Cold-related injuries in a cohort of homeless adults

People experiencing homelessness have an increased risk of cold-related injuries. This study determined the rate of emergency department (ED) visits for cold-related injuries among homeless adults and low-income controls in Toronto, Canada. Homeless individuals were recruited at shelters and meal programs. Age- and sex-matched controls living in low-income neighborhoods were selected. ED utilization was ascertained over 4-years of follow-up (2005–9) using administrative databases. A total of 16 ED visits for cold-related injuries were observed among 587 homeless men and 296 homeless women. The rate of ED visits was 6.7 (95% CI, 4.2–12.4) per 1000 person-years of observation among homeless men and 0.9 (95% CI, 0.03–5.6) among homeless women. ED visit rates were significantly higher among homeless men compared to low-income men (P?<?0.001) and significantly higher among homeless men compared to homeless women (P?=?0.03). Targeted public health interventions are needed to reduce the risk of cold-related injuries among people experiencing homelessness.     

Harmonizing databases? Developing a quasi-experimental design to evaluate a public mental health re-entry program

Our study is the first-ever initiative to merge administrative databases in Massachusetts to evaluate an important public mental health program. It examines post-incarceration outcomes of adults with serious mental illness (SMI) enrolled in the Massachusetts Department of Mental Health (DMH) Forensic Transition Team (FTT) program. The program began in 1998 with the goal of transitioning offenders with SMI released from state and local correctional facilities utilizing a core set of transition activities. In this study we evaluate the program's effectiveness using merged administrative data from various state agencies for the years 2007-2011, comparing FTT clients to released prisoners who, despite having serious mental health disorders, did not meet the criterion for DMH services. By systematically describing our original study design and the barriers we encountered, this report will inform future efforts to evaluate public programs using merged administrative databases and electronic health records.     

Practice and Research in Career Counseling and Development—2011

The Career Development Quarterly celebrated its 100th anniversary during the past year and continues to provide high‐quality research and conceptual articles of import to the study of career development and intervention. This article reviews the 2011 career counseling and development literature to highlight advances in theory, assessment, and intervention presented within the following themes: (a) from the past to the future, (b) work and well‐being, (c) diversity and career, (d) career theory and concepts, (e) career assessment, (f) career intervention, (g) career development: life‐span perspectives, and (h) international perspectives.     

Factors Influencing Family-Member Perception of “Homelikeness” in Long-Term Care Homes

Background: A number of long-term care homes in Nova Scotia, Canada, have been built or redesigned with new models of care with expanded care aide scope of practice and neighborhood-style layouts. Our objective was to examine what physical characteristics (bed size, owner-operator), model of care, and relational (family–staff relationship, perceived staff–resident relationship) factors were associated with increased family-member perception of homelikeness in long-term care homes.

Methods: We analyzed surveys collected from 273 family members from 23 long-term care homes in Nova Scotia, Canada. We conducted a multivariate linear regression to assess variables associated with increased family-member perception of homelikeness.

Results: We found that relationships between family and staff, perceived resident-to-resident relationships, and family involvement in decision making were positively associated with increased family perception of homelikeness. We found no significant associations between model of care or physical characteristics and increased family perception of homelikeness.

Conclusion: Relationships among family members, residents, and staff are integral to family members feeling at home in their loved one's long-term care home. Feeling at home in long-term care is largely related to family-member perception of meaningful social interactions between family and staff, and between residents.     

Civil Citations for Cannabis Possession: Alternatives to Arrest for Adolescent Substance Use

Results from the Substance Abuse and Mental Health Services Administration (SAMHSA) National Survey on Drug Use and Health (NSDUH) have indicated that approximately 8% of responding adolescents ages 12–17 engaged in illicit substance use during the past year; the most commonly reported substance used was marijuana (Substance Abuse and Mental Health Services Administration (SAMHSA), NSDUH series H-44, HHS publication no. (SMA) 12-4713, Substance Abuse and Mental Health Services Administration, Rockville, MD, 2012). Importantly, marijuana use places adolescents at risk of arrest when found in possession of cannabis. Drug abuse violations are associated with multiple consequences for the youth, their families, and communities. Policy makers, therefore, have encouraged the use of civil citations to reduce drug abuse related arrests for youth. Purpose: The current study sought to identify and describe civil citations use for youth marijuana possession. Methods: Using a secondary dataset, we examined aggregate arrests in a Central Florida county. Results: During a 3-year period, 1635 arrests were made for cannabis possession. The vast majority of such arrests were for multiple charges (n?=?1272; 78%). For those arrested due to cannabis possession alone (n?=?363; 22%), over 75% were adults (n?=?281). Therefore, only 82 youth were arrested under the charge, accounting for less than one quarter of all arrests for F.S. §893.13.6b (2013). However, the majority of these youth were detained in juvenile assessment centers (65%, n?=?59); a rate markedly higher than their adult counterparts (37%, n?=?105). Discussion: Due to the concerns associated with arrest and detainment, the authors contend efforts should be made to increase use of civil citations for youth with cannabis possession when possible. Implications for policy are presented.     

Palestinian perceptions of home and belonging in Britain: negotiating between rootedness and mobility

In this article based on ethnographic research among Palestinians in Britain, I argue that applying a ‘decentred’ conception of diaspora provides an understanding of the complexity of Palestinian identity-making in Britain. After a critical review of theorizations of the notion of diaspora and its relevance to this case study, I discuss ethnographic data to illustrate how processes of rooting and mobility are linked together in various contexts in which personal migration trajectories and positionalities play an important part. I demonstrate that, for Palestinians in Britain, diaspora relates to connections constructed both in relation to their homeland and other frames of reference: in relation to both roots and mobility.