Examining the Role of Duration and Frequency of Homelessness on Health Outcomes Among Unsheltered Young Adults.

PURPOSE: We examined the impact of duration and number of homelessness episodes on health outcomes for unsheltered homeless young adults. METHODS: We analyzed the 2018/2019 Los Angeles County homeless youth demographic surveys. We addressed five summary health outcomes: physical health, mental health, substance use disorder, tri-morbidity, and any condition. Respondents were classified into three homeless trajectory groups: (1) short-term-homeless < 1 year in one episode, (2) episodic-homeless < 1 year and multiple episodes, and (3) long-term-homeless continuously for > 1 year. Weighted bivariate and multivariate logistic regression models tested the relationship between homeless trajectory group and health, with controls for sociodemographic factors and structural exposures. RESULTS: Mental health and substance use were high among unsheltered young adults compared to national rates. Long-term homeless respondents were significantly more likely than short-term to report a mental health condition (53.3% vs. 39.8%, p < .001), substance use disorder (25.5% vs. 18.3%, p < .001), and physical conditions (26.0% vs. 15.6%, p = .008). Episodic respondents were more likely to report a mental health condition (50.5%, p < .001). In multivariate models, long-term respondents had twice the odds of tri-morbidity (odds ratio [OR] = 2.14, p < .05) and any health condition (OR 2.00, p < .01) as short term and significantly higher odds of a physical health condition (OR = 1.64, p < .05). DISCUSSION: Youth with longer durations and more frequent episodes of homelessness have substantially poorer health outcomes. The association of longer duration to poorer health persisted in multivariate models. Longer duration of unsheltered homelessness may drive the onset of physical and mental health problems.

Race and Ethnicity and Sex Variation in COVID-19 Mortality Risks Among Adults Experiencing Homelessness in Los Angeles County, California.

Importance: Few studies have used precise age-specific data to construct age-standardized estimates of the relative risks (RRs) of COVID-19 mortality for people experiencing homelessness (PEH) vs the general population, and none to date has addressed race and ethnicity and sex variations in COVID-19 mortality among PEH with COVID-19 infection. Objective: To measure age-standardized mortality rate ratios for PEH vs the general population overall and by sex and race and ethnicity. Design, Setting, and Participants: In this cross-sectional study, crude and age-specific COVID-19 mortality rates per 100 000 people were calculated using 5-year age groups and standardized mortality ratios for PEH and the general population aged 25 years and older, assessing differences by race and ethnicity and sex, from January 1, 2020, to November 1, 2021. Mortality and population estimates came from COVID-19 mandatory case reporting conducted by the Los Angeles County Department of Public Health, the annual point-in-time homeless count, and the US Census. Main Outcomes and Measures: The main outcome was COVID-19 deaths sourced from clinician reports, death certificates, medical examiner reports, and vital records deaths. PEH status was determined using the US Department of Housing and Urban Development definitions for homelessness at the time of COVID-19 diagnosis or symptom onset. Results: The study population included 25 441 deaths among an estimated 6 382 402 general population individuals and 256 deaths among an estimated 52 015 PEH. The race and ethnicity of the PEH sample was as follows: 15 539 Black (29.9%), 18 057 Hispanic (34.7%), 14 871 female (28.6%), 37 007 male (71.3%), and 3380 aged 65 years or older (6.5%), compared with the estimated general population of 6 382 402, which was 591 003 Black (9.3%), 2 854 842 Hispanic (44.7%), 3 329 765 female (52.2%), 3 052 637 male (47.8%), and 1 190 979 aged 65 years or older (18.7%). Crude death rates were 0.49% for PEH and 0.40% for the general population, but PEH experienced age-specific COVID-19 mortality risk 2.35 (95% CI, 2.08-2.66) times higher than the general population. There was significant risk associated with PEH status compared with their counterparts in the general population for Black PEH (RR, 1.69; 95% CI, 1.31-2.18), Hispanic PEH (RR, 2.34; 95% CI, 1.96-2.79), White PEH (RR, 8.33; 95% CI, 6.37-10.88), female PEH (RR, 3.39; 95% CI, 2.56-4.48), and male PEH (RR, 1.74; 95% CI, 1.52-2.00). Conclusions and Relevance: This cross-sectional study of COVID-19 mortality among PEH with COVID-19 infection provides evidence suggesting excess risk of age-adjusted COVID-19 mortality among PEH compared with the general population. This study furthers understanding of the intersectional association between homelessness and race and ethnicity, as higher levels of mortality but narrower racial disparities among PEH than in the general population were observed.

Unrewarding work and major depressive episode: Cross-sectional and prospective evidence from the U.S. MIDUS study.

Depression is a serious mental health condition and is the leading cause of disability worldwide. Previous research has demonstrated that work stress may contribute to the development of depression through psychophysiological pathways. The present study assessed associations of work stress - in terms of the effort-reward imbalance (ERI) model measuring unrewarding work - with major depressive episode (MDE). Data were from the Mid-life in the United States study, a national, population-based sample of U.S. workers with 9-year follow-up prospective cohort design. The cross-sectional sample at baseline had 2204 workers, and the prospective sample had 1591 workers at follow-up (78.7% follow-up rate). Multivariable Bayesian logistic regression and Poisson regression were applied for examining cross-sectional and prospective associations, respectively. ERI was assessed by a validated 17-item scale at baseline, and MDE in the past 12 months was assessed by the Composite International Diagnostic Interview Short Form at both baseline and follow-up. It was found that ERI at baseline was associated with higher odds of prevalent MDE in the cross-sectional sample (OR = 1.47, HPD interval [1.26-1.69]), and with higher risk of MDE at follow-up in the prospective sample (RR = 1.29, HPD interval [1.01-1.60]). In both cross-sectional and prospective analyses, strongest associations were observed among workers with the highest quartile of ERI, after adjusting for demographic, socioeconomic, lifestyle, and other psychosocial factors. The stable and robust findings strengthen and extend previous findings that unrewarding work is a risk factor of mental health. If confirmed by further evidence, intervention targeting work stress reduction is warranted.

Spiritual Benefit from Cannabis.

Like many mind-altering plants, cannabis has been part of spiritual practices for thousands of years. It has deep roots in Hinduism, Islam, Rastafarianism, and indigenous traditions in Asia, Africa, and elsewhere. Yet almost no attention has been given to how contemporary adults employ it spiritually. A sample of 1087 participants (mean age = 38.9) completed an online survey assessing their use of cannabis and other substances, as well as spiritual and psychological characteristics. Spiritual benefit from cannabis was reported by 66.1% of the sample, and 5.5% reported it had sometimes been a spiritual hindrance. A MANOVA showed that those who reported spiritual benefit differed significantly from those who did not on several outcome variables, and a post hoc descriptive discriminant analysis revealed that expansiveness motivation, non-theistic daily spiritual experience, meditation frequency, and two mindfulness facets contributed most to differentiating the two groups. The majority of the sample (63%) was free of cannabis use disorder. Compared to disordered groups, the non-disordered group was significantly older and scored lower on experiential avoidance, psychological distress, and several motives for use. Results suggest that spiritual motives for cannabis use may be widespread. Implications for future research on spiritual use of cannabis are discussed.

Jean Lau Chin (1944-2020).

Memorializes Jean Lau Chin (1944-2020). Jean was an academic leader. At the time of her death, Jean was Professor of Psychology, Gordon F. Derner School of Psychology, Adelphi University, where she served as Dean for 4 years. Prior to Adelphi, Jean was Dean of the California School of Professional Psychology, Alliant International University, where she administered more than 15 doctoral and master's programs in clinical psychology, marriage and family therapy, and clinical counseling across six campuses in California, Mexico City, Japan, and Hong Kong. She served as President of the National Council of Schools and Programs of Professional Psychology. Jean was also a leader in health and mental health service delivery. She had been the Regional Director, Massachusetts Behavioral Health Partnership; the Executive Director, South Cove Community Health Center in Boston; and Co-Director, the Thom Child Guidance Clinic, Boston. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Unique grief experiences: The needs of emerging adults facing the death of a parent.

Enduring the death of a family member during emerging adulthood is associated with intense grief. In total, 15 adults between the ages of 18-32 were interviewed about their experiences. Results indicated emerging adults experience a range of mixed emotions after losing a parent, face unique challenges related to their developmental stage, and tend to be resilient moving forward. Emerging adults need opportunities to engage with others experiencing grief related to parental death and may benefit from specialized support groups that address the developmental challenges inherent among this population.

Training Dogs to Feel Good: Embodying Well-being in Multispecies Relations.

Social science concepts of well-being are largely premised on notions of a common humanity with shared physical needs and broadly legible experiences of the world. While medical anthropologists have interrogated ideas of universal bodily subjectivities, articulations of well-being across species boundaries remain underexplored. This article offers a conceptualization of well-being that attends to species difference. Drawing on ethnographic research with an animal rescue organization, I argue that in the context of partially connected bodily experiences, rescue workers navigate distinctions between dogs' internal feelings and external actions, and they train their bodies alongside dogs' bodies to cultivate canine well-being. A multispecies perspective complicates ideals of autonomy and self-actualization long associated with well-being and opens up avenues for considering well-being as an intercorporeal relationship conditioned in unequal bodies and embodied interactions.

Damage mechanisms at the cement-implant interface of polished cemented femoral stems.

The occurrence of damage on polished femoral stems has been widely reported in the literature, and bone cement has been implicated in a tribocorrosive failure process. However, the mechanisms of cement-mediated damage and the impact of cement formulation on this process are not well understood. In this study, 13 Zimmer CPT polished femoral stems, and the corresponding cement specimens were retrieved at revision surgery and analyzed using high-resolution imaging techniques. Surface damage attributed to tribocorrosion was observed on all stems. Corrosion product, in the form of black flaky surface debris, was observed on the surface of cement specimens; both energy-dispersive X-ray spectroscopy and inductively coupled plasma mass spectrometry(ICP-MS) confirmed the presence of cobalt and chromium, with the ICP-MS showing much higher levels of Cr compared to Co when compared to the original stem material. Agglomerates of ZrO2 radiopacifier were also identified on the cement surface and, in some cases, showed evidence of abrasive wear; the size of these particles correlated well with elliptical pitting evident on the surfaces of the corresponding stems. This evidence supports the hypothesis that agglomerates of hard radiopacifier particles within the cement may induce a wear-dominated tribocorrosive interaction at the stem-cement interface that damages the surface of polished CoCr femoral stems. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2027-2033, 2017.

Containment and competition: transgenic animals in the One Health agenda.

The development of the One World, One Health agenda coincides in time with the appearance of a different model for the management of human-animal relations: the genetic manipulation of animal species in order to curtail their ability as carriers of human pathogens. In this paper we examine two examples of this emergent transgenic approach to disease control: the development of transgenic chickens incapable of shedding avian flu viruses, and the creation of transgenic mosquitoes refractory to dengue or malaria infection. Our analysis elaborates three distinctions between the One World, One Health agenda and its transgenic counterpoint. The first concerns the conceptualization of outbreaks and the forms of surveillance that support disease control efforts. The second addresses the nature of the interspecies interface, and the relative role of humans and animals in preventing pathogen transmission. The third axis of comparison considers the proprietary dimensions of transgenic animals and their implications for the assumed public health ethos of One Health programs. We argue that the fundamental difference between these two approaches to infectious disease control can be summarized as one between strategies of containment and strategies of competition. While One World, One Health programs seek to establish an equilibrium in the human-animal interface in order to contain the circulation of pathogens across species, transgenic strategies deliberately trigger a new ecological dynamic by introducing novel animal varieties designed to out-compete pathogen-carrying hosts and vectors. In other words, while One World, One Health policies focus on introducing measures of inter-species containment, transgenic approaches derive their prophylactic benefit from provoking new cycles of intra-species competition between GM animals and their wild-type counterparts. The coexistence of these divergent health protection strategies, we suggest, helps to elucidate enduring tensions and concerns about how humans should relate to, appraise, and intervene on animals and their habitats.

Modulation sensitivity in the perceptual organization of speech.

In a spoken utterance, a talker expresses linguistic constituents in serial order. A listener resolves these linguistic properties in the rapidly fading auditory sample. Classic measures agree that auditory integration occurs at a fine temporal grain. In contrast, recent studies have proposed that sensory integration of speech occurs at a coarser grain, approximate to the syllable, on the basis of indirect and relatively insensitive perceptual measures. Evidence from cognitive neuroscience and behavioral primatology has also been adduced to support the claim of sensory integration at the pace of syllables. In the present investigation, we used direct performance measures of integration, applying an acoustic technique to isolate the contribution of short-term acoustic properties to the assay of modulation sensitivity. In corroborating the classic finding of a fine temporal grain of integration, these functional measures can inform theory and speculation in accounts of speech perception.

Challenges to professional psychology education in the 21st century: response to Peterson.

Professional psychology education faces many critical challenges brought about by the major changes occurring in the health care arena. This article shows that professional schools and programs have a good record of responding to these challenges and of taking proactive steps sponding to prepare their graduates for new health care roles and delivery systems. Data on admissions to psychology doctoral training programs demonstrate little support for the toral concerns raised by Donald R. Peterson (2003, this issue) about the preparation of students for graduate training in professional programs. Although quality concerns are important to investigate, such examination best resides with portant the American Psychological Association's Committee on Accreditation, which has the promotion of quality and excellence in professional psychology education and training as its major goal and responsibility.