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Individuals starting a recovery journey enter recovery housing with diverse sociodemographic backgrounds, substance use histories, and levels of recovery capital, which influence the length of stay in recovery housing. This study examined which admission characteristics correspond to length of stay in recovery residences and used survival mixture clustering to characterise heterogeneity in retention trajectories. This study included data from 2534 residents across 61 U.S. recovery residences between 2019 and 2023. Cox proportional-hazards regression identified baseline correlates of length of stay, with cluster-robust standard errors at the residence level. A complementary survival mixture clustering algorithm jointly modelled latent retention trajectories and survival functions using sociodemographic characteristics, recovery capital, barriers, unmet service needs, and substance use indicators. Older age, higher quality of life, greater recovery group participation, an unmet alcohol treatment need, and criminal legal system involvement associated with longer stays. By contrast, a history of cannabis use, drug use within 90 days before admission, and an unmet drug treatment need associated with shorter stays. Survival mixture clustering supported a nine-cluster solution, with median lengths of stay ranging from 29 to 91 days. Clusters with shorter stays exhibited lower recovery capital, higher unmet needs, and greater recent substance use, whereas longer-stay clusters demonstrated higher quality of life, stronger engagement with support structures, and higher proportions of criminal legal system involvement. Model discrimination was modest overall, indicating that baseline characteristics explain only part of the variation in retention trajectories. Residents reporting recent drug use before admission to recovery housing or an unmet drug treatment need may benefit from proactive support at admission, while peer engagement and structured support pathways may promote longer lengths of stay. Because effect sizes were modest and discharge outcomes were heterogeneous, these findings should inform adaptive and equity-conscious service responses rather than individual risk classification. Future research should disaggregate accrual and loss of recovery capital during initial residence and distinguish between disengagement and recovery-readiness exits.

This study evaluated the influence of prior gabapentin administration, associated or not with integrative practices, on sedation scores, physiological parameters, and propofol requirement in cats sedated with dexmedetomidine undergoing elective orchiectomy. Forty healthy cats (3.76 ± 0.69 kg) were enrolled (T0) and randomized into four groups (n = 10). GAB group received gabapentin (100 mg administered orally) under standard housing, GAB-GCW group received the same treatment but was housed in a cat ward with integrative practices. Control groups received placebo in a cat ward with integrative practices (GCW) or standard housing (GC). After 120 minutes, all cats received dexmedetomidine (5 µg/kg IM). Heart rate (HR), respiratory rate (RR), systolic blood pressure (SBP), temperature and sedation scores were assessed before (T1) and 30 minutes after dexmedetomidine (T2). Propofol induction dose, recovery times and quality were recorded. In T1, GAB-GCW showed higher sedation scores [6 (3-9)] than GAB [3 (2-5)] and GC [3 (1-5)], but not GCW. In T2, GAB [9 (2-12)] and GAB-GCW [7.5 (5-12)] scored higher than GC and GCW. Propofol requirements were lower in GAB (4.2 ± 1.9 mg/kg) than GCW (6.8 ± 1.5 mg/kg) and GC (7.2 ± 2 mg/kg) but not GAB-GCW (5.4 ± 1.7 mg/kg). Gabapentin had no effect on physiological variables or recovery. In conclusion, 100 mg of gabapentin given 120 minutes before handling enhances dexmedetomidine sedation and provides a significant propofol-sparing effect for anesthetic induction in cats, although integrative practices alone appear to have limited impact on these outcomes.

The aim of this study was to evaluate the association between socioeconomic status (SES) and all-cause mortality among individuals with diabetes. We also examined how individual SES components, including income, employment, education, and housing conditions, were associated with mortality risk. Following PRISMA 2020 guidelines, we searched PubMed, Embase, the Cochrane Library, and Web of Science through September 2025. Eligible studies included adults with type 1 or type 2 diabetes reporting associations between SES indicators (income, education, occupation, or area-level deprivation) and all-cause mortality. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using fixed- or random-effects models based on heterogeneity (I2). Publication bias was assessed using funnel plots and Egger's test. Nineteen studies were included. Low SES was associated with a higher risk of all-cause mortality (OR&#x202f;=&#x202f;1.67; 95% CI: 1.49-1.88; p&#x202f;<&#x202f;0.00001). Similar associations were observed across income, education, housing, and employment domains. Heterogeneity was substantial (I 2&#x202f;=&#x202f;99%), indicating considerable variability across studies. Sensitivity analyses showed that no single study materially influenced the pooled estimate, and publication bias appeared minimal. Low socioeconomic status is associated with increased mortality among individuals with diabetes. Addressing socioeconomic inequalities through improved access to education, employment opportunities, healthy environments, and equitable healthcare may help reduce survival disparities and mitigate the overall burden of diabetes. https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=1248984, identifier PROSPERO (CRD420251248984).

Housing is a key social determinant of health, yet little is known about how homelessness shapes migrants' health in Nordic welfare states where legal status, labour market attachment and welfare entitlements are unevenly distributed. This article examines how homelessness affects the physical and mental health of migrants, and how structural barriers limit their capacity to navigate access to health care. Exploratory mixed-methods study combining registry data on shelter use in Oslo (2019-2023) and interviews with ten frontline health and social care staff at a long-term, NGO-run shelter. Analyses were informed by precarious citizenship and structural vulnerability. Homeless migrants represented a heterogeneous group in terms of citizenship status and health problems. Migrants' region of origin influenced their resident status, the uncertainty of their situation, and the duration of their stay. Homelessness interacted with migrants' pre-existing vulnerabilities, such as precarious legal and economic status, language barriers, limited access to public services, and untreated chronic disease, to accelerate health decline. Precarious citizenship can be enacted through gendered arenas of exploitation, with consequences for safety, access to care and possibilities for recovery. Homelessness among migrants reflects structural vulnerability and contributes to cumulative disadvantage. Homelessness is not simply a backdrop to migrant ill-health; it is an active health risk that exacerbates disease, disrupts treatment, and limits recovery. Shelters and low-threshold services play a crucial bridging role by enabling access to treatment and rehabilitation. Addressing migrant health inequities requires rights-based approaches and integrated policies linking housing stability and health care access.

Place significantly impacts health and belonging, yet little is known about how place and loneliness intersect for people with chronic conditions. This qualitative study examined how people with chronic illness experience places in their daily lives, and how these place-based experiences shape feelings of loneliness. We conducted in-depth interviews, walking interviews and photo-elicitation with 40 participants across urban and regional Australia, analysing how place relationships intersected with loneliness and illness experiences. Our analysis revealed three distinct patterns. 'Effortless belonging' characterised those with pre-existing advantages (spatial stability, economic security, established networks) who maintained unconscious protective buffers against loneliness through deep place familiarity despite illness. 'Strategic spatial negotiation' described participants who actively curated place engagement - using home as refuge during symptomatic periods while selecting accessible public spaces to maintain social identity. 'Geographic disenfranchisement' emerged where chronic illness compounded structural vulnerabilities (poverty, housing instability, marginalisation) creating compromised place connections where locality intensified rather than alleviated loneliness. Findings reveal chronic illness fundamentally but not uniformly reshapes place-loneliness relationships by intersecting with existing structural conditions to create divergent spatial experiences. For participants with structural advantages, bodily vulnerabilities were buffered by stable place connections, while those with pre-existing disadvantages experienced chronic illness as compounding spatial marginalisation. Strong place attachment could coexist with spatial constraint, particularly in disadvantaged areas, challenging assumptions about the inherent benefits of place belonging. Findings underscore the need for spatially-informed interventions addressing structural inequalities (housing instability, inaccessible spaces, socioeconomic disadvantage) that determine whether chronic illness becomes a pathway to place-based connection or disconnection.

This pilot study investigates whether trained behavioral tasks may serve as early, non-invasive indicators of distress in high-severity disease models in laboratory rats. Therefore, six Wistar rats in a diethylnitrosamine-induced hepatocellular carcinoma model, were trained to perform two tasks: lockbox solving and scale climbing. They were assessed over 18&#x2009;weeks by body weight, hair corticosterone (hCORT), and Grimace Scale. Changes in task performance time and hCORT levels were observed and revealed a three-phase pattern. Initially, poor task performance (mean lockbox solving time 22&#x2009;s) and elevated hCORT (mean 10.8&#x2009;pg/mg) indicated a process of adaptation to the experiment. This was followed by improved performance (mean lockbox solving time 2&#x2009;s) and reduced hCORT (mean 7.9&#x2009;pg/mg), suggesting acclimatization. Later, performance declined again (mean lockbox solving time 9&#x2009;s), accompanied by rising hCORT (mean 8.3&#x2009;pg/mg), likely reflecting tumor progression and repeated anesthesia exposure. Lockbox solving appeared more variable than scale climbing. Acute stressors, such as room changes and prolonged anesthesia, had an impact on lockbox solving and scale climbing. After the initial housing room change lockbox solving time increased from 20&#x2009;s to 49&#x2009;s while scale climbing time rose from 12&#x2009;s to 26&#x2009;s. Case observations confirmed that task performance deficits coincided with illness or larger tumor burden. These findings support the use of trained behavior as a sensitive tool to detect distress. This approach could improve welfare monitoring in long-term or high-severity animal studies.

In response to recurrent epizootics of highly pathogenic avian influenza (HPAI), France launched a national vaccination programme targeting ducks in October 2023. It was completed by a three-pillar post-vaccination surveillance system, comprising enhanced passive surveillance, active virological testing, and end-point serological testing. Using national-level data from mandatory reporting systems, this study (i) evaluates the implementation of the post-vaccination surveillance system during its first year, and (ii) presents initial results regarding the detection of avian influenza virus (AIV) circulation in vaccinated flocks through this surveillance programme. A total of 18,881 enhanced passive surveillance operations were recorded across 1604 establishments, representing a coverage rate of 55.2%. In addition, 17,951 active surveillance operations were conducted in 2011 establishments, with virological testing performed in 89.0% of targeted sites and serological testing in 83.4%. All surveillance items considered, 92.3% of the establishments housing vaccinated ducks carried out at least one surveillance operation over the studied period. The three surveillance components proved complementary: AIV prevalence at the establishment level was estimated at 6.8%, 7.3% and 13.7% through passive surveillance, active virological testing, and end-point serological testing, respectively, with only low pathogenic AIV detected. These findings underscore (i) the unprecedented scale of AIV surveillance within the French duck farming sector, (ii) the importance of evaluating stakeholders' adherence as a prerequisite for assessing surveillance effectiveness; (iii) the interest of monitoring AIV circulation to detect the potential emergence of antigenically modified virus strains and to inform timely adjustments to control strategies.

Wealth inequality is a central dimension of social stratification, yet the early-life processes underlying its emergence remain insufficiently understood. This article examines whether childhood residential mobility contributes to adult wealth accumulation, through which developmental pathways, and under what conditions. Drawing on longitudinal data from the 1958 National Child Development Study, I link residential histories from birth to age 16 to homeownership and net financial wealth at age 33. Childhood mobility is conceptualised as a multidimensional process that captures the frequency and timing of moves, as well as whether residential change coincided with school disruption. The results reveal a clear stratified pattern. Occasional moves are largely benign by early adulthood, but repeated mobility is associated with lower wealth and reduced access to homeownership, especially when it extends into adolescence or disrupts schooling. Mediation analyses indicate that these associations operate more clearly through adolescent psychosocial difficulties than through cognitive performance. Moderated mediation models further indicate that psychosocial pathways are concentrated among children who are outside financially secure owner-occupied households at age 16. By highlighting how childhood residential instability becomes embedded in later wealth accumulation, this study extends sociological accounts of stratification beyond labour market outcomes to the developmental and housing foundations of asset inequality.

Juvenile delinquency is closely linked to complex psychosocial and value-based developmental trajectories. This study compares life-course narratives (childhood and school experiences, daily life structure), value orientation, self-concept, and standardized self-reports of emotions among adolescents with delinquent behavior, adolescents with psychiatric disorders, and healthy peers. Using a mixed-methods design, narrative interviews were conducted with all three groups (N&#x2009;=&#x2009;48). Participants were asked to describe their feelings in relation to these domains in order to assess emotional processing, measured by the Positive and Negative Affect Schedule (PANAS). Compared with their healthy peers, narratives from adolescents with delinquent behavior were characterized by greater strain across their developmental course. These descriptions were marked by housing and caregiving instability, insecure bonding experiences with primary caregivers, difficulties in forming coherent and socially oriented value systems, and a tendency toward self-concepts marked by overcompensation. Regarding emotional experience, PANAS results indicate that both the delinquent and psychiatric groups reported higher levels of negative affect than healthy adolescents. Although adolescents with psychiatric disorders also reported adversity, their narratives tended to reflect greater variability in protective factors and more opportunities to benefit from therapeutic and relational support. The findings suggest that delinquent behavior may arise from the cumulative interplay of early adversity, environmental instability, disrupted relational experiences, and challenges in developing individualized values and stable, non-compensatory self-concepts. These results highlight the importance of interventions that address potential moral injury, strengthen reliable relational contexts, and promote socially integrated value orientations. Qualitative approaches provide important insights into these mechanisms and should complement quantitative assessments when working with high-risk youth.

Social frailty is defined as the risk of losing the necessary resources to meet basic social needs. This study aimed to assess social frailty and its associated factors in older adults in Kashan in 2023. In this cross-sectional study, 250 older adults were selected through multistage random sampling from comprehensive health centers. Data collection instruments included a demographic questionnaire, abbreviated mental test, social frailty scale, Lubben social network scale, and a specific quality of life scale. Data were analyzed using Jamovi v.2.3.28. Associated factors were identified using independent t-tests, analysis of variance, Pearson correlation coefficient, and multiple linear regression. The mean social frailty score was 1.244 (&#xb1;&#x2009;1.345), and it was estimated to be 1.077-1.411 (on a scale of 0-6) in the community. Additionally, 65.2% of participants had at least one component of social frailty. Standard multiple linear regression showed that five variables were independently associated with social frailty: social isolation, quality of life, housing type, health insurance coverage, and age (F&#x2009;=&#x2009;9.834, p&#x2009;<&#x2009;0.001). These variables explained 40.3% of the observed variance. This study highlights the social frailty of older adults covered by comprehensive health centers. Longitudinal studies are needed to determine whether implementing programs targeting these associated factors could potentially reduce the risk of social frailty among older adults in Iran.

Despite the recognition of substance use and sex work as public health issues, the intersection of these areas, especially within the rural US, is an area of special importance. The Rural Opioid Initiative comprises of eight research cohorts spanning 10 states and 65 rural US counties. Between 1/2018-3/2020, individuals who reported past 30-day substance injection or opioid misuse were recruited. Analyses were restricted to people who use drugs (PWUD) who reported trading "vaginal or anal sex for drugs, money, housing, or other things you need" in the past 30 days. We analyzed cross-sectional associations between injection drug use and sexual behaviors associated with hepatitis C virus (HCV)/HIV infection transmission, access to harm reduction, and HCV status among PWUD and engaged in sex work in rural US areas. Of the 2045 participants, 9% (n=180) reported engagement with sex work, with just over half being women (58% [n=104]). In adjusted models, people who engaged in sex work, compared to PWUD who did not, had higher prevalence ratios of past 30-day receptive syringe sharing (adjusted prevalence ratio [aPR]=1.69, 95% Confidence Interval [95%CI]=1.44-1.98), practice of multiple injections per injection episode (aPR = 1.28, 95% CI = 1.15-1.43), practice of syringe mediated drug sharing (aPR=1.50, 95% CI=1.32-1.71), condomless sex (aPR=1.62, 95% CI=1.48-1.77) and condomless sex with someone who injects drugs (aPR=2.05, 95% CI=1.76-2.39). PWUD engaged in sex work were less likely to report easy condom access (aPR=0.88, 95% CI=0.80-0.96), while no significant differences were observed for most other harm reduction access measures. PWUD engaged in sex work in the rural US had higher likelihood of injection drug use and sexual behaviors associated with HCV/HIV infection transmission, while having lower use of and access to condoms. This study emphasizes the importance of ensuring affordable access to condoms within the context of harm reduction services, especially given the limited access to health care and supportive services, particularly in rural communities.

Post Covid-19 Condition (PCC) can fluctuate over time, yet, no in-depth investigation of the heterogeneous PCC trajectories that can exist in children and young people (CYP) has been undertaken. We aim to examine associations between PCC trajectories in CYP over 2-years following infection and (i) factors prior to the COVID-19 pandemic/infection including socio-demographic variables (e.g., age, sex, ethnicity), health and educational needs status and (ii) factors subsequent to infection including the nature, number, functional impact and severity of symptoms, as well as mental health and wellbeing. 943 PCR-test positive CYP (enrolled January-March 2021) were followed-up over two-years (till January-March 2023). Five PCC trajectory groups were specified: (i) chronic, (ii) recovered, (iii) fluctuating, (iv) late onset and (v) never PCC. These groups were compared in terms of factors at baseline using multinomial logistic regression and concurrent health during the two-year period using Chi-Square/Fisher's Exact tests. Baseline factors prior to the pandemic/infection such as female sex, older age, poorer pre-infection mental and physical health, prior healthcare use, and educational needs were strongly and consistently associated with adverse PCC trajectories. Compared to those aged 11-to-14-years at infection, those aged 15-to-17-years had a 2.44 (95%CI:1.39,4.26) higher risk of being in the chronic group (compared to the never group). Similarly, the risk of being in the fluctuating group was 1.57 (95%CI:1.04,2.37), the recovered group was 2.08 (95%CI:1.10,3.92) and the late-onset group was 1.50 (95%CI:1.08,2.07). Other sociodemographic factors, such as ethnicity and region of residence, had more modest and inconsistent associations. PCC trajectories differed by concurrent number, frequency, functional impact and severity of symptoms and mental health. CYP with chronic PCC consistently reported a higher median number of symptoms (5+) compared to the other groups (median symptoms&#x2009;&#x2264;&#x2009;3). Mental health and wellbeing, of the chronic PCC group was also consistently worse (e.g., 41% of the chronic group consistently were classified as 'cases' on the Strengths and Difficulties scale vs 17%-to-2% of the other groups). There were consistent differences between PCC trajectories, in terms of sex, age, pre-infection mental and physical health, healthcare use, and educational needs. Understanding factors associated with PCC trajectory heterogeneity in CYP and how these trajectories differ over time can help with treatment planning.

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Titanium dioxide nanoparticles (TiO&#x2082;-NPs) are extensively used in industrial and biomedical applications and have been reported to induce hepato-renal toxicity through oxidative stress and inflammation. This study evaluated the protective effects of virgin olive oil (VOO) against TiO&#x2082;-NP-induced damage, while characterizing its chemical composition and exploring the molecular interactions of its bioactive compounds. VOO composition was analyzed by UV-visible spectrophotometry, HPLC-PDA, and GC-FID, and its antioxidant activity was assessed using the DPPH assay. Twenty-four male Wistar rats were divided into four groups (n&#x2009;=&#x2009;6): a control group and three TiO&#x2082;-NP-exposed groups, two of which received VOO at 2 and 4&#xa0;g/kg body weight, respectively, starting 24&#xa0;h post-exposure. After six weeks, hematological, biochemical, oxidative stress, and histopathological parameters were evaluated. Molecular docking was performed to explore interactions between identified phenolics and key antioxidant and inflammatory enzymes (GSTP1-1, COX-2, CAT, and 5-LOX). VOO exhibited notable antioxidant activity (DPPH inhibition: 54.80%) and a high content of phenolic compounds, including quercetin, rutin, and 4-hydroxybenzoic acid. TiO&#x2082;-NP exposure induced significant oxidative stress, evidenced by increased malondialdehyde levels, decreased glutathione content, reduced antioxidant enzyme activities (GPx, GST, and CAT), and altered hematological parameters. VOO supplementation significantly attenuated these alterations in a dose-dependent manner, partially restored antioxidant defenses, and improved biochemical and hematological profiles, while helping to preserve tissue architecture. Docking analysis revealed notable binding affinities of phenolic compounds toward target enzymes, suggesting interactions consistent with the in vivo findings. In conclusion, VOO may mitigate TiO&#x2082;-NP-induced hepato-renal toxicity in rats, possibly through antioxidant and anti-inflammatory mechanisms. These effects are likely associated with its phenolic compounds, as suggested by both in-vivo and in silico findings.

To examine the relationship between resident-level (intrinsic) and facility-level (extrinsic) factors associated with pressure injury development among nursing home residents. Exploratory, retrospective cohort design using secondary data from the Turn Everyone and Move for Pressure Ulcer Prevention study. Data from a convenience sample of 998 residents across nine nursing homes were analysed. Resident-level factors included demographics, body mass index, comorbidities, Braden Scale scores, and clinical severity. Facility-level factors included staffing hours and location. Multivariable logistic regression identified factors associated with pressure injury development. Of 998 residents, 61 (6.1%) developed new pressure injuries. Four significant predictors were: higher clinical severity laboratory values, underweight, fewer licensed practical nurse staffing hours, and lower Braden Scale Mobility subscale scores. This study highlights the importance of considering both intrinsic resident-level and extrinsic facility-level factors when assessing pressure injury risk in nursing home residents. Clinical severity measures capturing individualized physiological status may provide valuable information beyond traditional risk assessment tools. Pressure injury prevention benefits from incorporating physiological markers with traditional risk factors, enhancing early identification of high-risk residents. Effective prevention strategies address both resident vulnerability and care environment factors, particularly staffing levels. Clinical mobility assessments remain essential but gain value when integrated with physiological markers. As electronic health record use increases in nursing homes, future research can leverage these data to develop targeted interventions. Elevated pressure injury rates in nursing homes are a persistent problem. Main findings reveal that intrinsic resident-level and extrinsic facility-level factors influence pressure injury risk. These findings enable a shift in assessment focus from primarily mobility-based to more comprehensive risk profile evaluations. Vulnerable residents will benefit from earlier risk identification that leads to targeted interventions. For healthcare systems and administrators, it highlights the importance of adequate staffing models in pressure injury prevention efforts. Data were from resident participants in the implementation of the parent study.

The species pool is a fundamental concept with the potential to connect ecological and evolutionary processes in community ecology and biogeography. However, current definitions of the concept primarily focus on contemporary ecological processes, ignoring the historical and evolutionary processes that generated the species pool. We propose a phylogenetic framework that defines the species pool by inferring evolutionary connectivity between communities in a biogeographic region. Our framework is better suited to addressing questions regarding assembly processes occurring over long time periods, offering deeper evolutionary insights for community ecology and conservation biogeography.

This Evidence-to-Recommendation (EtR) framework underpins the ACE Clinical Guideline (ACG) for the diagnosis and management of allergic rhinitis (AR), providing justifications for its recommendations. Allergic rhinitis is highly prevalent in Singapore, with most cases being moderate to severe. While AR is not associated with severe outcomes, poorly controlled or untreated AR can lead to complications, such as asthma, sinusitis or otitis media with effusion. The ACG covers the diagnosis and management of perennial AR, which is the predominant local form of AR and is largely attributed to house dust mites. The Grading of Recommendations Assessment, Development and Evaluation framework was followed to develop four evidence-based recommendations that cover diagnosis, role of allergy testing, and management through pharmacological interventions and allergen avoidance. This EtR framework summarises factors that have informed the direction and strength of the ACG recommendations, including balance of benefits and risks, certainty of evidence, patient preferences and values, resources and feasibility considerations, and acceptability. The ACG can be found at https://go.gov.sg/acg-ar.