Physical illnesses associated with childhood homelessness - a literature review

Abstract Background and aims Childhood homelessness is a growing concern in Ireland creating a Pediatric subpopulation at increased risk of physical illnesses, many with life-long consequences. Our aim was to identify and categorize the physical morbidities prevalent in homeless children. Methods A review of the English-language literature on physical morbidities affecting homeless children (defined as &amp;lt; 18 years of age), published from 1999-2019 was conducted. A total of 1194 articles were identified, 33 articles of which met our inclusion criteria. Results Respiratory issues were the most commonly cited illnesses affecting homeless children; including asthma, upper respiratory tract infections, and chronic cough. Homeless children were described as being at increased risk of contracting infectious diseases, many studies placing emphasis on STI and HIV/AIDS transmission. Dermatologic concerns comprised of scabies and head lice infestation, dermatitis, and abrasions. Malnutrition manifested as a range of physical morbidities; including childhood obesity, iron deficiency anemia, and stunted growth. Studies found a higher prevalence of poor dental and ocular health in this population as well. Many articles also commented on the risk factors predisposing homeless children to these physical health concerns, which can broadly be categorized as limited access to health care, poor living conditions, and lack of education. Conclusions This literature review summarized the physical illnesses prevalent among homeless children and the contributing factors leading to them. Gaps in the literature were also identified, and included a dearth of studies focusing on younger children compared to adolescents. We believe that the current issue of child homelessness is socially and medically unacceptable and that homelessness occurring today will be one of the scandals of the next generation. Further research into prevention and intervention programs for this vulnerable population is urgently needed. Key messages This literature review shows that homeless children are at an increased risk of several physical morbidities and identified the common themes among them. Based on this literature review, it is recommended that more research be done into developing appropriate intervention and prevention strategies to help this vulnerable population. </jats:sec

Physical illnesses associated with childhood homelessness: a literature review.

BACKGROUND Childhood homelessness is a growing concern in Ireland [1] creating a paediatric subpopulation at increased risk of physical illnesses, many with life-long consequences [2]. AIM Our aim was to identify and categorize the physical morbidities prevalent in homeless children. METHODS A review of the English-language literature on physical morbidities affecting homeless children (defined as ≤ 18 years of age) published from 1999 to 2019 was conducted. RESULTS Respiratory issues were the most commonly cited illnesses affecting homeless children, including asthma, upper respiratory tract infections, and chronic cough [3]. Homeless children were described as being at increased risk for contracting infectious diseases, with many studies placing emphasis on the risks of sexually transmitted infections (STIs) and HIV/AIDS transmission [4, 5]. Dermatologic concerns for this population comprised of scabies and head lice infestation, dermatitis, and abrasions [3, 6]. Malnutrition manifested as a range of physical morbidities, including childhood obesity [7], iron deficiency anemia [4], and stunted growth [8]. Studies demonstrated a higher prevalence of poor dental [7] and ocular health [9] in this population as well. Many articles also commented on the risk factors predisposing homeless children to these physical health concerns, which can broadly be categorized as limited access to health care, poor living conditions, and lack of education [3, 10]. CONCLUSION This literature review summarized the physical illnesses prevalent among homeless children and the contributing factors leading to them. Gaps in the literature were also identified and included a dearth of studies focusing on younger children compared with adolescents. Further research into prevention and intervention programs for this vulnerable population is urgently needed

A phase I-II study of intensive-dose adriamycin for advanced breast cancer.

Twenty-six women with metastatic breast cancer were treated with intensive Adriamycin (Adria Laboratories, Columbus, OH) as a single agent administered for three successive days once a month. Dosing started at 25 or 30 mg/m2/d three times, and was escalated by 5 mg/m2/d monthly to maximal tolerance based on hematologic, mucosal, or cardiac toxicities. Four patients (15%) had complete remissions (CRs) pathologically proven, and six others (23%) sustained complete CRs, but were found to have microscopic residual tumor (three) or refused biopsy (three). Twelve patients (46%) attained partial remission (PR). The overall response (85%) and CR rates (38%) were approximately double those reported with conventional Adriamycin doses. Median unmaintained remission duration for the ten patients in CR was 11 months. Cardiotoxicity, determined by radionuclide physiologic studies, occurred in 16 patients at a mean dose of 459 mg/m2; three patients developed reversible congestive failure. There were no toxic deaths. The median overall survival was 18 months. These data suggest that there is steep dose responsiveness to Adriamycin in metastatic breast cancer, and that more effective techniques for using Adriamycin may exist than those conventionally used. </jats:p