Housing Health Research Articles

Is the Refugee Health Screener a Useful Tool when Screening 14- to 18-Year-Old Refugee Adolescents for Emotional Distress?

Abstract The high number of asylum seekers in Sweden has highlighted the need for structured assessment tools to screen for refugee mental health problems in clinical services. We examined the utility of the Refugee Health Screener (RHS) in refugee adolescents, aged 14–18, attending routine clinical examinations or staying in group homes/refugee centres (N = 29). Participants completed a survey, including the RHS, administered through iPads in their native language. The RHS showed excellent internal consistency (α = 0.96) and correlated moderately with symptoms of post-traumatic stress disorder (r = 0.41, p = 0.025). Mean scores and prevalence rates were comparable to a study of adult refugees in Sweden. Unaccompanied refugee minors (URMs) scored significantly higher (M = 32.0, SD = 12.9) compared to youth staying with their families (M = 7.5, SD = 8.2, p < 0.001, d = 2.27). Our findings confirm that the RHS can be used in the adolescent population in Sweden. These findings moreover suggest that URMs are a particularly vulnerable group with a large burden of mental health problems. In 2015, 162,877 persons sought asylum in Sweden, 35,369 of whom were unaccompanied refugee minors (URMs) and another 35,015 children in families (Swedish Migration Agency, 2017). Most URMs (86 per cent) are boys, mainly from Afghanistan, Syria, Somalia and Eritrea, whereas children in families (accompanied refugee minors) more often come from Syria and Iraq with an equal gender distribution. During the asylum process, lasting up to 30 months, children have access to free education and health care. URMs are under the care of the social services and are assigned a legal guardian until they turn 18. Adults are entitled to acute health care and housing but cannot work and have no access to studies. If granted asylum, the person/family is assigned to a municipality that assumes responsibility for them. Thus, on top of adverse events before and during migration, the asylum and resettlement process per se involves stressors and a lack of control for refugees, which increases the risk of developing mental health problems.

Assessing the impacts of daily Cannabis versus alcohol and methamphetamines on young Australians in youth AOD treatment

BackgroundCannabis is the most widely used illicit substance by Australian young people, including those engaged with youth alcohol and other drug (AOD) systems. While recreational cannabis use in young people may be a developmental activity for some, for others, this usage becomes regular and be associated with poorer long term outcomes. This study reports on the rates of cannabis use and co-existing psychosocial complexity factors in the Youth Needs Census (2013 and 2016) where workers report on all clients in the youth AOD system, a cohort considered highly vulnerable.MethodsData was examined for two rounds of data collection for the Youth Needs Census, including 823 youth AOD service engaged young people in 2016 and 1000 AOD service engaged young people in 2013, to identify usage rates, psychosocial outcomes, and changes over time.ResultsDaily use of cannabis alone significantly exceeded daily usage rates for methamphetamines, alcohol, and cannabis used alongside other substances. Daily cannabis use was significantly associated with mental health problems, employment problems, education problems, family problems, and housing problems. Daily cannabis use was associated with most psychosocial complexity factors to the same extent as daily methamphetamine use and daily alcohol use, with daily cannabis users only showing lower incidence of the drug-related harm measure. Notably, daily cannabis use also increased from 2013 (47.5%) to 2016 (54.2%).ConclusionsIt is imperative that the number of individuals using cannabis is considered alongside the severity of harm when assessing the social impact of this substance. Within cannabis users engaged with the youth AOD system, who often have high levels of psychosocial complexity, cannabis is used daily by a large proportion of these youths and may play a role in negatively impacting their lives.

Using data linkage innovation and collaboration to create a cross-sectoral data repository for Western Australia

Background/rationaleThe Western Australian (WA) government and the Centre for Data Linkage (CDL) at Curtin University are creating a large, de-identified researchable database – the Social Investment Data Resource (SIDR) – to support a key government initiative called Target 120 (T120). T120 delivers targeted early interventions to young offenders and their families to reduce the likelihood of re-offending.
 Main AimThe SIDR brings together de-identified data from across government to be used for actuarial assessment and social investment analytics to assess long-term costs and benefits of T120 interventions.
 MethodsSIDR adopts a distributed linkage model where linkage workload is shared between the Department of Health Data Linkage Branch who curate WA Data Linkage System (WADLS) and the CDL. Design elements of the model included a common spine (embedded into the infrastructure of both groups), methods for leveraging quality from WADLS, and inclusion of family relationships data from the WA Family Connections database. The linkage model uses a combination of traditional and privacy-preserving record linkage (PPRL) methods. PPRL does not require release of personal identifiers; instead, data is irreversibly hashed prior to release for probabilistic linkage.
 The resultant SIDR repository has been designed to be securely and strictly managed. Access is by authorised, approved users only.
 ResultsUse of a distributed linkage model, coupled with traditional and PPRL methods, is an innovative yet pragmatic way of delivering data linkage services to a large, cross-sectoral research project. PPRL methods enable inclusion of otherwise excluded datasets in the project. Sharing of workload harnesses linkage capacity and capabilities across the state. The SIDR includes health data, education records, justice, child protection, disability and housing data.
 ConclusionSIDR provides a resource for whole-of-government policy development, service evaluation, academic research and social investment analytics for T120 and beyond. The SIDR distributed linkage model has potential for adaptation and use elsewhere.

Setting the agenda for further research on health and welfare

Abstract Background Given the recognised relationship between poverty, welfare provision and health, welfare rights advice has emerged as a potentially key intervention in improving health and reducing inequalities. The generation of evidence in this area has proven difficult however, creating a need to take stock of existing research and develop an agenda for future work. Methods A series of four workshops was convened involving researchers from four UK universities who had previously undertaken work examining the relationship between welfare advice and health, from a range of methodological perspectives. Run concurrently to a scoping of the literature, these workshops aimed to synthesise lessons from prior research; formulate outstanding research questions; and outline potential methodological approaches for addressing these. A survey was undertaken with professionals (from welfare or legal advice sectors, the health sector, commissioning, local government, and housing services, n = 50) to test out, refine and add to these research questions. Results Key research questions developed from these workshops were: Are there inequalities in the impact and reach of advice services across social groups? How/ does advice delivery mode matter?What are the individual and system level impacts of the de-implementation of advice services?What are the impacts of changes to welfare provision on children, inter-generationally and throughout the life course?How do experiences of social welfare vary by social group, geographically and across generations? How do different identities combine to influence how social welfare is understood? Conclusions While the collaborative process brought challenges in balancing research and practitioner expertise, this model of working has been successful in setting an agenda for further research with maximum utility to practice. Direct outputs from the projects have been the collaborative submission of a journal article and a research bid. Key messages The collaboration, which was supported by the NIHR School of Public Health Research, led to the establishment of a concise research agenda. Through extensive stakeholder consultation, this will have maximal utility for practice.

The right-remedy gap in economic and social rights adjudication: Holism versus separability

If the right-remedy gap is an inevitable feature of constitutional law, it is all the more so for constitutional economic and social rights. Yet such rights – to have access, for example, to health care, education, social security, housing, food, water, sanitation, or other good or service or opportunity deemed fundamental to human freedom and dignity – are not uniform in the remedial gaps that occur. This article introduces the orientations of holism and separability to demarcate the distinctive challenges of rights adjudication across different policy domains. A holistic understanding of economic and social rights points to the institutional challenges faced by courts in reviewing socio-economic laws and policies in general. A separable analysis of discrete economic and social rights helps to clarify the remedial constraints of each. These effects are demonstrated by the remedies ordered by courts with respect to identified infringements of South Africa’s constitutional rights to housing, health care, social security, and education.

Supporting Efforts by Intellectually Disabled Adults to Exit Homelessness: Key Ingredients of a Cross-Sector Partnership.

This column describes the development of a partnership between health care, housing, and intellectual disability services to support efforts by homeless adults with intellectual disabilities to exit homelessness. Applying a Housing First approach and philosophy, the partners launched a pilot intervention, which at its first phase engaged 26 homeless adults with intellectual disabilities in Toronto. This cross-sector service model was acceptable to service users, who reported positive experiences and good program engagement. Key enablers of success included the program's capacity to address complexity, stakeholders' approach to choice and compromise, and fulsome collaboration and communication at every level.

299 Adverse Social Determinants of Health Are Associated With Higher Primary Care Treatable and Emergency Department Care Needed Visit Rates Among a Sample of Medicaid Beneficiaries

To examine the association between social determinant of health (SDH) factors and types of emergency department (ED) visits controlling for illness severity. We estimated the relative rate of primary care treatable (PCT) and emergency department care needed (EDCN) visits during a two-year period among Medicaid beneficiaries with different SDH risk profiles and medical conditions adjusted for the Chronic Disability Payment Score (CDPS), age and sex. We prospectively enrolled 6,719 subjects enrolled in the District of Columbia Medicaid program who had a medical encounter at two EDs, a primary care clinic or an obstetrics and gynecology clinic during a 15-month enrollment period. At enrollment, subjects completed a SDH survey that included questions about education and employment, health behaviors, living circumstances, financial difficulties, food insecurity, housing instability, mental health, and receipt of social services. We used latent class analysis to develop risk profiles based on their SDH data. We also obtained subjects’ Medicaid claims data for a two-year period and merged it with the SDH data. We used the claims data to count the total number of PCT and EDCN visits during the two-year period, to calculate the CDPS and to identify subjects with selected types of medical conditions. We separately modeled the total number of PCT and EDCN visits as a function of the SDH risk class, medical condition, age, sex and the CDPS using a generalized linear mixed effect model (GLIMMIX) with poisson distribution. The mean age of the study sample was 39, 67% were female and 91% black. Eighty percent of subjects were enrolled in the DC Medicaid program for the entire 2-year study period. The mean number of PCT and EDCN visits was 2.0 and 4.4 respectively. The latent class analysis revealed three distinct SDH profiles: group 1 (47%) reported few SDH adversities and receipt of few social services; group 2 (30%) reported more SDH adversities and receipt of more social services; and group 3 (23%) reported more SDH adversities but reported receiving few social services. As displayed in the table below, the higher SDH risk classes were associated with increased relative rates of PCT and EDCN visits compared to the lower SDH risk class.TableRegression Coefficients of GLIMMIX models With CDPS And Selected Medical Conditions.∗Compared to the low risk SDH risk class, adjusted for age, sex, and the CDPS. ‡ p ≤ 0.05.ED VisitCDPS OnlyCDPS, DiabetesCDPS, CardiovascularCDPS, RenalCDPS, PsychiatricCDPS, Substance AbuseA. Primary Care Treatable (PCT)Class 2: Higher SDH, more services0.12‡0.11‡0.11‡0.12‡0.060.09‡Class 3: Higher SDH, fewer services0.19‡0.19‡0.19‡0.18‡0.13‡0.14‡Medical condition type-0.010.020.17‡0.41‡0.45‡B. ED Care Needed (EDCN)Class 2: Higher SDH, more services0.09‡0.08‡0.09‡0.08‡0.070.07Class 3: Higher SDH, fewer services0.15‡0.15‡0.16‡0.14‡0.14‡0.10‡Medical condition type-0.14‡0.35‡0.32‡0.36‡0.49‡∗ Compared to the low risk SDH risk class, adjusted for age, sex, and the CDPS. ‡ p ≤ 0.05. Open table in a new tab Over and above illness severity and types of medical conditions, the relative rate of PCT and EDCN visits varied significantly by the socio-economic adversities Medicaid beneficiaries experience.

G 지역사회의 아동친화도와 아동ㆍ청소년의 삶의 만족에 관한 연구

This study investigated the difference of life satisfaction according to the general characteristics and child friendliness of a city, and this study also examined the effect of the general characteristics and child friendliness of a city on the life satisfaction of children and adolescents. The subjects of this study were 275 elementary school students, 153 middle school students and 185 high school students. The data was analyzed using PASW ver. 21.0 to conduct descriptive statistics, t-test, one-way ANOVA, correlation analysis and the hierarchial regression analysis. The main results of the analysis can be summarized as follows. First, there was a significant difference in life satisfaction of the children and adolescents according to the general characteristics and child friendliness of a city. Second, the general characteristics among children’s’ school level and their academic achievement had an influence upon the life satisfaction of children and adolescents. The child friendliness of a city, a city’s safety and protection, health and social services and housing had an influence upon the life satisfaction of children and adolescents. These results show that a local community approach is needed for the life satisfaction of children and adolescents. This study is meaningful to provide basic data for the creation of child friendly cities and the policies that affect the life satisfaction of children.

Hubungan Kualitas Fisik Rumah Dengan Kejadian TBC Paru Di Wilayah Kerja Puskesmas I Denpasar Selatan Tahun 2018

Indonesia is the second country with the highest population of Tuberculosis in the world after India. Tuberculosis is caused by Microbacterium tuberculosis wich transmitted through the airborne. One of the efforts for prevent the TBC transmitted is keeping the healthy quality physical of home. This research purposed to know the correlation between quality physical of home with lung TBC case at Puskesmas I South Denpasar working area. The types of this research is observasional retrospektif using case control design. Sampling procedures using total population sampling technique. The case group sample amount 34 patient with TBC in 2016 at Puskesmas I South Denpasar. The control grup sample amount 34 people who never suffer lung TBC and has same characteristics with the case group sample. Data collection using observation paper and analys statistic test using chi square method, continued with counting Coefficient Contigency (CC). Based on the chi square method result, showing the relation between lighting (p=0,001 CC=0,361), ventilation (p=0,014 CC=0,286), humadity (p=0,013 CC=0,290) dan temperature (p=0,000 CC=0,246) of home with lung TBC. There are no relation between the number of occupants home (p=0,086) and wall floor quality’s (p=0,088) with lung TBC case. Submitted suggestion in this research are 1) for community, please keep your attention for healthy and hygiene home, 2) for Puskesmas I South Denpasar, should be increased the health promotion about health housing wich related with Lung TBC.

Transitional Justice Housing in Forensic Mental Health: Considering Consumer Lived Experience

Abstract Date Presented 04/04/19 Consideration of transitional housing in the forensic mental-health context has been limited. Largely, macro outcome measurement (recidivism or community tenure) has guided this work. While compelling, this does not speak to occupational performance outcomes or the practical impacts of day-to-day participation for consumers. Employing a qualitative phenomenological methodology, this study focuses upon consumer lived experience in transitional housing within the forensic mental-health context. Primary Author and Speaker: Clark Heard Contributing Authors: Jared Scott, Allan Tetzlaff, Heather Lumley

Seven Challenges Assisted Living Must Get Right

Seven Challenges Assisted Living Must Get Right

The use of biochar in animal feeding.

Biochar, that is, carbonized biomass similar to charcoal, has been used in acute medical treatment of animals for many centuries. Since 2010, livestock farmers increasingly use biochar as a regular feed supplement to improve animal health, increase nutrient intake efficiency and thus productivity. As biochar gets enriched with nitrogen-rich organic compounds during the digestion process, the excreted biochar-manure becomes a more valuable organic fertilizer causing lower nutrient losses and greenhouse gas emissions during storage and soil application. Scientists only recently started to investigate the mechanisms of biochar in the different stages of animal digestion and thus most published results on biochar feeding are based so far on empirical studies. This review summarizes the state of knowledge up to the year 2019 by evaluating 112 relevant scientific publications on the topic to derive initial insights, discuss potential mechanisms behind observations and identify important knowledge gaps and future research needs. The literature analysis shows that in most studies and for all investigated farm animal species, positive effects on different parameters such as toxin adsorption, digestion, blood values, feed efficiency, meat quality and/or greenhouse gas emissions could be found when biochar was added to feed. A considerable number of studies provided statistically non-significant results, though tendencies were mostly positive. Rare negative effects were identified in regard to the immobilization of liposoluble feed ingredients (e.g., vitamin E or Carotenoids) which may limit long-term biochar feeding. We found that most of the studies did not systematically investigate biochar properties (which may vastly differ) and dosage, which is a major drawback for generalizing results. Our review demonstrates that the use of biochar as a feed additive has the potential to improve animal health, feed efficiency and livestock housing climate, to reduce nutrient losses and greenhouse gas emissions, and to increase the soil organic matter content and thus soil fertility when eventually applied to soil. In combination with other good practices, co-feeding of biochar may thus have the potential to improve the sustainability of animal husbandry. However, more systematic multi-disciplinary research is definitely needed to arrive at generalizable recommendations.

Brève biographie de Pierre-Antoine Prost

Prost has hardly left his name in history as Dr. Blanche's predecessor in Montmartre. He is, however, the author of an original scientific work based on the anatomoclinical method. Military surgeon then civilian became doctor of medicine, founder and director of an important health house for lunatics, then merchant passementerie before returning to the practice of the art of healing, he was especially one of the first French alienists.

The community-based integrated care system in Japan: Health care and nursing care challenges posed by super-aged society.

Japan is experiencing unprecedented aging of its population. People age 65 years or older accounted for 28.1% of the total population in 2018, and that proportion is expected to reach 33.3% in 2036 and 38.4% in 2065. In 2017, the average life expectancy in Japan was 81.09 years for men and 87.26 years for women. By 2065, it is expected to reach 84.95 years for men and 91.35 years for women. Population aging affects health and long-term care systems. The government proposed the establishment of "a community-based integrated care system" by 2025 with the purpose of comprehensively ensuring the provision of health care, nursing care, preventive care, housing, and livelihood support. This will require health care and nursing care professionals who are capable of fully understanding the physical and mental characteristics of elderly people and the fostering of organic collaboration with others professionals in the community-based integrated care system. A department of gerontology or geriatric medicine is desired to be established in each medical school to teach students medicine and efficient medical care, to conduct research, and to develop personnel to facilitate this paradigm shift. In 2018, there were 263 colleges of nursing with an admissions capacity of 23,667. In Japan, Certified Nurse Specialists can specialize in 13 areas as of December 2016. The number of Certified Nurse Specialists increased to 2,279 as of December 2018. One hundred and forty-four of those specialists specialized in Gerontological Nursing while 53 specialized in Home Care Nursing. The number of nurses specializing in Gerontological Nursing and Home Care Nursing is desired to be increased in order to implement and improve community-based comprehensive care.

Accuracy and quality of immunization data in Iran: findings from data quality self-assessment survey in 2017

BackgroundThe aim of this study was to assess the accuracy and quality of immunization data on the pentavalent (diphtheria, pertussis, tetanus, hepatitis B and Haemophilus influenzae type B (Hib)) and MMR vaccines as the administrative data of the expanded program on immunization (EPI) in Iran.MethodsWe conducted a Data Quality Self-assessment (DQS) survey from October to December 2017. Standardized DQS tools were used to assess the accuracy of reported immunizations data and quality of the immunization monitoring system at the provincial level of the healthcare system including health houses, health posts, rural and urban health centers and district health centers. Multistage cluster random sampling with proportional to size (PPS) weights was used to select target provinces and related health units. Accuracy ratio, quality index (QI), completeness and relevant quality indices of first dose of MMR (MMR1) and third dose of pentavalent vaccines were reported. Corresponding period of the survey was limited to reported administrative immunization data during the first 6 months of 2016.ResultsIn relation to accuracy ratio, there was some evidence of under reporting of pentavalent (3rd dose) and MMR1 vaccines in health house units which were 100.94 and 101.1%, respectively. Completeness of reporting for both vaccines at different provincial levels was near 100%. However, the corresponding value for pentavalent (3rd dose) and MMR1 vaccines at the level of urban health centers was 96.67 and 94.17% respectively.Among the five components of a monitoring system data usage and core output had the lowest QI scores in either rural or urban as well as district healthcare centers.ConclusionsFindings from our DQS survey reveals that administrative reporting of the immunization data was adequate at provincial and district levels of the healthcare centers. Although, addressing the existing concerns regarding timelines of the reporting by health authorities and staffs of EPI is warranted.

Image of Health house in Indonesia Based on Susenas 2017

Houses are a primary need for humans. The need for houses that meet healthy requirements is very important in order to improve household health status and prevent disease. The parameters of a healthy house have been regulated by a law issued by the Ministry of Health where there are 17 parameters that must be met. The purpose of this paper is to know the overview of healthy houses in Indonesia. The data used is the 2017 Susenas module. The assessment of healthy houses is based on 17 parameters which are divided into three categories, namely good, medium and less. From the results of the analysis it was found that the number of healthy houses in Indonesia was 11.3% good / fulfilling healthy conditions, 75.70% moderate categories, and 13.00% less categories. The results of mapping the number of houses in good condition are mostly in Java, Bali and southern Sumatra. Keywords : house, healthy house, mapping

Iranian Primary Healthcare providers` Perspectives on Providing Pre-hospital Emergency Services in Primary Levels of Healthcare System: A Qualitative Study

Background and purpose: Due to the important role of emergencies and accidents as mainspring of mortality and morbidity, providing emergency services must be taken into account at all levels of health system. The aim of this study was to investigate the perspectives of healthcare providers on providing pre-hospital emergency services and its challenges in primary healthcare (PHC) levels in Golestan Province, northern Iran.Materials and Methods: The researchers conducted 31 interviews totally (n=21 community health workers and n=10 family physicians) using semi-structured and in-depth interviews in Golestan Province, north of Iran in the year 2014. All interviews were digitally recorded and transcribed. The collected data was then analyzed through qualitative content analysis.Results: In total, three categories were identified related to emergency services in the primary healthcare system, including 1) Different status of providing primary preventive and emergency care in primary healthcare levels, 2) Need to develop the emergency services in health houses, and 3) Challenges of providing appropriate emergency services in the primary levels of healthcare system, such as lack of physical and human resources, weakness in monitoring and education system, inadequate skills, motivation in health team, heavy workload, and insufficient cooperation with other related organizations.Conclusion: The primary levels of healthcare system were not properly serviced in emergencies. They were also faced with numerous challenges that necessitate health policy makers to plan for promoting and providing required services at this level of healthcare system.

Advancing Equity in Nephrology: Enhancing Care for LGBTQ+ Patients and Our Workforce.

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals face social, economic, legal, health, and health care–related disparities amid evolving threats to sociopolitical advances made in the last decade ([1][1],[2][2]). In response, organizations, including the National Institutes of

Transitional housing in forensic mental health: considering consumer lived experience

BackgroundFor individuals involved in the forensic mental health system, access to transitional housing can offer a bridge between custody and independence. Using a methodology consistent with interpretative phenomenological analysis (IPA), this study considers the meaning associated with such participation. In this Canadian study, data was collected via interview with six individuals (n = 6) who resided, for a minimum six (6) months, in justice focused transitional housing that involved a partnership between a rural forensic mental health care facility and a nearby urban transitional housing provider.ResultsFollowing each participant interview, data was transcribed verbatim and coded for themes. Multiple methods were employed to support trustworthiness. Results indicate that participation enabled enhanced social participation, self-esteem/efficacy, community integration and renewal of daily living skills. Participants identified that involvement in justice focused transitional housing enabled development of community living skills, cultivated self-confidence and enhanced personal resilience in their transition from a secure forensic mental health facility to more independent community tenure.ConclusionsParticipants in this research clearly identified the importance of transitional housing programs in supporting their move from a forensic mental health facility to the community. Not all forensic involved individuals will need this type or level of support to support their transition. Practically, however, the nature of forensic hospitalization can present real challenges for occupational participation and maintenance of community living skills. Transitional housing, accountable to unique forensic mental health and justice inputs, can offer a valuable bridge to the community.

The importance of altruism to biomarker development for pancreatic cancer.

11626 Background: Longitudinal donation of tissue and health information by patients with pancreatic ductal adenocarcinoma (PDAC) is critical to validating algorithms for precision treatment. Unlike therapeutic trials offering potential survival benefit, factors motivating long-term participation in biomarker studies are poorly understood. We hypothesized that long-term participation (PART) depends on identifiable factors motivating study volunteers in non-therapeutic biomarker studies. Methods: A prospective, single-institution biomarker study was screened to identify participants with, or at elevated risk for, PDAC and periampullary cancer (Jul 2015-Dec 2018). Study consent precluded individual receipt of value or research benefit. Detailed biospecimen and clinical data (n = 294) were analyzed using multivariable modeling and Bayesian AI (bAIcis) to characterize motivators of PART. Results: Of 294 participants, 185 had PDAC (63%); 89 had premalignant lesions (30%) or tumors (20; 7%) mimicking PDAC. Mean age was 68 years, 54% male, 26% with prior cancers, and 18% family PDAC history. Treatment was not indicated (37% no cancer), potentially curative (27%), non-curative (35%); or refused (1.4%). Bayesian AI showed PDAC diagnosis to be the leading predictor of PART. Using multivariable modeling and adjusting for the competing risk of death, none of the following domains predicted PART: demographics, perceived personal/family cancer risk, health insurance type, median income, housing price, travel time/distance or charitable expense, or primary institution providing clinical treatment. The following motivators were significant predictors of PART: worsening symptoms (McGill Brisbane > 9; HR 0.54; p = 0.045), non-curative treatment (HR 0.55; p = 0.042); and shorter AJCC predicted survival (HR 0.77, p = 0.042). Conclusions: Volunteers with symptomatic PDAC and shorter predicted survival who received non-curative treatment were more motivated to participate in biomarker discovery. Volunteers were undeterred by apparent self-interests such as travel time, insurance type, income, charitable expense, and personal life expectancy. We attribute these findings to altruistic behaviors among patients most likely to die of PDAC.