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1.
Nature ; 621(7977): 94-99, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37468636

RESUMO

The wildland-urban interface (WUI) is where buildings and wildland vegetation meet or intermingle1,2. It is where human-environmental conflicts and risks can be concentrated, including the loss of houses and lives to wildfire, habitat loss and fragmentation and the spread of zoonotic diseases3. However, a global analysis of the WUI has been lacking. Here, we present a global map of the 2020 WUI at 10 m resolution using a globally consistent and validated approach based on remote sensing-derived datasets of building area4 and wildland vegetation5. We show that the WUI is a global phenomenon, identify many previously undocumented WUI hotspots and highlight the wide range of population density, land cover types and biomass levels in different parts of the global WUI. The WUI covers only 4.7% of the land surface but is home to nearly half its population (3.5 billion). The WUI is especially widespread in Europe (15% of the land area) and the temperate broadleaf and mixed forests biome (18%). Of all people living near 2003-2020 wildfires (0.4 billion), two thirds have their home in the WUI, most of them in Africa (150 million). Given that wildfire activity is predicted to increase because of climate change in many regions6, there is a need to understand housing growth and vegetation patterns as drivers of WUI change.


Assuntos
Biomassa , Cidades , Mapeamento Geográfico , Densidade Demográfica , Meio Selvagem , Humanos , Florestas , Incêndios Florestais/prevenção & controle , Incêndios Florestais/estatística & dados numéricos , Urbanização , Cidades/estatística & dados numéricos , África , Europa (Continente) , Habitação/provisão & distribuição , Habitação/tendências , Mudança Climática
2.
Am J Public Health ; 112(2): 277-283, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35080960

RESUMO

Objectives. To develop an approach to project quarantine needs during an outbreak, particularly for communally housed individuals who interact with outside individuals. Methods. We developed a method that uses basic surveillance data to do short-term projections of future quarantine needs. The development of this method was rigorous, but it is conceptually simple and easy to implement and allows one to anticipate potential superspreading events. We demonstrate how this method can be used with data from the fall 2020 semester of a large urban university in Boston, Massachusetts, that provided quarantine housing for students living on campus in response to the COVID-19 pandemic. Our approach accounted for potentially infectious interactions between individuals living in university housing and those who did not. Results. Our approach was able to accurately project 10-day-ahead quarantine utilization for on-campus students in a large urban university. Our projections were most accurate when we anticipated weekend superspreading events around holidays. Conclusions. We provide an easy-to-use software tool to project quarantine utilization for institutions that can account for mixing with outside populations. This software tool has potential application for universities, corrections facilities, and the military. (Am J Public Health. 2022;112(2):277-283. https://doi.org/10.2105/AJPH.2021.306573).


Assuntos
Previsões/métodos , Quarentena/tendências , Software , Boston/epidemiologia , Necessidades e Demandas de Serviços de Saúde/tendências , Habitação/tendências , Humanos , Universidades
3.
J Gerontol B Psychol Sci Soc Sci ; 77(2): 429-434, 2022 02 03.
Artigo em Inglês | MEDLINE | ID: mdl-33247929

RESUMO

OBJECTIVES: Utilizing policy innovation and diffusion theory, this study aims to explain why city governments adopt housing adaptation policies that primarily benefit older people based on the case of China. METHODS: The data are drawn from an event history data set of a housing adaptation policy for older people collected from 283 Chinese cities from 2010 to 2018. Piecewise constant exponential models are utilized. RESULTS: The results indicate that cities facing greater internal pressure and a higher political status are more likely to adopt a housing adaptation policy for older people. Policy adoption by neighboring cities could further facilitate this process. DISCUSSION: Policy innovation and diffusion theory provide a useful framework for this study. That is, the Chinese city government's adoption of housing adaptation policy for older adults is initially driven by local needs and then accelerated by interactions among neighboring governments.


Assuntos
Acessibilidade Arquitetônica , Regulamentação Governamental , Habitação , Vida Independente , Governo Local , Política Pública , Atividades Cotidianas , Idoso , Acessibilidade Arquitetônica/legislação & jurisprudência , Acessibilidade Arquitetônica/métodos , Acessibilidade Arquitetônica/normas , China , Feminino , Habitação/organização & administração , Habitação/normas , Habitação/tendências , Humanos , Vida Independente/psicologia , Vida Independente/normas , Vida Independente/tendências , Perspectiva de Curso de Vida , Masculino , Formulação de Políticas , Política Pública/legislação & jurisprudência , Política Pública/tendências , Participação Social , Desenvolvimento Sustentável/tendências
4.
PLoS One ; 16(7): e0254846, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34283882

RESUMO

The trend towards efficient and intensive use of land resources is an inevitable outcome of current social development. The rational matching of urban land prices and land use intensity has become an important factor under accelerating urbanization, and promotes the healthy development of the social economy. Using data on residential land price and on land use intensity for 31 provinces and cities in China, we employ the E-G cointegration test and quadrant map classification to determine the coordination relationship between land price and land use intensity. We then employ HR coordination to calculate the coordination degree of land price and land use intensity, and classify the coordination type accordingly. Our results are as follows. (1) The spatio-temporal distribution of urban land price shows high variability with multiple maxima, and follows a decreasing trend from the southeast coastal area to the northwest inland area and the northeast. (2) The overall land use intensity is at or above the middle level, and shows large spatial differences between provinces, but the agglomeration between provinces is increasing. (3) From the perspective of the relationship between urban land price and land use intensity at the inter-provincial scale, we find that the land price and land use intensity are well coordinated, and the number of provinces has been dynamically changing during different development periods. There is an east-west difference in the spatial distribution of land price and land use intensity coordination level. Different provinces and cities with the same coordination stage show differences in their land price and land use intensity level.


Assuntos
Desenvolvimento Econômico/tendências , Recursos Naturais/provisão & distribuição , Urbanização/tendências , China , Cidades , Conservação dos Recursos Naturais/economia , Conservação dos Recursos Naturais/métodos , Habitação/economia , Habitação/tendências , Humanos , Mudança Social , Análise Espaço-Temporal
5.
Health Qual Life Outcomes ; 19(1): 128, 2021 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-33882927

RESUMO

BACKGROUND: In health and social service evaluations, including research on homelessness, quality of Life (QOL) is often used as a key indicator of well-being among service users. However, no typology has been developed on changes in QOL over a 12-month period for a heterogenous sample of homeless individuals. METHODS: Cluster analysis was employed to identify a typology of change in QOL for 270 currently or formerly homeless individuals using emergency shelters, temporary housing (TH) and permanent housing (PH) services in Quebec (Canada). Participant interviews were conducted at baseline and 12 months later. An adapted Gelberg-Andersen Model helped organize QOL-related sociodemographic, clinical, and service use variables into predisposing, needs, and enabling factors, respectively. Comparison analyses were performed to determine group differences. RESULTS: Four groups emerged from the analyses: (1) young women in stable-PH or improved housing status with moderately high needs and specialized ambulatory care service use, with improved QOL over 12 months; (2) middle-age to older men with stable housing status, few needs and low acute care service use, with most improvement in QOL over 12 months; (3) older individuals residing in stable-PH or improved housing status with very high needs and reduced QOL over 12 months; and (4) men in stable-TH or worse housing status, with high substance use disorder, using few specialized ambulatory care services and showing decline in QOL over 12 months. CONCLUSIONS: Findings suggest that positive change in QOL over 12 months was mainly associated with fewer needs, and stability in housing status more than housing improvement. Specific recommendations, such as assertive community treatment and harm reduction programs, should be prioritized for individuals with high needs or poor housing status, and among those experiencing difficulties related to QOL, whereas individuals with more favourable profiles could be encouraged to maintain stable housing and use services proportional to their needs.


Assuntos
Habitação/estatística & dados numéricos , Habitação/tendências , Pessoas Mal Alojadas/psicologia , Pessoas Mal Alojadas/estatística & dados numéricos , Qualidade de Vida/psicologia , Adolescente , Adulto , Canadá , Análise por Conglomerados , Feminino , Previsões , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Quebeque , Fatores de Tempo , Adulto Jovem
6.
PLoS One ; 16(3): e0248647, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33735239

RESUMO

As in other countries, short-term rentals for tourism services are growing rapidly in China's tourist cities, which are mainly operated through Airbnb. This paper explores whether the spatial distribution of Airbnb in China's rapid urbanization process exhibits characteristics, paths, and drivers that are different from those of cities in other countries. Airbnb is a model for the global sharing economy, but it is increasingly influenced by other functions and facilities in cities as it grows. In this paper, the zero-expansion negative binomial regression was used to study the factors affecting the spatial distribution of Airbnb in Nanjing, China. The results showed that the spatial distribution of Airbnb listings was correlated with the distribution of cultural attractions, universities, public transport accessibility, shopping centers, and business apartments. By analyzing the driving forces of Airbnb's development in Nanjing, this paper found that a large number of business apartments developed in cities were essential providers of Airbnb listings, and affected its spatial distribution. The gap between short-term and long-term rentals was also correlated with the distribution of Airbnb. In addition, similar to the previous literature findings, the increase in the proportion of professional hosts changes the original intention of Airbnb for sharing and communication. Our empirical results applies to the current situation of Airbnb in Chinese cities, which is conducive to the government's more intelligent management and effective promotion of the Airbnb market. Our findings also provide positive references for urban renewal policies and public participation methods in China.


Assuntos
Habitação/tendências , Turismo , Urbanização/tendências , China , Cidades/estatística & dados numéricos , Geografia , Habitação/estatística & dados numéricos , Humanos , Internet/estatística & dados numéricos , Internet/tendências , Análise Espacial
7.
PLoS One ; 16(3): e0247712, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33760839

RESUMO

In this paper we apply a gravity framework to user-generated data of a large online housing market platform. We show that gravity describes the patterns of inflow and outflow of hits (mouse clicks, etc.) from one municipality to another, where the municipality of the user defines the origin and the municipality of the property that is viewed defines the destination. By distinguishing serious searchers from recreational searchers we demonstrate that the gravity framework describes geographic search patterns of both types of users. The results indicate that recreational search is centered more around the user's location than serious search. However, this finding is driven entirely by differences in border effects as there is no difference in the distance effect. By demonstrating that geographic search patterns of both serious and recreational searchers are explained by their physical locations, we present clear evidence that physical location is an important determinant of economic behavior in the virtual realm too.


Assuntos
Comércio/tendências , Comportamento Exploratório , Habitação/tendências , Modelos Psicológicos , Geografia , Habitação/economia , Humanos , Internet , Países Baixos
8.
PLoS One ; 16(2): e0244953, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33571198

RESUMO

Housing value is a major component of the aggregate expenditure used in the analyses of welfare status of households in the development economics literature. Therefore, an accurate estimation of housing services is important to obtain the value of housing in household surveys. Data show that a significant proportion of households in a typical Living Standard Measurement Survey (LSMS), adopted by the Word Bank and others, are self-owned. The standard approach to predict the housing value for such surveys is based on the rental cost of the house. A hedonic pricing applying an Ordinary Least Squares (OLS) method is normally used to predict rental values. The literature shows that Machine Learning (ML) methods, shown to uncover generalizable patterns based on a given data, have better predictive power over OLS applied in other valuation exercises. We examined whether or not a class of ML methods (e.g. Ridge, LASSO, Tree, Bagging, Random Forest, and Boosting) provided superior prediction of rental value of housing over OLS methods accounting for spatial autocorrelations using household level survey data from Uganda, Tanzania, and Malawi, across multiple years. Our results showed that the Machine Learning methods (Boosting, Bagging, Forest, Ridge and LASSO) are the best models in predicting house values using out-of-sample data set for all the countries and all the years. On the other hand, Tree regression underperformed relative to the various OLS models, over the same data sets. With the availability of abundant data and better computing power, ML methods provide viable alternative to predicting housing values in household surveys.


Assuntos
Previsões/métodos , Habitação/economia , Habitação/provisão & distribuição , Custos e Análise de Custo , Características da Família , Habitação/tendências , Humanos , Aprendizado de Máquina , Malaui , Propriedade , Fatores Socioeconômicos , Tanzânia , Uganda
9.
Int J Environ Health Res ; 31(3): 325-343, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33615929

RESUMO

Ensuring sufficient and adequately maintained housing in Indigenous Australian communities remains an ongoing policy challenge for government, with major implications for the health of Indigenous Australians. This study sought to characterise the current status of housing conditions experienced by Indigenous Australians, with special reference to the Northern Territory. The assessment examined a range of indicators relating to crowding, dwelling condition, 'health hardware', and provision of maintenance and repairs. While acknowledging data deficiencies and inconsistencies, the analysis produced mixed results. There was evidence of a reduction in crowding but little observable improvement in the provision of maintenance and repairs. Some housing-related health outcomes have shown improvement, though these have tended to coincide with mass treatment campaigns. Achieving the goal of healthy homes - and ultimately closing the gap on Indigenous disadvantage - requires further investment in new houses that are appropriately designed and constructed, alongside an increased emphasis on cyclical maintenance.


Assuntos
Nível de Saúde , Habitação/tendências , Havaiano Nativo ou Outro Ilhéu do Pacífico/estatística & dados numéricos , Austrália , Humanos , Northern Territory
10.
JAMA Netw Open ; 4(2): e2036809, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33544146

RESUMO

Importance: Studying long-term changes in neighborhood socioeconomic status (SES) may help to better understand the associations between neighborhood exposure and weight outcomes and provide evidence supporting neighborhood interventions. Little previous research has been done to examine associations between neighborhood SES and weight loss, a risk factor associated with poor health outcomes in the older population. Objective: To determine whether improvements in neighborhood SES are associated with reduced likelihoods of excessive weight gain and excessive weight loss and whether declines are associated with increased likelihoods of these weight outcomes. Design, Study, and Participants: This cohort study was conducted using data from the National Institutes of Health-AARP (formerly known as the American Association of Retired Persons) Diet and Health study (1995-2006). The analysis included a cohort of 126 179 adults (aged 50-71 years) whose neighborhoods at baseline (1995-1996) were the same as at follow-up (2004-2006). All analyses were performed from December 2018 through December 2020. Exposures: Living in a neighborhood that experienced 1 of 8 neighborhood SES trajectories defined based on a national neighborhood SES index created using data from the US Census and American Community Survey. The 8 trajectory groups, in which high, or H, indicated rankings at or above the sample median of a specific year and low, or L, indicated rankings below the median, were HHH (ie, high in 1990 to high in 2000 to high in 2010), or stable high; HLL, or early decline; HHL, or late decline; HLH, or transient decline; LLL, or stable low; LHH, or early improvement; LLH, or late improvement; and LHL, or transient improvement. Main Outcomes and Measures: Excessive weight gain and loss were defined as gaining or losing 10% or more of baseline weight. Results: Among 126 179 adults, 76 225 (60.4%) were men and the mean (SD) age was 62.1 (5.3) years. Improvements in neighborhood SES were associated with lower likelihoods of excessive weight gain and weight loss over follow-up, while declines in neighborhood SES were associated with higher likelihoods of excessive weight gain and weight loss. Compared with the stable low group, the risk was significantly reduced for excessive weight gain in the early improvement group (odds ratio [OR], 0.87; 95% CI, 0.79-0.95) and for excessive weight loss in the late improvement group (OR, 0.89; 95% CI, 0.80-1.00). Compared with the stable high group, the risk of excessive weight gain was significantly increased for the early decline group (OR, 1.19; 95% CI, 1.08-1.31) and late decline group (OR, 1.13; 95% CI, 1.04-1.24) and for excessive weight loss in the early decline group (OR, 1.15; 95% CI, 1.02-1.28). The increases in likelihood were greater when the improvement or decline in neighborhood SES occurred early in the study period (ie, 1990-2000) and was substantiated throughout the follow-up (ie, the early decline and early improvement groups). Overall, we found a linear association between changes in neighborhood SES and weight outcomes, in which every 5 percentile decline in neighborhood SES was associated with a 1.2% to 2.4% increase in the risk of excessive weight gain or loss (excessive weight gain: OR, 1.01; 95% CI, 1.00-1.02 for women; OR, 1.02; 95% CI, 1.01-1.03 for men; excessive weight loss: OR, 1.02; 95% CI, 1.01-1.03 for women; OR, 1.02; 95% CI, 1.01-1.03 for men; P for- trend < .0001). Conclusions and Relevance: These findings suggest that changing neighborhood environment was associated with changes in weight status in older adults.


Assuntos
Trajetória do Peso do Corpo , Características de Residência/estatística & dados numéricos , Classe Social , Idoso , Escolaridade , Etnicidade , Feminino , Habitação/tendências , Humanos , Renda/tendências , Masculino , Pessoa de Meia-Idade , Assistência Pública/tendências , Família Monoparental , Fatores Socioeconômicos , Desemprego/tendências , Estados Unidos , Aumento de Peso , Redução de Peso
11.
Proc Natl Acad Sci U S A ; 118(2)2021 01 12.
Artigo em Inglês | MEDLINE | ID: mdl-33397722

RESUMO

Studies examining the long-term health consequences of residential displacement following large-scale disasters remain sparse. Following the 2011 Japan Earthquake and Tsunami, victims who lost their homes were resettled by two primary means: 1) group relocation to public housing or 2) individual relocation, in which victims moved into public housing by lottery or arranged for their own accommodation. Little is known about how the specific method of residential relocation affects survivors' health. We examined the association between residential relocation and long-term changes in mental and physical well-being. Our baseline assessment predated the disaster by 7 mo. Two follow-up surveys were conducted ∼2.5 y and 5.5 y after the disaster to ascertain the long-term association between housing arrangement and health status. Group relocation was associated with increased body mass index and depressive symptoms at 2.5-y follow-up but was no longer significantly associated with these outcomes at 5.5-y follow-up. Individual relocation at each follow-up survey was associated with lower instrumental activities of daily living as well as higher risk of cognitive impairment. Our findings underscore the potential complexity of long-term outcomes associated with residential displacement, indicating both positive and negative impacts on mental versus physical dimensions of health.


Assuntos
Desastres Naturais/economia , Avaliação de Resultados em Cuidados de Saúde/tendências , Sobreviventes/psicologia , Atividades Cotidianas , Adulto , Idoso , Idoso de 80 Anos ou mais , Terremotos , Feminino , Seguimentos , Nível de Saúde , Habitação/economia , Habitação/tendências , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde/economia , Tsunamis
12.
Psicol. soc. (Online) ; 33: e236675, 2021.
Artigo em Português | LILACS, Index Psicologia - Periódicos | ID: biblio-1351380

RESUMO

Resumo Diante das crises econômicas e ambientais que o mundo tem vivido e do excessivo foco dado à individualização, as ecovilas têm surgido como alternativas contra esses efeitos societários. O artigo tem por objetivo investigar como os estudos sobre ecovilas abordam os modos de governo e os processos de subjetivação existentes na relação dos sujeitos com o coletivo, consigo mesmos e com o meio ambiente. Baseamo-nos na noção foucaultiana de governo de si e dos outros, para compreendermos os processos de subjetivação. Fizemos uma revisão integrativa de artigos que apresentavam relatos de pesquisa empírica. As análises apontam a relação entre governo e processos de subjetivação em ecovilas na medida em que em cada aspecto analisado essa relação implica o exercício do governo de si, do cuidado de si e das práticas de si para que os sujeitos se transformem a fim de atingir os objetivos específicos de cada contexto.


Resumen Ante las crisis económicas y ambientales que ha estado experimentando el mundo y el enfoque excesivo que se le ha dado a la individualización, las ecoaldeas han surgido como alternativas contra estos efectos sociales. El artículo tiene como objetivo investigar cómo los estudios sobre ecoaldeas abordan los modos de gobierno y los procesos de subjetividad existentes en la relación de los sujetos con el colectivo, con ellos mismos y con el medio ambiente. Nos basamos en la noción foucaultiana de gobernarse a uno mismo y a los demás para comprender los procesos de subjetivación. Realizamos una revisión integrativa de artículos que presentaban informes de investigación empírica. Los análisis señalan la relación entre gobierno y procesos de subjetivación en las ecoaldeas en la medida en que en cada aspecto analizado esta relación implica el ejercicio del gobierno de si, el cuidado de si y las prácticas de si para que los sujetos se transformen para alcanzar los objetivos específicos de cada contexto.


Abstract Facing the economic and environmental crises that the world has been experiencing and the excessive focus given to individualization, ecovillages have emerged as alternatives against these societal effects. The article aims to investigate how the studies on ecovillages address the modes of government and the processes of subjectivation that exist in the relationship of subjects with the collective, with themselves and the with the environment. We based the study on the Foucaultian notion of government of oneself and of others in order to understand the processes of subjectification. We conducted an integrative review of articles that presented empirical research reports. The analyzes point out the relationship between government and subjectivation processes in ecovillages as in each aspect analyzed implied the exercise of the government of the self, care of the self, and practice of the self so that the subjects transformed themselves in order to achieve the specific objectives of each context.


Assuntos
Características de Residência , Meio Ambiente , Governo , Habitação/tendências , Identificação Social , Ecologia Humana , Individualidade
14.
Buenos Aires; GCBA. Dirección General de Estadística y Censos; nov. 2020. a) f: 20 l:17 p. tab, graf.(Población de Buenos Aires, 17, 29).
Monografia em Espanhol | UNISALUD, BINACIS, InstitutionalDB, LILACS | ID: biblio-1146286

RESUMO

En este artículo analizamos los rasgos que asumió la estructura de clases de la Ciudad Autónoma de Buenos Aires (CABA) en el período 2004-2015. Utilizando como fuente de datos, principalmente, la Encuesta Anual de Hogares (EAH) relevada anualmente por la Dirección General de Estadística y Censos del Gobierno de la CABA, nos preguntamos acerca de cómo han evolucionado las clases sociales en términos de tamaño y composición, y cuánto se han distanciado o acercado respecto al bienestar material de los hogares que las conforman. Del análisis de los datos se desprende que la estructura de clases mantiene la configuración signada durante los años noventa, aunque con una relativa composición de la clase obrera calificada y la clase directivo-profesional. Por otro lado, el estudio de los ingresos y el acceso a la vivienda, en tanto dos activos del bienestar material de los hogares, muestra cierta reducción de la desigualdad respecto al primero, pero un fortalecimiento en las brechas respecto a la propiedad de la vivienda. (AU)


Assuntos
Classe Social , Mobilidade Social/tendências , Mobilidade Social/estatística & dados numéricos , Seguridade Social/tendências , Seguridade Social/estatística & dados numéricos , Fatores Socioeconômicos , /história , /estatística & dados numéricos , Habitação/tendências , Renda/estatística & dados numéricos
15.
Artigo em Inglês | MEDLINE | ID: mdl-32867382

RESUMO

Housing stability is a key outcome in studies evaluating housing services for the homeless population. Housing stability has typically been defined dichotomously and based on a fixed duration of maintenance in housing accommodations, which does not fully capture change in housing status among homeless individuals. Moreover, few typologies have examined housing trajectories across different housing types. Cluster analysis was used to develop a typology of housing status change for 270 currently or formerly homeless individuals in Quebec (Canada) residing in shelters and temporary and permanent housing. Participants were interviewed at baseline (T0) and 12 months later (T1). The Gelberg-Andersen Model was used to organize housing-related variables into predisposing, needs and enabling factors. Comparison analyses were conducted to assess group differences. Three groups (Groups 1, 3 and 4) had more favorable and two (Groups 2 and 5) less favorable, housing status at T1. Findings suggest that maintenance or improvement of housing status requires suitable types and frequencies of service use (enabling factors) that are well adapted to the nature and complexity of health problems (needs factors) among homeless individuals. Specific interventions, such as outreach programs and case management, should be prioritized for individuals at higher risk for returning to homelessness.


Assuntos
Habitação/estatística & dados numéricos , Pessoas Mal Alojadas/psicologia , Qualidade de Vida/psicologia , Adolescente , Adulto , Idoso , Canadá , Feminino , Pessoas Mal Alojadas/estatística & dados numéricos , Habitação/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Quebeque , Adulto Jovem
16.
Drug Alcohol Depend ; 217: 108252, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-32919207

RESUMO

INTRODUCTION: The use of controlled substances like cocaine increases the risk of cardiovascular disease (CVD) and myocardial infarction (MI). However, outside of alcohol and tobacco, substance use is not included in CVD risk assessment tools. We identified the effects of using multiple substances (nicotine/cotinine, cannabis, alcohol, cocaine, methamphetamine, heroin and other opioids) on cardiac injury measured by high-sensitivity troponin (hsTnI) in homeless and unstably housed women. METHODS: We recruited 245 homeless and unstably housed women from shelters, free meal programs and street encampments. Participants completed six monthly study visits. Adjusting for traditional CVD risk factors, we examined longitudinal associations between substance use and hsTnI. RESULTS: Median participant age was 53 years and 74 % were ethnic minority women. At baseline, 76 % of participants had hypertension, 31 % were HIV-positive, 8% had a history of a prior MI and 12 % of prior stroke. The most commonly used substances were cotinine/nicotine (80 %), cannabis (68 %) and cocaine (66 %). HsTnI exceeding the 99th percentile (14.7 ng/L) - a level high enough to signal possible MI - was observed in 14 participants during >1 study visit (6%). In adjusted analysis, cocaethylene and fentanyl were significantly associated with higher hsTnI levels. CONCLUSIONS: Fentanyl use and the co-use of cocaine and alcohol are associated with myocardial injury, suggesting that the use of these substances may act as long-term cardiac insults. Whether risk counseling on these specific substances and/or including their use in CVD risk stratification would improve CVD outcomes in populations where substance use is high merits further investigation.


Assuntos
Doenças Cardiovasculares/sangue , Habitação/tendências , Pessoas Mal Alojadas , Transtornos Relacionados ao Uso de Substâncias/sangue , Troponina I/sangue , Adulto , Biomarcadores/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
17.
Child Abuse Negl ; 107: 104625, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32682143

RESUMO

BACKGROUND: Homelessness is a risk factor for family involvement with child welfare services (CWS). Housing interventions are promising-but reasons for this are not well understood, and housing resources could be better targeted to families at risk of increased CWS involvement. OBJECTIVE: We sought to better understand the relationship between homelessness and CWS involvement and examine whether homeless shelter data could combine with CWS data to enhance intervention targeting. PARTICIPANTS AND SETTING: For 4 years, we followed 2063 families investigated by the San Francisco Human Services Agency in 2011. METHODS: Matching CWS data to homeless shelter data, we fit Cox models to examine the relationship between shelter use and subsequent CWS outcomes and produced ROC curves to judge model accuracy with and without shelter information. RESULTS: Absent CWS covariates (family demographics, CWS history, and family safety and risk), past shelter entry predicted repeat maltreatment referral (HR = 1.92, p < .001), in-home case opening (HR = 1.51, p < .05), and child removal (HR = 1.95, p < .01), but not child reunification. With CWS covariates, past shelter use no longer predicted case opening and child removal, but still predicted referral (HR = 1.58, p < .01). Shelter data did not contribute to models' predictive accuracy. CONCLUSIONS: We find mixed evidence that shelter use independently leads to CWS involvement. Housing interventions might help by addressing present housing problems and family experiences correlated with past shelter use. However, we find no evidence that data matches with shelter systems could enhance targeting.


Assuntos
Serviços de Proteção Infantil/métodos , Serviços de Proteção Infantil/tendências , Família/psicologia , Habitação/tendências , Pessoas Mal Alojadas/psicologia , Adulto , California/epidemiologia , Criança , Feminino , Humanos , Masculino , Fatores de Risco , Problemas Sociais/psicologia , Problemas Sociais/tendências , Seguridade Social/psicologia , Seguridade Social/tendências , Inquéritos e Questionários
20.
Psychiatry Res ; 288: 112947, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32315878

RESUMO

Although housing instability moderates suicide risk among military veterans, it is unknown whether suicide methods differ between stably and unstably housed veterans. The Veterans Health Administration screened 5,849,870 veterans for housing instability between October 1, 2012 and September 30, 2016. Death data were from the National Death Index. Unstably housed veterans had greater hazards of suicide mortality by jumping from a height (aHR = 3.07, 95%CI = 1.20-7.98) and unspecified means (aHR = 2.80, 95%CI = 1.63-4.80) than stably housed veterans. Translating these findings into optimal suicide prevention programming tailored to unstably housed veterans is essential.


Assuntos
Habitação , Pessoas Mal Alojadas/psicologia , Suicídio/psicologia , United States Department of Veterans Affairs , Veteranos/psicologia , Adulto , Atenção à Saúde/métodos , Atenção à Saúde/tendências , Feminino , Habitação/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Suicídio/tendências , Estados Unidos/epidemiologia , United States Department of Veterans Affairs/tendências
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