad mothers or promiscuous. Their actions were seen as resulting in the suffering of others—the future child, the family, and even the community. These narratives were underpinned by cultural and religious discourses. Women managed the shame accruing to them through avoidance and concealment; families instructed women to self-exclude or distanced themselves from the women’s behavior; and institutions subtly or overtly excluded women. The shaming of these women, and the mechanisms by which such shame was managed, did little to decrease drinking or to increase maternal health and welfare. Overall, this article demonstrates how the shame of drinking alcohol during pregnancy produces avoidance behavior, concealment, and exclusion, which are not constructive in terms of maternal health and well-being. The implications for a feminist narrative approach to drinking during pregnancy are outlined: moving beyond a focus on individual behavior change to locating personal stories within the meta-narratives and social discourses that shape pregnant women’s lives.

Well-known archaeologist, ethnographer, and local historian Khrysanf Petrovych Yashchurzhynskyi left a significant mark in Ukrainian history with his work. His pedagogical activity, archeological researches, and publications of ethnographic materials are reflected in the works of modern scholars. However, in the biography of the scholar, the least studied period is his life in the village of Molodetske in Uman region (1911-1923). There are very few sources about this period of Khrysanf Yashchurzhynskyi life. However, the transactions of Uman Branch of Kyiv Society for the Preservation of Ancient and Artistic Monuments, as well as the letters of Khrysanf Petrovych Yashchurzhynskyi, deposited in the archives, in combination with the diaries of P.F. Kurinnyi, give the opportunity to get detailed information about the scholar. The little-known facts of the biography of Chrysanthus Aserinsky in the period of 1911-1923, during his stay in the village of Molodetske in Uman region, are highlighted in the publication, and the main directions of scholar’s ethnographic that time studies of Uman region are analyzed. It is noted that on the initiative of Khrysanf Yashchurzhynskyi, a Society for the Preservation of Monuments was founded in Uman. Khr. Yashchurzhynskyi was actually the chairman of the society. The society was engaged in collecting information about historical sites, mounds, settlements; studying topography, ramparts, and fortifications of old Uman; studying Koliivshchyna; collecting documents and folk tales; collecting music pieces and folklore materials. Khrysanf Petrovych Yashchurzhynskyi worked on a program of the ethnographic study of the region, which he planned to send to priests and teachers in the region. The most productive society worked in 1913-1916. During that time, the work was carried out to find archival documents on the history of Uman, some ancient monuments (churches, mounds, tombstones, and buildings) were examined, and archaeological tours and expeditions were undertaken. Khrysanf Yashchurzhynskyi regularly reported during the meetings of the society on the results of his own ethnographic studies in Uman region. Since 1917 Khr. Yashchurzhynskyi, due to ill health, withdrew from active work in the society. However, he continued to be interested in monument protection in Uman region and helped to establish a museum in Uman. Because of the limited source base on the life of Khrysanf Petrovych Yashchurzhynskyi after 1911, four letters of the scholar (of 1914, 1917, and 1918) are included in the paper. The little-known facts of the biography of Chrysanthus Aserinsky in the period of 1911-1923, during his stay in the village of Molodetske in Uman region, are highlighted in the publication, and the main directions of scholar’s ethnographic that time studies of Uman region are analyzed. It is noted that on the initiative of Chrysanthus Aserinsky, a Society for the Preservation of Monuments was founded in Uman. Chr. Aserinsky was actually the chairman of the society. The society was engaged in collecting information about historical sites, mounds, settlements; studying topography, ramparts, and fortifications of old Uman; studying Koliivshchyna; collecting documents and folk tales; collecting music pieces and folklore materials. Chrysanthus Petrovich Aserinsky worked on a program of the ethnographic study of the region, which he planned to send to priests and teachers in the region. The most productive society worked in 1913-1916. During that time, the work was carried out to find archival documents on the history of Uman, some ancient monuments (churches, mounds, tombstones, and buildings) were examined, and archaeological tours and expeditions were undertaken. Chrysanthus Aserinsky regularly reported during the meetings of the society on the results of his own ethnographic studies in Uman region. Since 1917 Chr. Aserinsky, due to ill health, withdrew from active work in the society. However, he continued to be interested in monument protection in Uman region and helped to establish a museum in Uman. Because of the limited source base on the life of Chrysanthus Petrovich Aserinsky after 1911, four letters of the scholar (of 1914, 1917, and 1918) are included in the paper.

In recent years South Africa has had to deal with the problem of multiple disease burdens. Non-communicable diseases (NCDs) are rising and emerging as the leading causes of death in the country. Ex...

Is mental ill health an aspect of ‘neurodiversity’? If so, is it ok to be neurodiverse within the context of mental health and how should those who are ‘neurotypical’ respond? Are people comfortable with the ‘labels’ of, and language and social constructs associated with, being neurodiverse and neurotypical as applied to mental health? These are the central questions that will be explored in this article through the lens of disability models.

A large body of research has found that mothers from ethnic minority groups are at high risk of maternal mental health difficulties. This article presents a study of women from ethnic minority and migrant groups in the UK who experienced mental health difficulties in order to investigate obstacles they met in communicating their challenges with health professionals. Thirty qualitative, semi-structured interviews were conducted and analysed. The findings show that mental health is often a taboo in ethnic minority communities, and that a lack of stimulus and ability to communicate their struggles is one of the main drivers of mental ill-health. Support groups and social media create promising opportunities for combating the issue at hand, but social services, medication, NHS understaffing and insufficient attention paid to mothers by health professionals are the main obstacles met by participants in sourcing support. Research is concluded with recommendations regarding the findings.

A growing number of frail and disabled older adults suffer from a decline in functional capacities. This decline can lead to difficulties in performing the necessary activities of daily living and exposes older adults to the risk of accidents because the build environment is not adapted to the functional capacities of frail older residents with sarcopenia. Smart, age-friendly environments with embedded ambient-assisted living technologies will be an essential part of how ageing societies will maintain and improve the quality of life for a growing number of older adults with declining functional capacities. A review of relevant literature revealed the central gap, which includes the lack of models for locating the assistance centres, lack of common standards for measurement and recording patterns of functional decline, and lack of identification of common risk factors in the events that lead to ill health and disability.

An escalating proportion of the aged group is associated with a growth in the prevalence of ill health. With the complexity of age-related diseases, a good medication management system is important to prevent medication errors. This study was aimed to develop a questionnaire to assess the knowledge, attitude and practice (KAP) of caregivers on medication management at residential aged care facilities (RACFs). A cross-sectional study was performed involving caregivers from 90 RACFs throughout Malaysia. The validated self-administered questionnaire was developed based on the extensive literature review and expert`s opinions containing 41-items divided into three domains. In this study, the response rate was 71% with 128 questionnaires returned. Median scores obtained for knowledge, attitude and practice were 77.27, 70.83 and 68.66, respectively. Majority of the caregivers (71.9%) deemed to know what medication management was. However, nearly half of them (48.4%) did not experience any training. More than half of the caregivers possessed good level of knowledge (69.5%, n = 89), around half (57.8%, n= 74) had a good attitude and less than half had a good practice (46.9%, n= 60) of medication management. Level of education, special qualification and experience of medication management training were the factors that correlated with good score outcome (p

In this paper, we attempt to show how the novel coronavirus disease (COVID-19) has disrupted routine health services in India and has created further inequalities in the society. By taking a few examples of non-COVID diseases and conditions like immunization, maternal health services, tuberculosis and non-communicable diseases, this paper shows how these services have been disrupted by the pandemic. The paper argues that these disruptions have not emerged only as a result of the current crisis, but because of the paradigm shifts in the healthcare delivery in the country towards privatization which have disproportionately marginalized particular sections of the society. The paper concludes by stating that if adequate measures are not taken now to transform the health system and strengthen the public healthcare system, it might lead to catastrophic consequences in the future, especially for the marginalized sections.

Objectives: The study was designed to estimate the prevalence of mental disorders in a cohort of firefighters who had been deployed to a devastating fire in Fort McMurray, Alberta, in 2016. Methods: A cohort of firefighters was established and followed up by online questionnaires. The contact in October 2018 to March 2019 included the PCL-5 questionnaire screening for post-traumatic stress disorder (PTSD) and the Hospital Anxiety and Depression Scale (HADS) screening for anxiety and depression. A sample was selected comprising all scoring ≥31 on the PCL-5 or ≥12 on either scale of the HADS, 30% of those scoring 8 to 11 on the HADS, and 10% of those with lower scores on all scales. This sample was assessed through a structured clinical interview to categorize disorders as defined in Diagnostic and Statistical Manual for Mental Disorders, fifth edition ( DSM-5). Interviews were carried out face-to-face or by telephone between August 2019 and February 2020. Diagnoses in the interview sample were reweighted to obtain prevalence estimates for the whole cohort. In an analysis of receiver operating characteristics (ROC), possible cut points for scores from each screening questionnaire were examined. Results: In 2018 to 2019, 1,000 of the cohort of 1,234 firefighters completed the HADS and 998 completed the PCL-5. Of these, 282 were identified for structured clinical interviews for DSM-5 (SCID) assessment. Interviews were carried out with 192. Among those assessed, 40.6% met the criteria for PTSD, 30.7% for an anxiety disorder, and 28.5% for a depressive disorder. When reweighted to allow for sampling and losses to assessment, cohort prevalence estimates were as follows: PTSD 21.4% (15.7% to 29.1%), anxiety disorders 15.8% (11.0% to 22.5%), and depressive disorders 14.3% (9.9% to 20.8%). Lower prevalence estimates were obtained when using the cut point with least misclassification in the ROC analysis. Conclusion: Using the gold-standard SCID assessment, high rates of mental disorders were found in this cohort of firefighters who had experienced a devastating fire. Fewer cases would have been identified by screening questionnaire alone.

India has experienced a significant increase in income inequality in the past decade. It is widely accepted in the literature that income inequality is detrimental to individual health. Against this backdrop, the objective of the paper is to analyze the effect of income inequality on individual health status in the Indian context. We have examined two aspects: the impact of inequality on society in general and whether the effect of inequality is harsher on the poor as compared to the rich. We tested the income inequality hypothesis to answer the research questions. Using two rounds of India Human Development Survey data, a large-scale, nationally representative, panel data set collected in 2004–05 and 2011–12, we found a negative association between income inequality and individual health. Moreover, the poor are found to be the worst sufferers of income inequality and are more sensitive to ill health.

Background Six thousand children are hospitalized each year in New Zealand with housing sensitive conditions, and 86.2% of these children are rehospitalized during childhood. The Healthy Homes Initiative, set up by the Ministry of Health, and implemented in Wellington through Well Homes, carries out housing assessments and delivers a range of housing interventions. Method Housing assessments were carried out by trained community workers. Philanthropic funding was received for the interventions through a local charitable trust. Results Well Homes saw 895 families. Mold in the home was the most commonly recorded area of poor housing quality, in 836 homes (93%). Partial or complete lack of insulation was also common, with 452 records (51%) having a documented need for further assessment and either an upgrade or full installation. Eighty-three percent of homes had insufficient sources of heating. A total of 5,537 interventions were delivered. Bedding, heaters, and draft stopping were delivered over 90% of the time. In contrast, insulation and carpets were only delivered 40% of the time. Interventions were least likely to be delivered in private rental housing. Discussion Targeted interventions using social partnerships can deliver housing improvements for relatively little health spending. Well Homes provides immediate and practical interventions, education, connection with social agencies, and advocacy for more substantial structural home improvements to help families keep their home warmer, drier, and healthier. This approach will be strengthened when combined with a new regulatory framework to raise the standards of private rental housing.