Understanding Homelessness Among Young People to Improve Outcomes.

In the United States, an estimated 4.2 million young people experience homelessness during critical stages in their development-adolescence and emerging adulthood. While research on youth homelessness often emphasizes risk and vulnerability, the field must situate these issues within the developmental trajectories of adolescence and emerging adulthood to effectively prevent and end youth homelessness. This review uses the Risk Amplification and Abatement Model (RAAM) as a conceptual framework for contextualizing the landscape of youth homelessness research in the United States since 2010. An extension of ecological models of risk-taking, RAAM emphasizes both risk and resilience, positing that negative as well as positive socialization processes across interactions with family, peers, social services, and formal institutions affect key housing, health, and behavioral outcomes for youth experiencing homelessness. This review applies RAAM to our understanding of the causes and consequences of youth homelessness, recent interventions, and recommendations for future directions. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 20 is May 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Primary medication nonadherence rates to specialty disease-modifying antirheumatic drugs for rheumatoid arthritis within a health system specialty pharmacy.

BACKGROUND: Assessing primary medication nonadherence, the rate at which a medication is prescribed for a patient but is not obtained or replaced with an alternative medication within a reasonable time period, can provide a better understanding of the frequency and impact of these barriers to medication access. Previous literature has reported high rates of primary medication nonadherence, ranging from approximately 20% to 55% in patients with rheumatoid arthritis (RA) treated with specialty disease-modifying antirheumatic drugs (DMARDs). The high primary medication nonadherence rate may reflect the difficulties associated with obtaining specialty medications, such as high costs, extended prior authorizations, and pretreatment safety requirements. OBJECTIVE: To evaluate reasons for and rates of primary medication nonadherence to specialty DMARDs in patients with RA referred to an integrated health systems specialty pharmacy. METHODS: We conducted a retrospective cohort study examining eligible patients with a specialty DMARD referral from a health system rheumatology provider to the health system specialty pharmacy. Initially, pharmacy claims were used to identify primary medication nonadherence, defined as the lack of a fill event within 60 days following the medication referral for patients without a specialty DMARD claim in the 180 days prior. Referrals from July 1, 2020, to July 1, 2021, were eligible. Exclusion criteria included duplicate referrals, use for non-RA indications, switches to clinic-administered therapies, and alternate filling methods. Medical record reviews were conducted to confirm referral outcomes. Outcomes included rate of and reasons for primary medication nonadherence. RESULTS: We included 480 eligible patients, 100 of whom had no documented fill event. After medical record review, 27 patients were removed due to having a non-RA diagnosis and 65 patients were removed due to having alternative fill methods, most due to external prescription routing (83.1%). The final primary medication nonadherence rate was 2.1%. Out of the 8 cases of true primary medication nonadherence, 3 patients held specialty DMARD therapy because of other existing disease states, 3 patients were unreachable, and 2 patients were unable to afford medication. CONCLUSIONS: Rates of primary medication nonadherence to specialty DMARDs were low in patients with RA managed by a health system specialty pharmacy. A total of 8 primary medication nonadherence cases were related to safety concerns in non-RA diseases states, patient unreachability, and affordability. However, the limited number of primary medication nonadherence cases limits the generalizability of reasons for primary medication nonadherence found in this study. Key elements of the health systems specialty pharmacy model that likely contribute to low primary medication nonadherence include dedicated financial assistance navigation services, in-clinic pharmacist availability, and open communication between provider offices.

Infected grasses as inoculum for Fusarium infestation and mycotoxin accumulation in wheat with and without irrigation.

Grasses growing next to agricultural fields influence the Fusarium abundance, the species composition, and the mycotoxin accumulation of wheat plants, especially the field parts directly adjacent to grasses, are highly affected. Grasses are a more attractive and suitable habitat for Fusarium fungi compared to other arable weeds and occur at mostly every semi-natural landscape element (e.g., kettle holes, hedgerows, field-to-field-borders). In our study, we analyzed the ability of a highly Fusarium infected grass stripe (F. graminearum, F. culmorum, F. sporotrichioides) to infect an adjacent wheat field with these species. Results show that the primary inoculated Fusarium species were as well the dominant species isolated from the wheat field. Regarding transects originating from the grass stripe going into the field, the results demonstrate that wheat ears next to the infected grass stripe have a higher Fusarium abundance and furthermore show higher mycotoxin accumulation in the wheat kernels. This effect was highly promoted by irrigation. Therefore, grass stripes next to arable fields must be considered as reservoirs for fungal infections and as a source for a contamination with mycotoxins.

Discursos dos cursos da área da saúde sobre gênero e biotecnologias no âmbito da formação / Discursos de los cursos de salud sobre género y biotecnologías en el contexto de la formación / Discourses of health courses on gender and biotechnologies in the context of training

RESUMO Objetivo: investigar os discursos sobre gênero e biotecnologias no âmbito da formação dos cursos da área da saúde. Metodologia: trata-se de uma pesquisa qualitativa exploratória descritiva que está alicerçada em um estudo maior - projeto de pesquisa - desenvolvido pelo Grupo de Estudos e Pesquisas em Saúde (GEPS), intitulado "Gênero e Biotecnologias: Interfaces entre discursos e instituições na formação de alunos dos cursos da área da saúde". A pesquisa ocorreu entre os meses de março e outubro de 2019, sendo realizada por meio de entrevistas semiestruturadas com estudantes brasileiros e espanhóis da área da saúde, gravadas em áudio e transcritas para Análise do Discurso. Resultados e Discussão: os achados indicam que Gênero e Biotecnologia são temáticas que não subsidiam as discussões da formação de futuros profissionais da saúde, mostrando um entendimento de gênero centrado numa norma binária, não havendo espaço para outras possibilidades identitárias, além de a heterossexualidade ser vista como padrão de comportamento a ser seguido. Percebe-se uma certa complexidade na formulação dos discursos dos estudantes no que se refere aos aspectos em que gênero e biotecnologias escapam da relação entre corpo biológico e utilização tecnológica para esses enquadramentos físicos e mentais. Considerações Finais: as discussões sobre gênero e biotecnologias nas universidades estudadas têm sido realizadas de forma isolada, sendo necessária uma reestruturação de seus currículos de modo que os temas apresentados passem a ser contemplados para que, efetivamente, componham a formação equitativa e integral de profissionais.

RESUMEN Objetivo: investigar los discursos sobre género y biotecnologías en el contexto de la formación de los cursos de salud. Metodología: se trata de una investigación exploratoria descriptiva cualitativa que se basa en un estudio más amplio -proyecto de investigación- desarrollado por el Grupo de Estudios e Investigación en Salud (GEPS), titulado: "Género y Biotecnologías: Interfaces entre discursos e instituciones en la formación de estudiantes de cursos de salud", que se produjo entre los meses de marzo y octubre de 2019 a través de entrevistas semiestructuradas, con estudiantes de salud brasileños y españoles, grabadas en audio y transcritas para el Análisis del Discurso. Resultados y discusión: los hallazgos indican que el Género y la Biotecnología son temas que no subsidian las discusiones de la formación de los futuros profesionales de la salud, mostrando una comprensión del género centrada en una norma binaria en la que no hay espacio para otras posibilidades de identidad y la heterosexualidad como norma de comportamiento a seguir. Se percibe cierta complejidad en la formulación de los discursos de los estudiantes, en cuanto a los aspectos en los que el género y las biotecnologías escapan de la relación entre el cuerpo biológico y el uso de la tecnología para estos marcos físicos y mentales. Consideraciones finales: las discusiones sobre género y biotecnologías en las universidades brasileñas y españolas se han llevado a cabo de forma aislada, y es necesario reestructurar estos planes de estudio para que los temas presentados puedan ser contemplados en los planes de estudio para que efectivamente compongan la formación equitativa e integral de los profesionales.

ABSTRACT Objective: to investigate the discourses on gender and biotechnologies within the training of health courses. Methodology: this is a qualitative, exploratory, and descriptive study that is based on a larger study - a research project - developed by the Studies and Research Group in Health (GEPS), entitled "Gender and Biotechnologies: Interfaces between discourses and institutions in the training of students from health courses." The research took place between March and October 2019 and was carried out through semi-structured interviews with Brazilian and Spanish health students, audio-recorded, and transcribed for Discourse Analysis. Results and Discussion: the findings indicate that Gender and Biotechnology are themes that do not subsidize the discussions of the training of future health professionals, showing an understanding of gender centered on a binary norm, with no space for other identity possibilities besides heterosexuality being seen as a standard of behavior to be followed. A certain complexity is perceived in the formulation of the students' speeches regarding the aspects in which gender and biotechnologies escape from the relationship between the biological body and the technological use for these physical and mental frameworks. Final Considerations: the discussions about gender and biotechnologies in the studied universities have been carried out in an isolated way, making it necessary to restructure their curricula so that the themes presented can be contemplated to effectively compose the equitable and integral formation of professionals.

The application of GIS in homelessness research and service delivery: A qualitative systematic review.

GIS is increasingly popular in the study of complex social issues, such as homelessness. This study aims to assess how GIS has been leveraged and applied to homelessness research and service delivery. Systematic searching of sixteen databases was completed between January and March of 2021 using the terms "homeless" and "Geospatial Information Systems (GIS)." A final sample of 19 sources were identified from a total of 1719 identified sources. Through quantitative and qualitative methods, the included sources examined 1) static location characteristics associated with homelessness, and 2) mobility of homeless persons.

Who Is Couch-Surfing and Who Is on the Streets? Disparities Among Racial and Sexual Minority Youth in Experiences of Homelessness.

PURPOSE: Youth experiencing homelessness (YEH) often engage in "couch-surfing," or frequently moving from one tenuous living arrangement to another. Understanding the characteristics and risk factors associated with couch-surfing is necessary to designing adequate responses to youth homelessness. The present study aims to investigate factors associated with youth at risk of couch-surfing or sleeping on the streets relative to staying in a shelter. METHODS: The present study used Homeless Management Information System administrative data sourced from 16 communities across the U.S. between January 2015 and February 2017 (n = 9,417). Multinomial logistic regression models were used to explore correlates (e.g., demographics, homeless histories, risk and victimization, behavioral health, and self-sufficiency) of couch-surfing or sleeping on the streets relative to staying in an emergency shelter program. RESULTS: YEH identifying as female; Black or another non-Latinx youth of color; or as lesbian, gay, bisexual, questioning, or another sexual orientation (LGBQ+) were at greater risk of couch-surfing relative to staying in a shelter. YEH who threatened to harm themselves or others in the preceding 12 months or who attributed their homelessness to an abusive relationship were significantly more likely to either be couch-surfing or on the streets. DISCUSSION: Service providers must recognize and validate the vulnerabilities and risks experienced by couch-surfing YEH in order to help reduce barriers to accessing services faced by this population. Federal definitions of homelessness should be aligned to correct systemic biases and more accurately reflect the realities of how youth experience homelessness.

Correlates of Housing Sustainability Among Youth Placed Into Permanent Supportive Housing and Rapid Re-Housing: A Survival Analysis.

PURPOSE: Youth experiencing homelessness (YEH) are vulnerable to multiple adverse health outcomes. Connecting YEH with housing is critical to addressing youth homelessness and to preventing long-term negative health consequences among this vulnerable population. Using administrative data, this study aims to explore correlates of YEH's sustainability in two major housing programs: permanent supportive housing (PSH) and rapid re-housing (RRH) programs. METHODS: This study used Homelessness Management Information System administrative data collected from 16 communities across the U.S. between January 1, 2015 and May 1, 2017 (n = 10,902). We conducted Cox proportional hazards survival analyses to explore correlates (e.g., demographics, homeless experiences, and overall vulnerability) of YEH's PSH (n = 577) and RRH (n = 2,883) sustainability separately. RESULTS: For YEH receiving PSH, only individuals' level of vulnerability is associated with greater hazard of exiting PSH. As for RRH sustainability, YEH who were 17 years old or younger, black or Latinx (as compared to white), of higher level of vulnerability, or previously spent most nights couch surfing or in transitional living programs (as compared to on the street) are associated with higher hazard of exiting RRH. CONCLUSIONS: Both PSH and RRH programs should incorporate comprehensive services targeting youth experiencing high vulnerability to prevent them from re-entering homelessness. Future RRH programming should also address housing sustainability disparities faced by racial and ethnic minority YEH, especially when they are disproportionately influenced by homelessness. Finally, RRH programs should incorporate services to foster independent living among younger YEH to sustain their housing status once temporary housing subsidies expire.

Collagen I Promotes Adipocytogenesis in Adipose-Derived Stem Cells In Vitro.

A hallmark of ageing is the redistribution of body fat. Particularly, subcutaneous fat decreases paralleled by a decrease of skin collagen I are typical for age-related skin atrophy. In this paper, we hypothesize that collagen I may be a relevant molecule stimulating the differentiation of adipose-derived stem cells (ASCs) into adipocytes augmenting subcutaneous fat. In this context lipogenesis, adiponectin, and collagen I receptor expression were determined. Freshly isolated ASCs were characterized by stemness-associated surface markers by FACS analysis and then transdifferentiated into adipocytes by specific medium supplements. Lipogenesis was evaluated using Nile Red staining and documented by fluorescence microscopy or quantitatively measured by using a multiwell spectrofluorometer. Expression of adiponectin was measured by real-time RT-PCR and in cell-free supernatants by ELISA, and expression of collagen I receptors was observed by western blot analysis. It was found that supports coated with collagen I promote cell adhesion and lipogenesis of ASCs. Interestingly, a reverse correlation to adiponectin expression was observed. Moreover, we found upregulation of the collagen receptor, discoidin domain-containing receptor 2; receptors of the integrin family were absent or downregulated. These findings indicate that collagen I is able to modulate lipogenesis and adiponectin expression and therefore may contribute to metabolic dysfunctions associated with ageing.

A case of Satoyoshi syndrome: a multisystem disorder.

A 14-year-old boy with Satoyoshi syndrome is reported. Less than 50 patients with Satoyoshi syndrome have been reported in the world literature. This patient had alopecia, muscle spasms, and skeletal abnormalities, which are three of the most common clinical features of Satoyoshi syndrome. Despite extensive laboratory evaluation, an alternate explanation was not documented for the cluster of clinical findings in this patient. Immune dysregulation is believed to be an underlying mechanism for the development of Satoyoshi syndrome. In contrast to some reports, this patient failed to respond to intravenous immunoglobulin therapy. However, he responded dramatically to steroids.