Halfway House Research Articles

Movement is Life-Optimizing Patient Access to Total Joint Arthroplasty: Housing Security and Discharge Planning Disparities.

Patients undergoing total joint arthroplasty should be screened for housing insecurity. Housing insecurity in the United States ranges from 10% to 15%, which is predisposed to those who are low-income, racial minorities, and unmarried. Osteoarthritic pain has a notable effect on function and quality of life and may prevent many individuals from continuing with their jobs. There is an inexorable, cyclic, structurally reinforced relationship between housing and health: where chronic illness affects housing security leading to issues with access to care and ultimately issues with health status. Housing insecurity is currently an imposed barrier to surgery. However, creative solutions exist to address housing insecurity, such as insurance company waivers, community resources (eg, churches) and organizations (eg, Meals on Wheels), halfway houses, and temporary housing (eg, hotels). Optimization for discharge planning in these vulnerable populations includes short-term stay in rehabilitation or skilled nursing facilities, home health services, or outpatient therapy.

Imaging Sin and the Passage to Holiness: René Girard, Ecclesial Vision, and the Spiritual Reshaping of Desires

In his 2018 book, Stumbling in Holiness, Brian Flanagan presents the knotty ecclesiological dialogue over the purity of the Church-body. There is a continuing inducement to evade acknowledgment of a sinful dimension in the body of the Church. Sometimes Christians forswear that gravely sinful people are actually members. The converse, cynical perspective turns up as well. This present article advances Girardian theological anthropology and the ecclesiology of the Halfway House as a pathway forward. The Church and church members have a situatedness in sinful culture, generating desires and cultivating conflict. The Cross exposes the destructiveness of such desires; Jesus calls for Christians to imitate his renunciation of worldly aspiration. James Alison’s vision of the Church as Halfway House fosters the notion of Christians as people undergoing forgiveness. Girardian ecclesial vision results in the spirituality of the reshaping of desires, inspired by Jesus’ bestowal of friendship and love in John 15.

Acceptance of medications for opioid use disorder in recovery housing programs in Missouri

BackgroundRecovery housing plays an important role in supporting individuals in their recovery by building recovery capital and providing stable living environments; however, the extent to which medications for opioid use disorder (MOUD), the gold standard for OUD treatment, are accepted in recovery housing settings is unclear. The purpose of this study, as part of a larger statewide evaluation of Missouri recovery homes, was to identify the extent to which Missouri recovery houses were accepting of methadone, buprenorphine, and naltrexone as well as the extent to which the acceptance of each medication was linked to whether the recovery home encouraged tapering off MOUDs. MethodsSixty-four recovery housing managers and/or staff, out of 66 eligible recovery homes in Missouri completed the survey. ResultsResults indicated that methadone was the least accepted medication for long-term use followed by buprenorphine and then naltrexone. Recovery houses that had significantly lower overall acceptance of methadone encouraged tapering; however, the overall acceptance for buprenorphine and naltrexone was not significantly related to the encouragement of tapering off MOUDs. ConclusionThis work highlights the need to develop reliable instruments to measure and assess MOUD-capable recovery homes and to increase knowledge and acceptance of MOUD within recovery home settings.

Clarification

In our article on recovery housing in a recent issue (see “Recovery housing: Where is it?,” ADAW, Jan. 24; https://onlinelibrary.wiley.com/doi/10.1002/adaw.33319), there was a confusing sentence referring to confidentiality of substance use disorder (SUD) treatment. There is no “end of patient consent” for release of information — at this time. The initial disclosure is still protected. It's what happens afterward that is in question. Thanks to the Legal Action Center for this clarification.

Study shows gaps in locating quality recovery housing

Many young people coming out of treatment for substance use disorders (SUDs) need a safe place — away from alcohol and other drugs — to live life. This is known as recovery housing, and one of the biggest problems for health care providers is finding out where it is and how good it is.

Point-of-care hepatitis C screening with direct access referral to improve linkage to care among halfway house residents: a pilot randomised study.

Linkage to care among individuals with substance misuse remains a barrier to the elimination of the hepatitis C virus (HCV). We aimed to determine whether point-of-care (PoC) education, screening and staging for liver disease with direct access to hospitals would improve linkage to care among this group. All participants were offered PoC education and HCV screening. HCV-positive participants were randomised to standard care (controls) or direct access, which provided a direct pathway to hospitals. Linkage to care was determined by reviewing electronic medical records. Linkage of care cascade was defined as attendance at the specialist clinic, confirmation of viraemia by HCV RNA testing, discussion about HCV treatment and initiation of treatment. 351 halfway house residents were screened. The overall HCV prevalence was 30.5% (n = 107), with 69 residents in the control group and 38 in the direct access group. The direct access group had a significantly higher percentage of cases linked to specialist review for confirmatory RNA testing (63.2% vs. 40.6%, p = 0.025), HCV treatment discussion (p = 0.009) and treatment initiation (p = 0.01) compared to the controls. Overall, only 12.6% (n = 13) had treatment initiation during follow-up. PoC HCV screening with direct access referral had significantly higher linkage to HCV treatment initiation (adjusted odds ratio 9.13, p = 0.005) in multivariate analysis. PoC HCV screening with direct access improves linkage to care and simplifies the HCV care cascade, leading to improved treatment uptake. PoC education, screening, diagnosis and treatment may be an effective strategy to achieving HCV micro-elimination in this population.

Financial landscape of recovery housing in the United States

Objectives: Recovery housing provides substance-free living environments that use peer-support to empower individuals in recovery from substance use disorder. This study estimated the total revenue of the recovery housing industry from recovery houses, nationwide. Methods: Using survey data collected in June and July of 2020, we calculate the total revenue of the recovery housing industry and determine the share of revenue that comes from different sources for rural and nonrural houses. Results: We find that individual recovery houses operate with an annual revenue of $250,000 and the whole industry accounts for $4.5 billion annually. COVID-19 has reduced industry revenue by 4%. Rural and nonrural houses differ significantly in their sources of revenue. Conclusions: Our results suggest that COVID-19 reduced the size of the recovery housing industry. Houses in nonrural regions may need more federal support due to the relatively high reliance on resident fees, which may be unreliable during COVID-19.

Recovery housing: Where is it?

The need for recovery housing — perhaps better termed as homes for people in recovery — has never been greater, but what and where these homes are is still elusive. The National Study of Treatment and Addiction Recovery Residences (NSTARR) report, published late last year online in Drug and Alcohol Dependence, found that the first step — defining and finding such homes — still needs to be taken.

Understanding cannabis use in Singapore: profile of users and drug progression.

Cannabis has consistently been the third most commonly abused drug among drug arrestees in Singapore over the past few years. Accordingly, this study aimed to understand the profile of cannabis users in Singapore and explore the effects of cannabis use on drug progression. A total of 450 participants who had used cannabis at least once in their lifetime were recruited from the National Addictions Management Service, prisons, the Community Rehabilitation Centre and halfway houses from August 2017 to May 2018. A face-to-face questionnaire was administered and descriptive analyses were conducted. The mean participant age was 40.9 ± 14.51 years, and 93.1% of them were male. The participants generally initiated cannabis use during adolescence, at a mean onset age of 16.5 ± 4.46 years. Most (89.6%) were introduced to cannabis by peers. Approximately half of them (46.9%) had used cannabis before other illicit drugs and 42.1% of them had used heroin as the succeeding drug. In Singapore, cannabis use is often initiated during adolescence, largely under peer influence. Cannabis users may progress to other illicit drugs, particularly heroin, later in life.

Social rehabilitation of persons serving prison sentence in a halfway house from professional perspective

Social rehabilitation of persons serving prison sentence in a halfway house from professional perspective

Kaitan Tingkat Intensitas Bunyi terhadap Jarak dari Mesin Pembangkit Listrik (Genset) di RSUD Dayaku Raja Kota Bangun

Research has been carried out on the relationship between the level of sound intensity and the distance on region 1 and region 2 from a power generator set (genset) at the Dayaku Raja Hospital, Kota Bangun. The sound intensity level value (β) is used as the dependent variable and the distance value (d) is used as the independent variable. Measurement distance in region 1 is 7 meters, while in region 2 is 30 meters, where measurement space of β is 1 meter used Sound Level Meter. Furthermore, average of β plotted with the distance (d), which the distance from the outer surface of the gensets house wall to measurement point of β (region 1) and the distance from the inner surface of the halfway house wall to measurement point of β (region 2) which the longer of the distance the smaller β are produced, where the linier curves with negative gradient are produced, that is (-1,6dB/m)d + 71,9dB (region 1) dan β = (-0,2dB/m)d + 50,1dB (region 2). On the research, β is on the range of 60 dB to 70 dB on region 1 and 40 dB to 50 dB on region 2 are produced. Thus, β from a power generator (genset) at the Dayaku Raja Hospital Kota Bangun less than Noise Threshold Value based on Peraturan Menteri Tenaga Kerja dan Transmigrasi No. 13/MEN/X/2011.

Needing More Guidance: Adherence to Offender Needs in Case Plan Objectives

ABSTRACT The risk-need-responsivity (RNR) model has become a standard formula for developing and assessing offender treatment programs. It has also become increasingly used to guide case management practices. However, less focus has been given to the impact of adhering to these principles within the development of case plan objectives. The current study has two objectives. The first objective is to draw attention to the lack of literature examining the impacts of case plan adherence to RNR on offender outcomes. The second intention is to contribute to this field by examining the impact of case plan adherence to the need principle on recidivism among a sample of halfway house clients. Results show that higher adherence within one need domain, employment/education, was related to significantly lower recidivism. Overall, these findings indicate that adherence to the need principle in offender case plans may improve client outcomes. They also underline a need for more research on the development and impacts of case plan objectives.

Resiliensi Anak Jalanan yang Bersekolah di Rumah Singgah Diponegoro Surabaya

This study aims to describe the causes of decreased resilience of street kids and also to describe the factors that make children classified as having resilience or not. The approach used in this research is a qualitative approach with a case study design. The subjects in this study were street kids who to school at the Diponegoro Halfway House. Â Â Â Â Â Â Â Â Â Â Â Collecting data using interviews, observation, and documentation. From the results of the research conducted, it was found that the resilience of the four research subjects. Subjects had the ability of seven aspects of resilience with different strengths. Economic conditions and parental affection are several reasons why children take to the streets. At their age, who should be used to study in school, it is still a big task for educators. Not all street children who go to school have good resilience abilities, as the results of this study. The results showed that in general the street kids at Diponegoro Halfway House had good abilities and there was one subject who was not resilient. The different in strength is due to family background, the origin, of the child taking to different paths and associations at school. Â Keywords : resilience, street kids.

Identifying the availability of recovery housing in the U.S.: The NSTARR project

BackgroundHome is essential to recovery, and recovery housing can play an important role for individuals seeking a supportive environment. The National Study of Treatment and Addiction Recovery Residences (NSTARR) Project constitutes the largest and most diverse study of recovery housing to date. We describe the development of a national sampling frame to study recovery housing, as well as findings on availability and distribution of recovery housing across the U.S. MethodsData from publicly available sources and lists maintained by entities tracking recovery housing were compiled. Residences for which locating information was available were geocoded and linked with U.S. Census data and drug and alcohol mortality data. We used hot spot analysis and multilevel models to describe the geographic distribution of recovery residences and assess whether residences are located in areas of high need. ResultsThe NSTARR database contains information on 10,358 residences operated by 3628 providers in all 50 states. Residences were more likely (p < 0.05) to be in urban areas and in counties with higher substance use mortality; they were less likely to be in economically disadvantaged areas. Recovery housing density also was greater in urban areas and areas with a greater proportion of non-White residents, but lower in economically disadvantaged areas. ConclusionsDespite a wealth of research on some types of recovery housing, critical gaps in the field’s understanding about the nature of recovery housing remain. The NSTARR Project represents an important first step to expand research on recovery housing across the country.

Survival Strategy of Street Children Who Do Not Occupy in Halfway House against Violence in the City of Surabaya through the Assistance of ALIT Foundation

Children are the young generation who are the hope and future of the nation. Every child needs protection and guidance in the process of growth and development both physically, mentally and socially. Especially for street children who do not live in a halfway house in the face of violence in the city of Surabaya. Community involvement in the protection of street children is also an important part in improving the quality of the nation’s next generation. One of the community’s involvements in child protection is realized through Non-Governmental Organizations. This study aims to determine the role of the ALIT Foundation in providing assistance to street children who do not live in a halfway house. This study uses a qualitative approach located along the Ketintang Surabaya railway. The results showed that the survival strategy of street children who did not occupy in halfway house against violence in the city of Surabaya was through the assistance of the ALIT Foundation and in accordance with Grindle’s theory, there were two main variables that became indicators of the success of policy implementation, namely the policy content variable and the implementation environment.

Optimizing a Halfway House to Meet Mental Health Care Users' Occupational Needs.

Background. Halfway houses (HwH) may support community reintegration of mental health care users and can be effective in meeting occupational needs of residents. However, they are not optimally used in South Africa. Purpose. This study aimed to improve the functioning of a HwH so that it better meets occupational needs of the resident mental health care users. It draws on Doble & Santha (2008); seven occupational needs. Method. A four-phase Participatory Action Research methodology was used. We conducted thematic analysis to describe met and unmet needs within PAR phases. Findings. Occupational needs of accomplishment, renewal, pleasure and companionship were being met. However, coherence, agency and affirmation needs were not being met. An additional occupational need for interdependence, based on the African ethic of Ubuntu, was identified. Implications. HwH functioning affected residents' experiences of health and wellbeing. Engagement in collective occupations can contribute to meeting the occupational need of interdependence.

Using the science of positive psychology in the formative evaluation of social justice interventions: A case example

The pursuit of culturally responsive approaches for designing and evaluating programs to promote social justice has become of the utmost importance to the evaluation community in the past decade. A strengths-focused evaluation approach has great promise for empowering individuals, groups, communities, and organizations, and identifying program strengths to build upon in addition to illuminating program deficits. However, there is a dearth of literature on using a strengths approach to evaluate interventions and programs to promote social justice. Drawing from the two disciplines of positive psychology and evaluation, this article illustrates a strengths-focused approach to formative evaluation using a case example of a halfway house for previously incarcerated women. The findings exemplify the positive psychological phenomena that emerge as a result of focusing the evaluation on program strengths. The case demonstrates that the application of a strengths-focused approach to evaluating social justice interventions can be empowering for institutions and the communities they serve.

The role of recovery housing during outpatient substance use treatment

BackgroundRecovery housing generally refers to alcohol- and drug-free living environments that provide peer support for those wanting to initiate and sustain recovery from alcohol and other drug (AOD) disorders. Despite a growing evidence base for recovery housing, relatively little research has focused on how recovery housing may benefit individuals accessing outpatient substance use treatment. MethodsUsing administrative and qualitative data from individuals attending an outpatient substance use treatment program in the Midwestern United States that provides recovery housing in a structured sober living environment, this mixed methods study sought to: (1) determine whether individuals who opted to live in structured sober living during outpatient treatment (N = 138) differed from those who did not (N = 842) on demographic, clinical, or service use characteristics; (2) examine whether living in structured sober living was associated with greater likelihood of satisfactory discharge and longer lengths of stay in outpatient treatment; and (3) explore what individuals (N = 7) who used the structured sober living during outpatient treatment were hoping to gain from the experience. ResultsFactors associated with the use of recovery housing during outpatient treatment in multivariate models included gender, age, and receiving more services across episodes of care. Living in structured sober housing was associated with greater likelihood of satisfactory discharge and longer length of stays in outpatient treatment. Focus group participants reported needing additional structure and recovery support, with many noting that structure and accountability, learning and practicing life, coping, and other recovery skills, as well as receiving social and emotional support from others were particularly beneficial aspects of the sober living environment. ConclusionsFindings underscore the importance of safe and supportive housing during outpatient substance use treatment as well as the need for future research on how housing environments may affect engagement, retention, and outcomes among individuals accessing outpatient substance use treatment.

The Uncertain Structure of Process Review in the EU: Beyond the Debate on the CJEU\u2019s Weiss Ruling and the German Federal Constitutional Court\u2019s PSPP Ruling

The obligation to provide reasons (e.g. in Art. 296 TFEU) may appear rather a simple and straightforward, but in actual practice—as the mutually antagonistic Weiss rulings of the CJEU and the German Bundesverfassungsgericht (“BVG”) amply demonstrate—is fraught with constitutional complication. On the one side, there lies the concern with a deeply intrusive form of judicial review which substitutes judicially determined “good” reasons for those of the reviewee decisionmaker—legislatures, administrative agencies, or, as in Weiss, the European Central Bank (ECB). On the other side lies the concern with judicial abdication in the face of technical expertise, uncertainty and complexity, turning the reason-giving requirement into a mere façade thereby placing democratic accountability in the modern administrative state beyond law’s remit. Either way, normatively and conceptually, we seem left with a half-way house only. Drawing on the recent US administrative law discourse—the neo-Fullerian concept of an “internal morality of law” (Sunstein / Vermeule) and democratic experimentalism (Sabel / Kessler)—this paper explores the concept of process review as tertium datur. Process review responds to concerns over the rule of law and administrative discretion through indirect, procedural safeguards, by imposing requirements of reasoned justification, rather than through wholesale invalidation or aggressive substantive review.

Ethics, Patents and Genome Editing: A Critical Assessment of Three Options of Technology Governance

Current methods of genome editing have been steadily realising the once remote possibilities of making effective and realistic genetic changes to humans, animals and plants. To underpin this, only 6 years passed between Charpentier and Doudna’s 2012 CRISPR-Cas9 paper and the first confirmed (more or less) case of gene-edited humans. While the traditional legislative and regulatory approach of governments and international bodies is evolving, there is still considerable divergence, unevenness and lack of clarity. However, alongside the technical progress, innovation has also been taking place in terms of ethical guidance from the field of patenting. The rise of so-called “ethical licensing” is one such innovation, where patent holders’ control over genome editing techniques, such as CRISPR, creates a form of private governance over possible uses of gene-editing through ethical constraints built into their licensing agreements. While there are some immediately apparent advantages (epistemic, speed, flexibility, global reach, court enforced), this route seems problematic for, at least, three important reasons: 1) lack of democratic legitimacy/procedural justice, 2) voluntariness, wider/global coordination, and sustainability/stability challenges and 3) potential motivational effects/problems. Unless these three concerns are addressed, it is not clear if this route is an improvement on the longer, slower traditional regulatory route (despite the aforementioned problems). Some of these concerns seem potentially addressed by another emerging patent-based approach. Parthasarathy proposes government-driven regulation using the patent system, which, she argues, has more transparency and legitimacy than the ethical licensing approach. This proposal includes the formation of an advisory committee that would guide this government-driven approach in terms of deciding when to exert control over gene editing patents. There seem to be some apparent advantages with this approach (over traditional regulation and over the ethical licensing approach mentioned above—speed and stability being central, as well as increased democratic legitimacy). However, problems also arise—such as a “half-way house” of global democratic legitimacy that may not be legitimate enough whilst still compromising speed of decision-making under the “ethical licensing” approach). This paper seeks to highlight the various advantages and disadvantages of the three main regulatory options—traditional regulation, ethical licensing and Parthasarathy’s approach—before suggesting an important, yet realistically achievable, amendment of TRIPS and an alternative proposal of a WTO ethics advisory committee.