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Gomes ATPC, Mendes K, Ferrito C, Andrade F, Neves-Amado J, Resende A, Santos P, Manso D, Almeida A, Vollrath A, Lopes R, Barros M, Rosa N, Figueiredo AS. Exploring the inflammatory profile of homelessness population: a comprehensive analysis of individuals in two temporary shelters in Lisbon. Front Public Health 2024; 12:1432044. [PMID: 39328992 PMCID: PMC11424544 DOI: 10.3389/fpubh.2024.1432044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 08/29/2024] [Indexed: 09/28/2024] Open
Abstract
Background Homeless people are continuously facing adverse living conditions as poor access to basic nutrition, hygiene conditions and healthcare services, being at increased risk of severe infectious diseases as HIV and hepatitis as well as cardiovascular diseases and mental disorders. The characterization of homeless people's health is fundamental to identify their health care needs. Considering that the aforementioned diseases are associated with chronic inflammatory processes, the main goal of this study was to characterize the inflammatory profile of a homeless population through quantification in saliva of a panel of inflammatory cytokines. Methods The inflammatory profile was assessed in 114 individuals residing in two temporary shelters located in Lisbon and that accepted to participated in the study. Inflammatory proteins were quantified using a Multiplex Immunoassay approach. Data analysis was performed using the GraphPad Prism software and statistical significance among the groups was assessed using the nonparametric Mann-Whitney test. Results Even though some protein levels might be masked by drug treatment, data analysis showed high levels of INF-ϒ, IL-10 and TNF-α in the infectious disease group, critical cytokines for the immune response against viruses and bacteria. Also, cytokines like IL-1β and IL-6 were detected at statistically significant levels in the cardiovascular disease group and all cytokines included in this study were quantified in the mental disorders group. Conclusion These findings may help the healthcare services in the evaluation of treatment efficacy and disease monitoring, and in the development of effective public healthcare strategies and policy interventions to improve quality of life of the homeless population.
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Affiliation(s)
- Ana T P C Gomes
- Centre for Interdisciplinary Research in Health (CIIS), Faculty of Dental Medicine, Universidade Católica Portuguesa, Viseu, Portugal
| | - Karina Mendes
- Centre for Interdisciplinary Research in Health (CIIS), Faculty of Dental Medicine, Universidade Católica Portuguesa, Viseu, Portugal
| | - Cândida Ferrito
- Centre for Interdisciplinary Research in Health (CIIS), Faculty of Health Science and Nursing, Universidade Católica Portuguesa, Lisbon, Portugal
| | - Filipa Andrade
- Faculty of Health Science and Nursing, Universidade Católica Portuguesa, Lisbon, Portugal
| | - João Neves-Amado
- Faculty of Health Science and Nursing, Universidade Católica Portuguesa, Porto, Portugal
| | - Ana Resende
- Faculty of Health Science and Nursing, Universidade Católica Portuguesa, Lisbon, Portugal
| | - Paulo Santos
- Núcleo de Planeamento e Intervenção Sem-Abrigo (NPISA), Lisbon, Portugal
| | - Dina Manso
- Núcleo de Planeamento e Intervenção Sem-Abrigo (NPISA), Lisbon, Portugal
| | - António Almeida
- Centre for Interdisciplinary Research in Health, Católica Medical School, Universidade Católica Portuguesa, Lisbon, Portugal
| | - Antónia Vollrath
- Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastian, Santiago, Chile
| | - Rafaela Lopes
- Centre for Interdisciplinary Research in Health (CIIS), Faculty of Dental Medicine, Universidade Católica Portuguesa, Viseu, Portugal
| | - Marlene Barros
- Centre for Interdisciplinary Research in Health (CIIS), Faculty of Dental Medicine, Universidade Católica Portuguesa, Viseu, Portugal
| | - Nuno Rosa
- Centre for Interdisciplinary Research in Health (CIIS), Faculty of Dental Medicine, Universidade Católica Portuguesa, Viseu, Portugal
| | - Amélia Simões Figueiredo
- Centre for Interdisciplinary Research in Health (CIIS), Faculty of Health Science and Nursing, Universidade Católica Portuguesa, Lisbon, Portugal
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Miller JP, Hutton J, Doherty C, Vallesi S, Currie J, Rushworth K, Larkin M, Scott M, Morrow J, Wood L. A scoping review examining patient experience and what matters to people experiencing homelessness when seeking healthcare. BMC Health Serv Res 2024; 24:492. [PMID: 38643146 PMCID: PMC11031864 DOI: 10.1186/s12913-024-10971-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 04/09/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Homelessness is associated with significant health disparities. Conventional health services often fail to address the unique needs and lived experience of homeless individuals and fail to include participatory design when planning health services. This scoping review aimed to examine areas of patient experience that are most frequently reported by people experiencing homelessness when seeking and receiving healthcare, and to identify existing surveys used to measure patient experience for this cohort. METHODS A scoping review was undertaken reported according to the PRISMA-ScR 2020 Statement. Databases were searched on 1 December 2022: MEDLINE, EMBASE, APA PsychINFO and CINAHL. Included studies focused on people experiencing homelessness, healthcare services and patient experience, primary research, published in English from 2010. Qualitative papers and findings were extracted and synthesized against a modified framework based on the National Institute for Health and Care Excellence guidelines for care for people experiencing homelessness, the Institute of Medicine Framework and Lachman's multidimensional quality model. People with lived experience of homelessness were employed as part of the research team. RESULTS Thirty-two studies were included. Of these, 22 were qualitative, seven quantitative and three mixed methods, from the United States of America (n = 17), United Kingdom (n = 5), Australia (n = 5) and Canada (n = 4). Health services ranged from primary healthcare to outpatient management, acute care, emergency care and hospital based healthcare. In qualitative papers, the domains of 'accessible and timely', 'person-centred', and values of 'dignity and respect' and 'kindness with compassion' were most prevalent. Among the three patient experience surveys identified, 'accessible and timely' and 'person-centred' were the most frequent domains. The least frequently highlighted domains and values were 'equitable' and 'holistic'. No questions addressed the 'safety' domain. CONCLUSIONS The Primary Care Quality-Homeless questionnaire best reflected the priorities for healthcare provision that were highlighted in the qualitative studies of people experiencing homelessness. The most frequently cited domains and values that people experiencing homelessness expressed as important when seeking healthcare were reflected in each of the three survey tools to varying degrees. Findings suggest that the principles of 'Kindness and compassion' require further emphasis when seeking feedback on healthcare experiences and the domains of 'safety', 'equitable', and 'efficiency' are not adequately represented in existing patient experience surveys.
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Affiliation(s)
| | - Jennie Hutton
- St Vincent's Hospital Melbourne, Melbourne, Australia.
- The University of Melbourne, Melbourne, Australia.
- Victorian Virtual Emergency Department, Northern Hospital, Melbourne, Australia.
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
| | | | | | - Jane Currie
- Queensland University of Technology, Brisbane, Australia
| | | | | | - Matthew Scott
- St Vincent's Hospital Melbourne, Melbourne, Australia
- Lived Experience Representative, Melbourne, Australia
| | - James Morrow
- Lived Experience Representative, Melbourne, Australia
| | - Lisa Wood
- The University of Notre Dame Australia, Perth, Australia
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Javdani S, Larsen SE, Allen NE, Blackburn AM, Griffin B, Rieger A. Mixed methods in community psychology: A values-forward synthesis. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 72:355-365. [PMID: 37786971 PMCID: PMC10843471 DOI: 10.1002/ajcp.12703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/20/2023] [Accepted: 08/01/2023] [Indexed: 10/04/2023]
Abstract
Mixed methods research (MMR) combines multiple traditions, methods, and worldviews to enrich research design and interpretation of data. In this virtual special issue, we highlight the use of MMR within the field of community psychology. The first MMR studies appeared in flagship community psychology journals over 30 years ago (in 1991). To explore the uses of MMR in the field, we first review existing literature by identifying all papers appearing in either Journal of Community Psychology or American Journal of Community Psychology in which the word "mixed" appeared. A total of 88 publications were identified. Many of these papers illustrate the pragmatic use of MMR to evaluate programs and to answer different research questions using different methods. We coded articles based on Green et al.'s classifications of the purpose of the mixing: triangulation, development, complementarity, expansion, and initiation. Complementarity was the most frequently used purpose (46.6% of articles), and nearly a quarter of articles mixed for multiple purposes (23.86%). We also coded for any community psychology values advanced by the use of mixed methods. We outline three themes here with corresponding exemplars. These articles illustrate how MMR can highlight ecological analysis and reconsider dominant, individual-level paradigms; center participant and community member experiences; and unpack paradoxes to increase the usefulness of research findings.
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Affiliation(s)
- Shabnam Javdani
- Department of Applied Psychology, New York University, New York, New York, USA
| | - Sadie E. Larsen
- Department of Psychiatry and Behavioral Medicine, Medical College of WI, Milwaukee, Wisconsin, USA
- National Center for PTSD, Executive Division, White River Junction, Vermont, USA
| | - Nicole E. Allen
- Department of Human and Organizational Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Allyson M. Blackburn
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Breana Griffin
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Agnes Rieger
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
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Richson BN, Hazzard VM, Christensen KA, Hagan KE. Do the SCOFF items function differently by food-security status in U.S. college students?: Statistically, but not practically, significant differences. Eat Behav 2023; 49:101743. [PMID: 37209568 PMCID: PMC10681748 DOI: 10.1016/j.eatbeh.2023.101743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/05/2023] [Accepted: 04/24/2023] [Indexed: 05/22/2023]
Abstract
Despite food insecurity (FI) being associated with eating disorders (EDs), little research has examined if ED screening measures perform differently in individuals with FI. This study tested whether items on the SCOFF performed differently as a function of FI. As many people with FI hold multiple marginalized identities, this study also tested if the SCOFF performs differently as a function of food-security status in individuals with different gender identities and different perceived weight statuses. Data were from the 2020/2021 Healthy Minds Study (N = 122,269). Past-year FI was established using the two-item Hunger Vital Sign. Differential item functioning (DIF) assessed whether SCOFF items performed differently (i.e., had different probabilities of endorsement) in groups of individuals with FI versus those without. Both uniform DIF (constant between-group difference in item-endorsement probability across ED pathology) and non-uniform DIF (variable between-group difference in item-endorsement probability across ED pathology) were examined. Several SCOFF items demonstrated both statistically significant uniform and non-uniform DIF (ps < .001), but no instances of DIF reached practical significance (as indicated by effect sizes pseudo ΔR2 ≥ 0.035; all pseudo ΔR2's ≤ 0.006). When stratifying by gender identity and weight status, although most items demonstrated statistically significant DIF, only the SCOFF item measuring body-size perception showed practically significant non-uniform DIF for perceived weight status. Findings suggest the SCOFF is an appropriate screening measure for ED pathology among college students with FI and provide preliminary support for using the SCOFF in individuals with FI and certain marginalized identities.
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Affiliation(s)
- Brianne N Richson
- Department of Psychology, University of Kansas, Lawrence, KS, USA; Department of Psychiatry, University of California San Diego Eating Disorders Center for Treatment and Research, San Diego, CA, USA.
| | - Vivienne M Hazzard
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Kara A Christensen
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Kelsey E Hagan
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
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