Journal of urban health : bulletin of the New York Academy of Medicine
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To describe the characteristics and outcomes of the first 3 years of admissions to a dedicated skilled nursing facility for people with acquired immunodeficiency syndrome (AIDS). ⋯ A dedicated skilled nursing facility for people with AIDS can fill an important service need for patients with advanced disease, acute convalescence, long-term care, and terminal care. The need for long-term care may continue to grow for patients who do not respond fully to current antiretroviral therapies and/or have significant neuropsychiatric comorbidities. This level of care may be increasingly important not only in reducing lengths of stay in the hospital, but also as a bridge to community-based residential options in the emerging chronic disease phase of the AIDS epidemic.
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The concept of slow virus diseases was developed by Sigurdsson in the 1950s in studies of infections of Icelandic sheep, including Visna, a slow (lenti) viral infection of the central nervous system. Human immunodeficiency virus (HIV) belongs to the same lentivirus subfamily of retroviruses and causes significant dysfunction of all levels of the nervous system. ⋯ As a consequence, major disabilities in the chronic-treated phase of the HIV epidemic may include cognitive impairment, gait disorders, and various pain syndromes. Policy planning will need to take into account the long-term residential, social, and health care needs of this population.
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This article provides an overview of the ways in which the home environment can affect human health, describes how specific health hazards in housing are related, and considers implications of these concerns for research and programs to address the health-housing connection. The widespread availability of decent housing has contributed greatly to improvements in health status in developed countries through, for example, provision of safe drinking water, proper sewage disposal, and protection from the elements. However, a lack of decent housing and homelessness among a significant number of Americans remains a significant public health concern. ⋯ Specific health hazards related to housing include unintentional injuries, exposure to lead, exposure to allergens that may cause or worsen asthma, moisture and fungi (mold), rodent and insect pests, pesticide residues, and indoor air pollution. A number of these specific hazards share underlying causes, such as excess moisture, and all may be influenced by factors in the community environment or by occupant behaviors. We make recommendations for developing programs and research efforts that address multiple housing problems in an integrated way, rather than categorically, and for closer collaboration between housing and public health programs.
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Biography Historical Article Classical Article
Eighty years of public health in New York City. 1947.