Sample records for younger homeless adults

  1. Characteristics of Emergency Department Visits by Older Versus Younger Homeless Adults in the United States

    PubMed Central

    Steinman, Michael A.

    2013-01-01

    Objectives. We compared the characteristics of emergency department (ED) visits of older versus younger homeless adults. Methods. We analyzed 2005–2009 data from the National Hospital Ambulatory Medical Care Survey, a nationally representative survey of visits to hospitals and EDs, and used sampling weights, strata, and clustering variables to obtain nationally representative estimates. Results. The ED visits of homeless adults aged 50 years and older accounted for 36% of annual visits by homeless patients. Although demographic characteristics of ED visits were similar in older and younger homeless adults, clinical and health services characteristics differed. Older homeless adults had fewer discharge diagnoses related to psychiatric conditions (10% vs 20%; P = .002) and drug abuse (7% vs 15%; P = .003) but more diagnoses related to alcohol abuse (31% vs 23%; P = .03) and were more likely to arrive by ambulance (48% vs 36%; P = .02) and to be admitted to the hospital (20% vs 11%; P = .003). Conclusions. Older homeless adults’ patterns of ED care differ from those of younger homeless adults. Health care systems need to account for these differences to meet the needs of the aging homeless population. PMID:23597348

  2. Health Services Utilization between Older and Younger Homeless Adults.(author Abstract)

    ERIC Educational Resources Information Center

    Nakonezny, Paul A.; Ojeda, Michael

    2005-01-01

    Purpose: Our purpose in the current study was to examine the relationship between health services utilization delivered by means of the Homeless Outreach Medical Services (HOMES) program and health services utilization delivered by means of the Parkland emergency room and inpatient units among a sample of older and younger homeless adults being…

  3. Physical and Mental Health Issues among Homeless Youth in British Columbia, Canada: Are they Different from Older Homeless Adults?

    PubMed

    Saddichha, Sahoo; Linden, Isabelle; Krausz, Michael Reinhardt

    2014-09-01

    Youth homelessness is on the rise in North America, yet this vulnerable population is rarely studied and compared with adults. This paper aimed to study the homeless youth and identify specific vulnerabilities, which rendered them different from the adult homeless population. It also aimed to describe the youth homeless population and their significant co-morbidities. DATA WAS DERIVED FROM THE BC HEALTH OF THE HOMELESS STUDY (BCHOHS), CARRIED OUT IN THREE CITIES IN BRITISH COLUMBIA, CANADA: the large urban centre Vancouver (n=250); the mid-sized city and capital of the province Victoria (n=150). Measures included socio-demographic information, the Maudsley Addiction Profile (MAP), the Childhood Trauma Questionnaire (CTQ) and the Mini International Neuropsychiatric Interview (MINI) Plus. Youth constituted 16.5% (n=82) of the homeless population. Compared to the adult homeless, the homeless youth were more often female (55%), were Aboriginal (47.6%), had greater substance abuse of alcohol (70.7%), amphetamines (8.5%) and cannabis (75.6%). A lower prevalence of sexually transmitted diseases (0.2%) and psychotic disorders (13.4%) was also observed. The prevalence of traumatic experiences, other psychiatric disorders and physical illnesses were similar between the adult and homeless youth. Homeless youth have high rates of physical and psychiatric comorbidity, similar to the adult homeless, despite being 20 years younger. An urgent need for interventions that go beyond the standardized ones being offered to homeless populations as a whole, and to derive specific strategies that target this vulnerable population is required.

  4. Hepatitis A/B vaccine completion among homeless adults with history of incarceration.

    PubMed

    Nyamathi, Adeline M; Marlow, Elizabeth; Branson, Catherine; Marfisee, Mary; Nandy, Karabi

    2012-03-01

    Hepatitis B virus (HBV) vaccination rates for incarcerated adults remain low despite their high risk for infection. This study determined predictors of vaccine completion in homeless adults (N= 297) who reported histories of incarceration and who participated in one of three nurse-led hepatitis programs of different intensity. Moreover time since release from incarceration was also considered. Just over half of the former prisoners completed the vaccine series. Older age (≥40), having a partner, and chronic homelessness were associated with vaccine completion. Recent research has documented the difficulty in providing vaccine services to younger homeless persons and homeless males at risk for HBV. Additional strategies are needed to achieve HBV vaccination completion rates greater than 50% for formerly incarcerated homeless men. © 2012 International Association of Forensic Nurses.

  5. Residential patterns in older homeless adults: Results of a cluster analysis.

    PubMed

    Lee, Christopher Thomas; Guzman, David; Ponath, Claudia; Tieu, Lina; Riley, Elise; Kushel, Margot

    2016-03-01

    Adults aged 50 and older make up half of individuals experiencing homelessness and have high rates of morbidity and mortality. They may have different life trajectories and reside in different environments than do younger homeless adults. Although the environmental risks associated with homelessness are substantial, the environments in which older homeless individuals live have not been well characterized. We classified living environments and identified associated factors in a sample of older homeless adults. From July 2013 to June 2014, we recruited a community-based sample of 350 homeless men and women aged fifty and older in Oakland, California. We administered structured interviews including assessments of health, history of homelessness, social support, and life course. Participants used a recall procedure to describe where they stayed in the prior six months. We performed cluster analysis to classify residential venues and used multinomial logistic regression to identify individual factors prior to the onset of homelessness as well as the duration of unstable housing associated with living in them. We generated four residential groups describing those who were unsheltered (n = 162), cohabited unstably with friends and family (n = 57), resided in multiple institutional settings (shelters, jails, transitional housing) (n = 88), or lived primarily in rental housing (recently homeless) (n = 43). Compared to those who were unsheltered, having social support when last stably housed was significantly associated with cohabiting and institution use. Cohabiters and renters were significantly more likely to be women and have experienced a shorter duration of homelessness. Cohabiters were significantly more likely than unsheltered participants to have experienced abuse prior to losing stable housing. Pre-homeless social support appears to protect against street homelessness while low levels of social support may increase the risk for becoming homeless immediately after

  6. Pathways to Homelessness among Older Homeless Adults: Results from the HOPE HOME Study.

    PubMed

    Brown, Rebecca T; Goodman, Leah; Guzman, David; Tieu, Lina; Ponath, Claudia; Kushel, Margot B

    2016-01-01

    Little is known about pathways to homelessness among older adults. We identified life course experiences associated with earlier versus later onset of homelessness in older homeless adults and examined current health and functional status by age at first homelessness. We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling. Participants reported age at first episode of adult homelessness and their life experiences during 3 time periods: childhood (<18 years), young adulthood (ages 18-25), and middle adulthood (ages 26-49). We used a structured modeling approach to identify experiences associated with first adult homelessness before age 50 versus at age 50 or older. Participants reported current health and functional status, including recent mental health and substance use problems. Older homeless adults who first became homeless before 50 had more adverse life experiences (i.e., mental health and substance use problems, imprisonment) and lower attainment of adult milestones (i.e., marriage, full-time employment) compared to individuals with later onset. After multivariable adjustment, adverse experiences were independently associated with experiencing a first episode of homelessness before age 50. Individuals who first became homeless before age 50 had higher prevalence of recent mental health and substance use problems and more difficulty performing instrumental activities of daily living. Life course experiences and current vulnerabilities of older homeless adults with first homelessness before age 50 differed from those with later onset of homelessness. Prevention and service interventions should be adapted to meet different needs.

  7. Pathways to Homelessness among Older Homeless Adults: Results from the HOPE HOME Study

    PubMed Central

    Brown, Rebecca T.; Goodman, Leah; Guzman, David; Tieu, Lina; Ponath, Claudia; Kushel, Margot B.

    2016-01-01

    Little is known about pathways to homelessness among older adults. We identified life course experiences associated with earlier versus later onset of homelessness in older homeless adults and examined current health and functional status by age at first homelessness. We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling. Participants reported age at first episode of adult homelessness and their life experiences during 3 time periods: childhood (<18 years), young adulthood (ages 18–25), and middle adulthood (ages 26–49). We used a structured modeling approach to identify experiences associated with first adult homelessness before age 50 versus at age 50 or older. Participants reported current health and functional status, including recent mental health and substance use problems. Older homeless adults who first became homeless before 50 had more adverse life experiences (i.e., mental health and substance use problems, imprisonment) and lower attainment of adult milestones (i.e., marriage, full-time employment) compared to individuals with later onset. After multivariable adjustment, adverse experiences were independently associated with experiencing a first episode of homelessness before age 50. Individuals who first became homeless before age 50 had higher prevalence of recent mental health and substance use problems and more difficulty performing instrumental activities of daily living. Life course experiences and current vulnerabilities of older homeless adults with first homelessness before age 50 differed from those with later onset of homelessness. Prevention and service interventions should be adapted to meet different needs. PMID:27163478

  8. Psychological distress among homeless adults.

    PubMed

    Gelberg, L; Linn, L S

    1989-05-01

    Recent studies have reported a high prevalence of mental illness among the homeless. As part of a community-based survey of 529 homeless adults, we developed and tested a model to increase our understanding of the factors related to their psychological distress. Using a previously validated and reliable scale of perceived psychological distress, we found that homeless adults were more likely to report psychological distress than the general population (80% vs. 49%). Distress levels were not associated with most demographic or homeless characteristics or general appearance. However, distress was related to unemployment, greater cigarette and alcohol use, worse physical health, fewer social supports, and perceived barriers to obtaining needed medical care. Since mental, physical, and social health are strongly related among homeless adults, alleviating distress among them may be most effectively done by implementing a broad-based health services package coupled with employment programs provided in an accessible service delivery setting.

  9. Art messaging to engage homeless young adults.

    PubMed

    Nyamathi, Adeline; Slagle, Alexandra; Thomas, Alexandra; Hudson, Angela; Kahilifard, Farinaz; Avila, Glenna; Orser, Julie; Cuchilla, Manuel

    2011-01-01

    Art has been shown to be an empowering and engaging entity with numerous benefits to vulnerable populations, including the homeless persons and young adults. However, little is known how homeless young adults perceive the use of art as messages that can communicate the danger of initiating or continuing drug and alcohol use. The purpose of this study was to solicit perspectives of homeless, drug-using young adults as to how art can be used to design messages for their peers about the danger of initiating or continuing drug and alcohol use. Qualitative methodology via focus group discussions was utilized to engage 24 homeless young adults enrolled from a drop-in site in Santa Monica, California. The findings revealed support for a myriad of delivery styles, including in-person communication, flyers, music, documentary film, and creative writing. The young adults also provided insight into the importance of the thematic framework of messages. Such themes ranged from empowering and hopeful messages to those designed to scare young homeless adults into not experimenting with drugs. The findings indicate that in addition to messages communicating the need to prevent or reduce drug and alcohol use, homeless young adults respond to messages that remind them of goals and dreams they once had for their future, and to content that is personal, real, and truthful. Our research indicates that messages that reinforce protective factors such as hope for the future and self-esteem may be as important to homeless young adults as information about the risks and consequences of drug use.

  10. The health encounter as a treatable moment for homeless substance-using adults: the role of homelessness, health seeking behavior, readiness for behavior change and motivation for treatment.

    PubMed

    O'Toole, Thomas P; Pollini, Robin A; Ford, Daniel E; Bigelow, George

    2008-09-01

    Substance-using homeless persons frequent emergency departments and hospitals often. However, little is known about how homelessness affects when they seek care and their motivation for substance abuse treatment (SAT). We surveyed homeless (N=266) and non-homeless (N=104) substance-using adults sequentially admitted to an urban hospital medicine service, comparing demographics, readiness for change (URICA), and motivating reasons for SAT. Homeless respondents were more likely to be younger, uninsured, have hepatitis B/C, and <12th grade education. The majority in both groups were in either a precontemplative or contemplative stage of change, although more homeless respondents were in an action stage. They also had similar motivating reasons for wanting SAT, although being homeless was an additional motivator for the majority of homeless respondents. Almost half reported that being homeless caused them to delay seeking health care; paradoxically those citing physical health as a SAT motivator were 3.4 times more likely to have delayed care. While acutely ill homeless persons were at least as motivated for SAT, these data suggest the challenge is getting them to care in a timely manner and tailoring interventions during the care episode to avail of this motivation.

  11. Mental Health, Substance Abuse, and Suicide Among Homeless Adults.

    PubMed

    Lee, Kyoung Hag; Jun, Jung Sim; Kim, Yi Jin; Roh, Soonhee; Moon, Sung Seek; Bukonda, Ngoyi; Hines, Lisa

    2017-01-01

    This study explored the role of mental health and substance abuse problems on the suicidal ideation and suicide attempts of 156 homeless adults. The logistic regression results indicated that homeless adults with anxiety were significantly more likely than those without anxiety to have both suicidal ideation and suicide attempts. Also, homeless adults with drug abuse were significantly more likely than those without drug abuse to have suicidal ideation. The study suggests that to reduce the suicide of the homeless, case managers need to screen mental health and substance abuse issues and to provide appropriate treatment services at homeless shelters.

  12. Predictors of Transience among Homeless Emerging Adults

    ERIC Educational Resources Information Center

    Ferguson, Kristin M.; Bender, Kimberly; Thompson, Sanna J.

    2014-01-01

    This study identified predictors of transience among homeless emerging adults in three cities. A total of 601 homeless emerging adults from Los Angeles, Austin, and Denver were recruited using purposive sampling. Ordinary least squares regression results revealed that significant predictors of greater transience include White ethnicity, high…

  13. Education for Homeless Adults: Strategies for Implementation.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Office of Workplace Preparation and Continuing Education.

    This instructional guide is intended for use by adult education teachers who deal with homeless students either on an occasional or an exclusive basis. An introduction defines homelessness, describes how education can help, and offers a mission statement. The second section focuses on what teachers of the homeless need. It defines categories of…

  14. A Review of the Literature on LGBTQ Adults Who Experience Homelessness.

    PubMed

    Ecker, John; Aubry, Tim; Sylvestre, John

    2017-12-05

    Little is known about lesbian, gay, bisexual, transgender, and queer (LGBTQ) adults who experience homelessness. The current review critically analyzes the scant literature on LGBTQ adults who experience homelessness, with a particular focus on: (1) pathways into homelessness; (2) support needs; (3) targeted programming; and (4) exits out of homelessness. A total of 143 articles were identified, and 16 articles met the criteria of appropriate age range, article quality, and relevance of topic. Results from this review demonstrate that homeless LGBTQ adults have unique physical and mental health challenges, largely concerning HIV and substance use. Transgender and gender non-conforming adults who experience homelessness encounter several challenges in the homelessness system, particularly in regard to safety and gender-affirming supports. Recommendations focus on practical implications for support and suggestions for future research.

  15. A typology of childhood problems among chronically homeless adults and its association with housing and clinical outcomes.

    PubMed

    Tsai, Jack; Edens, Ellen L; Rosenheck, Robert A

    2011-08-01

    Studies of chronically homeless adults have not adequately investigated the impact of adverse childhood experiences. The current retrospective, longitudinal study profiles the childhood experiences reported by 738 participants in an 11-site supported housing initiative and examines how their childhood profile is related to their homeless history, their psychosocial status before entry into supported housing, and their outcomes once enrolled in supported housing. A two-step cluster analysis revealed three childhood profiles: Relatively Numerous Childhood Problems, Disrupted Family, and Relatively Few Childhood Problems. Results found that participants with Relatively Numerous Childhood Problems were significantly younger when they were first homeless and had worse drug use before entry into supported housing than other participants. There were no differences in housing, substance use, or mental and physical health outcomes once participants were enrolled in supported housing. Prevention of homelessness should focus, to the extent possible, on individuals with extensive childhood problems.

  16. Adult Education for the Homeless: A Program in Jeopardy.

    ERIC Educational Resources Information Center

    Office of Vocational and Adult Education (ED), Washington, DC. Div. of Adult Education and Literacy.

    During its 8-year history, the federal Adult Education for the Homeless Program (AEH) pioneered new methods of service to adults in need and benefited over 320,000 homeless adults and families. Despite an evaluation that documented program success, funding was rescinded from the 1995 federal budget and never reinstated. AEH programs developed the…

  17. The effects of the therapeutic workplace and heavy alcohol use on homelessness among homeless alcohol-dependent adults.

    PubMed

    Carlson, Emily; Holtyn, August F; Fingerhood, Michael; Friedman-Wheeler, Dara; Leoutsakos, Jeannie-Marie S; Silverman, Kenneth

    2016-11-01

    A clinical trial demonstrated that a therapeutic workplace could promote alcohol abstinence in homeless, alcohol-dependent adults. This secondary-data analysis examined rates of homelessness and their relation to the therapeutic workplace intervention and alcohol use during the trial. In the trial, homeless, alcohol-dependent adults could work in a therapeutic workplace for 6 months and were randomly assigned to Unpaid Training, Paid Training, or Contingent Paid Training groups. Unpaid Training participants were not paid for working. Paid Training participants were paid for working. Contingent Paid Training participants were paid for working if they provided alcohol-negative breath samples. Rates of homelessness during the study were calculated for each participant and the three groups were compared. Mixed-effects regression models were conducted to examine the relation between alcohol use (i.e., heavy drinking, drinks per drinking day, and days of alcohol abstinence) and homelessness. Unpaid Training, Paid Training, and Contingent Paid Training participants did not differ in the percentage of study days spent homeless (31%, 28%, 17%; respectively; F(2,94)=1.732, p=0.183). However, participants with more heavy drinking days (b=0.350, p<0.001), more drinks per drinking day (b=0.267, p<0.001), and fewer days of alcohol abstinence (b=-0.285, p<0.001) spent more time homeless. Reducing heavy drinking and alcohol use may help homeless, alcohol-dependent adults transition out of homelessness. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Health Outcomes of Obtaining Housing Among Older Homeless Adults.

    PubMed

    Brown, Rebecca T; Miao, Yinghui; Mitchell, Susan L; Bharel, Monica; Patel, Mitkumar; Ard, Kevin L; Grande, Laura J; Blazey-Martin, Deborah; Floru, Daniella; Steinman, Michael A

    2015-07-01

    We determined the impact of obtaining housing on geriatric conditions and acute care utilization among older homeless adults. We conducted a 12-month prospective cohort study of 250 older homeless adults recruited from shelters in Boston, Massachusetts, between January and June 2010. We determined housing status at follow-up, determined number of emergency department visits and hospitalizations over 12 months, and examined 4 measures of geriatric conditions at baseline and 12 months. Using multivariable regression models, we evaluated the association between obtaining housing and our outcomes of interest. At 12-month follow-up, 41% of participants had obtained housing. Compared with participants who remained homeless, those with housing had fewer depressive symptoms. Other measures of health status did not differ by housing status. Participants who obtained housing had a lower rate of acute care use, with an adjusted annualized rate of acute care visits of 2.5 per year among participants who obtained housing and 5.3 per year among participants who remained homeless. Older homeless adults who obtained housing experienced improved depressive symptoms and reduced acute care utilization compared with those who remained homeless.

  19. Health Outcomes of Obtaining Housing Among Older Homeless Adults

    PubMed Central

    Miao, Yinghui; Mitchell, Susan L.; Bharel, Monica; Patel, Mitkumar; Ard, Kevin L.; Grande, Laura J.; Blazey-Martin, Deborah; Floru, Daniella; Steinman, Michael A.

    2015-01-01

    Objectives. We determined the impact of obtaining housing on geriatric conditions and acute care utilization among older homeless adults. Methods. We conducted a 12-month prospective cohort study of 250 older homeless adults recruited from shelters in Boston, Massachusetts, between January and June 2010. We determined housing status at follow-up, determined number of emergency department visits and hospitalizations over 12 months, and examined 4 measures of geriatric conditions at baseline and 12 months. Using multivariable regression models, we evaluated the association between obtaining housing and our outcomes of interest. Results. At 12-month follow-up, 41% of participants had obtained housing. Compared with participants who remained homeless, those with housing had fewer depressive symptoms. Other measures of health status did not differ by housing status. Participants who obtained housing had a lower rate of acute care use, with an adjusted annualized rate of acute care visits of 2.5 per year among participants who obtained housing and 5.3 per year among participants who remained homeless. Conclusions. Older homeless adults who obtained housing experienced improved depressive symptoms and reduced acute care utilization compared with those who remained homeless. PMID:25973822

  20. Geriatric Conditions in a Population-Based Sample of Older Homeless Adults.

    PubMed

    Brown, Rebecca T; Hemati, Kaveh; Riley, Elise D; Lee, Christopher T; Ponath, Claudia; Tieu, Lina; Guzman, David; Kushel, Margot B

    2017-08-01

    Older homeless adults living in shelters have high rates of geriatric conditions, which may increase their risk for acute care use and nursing home placement. However, a minority of homeless adults stay in shelters and the prevalence of geriatric conditions among homeless adults living in other environments is unknown. We determined the prevalence of common geriatric conditions in a cohort of older homeless adults, and whether the prevalence of these conditions differs across living environments. We interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling in Oakland, CA. We evaluated participants for common geriatric conditions. We assessed living environment using a 6-month follow-back residential calendar, and used cluster analysis to identify participants' primary living environment over the prior 6 months. Participants stayed in 4 primary environments: unsheltered locations (n = 162), multiple locations including shelters and hotels (n = 88), intermittently with family/friends (n = 57), and, in a recently homeless group, rental housing (n = 43). Overall, 38.9% of participants reported difficulty performing 1 or more activities of daily living, 33.7% reported any falls in the past 6 months, 25.8% had cognitive impairment, 45.1% had vision impairment, and 48.0% screened positive for urinary incontinence. The prevalence of geriatric conditions did not differ significantly across living environments. Geriatric conditions were common among older homeless adults living in diverse environments, and the prevalence of these conditions was higher than that seen in housed adults 20 years older. Services that address geriatric conditions are needed for older homeless adults living across varied environments. Published by Oxford University Press on behalf of the Gerontological Society of America 2016.

  1. Aging on the Street: Homeless Older Adults in America.

    PubMed

    Sorrell, Jeanne M

    2016-09-01

    Older adults are at greater risk for homelessness today than at any time in recent history. Approximately one half of homeless individuals in America are older than 50, which has created serious challenges for how cities, governments, and health care providers care for homeless populations. Systems established in the 1980s to help care for homeless individuals were not designed to address problems of aging. It is critical that nurses and all health professionals have a better understanding of the unique needs and concerns of homeless older adults. Nurses can be an important part of the solution, not only through direct patient care but by advocating for improvements in care for this vulnerable population. [Journal of Psychosocial Nursing and Mental Health Services, 54(9), 25-29.]. Copyright 2016, SLACK Incorporated.

  2. 34 CFR 491.1 - What is the Adult Education for the Homeless Program?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 3 2012-07-01 2012-07-01 false What is the Adult Education for the Homeless Program...) OFFICE OF VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION ADULT EDUCATION FOR THE HOMELESS PROGRAM General § 491.1 What is the Adult Education for the Homeless Program? The Adult Education for the...

  3. 34 CFR 491.1 - What is the Adult Education for the Homeless Program?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 3 2011-07-01 2011-07-01 false What is the Adult Education for the Homeless Program...) OFFICE OF VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION ADULT EDUCATION FOR THE HOMELESS PROGRAM General § 491.1 What is the Adult Education for the Homeless Program? The Adult Education for the...

  4. 34 CFR 491.1 - What is the Adult Education for the Homeless Program?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false What is the Adult Education for the Homeless Program...) OFFICE OF VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION ADULT EDUCATION FOR THE HOMELESS PROGRAM General § 491.1 What is the Adult Education for the Homeless Program? The Adult Education for the...

  5. 34 CFR 491.1 - What is the Adult Education for the Homeless Program?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 3 2013-07-01 2013-07-01 false What is the Adult Education for the Homeless Program...) OFFICE OF VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION ADULT EDUCATION FOR THE HOMELESS PROGRAM General § 491.1 What is the Adult Education for the Homeless Program? The Adult Education for the...

  6. 34 CFR 491.1 - What is the Adult Education for the Homeless Program?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 3 2014-07-01 2014-07-01 false What is the Adult Education for the Homeless Program...) OFFICE OF VOCATIONAL AND ADULT EDUCATION, DEPARTMENT OF EDUCATION ADULT EDUCATION FOR THE HOMELESS PROGRAM General § 491.1 What is the Adult Education for the Homeless Program? The Adult Education for the...

  7. Health insurance coverage and healthcare utilization among homeless young adults in Venice, CA

    PubMed Central

    Winetrobe, H.; Rice, E.; Rhoades, H.; Milburn, N.

    2016-01-01

    Background Homeless young adults are a vulnerable population with great healthcare needs. Under the Affordable Care Act, homeless young adults are eligible for Medicaid, in some states, including California. This study assesses homeless young adults' health insurance coverage and healthcare utilization prior to Medicaid expansion. Methods All homeless young adults accessing services at a drop-in center in Venice, CA, were invited to complete a self-administered questionnaire; 70% of eligible clients participated (n = 125). Results Within this majority White, heterosexual, male sample, 70% of homeless young adults did not have health insurance in the prior year, and 39% reported their last healthcare visit was at an emergency room. Past year unmet healthcare needs were reported by 31%, and financial cost was the main reported barrier to receiving care. Multivariable logistic regression found that homeless young adults with health insurance were almost 11 times more likely to report past year healthcare utilization. Conclusions Health insurance coverage is the sole variable significantly associated with healthcare utilization among homeless young adults, underlining the importance of insurance coverage within this vulnerable population. Service providers can play an important role by assisting homeless young adults with insurance applications and facilitating connections with regular sources of health care. PMID:25635142

  8. Health insurance coverage and healthcare utilization among homeless young adults in Venice, CA.

    PubMed

    Winetrobe, H; Rice, E; Rhoades, H; Milburn, N

    2016-03-01

    Homeless young adults are a vulnerable population with great healthcare needs. Under the Affordable Care Act, homeless young adults are eligible for Medicaid, in some states, including California. This study assesses homeless young adults' health insurance coverage and healthcare utilization prior to Medicaid expansion. All homeless young adults accessing services at a drop-in center in Venice, CA, were invited to complete a self-administered questionnaire; 70% of eligible clients participated (n = 125). Within this majority White, heterosexual, male sample, 70% of homeless young adults did not have health insurance in the prior year, and 39% reported their last healthcare visit was at an emergency room. Past year unmet healthcare needs were reported by 31%, and financial cost was the main reported barrier to receiving care. Multivariable logistic regression found that homeless young adults with health insurance were almost 11 times more likely to report past year healthcare utilization. Health insurance coverage is the sole variable significantly associated with healthcare utilization among homeless young adults, underlining the importance of insurance coverage within this vulnerable population. Service providers can play an important role by assisting homeless young adults with insurance applications and facilitating connections with regular sources of health care. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Universal health insurance and health care access for homeless persons.

    PubMed

    Hwang, Stephen W; Ueng, Joanna J M; Chiu, Shirley; Kiss, Alex; Tolomiczenko, George; Cowan, Laura; Levinson, Wendy; Redelmeier, Donald A

    2010-08-01

    We examined the extent of unmet needs and barriers to accessing health care among homeless people within a universal health insurance system. We randomly selected a representative sample of 1169 homeless individuals at shelters and meal programs in Toronto, Ontario. We determined the prevalence of self-reported unmet needs for health care in the past 12 months and used regression analyses to identify factors associated with unmet needs. Unmet health care needs were reported by 17% of participants. Compared with Toronto's general population, unmet needs were significantly more common among homeless individuals, particularly among homeless women with dependent children. Factors independently associated with a greater likelihood of unmet needs were younger age, having been a victim of physical assault in the past 12 months, and lower mental and physical health scores on the 12-Item Short Form Health Survey. Within a system of universal health insurance, homeless people still encounter barriers to obtaining health care. Strategies to reduce nonfinancial barriers faced by homeless women with children, younger adults, and recent victims of physical assault should be explored.

  10. Universal Health Insurance and Health Care Access for Homeless Persons

    PubMed Central

    Ueng, Joanna J. M.; Chiu, Shirley; Kiss, Alex; Tolomiczenko, George; Cowan, Laura; Levinson, Wendy; Redelmeier, Donald A.

    2010-01-01

    Objectives. We examined the extent of unmet needs and barriers to accessing health care among homeless people within a universal health insurance system. Methods. We randomly selected a representative sample of 1169 homeless individuals at shelters and meal programs in Toronto, Ontario. We determined the prevalence of self-reported unmet needs for health care in the past 12 months and used regression analyses to identify factors associated with unmet needs. Results. Unmet health care needs were reported by 17% of participants. Compared with Toronto's general population, unmet needs were significantly more common among homeless individuals, particularly among homeless women with dependent children. Factors independently associated with a greater likelihood of unmet needs were younger age, having been a victim of physical assault in the past 12 months, and lower mental and physical health scores on the 12-Item Short Form Health Survey. Conclusions. Within a system of universal health insurance, homeless people still encounter barriers to obtaining health care. Strategies to reduce nonfinancial barriers faced by homeless women with children, younger adults, and recent victims of physical assault should be explored. PMID:20558789

  11. Mortality Among Homeless Adults in Boston: Shifts in Causes of Death Over a 15-year Period

    PubMed Central

    Baggett, Travis P.; Hwang, Stephen W.; O'Connell, James J.; Porneala, Bianca C.; Stringfellow, Erin J.; Orav, E. John; Singer, Daniel E.; Rigotti, Nancy A.

    2013-01-01

    Background Homeless persons experience excess mortality, but U.S.-based studies on this topic are outdated or lack information about causes of death. No studies have examined shifts in causes of death for this population over time. Methods We assessed all-cause and cause-specific mortality rates in a cohort of 28,033 adults aged 18 years or older who were seen at Boston Health Care for the Homeless Program between January 1, 2003, and December 31, 2008. Deaths were identified through probabilistic linkage to the Massachusetts death occurrence files. We compared mortality rates in this cohort to rates in the 2003–08 Massachusetts population and a 1988–93 cohort of homeless adults in Boston using standardized rate ratios with 95% confidence intervals. Results 1,302 deaths occurred during 90,450 person-years of observation. Drug overdose (n=219), cancer (n=206), and heart disease (n=203) were the major causes of death. Drug overdose accounted for one-third of deaths among adults <45 years old. Opioids were implicated in 81% of overdose deaths. Mortality rates were higher among whites than non-whites. Compared to Massachusetts adults, mortality disparities were most pronounced among younger individuals, with rates about 9-fold higher in 25–44 year olds and 4.5-fold higher in 45–64 year olds. In comparison to 1988–93, reductions in HIV deaths were offset by 3- and 2-fold increases in deaths due to drug overdose and psychoactive substance use disorders, resulting in no significant difference in overall mortality. Conclusions The all-cause mortality rate among homeless adults in Boston remains high and unchanged since 1988–93 despite a major interim expansion in clinical services. Drug overdose has replaced HIV as the emerging epidemic. Interventions to reduce mortality in this population should include behavioral health integration into primary medical care, public health initiatives to prevent and reverse drug overdose, and social policy measures to end

  12. Perceptions of Resiliency and Coping: Homeless Young Adults Speak Out

    ERIC Educational Resources Information Center

    Thompson, Sanna J.; Ryan, Tiffany N.; Montgomery, Katherine L.; Lippman, Angie Del Prado; Bender, Kimberly; Ferguson, Kristin

    2016-01-01

    This study explored the perceptions of resilience and coping among homeless young adults, a focus that differs from previous research by considering the unconventional resilience and coping of this high-risk population. Semistructured qualitative interviews were conducted with 45 homeless young adults. Individual interviews were audio recorded,…

  13. Community-Level Characteristics Associated With Variation in Rates of Homelessness Among Families and Single Adults

    PubMed Central

    Fargo, Jamison D.; Munley, Ellen A.; Byrne, Thomas H.; Montgomery, Ann Elizabeth; Culhane, Dennis P.

    2013-01-01

    Objectives. We modeled rates of family and single-adult homelessness in the United States in metropolitan and nonmetropolitan regions and as a function of community-level demographic, behavioral, health, economic, and safety net characteristics. Methods. We entered community-level characteristics and US Department of Housing and Urban Development point-in-time counts for a single night in January 2009 into separate mixed-effects statistical analyses that modeled homelessness rates for 4 subpopulations: families and single adults in metropolitan and nonmetropolitan regions. Results. Community-level factors accounted for 25% to 50% of the variance in homelessness rates across models. In metropolitan regions, alcohol consumption, social support, and several economic indicators were uniquely associated with family homelessness, and drug use and homicide were uniquely associated with single-adult homelessness. In nonmetropolitan regions, life expectancy, religious adherence, unemployment, and rent burden were uniquely associated with family homelessness, and health care access, crime, several economic indicators, and receipt of Supplemental Security Income were uniquely associated with single-adult homelessness. Conclusions. Considering homeless families and single adults separately enabled more precise modeling of associations between homelessness rates and community-level characteristics, indicating targets for interventions to reduce homelessness among these subpopulations. PMID:24148057

  14. Community-level characteristics associated with variation in rates of homelessness among families and single adults.

    PubMed

    Fargo, Jamison D; Munley, Ellen A; Byrne, Thomas H; Montgomery, Ann Elizabeth; Culhane, Dennis P

    2013-12-01

    We modeled rates of family and single-adult homelessness in the United States in metropolitan and nonmetropolitan regions and as a function of community-level demographic, behavioral, health, economic, and safety net characteristics. We entered community-level characteristics and US Department of Housing and Urban Development point-in-time counts for a single night in January 2009 into separate mixed-effects statistical analyses that modeled homelessness rates for 4 subpopulations: families and single adults in metropolitan and nonmetropolitan regions. Community-level factors accounted for 25% to 50% of the variance in homelessness rates across models. In metropolitan regions, alcohol consumption, social support, and several economic indicators were uniquely associated with family homelessness, and drug use and homicide were uniquely associated with single-adult homelessness. In nonmetropolitan regions, life expectancy, religious adherence, unemployment, and rent burden were uniquely associated with family homelessness, and health care access, crime, several economic indicators, and receipt of Supplemental Security Income were uniquely associated with single-adult homelessness. Considering homeless families and single adults separately enabled more precise modeling of associations between homelessness rates and community-level characteristics, indicating targets for interventions to reduce homelessness among these subpopulations.

  15. Adapting the Individual Placement and Support Model with Homeless Young Adults

    ERIC Educational Resources Information Center

    Ferguson, Kristin M.; Xie, Bin; Glynn, Shirley

    2012-01-01

    Background: Prior research reveals high unemployment rates among homeless young adults. The literature offers many examples of using evidence-based supported employment models with vulnerable populations to assist them in obtaining and maintaining competitive employment; yet few examples exist to date with homeless young adults with mental…

  16. Meeting the Housing and Care Needs of Older Homeless Adults: A Permanent Supportive Housing Program Targeting Homeless Elders.

    PubMed

    Brown, Rebecca T; Thomas, M Lori; Cutler, Deborah F; Hinderlie, Mark

    2013-01-01

    The homeless population is aging faster than the general population in the United States. As this vulnerable population continues to age, addressing complex care and housing needs will become increasingly important. This article reviews the often-overlooked issue of homelessness among older adults, including their poor health status and unique care needs, the factors that contribute to homelessness in this population, and the costs of homelessness to the U.S. health care system. Permanent supportive housing programs are presented as a potential solution to elder homelessness, and Hearth, an outreach and permanent supportive housing model in Boston, is described. Finally, specific policy changes are presented that could promote access to housing among the growing older homeless population.

  17. Meeting the Housing and Care Needs of Older Homeless Adults: A Permanent Supportive Housing Program Targeting Homeless Elders

    PubMed Central

    Brown, Rebecca T.; Thomas, M. Lori; Cutler, Deborah F.; Hinderlie, Mark

    2014-01-01

    The homeless population is aging faster than the general population in the United States. As this vulnerable population continues to age, addressing complex care and housing needs will become increasingly important. This article reviews the often-overlooked issue of homelessness among older adults, including their poor health status and unique care needs, the factors that contribute to homelessness in this population, and the costs of homelessness to the U.S. health care system. Permanent supportive housing programs are presented as a potential solution to elder homelessness, and Hearth, an outreach and permanent supportive housing model in Boston, is described. Finally, specific policy changes are presented that could promote access to housing among the growing older homeless population. PMID:24729832

  18. Conceptualizing Social Integration among Formerly Homeless Adults with Severe Mental Illness

    ERIC Educational Resources Information Center

    Tsai, Jack; Rosenheck, Robert A.

    2012-01-01

    The multiple dimensions of social integration among formerly homeless adults with severe mental illness have not been well-studied. Previous studies have focused on clinical measures or narrow components of social integration. We used a multisite study of chronically homeless adults who were provided housing to (a) identify the main factors…

  19. The Unmet Health Care Needs of Homeless Adults: A National Study

    PubMed Central

    O'Connell, James J.; Singer, Daniel E.; Rigotti, Nancy A.

    2010-01-01

    Objectives. We assessed the prevalence and predictors of past-year unmet needs for 5 types of health care services in a national sample of homeless adults. Methods. We analyzed data from 966 adult respondents to the 2003 Health Care for the Homeless User Survey, a sample representing more than 436 000 individuals nationally. Using multivariable logistic regression, we determined the independent predictors of each type of unmet need. Results. Seventy-three percent of the respondents reported at least one unmet health need, including an inability to obtain needed medical or surgical care (32%), prescription medications (36%), mental health care (21%), eyeglasses (41%), and dental care (41%). In multivariable analyses, significant predictors of unmet needs included food insufficiency, out-of-home placement as a minor, vision impairment, and lack of health insurance. Individuals who had been employed in the past year were more likely than those who had not to be uninsured and to have unmet needs for medical care and prescription medications. Conclusions. This national sample of homeless adults reported substantial unmet needs for multiple types of health care. Expansion of health insurance may improve health care access for homeless adults, but addressing the unique challenges inherent to homelessness will also be required. PMID:20466953

  20. Food Insecurity among Homeless Adults with Mental Illness

    PubMed Central

    Parpouchi, Milad; Moniruzzaman, Akm; Russolillo, Angela; Somers, Julian M.

    2016-01-01

    Background The prevalence of food insecurity and food insufficiency is high among homeless people. We investigated the prevalence and correlates of food insecurity among a cohort of homeless adults with mental illness in Vancouver, British Columbia, Canada. Methods Data collected from baseline questionnaires in the Vancouver At Home study were analysed to calculate the prevalence of food insecurity within the sample (n = 421). A modified version of the U.S. Department of Agriculture’s Adult Food Security Survey Module was used to ascertain food insecurity. Univariable and multivariable logistic regression were used to examine potential correlates of food insecurity. Results The prevalence of food insecurity was 64%. In the multivariable model, food insecurity was significantly associated with age (adjusted odds ratio [aOR] = 0.97; 95% CI: 0.95–0.99), less than high school completion (aOR = 0.57; 95% CI: 0.35–0.93), needing health care but not receiving it (aOR = 1.65; 95% CI: 1.00–2.72), subjective mental health (aOR = 0.97; 95% CI: 0.96–0.99), having spent over $500 for drugs and alcohol in the past month (aOR = 2.25; 95% CI: 1.16–4.36), HIV/AIDS (aOR = 4.20; 95% CI: 1.36–12.96), heart disease (aOR = 0.39; 95% CI: 0.16–0.97) and having gone to a drop-in centre, community meal centre or program/food bank (aOR = 1.65; 95% CI: 1.01–2.68). Conclusions The prevalence of food insecurity was extremely high in a cohort with longstanding homelessness and serious mental illness. Younger age, needing health care but not receiving it, poorer subjective mental health, having spent over $500 for drugs and alcohol in the past month, HIV/AIDS and having gone to a drop-in centre, community meal centre or program/food bank each increased odds of food insecurity, while less than high school completion and heart disease each decreased odds of food insecurity. Interventions to reduce food insecurity in this population are urgently needed. PMID:27437937

  1. Examining mortality among formerly homeless adults enrolled in Housing First: An observational study.

    PubMed

    Henwood, Benjamin F; Byrne, Thomas; Scriber, Brynn

    2015-12-04

    Adults who experience prolonged homelessness have mortality rates 3 to 4 times that of the general population. Housing First (HF) is an evidence-based practice that effectively ends chronic homelessness, yet there has been virtually no research on premature mortality among HF enrollees. In the United States, this gap in the literature exists despite research that has suggested chronically homeless adults constitute an aging cohort, with nearly half aged 50 years old or older. This observational study examined mortality among formerly homeless adults in an HF program. We examined death rates and causes of death among HF participants and assessed the timing and predictors of death among HF participants following entry into housing. We also compared mortality rates between HF participants and (a) members of the general population and (b) individuals experiencing homelessness. We supplemented these analyses with a comparison of the causes of death and characteristics of decedents in the HF program with a sample of adults identified as homeless in the same city at the time of death through a formal review process. The majority of decedents in both groups were between the ages of 45 and 64 at their time of death; the average age at death for HF participants was 57, compared to 53 for individuals in the homeless sample. Among those in the HF group, 72% died from natural causes, compared to 49% from the homeless group. This included 21% of HF participants and 7% from the homeless group who died from cancer. Among homeless adults, 40% died from an accident, which was significantly more than the 14% of HF participants who died from an accident. HIV or other infectious diseases contributed to 13% of homeless deaths compared to only 2% of HF participants. Hypothermia contributed to 6% of homeless deaths, which was not a cause of death for HF participants. Results suggest HF participants face excess mortality in comparison to members of the general population and that mortality

  2. Perceived racial, sexual identity, and homeless status-related discrimination among Black adolescents and young adults experiencing homelessness: Relations with depressive symptoms and suicidality.

    PubMed

    Gattis, Maurice N; Larson, Andrea

    2016-01-01

    There is a dearth of empirical evidence that addresses how racial minority, sexual minority, and homeless statuses, with their accompanying experiences of stigma and discrimination, are related to mental health in adolescent and young adult populations. The current study addresses this gap by examining the associations between multiple forms of discrimination, depressive symptoms, and suicidality in a sample of 89 Black adolescents and young adults (52% female; 47% nonheterosexual, ages 16-24) experiencing homelessness. Results from a series of ordinary least squares and logistic regressions suggested that perceived homelessness stigma and racial discrimination were associated with higher levels of depressive symptoms, controlling for gender, age, and other types of discrimination, while perceived sexual identity discrimination showed no association. Having ever spent a homeless night on the street, an indicator of homelessness severity, accounted for a substantial amount of the association between homelessness stigma and depressive symptoms. In contrast, suicidality was not significantly associated with any measure of discrimination, homelessness severity, or personal characteristics. We also found no indication that the associations between perceived discrimination targeted at racial and homelessness statuses and mental health differed by sexual minority status. Our results suggest that depressive symptoms and suicidality are prevalent among Black homeless youth, and that depressive symptoms are particularly associated with racial discrimination and indicators of homelessness. The roles of discrimination and a lack of safe housing may be taken into account when designing programs and policies that address the mental health of Black adolescents and young adults experiencing homelessness. (c) 2016 APA, all rights reserved).

  3. Predictors of homeless services re-entry within a sample of adults receiving Homelessness Prevention and Rapid Re-Housing Program (HPRP) assistance.

    PubMed

    Brown, Molly; Vaclavik, Danielle; Watson, Dennis P; Wilka, Eric

    2017-05-01

    Local and national evaluations of the federal Homelessness Prevention and Rapid Re-Housing Program (HPRP) have demonstrated a high rate of placement of program participants in permanent housing. However, there is a paucity of research on the long-term outcomes of HPRP, and research on rehousing and prevention interventions for single adults experiencing homelessness is particularly limited. Using Homeless Management Information System data from 2009 to 2015, this study examined risk of return to homeless services among 370 permanently housed and 71 nonpermanently housed single adult HPRP participants in Indianapolis, Indiana. Kaplan-Meier survival curves were conducted to analyze time-to-service re-entry for the full sample, and the homelessness prevention and rapid rehousing participants separately. With an average follow-up of 4.5 years after HPRP exit, 9.5% of the permanently housed HPRP participants and 16.9% of those nonpermanently housed returned to homeless services. By assistance type, 5.4% of permanently housed and 15.8% of nonpermanently housed homelessness prevention recipients re-entered services, and 12.8% of permanently housed and 18.2% of nonpermanently housed rapid rehousing recipients re-entered during the follow-up period. Overall, veterans, individuals receiving rapid rehousing services, and those whose income did not increase during HPRP had significantly greater risk of returning to homeless services. Veterans were at significantly greater risk of re-entry when prevention and rehousing were examined separately. Findings suggest a need for future controlled studies of prevention and rehousing interventions for single adults, aiming to identify unique service needs among veterans and those currently experiencing homelessness in need of rehousing to inform program refinement. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  4. Results of Innovative and Supportive Learning Programs for Homeless Children and Adults

    ERIC Educational Resources Information Center

    Sinatra, Richard; Eschenauer, Robert

    2012-01-01

    Four-week summer academy programs served homeless children and adults in two contiguous innovative learning programs. The programs may be the first of their kind in the homeless literature in which both adults and children were exposed to career, academic, and leadership opportunities in the supportive learning environment of a university campus,…

  5. Perceptions of homelessness in older homeless veterans, VA homeless program staff liaisons, and housing intervention providers.

    PubMed

    Molinari, Victor A; Brown, Lisa M; Frahm, Kathryn A; Schinka, John A; Casey, Roger

    2013-05-01

    To understand the needs and challenges encountered by older homeless veterans. We conducted six focus groups of older veterans, two focus groups, and one semi-structured interview of VA staff liaisons, and two focus groups and one semi-structured interview of housing intervention providers. Major themes for older veterans: 1) negative homelessness experience; 2) benefits of the structured transitional housing program; 3) importance of peer outreach; and 4) need for age-tailored job placement programs. Major themes for VA staff liaison/housing intervention providers: 1) belief that the transitional housing program has made a positive change; 2) need for individualized criteria to address the unique needs of veterans; 3) distinct differences between older and younger homeless veterans; 4) outreach services; 5) permanent housing issues; and 6) coordination of services. Compared with younger veterans, older veterans have less social support, greater employment and health challenges, and, perhaps greater motivation to change.

  6. Private Lives/Public Spaces: Homeless Adults on the Streets of New York City.

    ERIC Educational Resources Information Center

    Baxter, Ellen; Hopper, Kim

    This paper reports the findings of a study which examined the problems of homeless adults in New York City. The goals of the study were twofold: (1) to document and analyze the life circumstances of homeless adults in New York City who are dependent upon the public sector for their sustenance; and (2) to develop explicit standards for the…

  7. Factors associated with substance use in older homeless adults: Results from the HOPE HOME study.

    PubMed

    Spinelli, Matthew A; Ponath, Claudia; Tieu, Lina; Hurstak, Emily E; Guzman, David; Kushel, Margot

    2017-01-01

    The median age of the single adult homeless population is 50 and rising. Although the prevalence of substance use decreases as individuals age, older adults now have a higher prevalence of substance use than older adults did 10 years ago. Homeless individuals have a higher prevalence of substance use disorders than the general population. However, little is known about substance use in older homeless adults. The objective of the study was to examine prevalence of and factors associated with substance use in a population-based sample (N = 350) of homeless individuals aged 50 and older in Oakland, California. Dependent variables included moderate or greater severity illicit drug symptoms (Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) score >3) and moderate or greater alcohol symptoms (Alcohol Use Disorders Identification Test (AUDIT) score >7). Independent variables included demographics, mental health problems, and negative life course events such as physical and sexual abuse, school expulsion, and onset of homelessness. Almost two thirds of participants, 64.6%, had moderate or greater severity symptoms for at least 1 illicit drug; 25.8% had moderate or greater severity alcohol symptoms. History of psychiatric hospitalization was associated with moderate or greater illicit drug symptoms (adjusted odds ratio [AOR] = 1.9, 1.0-3.6). The presence of major depressive symptoms was associated with moderate or greater severity alcohol symptoms (AOR = 1.8, 1.1-3.0). In this sample of older homeless adults, substance use is common. There is a need for substance use treatment programs, integrated with mental health services, which are targeted towards the needs of older homeless adults.

  8. Dietary intake, nutritional status and mental wellbeing of homeless adults in Reading, UK.

    PubMed

    Fallaize, Rosalind; Seale, Josephine V; Mortin, Charlotte; Armstrong, Lisha; Lovegrove, Julie A

    2017-11-01

    Malnutrition has been reported in the homeless, yet the specific nutritional issues faced by each homeless community are unclear. This is in part due to nutrient intake often being compared with dietary reference values as opposed to a comparative housed population. In addition, the complex interplay between nutrient intake, reward mediated behaviour and mental illness is frequently overlooked. This study aimed to compare the dietary intake, nutritional status and mental wellbeing of homeless and housed adults. Homeless (n 75) and matched housed (n 75) adults were recruited from Reading (UK). Nutrient intake was determined using the European Prospective Investigation into Cancer and Nutrition Norfolk FFQ. The Patient Health Questionnaire: Somatic Anxiety Depressive Symptoms (PHQ-SADS) assessed for signs of mental illness. Demographic, behavioural and physiological information was collected using closed-ended questions and anthropometric measurements. Overall, dietary intake was poorer in homeless adults who reported higher intakes of salt (8·0 v. 6·4 g, P=0·017), SFA (14·6 v. 13·0 %, P=0·002) and alcohol (5·3 v. 1·9 %, P<0·001) and lower intakes of fibre (13·4 v. 16·3 g, P<0·001), vitamin C (79 v. 109 mg, P<0·001) and fruit (96 v. 260 g, P<0·001) than housed. Smoking, substance misuse and PHQ-SADS scores were also higher in the homeless (P<0·001). Within the homeless population, street homeless (n 24) had lower SFA (13·7 v.15·0 %, P=0·010), Ca (858 v. 1032 mg, P=0·027) and milk intakes (295 v. 449 g, P=0·001) than hostel residents (n 51), which may reflect the issues with food storage. This study highlights the disparity between nutritional status in homeless and housed populations and the need for dietary intervention in the homeless community.

  9. Framing Effects in Younger and Older Adults

    PubMed Central

    Kim, Sunghan; Goldstein, David; Hasher, Lynn; Zacks, Rose T.

    2006-01-01

    A growing literature on decision making in older adults suggests that they are more likely to use heuristic processing than are younger adults. We assessed this tendency in the context of a framing effect, a decision-making phenomenon whereby the language used to describe options greatly influences the decision maker’s choice. We compared decision making under a standard (“heuristic”) condition and also under a “justification” condition known to reduce reliance on heuristics. In the standard condition, older adults were more susceptible than younger adults to framing but the two groups did not differ when participants were asked to provide a justification. Thus, although older adults may spontaneously rely more on heuristic processing than younger adults, they can be induced to take a more systematic approach to decision making. PMID:15980289

  10. Framing effects in younger and older adults.

    PubMed

    Kim, Sunghan; Goldstein, David; Hasher, Lynn; Zacks, Rose T

    2005-07-01

    A growing literature on decision making in older adults suggests that they are more likely to use heuristic processing than are younger adults. We assessed this tendency in the context of a framing effect, a decision-making phenomenon whereby the language used to describe options greatly influences the decision maker's choice. We compared decision making under a standard ("heuristic") condition and also under a "justification" condition known to reduce reliance on heuristics. In the standard condition, older adults were more susceptible than younger adults to framing but the two groups did not differ when participants were asked to provide a justification. Thus, although older adults may spontaneously rely more on heuristic processing than younger adults, they can be induced to take a more systematic approach to decision making.

  11. Comparing the characteristics of homeless adults in Poland and the United States.

    PubMed

    Toro, Paul A; Hobden, Karen L; Wyszacki Durham, Kathleen; Oko-Riebau, Marta; Bokszczanin, Anna

    2014-03-01

    This study compared the characteristics of probability samples of homeless adults in Poland (N = 200 from two cities) and the United States (N = 219 from one city), using measures with established reliability and validity in homeless populations. The same measures were used across nations and a systemic translation procedure assured comparability of measurement. The two samples were similar on some measures: In both nations, most homeless adults were male, many reported having dependent children and experiencing out-of-home placements when they themselves were children, and high levels of physical health problems were observed. Significant national differences were also found: Those in Poland were older, had been homeless for longer, showed lower rates on all psychiatric diagnoses assessed (including severe mental and substance abuse disorders), reported less contact with family and supportive network members, were less satisfied when they sought support from their networks, and reported fewer recent stressful life events and fewer risky sexual behaviors. Culturally-informed interpretations of these findings and their implications are presented.

  12. The relationship between victimization and mental health functioning in homeless youth and adults.

    PubMed

    Rattelade, Stephanie; Farrell, Susan; Aubry, Tim; Klodawsky, Fran

    2014-06-01

    This study examined the relationship between victimization and mental health functioning in homeless individuals. Homeless populations experience higher levels of victimization than the general population, which in turn have a detrimental effect on their mental health. A sample of 304 homeless adults and youth completed one-on-one interviews, answering questions on mental health, past victimization, and recent victimization experiences. A hierarchical linear regression showed that experiences of childhood sexual abuse predicted lower mental health functioning after controlling for the sex and age of individuals. The study findings are applicable to current support programs for victims in the homeless population and are relevant to future research on homelessness and victimization.

  13. Persisting Barriers to Employment for Recently Housed Adults with Mental Illness Who Were Homeless.

    PubMed

    Poremski, Daniel; Woodhall-Melnik, Julia; Lemieux, Ashley J; Stergiopoulos, Vicky

    2016-02-01

    Adults with mental illness who are homeless experience multiple barriers to employment, contributing to difficulties securing and maintaining housing. Housing First programs provide quick, low-barrier access to housing and support services for this population, but their success in improving employment outcomes has been limited. Supported employment interventions may augment Housing First programs and address barriers to employment for homeless adults with mental illness. The present paper presents data from qualitative interviews to shed light on the persisting barriers to employment among people formerly homeless. Once housed, barriers to employment persisted, including the following: (1) worries about disclosing sensitive information, (2) fluctuating motivation, (3) continued substance use, and (4) fears about re-experiencing homelessness-related trauma. Nevertheless, participants reported that their experiences of homelessness helped them develop interpersonal strength and resilience. Discussing barriers with an employment specialist helps participants develop strategies to overcome them, but employment specialists must be sensitive to specific homelessness-related experiences that may not be immediately evident. Supported housing was insufficient to help people return to employment. Supported employment may help people return to work by addressing persisting barriers.

  14. Attributions about homelessness in homeless and domiciled people in Madrid, Spain: "Why are they homeless people?".

    PubMed

    Vázquez, José Juan; Panadero, Sonia; Zúñiga, Claudia

    2018-01-01

    Causal attributions of homelessness may affect both the design and acceptance of public policies aimed at improving the situation of homeless people and the strategies that homeless people themselves decide to adopt in order to cope with their situation. This article analyzes the differences in causal attributions of homelessness based on gender, age, nationality, educational background, perceived social class, evolution of personal economic situation, and future expectations between the members of 2 groups: (a) "homeless group", consisting of a representative sample of homeless people in Madrid, Spain (n = 188); and (b) "domiciled group", consisting of a sample of people in Madrid at no risk of homelessness (n = 180), matched for sex, age and nationality. Results show that among domiciled population, women, older people, those without university education, those considering themselves to belong to lower income social classes, those who considered their economic situation to have worsened, and those who expressed negative expectations for the future attributed homelessness to individualistic courses to a greater extent. Meanwhile, among homeless group, younger people, those without university education, those considering themselves to belong to higher social classes, those who perceived their economic situation as having improved in recent years, and those who expressed positive expectations for the future generally attributed homelessness to individualistic courses to a greater extent. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  15. Self-transcendence and well-being in homeless adults.

    PubMed

    Runquist, Jennifer J; Reed, Pamela G

    2007-03-01

    This study examines the relationships of spiritually and physically related variables to well-being among homeless adults. A convenience sample of 61 sheltered homeless persons completed the Spiritual Perspective Scale, the Self-Transcendence Scale, the Index of Well-Being, and items measuring fatigue and health status. The data were subjected to correlational and multiple regression analysis. Positive, significant correlations were found among spiritual perspective, self-transcendence, health status, and well-being. Fatigue was inversely correlated with health status and well-being. Self-transcendence and health status together explained 59% of the variance in well-being. The findings support Reed's theory of self-transcendence, in which there is the basic assumption that human beings have the potential to integrate difficult life situations. This study contributes to the growing body of evidence that conceptualizes homeless persons as having spiritual, emotional, and physical capacities that can be used by health care professionals to promote well-being in this vulnerable population.

  16. Exploring the Psychosocial and Behavioral Adjustment Outcomes of Multi-Type Abuse among Homeless Young Adults

    ERIC Educational Resources Information Center

    Ferguson, Kristin M.

    2009-01-01

    This article explores the psychosocial and behavioral adjustment outcomes associated with verbal, emotional, physical, and sexual abuse among homeless young adults as well as the associations among abuse types. Convenience sampling was used to select 28 homeless young adults (ages 18 to 24) from one drop-in center. Overall, subjects experienced…

  17. Diabetes and Hypertension Prevalence in Homeless Adults in the United States: A Systematic Review and Meta-Analysis

    PubMed Central

    Meurer, Linda N.; Plumb, Ellen J.; Jackson, Jeffrey L.

    2015-01-01

    We estimated hypertension and diabetes prevalence among US homeless adults compared with the general population, and investigated prevalence trends. We systematically searched 5 databases for published studies (1980–2014) that included hypertension or diabetes prevalence for US homeless adults, pooled disease prevalence, and explored heterogeneity sources. We used the National Health Interview Survey for comparison. We included data from 97 366 homeless adults. The pooled prevalence of self-reported hypertension was 27.0% (95% confidence interval = 23.8%, 29.9%; n = 43 studies) and of diabetes was 8.0% (95% confidence interval = 6.8%, 9.2%; n = 39 studies). We found no difference in hypertension or diabetes prevalence between the homeless and general population. Additional health care and housing resources are needed to meet the significant, growing burden of chronic disease in the homeless population. PMID:25521899

  18. Older Adults Make Less Advantageous Decisions than Younger Adults: Cognitive and Psychological Correlates

    PubMed Central

    Fein, George; McGillivray, Shannon; Finn, Peter

    2007-01-01

    This study tested the hypotheses that older adults make less advantageous decisions than younger adults on the Iowa gambling task (IGT). Less advantageous decisions, as measured by the IGT, are characterized by choices that favor larger versus smaller immediate rewards, even though such choices may result in long-term negative consequences. The IGT, and measures of neuropsychological function, personality, and psychopathology were administered to 164 healthy adults 18–85 years of age. Older adults performed less advantageously on the IGT compared with younger adults. Additionally, a greater number of older adult’s IGT performances were classified as ‘impaired’ when compared to younger adults. Less advantageous decisions were associated with obsessive symptoms in older adults and with antisocial symptoms in younger adults. Performance on the IGT was positively associated with auditory working memory and psychomotor function in young adults, and in immediate memory in older adults. PMID:17445297

  19. Childhood Risk Factors in Dually Diagnosed Homeless Adults.

    ERIC Educational Resources Information Center

    Blankertz, Laura E.; And Others

    1993-01-01

    Examined prevalence of five childhood risk factors (sexual abuse, physical abuse, parental mental illness, substance abuse, out-of-home placement) among dually diagnosed (mentally ill and substance abusing) homeless adults (n=156) in rehabilitation programs. Findings suggest that childhood risk factors, whether single or multiple, are very…

  20. A web-based personal health information system for homeless youth and young adults.

    PubMed

    Dang, Michelle T; Whitney, Kimberley D; Virata, Maria Catrina D; Binger, Melissa M; Miller, Elizabeth

    2012-01-01

    Runaway and homeless youth face multiple challenges to their health and experience inadequate access to health care services. This article describes a web-based personal health information system (PHIS) called Healthshack that was specifically designed to improve health care access and health outcomes for runaway and homeless youth at a community-based agency that served homeless youth and young adults up to age 24. The program was developed in partnership with homeless youth and piloted by public health nurses. Preliminary findings from the program indicate that a PHIS is acceptable to runaway and homeless youth and feasible to incorporate into the flow of a youth agency. Thus, a PHIS may be an innovative model of service delivery for other marginalized populations. © 2011 Wiley Periodicals, Inc.

  1. Predicting Homelessness among Emerging Adults Aging Out of Foster Care.

    PubMed

    Shah, Melissa Ford; Liu, Qinghua; Mark Eddy, J; Barkan, Susan; Marshall, David; Mancuso, David; Lucenko, Barbara; Huber, Alice

    2017-09-01

    This study examines risk and protective factors associated with experiencing homelessness in the year after "aging out" of foster care. Using a state-level integrated administrative database, we identified 1,202 emerging adults in Washington State who exited foster care between July 2010 and June 2012. Initial bivariate analyses were conducted to assess the association between candidate predictive factors and an indicator of homelessness in a 12-month follow-up period. After deploying a stepwise regression process, the final logistic regression model included 15 predictive factors. Youth who were parents, who had recently experienced housing instability, or who were African American had approximately twice the odds of experiencing homelessness in the year after exiting foster care. In addition, youth who had experienced disrupted adoptions, had multiple foster care placements (especially in congregate care settings), or had been involved with the juvenile justice system were more likely to become homeless. In contrast, youth were less likely to experience homelessness if they had ever been placed with a relative while in foster care or had a high cumulative grade point average relative to their peers. © Society for Community Research and Action 2016.

  2. Life Goals Over Time Among Homeless Adults in Permanent Supportive Housing.

    PubMed

    Wenzel, S L; Rhoades, H; Moore, H; Lahey, J; Henwood, B; La Motte-Kerr, W; Bird, M

    2018-03-14

    Permanent supportive housing (PSH) is a widely-accepted solution to the challenge of chronic homelessness. While housing support and retention, physical health, and healthcare continue to be important for formerly homeless persons in PSH, "higher-order" and humanistic needs such as thriving have received less attention and as a result are less well understood in this population. One important indicator of thriving is the ability to establish and articulate life goals. This study utilizes longitudinal data from 421 formerly homeless adults prior to their move into PSH, and at 3-, 6- and 12-months after move-in (369 respondents completed all four interviews), to examine what life goals are articulated by this population and how those goals change over time. Prior to housing, most respondents articulated housing attainment as their primary life goal, whereas at follow-up interviews health goals, housing relocation, and financial goals became more prevalent. Aspirational goals (e.g., independence, self-improvement, artistic pursuits) were also common, but demonstrated a decrease over time in housing. Relationship goals remained common and consistent over time. Findings indicate that housing is a necessary, but perhaps not sufficient, step for improving thriving among formerly homeless adults. Implications for practice and future research are discussed. © Society for Community Research and Action 2018.

  3. Setting the stage for chronic health problems: cumulative childhood adversity among homeless adults with mental illness in Vancouver, British Columbia.

    PubMed

    Patterson, Michelle L; Moniruzzaman, Akm; Somers, Julian M

    2014-04-12

    It is well documented that childhood abuse, neglect and household dysfunction are disproportionately present in the backgrounds of homeless adults, and that these experiences adversely impact child development and a wide range of adult outcomes. However, few studies have examined the cumulative impact of adverse childhood experiences on homeless adults with mental illness. This study examines adverse events in childhood as predictors of duration of homelessness, psychiatric and substance use disorders, and physical health in a sample of homeless adults with mental illness. This study was conducted using baseline data from a randomized controlled trial in Vancouver, British Columbia for participants who completed the Adverse Childhood Experiences (ACE) scale at 18 months follow-up (n=364). Primary outcomes included current mental disorders; substance use including type, frequency and severity; physical health; duration of homelessness; and vocational functioning. In multivariable regression models, ACE total score independently predicted a range of mental health, physical health, and substance use problems, and marginally predicted duration of homelessness. Adverse childhood experiences are overrepresented among homeless adults with complex comorbidities and chronic homelessness. Our findings are consistent with a growing body of literature indicating that childhood traumas are potent risk factors for a number of adult health and psychiatric problems, particularly substance use problems. Results are discussed in the context of cumulative adversity and self-trauma theory. This trial has been registered with the International Standard Randomized Control Trial Number Register and assigned ISRCTN42520374.

  4. Project Re-Start. A Program for Homeless Adults.

    ERIC Educational Resources Information Center

    Pelzer, Dagmar F.; And Others

    Project Re-Start, of the Dade County Public Schools in Florida, was funded under the Adult Education Act and the Stewart B. McKinney Homeless Assistance Act. Classes in literacy skills, General Educational Development (GED) preparation, English for speakers of other languages, employability skills, and life coping skills were conducted at most of…

  5. Characterizing Concurrent Tobacco Product Use Among Homeless Cigarette Smokers.

    PubMed

    Kish, Daniel H; Reitzel, Lorraine R; Kendzor, Darla E; Okamoto, Hiroe; Businelle, Michael S

    2015-09-01

    Cigarette smoking prevalence rates are high among homeless adults (>70%); however, little is known about concurrent tobacco or other nicotine product use (i.e., concurrent use [CU]) in this population. CU may impact smoking quit rates and confer greater risk of health problems within this vulnerable population. This study characterized CU in a sample of homeless smokers and compared cigarette-only smokers (C-OS) to concurrent users (CUs) on participant characteristics and factors known to be associated with smoking cessation. Participants were 178 adult conventional cigarette smokers from a homeless shelter in Dallas, TX. Sociodemographic characteristics, number of homelessness episodes, tobacco dependence, and items characterizing use of several tobacco/nicotine products over the last 30 days including use frequency, reasons for use, and perceived health risks were described. Sociodemographic characteristics, number of homelessness episodes, tobacco dependence, stress, readiness to quit (RTQ) smoking, and number of smoking quit attempts in the last year were compared between the C-OS and CUs groups using t tests and chi-square tests. CU was prevalent (n = 91; 51.1%), and 49.5% of CUs reported the use of ≥2 products in addition to conventional cigarettes. Compared with C-OS, CUs were younger and had more homelessness episodes, higher expired breath carbon monoxide levels, and higher stress (ps < .05). Groups did not differ on sex, race, other dependence indicators, RTQ, or previous quit attempts. CU is common among homeless smokers. CUs and C-OS did not differ in their RTQ smoking, though greater stress among the CUs may represent a hurdle for cessation. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. How retellings shape younger and older adults' memories.

    PubMed

    Barber, Sarah J; Mather, Mara

    2014-04-01

    The way a story is retold influences the way it is later remembered; after retelling an event in a biased manner people subsequently remember the event in line with their distorted retelling. This study tested the hypothesis that this should be especially true for older adults. To test this, older and younger adults retold a story to be entertaining, to be accurate, or did not complete an initial retelling. Later, all participants recalled the story as accurately as possible. On this final test younger adults were unaffected by how they had previously retold the story. In contrast, older adults had better memory for the story's content and structure if they had previously retold the story accurately. Furthermore, for older adults, greater usage of storytelling language during the retelling was associated with lower subsequent recall. In summary, retellings exerted a greater effect on memory in older, compared with younger, adults.

  7. Adults Experiencing Homelessness in the US–Mexico Border Region: A Photovoice Project

    PubMed Central

    Moya, Eva Margarita; Chavez-Baray, Silvia M.; Loweree, Jacqueline; Mattera, Brian; Martinez, Nahomi

    2017-01-01

    Homelessness is a social, economic, and political crisis in the United States. In particular, the US–Mexico Border region has seen a surge of homelessness, specifically among veterans, women victims of intimate partner violence, and immigrants. In 2014, 12 persons in El Paso, TX, with experience of being homeless used the photovoice methodology to participate in a project titled, “The Voices and Images of the Residents of the Opportunity Center for the Homeless: A Visual Project on the Identity and Challenges Homeless Adults Face on the Border Region.” The project was led by faculty from the Department of Social Work and facilitated by graduate students from the Departments of Social Work, Sociology, and Anthropology at the University of Texas at El Paso. In partnership with the Opportunity Center for the Homeless, a community-based organization, a gallery of photographs with respective narratives was produced along with a video documentary. The participants identified four themes: broken systems, invisibility, opportunities and what works, and growth and determination. These themes represent participants’ life experiences with homelessness and their aspirations. In addition to the photo gallery, participants supported the development of a Call to Action asking the community, policy, and decision makers to commit to changing the current social, economic, and political conditions affecting individuals experiencing homelessness. The gallery, Call to Action, and overall participant experiences with photovoice were shared during local, regional, and national conferences and events, including three State of the Homeless Conferences led by the Opportunity Center for the Homeless in partnership with the university. PMID:28580355

  8. How Arousal Affects Younger and Older Adults' Memory Binding

    PubMed Central

    Nashiro, Kaoru; Mather, Mara

    2009-01-01

    A number of recent studies have shown that associative memory for within-item features is enhanced for emotionally arousing items, whereas arousal-enhanced binding is not seen for associations between distinct items (for a review see Mather, 2007). The costs and benefits of arousal in memory binding have been examined for younger adults but not for older adults. The present experiment examined whether arousal would enhance younger and older adults' within-item and between-item memory binding. The results revealed that arousal improved younger adults' within-item memory binding but not that of older adults. Arousal worsened both groups' between-item memory binding. PMID:21240821

  9. How arousal affects younger and older adults' memory binding.

    PubMed

    Nashiro, Kaoru; Mather, Mara

    2011-01-01

    A number of recent studies have shown that associative memory for within-item features is enhanced for emotionally arousing items, whereas arousal-enhanced binding is not seen for associations between distinct items (for a review, see Mather, 2007, Perspectives on Psychological Science, 2, 33-52). The costs and benefits of arousal in memory binding have been examined for younger adults but not for older adults. The present experiment examined whether arousal would enhance younger and older adults' within-item and between-item memory binding. The results revealed that arousal improved younger adults' within-item memory binding but not that of older adults. Arousal worsened both groups' between-item memory binding.

  10. Stressful Life Event Experiences of Homeless Adults: A Comparison of Single Men, Single Women, and Women with Children

    ERIC Educational Resources Information Center

    Zugazaga, Carole

    2004-01-01

    This article describes stressful life events experienced by a multi-shelter sample of 162 homeless adults in the Central Florida area. Participants included homeless single men (n = 54), homeless single women (n = 54), and homeless women with children (n = 54). Subjects were interviewed with a modified version of the List of Threatening…

  11. Health-Seeking Challenges Among Homeless Youth

    PubMed Central

    Hudson, Angela L.; Nyamathi, Adeline; Greengold, Barbara; Slagle, Alexandra; Koniak-Griffin, Deborah; Khalilifard, Farinaz; Getzoff, Daniel

    2010-01-01

    Background Approximately 1.5 to 2 million homeless young persons live on the streets in the United States. With the current economic situation, research is needed on quality of services geared toward homeless young adults. Objectives The objective of this study was to explore homeless young adults' perspectives on barriers and facilitators of health-care-seeking behavior and their perspectives on improving existing programs for homeless persons. Methods This article is a descriptive qualitative study using focus groups, with a purposeful sample of 24 homeless drug-using young adults. Results Identified themes were failing access to care based on perceived structural barriers (limited clinic sites, limited hours of operation, priority health conditions, and long wait times) and social barriers (perception of discrimination by uncaring professionals, law enforcement, and society in general). Discussion Results provide insight into programmatic and agency resources that facilitate health-seeking behaviors among homeless young adults and include implications for more research with providers of homeless health and social services. PMID:20404776

  12. Psychiatric disorders and treatment among newly homeless young adults with histories of foster care.

    PubMed

    Thompson, Ronald G; Hasin, Deborah

    2012-09-01

    Although foster care placement is often preceded by stressful events such as child abuse, foster care itself often exposes children to additional severe stressors. A history of foster care, as well as the childhood abuse that often precedes it, is common among homeless young adults. This study examined whether a history of foster care was associated with psychiatric disorders, prior psychiatric counseling, prescription of psychiatric medications, and prior psychiatric hospitalization among newly homeless young adults. A consecutive sample of 423 adults aged 18 to 21 years who sought emergency shelter for the first time between October 1, 2007, and February 29, 2008, were assessed at intake. Logistic regression analyses determined the associations between foster care and any psychiatric disorder (affective, anxiety, personality, and psychotic) and psychiatric treatment. The analyses adjusted for demographic characteristics, childhood abuse, substance use, prior arrest, unemployment, lack of high school diploma, and histories of psychiatric disorders and drug abuse among biological relatives. Homeless young adults with histories of foster care were 70% more likely than those without such histories to report any psychiatric disorder. They were more than twice as likely to have received mental health counseling for a psychiatric disorder, to have been prescribed psychiatric medication, and to have been hospitalized for psychiatric problems. Histories of foster care among homeless young adults should trigger screening for psychiatric disorders to aid in the provision of treatment (counseling, medication, and hospitalization) tailored to the psychiatric needs of this highly vulnerable population.

  13. Destination memory accuracy and confidence in younger and older adults.

    PubMed

    Johnson, Tara L; Jefferson, Susan C

    2018-01-01

    Background/Study Context: Nascent research on destination memory-remembering to whom we tell particular information-suggested that older adults have deficits in destination memory and are more confident on inaccurate responses than younger adults. This study assessed the effects of age, attentional resources, and mental imagery on destination memory accuracy and confidence in younger and older adults. Using computer format, participants told facts to pictures of famous people in one of four conditions (control, self-focus, refocus, imagery). Older adults had lower destination memory accuracy than younger adults, driven by a higher level of false alarms. Whereas younger adults were more confident in accurate answers, older adults were more confident in inaccurate answers. Accuracy across participants was lowest when attention was directed internally but significantly improved when mental imagery was used. Importantly, the age-related differences in false alarms and high-confidence inaccurate answers disappeared when imagery was used. Older adults are more likely than younger adults to commit destination memory errors and are less accurate in related confidence judgments. Furthermore, the use of associative memory strategies may help improve destination memory across age groups, improve the accuracy of confidence judgments in older adults, and decrease age-related destination memory impairment, particularly in young-old adults.

  14. Effects of psychosocial and situational variables on substance abuse among homeless adults.

    PubMed

    Stein, Judith A; Dixon, Elizabeth L; Nyamathi, Adeline M

    2008-09-01

    Finding direct and indirect influences of salient psychosocial and situational variables on problem substance use among homeless people is important in designing evidence-based, effective, and relevant interventions for this special population. A stress-coping paradigm in conjunction with situational items specialized for homeless people was used to explore predictive relationships in a sample of homeless adults (N = 664) among (a) psychosocial variables of self-esteem, social support, positive and negative coping, and emotional distress, (b) situational variables of homelessness history and quality of recent housing, and (c) outcomes of alcohol use, injection drug use (IDU), and non-IDU. Lower self-esteem predicted greater emotional distress, lower positive coping, greater negative coping, and more alcohol use. Social support predicted less emotional distress and more positive coping. Chronic homelessness predicted more emotional distress, less positive coping, greater alcohol use, and IDU. Poor housing was associated with more alcohol use and IDU. Substance abuse interventions among the homeless should have a dual focus that includes attention to psychological issues and negative coping patterns while also addressing situational, environmental factors, including encouraging provision of permanent supportive housing. (c) 2008 APA, all rights reserved.

  15. OCCURRENCE OF COLORECTAL ADENOMAS IN YOUNGER ADULTS: AN EPIDEMIOLOGIC NECROPSY STUDY

    PubMed Central

    Pendergrass, Cheryl J.; Edelstein, Daniel L.; Hylind, Linda M.; Phillips, Blaine T.; Iacobuzio-Donahue, Christine; Romans, Katharine; Griffin, Constance A.; Cruz-Correa, Marcia; Tersmette, Anne C.; Offerhaus, G. Johan A.; Giardiello, Francis M.

    2009-01-01

    Background and Aims The colorectal adenoma is the precursor lesion in virtually all colorectal cancers. Occurrence of colorectal adenomas has been studied in older adults but analysis in younger adults is lacking. Methods The prevalence by age, sex, race, and location, and the number of colorectal adenomas detected was investigated using epidemiologic necropsy in 3558 persons aged 20–89 autopsied from 1985 to 2004 at the Johns Hopkins Hospital. Results were standardized to the general population. Younger adults 20–49 years old were compared to older adults 50 to 89 years old. Results The prevalence of colorectal adenomas in younger adults increased from 1.72% to 3.59% from the 3rd to 5th decade of life and then sharply increased after age 50. In younger adults, adenomas were more prevalent in men than women (RR= 1.09, CI 1.07–1.11) and whites than blacks (RR=1.28, CI 1.26–1.31). Overall, both younger and older adults had predominately left-sided adenomas, but blacks in both age groups had more right-sided adenomas. Occurrence of two or more adenomas in younger adults and five or more in older adults was greater than 2 standard deviations from the mean. Conclusions Colorectal adenomas infrequently occur in younger adults and are more prevalent in the left colon. Irrespective of age, blacks have more right-sided adenomas suggesting need for screening the entire colorectum. Two or more adenomas in younger adults and five or more in older adults represents polyp burden outside the normal expectation. PMID:18558514

  16. Perceptions of emotion and age among younger, midlife, and older adults.

    PubMed

    Santorelli, Gennarina D; Ready, Rebecca E; Mather, Molly A

    2018-03-01

    Older adults report greater emotional well-being than younger persons, yet negative stereotypes about aging are pervasive. Little is known about age group perceptions of emotion in adulthood, particularly for familiar persons. Thus, this project determined perceptions of general affect in familiar younger and older adults. In two studies, participants (Study 1, younger adult n = 123, older adult n = 43; Study 2, younger adult n = 34, midlife adult n = 41, older adult n = 16) provided self-report data about their affect in general, as well as reported on the affect of a familiar younger person (aged 18--34) and a familiar older person (aged 65 or older). Emotion scales assessed high- and low-arousal positive and negative affect. Results suggest a less favorable perception of emotion experiences of older adults compared to younger adults. Specifically, participants of all age groups rated older adults as having lower positive emotions and higher negative emotions than is found in self-report data. Perceptions of emotion in older adulthood reflect stereotypes of negative functioning. Older adult participants were not immune to holding negative views about older adults. Negative perceptions about emotion experiences in later life may be detrimental to the physical and mental health of older adults.

  17. Tobacco Cessation Behaviors Among Older Homeless Adults: Results From the HOPE HOME Study.

    PubMed

    Vijayaraghavan, Maya; Tieu, Lina; Ponath, Claudia; Guzman, David; Kushel, Margot

    2016-08-01

    Tobacco-attributable deaths contribute significantly to the increased mortality observed among homeless adults aged 50 years or more. Little is known about the epidemiology of tobacco use among older homeless individuals. This longitudinal cohort study examines smoking behaviors and factors associated with smoking cessation among homeless individuals aged 50 years or more. We recruited a prospective cohort of 350 homeless individuals sampled from the community in Oakland, California. At 6 months follow-up, participants reported their cigarette quit attempts and 30-day abstinence. We used multivariable logistic regression to examine factors associated with making a quit attempt at follow-up, hypothesizing that heavier smokers would be less likely to make a quit attempt. Of the 272 ever-smokers, 229 (84.2%) were current smokers (quit ratio 15.8). Among current smokers at enrollment who had a follow-up interview at 6 months, 43.6% (n = 71) reported making a quit attempt during the follow-up. Of those who reported making a quit attempt, 14.3% (n = 10) reported 30-day abstinence at follow-up. Among those who had reported making a quit attempt at follow-up, 22.5% had used nicotine replacement therapy (NRT). Staying in shelters (adjusted odds ratio [AOR] = 2.5, 95% confidence interval [CI] = 1.0-5.8) was associated with higher odds of making a quit attempt at follow-up. Higher cigarette consumption was associated with lower odds of making a quit attempt (AOR = 0.9, 95% CI = 0.8-0.9). In this study of tobacco use in older homeless adults, rates of quit attempts were similar to that observed in the general population, but successful quitting was lower. The current study is among the first studies to focus specifically on tobacco use and cessation behaviors among older homeless adults. The high prevalence of smoking and the low rates of successful quitting highlight numerous opportunities to intervene to increase quitting rates among this population. Among these, increasing

  18. Optimism for the Future in Younger and Older Adults.

    PubMed

    Durbin, Kelly A; Barber, Sarah J; Brown, Maddalena; Mather, Mara

    2018-01-09

    Research has suggested that older adults are less optimistic about their future than younger adults; however, a limitation of prior studies is that younger and older adults were forecasting to different ages and stages of life. To address this, we investigated whether there are age differences in future optimism when people project to the exact same age. We also tested whether optimism differs when projecting one's own future versus another person's future. Participants were 285 younger and 292 older adults recruited from Amazon Mechanical Turk. Participants completed writing and word-rating tasks in which they imagined their own future in 15 years, their own future at age 85, or the average person's future at age 85. Younger adults were more optimistic than older adults about their own future in 15 years. In contrast, both age groups were similarly optimistic about their future at age 85 and expected it to be more positive than others' future at age 85. Contrary to previous research, younger and older adults had comparable future forecasts when projecting to the exact same age. These findings emphasize the need to consider age and stage of life when examining age differences in future optimism. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. The Effects of Feedback on Memory Strategies of Younger and Older Adults

    PubMed Central

    Zhang, Fan; Zhang, Xin; Luo, Meng; Geng, Haiyan

    2016-01-01

    Existing literature suggests that feedback could effectively reduce false memories in younger adults. However, it is unclear whether memory performance in older adults also might be affected by feedback. The current study tested the hypothesis that older adults can use immediate feedback to adjust their memory strategy, similar to younger adults, but after feedback is removed, older adults may not be able to maintain using the memory strategy. Older adults will display more false memories than younger adults due to a reduction in attentional resources. In Study 1, both younger and older adults adjusted gist processing and item-specific processing biases based on the feedback given (i.e., biased and objective feedback). In Study 2 after the feedback was removed, only younger adults with full attention were able to maintain the feedback-shaped memory strategy; whereas, both younger adults with divided attention and older adults had increased false memories after feedback was removed. The findings suggest that environmental support helps older adults as well as younger adults to adopt a memory strategy that demands high attentional resources, but when the support is removed, older adults can no longer maintain such a strategy. PMID:28033327

  20. The Effects of Feedback on Memory Strategies of Younger and Older Adults.

    PubMed

    Zhang, Fan; Zhang, Xin; Luo, Meng; Geng, Haiyan

    2016-01-01

    Existing literature suggests that feedback could effectively reduce false memories in younger adults. However, it is unclear whether memory performance in older adults also might be affected by feedback. The current study tested the hypothesis that older adults can use immediate feedback to adjust their memory strategy, similar to younger adults, but after feedback is removed, older adults may not be able to maintain using the memory strategy. Older adults will display more false memories than younger adults due to a reduction in attentional resources. In Study 1, both younger and older adults adjusted gist processing and item-specific processing biases based on the feedback given (i.e., biased and objective feedback). In Study 2 after the feedback was removed, only younger adults with full attention were able to maintain the feedback-shaped memory strategy; whereas, both younger adults with divided attention and older adults had increased false memories after feedback was removed. The findings suggest that environmental support helps older adults as well as younger adults to adopt a memory strategy that demands high attentional resources, but when the support is removed, older adults can no longer maintain such a strategy.

  1. Attitudes toward Younger and Older Adults: The German Aging Semantic Differential

    ERIC Educational Resources Information Center

    Gluth, Sebastian; Ebner, Natalie C.; Schmiedek, Florian

    2010-01-01

    The present study used the German Aging Semantic Differential (ASD) to assess attitudes toward younger and older adults in a heterogeneous sample of n = 151 younger and n = 143 older adults. The questionnaire was administered in two versions, one referring to the evaluation of younger adults, the other to the evaluation of older adults.…

  2. Long-term and chronic homelessness in homeless women and women with children.

    PubMed

    Zlotnick, Cheryl; Tam, Tammy; Bradley, Kimberly

    2010-09-01

    The Chronic Homelessness initiative has directed millions of federal dollars to services for single "unaccompanied homeless" individuals, specifically excluding women living with their children. Using a data set with a nationally representative sample of homeless adults, we calculated the prevalence rates and profiles of long-term homelessness in homeless women (n = 849). With the exception of the criterion of being a single "unaccompanied individual," many women, including women with children, met the criteria for chronic homelessness including having a disability of mental health or substance abuse problems. Our findings suggest that the federal definition of chronic homelessness needs to be revised.

  3. Personality assessment of homeless adults as a tool for service planning.

    PubMed

    Tolomiczenko, G S; Sota, T; Goering, P N

    2000-01-01

    The psychiatric status of homeless adults has been described primarily in terms of Axis I disorders. By adding a subset of the Personality Assessment Inventory, this study tests the feasibility and usefulness of a brief, self-administered questionnaire to obtain scores on several dimensions of personality. Cluster analysis sorted 112 tested subjects into four groups characterized by distinct profiles. Two of these were characterized by extreme scores on pathological dimensions of personality (borderline features, antisocial traits, and aggressivity) and differed primarily on the dimension of suicidality. The third reflected moderate levels of personality dysfunction and the fourth did not deviate from adult nonclinical norms. The validity of the clusters was supported by demographic, background, and diagnostic subgroup differences. Brief personality assessment can be a cost-effective approach to matching services with clinical needs of homeless adults by attending to interpersonal dimensions that will likely affect service provision.

  4. Prevalence of mental illness, intellectual disability, and developmental disability among homeless people in Nagoya, Japan: A case series study.

    PubMed

    Nishio, Akihiro; Yamamoto, Mayumi; Ueki, Hirofumi; Watanabe, Takahiro; Matsuura, Kenshin; Tamura, Osamu; Uehara, Ryosuke; Shioiri, Toshiki

    2015-09-01

    While it has been reported that the prevalence of mental illness is higher in homeless people than in the national population, few studies have investigated the prevalence of intellectual and developmental disability among the homeless. In this study, we conducted a survey to comprehensively assess these mental problems among homeless people in Nagoya, Japan. The subjects were 18 homeless men. Mental illness was diagnosed with semi-structured interviews conducted by psychiatrists. We used the Wechsler Adult Intelligence Scale III to diagnose intellectual disability. Discrepancies between Wechsler Adult Intelligence Scale III subtest scores were used as criteria for developmental disability. Eleven of the 18 participants were diagnosed with mental illness: six with mood disorder, two with psychotic disorder, and six with alcohol problems. The mean IQ of all subjects was 83.4 ± 27.4. The 95% confidence interval (CI) was 96.2-69.1. Seven participants were found to have intellectual disability. Three men showed discrepancies of more than 10 between subtest scores, and all of them were diagnosed with a mental illness. We divided the participants into four groups: those with mental illness only; those with intellectual disability only; those with both problems; and those without diagnosis. The men with intellectual disability only were significantly younger and had been homeless since a younger age than the other groups. Participants diagnosed with a mental illness had been homeless for longer than those without mental health problems. Although the sample size was limited, this study revealed the high prevalence of mental illness and intellectual disability, 61% (95%CI, 35-83%) and 39% (95%CI, 17-64%), respectively, in homeless people in Nagoya, Japan. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  5. A Cluster Randomized Controlled Trial Testing the Effectiveness of Houvast: A Strengths-Based Intervention for Homeless Young Adults

    ERIC Educational Resources Information Center

    Krabbenborg, Manon A. M.; Boersma, Sandra N.; van der Veld, William M.; van Hulst, Bente; Vollebergh, Wilma A. M.; Wolf, Judith R. L. M.

    2017-01-01

    Objective: To test the effectiveness of Houvast: a strengths-based intervention for homeless young adults. Method: A cluster randomized controlled trial was conducted with 10 Dutch shelter facilities randomly allocated to an intervention and a control group. Homeless young adults were interviewed when entering the facility and when care ended.…

  6. Gender, coping strategies, homelessness stressors, and income generation among homeless young adults in three cities.

    PubMed

    Ferguson, Kristin M; Bender, Kimberly; Thompson, Sanna J

    2015-06-01

    This study examined gender differences among homeless young adults' coping strategies and homelessness stressors as they relate to legal (e.g., full-time employment, selling personal possessions, selling blood/plasma) and illegal economic activity (e.g., selling drugs, theft, prostitution). A sample of 601 homeless young adults was recruited from 3 cities (Los Angeles, CA [n = 200], Austin, TX [n = 200], and Denver, CO [n = 201]) to participate in semi-structured interviews from March 2010 to July 2011. Risk and resilience correlates of legal and illegal economic activity were analyzed using six Ordinary Least Squares regression models with the full sample and with the female and male sub-samples. In the full sample, three variables (i.e., avoidant coping, problem-focused coping, and mania) were associated with legal income generation whereas eight variables (i.e., social coping, age, arrest history, transience, peer substance use, antisocial personality disorder [ASPD], substance use disorder [SUD], and major depressive episode [MDE]) were associated with illegal economic activity. In the female sub-sample, three variables (i.e., problem-focused coping, race/ethnicity, and transience) were correlated with legal income generation whereas six variables (i.e., problem-focused coping, social coping, age, arrest history, peer substance use, and ASPD) were correlated with illegal economic activity. Among males, the model depicting legal income generation was not significant yet seven variables (i.e., social coping, age, transience, peer substance use, ASPD, SUD, and MDE) were associated with illegal economic activity. Understanding gender differences in coping strategies and economic activity might help customize interventions aimed at safe and legal income generation for this population. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Psychopharmacologic Services for Homeless Veterans: Comparing Psychotropic Prescription Fills Among Homeless and Non-Homeless Veterans with Serious Mental Illness.

    PubMed

    Hermes, Eric; Rosenheck, Robert

    2016-02-01

    Using national Veterans Health Administration (VHA) administrative data, this study evaluated differences in psychotropic medication use between homeless and non-homeless adults with serious mental illness (SMI) who used VHA services in 2010. The adjusted mean number of psychotropic prescription fills associated with homeless individuals were identified using regression models adjusted for socio-demographics, diagnoses, and use of health services. Of the 876,989 individuals with SMI using VHA services, 7.2 % were homeless at some time during 2010. In bivariate analysis, homeless individuals filled more psychotropic medication prescriptions compared with non-homeless individuals. However, after adjusting for potentially confounding variables, homeless individuals were found to have filled 16.2 % fewer prescriptions than non-homeless individuals when all psychotropics were analyzed together (F = 6947.1, p < .001) and for most individual classes of psychotropics. Greater use of residential/inpatient mental health services by the homeless was the most important single factor associated with filling more psychotropic prescriptions than non-homeless individuals.

  8. Is smoking cessation associated with worse comorbid substance use outcomes among homeless adults?

    PubMed

    Reitzel, Lorraine R; Nguyen, Nga; Eischen, Sara; Thomas, Janet; Okuyemi, Kolawole S

    2014-12-01

    Smoking prevalence among homeless adults is exceedingly high, and high rates of comorbid substance use are among the barriers to abstinence experienced by this group. The extent to which smoking cessation might engender an escalation in comorbid substance use could be a concern prohibiting treatment provision and engagement. This study examined whether smoking abstinence status was associated with alcohol and substance use at 26 weeks post-randomization among homeless smokers in a smoking cessation trial. The current study was a secondary analysis of randomized smoking cessation intervention trial data. The parent study was conducted in the Minneapolis/St Paul area of Minnesota, USA. Participants were 427 homeless adult smokers interested in quitting smoking. Covariates collected at baseline included alcohol, cocaine, marijuana/hashish, heroin and 'any' drug use, age, sex, race/ethnicity, education, tobacco dependence, length of time homeless and treatment group. Biochemically verified smoking abstinence and self-reported alcohol and substance use were collected at 26 weeks post-randomization. Smoking abstinence was associated with fewer drinking days (P = 0.03), fewer drinks consumed on drinking days (P = 0.01), and lower odds of heavy drinking (P = 0.05), but not with differences in the number of days of cocaine, marijuana/hashish, heroin or any drug use. In homeless smokers, achieving smoking abstinence may be associated with a reduction in alcohol consumption but appears not to be associated with a substantial change in other drug use. © 2014 Society for the Study of Addiction.

  9. Is Smoking Cessation Associated with Worse Comorbid Substance Use Outcomes among Homeless Adults?

    PubMed Central

    Reitzel, Lorraine R.; Nguyen, Nga; Eischen, Sara; Thomas, Janet; Okuyemi, Kolawole S.

    2014-01-01

    Background and Aims Smoking prevalence among homeless adults is exceedingly high, and high rates of comorbid substance use are among the barriers to abstinence experienced by this group. The extent to which smoking cessation might engender an escalation in comorbid substance use could be a concern prohibiting treatment provision and engagement. This study examined whether smoking abstinence status was associated with alcohol and substance use at 26 weeks post-randomization among homeless smokers in a smoking cessation trial. Design The current study was a secondary analysis of randomized smoking cessation intervention trial data. Setting The parent study was conducted in the Minneapolis/St. Paul area of Minnesota, USA. Participants Participants were 427 homeless adult smokers interested in quitting smoking. Measurements Covariates collected at baseline included alcohol, cocaine, marijuana/hashish, heroin, and “any” drug use, age, sex, race/ethnicity, education, tobacco dependence, length of time homeless, and treatment group. Biochemically-verified smoking abstinence and self-reported alcohol and substance use were collected at 26 weeks post-randomization. Findings Smoking abstinence was associated with fewer drinking days (p=.03), fewer drinks consumed on drinking days (p=.01), and lower odds of heavy drinking (p=.05), but not with differences in the number of days of cocaine, marijuana/hashish, heroin, or any drug use. Conclusions In homeless smokers, achieving smoking abstinence may be associated with a reduction in alcohol consumption but appears not to be associated with a substantial change in other drug use. PMID:25041459

  10. Materials for Serving Homeless Adult Learners. A Resource Guide.

    ERIC Educational Resources Information Center

    Office of Vocational and Adult Education (ED), Washington, DC. Div. of Adult Education and Literacy.

    This guide is intended to assist in linking service providers to existing resources and models and to build awareness of the body of innovative work that has been developed to respond to needs of homeless adult learners. It describes materials for instruction, outreach, and program management that were primarily developed in projects funded under…

  11. Homeless adults engagement in art: first steps towards identity, recovery and social inclusion.

    PubMed

    Thomas, Yvonne; Gray, Marion; McGinty, Sue; Ebringer, Sally

    2011-12-01

    The Australian policy on homelessness identifies participation in structured activities as the first step towards social inclusion and increasing the likelihood of permanently leaving a homeless lifestyle. Art interventions increase interpersonal function and social participation and provide a means of expression and transformation with people who are homeless. This study explores the value of an art programme provided by a non-government agency for homeless adults. Qualitative methods including participant observation and purposive interviews were analysed inductively and thematically to gain an understanding of the participants' experience of art and its value. Interviews with stakeholders provided additional information and triangulation of the data. The study demonstrates that art occupations provide a starting point for participation in community and a positive experience that encourages the construction of new identities, routines and roles. Furthermore, art provides an alternative from the problems associated with homelessness, mental health and substance abuse and allows for public recognition and social inclusion. Health professionals should work towards the social inclusion of homeless people through providing occupational opportunities for participation in safe settings as a first step to community engagement. © 2011 The Authors. Australian Occupational Therapy Journal © 2011 Occupational Therapy Australia.

  12. Neural basis for recognition confidence in younger and older adults.

    PubMed

    Chua, Elizabeth F; Schacter, Daniel L; Sperling, Reisa A

    2009-03-01

    Although several studies have examined the neural basis for age-related changes in objective memory performance, less is known about how the process of memory monitoring changes with aging. The authors used functional magnetic resonance imaging to examine retrospective confidence in memory performance in aging. During low confidence, both younger and older adults showed behavioral evidence that they were guessing during recognition and that they were aware they were guessing when making confidence judgments. Similarly, both younger and older adults showed increased neural activity during low- compared to high-confidence responses in the lateral prefrontal cortex, anterior cingulate cortex, and left intraparietal sulcus. In contrast, older adults showed more high-confidence errors than younger adults. Younger adults showed greater activity for high compared to low confidence in medial temporal lobe structures, but older adults did not show this pattern. Taken together, these findings may suggest that impairments in the confidence-accuracy relationship for memory in older adults, which are often driven by high-confidence errors, may be primarily related to altered neural signals associated with greater activity for high-confidence responses.

  13. Neural basis for recognition confidence in younger and older adults

    PubMed Central

    Chua, Elizabeth F.; Schacter, Daniel L.; Sperling, Reisa A.

    2008-01-01

    Although several studies have examined the neural basis for age-related changes in objective memory performance, less is known about how the process of memory monitoring changes with aging. We used fMRI to examine retrospective confidence in memory performance in aging. During low confidence, both younger and older adults showed behavioral evidence that they were guessing during recognition, and that they were aware they were guessing when making confidence judgments. Similarly, both younger and older adults showed increased neural activity during low compared to high confidence responses in lateral prefrontal cortex, anterior cingulate cortex, and left intraparietal sulcus. In contrast, older adults showed more high confidence errors than younger adults. Younger adults showed greater activity for high compared to low confidence in medial temporal lobe structures, but older adults did not show this pattern. Taken together, these findings may suggest that impairments in the confidence-accuracy relationship for memory in older adults, which are often driven by high confidence errors, may be primarily related to altered neural signals associated with greater activity for high confidence responses. PMID:19290745

  14. Adult Education for the Homeless. FY 89 Project Abstracts. Twenty-Eight Programs that Can Help the Homeless.

    ERIC Educational Resources Information Center

    Office of Vocational and Adult Education (ED), Washington, DC. Clearinghouse on Adult Education and Literacy.

    In the first portion of this document, abstracts are given for 30 projects that were designed to provide basic skills and literacy training to homeless adults in fiscal year 1989. The following information is provided for each project: state; grant award number; grantee; project title; project director, telephone number, and address; and…

  15. [Health and healthcare of homeless persons].

    PubMed

    Jackson, Yves; Wuillemin, Timothée; Bodenmann, Patrick

    2016-10-05

    Homelessness is a complex issue linked to poverty and structural conditions. It is increasing in Western countries with younger people and multiple generations being affected. Hard and unstable living conditions and inappropriate access to care predispose people to increase morbidity with poor health outcomes. This article reviews recent evidence about homeless health and strategies to improve health outcomes while harnessing societal benefits.

  16. Comparison for younger and older adults: Stimulus temporal asynchrony modulates audiovisual integration.

    PubMed

    Ren, Yanna; Ren, Yanling; Yang, Weiping; Tang, Xiaoyu; Wu, Fengxia; Wu, Qiong; Takahashi, Satoshi; Ejima, Yoshimichi; Wu, Jinglong

    2018-02-01

    Recent research has shown that the magnitudes of responses to multisensory information are highly dependent on the stimulus structure. The temporal proximity of multiple signal inputs is a critical determinant for cross-modal integration. Here, we investigated the influence that temporal asynchrony has on audiovisual integration in both younger and older adults using event-related potentials (ERP). Our results showed that in the simultaneous audiovisual condition, except for the earliest integration (80-110ms), which occurred in the occipital region for older adults was absent for younger adults, early integration was similar for the younger and older groups. Additionally, late integration was delayed in older adults (280-300ms) compared to younger adults (210-240ms). In audition‑leading vision conditions, the earliest integration (80-110ms) was absent in younger adults but did occur in older adults. Additionally, after increasing the temporal disparity from 50ms to 100ms, late integration was delayed in both younger (from 230 to 290ms to 280-300ms) and older (from 210 to 240ms to 280-300ms) adults. In the audition-lagging vision conditions, integration only occurred in the A100V condition for younger adults and in the A50V condition for older adults. The current results suggested that the audiovisual temporal integration pattern differed between the audition‑leading and audition-lagging vision conditions and further revealed the varying effect of temporal asynchrony on audiovisual integration in younger and older adults. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. History of foster care among homeless adults with mental illness in Vancouver, British Columbia: a precursor to trajectories of risk.

    PubMed

    Patterson, Michelle L; Moniruzzaman, Akm; Somers, Julian M

    2015-02-26

    It is well documented that a disproportionate number of homeless adults have childhood histories of foster care placement(s). This study examines the relationship between foster care placement as a predictor of adult substance use disorders (including frequency, severity and type), mental illness, vocational functioning, service use and duration of homelessness among a sample of homeless adults with mental illness. We hypothesize that a history of foster care predicts earlier, more severe and more frequent substance use, multiple mental disorder diagnoses, discontinuous work history, and longer durations of homelessness. This study was conducted using baseline data from two randomized controlled trials in Vancouver, British Columbia for participants who responded to a series of questions pertaining to out-of-home care at 12 months follow-up (n = 442). Primary outcomes included current mental disorders; substance use including type, frequency and severity; physical health; duration of homelessness; vocational functioning; and service use. In multivariable regression models, a history of foster care placement independently predicted incomplete high school, duration of homelessness, discontinuous work history, less severe types of mental illness, multiple mental disorders, early initiation of drug and/or alcohol use, and daily drug use. This is the first Canadian study to investigate the relationship between a history of foster care and current substance use among homeless adults with mental illness, controlling for several other potential confounding factors. It is important to screen homeless youth who exit foster care for substance use, and to provide integrated treatment for concurrent disorders to homeless youth and adults who have both psychiatric and substance use problems. Both trials are registered with the International Standard Randomized Control Trial Number Register and were assigned ISRCTN57595077 (Vancouver At Home Study: Housing First plus

  18. Advance Care Planning for Older Homeless-Experienced Adults: Results from the Health Outcomes of People Experiencing Homelessness in Older Middle Age Study.

    PubMed

    Sudore, Rebecca L; Cuervo, Isabel Arellano; Tieu, Lina; Guzman, David; Kaplan, Lauren M; Kushel, Margot

    2018-05-09

    Older homeless-experienced adults have low engagement in advance care planning (ACP) despite high morbidity and mortality. We conducted a cross-sectional analysis of a cohort of 350 homeless-experienced adults aged 50 and older in Oakland, California. We assessed the prevalence of potential surrogate decision-makers, ACP contemplation, discussions, and ACP documentation (surrogate designation, advance directives). We used multivariable logistic regression to examine factors associated with ACP discussions and documentation. The median age of the cohort was 59 (range 52-82), 75.2% were male, and 82.1% were black. Sixty-one percent reported a potential surrogate, 21.5% had discussed ACP, and 19.0% reported ACP documentation. In multivariable models, having 1 to 5 confidants versus none (adjusted odds ratio (aOR)=5.8, 95% confidence interval (CI)=1.7-20.0), 3 or more chronic conditions versus none (aOR=2.3, 95% CI=0.9-5.6), and a recent primary care visit (aOR=2.1, 95% CI=1.0-4.4) were associated with higher odds of ACP discussions and each additional 5 years of homelessness (aOR=0.7, 95% CI=0.5-0.9) with lower odds. Having 1 to 5 confidants (aOR=5.0, 95% CI=1.4-17.5), being black (aOR=5.5, 95% CI=1.5-19.5), and having adequate versus limited literacy (aOR=7.0, 95% CI=1.5-32.4) were associated with higher odds of ACP documentation and illicit drug use (aOR=0.3, 95% CI=0.1-0.9) with lower odds. Although the majority of older homeless-experienced adults have a potential surrogate, few have discussed or documented their ACP wishes; the odds of both were greater with larger social networks. Future interventions must be customized for individuals with limited social networks and address the instability of homelessness, health literacy, and the constraints of safety-net healthcare settings. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

  19. Neurocognitive impairment in a large sample of homeless adults with mental illness.

    PubMed

    Stergiopoulos, V; Cusi, A; Bekele, T; Skosireva, A; Latimer, E; Schütz, C; Fernando, I; Rourke, S B

    2015-04-01

    This study examines neurocognitive functioning in a large, well-characterized sample of homeless adults with mental illness and assesses demographic and clinical factors associated with neurocognitive performance. A total of 1500 homeless adults with mental illness enrolled in the At Home Chez Soi study completed neuropsychological measures assessing speed of information processing, memory, and executive functioning. Sociodemographic and clinical data were also collected. Linear regression analyses were conducted to examine factors associated with neurocognitive performance. Approximately half of our sample met criteria for psychosis, major depressive disorder, and alcohol or substance use disorder, and nearly half had experienced severe traumatic brain injury. Overall, 72% of participants demonstrated cognitive impairment, including deficits in processing speed (48%), verbal learning (71%) and recall (67%), and executive functioning (38%). The overall statistical model explained 19.8% of the variance in the neurocognitive summary score, with reduced neurocognitive performance associated with older age, lower education, first language other than English or French, Black or Other ethnicity, and the presence of psychosis. Homeless adults with mental illness experience impairment in multiple neuropsychological domains. Much of the variance in our sample's cognitive performance remains unexplained, highlighting the need for further research in the mechanisms underlying cognitive impairment in this population. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. An intensive assessment of alcohol use and emergency department utilization in homeless alcohol-dependent adults.

    PubMed

    Holtyn, August F; Jarvis, Brantley P; Subramaniam, Shrinidhi; Wong, Conrad J; Fingerhood, Michael; Bigelow, George E; Silverman, Kenneth

    2017-09-01

    Excessive alcohol use among the homeless may contribute to their high rates of emergency department use. Survey-based studies have provided some information on the relation between alcohol and emergency department use among the homeless. This study used an intensive schedule of random breath collections and self-report assessments to examine the relation between emergency department utilization and alcohol use in homeless alcohol-dependent adults. Data were from homeless alcohol-dependent adults (N=116) who were participating in a therapeutic workplace that provided job-skills training every weekday for 26 weeks. Breath-sample collections and assessments of self-reported alcohol use were scheduled each week, an average of twice per week per participant, at random times between 9:00 A.M. and 5:00 P.M. Participants received $35 for each breath sample collected. Self-reports of emergency department use were assessed throughout the study. Thirty-four percent of participants reported attending an emergency department and reported an average of 2.2 emergency department visits (range 1-10 visits). Alcohol intoxication was the most common reason for emergency department use. Participants who used the emergency department had significantly more alcohol-positive breath samples and more self-reported heavy alcohol use than participants who did not use the emergency department. This study provided a rare intensive assessment of alcohol and emergency department use in homeless alcohol-dependent adults over an extended period. Emergency department use was high and was significantly related to indices of alcohol use. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. The effects of emotion on younger and older adults' monitoring of learning.

    PubMed

    Tauber, Sarah K; Dunlosky, John; Urry, Heather L; Opitz, Philipp C

    2017-09-01

    Age-related differences in memory monitoring appear when people learn emotional words. Namely, younger adults' judgments of learning (JOLs) are higher for positive than neutral words, whereas older adults' JOLs do not discriminate between positive versus neutral words. In two experiments, we evaluated whether this age-related difference extends to learning positive versus neutral pictures. We also evaluated the contribution of two dimensions of emotion that may impact younger and older adults' JOLs: valence and arousal. Younger and older adults studied pictures that were positive or neutral and either high or low in arousal. Participants made immediate JOLs and completed memory tests. In both experiments, the magnitude of older adults' JOLs was influenced by emotion, and both younger and older adults demonstrated an emotional salience effect on JOLs. As important, the magnitude of participants' JOLs was influenced by valence, and not arousal. Emotional salience effects were also evident on participants' free recall, and older adults recalled as many pictures as did younger adults. Taken together, these data suggest that older adults do not have a monitoring deficit when learning positive (vs. neutral) pictures and that emotional salience effects on younger and older adults' JOLs are produced more by valence than by arousal.

  2. Providing Homeless Adults with Advantage: A Sustainable University Degree Program

    ERIC Educational Resources Information Center

    Sinatra, Richard; Lanctot, Melissa Kim

    2016-01-01

    A university partnered with the New York City Department of Homeless Services (NYC DHS) to provide cohorts of adults a 60-credit Associate Degree Program in Business Administration over a 2-year period. Results of two cohorts of 30 Advantage Academy Program graduates revealed significant improvement in College Board AccuPlacer (ACPL) Arithmetic…

  3. Characteristics of Homeless Adults Who Died of Drug Overdose: A Retrospective Record Review

    PubMed Central

    Brody, Jennifer K.; León, Casey; Baggett, Travis P.

    2016-01-01

    Drug overdose is a major cause of death among homeless people, but little is known about the characteristics of homeless overdose decedents. We conducted a retrospective record review of 219 adult patients of Boston Health Care for the Homeless Program (BHCHP) who died of drug overdose in 2003–2008. We assessed the substances implicated in overdose and the health and service use characteristics of decedents prior to death. Eighty-one percent of overdose deaths involved opioids and 40% involved multiple drugs. Problem substance use (85%), psychiatric illness (61%), and chronic pain (45%) were common, and 32% had documentation of all three. Half were well-connected to BHCHP, and 35% had a clinic visit within 90 days of death. The complex health histories and frequent health care contacts of homeless drug overdose decedents suggest that clinical facilities may be an important frontline venue for overdose education, naloxone distribution, and integrated substance use treatment programming. PMID:27180712

  4. Atomoxetine Treatment for ADHD: Younger Adults Compared with Older Adults

    ERIC Educational Resources Information Center

    Durell, Todd; Adler, Lenard; Wilens, Timothy; Paczkowski, Martin; Schuh, Kory

    2010-01-01

    Objective: Atomoxetine is a nonstimulant medication for treating child, adolescent, and adult ADHD. This meta-analysis compared the effects in younger and older adults. Method: A post hoc analysis was conducted using data from two double-blind, placebo-controlled clinical trials. Data from patients aged 18-25 years were compared with data from…

  5. Effects of a nurse-managed program on hepatitis A and B vaccine completion among homeless adults.

    PubMed

    Nyamathi, Adeline; Liu, Yihang; Marfisee, Mary; Shoptaw, Steven; Gregerson, Paul; Saab, Sammy; Leake, Barbara; Tyler, Darlene; Gelberg, Lillian

    2009-01-01

    Hepatitis B virus (HBV) infection constitutes a major health problem for homeless persons. Ability to complete an HBV vaccination series is complicated by the need to prioritize competing needs, such as addiction issues, safe places to sleep, and food, over health concerns. The objectives of this study were to evaluate the effectiveness of a nurse-case-managed intervention compared with that of two standard programs on completion of the combined hepatitis A virus (HAV) and HBV vaccine series among homeless adults and to assess sociodemographic factors and risk behaviors related to the vaccine completion. A randomized, three-group, prospective, quasi-experimental design was conducted with 865 homeless adults residing in homeless shelters, drug rehabilitation sites, and outdoor areas in the Skid Row area of Los Angeles. The programs included (a) nurse-case-managed sessions plus targeted hepatitis education, incentives, and tracking (NCMIT); (b) standard targeted hepatitis education plus incentives and tracking (SIT); and (c) standard targeted hepatitis education and incentives only (SI). Sixty-eight percent of the NCMIT participants completed the three-series vaccine at 6 months, compared with 61% of SIT participants and 54% of SI participants. NCMIT participants had almost 2 times greater odds of completing vaccination than those of participants in the SI program. Completers were more likely to be older, to be female, to report fair or poor health, and not to have participated in a self-help drug treatment program. Newly homeless White adults were significantly less likely than were African Americans to complete the vaccine series. The use of vaccination programs incorporating nurse case management and tracking is critical in supporting adherence to completion of a 6-month HAV/HBV vaccine. The finding that White homeless persons were the least likely to complete the vaccine series suggests that programs tailored to address their unique cultural issues are needed.

  6. Justice Making in Groups for Homeless Adults: The Emancipatory Communitarian Way

    ERIC Educational Resources Information Center

    Brubaker, Michael D.; Garrett, Michael Tlanusta; Rivera, Edil Torres; Tate, Kevin A.

    2010-01-01

    The need for group counseling services for homeless adults is increasing with recent economic and natural disasters, representing crises that exacerbate the ongoing financial and social marginalization of this population. To address their needs, Emancipatory Communitarianism (EC; Prilleltensky, 1997) is suggested for group counselors working to…

  7. Both younger and older adults have difficulty updating emotional memories.

    PubMed

    Nashiro, Kaoru; Sakaki, Michiko; Huffman, Derek; Mather, Mara

    2013-03-01

    The main purpose of the study was to examine whether emotion impairs associative memory for previously seen items in older adults, as previously observed in younger adults. Thirty-two younger adults and 32 older adults participated. The experiment consisted of 2 parts. In Part 1, participants learned picture-object associations for negative and neutral pictures. In Part 2, they learned picture-location associations for negative and neutral pictures; half of these pictures were seen in Part 1 whereas the other half were new. The dependent measure was how many locations of negative versus neutral items in the new versus old categories participants remembered in Part 2. Both groups had more difficulty learning the locations of old negative pictures than of new negative pictures. However, this pattern was not observed for neutral items. Despite the fact that older adults showed overall decline in associative memory, the impairing effect of emotion on updating associative memory was similar between younger and older adults.

  8. Diffusion of Technology: Frequency of Use for Younger and Older Adults

    PubMed Central

    Olson, Katherine E.; O’Brien, Marita A.; Rogers, Wendy A.; Charness, Neil

    2012-01-01

    Objectives When we think of technology-savvy consumers, older adults are typically not the first persons that come to mind. The common misconception is that older adults do not want to use or cannot use technology. But for an increasing number of older adults, this is not true (Pew Internet and American Life Project, 2003). Older adults do use technologies similar to their younger counterparts, but perhaps at different usage rates. Previous research has identified that there may be subgroups of older adults, “Silver Surfers”, whose adoption patterns mimic younger adults (Pew Internet and American Life Project, 2003). Much of the previous research on age-related differences in technology usage has only investigated usage broadly -- from a “used” or “not used” standpoint. The present study investigated age-related differences in overall usage of technologies, as well as frequency of technology usage (i.e., never, occasional, or frequent). Methods The data were gathered through a questionnaire from younger adults (N=430) and older adults (N=251) in three geographically separate and ethnically diverse areas of the United States. Results We found that younger adults use a greater breadth of technologies than older adults. However, age-related differences in usage and the frequency of use depend on the technology domain. Conclusion This paper presents technology usage and frequency data to highlight age-related differences and similarities. The results provide insights into older and younger adults’ technology-use patterns, which in turn provide a basis for expectations about knowledge differences. Designers and trainers can benefit from understanding experience and knowledge differences. PMID:22685360

  9. Causes of homelessness prevalence: Relationship between homelessness and disability.

    PubMed

    Nishio, Akihiro; Horita, Ryo; Sado, Tadahiro; Mizutani, Seiko; Watanabe, Takahiro; Uehara, Ryosuke; Yamamoto, Mayumi

    2017-03-01

    Many studies have reported that the prevalence of mental illness and cognitive disability is higher among homeless individuals compared to the general population, and the rates of mental illness among the homeless population have recently increased. This study: (i) compares causes of homelessness or barriers to escaping homelessness for people with/without mental illness/cognitive disability; (ii) reveals problems with the Japanese homeless policy; and (iii) proposes an effective and necessary support system. The participants were 114 homeless individuals. A psychiatric diagnostic interview and the Wechsler Adult Intelligence Scale, version III were used to measure participants' mental health and cognitive abilities. A questionnaire was administered comprising 17 items related to the causes of their homelessness and barriers to escaping from it. Participants were divided into four groups - with/without mental illness or cognitive disability - and Fisher's exact test was used to compare the questionnaire results. Individuals with cognitive disabilities considered bad relationships with their family members to be the cause of their homelessness. Conversely, normal individuals considered their homelessness to be the result of debt more so than did individuals with mental problems. Individuals with mental illness had more difficulties escaping homelessness than did either normal individuals or individuals with cognitive disability. This tendency was observed most strongly among individuals with both mental illness and cognitive disability. Most homeless individuals considered economic problems to be the cause of their homelessness; however, difficulties with human relationships were also important factors and were more difficult for participants to acknowledge. Furthermore, these difficulties were exacerbated among those individuals with mental problems. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

  10. Neurobehavioural and cognitive function is linked to childhood trauma in homeless adults.

    PubMed

    Pluck, Graham; Lee, Kwang-Hyuk; David, Rajan; Macleod, Diana C; Spence, Sean A; Parks, Randolph W

    2011-03-01

    To describe levels of traumatic childhood events in a sample of homeless individuals and to assess the contribution of traumatic events to neurobehavioural traits (measured with the Frontal Systems Behaviour Scale, FrSBe) and general cognitive function (IQ). A sample of 55 homeless adults was recruited from homeless services in the city of Sheffield, UK. All were interviewed to acquire substance misuse information, record experiences of childhood trauma, and assess cognitive and neurobehavioural traits. Experiences of abuse and neglect were assessed with the Childhood Trauma Questionnaire. Participants also completed the Wechsler Abbreviated Scale of Intelligence and the FrSBe, which was completed with respect to current behaviour and conduct prior to homelessness. Around three-quarters of the sample scored in the clinically significant range for current neurobehavioural impairment. They also reported high levels of impairment when rating retrospectively for the period before they were homeless. The mean group IQ was below average at 88. Abuse or neglect during their upbringing was reported by 89% of the sample. Emotional abuse, emotional neglect, and physical neglect were all positively correlated with total FrSBe scores. Sexual abuse, emotional neglect, and physical neglect were all negatively correlated with IQ. The associations between trauma and IQ and neurobehavioural traits appear generally unrelated to the presence of substance misuse in the sample. Our homeless sample displayed relatively low IQ with high levels of neurobehavioural impairment. Our evidence suggests that these neuropsychological factors may, in part, constitute a long-term consequence of childhood trauma. ©2010 The British Psychological Society.

  11. A Comprehensive Assessment of Health Care Utilization Among Homeless Adults Under a System of Universal Health Insurance

    PubMed Central

    Chambers, Catharine; Chiu, Shirley; Katic, Marko; Kiss, Alex; Redelmeier, Donald A.; Levinson, Wendy

    2013-01-01

    Objectives. We comprehensively assessed health care utilization in a population-based sample of homeless adults and matched controls under a universal health insurance system. Methods. We assessed health care utilization by 1165 homeless single men and women and adults in families and their age- and gender-matched low-income controls in Toronto, Ontario, from 2005 to 2009, using repeated-measures general linear models to calculate risk ratios and 95% confidence intervals (CIs). Results. Homeless participants had mean rates of 9.1 ambulatory care encounters (maximum = 141.1), 2.0 emergency department (ED) encounters (maximum = 104.9), 0.2 medical–surgical hospitalizations (maximum = 14.9), and 0.1 psychiatric hospitalizations per person-year (maximum = 4.8). Rate ratios for homeless participants compared with matched controls were 1.76 (95% CI = 1.58, 1.96) for ambulatory care encounters, 8.48 (95% CI = 6.72, 10.70) for ED encounters, 4.22 (95% CI = 2.99, 5.94) for medical–surgical hospitalizations, and 9.27 (95% CI = 4.42, 19.43) for psychiatric hospitalizations. Conclusions. In a universal health insurance system, homeless people had substantially higher rates of ED and hospital use than general population controls; these rates were largely driven by a subset of homeless persons with extremely high-intensity usage of health services. PMID:24148051

  12. Employment Status and Income Generation among Homeless Young Adults: Results from a Five-City, Mixed-Methods Study

    ERIC Educational Resources Information Center

    Ferguson, Kristin M.; Bender, Kimberly; Thompson, Sanna J.; Maccio, Elaine M.; Pollio, David

    2012-01-01

    This mixed-methods study identified correlates of unemployment among homeless young adults in five cities. Two hundred thirty-eight homeless young people from Los Angeles (n = 50), Austin (n = 50), Denver (n = 50), New Orleans (n = 50), and St. Louis (n = 38) were recruited using comparable sampling strategies. Multivariate logistic regression…

  13. High Utilizers of Emergency Health Services in a Population-Based Cohort of Homeless Adults

    PubMed Central

    Chambers, Catharine; Chiu, Shirley; Katic, Marko; Kiss, Alex; Redelmeier, Donald A.; Levinson, Wendy

    2013-01-01

    Objectives. We identified predictors of emergency department (ED) use among a population-based prospective cohort of homeless adults in Toronto, Ontario. Methods. We assessed ED visit rates using administrative data from the Institute for Clinical Evaluative Sciences (2005–2009). We then used logistic regression to identify predictors of ED use. Frequent users were defined as participants with rates in the top decile (≥ 4.7 visits per person-year). Results. Among 1165 homeless adults, 892 (77%) had at least 1 ED visit during the study. The average rate of ED visits was 2.0 visits per person-year, whereas frequent users averaged 12.1 visits per person-year. Frequent users accounted for 10% of the sample but contributed more than 60% of visits. Predictors of frequent use in adjusted analyses included birth in Canada, higher monthly income, lower health status, perceived unmet mental health needs, and perceived external health locus of control from powerful others; being accompanied by a partner or dependent children had a protective effect on frequent use. Conclusions. Among homeless adults with universal health insurance, a small subgroup accounted for the majority of visits to emergency services. Frequent use was driven by multiple predisposing, enabling, and need factors. PMID:24148033

  14. Tobacco-, Alcohol-, and Drug-Attributable Deaths and Their Contribution to Mortality Disparities in a Cohort of Homeless Adults in Boston

    PubMed Central

    Chang, Yuchiao; Singer, Daniel E.; Porneala, Bianca C.; Gaeta, Jessie M.; O’Connell, James J.; Rigotti, Nancy A.

    2015-01-01

    Objectives. We quantified tobacco-, alcohol-, and drug-attributable deaths and their contribution to mortality disparities among homeless adults. Methods. We ascertained causes of death among 28 033 adults seen at the Boston Health Care for the Homeless Program in 2003 to 2008. We calculated population-attributable fractions to estimate the proportion of deaths attributable to tobacco, alcohol, or drug use. We compared attributable mortality rates with those for Massachusetts adults using rate ratios and differences. Results. Of 1302 deaths, 236 were tobacco-attributable, 215 were alcohol-attributable, and 286 were drug-attributable. Fifty-two percent of deaths were attributable to any of these substances. In comparison with Massachusetts adults, tobacco-attributable mortality rates were 3 to 5 times higher, alcohol-attributable mortality rates were 6 to 10 times higher, and drug-attributable mortality rates were 8 to 17 times higher. Disparities in substance-attributable deaths accounted for 57% of the all-cause mortality gap between the homeless cohort and Massachusetts adults. Conclusions. In this clinic-based cohort of homeless adults, over half of all deaths were substance-attributable, but this did not fully explain the mortality disparity with the general population. Interventions should address both addiction and non-addiction sources of excess mortality. PMID:25521869

  15. SSI/SSDI Outreach, Access, and Recovery (SOAR): Disability Application Outcomes Among Homeless Adults.

    PubMed

    Lowder, Evan M; Desmarais, Sarah L; Neupert, Shevaun D; Truelove, Melissa A

    2017-11-01

    The SSI/SSDI Outreach, Access, and Recovery (SOAR) program has been shown to increase access to Supplemental Security Income and Social Security Disability Insurance benefits among homeless adults. However, little empirical data exist on how or for whom SOAR achieves successful application outcomes. This study investigated applicant and application characteristics associated with disability application outcomes among homeless adults. Secondary data on 6,361 SOAR-assisted applications were obtained. Multilevel models investigated between-applicant differences in application processing time and decision as a function of applicant and application characteristics. Older age and living in an institution were associated with greater odds of application approval. Female gender and receipt of public assistance were associated with longer processing time and lower odds of approval. Except for quality review, SOAR critical components were associated with greater odds of approval. Women and adults receiving public assistance appear disadvantaged in the SOAR application process. SOAR critical components promote successful disability application outcomes.

  16. Hospital Readmissions in a Community-based Sample of Homeless Adults: a Matched-cohort Study.

    PubMed

    Saab, Dima; Nisenbaum, Rosane; Dhalla, Irfan; Hwang, Stephen W

    2016-09-01

    Hospital readmission rates are a widely used quality indicator that may be elevated in disadvantaged populations. The objective of this study was to compare the hospital readmission rate among individuals experiencing homelessness with that of a low-income matched control group, and to identify risk factors associated with readmission within the group experiencing homelessness. We conducted a 1:1 matched cohort study comparing 30-day hospital readmission rates between homeless patients and low-income controls matched on age, sex and primary reason for admission. Multivariate analyses using generalized estimating equations were used to assess risk factors associated with 30-day readmission in the homeless cohort. This study examined a cohort of 1,165 homeless adults recruited at homeless shelters and meal programs in Toronto, Ontario, between 6 December 2004 and 20 December 2005. The primary outcome was the occurrence of an unplanned medical or surgical readmission within 30 days of discharge from hospital. Between 6 December 2004 and 31 March 2009, homeless participants (N = 203) had 478 hospitalizations and a 30-day readmission rate of 22.2 %, compared to 300 hospitalizations and a readmission rate of 7.0 % among matched controls (OR = 3.79, 95 % CI 1.93-7.39). In the homeless cohort, having a primary care physician (OR = 2.65, 95 % CI 1.05-6.73) and leaving against medical advice (OR = 1.96, 95 % CI 0.99-3.86) were associated with an increased risk of 30-day readmission. Homeless patients had nearly four times the odds of being readmitted within 30-days as compared to low-income controls matched on age, sex and primary reason for admission to hospital. Further research is needed to evaluate interventions to reduce readmissions among this patient population.

  17. Memory-guided force control in healthy younger and older adults.

    PubMed

    Neely, Kristina A; Samimy, Shaadee; Blouch, Samantha L; Wang, Peiyuan; Chennavasin, Amanda; Diaz, Michele T; Dennis, Nancy A

    2017-08-01

    Successful performance of a memory-guided motor task requires participants to store and then recall an accurate representation of the motor goal. Further, participants must monitor motor output to make adjustments in the absence of visual feedback. The goal of this study was to examine memory-guided grip force in healthy younger and older adults and compare it to performance on behavioral tasks of working memory. Previous work demonstrates that healthy adults decrease force output as a function of time when visual feedback is not available. We hypothesized that older adults would decrease force output at a faster rate than younger adults, due to age-related deficits in working memory. Two groups of participants, younger adults (YA: N = 32, mean age 21.5 years) and older adults (OA: N = 33, mean age 69.3 years), completed four 20-s trials of isometric force with their index finger and thumb, equal to 25% of their maximum voluntary contraction. In the full-vision condition, visual feedback was available for the duration of the trial. In the no vision condition, visual feedback was removed for the last 12 s of each trial. Participants were asked to maintain constant force output in the absence of visual feedback. Participants also completed tasks of word recall and recognition and visuospatial working memory. Counter to our predictions, when visual feedback was removed, younger adults decreased force at a faster rate compared to older adults and the rate of decay was not associated with behavioral performance on tests of working memory.

  18. The hypercorrection effect in younger and older adults.

    PubMed

    Eich, Teal S; Stern, Yaakov; Metcalfe, Janet

    2013-01-01

    ABSTRACT The hypercorrection effect, which refers to the finding that errors committed with high confidence are more likely to be corrected than are low confidence errors, has been replicated many times, and with both young adults and children. In the present study, we contrasted older with younger adults. Participants answered general-information questions, made confidence ratings about their answers, were given corrective feedback, and then were retested on questions that they had gotten wrong. While younger adults showed the hypercorrection effect, older adults, despite higher overall accuracy on the general-information questions and excellent basic metacognitive ability, showed a diminished hypercorrection effect. Indeed, the correspondence between their confidence in their errors and the probability of correction was not significantly greater than zero, showing, for the first time, that a particular participant population is selectively impaired on this error correction task. These results potentially offer leverage both on the mechanisms underlying the hypercorrection effect and on reasons for older adults' memory impairments, as well as on memory functions that are spared.

  19. Walking through doorways causes forgetting: Younger and older adults.

    PubMed

    Radvansky, Gabriel A; Pettijohn, Kyle A; Kim, Joonsung

    2015-06-01

    Previous research on event cognition has found that walking through doorways can cause forgetting. The explanation for this finding is that there is a competition between event models, producing interference, and depressing performance. The current study explored the degree to which this might be affected by the natural aging process. This is of interest because there is some evidence that older adults have trouble coordinating sources of interference, which is what is thought to underlie this effect. This would suggest that older adults should do worse on this task. Alternatively, there is also evidence that older adults are typically not disrupted at the event level of processing per se. This would suggest that older adults should perform similarly to younger adults on this task. In the study reported here, younger and older participants navigated through a virtual environment, and memory was tested with probes either before or after a shift and for objects that were associated with the participant (i.e., just picked up). In general, both younger and older adults had memory disrupted after walking through a doorway. Importantly, the magnitude of this disruption was similar in the 2 age groups. This is consistent with the idea that processing at the event level is relatively unaffected by the natural aging process. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  20. The effect of victimization, mental health, and protective factors on crime and illicit drug use among homeless young adults.

    PubMed

    Tyler, Kimberly A; Kort-Butler, Lisa A; Swendener, Alexis

    2014-01-01

    Although research has found high rates of child maltreatment, widespread victimization, and other negative outcomes among homeless youth and young adults, resiliency among this population has largely been understudied. Specifically, a gap remains in terms of how protective factors such as self-efficacy, low deviant beliefs, and religiosity operate among homeless youth and young adults. The purpose of this study is to examine the relationship between various forms of victimization, mental health, and protective factors with property and violent crime and illicit drug use among homeless young adults. Results from regression analyses indicate that running away from home more frequently, experiencing more physical victimization on the street, higher levels of self-efficacy, and more deviant beliefs were associated with greater property crime. Significant correlates of violent crime included being male, running away from home more frequently, greater sexual and physical victimization on the street, higher levels of self-efficacy, and more deviant beliefs. Finally, being male, running away more frequently from home, greater child physical abuse and partner victimization, and more deviant beliefs were all associated with greater illicit drug use. Self-efficacy was positively related to both property and violent crime, suggesting that it may not operate for homeless young adults in the same manner as it does for normative populations.

  1. Florida's Adult Homeless Literacy Training & Basic Skills Assistance Project.

    ERIC Educational Resources Information Center

    Florida State Dept. of Education, Tallahassee. Div. of Vocational, Adult, and Community Education.

    Some facts about the homeless population in Florida are the following: (1) 40,000 persons in Florida are homeless on any given day, with 40 percent of the total being families; (2) 65 percent are new homeless (not chronic); (3) 30 percent of the homeless are addicted to drugs or alcohol and 20 percent are mentally ill; (4) causes of homelessness…

  2. Unpleasant Situations Elicit Different Emotional Responses in Younger and Older Adults

    PubMed Central

    Charles, Susan Turk; Carstensen, Laura L.

    2008-01-01

    Older adults report less distress in response to interpersonal conflicts than do younger adults, yet few researchers have examined factors that may contribute to these age differences. Emotion regulation is partially determined by the initial cognitive and emotional reactions that events elicit. We examined reported thoughts and emotions of younger and older adults (N = 195) while they listened to three different audio-taped conversations in which people were ostensibly making disparaging remarks about them. At four points during each scenario, the tape paused and participants engaged in a talk-aloud procedure and rated their level of anger and sadness. Findings revealed that older adults reported less anger but equal levels of sadness compared to younger adults, and their comments were judged by coders as less negative. Older adults made fewer appraisals about the people speaking on the tape and expressed less interest in learning more about their motives. Together, findings are consistent with age-related increases in processes that promote disengagement from offending situations. PMID:18808240

  3. Cross-National Variations in Behavioral Profiles Among Homeless Youth

    PubMed Central

    Milburn, Norweeta G.; Rotheram-Borus, Mary Jane; Rice, Eric; Mallet, Shelley; Rosenthal, Doreen

    2010-01-01

    Cross-national comparisons of homeless youth in Melbourne, Australia, and Los Angeles, CA, United States were conducted. Newly (n = 427) and experienced (n = 864) homeless youth were recruited from each site. Compared to Australia, homeless youth in the United States were younger, more likely to be in school or jail, demonstrated fewer sexual and substance use risk acts, fewer suicidal acts, and reported less need for social services. Across sites, experienced homeless youth were more likely to be older, male, engage in sexual and substance use, report greater need for social services, and make greater use of work, substance use, and health-related services. Homeless youth have different behavioral profiles in Australia and the United States, reflecting differences in the effectiveness of service systems in the two countries in keeping youth with fewer problems out of homelessness. PMID:16680537

  4. Cross-national variations in behavioral profiles among homeless youth.

    PubMed

    Milburn, Norweeta G; Rotheram-Borus, Mary Jane; Rice, Eric; Mallet, Shelley; Rosenthal, Doreen

    2006-03-01

    Cross-national comparisons of homeless youth in Melbourne, Australia, and Los Angeles, CA, United States were conducted. Newly (n = 427) and experienced (n = 864) homeless youth were recruited from each site. Compared to Australia, homeless youth in the United States were younger, more likely to be in school or jail, demonstrated fewer sexual and substance use risk acts, fewer suicidal acts, and reported less need for social services. Across sites, experienced homeless youth were more likely to be older, male, engage in sexual and substance use, report greater need for social services, and make greater use of work, substance use, and health-related services. Homeless youth have different behavioral profiles in Australia and the United States, reflecting differences in the effectiveness of service systems in the two countries in keeping youth with fewer problems out of homelessness.

  5. A Qualitative Examination of Smoke-Free Policies and Electronic Cigarettes Among Sheltered Homeless Adults.

    PubMed

    Vijayaraghavan, Maya; Hurst, Samantha; Pierce, John P

    2017-05-01

    To examine attitudes toward smoke-free policies and perceptions of e-cigarette use among homeless adults. A cross-sectional qualitative study was conducted. Study setting comprised seven transitional homeless shelters with indoor smoke-free policies in San Diego County; facilities differed in outdoor restrictions on smoking. Sixty-six current or former smokers were the study participants. Participants completed a questionnaire on smoking behaviors, perceived antitobacco norms, and attitudes toward smoke-free policies, and attended a focus group interview that explored these topics. We used a directed content analysis approach to analyze the focus group transcripts. Clients in facilities with outdoor restrictions on smoking had stronger perceived antitobacco norms than those in facilities without such restrictions. We identified the following major themes: attitudes toward smoke-free policies, the use of e-cigarettes, the addictive potential of cigarettes, vulnerability to tobacco industry marketing, and interest in smoking cessation. The consensus was that smoke-free policies were important because they limited secondhand smoke exposure to nonsmokers and children. All were curious about e-cigarettes, particularly if they could be smoked in areas where smoking was prohibited and/or used as a cessation aid. In this study of homeless adults, there was strong support for indoor and outdoor smoke-free policies. However, misperceptions that e-cigarettes could be used indoors could threaten antitobacco norms, highlighting opportunities to educate about the potential risks of e-cigarette use among homeless individuals.

  6. Older and younger adults differently judge the similarity between negative affect terms.

    PubMed

    Ready, Rebecca E; Santorelli, Gennarina D; Mather, Molly A

    2018-01-02

    Theoretical models of aging suggest changes across the adult lifespan in the capacity to differentiate emotions. Greater emotion differentiation is associated with advantages in terms of emotion regulation and emotion resiliency. This study utilized a novel method that directly measures judgments of affect differentiation and does not confound affective experience with knowledge about affect terms. Theoretical predictions that older adults would distinguish more between affect terms than younger persons were tested. Older (n = 27; aged 60-92) and younger (n = 56; aged 18-32) adults rated the difference versus similarity of 16 affect terms from the Kessler and Staudinger ( 2009 ) scales; each of the 16 items was paired with every other item for a total of 120 ratings. Participants provided self-reports of trait emotions, alexithymia, and depressive symptoms. Older adults significantly differentiated more between low arousal and high arousal negative affect (NA) items than younger persons. Depressive symptoms were associated with similarity ratings across and within valence and arousal. Findings offer partial support for theoretical predictions that older adults differentiate more between affect terms than younger persons. To the extent that differentiating between negative affects can aid in emotion regulation, older adults may have an advantage over younger persons. Future research should investigate mechanisms that underlie age group differences in emotion differentiation.

  7. Predictors of Medical or Surgical and Psychiatric Hospitalizations Among a Population-Based Cohort of Homeless Adults

    PubMed Central

    Chambers, Catharine; Katic, Marko; Chiu, Shirley; Redelmeier, Donald A.; Levinson, Wendy; Kiss, Alex

    2013-01-01

    Objectives. We identified factors associated with inpatient hospitalizations among a population-based cohort of homeless adults in Toronto, Ontario. Methods. We recruited participants from shelters and meal programs. We then linked them to administrative databases to capture hospital admissions during the study (2005–2009). We used logistic regression to identify predictors of medical or surgical and psychiatric hospitalizations. Results. Among 1165 homeless adults, 20% had a medical or surgical hospitalization, and 12% had a psychiatric hospitalization during the study. These individuals had a total of 921 hospitalizations, of which 548 were medical or surgical and 373 were psychiatric. Independent predictors of medical or surgical hospitalization included birth in Canada, having a primary care provider, higher perceived external health locus of control, and lower health status. Independent predictors of psychiatric hospitalization included being a current smoker, having a recent mental health problem, and having a lower perceived internal health locus of control. Being accompanied by a partner or dependent children was protective for hospitalization. Conclusions. Health care need was a strong predictor of medical or surgical and psychiatric hospitalizations. Some hospitalizations among homeless adults were potentially avoidable, whereas others represented an unavoidable use of health services. PMID:24148040

  8. The visual discrimination of negative facial expressions by younger and older adults.

    PubMed

    Mienaltowski, Andrew; Johnson, Ellen R; Wittman, Rebecca; Wilson, Anne-Taylor; Sturycz, Cassandra; Norman, J Farley

    2013-04-05

    Previous research has demonstrated that older adults are not as accurate as younger adults at perceiving negative emotions in facial expressions. These studies rely on emotion recognition tasks that involve choosing between many alternatives, creating the possibility that age differences emerge for cognitive rather than perceptual reasons. In the present study, an emotion discrimination task was used to investigate younger and older adults' ability to visually discriminate between negative emotional facial expressions (anger, sadness, fear, and disgust) at low (40%) and high (80%) expressive intensity. Participants completed trials blocked by pairs of emotions. Discrimination ability was quantified from the participants' responses using signal detection measures. In general, the results indicated that older adults had more difficulty discriminating between low intensity expressions of negative emotions than did younger adults. However, younger and older adults did not differ when discriminating between anger and sadness. These findings demonstrate that age differences in visual emotion discrimination emerge when signal detection measures are used but that these differences are not uniform and occur only in specific contexts.

  9. Testing the Limits of Optimizing Dual-Task Performance in Younger and Older Adults

    PubMed Central

    Strobach, Tilo; Frensch, Peter; Müller, Herrmann Josef; Schubert, Torsten

    2012-01-01

    Impaired dual-task performance in younger and older adults can be improved with practice. Optimal conditions even allow for a (near) elimination of this impairment in younger adults. However, it is unknown whether such (near) elimination is the limit of performance improvements in older adults. The present study tests this limit in older adults under conditions of (a) a high amount of dual-task training and (b) training with simplified component tasks in dual-task situations. The data showed that a high amount of dual-task training in older adults provided no evidence for an improvement of dual-task performance to the optimal dual-task performance level achieved by younger adults. However, training with simplified component tasks in dual-task situations exclusively in older adults provided a similar level of optimal dual-task performance in both age groups. Therefore through applying a testing the limits approach, we demonstrated that older adults improved dual-task performance to the same level as younger adults at the end of training under very specific conditions. PMID:22408613

  10. Different faces of discrimination: perceived discrimination among homeless adults with mental illness in healthcare settings.

    PubMed

    Skosireva, Anna; O'Campo, Patricia; Zerger, Suzanne; Chambers, Catharine; Gapka, Susan; Stergiopoulos, Vicky

    2014-09-07

    Research on discrimination in healthcare settings has primarily focused on health implications of race-based discrimination among ethno-racial minority groups. Little is known about discrimination experiences of other marginalized populations, particularly groups facing multiple disadvantages who may be subjected to other/multiple forms of discrimination. (1) To examine the prevalence of perceived discrimination due to homelessness/poverty, mental illness/alcohol/drug related problems, and race/ethnicity/skin color while seeking healthcare in the past year among racially diverse homeless adults with mental illness; (2) To identify whether perceiving certain types of discrimination is associated with increased likelihood of perceiving other kinds of discrimination; and (3) To examine association of these perceived discrimination experiences with socio-demographic characteristics, self-reported measures of psychiatric symptomatology and substance use, and Emergency Department utilization. We used baseline data from the Toronto site of the At Home/Chez Soi randomized controlled trial of Housing First for homeless adults with mental illness (n = 550). Bivariate statistics and multivariable logistic regression models were used for the analysis. Perceived discrimination related to homelessness/poverty (30.4%) and mental illness/alcohol/substance use (32.5%) is prevalent among ethnically diverse homeless adults with mental illness in healthcare settings. Only 15% of the total participants reported discrimination due to race/ethnicity/skin color. After controlling for relevant confounders and presence of psychosis, all types of discrimination in healthcare settings were associated with more frequent ED use, a greater - 3 - severity of lifetime substance abuse, and mental health problems. Perceiving discrimination of one type was associated with increased likelihood of perceiving other kinds of discrimination. Understanding the experience of discrimination in healthcare

  11. Risk Factors for Homelessness Among US Veterans

    PubMed Central

    Tsai, Jack; Rosenheck, Robert A.

    2015-01-01

    Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans. PMID:25595171

  12. Smartphone Text Input Method Performance, Usability, and Preference With Younger and Older Adults.

    PubMed

    Smith, Amanda L; Chaparro, Barbara S

    2015-09-01

    User performance, perceived usability, and preference for five smartphone text input methods were compared with younger and older novice adults. Smartphones are used for a variety of functions other than phone calls, including text messaging, e-mail, and web browsing. Research comparing performance with methods of text input on smartphones reveals a high degree of variability in reported measures, procedures, and results. This study reports on a direct comparison of five of the most common input methods among a population of younger and older adults, who had no experience with any of the methods. Fifty adults (25 younger, 18-35 years; 25 older, 60-84 years) completed a text entry task using five text input methods (physical Qwerty, onscreen Qwerty, tracing, handwriting, and voice). Entry and error rates, perceived usability, and preference were recorded. Both age groups input text equally fast using voice input, but older adults were slower than younger adults using all other methods. Both age groups had low error rates when using physical Qwerty and voice, but older adults committed more errors with the other three methods. Both younger and older adults preferred voice and physical Qwerty input to the remaining methods. Handwriting consistently performed the worst and was rated lowest by both groups. Voice and physical Qwerty input methods proved to be the most effective for both younger and older adults, and handwriting input was the least effective overall. These findings have implications to the design of future smartphone text input methods and devices, particularly for older adults. © 2015, Human Factors and Ergonomics Society.

  13. Category learning strategies in younger and older adults: Rule abstraction and memorization.

    PubMed

    Wahlheim, Christopher N; McDaniel, Mark A; Little, Jeri L

    2016-06-01

    Despite the fundamental role of category learning in cognition, few studies have examined how this ability differs between younger and older adults. The present experiment examined possible age differences in category learning strategies and their effects on learning. Participants were trained on a category determined by a disjunctive rule applied to relational features. The utilization of rule- and exemplar-based strategies was indexed by self-reports and transfer performance. Based on self-reported strategies, the frequencies of rule- and exemplar-based learners were not significantly different between age groups, but there was a significantly higher frequency of intermediate learners (i.e., learners not identifying with a reliance on either rule- or exemplar-based strategies) in the older than younger adult group. Training performance was higher for younger than older adults regardless of the strategy utilized, showing that older adults were impaired in their ability to learn the correct rule or to remember exemplar-label associations. Transfer performance converged with strategy reports in showing higher fidelity category representations for younger adults. Younger adults with high working memory capacity were more likely to use an exemplar-based strategy, and older adults with high working memory capacity showed better training performance. Age groups did not differ in their self-reported memory beliefs, and these beliefs did not predict training strategies or performance. Overall, the present results contradict earlier findings that older adults prefer rule- to exemplar-based learning strategies, presumably to compensate for memory deficits. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  14. Risk factors associated with recurrent homelessness after a first homeless episode.

    PubMed

    McQuistion, Hunter L; Gorroochurn, Prakash; Hsu, Eustace; Caton, Carol L M

    2014-07-01

    Alcohol and drug use are commonly associated with the experience of homelessness. In order to better understand this, we explored the prevalence of drug and alcohol use as it related to successful re-housing within a sample of first-time single homeless adults at municipal shelters. From within this sample, we compared the features of recurrent homelessness with those of chronic homelessness and of being stably housed. We interviewed 344 subjects upon shelter entry and followed each one every six months for 18 months using standardized social and mental health measures. We analyzed baseline assessments relative to housing experiences during follow-up using Chi square and multinomial logistic regression. Eighty-one percent (N = 278) obtained housing over 18 months, of which 23.7 % (N = 66) experienced homelessness again. Recurrent homelessness was more common among those with a high school education and if initially re-housed with family. Bivariate analysis resulted in the observation of the highest rate of alcohol and other drug use among this recurrent group and multinomial logistic regression supported this only with the coupling of arrest history and diagnosed antisocial personality disorder. With relatively high rates of recurrent homelessness, there were differences between subjects who experienced recurrent homelessness compared to those who were stably housed and with chronic homelessness. That alcohol and other substance use disorders were associated with recurrent homelessness only if they were linked to other risk factors highlights the complexity of causes for homelessness and a resultant need to organize them into constellations of causal risk factors. Consistent with this, there should be initiatives that span bureaucratic boundaries so as to flexibly meet multiple complex service needs, thus improving outcomes concerning episodes of recurrent homelessness.

  15. Increasing Access to Higher Education for Unaccompanied Homeless Youth: Information for Colleges and Universities. Best Practices in Homeless Education Brief Series

    ERIC Educational Resources Information Center

    National Center for Homeless Education at SERVE, 2012

    2012-01-01

    Each year, more than a million young people in the United States experience homelessness; some of these young people, known as unaccompanied homeless youth, will face the challenges of homelessness while living on their own without the support of a caring adult. Unaccompanied homeless youth face the same struggles as other young people: trying to…

  16. Understanding the effect of workload on automation use for younger and older adults.

    PubMed

    McBride, Sara E; Rogers, Wendy A; Fisk, Arthur D

    2011-12-01

    This study examined how individuals, younger and older, interacted with an imperfect automated system. The impact of workload on performance and automation use was also investigated. Automation is used in situations characterized by varying levels of workload. As automated systems spread to domains such as transportation and the home, a diverse population of users will interact with automation. Research is needed to understand how different segments of the population use automation. Workload was systematically manipulated to create three levels (low, moderate, high) in a dual-task scenario in which participants interacted with a 70% reliable automated aid. Two experiments were conducted to assess automation use for younger and older adults. Both younger and older adults relied on the automation more than they complied with it. Among younger adults, high workload led to poorer performance and higher compliance, even when that compliance was detrimental. Older adults' performance was negatively affected by workload, but their compliance and reliance were unaffected. Younger and older adults were both able to use and double-check an imperfect automated system. Workload affected how younger adults complied with automation, particularly with regard to detecting automation false alarms. Older adults tended to comply and rely at fairly high rates overall, and this did not change with increased workload. Training programs for imperfect automated systems should vary workload and provide feedback about error types, and strategies for identifying errors. The ability to identify automation errors varies across individuals, thereby necessitating training.

  17. Emergency Department Use in a Cohort of Older Homeless Adults: Results from the HOPE HOME Study

    PubMed Central

    Raven, Maria C.; Tieu, Lina; Lee, Christopher T.; Ponath, Claudia; Guzman, David; Kushel, Margot

    2018-01-01

    Objective The median age of single homeless adults is over 50, yet little is known about their emergency department (ED) use. We describe use of and factors associated with ED use in a sample of homeless adults 50 and older. Methods We recruited 350 participants who were homeless and 50 or older in Oakland, CA. We interviewed participants about residential history in the prior six months, health status, health-related behaviors, and health services use, and assessed cognition and mobility. Our primary outcome was the number of ED visits in the prior six months based on medical record review. We used negative binomial regression to examine factors associated with ED use. Results In the six months prior to enrollment, 46.3% of participants spent the majority of their time unsheltered, 25.1% cycled through multiple institutions including shelters, hospitals and jails, 16.3% primarily stayed with family or friends, and 12.3% had become homeless recently after spending much of the prior six months housed. Half (49.7%) of participants made at least one ED visit in the past six months; 6.6% of participants accounted for 49.9% of all visits. Most (71.8%) identified a regular non-ED source of healthcare; 7.3% of visits resulted in hospitalization. In multivariate models, study participants who used multiple institutions (incidence rate ratio [IRR] = 2.27; 95% confidence interval [CI] = 1.08–4.77) and who were unsheltered (IRR = 2.29; 95% CI = 1.17–4.48) had higher ED use rates than participants who had been housed for most of the prior six months. In addition, having health insurance/coverage (IRR= 2.6; CI = 1.5–4.4), a history of psychiatric hospitalization (IRR = 1.80; 95% CI = 1.09–2.99), and severe pain (IRR = 1.72; 95% CI = 1.07–2.76) were associated with higher ED visit rates. Conclusions A sample of adults aged 50 and older who were homeless at study entry had higher rates of ED use in the prior six months than the general US age-matched population. Within

  18. Prevalence and Correlates of Substance Use in Homeless Youth and Young Adults.

    PubMed

    Santa Maria, Diane M; Narendorf, Sarah C; Cross, Matthew B

    Substance use is higher among homeless youth than among the general population. Although substance use has been well studied, little is known about the risk factors associated with specific substances used by homeless youth, particularly in the Houston, Texas, area. Therefore, we conducted this study to examine the rates of lifetime and past-month substance use in a sample of homeless youth in Harris County, Texas, and examine the relations between substance type and race/ethnicity, age, gender identity, sexual orientation, shelter status, stress, and trauma history. Participants were recruited during October and November 2014 as part of the study YouthCount 2.0! and completed a survey to assess demographics, stress, abuse, substance use, and risk behaviors. The sample (N = 416) was predominantly young adult (13-17 years old: 55 and 18-24 years old: 361), African American (54.5%), and male (55.9%). Nearly one quarter identified as lesbian, gay, bisexual, or questioning (n = 102). Over a third of youth had used alcohol (38%) or marijuana (36%) in the past month, and 36% had ever used synthetic marijuana. Bivariate analyses showed that substance use was significantly associated with race/ethnicity, age, gender identity, sexual orientation, shelter status, stress, and trauma scores. Youth in this study had lower rates of alcohol and some substance use than other samples of homeless youth, although use still exceeded national rates for housed youth. Substance use prevention interventions for homeless youth should be trauma informed and include housing navigation and stress management strategies. The most at-risk subgroups included street-dwelling and lesbian, gay, bisexual, or questioning youth.

  19. Stress, Social Support, and Outcomes in Two Probability Samples of Homeless Adults

    ERIC Educational Resources Information Center

    Toro, Paul A.; Tulloch, Elizabeth; Ouellette, Nicole

    2008-01-01

    This study investigated the main effects of social support measures and their stress-buffering effects in two samples of homeless adults (Ns =249 and 219) obtained in the same large county (surrounding Detroit) at different points in time over an 8-year period (1992-1994 and 2000-2002). The findings suggest that the construct of social support,…

  20. Rural Homelessness in Northwest Ohio: Reasons, Patterns, Statistics, and Trends.

    ERIC Educational Resources Information Center

    Podlin, Georgette A.

    Rural homelessness in America is difficult to define, to count, and to see. This article reports the findings of a 1993 county-wide study of rural homelessness. During a one year survey, 118 homeless households were interviewed. Of those surveyed, 25.8 percent were male adults, 30.9 percent were female adults, and 43.2 percent were children.…

  1. Reducing the framing effect in older and younger adults by encouraging analytic processing.

    PubMed

    Thomas, Ayanna K; Millar, Peter R

    2012-03-01

    The present study explored whether the framing effect could be reduced in older and younger adults using techniques that influenced the accessibility of information relevant to the decision-making processing. Accessibility was manipulated indirectly in Experiment 1 by having participants engage in concurrent tasks, and directly in Experiment 2, through an instructions manipulation that required participants to maintain a goal of analytic processing throughout the experimental trial. We tested 120 older and 120 younger adults in Experiment 1. Participants completed 28 decision trials while concurrently either performing a probability calculation task or a memory task. In Experiment 2, we tested 136 older and 136 younger adults. Participants completed 48 decision trials after either having been instructed to "think like a scientist" or base decisions on "gut reactions." Results demonstrated that the framing effect was reduced in older and younger adults in the probability calculation task in Experiment 1 and under the "think like a scientist" instructions manipulation in Experiment 2. These results suggest that when information relevant to unbiased decision making was made more accessible, both older and younger adults were able to reduce susceptibility to the framing effect.

  2. Mastery matters: consumer choice, psychiatric symptoms and problematic substance use among adults with histories of homelessness.

    PubMed

    Greenwood, Ronni Michelle; Manning, Rachel M

    2017-05-01

    Previous research demonstrated the importance of consumer choice and mastery to residential stability and psychiatric functioning for adults with histories of homelessness. In the present study, we investigated whether these relationships hold, even in the context of problem-related substance misuse. Questionnaire data were collected in Ireland from 101 residents of long-term homeless accommodation in 2010. Hayes' PROCESS macro for mediation and moderation analysis in SPSS was employed to test our hypotheses. Findings demonstrated that the indirect effect of choice through mastery on psychiatric functioning was stronger for individuals with more recent problem-related substance use than for those with no or distant histories of problem-related substance use. Our findings confirm that consumer choice in housing and services is important to homeless services users' recovery experiences. Because of its relationship with mastery, consumer choice in housing and services protects homeless services users' psychiatric functioning, especially when substance use-related choices have had negative consequences. Our findings suggest that if homeless services take away consumer choice when substance use causes problems, they may actually undermine, rather than foster, service users' psychiatric functioning. © 2016 John Wiley & Sons Ltd.

  3. The Effect of Stimulus Valence on Lexical Retrieval in Younger and Older Adults.

    PubMed

    Blackett, Deena Schwen; Harnish, Stacy M; Lundine, Jennifer P; Zezinka, Alexandra; Healy, Eric W

    2017-07-12

    Although there is evidence that emotional valence of stimuli impacts lexical processes, there is limited work investigating its specific impact on lexical retrieval. The current study aimed to determine the degree to which emotional valence of pictured stimuli impacts naming latencies in healthy younger and older adults. Eighteen healthy younger adults and 18 healthy older adults named positive, negative, and neutral images, and reaction time was measured. Reaction times for positive and negative images were significantly longer than reaction times for neutral images. Reaction times for positive and negative images were not significantly different. Whereas older adults demonstrated significantly longer naming latencies overall than younger adults, the discrepancy in latency with age was far greater when naming emotional pictures. Emotional arousal of pictures appears to impact naming latency in younger and older adults. We hypothesize that the increase in naming latency for emotional stimuli is the result of a necessary disengagement of attentional resources from the emotional images prior to completion of the naming task. We propose that this process may affect older adults disproportionately due to a decline in attentional resources as part of normal aging, combined with a greater attentional preference for emotional stimuli.

  4. Category Learning Strategies in Younger and Older Adults: Rule Abstraction and Memorization

    PubMed Central

    Wahlheim, Christopher N.; McDaniel, Mark A.; Little, Jeri L.

    2016-01-01

    Despite the fundamental role of category learning in cognition, few studies have examined how this ability differs between younger and older adults. The present experiment examined possible age differences in category learning strategies and their effects on learning. Participants were trained on a category determined by a disjunctive rule applied to relational features. The utilization of rule- and exemplar-based strategies was indexed by self-reports and transfer performance. Based on self-reported strategies, both age groups had comparable frequencies of rule- and exemplar-based learners, but older adults had a higher frequency of intermediate learners (i.e., learners not identifying with a reliance on either rule- or exemplar-based strategies). Training performance was higher for younger than older adults regardless of the strategy utilized, showing that older adults were impaired in their ability to learn the correct rule or to remember exemplar-label associations. Transfer performance converged with strategy reports in showing higher fidelity category representations for younger adults. Younger adults with high working memory capacity were more likely to use an exemplar-based strategy, and older adults with high working memory capacity showed better training performance. Age groups did not differ in their self-reported memory beliefs, and these beliefs did not predict training strategies or performance. Overall, the present results contradict earlier findings that older adults prefer rule- to exemplar-based learning strategies, presumably to compensate for memory deficits. PMID:26950225

  5. Chronically homeless women report high rates of substance use problems equivalent to chronically homeless men.

    PubMed

    Edens, Ellen Lockard; Mares, Alvin S; Rosenheck, Robert A

    2011-01-01

    The U.S. federal government recently committed itself to ending chronic homelessness within 5 years. Women constitute one out of four chronically homeless adults and represent a particularly vulnerable group, but have been little studied. To identify potentially unique needs in this group, we report characteristics and 2-year outcomes in a large sample of male and female chronically homeless adults participating in a multisite, supportive housing program. Men and women participating in the outcome evaluation of the 11-site Collaborative Initiative on Chronic Homelessness (n = 714) supportive housing program and who received at least one follow-up assessment were compared on baseline characteristics and up to 2-year follow-up outcomes. Mixed model multivariate regression adjusted outcome findings for baseline group differences. Few significant baseline differences existed between males and females, with both sexes self-reporting very high rates of lifetime mental health (83% women, 74% men) and substance use (68% women, 73% men) problems. Throughout the 2-year follow-up, both men and women dramatically increased the number of days housed, showed minimal changes in substance use patterns, and had modest improvements in mental health outcomes, without significant differences between genders. Unlike other U.S. populations, chronically homeless adults do not demonstrate substantial gender differences on mental health or addiction problems. Policy and service delivery must address these remarkably high rates of substance use and mental illness. Published by Elsevier Inc.

  6. Why older adults make more immediate treatment decisions about cancer than younger adults.

    PubMed

    Meyer, Bonnie J F; Talbot, Andrew P; Ranalli, Carlee

    2007-09-01

    Literature relevant to medical decision making was reviewed, and a model was outlined for testing. Two studies examined whether older adults make more immediate decisions than younger adults about treatments for prostate or breast cancer in authentic scenarios. Findings clearly showed that older adults were more likely to make immediate decisions than younger adults. The research is important because it not only demonstrates the consistency of this age-related effect across disease domains, gender, ethnic groups, and prevalent education levels but begins to investigate a model to explain the effect. Major reasons for the effect focus on treatment knowledge, interest and engagement, and cognitive resources. Treatment knowledge, general cancer knowledge, interest, and cognitive resources relate to different ways of processing treatment information and preferences for immediate versus delayed decision making. Adults with high knowledge of treatments on a reliable test tended to make immediate treatment decisions, which supports the knowledge explanation. Adults with more cognitive resources and more interest tended to delay their treatment decisions. Little support was found for a cohort explanation for the relationship between age and preference for immediate medical decision making. (PsycINFO Database Record (c) 2007 APA, all rights reserved).

  7. Exploration of older and younger British adults' performance on The Awareness of Social Inference Test (TASIT).

    PubMed

    Burdon, Paul; Dipper, Lucy; Cocks, Naomi

    2016-09-01

    Social perception is an important skill. One assessment that is commonly used to assess social perception abilities is The Awareness of Social Inference Test (TASIT). The only normative data available for this test are for Australian younger adults. Despite no normative data being available for British adults, the test is widely used in the UK with older and younger adults. There is a growing body of research that suggests that older adults have difficulty with skills associated with social perception. There is therefore a need to determine whether British adults, and more specifically British older adults, perform similarly to the Australian normative TASIT scores available in the manual. To explore the differences between older and younger British adults' performance on TASIT, and to determine whether younger and older British adults perform similarly to the data from Australian adults in TASIT manual. TASIT was administered to a total of 42 native British English speaking participants. The participants were split into two age groups 18-45 and 60-90 years. Comparisons were made between the two groups and the Australian data in TASIT manual. The younger British and Australian adults obtained similar scores on all parts of TASIT. The older British adults though, obtained significantly lower scores than the Australian younger adults on all parts of TASIT and when education was controlled for they obtained significantly lower scores than the British younger adults. The findings are discussed in the light of previous research that has found that older adults are worse than younger adults at social inferences. The findings of the current study suggest that caution should be used when using TASIT with older British adults to assess social perception abilities. © 2016 Royal College of Speech and Language Therapists.

  8. Risk factors for homelessness among US veterans.

    PubMed

    Tsai, Jack; Rosenheck, Robert A

    2015-01-01

    Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  9. The effects of sleep on episodic memory in older and younger adults.

    PubMed

    Aly, Mariam; Moscovitch, Morris

    2010-04-01

    Evidence on sleep-dependent benefits for episodic memory remains elusive. Furthermore we know little about age-related changes on the effects of sleep on episodic memory. The study we report is the first to compare the effects of sleep on episodic memories in younger and older adults. Memories of stories and personal events were assessed following a retention interval that included sleep and following an equal duration of wakefulness. Both older and younger adults have superior memory following sleep compared to following wakefulness for both types of material. Amount of forgetting of personal events was less during wakefulness in older adults than in younger adults, possibly due to spontaneous rehearsal. Amount of time spent sleeping correlated highly with sleep benefit in older adults, suggesting that quantity of total sleep, and/or time spent in some stages of sleep, are important contributors to age-related differences in memory consolidation or protection from interference during sleep.

  10. Understanding the Effect of Workload on Automation Use for Younger and Older Adults

    PubMed Central

    McBride, Sara E.; Rogers, Wendy A.; Fisk, Arthur D.

    2018-01-01

    Objective This study examined how individuals, younger and older, interacted with an imperfect automated system. The impact of workload on performance and automation use was also investigated. Background Automation is used in situations characterized by varying levels of workload. As automated systems spread to domains such as transportation and the home, a diverse population of users will interact with automation. Research is needed to understand how different segments of the population use automation. Method Workload was systematically manipulated to create three levels (low, moderate, high) in a dual-task scenario in which participants interacted with a 70% reliable automated aid. Two experiments were conducted to assess automation use for younger and older adults. Results Both younger and older adults relied on the automation more than they complied with it. Among younger adults, high workload led to poorer performance and higher compliance, even when that compliance was detrimental. Older adults’ performance was negatively affected by workload, but their compliance and reliance were unaffected. Conclusion Younger and older adults were both able to use and double-check an imperfect automated system. Workload affected how younger adults complied with automation, particularly with regard to detecting automation false alarms. Older adults tended to comply and rely at fairly high rates overall, and this did not change with increased workload. Application Training programs for imperfect automated systems should vary workload and provide feedback about error types, and strategies for identifying errors. The ability to identify automation errors varies across individuals, thereby necessitating training. PMID:22235529

  11. Profiles of criminal justice system involvement of mentally ill homeless adults.

    PubMed

    Roy, Laurence; Crocker, Anne G; Nicholls, Tonia L; Latimer, Eric; Gozdzik, Agnes; O'Campo, Patricia; Rae, Jennifer

    2016-01-01

    This study aims to examine the rates of self-reported contacts with the criminal justice system among homeless adults with mental illness, to identify the characteristics of participants who have had contacts with the criminal justice system, to report the dimensional structure of criminal justice system involvement in this sample, and to identify typologies of justice-involved participants. Self-report data on criminal justice system involvement of 2221 adults participating in a Canadian Housing First trial were analyzed using multiple correspondence and cluster analysis. Almost half of the participants had at least one contact with the criminal justice system in the 6months prior to study enrollment. Factors associated with justice involvement included age, gender, ethnic background, diagnosis, substance misuse, impulse control, compliance, victimization, service use, and duration of homelessness. A typology of criminal justice involvement was developed. Seven criminal justice system involvement profiles emerged; substance use and impulse control distinguished the clusters, whereas demographic and contextual variables did not. The large number of profiles indicates the need for a diverse and flexible range of interventions that could be integrated within or in addition to current support of housing services, including integrated substance use and mental health interventions, risk management strategies, and trauma-oriented services. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Factors associated with cognitive impairment in a cohort of older homeless adults: Results from the HOPE HOME study.

    PubMed

    Hurstak, Emily; Johnson, Julene K; Tieu, Lina; Guzman, David; Ponath, Claudia; Lee, Christopher T; Jamora, Christina Weyer; Kushel, Margot

    2017-09-01

    We evaluated cognitive function and factors associated with cognitive impairment in a cohort of older homeless adults. We hypothesized that substance use and a history of traumatic brain injury would be associated with cognitive impairment. We recruited 350 homeless individuals aged ≥50 years using population-based sampling and conducted structured interviews and neuropsychological testing. We evaluated alcohol use with the Alcohol Use Disorder Identification Test, defining high-severity alcohol use as a total score ≥16 or ≥4 on the alcohol dependency sub-scale. We assessed global cognition with the Modified Mini-Mental State Test (3MS) and processing speed and executive function with the Trail Making Test (TMTB), defining impairment as performing 1.5 standard deviations below the standardized mean. We used multivariable logistic regression to examine the association between alcohol use and cognition. Participants had a median age of 58 years [IQR 54-61], 76.7% were men, and 79.9% were African American. A quarter (25.1%) of participants met criteria for impairment on the 3MS; 32.9% met criteria for impairment on TMTB. In models adjusted for sociodemographic variables and health conditions, high-severity alcohol use was associated with global cognitive impairment (AOR 2.39, CI 1.19-4.79) and executive dysfunction (AOR 3.09, CI 1.61-5.92). Older homeless adults displayed a prevalence of cognitive impairment 3-4 times higher than has been observed in general population adults aged 70 and older. Impaired cognition in older homeless adults could impact access to housing programs and the treatment of health conditions, including the treatment of alcohol use disorders. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Emergency Department Use in a Cohort of Older Homeless Adults: Results From the HOPE HOME Study.

    PubMed

    Raven, Maria C; Tieu, Lina; Lee, Christopher T; Ponath, Claudia; Guzman, David; Kushel, Margot

    2017-01-01

    The median age of single homeless adults is over 50, yet little is known about their emergency department (ED) use. We describe use of and factors associated with ED use in a sample of homeless adults 50 and older. We recruited 350 participants who were homeless and 50 or older in Oakland, California. We interviewed participants about residential history in the prior 6 months, health status, health-related behaviors, and health services use and assessed cognition and mobility. Our primary outcome was the number of ED visits in the prior 6 months based on medical record review. We used negative binomial regression to examine factors associated with ED use. In the 6 months prior to enrollment, 46.3% of participants spent the majority of their time unsheltered; 25.1% cycled through multiple institutions including shelters, hospitals, and jails; 16.3% primarily stayed with family or friends; and 12.3% had become homeless recently after spending much of the prior 6 months housed. Half (49.7%) of participants made at least one ED visit in the past 6 months; 6.6% of participants accounted for 49.9% of all visits. Most (71.8%) identified a regular non-ED source of healthcare; 7.3% of visits resulted in hospitalization. In multivariate models, study participants who used multiple institutions (incidence rate ratio [IRR] = 2.27; 95% confidence interval [CI] = 1.08 to 4.77) and who were unsheltered (IRR = 2.29; 95% CI = 1.17 to 4.48) had higher ED use rates than participants who had been housed for most of the prior 6 months. In addition, having health insurance/coverage (IRR = 2.6; CI = 1.5 to 4.4), a history of psychiatric hospitalization (IRR = 1.80; 95% CI = 1.09 to 2.99), and severe pain (IRR = 1.72; 95% CI = 1.07 to 2.76) were associated with higher ED visit rates. A sample of adults aged 50 and older who were homeless at study entry had higher rates of ED use in the prior 6 months than the general U.S. age-matched population. Within the sample

  14. Learning To Hope: A Study of the Adult Education for the Homeless Program.

    ERIC Educational Resources Information Center

    Drury, Darrel; Koloski, Judy

    A comprehensive study of the Adult Education for the Homeless Program (AEH) was conducted using data from the following sources: program files; focus groups conducted with state project administrators; site visits to 9 local programs in 3 states; surveys of 32 state projects, 230 local programs, 588 service delivery sites, and 2,943 program…

  15. The Relationship between Literacy and Depression and Anxiety in Homeless Adults

    ERIC Educational Resources Information Center

    Holland, Mark Edward

    2014-01-01

    Homelessness is a problem that has correlating social, psychological, and health problems. The pathways that lead to homelessness are plentiful and varied, as are the risk factors that are associated with chronic homelessness. Much of the research that has been completed with homeless individuals has focused on substance use or psychological…

  16. Posttraumatic Stress Symptoms and Their Association With Smoking Outcome Expectancies Among Homeless Smokers in Boston

    PubMed Central

    Campbell, Eric G.; Chang, Yuchiao; Magid, Leah M.; Rigotti, Nancy A.

    2016-01-01

    Introduction: Cigarette smoking and traumatic life experiences are each common among homeless adults, but the prevalence and correlates of posttraumatic stress disorder (PTSD) symptoms among homeless smokers are not known. We assessed symptoms of PTSD and their association with smoking outcome expectancies in a sample of homeless smokers in Boston. Methods: We used time-location sampling to conduct an in-person survey of homeless adult smokers using Boston Health Care for the Homeless Program clinical services. We assessed symptoms of PTSD with the PTSD Checklist—Civilian version and considered scores at least 14 as positive. We used the Smoking Effects Questionnaire to assess positive and negative smoking outcome expectancies. We modeled the associations between PTSD screening status and smoking expectancies using design-adjusted linear regression. Results: Eighty-six percent of eligible individuals participated (N = 306). Sixty-eight percent of participants screened positive for PTSD. Screen-positive respondents were younger (P = .001), more likely to report fair/poor health (P = .01), chronic obstructive pulmonary disease (P = .02), and past-month hallucinations (P = .004), and had greater drug (P < .001) and alcohol (P < .001) use severity and cigarette dependence (P = .002). In analyses controlling for these confounders, PTSD screen-positive participants more strongly endorsed smoking to reduce negative affect (P = .01), smoking for social benefits (P = .002), and smoking for weight control (P = .03). Exploratory analyses suggested that these associations were driven by avoidance/numbing and re-experiencing symptoms. Conclusions: Symptoms of posttraumatic stress are common among homeless smokers and strongly associated with positive smoking outcome expectancies. Tobacco cessation programs for this population should consider screening for PTSD and fostering a trauma-sensitive treatment environment. Implications: In this study of homeless cigarette smokers in

  17. Postural adjustment errors during lateral step initiation in older and younger adults

    PubMed Central

    Sparto, Patrick J.; Fuhrman, Susan I.; Redfern, Mark S.; Perera, Subashan; Jennings, J. Richard; Furman, Joseph M.

    2016-01-01

    The purpose was to examine age differences and varying levels of step response inhibition on the performance of a voluntary lateral step initiation task. Seventy older adults (70 – 94 y) and twenty younger adults (21 – 58 y) performed visually-cued step initiation conditions based on direction and spatial location of arrows, ranging from a simple choice reaction time task to a perceptual inhibition task that included incongruous cues about which direction to step (e.g. a left pointing arrow appearing on the right side of a monitor). Evidence of postural adjustment errors and step latencies were recorded from vertical ground reaction forces exerted by the stepping leg. Compared with younger adults, older adults demonstrated greater variability in step behavior, generated more postural adjustment errors during conditions requiring inhibition, and had greater step initiation latencies that increased more than younger adults as the inhibition requirements of the condition became greater. Step task performance was related to clinical balance test performance more than executive function task performance. PMID:25595953

  18. Postural adjustment errors during lateral step initiation in older and younger adults

    PubMed Central

    Sparto, Patrick J.; Fuhrman, Susan I.; Redfern, Mark S.; Perera, Subashan; Jennings, J. Richard; Furman, Joseph M.

    2014-01-01

    The purpose was to examine age differences and varying levels of step response inhibition on the performance of a voluntary lateral step initiation task. Seventy older adults (70 – 94 y) and twenty younger adults (21 – 58 y) performed visually-cued step initiation conditions based on direction and spatial location of arrows, ranging from a simple choice reaction time task to a perceptual inhibition task that included incongruous cues about which direction to step (e.g. a left pointing arrow appearing on the right side of a monitor). Evidence of postural adjustment errors and step latencies were recorded from vertical ground reaction forces exerted by the stepping leg. Compared with younger adults, older adults demonstrated greater variability in step behavior, generated more postural adjustment errors during conditions requiring inhibition, and had greater step initiation latencies that increased more than younger adults as the inhibition requirements of the condition became greater. Step task performance was related to clinical balance test performance more than executive function task performance. PMID:25183162

  19. Goal-setting, self-efficacy, and memory performance in older and younger adults.

    PubMed

    West, R L; Thorn, R M

    2001-01-01

    Research in field and laboratory settings has shown that goals lead to improved self-efficacy and performance, especially when individuals also receive positive feedback. The present study extended goal-setting theory to examine self-set goals and feedback in relation to younger and older adults' memory performance and self-efficacy. Following a baseline recall trial, participants completed three shopping list recall trials. Half of the participants were instructed to set goals for the three experimental trials, and half in each goal condition received performance feedback after each trial. Young adults' self-efficacy, clustering, and recall exceeded that of older adults. Goal setting increased self-efficacy for younger but not older adults, and it did not affect performance. Younger adults and participants in the feedback condition increased their goals across trials, as did participants for whom feedback indicated success. These data provide a first look at the motivational impact of feedback and self-set recall goals in memory aging. Additional study is needed to understand the interactive effects of type of feedback, memory task difficulty, and type of goal setting at different ages.

  20. Situation Selection and Modification for Emotion Regulation in Younger and Older Adults.

    PubMed

    Livingstone, Kimberly M; Isaacowitz, Derek M

    2015-11-01

    This research investigated age differences in use and effectiveness of situation selection and situation modification for emotion regulation. Socioemotional selectivity theory suggests stronger emotional well-being goals in older age; emotion regulation may support this goal. Younger and older adults assigned to an emotion regulation or "just view" condition first freely chose to engage with negative, neutral, or positive material (situation selection), then chose to view or skip negative and positive material (situation modification), rating affect after each experience. In both tasks, older adults in both goal conditions demonstrated pro-hedonic emotion regulation, spending less time with negative material compared to younger adults. Younger adults in the regulate condition also engaged in pro-hedonic situation selection, but not modification. Whereas situation selection was related to affect, modification of negative material was not. This research supports more frequent pro-hedonic motivation in older age, as well as age differences in use of early-stage emotion regulation.

  1. Situation Selection and Modification for Emotion Regulation in Younger and Older Adults

    PubMed Central

    Livingstone, Kimberly M.; Isaacowitz, Derek M.

    2016-01-01

    This research investigated age differences in use and effectiveness of situation selection and situation modification for emotion regulation. Socioemotional selectivity theory suggests stronger emotional well-being goals in older age; emotion regulation may support this goal. Younger and older adults assigned to an emotion regulation or “just view” condition first freely chose to engage with negative, neutral, or positive material (situation selection), then chose to view or skip negative and positive material (situation modification), rating affect after each experience. In both tasks, older adults in both goal conditions demonstrated pro-hedonic emotion regulation, spending less time with negative material compared to younger adults. Younger adults in the regulate condition also engaged in pro-hedonic situation selection, but not modification. Whereas situation selection was related to affect, modification of negative material was not. This research supports more frequent pro-hedonic motivation in older age, as well as age differences in use of early-stage emotion regulation. PMID:26998196

  2. On the Road: Examining Self-Representation and Discourses of Homelessness in Young Adult Texts

    ERIC Educational Resources Information Center

    Rogers, Theresa; Marshall, Elizabeth

    2012-01-01

    In this article, the authors analyze representations of social issues within contemporary memoirs written for and marketed to a young adult audience and multimodal zines produced by homeless youth. To read across these distinctly different texts (mass marketed and do-it-yourself cultural productions) and genres (memoir and zines), the authors…

  3. Task Inhibition and Response Inhibition in Older vs. Younger Adults: A Diffusion Model Analysis

    PubMed Central

    Schuch, Stefanie

    2016-01-01

    Differences in inhibitory ability between older (64–79 years, N = 24) and younger adults (18–26 years, N = 24) were investigated using a diffusion model analysis. Participants performed a task-switching paradigm that allows assessing n−2 task repetition costs, reflecting inhibitory control on the level of tasks, as well as n−1 response-repetition costs, reflecting inhibitory control on the level of responses. N−2 task repetition costs were of similar size in both age groups. Diffusion model analysis revealed that for both younger and older adults, drift rate parameters were smaller in the inhibition condition relative to the control condition, consistent with the idea that persisting task inhibition slows down response selection. Moreover, there was preliminary evidence for task inhibition effects in threshold separation and non-decision time in the older, but not the younger adults, suggesting that older adults might apply different strategies when dealing with persisting task inhibition. N−1 response-repetition costs in mean RT were larger in older than younger adults, but in mean error rates tended to be larger in younger than older adults. Diffusion-model analysis revealed longer non-decision times in response repetitions than response switches in both age groups, consistent with the idea that motor processes take longer in response repetitions than response switches due to persisting response inhibition of a previously executed response. The data also revealed age-related differences in overall performance: Older adults responded more slowly and more accurately than young adults, which was reflected by a higher threshold separation parameter in diffusion model analysis. Moreover, older adults showed larger non-decision times and higher variability in non-decision time than young adults, possibly reflecting slower and more variable motor processes. In contrast, overall drift rate did not differ between older and younger adults. Taken together

  4. The Effects of Prior Exposure on Face Processing in Younger and Older Adults

    PubMed Central

    Heisz, Jennifer J.; Ryan, Jennifer D.

    2011-01-01

    Older adults differ from their younger counterparts in the way they view faces. We assessed whether older adults can use past experience to mitigate these typical face-processing differences; that is, we examined whether there are age-related differences in the use of memory to support current processing. Eye movements of older and younger adults were monitored as they viewed faces that varied in the type/amount of prior exposure. Prior exposure was manipulated by including famous and novel faces, and by presenting faces up to five times. We expected that older adults may have difficulty quickly establishing new representations to aid in the processing of recently presented faces, but would be able to invoke face representations that have been stored in memory long ago to aid in the processing of famous faces. Indeed, younger adults displayed effects of recent exposure with a decrease in the total fixations to the faces and a gradual increase in the proportion of fixations to the eyes. These effects of recent exposure were largely absent in older adults. In contrast, the effect of fame, revealed by a subtle increase in fixations to the inner features of famous compared to non-famous faces, was similar for younger and older adults. Our results suggest that older adults’ current processing can benefit from lifetime experience, however the full benefit of recent experience on face processing is not realized in older adults. PMID:22007169

  5. Using mHealth to Increase Treatment Utilization Among Recently Incarcerated Homeless Adults (Link2Care): Protocol for a Randomized Controlled Trial.

    PubMed

    Reingle Gonzalez, Jennifer M; Businelle, Michael S; Kendzor, Darla; Staton, Michele; North, Carol S; Swartz, Michael

    2018-06-05

    There is a significant revolving door of incarceration among homeless adults. Homeless adults who receive professional coordination of individualized care (ie, case management) during the period following their release from jail experience fewer mental health and substance use problems, are more likely to obtain stable housing, and are less likely to be reincarcerated. This is because case managers work to meet the various needs of their clients by helping them to overcome barriers to needed services (eg, food, clothing, housing, job training, substance abuse and mental health treatment, medical care, medication, social support, proof of identification, and legal aid). Many barriers (eg, limited transportation, inability to schedule appointments, and limited knowledge of available services) prevent homeless adults who were recently released from incarceration from obtaining available case management, crisis management, substance abuse, and mental health services. The aim of the Link2Care study is to assess the effectiveness of a smartphone app for increasing case management and treatment service utilization, and in turn reduce homelessness and rearrest. The goals of this research are to (1) assess the impact of an innovative smartphone app that will prompt and directly link recently incarcerated homeless adults to community-based case management services and resources and (2) utilize in-person and smartphone-based assessments to identify key variables (eg, alcohol or drug use, social support, psychological distress, and quality of life) that predict continued homelessness and rearrest. Homeless adults (N=432) who enroll in a shelter-based Homeless Recovery Program after release from the Dallas County Jail will be randomly assigned to one of the three treatment groups: (1) usual case management, (2) usual case management plus smartphone, and (3) usual case management with a study-provided smartphone that is preloaded with an innovative case management app

  6. Trends in colorectal cancer incidence among younger adults-Disparities by age, sex, race, ethnicity, and subsite.

    PubMed

    Crosbie, Amanda B; Roche, Lisa M; Johnson, Linda M; Pawlish, Karen S; Paddock, Lisa E; Stroup, Antoinette M

    2018-06-22

    Millennials (ages 18-35) are now the largest living generation in the US, making it important to understand and characterize the rising trend of colorectal cancer incidence in this population, as well as other younger generations of Americans. Data from the New Jersey State Cancer Registry (n = 181 909) and Surveillance, Epidemiology, and End Results program (n = 448 714) were used to analyze invasive CRC incidence trends from 1979 to 2014. Age, sex, race, ethnicity, subsite, and stage differences between younger adults (20-49) and screening age adults (≥50) in New Jersey (NJ) were examined using chi-square; and, we compared secular trends in NJ to the United States (US). Whites, men, and the youngest adults (ages 20-39) are experiencing greater APCs in rectal cancer incidence. Rates among younger black adults, overall, were consistently higher in both NJ and the US over time. When compared to older adults, younger adults with CRC in NJ were more likely to be: diagnosed at the late stage, diagnosed with rectal cancer, male, non-white, and Hispanic. Invasive CRC incidence trends among younger adults were found to vary by age, sex, race, ethnicity, and subsite. Large, case-level, studies are needed to understand the role of genetics, human papillomavirus (HPV), and cultural and behavioral factors in the rise of CRC among younger adults. Provider and public education about CRC risk factors will also be important for preventing and reversing the increasing CRC trend in younger adults. © 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  7. Reflections of distraction in memory: transfer of previous distraction improves recall in younger and older adults.

    PubMed

    Thomas, Ruthann C; Hasher, Lynn

    2012-01-01

    Three studies explored whether younger and older adults' free recall performance can benefit from prior exposure to distraction that becomes relevant in a memory task. Participants initially read stories that included distracting text. Later, they studied a list of words for free recall, with half of the list consisting of previously distracting words. When the memory task was indirect in its use of distraction (Study 1), only older adults showed transfer, with better recall of previously distracting compared with new words, which increased their recall to match that of younger adults. However, younger adults showed transfer when cued about the relevance of previous distraction both before studying the words (Study 2) and before recalling the words (Study 3) in the memory test. Results suggest that both younger and older adults encode distraction, but younger adults require explicit cueing to use their knowledge of distraction. In contrast, older adults transfer knowledge of distraction in both explicitly cued and indirect memory tasks. Results are discussed in terms of age differences in inhibition and source-constrained retrieval.

  8. Trichomonas vaginalis infection among homeless and unstably housed adult women living in a resource-rich urban environment.

    PubMed

    Riley, Elise D; Cohen, Jennifer; Dilworth, Samantha E; Grimes, Barbara; Marquez, Carina; Chin-Hong, Peter; Philip, Susan S

    2016-06-01

    The social context of poverty is consistently linked to Trichomonas vaginalis infection, yet few studies regarding T. vaginalis have been conducted exclusively among low-income individuals. We identified social determinants of health associated with prevalent T. vaginalis infection among homeless and unstably housed adult women. Between April and October of 2010, we conducted cross-sectional T. vaginalis screening and behavioural interviews in an existing cohort of San Francisco homeless and unstably housed women. Data were analysed using multivariable logistical regression. Among 245 study participants, the median age was 47 years and 72% were of non-Caucasian race/ethnicity. T. vaginalis prevalence was 12%, compared to 3% in the general population, and 33% of infected individuals reported no gynaecological symptoms. In adjusted analysis, the odds of T. vaginalis infection were lower among persons older than 47 years, the population median (OR=0.14, 95% CI 0.04 to 0.38), and higher among those reporting recent short-term homeless shelter stays (OR=5.36, 95% CI 1.57 to 18.26). Race and income did not reach levels of significance. Sensitivity analyses indicated that testing all women who report recent unprotected sex would identify more infections than testing those who report gynaecological symptoms (20/30 vs 10/30; p=0.01). The prevalence of T. vaginalis is high among homeless and unstably housed adult women, over one-third of infected individuals have no gynaecological symptoms, and correlates of infection differ from those reported in the general population. Targeted screening and treatment among impoverished women reporting recent unprotected sex, particularly young impoverished women and all women experiencing short-term homelessness, may reduce complications related to this treatable infection. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. Clear speech and lexical competition in younger and older adult listeners.

    PubMed

    Van Engen, Kristin J

    2017-08-01

    This study investigated whether clear speech reduces the cognitive demands of lexical competition by crossing speaking style with lexical difficulty. Younger and older adults identified more words in clear versus conversational speech and more easy words than hard words. An initial analysis suggested that the effect of lexical difficulty was reduced in clear speech, but more detailed analyses within each age group showed this interaction was significant only for older adults. The results also showed that both groups improved over the course of the task and that clear speech was particularly helpful for individuals with poorer hearing: for younger adults, clear speech eliminated hearing-related differences that affected performance on conversational speech. For older adults, clear speech was generally more helpful to listeners with poorer hearing. These results suggest that clear speech affords perceptual benefits to all listeners and, for older adults, mitigates the cognitive challenge associated with identifying words with many phonological neighbors.

  10. Homelessness in the state and federal prison population.

    PubMed

    Greenberg, Greg A; Rosenheck, Robert A

    2008-01-01

    This study sought to investigate the rates and correlates of homelessness (i.e. living on the street or in a homeless shelter), including mental illness, among US adult state and federal prison inmates (ASFPIs). Data from a national survey of ASFPIs based on a random sampling survey (N = 17,565) were used to compare the homelessness rate among AFSPIs with that in the general population. Logistic regression was then used to examine the association of homelessness among ASFPIs with factors including symptoms, treatment of mental illness, previous criminal justice involvement, specific crimes, and demographic characteristics. Nine percent of ASFPIs reported an episode of homelessness in the year prior to arrest, 4-6 times the estimated rate in the general US adult population after allowing for age, race/ethnicity, and gender. In comparison to other inmates, these homeless inmates were more likely to be currently incarcerated for a property crime, but also to have had previous criminal justice system involvement for both property and violent crimes, to suffer from mental health and/or substance abuse problems, and to be more likely to have been unemployed and with a low income. Recent homelessness is far more common among ASFPIs than the general population. Prior incarceration, mental illness, substance abuse and disadvantageous socio-demographic characteristics were all found to be associated with homelessness among prison inmates, suggesting that there are several important factors in addition to efforts to survive with limited resources through criminal acts that influence the rates of homelessness among incarcerated individuals.

  11. Reflections of Distraction in Memory: Transfer of Previous Distraction Improves Recall in Younger and Older Adults

    PubMed Central

    Thomas, Ruthann C.; Hasher, Lynn

    2012-01-01

    Three studies explored whether younger and older adults’ free recall performance can benefit from prior exposure to distraction that becomes relevant in a memory task. Participants initially read stories that included distracting text. Later, they studied a list of words for free recall, with half of the list consisting of previously distracting words. When the memory task was indirect in its use of distraction (Study 1), only older adults showed transfer, with better recall of previously distracting compared with new words, which increased their recall to match that of younger adults. However, younger adults showed transfer when cued about the relevance of previous distraction both before studying the words (Study 2) and before recalling the words (Study 3) in the memory test. Results suggest that both younger and older adults encode distraction, but younger adults require explicit cueing to use their knowledge of distraction. In contrast, older adults transfer knowledge of distraction in both explicitly cued and indirect memory tasks. Results are discussed in terms of age differences in inhibition and source-constrained retrieval. PMID:21843024

  12. The Relationship between Learning Disabilities and Homelessness in Adults

    ERIC Educational Resources Information Center

    Markos, Patricia A.; Strawser, Sherri

    2004-01-01

    This article describes the relationship between learning disabilities (LD) and homelessness. Research describing the connection between disabilities and homelessness has focused on individuals presenting with disabilities such as mental illness, physical disabilities, medical disabilities, or substance abuse. At this time, the presence of LD in…

  13. Positive Outcomes Enhance Incidental Learning for Both Younger and Older Adults

    PubMed Central

    Mather, Mara; Schoeke, Andrej

    2011-01-01

    Previous studies suggest that memory encoding is enhanced when people are anticipating a potential reward, consistent with the idea that dopaminergic systems that respond to motivationally relevant information also enhance memory for that information. In the current study, we examined how anticipating and receiving rewards versus losses affect incidental learning of information. In addition, we compared the modulatory effects of reward anticipation and outcome on memory for younger and older adults. Forty-two younger (aged 18–33 years) and 44 older (aged 66–92 years) adults played a game involving pressing a button as soon as they saw a target. Gain trials began with a cue that they would win $0.25 if they pressed the button fast enough, loss trials began with a cue that they would avoid losing $0.25 if they pressed the button fast enough, and no-outcome trials began with a cue indicating no monetary outcome. The target was a different photo-object on each trial (e.g., balloon, dolphin) and performance outcomes were displayed after the photo disappeared. Both younger and older adults recalled and recognized pictures from trials with positive outcomes (either rewarding or loss avoiding) better than from trials with negative outcomes. Positive outcomes were associated with not only enhanced memory for the picture just seen in that trial, but also with enhanced memory for the pictures shown in the next two trials. Although anticipating a reward also enhanced incidental memory, this effect was seen only in recognition memory of positive pictures and was a smaller effect than the outcome effect. The fact that older adults showed similar incidental memory effects of reward anticipation and outcome as younger adults suggests that reward–memory system interactions remain intact in older age. PMID:22125509

  14. Time perspective and social preference in older and younger adults: Effects of self-regulatory fatigue.

    PubMed

    Segerstrom, Suzanne C; Geiger, Paul J; Combs, Hannah L; Boggero, Ian A

    2016-09-01

    Socioemotional selectivity theory predicts that when perceived time in life is limited, people will prefer emotionally close social partners over less emotionally rewarding partners. Regulating social choices with regard to time perspective can make the best use of time with regard to well-being. However, doing so may depend on the self-regulatory capacity of the individual. Two studies, 1 with younger adults (N = 101) and 1 with younger (N = 42) and older (N = 39) adults, experimentally tested the effects of time perspective and self-regulatory fatigue on preferences for emotionally close partners and knowledgeable partners. In both studies and across younger and older adults, when self-regulatory fatigue was low, the perception of limited time resulted in a greater preference for close social partners relative to knowledgeable social partners. However, this shift was eliminated by self-regulatory fatigue. In Study 2, when fatigued, younger adults preferred close social partners to knowledgeable partners across time perspectives; older adults preferred close and knowledgeable partners more equally across time perspectives. These findings have implications for social decision-making and satisfaction among people who experience chronic self-regulatory fatigue. They also contradict previous suggestions that only younger adults are susceptible to self-regulatory fatigue. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  15. Time Perspective and Social Preference in Older and Younger Adults: Effects of Self-Regulatory Fatigue

    PubMed Central

    Segerstrom, Suzanne C.; Geiger, Paul J.; Combs, Hannah L.; Boggero, Ian A.

    2016-01-01

    Socioemotional selectivity theory predicts that when perceived time in life is limited, people will prefer emotionally close social partners over less emotionally rewarding partners. Regulating social choices with regard to time perspective can make the best use of time with regard to well-being. However, doing so may depend on the self-regulatory capacity of the individual. Two studies, one with younger adults (N = 101) and one with younger (N = 42) and older (N = 39) adults, experimentally tested the effects of time perspective and self-regulatory fatigue on preferences for emotionally close partners and knowledgeable partners. In both studies and across younger and older adults, when self-regulatory fatigue was low, the perception of limited time resulted in a greater preference for close social partners relative to knowledgeable social partners. However, this shift was eliminated by self-regulatory fatigue. In Study 2, when fatigued, younger adults preferred close social partners to knowledgeable partners across time perspectives; older adults preferred close and knowledgeable partners more equally across time perspectives. These findings have implications for social decision-making and satisfaction among people who experience chronic self-regulatory fatigue. They also contradict previous suggestions that only younger adults are susceptible to self-regulatory fatigue. PMID:27243763

  16. How Positive Is Their Future? Assessing the Role of Optimism and Social Support in Understanding Mental Health Symptomatology among Homeless Adults.

    PubMed

    Fitzpatrick, Kevin M

    2017-04-01

    Optimism has been noted as a primary protective factor in understanding mental health symptomatology in clinical and non-clinical settings. Any exploration of optimism has been absent in understanding mental health outcomes among homeless people. This study, using intensive interviews with 168 homeless adults in Northwest Arkansas, examines the role that social support and optimism play in lessening the negative impact of homeless circumstances/experiences on mental health symptomatology. Using OLS, findings support a mediating/protective role that social support and optimism play in lowering the negative effects of childhood life experiences on depressive symptoms among homeless persons. Despite the overwhelming conditions of homelessness, persons with higher levels of optimism and social support report lower depression and anxiety symptoms. The findings are discussed paying particular attention to the importance of developing and maintaining the perception of support and resiliency in preserving a positive outlook for the future among homeless persons facing often-debilitating circumstances. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  17. Age Differences in Emotion Regulation Choice: Older Adults Use Distraction Less Than Younger Adults in High-Intensity Positive Contexts.

    PubMed

    Martins, Bruna; Sheppes, Gal; Gross, James J; Mather, Mara

    2018-04-16

    Previous research demonstrates that younger and older adults prefer distraction over engagement (reappraisal) when regulating high-intensity negative emotion. Older adults also demonstrate a greater bias for positive over negative information in attention and memory compared with younger adults. In this study, we investigated whether emotion regulation choice preferences may differ as a function of stimulus valence with age. The effect of stimulus intensity on negative and positive emotion regulation strategy preferences was investigated in younger and older men. Participants indicated whether they favored distraction or reappraisal to attenuate emotional reactions to negative and positive images that varied in intensity. Men in both age-groups preferred distraction over reappraisal when regulating high-intensity emotion. As no age-related strategic differences were found in negative emotion regulation preferences, older men chose to distract less from high-intensity positive images than did younger men. Older men demonstrated greater engagement with highly positive emotional contexts than did younger men. Thus, age differences in emotion regulation goals when faced with intense emotional stimuli depend on the valence of the emotional stimuli.

  18. Medication adherence and rejection rates in older versus younger adult liver transplant recipients

    PubMed Central

    Leven, Emily A.; Annunziato, Rachel; Helcer, Jacqueline; Lieber, Sarah R.; Knight, Christopher S.; Wlodarkiewicz, Catherine; Soriano, Rainier P.; Florman, Sander S.; Schiano, Thomas D.; Shemesh, Eyal

    2017-01-01

    A growing number of older adults are undergoing liver transplantation (LT) in the US. In some settings, it is thought that adherence declines with age. This retrospective study examined adherence and clinical outcomes in older versus younger adult LT recipients. Medical records of adult LT recipients from 2009–2012 from a single urban center were reviewed. The medication level variability index (MLVI) was the pre-defined primary outcome, with nonadherence defined as MLVI >2.5. The secondary outcome was incidence of rejection. Outcomes were evaluated starting one year post-LT until 2015. 42/248 patients were ≥65 at transplant. Older adults had significantly better adherence than younger ones (65% ≥65 were adherent vs. 42% younger adults; Chi-Square two-tailed p=0.02). Survival analyses of rejection between age groups censored by time since transplant showed no difference among the four age groups (χ2 = 0.84, p=0.84). Older age was not found to be a risk factor for reduced adherence or graft rejection in patients surviving at least one year post-LT. PMID:28370346

  19. State-based versus reward-based motivation in younger and older adults.

    PubMed

    Worthy, Darrell A; Cooper, Jessica A; Byrne, Kaileigh A; Gorlick, Marissa A; Maddox, W Todd

    2014-12-01

    Recent decision-making work has focused on a distinction between a habitual, model-free neural system that is motivated toward actions that lead directly to reward and a more computationally demanding goal-directed, model-based system that is motivated toward actions that improve one's future state. In this article, we examine how aging affects motivation toward reward-based versus state-based decision making. Participants performed tasks in which one type of option provided larger immediate rewards but the alternative type of option led to larger rewards on future trials, or improvements in state. We predicted that older adults would show a reduced preference for choices that led to improvements in state and a greater preference for choices that maximized immediate reward. We also predicted that fits from a hybrid reinforcement-learning model would indicate greater model-based strategy use in younger than in older adults. In line with these predictions, older adults selected the options that maximized reward more often than did younger adults in three of the four tasks, and modeling results suggested reduced model-based strategy use. In the task where older adults showed similar behavior to younger adults, our model-fitting results suggested that this was due to the utilization of a win-stay-lose-shift heuristic rather than a more complex model-based strategy. Additionally, within older adults, we found that model-based strategy use was positively correlated with memory measures from our neuropsychological test battery. We suggest that this shift from state-based to reward-based motivation may be due to age related declines in the neural structures needed for more computationally demanding model-based decision making.

  20. Quality of Health Care: The Views of Homeless Youth

    PubMed Central

    Ensign, Josephine

    2004-01-01

    Objective To develop homeless-youth-identified process and outcome measures of quality of health care. Data Sources/Study Setting Primary data collection with homeless youth from both street and clinic settings in Seattle, Washington, for calendar year 2002. Study Design The research was a focused ethnography, using key informant and in-depth individual interviews as well as focus groups with a purposeful sample of 47 homeless youth aged 12–23 years. Data Collection/Extraction Methods All interviews and focus groups were tape-recorded, transcribed, and preliminarily coded, with final coding cross-checked and verified with a second researcher. Principal Findings Homeless youth most often stated that cultural and interpersonal aspects of quality of care were important to them. Physical aspects of quality of care reported by the youth were health care sites separate from those for homeless adults, andsites that offered a choice of allopathic and complementary medicine. Outcomes of health care included survival of homelessness, functional and disease-state improvement, and having increased trust and connections with adults and with the wider community. Conclusions Homeless youth identified components of quality of care as well as how quality of care should be measured. Their perspectives will be included in a larger follow-up study to develop quality of care indicators for homeless youth. PMID:15230923

  1. Strategies adopted by younger and older adults while operating a non-pedal tricycle.

    PubMed

    Calve, Tatiane; Russo Júnior, Douglas Vicente; Barela, Ana Maria Forti

    Exercises that could prevent gait impairment of older adults should be implemented in such a way that practitioners can keep motivation and adherence independent of older adults fitness levels. This study describes how younger and older adults use a non-pedal tricycle to transport their bodies along a pathway. Nine younger (24±4.9y) and nine older (66±4.0y) adults participated in this study. They moved along a straight pathway at a self-selected comfortable speed with reflective markers on their main lower limb landmarks. A computerized gait analysis system with infrared cameras was used to obtain kinematic data to calculate spatial-temporal parameters and lower limb angles. Overall, participants from both groups were able to perform the task moving at a similar mean speed, with similar stride length and ankle joint excursion. Older adults had higher cadence (mean difference of 17steps/min; 95% CI=0.99-1.15) and hip excursion (mean difference of 12°; 95% CI=28-33), longer stance duration (mean difference of 3.4%; 95% CI=56.2-59.5), and lower knee excursion (mean difference of 6°; 95% CI=47.9-53.8) than younger adults. Older adults were able to transport their body with a non-pedal tricycle with more hip and less knee excursion than younger adults. Professionals that work with the older population should look at and take into consideration the use of non-pedal tricycles in exercise protocols and investigate the long-term impacts. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

  2. Where do people go when they first become homeless? A survey of homeless adults in the USA.

    PubMed

    O'Toole, Thomas P; Conde-Martel, Alicia; Gibbon, Jeanette L; Hanusa, Barbara H; Freyder, Paul J; Fine, Michael J

    2007-09-01

    The longer a person is homeless, the more likely he or she is to experience poor health and be placed at higher risk for premature death. This makes interventions early in one's homelessness an important prevention strategy. However, little is known about where someone goes for help when they first become homeless and how well those sites are prepared to address the multitude of issues facing a homeless person. In order to address this question, we conducted a cross-sectional community-based survey in two US cities in 1997 using population proportionate sampling of homeless persons identified at 91 sites to identify 'first-stop' access sites and reasons for seeking help at those sites. A total of 230 persons participated in the face-to-face interview (93% response rate). From a list of 20 possible 'first-stop' sites, 105 (45.7%) reported going to a soup kitchen, 71 (30.9%) went to a welfare office, 64 (27.8%) sought admission to a detoxification centre, 60 (26.1%) met with a homeless outreach team, 57 (24.8%) went to a family member, and 54 (23.5%) went to an emergency room. Individuals with a chronic medical or mental health condition were significantly more likely to access a healthcare site (medical: 62.6% vs. 47.6%, P = 0.02; mental health: 62.4% vs. 38.8%, P < 0.01) or social service agency (medical: 64.0% vs. 43.3%, P = 0.02; mental health: 59.1% vs. 40.7%, P < 0.01). Those persons reporting a need for alcohol treatment were significantly more likely to first go to a healthcare site (46.4% vs. 29.1%, P < 0.01) and those with alcohol abuse/dependence were less likely to seek help from family or friends (66.7% vs. 81.9%, P < 0.01). Most respondents sought assistance for concerns directly associated with an immediate need as opposed to seeking care for issues causing their actual homelessness. These findings suggest the need to expand and integrate the availability of services at 'first-stop' access sites that facilitate early exits from homelessness.

  3. The Impact of Presentation Format on Younger and Older Adults' Self-Regulated Learning.

    PubMed

    Price, Jodi

    2017-01-01

    Background/Study Context: Self-regulated learning involves deciding what to study and for how long. Debate surrounds whether individuals' selections are influenced more by item complexity, point values, or if instead people select in a left-to-right reading order, ignoring item complexity and value. The present study manipulated whether point values and presentation format favored selection of simple or complex Chinese-English pairs to assess the impact on younger and older adults' selection behaviors. One hundred and five younger (M age  = 20.26, SD = 2.38) and 102 older adults (M age  = 70.28, SD = 6.37) participated in the experiment. Participants studied four different 3 × 3 grids (two per trial), each containing three simple, three medium, and three complex Chinese-English vocabulary pairs presented in either a simple-first or complex-first order, depending on condition. Point values were assigned in either a 2-4-8 or 8-4-2 order so that either simple or complex items were favored. Points did not influence the order in which either age group selected items, whereas presentation format did. Younger and older adults selected more simple or complex items when they appeared in the first column. However, older adults selected and allocated more time to simpler items but recalled less overall than did younger adults. Memory beliefs and working memory capacity predicted study time allocation, but not item selection, behaviors. Presentation format must be considered when evaluating which theory of self-regulated learning best accounts for younger and older adults' study behaviors and whether there are age-related differences in self-regulated learning. The results of the present study combine with others to support the importance of also considering the role of external factors (e.g., working memory capacity and memory beliefs) in each age group's self-regulated learning decisions.

  4. Homelessness, cigarette smoking and desire to quit: results from a US national study.

    PubMed

    Baggett, Travis P; Lebrun-Harris, Lydie A; Rigotti, Nancy A

    2013-11-01

    We determined whether or not homelessness is associated with cigarette smoking independent of other socio-economic measures and behavioral health factors, and whether homeless smokers differ from non-homeless smokers in their desire to quit. We analyzed data from 2678 adult respondents to the 2009 Health Center Patient Survey, a nationally representative cross-sectional survey of homeless and non-homeless individuals using US federally funded community health centers. We used multivariable logistic regression to examine the association between homelessness and (i) current cigarette smoking among all adults, and (ii) past-year desire to quit among current smokers, adjusting for demographic, socio-economic and behavioral health characteristics. Adults with any history of homelessness were more likely than never homeless respondents to be current smokers (57 versus 27%, P < 0.001). In multivariable models, a history of homelessness was associated independently with current smoking [adjusted odds ratio (AOR) 2.09; 95% confidence interval (CI) = 1.49-2.93], even after adjusting for age, sex, race, veteran status, insurance, education, employment, income, mental illness and alcohol and drug abuse. Housing status was not associated significantly with past-year desire to stop smoking in unadjusted (P = 0.26) or adjusted (P = 0.60) analyses; 84% of currently homeless, 89% of formerly homeless and 82% of never homeless smokers reported wanting to quit. Among patients of US health centers, a history of homelessness doubles the odds of being a current smoker independent of other socio-economic factors and behavioral health conditions. However, homeless smokers do not differ from non-homeless smokers in their desire to quit and should be offered effective interventions. © 2013 Society for the Study of Addiction.

  5. Posttraumatic Stress Symptoms and Their Association With Smoking Outcome Expectancies Among Homeless Smokers in Boston.

    PubMed

    Baggett, Travis P; Campbell, Eric G; Chang, Yuchiao; Magid, Leah M; Rigotti, Nancy A

    2016-06-01

    Cigarette smoking and traumatic life experiences are each common among homeless adults, but the prevalence and correlates of posttraumatic stress disorder (PTSD) symptoms among homeless smokers are not known. We assessed symptoms of PTSD and their association with smoking outcome expectancies in a sample of homeless smokers in Boston. We used time-location sampling to conduct an in-person survey of homeless adult smokers using Boston Health Care for the Homeless Program clinical services. We assessed symptoms of PTSD with the PTSD Checklist-Civilian version and considered scores at least 14 as positive. We used the Smoking Effects Questionnaire to assess positive and negative smoking outcome expectancies. We modeled the associations between PTSD screening status and smoking expectancies using design-adjusted linear regression. Eighty-six percent of eligible individuals participated (N = 306). Sixty-eight percent of participants screened positive for PTSD. Screen-positive respondents were younger (P = .001), more likely to report fair/poor health (P = .01), chronic obstructive pulmonary disease (P = .02), and past-month hallucinations (P = .004), and had greater drug (P < .001) and alcohol (P < .001) use severity and cigarette dependence (P = .002). In analyses controlling for these confounders, PTSD screen-positive participants more strongly endorsed smoking to reduce negative affect (P = .01), smoking for social benefits (P = .002), and smoking for weight control (P = .03). Exploratory analyses suggested that these associations were driven by avoidance/numbing and re-experiencing symptoms. Symptoms of posttraumatic stress are common among homeless smokers and strongly associated with positive smoking outcome expectancies. Tobacco cessation programs for this population should consider screening for PTSD and fostering a trauma-sensitive treatment environment. In this study of homeless cigarette smokers in Boston, over two-thirds of participants screened positive for

  6. Services Receipt Following Veteran Outpatients' Positive Screen for Homelessness.

    PubMed

    Montgomery, Ann E; Dichter, Melissa E; Thomasson, Arwin M; Roberts, Christopher B

    2016-03-01

    The Veterans Health Administration seeks to reduce homelessness among Veterans by identifying, and providing prevention and supportive services to, patients with housing concerns. The objectives of this study were to assess the proportion of Veterans Health Administration patients who received homeless or social work services within 6 months of a positive screen for homelessness or risk in the Veterans Health Administration and the demographic and clinical characteristics that predicted services utilization. Data were from a cohort of 27,403 Veteran outpatients who screened positive for homelessness or risk between November 1, 2012 and January 31, 2013. During 2013, AORs were calculated using a mixed-effects logistic regression to estimate the likelihood of patients' receipt of VHA homeless or social work services based on demographic and clinical characteristics. The majority of patients received services within 6 months post-screening; predictors of services utilization varied by gender. Among women, diagnosis of drug abuse and psychosis predicted receipt of services, being unmarried increased the odds of using services among those screening positive for homelessness, and a diagnosis of post-traumatic stress disorder increased the odds of receiving services for at-risk women. Among men, being younger, unmarried, not service-connected/Medicaid-eligible, and having a medical or behavioral health condition predicted receipt of services. Receipt of housing support services among Veterans post-homelessness screening differs by patient demographic and clinical characteristics. Future research should investigate the role that primary and secondary prevention interventions play in Veterans' resolution of risk for homelessness and experience of homelessness. Published by Elsevier Inc.

  7. Interventions by healthcare professionals to improve management of physical long-term conditions in adults who are homeless: a systematic review protocol

    PubMed Central

    Hanlon, Peter; Yeoman, Lynsey; Esiovwa, Regina; Gibson, Lauren; Williamson, Andrea E; Mair, Frances S; Lowrie, Richard

    2017-01-01

    Introduction People experiencing homelessness are at increased risk of, and have poorer outcomes from, a range of physical long-term conditions (LTCs). It is increasingly recognised that interventions targeting people who are homeless should be tailored to the specific needs of this population. This systematic review aims to identify, describe and appraise trials of interventions that aim to manage physical LTCs in homeless adults and are delivered by healthcare professionals. Methods and analysis Seven electronic databases (Medline, EMBASE, Cochrane Central Register of Controlled Trials, Assia, Scopus, PsycINFO and CINAHL) will be searched from 1960 (or inception) to October 2016 and supplemented by forward citation searching, handsearching of reference lists and searching grey literature. Two reviewers will independently review titles, abstract and full-texts using DistillerSR software. Inclusion criteria include (1) homeless adults with any physical LTC, (2) interventions delivered by a healthcare professional (any professional trained to provide any form of healthcare, but excluding social workers and professionals without health-related training), (3) comparison with usual care or an alternative intervention, (4) report outcomes such as healthcare usage, physical and psychological health or well-being or cost-effectiveness, (5) randomised controlled trials, non-randomised controlled trials, controlled before-after studies. Quality will be assessed using the Cochrane EPOC Risk of Bias Tool. A meta-analysis will be performed if sufficient data are identified; however, we anticipate a narrative synthesis will be performed. Ethics and dissemination This review will synthesise existing evidence for interventions delivered by healthcare professionals to manage physical LTCs in adults who are homeless. The findings will inform the development of future interventions and research aiming to improve the management of LTCs for people experiencing homelessness. Ethical

  8. Exploring Interhemispheric Collaboration in Older Compared to Younger Adults

    ERIC Educational Resources Information Center

    Cherry, Barbara J.; Yamashiro, Mariana; Anderson, Erin; Barrett, Christopher; Adamson, Maheen M.; Hellige, Joseph B.

    2010-01-01

    Physical and Name Identity letter-matching tasks were used to explore differences in interhemispheric collaboration in younger and older adults. To determine whether other factors might also be related to across/within-hemisphere processing or visual field asymmetries, neuropsychological tests measuring frontal/executive functioning were…

  9. Homelessness, Cigarette Smoking, and Desire to Quit: Results from a U.S. National Study

    PubMed Central

    Baggett, Travis P.; Lebrun-Harris, Lydie A.; Rigotti, Nancy A.

    2013-01-01

    Aims We determined whether homelessness is associated with cigarette smoking independent of other socioeconomic measures and behavioral health factors, and whether homeless smokers differ from non-homeless smokers in their desire to quit. Design, Setting, and Participants We analyzed data from 2,678 adult respondents to the 2009 Health Center Patient Survey, a nationally representative cross-sectional survey of homeless and non-homeless individuals using U.S. federally-funded community health centers. Measurements We used multivariable logistic regression to examine the association between homelessness and (1) current cigarette smoking among all adults, and (2) past-year desire to quit among current smokers, adjusting for demographic, socioeconomic, and behavioral health characteristics. Findings Adults with any history of homelessness were more likely than never homeless respondents to be current smokers (57% vs. 27%, p<0.001). In multivariable models, a history of homelessness was independently associated with current smoking (AOR 2.09; 95% CI 1.49-2.93), even after adjusting for age, sex, race, veteran status, insurance, education, employment, income, mental illness, and alcohol and drug abuse. Housing status was not significantly associated with past-year desire to stop smoking in unadjusted (p=0.26) or adjusted (p=0.60) analyses; 84% of currently homeless, 89% of formerly homeless, and 82% of never homeless smokers reported wanting to quit. Conclusions Among patients of U.S. health centers, a history of homelessness doubles the odds of being a current smoker independent of other socioeconomic factors and behavioral health conditions. However, homeless smokers do not differ from non-homeless smokers in their desire to quit and should be offered effective interventions. PMID:23834157

  10. Improving health status of homeless patients at a nurse-managed clinic in the Midwest USA.

    PubMed

    Savage, Christine L; Lindsell, Christopher J; Gillespie, Gordon L; Lee, Roberta J; Corbin, Adele

    2008-09-01

    Homeless adults have a higher rate of morbidity and mortality than their housed counterparts. Improving the health of homeless adults is a complex problem because of the overlay of individual risk factors, social issues and lack of economic resources. Due to the increased morbidity and mortality rate in homeless adults, it is imperative to develop interventions with demonstrated efficacy that result in improved health outcomes. The purpose of this pre-post pilot study was to compare pre- and post-test scores on specific health outcomes in a group of homeless adults receiving a nurse intervention when utilising a nurse-managed clinic located in the urban core of a Midwestern city in the USA. Between September of 2004 and January 2006, 43 homeless adults completed a health survey at baseline and 2 months later that included measures of health-related quality of life (HRQOL), substance use and health resource use. There was a significant improvement on the post-test scores including substance use, perceived quality and availability of health care, and on two domains of HRQOL: mental health and vitality. This study provides evidence that a nursing intervention can result in improved health outcomes for adult homeless persons.

  11. Short-term and long-term collaboration benefits on individual recall in younger and older adults

    PubMed Central

    Stern, Yaakov

    2011-01-01

    A recent study of younger adults suggests that, compared to repeated individual recall trials, repeated collaborative recall trials produce better individual recall after a short delay (Blumen & Rajaram, 2008). Our study was designed to determine if such collaboration benefits would remain after a one-week delay, in both younger and older adults. Sixty younger (M age = 24.60) and 60 older (M age = 67.35) adults studied a list of words and then completed either two collaborative recall trials followed by two individual recall trials, or four individual recall trials. A five-min delay was inserted between the first three recall trials. The fourth recall trial was administered 1 week later. Collaborative recall was completed in groups of three individuals working together. Both younger and older adults benefitted from repeated collaborative recall trials to a greater extent than repeated individual recall trials, and such collaboration benefits remained after a one-week delay. This is the first demonstration of collaboration benefits on later individual recall at delays as long as 1 week, in both younger and older adults. Findings are discussed within the context of the negative effects of collaboration associated with group memory (collaborative inhibition) and the positive effects of collaboration associated with later individual memory (collaboration benefits). PMID:21264617

  12. Short-term and long-term collaboration benefits on individual recall in younger and older adults.

    PubMed

    Blumen, Helena M; Stern, Yaakov

    2011-01-01

    A recent study of younger adults suggests that, compared to repeated individual recall trials, repeated collaborative recall trials produce better individual recall after a short delay (Blumen & Rajaram, 2008). Our study was designed to determine if such collaboration benefits would remain after a one-week delay, in both younger and older adults. Sixty younger (M age = 24.60) and 60 older (M age = 67.35) adults studied a list of words and then completed either two collaborative recall trials followed by two individual recall trials, or four individual recall trials. A five-min delay was inserted between the first three recall trials. The fourth recall trial was administered 1 week later. Collaborative recall was completed in groups of three individuals working together. Both younger and older adults benefitted from repeated collaborative recall trials to a greater extent than repeated individual recall trials, and such collaboration benefits remained after a one-week delay. This is the first demonstration of collaboration benefits on later individual recall at delays as long as 1 week, in both younger and older adults. Findings are discussed within the context of the negative effects of collaboration associated with group memory (collaborative inhibition) and the positive effects of collaboration associated with later individual memory (collaboration benefits).

  13. For Youth, by Youth: A Third Student-Run Homeless Shelter

    ERIC Educational Resources Information Center

    Seider, Scott C.

    2016-01-01

    This past winter, the third student-run homeless shelter in the United States came into being. Two recent Harvard graduates, Sam Greenberg and Sarah Rosenkrantz, who had volunteered at the Harvard Square Homeless Shelter as college students, saw a need within the Boston and Cambridge communities for a homeless shelter serving young adults. Drawing…

  14. Adverse Childhood Experiences and the Risk of Criminal Justice Involvement and Victimization Among Homeless Adults With Mental Illness.

    PubMed

    Edalati, Hanie; Nicholls, Tonia L; Crocker, Anne G; Roy, Laurence; Somers, Julian M; Patterson, Michelle L

    2017-12-01

    Exposure to adverse childhood experiences (ACEs) is highly prevalent among homeless individuals and is associated with negative consequences during homelessness. This study examined the effect of ACEs on the risk of criminal justice involvement and victimization among homeless individuals with mental illness. The study used baseline data from a demonstration project (At Home/Chez Soi) that provided Housing First and recovery-oriented services to homeless adults with mental illness. The sample was recruited from five Canadian cities and included participants who provided valid responses on an ACEs questionnaire (N=1,888). Fifty percent reported more than four types of ACE, 19% reported three or four types, 19% reported one or two, and 12% reported none. Rates of criminal justice involvement and victimization were significantly higher among those with a history of ACEs. For victimization, the association was significant for all ten types of ACE, and for justice involvement, it was significant for seven types. Logistic regression models indicated that the effect of cumulative childhood adversity on the two outcomes was significant regardless of sociodemographic factors, duration of homelessness, and psychiatric diagnosis, with one exception: the relationship between cumulative childhood adversity and criminal justice involvement did not remain significant when the analysis controlled for a diagnosis of posttraumatic stress disorder and substance dependence. Findings support the need for early interventions for at-risk youths and trauma-informed practice and violence prevention policies that specifically target homeless populations.

  15. Coping and resilience among ethnoracial individuals experiencing homelessness and mental illness.

    PubMed

    Paul, Sayani; Corneau, Simon; Boozary, Tanya; Stergiopoulos, Vicky

    2018-03-01

    The multiple challenges that ethnoracial homeless individuals experiencing mental illness face are well documented. However, little is known about how this homeless subpopulation copes with the compounding stressors of racial discrimination, homelessness and mental illness. This study is an in-depth investigation of the personal perceived strengths, attitudes and coping behaviors of homeless adults of diverse ethnoracial backgrounds experiencing homelessness and mental illness in Toronto, Canada. Using qualitative methods, 36 in-depth semi-structured interviews were conducted to capture the perspectives of ethnoracial homeless participants with mental illness on coping and resilience. Transcripts were analyzed using thematic analysis. Similar to prior findings in the general homeless population, study participants recognized personal strengths and attitudes as great sources of coping and resilience, describing hope and optimism, self-esteem and confidence, insight into their challenges and spirituality as instrumental to overcoming current challenges. In addition, participants described several coping strategies, including seeking support from family, friends and professionals; socializing with peers; engaging in meaningful activities; distancing from overwhelming challenges; and finding an anchor. Findings suggest that homeless adults with mental illness from ethnoracial groups use similar coping strategies and sources of resilience with the general homeless population and highlight the need for existing services to foster hope, recognize and support individual coping strategies and sources of resilience of homeless individuals experiencing complex challenges.

  16. The effects of value on context-item associative memory in younger and older adults.

    PubMed

    Hennessee, Joseph P; Knowlton, Barbara J; Castel, Alan D

    2018-02-01

    Valuable items are often remembered better than items that are less valuable by both older and younger adults, but older adults typically show deficits in binding. Here, we examine whether value affects the quality of recognition memory and the binding of incidental details to valuable items. In Experiment 1, participants learned English words each associated with a point-value they earned for correct recognition with the goal of maximizing their score. In Experiment 2, value was manipulated by presenting items that were either congruent or incongruent with an imagined state of physiological need (e.g., hunger). In Experiment 1, point-value was associated with enhanced recollection in both age groups. Memory for the color associated with the word was in fact reduced for high-value recollected items compared with low-value recollected items, suggesting value selectively enhances binding of task-relevant details. In Experiment 2, memory for learned images was enhanced by value in both age groups. However, value differentially enhanced binding of an imagined context to the item in younger and older adults, with a strong trend for increased binding in younger adults only. These findings suggest that value enhances episodic encoding in both older and younger adults but that binding of associated details may be reduced for valuable items compared to less valuable items, particularly in older adults. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  17. Neurophysiological and Behavioral Differences between Older and Younger Adults When Processing Violations of Tonal Structure in Music

    PubMed Central

    Lagrois, Marie-Élaine; Peretz, Isabelle; Zendel, Benjamin Rich

    2018-01-01

    Aging is associated with decline in both cognitive and auditory abilities. However, evidence suggests that music perception is relatively spared, despite relying on auditory and cognitive abilities that tend to decline with age. It is therefore likely that older adults engage compensatory mechanisms which should be evident in the underlying functional neurophysiology related to processing music. In other words, the perception of musical structure would be similar or enhanced in older compared to younger adults, while the underlying functional neurophysiology would be different. The present study aimed to compare the electrophysiological brain responses of younger and older adults to melodic incongruities during a passive and active listening task. Older and younger adults had a similar ability to detect an out-of-tune incongruity (i.e., non-chromatic), while the amplitudes of the ERAN and P600 were reduced in older adults compared to younger adults. On the other hand, out-of-key incongruities (i.e., non-diatonic), were better detected by older adults compared to younger adults, while the ERAN and P600 were comparable between the two age groups. This pattern of results indicates that perception of tonal structure is preserved in older adults, despite age-related neurophysiological changes in how melodic violations are processed. PMID:29487498

  18. Neurophysiological and Behavioral Differences between Older and Younger Adults When Processing Violations of Tonal Structure in Music.

    PubMed

    Lagrois, Marie-Élaine; Peretz, Isabelle; Zendel, Benjamin Rich

    2018-01-01

    Aging is associated with decline in both cognitive and auditory abilities. However, evidence suggests that music perception is relatively spared, despite relying on auditory and cognitive abilities that tend to decline with age. It is therefore likely that older adults engage compensatory mechanisms which should be evident in the underlying functional neurophysiology related to processing music. In other words, the perception of musical structure would be similar or enhanced in older compared to younger adults, while the underlying functional neurophysiology would be different. The present study aimed to compare the electrophysiological brain responses of younger and older adults to melodic incongruities during a passive and active listening task. Older and younger adults had a similar ability to detect an out-of-tune incongruity (i.e., non-chromatic), while the amplitudes of the ERAN and P600 were reduced in older adults compared to younger adults. On the other hand, out-of-key incongruities (i.e., non-diatonic), were better detected by older adults compared to younger adults, while the ERAN and P600 were comparable between the two age groups. This pattern of results indicates that perception of tonal structure is preserved in older adults, despite age-related neurophysiological changes in how melodic violations are processed.

  19. The cognitive control of emotional versus value-based information in younger and older adults.

    PubMed

    Eich, Teal S; Castel, Alan D

    2016-08-01

    We investigated age-related changes in the cognitive control of value-based and emotionally valenced information. In 2 experiments, participants completed a selectivity task in which to-be-recalled words differed in value and emotional salience. In Experiment 1, all low-valued words were emotional, and emotional valence (positive/negative) was manipulated between subjects. In Experiment 2, valence was manipulated within subjects, with the addition of a control condition in which all words (emotional and neutral) were equally valued. We found that older and younger adults recalled more neutral words than emotional words in both experiments when emotional words were low-valued, and more emotional words than neutral words in the control condition. Emotion did not interact with age in either experiment, suggesting that the impact of emotional saliency on memory is age-invariant. We also found that the number of items recalled was lower for older compared to younger adults in both experiments. Despite this, older and younger adults showed equivalent selectivity in terms of which words they recalled. These results suggest that older adults employ strategic control and use value-based information to guide memory processes equivalently to younger adults, even in the face of salient emotional information. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  20. Viral hepatitis in a homeless shelter in Hawai'i.

    PubMed

    Boyce, Daniel E C; Tice, Alan D; Ona, Fernando V; Akinaka, Kenneth T; Lusk, Heather

    2009-06-01

    It is estimated that as many as 21,000 people in the state of Hawai'i may be infected with HCV Most of those infected with viral hepatitis are unaware they are infected. Complications from viral hepatitis include liver cirrhosis and hepatocellular carcinoma. Hawai'i has the highest incidence of hepatocellular carcinoma in the United States. In 2003 there were over 6000 homeless and over 155,000 people at-risk of becoming homeless living in the state of Hawai'i. Risk factors for hepatitis, such as drug use, tattoos, sexual contact, and sharing of personal hygiene equipment are more prevalent in the homeless population. To determine the incidence of hepatitis B and C among a population of homeless individuals, a health fair was held at a Honolulu area homeless shelter with approximately 200 residents. The incidence of hepatitis B and C was determined by anti-HCV and HBsAg blood tests. A survey was also conducted regarding risk factors and basic demographics. Fifty-nine homeless adults volunteered for testing and took the survey. Thirty-one (52%) volunteers were born in Micronesia, twenty-four (41%) were born in the United States, two (3%) were born in Samoa, one (2%) was born in the Philippines, and one (2%) was born in the Marshall Islands. Forty adults were tested for Hepatitis C antibody, three of which tested positive. The primary risk factor among this group was jail time (100%), followed by illegal drug injection (67%), tattoos (67%), ear/body piercing (67%), snorting drugs (33%), blood transfusions (33%), and a sex partner with hepatitis (33%). Forty adults were also tested for HBsAg, One of which tested positive. This was a recent immigrant from Micronesia. Homeless people in Hawai'i are more likely to have hepatitis B or C because risk factors are common among this population. Additionally a large proportion of Hawai'i's homeless people come from the Pacific Islands, where the prevalence of hepatitis B is one of the highest in the world. In addition there

  1. A Literature Review of Homelessness and Aging: Suggestions for a Policy and Practice-Relevant Research Agenda.

    PubMed

    Grenier, Amanda; Barken, Rachel; Sussman, Tamara; Rothwell, David; Bourgeois-Guérin, Valérie; Lavoie, Jean-Pierre

    2016-03-01

    Homelessness among older people is a growing concern across Canada and is expected to rise with demographic change (Crane & Warnes, 2010; Culhane, Metraux, Byrne, Stino, & Bainbridge, 2013). Yet current knowledge, policies, and practices on homelessness largely focus on younger populations. Likewise, research and policies on aging typically overlook homelessness. Responses to homelessness among older people must address complex needs related to health, income security, and housing. Based on a comprehensive literature review, this article outlines the existing and needed research with regards to homelessness among older people. We clarify the intersections of aging and homelessness; review the relevant statistics, including estimated prevalence; discuss pathways and variations in experience; and identify gaps in knowledge. We conclude with a call for an inclusive research agenda that will help build policies and practices to reduce and ultimately to eliminate homelessness among older people in Canada.

  2. Visual feature binding in younger and older adults: encoding and suffix interference effects.

    PubMed

    Brown, Louise A; Niven, Elaine H; Logie, Robert H; Rhodes, Stephen; Allen, Richard J

    2017-02-01

    Three experiments investigated younger (18-25 yrs) and older (70-88 yrs) adults' temporary memory for colour-shape combinations (binding). We focused upon estimating the magnitude of the binding cost for each age group across encoding time (Experiment 1; 900/1500 ms), presentation format (Experiment 2; simultaneous/sequential), and interference (Experiment 3; control/suffix) conditions. In Experiment 1, encoding time did not differentially influence binding in the two age groups. In Experiment 2, younger adults exhibited poorer binding performance with sequential relative to simultaneous presentation, and serial position analyses highlighted a particular age-related difficulty remembering the middle item of a series (for all memory conditions). Experiments 1-3 demonstrated small to medium binding effect sizes in older adults across all encoding conditions, with binding less accurate than shape memory. However, younger adults also displayed negative effects of binding (small to large) in two of the experiments. Even when older adults exhibited a greater suffix interference effect in Experiment 3, this was for all memory types, not just binding. We therefore conclude that there is no consistent evidence for a visual binding deficit in healthy older adults. This relative preservation contrasts with the specific and substantial deficits in visual feature binding found in several recent studies of Alzheimer's disease.

  3. Reduced impact of alcohol use on next-day tiredness in older relative to younger adults: A role for sleep duration.

    PubMed

    Lydon-Staley, David M; Ram, Nilam; Brose, Annette; Schmiedek, Florian

    2017-11-01

    Recent work has suggested that older adults may be less susceptible to the next-day effects of alcohol relative to younger adults. The effects of alcohol in younger adults may be mediated by sleep duration, but due to age differences in the contexts of alcohol use, this mediation process may not generalize to older adults. The present study examined age-group (younger vs. older adults) differences in how alcohol use influenced next-day tiredness during daily life. Reports of alcohol use, sleep duration, and next-day tiredness obtained on ∼101 days from 91 younger adults (ages 20-31 years) and 75 older adults (ages 65-80 years) were modeled using a multilevel, moderated mediation framework. Findings indicated that (a) greater-than-usual alcohol use was associated with greater-than-usual tiredness in younger adults only, (b) greater-than-usual alcohol use was associated with shorter-than-usual sleep duration in younger adults only, and (c) shorter-than-usual sleep duration was associated with greater tiredness in both younger and older adults. For the prototypical younger adult, a significant portion (43%) of the association between alcohol use and next-day tiredness could be explained assuming mediation through sleep duration, whereas there was no evidence of mediation for the prototypical older adult. Findings of age differences in the mediation process underlying associations among alcohol use, sleep, and tiredness provide insight into the mechanisms driving recent observations of reduced next-day effects of alcohol in older relative to younger adults. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  4. Preliminary Findings on Rural Homelessness in Ohio.

    ERIC Educational Resources Information Center

    First, Richard J.; And Others

    This report is designed to present preliminary findings from the first comprehensive study of rural homelessness in the United States. The study was conducted during the first 6 months of 1990, and data were collected from interviews with 921 homeless adults in 21 randomly selected rural counties in Ohio. The sample counties represent 26% of the…

  5. Similarity to the Self Affects Memory for Impressions of Others in Younger and Older Adults

    PubMed Central

    Park, Jung M.; Gutchess, Angela H.

    2015-01-01

    Objectives. Similarity to the self has been shown to affect memory for impressions in younger adults, suggesting a self-reference effect in person memory. Because older adults show comparable self-reference effects, but prioritize memory for positive over negative information relative to young adults, we examined age differences in self-similarity effects on memory for positive and negative impressions. Method. Younger and older adults formed positive and negative impressions of others differing in the degree of similarity to the self (high, medium, low). Results. For positive impressions, both groups showed enhanced memory for self-similar others relative to dissimilar others, whereas for negative impressions, memory was poorer for those similar to the self. When collapsed across similarity to the self, younger adults remembered negative impressions better than older adults, but interestingly, older adults exhibited a trend for better memory for the positive impressions. Discussion. Results suggest that self-reference effects in impression memory are preserved with age and that older adults exhibit positivity effects in person memory consistent with previous findings. PMID:24389124

  6. Screening for Dyslipidemia in Younger Adults: A Systematic Review for the U.S. Preventive Services Task Force.

    PubMed

    Chou, Roger; Dana, Tracy; Blazina, Ian; Daeges, Monica; Bougatsos, Christina; Jeanne, Thomas L

    2016-10-18

    Dyslipidemia may occur in younger adults (defined as persons aged 21 to 39 years) and is an important risk factor for cardiovascular disease. Screening might identify younger adults with asymptomatic dyslipidemia who may benefit from lipid-lowering therapies. To update the 2008 U.S. Preventive Services Task Force review on dyslipidemia screening in younger adults. The Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and MEDLINE through May 2016, and reference lists. Randomized, controlled trials; cohort studies; and case-control studies on screening for or treatment of asymptomatic dyslipidemia in adults aged 21 to 39 years. The plan was for 1 investigator to abstract data and a second to check their accuracy, and for 2 investigators to independently assess study quality; however, no studies met the inclusion criteria. No study evaluated the effects of lipid screening versus no screening, treatment versus no treatment, or delayed versus earlier treatment on clinical outcomes in younger adults. In addition, no study evaluated the diagnostic yield of alternative screening strategies (such as targeted screening of persons with a family history of hyperlipidemia vs. general screening) in younger adults. No direct relevant evidence. Direct evidence on the benefits and harms of screening for or treatment of dyslipidemia in younger adults remains unavailable. Estimating the potential effects of screening for dyslipidemia in this population requires extrapolation from studies performed in older adults. Agency for Healthcare Research and Quality.

  7. Memory for general and specific value information in younger and older adults: measuring the limits of strategic control.

    PubMed

    Castel, Alan D; Farb, Norman A S; Craik, Fergus I M

    2007-06-01

    The ability to selectively remember important information is a critical function of memory. Although previous research has suggested that older adults are impaired in a variety of episodic memory tasks, recent work has demonstrated that older adults can selectively remember high-value information. In the present research, we examined how younger and older adults selectively remembered words with various assigned numeric point values, to see whether younger adults could remember more specific value information than could older adults. Both groups were equally good at recalling point values when recalling the range of high-value words, but younger adults outperformed older adults when recalling specific values. Although older adults were more likely to recognize negative value words, both groups exhibited control by not recalling negative value information. The findings suggest that although both groups retain high-value information, older adults rely more on gist-based encoding and retrieval operations, whereas younger adults are able to remember specific numeric value information.

  8. Nutrition and health services needs among the homeless.

    PubMed Central

    Wiecha, J L; Dwyer, J T; Dunn-Strohecker, M

    1991-01-01

    This review discusses nutrition and related health problems among homeless Americans, summarizes recent information, and identifies needs for services and future research. The nature of homelessness today provides a context for the discussion. Many homeless persons eat fewer meals per day, lack food more often, and are more likely to have inadequate diets and poorer nutritional status than housed U.S. populations. Yet many homeless people eligible for food stamps do not receive them. While public and private agencies provide nutritious food and meals for homeless persons, availability of the services to homeless persons is limited. Many homeless people lack appropriate health care, and certain nutrition-related health problems are prevalent among them. Compared with housed populations, alcoholism, anemia, and growth problems are more common among homeless persons, and pregnancy rates are higher. The risks vary among homeless persons for malnutrition, nutrition-related health problems, drug and alcohol abuse, and mental illness. For example, among homeless persons, fewer heads of families than single adults are substance abusers, and mental illness varies in prevalence among single men, single women, and parents in homeless families. Homeless persons need improved access to food, nutrition, and health services. More nutrition education needs to be available to them and to service providers. Use of representative samples and validation of self-reported nutrition and health data will help future investigators to clarify the relationships between the characteristics of the homeless and their nutritional status. PMID:1908587

  9. Network Approaches to Substance Use and HIV/Hepatitis C Risk among Homeless Youth and Adult Women in the United States: A Review.

    PubMed

    Dombrowski, Kirk; Sittner, Kelley; Crawford, Devan; Welch-Lazoritz, Melissa; Habecker, Patrick; Khan, Bilal

    2016-09-01

    During the United States economic recession of 2008-2011, the number of homeless and unstably housed people in the United States increased considerably. Homeless adult women and unaccompanied homeless youth make up the most marginal segments of this population. Because homeless individuals are a hard to reach population, research into these marginal groups has traditionally been a challenge for researchers interested in substance abuse and mental health. Network analysis techniques and research strategies offer means for dealing with traditional challenges such as missing sampling frames, variation in definitions of homelessness and study inclusion criteria, and enumeration/population estimation procedures. This review focuses on the need for, and recent steps toward, solutions to these problems that involve network science strategies for data collection and analysis. Research from a range of fields is reviewed and organized according to a new stress process framework aimed at understanding how homeless status interacts with issues related to substance abuse and mental health. Three types of network innovation are discussed: network scale-up methods, a network ecology approach to social resources, and the integration of network variables into the proposed stress process model of homeless substance abuse and mental health. By employing network methods and integrating these methods into existing models, research on homeless and unstably housed women and unaccompanied young people can address existing research challenges and promote more effective intervention and care programs.

  10. Differences in Health and Social Support between Homeless Men and Women Entering Permanent Supportive Housing

    PubMed Central

    Winetrobe, Hailey; Wenzel, Suzanne; Rhoades, Harmony; Henwood, Benjamin; Rice, Eric; Harris, Taylor

    2017-01-01

    Background Permanent supportive housing (PSH) is the leading intervention to end chronic homelessness. Little is known, however, about gender differences, including potential disparities in physical and mental health and social support, that might inform services available through PSH. Methods 421 homeless adults, at least 39 years old, English- or Spanish-speaking, who were moving into PSH through 26 different agencies in the Los Angeles area participated. Results Compared to men entering PSH, homeless women (28% of the sample) were younger (p<0.01), less likely to have achieved at least a high school education (p<0.05), and had lower incomes (p<0.01). Women had more chronic physical health conditions (p<0.01), were more likely to have any chronic mental health condition (OR: 2.5, p<0.01), and had more chronic mental health conditions than men (p<0.01). Women had more relatives in their social networks (Coef: 0.79, p<0.01) and more relatives who provided support (Coef: 0.38, p<0.05), but also more relatives with whom they had conflict (Coef: 0.19, p<0.01). Additionally, women were less likely to have caseworkers (Coef: −0.59, p<0.001) or physical and mental healthcare providers in their networks (Coef: −0.23, p<0.01; Coef: −0.37, p<0.001, respectively). However, after correcting for multiple testing, three outcomes lost significance: number of chronic physical health conditions, number of relatives who provided any support, and number of relatives with whom there was conflict. Conclusions There is evidence of gender differences in mental health and social support among homeless adults moving into PSH. PSH cannot be a one-size-fits-all approach. Supportive services within housing should be tailored based on gender and other individual needs. PMID:28153741

  11. Do older adults with chronic low back pain differ from younger adults in regards to baseline characteristics and prognosis?

    PubMed

    Manogharan, S; Kongsted, A; Ferreira, M L; Hancock, M J

    2017-05-01

    Low back pain (LBP) in older adults is poorly understood because the vast majority of the LBP research has focused on the working aged population. The aim of this study was to compare older adults consulting with chronic LBP to middle aged and young adults consulting with chronic LBP, in terms of their baseline characteristics, and pain and disability outcomes over 1 year. Data were systematically collected as part of routine care in a secondary care spine clinic. At initial presentation patients answered a self-report questionnaire and underwent a physical examination. Patients older than 65 were classified as older adults and compared to middle aged (45-65 years old) and younger adults (17-44 years old) for 10 baseline characteristics. Pain intensity and disability were collected at 6 and 12 month follow-ups and compared between age groups. A total of 14,479 participants were included in the study. Of these 3087 (21%) patients were older adults, 6071 (42%) were middle aged and 5321 (37%) were young adults. At presentation older adults were statistically different to the middle aged and younger adults for most characteristics measured (e.g. less intense back pain, more leg pain and more depression); however, the differences were small. The change in pain and disability over 12 months did not differ between age groups. This study found small baseline differences in older people with chronic LBP compared to middle aged and younger adults. There were no associations between age groups and the clinical course. Small baseline differences exist in older people with chronic low back pain compared to middle aged and younger adults referred to secondary care for chronic low back pain. Older adults present with slightly less intense low back pain but slightly more intense leg pain. Changes in pain intensity and disability over a 12 month period were similar across all age groups. © 2017 European Pain Federation - EFIC®.

  12. Gaze Behavior Consistency among Older and Younger Adults When Looking at Emotional Faces

    PubMed Central

    Chaby, Laurence; Hupont, Isabelle; Avril, Marie; Luherne-du Boullay, Viviane; Chetouani, Mohamed

    2017-01-01

    The identification of non-verbal emotional signals, and especially of facial expressions, is essential for successful social communication among humans. Previous research has reported an age-related decline in facial emotion identification, and argued for socio-emotional or aging-brain model explanations. However, more perceptual differences in the gaze strategies that accompany facial emotional processing with advancing age have been under-explored yet. In this study, 22 young (22.2 years) and 22 older (70.4 years) adults were instructed to look at basic facial expressions while their gaze movements were recorded by an eye-tracker. Participants were then asked to identify each emotion, and the unbiased hit rate was applied as performance measure. Gaze data were first analyzed using traditional measures of fixations over two preferential regions of the face (upper and lower areas) for each emotion. Then, to better capture core gaze changes with advancing age, spatio-temporal gaze behaviors were deeper examined using data-driven analysis (dimension reduction, clustering). Results first confirmed that older adults performed worse than younger adults at identifying facial expressions, except for “joy” and “disgust,” and this was accompanied by a gaze preference toward the lower-face. Interestingly, this phenomenon was maintained during the whole time course of stimulus presentation. More importantly, trials corresponding to older adults were more tightly clustered, suggesting that the gaze behavior patterns of older adults are more consistent than those of younger adults. This study demonstrates that, confronted to emotional faces, younger and older adults do not prioritize or ignore the same facial areas. Older adults mainly adopted a focused-gaze strategy, consisting in focusing only on the lower part of the face throughout the whole stimuli display time. This consistency may constitute a robust and distinctive “social signature” of emotional

  13. Medical Care of the Homeless: An American and International Issue.

    PubMed

    Fleisch, Sheryl B; Nash, Robertson

    2017-03-01

    Homeless persons die significantly younger than their housed counterparts. In many cases, relatively straightforward primary care issues escalate into life-threatening, expensive emergencies. Poor health outcomes driven by negative interactions between comorbid symptoms meet the definition of a health syndemic in this population. Successful primary care of patients struggling with homelessness may result in long-term lifesaving measures along with decreased expenditure to hospital systems. This primary prevention requires patience, creativity, and acknowledgment that the source of many confounders may lay outside the control of these patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Housing First Improves Residential Stability in Homeless Adults With Concurrent Substance Dependence and Mental Disorders

    PubMed Central

    Patterson, Michelle L.; Moniruzzaman, Akm; Frankish, C. James; Somers, Julian

    2013-01-01

    Objectives. We examined the relationship between substance dependence and residential stability in homeless adults with current mental disorders 12 months after randomization to Housing First programs or treatment as usual (no housing or support through the study). Methods. The Vancouver At Home study in Canada included 2 randomized controlled trials of Housing First interventions. Eligible participants met the criteria for homelessness or precarious housing, as well as a current mental disorder. Residential stability was defined as the number of days in stable residences 12 months after randomization. We used negative binomial regression modeling to examine the independent association between residential stability and substance dependence. Results. We recruited 497 participants, and 58% (n = 288) met the criteria for substance dependence. We found no significant association between substance dependence and residential stability (adjusted incidence rate ratio = 0.97; 95% confidence interval = 0.69, 1.35) after adjusting for housing intervention, employment, sociodemographics, chronic health conditions, mental disorder severity, psychiatric symptoms, and lifetime duration of homelessness. Conclusions. People with mental disorders might achieve similar levels of housing stability from Housing First regardless of whether they experience concurrent substance dependence. PMID:24148035

  15. Comparative cost analysis of housing and case management program for chronically ill homeless adults compared to usual care.

    PubMed

    Basu, Anirban; Kee, Romina; Buchanan, David; Sadowski, Laura S

    2012-02-01

    To assess the costs of a housing and case management program in a novel sample-homeless adults with chronic medical illnesses. The study used data from multiple sources: (1) electronic medical records for hospital, emergency room, and ambulatory medical and mental health visits; (2) institutional and regional databases for days in respite centers, jails, or prisons; and (3) interviews for days in nursing homes, shelters, substance abuse treatment centers, and case manager visits. Total costs were estimated using unit costs for each service. Randomized controlled trial of 407 homeless adults with chronic medical illnesses enrolled at two hospitals in Chicago, Illinois, and followed for 18 months. Compared to usual care, the intervention group generated an average annual cost savings of (-)$6,307 per person (95 percent CI: -16,616, 4,002; p = .23). Subgroup analyses of chronically homeless and those with HIV showed higher per person, annual cost savings of (-)$9,809 and (-)$6,622, respectively. Results were robust to sensitivity analysis using unit costs. The findings of this comprehensive, comparative cost analyses demonstrated an important average annual savings, though in this underpowered study these savings did not achieve statistical significance. © Health Research and Educational Trust.

  16. Self-Regulated Learning in Younger and Older Adults: Does Aging Affect Metacognitive Control?

    PubMed Central

    Price, Jodi; Hertzog, Christopher; Dunlosky, John

    2011-01-01

    Two experiments examined whether younger and older adults’ self-regulated study (item selection and study time) conformed to the region of proximal learning (RPL) model when studying normatively easy, medium, and difficult vocabulary pairs. Experiment 2 manipulated the value of recalling different pairs and provided learning goals for words recalled and points earned. Younger and older adults in both experiments selected items for study in an easy-to-difficult order, indicating the RPL model applies to older adults’ self-regulated study. Individuals allocated more time to difficult items, but prioritized easier items when given less time or point values favoring difficult items. Older adults studied more items for longer but realized lower recall than did younger adults. Older adults’ lower memory self-efficacy and perceived control correlated with their greater item restudy and avoidance of difficult items with high point values. Results are discussed in terms of RPL and agenda-based regulation models. PMID:19866382

  17. Expiratory flow limitation and operating lung volumes during exercise in older and younger adults.

    PubMed

    Smith, Joshua R; Kurti, Stephanie P; Meskimen, Kayla; Harms, Craig A

    2017-06-01

    We determined the effect of aging on expiratory flow limitation (EFL) and operating lung volumes when matched for lung size. We hypothesized that older adults will exhibit greater EFL and increases in EELV during exercise compared to younger controls. Ten older (5M/5W; >60years old) and nineteen height-matched young adults (10M/9W) were recruited. Young adults were matched for%predicted forced vital capacity (FVC) (Y-matched%Pred FVC; n=10) and absolute FVC (Y-matched FVC; n=10). Tidal flow-volume loops were recorded during the incremental exercise test with maximal flow-volume loops measured pre- and post-exercise. Compared to younger controls, older adults exhibited more EFL at ventilations of 26, 35, 51, and 80L/min. The older group had higher end-inspiratory lung volume compared to Y-matched%Pred FVC group during submaximal ventilations. The older group increased EELV during exercise, while EELV stayed below resting in the Y-matched%Pred FVC group. These data suggest older adults exhibit more EFL and increase EELV earlier during exercise compared to younger adults. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Unmet eye care needs among a homeless youth population.

    PubMed

    Noel, Christopher W; Srivastava, Raman; Lo, Ryan; Berger, Alan; Tehrani, Nasrin; Lichter, Myrna

    2016-06-01

    To assess the rate of visual impairment and quantify the unmet eye care needs within Toronto's homeless youth community. Prospective and cross sectional. Ninety randomly selected homeless youth aged 16-24 years. From each of 9 participating homeless youth shelters and drop-in centres in Toronto, 10 English-speaking youths between ages 16 and 24 were randomly recruited. Information regarding sociodemographics, medical history, subjective visual acuity, and access to eye care was collected. Comprehensive visual screening and undilated direct fundoscopy were also performed. The median age of participants was 21 years (interquartile range = 19-23 years), and 62.2% were male. Most participants were homeless for less than 5 years (90%) and earning less than $500 monthly (57.8%). Despite 51.1% of participants having previously owned corrective lenses, only 20% of participants currently owned them when assessed/at study time. When analyzing the better-seeing eye, presenting visual acuity was 20/50 or worse in 18.9% (95% CI 10.8%-27.0%) of participants. Pinhole occlusion decreased the number to 2.2% (95% CI 0%-5.3%). The most common cause of visual impairment was uncorrected refractive error. Ocular pathology was observed in 8 participants. Compared to adults, youth have similar functional visual impairment (adults 24.0%, youth 18.9%) but less impairment uncorrectable by pinhole occlusion (adults 11.0%, youth 2.2%) and are less dissatisfied with their vision (adults 70.0%, youths 36.7%). Although a higher proportion of homeless youths have visited an eye specialist in the past year (adults 14.0%; youths 17.8%), neither group is visiting as frequently as the Canadian average (41%) (p < 0.01). Homeless youth have a high prevalence of visual impairment, even when living within a system of universal health insurance. Ongoing vision-screening programs, readily accessible free eye clinics, and particularly low-cost glasses may help address this need. Copyright © 2016 Canadian

  19. Impact of age-relevant goals on future thinking in younger and older adults.

    PubMed

    Lapp, Leann K; Spaniol, Julia

    2017-10-01

    This study investigated how personal goals influence age differences in episodic future thinking. Research suggests that personal goals change with age and like autobiographical memory, future thinking is thought to be organised and impacted by personal goals. It was hypothesised that cueing older adults with age-relevant goals should modulate age differences in episodic details and may also influence phenomenological characteristics of imagined scenarios. Healthy younger and older adults completed the Future Thinking Interview [Addis, D. R., Wong, A. T., & Schacter, D. L. (2008). Age-related changes in the episodic simulation of future events. Psychological Science, 19(1), 33-41. doi: 10.1111/j.1467-9280.2008.02043.x ] adapted to activate age-appropriate goals. Narratives were scored with an established protocol to obtain objective measures of episodic and semantic details. Subjective features such as emotionality and personal significance showed age differences as a function of goal domain while other features (e.g., vividness) were unaffected. However, consistent with prior reports, older adults produced fewer episodic details than younger adults and this was not modulated by goal domain. The results do not indicate that goal activation affects level of episodic detail. With respect to phenomenological aspects of future thinking, however, younger adults show more sensitivity to goal activation, compared with older adults.

  20. Interventions by healthcare professionals to improve management of physical long-term conditions in adults who are homeless: a systematic review protocol.

    PubMed

    Hanlon, Peter; Yeoman, Lynsey; Esiovwa, Regina; Gibson, Lauren; Williamson, Andrea E; Mair, Frances S; Lowrie, Richard

    2017-08-21

    People experiencing homelessness are at increased risk of, and have poorer outcomes from, a range of physical long-term conditions (LTCs). It is increasingly recognised that interventions targeting people who are homeless should be tailored to the specific needs of this population. This systematic review aims to identify, describe and appraise trials of interventions that aim to manage physical LTCs in homeless adults and are delivered by healthcare professionals. Seven electronic databases (Medline, EMBASE, Cochrane Central Register of Controlled Trials, Assia, Scopus, PsycINFO and CINAHL) will be searched from 1960 (or inception) to October 2016 and supplemented by forward citation searching, handsearching of reference lists and searching grey literature. Two reviewers will independently review titles, abstract and full-texts using DistillerSR software. Inclusion criteria include (1) homeless adults with any physical LTC, (2) interventions delivered by a healthcare professional (any professional trained to provide any form of healthcare, but excluding social workers and professionals without health-related training), (3) comparison with usual care or an alternative intervention, (4) report outcomes such as healthcare usage, physical and psychological health or well-being or cost-effectiveness, (5) randomised controlled trials, non-randomised controlled trials, controlled before-after studies. Quality will be assessed using the Cochrane EPOC Risk of Bias Tool. A meta-analysis will be performed if sufficient data are identified; however, we anticipate a narrative synthesis will be performed. This review will synthesise existing evidence for interventions delivered by healthcare professionals to manage physical LTCs in adults who are homeless. The findings will inform the development of future interventions and research aiming to improve the management of LTCs for people experiencing homelessness. Ethical approval will not be required for this systematic review as

  1. Action Prediction in Younger versus Older Adults: Neural Correlates of Motor Familiarity

    PubMed Central

    Diersch, Nadine; Mueller, Karsten; Cross, Emily S.; Stadler, Waltraud; Rieger, Martina; Schütz-Bosbach, Simone

    2013-01-01

    Generating predictions during action observation is essential for efficient navigation through our social environment. With age, the sensitivity in action prediction declines. In younger adults, the action observation network (AON), consisting of premotor, parietal and occipitotemporal cortices, has been implicated in transforming executed and observed actions into a common code. Much less is known about age-related changes in the neural representation of observed actions. Using fMRI, the present study measured brain activity in younger and older adults during the prediction of temporarily occluded actions (figure skating elements and simple movement exercises). All participants were highly familiar with the movement exercises whereas only some participants were experienced figure skaters. With respect to the AON, the results confirm that this network was preferentially engaged for the more familiar movement exercises. Compared to younger adults, older adults recruited visual regions to perform the task and, additionally, the hippocampus and caudate when the observed actions were familiar to them. Thus, instead of effectively exploiting the sensorimotor matching properties of the AON, older adults seemed to rely predominantly on the visual dynamics of the observed actions to perform the task. Our data further suggest that the caudate played an important role during the prediction of the less familiar figure skating elements in better-performing groups. Together, these findings show that action prediction engages a distributed network in the brain, which is modulated by the content of the observed actions and the age and experience of the observer. PMID:23704980

  2. Action prediction in younger versus older adults: neural correlates of motor familiarity.

    PubMed

    Diersch, Nadine; Mueller, Karsten; Cross, Emily S; Stadler, Waltraud; Rieger, Martina; Schütz-Bosbach, Simone

    2013-01-01

    Generating predictions during action observation is essential for efficient navigation through our social environment. With age, the sensitivity in action prediction declines. In younger adults, the action observation network (AON), consisting of premotor, parietal and occipitotemporal cortices, has been implicated in transforming executed and observed actions into a common code. Much less is known about age-related changes in the neural representation of observed actions. Using fMRI, the present study measured brain activity in younger and older adults during the prediction of temporarily occluded actions (figure skating elements and simple movement exercises). All participants were highly familiar with the movement exercises whereas only some participants were experienced figure skaters. With respect to the AON, the results confirm that this network was preferentially engaged for the more familiar movement exercises. Compared to younger adults, older adults recruited visual regions to perform the task and, additionally, the hippocampus and caudate when the observed actions were familiar to them. Thus, instead of effectively exploiting the sensorimotor matching properties of the AON, older adults seemed to rely predominantly on the visual dynamics of the observed actions to perform the task. Our data further suggest that the caudate played an important role during the prediction of the less familiar figure skating elements in better-performing groups. Together, these findings show that action prediction engages a distributed network in the brain, which is modulated by the content of the observed actions and the age and experience of the observer.

  3. From homeless to housed: caring for people in transition.

    PubMed

    Drury, Lin J

    2008-01-01

    This ethnographic study was conducted to determine what homeless people experience during the transition from street life into community housing. Data were gathered through participant observation at a program designed to secure housing and support services for homeless people upon discharge from a psychiatric hospital. Sixty homeless, mentally ill adults were followed from hospital discharge through their first 2 years in community housing. Homeless people interact with health care providers across a cultural divide produced by vast differences in their lived experiences. This cultural distance limits access to the services that these individuals require to achieve residential stability.

  4. Goals-feedback conditions and episodic memory: Mechanisms for memory gains in older and younger adults.

    PubMed

    West, Robin L; Dark-Freudeman, Alissa; Bagwell, Dana K

    2009-02-01

    Research has established that challenging memory goals always lead to score increases for younger adults, and can increase older adults' scores under supportive conditions. This study examined beliefs and on-task effort as potential mechanisms for these self-regulatory gains, in particular to learn whether episodic memory gains across multiple trials of shopping list recall are controlled by the same factors for young and old people. Goals with feedback led to higher recall and strategic categorisation than a control condition. Strategy usage was the strongest predictor of gains over trials for both age groups. Age, goal condition, and effort also predicted scores across the entire sample. Older adults' gains, but not younger adults' gains, were affected significantly by the interaction of self-efficacy beliefs and goal condition, and condition interacted with locus of control to predict younger adult gains. These results emphasise the importance of self-regulatory effort and positive beliefs for facilitating goal-related memory gains.

  5. Becoming homeless, being homeless, and resolving homelessness among women.

    PubMed

    Finfgeld-Connett, Deborah

    2010-07-01

    The purpose of this investigation was to more comprehensively articulate the experiences of homeless women and make evidence-based inferences regarding optimal social services. This study was conducted using qualitative meta-synthesis methods. As youth, homeless women experience challenging circumstances that leave them ill-prepared to prevent and resolve homelessness in adulthood. Resolution of homelessness occurs in iterative stages: crisis, assessment, and sustained action. To enhance forward progression through these stages, nurses are encouraged to promote empowerment in concordance with the Transtheoretical and Harm Reduction Models. Services that are highly valued include physical and mental health care and child care assistance.

  6. Homelessness and drug misuse in developing countries: A mathematical approach

    NASA Astrophysics Data System (ADS)

    Bhunu, C. P.

    2014-06-01

    Homelessness and drug-misuse are known to exist like siamese twins. We present a model to capture the dynamics in the growth in the number of homeless (street kids and street adults) and drug misusers. The reproduction numbers of the model are determined and analyzed. Results from this study suggests that adult peer pressure plays a more significant role in the growth of drug-misuse and the number of street kids. This result suggests that in resource constrained settings intervention strategies should be tailor made to target adults whose behaviour influence others to misuse drugs and abuse children. Furthermore, numerical simulations show that homelessness and drug-misuse positively enhances, the growth of each other. Thus, to effectively control these two social problems require strategies targeting both of them.

  7. Memory for staged events: Supporting older and younger adults' memory with SenseCam.

    PubMed

    Mair, Ali; Poirier, Marie; Conway, Martin A

    2018-03-01

    Two experiments measured the effect of retrieval support provided by a wearable camera, SenseCam, on older and younger adults' memory for a recently experienced complex staged event. In each experiment, participants completed a series of tasks in groups, and the events were recalled 2 weeks later, after viewing SenseCam images (experimental condition) or thinking about the event (control condition). When IQ and education were matched, young adults recalled more event details than older adults, demonstrating an age-related deficit for novel autobiographical material. Reviewing SenseCam images increased the number of details recalled by older and younger adults, and the effect was similar for both groups. These results suggest that memory can be supported by the use of SenseCam, but the age-related deficit is not eliminated.

  8. Modeling the mental health effects of victimization among homeless persons

    PubMed Central

    Perron, Brian Edward; Alexander-Eitzman, Ben; Gillespie, David F.; Pollio, David

    2014-01-01

    Homeless persons are victims of violent and non-violent crime at higher rates than housed populations. While studies have suggested that victimization can induce or exacerbate mental health problems, there is very little known about factors that may buffer the effects of victimization. This cross-sectional study examined the influence of victimization on depressive symptoms in over 9600 homeless and mentally ill adults participating in the Access to Community Care and Effective Services and Supports study (ACCESS) conducted in multiple cities across the USA relationships between victimization, depressive symptoms, and perceived safety were tested within a structural equation modeling framework using data collected at the baseline interview. The overall model exhibited a good fit with the data. Non-physical victimization was associated with higher levels of depressive symptoms, and physical victimization was associated with lower levels of perceived safety. As hypothesized, perceived safety was a significant partial mediator of depressive symptoms. These results underscore the complexity of the relationships between victimization and depression in homeless adults and the importance of addressing different types of victimization in homeless and mentally ill adults. PMID:18703266

  9. Modeling the mental health effects of victimization among homeless persons.

    PubMed

    Perron, Brian Edward; Alexander-Eitzman, Ben; Gillespie, David F; Pollio, David

    2008-11-01

    Homeless persons are victims of violent and non-violent crime at higher rates than housed populations. While studies have suggested that victimization can induce or exacerbate mental health problems, there is very little known about factors that may buffer the effects of victimization. This cross-sectional study examined the influence of victimization on depressive symptoms in over 9600 homeless and mentally ill adults participating in the Access to Community Care and Effective Services and Supports study (ACCESS) conducted in multiple cities across the USA relationships between victimization, depressive symptoms, and perceived safety were tested within a structural equation modeling framework using data collected at the baseline interview. The overall model exhibited a good fit with the data. Non-physical victimization was associated with higher levels of depressive symptoms, and physical victimization was associated with lower levels of perceived safety. As hypothesized, perceived safety was a significant partial mediator of depressive symptoms. These results underscore the complexity of the relationships between victimization and depression in homeless adults and the importance of addressing different types of victimization in homeless and mentally ill adults.

  10. Relationship between perceptual learning in speech and statistical learning in younger and older adults

    PubMed Central

    Neger, Thordis M.; Rietveld, Toni; Janse, Esther

    2014-01-01

    Within a few sentences, listeners learn to understand severely degraded speech such as noise-vocoded speech. However, individuals vary in the amount of such perceptual learning and it is unclear what underlies these differences. The present study investigates whether perceptual learning in speech relates to statistical learning, as sensitivity to probabilistic information may aid identification of relevant cues in novel speech input. If statistical learning and perceptual learning (partly) draw on the same general mechanisms, then statistical learning in a non-auditory modality using non-linguistic sequences should predict adaptation to degraded speech. In the present study, 73 older adults (aged over 60 years) and 60 younger adults (aged between 18 and 30 years) performed a visual artificial grammar learning task and were presented with 60 meaningful noise-vocoded sentences in an auditory recall task. Within age groups, sentence recognition performance over exposure was analyzed as a function of statistical learning performance, and other variables that may predict learning (i.e., hearing, vocabulary, attention switching control, working memory, and processing speed). Younger and older adults showed similar amounts of perceptual learning, but only younger adults showed significant statistical learning. In older adults, improvement in understanding noise-vocoded speech was constrained by age. In younger adults, amount of adaptation was associated with lexical knowledge and with statistical learning ability. Thus, individual differences in general cognitive abilities explain listeners' variability in adapting to noise-vocoded speech. Results suggest that perceptual and statistical learning share mechanisms of implicit regularity detection, but that the ability to detect statistical regularities is impaired in older adults if visual sequences are presented quickly. PMID:25225475

  11. Relationship between perceptual learning in speech and statistical learning in younger and older adults.

    PubMed

    Neger, Thordis M; Rietveld, Toni; Janse, Esther

    2014-01-01

    Within a few sentences, listeners learn to understand severely degraded speech such as noise-vocoded speech. However, individuals vary in the amount of such perceptual learning and it is unclear what underlies these differences. The present study investigates whether perceptual learning in speech relates to statistical learning, as sensitivity to probabilistic information may aid identification of relevant cues in novel speech input. If statistical learning and perceptual learning (partly) draw on the same general mechanisms, then statistical learning in a non-auditory modality using non-linguistic sequences should predict adaptation to degraded speech. In the present study, 73 older adults (aged over 60 years) and 60 younger adults (aged between 18 and 30 years) performed a visual artificial grammar learning task and were presented with 60 meaningful noise-vocoded sentences in an auditory recall task. Within age groups, sentence recognition performance over exposure was analyzed as a function of statistical learning performance, and other variables that may predict learning (i.e., hearing, vocabulary, attention switching control, working memory, and processing speed). Younger and older adults showed similar amounts of perceptual learning, but only younger adults showed significant statistical learning. In older adults, improvement in understanding noise-vocoded speech was constrained by age. In younger adults, amount of adaptation was associated with lexical knowledge and with statistical learning ability. Thus, individual differences in general cognitive abilities explain listeners' variability in adapting to noise-vocoded speech. Results suggest that perceptual and statistical learning share mechanisms of implicit regularity detection, but that the ability to detect statistical regularities is impaired in older adults if visual sequences are presented quickly.

  12. Network Approaches to Substance Use and HIV/Hepatitis C Risk among Homeless Youth and Adult Women in the United States: A Review

    PubMed Central

    Dombrowski, Kirk; Sittner, Kelley; Crawford, Devan; Welch-Lazoritz, Melissa; Habecker, Patrick; Khan, Bilal

    2016-01-01

    During the United States economic recession of 2008–2011, the number of homeless and unstably housed people in the United States increased considerably. Homeless adult women and unaccompanied homeless youth make up the most marginal segments of this population. Because homeless individuals are a hard to reach population, research into these marginal groups has traditionally been a challenge for researchers interested in substance abuse and mental health. Network analysis techniques and research strategies offer means for dealing with traditional challenges such as missing sampling frames, variation in definitions of homelessness and study inclusion criteria, and enumeration/population estimation procedures. This review focuses on the need for, and recent steps toward, solutions to these problems that involve network science strategies for data collection and analysis. Research from a range of fields is reviewed and organized according to a new stress process framework aimed at understanding how homeless status interacts with issues related to substance abuse and mental health. Three types of network innovation are discussed: network scale-up methods, a network ecology approach to social resources, and the integration of network variables into the proposed stress process model of homeless substance abuse and mental health. By employing network methods and integrating these methods into existing models, research on homeless and unstably housed women and unaccompanied young people can address existing research challenges and promote more effective intervention and care programs. PMID:28042394

  13. Make or Break: How Homeless Young People Struggle To Fulfil Their Potential.

    ERIC Educational Resources Information Center

    Foyer Foundation, London (England).

    Homelessness in the United Kingdom has very wide ramifications. Young homeless people face a difficult transition into adult life as poverty, low self-esteem, lack of family support, and lack of qualifications reinforce each others' effects. Homeless young people start behind their peers in educational achievement. Government policies put up…

  14. Homeless Status, Postdischarge Health Care Utilization, and Readmission After Surgery.

    PubMed

    Titan, Ashley; Graham, Laura; Rosen, Amy; Itani, Kamal; Copeland, Laurel A; Mull, Hillary J; Burns, Edith; Richman, Joshua; Kertesz, Stefan; Wahl, Tyler; Morris, Melanie; Whittle, Jeffery; Telford, Gordon; Wilson, Mark; Hawn, Mary

    2018-06-01

    Homeless Veterans are vulnerable to poor care transitions, yet little research has examined their risk of readmission following inpatient surgery. This study investigates the predictors of surgical readmission among homeless relative to housed Veteran patients. Inpatient general, vascular, and orthopedic surgeries occurring in the Veterans Health Administration from 2008 to 2014 were identified. Administrative International Classification of Diseases, Ninth Revision, Clinical Modification codes and Veterans Health Administration clinic stops were used to identify homeless patients. Bivariate analyses examined characteristics and predictors of readmission among homeless patients. Multivariate logistic models were used to estimate the association between homeless experience and housed patients with readmission following surgery. Our study included 232,373 surgeries: 43% orthopedic, 39% general, and 18% vascular with 5068 performed on homeless patients. Homeless individuals were younger (56 vs. 64 y, P<0.01), more likely to have a psychiatric comorbidities (51.3% vs. 19.4%, P<0.01) and less likely to have other medical comorbidities such as hypertension (57.1% vs. 70.8%, P<0.01). Homeless individuals were more likely to be readmitted [odds ratio (OR), 1.43; confidence interval (CI), 1.30-1.56; P<0.001]. Discharge destination other than community (OR, 0.57; CI, 0.44-0.74; P<0.001), recent alcohol abuse (OR, 1.45; CI, 1.15-1.84; P<0.01), and elevated American Society Anesthesiologists classification (OR, 1.86; CI, 1.30-2.68; P<0.01) were significant risk factors associated with readmissions within the homeless cohort. Readmissions are higher in homeless individuals discharged to the community after surgery. Judicious use of postoperative nursing or residential rehabilitation programs may be effective in reducing readmission and improving care transitions among these vulnerable Veterans. Relative costs and benefits of alternatives to community discharge merit

  15. All-cause, drug-related, and HIV-related mortality risk by trajectories of jail incarceration and homelessness among adults in New York City.

    PubMed

    Lim, Sungwoo; Harris, Tiffany G; Nash, Denis; Lennon, Mary Clare; Thorpe, Lorna E

    2015-02-15

    We studied a cohort of 15,620 adults who had experienced at least 1 jail incarceration and 1 homeless shelter stay in 2001-2003 in New York City to identify trajectories of these events and tested whether a particular trajectory was associated with all-cause, drug-related, or human immunodeficiency virus (HIV)-related mortality risk in 2004-2005. Using matched data on jail time, homeless shelter stays, and vital statistics, we performed sequence analysis and assessed mortality risk using standardized mortality ratios (SMRs) and marginal structural modeling. We identified 6 trajectories. Sixty percent of the cohort members had a temporary pattern, which was characterized by sporadic experiences of brief incarceration and homelessness, whereas the rest had the other 5 patterns, which reflected experiences of increasing, decreasing, or persistent jail or shelter stays. Mortality risk among individuals with a temporary pattern was significantly higher than those of adults who had not been incarcerated or stayed in a homeless shelter during the study period (all-cause SMR: 1.35, 95% confidence interval (CI): 1.14, 1.59; drug-related SMR: 4.60, 95% CI: 3.17, 6.46; HIV-related SMR: 1.54, 95% CI: 1.03, 2.21); all-cause and HIV-related SMRs in other patterns were not statistically significantly different. When we compared all 6 trajectories, the temporary pattern was more strongly associated with higher mortality risk than was the continuously homelessness pattern. Institutional interventions to reduce recurrent cycles of incarceration and homelessness are needed to augment behavioral interventions to reduce mortality risk. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Monetary Incentives to Reinforce Engagement and Achievement in a Job-Skills Training Program for Homeless, Unemployed Adults

    ERIC Educational Resources Information Center

    Koffarnus, Mikhail N.; Wong, Conrad J.; Fingerhood, Michael; Svikis, Dace S.; Bigelow, George E.; Silverman, Kenneth

    2013-01-01

    The current study examined whether monetary incentives could increase engagement and achievement in a job-skills training program for unemployed, homeless, alcohol-dependent adults. Participants (n?=?124) were randomized to a no-reinforcement group (n?=?39), during which access to the training program was provided but no incentives were given; a…

  17. Posthumously Assessing a Homeless Population: Services Use and Characteristics.

    PubMed

    Metraux, Stephen; Manjelievskaia, Janna; Treglia, Dan; Hoffman, Roy; Culhane, Dennis P; Ku, Bon S

    2016-12-01

    Data on services use, characteristics, and geographic distribution of homeless individuals who died in Philadelphia from 2009 to 2011 provided perspective on assessments of the homeless population that rely on conventional counts and surveys. Data from the City of Philadelphia Medical Examiner's Office were used to parse homeless decedents into three groups on the basis of use of homelessness services (known users, occasional users, and nonusers), and differences among the groups were assessed by using descriptive and multivariate methods. Of 141 adult decedents, 49% made substantial use of the homelessness services system (known users), 27% made occasional use of these services (occasional users), and 24% had no record of use of homelessness services (nonusers). Compared with known users, nonusers and occasional users were less likely to have had a severe mental illness diagnosis or to have received either disability benefits or Medicaid coverage and were more likely to be white. Nonusers and occasional users were also more likely than known users to have died in outlying parts of the city. More conventional homeless surveys and enumerations miss a substantial portion of the homeless population. Including these "hidden homeless" persons would alter perceptions about the composition of Philadelphia's homeless population, lowering estimates of the incidence of psychiatric disability and increasing estimates of racial diversity.

  18. Variability in reaction time performance of younger and older adults.

    PubMed

    Hultsch, David F; MacDonald, Stuart W S; Dixon, Roger A

    2002-03-01

    Age differences in three basic types of variability were examined: variability between persons (diversity), variability within persons across tasks (dispersion), and variability within persons across time (inconsistency). Measures of variability were based on latency performance from four measures of reaction time (RT) performed by a total of 99 younger adults (ages 17--36 years) and 763 older adults (ages 54--94 years). Results indicated that all three types of variability were greater in older compared with younger participants even when group differences in speed were statistically controlled. Quantile-quantile plots showed age and task differences in the shape of the inconsistency distributions. Measures of within-person variability (dispersion and inconsistency) were positively correlated. Individual differences in RT inconsistency correlated negatively with level of performance on measures of perceptual speed, working memory, episodic memory, and crystallized abilities. Partial set correlation analyses indicated that inconsistency predicted cognitive performance independent of level of performance. The results indicate that variability of performance is an important indicator of cognitive functioning and aging.

  19. Attitudes toward the Homeless: A U.S.-Japan Comparison.

    ERIC Educational Resources Information Center

    Guzewicz, Tony D.; Takooshian, Harold

    1993-01-01

    Compares attitudes toward the homeless in Japan and the United States through a survey of 268 Japanese and 254 U.S. adults and adolescents interviewed in public places. In Japan, homelessness is seldom discussed, and poverty, which may be as widespread as in the United States, is often not recognized. (SLD)

  20. An Observational Study of Suicide Death in Homeless and Precariously Housed People in Toronto.

    PubMed

    Sinyor, Mark; Kozloff, Nicole; Reis, Catherine; Schaffer, Ayal

    2017-07-01

    Homelessness has been identified as an important risk factor for suicide death, but there is limited research characterising homeless people who die by suicide. The goal of this study is to identify personal, clinical, and suicide method-related factors that distinguish homeless and precariously housed people who die from suicide from those who are not homeless at the time of suicide. Coroner records were reviewed for all suicide deaths in Toronto from 1998 to 2012. Data abstracted included housing status as well as other demographics, clinical variables such as the presence of mental illness, and suicide method. Of 3319 suicide deaths, 60 (1.8%) were homeless and 230 (6.9%) were precariously housed. Homeless and precariously housed people were each younger than nonhomeless people ( P < 0.0001). Compared with nonhomeless, homeless people were more likely to be male and less likely to be married, to have interpersonal conflict, or to leave a suicide note. Homeless people and precariously housed were more likely to have died by fall/jump than nonhomeless people (62%, 57%, and 29%, respectively). Homeless and precariously housed people are overrepresented among suicide deaths in a large urban center and differ demographically, clinically, and in their suicide method from nonhomeless people who die by suicide. Targeted suicide prevention strategies should aim to address factors specific to homeless people.

  1. A national evaluation of homeless and nonhomeless veterans' experiences with primary care.

    PubMed

    Jones, Audrey L; Hausmann, Leslie R M; Haas, Gretchen L; Mor, Maria K; Cashy, John P; Schaefer, James H; Gordon, Adam J

    2017-05-01

    Persons who are homeless, particularly those with mental health and/or substance use disorders (MHSUDs), often do not access or receive continuous primary care services. In addition, negative experiences with primary care might contribute to homeless persons' avoidance and early termination of MHSUD treatment. The patient-centered medical home (PCMH) model aims to address care fragmentation and improve patient experiences. How homeless persons with MHSUDs experience care within PCMHs is unknown. This study compared the primary care experiences of homeless and nonhomeless veterans with MHSUDs receiving care in the Veterans Health Administration's medical home environment, called Patient Aligned Care Teams. The sample included VHA outpatients who responded to the national 2013 PCMH-Survey of Health Care Experiences of Patients (PCMH-SHEP) and had a past-year MSHUD diagnosis. Veterans with evidence of homelessness (henceforth "homeless") were identified through VHA administrative records. PCMH-SHEP survey respondents included 67,666 veterans with MHSUDs (9.2% homeless). Compared with their nonhomeless counterparts, homeless veterans were younger, more likely to be non-Hispanic Black and nonmarried, had less education, and were more likely to live in urban areas. Homeless veterans had elevated rates of most MHSUDs assessed, indicating significant co-occurrence. After controlling for these differences, homeless veterans reported more negative and fewer positive experiences with communication; more negative provider ratings; and more negative experiences with comprehensiveness, care coordination, medication decision-making, and self-management support than nonhomeless veterans. Homeless persons with MHSUDs may need specific services that mitigate negative care experiences and encourage their continuation in longitudinal primary care services. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  2. Theory of mind through the ages: older and middle-aged adults exhibit more errors than do younger adults on a continuous false belief task.

    PubMed

    Bernstein, Daniel M; Thornton, Wendy Loken; Sommerville, Jessica A

    2011-10-01

    Theory of mind (ToM), or the ability to understand mental states, is a fundamental aspect of social cognition. Previous research has documented marked advances in ToM in preschoolers, and declines in ToM in older-aged adults. In the present study, younger (n=37), middle-aged (n=20), and older (n=37) adults completed a continuous false belief task measuring ToM. Middle-aged and older adults exhibited more false belief bias than did younger adults, irrespective of language ability, executive function, processing speed, and memory. The authors conclude that ToM declines from younger to older adulthood, independent of age-related changes to domain-general cognitive functioning.

  3. Homelessness in female-headed families: childhood and adult risk and protective factors.

    PubMed Central

    Bassuk, E L; Buckner, J C; Weinreb, L F; Browne, A; Bassuk, S S; Dawson, R; Perloff, J N

    1997-01-01

    OBJECTIVES: To identify risk and protective factors for family homelessness, a case-control study of homeless and low-income, never-homeless families, all female-headed, was conducted. METHODS: Homeless mothers (n = 220) were enrolled from family shelters in Worcester, Mass. Low-income housed mothers receiving welfare (n = 216) formed the comparison group. The women completed an interview covering socioeconomic, social support, victimization, mental health, substance use, and health domains. RESULTS: Childhood predictors of family homelessness included foster care placement and respondent's mother's use of drugs. Independent risk factors in adulthood included minority status, recent move to Worcester, recent eviction, interpersonal conflict, frequent alcohol or heroin use, and recent hospitalization for a mental health problem. Protective factors included being a primary tenant, receiving cash assistance or a housing subsidy, graduating from high school, and having a larger social network. CONCLUSIONS: Factors that compromise an individual's economic and social resources are associated with greater risk of losing one's home. PMID:9103104

  4. Local Medicaid Home- and Community-Based Services Spending and Nursing Home Admissions of Younger Adults

    PubMed Central

    Keohane, Laura; Mor, Vincent

    2014-01-01

    We used fixed-effect models to examine the relationship between local spending on home- and community-based services (HCBSs) for cash-assisted Medicaid-only disabled (CAMOD) adults and younger adult admissions to nursing homes in the United States during 2001 through 2008, with control for facility and market characteristics and secular trends. We found that increased CAMOD Medicaid HCBS spending at the local level is associated with decreased admissions of younger adults to nursing homes. Our findings suggest that states’ efforts to expand HCBS for this population should continue. PMID:25211711

  5. Local Medicaid home- and community-based services spending and nursing home admissions of younger adults.

    PubMed

    Thomas, Kali S; Keohane, Laura; Mor, Vincent

    2014-11-01

    We used fixed-effect models to examine the relationship between local spending on home- and community-based services (HCBSs) for cash-assisted Medicaid-only disabled (CAMOD) adults and younger adult admissions to nursing homes in the United States during 2001 through 2008, with control for facility and market characteristics and secular trends. We found that increased CAMOD Medicaid HCBS spending at the local level is associated with decreased admissions of younger adults to nursing homes. Our findings suggest that states' efforts to expand HCBS for this population should continue.

  6. Are the mentally ill homeless a distinct homeless subgroup?

    PubMed

    North, C S; Smith, E M; Pollio, D E; Spitznagel, E L

    1996-09-01

    The question has been raised whether it is useful or meaningful to dichotomize the homeless population by mental illness - i.e., to consider the mentally ill homeless as distinct from other homeless people. The current article presents evidence from a single data set to address this question empirically. Data from a randomly sampled population of 900 homeless men and women systemically interviewed using the Diagnostic Interview Schedule were examined to determine associations of mental illness with the problems of homelessness, controlling for the presence of substance abuse in the analyses. Although a few clinically meaningful associations with mental illness were found that might suggest directions for appropriate interventions, mental illness did not differentiate individuals in many important demographic and biographic respects. Individual diagnoses did not perform much better in differentiating the homeless by mental illness. Schizophrenia and bipolar mania showed a few significant associations not identified by the "major mental illness" construct. Major depression, constituting the majority of nonsubstance Axis I disorder in the homeless, provided no association beyond that obtained with the "major mental illness" category. The data provide little support for conceptualizing homeless subgroups or homelessness in general on the basis of mental illness alone. To do so also risks neglecting the emotional distress of the majority without major mental illness and the other problems that homeless persons share regardless of psychiatric illness. While serious mental illness is overrepresented among the homeless, it represents just one of many important vulnerability factors for homelessness. Substance abuse is far more prevalent than other Axis I disorders. Media images equating homelessness with major mental illness unnecessarily stigmatize homeless people and encourage oversimplified and narrowly conceived psychiatric interventions. While continuing attention is

  7. Using warnings to reduce categorical false memories in younger and older adults.

    PubMed

    Carmichael, Anna M; Gutchess, Angela H

    2016-07-01

    Warnings about memory errors can reduce their incidence, although past work has largely focused on associative memory errors. The current study sought to explore whether warnings could be tailored to specifically reduce false recall of categorical information in both younger and older populations. Before encoding word pairs designed to induce categorical false memories, half of the younger and older participants were warned to avoid committing these types of memory errors. Older adults who received a warning committed fewer categorical memory errors, as well as other types of semantic memory errors, than those who did not receive a warning. In contrast, young adults' memory errors did not differ for the warning versus no-warning groups. Our findings provide evidence for the effectiveness of warnings at reducing categorical memory errors in older adults, perhaps by supporting source monitoring, reduction in reliance on gist traces, or through effective metacognitive strategies.

  8. Preferences for emotional information in older and younger adults: a meta-analysis of memory and attention tasks.

    PubMed

    Murphy, Nora A; Isaacowitz, Derek M

    2008-06-01

    The authors conducted a meta-analysis to determine the magnitude of older and younger adults' preferences for emotional stimuli in studies of attention and memory. Analyses involved 1,085 older adults from 37 independent samples and 3,150 younger adults from 86 independent samples. Both age groups exhibited small to medium emotion salience effects (i.e., preference for emotionally valenced stimuli over neutral stimuli) as well as positivity preferences (i.e., preference for positively valenced stimuli over neutral stimuli) and negativity preferences (i.e., preference for negatively valenced stimuli to neutral stimuli). There were few age differences overall. Type of measurement appeared to influence the magnitude of effects; recognition studies indicated significant age effects, where older adults showed smaller effects for emotion salience and negativity preferences than younger adults.

  9. Age differences in emotion regulation effort: Pupil response distinguishes reappraisal and distraction for older but not younger adults.

    PubMed

    Martins, Bruna; Florjanczyk, Jan; Jackson, Nicholas J; Gatz, Margaret; Mather, Mara

    2018-03-01

    In previous research, older adults show greater emotional benefits from distracting themselves than from reappraising an event when strategically regulating emotion. Older adults also demonstrate an attentional preference to avoid, while younger adults show a bias toward approaching negative stimuli. This suggests a possible age-related differentiation of cognitive effort across approach and avoidance of negative stimuli during emotion regulation. In this study, we tracked cognitive effort via pupil dilation during the use of distraction (avoidance) and reappraisal (approach) strategies across age. Forty-eight younger adults (M = 20.94, SD = 1.78; 19 men) and 48 older adults (M = 68.82, SD = 5.40; 15 men) viewed a slideshow of negative images and were instructed to distract, reappraise, or passively view each image. Older adults showed greater pupil dilation during reappraisal than distraction, but younger adults displayed no difference between conditions-an effect that survived when controlling for gaze patterns. Gaze findings revealed that older adults looked less within images during active emotion regulation compared with passive viewing (no difference between distraction and reappraisal), and younger adults showed no difference across strategies. Younger adults gazed less within the most emotional image areas during distraction, but this did not significantly contribute to pupil response. Our findings support that distraction is less cognitively effortful than reinterpreting negative information in later life. These findings could be explained by older adults' motivational bias to disengage from negative information because of the age-related positivity effect, or compensation for decreased working memory resources across the life span. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  10. Binaural Advantage for Younger and Older Adults with Normal Hearing

    ERIC Educational Resources Information Center

    Dubno, Judy R.; Ahlstrom, Jayne B.; Horwitz, Amy R.

    2008-01-01

    Purpose: Three experiments measured benefit of spatial separation, benefit of binaural listening, and masking-level differences (MLDs) to assess age-related differences in binaural advantage. Method: Participants were younger and older adults with normal hearing through 4.0 kHz. Experiment 1 compared spatial benefit with and without head shadow.…

  11. A Group-Based Motivational Interviewing Brief Intervention to Reduce Substance Use and Sexual Risk Behavior among Homeless Young Adults

    PubMed Central

    Tucker, Joan S.; D’Amico, Elizabeth J.; Ewing, Brett A.; Miles, Jeremy N. V.; Pedersen, Eric R.

    2017-01-01

    Homeless young adults ages 18–25 exhibit high rates of alcohol and other drug (AOD) use, and sexual risk behaviors such as unprotected sex. Yet few programs exist for this population that are both effective and can be easily incorporated into settings serving this population. This pilot cluster cross-over randomized controlled trial evaluates AWARE, a voluntary four session group-based motivational interviewing (MI) intervention to reduce AOD use and sexual risk behavior. We evaluated AWARE with 200 homeless young adults using drop-in center services in Los Angeles County (mean age=21.8 years; 73% male; 79% heterosexual; 31% non-Hispanic White, 25% African American, 24% Hispanic, 21% multiracial/other). Surveys were completed at baseline and three months after program completion. Retention in the AWARE program was excellent (79% attended multiple sessions) and participants reported high levels of satisfaction with the program. AWARE participants self-reported positive change in their past 3 month and past 30 day alcohol use (ps ≤ .05), motivation to change drug use (ps < .05), and condom use self-efficacy (p = .05) compared to the control group. Among those with multiple sex partners, AWARE participants showed a decrease in unprotected sexual events (p < .05), whereas the control group did not. Results from this pilot evaluation are promising, suggesting that a brief group-MI risk reduction intervention can be effective in helping homeless young adults make positive changes in their alcohol and condom use. Further work is needed to more fully evaluate the efficacy of AWARE on AOD behavior and sexual risk behavior outcomes. PMID:28340904

  12. Story Processing Ability in Cognitively Healthy Younger and Older Adults

    PubMed Central

    Wright, Heather Harris; Capilouto, Gilson J.; Srinivasan, Cidambi; Fergadiotis, Gerasimos

    2012-01-01

    Purpose The purpose of the study was to examine the relationships among measures of comprehension and production for stories depicted in wordless pictures books and measures of memory and attention for 2 age groups. Method Sixty cognitively healthy adults participated. They consisted of two groups—young adults (20–29 years of age) and older adults (70–89 years of age). Participants completed cognitive measures and several discourse tasks; these included telling stories depicted in wordless picture books and answering multiple-choice comprehension questions pertaining to the story. Results The 2 groups did not differ significantly for proportion of story propositions conveyed; however, the younger group performed significantly better on the comprehension measure as compared with the older group. Only the older group demonstrated a statistically significant relationship between the story measures. Performance on the production and comprehension measures significantly correlated with performance on the cognitive measures for the older group but not for the younger group. Conclusions The relationship between adults’ comprehension of stimuli used to elicit narrative production samples and their narrative productions differed across the life span, suggesting that discourse processing performance changes in healthy aging. Finally, the study’s findings suggest that memory and attention contribute to older adults’ story processing performance. PMID:21106701

  13. [Mental health of homeless persons. Critical review of the Anglo-Saxon literature].

    PubMed

    Ducq, H; Guesdon, I; Roelandt, J L

    1997-01-01

    Because the visibility of homeless persons congregating in urban areas has increased since the 1980's, the relationship between homelessness and mental illness has caused more and more concern. A multitude of epidemiological surveys have been organized in Great Britain, Australia, Canada, and mainly in United States, and have attempted to evaluate scientifically the psychiatric morbidity of this population. This literature review reveals disparity of epidemiological methods in assessing the type and extent of mental illness among homeless adults. The lack of consensual definition of homelessness, the choice of different settings in which the research is organized (street, health centres, shelters), and the use of diverse instruments of psychiatric evaluation (diagnosis by clinician, by scale or by structured diagnostic interview) lead to a great disparity of the results. Thus, 1/3 of the homeless adults had prior history of psychiatric hospitalisation. Rates of psychosis range to 70% and it is estimated that 4% to 74% of the homeless persons suffer from affective disorders. Substance abuse disorder remains a problem for a significant number of these individuals, with a high frequency of dual diagnosis. Such divergent data highlight the anglo-saxon debate between those who accuse desinstitutionnalisation as a reason of homelessness, and those who blame the socioeconomic background.

  14. Pioglitazone is equally effective for diabetes prevention in older versus younger adults with impaired glucose tolerance.

    PubMed

    Espinoza, Sara E; Wang, Chen-Pin; Tripathy, Devjit; Clement, Stephen C; Schwenke, Dawn C; Banerji, Mary Ann; Bray, George A; Buchanan, Thomas A; Henry, Robert R; Kitabchi, Abbas E; Mudaliar, Sunder; Stentz, Frankie B; Reaven, Peter D; DeFronzo, Ralph A; Musi, Nicolas

    2016-12-01

    To determine the efficacy of pioglitazone to prevent type 2 diabetes in older compared to younger adults with pre-diabetes. Six hundred two participants with impaired glucose tolerance (IGT) were randomized in double blind fashion to placebo or pioglitazone for diabetes prevention in the ACT NOW study (NEJM 364:1104-1115, 2011). Cox proportional hazard regression was used to compare time to development of diabetes over a mean of 2 years between older (≥61 years) and younger participants. We compared effects of pioglitazone versus placebo on metabolic profiles, inflammatory markers, adipokines, β cell function (disposition index), insulin sensitivity (Matsuda index), and body composition by ANOVA. Diabetes incidence was reduced by 85 % in older and 69 % in younger subjects (p = 0.41). β cell function (disposition index) increased by 35.0 % in the older and 26.7 % in younger subjects (p = 0.83). Insulin sensitivity (Matsuda index) increased by 3.07 (5.2-fold) in older and by 2.54 (3.8-fold) in younger participants (p = 0.58). Pioglitazone more effectively increased adiponectin in older versus younger subjects (22.9 ± 3.2 μg/mL [2.7-fold] vs. 12.7 ± 1.4 μg/mL [2.2-fold], respectively; p = 0.04). Younger subjects tended to have a greater increase in whole body fat mass compared to older subjects (3.6 vs. 3.1 kg; p = 0.061). Younger and older subjects had similar decreases in bone mineral density (0.018 ± 0.0071 vs. 0.0138 ± 0.021 g/cm 2 ). Younger and older pre-diabetic adults taking pioglitazone had similar reductions in conversion to diabetes and older adults had similar or greater improvements in metabolic risk factors, demonstrating that pioglitazone is useful in preventing diabetes in older adults.

  15. The choices we make: An examination of situation selection in younger and older adults

    PubMed Central

    Rovenpor, Daniel R.; Skogsberg, Nikolaus J.; Isaacowitz, Derek M.

    2013-01-01

    The current study examined the effects of age and control beliefs on the use of situation selection. Younger and older adults spent 15 minutes in a room containing multiple affective streams that varied in emotional valence, and were given free choice to engage with whatever they wanted. No significant main effect of age emerged on the number of choices of, or time spent with, material of each valence. However, age and beliefs interacted such that older adults with strong emotion regulation self-efficacy and general control beliefs chose fewer negative stimuli, whereas younger adults with strong beliefs chose more negative stimuli. Results are discussed from aging and individual differences perspectives. PMID:23088197

  16. Evaluating suggestibility to additive and contradictory misinformation following explicit error detection in younger and older adults.

    PubMed

    Huff, Mark J; Umanath, Sharda

    2018-06-01

    In 2 experiments, we assessed age-related suggestibility to additive and contradictory misinformation (i.e., remembering of false details from an external source). After reading a fictional story, participants answered questions containing misleading details that were either additive (misleading details that supplemented an original event) or contradictory (errors that changed original details). On a final test, suggestibility was greater for additive than contradictory misinformation, and older adults endorsed fewer false contradictory details than younger adults. To mitigate suggestibility in Experiment 2, participants were warned about potential errors, instructed to detect errors, or instructed to detect errors after exposure to examples of additive and contradictory details. Again, suggestibility to additive misinformation was greater than contradictory, and older adults endorsed less contradictory misinformation. Only after detection instructions with misinformation examples were younger adults able to reduce contradictory misinformation effects and reduced these effects to the level of older adults. Additive misinformation however, was immune to all warning and detection instructions. Thus, older adults were less susceptible to contradictory misinformation errors, and younger adults could match this misinformation rate when warning/detection instructions were strong. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  17. A Population-Based Assessment of the Health of Homeless Families in New York City, 2001–2003

    PubMed Central

    Bainbridge, Jay; Kennedy, Joseph; Bennani, Yussef; Agerton, Tracy; Marder, Dova; Forgione, Lisa; Faciano, Andrew; Thorpe, Lorna E.

    2011-01-01

    Objectives. We compared estimated population-based health outcomes for New York City (NYC) homeless families with NYC residents overall and in low-income neighborhoods. Methods. We matched a NYC family shelter user registry to mortality, tuberculosis, HIV/AIDS, and blood lead test registries maintained by the NYC Department of Health and Mental Hygiene (2001–2003). Results. Overall adult age-adjusted death rates were similar among the 3 populations. HIV/AIDS and substance-use deaths were 3 and 5 times higher for homeless adults than for the general population; only substance-use deaths were higher than for low-income adults. Children who experienced homelessness appeared to be at an elevated risk of mortality (41.3 vs 22.5 per 100 000; P < .05). Seven in 10 adult and child deaths occurred outside shelter. Adult HIV/AIDS diagnosis rates were more than twice citywide rates but comparable with low-income rates, whereas tuberculosis rates were 3 times higher than in both populations. Homeless children had lower blood lead testing rates and a higher proportion of lead levels over 10 micrograms per deciliter than did both comparison populations. Conclusions. Morbidity and mortality levels were comparable between homeless and low-income adults; homeless children's slightly higher risk on some measures possibly reflects the impact of poverty and poor-quality, unstable housing. PMID:21233439

  18. Age Differences in Attachment Orientations among Younger and Older Adults: Evidence from Two Self-Report Measures of Attachment

    ERIC Educational Resources Information Center

    Segal, Daniel L.; Needham, Tracy N.; Coolidge, Frederick L.

    2009-01-01

    The attachment patterns of younger and older adults were studied using two-dimensional self-report measures of adult attachment. Community-dwelling younger (n = 144, M = 22.5 years, SD = 3.6) and older (n = 106, M = 68.6 years, SD = 8.3) adults completed the Measure of Attachment Qualities (MAQ; Carver, 1997) and the Relationship Style…

  19. iNOS-dependent sweating and eNOS-dependent cutaneous vasodilation are evident in younger adults, but are diminished in older adults exercising in the heat

    PubMed Central

    Fujii, Naoto; Meade, Robert D.; Alexander, Lacy M.; Akbari, Pegah; Foudil-bey, Imane; Louie, Jeffrey C.; Boulay, Pierre

    2015-01-01

    Nitric oxide synthase (NOS) contributes to sweating and cutaneous vasodilation during exercise in younger adults. We hypothesized that endothelial NOS (eNOS) and neuronal NOS (nNOS) mediate NOS-dependent sweating, whereas eNOS induces NOS-dependent cutaneous vasodilation in younger adults exercising in the heat. Further, aging may upregulate inducible NOS (iNOS), which may attenuate sweating and cutaneous vasodilator responses. We hypothesized that iNOS inhibition would augment sweating and cutaneous vasodilation in exercising older adults. Physically active younger (n = 12, 23 ± 4 yr) and older (n = 12, 60 ± 6 yr) adults performed two 30-min bouts of cycling at a fixed rate of metabolic heat production (400 W) in the heat (35°C). Sweat rate and cutaneous vascular conductance (CVC) were evaluated at four intradermal microdialysis sites with: 1) lactated Ringer (control), 2) nNOS inhibitor (nNOS-I, NPLA), 3) iNOS inhibitor (iNOS-I, 1400W), or 4) eNOS inhibitor (eNOS-I, LNAA). In younger adults during both exercise bouts, all inhibitors decreased sweating relative to control, albeit a lower sweat rate was observed at iNOS-I compared with eNOS-I and nNOS-I sites (all P < 0.05). CVC at the eNOS-I site was lower than control in younger adults throughout the intermittent exercise protocol (all P < 0.05). In older adults, there were no differences between control and iNOS-I sites for sweating and CVC during both exercise bouts (all P > 0.05). We show that iNOS and eNOS are the main contributors to NOS-dependent sweating and cutaneous vasodilation, respectively, in physically active younger adults exercising in the heat, and that iNOS inhibition does not alter sweating or cutaneous vasodilation in exercising physically active older adults. PMID:26586908

  20. iNOS-dependent sweating and eNOS-dependent cutaneous vasodilation are evident in younger adults, but are diminished in older adults exercising in the heat.

    PubMed

    Fujii, Naoto; Meade, Robert D; Alexander, Lacy M; Akbari, Pegah; Foudil-Bey, Imane; Louie, Jeffrey C; Boulay, Pierre; Kenny, Glen P

    2016-02-01

    Nitric oxide synthase (NOS) contributes to sweating and cutaneous vasodilation during exercise in younger adults. We hypothesized that endothelial NOS (eNOS) and neuronal NOS (nNOS) mediate NOS-dependent sweating, whereas eNOS induces NOS-dependent cutaneous vasodilation in younger adults exercising in the heat. Further, aging may upregulate inducible NOS (iNOS), which may attenuate sweating and cutaneous vasodilator responses. We hypothesized that iNOS inhibition would augment sweating and cutaneous vasodilation in exercising older adults. Physically active younger (n = 12, 23 ± 4 yr) and older (n = 12, 60 ± 6 yr) adults performed two 30-min bouts of cycling at a fixed rate of metabolic heat production (400 W) in the heat (35°C). Sweat rate and cutaneous vascular conductance (CVC) were evaluated at four intradermal microdialysis sites with: 1) lactated Ringer (control), 2) nNOS inhibitor (nNOS-I, NPLA), 3) iNOS inhibitor (iNOS-I, 1400W), or 4) eNOS inhibitor (eNOS-I, LNAA). In younger adults during both exercise bouts, all inhibitors decreased sweating relative to control, albeit a lower sweat rate was observed at iNOS-I compared with eNOS-I and nNOS-I sites (all P < 0.05). CVC at the eNOS-I site was lower than control in younger adults throughout the intermittent exercise protocol (all P < 0.05). In older adults, there were no differences between control and iNOS-I sites for sweating and CVC during both exercise bouts (all P > 0.05). We show that iNOS and eNOS are the main contributors to NOS-dependent sweating and cutaneous vasodilation, respectively, in physically active younger adults exercising in the heat, and that iNOS inhibition does not alter sweating or cutaneous vasodilation in exercising physically active older adults. Copyright © 2016 the American Physiological Society.

  1. Community care for people who are homeless and mentally ill.

    PubMed

    Drury, Lin J

    2003-05-01

    This qualitative longitudinal study documents the experiences of 60 people who are homeless and mentally ill from their state mental hospital discharge through their first two years in community housing. The study explores the personal, cultural, and environmental contexts of life for adults who are homeless and mentally ill and examines the interaction between an individual's needs and community resources. The research identifies forces that perpetuate homelessness and traces the struggles that people who are homeless and mentally ill encounter during the transition from the streets to stable housing. The findings describe a culturally based pattern of mutual avoidance between homeless mentally ill clients and caregivers, which limits delivery of services to the population. Recommendations include development of alternative systems of care delivery, expansion of educational experiences with underserved populations, and increased funding for service or research with people who are homeless and mentally ill.

  2. Finding shelter: two-year housing trajectories among homeless youth.

    PubMed

    Tevendale, Heather D; Comulada, W Scott; Lightfoot, Marguerita A

    2011-12-01

    The aim of this study was to (1) identify trajectories of homeless youth remaining sheltered or returning to shelter over a period of 2 years, and (2) to identify predictors of these trajectories. A sample of 426 individuals aged 14-24 years receiving services at homeless youth serving agencies completed six assessments over 2 years. Latent class growth analysis was applied to the reports of whether youth had been inconsistently sheltered (i.e., living on the street or in a squat, abandoned building, or automobile) or consistently sheltered (i.e., not living in any of those settings) during the past 3 months. Three trajectories of homeless youth remaining sheltered or returning to shelter were identified: consistently sheltered (approximately 41% of the sample); inconsistently sheltered, short-term (approximately 20%); and inconsistently sheltered, long-term (approximately 39%). Being able to go home and having not left of one's own accord predicted greater likelihood of membership in the short-term versus the long-term inconsistently sheltered trajectory. Younger age, not using drugs other than alcohol or marijuana, less involvement in informal sector activities, being able to go home, and having been homeless for <1 year predicted membership in the consistently sheltered groups versus the long-term inconsistently sheltered groups in the multivariate analyses. Findings suggest that being able to return home is more important than the degree of individual impairment (e.g., substance use or mental health problems) when determining the likelihood that a homeless youth follows a more or a less chronically homeless pathway. Copyright © 2011. Published by Elsevier Inc.

  3. Amphetamine modulates brain signal variability and working memory in younger and older adults.

    PubMed

    Garrett, Douglas D; Nagel, Irene E; Preuschhof, Claudia; Burzynska, Agnieszka Z; Marchner, Janina; Wiegert, Steffen; Jungehülsing, Gerhard J; Nyberg, Lars; Villringer, Arno; Li, Shu-Chen; Heekeren, Hauke R; Bäckman, Lars; Lindenberger, Ulman

    2015-06-16

    Better-performing younger adults typically express greater brain signal variability relative to older, poorer performers. Mechanisms for age and performance-graded differences in brain dynamics have, however, not yet been uncovered. Given the age-related decline of the dopamine (DA) system in normal cognitive aging, DA neuromodulation is one plausible mechanism. Hence, agents that boost systemic DA [such as d-amphetamine (AMPH)] may help to restore deficient signal variability levels. Furthermore, despite the standard practice of counterbalancing drug session order (AMPH first vs. placebo first), it remains understudied how AMPH may interact with practice effects, possibly influencing whether DA up-regulation is functional. We examined the effects of AMPH on functional-MRI-based blood oxygen level-dependent (BOLD) signal variability (SD(BOLD)) in younger and older adults during a working memory task (letter n-back). Older adults expressed lower brain signal variability at placebo, but met or exceeded young adult SD(BOLD) levels in the presence of AMPH. Drug session order greatly moderated change-change relations between AMPH-driven SD(BOLD) and reaction time means (RT(mean)) and SDs (RT(SD)). Older adults who received AMPH in the first session tended to improve in RT(mean) and RT(SD) when SD(BOLD) was boosted on AMPH, whereas younger and older adults who received AMPH in the second session showed either a performance improvement when SD(BOLD) decreased (for RT(mean)) or no effect at all (for RT(SD)). The present findings support the hypothesis that age differences in brain signal variability reflect aging-induced changes in dopaminergic neuromodulation. The observed interactions among AMPH, age, and session order highlight the state- and practice-dependent neurochemical basis of human brain dynamics.

  4. Amphetamine modulates brain signal variability and working memory in younger and older adults

    PubMed Central

    Garrett, Douglas D.; Nagel, Irene E.; Preuschhof, Claudia; Burzynska, Agnieszka Z.; Marchner, Janina; Wiegert, Steffen; Jungehülsing, Gerhard J.; Nyberg, Lars; Villringer, Arno; Li, Shu-Chen; Heekeren, Hauke R.; Bäckman, Lars; Lindenberger, Ulman

    2015-01-01

    Better-performing younger adults typically express greater brain signal variability relative to older, poorer performers. Mechanisms for age and performance-graded differences in brain dynamics have, however, not yet been uncovered. Given the age-related decline of the dopamine (DA) system in normal cognitive aging, DA neuromodulation is one plausible mechanism. Hence, agents that boost systemic DA [such as d-amphetamine (AMPH)] may help to restore deficient signal variability levels. Furthermore, despite the standard practice of counterbalancing drug session order (AMPH first vs. placebo first), it remains understudied how AMPH may interact with practice effects, possibly influencing whether DA up-regulation is functional. We examined the effects of AMPH on functional-MRI–based blood oxygen level-dependent (BOLD) signal variability (SDBOLD) in younger and older adults during a working memory task (letter n-back). Older adults expressed lower brain signal variability at placebo, but met or exceeded young adult SDBOLD levels in the presence of AMPH. Drug session order greatly moderated change–change relations between AMPH-driven SDBOLD and reaction time means (RTmean) and SDs (RTSD). Older adults who received AMPH in the first session tended to improve in RTmean and RTSD when SDBOLD was boosted on AMPH, whereas younger and older adults who received AMPH in the second session showed either a performance improvement when SDBOLD decreased (for RTmean) or no effect at all (for RTSD). The present findings support the hypothesis that age differences in brain signal variability reflect aging-induced changes in dopaminergic neuromodulation. The observed interactions among AMPH, age, and session order highlight the state- and practice-dependent neurochemical basis of human brain dynamics. PMID:26034283

  5. Elderly homeless veterans in Los Angeles: chronicity and precipitants of homelessness.

    PubMed

    van den Berk-Clark, Carissa; McGuire, James

    2013-12-01

    We compared the characteristics of chronically homeless and acutely homeless elderly veterans to better understand precipitants of homelessness. We conducted interviews with 33 chronically and 26 acutely homeless veterans aged 65 years and older receiving transitional housing services in Los Angeles, California, between 2003 and 2005. We asked questions regarding their sociodemographic characteristics and other social status measures. Other precipitants of homelessness were acquired via observation and open-ended and structured questions. Both veterans groups were more similar than different, with substantial levels of physical, psychiatric, and social impairment. They differed significantly in homelessness history, with chronically homeless veterans having more homelessness episodes and more total time homeless. They were also less educated and had smaller social networks. In response to open-ended questioning, elderly homeless veterans revealed how health and substance use issues interacted with loss of social support and eviction to exacerbate homelessness. Assessment of a range of factors is needed to address risk factors and events leading to homelessness. Further research with larger samples is needed to confirm the characteristics and needs of the elderly homeless veteran population.

  6. Differences in Health and Social Support between Homeless Men and Women Entering Permanent Supportive Housing.

    PubMed

    Winetrobe, Hailey; Wenzel, Suzanne; Rhoades, Harmony; Henwood, Benjamin; Rice, Eric; Harris, Taylor

    Permanent supportive housing (PSH) is the leading intervention to end chronic homelessness. Little is known, however, about gender differences, including potential disparities in physical and mental health and social support, that might inform services available through PSH. This study included 421 homeless adults, at least 39 years old, English- or Spanish-speaking, who were moving into PSH through 26 different agencies in the Los Angeles area. Compared with men entering PSH, homeless women (28% of the sample) were younger (p < .01), less likely to have achieved at least a high school education (p < .05), and had lower incomes (p < .01). Women had more chronic physical health conditions (p < .01), were more likely to have any chronic mental health condition (odds ratio, 2.5; p < .01), and had more chronic mental health conditions than men (p < .01). Women had more relatives in their social networks (Coefficient, 0.79, p < .01) and more relatives who provided support (coefficient, 0.38; p < .05), but also more relatives with whom they had conflict (coefficient, 0.19; p < .01). Additionally, women were less likely to have caseworkers (coefficient, -0.59; p < .001) or physical and mental health care providers in their networks (coefficient, -0.23 [p < .01]; coefficient, -0.37 [p < .001], respectively). However, after correcting for multiple testing, three outcomes lost significance: number of chronic physical health conditions, number of relatives who provided any support, and number of relatives with whom there was conflict. There is evidence of gender differences in mental health and social support among homeless adults moving into PSH. PSH cannot be a one-size-fits-all approach. Supportive services within housing should be tailored based on gender and other individual needs. Copyright © 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  7. Relate it! Objective and subjective evaluation of mediator-based strategies for improving source memory in younger and older adults.

    PubMed

    Kuhlmann, Beatrice G; Touron, Dayna R

    2017-06-01

    The present study examined younger and older adults' ability to improve their source memory for different types of sources through imaginal and verbal (sentence) mediators. Younger (18-29 years) and older (60-75 years) adults' strategy use and source memory for either text-type (bold vs italic) or person (woman vs man) sources was assessed; strategy use was either spontaneous or the generation of imaginal mediators was instructed before encoding. Younger and older adults did not differ in spontaneous use of mediator-based strategies; however, older adults generated more images but fewer verbal mediators than younger adults. Participants were able to increase mediator generation when instructed to, resulting in substantial increases in both item and source memory for the instructed conditions in both age groups. Use of verbal mediators was more likely for the more concrete person sources for which source memory was generally better. Importantly, these objective benefits of mediator-based strategies translated into subjective benefits for both younger and older adults: Increased use of either mediator type was correlated with lower experienced task difficulty; the instructions to use imaginal mediators resulted in a significant decrease in difficulty ratings on the group level. Participants were generally able to monitor mediator benefits to both item and source memory and accurately judged mediator strategies (especially imagery) as more effective than repetition; older adults, however, rated all strategies as less effective than younger adults. Implications of these findings, especially for neuropsychological studies on source monitoring, are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Audio-Visual and Meaningful Semantic Context Enhancements in Older and Younger Adults.

    PubMed

    Smayda, Kirsten E; Van Engen, Kristin J; Maddox, W Todd; Chandrasekaran, Bharath

    2016-01-01

    Speech perception is critical to everyday life. Oftentimes noise can degrade a speech signal; however, because of the cues available to the listener, such as visual and semantic cues, noise rarely prevents conversations from continuing. The interaction of visual and semantic cues in aiding speech perception has been studied in young adults, but the extent to which these two cues interact for older adults has not been studied. To investigate the effect of visual and semantic cues on speech perception in older and younger adults, we recruited forty-five young adults (ages 18-35) and thirty-three older adults (ages 60-90) to participate in a speech perception task. Participants were presented with semantically meaningful and anomalous sentences in audio-only and audio-visual conditions. We hypothesized that young adults would outperform older adults across SNRs, modalities, and semantic contexts. In addition, we hypothesized that both young and older adults would receive a greater benefit from a semantically meaningful context in the audio-visual relative to audio-only modality. We predicted that young adults would receive greater visual benefit in semantically meaningful contexts relative to anomalous contexts. However, we predicted that older adults could receive a greater visual benefit in either semantically meaningful or anomalous contexts. Results suggested that in the most supportive context, that is, semantically meaningful sentences presented in the audiovisual modality, older adults performed similarly to young adults. In addition, both groups received the same amount of visual and meaningful benefit. Lastly, across groups, a semantically meaningful context provided more benefit in the audio-visual modality relative to the audio-only modality, and the presence of visual cues provided more benefit in semantically meaningful contexts relative to anomalous contexts. These results suggest that older adults can perceive speech as well as younger adults when both

  9. Audio-Visual and Meaningful Semantic Context Enhancements in Older and Younger Adults

    PubMed Central

    Smayda, Kirsten E.; Van Engen, Kristin J.; Maddox, W. Todd; Chandrasekaran, Bharath

    2016-01-01

    Speech perception is critical to everyday life. Oftentimes noise can degrade a speech signal; however, because of the cues available to the listener, such as visual and semantic cues, noise rarely prevents conversations from continuing. The interaction of visual and semantic cues in aiding speech perception has been studied in young adults, but the extent to which these two cues interact for older adults has not been studied. To investigate the effect of visual and semantic cues on speech perception in older and younger adults, we recruited forty-five young adults (ages 18–35) and thirty-three older adults (ages 60–90) to participate in a speech perception task. Participants were presented with semantically meaningful and anomalous sentences in audio-only and audio-visual conditions. We hypothesized that young adults would outperform older adults across SNRs, modalities, and semantic contexts. In addition, we hypothesized that both young and older adults would receive a greater benefit from a semantically meaningful context in the audio-visual relative to audio-only modality. We predicted that young adults would receive greater visual benefit in semantically meaningful contexts relative to anomalous contexts. However, we predicted that older adults could receive a greater visual benefit in either semantically meaningful or anomalous contexts. Results suggested that in the most supportive context, that is, semantically meaningful sentences presented in the audiovisual modality, older adults performed similarly to young adults. In addition, both groups received the same amount of visual and meaningful benefit. Lastly, across groups, a semantically meaningful context provided more benefit in the audio-visual modality relative to the audio-only modality, and the presence of visual cues provided more benefit in semantically meaningful contexts relative to anomalous contexts. These results suggest that older adults can perceive speech as well as younger adults when

  10. Below-baseline suppression of competitors during interference resolution by younger but not older adults.

    PubMed

    Healey, M Karl; Ngo, K W Joan; Hasher, Lynn

    2014-01-01

    Resolving interference from competing memories is a critical factor in efficient memory retrieval, and several accounts of cognitive aging suggest that difficulty resolving interference may underlie memory deficits such as those seen in the elderly. Although many researchers have suggested that the ability to suppress competitors is a key factor in resolving interference, the evidence supporting this claim has been the subject of debate. Here, we present a new paradigm and results demonstrating that for younger adults, a single retrieval attempt is sufficient to suppress competitors to below-baseline levels of accessibility even though the competitors are never explicitly presented. The extent to which individual younger adults suppressed competitors predicted their performance on a memory span task. In a second experiment, older adults showed no evidence of suppression, which supports the theory that older adults' memory deficits are related to impaired suppression.

  11. The role of reduced working memory storage and processing resources in the associative memory deficit of older adults: simulation studies with younger adults.

    PubMed

    Hara, Yoko; Naveh-Benjamin, Moshe

    2015-01-01

    Previous research indicates that relative to younger adults, older adults show a larger decline in long-term memory (LTM) for associations than for the components that make up these associations. The purpose of the present study was to investigate whether we can impair associative memory performance in young adults by reducing their working memory (WM) resources, hence providing potential clues regarding the underlying causes of the associative memory deficit in older adults. With two experiments, we investigated whether we can reduce younger adults' long-term associative memory using secondary tasks in which either storage or processing WM loads were manipulated, while participants learned name-face pairs and then remembered the names, the faces, and the name-face associations. Results show that reducing either the storage or the processing resources of WM produced performance patterns of an associative long-term memory deficit in young adults. Furthermore, younger adults' associative memory deficit was a function of their performance on a working memory span task. These results indicate that one potential reason older adults have an associative deficit is a reduction in their WM resources but further research is needed to assess the mechanisms involved in age-related associative memory deficits.

  12. The prone bridge test: Performance, validity, and reliability among older and younger adults.

    PubMed

    Bohannon, Richard W; Steffl, Michal; Glenney, Susan S; Green, Michelle; Cashwell, Leah; Prajerova, Kveta; Bunn, Jennifer

    2018-04-01

    The prone bridge maneuver, or plank, has been viewed as a potential alternative to curl-ups for assessing trunk muscle performance. The purpose of this study was to assess prone bridge test performance, validity, and reliability among younger and older adults. Sixty younger (20-35 years old) and 60 older (60-79 years old) participants completed this study. Groups were evenly divided by sex. Participants completed surveys regarding physical activity and abdominal exercise participation. Height, weight, body mass index (BMI), and waist circumference were measured. On two occasions, 5-9 days apart, participants held a prone bridge until volitional exhaustion or until repeated technique failure. Validity was examined using data from the first session: convergent validity by calculating correlations between survey responses, anthropometrics, and prone bridge time, known groups validity by using an ANOVA comparing bridge times of younger and older adults and of men and women. Test-retest reliability was examined by using a paired t-test to compare prone bridge times for Session1 and Session 2. Furthermore, an intraclass correlation coefficient (ICC) was used to characterize relative reliability and minimal detectable change (MDC 95% ) was used to describe absolute reliability. The mean prone bridge time was 145.3 ± 71.5 s, and was positively correlated with physical activity participation (p ≤ 0.001) and negatively correlated with BMI and waist circumference (p ≤ 0.003). Younger participants had significantly longer plank times than older participants (p = 0.003). The ICC between testing sessions was 0.915. The prone bridge test is a valid and reliable measure for evaluating abdominal performance in both younger and older adults. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Incidental Memory of Younger and Older Adults for Objects Encountered in a Real World Context

    PubMed Central

    Qin, Xiaoyan; Bochsler, Tiana M.; Aizpurua, Alaitz; Cheong, Allen M. Y.; Koutstaal, Wilma; Legge, Gordon E.

    2014-01-01

    Effects of context on the perception of, and incidental memory for, real-world objects have predominantly been investigated in younger individuals, under conditions involving a single static viewpoint. We examined the effects of prior object context and object familiarity on both older and younger adults’ incidental memory for real objects encountered while they traversed a conference room. Recognition memory for context-typical and context-atypical objects was compared with a third group of unfamiliar objects that were not readily named and that had no strongly associated context. Both older and younger adults demonstrated a typicality effect, showing significantly lower 2-alternative-forced-choice recognition of context-typical than context-atypical objects; for these objects, the recognition of older adults either significantly exceeded, or numerically surpassed, that of younger adults. Testing-awareness elevated recognition but did not interact with age or with object type. Older adults showed significantly higher recognition for context-atypical objects than for unfamiliar objects that had no prior strongly associated context. The observation of a typicality effect in both age groups is consistent with preserved semantic schemata processing in aging. The incidental recognition advantage of older over younger adults for the context-typical and context-atypical objects may reflect aging-related differences in goal-related processing, with older adults under comparatively more novel circumstances being more likely to direct their attention to the external environment, or age-related differences in top-down effortful distraction regulation, with older individuals’ attention more readily captured by salient objects in the environment. Older adults’ reduced recognition of unfamiliar objects compared to context-atypical objects may reflect possible age differences in contextually driven expectancy violations. The latter finding underscores the theoretical and

  14. Elderly Homeless Veterans in Los Angeles: Chronicity and Precipitants of Homelessness

    PubMed Central

    van den Berk-Clark, Carissa; McGuire, James

    2013-01-01

    Objectives. We compared the characteristics of chronically homeless and acutely homeless elderly veterans to better understand precipitants of homelessness. Methods. We conducted interviews with 33 chronically and 26 acutely homeless veterans aged 65 years and older receiving transitional housing services in Los Angeles, California, between 2003 and 2005. We asked questions regarding their sociodemographic characteristics and other social status measures. Other precipitants of homelessness were acquired via observation and open-ended and structured questions. Results. Both veterans groups were more similar than different, with substantial levels of physical, psychiatric, and social impairment. They differed significantly in homelessness history, with chronically homeless veterans having more homelessness episodes and more total time homeless. They were also less educated and had smaller social networks. In response to open-ended questioning, elderly homeless veterans revealed how health and substance use issues interacted with loss of social support and eviction to exacerbate homelessness. Conclusions. Assessment of a range of factors is needed to address risk factors and events leading to homelessness. Further research with larger samples is needed to confirm the characteristics and needs of the elderly homeless veteran population. PMID:24148059

  15. Pathways In and Out of Substance Use among Homeless-Emerging Adults

    ERIC Educational Resources Information Center

    Tyler, Kimberly A.; Johnson, Katherine A.

    2006-01-01

    Although high rates of alcohol and drug use have been found among homeless young people, less is known about who is responsible for their initiation, the reasons for their continued use, and why some individuals eventually transition out of using whereas others do not. Based on qualitative interviews with 40 homeless individuals 19 to 21 years of…

  16. Cardiovascular reactivity of younger and older adults to positive-, negative-, and mixed-emotion cognitive challenge.

    PubMed

    Hogan, Michael J; James, Jack E; McCabe, Tadhg R; Kilmartin, Liam; Howard, Siobhán; Noone, Chris

    2012-03-01

    Although aging is associated with progressive increases in blood pressure level, previous research has been inconsistent as to whether older adults show greater or lesser cardiovascular reactivity (CVR) to emotion than do younger adults. There is reason to believe that these inconsistencies could be clarified by examining age-related differences in hemodynamic profile revealed by measuring the pattern of cardiac output and total peripheral resistance associated with changes in blood pressure reactivity. Accordingly, the present study examined the performance, CVR, and hemodynamic profile of younger and older adults during encoding and recognition of word pairs involving four valence types: positive, negative, mixed (positive/negative), and neutral word pairs. Results revealed higher baseline blood pressure, increased CVR characterized by a vascular hemodynamic profile, and more rapid recovery (especially during encoding) for older than for younger participants. Results are discussed in light of research and theory on the relationship between aging and cardiovascular health. Copyright © 2012 Elsevier B.V. All rights reserved.

  17. Prevalence and Correlates of Youth Homelessness in the United States

    PubMed Central

    Morton, Matthew H.; Dworsky, Amy; Matjasko, Jennifer L.; Curry, Susanna R.; Schlueter, David; Chávez, Raúl; Farrell, Anne F.

    2018-01-01

    Purpose Unaccompanied youth homelessness is a serious concern. Response, however, has been constrained by the absence of credible data on the size and characteristics of the population and reliable means to track youth homelessness over time. We sought to address these gaps. Methods Using a nationally representative phone-based survey (N = 26,161), we solicited household and individual reports on different types of youth homelessness. We collected household reports on adolescents aged 13–17 and young adults aged 18–25, as well as self-reports from young adults aged 18–25. Follow-up interviews with a subsample (n = 150) provided additional information on youth experiences and enabled adjustment for inclusion errors. Results Over a 12-month period, approximately 3.0% of households with 13- to 17-year-olds reported explicit youth homelessness (including running away or being asked to leave) and 1.3% reported experiences that solely involved couch surfing, resulting in an overall 4.3% household prevalence of any homelessness, broadly defined. For 18- to 25-year-olds, household prevalence estimates were 5.9% for explicitly reported homelessness, 6.6% for couch surfing only, and 12.5% overall. The 12-month population prevalence estimates, available only for 18- to 25-year-olds, were 5.2%, 4.5%, and 9.7%, respectively. Incidence rates were about half as high as prevalence rates. Prevalence rates were similar across rural and nonrural counties. Higher risk of homelessness was observed among young parents; black, Hispanic, and lesbian, gay, bisexual, or transgender (LGBT) youth; and those who did not complete high school. Conclusions The prevalence and incidence of youth homelessness reveal a significant need for prevention and youth-centric systems and services, as well as strategies to address disproportionate risks of certain subpopulations. PMID:29153445

  18. Prevalence and Correlates of Youth Homelessness in the United States.

    PubMed

    Morton, Matthew H; Dworsky, Amy; Matjasko, Jennifer L; Curry, Susanna R; Schlueter, David; Chávez, Raúl; Farrell, Anne F

    2018-01-01

    Unaccompanied youth homelessness is a serious concern. Response, however, has been constrained by the absence of credible data on the size and characteristics of the population and reliable means to track youth homelessness over time. We sought to address these gaps. Using a nationally representative phone-based survey (N = 26,161), we solicited household and individual reports on different types of youth homelessness. We collected household reports on adolescents aged 13-17 and young adults aged 18-25, as well as self-reports from young adults aged 18-25. Follow-up interviews with a subsample (n = 150) provided additional information on youth experiences and enabled adjustment for inclusion errors. Over a 12-month period, approximately 3.0% of households with 13- to 17-year-olds reported explicit youth homelessness (including running away or being asked to leave) and 1.3% reported experiences that solely involved couch surfing, resulting in an overall 4.3% household prevalence of any homelessness, broadly defined. For 18- to 25-year-olds, household prevalence estimates were 5.9% for explicitly reported homelessness, 6.6% for couch surfing only, and 12.5% overall. The 12-month population prevalence estimates, available only for 18- to 25-year-olds, were 5.2%, 4.5%, and 9.7%, respectively. Incidence rates were about half as high as prevalence rates. Prevalence rates were similar across rural and nonrural counties. Higher risk of homelessness was observed among young parents; black, Hispanic, and lesbian, gay, bisexual, or transgender (LGBT) youth; and those who did not complete high school. The prevalence and incidence of youth homelessness reveal a significant need for prevention and youth-centric systems and services, as well as strategies to address disproportionate risks of certain subpopulations. Copyright © 2017 The Society for Adolescent Health and Medicine. All rights reserved.

  19. Temporo-spatial gait parameters during street crossing conditions: a comparison between younger and older adults.

    PubMed

    Vieira, Edgar R; Lim, Hyun-Hwa; Brunt, Denis; Hallal, Camilla Z; Kinsey, Laura; Errington, Lisa; Gonçalves, Mauro

    2015-02-01

    Most traffic accidents involving pedestrians happen during street crossing. Safe street crossing by older adults requires complex planning and imposes high cognitive demands. Understanding how street crossing situations affect younger and older adults' gait is important to create evidence-based policies, education and training. The objective of this study was to develop and test a method to evaluate temporo-spatial gait parameters of younger and older adults during simulated street crossing situations. Twenty-two younger (25±2 years old) and 22 older adults (73±6 years old) who lived independently in the community completed 3 walking trials at preferred gait speed and during simulated street crossing with regular and with reduced time. There were significant differences between groups (p<0.001) and conditions (p<0.001). Older adults' street crossing walking speed was higher than their preferred speed (p<0.001). Gait during simulated street crossing resulted in significant and progressive gait changes. The methods developed and tested can be used to (1) evaluate if people are at risk of falls and accidents during street crossing situations, (2) to compare among different groups, and (3) to help establish appropriate times for older pedestrians to cross streets safely. The current time to cross streets is too short even for healthy older adults. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Younger and older adults' collaborative recall of shared and unshared emotional pictures.

    PubMed

    Barber, Sarah J; Castrellon, Jaime J; Opitz, Philipp; Mather, Mara

    2017-07-01

    Although a group of people working together recalls more items than any one individual, they recall fewer unique items than the same number of people working apart whose responses are combined. This is known as collaborative inhibition, and it is a robust effect that occurs for both younger and older adults. However, almost all previous studies documenting collaborative inhibition have used stimuli that were neutral in emotional valence, low in arousal, and studied by all group members. In the current experiments, we tested the impact of picture-stimuli valence, picture-stimuli arousal, and information distribution in modulating the magnitude of collaborative inhibition. We included both younger and older adults because there are age differences in how people remember emotional pictures that could modulate any effects of emotion on collaborative inhibition. Results revealed that when information was shared (i.e., studied by all group members), there were robust collaborative inhibition effects for both neutral and emotional stimuli for both younger and older adults. However, when information was unshared (i.e., studied by only a single group member), these effects were attenuated. Together, these results provide mixed support for the retrieval strategy disruption account of collaborative inhibition. Supporting the retrieval strategy disruption account, unshared study information was less susceptible to collaborative inhibition than shared study information. Contradicting the retrieval strategy disruption account, emotional valence and arousal did not modulate the magnitude of collaborative inhibition despite the fact that participants clustered the emotional, but not neutral, information together in memory.

  1. The Influence of Emotional Material on Encoding and Retrieving Intentions: An ERP Study in Younger and Older Adults

    PubMed Central

    Hering, Alexandra; Kliegel, Matthias; Bisiacchi, Patrizia S.; Cona, Giorgia

    2018-01-01

    Prospective memory is a cognitive process that comprises the encoding and maintenance of an intention until the appropriate moment of its retrieval. It is of highly relevance for an independent everyday life, especially in older adults; however, there is ample evidence that prospective memory declines with increasing age. Because most studies have used neutral stimuli, it is still an open question how emotional factors influence age-related differences in prospective remembering. The aim of the study was to investigate the influence of emotional material on prospective memory encoding, monitoring, maintaining, and retrieval in younger and older adults using behavioral and electrophysiological measures. We tested 24 younger adults (M = 26.4 years) and 20 older adults (M = 68.1 years) using a picture one-back task as ongoing activity with an embedded prospective memory instruction. The experimental task consisted of three sessions. In each session, participants had to encode series of images that represented the prospective memory cues for the consecutive block. The images were either of pleasant, unpleasant, or neutral valence. The pictures used in the ongoing task were likewise of pleasant, unpleasant, or neutral valence. Event-related potentials (ERPs) were recorded to assess the neural correlates of intention encoding, maintenance, and self-initiated retrieval. We did not find age differences between younger and older adults on the behavioral level. However, the ERP results revealed an interesting pattern that suggested for both age groups elevated attentional processing of emotional cues during encoding indicated by an elevated LPP for the emotional cues. Additionally, younger adults showed increased activity for unpleasant cues. During the maintenance phase, both age groups engaged in strategic monitoring especially for pleasant cues, which led to enhanced sustained positivity. During retrieval, older adults showed increased activity of ERP components related

  2. Homelessness Experiences, Sexual Orientation, and Sexual Risk Taking among High School Students in Los Angeles

    PubMed Central

    Rice, Eric; Barman-Adhikari, Anamika; Rhoades, Harmony; Winetrobe, Hailey; Fulginiti, Anthony; Astor, Roee; Montoya, Jorge; Plant, Aaron; Kordic, Timothy

    2013-01-01

    Purpose Prior studies reported homeless adolescents engage in more sexual risk than their housed peers. However, these comparisons are typically made post hoc by comparing homeless adolescent community-based samples with high school probability samples. This study utilizes a random sample of high school students to examine homelessness experiences and sexual risk behaviors. Methods A supplemental survey to the Youth Risk Behavior Survey containing questions regarding homelessness and sexual health was administered to Los Angeles high school students (N=1,839). Multivariate logistic regressions assessed the associations between demographics, past year homelessness experiences (i.e., place of nighttime residence), and being sexually active and condom use at last intercourse. Results Homelessness experiences consisted of staying in a shelter (10.4%), a public place (10.1%), and with a stranger (5.6%). Lesbian, gay, bisexual, transgender, questioning (LGBTQ), younger, and male adolescents were more likely to experience homelessness. LGBTQ adolescents were also more likely to report staying with a stranger and less likely to report staying in a shelter. Compared to adolescents who stayed in shelters, adolescents who stayed with strangers and in public places were more likely to engage in unprotected sex at last intercourse. Conclusions Adolescents who report sexual activity and sexual risk taking are more likely to report homelessness experiences. With regard to sexual health, staying with strangers could be a particularly risky form of homelessness; LGBTQ and Black adolescents are more likely to experience this form of homelessness. Efforts to reduce homelessness and sexual risk-taking need to recognize the specific vulnerabilities faced by these populations. PMID:23360897

  3. The individual and beyond: a socio-rational choice model of service participation among homeless adults with substance abuse problems.

    PubMed

    Sosin, Michael R; Grossman, Susan F

    2003-01-01

    While substance user service programs can help homeless adults solve their substance use and housing problems, relatively few needy individuals use and complete these programs. The lack of participation is poorly explained by typical empirical studies, most of which consider the role in service participation of various personal traits and client problems. The current article instead seeks to explain service participation through the application of an alternative, "socio-rational choice" model. This model has three premises: Clients weigh the costs and benefits of participating in services against alternative uses of their time and resources. The clients' weighing procedures reflect their personal situations and perceptions of the treatment environment. The perceptions of their personal situations and perceptions of the treatment environment are affected by the manner in which clients react to representatives of service systems, members of their social network including both housed and homeless persons, and other individuals. Secondary evidence supports many of the model's hypotheses and generally suggests that homeless clients may be heavily affected by their experiences with individuals and systems with which they come into contact.

  4. Drug problems among homeless individuals in Toronto, Canada: prevalence, drugs of choice, and relation to health status

    PubMed Central

    2010-01-01

    Background Drug use is believed to be an important factor contributing to the poor health and increased mortality risk that has been widely observed among homeless individuals. The objective of this study was to determine the prevalence and characteristics of drug use among a representative sample of homeless individuals and to examine the association between drug problems and physical and mental health status. Methods Recruitment of 603 single men, 304 single women, and 284 adults with dependent children occurred at homeless shelters and meal programs in Toronto, Canada. Information was collected on demographic characteristics and patterns of drug use. The Addiction Severity Index was used to assess whether participants suffered from drug problems. Associations of drug problems with physical and mental health status (measured by the SF-12 scale) were examined using regression analyses. Results Forty percent of the study sample had drug problems in the last 30 days. These individuals were more likely to be single men and less educated than those without drug problems. They were also more likely to have become homeless at a younger age (mean 24.8 vs. 30.9 years) and for a longer duration (mean 4.8 vs. 2.9 years). Marijuana and cocaine were the most frequently used drugs in the past two years (40% and 27%, respectively). Drug problems within the last 30 days were associated with significantly poorer mental health status (-4.9 points, 95% CI -6.5 to -3.2) but not with poorer physical health status (-0.03 points, 95% CI -1.3 to 1.3)). Conclusions Drug use is common among homeless individuals in Toronto. Current drug problems are associated with poorer mental health status but not with poorer physical health status. PMID:20181248

  5. Phoneme categorization and discrimination in younger and older adults: a comparative analysis of perceptual, lexical, and attentional factors.

    PubMed

    Mattys, Sven L; Scharenborg, Odette

    2014-03-01

    This study investigates the extent to which age-related language processing difficulties are due to a decline in sensory processes or to a deterioration of cognitive factors, specifically, attentional control. Two facets of attentional control were examined: inhibition of irrelevant information and divided attention. Younger and older adults were asked to categorize the initial phoneme of spoken syllables ("Was it m or n?"), trying to ignore the lexical status of the syllables. The phonemes were manipulated to range in eight steps from m to n. Participants also did a discrimination task on syllable pairs ("Were the initial sounds the same or different?"). Categorization and discrimination were performed under either divided attention (concurrent visual-search task) or focused attention (no visual task). The results showed that even when the younger and older adults were matched on their discrimination scores: (1) the older adults had more difficulty inhibiting lexical knowledge than did younger adults, (2) divided attention weakened lexical inhibition in both younger and older adults, and (3) divided attention impaired sound discrimination more in older than younger listeners. The results confirm the independent and combined contribution of sensory decline and deficit in attentional control to language processing difficulties associated with aging. The relative weight of these variables and their mechanisms of action are discussed in the context of theories of aging and language. (c) 2014 APA, all rights reserved.

  6. Intelligibility of emotional speech in younger and older adults.

    PubMed

    Dupuis, Kate; Pichora-Fuller, M Kathleen

    2014-01-01

    Little is known about the influence of vocal emotions on speech understanding. Word recognition accuracy for stimuli spoken to portray seven emotions (anger, disgust, fear, sadness, neutral, happiness, and pleasant surprise) was tested in younger and older listeners. Emotions were presented in either mixed (heterogeneous emotions mixed in a list) or blocked (homogeneous emotion blocked in a list) conditions. Three main hypotheses were tested. First, vocal emotion affects word recognition accuracy; specifically, portrayals of fear enhance word recognition accuracy because listeners orient to threatening information and/or distinctive acoustical cues such as high pitch mean and variation. Second, older listeners recognize words less accurately than younger listeners, but the effects of different emotions on intelligibility are similar across age groups. Third, blocking emotions in list results in better word recognition accuracy, especially for older listeners, and reduces the effect of emotion on intelligibility because as listeners develop expectations about vocal emotion, the allocation of processing resources can shift from emotional to lexical processing. Emotion was the within-subjects variable: all participants heard speech stimuli consisting of a carrier phrase followed by a target word spoken by either a younger or an older talker, with an equal number of stimuli portraying each of seven vocal emotions. The speech was presented in multi-talker babble at signal to noise ratios adjusted for each talker and each listener age group. Listener age (younger, older), condition (mixed, blocked), and talker (younger, older) were the main between-subjects variables. Fifty-six students (Mage= 18.3 years) were recruited from an undergraduate psychology course; 56 older adults (Mage= 72.3 years) were recruited from a volunteer pool. All participants had clinically normal pure-tone audiometric thresholds at frequencies ≤3000 Hz. There were significant main effects of

  7. Youth Homelessness: The Impact of Supportive Relationships on Recovery.

    PubMed

    Gasior, Sara; Forchuk, Cheryl; Regan, Sandra

    2018-03-01

    Background Homeless youth are the fastest growing sub-group within the homeless population. They face impaired access to health services and are often left unsupported. They lack social and family support or relationships with service providers. Unsupported homeless youth often become homeless adults. Purpose To test a model based on Peplau's Theory of Interpersonal Relations, examining the influence of a network of service providers, perceptions of social supports, and family relations on a homeless youth's perceptions of recovery. Methods This study is a secondary analysis and used a sample (n = 187) of data collected as part of the original Youth Matters in London study. A cross-sectional design was used to analyze the relationship between variables. Participants were interviewed at 6-month intervals over a 2.5-year period. Hierarchical multiple regression analysis was used. Results Network of service providers, perceived social supports, and perceived family relations explained 21.8% of the variance in homeless youth perceptions of recovery. Perceived social support and family relations were significantly, positively correlated to perceptions of recovery. Network of service providers was not significantly correlated to perceptions of recovery. Conclusions The findings suggest that stronger social supports and family relations may contribute to increased perceptions of recovery among homeless youth.

  8. Younger and older adults' associative memory for social information: The role of information importance.

    PubMed

    Hargis, Mary B; Castel, Alan D

    2017-06-01

    The ability to associate items in memory is critical for social interactions. Older adults show deficits in remembering associative information but can sometimes remember high-value information. In two experiments, younger and older participants studied faces, names, and occupations that were of differing social value. There were no age differences in the recall of important information in Experiment 1, but age differences were present for less important information. In Experiment 2, when younger adults' encoding time was reduced, age differences were largely absent. These findings are considered in light of value-directed strategies when remembering social associative information. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  9. Emotional expressivity in older and younger adults' descriptions of personal memories.

    PubMed

    Schryer, Emily; Ross, Michael; St Jacques, Peggy; Levine, Brian; Fernandes, Myra

    2012-01-01

    BACKGROUND/STUDY CONTEXT: According to the socioemotional selectivity theory (SST; Mather & Carstensen, 2003, Psychological Sciences, 14, 409-415), aging is associated with greater motivation to regulate emotions. The authors propose that the language people use to describe personal memories provides an index of age differences in emotional self-regulation. In the present article, the authors reanalyzed three previously published studies in which older (aged 60-88) and younger (aged 17-33) participants described emotional and neutral memories from their recent and distant pasts. The authors analyzed the language of the memories using Pennebaker, Booth, and Francis's (2007) Linguistic Inquiry Word Count program (Austin, TX: LIWC Inc.), which calculates the percentage of positive and negative emotion words. In Studies 1 and 2, older adults used more positive emotion words than did younger adults to describe their autobiographical memories from the recent past, particularly when these were of a neutral valence. In Study 3, older adults used more positive emotion words when describing more recent memories (from the past 5 years) but not when describing distant childhood or adolescent memories. The authors suggest that these age differences in emotional expressivity support SST, and represent an as-yet unreported age difference that may stem from differences in motivation to regulate emotion.

  10. Memory, priority encoding, and overcoming high-value proactive interference in younger and older adults.

    PubMed

    Friedman, Michael C; Castel, Alan D

    2013-01-01

    It is often necessary to remember important information while directing attention away from encoding less valuable information. To examine how aging influences the ability to control and update the encoding of high-value information, younger and older adults studied six lists of words that varied in terms of the point values associated with each word. The words were paired with the same high and low point values for three study-test cycles, but on the fourth and subsequent cycles the value-word pairings were switched such that the lowest value pairs became the highest values (and vice versa). For the first three study-test cycles, younger adults outperformed older adults in terms of the number of words recalled and overall point totals, but performance was similar in terms of selectively remembering high-value words. When the values were switched, both groups displayed substantial interference from the previous pairings. Although both groups improved with additional study-test cycles, only younger adults were able to fully recover from the interference effects. A similar, and more pronounced, set of results were obtained when positive and negative point values were paired with the words. The findings are interpreted in a value-directed remembering framework, emphasizing the role of benefits and costs of strategic encoding and age-related differences in the effects of interference on memory.

  11. Younger and Older Adults' "Good-Enough" Interpretations of Garden-Path Sentences

    ERIC Educational Resources Information Center

    Christianson, Kiel; Williams, Carrick C.; Zacks, Rose T.; Ferreira, Fernanda

    2006-01-01

    We report 3 experiments that examined younger and older adults' reliance on "good-enough" interpretations for garden-path sentences (e.g., "While Anna dressed the baby played in the crib") as indicated by their responding "Yes" to questions probing the initial, syntactically unlicensed interpretation (e.g., "Did Anna dress the baby?"). The…

  12. Homelessness in a national sample of incarcerated veterans in state and federal prisons.

    PubMed

    Tsai, Jack; Rosenheck, Robert A; Kasprow, Wesley J; McGuire, James F

    2014-05-01

    The Veterans Health Administration (VHA) has been increasing efforts to reach out to assist incarcerated veterans. While previous studies have shown strong associations between incarceration and homelessness, few studies have examined distinctive characteristics of incarcerated homeless and non-homeless veterans. National administrative data on 30,348 incarcerated veterans served by the Health Care for Re-entry Veterans (HCRV) program were analyzed. Incarcerated veterans were classified into four groups based on their history of past homelessness: not homeless, transiently homeless, episodically homeless, and chronically homeless. Multinomial logistic regression was used to compare groups on sociodemographic characteristics, criminal justice status, clinical status, and their interest in using VHA services. Of the sample, 70 % were classified as not homeless, 8 % as transiently homeless, 11 % as episodically homeless, and 11 % as chronically homeless. Thus, 30 % of the sample had a homeless history, which is five times the 6 % rate of past homelessness among adult men in the general population. Compared to non-homeless incarcerated veterans, all three homeless groups reported significantly more mental health problems, more substance abuse, more times arrested in their lifetime, more likely to be incarcerated for a non-violent offense, and were more interested in receiving VHA services after release from prison. Together, these findings suggest re-entry programs, like HCRV, can address relevant mental health-related service needs, especially among formerly homeless veterans and veterans in need of services are receptive to the offer of assistance.

  13. Pharmacokinetics and effect on the corrected QT interval of single-dose escitalopram in healthy elderly compared with younger adults.

    PubMed

    Chung, Hyewon; Kim, Anhye; Lim, Kyoung Soo; Park, Sang-In; Yu, Kyung-Sang; Yoon, Seo Hyun; Cho, Joo-Youn; Chung, Jae-Yong

    2017-01-01

    Escitalopram is the (S)-enantiomer of citalopram that has a potential QT prolonging effect. In this study, 12 healthy elderly individuals received a single oral dose of escitalopram (20 mg), and their pharmacokinetics and QT effect data were compared with data from 33 younger adults obtained in a previous study. Serial blood samples for pharmacokinetic analysis were collected and ECG was performed up to 48 h postdose. The elderly and younger adults showed similar pharmacokinetic profiles. The geometric mean ratios (90% confidence interval) of the elderly compared with the younger adults were 1.02 (0.89-1.17) and 1.01 (0.86-1.17) for the maximum plasma concentration and area under the concentration-time curve, respectively. The mean baseline-adjusted QT (dQT) time profiles were similar and the mean values of maximum dQT were not significantly different between the elderly and the younger adults. The linear mixed-effect model indicated a weak but positive relationship between the escitalopram concentration and dQT, with an estimated coefficient of concentration of 0.43-0.54. In conclusion, the pharmacokinetics and QT effect of a single dose of escitalopram observed in the elderly without comorbidities and younger adults were generally similar.

  14. Effects of Arousal and Context on Recognition Memory for Emotional Pictures in Younger and Older Adults.

    PubMed

    Wang, Yang; Yang, Jiongjiong

    2017-01-01

    Background/Study Context: Previous studies found that older adults tend to remember more positive than negative information (i.e., positivity bias), leading to an age-related positivity effect. However, the extent to which factors of arousal and contextual information influence the positivity bias in older adults remains to be determined. In this study, 27 Chinese younger adults (20.00 ± 1.75 years) and 33 Chinese older adults (70.76 ± 5.49) learned pictures with negative, positive, and neutral valences. Half of the pictures had a human context, and the other half did not. In addition, emotional dimensions of negative and positive pictures were divided into high-arousal and low-arousal. The experimental task was to provide old/new recognition and confidence rating judgments. Both groups of subjects showed the positivity bias for low-arousal pictures, but the positivity bias was restricted to low-arousal pictures without the human context in older adults. In addition, the positivity bias was mainly driven by the recollection process in younger adults, and it was mainly driven by both the recollection and familiarity processes in older adults. The recognition of the nonhuman positive pictures was correlated with cognitive control abilities, but the recognition of pictures with human contexts was correlated with general memory abilities in older adults. This study highlights the importance of arousal and contextual information in modulating emotional memory in younger and older adults. It suggests that there are different mechanisms for memorizing pictures with and without human contexts in older adults.

  15. Effects of arousal and context on recognition memory for emotional pictures in younger and older adults

    PubMed Central

    Wang, Yang; Yang, Jiongjiong

    2017-01-01

    Background/Study context Previous studies found that older adults tend to remember more positive than negative information (i.e., positivity bias), leading to an age-related positivity effect. However, the extent to which factors of arousal and contextual information influence the positivity bias in older adults remains to be determined. Methods In this study, 27 Chinese younger adults (20.00±1.75 years) and 33 Chinese older adults (70.76 ± 5.49) learned pictures with negative, positive and neutral valences. Half of the pictures had a human context, and the other half did not. In addition, emotional dimensions of negative and positive pictures were divided into high-arousal and low-arousal. The experimental task was to provide old/new recognition and confidence rating judgments. Results Both groups of subjects showed the positivity bias for low-arousal pictures, but the positivity bias was restricted to low-arousal pictures without the human context in older adults. In addition, the positivity bias was mainly driven by the recollection process in younger adults, and it was mainly driven by both the recollection and familiarity processes in older adults. The recognition of the nonhuman positive pictures was correlated with cognitive control abilities, but the recognition of pictures with human contexts was correlated with general memory abilities in older adults. Conclusion This study highlights the importance of arousal and contextual information in modulating emotional memory in younger and older adults. It suggests that there are different mechanisms for memorizing pictures with and without human contexts in older adults. PMID:28230422

  16. Homelessness among a nationally representative sample of US veterans: prevalence, service utilization, and correlates.

    PubMed

    Tsai, Jack; Link, Bruce; Rosenheck, Robert A; Pietrzak, Robert H

    2016-06-01

    To examine the prevalence of lifetime homelessness among veterans and use of Veterans Affairs (VA) homeless services, as well as their association with sociodemographic and clinical characteristics. A nationally representative sample of 1533 US veterans was surveyed July-August 2015. Among all veterans, 8.5 % reported any lifetime homelessness in their adult life, but only 17.2 % of those reported using VA homeless services. Prevalence of homelessness and VA homeless service use did not significantly differ by gender. Being low income, aged 35-44, and having poor mental and physical health were each independently associated with lifetime homelessness. Veterans who were White or lived in rural areas were significantly less likely to have used VA homeless services. Homelessness remains a substantial problem across different generations of veterans. The low reported uptake of VA homeless services suggests there are barriers to care in this population, especially for veterans who live in rural areas. Governmental resources dedicated to veteran homelessness should be supported, and obtaining accurate prevalence estimates are important to tracking progress over time.

  17. Attitudinal and Intentional Acceptance of Domestic Robots by Younger and Older Adults

    PubMed Central

    Ezer, Neta; Fisk, Arthur D.; Rogers, Wendy A.

    2014-01-01

    A study was conducted to examine the expectations that younger and older individuals have about domestic robots and how these expectations relate to robot acceptance. In a questionnaire participants were asked to imagine a robot in their home and to indicate how much items representing technology, social partner, and teammate acceptance matched their robot. There were additional questions about how useful and easy to use they thought their robot would be. The dependent variables were attitudinal and intentional acceptance. The analysis of the responses of 117 older adults (aged 65–86) and 60 younger adults (aged 18–25) indicated that individuals thought of robots foremost as performance-directed machines, less so as social devices, and least as unproductive entities. The robustness of the Technology Acceptance Model to robot acceptance was supported. Technology experience accounted for the variance in robot acceptance due to age. PMID:25584365

  18. Increasing Access to Higher Education for Unaccompanied Youth: Information for Colleges and Universities. Best Practices in Homeless Education

    ERIC Educational Resources Information Center

    National Center for Homeless Education at SERVE, 2010

    2010-01-01

    Each year, more than a million young people in the United States experience homelessness; some of these young people, known as unaccompanied homeless youth, will face the challenges of homelessness while living on their own without the support of a caring adult. Unaccompanied homeless youth face the same struggles as other young people: trying to…

  19. Comparing daily drivers of problem drinking among older and younger adults: An electronic daily diary study using smartphones.

    PubMed

    Kuerbis, Alexis; Treloar Padovano, Hayley; Shao, Sijing; Houser, Jessica; Muench, Frederick J; Morgenstern, Jon

    2018-02-01

    By 2030, numbers and proportions of older adults with substance-use problems are expected to increase. While risk factors for problem drinking in late life have been identified, it remains unknown whether these factors drive daily drinking among older problem drinkers. This study examined the daily drivers of drinking among problem drinkers, moderated by age, utilizing ecological momentary assessment (EMA). Participants (N = 139), ages 20-73, received daily EMA online surveys completed via a smartphone prior to initiation of treatment. Multilevel modeling tested the moderating impact of age on within- and between-person relationships between drinking and focal predictors (mood, loneliness, boredom, stress, poor sleep, social factors, alcohol salience, commitment and confidence not to drink heavily). Older adults reported greater alcohol consumption when daily boredom levels were higher. Heavier drinking among younger adults was associated with poorer sleep quality. Greater daily confidence, daily commitment and daily alcohol salience did not impact drinking to the same extent for older adults as for younger adults. Greater person-level commitment predicted reduced drinking equivalently across age, but low person-level commitment predicted greater drinking among older adults compared to their younger counterparts. Older adults may have unique daily drivers of drinking that are not fully realized in current research and intervention efforts. Addressing the growing substance-use treatment needs among this population will require identifying the unique drivers of drinking among older adults, such as boredom, when compared to younger adults. Copyright © 2018 Elsevier B.V. All rights reserved.

  20. Adult Support and Substance Use among Homeless Youths Who Attend High School

    ERIC Educational Resources Information Center

    Ferguson, Kristin M.; Xie, Bin

    2012-01-01

    Background: Despite high rates of substance use among homeless youths, little is known about the interaction of substance-use risk and protective factors. Further, limited research exists on substance use by school-attending homeless youths, as extant studies have relied on street- and shelter-based samples. Objective: The purpose of this study…

  1. Thirst for knowledge: The effects of curiosity and interest on memory in younger and older adults.

    PubMed

    McGillivray, Shannon; Murayama, Kou; Castel, Alan D

    2015-12-01

    Given age-related memory impairments, one's level of curiosity or interest could enhance memory for certain information. In the current study, younger and older adults read trivia questions, rated how curious they were to learn each answer, provided confidence and interest ratings, and judgments of learning after learning the answer. No age-related differences in memory were found. Analyses indicated that curiosity and interest contributed to the formation of judgments of learning. Additionally, interest had a unique increasing relationship with older, but not younger, adults' memory performance after a one-week delay. The results suggest that subjective interest may serve to enhance older adults' memory. (c) 2015 APA, all rights reserved).

  2. Healthcare Barriers and Utilization Among Adolescents and Young Adults Accessing Services for Homeless and Runaway Youth.

    PubMed

    Chelvakumar, Gayathri; Ford, Nancy; Kapa, Hillary M; Lange, Hannah L H; McRee, Annie-Laurie; Bonny, Andrea E

    2017-06-01

    Homeless and runaway youth are at disproportionate risk for adverse health outcomes. Many barriers to accessing healthcare have been documented; however, the relative impact of discrete barriers on homeless youth healthcare utilization behavior is not firmly established. We administered a survey examining reported barriers and healthcare utilization among adolescents and young adults accessing services at three community centers for homeless and runaway youth. Of 180 respondents, 57 % were male, 80 % non-White, and 21 % identified as a sexual minority. Stepwise logistic regression models, controlling for age and study site, explored associations between barriers and 3 healthcare utilization outcomes (doctor visit in past 12 months; regular care provider; frequent emergency department (ED) visits). The most commonly reported barriers were "don't have a ride" (27.2 %), "no insurance" (23.3 %), and "costs too much" (22.8 %). All fear-based barriers (e.g., "I don't trust the doctors") were reported by <5 % of surveyed youth. Significant predictors of having seen a doctor in the past 12 months included sexual minority status (OR 2.8, p = 0.04) and possession of health insurance (OR 4.9, p < 0.001). Female sex (OR 5.2, p < 0.001) and reported external barriers other than health insurance (OR 0.2, p < 0.001) were associated with having a regular care provider. Fear-based concerns were associated (OR 3.8, p = 0.02) with frequent ED visits, as was being insured (OR 2.2, p = 0.03). These results underscore the need to clearly define healthcare outcomes when investigating barriers to care among homeless and runaway youth as the impact of discrete barriers varies depending on outcome of focus.

  3. Inner resources for survival: integrating interpersonal psychotherapy with spiritual visualization with homeless youth.

    PubMed

    Mastropieri, Biagio; Schussel, Lorne; Forbes, David; Miller, Lisa

    2015-06-01

    Homeless youth have particular need to develop inner resources to confront the stress, abusive environment of street life, and the paucity of external resources. Research suggests that treatment supporting spiritual awareness and growth may create a foundation for coping, relationships, and negotiating styles to mitigate distress. The current pilot study tests the feasibility, acceptability, and helpfulness of an interpersonal spiritual group psychotherapy, interpersonal psychotherapy (IPT) integrated with spiritual visualization (SV), offered through a homeless shelter, toward improving interpersonal coping and ameliorating symptoms of depression, distress, and anxiety in homeless youth. An exploratory pilot of integrative group psychotherapy (IPT + SV) for homeless young adults was conducted in a New York City on the residential floor of a shelter-based transitional living program. Thirteen young adult men (mean age 20.3 years, SD = 1.06) participated in a weekly evening psychotherapy group (55 % African-American, 18 % biracial, 18 % Hispanic, 9 % Caucasian). Measures of psychological functioning were assessed at pre-intervention and post-intervention using the General Health Questionnaire (GHQ-12), Patient Health Questionnaire (PHQ-9, GAD-7), and the Inventory of Interpersonal Problems (IIP-32). A semi-structured exit interview and a treatment satisfaction questionnaire were also employed to assess acceptability following treatment. Among homeless young adults to participate in the group treatment, significant decreases in symptoms of general distress and depression were found between baseline and termination of treatment, and at the level of a trend, improvement in overall interpersonal functioning and levels of general anxiety. High utilization and treatment satisfaction showed the intervention to be both feasible and acceptable. Offered as an adjunct to the services-as-usual model at homeless shelters serving young adults, interpersonal psychotherapy

  4. Contrasting outcomes of older versus middle-aged and younger adult chemical dependency patients in a managed care program.

    PubMed

    Satre, Derek D; Mertens, Jennifer; Areán, Patricia A; Weisner, Constance

    2003-07-01

    This study examined how well older chemical dependency patients succeed in treatment relative to middle-aged and younger patients in a mixed-age private HMO outpatient program. To predict successful outcome, we tested a model incorporating age group differences in individual, treatment and extratreatment factors. The sample included 89 patients aged 55 and over, 379 patients aged 40 to 54, and 736 patients aged 18-39 (N = 1,204). Baseline measures included DSM-IV substance misuse diagnoses, Addiction Severity Index (ASI), psychiatric symptom checklist, sources of suggestion to enter treatment, treatment history and motivation. Outcome measures were abstinence rates and ASI score 6 months posttreatment. At baseline, older adults showed higher levels of alcohol dependence, lower rates of drug dependence and lower psychiatric symptoms relative to younger individuals. Source of suggestions to enter treatment differed by age. Older and middle-aged patients were more likely to have an abstinence goal and to stay in treatment longer than younger adults. At 6 months posttreatment, 55% of older adults reported abstinence in the preceding 30 days, versus 59% of middle-aged adults and 50% of younger adults (p = .035). Lower rates of dependence and hostility, and greater abstinence motivation and length of stay in treatment--all of which were associated with greater age--positively affect prognosis of older adults in treatment.

  5. Multiple Types of Childhood and Adult Violence Among Homeless and Unstably Housed Women in San Francisco.

    PubMed

    Wong, Lauren H; Shumway, Martha; Flentje, Annesa; Riley, Elise D

    2016-12-01

    This study examined the relationship between different forms of childhood violence (emotional, physical, and sexual) and these same forms of violence in adulthood, using a crosssectional baseline survey of 298 homeless and unstably housed women in San Francisco, California. We also examined other related factors, including mental illnesses diagnosis, sex exchange, jail time, HIV status, and sociodemographic information. Regression analysis indicated that although several of these factors were associated with experiences of violence as an adult, specific types of child violence (e.g., sexual violence) predicted instances of that same type of violence as an adult but not necessarily other types. Thus, risk of adult violence among low-income women may be better predicted and addressed through histories of same-type childhood violence, despite years of intervening exposures and stressors.

  6. Multiple types of childhood and adult violence among homeless and unstably housed women in San Francisco

    PubMed Central

    Wong, Lauren H.; Shumway, Martha; Flentje, Annesa; Riley, Elise D.

    2017-01-01

    The present study examined the relationship between different forms of childhood violence (emotional, physical, and sexual) and these same forms of violence in adulthood, using a cross-sectional baseline survey of 298 homeless and unstably housed women in San Francisco, California. We also examined other related factors, including mental illnesses diagnosis, sex exchange, jail time, HIV status, and sociodemographic information. Regression analysis indicated that while several of these factors were associated with experiences of violence as an adult, specific types of child violence (e.g. sexual violence) predicted instances of that same type of violence as an adult, but not necessarily other types. Thus, risk of adult violence among low-income women may be better predicted and addressed through histories of same-type childhood violence, despite competing current stressors. PMID:27640925

  7. Body Image in Adult Women: Moving Beyond the Younger Years

    PubMed Central

    Kilpela, Lisa Smith; Becker, Carolyn Black; Wesley, Nicole; Stewart, Tiffany

    2015-01-01

    In spite of copious literature investigating body dissatisfaction and its correlates in adolescents and young adult women, exploration of body image disturbances in adult women remains an underrepresented domain in the literature. Yet, there are many reasons to suspect that body image in adult women both may differ from and possibly be more complex than that of younger women. Adult women face myriad factors influencing body image beyond those delineated in the body image literature on adolescents and young adult women. For instance, aging-related physiological changes shift the female body further away from the thin-young-ideal, which is the societal standard of female beauty. Further, life priorities and psychological factors evolve with age as well. As such, adult women encounter changes that may differentially affect body image across the lifespan. This paper aims to provide an up-to-date review of the current literature on the relationship between body image and associated mental and physical health problems and behaviors in adult women. In addition, we explore factors that may influence body image in adult women. Lastly, we use this review to identify significant gaps in the existing literature with the aim of identifying critical targets for future research. PMID:26052476

  8. Exploring the experience of episodic past, future, and counterfactual thinking in younger and older adults: A study of a Colombian sample.

    PubMed

    De Brigard, Felipe; Rodriguez, Diana Carolina; Montañés, Patricia

    2017-05-01

    Although extant evidence suggests that many neural and cognitive mechanisms underlying episodic past, future, and counterfactual thinking overlap, recent results have uncovered differences among these three processes. However, the extent to which there may be age-related differences in the phenomenological characteristics associated with episodic past, future and counterfactual thinking remains unclear. This study used adapted versions of the Memory Characteristics Questionnaire and the Autobiographical Interview in younger and older adults to investigate the subjective experience of episodic past, future and counterfactual thinking. The results suggest that, across all conditions, younger adults generated more internal details than older adults. However, older adults generated more external details for episodic future and counterfactual thinking than younger adults. Additionally, younger and older adults generated more internal details, and gave higher sensory and contextual ratings, for memories rather than future and counterfactual thoughts. Methodological and theoretical consequences for extant theories of mental simulation are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Risk and Resilience Factors Associated with Formal and Informal Income Generation among Homeless Young Adults in Three U.S. Cities

    ERIC Educational Resources Information Center

    Ferguson, Kristin M.; Bender, Kimberly; Thompson, Sanna J.

    2018-01-01

    This study used the risk and resilience framework to examine predictors of formal and informal sources of income among homeless young adults. Formal sources of income generation consisted of full-time, part-time, or paid, temporary work. Informal sources included earning money from selling personal possessions, selling drugs, and theft. In all,…

  10. A cross-sectional observational study of unmet health needs among homeless and vulnerably housed adults in three Canadian cities

    PubMed Central

    2013-01-01

    Background Homeless persons experience a high burden of health problems; yet, they face significant barriers in accessing health care. Less is known about unmet needs for care among vulnerably housed persons who live in poor-quality or temporary housing and are at high risk of becoming homeless. The objectives of this study were to examine the prevalence of and factors associated with unmet needs for health care in a population-based sample of homeless and vulnerably housed adults in three major cities within a universal health insurance system. Methods Participants were recruited at shelters, meal programs, community health centers, drop-in centers, rooming houses, and single room occupancy hotels in Vancouver, Toronto, and Ottawa, Canada, throughout 2009. Baseline interviews elicited demographic characteristics, health status, and barriers to health care. Logistic regression was used to identify factors associated with self-reported unmet needs for health care in the past 12 months. Results Of the 1,181 participants included in the analysis, 445 (37%) reported unmet needs. In adjusted analyses, factors associated with a greater odds of reporting unmet needs were having employment in the past 12 months (AOR = 1.40, 95% CI = 1.03–1.91) and having ≥3 chronic health conditions (AOR = 2.17, 95% CI = 1.24–3.79). Having higher health-related quality of life (AOR = 0.21, 95% CI = 0.09–0.53), improved mental (AOR = 0.97, 95% CI = 0.96–0.98) or physical health (AOR = 0.98, 95% CI = 0.96–0.99), and having a primary care provider (AOR = 0.63, 95% CI = 0.46–0.85) decreased the odds of reporting unmet needs. Conclusions Homeless and vulnerably housed adults have a similar likelihood of experiencing unmet health care needs. Strategies to improve access to primary care and reduce barriers to accessing care in these populations are needed. PMID:23764199

  11. 'Hello, you're not supposed to be here': homeless emerging adults' experiences negotiating food access.

    PubMed

    Bowen, Elizabeth A; Irish, Andrew

    2018-07-01

    We aimed to examine the food-seeking experiences of homeless emerging adults (age 18-24 years) in a US urban context. The study used a qualitative descriptive design, combining semi-structured interviews with a standardized quantitative measure of food insecurity. Interview data were coded using constant comparative methods to identify patterns across and within interviews. Emerging themes were confirmed and refined through member checking. Buffalo, a mid-sized city in the Northeastern USA. A sample of thirty participants was recruited through community-based methods. Eligibility criteria specified that participants were aged 18-24 years and did not have a stable place to live. The sample was demographically diverse and included participants who were couch-surfing, staying on the streets and/or using shelters. Participants' food access strategies varied across their living circumstances. Common strategies included purchasing food with cash or benefits (reported by 77 %), using free meal programmes (70 %) and eating at friends' or relatives' homes (47 %). Although 70 % of participants received Supplemental Nutrition Assistance Program benefits, several reported access barriers, including initial denials of eligibility due to being listed on a parent's application even when the participant no longer resided in the household. Participants described a stigma associated with using food pantries and free meal programmes and expressed preference for less institutionalized programmes such as Food Not Bombs. Given endemic levels of food insecurity among homeless youth and young adults, policy modifications and service interventions are needed to improve food access for this population.

  12. Leg Strength Comparison between Younger and Middle-age Adults

    PubMed Central

    Kim, Sukwon; Lockhart, Thurmon; Nam, Chang S.

    2009-01-01

    Although a risk of occupational musculoskeletal diseases has been identified with age-related strength degradation, strength measures from working group are somewhat sparse. This is especially true for the lower extremity strength measures in dynamic conditions (i.e., isokinetic). The objective of this study was to quantify the lower extremity muscle strength characteristics of three age groups (young, middle, and the elderly). Total of 42 subjects participated in the study: 14 subjects for each age group. A commercial dynamometer was used to evaluate isokinetic and isometric strength at ankle and knee joints. 2 × 2 (Age group (younger, middle-age, and older adult groups) × Gender (male and female)) between-subject design and Post-hoc analysis were performed to evaluate strength differences among three age groups. Post-hoc analysis indicated that, overall, middle-age workers’ leg strengths (i.e. ankle and knee muscles) were significantly different from younger adults while middle-age workers’ leg strengths were virtually identical to older adults’ leg strengths. These results suggested that, overall, 14 middle-age workers in the present study could be at a higher risk of musculoskeletal injuries. Future studies looking at the likelihood of musculoskeletal injuries at different work places and from different working postures at various age levels should be required to validate the current findings. The future study would be a valuable asset in finding intervention strategies such that middle-age workers could stay healthier longer. PMID:20436934

  13. Designing an information search interface for younger and older adults.

    PubMed

    Pak, Richard; Price, Margaux M

    2008-08-01

    The present study examined Web-based information retrieval as a function of age for two information organization schemes: hierarchical organization and one organized around tags or keywords. Older adults' performance in information retrieval tasks has traditionally been lower compared with younger adults'. The current study examined the degree to which information organization moderated age-related performance differences on an information retrieval task. The theory of fluid and crystallized intelligence may provide insight into different kinds of information architectures that may reduce age-related differences in computer-based information retrieval performance. Fifty younger (18-23 years of age) and 50 older (55-76 years of age) participants browsed a Web site for answers to specific questions. Half of the participants browsed the hierarchically organized system (taxonomy), which maintained a one-to-one relationship between menu link and page, whereas the other half browsed the tag-based interface, with a many-to-one relationship between menu and page. This difference was expected to interact with age-related differences in fluid and crystallized intelligence. Age-related differences in information retrieval performance persisted; however, a tag-based retrieval interface reduced age-related differences, as compared with a taxonomical interface. Cognitive aging theory can lead to interface interventions that reduce age-related differences in performance with technology. In an information retrieval paradigm, older adults may be able to leverage their increased crystallized intelligence to offset fluid intelligence declines in a computer-based information search task. More research is necessary, but the results suggest that information retrieval interfaces organized around keywords may reduce age-related differences in performance.

  14. Listening effort in younger and older adults: A comparison of auditory-only and auditory-visual presentations

    PubMed Central

    Sommers, Mitchell S.; Phelps, Damian

    2016-01-01

    One goal of the present study was to establish whether providing younger and older adults with visual speech information (both seeing and hearing a talker compared with listening alone) would reduce listening effort for understanding speech in noise. In addition, we used an individual differences approach to assess whether changes in listening effort were related to changes in visual enhancement – the improvement in speech understanding in going from an auditory-only (A-only) to an auditory-visual condition (AV) condition. To compare word recognition in A-only and AV modalities, younger and older adults identified words in both A-only and AV conditions in the presence of six-talker babble. Listening effort was assessed using a modified version of a serial recall task. Participants heard (A-only) or saw and heard (AV) a talker producing individual words without background noise. List presentation was stopped randomly and participants were then asked to repeat the last 3 words that were presented. Listening effort was assessed using recall performance in the 2-back and 3-back positions. Younger, but not older, adults exhibited reduced listening effort as indexed by greater recall in the 2- and 3-back positions for the AV compared with the A-only presentations. For younger, but not older adults, changes in performance from the A-only to the AV condition were moderately correlated with visual enhancement. Results are discussed within a limited-resource model of both A-only and AV speech perception. PMID:27355772

  15. Longitudinal Predictors of Homelessness: Findings from the National Longitudinal Survey of Youth-97

    PubMed Central

    Sznajder-Murray, Brittany; Jang, Joy Bohyun; Slesnick, Natasha; Snyder, Anastasia

    2016-01-01

    Homeless youth represent a vulnerable and understudied population. Little research has prospectively identified factors that may place youth at risk for experiencing homelessness. The current study utilizes data from the National Longitudinal Survey of Youth-97 (NLSY-97) to examine predictors of experiencing homelessness as a young adult (before age 25). The NLSY-97 includes a nationally representative sample of 8,984 youth. Data were first collected from these youth when they were between the ages of 12 to 18 years. The current study examined whether individual and family risk factors reported during adolescence predict homelessness by the age of 25. The findings showed that multiple runaway episodes, non-traditional family structure, lower educational attainment, and parental work limitations due to health increased the risk of homelessness. A permissive parenting style and being Hispanic protected against homelessness. This study offers unique insight into risk and protective factors for youth homelessness, and has important clinical implications. PMID:27774034

  16. Characterizing the subjective experience of episodic past, future, and counterfactual thinking in healthy younger and older adults.

    PubMed

    De Brigard, Felipe; Giovanello, Kelly S; Stewart, Gregory W; Lockrow, Amber W; O'Brien, Margaret M; Spreng, R Nathan

    2016-12-01

    Recent evidence demonstrates remarkable overlap in the neural and cognitive mechanisms underlying episodic memory, episodic future thinking, and episodic counterfactual thinking. However, the extent to which the phenomenological characteristics associated with these mental simulations change as a result of ageing remains largely unexplored. The current study employs adapted versions of the Memory Characteristics Questionnaire and the Autobiographical Interview to compare the phenomenological characteristics associated with both positive and negative episodic past, future, and counterfactual simulations in younger and older adults. Additionally, it explores the influence of perceived likelihood in the experience of such simulations. The results indicate that, across all simulations, older adults generate more external details and report higher ratings of vividness, composition, and intensity than young adults. Conversely, younger adults generate more internal details across all conditions and rated positive and negative likely future events as more likely than did older adults. Additionally, both younger and older adults reported higher ratings for sensory, composition, and intensity factors during episodic memories relative to future and counterfactual thoughts. Finally, for both groups, ratings of spatial coherence and composition were higher for likely counterfactuals than for both unlikely counterfactuals and future simulations. Implications for the psychology of mental simulation and ageing are discussed.

  17. Desired Destinations of Homeless Women: Realizing Aspirations Within the Context of Homelessness.

    PubMed

    Biederman, Donna J; Forlan, Nicole

    2016-08-01

    Despite recent decreases, homelessness remains a substantial problem in the United States. Homelessness is associated with poor health, and homeless women experience earlier mortality than their housed counterparts. Understanding the aspirations of homeless women may offer service providers avenues for intervention to increase well-being among this vulnerable population. This study, a secondary analysis of transcribed interviews (n = 20), provides insight into the aspirations of homeless women. Opportunities for service providers to intervene on these aspirations within the context of homelessness are offered.

  18. Smoking policy change at a homeless shelter: attitudes and effects.

    PubMed

    Businelle, Michael S; Poonawalla, Insiya B; Kendzor, Darla E; Rios, Debra M; Cuate, Erica L; Savoy, Elaine J; Ma, Ping; Baggett, Travis P; Reingle, Jennifer; Reitzel, Lorraine R

    2015-01-01

    Homeless adults are exposed to more smokers and smoke in response to environmental tobacco cues more than other socioeconomically disadvantaged groups. Addressing the culture of smoking in homeless shelters through policy initiatives may support cessation and improve health in this vulnerable and understudied population. This study examined support for and expected/actual effects of a smoking ban at a homeless shelter. A 2-wave cross-sectional study with an embedded cohort was conducted in the summer of 2013 two weeks before (wave 1) and two months after (wave 2) a partial outdoor smoking ban was implemented. A total of 394 homeless adults were surveyed (i.e., wave 1 [n=155]; wave 2 [n=150]; and 89 additional participants completed both waves). On average, participants were 43 years old, primarily African American (63%), male (72%), and had been homeless for the previous 12 months (median). Most participants were smokers (76%) smoking 12 cigarettes per day on average. Most participants supported the creation of a large smoke-free zone on the shelter campus, but there was less support for a shelter-wide smoking ban. Average cigarettes smoked per day did not differ between study waves. However, participants who completed both study waves experienced a reduction in expired carbon monoxide at wave 2 (W1=18.2 vs. W2=15.8 parts per million, p=.02). Expected effects of the partial ban were similar to actual effects. Partial outdoor smoking bans may be well supported by homeless shelter residents and may have a positive impact on shelter resident health. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. The Unique Needs of Homeless Youths With Mental Illness: Baseline Findings From a Housing First Trial.

    PubMed

    Kozloff, Nicole; Stergiopoulos, Vicky; Adair, Carol E; Cheung, Amy H; Misir, Vachan; Townley, Greg; Bourque, Jimmy; Krausz, Michael; Goering, Paula

    2016-10-01

    Although youth homelessness presents a significant public health problem, the needs of homeless youths with mental illness, as distinct from adults, are not well understood. This study examined the unique demographic, clinical, and service use characteristics of homeless youths. At Home/Chez Soi was a large randomized controlled trial of the Housing First model in five cities in Canada. Of 2,255 participants, 7% (N=164) were youths ages 18 to 24. Youths were compared with older participants on baseline demographic, clinical, and service use characteristics. More youths than adults had not finished high school (76% versus 54%), had a drug use disorder (66% versus 52%), and had been assaulted in the past six months (44% versus 36%) (all p<.05). Fewer than half the youths (49%) had a regular medical doctor, 50% reported unmet need for health care, and 61% visited an emergency department in the past six months. This sample of homeless youths with mental illness had low education, high rates of substance use disorders and victimization, and problems accessing services. These findings suggest that youths have trajectories to homelessness and service needs that are distinct from adults and may guide future planning for this vulnerable population.

  20. Youth Homelessness 2006

    ERIC Educational Resources Information Center

    MacKenzie, David; Chamberlain, Chris

    2008-01-01

    The third national census of homeless school students, conducted in 2006, found that the number of homeless students had decreased since 2001. There were 9,389 homeless students in 2006 compared with 12,227 in 2001. Three groups were over-represented in the homeless population: Indigenous students, young people from single parent and blended…

  1. Childhood Adversities Associated with Poor Adult Mental Health Outcomes in Older Homeless Adults: Results From the HOPE HOME Study.

    PubMed

    Lee, Chuan Mei; Mangurian, Christina; Tieu, Lina; Ponath, Claudia; Guzman, David; Kushel, Margot

    2017-02-01

    To examine whether childhood adversity is associated with depressive symptoms, suicide attempts, or psychiatric hospitalization. History of seven childhood adversities (physical neglect, verbal abuse, physical abuse, sexual abuse, parental death, parental incarceration, and child welfare system placement) was gathered through in-person interviews. Multivariate models examined associations between history of childhood adversities and moderate to severe depressive symptoms, lifetime history of suicide attempt, or lifetime history of psychiatric hospitalization. The study enrolled 350 homeless adults, aged 50 and older, in Oakland, California, using population-based sampling methods. Moderate to severe depressive symptoms were measured on a Center for Epidemiologic Studies-Depression Scale (≥22), self-reported lifetime history of suicide attempt, and self-reported lifetime history of psychiatric hospitalization. Participants with exposure to one childhood adversity had elevated odds of reporting moderate to severe depressive symptoms (adjusted odds ratio [AOR]: 2.0; 95% confidence interval [CI]: 1.1-3.7) and lifetime history of suicide attempt (AOR: 4.6; 95% CI: 1.0-21.6) when compared with those who had none; the odds of these two outcomes increased with exposure to additional childhood adversities. Participants with four or more childhood adversities had higher odds of having a lifetime history of psychiatric hospitalization (AOR: 7.1; 95% CI: 2.8-18.0); no increase with fewer adversities was found. Childhood adversities are associated with poor mental health outcomes among older homeless adults. Clinicians should collect information about childhood adversities among this high-risk population to inform risk assessment and treatment recommendations. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  2. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study

    PubMed Central

    2012-01-01

    Background The aim of this study was to identify what is most important to the quality of life (QoL) of those who experience homelessness by directly soliciting the views of homeless and hard-to-house Canadians themselves. These individuals live within a unique social context that differs considerably from that of the general population. To understand the life areas that are most important to them, it is critical to have direct input from target populations of homeless and hard-to-house persons. Methods Focus groups were conducted with 140 individuals aged 15 to 73 years who were homeless or hard-to-house to explore the circumstances in which they were living and to capture what they find to be important and relevant domains of QoL. Participants were recruited in Toronto, Ottawa, Montreal, and Vancouver. Content analysis was used to analyze the data. Results Six major content themes emerged: Health/health care; Living conditions; Financial situation; Employment situation; Relationships; and Recreational and leisure activities. These themes were linked to broader concepts that included having choices, stability, respect, and the same rights as other members of society. Conclusions These findings not only aid our understanding of QoL in this group, but may be used to develop measures that capture QoL in this population and help programs and policies become more effective in improving the life situation for persons who are homeless and hard-to-house. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study. PMID:22894551

  3. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: a multi-site focus group study.

    PubMed

    Palepu, Anita; Hubley, Anita M; Russell, Lara B; Gadermann, Anne M; Chinni, Mary

    2012-08-15

    The aim of this study was to identify what is most important to the quality of life (QoL) of those who experience homelessness by directly soliciting the views of homeless and hard-to-house Canadians themselves. These individuals live within a unique social context that differs considerably from that of the general population. To understand the life areas that are most important to them, it is critical to have direct input from target populations of homeless and hard-to-house persons. Focus groups were conducted with 140 individuals aged 15 to 73 years who were homeless or hard-to-house to explore the circumstances in which they were living and to capture what they find to be important and relevant domains of QoL. Participants were recruited in Toronto, Ottawa, Montreal, and Vancouver. Content analysis was used to analyze the data. Six major content themes emerged: Health/health care; Living conditions; Financial situation; Employment situation; Relationships; and Recreational and leisure activities. These themes were linked to broader concepts that included having choices, stability, respect, and the same rights as other members of society. These findings not only aid our understanding of QoL in this group, but may be used to develop measures that capture QoL in this population and help programs and policies become more effective in improving the life situation for persons who are homeless and hard-to-house. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study.

  4. Happiness on the street: Overall happiness among homeless people in Madrid (Spain).

    PubMed

    Panadero, Sonia; Guillén, Ana Isabel; Vázquez, José Juan

    2015-07-01

    This article tests a hypothesized model of overall happiness among homeless people in Spain. The research was conducted based on a representative sample of homeless people in Madrid (n = 235), all adults, who had spent the night before the interview in a shelter for homeless people, on the street or in other places not initially designed for sleeping, or who were in supervised accommodation for homeless people at the time of the interview. Information was gathered using a structured interview. The results obtained show that around half of the homeless people in Madrid said that they were happy. A positive meta-stereotype and a better perceived general health were associated with a higher overall happiness, while feelings of loneliness were associated with a lower overall happiness. Happiness also showed a significant effect on future expectations. Disabilities and handicaps had a significant effect on perceived general health, which was in turn associated with overall happiness among homeless people. (c) 2015 APA, all rights reserved).

  5. Diagnostic patterns in hospital use by an urban homeless population.

    PubMed Central

    Morris, W; Crystal, S

    1989-01-01

    Because patterns of disease and health care system usage by the homeless constitute a neglected area of research in the medical literature, we undertook a retrospective analysis of inpatient records on medically indigent adults, controlling for housing status, to add to the growing body of research in the area of homeless health care. Data on all 4,243 indigent patients admitted over 2 fiscal years (1985 and 1986) under the county medical services program of San Diego County, California, revealed 5.3% (226) to be homeless. The commonest major diagnostic category among the homeless discharges was "diseases and disorders of the skin, subcutaneous tissue, and breast," constituting 21.2% as compared with only 8.7% of the discharge diagnoses for housed indigent persons. Within this major diagnostic category, the predominant diagnosis-related group was cellulitis, accounting for 12.8% of diagnoses in the homeless and only 4.0% of discharge diagnoses in other medically indigent persons. A homeless housing status was also correlated with a higher percentage of discharges with the major diagnostic category of "substance use and substance-induced organic mental disorders" but was negatively correlated with that of "diseases and disorders of the circulatory system." PMID:2588589

  6. The effect of the global financial crisis on preventable hospitalizations among the homeless in New York State.

    PubMed

    White, Brandi; Ellis, Charles; Jones, Walter; Moran, William; Simpson, Kit

    2018-04-01

    Objective Periods of economic instability may increase preventable hospitalizations because of increased barriers to accessing primary care. For underserved populations such as the homeless, these barriers may be more pronounced due to limited resources in the health care safety net. This study examined the impact of the global financial crisis of 2007-2008 on access to care for the homeless in New York State. Methods Hospitalizations for ambulatory care sensitive conditions (ACSCs) were used as a proxy measure for primary care access. Admissions for ACSCs were identified in the New York State Inpatient Database from 2006 to 2012. Hospitalization rates for ACSCs were calculated for the homeless and nonhomeless. Multivariable linear regression was used to investigate the impact of the financial crisis on hospitalization rates for ACSCs. Results The findings indicate that during the financial crisis, homeless adults had significantly higher preventable hospitalizations than nonhomeless adults, and the uninsured homeless had significantly higher preventable hospitalizations when compared to other homeless subgroups. After the financial crisis, preventable hospitalizations for the homeless stabilized but remained at higher rates than those for the nonhomeless. Conclusions These findings are important to developing health policies designed to provide effective care for underserved population such as the homeless.

  7. The impact of age stereotypes on source monitoring in younger and older adults.

    PubMed

    Kuhlmann, Beatrice G; Bayen, Ute J; Meuser, Katharina; Kornadt, Anna E

    2016-12-01

    In 2 experiments, we examined reliance on age stereotypes when reconstructing the sources of statements. Two sources presented statements (half typical for a young adult, half for an old adult). Afterward, the sources' ages-23 and 70 years-were revealed and participants completed a source-monitoring task requiring attribution of statements to the sources. Multinomial model-based analyses revealed no age-typicality effect on source memory; however, age-typicality biased source-guessing: When not remembering the source, participants predominantly guessed the source for whose age the statement was typical. Thereby, people retrospectively described the sources as having made more statements that fit with stereotypes about their age group than they had truly made. In Experiment 1, older (60-84 years) participants' guessing bias was stronger than younger (17-26 years) participants', but they also had poorer source memory. Furthermore, older adults with better source memory were less biased than those with poorer source memory. Similarly, younger adults' age-stereotype reliance was larger when source memory was impaired in Experiment 2. Thus, age stereotypes bias source attributions, and individuals with poor source memory are particularly prone to this bias, which may contribute to the maintenance of age stereotypes over time. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  8. Valuation of active blind spot detection systems by younger and older adults.

    PubMed

    Souders, Dustin J; Best, Ryan; Charness, Neil

    2017-09-01

    Due to their disproportional representation in fatal crashes, younger and older drivers both stand to benefit from in-vehicle safety technologies, yet little is known about how they value such technologies, or their willingness to adopt them. The current study investigated older (aged 65 and greater; N=49) and younger (ages 18-23; N=40) adults' valuation of a blind spot monitor and asked if self-reported visual difficulties while driving predicted the amount participants were willing to pay for a particular system (BMW's Active Blind Spot Detection System) that was demonstrated using a short video. Large and small anchor values ($250 and $500, respectively) were used as between subjects manipulations to examine the effects of initial valuation, and participants proceeded through a short staircase procedure that offered them either the free installation of the system on their current vehicle or a monetary prize ($25-$950) that changed in value according to which option they had selected in the previous step of the staircase procedure. Willingness to use other advanced driver assistance systems (lane-departure warning, automatic lane centering, emergency braking, adaptive cruise control, and self-parking systems) was also analyzed, additionally controlling for prior familiarity of those systems. Results showed that increased age was associated with a higher valuation for the Active Blind Spot Detection System in both the large and small anchor value conditions controlling for income, gender, and technology self-efficacy. Older adults valued blind spot detection about twice as much ($762) as younger adults ($383) in the large anchor condition, though both groups' values were in the range for the current cost of an aftermarket system. Similarly, age was the most robust positive predictor of willingness to adopt other driving technologies, along with system familiarity. Difficulties with driving-related visual factors also positively predicting acceptance levels for

  9. Who's There to Help? Assessment of Social Supports Received by Homeless and Unaccompanied Youth in High School

    ERIC Educational Resources Information Center

    Brase, Monica Kay

    2011-01-01

    The purpose of this qualitative study was to examine how urban, young adults assessed received social supports (Vaux, 1988) during homelessness in high school. According to the National Alliance to End Homelessness (2007), approximately 1 to 1.5 million youth under the age of 18 in America experience at least one incident of homelessness each…

  10. Mistakes as Stepping Stones: Effects of Errors on Episodic Memory among Younger and Older Adults

    ERIC Educational Resources Information Center

    Cyr, Andrée-Ann; Anderson, Nicole D.

    2015-01-01

    The memorial costs and benefits of trial-and-error learning have clear pedagogical implications for students, and increasing evidence shows that generating errors during episodic learning can improve memory among younger adults. Conversely, the aging literature has found that errors impair memory among healthy older adults and has advocated for…

  11. Actors, observers, and causal attributions of homelessness: Differences in attribution for the causes of homelessness among domiciled and homeless people in Madrid (Spain).

    PubMed

    Vázquez, José Juan; Panadero, Sonia; Zúñiga, Claudia

    2017-01-01

    The study analyzes the differences in causal attributions of homelessness and attributions of responsibility among the members of 3 groups: homeless group, consisting of a representative sample of homeless people in Madrid, Spain (n = 188); domiciled service-users group, consisting of people at risk of homelessness (n = 164); and domiciled nonservice-users group, consisting of people at no imminent risk of homelessness (n = 180). The domiciled service-users group and domiciled nonservice-users group were matched to the homeless group or sex, age, and nationality. The article also analyzes homeless people's causal attributions as regards their own situation. The results show that compared with the domiciled nonservice-users group, a higher percentage of members of the homeless group and domiciled service-users group attributed homelessness to individualistic causes and they blamed homeless people for their situation to a greater extent. The results also show that there was no "actor-observer bias" in causal attributions for homelessness in Madrid. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. Life Shocks and Homelessness

    PubMed Central

    Corman, Hope; Noonan, Kelly; Reichman, Nancy E.

    2014-01-01

    We exploited an exogenous health shock—namely, the birth of a child with a severe health condition—to investigate the effect of a life shock on homelessness in large cities in the United States as well as the interactive effects of the shock with housing market characteristics. We considered a traditional measure of homelessness, two measures of housing instability thought to be precursors to homelessness, and a combined measure that approximates the broadened conceptualization of homelessness under the 2009 Homeless Emergency Assistance and Rapid Transition to Housing Act (2010). We found that the shock substantially increases the likelihood of family homelessness, particularly in cities with high housing costs. The findings are consistent with the economic theory of homelessness, which posits that homelessness results from a conjunction of adverse circumstances in which housing markets and individual characteristics collide. PMID:23868747

  13. YogaHome: teaching and research challenges in a yoga program with homeless adults.

    PubMed

    Davis-Berman, Jennifer; Farkas, Jean

    2012-01-01

    YogaHome is a therapeutic yoga program for homeless women. Developing and refining YogaHome provided a unique opportunity to explore the process of teaching yoga to women faced with the physical and emotional stress of living in a homeless shelter. Unique teaching and research challenges are presented and recommendations for future programs are discussed.

  14. Superior Recognition Performance for Happy Masked and Unmasked Faces in Both Younger and Older Adults

    PubMed Central

    Svärd, Joakim; Wiens, Stefan; Fischer, Håkan

    2012-01-01

    In the aging literature it has been shown that even though emotion recognition performance decreases with age, the decrease is less for happiness than other facial expressions. Studies in younger adults have also revealed that happy faces are more strongly attended to and better recognized than other emotional facial expressions. Thus, there might be a more age independent happy face advantage in facial expression recognition. By using a backward masking paradigm and varying stimulus onset asynchronies (17–267 ms) the temporal development of a happy face advantage, on a continuum from low to high levels of visibility, was examined in younger and older adults. Results showed that across age groups, recognition performance for happy faces was better than for neutral and fearful faces at durations longer than 50 ms. Importantly, the results showed a happy face advantage already during early processing of emotional faces in both younger and older adults. This advantage is discussed in terms of processing of salient perceptual features and elaborative processing of the happy face. We also investigate the combined effect of age and neuroticism on emotional face processing. The rationale was previous findings of age-related differences in physiological arousal to emotional pictures and a relation between arousal and neuroticism. Across all durations, there was an interaction between age and neuroticism, showing that being high in neuroticism might be disadvantageous for younger, but not older adults’ emotion recognition performance during arousal enhancing tasks. These results indicate that there is a relation between aging, neuroticism, and performance, potentially related to physiological arousal. PMID:23226135

  15. Youth Homelessness and Vulnerability: How Does Couch Surfing Fit?

    PubMed

    Curry, Susanna R; Morton, Matthew; Matjasko, Jennifer L; Dworsky, Amy; Samuels, Gina M; Schlueter, David

    2017-09-01

    Youth homelessness is a problem characterized by high levels of vulnerability. The extent to which couch surfing - moving from one temporary housing arrangement to another - is part of youth homelessness is not well understood. Chapin Hall's Voices of Youth Count, a national research initiative, involves a multicomponent approach to studying youth homelessness. This study reports emerging findings regarding couch surfing and homelessness primarily from a national survey of 13,113 adults with youth ages 13-25 in their households or who are themselves ages 18-25. Findings suggest that couch surfing is relatively common, particularly among the older age group. Among households with 13- to 17-year-olds and 18- to 25-year-olds, 4.0% and 20.5%, respectively, reported that any of them had couch surfed in the last 12 months. There are notable social, economic, and educational differences, on average, between youth reporting homelessness and those reporting only couch surfing. However, most youth who report experiencing homelessness also report couch surfing, and these youth who experience both circumstances present high levels of socioeconomic vulnerability. Couch surfing encompasses a range of experiences, some of which likely include need for services. Interviews currently in the field, and expanded analysis of data, will contribute more nuanced policy insights. © Society for Community Research and Action 2017.

  16. The ‘apparent clearance’ of free phenytoin in elderly vs. younger adults

    PubMed Central

    Wright, Daniel F B; Begg, Evan J

    2010-01-01

    AIMS To test the hypothesis that the ‘apparent clearance’ of free phenytoin is reduced in elderly patients. METHODS Two separate studies were conducted comparing free phenytoin ‘apparent clearance’ in elderly vs. younger adults. The first study was a retrospective analysis of free phenytoin concentrations measured at Christchurch Hospital from 1997 to 2006. In the second study free phenytoin concentrations were measured prospectively in ambulatory subjects who were taking phenytoin regularly. RESULTS In the retrospective study (n = 29), free phenytoin ‘apparent clearance’ was 0.27 ± 0.04 l kg−1 day−1 (95% CI 0.19, 0.34) in the elderly cohort vs. 0.37 ± 0.06 l kg−1 day−1 (95% CI 0.22, 0.52) in younger adults, but the difference was not statistically significant. In the prospective study, free phenytoin ‘apparent clearance’ showed a non-significant trend to being reduced in the elderly patients (0.12 ± 0.02 l kg−1 day−1, 95% CI 0.07, 0.17) compared with the younger cohort (0.18 ± 0.07 l kg−1 day−1, 95% CI 0.09, 0.26) in those not taking interacting drugs (n = 21). CONCLUSIONS This research does not prove the hypothesis that the ‘apparent clearance’ of free phenytoin is reduced in the elderly. However, the trends found in these two studies are supported by trends in the same direction in other published studies, suggesting an age effect. PMID:20642556

  17. Ultra-long pharmacokinetic properties of insulin degludec are comparable in elderly subjects and younger adults with type 1 diabetes mellitus.

    PubMed

    Korsatko, S; Deller, S; Mader, J K; Glettler, K; Koehler, G; Treiber, G; Urschitz, M; Wolf, M; Hastrup, H; Søndergaard, F; Haahr, H; Pieber, T R

    2014-01-01

    Management of diabetes in elderly subjects is complex and careful management of glucose levels is of particular importance in this population because of an increased risk of diabetes-related complications and hypoglycaemia. The aim of this study was to evaluate the pharmacokinetic and pharmacodynamic properties of insulin degludec (IDeg), a basal insulin with an ultra-long duration of action, in elderly subjects with type 1 diabetes compared with younger adults. This trial was a randomised, double-blind, two-period, crossover trial conducted in a single centre and included both inpatient and outpatient periods. Subjects were men and women aged 18-35 years inclusive (younger adult group) or ≥65 years (elderly group) with type 1 diabetes who received IDeg (0.4 U/kg) via subcutaneous injection in the thigh once-daily for six days. Following 6-day dosing, a 26-hour euglycaemic glucose clamp procedure was conducted to evaluate the steady-state pharmacodynamic effects of IDeg. Blood samples were taken for pharmacokinetic analysis up to 120 h post-dose. Pharmacokinetic endpoints included the total exposure of IDeg, ie the area under the IDeg serum concentration curve during one dosing interval at steady state (AUC(IDeg,τ,SS)) (τ = 0-24 h, equal to one dosing interval) and the maximum IDeg serum concentration at steady state (C(max,IDeg,SS)). Pharmacodynamic endpoints included the total glucose-lowering effect of IDeg, ie the area under the glucose infusion rate (GIR) curve at steady state (AUC(GIR,τ,SS)), and the maximum GIR at steady state (GIR(max,IDeg,SS)). Total exposure (AUC(IDeg,τ,SS)) and maximum concentration (C(max,IDeg,SS)) of IDeg were comparable between elderly subjects and younger adults. Estimated mean age group ratios (elderly/younger adult) for AUC(IDeg,τ,SS) and C(max,IDeg,SS) and corresponding two-sided 95 % confidence intervals (CIs) were 1.04 (95 % CI 0.73-1.47) and 1.02 (95 % CI 0.74-1.39), respectively. Mean AUC(IDeg,0-12h

  18. Feelings towards Older vs. Younger Adults: Results from the European Social Survey

    ERIC Educational Resources Information Center

    Ayalon, Liat

    2013-01-01

    The study evaluated the association of modernization (at the macro/societal-level) and modernity (at the micro/individual-level) with feelings towards older vs. younger adults. Analysis was based on the fourth wave of the European Social Survey, which includes a rotated module on ageism. The sample consisted of 28 countries and a total of 54,988…

  19. Movement Skills of Younger versus Older Adults with and without Down Syndrome

    ERIC Educational Resources Information Center

    Carmeli, Eli; Ariav, Claudette; Bar-Yossef, Tamar; Levy, Ran; Imam, Bita

    2012-01-01

    Adults with Down syndrome (DS) are often physically inactive, which may accelerate the onset of disease and aging symptoms. Eight older persons with DS (aged 54-61), and 10 younger persons with DS (aged 26-35) living in a residential care center were examined. Eighteen age- and gender-matched individuals without DS served as control groups.…

  20. Factors associated with the uptake of seasonal influenza vaccination in older and younger adults: a large, population-based survey in Beijing, China.

    PubMed

    Wu, Shuangsheng; Su, Jianting; Yang, Peng; Zhang, Haiyan; Li, Hongjun; Chu, Yanhui; Hua, Weiyu; Li, Chao; Tang, Yaqing; Wang, Quanyi

    2017-09-25

    The present study aimed to estimate the influenza vaccination coverage rate in Beijing, China, and identify its determinants in older and younger adults. A survey was conducted among Chinese adults using a self-administered, anonymous questionnaire in May-June 2015. The main outcome was seasonal influenza vaccination uptake. Multivariate logistic regression models were performed to identify factors associated with uptake. A total of 7106 participants completed the questionnaire. The overall coverage rate was 20.6% (95% CI 19.7% to 21.5%) in the 2014/2015 influenza season. Lower education (older adults: OR 1.6; 95% CI 1.2 to 2.1; younger adults: OR 1.9; 95% CI 1.4 to 2.6), having a chronic illness (older adults: OR 1.9; 95% CI 1.5 to 2.4; younger adults: OR 1.4; 95% CI 1.2 to 1.7) and recommendations from healthcare workers (older adults: OR 5.4; 95% CI 3.9 to 7.4; younger adults: OR 4.5; 95% CI 3.7 to 5.4) were positively associated with uptake; perceived side effects of vaccination had a negative impact (older adults: OR 0.6; 95% CI 0.4 to 0.7; younger adults: OR 0.8; 95% CI 0.7 to 1.0). Perceived susceptibility to influenza (OR 1.5; 95% CI 1.2 to 2.0) and awareness of the free influenza vaccine policy (OR 1.9; 95% CI 1.2 to 2.9) were only associated with vaccine uptake in older adults, while perceived effectiveness of vaccination (OR 2.2; 95% CI 1.7 to 2.8) was only a predictor for younger adults. Older adults were more likely to receive recommendations from healthcare professionals and perceive the severity of seasonal influenza, and less likely to worry about side effects of vaccination. The influenza vaccination coverage rate was relatively low in Beijing. Apart from free vaccinations for older adults, age disparity in the rate between older and younger adults (48.7% vs 16.0%) may be explained by differing professional recommendations and public perceptions. Vaccination campaigns targeting increasing professional recommendations and

  1. Characterizing Stressors and Modifiable Health Risk Factors among Homeless Smokers: An Exploratory Pilot Study

    ERIC Educational Resources Information Center

    Kendzor, Darla E.; Reitzel, Lorraine R.; Businelle, Michael S.

    2015-01-01

    This pilot study was conducted to explore the associations between stressors related to homelessness and modifiable health risk factors (poor diet, insufficient physical activity, and overweight/obesity) and to provide direction for future research. Participants (N = 57) were homeless adults enrolled in a smoking cessation program. Analyses were…

  2. An fMRI comparison of neural activity associated with recognition of familiar melodies in younger and older adults

    PubMed Central

    Sikka, Ritu; Cuddy, Lola L.; Johnsrude, Ingrid S.; Vanstone, Ashley D.

    2015-01-01

    Several studies of semantic memory in non-musical domains involving recognition of items from long-term memory have shown an age-related shift from the medial temporal lobe structures to the frontal lobe. However, the effects of aging on musical semantic memory remain unexamined. We compared activation associated with recognition of familiar melodies in younger and older adults. Recognition follows successful retrieval from the musical lexicon that comprises a lifetime of learned musical phrases. We used the sparse-sampling technique in fMRI to determine the neural correlates of melody recognition by comparing activation when listening to familiar vs. unfamiliar melodies, and to identify age differences. Recognition-related cortical activation was detected in the right superior temporal, bilateral inferior and superior frontal, left middle orbitofrontal, bilateral precentral, and left supramarginal gyri. Region-of-interest analysis showed greater activation for younger adults in the left superior temporal gyrus and for older adults in the left superior frontal, left angular, and bilateral superior parietal regions. Our study provides powerful evidence for these musical memory networks due to a large sample (N = 40) that includes older adults. This study is the first to investigate the neural basis of melody recognition in older adults and to compare the findings to younger adults. PMID:26500480

  3. Cognitive control adjustments in healthy older and younger adults: Conflict adaptation, the error-related negativity (ERN), and evidence of generalized decline with age.

    PubMed

    Larson, Michael J; Clayson, Peter E; Keith, Cierra M; Hunt, Isaac J; Hedges, Dawson W; Nielsen, Brent L; Call, Vaughn R A

    2016-03-01

    Older adults display alterations in neural reflections of conflict-related processing. We examined response times (RTs), error rates, and event-related potential (ERP; N2 and P3 components) indices of conflict adaptation (i.e., congruency sequence effects) a cognitive control process wherein previous-trial congruency influences current-trial performance, along with post-error slowing, correct-related negativity (CRN), error-related negativity (ERN) and error positivity (Pe) amplitudes in 65 healthy older adults and 94 healthy younger adults. Older adults showed generalized slowing, had decreased post-error slowing, and committed more errors than younger adults. Both older and younger adults showed conflict adaptation effects; magnitude of conflict adaptation did not differ by age. N2 amplitudes were similar between groups; younger, but not older, adults showed conflict adaptation effects for P3 component amplitudes. CRN and Pe, but not ERN, amplitudes differed between groups. Data support generalized declines in cognitive control processes in older adults without specific deficits in conflict adaptation. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Sex Trade Behavior Among Heterosexually Active Homeless Men

    PubMed Central

    Tucker, Joan S.; Wenzel, Suzanne L.; Kennedy, David P.; Golinelli, Daniela; Ewing, Brett

    2013-01-01

    Sex trade behavior is fairly common among homeless adults and may contribute to higher rates of HIV/AIDS in this population. This study provides a detailed examination of the sex trade-related attitudes and behaviors of homeless men by: (1) determining the prevalence of sex trade-related behaviors, including sex with female sex workers (FSWs); (2) identifying risk factors for having sex with FSWs; and (3) comparing men's relationships with FSWs and non-FSWs in terms of relationship qualities and HIV-related risk behaviors, such as condom use. Structured interviews were conducted with a probability sample of 305 heterosexually active homeless men recruited from meal lines in Los Angeles. Recent sex with a FSW was reported by 26% of men, and more likely among those who were older, used crack cocaine, had more sex partners, believed that sometimes men just need to have sex no matter what, and were embedded in networks that were denser and where risky sex was more normative. Compared to non-FSW partners, men with FSW partners felt less emotionally close to them, were more likely to believe the partner had never been tested for HIV, and were more likely to have sex with them under the influence of drugs or alcohol; however, they were not more likely to talk about using condoms or to use condoms with FSWs. Whether the relationship was considered “serious” was a stronger correlate of condom use than whether the partner was a FSW. Implications of these findings for HIV prevention efforts among homeless adults are discussed. PMID:23720137

  5. Methamphetamine Use among Homeless Former Foster Youth: The Mediating Role of Social Networks

    PubMed Central

    Yoshioka-Maxwell, Amanda; Rice, Eric; Rhoades, Harmony; Winetrobe, Hailey

    2015-01-01

    Objectives Social network analysis can provide added causal insight into otherwise confusing epidemiologic findings in public health research. Although foster care and homelessness are risk factors for methamphetamine use, current research has failed to explicate why homeless youth with foster care experience engage in methamphetamine use at higher rates than other homeless young adults. This study examined the mediating effect of network engagement and time spent homeless on the relationship between foster care experience and recent methamphetamine use among homeless youth in Los Angeles. Methods Egocentric network data from a cross-sectional community-based sample (n = 652) of homeless youth aged 13–25 were collected from drop-in centers in Los Angeles. Questions addressed foster care experience, time spent homeless, methamphetamine use, and perceived drug use in social networks. Path analysis was performed in SAS to examine mediation. Results Controlling for all other variables, results of path analysis regarding recent methamphetamine use indicated a direct effect between foster care experience and recent methamphetamine use (B = .269, t = 2.73, p < .01). However, this direct effect became statistically nonsignificant when time spent homeless and network methamphetamine use were added to the model, and indirect paths from time spent homeless and network methamphetamine use became statistically significant. Conclusions Foster care experience influenced recent methamphetamine use indirectly through time spent homeless and methamphetamine use by network members. Efforts to reduce methamphetamine use should focus on securing stable housing and addressing network interactions among homeless former foster youth. PMID:26146647

  6. Veterans and Homelessness

    DTIC Science & Technology

    2011-04-01

    definition of “homeless individual” under McKinney-Vento. The Homeless Emergency Assistance and Rapid Transition to Housing ( HEARTH ) Act was enacted...as part of the Helping Families Save Their Homes Act of 2009 (P.L. 111-22) on May 20, 2009. The changes in the HEARTH Act were to take effect at the...definition of homelessness, continue in place.10 The HEARTH Act amended Section 103(a) of McKinney-Vento to broaden the definition of homeless individuals

  7. Older and Younger Family Caregivers of Adults with Intellectual Disability: Factors Associated with Future Plans

    ERIC Educational Resources Information Center

    Chou, Yueh-Ching; Lee, Yue-Chune; Lin, Li-Chan; Kroger, Teppo; Chang, Ai-Ning

    2009-01-01

    A structured interview survey was conducted in a major city in Taiwan to explore and compare older and younger family primary caregivers' well being and their future caregiving plans for these adults with intellectual disability. The sample size was 315 caregivers who were 55 years or older and who cared for adults with intellectual disability and…

  8. Comparison of insight and clinical variables in homeless and non-homeless psychiatric inpatients in China.

    PubMed

    Fu, Yan-Nan; Cao, Xiao-Lan; Hou, Cai-Lan; Ng, Chee H; Ungvari, Gabor S; Chiu, Helen F K; Lin, Yong-Qiang; Wang, Lihui; Zheng, Xiaocong; Jia, Fu-Jun; Xiang, Yu-Tao

    2017-09-01

    There are no published data on insight in homeless patients with psychiatric disorders in China. This study examined insight in homeless and non-homeless Chinese psychiatric inpatients in relation to demographic and clinical variables. A total of 278 homeless and 222 non-homeless inpatients matched in age and gender were included in the study. Demographic and clinical characteristics were collected based on a review of medical charts and a clinical interview with standardized instruments. Insight was evaluated with the Insight and Treatment Attitudes Questionnaire. Altogether 20.5% of homeless inpatients and 43.7% of the non-homeless controls had good insight. Compared with homeless inpatients with impaired insight, homeless inpatients with good insight had higher physical quality of life, longer duration of illness and less severe positive and negative symptoms. Impaired insight appeared more common in homeless psychiatric inpatients in China. Further studies should address the need for effective therapeutic interventions that promote homeless patients' insight. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  9. Homelessness as culture: How transcultural nursing theory can assist caring for the homeless.

    PubMed

    Law, Kate; John, William

    2012-11-01

    The concepts of culture and homelessness are both complex and contested. This paper examines homelessness through the lens of transcultural nursing theory, increasing understanding of both homelessness and transcultural theory. We argue that homelessness can be usefully conceptualised as a culture and that the application of transcultural theory to caring for homeless people will add further to the utility of these theories. The application of transcultural theory can add to the repertoire of skills the nurse needs to care for not only homeless clients, but, for a diverse range of client groups. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Spatial-Sequential Working Memory in Younger and Older Adults: Age Predicts Backward Recall Performance within Both Age Groups

    PubMed Central

    Brown, Louise A.

    2016-01-01

    Working memory is vulnerable to age-related decline, but there is debate regarding the age-sensitivity of different forms of spatial-sequential working memory task, depending on their passive or active nature. The functional architecture of spatial working memory was therefore explored in younger (18–40 years) and older (64–85 years) adults, using passive and active recall tasks. Spatial working memory was assessed using a modified version of the Spatial Span subtest of the Wechsler Memory Scale – Third Edition (WMS-III; Wechsler, 1998). Across both age groups, the effects of interference (control, visual, or spatial), and recall type (forward and backward), were investigated. There was a clear effect of age group, with younger adults demonstrating a larger spatial working memory capacity than the older adults overall. There was also a specific effect of interference, with the spatial interference task (spatial tapping) reliably reducing performance relative to both the control and visual interference (dynamic visual noise) conditions in both age groups and both recall types. This suggests that younger and older adults have similar dependence upon active spatial rehearsal, and that both forward and backward recall require this processing capacity. Linear regression analyses were then carried out within each age group, to assess the predictors of performance in each recall format (forward and backward). Specifically the backward recall task was significantly predicted by age, within both the younger and older adult groups. This finding supports previous literature showing lifespan linear declines in spatial-sequential working memory, and in working memory tasks from other domains, but contrasts with previous evidence that backward spatial span is no more sensitive to aging than forward span. The study suggests that backward spatial span is indeed more processing-intensive than forward span, even when both tasks include a retention period, and that age predicts

  11. Spatial-Sequential Working Memory in Younger and Older Adults: Age Predicts Backward Recall Performance within Both Age Groups.

    PubMed

    Brown, Louise A

    2016-01-01

    Working memory is vulnerable to age-related decline, but there is debate regarding the age-sensitivity of different forms of spatial-sequential working memory task, depending on their passive or active nature. The functional architecture of spatial working memory was therefore explored in younger (18-40 years) and older (64-85 years) adults, using passive and active recall tasks. Spatial working memory was assessed using a modified version of the Spatial Span subtest of the Wechsler Memory Scale - Third Edition (WMS-III; Wechsler, 1998). Across both age groups, the effects of interference (control, visual, or spatial), and recall type (forward and backward), were investigated. There was a clear effect of age group, with younger adults demonstrating a larger spatial working memory capacity than the older adults overall. There was also a specific effect of interference, with the spatial interference task (spatial tapping) reliably reducing performance relative to both the control and visual interference (dynamic visual noise) conditions in both age groups and both recall types. This suggests that younger and older adults have similar dependence upon active spatial rehearsal, and that both forward and backward recall require this processing capacity. Linear regression analyses were then carried out within each age group, to assess the predictors of performance in each recall format (forward and backward). Specifically the backward recall task was significantly predicted by age, within both the younger and older adult groups. This finding supports previous literature showing lifespan linear declines in spatial-sequential working memory, and in working memory tasks from other domains, but contrasts with previous evidence that backward spatial span is no more sensitive to aging than forward span. The study suggests that backward spatial span is indeed more processing-intensive than forward span, even when both tasks include a retention period, and that age predicts

  12. Cigarette Purchasing Patterns, Readiness to Quit, and Quit Attempts Among Homeless Smokers.

    PubMed

    Wrighting, Quentaxia; Businelle, Michael S; Kendzor, Darla E; LeBlanc, Hannah; Reitzel, Lorraine R

    2017-11-07

    Cigarette purchasing patterns may be linked with greater readiness to make a quit attempt and more quit attempts among domiciled samples. However, little is known about the cigarette purchasing patterns of homeless smokers or their potential relations to quitting intention and behaviors. This study redressed this gap among a convenience sample of homeless adult smokers from a large shelter in Dallas, Texas. Participants (N = 207; Mage = 43; 71.5% male) smoked ≥100 cigarettes over the lifetime and endorsed current daily smoking. Variables assessed included cigarette dependence (time to first cigarette of the day), monthly income, quantity of cigarettes most recently purchased, average money spent on cigarettes weekly, readiness/motivation to quit smoking, and the number intentional quit attempts lasting ≥24h in the past year. Regression analyses were conducted to characterize associations of cigarette purchasing patterns with readiness to quit and quit attempts controlling for sex, age, cigarette dependence, and income. Most participants purchased cigarettes by the pack (61.4%), and more than half the sample spent ≤$20 on cigarettes per week. Results indicated that spending less money per week on cigarettes was associated with greater readiness to quit (P = .016), even when controlling for income, cigarette dependence, and other covariates. Stratified analyses indicated that this association was significant only for homeless smokers reporting no regular monthly income. Homeless daily smokers with no reported income who spend little money on cigarettes may make particularly apt targets for cessation interventions due to potential associations with quitting motivation. Adults who are homeless smoke at greater rates and quit at lower rates than domiciled adults, leading to significant smoking-related health disparities among this group. Findings suggest that cigarette purchasing patterns are linked with readiness to quit smoking among smokers who are homeless

  13. Homelessness in America.

    ERIC Educational Resources Information Center

    Baumohl, Jim, Ed.

    This book about homelessness in the United States offers 16 chapters in three parts. Part 1, "History Definitions, and Causes," includes: (1) "Redefining the Cursed Word: A Historical Interpretation of American Homelessness" (Kim Hopper and Jim Baumohl); (2) "Homelessness: Definitions and Counts" (Martha R. Burt); (3)…

  14. Receptive Vocabulary, Cognitive Flexibility, and Inhibitory Control Differentially Predict Older and Younger Adults' Success Perceiving Speech by Talkers with Dysarthria

    ERIC Educational Resources Information Center

    Ingvalson, Erin M.; Lansford, Kaitlin L.; Fedorova, Valeriya; Fernandez, Gabriel

    2017-01-01

    Purpose: Previous research has demonstrated equivocal findings related to the effect of listener age on intelligibility ratings of dysarthric speech. The aim of the present study was to investigate the mechanisms that support younger and older adults' perception of speech by talkers with dysarthria. Method: Younger and older adults identified…

  15. Homelessness and the Homeless: Responses and Innovations. A Canadian Contribution to IYSH 1987.

    ERIC Educational Resources Information Center

    Oberlander, H. Peter; Fallick, Arthur L.

    This report presents descriptions of successful Canadian public and private programs to aid the homeless and alleviate homelessness as part of participation in the International Year of Shelter for the Homeless (IYSH). Part 1, "The International Year of Shelter for the Homeless," includes the following: (1) objectives; (2) global…

  16. The Effect of Stimulus Valence on Lexical Retrieval in Younger and Older Adults

    ERIC Educational Resources Information Center

    Blackett, Deena Schwen; Harnish, Stacy M.; Lundine, Jennifer P.; Zezinka, Alexandra; Healy, Eric W.

    2017-01-01

    Purpose: Although there is evidence that emotional valence of stimuli impacts lexical processes, there is limited work investigating its specific impact on lexical retrieval. The current study aimed to determine the degree to which emotional valence of pictured stimuli impacts naming latencies in healthy younger and older adults. Method: Eighteen…

  17. Characteristics of sheltered homeless families.

    PubMed Central

    Bassuk, E L; Rubin, L; Lauriat, A S

    1986-01-01

    To describe the characteristics of homeless families, we interviewed 80 homeless mothers and 151 children living in 14 family shelters in Massachusetts (two-thirds of the shelters in the state). Ninety-four per cent of the families were headed by women, 91 per cent were on AFDC (aid to families with dependent children), with twice as many as the state average having been on AFDC for at least two years; most had long histories of residential instability. Although 60 per cent had completed high school, only a third had worked for longer than one month. One-third of the mothers reported having been abused during their childhood, and two-thirds had experienced a major family disruption. At the time of the interview, almost two-thirds either lacked or had minimal supportive relationships and one-fourth of these named their child as the major support. Eighteen mothers were involved with the Department of Social Services because of probable child abuse or neglect. Seventy-one per cent of the mothers had personality disorders. In contrast to many adult homeless individuals, however, deinstitutionalized persons or those suffering from psychoses were not overrepresented. About 50 percent of the homeless children were found to have developmental lags, anxiety, depression, and learning difficulties, and about half required further psychiatric evaluation. Two-thirds described housing and social welfare agencies as not helpful. Given the many serious problems of the mothers and the difficulties already manifested by their children, comprehensive psychosocial and economic interventions must be made to interrupt a cycle of extreme instability and family breakdown. PMID:3740332

  18. Acute stress disorder in older, middle-aged and younger adults in reaction to the second Lebanon war.

    PubMed

    Cohen, Miri

    2008-01-01

    To compare rate of acute stress disorder (ASD) and intensity of acute stress symptoms (ASS) in younger, middle-aged and older Israeli citizens exposed to missile attacks during the second Lebanon war. A telephone survey of a random sample of residents in the northern area of Israel was conducted in July 2006, during the third week of Lebanon war. Respondents were divided into groups aged 18-40, 41-69 and 70+. ASD and ASS were measured by the Acute Stress Interview questionnaire and by war-related exposure variables and demographic data. Exposure variables were similar in the three age groups. Older respondents reported lower intensity of ASS and obtained lower means for each of the symptoms criteria than the young adults, while the middle-aged adults were in between the younger and the older group. ASD criteria were met by 13.2% of the younger, 4.7% of middle-aged and 4.3% of older respondents (p > 0.05), and subsyndromal ASD was found in 20.5%, 14.1% and 4.4% (p < 0.05) respectively. Twenty-two percent of ASS variance was explained by younger age, female gender and higher perceived proximity to missile falling. Older adults reacted to the war situation with lower level of acute stress symptoms. Long-term effects of war on different age groups should be further studied.

  19. Double Jeopardy: Homeless & Illiterate.

    ERIC Educational Resources Information Center

    BCEL Newsletter for the Business Community, 1988

    1988-01-01

    For the first time, federal funding for literacy services will focus new attention on the plight of the homeless. Under the McKinney Homeless Assistance Act, each state will receive funds for literacy for the homeless. Although there are no firm estimates on how many persons are homeless, a number of indicators point to a problem of major and…

  20. Lexical influences on competing speech perception in younger, middle-aged, and older adults

    PubMed Central

    Helfer, Karen S.; Jesse, Alexandra

    2015-01-01

    The influence of lexical characteristics of words in to-be-attended and to-be-ignored speech streams was examined in a competing speech task. Older, middle-aged, and younger adults heard pairs of low-cloze probability sentences in which the frequency or neighborhood density of words was manipulated in either the target speech stream or the masking speech stream. All participants also completed a battery of cognitive measures. As expected, for all groups, target words that occur frequently or that are from sparse lexical neighborhoods were easier to recognize than words that are infrequent or from dense neighborhoods. Compared to other groups, these neighborhood density effects were largest for older adults; the frequency effect was largest for middle-aged adults. Lexical characteristics of words in the to-be-ignored speech stream also affected recognition of to-be-attended words, but only when overall performance was relatively good (that is, when younger participants listened to the speech streams at a more advantageous signal-to-noise ratio). For these listeners, to-be-ignored masker words from sparse neighborhoods interfered with recognition of target speech more than masker words from dense neighborhoods. Amount of hearing loss and cognitive abilities relating to attentional control modulated overall performance as well as the strength of lexical influences. PMID:26233036

  1. The test-retest reliability and minimal detectable change of spatial and temporal gait variability during usual over-ground walking for younger and older adults.

    PubMed

    Almarwani, Maha; Perera, Subashan; VanSwearingen, Jessie M; Sparto, Patrick J; Brach, Jennifer S

    2016-02-01

    Gait variability is a marker of gait performance and future mobility status in older adults. Reliability of gait variability has been examined mainly in community dwelling older adults who are likely to fluctuate over time. The purpose of this study was to compare test-retest reliability and determine minimal detectable change (MDC) of spatial and temporal gait variability in younger and older adults. Forty younger (mean age=26.6 ± 6.0 years) and 46 older adults (mean age=78.1 ± 6.2 years) were included in the study. Gait characteristics were measured twice, approximately 1 week apart, using a computerized walkway (GaitMat II). Participants completed 4 passes on the GaitMat II at their self-selected walking speed. Test-retest reliability was calculated using Intra-class correlation coefficients (ICCs(2,1)), 95% limits of agreement (95% LoA) in conjunction with Bland-Altman plots, relative limits of agreement (LoA%) and standard error of measurement (SEM). The MDC at 90% and 95% level were also calculated. ICCs of gait variability ranged 0.26-0.65 in younger and 0.28-0.74 in older adults. The LoA% and SEM were consistently higher (i.e. less reliable) for all gait variables in older compared to younger adults except SEM for step width. The MDC was consistently larger for all gait variables in older compared to younger adults except step width. ICCs were of limited utility due to restricted ranges in younger adults. Based on absolute reliability measures and MDC, younger had greater test-retest reliability and smaller MDC of spatial and temporal gait variability compared to older adults. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Typography manipulations can affect priming of word stem completion in older and younger adults.

    PubMed

    Gibson, J M; Brooks, J O; Friedman, L; Yesavage, J A

    1993-12-01

    The experiments reported here investigated whether changes of typography affected priming of word stem completion performance in older and younger adults. Across all experiments, the typeface in which a word appeared at presentation either did or did not match that of its 3-letter stem at test. In Experiment 1, no significant evidence of a typography effect was found when words were presented with a sentence judgment or letter judgment task. However, subsequent experiments revealed that, in both older and younger adults, only words presented with a syllable judgment task gave rise to the typography effect (Experiments 2-4). Specifically, performance was greater, when the presentation and test typeface matched than when they did not. Experiment 5, which used stem-cued recall, did not reveal a difference between syllable and letter judgment tasks. These findings highlight the complex nature of word stem completion performance.

  3. A Case Study of a Post-Secondary Pilot Program That Provides Education to Qualified Homeless Students at a Private University

    ERIC Educational Resources Information Center

    Blanchard, Weedens E.

    2017-01-01

    The purpose of this research case study was to examine a post-secondary pilot program that provides education to select New York City homeless adults at a private university. In this study, the researcher examined how the Academy program assists homeless and disadvantaged adults to obtain post-graduate employment opportunities through academic…

  4. Differences in the way older and younger adults rate threat in faces but not situations.

    PubMed

    Ruffman, Ted; Sullivan, Susan; Edge, Nigel

    2006-07-01

    We compared young and healthy older adults' ability to rate photos of faces and situations (e.g., sporting activities) for the degree of threat they posed. Older adults did not distinguish between more and less dangerous faces to the same extent as younger adults did. In contrast, we found no significant age differences in young and older adults' ability to distinguish between high- and low-danger situations. The differences between young and older adults on the face task were independent of age differences in older adults' fluid IQ. We discuss results in relation to differences between young and older adults on emotion-recognition tasks; we also discuss sociocognitive and neuropsychological (e.g., amygdala) theories of aging.

  5. Impact of Nursing Intervention on Decreasing Substances among Homeless Youth

    PubMed Central

    Nyamathi, Adeline; Branson, Catherine; Kennedy, Barbara; Salem, Benissa; Khalilifard, Farinaz; Marfisee, Mary; Getzoff, Daniel; Leake, Barbara

    2013-01-01

    Background Alcohol use, and in particular, binge drinking, and methamphetamine use is pervasive among homeless youth and remains a social pressure among this vulnerable population. However, there is no compelling evidence that specific interventions for reducing drug and alcohol use are effective for homeless youth. Objectives This community-based participatory action pilot study assessed the impact of an intervention study focused on decreasing use of drugs and alcohol among a sample of homeless young adults (N=154) visiting a drop-in site in Santa Monica, California. The two programs consisted of a HIV/AIDS and Hepatitis Health Promotion (HHP) program led by nurses and an Art Messaging (AM) program led by artists. Six-month follow-up data were obtained from 100 of these individuals. Results Findings revealed significant reductions in alcohol and marijuana use and binge drinking in both the HHP and AM programs. However, homeless youth in the HHP program reported additional reductions in methamphetamine, cocaine and hallucinogen use at six-month follow-up. Conclusions Reductions in drugs and alcohol are important as these substances are linked to HIV/AIDS, hepatitis and other health risks in homeless youth. Scientific Significance The successful outcomes of the study intervention validate the utility of nurse-led and artistic health promotion strategies to decrease drug and alcohol use and other risky behaviors in homeless youth populations. PMID:23082836

  6. Impact of nursing intervention on decreasing substances among homeless youth.

    PubMed

    Nyamathi, Adeline; Branson, Catherine; Kennedy, Barbara; Salem, Benissa; Khalilifard, Farinaz; Marfisee, Mary; Getzoff, Daniel; Leake, Barbara

    2012-01-01

    Alcohol use, and in particular, binge drinking, and methamphetamine use is pervasive among homeless youth and remains a social pressure among this vulnerable population. However, there is no compelling evidence that specific interventions for reducing drug and alcohol use are effective for homeless youth. This community-based participatory action pilot study assessed the impact of an intervention study focused on decreasing use of drugs and alcohol among a sample of homeless young adults (N= 154) visiting a drop-in site in Santa Monica, California. The two programs consisted of an HIV/AIDS and Hepatitis Health Promotion (HHP) program led by nurses and an Art Messaging (AM) program led by artists. Six-month follow-up data were obtained from 100 of these individuals. Findings revealed significant reductions in alcohol and marijuana use and binge drinking in both the HHP and AM programs. However, homeless youth in the HHP program reported additional reductions in methamphetamine, cocaine, and hallucinogen use at 6-month follow-up. Reductions in drugs and alcohol are important as these substances are linked to HIV/AIDS, hepatitis, and other health risks in homeless youth. The successful outcomes of the study intervention validate the utility of nurse-led and artistic health promotion strategies to decrease drug and alcohol use and other risky behaviors in homeless youth populations. Copyright © American Academy of Addiction Psychiatry.

  7. Differential Impact of Homelessness on Glycemic Control in Veterans with Type 2 Diabetes Mellitus.

    PubMed

    Axon, R Neal; Gebregziabher, Mulugeta; Dismuke, Clara E; Hunt, Kelly J; Yeager, Derik; Ana, Elizabeth J Santa; Egede, Leonard E

    2016-11-01

    Veterans with evidence of homelessness have high rates of mental health and substance abuse disorders, but chronic medical conditions such as diabetes are also prevalent. We aimed to determine the impact of homelessness on glycemic control in patients with type 2 diabetes mellitus. Longitudinal analysis of a retrospective cohort. A national cohort of 1,263,906 Veterans with type 2 diabetes. Subjects with evidence of homelessness were identified using a combination of diagnostic and administrative codes. Odds for poor glycemic control using hemoglobin A1C (HbA1C) cutoff values of 8 % and 9 %. Homeless defined as a score based on the number of indicator variables for homelessness within a veterans chart. Veterans with evidence of homelessness had a significantly greater annual mean HbA1C ≥ 8 (32.6 % vs. 20.43 %) and HbA1C ≥ 9 (21.4 % vs. 9.9 %), tended to be younger (58 vs. 67 years), were more likely to be non-Hispanic black (39.1 %), divorced (43 %) or never married (34 %), to be urban dwelling (88.8 %), and to have comorbid substance abuse (46.7 %), depression (42.3 %), psychoses (39.7 %), liver disease (18.8 %), and fluid/electrolyte disorders (20.4 %), relative to non-homeless veterans (all p < 0.0001). Homelessness was modeled as an ordinal variable that scored the number of times a homelessness indicator was found in the Veterans medical record. We observed a significant interaction between homelessness and race/ethnicity on the odds of poor glycemic control. Homelessness, across all racial-ethnic groups, was associated with increased odds of uncontrolled diabetes at a cut-point of 8 % and 9 % for hemoglobin A1C ; however, the magnitude of the association was greater in non-Hispanic whites [8 %, OR 1.55 (1.47;1.63)] and Hispanics [8 %, OR 2.11 (1.78;2.51)] than in non-Hispanic blacks [8 %, OR 1.22 (1.15;1.28)]. Homelessness is a significant risk factor for uncontrolled diabetes in Veterans, especially among non-Hispanic white

  8. The influence of monetary incentives on context processing in younger and older adults: an event-related potential study.

    PubMed

    Schmitt, Hannah; Ferdinand, Nicola K; Kray, Jutta

    2015-06-01

    Recent evidence has indicated that neuronal activity related to reward anticipation benefits subsequent stimulus processing, but the effect of penalties remains largely unknown. Since the dual-mechanisms-of-control theory (DMC; Braver & Barch, Neuroscience and Biobehavioral Reviews, 26, 809-81, 2002) assumes that temporal differences in context updating underlie age differences in cognitive control, in this study we investigated whether motivational cues (signaling the chance to win or the risk to lose money, relative to neutral cues) preceding context information in a modified AX-CPT paradigm influence the temporal stages of context processing in younger and older adults. In the behavioral data, younger adults benefited from gain cues, evident in their enhanced context updating, whereas older adults exhibited slowed responding after motivational cues, irrespective of valence. Event-related potentials (ERPs) revealed that the enhanced processing of motivational cues in the P2 and P3b was mainly age-invariant, whereas age-differential effects were found for the ERP correlates of context processing. Younger adults showed improved context maintenance (i.e., a larger negative-going CNV), as well as increased conflict detection (larger N450) and resolution (indicated by a sustained positivity), whenever incorrect responding would lead to a monetary loss. In contrast, motivationally salient cues benefited context representations (in cue-locked P3b amplitudes), but increased working memory demands during response preparation (via a temporally prolonged P3b) in older adults. In sum, motivational valence and salience effects differentially modulated the temporal stages of context processing in younger and older adults. These results are discussed in terms of the DMC theory, recent findings of emotion regulation in old age, and the relationship between cognitive and affective processing.

  9. Inertial Sensor Based Analysis of Lie-to-Stand Transfers in Younger and Older Adults

    PubMed Central

    Schwickert, Lars; Boos, Ronald; Klenk, Jochen; Bourke, Alan; Becker, Clemens; Zijlstra, Wiebren

    2016-01-01

    Many older adults lack the capacity to stand up again after a fall. Therefore, to analyse falls it is relevant to understand recovery patterns, including successful and failed attempts to get up from the floor in general. This study analysed different kinematic features of standing up from the floor. We used inertial sensors to describe the kinematics of lie-to-stand transfer patterns of younger and healthy older adults. Fourteen younger (20–50 years of age, 50% men) and 10 healthy older community dwellers (≥60 years; 50% men) conducted four lie-to-stand transfers from different initial lying postures. The analysed temporal, kinematic, and elliptic fitting complexity measures of transfer performance were significantly different between younger and older subjects (i.e., transfer duration, angular velocity (RMS), maximum vertical acceleration, maximum vertical velocity, smoothness, fluency, ellipse width, angle between ellipses). These results show the feasibility and potential of analysing kinematic features to describe the lie-to-stand transfer performance, to help design interventions and detection approaches to prevent long lies after falls. It is possible to describe age-related differences in lie-to-stand transfer performance using inertial sensors. The kinematic analysis remains to be tested on patterns after real-world falls. PMID:27529249

  10. Anxiety Sensitivity, Experiential Avoidance, and Mindfulness Among Younger and Older Adults: Age Differences in Risk Factors for Anxiety Symptoms.

    PubMed

    Mahoney, Colin T; Segal, Daniel L; Coolidge, Frederick L

    2015-10-01

    In this cross-sectional study, we examined age-related differences in anxiety sensitivity (AS), experiential avoidance (EA), and mindfulness among younger adult students (N=426; M age=20.1 years) and community-dwelling older adults (N=85; M age=71.8 years). Participants anonymously completed the Anxiety Sensitivity Index-3, Acceptance and Action Questionnaire-II, Mindful Attention Awareness Scale, Kentucky Inventory of Mindfulness Skills, Beck Anxiety Inventory, Geriatric Anxiety Scale, and State-Trait Anxiety Inventory. Independent t tests indicated that younger adults reported significantly higher levels of AS and EA, whereas older adults reported significantly higher levels of trait mindfulness. Correlational analyses demonstrated that AS and EA were significantly associated with each other and with anxiety-related symptoms. However, trait mindfulness was significantly inversely related to AS, EA, and to trait and state anxiety. To date, these three factors have yet to be examined simultaneously within the context of age differences, and the present study illuminates these differences as well as their relationships. AS, EA, and low mindfulness appear to be significant correlates for anxiety-related symptoms in younger and older adults. © The Author(s) 2015.

  11. Educating Homeless Students.

    ERIC Educational Resources Information Center

    Berliner, BethAnn

    2002-01-01

    Over the past decade, the number of homeless children in America has more than doubled. Educators, however, are still legally obligated to enroll and support them, because of the passage of the "No Child Left Behind" Act of 2001, which reauthorized the McKinney-Vento Homeless Assistance Act. Although schools cannot solve homelessness,…

  12. Exploration of Older and Younger British Adults' Performance on the Awareness of Social Inference Test (TASIT)

    ERIC Educational Resources Information Center

    Burdon, Paul; Dipper, Lucy; Cocks, Naomi

    2016-01-01

    Background: Social perception is an important skill. One assessment that is commonly used to assess social perception abilities is The Awareness of Social Inference Test (TASIT). The only normative data available for this test are for Australian younger adults. Despite no normative data being available for British adults, the test is widely used…

  13. Younger and older adults' beliefs about the experience and expression of emotions across the life span.

    PubMed

    Montepare, Joann M; Dobish, Heidi

    2014-11-01

    Although theorists acknowledge that beliefs about emotions may play a role in age-related emotion behavior, no research has explored these beliefs. This research examined beliefs about the experience and expression of emotions across the life span, especially across the adult years. Younger and older adults rated the extent to which infants, children, adolescents, young adults, middle-aged adults, and older adults were likely to experience and express a range of emotions. Younger and older adults held similar beliefs about the course of emotions across the life span. Moreover, these beliefs differed across emotion categories. In particular, although older adults were believed to experience and express fewer highly charged, negative emotions, they were expected to be more likely to experience and express positive, low arousal emotions, as well as negative, low arousal emotions. The experience and expression of positive, high arousal emotions were seen as more characteristic of very young age groups as opposed to older age groups. These findings beg questions about if and how beliefs about emotion may affect age-related emotion regulation strategies and other everyday emotion-focused behaviors, as well as social reactions to older adults observed experiencing and expressing particular types of emotions. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. What is it that lingers? Garden-path (mis)interpretations in younger and older adults.

    PubMed

    Malyutina, Svetlana; den Ouden, Dirk-Bart

    2016-01-01

    Previous research has shown that comprehenders do not always conduct a full (re)analysis of temporarily ambiguous "garden-path" sentences. The present study used a sentence-picture matching task to investigate what kind of representations are formed when full reanalysis is not performed: Do comprehenders "blend" two incompatible representations as a result of shallow syntactic processing or do they erroneously maintain the initial incorrect parsing without incorporating new information, and does this vary with age? Twenty-five younger and 15 older adults performed a multiple-choice sentence-picture matching task with stimuli including early-closure garden-path sentences. The results suggest that the type of erroneous representation is affected by linguistic variables, such as sentence structure, verb type, and semantic plausibility, as well as by age. Older adults' response patterns indicate an increased reliance on inferencing based on lexical and semantic cues, with a lower bar for accepting an initial parse and with a weaker drive to reanalyse a syntactic representation. Among younger adults, there was a tendency to blend two representations into a single interpretation, even if this was not licensed by the syntax.

  15. Icons improve older and younger adults' comprehension of medication information.

    PubMed

    Morrow, D G; Hier, C M; Menard, W E; Leirer, V O

    1998-07-01

    We examined whether timeline icons improved older and younger adults' comprehension of medication information. In Experiment 1, comprehension of instructions with the icon (icon/text format) and without the icon (text-only format) was assessed by questions about information that was (a) implicit in the text but depicted explicitly by the icon (total dose in a 24 hour period), (b) stated and depicted in the icon/text condition (medication dose and times), and (c) stated but not depicted by the icon (e.g., side effects). In a separate task, participants also recalled medication instructions (with or without the icon) after a study period. We found that questions about dose and time information were answered more quickly and accurately when the icon was present in the instructions. Notably, icon benefits were greater for information that was implicit rather than stated in the text. This finding suggests that icons can improve older and younger adults' comprehension by reducing the need to draw some inferences. The icon also reduced effective study time (study time per item recalled). In Experiment 2, icon benefits did not occur for a less integrated version of the timeline icon that, like the text, required participants to integrate dose and time information in order to identify the total daily dose. The integrated version of the icon again improved comprehension, as in Experiment 1, as well as drawing inferences from memory. These findings show that integrated timeline icons improved comprehension primarily by aiding the integration of dose and time information. These findings are discussed in terms of a situation model approach to comprehension.

  16. Food choice and nutrient intake amongst homeless people.

    PubMed

    Sprake, E F; Russell, J M; Barker, M E

    2014-06-01

    Homeless people in the UK and elsewhere have typically been found to consume a nutritionally inadequate diet. There is need for contemporary research to update our understanding within this field. The present study aimed to provide an insight into the nutrient intake and food choice of a sample of homeless adults. In this mixed-methods study, 24 homeless individuals accessing two charitable meal services in Sheffield, UK, participated in up to four 24-h dietary recalls between April and August 2012. Twelve individuals took part in a semi-structured interview focusing on food choice. Energy intake was significantly lower than the estimated average requirement. Median intakes of vitamin A, zinc, magnesium, potassium and selenium were significantly lower than reference nutrient intakes. Contributions of saturated fat and nonmilk extrinsic sugars to total energy intake were significantly higher, whereas dietary fibre was significantly lower, than population average intakes. Charitable meals made an important contribution to intakes of energy and most micronutrients. Thematic analysis of interview transcripts revealed three major themes: food aspirations; constraints over food choice; and food representing survival. The present study reveals risk of dietary inadequacies amongst homeless people alongside a lack of control over food choices. Charitable meal services are suggested as a vehicle for improving the dietary intake and nutritional health of homeless people. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

  17. Comparison of tinnitus and psychological aspects between the younger and older adult patients with tinnitus.

    PubMed

    Park, So Young; Han, Jung Ju; Hwang, Jae Hyung; Whang, Eul Sung; Yeo, Sang Won; Park, Shi Nae

    2017-04-01

    To explore the differences in various tinnitus-related features and psychological aspects between the younger and older adult patients with tinnitus. We retrospectively reviewed the clinical data of the adult patients who visited our tinnitus clinic in 2013 and completed full tinnitus assessment including audiometry, tinnitus matching, standardized tinnitus questionnaires, and psychometric questionnaires. The younger group included patients aged 20-45 years (n=64), and the older group, those older than 65 years (n=76). Clinical features, hearing levels, matched tinnitus pitches and loudness, self-report tinnitus severity scores, Beck depression inventory scores, and stress scores were compared between the groups. Tinnitus duration was longer in the older group (p=0.002). Mean PTAs were 16dB HL in the younger, and 38dB HL in the older groups (p<0.001). Eighty-nine percent of the younger patients had normal hearing, while 82% of the older patients had hearing loss (p<0.001). Matched tinnitus loudness was greater in the older group (64dB HL vs. 36dB HL, p<0.001). All of the self-report tinnitus, depression, and stress scores did not differ between the groups. The older patients seemed to be more receptive to tinnitus. The majority of older tinnitus patients had concomitant hearing loss, and thus hearing rehabilitation should be considered preferentially for tinnitus management in this age group. Subjective tinnitus severity, depressive symptoms, and the stress levels were similar between the younger and older tinnitus patients. Therefore, treatment could be planned based upon the comprehensive understanding of the tinnitus characteristics and psychological aspects in each patient irrespective of age. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Homeless, Not Hopeless. An Informational Guide for School Personnel: Understanding and Educating Homeless Students.

    ERIC Educational Resources Information Center

    Seifert, Elli; Stauffer, Carol

    This guide explains how to educate homeless students within the public schools, focusing on the Saint Paul, Minnesota, public schools. Section 1 defines homelessness. Section 2 presents data on the increasing numbers of homeless students in the area. Section 3 describes common problems faced by homeless students, including family mobility,…

  19. Recognizing the Needs of the Homeless.

    ERIC Educational Resources Information Center

    France, Joseph B.

    This paper summarizes reports and research on the homeless in the United States, presents findings of a survey of Red Cross chapters on services to the homeless, and describes programs for the homeless of selected Red Cross chapters. Section 1 discusses definitions of homelessness and methodologies used to count homeless people. The homeless are…

  20. Feature-based interference from unattended visual field during attentional tracking in younger and older adults.

    PubMed

    Störmer, Viola S; Li, Shu-Chen; Heekeren, Hauke R; Lindenberger, Ulman

    2011-02-01

    The ability to attend to multiple objects that move in the visual field is important for many aspects of daily functioning. The attentional capacity for such dynamic tracking, however, is highly limited and undergoes age-related decline. Several aspects of the tracking process can influence performance. Here, we investigated effects of feature-based interference from distractor objects that appear in unattended regions of the visual field with a hemifield-tracking task. Younger and older participants performed an attentional tracking task in one hemifield while distractor objects were concurrently presented in the unattended hemifield. Feature similarity between objects in the attended and unattended hemifields as well as motion speed and the number of to-be-tracked objects were parametrically manipulated. The results show that increasing feature overlap leads to greater interference from the unattended visual field. This effect of feature-based interference was only present in the slow speed condition, indicating that the interference is mainly modulated by perceptual demands. High-performing older adults showed a similar interference effect as younger adults, whereas low-performing adults showed poor tracking performance overall.

  1. Characteristics and Use of Services Among Literally Homeless and Unstably Housed U.S. Veterans With Custody of Minor Children.

    PubMed

    Tsai, Jack; Rosenheck, Robert A; Kasprow, Wesley J; Kane, Vincent

    2015-10-01

    The study examined the number of homeless veterans with minor children in their custody ("children in custody"), compared sociodemographic and clinical characteristics among homeless veterans with and without children in custody, and observed differences in referral and admission patterns among veterans with and without children in custody for a variety of U.S. Department of Veterans Affairs (VA) programs for homeless veterans. Data were obtained from the VA Homeless Operations Management and Evaluation System for 89,142 literally homeless and unstably housed veterans. Sociodemographic, housing, health, and psychosocial characteristics of veterans were analyzed. Among literally homeless veterans, 9% of men and 30% of women had children in custody; among unstably housed veterans, 18% of men and 45% of women had children in custody. Both male and female veterans with children in custody were younger and less likely to have chronic general medical conditions and psychiatric disorders compared with other veterans, but, notably, 11% of homeless veterans with children in custody had psychotic disorders. Veterans with children in custody were more likely than other veterans to be referred and admitted to the VA's permanent supported housing program, and women were more likely than men to be admitted to the program. A substantial proportion of homeless veterans served by the VA have severe mental illness and children in custody, which raises concerns about the parenting environment for their children. Particular focus should be directed at VA's supported-housing program, and the practical and ethical implications of serving homeless parents and their children need to be considered.

  2. Back to the Future: Past and Future Era-Based Schematic Support and Associative Memory for Prices in Younger and Older Adults

    PubMed Central

    Castel, Alan D.; McGillivray, Shannon; Worden, Kendell M.

    2014-01-01

    Older adults typically display various associative memory deficits, but these deficits can be reduced when conditions allow for the use of prior knowledge or schematic support. To determine how era-specific schematic support and future simulation might influence associative memory, we examined how younger and older adults remember prices from the past as well as the future. Younger and older adults were asked to imagine the past or future, and then studied items and prices from approximately 40 years ago (market value prices from the 1970s) or 40 years in the future. In Experiment 1, all items were common items (e.g., movie ticket, coffee) and the associated prices reflected the era in question, whereas in Experiment 2, some item-price pairs were specific to the time period (e.g., typewriter, robot maid), to test different degrees of schematic support. After studying the pairs, participants were shown each item and asked to recall the associated price. In both experiments, older adults showed similar performance as younger adults in the past condition for the common items, whereas age-related differences were greater in the future condition and for the era-specific items. The findings suggest that in order for schematic support to be effective, recent (and not simply remote) experience is needed in order to enhance memory. Thus, whereas older adults can benefit from “turning back the clock,” younger adults better remember future-oriented information compared with older adults, outlining age-related similarities and differences in associative memory and the efficient use of past and future-based schematic support. PMID:24128073

  3. Burden of mental disorders and unmet needs among street homeless people in Addis Ababa, Ethiopia.

    PubMed

    Fekadu, Abebaw; Hanlon, Charlotte; Gebre-Eyesus, Emebet; Agedew, Melkamu; Solomon, Haddis; Teferra, Solomon; Gebre-Eyesus, Tsehaysina; Baheretibeb, Yonas; Medhin, Girmay; Shibre, Teshome; Workneh, Abraham; Tegegn, Teketel; Ketema, Alehegn; Timms, Philip; Thornicroft, Graham; Prince, Martin

    2014-08-20

    The impact of mental disorders among homeless people is likely to be substantial in low income countries because of underdeveloped social welfare and health systems. As a first step towards advocacy and provision of care, we conducted a study to determine the burden of psychotic disorders and associated unmet needs, as well as the prevalence of mental distress, suicidality, and alcohol use disorder among homeless people in Addis Ababa, the capital of Ethiopia. A cross-sectional survey was conducted among street homeless adults. Trained community nurses screened for potential psychosis and administered standardized measures of mental distress, alcohol use disorder and suicidality. Psychiatric nurses then carried out confirmatory diagnostic interviews of psychosis and administered a locally adapted version of the Camberwell Assessment of Needs Short Appraisal Schedule. We assessed 217 street homeless adults, about 90% of whom had experienced some form of mental or alcohol use disorder: 41.0% had psychosis, 60.0% had hazardous or dependent alcohol use, and 14.8% reported attempting suicide in the previous month. Homeless people with psychosis had extensive unmet needs with 80% to 100% reporting unmet needs across 26 domains. Nearly 30% had physical disability (visual and sensory impairment and impaired mobility). Only 10.0% of those with psychosis had ever received treatment for their illness. Most had lived on the streets for over 2 years, and alcohol use disorder was positively associated with chronicity of homelessness. Psychoses and other mental and behavioural disorders affect most people who are street homeless in Addis Ababa. Any programme to improve the condition of homeless people should include treatment for mental and alcohol use disorders. The findings have significant implications for advocacy and intervention programmes, particularly in similar low income settings.

  4. Nutritional assessment of charitable meal programmes serving homeless people in Toronto.

    PubMed

    Tse, Carmen; Tarasuk, Valerie

    2008-12-01

    To assess the potential nutritional contribution of meals provided in a sample of community programmes for homeless individuals, to determine the effect of food donations on meal quality and to develop food-based guidance for meals that would meet adults' total nutrient needs. Toronto, Canada. An analysis of weighed meal records from eighteen programmes. The energy and nutrient contents of meals were compared to requirement estimates to assess contribution to total needs, given that homeless people have limited access to nutritious foods. Mixed linear modelling was applied to determine the relationship between the use of food donations and meal quality. The composition of meals that would meet adults' nutrient requirements was determined by constructing simulated meals, drawing on the selection of foods available to programmes. In all, seventy meals, sampled from eighteen programmes serving homeless individuals. On average, the meals contained 2.6 servings of grain products, 1.7 servings of meat and alternatives, 4.1 servings of vegetables and fruits and 0.4 servings of milk products. The energy and nutrient contents of most meals were below adults' average daily requirements. Most meals included both purchased and donated foods; the vitamin C content of meals was positively associated with the percentage of energy from donations. Increasing portion sizes improved the nutrient contribution of meals, but the provision of more milk products and fruits and vegetables was required to meet adults' nutrient requirements. The meals assessed were inadequate to meet adults' nutrient requirements. Improving the nutritional quality of meals requires additional resources.

  5. Shelter-based palliative care for the homeless terminally ill.

    PubMed

    Podymow, Tiina; Turnbull, Jeffrey; Coyle, Doug

    2006-03-01

    The homeless have high rates of mortality, but live in environments not conducive to terminal care. Traditional palliative care hospitals may be reluctant to accept such patients, due to behavior or lifestyle concerns. The Ottawa Inner City Health Project (OICHP) is a pilot study to improve health care delivery to homeless adults. This is a retrospective analysis of a cohort of terminally ill homeless individuals and the effectiveness of shelter-based palliative care. As proof of principle, a cost comparison was performed. 28 consecutive homeless terminally ill patients were admitted and died at a shelter-based palliative care hospice. Demographics, diagnoses at admission and course were recorded. Burden of illness was assessed by medical and psychiatric diagnoses, addictions, Karnofsky scale and symptom management. An expert panel was convened to identify alternate care locations. Using standard costing scales, direct versus alternate care costs were compared. 28 patients had a mean age 49 years; average length of stay 120 days. DIAGNOSES: liver disease 43%, HIV/AIDS 25%, malignancy 25% and other 8%. Addiction to drugs or alcohol and mental illness in 82% of patients. Karnofsky performance score mean 40 +/- 16.8. Pain management with continuous opiates in 71%. The majority reunited with family. Compared to alternate care locations, the hospice projected 1.39 million dollars savings for the patients described. The homeless terminally ill have a heavy burden of disease including physical illness, psychiatric conditions and addictions. Shelter-based palliative care can provide effective end-of-life care to terminally ill homeless individuals at potentially substantial cost savings.

  6. Memory for Medication Side Effects in Younger and Older Adults: The Role of Subjective and Objective Importance

    PubMed Central

    Friedman, Michael C.; McGillivray, Shannon; Murayama, Kou; Castel, Alan D.

    2014-01-01

    Older adults often experience memory impairments, but can sometimes use selective processing and schematic support to remember important information. The current experiments investigate to what degree younger and healthy older adults remember medication side effects that were subjectively or objectively important to remember. Participants studied a list of common side effects, and rated how negative these effects were if they were to experience them, and were then given a free recall test. In Experiment 1, the severity of the side effects ranged from mild (e.g., itching) to severe (e.g., stroke), and in Experiment 2, certain side effects were indicated as critical to remember (i.e., “contact your doctor if you experience this”). There were no age differences in terms of free recall of the side effects, and older adults remembered more severe side effects relative to mild effects. However, older adults were less likely to recognize critical side effects on a later recognition test, relative to younger adults. The findings suggest that older adults can selectively remember medication side effects, but have difficulty identifying familiar but potentially critical side effects, and this has implications for monitoring medication use in older age. PMID:25331278

  7. A matter of focus: Detailed memory in the intentional autobiographical recall of older and younger adults.

    PubMed

    Aizpurua, Alaitz; Koutstaal, Wilma

    2015-05-01

    The intricately interwoven role of detailed autobiographical memory in our daily lives and in our imaginative envisioning of the future is increasingly recognized. But how is the detail-rich nature of autobiographical memory best assessed and, in particular, how can possible aging-related differences in autobiographical memory specificity be most effectively evaluated? This study examined whether a modified interview, involving fewer and time-matched events for older and younger adults, yielded age-related outcomes similar to those that have been previously reported. As in earlier studies, modest age-related changes in the specificity of autobiographical recall were observed, yet the largest most robust effect for both age groups was the substantial proportion of specific details retrieved. Both age groups rated recent memories as significantly less important and as less emotional than more temporally distant events. Our findings counter conceptions of older adults' autobiographical memories as invariably less episodically rich than those of younger adults. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. The Rights of Homeless Students.

    ERIC Educational Resources Information Center

    Strong, Penny

    This booklet presents information concerning homelessness and the education of homeless children nationwide and in Illinois. Estimates of the number of homeless children vary widely. Reasons for homeless children's failure to attend school include school residency requirements, delays in transfer of documents, and lack of transportation. The…

  9. 8-year trends in physical activity, nutrition, TV viewing time, smoking, alcohol and BMI: A comparison of younger and older Queensland adults.

    PubMed

    Alley, Stephanie J; Duncan, Mitch J; Schoeppe, Stephanie; Rebar, Amanda L; Vandelanotte, Corneel

    2017-01-01

    Lifestyle behaviours significantly contribute to high levels of chronic disease in older adults. The aims of the study were to compare the prevalence and the prevalence trends of health behaviours (physical activity, fruit and vegetable consumption, fast food consumption, TV viewing, smoking and alcohol consumption), BMI and a summary health behaviour indicator score in older (65+ years) versus younger adults (18-65 years). The self-report outcomes were assessed through the Queensland Social Survey annually between 2007-2014 (n = 12,552). Regression analyses were conducted to compare the proportion of older versus younger adults engaging in health behaviours and of healthy weight in all years combined and examine trends in the proportion of younger and older adults engaging in health behaviours and of healthy weight over time. Older adults were more likely to meet recommended intakes of fruit and vegetable (OR = 1.43, 95%CI = 1.23-1.67), not consume fast food (OR = 2.54, 95%CI = 2.25-2.86) and be non-smokers (OR = 3.02, 95%CI = 2.53-3.60) in comparison to younger adults. Conversely, older adults were less likely to meet the physical activity recommendations (OR = 0.86, 95%CI = 0.78-0.95) and watch less than 14 hours of TV per week (OR = 0.65, 95%CI = 0.58-0.74). Overall, older adults were more likely to report engaging in 3, or at least 4 out of 5 healthy behaviours. The proportion of both older and younger adults meeting the physical activity recommendations (OR = 0.97, 95%CI = 0.95-0.98 and OR = 0.94, 95%CI = 0.91-0.97 respectively), watching less than 14 hours of TV per week (OR = 0.96, 95%CI = 0.94-0.99 and OR = 0.94, 95%CI = 0.90-0.99 respectively) and who were a healthy weight (OR = 0.95, 95%CI = 0.92-0.99 and OR = 0.96, 95%CI = 0.94-0.98 respectively) decreased over time. The proportion of older adults meeting the fruit and vegetable recommendations (OR = 0.90, 95%CI = 0.84-0.96) and not consuming fast food (OR = 0.94, 95%CI = 0.88-0.99) decreased over time

  10. Feasibility and Acceptability of a Colocated Homeless-Tailored Primary Care Clinic and Emergency Department.

    PubMed

    Gabrielian, Sonya; Chen, Jennifer C; Minhaj, Beena P; Manchanda, Rishi; Altman, Lisa; Koosis, Ella; Gelberg, Lillian

    2017-10-01

    Homeless adults have low primary care engagement and high emergency department (ED) utilization. Homeless-tailored, patient-centered medical homes (PCMH) decrease this population's acute care use. We studied the feasibility (focused on patient recruitment) and acceptability (conceptualized as clinicians' attitudes/beliefs) of a pilot initiative to colocate a homeless-tailored PCMH with an ED. After ED triage, low-acuity patients appropriate for outpatient care were screened for homelessness; homeless patients chose between a colocated PCMH or ED visit. To study feasibility, we captured (from May to September 2012) the number of patients screened for homelessness, positive screens, unique patients seen, and primary care visits. We focused on acceptability to ED clinicians (physicians, nurses, social workers); we sent a 32-item survey to ED clinicians (n = 57) who worked during clinic hours. Questions derived from an instrument measuring clinician attitudes toward homeless persons; acceptability of homelessness screening and the clinic itself were also explored. Over the 5 months of interest, 281 patients were screened; 172 (61.2%) screened positive for homelessness; 112 (65.1%) of these positive screens were seen over 215 visits. Acceptability data were obtained from 56% (n = 32) of surveyed clinicians. Attitudes toward homeless patients were similar to prior studies of primary care physicians. Most (54.6%) clinicians agreed with the homelessness screening procedures. Nearly all (90.3%) clinicians supported expansion of the homeless-tailored clinic; a minority (42.0%) agreed that ED colocation worked well. Our data suggest the feasibility of recruiting patients to a homeless-tailored primary care clinic colocated with the ED; however, the clinic's acceptability was mixed. Future quality improvement work should focus on tailoring the clinic to increase its acceptability among ED clinicians, while assessing its impact on health, housing, and costs.

  11. Feasibility and Acceptability of a Colocated Homeless-Tailored Primary Care Clinic and Emergency Department

    PubMed Central

    Gabrielian, Sonya; Chen, Jennifer C.; Minhaj, Beena P.; Manchanda, Rishi; Altman, Lisa; Koosis, Ella; Gelberg, Lillian

    2017-01-01

    Objectives: Homeless adults have low primary care engagement and high emergency department (ED) utilization. Homeless-tailored, patient-centered medical homes (PCMH) decrease this population’s acute care use. We studied the feasibility (focused on patient recruitment) and acceptability (conceptualized as clinicians’ attitudes/beliefs) of a pilot initiative to colocate a homeless-tailored PCMH with an ED. After ED triage, low-acuity patients appropriate for outpatient care were screened for homelessness; homeless patients chose between a colocated PCMH or ED visit. Methods: To study feasibility, we captured (from May to September 2012) the number of patients screened for homelessness, positive screens, unique patients seen, and primary care visits. We focused on acceptability to ED clinicians (physicians, nurses, social workers); we sent a 32-item survey to ED clinicians (n = 57) who worked during clinic hours. Questions derived from an instrument measuring clinician attitudes toward homeless persons; acceptability of homelessness screening and the clinic itself were also explored. Results: Over the 5 months of interest, 281 patients were screened; 172 (61.2%) screened positive for homelessness; 112 (65.1%) of these positive screens were seen over 215 visits. Acceptability data were obtained from 56% (n = 32) of surveyed clinicians. Attitudes toward homeless patients were similar to prior studies of primary care physicians. Most (54.6%) clinicians agreed with the homelessness screening procedures. Nearly all (90.3%) clinicians supported expansion of the homeless-tailored clinic; a minority (42.0%) agreed that ED colocation worked well. Conclusion: Our data suggest the feasibility of recruiting patients to a homeless-tailored primary care clinic colocated with the ED; however, the clinic’s acceptability was mixed. Future quality improvement work should focus on tailoring the clinic to increase its acceptability among ED clinicians, while assessing its impact on

  12. Intellectual disability and homelessness.

    PubMed

    Mercier, C; Picard, S

    2011-04-01

    The association between poverty and intellectual disability (ID) has been well documented. However, little is known about persons with ID who face circumstances of extreme poverty, such as homelessness. This paper describes the situation of persons with ID who were or are homeless in Montreal and are currently receiving services from a team dedicated to homeless persons. (1) To describe the characteristics, history and current situation of these persons; and (2) to report within-group differences as a function of gender and current residential status. The data were collected from files using an anonymous chart summary. Descriptive statistics on the whole sample (n = 68) and inferential statistics on cross-tabulations by gender and residential status were performed. Persons with ID exhibited several related problems. Some of these persons, primarily women, experienced relatively short periods of homelessness and their situations stabilised once they were identified and followed up. Other persons with ID experienced chronic homelessness that appeared to parallel the number and severity of their other problems. When compared with a previous epidemiological study of the homeless in Montreal, the population of homeless persons with ID differed from the overall homeless population in a number of respects. The results suggest prevention and intervention targets. The need for epidemiological research appears particularly clear in light of the fact that below-average intellectual functioning has been identified as a risk factor for homelessness and a predisposing factor for vulnerability among street people. © 2011 The Authors. Journal of Intellectual Disability Research © 2011 Blackwell Publishing Ltd.

  13. CIU and Main Event Analyses of the Structured Discourse of Older and Younger Adults

    ERIC Educational Resources Information Center

    Capilouto, Gilson; Wright, Heather Harris; Wagovich, Stacy A.

    2005-01-01

    Correct information unit (CIU) and main event analyses are quantitative measures for analyzing discourse of individuals with aphasia. Comparative data from healthy younger (YG) and older (OD) adults and an investigation of the influence of stimuli type would considerably extend the usefulness of such analyses. The objectives were (a) to compare…

  14. Barriers to Homeless Persons Acquiring Health Insurance Through the Affordable Care Act.

    PubMed

    Fryling, Lauren R; Mazanec, Peter; Rodriguez, Robert M

    2015-11-01

    Medicaid expansion under the Affordable Care Act (ACA) is intended to provide a framework for increasing health care access for vulnerable populations, including the 1.2 million who experience homelessness each year in the United States. We sought to characterize homeless persons' knowledge of the ACA, identify barriers to their ACA enrollment, and determine access to various forms of communication that could be used to facilitate enrollment. At an urban county Level I trauma center, we interviewed all noncritically ill adults who presented to the emergency department (ED) during daytime hours and were able to provide consent. We assessed access to communication, awareness of the ACA, insurance status, and barriers preventing subjects from enrolling in health insurance and compared homeless persons' responses with concomitantly enrolled housed individuals. Of the 650 enrolled subjects, 134 (20.2%) were homeless. Homeless subjects were more likely to have never heard of the ACA (26% vs. 10%). "Not being aware if they qualify for Medicaid" was the most common (70%) and most significant (30%) barrier to enrollment reported by uninsured homeless persons. Of homeless subjects who were unsure if they qualified for Medicaid, 91% reported an income < 138% of the federal poverty level, likely qualifying them for enrollment. Although 99% of housed subjects reported access to either phone or internet, only 74% of homeless subjects reported access. Homeless persons report having less knowledge of the ACA than their housed counterparts, poor understanding of ACA qualification criteria, and limited access to phone and internet. ED-based outreach and education regarding ACA eligibility may increase their enrollment. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Serving the Homeless through Recreation Programs. Research Update.

    ERIC Educational Resources Information Center

    Kunstler, Robin

    1993-01-01

    Literature review examines problems faced by homeless adults and children and discusses how recreation programs can serve them. The recreation and leisure profession can offer to the healthy child development through play and recreation, physical fitness, stress management, socialization, opportunities to learn goal-setting, self-esteem building,…

  16. APOE ε4 associated with preserved executive function performance and maintenance of temporal and cingulate brain volumes in younger adults

    PubMed Central

    Taylor, Warren D.; Boyd, Brian; Turner, Rachel; McQuoid, Douglas R.; Ashley-Koch, Allison; MacFall, James R.; Saleh, Ayman; Potter, Guy G.

    2016-01-01

    The APOE ε4 allele is associated with cognitive deficits and brain atrophy in older adults, but studies in younger adults are mixed. We examined APOE genotype effects on cognition and brain structure in younger adults and whether genotype effects differed by age and with presence of depression. 157 adults (32% ε4 carriers, 46% depressed) between 20–50 years of age completed neuropsychological testing, 131 of which also completed 3T cranial MRI. We did not observe a direct effect of APOE genotype on cognitive performance or structural MRI measures. A significant genotype by age interaction was observed for executive function, where age had less of an effect on executive function in ε4 carriers. Similar interactions were observed for the entorhinal cortex, rostral and caudal anterior cingulate cortex and parahippocampal gyrus, where the effect of age on regional volumes was reduced in ε4 carriers. There were no significant interactions between APOE genotype and depression diagnosis. The ε4 allele benefits younger adults by allowing them to maintain executive function performance and volumes of cingulate and temporal cortex regions with aging, at least through age fifty years. PMID:26843007

  17. Characteristics of the Highest Users of Emergency Services in Veterans Affairs Hospitals: Homeless and Non-Homeless.

    PubMed

    Gundlapalli, Adi V; Jones, Audrey L; Redd, Andrew; Suo, Ying; Pettey, Warren B P; Mohanty, April; Brignone, Emily; Gawron, Lori; Vanneman, Megan; Samore, Matthew H; Fargo, Jamison D

    2017-01-01

    Efforts are underway to understand recent increases in emergency department (ED) use and to offer case management to those patients identified as high utilizers. Homeless Veterans are thought to use EDs for non-emergent conditions. This study identifies the highest users of ED services in the Department of Veterans Affairs and provides descriptive analyses of these Veterans, the diagnoses for which they were seen in the ED, and differences based on their homeless status. Homeless Veterans were more likely than non-homeless Veterans to have >10 visits in the 2014 calendar year (12% vs. <1%). Homeless versus non-homeless Veterans with >10 visits were more often male, <age 60, and non-married. Non-homeless Veterans with >10 ED visits were often treated for chest and abdominal pain, and back problems, whereas homeless Veterans were frequently treated for mental health/substance use. Tailored case management approaches may be needed to better link homeless Veterans with high ED use to appropriate outpatient care.

  18. Comparable Rest-related Promotion of Spatial Memory Consolidation in Younger and Older Adults

    PubMed Central

    Craig, Michael; Wolbers, Thomas; Harris, Mathew A.; Hauff, Patrick; Della Sala, Sergio; Dewar, Michaela

    2017-01-01

    Flexible spatial navigation depends on cognitive mapping, a function that declines with increasing age. In young adults, a brief period of post-navigation rest promotes the consolidation/integration of spatial memories into accurate cognitive maps. We examined (1) whether rest promotes spatial memory consolidation/integration in older adults and (2) whether the magnitude of the rest benefit changes with increasing age. Young and older adults learned a route through a virtual environment, followed by a 10min delay comprising either wakeful rest or a perceptual task, and a subsequent cognitive mapping task, requiring the pointing to landmarks from different locations. Pointing accuracy was lower in the older than younger adults. However, there was a comparable rest-related enhancement in pointing accuracy in the two age groups. Together our findings suggest that (i) the age-related decline in cognitive mapping cannot be explained by increased consolidation interference in older adults, and (ii) as we grow older rest continues to support the consolidation/integration of spatial memories. PMID:27689512

  19. "Homelessness and trauma go hand-in-hand": pathways to homelessness among women veterans.

    PubMed

    Hamilton, Alison B; Poza, Ines; Washington, Donna L

    2011-01-01

    Veterans comprise a disproportionate fraction of the nation's homeless population, with women veterans up to four times more likely to be homeless than non-veteran women. This paper provides a grounded description of women veterans' pathways into homelessness. Three focus groups were held in Los Angeles, California, with a total of 29 homeless women veterans. Five predominant "roots" (precipitating experiences) initiated pathways toward homelessness: 1) childhood adversity, 2) trauma and/or substance abuse during military service, 3) post-military abuse, adversity, and/or relationship termination, 4) post-military mental health, substance abuse, and/or medical problems, and 5) unemployment. Contextual factors, which promoted development of homelessness in the setting of primary roots, included women veterans' "survivor instinct," lack of social support and resources, sense of isolation, pronounced sense of independence, and barriers to care. These contextual factors also reinforced persistence of the roots of post-military adversity and mental health and substance abuse problems, serving to maintain cycles of chronic homelessness. Collectively, these multiple, interacting roots and contextual factors form a "web of vulnerability" that is a target for action. Multiple points along the pathways to homelessness represent critical junctures for VA and community-based organizations to engage in prevention or intervention efforts on behalf of women veterans. Considering the multiple, interconnected challenges that these women veterans described, solutions to homelessness should address multiple risk factors, include trauma-informed care that acknowledges women veterans' traumatic experiences, and incorporate holistic responses that can contribute to healing and recovery. Published by Elsevier Inc.

  20. The New Homelessness Revisited

    PubMed Central

    Lee, Barrett A.; Tyler, Kimberly A.; Wright, James D.

    2014-01-01

    The ‘new homelessness’ has drawn sustained attention from scholars over the past three decades. Definitional inconsistencies and data limitations rendered early work during this period largely speculative in nature. Thanks to conceptual, theoretical, and methodological progress, however, the research literature now provides a fuller understanding of homelessness. Contributions by sociologists and other social scientists since the mid-1990s differentiate among types of homelessness, provide credible demographic estimates, and show how being homeless affects a person's life chances and coping strategies. Agreement also exists about the main macro- and micro-level causes of homelessness. Active lines of inquiry examine public, media, and governmental responses to the problem as well as homeless people's efforts to mobilize on their own behalf. Despite the obstacles faced when studying a stigmatized population marked by high turnover and weak anchors to place, recent investigations have significantly influenced homelessness policy. A greater emphasis on prevention should further strengthen the research-policy nexus. PMID:24910495

  1. Back to the future: past and future era-based schematic support and associative memory for prices in younger and older adults.

    PubMed

    Castel, Alan D; McGillivray, Shannon; Worden, Kendell M

    2013-12-01

    Older adults typically display various associative memory deficits, but these deficits can be reduced when conditions allow for the use of prior knowledge or schematic support. To determine how era-specific schematic support and future simulation might influence associative memory, we examined how younger and older adults remember prices from the past as well as the future. Younger and older adults were asked to imagine the past or future, and then studied items and prices from approximately 40 years ago (market value prices from the 1970s) or 40 years in the future. In Experiment 1, all items were common items (e.g., movie ticket, coffee) and the associated prices reflected the era in question, whereas in Experiment 2, some item-price pairs were specific to the time period (e.g., typewriter, robot maid), to test different degrees of schematic support. After studying the pairs, participants were shown each item and asked to recall the associated price. In both experiments, older adults showed similar performance as younger adults in the past condition for the common items, whereas age-related differences were greater in the future condition and for the era-specific items. The findings suggest that in order for schematic support to be effective, recent (and not simply remote) experience is needed in order to enhance memory. Thus, whereas older adults can benefit from "turning back the clock," younger adults better remember future-oriented information compared with older adults, outlining age-related similarities and differences in associative memory and the efficient use of past and future-based schematic support. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  2. Housing First Improves Adherence to Antipsychotic Medication Among Formerly Homeless Adults With Schizophrenia: Results of a Randomized Controlled Trial

    PubMed Central

    Moniruzzaman, Akm; Fazel, Seena; McCandless, Lawrence; Procyshyn, Ric; Somers, Julian M.

    2017-01-01

    Abstract Adherence to antipsychotic medication is a significant challenge among homeless patients. No experimental trials have investigated the impact of Housing First on adherence among patients with schizophrenia. We investigated whether Housing First in congregate and scattered-site configurations resulted in superior adherence compared to usual care. Adult participants (n = 165) met criteria for homelessness, schizophrenia, and initiation of antipsychotic pharmacotherapy prior to recruitment to an unblinded, 3-arm randomized controlled trial in Vancouver, Canada. Randomization arms were: congregate Housing First (CHF) with on-site supports (including physician and pharmacy services); scattered-site Housing First (SHF) with Assertive Community Treatment; or treatment as usual (TAU) consisting of existing services. Participants were followed for an average of 2.6 years. Adherence to antipsychotic medication was measured using the medication possession ratio (MPR), and 1-way ANOVA was used to compare outcomes between the 3 conditions. Data were drawn from comprehensive pharmacy records. Prior to randomization, mean MPR among participants was very low (0.44–0.48). Mean MPR in the follow-up period was significantly different between study arms (P < .001) and approached the guideline threshold of 0.80 in SHF. Compared to TAU, antipsychotic adherence was significantly higher in SHF but not in CHF. The results demonstrate that further implementation of SHF is indicated among homeless people with schizophrenia, and that urgent action is needed to address very low levels of antipsychotic adherence in this population (trial registration: ISRCTN57595077). PMID:27665002

  3. Housing and Homelessness: A Report.

    ERIC Educational Resources Information Center

    National Alliance to End Homelessness, Washington, DC.

    This report focuses on options for rehousing the individuals and families who are currently homeless in America, and on strategies for preventing homelessness of additional people. As many as 736,000 persons are estimated to be homeless on any given night, and between 1.3 million and 2 million different individuals may experience homelessness at…

  4. Characteristics and Factors Associated With Pain in Older Homeless Individuals: Results From the Health Outcomes in People Experiencing Homelessness in Older Middle Age (HOPE HOME) Study.

    PubMed

    Landefeld, John C; Miaskowski, Christine; Tieu, Lina; Ponath, Claudia; Lee, Christopher T; Guzman, David; Kushel, Margot

    2017-09-01

    Individuals experiencing homelessness in the United States are aging; little is known about chronic pain in this population. In a cross-sectional, population-based study, we interviewed 350 homeless individuals aged 50 years and older to describe pain experienced by older persons experiencing homelessness and to assess factors associated with chronic moderate to severe pain, defined as pain lasting ≥3 months, with a past week average severity score of 5 to 10 (scale 0-10). The median age of participants was 58 years. Participants were predominantly African American (79.6%) and male (77.3%). Overall, 46.8% reported chronic moderate to severe pain. Almost half of participants reported a diagnosis of arthritis (44.3%) and one-third reported symptoms consistent with post-traumatic stress disorder (PTSD; 32.8%). Three-quarters (75.3%) endorsed a personal history of abuse. In multivariate analyses, PTSD (adjusted odds ratio [AOR]: 2.2, 95% confidence interval [CI], 1.4-3.7), arthritis (AOR: 4.8, 95% CI, 3.0-7.8), and history of experiencing abuse (AOR: 2.4, 95% CI, 1.3-4.3) were associated with chronic moderate to severe pain. HIV status, diabetes, depressive symptoms, and substance use were not associated with pain. Clinicians should consider the management of associated mental health conditions and the sequelae of experiencing abuse in the treatment of chronic pain in older adults experiencing homelessness. This article describes the prevalence and factors associated with chronic pain in older homeless adults. Almost half report chronic pain, which was associated with PTSD, arthritis, and personal history of abuse. Clinicians should address chronic pain, trauma, and the associated mental health conditions in this high-risk population. Copyright © 2017 American Pain Society. Published by Elsevier Inc. All rights reserved.

  5. 75 FR 22164 - Urban Non-Urban Homeless Female Veterans and Homeless Veterans With Families' Reintegration Into...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-27

    ... Non-Urban Homeless Female Veterans and Homeless Veterans With Families' Reintegration Into Employment... addresses complex problems facing Homeless Female Veterans and/or Veterans with Families eligible to... (including job readiness, literacy training, and skills training) to expedite the reintegration of homeless...

  6. The perceptions of homeless people regarding their healthcare needs and experiences of receiving health care.

    PubMed

    Rae, Bernadette Emma; Rees, Sharon

    2015-09-01

    To understand the perspective of the homeless about their healthcare encounters and how their experiences of receiving healthcare influence their health-seeking behaviour. A phenomenological study was undertaken because of the increasing levels of homelessness in the United Kingdom. Most of the current literature is American or Canadian. An interpretive phenomenological inquiry. An opportunistic sample of fourteen single homeless adults was recruited from one male hostel and one non-residential day centre. Data collection was done in 2013. Semi-structured audio-recorded interviews were conducted one-to-one. Colaizzi's method for data analysis was used. Three major themes were identified. Expressed Health Need, Healthcare Experiences and Attitudes to health care. Health problems are recognized by the homeless but the need for intervention is not always prioritised. Obstacles in access to health care in the UK are both perceived (attitudes towards the homeless; previous bad experience) and actual (difficulty in registering with a general practitioner, difficulty travelling to services, being forced to move to new area). Some homeless people feel that they are treated with prejudice and receive substandard care. Positive healthcare experiences were also reported. Positive and negative healthcare encounters can profoundly affect the homeless. Address apparent inconsistency of care; promote greater interdisciplinary communication and referrals to homeless services from prisons and hospitals; increase the availability of intermediate services; reduce obligation of homeless to move area; research experiences of homeless families. © 2015 John Wiley & Sons Ltd.

  7. Correlates of engaging in survival sex among homeless youth and young adults.

    PubMed

    Walls, N Eugene; Bell, Stephanie

    2011-09-01

    Using a sample of 1,625 homeless youth and young adults aged 10 to 25 from 28 different states in the United States, this study examines the correlates of having engaged in survival sex. Findings suggest that differences exist based on demographic variables (gender, age, race, and sexual orientation), lifetime drug use (inhalants, Valium™, crack cocaine, alcohol, Coricidin™, and morphine), recent drug use (alcohol, ecstasy, heroin, and methamphetamine), mental health variables (suicide attempts, familial history of substance use, and having been in substance abuse treatment), and health variables (sharing needles and having been tested for HIV). In addition to replicating previous findings, this study's findings suggest that African American youth; gay, lesbian, or bisexual youth; and youth who had been tested for HIV were significantly more likely to have engaged in survival sex than White, heterosexual youth, and youth who had not been tested for HIV, respectively. Implications for interventions with youth and suggestions for future research are discussed.

  8. Distress Tolerance Links Sleep Problems with Stress and Health in Homeless.

    PubMed

    Reitzel, Lorraine R; Short, Nicole A; Schmidt, Norman B; Garey, Lorra; Zvolensky, Michael J; Moisiuc, Alexis; Reddick, Carrie; Kendzor, Darla E; Businelle, Michael S

    2017-11-01

    We examined associations between sleep problems, distress intolerance, and perceived stress and health in a convenience sample of homeless adults. Participants (N = 513, 36% women, Mage = 44.5 ±11.9) self-reported sleep adequacy, sleep duration, unintentional sleep during the daytime, distress tolerance, urban stress, and days of poor mental health and days of poor physical health over the last month. The indirect effects of sleep problems on stress and health through distress tolerance were examined using a non-parametric, bias-corrected bootstrapping procedure. Sleep problems were prevalent (eg, 13.0 ±11.4 days of inadequate sleep and 4.7 ±7.9 days of unintentionally falling asleep during the preceding month). Distress intolerance partially accounted for the associations of inadequate sleep and unintentionally falling asleep, but not sleep duration, with urban stress and more days of poor mental and physical health. Many homeless individuals endure sleep problems. Given the connections between sleep and morbidity and mortality, results further support the need for more attention directed toward facilitating improvements in sleep quality to improve the quality of life of homeless adults, potentially including attention to improving distress tolerance skills.

  9. Mind-wandering in younger and older adults: converging evidence from the Sustained Attention to Response Task and reading for comprehension.

    PubMed

    Jackson, Jonathan D; Balota, David A

    2012-03-01

    One mechanism that has been hypothesized to contribute to older adults' changes in cognitive performance is goal neglect or impairment in maintaining task set across time. Mind-wandering and task-unrelated thought may underlie these potential age-related changes. The present study investigated age-related changes in mind-wandering in three different versions of the Sustained Attention to Response Task (SART), along with self-reported mind-wandering during a reading for comprehension task. In the SART, both younger and older adults produced similar levels of faster reaction times before No-Go errors of commission, whereas, older adults produced disproportionate post-error slowing. Subjective self-reports of mind-wandering recorded during the SART and the reading task indicated that older adults were less likely to report mind-wandering than younger adults. Discussion focuses on cognitive and motivational mechanisms that may account for older adults' relatively low levels of reported mind-wandering.

  10. Pennsylvania's Rural Homeless Reality.

    ERIC Educational Resources Information Center

    Center for Rural Pennsylvania, Harrisburg.

    The Center for Rural Pennsylvania analyzed data from the Pennsylvania Department of Public Welfare concerning rural homelessness for fiscal years 1997 through 1999. Findings indicate that rural Pennsylvania has a homeless population and it is growing. In 1999, more than 21,700 clients received homeless assistance in rural areas, 44 percent of whom…

  11. [Characteristics and health status of homeless women born in France and abroad: Results of Insee-Ined 2012 survey].

    PubMed

    Gomes do Espirito Santo, M-E; Perrine, A-L; Bonaldi, C; Guseva-Canu, I

    2018-03-01

    French national surveys among the homeless population in 2001 and 2012 provided a general description of the homeless beneficiaries of medical and social aids. However, given the increasing number of women in this population, mostly born abroad and accompanied by their children, a descriptive study of homeless women according to the fact of being born in France or abroad was conducted. A probability sample of 1470 French-speaking homeless women was recruited for the Insee-Ined 2012 survey. Socio-demographic characteristics, life trajectories, work and employment over the last 12 months, perceived health, reported morbidity, use of care and medical coverage have been described, comparing homeless women born abroad with those born in France. Homeless women are young (median age=34 y.), often single (55%), without a partner (71%) and often accompanied by children (52%). The vast majority (60%) reported no salary during the previous 12 months. Housing conditions were less precarious in women born in France, but these women had a more difficult life history, a more unfavorable perception of their health status, and a higher frequency of chronic health problems. Homeless women born abroad seemed to have more precarious conditions of life and more difficulties to access aids and medical coverage. Overall, despite a relatively good availability of medical insurance, homeless women, regardless of the place of birth, often reported health problems, which were not treated. This study suggests that homeless women often have to deal with chronic health problems that are not treated. Homeless women born abroad are characterized by more precarious living conditions that women born in France. Although younger, with an overall favorable perception of their health and declaring less often an addiction, their general state of health appears to be as fragile as for women born in France. Actions towards homeless women should be implemented to promote their access to care. Copyright

  12. 8-year trends in physical activity, nutrition, TV viewing time, smoking, alcohol and BMI: A comparison of younger and older Queensland adults

    PubMed Central

    Duncan, Mitch J.; Schoeppe, Stephanie; Rebar, Amanda L.; Vandelanotte, Corneel

    2017-01-01

    Lifestyle behaviours significantly contribute to high levels of chronic disease in older adults. The aims of the study were to compare the prevalence and the prevalence trends of health behaviours (physical activity, fruit and vegetable consumption, fast food consumption, TV viewing, smoking and alcohol consumption), BMI and a summary health behaviour indicator score in older (65+ years) versus younger adults (18–65 years). The self-report outcomes were assessed through the Queensland Social Survey annually between 2007–2014 (n = 12,552). Regression analyses were conducted to compare the proportion of older versus younger adults engaging in health behaviours and of healthy weight in all years combined and examine trends in the proportion of younger and older adults engaging in health behaviours and of healthy weight over time. Older adults were more likely to meet recommended intakes of fruit and vegetable (OR = 1.43, 95%CI = 1.23–1.67), not consume fast food (OR = 2.54, 95%CI = 2.25–2.86) and be non-smokers (OR = 3.02, 95%CI = 2.53–3.60) in comparison to younger adults. Conversely, older adults were less likely to meet the physical activity recommendations (OR = 0.86, 95%CI = 0.78–0.95) and watch less than 14 hours of TV per week (OR = 0.65, 95%CI = 0.58–0.74). Overall, older adults were more likely to report engaging in 3, or at least 4 out of 5 healthy behaviours. The proportion of both older and younger adults meeting the physical activity recommendations (OR = 0.97, 95%CI = 0.95–0.98 and OR = 0.94, 95%CI = 0.91–0.97 respectively), watching less than 14 hours of TV per week (OR = 0.96, 95%CI = 0.94–0.99 and OR = 0.94, 95%CI = 0.90–0.99 respectively) and who were a healthy weight (OR = 0.95, 95%CI = 0.92–0.99 and OR = 0.96, 95%CI = 0.94–0.98 respectively) decreased over time. The proportion of older adults meeting the fruit and vegetable recommendations (OR = 0.90, 95%CI = 0.84–0.96) and not consuming fast food (OR = 0.94, 95%CI = 0

  13. Retention of Homeless Smokers in the Power to Quit Study.

    PubMed

    Richards, Christina M; Sharif, Faduma; Eischen, Sara; Thomas, Janet; Wang, Qi; Guo, Hongfei; Luo, Xianghua; Okuyemi, Kolawole

    2015-09-01

    Concerns about retention are a major barrier to conducting studies enrolling homeless individuals. Since smoking is a major problem in homeless communities and research on effective methods of promoting smoking cessation is needed, we describe strategies used to increase retention and participant characteristics associated with retention in smoking cessation study enrolling homeless adults. The parent study was a 2-group randomized controlled trial with 26-week follow-up enrolling 430 homeless smokers from emergency shelters and transitional housing units in Minneapolis/Saint Paul, MN, USA. Multiple strategies were used to increase retention, including conducting visits at convenient locations for participants, collecting several forms of contact information from participants, using a schedule that was flexible and included frequent low-intensity visits, and providing incentives. Participant demographics as well as characteristics related to tobacco and drug use and health status were analyzed for associations with retention using univariate and multivariate analysis. Overall retention was 75% at 26 weeks. Factors associated with increased retention included greater age; having healthcare coverage; history of multiple homeless episodes, lower stress level; and higher PHQ-9 (Patient Health Questionnaire-9) score. A history of excessive drinking and drug use were associated with decreased retention. It is possible to successfully retain homeless individuals in a smoking cessation study if the study is designed with participants' needs in mind. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Can Better Emotion Regulation Protect against Suicidality in Traumatized Homeless Youth?

    PubMed

    Barr, Nicholas; Fulginiti, Anthony; Rhoades, Harmony; Rice, Eric

    2017-07-03

    A substantial majority of homeless youth and young adults (HYA) experience abuse prior to and during homelessness. HYA also have high rates of posttraumatic stress disorder (PTSD) and suicidal behavior. This study investigated relationships between traumatic experiences, PTSD symptoms, substance use, and the protective effects of emotion regulation on outcome variables suicidal ideation and suicide attempts. Data were drawn from a sample of 398 HYA interviewed at 3 drop-in centers in Los Angeles County. A bivariate logistic regression modeling strategy was employed to examine relationships among demographic characteristics and dependent and independent variables. Trauma prior to homelessness and trauma prior to and after homelessness were positively associated with suicidal ideation, whereas emotional awareness and control demonstrated negative associations. PTSD symptoms were positively associated with suicide attempts, whereas emotional awareness and control demonstrated negative associations. Better emotion regulation is associated with reduced odds of suicidal ideation and attempts in HYA and may protect against effects of traumatic experiences. Interventions targeting emotion regulation skills in HYA to reduce suicidality associated with traumatic experiences merit additional investigation.

  15. "Not Homeless Yet. I'm Kind of Couch Surfing": Finding Identities for People at a Homeless Shelter.

    PubMed

    Terui, Sachiko; Hsieh, Elaine

    2016-01-01

    The meanings of homelessness are fluid and socially constructed, providing resources and limitations for individuals to negotiate their identities and relationships in everyday life. In this study, we examine the strategies and corresponding resources utilized by people who are homeless to cope with the labeling of a homeless identity and to redefine their identities. We used constant comparative analysis to examine in-depth interviews with 16 participants (male = 11, female = 5) who access a local homeless shelter in the southwest United States for resources. We identified three strategies that homeless people adopt to cope with the labeling of homeless identity: (a) differentiating oneself from others who are homeless, (b) prioritizing certain aspects of life, and (c) embracing the status of homelessness. Although these strategies have been identified in previous literature, the authors extend this line of research by identifying the common resources people who are homeless utilize when adopting these strategies, which entail important implications for theory development and practical implications.

  16. Comparison of Younger and Older Adults' Acceptability of Treatment for Generalized Anxiety Disorder Co-Occurring with Parkinson's Disease

    ERIC Educational Resources Information Center

    Lundervold, Duane A.; Ament, Patrick A.; Holt, Peter S.; Hunt, Lauren S.

    2013-01-01

    Acceptability ratings of medication or Behavioral Relaxation Training (BRT), for general anxiety disorder (GAD) co-occurring with Parkinson's Disease (PD) were obtained from younger ("n" = 79) and older ("n" = 54) adults. Participants read a case description of an older adult with PD and comorbid GAD followed by a description…

  17. Memory for positive, negative and neutral events in younger and older adults: Does emotion influence binding in event memory?

    PubMed

    Earles, Julie L; Kersten, Alan W; Vernon, Laura L; Starkings, Rachel

    2016-01-01

    When remembering an event, it is important to remember both the features of the event (e.g., a person and an action) and the connections among features (e.g., who performed which action). Emotion often enhances memory for stimulus features, but the relationship between emotion and the binding of features in memory is unclear. Younger and older adults attempted to remember events in which a person performed a negative, positive or neutral action. Memory for the action was enhanced by emotion, but emotion did not enhance the ability of participants to remember which person performed which action. Older adults were more likely than younger adults to make binding errors in which they incorrectly remembered a familiar actor performing a familiar action that had actually been performed by someone else, and this age-related associative deficit was found for both neutral and emotional actions. Emotion not only increased correct recognition of old events for older and younger adults but also increased false recognition of events in which a familiar actor performed a familiar action that had been performed by someone else. Thus, although emotion may enhance memory for the features of an event, it does not increase the accuracy of remembering who performed which action.

  18. Comparisons of family environment between homeless and non-homeless individuals with schizophrenia in Xiangtan, Hunan.

    PubMed

    Chen, Jinliang; Chen, Jindong; Li, Shuchun; Liu, Jun; Ouyang, Guohua; Luo, Wenxuan; Guo, Xiaofeng; Li, Ting; Li, Kaijie; Li, Zhenkuo; Wang, Gan

    2015-06-25

    Homelessness is an increasingly important problem for individuals with serious mental illness in China. Identify the characteristics of families that are associated with homelessness among individuals with schizophrenia. Participants were 1856 homeless individuals with schizophrenia (defined as those who had no place of residence or involved caregivers for 7 consecutive days) and 1728 non-homeless individuals with schizophrenia from Xiangtan, Hunan. The self-completion Family Environment Scale-Chinese Version (FES-CV) was administered to these participants after their acute psychotic symptoms resolved. Compared to individuals in the non-homeless group, those in the homeless group were older and more likely to be non-locals (i.e., from outside of Xiangtan), be residents of rural (versus urban) communities, have temporary (versus permanent) jobs, be married, and have a low level of education. After controlling for demographic differences using multivariate logistic regression models, homelessness was independently associated higher scores in the FES-CV intellectual-cultural orientation, organization, achievement orientation, and control subscales and with lower scores in the FES-CV cohesion, moralreligious emphasis, independence, and active-recreational orientation subscales. After controlling for sociodemographic factors, certain aspects of the family environment areassociated with being homeless among patients with schizophrenia in China. Further work is needed to identify interventions that can reduce the risk of homelessness in high-risk individuals.

  19. Linguistic Context Versus Semantic Competition in Word Recognition by Younger and Older Adults With Cochlear Implants.

    PubMed

    Amichetti, Nicole M; Atagi, Eriko; Kong, Ying-Yee; Wingfield, Arthur

    The increasing numbers of older adults now receiving cochlear implants raises the question of how the novel signal produced by cochlear implants may interact with cognitive aging in the recognition of words heard spoken within a linguistic context. The objective of this study was to pit the facilitative effects of a constraining linguistic context against a potential age-sensitive negative effect of response competition on effectiveness of word recognition. Younger (n = 8; mean age = 22.5 years) and older (n = 8; mean age = 67.5 years) adult implant recipients heard 20 target words as the final words in sentences that manipulated the target word's probability of occurrence within the sentence context. Data from published norms were also used to measure response entropy, calculated as the total number of different responses and the probability distribution of the responses suggested by the sentence context. Sentence-final words were presented to participants using a word-onset gating paradigm, in which a target word was presented with increasing amounts of its onset duration in 50 msec increments until the word was correctly identified. Results showed that for both younger and older adult implant users, the amount of word-onset information needed for correct recognition of sentence-final words was inversely proportional to their likelihood of occurrence within the sentence context, with older adults gaining differential advantage from the contextual constraints offered by a sentence context. On the negative side, older adults' word recognition was differentially hampered by high response entropy, with this effect being driven primarily by the number of competing responses that might also fit the sentence context. Consistent with previous research with normal-hearing younger and older adults, the present results showed older adult implant users' recognition of spoken words to be highly sensitive to linguistic context. This sensitivity, however, also resulted in a

  20. Task-set switching under cue-based versus memory-based switching conditions in younger and older adults.

    PubMed

    Kray, Jutta

    2006-08-11

    Adult age differences in task switching and advance preparation were examined by comparing cue-based and memory-based switching conditions. Task switching was assessed by determining two types of costs that occur at the general (mixing costs) and specific (switching costs) level of switching. Advance preparation was investigated by varying the time interval until the next task (short, middle, very long). Results indicated that the implementation of task sets was different for cue-based switching with random task sequences and memory-based switching with predictable task sequences. Switching costs were strongly reduced under cue-based switching conditions, indicating that task-set cues facilitate the retrieval of the next task. Age differences were found for mixing costs and for switching costs only under cue-based conditions in which older adults showed smaller switching costs than younger adults. It is suggested that older adults adopt a less extreme bias between two tasks than younger adults in situations associated with uncertainty. For cue-based switching with random task sequences, older adults are less engaged in a complete reconfiguration of task sets because of the probability of a further task change. Furthermore, the reduction of switching costs was more pronounced for cue- than memory-based switching for short preparation intervals, whereas the reduction of switch costs was more pronounced for memory- than cue-based switching for longer preparation intervals at least for older adults. Together these findings suggest that the implementation of task sets is functionally different for the two types of task-switching conditions.

  1. Mobilizing homeless youth for HIV prevention: a social network analysis of the acceptability of a face-to-face and online social networking intervention

    PubMed Central

    Rice, Eric; Tulbert, Eve; Cederbaum, Julie; Barman Adhikari, Anamika; Milburn, Norweeta G.

    2012-01-01

    The objective of the study is to use social network analysis to examine the acceptability of a youth-led, hybrid face-to-face and online social networking HIV prevention program for homeless youth.Seven peer leaders (PLs) engaged face-to-face homeless youth (F2F) in the creation of digital media projects (e.g. You Tube videos). PL and F2F recruited online youth (OY) to participate in MySpace and Facebook communities where digital media was disseminated and discussed. The resulting social networks were assessed with respect to size, growth, density, relative centrality of positions and homophily of ties. Seven PL, 53 F2F and 103 OY created two large networks. After the first 50 F2F youth participated, online networks entered a rapid growth phase. OY were among the most central youth in these networks. Younger aged persons and females were disproportionately connected to like youth. The program appears highly acceptable to homeless youth. Social network analysis revealed which PL were the most critical to the program and which types of participants (younger youth and females) may require additional outreach efforts in the future. PMID:22247453

  2. Mobilizing homeless youth for HIV prevention: a social network analysis of the acceptability of a face-to-face and online social networking intervention.

    PubMed

    Rice, Eric; Tulbert, Eve; Cederbaum, Julie; Barman Adhikari, Anamika; Milburn, Norweeta G

    2012-04-01

    The objective of the study is to use social network analysis to examine the acceptability of a youth-led, hybrid face-to-face and online social networking HIV prevention program for homeless youth.Seven peer leaders (PLs) engaged face-to-face homeless youth (F2F) in the creation of digital media projects (e.g. You Tube videos). PL and F2F recruited online youth (OY) to participate in MySpace and Facebook communities where digital media was disseminated and discussed. The resulting social networks were assessed with respect to size, growth, density, relative centrality of positions and homophily of ties. Seven PL, 53 F2F and 103 OY created two large networks. After the first 50 F2F youth participated, online networks entered a rapid growth phase. OY were among the most central youth in these networks. Younger aged persons and females were disproportionately connected to like youth. The program appears highly acceptable to homeless youth. Social network analysis revealed which PL were the most critical to the program and which types of participants (younger youth and females) may require additional outreach efforts in the future.

  3. Anticipatory neural dynamics of spatial-temporal orienting of attention in younger and older adults.

    PubMed

    Heideman, Simone G; Rohenkohl, Gustavo; Chauvin, Joshua J; Palmer, Clare E; van Ede, Freek; Nobre, Anna C

    2018-05-04

    Spatial and temporal expectations act synergistically to facilitate visual perception. In the current study, we sought to investigate the anticipatory oscillatory markers of combined spatial-temporal orienting and to test whether these decline with ageing. We examined anticipatory neural dynamics associated with joint spatial-temporal orienting of attention using magnetoencephalography (MEG) in both younger and older adults. Participants performed a cued covert spatial-temporal orienting task requiring the discrimination of a visual target. Cues indicated both where and when targets would appear. In both age groups, valid spatial-temporal cues significantly enhanced perceptual sensitivity and reduced reaction times. In the MEG data, the main effect of spatial orienting was the lateralised anticipatory modulation of posterior alpha and beta oscillations. In contrast to previous reports, this modulation was not attenuated in older adults; instead it was even more pronounced. The main effect of temporal orienting was a bilateral suppression of posterior alpha and beta oscillations. This effect was restricted to younger adults. Our results also revealed a striking interaction between anticipatory spatial and temporal orienting in the gamma-band (60-75 Hz). When considering both age groups separately, this effect was only clearly evident and only survived statistical evaluation in the older adults. Together, these observations provide several new insights into the neural dynamics supporting separate as well as combined effects of spatial and temporal orienting of attention, and suggest that different neural dynamics associated with attentional orienting appear differentially sensitive to ageing. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  4. Military sexual trauma among homeless veterans.

    PubMed

    Pavao, Joanne; Turchik, Jessica A; Hyun, Jenny K; Karpenko, Julie; Saweikis, Meghan; McCutcheon, Susan; Kane, Vincent; Kimerling, Rachel

    2013-07-01

    Military sexual trauma (MST) is the Veteran Health Administration's (VHA) term for sexual assault and/or sexual harassment that occurs during military service. The experience of MST is associated with a variety of mental health conditions. Preliminary research suggests that MST may be associated with homelessness among female Veterans, although to date MST has not been examined in a national study of both female and male homeless Veterans. To estimate the prevalence of MST, examine the association between MST and mental health conditions, and describe mental health utilization among homeless women and men. National, cross-sectional study of 126,598 homeless Veterans who used VHA outpatient care in fiscal year 2010. All variables were obtained from VHA administrative databases, including MST screening status, ICD-9-CM codes to determine mental health diagnoses, and VHA utilization. Of homeless Veterans in VHA, 39.7 % of females and 3.3 % of males experienced MST. Homeless Veterans who experienced MST demonstrated a significantly higher likelihood of almost all mental health conditions examined as compared to other homeless women and men, including depression, posttraumatic stress disorder, other anxiety disorders, substance use disorders, bipolar disorders, personality disorders, suicide, and, among men only, schizophrenia and psychotic disorders. Nearly all homeless Veterans had at least one mental health visit and Veterans who experienced MST utilized significantly more mental health visits compared to Veterans who did not experience MST. A substantial proportion of homeless Veterans using VHA services have experienced MST, and those who experienced MST had increased odds of mental health diagnoses. Homeless Veterans who had experienced MST had higher intensity of mental health care utilization and high rates of MST-related mental health care. This study highlights the importance of trauma-informed care among homeless Veterans and the success of VHA homeless

  5. How retellings shape younger and older adults’ memories

    PubMed Central

    Mather, Mara

    2014-01-01

    The way a story is retold influences the way it is later remembered; after retelling an event in a biased manner people subsequently remember the event in line with their distorted retelling. This study tested the hypothesis that this should be especially true for older adults. To test this, older and younger adults retold a story to be entertaining, to be accurate, or did not complete an initial retelling. Later, all participants recalled the story as accurately as possible. On this final test younger adults were unaffected by how they had previously retold the story. In contrast, older adults had better memory for the story’s content and structure if they had previously retold the story accurately. Furthermore, for older adults, greater usage of storytelling language during the retelling was associated with lower subsequent recall. In summary, retellings exerted a greater effect on memory in older, compared with younger, adults. PMID:25436107

  6. Differences in anxiety and depression symptoms: comparison between older and younger clinical samples.

    PubMed

    Wuthrich, Viviana M; Johnco, Carly J; Wetherell, Julie L

    2015-09-01

    Anxiety and depression symptoms change over the lifespan and older adults use different terms to describe their mental health, contributing to under identification of anxiety and depression in older adults. To date, research has not examined these differences in younger and older samples with comorbid anxiety and depression. One hundred and seven treatment-seeking participants (47 older, 60% female, and 60 younger, 50% female) with anxiety and mood disorders completed the Anxiety Disorders Interview Schedule and a symptom checklist to examine differences in symptom severity, symptom profiles and terms used to describe anxiety and mood. The findings indicated several key differences between the presentation and description of anxiety and depression in younger and older adults. Older adults with Social Phobia reported fearing a narrower range of social situations and less distress and interference. Older adults with Generalized Anxiety Disorder (GAD) reported less worry about interpersonal relationships and work/school than younger adults, however, there were no differences between age groups for behavioral symptoms endorsed. Further older adults reported phobia of lifts/small spaces more frequently than younger adults. Depressed older depressed adults also reported more anhedonia compared to younger adults, but no differences in terms of reported sadness were found. Finally, older and younger adults differed in their descriptions of symptoms with older adults describing anxiety as feeling stressed and tense, while younger adults described anxiety as feeling anxious, worried or nervous. Clinicians need to assess symptoms broadly to avoid missing the presence of anxiety and mood disorders especially in older adults.

  7. Addressing Homelessness: Recent Happenings--Iowa, 2004

    ERIC Educational Resources Information Center

    Iowa Department of Education, 2004

    2004-01-01

    This guide provides information on the following resources available to the homeless in Iowa: (1) Funding Sources for School District Programs Serving Homeless Students; (2) Local Educational Liaison for Homeless Children and Youth; (3) Homeless Advisory Committee; (4) Identification, Counting, and Maintaining Data at the Local School District…

  8. Maslow and mental health recovery: a comparative study of homeless programs for adults with serious mental illness.

    PubMed

    Henwood, Benjamin F; Derejko, Katie-Sue; Couture, Julie; Padgett, Deborah K

    2015-03-01

    This mixed-methods study uses Maslow's hierarchy as a theoretical lens to investigate the experiences of 63 newly enrolled clients of housing first and traditional programs for adults with serious mental illness who have experienced homelessness. Quantitative findings suggests that identifying self-actualization goals is associated with not having one's basic needs met rather than from the fulfillment of basic needs. Qualitative findings suggest a more complex relationship between basic needs, goal setting, and the meaning of self-actualization. Transforming mental health care into a recovery-oriented system will require further consideration of person-centered care planning as well as the impact of limited resources especially for those living in poverty.

  9. Food security among individuals experiencing homelessness and mental illness in the At Home/Chez Soi Trial.

    PubMed

    O'Campo, Patricia; Hwang, Stephen W; Gozdzik, Agnes; Schuler, Andrée; Kaufman-Shriqui, Vered; Poremski, Daniel; Lazgare, Luis Ivan Palma; Distasio, Jino; Belbraouet, Slimane; Addorisio, Sindi

    2017-08-01

    Individuals experiencing homelessness are particularly vulnerable to food insecurity. The At Home/Chez Soi study provides a unique opportunity to first examine baseline levels of food security among homeless individuals with mental illness and second to evaluate the effect of a Housing First (HF) intervention on food security in this population. At Home/Chez Soi was a 2-year randomized controlled trial comparing the effectiveness of HF compared with usual care among homeless adults with mental illness, stratified by level of need for mental health services (high or moderate). Logistic regressions tested baseline associations between food security (US Food Security Survey Module), study site, sociodemographic variables, duration of homelessness, alcohol/substance use, physical health and service utilization. Negative binomial regression determined the impact of the HF intervention on achieving levels of high or marginal food security over an 18-month follow-up period (6 to 24 months). Community settings at five Canadian sites (Moncton, Montreal, Toronto, Winnipeg and Vancouver). Homeless adults with mental illness (n 2148). Approximately 41 % of our sample reported high or marginal food security at baseline, but this figure varied with gender, age, mental health issues and substance use problems. High need participants who received HF were more likely to achieve marginal or high food security than those receiving usual care, but only at the Toronto and Moncton sites. Our large multi-site study demonstrated low levels of food security among homeless experiencing mental illness. HF showed promise for improving food security among participants with high levels of need for mental health services, with notable site differences.

  10. Risky decision making across three arenas of choice: are younger and older adults differently susceptible to framing effects?

    PubMed

    Rönnlund, Michael; Karlsson, Erik; Laggnäs, Erica; Larsson, Lisa; Lindström, Therese

    2005-01-01

    In the present study, the authors investigated the effects of framing of options on risky decision making in groups of younger adults (M = 23.8 years, n = 192) and older adults (M = 69.1 years, n = 192). The participants were assigned to one of three scenarios varying in the goods at stake (human lives, paintings, money). The authors observed a majority preference in favor of the risky options after negative, but not positive framing. They also found, as they had predicted, that the type of framing effect varied across scenarios, with a bidirectional framing effect for the life-death scenario and unidirectional (risk averse) framing effects when public property (paintings) or personal property (money) were at stake. It is important to note that these choice preference patterns were highly similar across the age groups, which reinforced the conclusion that younger and older adults are equally susceptible to framing effects.

  11. Poor Parenting and Antisocial Behavior among Homeless Young Adults: Links to Dating Violence Perpetration and Victimization

    ERIC Educational Resources Information Center

    Tyler, Kimberly A.; Melander, Lisa A.

    2012-01-01

    Though research has examined risk factors associated with street victimization among homeless young people, little is known about dating violence experiences among this group. Given homeless youths' elevated rates of child maltreatment, it is likely that they are at high risk for dating violence. As such, the current study examined the association…

  12. Homelessness in Augusta, Georgia. Preliminary Report.

    ERIC Educational Resources Information Center

    George, Shirley A.; Bennett, Gerald

    Two studies examined homelessness in Augusta, Georgia. The Key Informant Survey, conducted in 1987, involved interviewing individuals (N=42) knowledgeable about homeless people in the community. In the Shelter and Street Surveys of homeless people, conducted in March (N=51) and July (N=71) of 1988, homeless subjects were interviewed concerning…

  13. Educating Homeless Youth in Texas: The McKinney-Vento Homeless Education Assistance Improvements Act of 2001.

    PubMed

    Windsor, Liliane Cambraia; Thompson, Sanna J

    2008-07-01

    This paper discusses homeless youth in the US focusing on educational issues addressed by the implementation of the McKinney-Vento Homeless Education Assistance Improvements Act of 2001. This law requires that states ensure each homeless child has equal access to public education. Moreover, the law requires states to identify and remove barriers to homeless children's education, such as requirements for previous school records and proof of residency. Following description of homelessness, educational issues, and barriers for homeless youth, the McKinney-Vento Act is described as it is applied in Texas. Finally, the paper concludes that further development, education, and commitment from service providers in schools and other community agencies will be needed to improve outcomes for these highly vulnerable youth.

  14. Phishing suspiciousness in older and younger adults: The role of executive functioning

    PubMed Central

    Zhao, Rui; John, Samantha E.; Bussell, Cara A.; Roberts, Jennifer R.; Yue, Chuan

    2017-01-01

    Phishing is the spoofing of Internet websites or emails aimed at tricking users into entering sensitive information, with such goals as financial or identity theft. The current study sought to determine whether age is associated with increased susceptibility to phishing and whether tests of executive functioning can predict phishing susceptibility. A total of 193 cognitively intact participants, 91 younger adults and 102 older adults, were primarily recruited through a Psychology department undergraduate subject pool and a gerontology research registry, respectively. The Executive Functions Module from the Neuropsychological Assessment Battery and the Iowa Gambling Task were the primary cognitive predictors of reported phishing suspiciousness. Other predictors included age group (older vs. younger), sex, education, race, ethnicity, prior knowledge of phishing, prior susceptibility to phishing, and whether or not browsing behaviors were reportedly different in the laboratory setting versus at home. A logistic regression, which accounted for a 22.7% reduction in error variance compared to the null model and predicted phishing suspiciousness with 73.1% (95% CI [66.0, 80.3]) accuracy, revealed three statistically significant predictors: the main effect of education (b = 0.58, SE = 0.27) and the interactions of age group with prior awareness of phishing (b = 2.31, SE = 1.12) and performance on the Neuropsychological Assessment Battery Mazes test (b = 0.16, SE = 0.07). Whether or not older adults reported being suspicious of the phishing attacks used in this study was partially explained by educational history and prior phishing knowledge. This suggests that simple educational interventions may be effective in reducing phishing vulnerability. Although one test of executive functioning was found useful for identifying those at risk of phishing susceptibility, four tests were not found to be useful; these results speak to the need for more ecologically valid tools in

  15. Divided Attention in Younger and Older Adults: Effects of Strategy and Relatedness on Memory Performance and Secondary Task Costs

    ERIC Educational Resources Information Center

    Naveh-Benjamin, Moshe; Craik, Fergus I. M.; Guez, Jonathan; Kreuger, Sharyn

    2005-01-01

    Divided attention at encoding leads to a significant decline in memory performance, whereas divided attention during retrieval has relatively little effect; nevertheless, retrieval carries significant secondary task costs, especially for older adults. The authors further investigated the effects of divided attention in younger and older adults by…

  16. Correlates of Serious Violent Crime for Recently Released Parolees With a History of Homelessness

    PubMed Central

    Nyamathi, Adeline; Marfisee, Mary; Khalilifard, Farinaz; Leake, Barbara; Marlow, Elizabeth; Zhang, Sheldon; Hall, Elizabeth; Farabee, David; Faucette, Mark

    2013-01-01

    This study used baseline data on recently-released homeless paroled men who are homeless (N = 157), residing in a residential drug treatment program, and enrolled in a longitudinal study to examine personal, developmental, and social correlates of parolees who are homeless and parolees who have committed serious violent offenses. Having experienced childhood sexual abuse, poor parental relationships, and early-onset incarceration (prior to 21 years of age) were important correlates of serious violent crimes. These findings highlight the need for interventions that address offenders’ prior adult and childhood victimization, and suggest that policies for reentering violent offenders should encompass an understanding of the broader family contexts in which these patterns of maltreatment often occur. PMID:23155727

  17. Intentions to Prevent Weight Gain in Older and Younger Adults; The Importance of Perceived Health and Appearance Consequences.

    PubMed

    Beeken, Rebecca J; Mahdi, Sundus; Johnson, Fiona; Meisel, Susanne F

    2018-01-01

    This study investigates whether health and appearance consequences predict intentions to prevent weight gain and whether these relationships differ in younger versus older adults and in men versus women. UK adults aged 18-26 years (younger adults; n = 584) or >45 years (older adults; n = 107) participated in an online survey. Logistic regression assessed associations between intentions to avoid gaining weight and age, gender as well as perceived negative consequences of weight gain for health and appearance. Co-variates were ethnicity, education, weight perception and perceived weight gain vulnerability. Interactions between age, gender and perceived health and appearance consequences of weight gain were also tested. Perceived negative appearance consequences of weight gain predicted weight gain prevention intentions (OR = 9.3, p < 0.001). Health concerns were not a significant predictor of intentions overall but were a strong predictor for older adults (age × health concern interaction: OR = 13.6, p > 0.01). Concerns about feeling unattractive predict intentions to prevent weight gain. However, health consequences of weight gain are only important motivators for older adults. Future research should identify ways to shift the focus of young people from appearance concerns towards the health benefits of maintaining a healthy weight. © 2018 The Author(s) Published by S. Karger GmbH, Freiburg.

  18. Reducing Risky Sexual Behavior and Substance Use Among Currently and Formerly Homeless Adults Living With HIV

    PubMed Central

    Desmond, Katherine; Comulada, W. Scott; Arnold, Elizabeth Mayfield; Johnson, Mallory

    2009-01-01

    Objectives. We examined the efficacy of the Healthy Living Program in reducing risky sexual behavior and substance use among adults with HIV infection who were marginally housed (i.e., homeless at some point over a 37-month period). Methods. We had previously conducted a randomized controlled trial with 936 adults living with HIV infection. In that study, 3 intervention modules of 5 sessions each addressed different goals: reducing risky sexual acts and drug use, improving the quality of life, and adhering to healthful behaviors. Participants were interviewed at baseline and at 5, 10, 15, 20, and 25 months; 746 completed 4 or more assessments. In this study, we analyzed sexual behavior and drug use outcomes for the 35% (n = 270 of 767) of participants who were considered marginally housed. Results. Among the marginally housed participants, there were significantly greater reductions in unprotected risky sexual acts, the number of sexual partners of HIV negative or unknown serostatus, alcohol or marijuana use, and hard drug use among the intervention group than among the control group. Conclusions. Intensive, skill-focused intervention programs may improve the lives of marginally housed adults living with HIV infection. PMID:18799777

  19. 34 CFR 303.17 - Homeless children.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true Homeless children. 303.17 Section 303.17 Education... DISABILITIES General Definitions Used in This Part § 303.17 Homeless children. Homeless children means children who meet the definition given the term homeless children and youths in section 725 (42 U.S.C. 11434a...

  20. 34 CFR 303.17 - Homeless children.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 2 2012-07-01 2012-07-01 false Homeless children. 303.17 Section 303.17 Education... DISABILITIES General Definitions Used in This Part § 303.17 Homeless children. Homeless children means children who meet the definition given the term homeless children and youths in section 725 (42 U.S.C. 11434a...

  1. 34 CFR 303.17 - Homeless children.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false Homeless children. 303.17 Section 303.17 Education... DISABILITIES General Definitions Used in This Part § 303.17 Homeless children. Homeless children means children who meet the definition given the term homeless children and youths in section 725 (42 U.S.C. 11434a...

  2. Perceived reasons for loss of housing and continued homelessness among homeless persons with mental illness.

    PubMed

    Mojtabai, Ramin

    2005-02-01

    The objective of this study was to examine the reasons for the most recent loss of housing and for continued homelessness as perceived by homeless persons with mental illness. A total of 2,974 currently homeless participants in the 1996 National Survey of Homeless Assistance Providers and Clients (NSHAPC) were asked about the reasons for their most recent loss of housing and continued homelessness. The responses of participants who had mental illness, defined both broadly and narrowly, were compared with responses of those who were not mentally ill. The broad definition of mental illness was based on a set of criteria proposed by NSHAPC investigators. The narrow definition included past psychiatric hospitalization in addition to the NSHAPC criteria. A total of 1,620 participants (56 percent) met the broad definition of mental illness, and 639 (22 percent) met the narrow definition; 1,345 participants (44 percent) did not meet any of these criteria and were categorized as not having a mental illness. Few differences in reasons for the most recent loss of housing were noted between the participants with and without mental illness. Both groups attributed their continued homelessness mostly to insufficient income, unemployment, and lack of suitable housing. Homeless persons with mental illness mostly report the same reasons for loss of housing and continued homelessness as those who do not have a mental illness. This finding supports the view that structural solutions, such as wider availability of low-cost housing and income support, would reduce the risk of homelessness among persons with mental illness, as among other vulnerable social groups.

  3. Veterans and Homelessness

    DTIC Science & Technology

    2007-05-31

    increased visibility of the homeless was due, in part, to the decriminalization of actions such as public drunkenness, loitering, and vagrancy.2 Homelessness...a racial or ethnic minority, childhood poverty, parental mental illness, experience of physical or sexual abuse prior to age 18, other trauma

  4. Homeless Health Concerns

    MedlinePlus

    ... make it worse. That's why the health of homeless people in the United States is worse than that of the general population. Common health problems include Mental health problems Substance abuse ... and skin infections Many homeless women are victims of domestic or sexual abuse. ...

  5. An Examination of the Social Networks and Social Isolation in Older and Younger Adults Living with HIV/AIDS

    ERIC Educational Resources Information Center

    Emlet, Charles A.

    2006-01-01

    This study examined social networks and social isolation in older (50 years or more) and younger (ages 20 to 39) adults with HIV/AIDS. The author conducted interviews with 88 individuals living with HIV/AIDS in the Pacific Northwest. Both groups' social networks had similar patterns; however, older adults were more likely to live alone. More than…

  6. Distal Stressors and Depression among Homeless Men.

    PubMed

    Coohey, Carol; Easton, Scott D

    2016-05-01

    Depression is a common problem among homeless men that may interfere with functional tasks, such as securing stable housing, obtaining employment, and accessing health services. Previous research on depression among homeless men has largely focused on current psychosocial resources, substance abuse, and past victimization. Guided by Ensel and Lin's life course stress process model, the authors examined whether distal stressors, including victimization and exposure to parent problems in childhood, contributed to men's depression above and beyond current (or proximal) stressors, such as substance abuse and health problems, and social resources. The sample consisted of 309 homeless men who had entered a federally funded emergency shelter. Using the Burns Depression Checklist, the authors found that one out of three men met the threshold for moderate to severe depression during the past week. The logistic regression showed that past exposure to parent problems was related to depression after accounting for current stressors and social resources (number of close adult relationships and whether their emotional support needs were met). Past victimization was not related to depression. To address men's depression, workers should concurrently provide services that meet men's basic needs (for example, housing) and address their relationship needs, including their need for emotional support.

  7. Distal Stressors and Depression among Homeless Men

    PubMed Central

    Coohey, Carol; Easton, Scott D.

    2016-01-01

    Depression is a common problem among homeless men that may interfere with functional tasks, such as securing stable housing, obtaining employment, and accessing health services. Previous research on depression among homeless men has largely focused on current psychosocial resources, substance abuse, and past victimization. Guided by Ensel and Lin’s life course stress process model, the authors examined whether distal stressors, including victimization and exposure to parent problems in childhood, contributed to men’s depression above and beyond current (or proximal) stressors, such as substance abuse and health problems, and social resources. The sample consisted of 309 homeless men who had entered a federally funded emergency shelter. Using the Burns Depression Checklist, the authors found that one out of three men met the threshold for moderate to severe depression during the past week. The logistic regression showed that past exposure to parent problems was related to depression after accounting for current stressors and social resources (number of close adult relationships and whether their emotional support needs were met). Past victimization was not related to depression. To address men’s depression, workers should concurrently provide services that meet men’s basic needs (for example, housing) and address their relationship needs, including their need for emotional support. PMID:27263201

  8. Faces of Homelessness: A Teacher's Guide.

    ERIC Educational Resources Information Center

    Massachusetts State Dept. of Education, Quincy.

    A brief teacher's guide supplements a videotape of two 15-minute segments on homelessness. The stated objective of the video is to cover the issues of homelessness as they exist today and to dispel the stereotypes of homelessness leftover from earlier eras. A family which has found itself homeless is introduced and then aspects of the phenomenon…

  9. Testing Alternative Definitions of Chronic Homelessness.

    PubMed

    Byrne, Thomas; Culhane, Dennis P

    2015-09-01

    This study examined the potential impact of a proposed change to the official federal definition of chronic homelessness. Using administrative data from the emergency shelters in a large U.S. city, this study estimated the number of persons identified as chronically homeless under the current definition of chronic homelessness, a proposed new federal definition, and two alternative definitions and examined shelter utilization for each group. Fewer than half as many people were considered chronically homeless under the proposed new federal definition compared with the current definition. Persons considered chronically homeless by the proposed new definition and, to a lesser extent, by the two alternative definitions, made heavier use of shelter compared with persons who met the current definition. A proposed new and two alternative definitions of chronic homelessness are better suited than the existing federal definition for identifying persons with the most protracted experiences of homelessness.

  10. Load Modulation of BOLD Response and Connectivity Predicts Working Memory Performance in Younger and Older Adults

    ERIC Educational Resources Information Center

    Nagel, Irene E.; Preuschhof, Claudia; Li, Shu-Chen; Nyberg, Lars; Backman, Lars; Lindenberger, Ulman; Heekeren, Hauke R.

    2011-01-01

    Individual differences in working memory (WM) performance have rarely been related to individual differences in the functional responsivity of the WM brain network. By neglecting person-to-person variation, comparisons of network activity between younger and older adults using functional imaging techniques often confound differences in activity…

  11. Are social network correlates of heavy drinking similar among black homeless youth and white homeless youth?

    PubMed

    Wenzel, Suzanne L; Hsu, Hsun-Ta; Zhou, Annie; Tucker, Joan S

    2012-11-01

    Understanding factors associated with heavy drinking among homeless youth is important for prevention efforts. Social networks are associated with drinking among homeless youth, and studies have called for attention to racial differences in networks that may affect drinking behavior. This study investigates differences in network characteristics by the racial background of homeless youth, and associations of network characteristics with heavy drinking. (Heavy drinking was defined as having five or more drinks of alcohol in a row within a couple of hours on at least one day within the past 30 days.) A probability sample of 235 Black and White homeless youths ages 13-24 were interviewed in Los Angeles County. We used chi-square or one-way analysis of variance tests to examine network differences by race and logistic regressions to identify network correlates of heavy drinking among Black and White homeless youth. The networks of Black youth included significantly more relatives and students who attend school regularly, whereas the networks of White youth were more likely to include homeless persons, relatives who drink to intoxication, and peers who drink to intoxication. Having peers who drink heavily was significantly associated with heavy drinking only among White youth. For all homeless youth, having more students in the network who regularly attend school was associated with less risk of heavy drinking. This study is the first to our knowledge to investigate racial differences in network characteristics and associations of network characteristics with heavy drinking among homeless youth. White homeless youth may benefit from interventions that reduce their ties with peers who drink. Enhancing ties to school-involved peers may be a promising intervention focus for both Black and White homeless youth.

  12. Homeless youth: a concept analysis.

    PubMed

    Washington, Philisie Starling

    2011-07-01

    INTRODUCTION. A variety of terms have been used to describe the homeless youth population. PURPOSE. The purpose of this article is to analyze the conceptual meanings of the term homeless youths by examining the evolution of the concept and its related terms in the current literature. Method. Online databases from 1990-2010 were analyzed using the Rodgers evolutionary approach. RESULTS. The 6 attributes relating to homeless youth were physical location, age, health, behavior, choice, and survival. CONCLUSION. The analysis provided insight and clarification of homeless youth from a variety of related terms in the literature.

  13. Practical issues regarding implementing a randomized clinical trial in a homeless population: strategies and lessons learned.

    PubMed

    Ojo-Fati, Olamide; Joseph, Anne M; Ig-Izevbekhai, Jed; Thomas, Janet L; Everson-Rose, Susan A; Pratt, Rebekah; Raymond, Nancy; Cooney, Ned L; Luo, Xianghua; Okuyemi, Kolawole S

    2017-07-05

    There is a critical need for objective data to guide effective health promotion and care for homeless populations. However, many investigators exclude homeless populations from clinical trials due to practical concerns about conducting research with this population. This report is based on our experience and lessons learned while conducting two large NIH-funded randomized controlled trials targeting smoking cessation among persons who are homeless. The current report also addresses challenges when conducting clinical trials among homeless populations and offers potential solutions. Homeless individuals face several challenges including the need to negotiate daily access to food, clothing, and shelter. Some of the critical issues investigators encounter include recruitment and retention obstacles; cognitive impairment, mental health and substance abuse disorders; transportation and scheduling challenges; issues pertaining to adequate study compensation; the need for safety protocols for study staff; and issues related to protecting the wellbeing of these potentially vulnerable adults. Anticipating realistic conditions in which to conduct studies with participants who are homeless will help investigators to design efficient protocols and may improve the feasibility of conducting clinical trials involving homeless populations and the quality of the data collected by the researchers. ClinicalTrials.gov, ID: NCT00786149 . Registered on 5 November 2008; ClinicalTrials.gov, ID: NCT01932996 . Registered on 20 November 2014.

  14. Effectiveness of Housing First with Intensive Case Management in an Ethnically Diverse Sample of Homeless Adults with Mental Illness: A Randomized Controlled Trial.

    PubMed

    Stergiopoulos, Vicky; Gozdzik, Agnes; Misir, Vachan; Skosireva, Anna; Connelly, Jo; Sarang, Aseefa; Whisler, Adam; Hwang, Stephen W; O'Campo, Patricia; McKenzie, Kwame

    2015-01-01

    Housing First (HF) is being widely disseminated in efforts to end homelessness among homeless adults with psychiatric disabilities. This study evaluates the effectiveness of HF with Intensive Case Management (ICM) among ethnically diverse homeless adults in an urban setting. 378 participants were randomized to HF with ICM or treatment-as-usual (TAU) in Toronto (Canada), and followed for 24 months. Measures of effectiveness included housing stability, physical (EQ5D-VAS) and mental (CSI, GAIN-SS) health, social functioning (MCAS), quality of life (QoLI20), and health service use. Two-thirds of the sample (63%) was from racialized groups and half (50%) were born outside Canada. Over the 24 months of follow-up, HF participants spent a significantly greater percentage of time in stable residences compared to TAU participants (75.1% 95% CI 70.5 to 79.7 vs. 39.3% 95% CI 34.3 to 44.2, respectively). Similarly, community functioning (MCAS) improved significantly from baseline in HF compared to TAU participants (change in mean difference = +1.67 95% CI 0.04 to 3.30). There was a significant reduction in the number of days spent experiencing alcohol problems among the HF compared to TAU participants at 24 months (ratio of rate ratios = 0.47 95% CI 0.22 to 0.99) relative to baseline, a reduction of 53%. Although the number of emergency department visits and days in hospital over 24 months did not differ significantly between HF and TAU participants, fewer HF participants compared to TAU participants had 1 or more hospitalizations during this period (70.4% vs. 81.1%, respectively; P=0.044). Compared to non-racialized HF participants, racialized HF participants saw an increase in the amount of money spent on alcohol (change in mean difference = $112.90 95% CI 5.84 to 219.96) and a reduction in physical community integration (ratio of rate ratios = 0.67 95% CI 0.47 to 0.96) from baseline to 24 months. Secondary analyses found a significant reduction in the number of days

  15. Effectiveness of Housing First with Intensive Case Management in an Ethnically Diverse Sample of Homeless Adults with Mental Illness: A Randomized Controlled Trial

    PubMed Central

    Stergiopoulos, Vicky; Gozdzik, Agnes; Misir, Vachan; Skosireva, Anna; Connelly, Jo; Sarang, Aseefa; Whisler, Adam; Hwang, Stephen W.; O’Campo, Patricia; McKenzie, Kwame

    2015-01-01

    Housing First (HF) is being widely disseminated in efforts to end homelessness among homeless adults with psychiatric disabilities. This study evaluates the effectiveness of HF with Intensive Case Management (ICM) among ethnically diverse homeless adults in an urban setting. 378 participants were randomized to HF with ICM or treatment-as-usual (TAU) in Toronto (Canada), and followed for 24 months. Measures of effectiveness included housing stability, physical (EQ5D-VAS) and mental (CSI, GAIN-SS) health, social functioning (MCAS), quality of life (QoLI20), and health service use. Two-thirds of the sample (63%) was from racialized groups and half (50%) were born outside Canada. Over the 24 months of follow-up, HF participants spent a significantly greater percentage of time in stable residences compared to TAU participants (75.1% 95% CI 70.5 to 79.7 vs. 39.3% 95% CI 34.3 to 44.2, respectively). Similarly, community functioning (MCAS) improved significantly from baseline in HF compared to TAU participants (change in mean difference = +1.67 95% CI 0.04 to 3.30). There was a significant reduction in the number of days spent experiencing alcohol problems among the HF compared to TAU participants at 24 months (ratio of rate ratios = 0.47 95% CI 0.22 to 0.99) relative to baseline, a reduction of 53%. Although the number of emergency department visits and days in hospital over 24 months did not differ significantly between HF and TAU participants, fewer HF participants compared to TAU participants had 1 or more hospitalizations during this period (70.4% vs. 81.1%, respectively; P=0.044). Compared to non-racialized HF participants, racialized HF participants saw an increase in the amount of money spent on alcohol (change in mean difference = $112.90 95% CI 5.84 to 219.96) and a reduction in physical community integration (ratio of rate ratios = 0.67 95% CI 0.47 to 0.96) from baseline to 24 months. Secondary analyses found a significant reduction in the number of days

  16. Predictors of Emergency Department Visits and Inpatient Admissions Among Homeless and Unstably Housed Adolescents and Young Adults.

    PubMed

    Mackelprang, Jessica L; Qiu, Qian; Rivara, Frederick P

    2015-12-01

    Individuals under age 25 years are estimated to comprise one third of the homeless population nationally. Understanding the reasons for utilization of hospitals by homeless youth is important for optimizing disposition planning. Objectives of the present study were to: (1) report prevalence of emergency department (ED) and inpatient admissions among homeless and unstably housed youth; (2) describe demographic characteristics of those youth who seek hospital care; (3) describe their patterns of injury, illness, psychiatric, and substance use conditions; and (4) identify demographic and diagnostic predictors of ED visit or hospital readmission. Retrospective cohort study of 15-25-year-olds (N=402) who were admitted to the ED or inpatient floors of 2 urban teaching hospitals in King County, WA between July 1, 2009 and June 30, 2012 and whose address was "homeless" or "none" or a homeless shelter or service agency (ie, homeless or unstably housed), during any recorded encounter between July 1, 2009 and June 30, 2012. A total of 1151 ED visits and 227 inpatient admissions were documented. Fifty percent of patients had an ED visit or hospital readmission within 1 year, with 43.1% receiving care within 30 days of discharge. Cox regression showed that female individuals with an injury diagnosis (hazard ratio=1.74, 95% confidence interval=1.06, 2.85) and male individuals with an acute medical condition (hazard ratio=1.59, 95% confidence interval=1.09, 2.32) at index visit were more likely to have an ED visit or hospital readmission during the following year, as were patients who provided a private address at their index visit. Homeless young people who seek hospital care demonstrate a high rate of ED visits and hospital readmissions, with unique predictors of utilization associated with sex and housing status. Additional research is necessary to determine how best to transition these young people from hospital-based to community-based care.

  17. Comparing the effects of an acute bout of physical exercise with an acute bout of interactive mental and physical exercise on electrophysiology and executive functioning in younger and older adults.

    PubMed

    Dimitrova, Julia; Hogan, Michael; Khader, Patrick; O'Hora, Denis; Kilmartin, Liam; Walsh, Jane C; Roche, Richard; Anderson-Hanley, Cay

    2017-10-01

    Physical exercise has been shown to improve cognitive and neural functioning in older adults. The current study compared the effects of an acute bout of physical exercise with a bout of interactive mental and physical exercise (i.e., "exergaming") on executive (Stroop) task performance and event-related potential (ERP) amplitudes in younger and older adults. Results revealed enhanced executive task performance in younger and older adults after exercise, with no differences in performance between exercise conditions. Stroop (RT) performance in older adults improved more than in younger adults from pre- to post-exercise. A significant increase in EEG amplitude from pre- to post-exercise was found at the Cz site from 320 to 700 ms post-stimulus for both younger and older adults, with older adults demonstrating a larger Stroop interference effect. While younger adults exhibited overall greater EEG amplitudes than older adults, they showed no differences between congruent and incongruent trials (i.e., minimal interference). Compared to peers with higher BMI (body mass index), older adults with lower BMI showed a greater reduction in Stroop interference effects from pre- to post-exercise. The beneficial effects of an acute bout of physical exercise on cognitive and neural functioning in younger and older adults were confirmed, with no difference between standard exercise and exergaming. Findings suggest that BMI, sometimes used as a proxy for fitness level, may modulate benefits that older adults derive from an acute bout of exercise. Findings have implications for future research that seeks to investigate unique effects of exergaming when compared to standard physical exercise.

  18. Effects of age and lean direction on the threshold of single-step balance recovery in younger, middle-aged and older adults.

    PubMed

    Carbonneau, Evelyne; Smeesters, Cécile

    2014-01-01

    Several studies have quantified and compared balance recovery between healthy younger and older adults, using a variety of large postural perturbations and loss of balance directions. However, to the best of our knowledge, no studies at the threshold of balance recovery, where avoiding a fall is not always possible, have included middle-aged adults. We thus determined the maximum lean angle from which 20 younger, 16 middle-aged and 16 older healthy adults could be suddenly released and still recover balance using a single step for forward, sideways and backward leans. Results showed that the maximum lean angles of younger adults were 23% greater than middle-aged adults and 48% greater than older adults. The maximum lean angles for forward leans were 23% greater than sideways leans and 22% greater than backward leans. These declines with age and lean direction were associated with declines in response initiation, execution and geometry. Finally exponential regressions showed that the critical ages at which the ability to recover balance and avoid a fall significantly decreases were 51.0, 60.6 and 69.9 yrs for forward, sideways and backward leans, respectively. Therefore, we have demonstrated that age affects the ability to recover balance nearly a decade earlier than the rate of falls. Future studies should thus not only include older adults over 65 yrs, but also middle-aged adults under 65 yrs, or recruit all ages from 18 to 85 yrs. Finally, the critical ages identified in this study may justify an earlier screening of aging adults to prevent future falls, especially the first fall. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. Group motivational interviewing for homeless young adults: Associations of change talk with substance use and sexual risk behavior.

    PubMed

    D'Amico, Elizabeth J; Houck, Jon M; Tucker, Joan S; Ewing, Brett A; Pedersen, Eric R

    2017-09-01

    Homeless young adults exhibit high rates of alcohol and other drug (AOD) use and sexual risk behaviors. This study is a secondary analysis of data collected in a randomized clinical trial of AWARE, a new 4 session group motivational interviewing intervention. AWARE mainly focused on alcohol use and sexual risk behavior given focus group feedback. We used sequential coding to analyze how the group process affected both AOD use and sexual risk behavior at 3-month follow up among homeless young adults by examining facilitator behavior and participant change talk (CT) and sustain talk (ST). We analyzed 57 group session digital recordings of 100 youth (69% male, 74% heterosexual, 28% non-Hispanic white, 23% African American, 26% Hispanic, 23% multiracial/other; mean age 21.75). Outcomes included importance and readiness to change AOD use and risky sexual behavior, AOD use and consequences, number of partners and unprotected sex, and condom self-efficacy. Sequential analysis indicated that facilitator open-ended questions and reflections of CT increased Group CT. Group CT was associated with a lower likelihood of being a heavy drinker 3 months later; Group ST was associated with decreased readiness and confidence to change alcohol use. There were no associations with CT or ST for drug use or risky sexual behavior. Facilitator speech and peer responses were related to CT and ST during the group sessions with this high risk population, which were then associated with individual changes for alcohol use. Further research is needed to explore associations with drug use and sexual risk behavior. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  20. Evaluating authentication options for mobile health applications in younger and older adults

    PubMed Central

    Khan, Hassan; Hengartner, Urs; Ong, Stephanie; Logan, Alexander G.; Vogel, Daniel; Gebotys, Robert; Yang, Jilan

    2018-01-01

    Objective Apps promoting patient self-management may improve health outcomes. However, methods to secure stored information on mobile devices may adversely affect usability. We tested the reliability and usability of common user authentication techniques in younger and older adults. Methodology Usability testing was conducted in two age groups, 18 to 30 years and 50 years and older. After completing a demographic questionnaire, each participant tested four authentication options in random order: four-digit personal identification number (PIN), graphical password (GRAPHICAL), Android pattern-lock (PATTERN), and a swipe-style Android fingerprint scanner (FINGERPRINT). Participants rated each option using the Systems Usability Scale (SUS). Results A total of 59 older and 43 younger participants completed the study. Overall, PATTERN was the fastest option (3.44s), and PIN had the fewest errors per attempt (0.02). Participants were able to login using PIN, PATTERN, and GRAPHICAL at least 98% of the time. FINGERPRINT was the slowest (26.97s), had an average of 1.46 errors per attempt, and had a successful login rate of 85%. Overall, PIN and PATTERN had higher SUS scores than FINGERPRINT and GRAPHICAL. Compared to younger participants, older participants were also less likely to find PATTERN to be tiring, annoying or time consuming and less likely to consider PIN to be time consuming. Younger participants were more likely to rate GRAPHICAL as annoying, time consuming and tiring than older participants. Conclusions On mobile devices, PIN and pattern-lock outperformed graphical passwords and swipe-style fingerprints. All participants took longer to authenticate using the swipe-style fingerprint compared to other options. Older participants also took two to three seconds longer to authenticate using the PIN, pattern and graphical passwords though this did not appear to affect perceived usability. PMID:29300736

  1. Evaluating authentication options for mobile health applications in younger and older adults.

    PubMed

    Grindrod, Kelly; Khan, Hassan; Hengartner, Urs; Ong, Stephanie; Logan, Alexander G; Vogel, Daniel; Gebotys, Robert; Yang, Jilan

    2018-01-01

    Apps promoting patient self-management may improve health outcomes. However, methods to secure stored information on mobile devices may adversely affect usability. We tested the reliability and usability of common user authentication techniques in younger and older adults. Usability testing was conducted in two age groups, 18 to 30 years and 50 years and older. After completing a demographic questionnaire, each participant tested four authentication options in random order: four-digit personal identification number (PIN), graphical password (GRAPHICAL), Android pattern-lock (PATTERN), and a swipe-style Android fingerprint scanner (FINGERPRINT). Participants rated each option using the Systems Usability Scale (SUS). A total of 59 older and 43 younger participants completed the study. Overall, PATTERN was the fastest option (3.44s), and PIN had the fewest errors per attempt (0.02). Participants were able to login using PIN, PATTERN, and GRAPHICAL at least 98% of the time. FINGERPRINT was the slowest (26.97s), had an average of 1.46 errors per attempt, and had a successful login rate of 85%. Overall, PIN and PATTERN had higher SUS scores than FINGERPRINT and GRAPHICAL. Compared to younger participants, older participants were also less likely to find PATTERN to be tiring, annoying or time consuming and less likely to consider PIN to be time consuming. Younger participants were more likely to rate GRAPHICAL as annoying, time consuming and tiring than older participants. On mobile devices, PIN and pattern-lock outperformed graphical passwords and swipe-style fingerprints. All participants took longer to authenticate using the swipe-style fingerprint compared to other options. Older participants also took two to three seconds longer to authenticate using the PIN, pattern and graphical passwords though this did not appear to affect perceived usability.

  2. Destination memory in social interaction: better memory for older than for younger destinations in normal aging?

    PubMed

    El Haj, Mohamad; Raffard, Stéphane; Fasotti, Luciano; Allain, Philippe

    2018-05-01

    Destination memory, a memory component allowing the attribution of information to its appropriate receiver (e.g., to whom did I lend my pen?), is compromised in normal aging. The present paper investigated whether older adults might show better memory for older destinations than for younger destinations. This hypothesis is based on empirical research showing better memory for older faces than for younger faces in older adults. Forty-one older adults and 44 younger adults were asked to tell proverbs to older and younger destinations (i.e., coloured faces). On a later recognition test, participants had to decide whether they had previously told some proverb to an older/younger destination or not. Prior to this task, participants reported their frequency of contact with other-age groups. The results showed lower destination memory in older adults than in younger adults. Interestingly, older adults displayed better memory for older than for younger destinations. The opposite pattern was seen in younger adults. The low memory for younger destinations, as observed in older adults, was significantly correlated with limited exposure to younger individuals. These findings suggest that for older adults, the social experience can play a crucial role in the destination memory, at least as far as exposure to other-age groups is concerned.

  3. Child Abuse, Street Victimization, and Substance Use among Homeless Young Adults

    ERIC Educational Resources Information Center

    Tyler, Kimberly A.; Melander, Lisa A.

    2015-01-01

    Although previous research documents high rates of child abuse, street victimization, and substance use among homeless youth, few studies have investigated these three constructs simultaneously, and thus little is known about how various forms of victimization are uniquely associated with substance use among this population. The purpose of this…

  4. Maslow and Mental Health Recovery: A Comparative Study of Homeless Programs for Adults with Serious Mental Illness

    PubMed Central

    Derejko, Katie-Sue; Couture, Julie; Padgett, Deborah K.

    2014-01-01

    This mixed-methods study uses Maslow’s hierarchy as a theoretical lens to investigate the experiences of 63 newly enrolled clients of housing first and traditional programs for adults with serious mental illness who have experienced homelessness. Quantitative findings suggests that identifying self-actualization goals is associated with not having one’s basic needs met rather than from the fulfillment of basic needs. Qualitative findings suggest a more complex relationship between basic needs, goal setting, and the meaning of self-actualization. Transforming mental health care into a recovery-oriented system will require further consideration of person-centered care planning as well as the impact of limited resources especially for those living in poverty. PMID:24518968

  5. Homelessness among a cohort of women in street-based sex work: the need for safer environment interventions.

    PubMed

    Duff, Putu; Deering, Kathleen; Gibson, Kate; Tyndall, Mark; Shannon, Kate

    2011-08-12

    Drawing on data from a community-based prospective cohort study in Vancouver, Canada, we examined the prevalence and individual, interpersonal and work environment correlates of homelessness among 252 women in street-based sex work. Bivariate and multivariate logistic regression using generalized estimating equations (GEE) was used to examine the individual, interpersonal and work environment factors that were associated with homelessness among street-based sex workers. Among 252 women, 43.3% reported homelessness over an 18-month follow-up period. In the multivariable GEE logistic regression analysis, younger age (adjusted odds ratio [aOR] = 0.93; 95%confidence interval [95%CI] 0.93-0.98), sexual violence by non-commercial partners (aOR = 2.14; 95%CI 1.06-4.34), servicing a higher number of clients (10+ per week vs < 10) (aOR = 1.68; 95%CI 1.05-2.69), intensive, daily crack use (aOR = 1.65; 95%CI 1.11-2.45), and servicing clients in public spaces (aOR = 1.52; CI 1.00-2.31) were independently associated with sleeping on the street. These findings indicate a critical need for safer environment interventions that mitigate the social and physical risks faced by homeless FSWs and increase access to safe, secure housing for women.

  6. Are Social Network Correlates of Heavy Drinking Similar Among Black Homeless Youth and White Homeless Youth?

    PubMed Central

    Wenzel, Suzanne L.; Hsu, Hsun-Ta; Zhou, Annie; Tucker, Joan S.

    2012-01-01

    Objective: Understanding factors associated with heavy drinking among homeless youth is important for prevention efforts. Social networks are associated with drinking among homeless youth, and studies have called for attention to racial differences in networks that may affect drinking behavior. This study investigates differences in network characteristics by the racial background of homeless youth, and associations of network characteristics with heavy drinking. (Heavy drinking was defined as having five or more drinks of alcohol in a row within a couple of hours on at least one day within the past 30 days.) Method: A probability sample of 235 Black and White homeless youths ages 13–24 were interviewed in Los Angeles County. We used chi-square or one-way analysis of variance tests to examine network differences by race and logistic regressions to identify network correlates of heavy drinking among Black and White homeless youth. Results: The networks of Black youth included significantly more relatives and students who attend school regularly, whereas the networks of White youth were more likely to include homeless persons, relatives who drink to intoxication, and peers who drink to intoxication. Having peers who drink heavily was significantly associated with heavy drinking only among White youth. For all homeless youth, having more students in the network who regularly attend school was associated with less risk of heavy drinking. Conclusions: This study is the first to our knowledge to investigate racial differences in network characteristics and associations of network characteristics with heavy drinking among homeless youth. White homeless youth may benefit from interventions that reduce their ties with peers who drink. Enhancing ties to school-involved peers may be a promising intervention focus for both Black and White homeless youth. PMID:23036205

  7. No Homeless Child Left behind

    ERIC Educational Resources Information Center

    Saxberg, David

    2011-01-01

    Although it is difficult to determine the precise number of homeless children, the National Coalition for the Homeless reports that there are more than 1.3 million children lacking a permanent residence on any given night. Further, 39 percent of the homeless population was comprised of children under the age of 18 in July 2009, the most recent…

  8. Disparities in Cancer Incidence, Stage, and Mortality at Boston Health Care for the Homeless Program

    PubMed Central

    Baggett, Travis P.; Chang, Yuchiao; Porneala, Bianca C.; Bharel, Monica; Singer, Daniel E.; Rigotti, Nancy A.

    2015-01-01

    Introduction Homeless people have a high burden of cancer risk factors and suboptimal rates of cancer screening, but the epidemiology of cancer has not been well described in this population. We assessed cancer incidence, stage, and mortality in homeless adults relative to general population standards. Methods We cross-linked a cohort of 28,033 adults seen at Boston Health Care for the Homeless Program in 2003–2008 to Massachusetts cancer registry and vital registry records. We calculated age-standardized cancer incidence and mortality ratios (SIRs and SMRs). We examined tobacco use among incident cases and estimated smoking-attributable fractions. Trend tests were used to compare cancer stage distributions with those in Massachusetts adults. Analyses were conducted in 2012–2015. Results During 90,450 person-years of observation, there were 361 incident cancers (SIR=1.13, 95% CI=1.02, 1.25) and 168 cancer deaths (SMR=1.88, 95% CI=1.61, 2.19) among men, and 98 incident cancers (SIR=0.93, 95% CI=0.76, 1.14) and 38 cancer deaths (SMR=1.61, 95% CI=1.14, 2.20) among women. For both sexes, bronchus and lung cancer was the leading type of incident cancer and cancer death, exceeding Massachusetts estimates more than twofold. Oropharyngeal and liver cancer cases and deaths occurred in excess among men, whereas cervical cancer cases and deaths occurred in excess among women. About one third of incident cancers were smoking-attributable. Colorectal, female breast, and oropharyngeal cancers were diagnosed at more-advanced stages than in Massachusetts adults. Conclusions Efforts to reduce cancer disparities in homeless people should include addressing tobacco use and enhancing participation in evidence-based screening. PMID:26143955

  9. Characteristics, clinical course, and outcomes of homeless and non-homeless patients admitted to ICU: A retrospective cohort study

    PubMed Central

    Kaur, Maninder; Ashraf, Said

    2017-01-01

    Background Little is known about homeless patients in intensive care units (ICUs). Objectives To compare clinical characteristics, treatments, and outcomes of homeless to non-homeless patients admitted to four ICUs in a large inner-city academic hospital. Methods 63 randomly-selected homeless compared to 63 age-, sex-, and admitting-ICU-matched non-homeless patients. Results Compared to matched non-homeless, homeless patients (average age 48±12 years, 90% male, 87% admitted by ambulance, 56% mechanically ventilated, average APACHE II 17) had similar comorbidities and illness severity except for increased alcohol (70% vs 17%,p<0.001) and illicit drug(46% vs 8%,p<0.001) use and less documented hypertension (16% vs 40%,p = 0.005) or prescription medications (48% vs 67%,p<0.05). Intensity of ICU interventions was similar except for higher thiamine (71% vs 21%,p<0.0001) and nicotine (38% vs 14%,p = 0.004) prescriptions. Homeless patients exhibited significantly lower Glasgow Coma Scores and significantly more bacterial respiratory cultures. Longer durations of antibiotics, vasopressors/inotropes, ventilation, ICU and hospital lengths of stay were not statistically different, but homeless patients had higher hospital mortality (29% vs 8%,p = 0.005). Review of all deaths disclosed that withdrawal of life-sustaining therapy occurred in similar clinical circumstances and proportions in both groups, regardless of family involvement. Using multivariable logistic regression, homelessness did not appear to be an independent predictor of hospital mortality. Conclusions Homeless patients, admitted to ICU matched to non-homeless patients by age and sex (characteristics most commonly used by clinicians), have higher hospital mortality despite similar comorbidities and illness severity. Trends to longer durations of life supports may have contributed to the higher mortality. Additional research is required to validate this higher mortality and develop strategies to improve outcomes

  10. Swallow Event Sequencing: Comparing Healthy Older and Younger Adults.

    PubMed

    Herzberg, Erica G; Lazarus, Cathy L; Steele, Catriona M; Molfenter, Sonja M

    2018-04-23

    Previous research has established that a great deal of variation exists in the temporal sequence of swallowing events for healthy adults. Yet, the impact of aging on swallow event sequence is not well understood. Kendall et al. (Dysphagia 18(2):85-91, 2003) suggested there are 4 obligatory paired-event sequences in swallowing. We directly compared adherence to these sequences, as well as event latencies, and quantified the percentage of unique sequences in two samples of healthy adults: young (< 45) and old (> 65). The 8 swallowing events that contribute to the sequences were reliably identified from videofluoroscopy in a sample of 23 healthy seniors (10 male, mean age 74.7) and 20 healthy young adults (10 male, mean age 31.5) with no evidence of penetration-aspiration or post-swallow residue. Chi-square analyses compared the proportions of obligatory pairs and unique sequences by age group. Compared to the older subjects, younger subjects had significantly lower adherence to two obligatory sequences: Upper Esophageal Sphincter (UES) opening occurs before (or simultaneous with) the bolus arriving at the UES and UES maximum distention occurs before maximum pharyngeal constriction. The associated latencies were significantly different between age groups as well. Further, significantly fewer unique swallow sequences were observed in the older group (61%) compared with the young (82%) (χ 2  = 31.8; p < 0.001). Our findings suggest that paired swallow event sequences may not be robust across the age continuum and that variation in swallow sequences appears to decrease with aging. These findings provide normative references for comparisons to older individuals with dysphagia.

  11. Vision Problems in Homeless Children.

    PubMed

    Smith, Natalie L; Smith, Thomas J; DeSantis, Diana; Suhocki, Marissa; Fenske, Danielle

    2015-08-01

    Vision problems in homeless children can decrease educational achievement and quality of life. To estimate the prevalence and specific diagnoses of vision problems in children in an urban homeless shelter. A prospective series of 107 homeless children and teenagers who underwent screening with a vision questionnaire, eye chart screening (if mature enough) and if vision problem suspected, evaluation by a pediatric ophthalmologist. Glasses and other therapeutic interventions were provided if necessary. The prevalence of vision problems in this population was 25%. Common diagnoses included astigmatism, amblyopia, anisometropia, myopia, and hyperopia. Glasses were required and provided for 24 children (22%). Vision problems in homeless children are common and frequently correctable with ophthalmic intervention. Evaluation by pediatric ophthalmologist is crucial for accurate diagnoses and treatment. Our system of screening and evaluation is feasible, efficacious, and reproducible in other homeless care situations.

  12. Thirst for Knowledge: The Effects of Curiosity and Interest on Memory in Younger and Older Adults

    PubMed Central

    McGillivray, Shannon; Murayama, Kou; Castel, Alan D.

    2015-01-01

    Given age-related memory impairments, one’s level of curiosity or interest could enhance memory for certain information. In the current study, younger and older adults read trivia questions, rated how curious they were to learn each answer, provided confidence and interest ratings, and judgments of learning (JOL) after learning the answer. No age-related differences in memory were found. Analyses indicated that curiosity and interest contributed to the formation of JOLs. Additionally, interest had a unique increasing relationship with older, but not younger, adults’ memory performance after a week. The results suggest that subjective interest may serve to enhance older adults’ memory. PMID:26479013

  13. Bidirectional Partner Violence among Homeless Young Adults: Risk Factors and Outcomes

    ERIC Educational Resources Information Center

    Tyler, Kimberly A.; Melander, Lisa A.; Noel, HarmoniJoie

    2009-01-01

    One of the most prevalent forms of violence in contemporary society is the victimization of intimate partners. Although it has been established that homeless young people experience high levels of victimization on the street, little is known about partner violence (PV) experiences among this group, especially bidirectional violence. As such, the…

  14. Dual-Task Processing in Younger and Older Adults: Similarities and Differences Revealed by fMRI

    ERIC Educational Resources Information Center

    Hartley, Alan A.; Jonides, John; Sylvester, Ching-Yune C.

    2011-01-01

    fMRI was used to explore age differences in the neural substrate of dual-task processing. Brain activations when there was a 100 ms SOA between tasks, and task overlap was high, were contrasted with activations when there was a 1000 ms SOA, and first task processing was largely complete before the second task began. Younger adults (M = 21 yrs)…

  15. Does increasing the intelligibility of a competing sound source interfere more with speech comprehension in older adults than it does in younger adults?

    PubMed

    Lu, Zihui; Daneman, Meredyth; Schneider, Bruce A

    2016-11-01

    A previous study (Schneider, Daneman, Murphy, & Kwong See, 2000) found that older listeners' decreased ability to recognize individual words in a noisy auditory background was responsible for most, if not all, of the comprehension difficulties older adults experience when listening to a lecture in a background of unintelligible babble. The present study investigated whether the use of a more intelligible distracter (a competing lecture) might reveal an increased susceptibility to distraction in older adults. The results from Experiments 1 and 2 showed that both normal-hearing and hearing-impaired older adults performed poorer than younger adults when everyone was tested in identical listening situations. However, when the listening situation was individually adjusted to compensate for age-related differences in the ability to recognize individual words in noise, age-related difference in comprehension disappeared. Experiment 3 compared the masking effects of a single-talker competing lecture to a babble of 12 voices directly after adjusting for word recognition. The results showed that the competing lecture interfered more than did the babble for both younger and older listeners. Interestingly, an increase in the level of noise had a deleterious effect on listening when the distractor was babble but had no effect when it was a competing lecture. These findings indicated that the speech comprehension difficulties of healthy older adults in noisy backgrounds primarily reflect age-related declines in the ability to recognize individual words.

  16. Short-term changes in general and memory-specific control beliefs and their relationship to cognition in younger and older adults.

    PubMed

    Bielak, Allison A M; Hultsch, David F; Levy-Ajzenkopf, Judi; MacDonald, Stuart W S; Hunter, Michael A; Strauss, Esther

    2007-01-01

    We examined short-term changes in younger and older adults' control beliefs. Participants completed measures of general and memory-specific competence and locus of control on 10 bi-monthly occasions. At each occasion, participants rated their control beliefs prior to and following completion of a battery of cognitive tasks. Exposure to the set of cognitively demanding tasks led to declines in older adults' ratings of both general and memory-specific competence compared to little change or increases in younger adults' ratings. Older adults were also more inconsistent in their reported locus of control beliefs across the 10 occasions. Analyses examining the relationship between control beliefs and actual cognitive performance revealed few significant effects, suggesting that short-term changes in perceived control are not driven by monitoring changes in actual performance. The results suggest the importance of assessing short-term as well as long-term changes in perceived control to obtain a complete picture of aging-related changes.

  17. Mind-wandering in Younger and Older Adults: Converging Evidence from the Sustained Attention to Response Task and Reading for Comprehension

    PubMed Central

    Jackson, Jonathan D.; Balota, David A.

    2011-01-01

    One mechanism that has been hypothesized to contribute to older adults’ changes in cognitive performance is goal neglect or impairment in maintaining task set across time. Mind-wandering and task-unrelated thought may underlie these potential age-related changes. The present study investigated age-related changes in mind-wandering in three different versions of the Sustained Attention to Response task (SART), along with self-reported mind-wandering during a reading for comprehension task. In the SART, both younger and older adults produced similar levels of faster reaction times before No-Go errors of commission, whereas, older adults produced disproportionate post-error slowing. Subjective self-reports of mind-wandering recorded during the SART and the reading task indicated that older adults were less likely to report mind-wandering than younger adults. Discussion focuses on cognitive and motivational mechanisms that may account for older adults’ relatively low levels of reported mind-wandering. PMID:21707183

  18. The Difference between Right and Wrong: Accuracy of Older and Younger Adults' Story Recall.

    PubMed

    Davis, Danielle K; Alea, Nicole; Bluck, Susan

    2015-09-02

    Sharing stories is an important social activity in everyday life. This study used fine-grained content analysis to investigate the accuracy of recall of two central story elements: the gist and detail of socially-relevant stories. Younger (M age = 28.06) and older (M age = 75.03) American men and women (N = 63) recalled fictional stories that were coded for (i) accuracy of overall gist and specific gist categories and (ii) accuracy of overall detail and specific detail categories. Findings showed no age group differences in accuracy of overall gist or detail, but differences emerged for specific categories. Older adults more accurately recalled the gist of when the event occurred whereas younger adults more accurately recalled the gist of why the event occurred. These differences were related to episodic memory ability and education. For accuracy in recalling details, there were some age differences, but gender differences were more robust. Overall, women remembered details of these social stories more accurately than men, particularly time and perceptual details. Women were also more likely to accurately remember the gist of when the event occurred. The discussion focuses on how accurate recall of socially-relevant stories is not clearly age-dependent but is related to person characteristics such as gender and episodic memory ability/education.

  19. Following your heart or your head: focusing on emotions versus information differentially influences the decisions of younger and older adults.

    PubMed

    Mikels, Joseph A; Löckenhoff, Corinna E; Maglio, Sam J; Goldstein, Mary K; Garber, Alan; Carstensen, Laura L

    2010-03-01

    Research on aging has indicated that whereas deliberative cognitive processes decline with age, emotional processes are relatively spared. To examine the implications of these divergent trajectories in the context of health care choices, we investigated whether instructional manipulations emphasizing a focus on feelings or details would have differential effects on decision quality among younger and older adults. We presented 60 younger and 60 older adults with health care choices that required them to hold in mind and consider multiple pieces of information. Instructional manipulations in the emotion-focus condition asked participants to focus on their emotional reactions to the options, report their feelings about the options, and then make a choice. In the information-focus condition, participants were instructed to focus on the specific attributes, report the details about the options, and then make a choice. In a control condition, no directives were given. Manipulation checks indicated that the instructions were successful in eliciting different modes of processing. Decision quality data indicate that younger adults performed better in the information-focus than in the control condition whereas older adults performed better in the emotion-focus and control conditions than in the information-focus condition. Findings support and extend extant theorizing on aging and decision making as well as suggest that interventions to improve decision-making quality should take the age of the decision maker into account.

  20. Addressing the health needs of the homeless.

    PubMed

    John, William; Law, Kate

    2011-03-01

    Several authors have alluded to the complex health needs of the homeless population in the UK. The correlation between homelessness and a wide range of health problems has been explored in the literature. This paper presents a literature review exploring the biological, psychosocial and sexual health needs of single homeless people. The relationship between health and homelessness is analysed in relation to theories of health inequalities, which suggest that being homeless may be both a cause and a consequence of ill health. The contemporary nurse can play a vital role in helping to overcome the barriers that homeless people face when accessing health services. This paper explores the skills and approaches that nurses in a wide variety of settings can employ in addressing the health issues of homeless clients.

  1. Understanding pregnancy-related attitudes and behaviors: a mixed-methods study of homeless youth.

    PubMed

    Tucker, Joan S; Sussell, Jesse; Golinelli, Daniela; Zhou, Annie; Kennedy, David P; Wenzel, Suzanne L

    2012-12-01

    Pregnancy rates are substantially higher among homeless youth than in the general population of youth, yet little is known about homeless adolescents' and young adults' pregnancy-related attitudes and behaviors. Pregnancy-related attitudes and behaviors were examined among two samples of sexually active homeless 13-24-year-olds in Los Angeles County. Data from 37 semistructured interviews conducted in March-April 2011 were analyzed using standard qualitative methods. Data from a structured survey with 277 respondents, conducted between October 2008 and August 2009, were analyzed primarily using regression modeling. More than half of interview respondents held ambivalent attitudes toward pregnancy, and ambivalent youth reported less contraceptive use than others. The interviews identified several potential influences on pregnancy attitudes: barriers associated with homelessness, readiness to settle down, desire to achieve goals, belief that a child would create something positive in life, and family and partners. In the survey, having positive attitudes toward pregnancy was positively associated with duration of homelessness (odds ratio, 1.6), contact with relatives (1.1) and relationship commitment (1.8); it was negatively associated with frequency of drinking (0.9). Relationship commitment was positively associated with nonuse of an effective contraceptive method at last sex (1.5). Effective and accessible pregnancy prevention and family planning programs for homeless youth are needed. Youths' ambivalence toward pregnancy and feelings of relationship commitment warrant attention as possible areas for programs to address. Copyright © 2012 by the Guttmacher Institute.

  2. Inconsistency in serial choice decision and motor reaction times dissociate in younger and older adults.

    PubMed

    Bunce, David; MacDonald, Stuart W S; Hultsch, David F

    2004-12-01

    Intraindividual variability (inconsistency) in reaction time (RT) latencies was investigated in a group of younger (M=25.46 years) and older (M=69.29 years) men. Both groups performed 300 trials in 2-, 4-, and 8-choice RT conditions where RTs for decision and motor components of the task were recorded separately. A dissociation was evident in that inconsistency was greater in older adults for decision RTs when task demands relating to the number of choices and fatigue arising from time-on-task were high. For younger persons, a weak trend toward greater inconsistency in motor RTs was evident. The results are consistent with accounts suggesting that inconsistency in neurobiological mechanisms increases with age, and that attentional lapses or fluctuations in executive control contribute to RT inconsistency.

  3. Younger Adults Show Long-Term Effects of Cognitive Training on Broad Cognitive Abilities over 2 Years

    ERIC Educational Resources Information Center

    Schmiedek, Florian; Lövdén, Martin; Lindenberger, Ulman

    2014-01-01

    In the COGITO study (Schmiedek, Lövdén, & Lindenberger, 2010), 101 younger adults practiced 12 tests of perceptual speed, working memory, and episodic memory for over 100 daily 1-hr sessions. The intervention resulted in positive transfer to broad cognitive abilities, including reasoning and episodic memory. Here, we examine whether these…

  4. Reflections of Distraction in Memory: Transfer of Previous Distraction Improves Recall in Younger and Older Adults

    ERIC Educational Resources Information Center

    Thomas, Ruthann C.; Hasher, Lynn

    2012-01-01

    Three studies explored whether younger and older adults' free recall performance can benefit from prior exposure to distraction that becomes relevant in a memory task. Participants initially read stories that included distracting text. Later, they studied a list of words for free recall, with half of the list consisting of previously distracting…

  5. Lessons from the Homeless: Civil and Uncivil Interactions with Nurses, Self-Care Behaviors, and Barriers to Care.

    PubMed

    Woith, Wendy M; Kerber, Cindy; Astroth, Kim S; Jenkins, Sheryl H

    2017-07-01

    Civility, rooted in social justice, is a fundamental value of nursing. Homeless people are particularly at risk for experiencing uncivil behavior from nurses. The purpose of this study was to explore homeless people's perceptions of their interactions with nurses. In this descriptive, qualitative study, we interviewed 15 homeless adults who described their experiences with nurses. The interview guide, developed by the researchers, consisted of open-ended questions and probes. Transcriptions and field notes were analyzed through thematic analysis. Three major themes emerged: nurses should be civil, self-care behaviors, and barriers to good care. Subthemes included listening, compassion, attentiveness, and judgment as components of civility; where they go for care and who cares for them as self-care behaviors; and lack of money and homeless status as barriers to care. Our findings indicate people who are homeless often perceive nurses to be uncivil and uncaring toward them; furthermore, our participants provide a unique description of healthcare interactions from the perspective of the homeless. These findings can be used as a basis for the development of education interventions for students and practicing nurses to assist them in learning to provide civil and compassionate care for the homeless. © 2016 Wiley Periodicals, Inc.

  6. The effect of lifetime fluoridation exposure on dental caries experience of younger rural adults.

    PubMed

    Crocombe, L A; Brennan, D S; Slade, G D; Stewart, J F; Spencer, A J

    2015-03-01

    The aim of this study was to confirm whether the level of lifetime fluoridation exposure is associated with lower dental caries experience in younger adults (15-46 years). Data of the cohort born between 1960 and 1990 residing outside Australia's capital cities from the 2004-2006 Australian National Survey of Adult Oral Health were analysed. Residential history questionnaires were used to determine the percentage of each person's lifetime exposure to fluoridated water (<50%/50+%). Examiners recorded decayed, missing and filled permanent teeth (DMFT). Socio-demographic variables, periodontal risk factors, and access to dental care were included in multivariable least-squares regression models. In bivariate analysis, the higher level of fluoridation category had significantly lower DMFT (mean 6.01 [SE=0.62]) than the lower level of fluoridation group (9.14 [SE=0.73] p<0.01) and lower numbers of filled teeth (4.08 [SE=0.43], 7.06 [SE=0.62], p<0.01). In multivariate analysis, the higher number of full-time equivalent dentists per 100,000 people was associated with a lower mean number of missing teeth (regression coefficient estimate=-1.75, p=0.03), and the higher level of water fluoridation with a lower mean DMFT (-2.45, p<0.01) and mean number of filled teeth (-2.52, p<0.01). The higher level of lifetime fluoridation exposure was associated with substantially lower caries experience in younger rural adults, largely due to a lower number of filled teeth. © 2015 Australian Dental Association.

  7. Can Better National Policy End Family Homelessness?

    ERIC Educational Resources Information Center

    Roman, Nan

    2010-01-01

    An understanding of the close link between federal policy and family homelessness is critical for ensuring that one day no child in the United States is homeless. This article discusses the nature of family homelessness, the national policy framework that exists to help vulnerable families, the homeless assistance system that federal policy has…

  8. A Comparison of Weight-Related Behaviors among High School Students Who Are Homeless and Non-Homeless

    ERIC Educational Resources Information Center

    Fournier, Mary E.; Austin, S. Bryn; Samples, Cathryn L.; Goodenow, Carol S.; Wylie, Sarah A.; Corliss, Heather L.

    2009-01-01

    Background: Previous research has shown that youth who are homeless engage in high-risk behaviors. However, there has been little information published on nutritional and physical activity behaviors in this population, and studies comparing homeless youth in school with their non-homeless peers are scarce. This study compares weight-related risk…

  9. Families’ Experiences of Doubling Up After Homelessness

    PubMed Central

    Bush, Hannah; Shinn, Marybeth

    2017-01-01

    This study examined experiences of doubling up among families after episodes of homelessness. Doubling up refers to two or more adults or families residing in the same housing unit, which has been an increasing trend in the United States in recent decades. Within the past 14 years, the number of households containing more than one family, related or unrelated, has more than tripled. Although doubling up is increasingly common among families at all income levels, this study seeks to understand the experiences of doubling up among families who have been homeless. Through qualitative interviews with caregivers of 29 families, we analyzed advantages and disadvantages of doubling up with the caregiver’s parent, other family, and nonfamily. Experiences were rated on a four-point scale—(1) mostly negative, (2) negative mixed, (3) positive mixed, and (4) mostly positive—and coded for various positive and negative themes. Overall, we found that doubling up was a generally negative experience for families in our sample, regardless of their relationship to their hosts. Common themes included negative effects on children, undesirable environments, interpersonal tension, and feelings of impermanence and instability. For formerly sheltered families in this study, doubling up after shelter did not resolve their period of housing instability and may be only another stop in an ongoing cycle of homelessness. PMID:29326758

  10. Overrepresentation of Women Veterans Among Homeless Women

    PubMed Central

    Gamache, Gail; Rosenheck, Robert; Tessler, Richard

    2003-01-01

    Objectives. This study estimated the proportion of veterans among homeless women and their risk of homelessness relative to that of nonveterans. Methods. Data came from 2 surveys of homeless women (1 clinical and 1 nonclinical) and 1 survey of domiciled women. Results. The proportion of veterans (4.4%, 3.1%) among homeless women was greater than the proportion among domiciled women (1.3%, 1.2%). When we computed odds ratios for being a veteran among homeless women compared with nonhomeless women, homeless women were significantly more likely than nonhomeless women to be veterans. Conclusions. Women veterans are at greater risk for homelessness than are nonveterans. Further study is needed to determine whether increased risks for veterans are a product of military service or reflect volunteers’ self-selection into the armed forces. (Am J Public Health. 2003;93:1132–1136) PMID:12835198

  11. Digital Clock Drawing: differentiating "thinking" versus "doing" in younger and older adults with depression.

    PubMed

    Cohen, Jamie; Penney, Dana L; Davis, Randall; Libon, David J; Swenson, Rodney A; Ajilore, Olusola; Kumar, Anand; Lamar, Melissa

    2014-10-01

    Psychomotor slowing has been documented in depression. The digital Clock Drawing Test (dCDT) provides: (i) a novel technique to assess both cognitive and motor aspects of psychomotor speed within the same task and (ii) the potential to uncover subtleties of behavior not previously detected with non-digitized modes of data collection. Using digitized pen technology in 106 participants grouped by Age (younger/older) and Affect (euthymic/unmedicated depressed), we recorded cognitive and motor output by capturing how the clock is drawn rather than focusing on the final product. We divided time to completion (TTC) for Command and Copy conditions of the dCDT into metrics of percent of drawing (%Ink) versus non-drawing (%Think) time. We also obtained composite Z-scores of cognition, including attention/information processing (AIP), to explore associations of %Ink and %Think times to cognitive and motor performance. Despite equivalent TTC, %Ink and %Think Command times (Copy n.s.) were significant (AgeXAffect interaction: p=.03)-younger depressed spent a smaller proportion of time drawing relative to thinking compared to the older depressed group. Command %Think time negatively correlated with AIP in the older depressed group (r=-.46; p=.02). Copy %Think time negatively correlated with AIP in the younger depressed (r=-.47; p=.03) and older euthymic groups (r=-.51; p=.01). The dCDT differentiated aspects of psychomotor slowing in depression regardless of age, while dCDT/cognitive associates for younger adults with depression mimicked patterns of older euthymics.

  12. The Jailing of America's Homeless: Evaluating the Rabble Management Thesis

    ERIC Educational Resources Information Center

    Fitzpatrick, Kevin M.; Myrstol, Brad

    2011-01-01

    The authors of this article test hypotheses derived from Irwin's rabble management thesis. The analysis uses data from 47,592 interviews conducted with jailed adults in 30 U.S. cities as part of the Arrestee Drug Abuse Monitoring program. Clearly, homeless persons are overrepresented among those arrested and booked into local jails. Bivariate…

  13. Parenting while Being Homeless

    ERIC Educational Resources Information Center

    Swick, Kevin J.; Williams, Reginald; Fields, Evelyn

    2014-01-01

    This article explores the dynamics of parenting while being in a homeless context. The mosaic of stressors involved in this homeless parenting process are explicated and discussed. In addition, resources and strategies that may support parenting are presented and discussed.

  14. Understanding the Homeless: From Research to Action.

    ERIC Educational Resources Information Center

    Baumann, Donald; Grigsby, Charles

    A study was conducted to examine the homeless population of Austin, Texas and to determine who the homeless were, how they became homeless, how they saw themselves and others, what their needs were, and how they were being served by agencies. Survey data were collected from 500 homeless persons. This document summarizes findings from 3 years of…

  15. Prevalence of Homelessness in the Emergency Department Setting.

    PubMed

    Feldman, Brett J; Calogero, Cristina G; Elsayed, Kareem S; Abbasi, Osman Z; Enyart, Joshua; Friel, Timothy J; Abunamous, Yasir H; Dusza, Stephen W; Greenberg, Marna Rayl

    2017-04-01

    According to the National Alliance to End Homelessness, the national rate of homelessness has been cited as 17.7 homeless people/10,000 people in the general population, and 24.8 homeless veterans/10,000 veterans in the general population. However, it is unknown what the prevalence of homelessness is in the emergency department (ED) setting. We set out to determine the prevalence of homelessness or at risk for homelessness in the ED setting. Using a five-question screening tool derived from the U.S. Department of Housing and Urban Development, Health and Human Services and the Veterans Administration definition for homelessness, we surveyed all patients meeting inclusion/exclusion criteria on scheduled shifts in one of three EDs in Northeastern Pennsylvania. To participate, subjects had to be a registered patient in the ED, be 18 years or older, speak English, have the capacity to answer survey questions, not be critically ill, be willing to participate, and not have taken the survey before. We selected two survey periods to represent seasonal variations. We included 4,395 subjects in the analysis. The mean age of those who screened positive for homelessness or at risk for homelessness was 43.1 (SD 16.6). Overall, 136 (3.1%) participants screened positive for at risk for homelessness and 309 (7.0%) screened positive for homelessness. A total of 103 subjects (9.8%) screened positive for homelessness or at risk for homelessness on weekends and 312 (10.3%) on weekdays (p=0.64). The proportion of those screening positive for homelessness or at risk for homelessness varied by site: 145 (7.5%) at the trauma center, 151(9.1%) at the suburban site, and 149 (18.7%) at the center city site, p<0.001.There was no statistical significance to the difference between the trauma center and the suburban site (p=.088), but there was statistical significance between both the suburban and the trauma center when compared to the center city site (both p<0.0001). The proportion of those

  16. The lived experiences of homeless men.

    PubMed

    Lafuente, C R; Lane, P L

    1995-01-01

    To investigate the phenomenon of social disaffiliation in homeless men, a qualitative study was conducted that used a framework of Bahr's (1973) social disaffiliation theory. Ten homeless men were interviewed to determine their reasons for becoming homeless, their feelings about being homeless, and the specific resources they used for maintaining life on the streets. Using a semistructured interview, audiotapes were made of the responses of the 10 men, 20 to 61 years old, who were using a shelter for the homeless in a U.S. southern city. For data analysis, Giorgi's phenomenological approach (cited in Omery, 1983) was used. Activities and resources that the men used to meet their social, economic, and other needs were described. The following three major themes were identified: rejection, uncertainty, and social isolation. Recommendations include changing nursing curricula and conducting staff development programs, testing interventions to alleviate social isolation, and assisting the homeless to return to the societal mainstream.

  17. Comparison of Homeless and Non-Homeless Problem Drug Users Recruited from Primary Care Safety-Net Clinics.

    PubMed

    Krupski, Antoinette; Graves, Meredith C; Bumgardner, Kristin; Roy-Byrne, Peter

    2015-11-01

    The present study of homeless non-treatment-seeking problem drug users was designed to complement and extend previous studies which focused exclusively on treatment-seeking homeless problem drug users. Data were available for 866 primary care patients with drug problems, 30% homeless and 70% housed. In the 2 years prior to baseline, homeless participants had less chronic medical co-morbidity than problem drug users who were housed yet were significantly more likely to have used emergency department services, to have used them more frequently, and at higher cost. Compared to their housed counterparts, homeless participants were also more likely to have been admitted to specialized chemical dependency treatment and/or detoxification services, to have been arrested for a felony or gross misdemeanor, and to report having psychiatric problems in the prior 30 days. Additional support may be necessary for homeless patients presenting in primary care to benefit from substance abuse treatment given their more severe drug use problems coupled with their co-morbid health, psychiatric, and psychosocial problems. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Effectiveness of case management for homeless persons: a systematic review.

    PubMed

    de Vet, Renée; van Luijtelaar, Maurice J A; Brilleslijper-Kater, Sonja N; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D; Wolf, Judith R L M

    2013-10-01

    We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized controlled trials or quasi-experimental studies comparing case management to other services. We found little evidence for the effectiveness of ICM. SCM improved housing stability, reduced substance use, and removed employment barriers for substance users. ACT improved housing stability and was cost-effective for mentally ill and dually diagnosed persons. CTI showed promise for housing, psychopathology, and substance use and was cost-effective for mentally ill persons. More research is needed on how case management can most effectively support rapid-rehousing approaches to homelessness.

  19. So You Think You Look Young? Matching Older Adults' Subjective Ages with Age Estimations Provided by Younger, Middle-Aged, and Older Adults

    ERIC Educational Resources Information Center

    Kotter-Gruhn, Dana; Hess, Thomas M.

    2012-01-01

    Perceived age plays an important role in the context of age identity and social interactions. To examine how accurate individuals are in estimating how old they look and how old others are, younger, middle-aged, and older adults rated photographs of older target persons (for whom we had information about objective and subjective age) in terms of…

  20. Homelessness and Its Effects on Children.

    ERIC Educational Resources Information Center

    Hart-Shegos, Ellen

    Homelessness influences every facet of children's lives, inhibiting their physical, emotional, cognitive, social, and behavioral development. Homeless women face such obstacles to healthy pregnancies as chemical abuse, chronic health problems, and lack of prenatal care. Homeless infants are more likely to have low birth weights and are at greater…