The impact of a Housing First intervention and health-related risk factors on incarceration among people with experiences of homelessness and mental illness in Canada

ObjectiveTo examine the effect of a Housing First (HF) intervention and health-related risk factors on incarceration among adults with experiences of homelessness and mental illness.MethodsParticipants (N = 508) were recruited at the Toronto site of the At Home/Chez Soi study. The outcome was incarceration in Ontario from 2009 to 2014. Exposures were intervention group (HF vs. treatment as usual), Axis I mental health diagnoses, emergency department (ED) visit, and history of traumatic brain injury (TBI). Logistic regression was used to examine the association between exposures and incarceration.ResultsOf 508 participants, 220 (43.3%) were incarcerated at least once during the study period. Among those incarcerated, 81.9% were male, 52.7% had been diagnosed with alcohol dependence/abuse, 60.9% had been diagnosed with substance dependence/abuse, 65.1% reported having visited an ED within the last 6 months, and 66.4% had a history of TBI. After adjusting for demographic covariates, substance dependence/abuse (aOR: 2.06; 95% CI: 1.40, 3.03), alcohol dependence/abuse (aOR: 1.52, 95% CI: 1.04, 2.22), ED visit (aOR: 1.54; 95% CI: 1.02, 2.32), and history of TBI (aOR: 2.60; 95% CI: 1.75, 3.85) were associated with incarceration. We found no significant effect of the HF intervention on incarceration outcome (aOR: 1.08; 95% CI: 0.76, 1.55).ConclusionsAmong adults with experiences of homelessness and severe mental illness, those with substance and alcohol dependence/abuse disorders, history of TBI, and recent ED visits were at increased odds of incarceration. Strategies are needed to prevent and reduce incarceration for this population, including treatment of mental illness in the community.Supplementary InformationThe online version of this article (10.17269/s41997-020-00433-z) contains supplementary material, which is available to authorized users.     

Vascularisation des glandes surrénales

Résumé La glande surrénale de l'homme réunit deux structures initialement sans rapport physiologique. Cette dualité phyllogénique et embryologique se retrouve dans sa structure vasculaire de façon paradoxale. Les artères métamériques de l'organe phéochrome irriguent en priorité le cortex. L'axe veineux de l'ébauche mésenchymateuse draine le réseau des capillaires sinusoïdaux vers la médulla. Le réseau lymphatique est quasi inexistant au niveau de la médulla. Bien développé dans le cortex, il se draine presque exclusivement de façon centrifuge le long des axes artériels. A côté de son intérêt anatomo-chirurgical évident, l'étude de la vascularisation des glandes surrénales se doit de répondre aux besoins des investigations morphologiques vasculaires. La connaissance des variations artérielles et de leur fréquence, des territoires glandulaires de distribution, des voies anastomotiques de suppléance et des regroupements typologiques a retenu notre attention. Elle facilitera la lecture des artériographies globales toujours difficile dans le plan rétro-péritonéal. Elle guidera l'angiographie artérielle sélective. La phlébographie cave occlusive permet d'obtenir des opacifications remarquables des veines centrales, en particulier à gauche. Cette méthode est utile dans l'étude des tumeurs rétro-péritonéales et dans l'exploration des masses ganglionnaires lombo-aortiques susceptibles d'imprimer leur empreinte sur les structures veineuses. Elle a d'autant plus d'intérêt que la lymphographie pédieuse qui opacifie bien les chaînes latéro-aortiques gauche et latérocave à droite, ne permet pas, sauf reflux à contrecourant, une étude de l'important carrefour inter-aortico-cave sous-rénal. Des cathétérismes et des prélèvements électifs au niveau des différentes voies excrétrices de cette glande endocrine (veines et lymphatiques) peuvent aider à une meilleure connaissance de la physiologie et de la pathologie de l'organe. Les voies de dérivations veineuses des glandes surrénales ont été étudiées dans cet esprit.     

Lack of protection from ischemic injury of monoamine oxidase B-deficient mice following middle cerebral artery occlusion

Recently, it has been shown that a single leucine-to-tyrosine mutation in the agonist binding domains of the homomerically expressed alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptors GluR3 and GluR1 is sufficient to completely block receptor desensitization. In the present study we tested heteromeric subunit combinations of AMPA receptors to demonstrate that the block of desensitization afforded by this mutation is dominant in heteromeric subunit complexes containing the leucine-to-tyrosine mutation in at least one of the subunits. In addition, by comparing mutated, desensitization-deficient forms of unedited GluR1 and GluR1 edited at the Q/R-site of the ion pore we demonstrate that the desensitization properties of AMPA receptors are not linked to the editing state of the ion pore domain and thus are independent of the permeability properties of the ion channel.     

The clinical nurse researcher in a military setting: bringing practice into research

The clinical nurse researcher (CNR) is emerging as an integral part of every major medical center. The CNR has six basic roles: facilitate the conduct of research projects; stimulate staff to conduct research: upgrade the research skills of the staff; participate on committees related to research; conduct and disseminate research; and obtain funding for research studies. Readiness issues for military missions, health promotion, and disease management and prevention are consistently of interest. The CNR should be an active participant on the institutional review board and should conduct primary studies that further the reputation of the facility. The viability of any military research program today is contingent on procurement of funding; therefore, the CNR must refine skills in grantsmanship. The demands of the medical facility and the needs of the staff must be a prime consideration in the development of the role of the CNR.     

Neuronal and endothelial nitric oxide synthase isoforms: quantification of protein and mRNA in the normal rat penis

Nitric oxide synthase (NOS) is an important enzyme for erection. We evaluated the content of neuronal (nNOS) and endothelial (eNOS) isoforms and their mRNA in the penis and major pelvic ganglion (MPG) of adult male rats by Western and Northern blot analysis. The cerebellum was evaluated as a control. nNOS protein and its mRNA were detected in abundance in the MPG, cerebellum, pelvic urethra and within the crura of the penis. In contrast, the penile urethra, neurovascular bundle and the shaft of penis contained smaller amounts of this protein. eNOS protein was most abundant in the penile and pelvic parts of the urethra, whereas a moderate level was found in the penile shaft, crura, neurovascular bundle, MPG and cerebellum. Similarly eNOS mRNA was abundant in the penile and pelvic parts of the urethra, MPG and cerebellum. Penile shaft, crura and neurovascular bundle showed moderate amounts of eNOS mRNA. In conclusion, nNOS and its mRNA are most abundant in the MPG and crura of penis whereas eNOS is most abundant in the urethra and to a lesser extent present in the penis. Importantly eNOS protein and mRNA were demonstrated in the MPG, where eNOS function has to be studied.     

Antibiotic sensitivity of enteric pathogens in Vietnam

The in vitro antimicrobial susceptibilities of 675 common enteropathogenic isolates from faecal specimens of patients with diarrhea (E. coli, Shigella, Salmonella and V. cholerae), and 568 E. coli isolates from faecal flora of healthy persons, which were collected as part of a National antibiotic resistance surveillance in Vietnam, were determined. The agar dilution method was used for the following nine antibiotics: ampicillin, doxycycline, chloramphenicol, gentamicin, nalidixic acid, kanamycin, trimethoprim, trimethoprim in combination with sulfamethoxazole (1/20), and sulfisomidin. Gentamicin was the most active of the antibiotics tested against all bacterial species with MICs in the range 0.125-4 mg/l. All strains were susceptible to nalidixic acid (0.125-8 mg/l) and more than 90% were susceptible to kanamycin. Among E. coli and Shigella isolates from patients the frequencies of resistance to commonly used antibiotics were high: ampicillin 73% and 84%, doxycycline 83% and 94%, chloramphenicol 71% and 91%, sulfisomidin 82% and 92%, respectively. Resistance to trimethoprin, as well as to the combination with sulfamethoxazole was found in 21% and 23%, respectively. The frequencies of multiple resistance (resistance to three or more antibiotics) were also high (77% and 89%, respectively). Less than 10% of Salmonellae and V. cholerae isolates were resistant to ampicillin, sulfisomidin or trimethoprim. Among E. coli from healthy people the frequencies of resistance were lower than in isolates from patients: ampicillin 23%, doxycycline 40%, chloramphenicol 21% and sulfisomidin 34%. However, the same patterns of multiple resistance were found in both groups.