scholarly journals population level study of SARS-CoV-2 prevalence amongst people experiencing homelessness in Wales, UK

2021 ◽  
Vol 5 (4) ◽  
Author(s):  
Ian Thomas ◽  
Peter Mackie
Keyword(s):  
General Population ◽  
Local Authority ◽  
Comparison Group ◽  
Population Level ◽  
Homeless Population ◽  
Area Deprivation ◽  
Policy And Practice ◽  
Testing Data ◽  
Logistic Regressions ◽  
Matched Comparison

IntroductionPrior research into the prevalence of SARS-CoV-2 infection amongst people experiencing homelessness (PEH) largely relates to people in communal forms of temporary accommodation in contexts where this type of accommodation remained a major part of the response to homelessness during the COVID-19 pandemic. Little is known about the prevalence of SARS-CoV-2 amongst PEH more broadly, and in a policy and practice context that favoured self-contained accommodation, such as Wales, UK. ObjectiveDescribe the prevalence of SARS-CoV-2 amongst PEH in Wales, UK, using routinely collected administrative data from the Secure Anonymised Information Linkage Databank. MethodsRoutinely collected data were used to identify PEH in Wales between 1st March 2020 and 1st March 2021. Using SARS-CoV-2 pathology testing data, prevalence rates were generated for PEH and three comparator groups: (1) the not-homeless population; (2) a cohort `exact matched' for age, sex, local authority and area deprivation; and (3) a matched comparison group created using these same variables and Propensity Score Matching (PSM). Three logistic regressions were run on samples containing each of the comparator groups to explore the effect of experiencing homelessness on testing positive for SARS-CoV-2. ResultsThe prevalence of SARS-CoV-2 infection amongst PEH was 5.0%, compared to the not-homeless population at 5.6%. For the exact matched and PSM match comparator groups, prevalence was 6.9% and 6.7%, respectively. Logistic regression found that SARS-CoV-2 infection was 0.9 times less likely amongst PEH compared to people not experiencing homelessness from the general population. The odds of SARS-CoV-2 infection for PEH was 0.75 and 0.73 where the `not-homeless' comparators were from the exact match and PSM samples, respectively. ConclusionOur analysis revealed that a year into the COVID-19 pandemic, the prevalence of SARS-CoV-2 amongst PEH in Wales was lower than the general population. A policy response to homelessness that moved away from communal accommodation may be partly responsible for the reduced SAR-CoV-2 infection amongst PEH.

scholarly journals Early Childhood Education and Adult Depression: An Attrition Reanalysis With Inverse Propensity Score Weighting

2020 ◽  
pp. 0193841X2097652
Author(s):  
Christina F. Mondi ◽  
Arthur J. Reynolds ◽  
Brandt A. Richardson
Keyword(s):  
Early Childhood ◽  
Depressive Symptoms ◽  
Comparison Group ◽  
Practical Significance ◽  
Point Estimate ◽  
Marginal Effect ◽  
Alternative Analysis ◽  
Point Reduction ◽  
Program Selection ◽  
Matched Comparison

In a previous study of the Child-Parent Centers (CPC) education program, preschool participation was linked to a 4.6 percentage point reduction (26%) in depressive symptoms at ages 22–24 over the matched comparison group enrolling the usual programs. The present study reanalyzed these data in the Chicago Longitudinal Study to address potential attrition bias since more than a quarter of the sample was missing on the outcome. Using inverse probability weighting (IPW) involving 32 predictors of sample retention, findings for the 1,142 participants growing up in high-poverty neighborhoods indicated that CPC participation was associated with a 7.1 percentage point reduction (95% CI = [−9.7, −5.4]) in one or more depressive symptoms (39% reduction over the comparison group). Although this marginal effect was within the confidence interval of the original study (95% CI = [−9.5, 0.3]), the 54% increase in the point estimate is substantial and of practical significance, suggesting underestimation in the prior study. Alternative analysis of different predictors and IPW models, including adjustments for program selection and attrition together, yielded similar results. Findings indicate that high-quality early childhood programs continue to be an important strategy for the prevention of depression and its debilitating effects on individuals and families.

Caffeine intake reduces incident atrial fibrillation at a population level

2018 ◽  
Vol 25 (10) ◽  
pp. 1055-1062 ◽  
Author(s):  
Edoardo Casiglia ◽  
Valérie Tikhonoff ◽  
Federica Albertini ◽  
Federica Gasparotti ◽  
Alberto Mazza ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
General Population ◽  
Univariate Analysis ◽  
Population Level ◽  
Caffeine Intake ◽  
General Belief ◽  
The Third ◽  
Chronic Caffeine ◽  
Artery Disease ◽  
Cox Analysis

Background The general belief is that caffeine increases the risk of hyperkinetic arrhythmias, including atrial fibrillation. The aim of this study is to investigate the effect of chronic caffeine intake on incident atrial fibrillation in general population. Design and methods A population cohort of 1475 unselected men and women observed for 12 years and left free to intake food or beverages containing caffeine was studied. Subjects were stratified into tertiles of caffeine intake both in the whole cohort and after genotyping for the –163C > A polymorphism of the CYP1A2 gene, regulating caffeine metabolism. Results In the whole cohort, the 12-year incidence of atrial fibrillation was significantly lower in the third (2.2%) than in the first (10.2%) or second (5.7%) tertile of caffeine intake ( P < 0.001). The same trend was observed in all genotypes; the apparently steeper reduction of atrial fibrillation in slow caffeine metabolisers found at univariate analysis was proved wrong by multivariate Cox analysis. Age, chronic pulmonary disease, history of heart failure and of coronary artery disease, and systolic blood pressure − but not the genotype or the caffeine ×  CYP1A2 interaction term − were significant confounders of the association between incident atrial fibrillation and being in the third tertile of caffeine intake (hazard ratio 0.249, 95% confidence intervals 0.161–0.458, P < 0.01). Conclusions A higher caffeine intake (>165 mmol/day or > 320 mg/day) is associated with a lower incidence of atrial fibrillation in the 12-year epidemiological prospective setting based on the general population.

Declining Physical Activity and the Socio-Cultural Context of the Geography of Industrial Restructuring: A Novel Conceptual Framework

2014 ◽  
Vol 11 (4) ◽  
pp. 683-692 ◽  
Author(s):  
Esther Rind ◽  
Andy Jones
Keyword(s):  
Physical Activity ◽  
Cultural Context ◽  
Population Level ◽  
Developed Countries ◽  
Industrial Restructuring ◽  
Activity Levels ◽  
Industrial Change ◽  
Policy And Practice ◽  
Sociocultural Processes ◽  
Employment Decline

Background:At the population level, the prevalence of physical activity has declined considerably in many developed countries in recent decades. There is some evidence that areas exhibiting the lowest activity levels are those which have undergone a particularly strong transition away from employment in physically demanding occupations. We propose that processes of deindustrialization may be causally linked to unexplained geographical disparities in levels of physical activity. While the sociocultural correlates of physical activity have been well studied, and prior conceptual frameworks have been developed to explain more general patterns of activity, none have explicitly attempted to identify the components of industrial change that may impact physical activity.Methods:In this work we review the current literature on sociocultural correlates of health behaviors before using a case study centered on the United Kingdom to present a novel framework that links industrial change to declining levels of physical activity.Results:We developed a comprehensive model linking sociocultural correlates of physical activity to processes associated with industrial restructuring and discuss implication for policy and practice.Conclusions:A better understanding of sociocultural processes may help to ameliorate adverse health consequences of employment decline in communities that have experienced substantial losses of manual employment.

‘It’s all considered to be unacceptable behaviour’

2016 ◽  
Vol 63 (4) ◽  
pp. 433-451 ◽  
Author(s):  
Vickie Cooper
Keyword(s):  
Criminal Justice ◽  
Housing Policy ◽  
Local Authority ◽  
Housing Authority ◽  
Policy And Practice ◽  
England And Wales ◽  
Critical Questions ◽  
Housing Options ◽  
Criminal Justice Practitioners

Despite a growing recognition of the intersectional relationship between homelessness and incarceration, we have a limited knowledge about housing policy and practice for people leaving custody and (ex)offender groups in the community. Addressing these gaps, this paper provides an overview of the main local housing authority statutory duties in the provision of housing support for prison leavers and (ex)offenders in England and Wales, and situates the issues with accessing accommodation within the wider context of austerity. The paper presents a case study that explores criminal justice practitioners’ experiences of working with local authority housing agencies. Stemming from 25 interviews with housing practitioners and criminal justice practitioners, the paper outlines the main challenges facing criminal justice agencies as they try to secure accommodation for homeless (ex)offenders and resettle them in the community. Finally, the paper concludes by raising critical questions about the housing options for this population, now and in the future.

scholarly journals Methodology of Natsal-COVID Wave 1: a large, quasi-representative survey with qualitative follow-up measuring the impact of COVID-19 on sexual and reproductive health in Britain

2021 ◽  
Vol 6 ◽  
pp. 209
Author(s):  
Emily Dema ◽  
Andrew J Copas ◽  
Soazig Clifton ◽  
Anne Conolly ◽  
Margaret Blake ◽  
...  
Keyword(s):  
General Population ◽  
Reproductive Health ◽  
Sexual Behaviour ◽  
Sexual And Reproductive Health ◽  
Service Use ◽  
Population Data ◽  
Population Level ◽  
Level Data ◽  
The Impact

Background: Britain’s National Surveys of Sexual Attitudes and Lifestyles (Natsal) have been undertaken decennially since 1990 and provide a key data source underpinning sexual and reproductive health (SRH) policy. The COVID-19 pandemic disrupted many aspects of sexual lifestyles, triggering an urgent need for population-level data on sexual behaviour, relationships, and service use at a time when gold-standard in-person, household-based surveys with probability sampling were not feasible. We designed the Natsal-COVID study to understand the impact of COVID-19 on the nation’s SRH and assessed the sample representativeness. Methods: Natsal-COVID Wave 1 data collection was conducted four months (29/7-10/8/2020) after the announcement of Britain’s first national lockdown (23/03/2020). This was an online web-panel survey administered by survey research company, Ipsos MORI. Eligible participants were resident in Britain, aged 18-59 years, and the sample included a boost of those aged 18-29. Questions covered participants’ sexual behaviour, relationships, and SRH service use. Quotas and weighting were used to achieve a quasi-representative sample of the British general population. Participants meeting criteria of interest and agreeing to recontact were selected for qualitative follow-up interviews. Comparisons were made with contemporaneous national probability surveys and Natsal-3 (2010-12) to understand bias. Results: 6,654 participants completed the survey and 45 completed follow-up interviews. The weighted Natsal-COVID sample was similar to the general population in terms of gender, age, ethnicity, rurality, and, among sexually-active participants, numbers of sexual partners in the past year. However, the sample was more educated, contained more sexually-inexperienced people, and included more people in poorer health. Conclusions: Natsal-COVID Wave 1 rapidly collected quasi-representative population data to enable evaluation of the early population-level impact of COVID-19 and lockdown measures on SRH in Britain and inform policy. Although sampling was less representative than the decennial Natsals, Natsal-COVID will complement national surveillance data and Natsal-4 (planned for 2022).

Chronic Mental Illnesses and Homelessness

2017 ◽  
pp. 1-20
Author(s):  
Prerna Kukreti ◽  
Prerna Khanna ◽  
Amit Khanna
Keyword(s):  
Risk Factors ◽  
Mental Illness ◽  
General Population ◽  
National Level ◽  
Economic Problem ◽  
Mental Illnesses ◽  
Homeless Population ◽  
Accurate Data ◽  
The West ◽  
Design Models

Homelessness is a complex socio-economic problem complicated by individual attributes and risk factors. The burning issue of homelessness has been a subject of concern in the modern day world often stretching the existing administrative system to innovate and design models for managing the same. With the changing definitions of homelessness, the estimates have also varied across cultures and countries. Because of the inherent difficulty in studying homelessness, accurate estimates of the number of homeless are lacking. Most studies in the West report that approximately 288 per 10,000 people are homeless. With the accurate data on homelessness lacking, the estimates of mental illness amongst homeless is even more obscure. The prevalence of mental illness amongst homeless is higher than that compared to the general population. Researchers have theorized various stressors related to homelessness as precipitating factors of mental illness. There is dearth of literature on mental illness in homeless population which is representative of the homeless population at a national level.

scholarly journals Robust association between autistic traits and psychotic-like experiences in the adult general population: epidemiological study from the 2007 Adult Psychiatric Morbidity Survey and replication with the 2014 APMS

2020 ◽  
pp. 1-7
Author(s):  
Anton P. Martinez ◽  
Sophie Wickham ◽  
Georgina Rowse ◽  
Elizabeth Milne ◽  
Richard P. Bentall
Keyword(s):  
General Population ◽  
Psychiatric Morbidity ◽  
Autistic Traits ◽  
Cross Sectional ◽  
Increased Risk ◽  
Dependent Variables ◽  
Independent Variable ◽  
Logistic Regressions ◽  
Specific Symptoms ◽  
First Time

Abstract Background Studies have shown that there are overlapping traits and symptoms between autism and psychosis but no study to date has addressed this association from an epidemiological approach in the adult general population. Furthermore, it is not clear whether autistic traits are associated with specific symptoms of psychosis or with psychosis in general. We assess these associations for the first time by using the Adult Psychiatric Morbidity Survey (APMS) 2007 and the APMS 2014, predicting an association between autistic traits and probable psychosis, and specific associations between autistic traits and paranoia and strange experiences. Methods Participants (N = 7353 in 2007 and 7500 in 2014) completed the Psychosis Screening Questionnaire (PSQ) and a 20-item version of the Autism Quotient (AQ-20). Binomial logistic regressions were performed using AQ-20 as the independent variable and probable psychosis and specific symptoms as dependent variables. Results In the APMS 2007 dataset, significant associations were found between autism traits and probable psychosis, paranoia, thought insertion, and strange experiences. These results were replicated in APMS 2014 but with the additional significant association between autistic traits and hallucinations. Participants in the highest quartile of the AQ-20, compared with the lowest quartile, had an increased risk of probable psychosis of odds ratio (OR) = 15.5 [95% confidence interval (CI) 4.57–52.6] in APMS 2007 and OR = 22.5 (95% CI 7.64–66.3) in APMS 2014. Conclusions Autistic traits are strongly associated with probable psychosis and psychotic experiences with the exception of mania. Limitations such as the cross-sectional nature of the study are discussed.

scholarly journals Cost-Effective Care Coordination for People With Dementia at Home

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Amber Willink ◽  
Karen Davis ◽  
Deirdre M Johnston ◽  
Betty Black ◽  
Melissa Reuland ◽  
...  
Keyword(s):  
Community Health ◽  
Care Coordination ◽  
Care Management ◽  
Comparison Group ◽  
Health Workers ◽  
Cost Effective ◽  
People With Dementia ◽  
Home Intervention ◽  
Matched Comparison ◽  
At Home

Abstract Background and Objectives People with dementia (PWD) represent some of the highest-need and highest-cost individuals living in the community. Maximizing Independence (MIND) at Home is a potentially cost-effective and scalable home-based dementia care coordination program that uses trained, nonclinical community workers as the primary contact between the PWD and their care partner, supported by a multidisciplinary clinical team with expertise in dementia care. Research Design and Methods Cost of care management services based on actual time spent by care management personnel over first 12 months of MIND at Home intervention was calculated for 342 MIND at Home recipients from Baltimore, Maryland and surrounding areas participating in a Centers for Medicare and Medicaid Services (CMS) funded Health Care Innovation Award demonstration project. Difference-in-differences analysis of claims-based Medicaid spending of 120 dually-eligible MIND at Home participants with their propensity score matched comparison group (n = 360). Results The average cost per enrollee per month was $110, or $1,320 per annum. Medicaid expenditures of dually-eligible participants grew 1.12 percentage points per quarter more slowly than that of the matched comparison group. Most savings came from slower growth in inpatient and long-term nursing home use. Net of the cost of the 5-year MIND at Home intervention, 5-year Medicaid savings are estimated at $7,052 per beneficiary, a 1.12-fold return on investment. Discussion and Implications Managed care plans with the flexibility to engage community health workers could benefit from a low-cost, high-touch intervention to meet the needs of enrollees with dementia. Limitations for using and reimbursing community health workers exist in Medicare fee-for-service, which CMS should address to maximize benefit for PWD.

scholarly journals Screening of problem gambling among a homeless population in Warsaw

2019 ◽  
Vol 36 (6) ◽  
pp. 542-555 ◽  
Author(s):  
Łukasz Wieczorek ◽  
Jakub Stokwiszewski ◽  
Justyna I Klingemann
Keyword(s):  
Public Health ◽  
General Population ◽  
Problem Gambling ◽  
Homeless People ◽  
Severity Index ◽  
Homeless Persons ◽  
Health Concern ◽  
Homeless Population ◽  
Addictive Disorders ◽  
Prevention Programmes

Background: While homelessness and problem gambling are both recognised as social and public health concerns and the prevalence of addictive disorders among homeless populations tends to be high. These questions have been studied predominantly independently. Aim: The aim of the study was to explore the co-occurrence of the two phenomena among the homeless population using shelters and night shelters in Warsaw, and, more specifically, to provide information about the forms and frequency of gambling in this homeless population. Method: Homeless persons ( N = 690) were interviewed in rehabilitation-shelters ( n = 17) and night-shelters ( n = 2) in Warsaw from November 2015 until January 2016. The core component of the questionnaire was a screening test (Problem Gambling Severity Index). In addition, data regarding the intensity of gambling and various types of games or settings were collected. Results: The prevalence of problem gambling in this population of homeless people was 11.3%, whereas the prevalence of problem gambling in the general population in Poland is much lower (0.7%). Similarly to the general population, the most prevalent gambling games in the homeless population were lotteries; however, homeless people gambled in lotteries almost three times more often compared to the general population. Conclusions: This is the first study examining the prevalence of problem gambling in the homeless population in Poland. The findings of the study suggest that problem gambling among the homeless is a significant social and public health concern. High rates of problem gambling in the homeless population show the need to identify and monitor this problem in shelters and consequently to provide easier access to gambling treatment or prevention programmes.

The role of dissociation and abuse among adolescents who self-harm

2019 ◽  
Vol 53 (10) ◽  
pp. 989-999 ◽  
Author(s):  
Carlos Hoyos ◽  
Vincent Mancini ◽  
Yulia Furlong ◽  
Nick Medford ◽  
Hugo Critchley ◽  
...  
Keyword(s):  
Childhood Abuse ◽  
Comparison Group ◽  
Psychiatric Patients ◽  
Later Life ◽  
Structured Interviews ◽  
Emergency Presentation ◽  
Self Harm ◽  
And Gender ◽  
Matched Comparison

Objectives: Retrospective recall of dissociative symptoms has been found to mediate the association between childhood abuse and deliberate self-harm (DSH) in later life. To disentangle the effect of recall bias, we tested whether dissociation symptoms ascertained during an acute DSH presentation mediates this link. Method: All participants with DSH were recruited during emergency presentation. Seventy-one individuals aged 11–17 years with overdose (OD) and/or self-injury (SI) participated in semi-structured interviews and psychiatric assessment to measure abuse and dissociation. An age- and gender-matched comparison group of 42 non-psychiatric patients admitted to the same service were also assessed. Results: The DSH groups reported significantly higher levels of abuse and dissociation compared to comparison group. Dissociation significantly mediated the association between abuse and DSH. Of the four dissociation subtypes, ‘depersonalisation’ was the primary mediator. Adolescents with chronic patterns of DSH and the ‘OD + SI’ self-harm type reported more severe dissociation. Conclusion: Exposure to abuse significantly increased the risk of DSH in adolescence. This association was mediated by dissociation. Our findings suggest a possible dose–response relationship between dissociation with DSH chronicity and the ‘OD + SI’ self-harm type, implicating the importance of evaluating dissociation and depersonalisation symptoms as well as abuse exposure in DSH management.

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