Homelessness in Orange County California
Homelessness in Orange County - II
The natural history of disease refers to the progress of the disease process in an individual over time and in the absence of intervention (Figure 1.1). Knowledge of the natural history of a disease helps us to understand the effects and mechanism of actions, potential interventions, and the different levels of the prevention of disease.
Natural history of disease Source: based on CDC (2002). The disease process begins with exposure to, or completion of, a sufficient cause of the disease. Without an appropriate intervention, the process ends with recovery, disability or death. For example, exposure to the measles virus in a susceptible individual initiates the stage of subclinical disease. The onset of fever on about the 10th day (range 7-18 days) after exposure marks the beginning of clinical disease. The disease, however, is usually diagnosed around the 14th day when the typical rashes appear and then the disease proceeds to recovery, to complications such as pneumonia, or to death, depending on host and other factors (Sulkowski Et Al., 2007).
Many diseases have a typical natural history, but the time frame and manifestations of disease may vary between individuals due to the presence of host factors (e.g. immunity and age) and other determinants of the disease. Many factors may affect the progress of a disease in an individual and the likely outcome. The estimation of an individual's outcome, taking into account the natural history of disease and other risk factors, is known as their prognosis. The course of a disease may also be modified at any point in the progression by preventive and therapeutic measures. The subclinical stage following exposure is usually called the incubation period (for infectious diseases) or the latency period (for chronic diseases).
In a relatively short time period, a great deal of knowledge was accumulated regarding the biology, pathogenesis, and natural history of infection with HIV. Application of serological testing revealed a wide range of clinical manifestations associated with HIV, including asymptomatic carriage for several years, nonspecific symptoms (often called AIDS-related complex) such as fever, diarrhea, weight loss, and generalized lymphadenopathy-increased susceptibility to certain opportunistic pathogens, increased severity of infection with certain conventional pathogens, development of malignancies including KS, primary lymphoma of the brain, other non-Hodgkin's lymphomas, and progressive encephalopathy (HIV dementia) (Wilkinson, 1996).
As the spectrum of illness associated with HIV expanded, the utility of the surveillance definition of AIDS used by the Centers for Disease Control in collecting case reports came under question. The case definition, which had undergone minor revisions and additions between 1982 and 1986, was designed to count only documented infections or malignancies that indicated severe immunodeficiency and occurred in the absence of known causes of reduced resistance. For each indicator disease, there were specific criteria for establishing a definitive diagnosis. Invasive procedures such as bronchoscopy or biopsy, and sophisticated laboratory analysis were often needed to establish that a patient had "CDC-defined" AIDS. If the specified tests were not done or were negative, the patient was not counted as an official AIDS case. In addition, morbidity and mortality due to AIDS-related complex, wasting syndrome, and encephalopathy were not included. Concern developed that a significant amount of HIV-related disease was being overlooked. In September 1987, a new surveillance definition with extensive changes was published (Bedimo Et Al., 2009) in an attempt to incorporate a broader range of HIV-related disease. Presumptive as well as definitive criteria for the diagnosis of opportunistic infections were listed, and HIV wasting syndrome and HIV dementia were added. A number of new infections and malignancies were added. Laboratory evidence of HIV infection (antibody testing, viral culture, or antigen detection) was also required in most of the cases.
An examination of the clinical spectrum of HIV-related disease and the changes in criteria for CDC-defined AIDS reveals a conceptual paradox for epidemiologists that has resulted from the discovery of AIDS and of HIV. "AIDS" is neither a disease nor a syndrome as traditionally defined. To have "AIDS," one must have some other disease, such as Pneumocystis carinii pneumonia or Kaposi's sarcoma. A person with "AIDS" may have both PCP and KS, as well as some other indicator disease, such as a herpes lesion that is progressive and fails to heal after four weeks. But a person with HIV infection who becomes ill and dies does not have "AIDS" unless evidence for one of these or a number of other conditions is found. Thus, "AIDS" is defined in relationship to other known diseases (Sulkowski Et Al., 2007). The statements...
Homelessness has remained one of the min problems for the countries who are wealthy and rich in resources. Some of these countries include UK and Canada. It is still one of the strangest facts that there are millions of homeless people still living on the streets of these wealthy countries in shattered homes or streets. Various studies have been conducted on the issues faced by these homeless people as well
Homelessness Is homelessness increasing in the United States? Homelessness has become progressively more apparent in the United States over the past quarter century. The U.S. Department of Housing and Urban Development has amassed a wealth of data that confirm low-income housing is a critical requirement. Even as some communities are realizing a decrease in their homeless population; others are experiencing the opposite. It is disheartening to note that the largest increase in
et al. (2005) Facts on Trauma and Homeless Children. National Child Traumatic Stress Network - Homelessness and Extreme Poverty Working Group. Online available at http://www.nctsnet.org/nctsn_assets/pdfs/promising_practices/Facts_on_Trauma_and_Homeless_Children.pdf Burt, Aron, Douglas, et al., (1999) Homelessness: Programs and the People They Serve: Summary Report - Findings of the National Survey of Homeless Assistance Providers and Clients Washington, DC: The Urban Institute, 1999 Burt, Martha, (2001) What Will it Take to End Homelessness? Washington, DC: The
" How many people are homeless? The number of homeless is difficult to ascertain because estimates vary depending on the methodology used. Numbers also vary substantially depending on whether a measurement is taken on a single night or is extrapolated to a given year. One approximation of the annual number of homeless in America is from a study done by the National Law Center on Homelessness and Poverty, which estimates between 2.3 and
Crime is not the only issue where homelessness is concerned, however, and homelessness in and of itself can be very difficult for someone to deal with, especially if the homelessness was unexpected or there are many familial obligations that suddenly will not be met (such as in the case of a single mother, for example). When homelessness occurs this way and causes these kinds of problems, there can be very
Homelessness Intervention Social Work Universally in the developed world, homelessness is something that communities want to end rather than manage. Co-ordinated social services can come together to create and enhance community-based responses that tackle the threat of homelessness rather than attempting to deal with it on the other end -- after the fact, after people are demoralized by the experience. An important part of any community response to homelessness is affordable housing. But
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