Retrospective Study of a Toronto-Based Palliative Care Program for Individuals Experiencing Homelessness.

Background: Individuals experiencing homelessness face increased morbidity and mortality. The Canadian Toronto-based Palliative Education and Care for the Homeless (PEACH) program was launched to better support those experiencing homelessness with life-limiting illness. Objective: To describe the population served by PEACH. Methods: A chart review of deceased clients from 2014 to 2017 was conducted. Results: Sixty-three individuals were included in the analysis. 85.7% were male and the median age was 60 years. 35.4% resided in shelters, 26.2% in supportive/transitional housing; only 3.2% were sleeping on the streets. Cancer was the most common diagnosis (61.9%). 58.7% of clients had mental health diagnoses and 61.9% endorsed substance use. Locations of death included palliative care unit and hospice (44.4%), hospital (23.8%), supportive housing (12.6%), and shelter (7.9%). Discussion: PEACH serves diverse clientele with unique care needs. This study will inform further palliative care research and interventions for those experiencing homelessness.

Methyl group rotation, 1H spin-lattice relaxation in an organic solid, and the analysis of nonexponential relaxation.

We report (1)H spin-lattice relaxation measurements in polycrystalline 4,4'-dimethoxybiphenyl at temperatures between 80 and 300 K at NMR frequencies of ω(0)/2π = 8.50, 22.5, and 53.0 MHz. The data are interpreted in terms of the simplest possible Bloch-Wangsness-Redfield methyl group hopping model. Different solid states are observed at low temperatures. The (1)H spin-lattice relaxation is nonexponential at higher temperatures where a stretched-exponential function fits the data very well, but this approach is phenomenological and not amenable to theoretical interpretation. (We provide a brief literature review of the stretched-exponential function.) The Bloch-Wangsness-Redfield model applies only to the relaxation rate that characterizes the initial (1)H magnetization decay in a high-temperature nonexponential (1)H spin-lattice relaxation measurement. A detailed procedure for determining this initial relaxation rate is described since large systematic errors can result if this is not done carefully.