Question 4761

Question Answered step-by-step base on the research presented below simplify, rearrange make… base on the research presented below simplify, rearrange make suggestions on the subquestion another way in asking the question?. Research Topic:        ETHICS AND HOMELESS PEOPLE’S TREATMENTResearch Question: Are youth homeless individuals discharged from hospital settings back to the streets without the necessary supplies and capabilities to continue effective care more at risk of developing negative outcomes than homeless youth patients who are discharged to a lower level of care?           Sub-questions:(1) Among youth ages 13-25, what are the effects of any interventions, compared to the absence of intervention or to alternative interventions, on preventing homelessness? (2) among youth ages 13-25 who experience homelessness, what are the effects of any interventions, compared to the absence of intervention or to alternative interventions, on any outcomes?Literature Review America’s homeless population is larger than that of any other advanced economy. On any given night, more than half a million people experience homelessness. One-third of them are in just one state, California. When homeless people are asked how they became homeless, they frequently say their troubles began when they lost their jobs. Which might lead one to conclude that unemployment is the root cause of homelessness. Yet, what many homeless people often omit when asked this question is that they lost their job due to illness. Homeless health care clinicians, including social workers , often interact with patients who have acute and urgent needs that take priority over general preventive measures. Particularly for county hospital with limited resources, services, and time, implementing regular and comprehensive preventive care measures can be a challenge. While guidelines for preventive care measures exist, they are not usually tailored to a homeless population that experiences different key morbidities and causes of mortality than the general population. For example, individuals experiencing homelessness have high occurrences of infectious diseases, substance abuse, and mental health issues, all of which are related to and compounded by lack of access to housing, regular medical care, health insurance, nutritious foods, transportation, employment, and other factors.  Seiji Hay­ashi writes, “Sickness and injuries make holding a job difficult, which leads to income declining and homelessness for those without a safety net.” Hayashi also notes that in a country where most people get health coverage through their employer, “no job means no health insurance.” Once one understands these dynamics, it becomes all too clear that homeless people don’t just lack housing. They’re also, quite often, sick. Diabetes. Hypertension. Heart Disease. Hepatitis C. HIV. These diseases are rampant among the homeless population.           As California Health Care Foundation found out, on any given day, more than 150,000 people experience homelessness in California. Being homeless is dangerous to your health: People who live on the streets die an average 20 years earlier than people who are housed (California Health Care Foundation). New research from UCLA epidemiologist found that homeless people who contracted COVID-19 in the last year were 30% more likely to die than those in the general population. In Los Angeles County, homeless COVID-19 patients were 50% more likely to die (Kathryn M. Leifheit PhD MSPH, Lelia H. Chaisson PhD MSc, Jesus Alejandro Medina,1,3 Rafik Wahbi MPH, and Chelsea L. Shover PhD). Key Screenings, an assembled panel of clinicians and service providers generated the following list of screenings that clinicians should consider utilizing when seeing people experiencing homelessness. This list accounts for common conditions amongst adults without homes, including diseases and risk factors that are less commonly found in the general population. Some of the conditions require more detailed screening processes than others; for example, asking every client to slip off their shoes can be a form of foot care screening—which is not on any formal guidelines but is an important screening for people experiencing homelessness who are at high risk of both diabetes and environmental injuries to their extremities.            Preventive Care Recommendations Early screening is important because if diseases are caught earlier, treatment can begin, reducing the impact of the disease and potentially curing it or mitigating symptoms and complications. Moreover, lifestyle changes may be more effective in the earliest stages of disease progression, and nutritional and disease management counseling are a crucial part of early screening and treatment. In some cases, necessary specialty care can be accessed after early detection of diseases. In addition to targeting patients for primary and secondary prevention, medical respite programs deliver tertiary preventive care, providing patients with recovery assistance to reduce complications of existing diseases and conditions. Greg Morris. ( Program Director of the Homeless Clinic at Peak Vista Community Health Center in Colorado Springs and the Executive Director ) has found that patients without homes who are discharged from emergency departments will usually return to the emergency department within 90 days “due to complications or not having a place to recuperate;” in fact, he says, “50 percent of patients without access to medical respite care end up in the hospital within a week, and 75 percent return within two weeks. Thus, medical respite care is a way to provide direct medical services that prevent recidivism back to the hospital and complications from the initial hospital visit. It provides a bridge as [patients] transition to a primary care setting.”  Extending telehealth services to vulnerable populations can be a challenge, since homeless populations may often lack “home-based” access to technology necessary for telehealth interactions. However, some care providers have begun to explore the relevance of telehealth for homeless populations. For example, one study evaluating the telehealth experience of recently homeless veterans found that peer support at enrollment, facilitated access to equipment, and peer support for technical difficulties may be helpful in bridging the “digital divide” and expanding the relevance of telehealth initiatives to populations experiencing homelessness. In addition, Youth homelessness in the United States (US) is a serious national challenge. National estimates among adolescents and young adults ages 13-25 indicate that 1 in 30 adolescents (ages 13-17) and nearly 1 in 10 young adults (ages 18-25) experienced some form of homelessness during a 12-month period (Morton et al., 2017). Young people who experience homelessness are at high risk for adverse outcomes such as physical and mental health problems, the experience of violence, early pregnancy, early school leaving, substance use, and early death (Auerswald et al., 2016, Greene et al., 1997, Greene and Ringwalt, 1998, Heerde et al., 2014, Hodgson et al., 2013, Medlow et al., 2014); Homeless youth are likely to behave in ways that are unsafe; they are also especially vulnerable. Homelessness exacerbates or can lead to serious mental and physical health problems, such as (California coalition for youth ) Chronic health conditions, including asthma, other lung problems, tuberculosis, diabetes, hepatitis, and HIV/AIDS are prevalent among homeless youth. These youth are also at high risk for sexually transmitted diseases. Homeless youth (especially street youth) show an elevated risk of mental health problems, including anxiety disorders, depression, post-traumatic stress disorder, and suicide due to increased exposure to violence while living on the street.Conclusion Effective and efficient strategies to prevent and end youth homelessness require a robust evidence base to inform decision-making. This review finds that the largest evidence base on the effectiveness of interventions for addressing youth homelessness relates to counseling and treatment interventions to address mental health or health risk behaviors. studies showed promising results, but few included long-term follow-up. A small number of experimental and quasi-experimental studies demonstrated that interventions can make a difference in preventing and reducing youth homelessness and housing instability, including through rental assistance with wraparound supports supportive housing and even intensive case management without direct housing assistance. Yet, we conclude that the field lacks rigorous evaluative evidence for many of the program models on which communities and governments currently rely to address youth homelessness (for example, street outreach, transitional living programs, youth shelters, host homes, and rapid rehousing). Evaluative evidence is further lacking on how the results of interventions vary by subpopulations inequitably exposed to homelessness, such as Youth of Color, LGBTQ-identifying youth, and pregnant and parenting youth.    REFERENCESAuerswald, C. L., Lin, J. S, & Parriott, A. (2016). Six-year mortality in a street-recruited cohort of homeless youth in San Francisco, California. PeerJ, Apr 14, 4:e1909. B. Duncan, G. Harris, J. Reedy, S. Krahe, R. Gillis, M. LagunaBharel M, Creaven B, Morris G, Robertshaw D, Uduhiri K, Valvassori P, Wismer B, MeinbresseM, Sergeant P (Ed.). Health Care Delivery Strategies: Addressing Key Preventive Health Measures in Homeless Health Care Settings, Nashville: Health Care for the Homeless Clinicians’ Network, National Health Care for the Homeless Council, 2011. Retrieved from http://  J.M. Greene, C.L. RingwaltPregnancy among three national samples of runaway and homeless youthJournal of Adolescent Health, 23 (6) (1998), pp. 370-377, 10.1016/S1054-139X(98)00071-8KeyPrevHealthMeas_FINAL.pdf. 2. O’Connell JJ. Premature Mortality in Homeless Populations: A Review of the Literature, Nashville: National Health Care for the Homeless Council, 2005. Retrieved from http:// santabarbarastreetmedicine. org/wp-content/ uploads/2011/04  Hodgson, K. J., Shelton, K. H., Bree, M. B. M. v. d., & Los, F. J. (2013). Psychopathology in young people experiencing homelessness: A systematic review. American Journal of Public Health, 103(6), e24-e37. doi:10.2105/ajph.2013.301318. Woan, J. Lin, C. AuerswaldThe health status of street children and youth in low-and middle-income countries: A systematic review of the literatureJournal of Adolescent Health, 53 (3) (2013), pp. 314-321   M.H. Morton, A. Dworsky, G.M. SamuelsMissed opportunities: Youth homelessness in America. National estimates  S. Medlow, E. Klineberg, K. SteinbeckThe health diagnoses of homeless adolescents: A systematic review of the literature  Health Science Science Nursing MSN NURS 540 Share QuestionEmailCopy link Comments (0)

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