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      Met and unmet needs of homeless individuals at different stages of housing reintegration: A mixed-method investigation

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          Abstract

          This study aimed to identify and compare major areas of met and unmet needs reported by 455 homeless or recently housed individuals recruited from emergency shelters, temporary housing, and permanent housing in Quebec (Canada). Mixed methods, guided by the Maslow framework, were used. Basic needs were the strongest needs category identified, followed by health and social services (an emergent category), and safety; very few participants expressed needs in the higher-order categories of love and belonging, self-esteem, and self-actualization. The only significant differences between the three housing groups occurred in basic needs met, which favored permanent housing residents. Safety was the only category where individuals reported more unmet than met needs. The study results suggested that increased overall access to and continuity of care with family physicians, MD or SUD clinicians and community organizations for social integration should be provided to help better these individuals. Case management, stigma prevention, supported employment programs, peer support and day centers should particularly be more widely implemented as interventions that may promote a higher incidence of met needs in specific needs categories.

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          Combining the power of stories and the power of numbers: mixed methods research and mixed studies reviews.

          This article provides an overview of mixed methods research and mixed studies reviews. These two approaches are used to combine the strengths of quantitative and qualitative methods and to compensate for their respective limitations. This article is structured in three main parts. First, the epistemological background for mixed methods will be presented. Afterward, we present the main types of mixed methods research designs and techniques as well as guidance for planning, conducting, and appraising mixed methods research. In the last part, we describe the main types of mixed studies reviews and provide a tool kit and examples. Future research needs to offer guidance for assessing mixed methods research and reporting mixed studies reviews, among other challenges.
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            Renovating the Pyramid of Needs: Contemporary Extensions Built Upon Ancient Foundations.

            Maslow's pyramid of human needs, proposed in 1943, has been one of the most cognitively contagious ideas in the behavioral sciences. Anticipating later evolutionary views of human motivation and cognition, Maslow viewed human motives as based in innate and universal predispositions. We revisit the idea of a motivational hierarchy in light of theoretical developments at the interface of evolutionary biology, anthropology, and psychology. After considering motives at three different levels of analysis, we argue that the basic foundational structure of the pyramid is worth preserving, but that it should be buttressed with a few architectural extensions. By adding a contemporary design feature, connections between fundamental motives and immediate situational threats and opportunities should be highlighted. By incorporating a classical element, these connections can be strengthened by anchoring the hierarchy of human motives more firmly in the bedrock of modern evolutionary theory. We propose a renovated hierarchy of fundamental motives that serves as both an integrative framework and a generative foundation for future empirical research.
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              The unmet health care needs of homeless adults: a national study.

              We assessed the prevalence and predictors of past-year unmet needs for 5 types of health care services in a national sample of homeless adults. We analyzed data from 966 adult respondents to the 2003 Health Care for the Homeless User Survey, a sample representing more than 436,000 individuals nationally. Using multivariable logistic regression, we determined the independent predictors of each type of unmet need. Seventy-three percent of the respondents reported at least one unmet health need, including an inability to obtain needed medical or surgical care (32%), prescription medications (36%), mental health care (21%), eyeglasses (41%), and dental care (41%). In multivariable analyses, significant predictors of unmet needs included food insufficiency, out-of-home placement as a minor, vision impairment, and lack of health insurance. Individuals who had been employed in the past year were more likely than those who had not to be uninsured and to have unmet needs for medical care and prescription medications. This national sample of homeless adults reported substantial unmet needs for multiple types of health care. Expansion of health insurance may improve health care access for homeless adults, but addressing the unique challenges inherent to homelessness will also be required.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: InvestigationRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                14 January 2021
                2021
                : 16
                : 1
                : e0245088
                Affiliations
                [1 ] Department of Psychiatry, McGill University, Montreal, Quebec, Canada
                [2 ] Douglas Mental Health University Institute Research Centre, Montreal, Quebec, Canada
                [3 ] McGill University School of Social Work, Montreal, Quebec, Canada
                [4 ] Département des Sciences de la Santé Communautaire, Université de Sherbrooke, Sherbrooke, Quebec, Canada
                [5 ] Département de Médecine Sociale et Préventive, Université Laval, Quebec City, Quebec, Canada
                [6 ] Département de Criminologie, Université de Montréal, Montreal, Canada
                Institute of Mental Health, SINGAPORE
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0002-4743-8611
                Article
                PONE-D-20-17432
                10.1371/journal.pone.0245088
                7808646
                33444366
                1f9663b0-3846-4018-8cf0-9f393fc7f920
                © 2021 Fleury et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 8 June 2020
                : 22 December 2020
                Page count
                Figures: 1, Tables: 3, Pages: 18
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100000155, Social Sciences and Humanities Research Council of Canada;
                Award ID: 435-2016-0761
                Award Recipient :
                This article is based on research funded by the Social Sciences and Humanities Research Council of Canada (SSHRC), Project # 435-2016-0761. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Earth Sciences
                Geography
                Human Geography
                Housing
                Social Sciences
                Human Geography
                Housing
                Medicine and Health Sciences
                Critical Care and Emergency Medicine
                Medicine and Health Sciences
                Health Care
                Health Care Providers
                Physicians
                People and Places
                Population Groupings
                Professions
                Medical Personnel
                Physicians
                Medicine and Health Sciences
                Health Care
                Health Care Policy
                Health Systems Strengthening
                Social Sciences
                Economics
                Labor Economics
                Employment
                Medicine and Health Sciences
                Health Care
                Health Services Administration and Management
                Medicine and Health Sciences
                Health Care
                Socioeconomic Aspects of Health
                Medicine and Health Sciences
                Public and Occupational Health
                Socioeconomic Aspects of Health
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Custom metadata
                In accordance with the applicable ethics regulations in the province of Quebec, the informed consent form must specifically inform the participants of the possibility of research data sharing with third parties, as well as the limitations and safety measures associated with such data sharing. Since the consent form approved by the Douglas Mental Health University Institute Research Ethics Board signed by participants for this research project did not specifically provide for such data sharing, the principal investigator is responsible towards the participants to keep these data confidential. data-related queries may be addressed to coordinator of the Douglas Mental Health University Institute Research Ethics Board ( cer.reb@ 123456douglas.mcgill.ca ).

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