Loading

Journal of Substance Abuse and Alcoholism

The Fetal Alcohol Spectrum Disorder and Homelessness Project: Making Connections for Promising Practice

Short Communication | Open Access Volume 3 | Issue 1 |

  • 1. Faculty of Social Work, University of Calgary, Canada
  • 2. Research and Policy Department, Calgary Homeless Foundation, Canada
+ Show More - Show Less
Corresponding Authors
Dorothy Badry, Faculty of Social Work, University of Calgary, 2500 University Drive NW, Calgary, AB, Canada, T2N 1N4 Tel: 1-403-220-4502; Fax: 1-403-282-7269
ABSTRACT

The focus of this brief paper is to describe a current research project exploring the lived experiences of individuals with Fetal Alcohol Spectrum Disorder (FASD) who are supported by the homeless-serving sector in Calgary, Alberta. Individuals with FASD are considered vulnerable due to their disability, which often goes unrecognized and thus viewed as social, emotional and behavioral challenges. It is widely known that individuals with FASD face challenges as a result of brain damage from prenatal alcohol exposure. It is suspected that many individuals with FASD are being served by the Calgary Homeless Foundation’s (CHF) frontline agencies without recognition ofthe specialized supports they may need. Our research aims to learn from the experiences of individuals with either diagnosed or suspected FASD who are or have been homeless and from interviews with a wide range of professionals working in the homeless-serving sector regarding their perception of needs and service gaps for this population.

KEYWORDS

• FASD
• Homelessness
• Housing
• Secondary disabilities

CITATION

Badry D, Walsh C, Bell M, Ramage K, Gibbon J (2015) The Fetal Alcohol Spectrum Disorder and Homelessness Project: Making Connections for Promising Practice. J Subst Abuse Alcohol 3(1): 1027.

ABBREVIATIONS

FASD: Fetal Alcohol Spectrum Disorder; CHF: Calgary Homeless Foundation; HMIS:Homeless Management Information System

INTRODUCTION

Homelessness describes the situation of an individual or family without stable, permanent, appropriate housing, or the immediate prospect, means and ability of acquiring it. It is the result of systemic or societal barriers, a lack of affordable and appropriate housing, the individual/household’s financial, mental, cognitive, behavioural or physical challenges, and/ or racism and discrimination [1]. Homelessness has grown to astronomical proportions throughout Canada, leading to what has been described as a “national crisis” [2]. In Calgary, homelessness grew by 800% between 1992 and 2008 [3], with the most recent point-in-time count estimating there are approximately 3500 people experiencing homelessness on any given night [4].

A critical area identified as requiring further investigation is in the area of Fetal Alcohol Spectrum Disorder (FASD). There is now robust research exploring the multifaceted and complex nature of homelessness including the unique pathways into homelessness for distinct subpopulations such as youth [5], families [6], Aboriginal peoples [7,8], and women [9,10]. However, an additional sub-group within this chronically homeless population who appear to experience significant challenges in obtaining and maintaining adequate housing is individuals with FASD. Little research has been done in the area of supporting individuals with FASD into sustainable housing and consequently, there is currently limited capacity in programming, trained staff, and knowledge to address the support needs of this population.

The University of Calgary, Faculty of Social Work and the Calgary Homeless Foundation (CHF) have partnered to examine the needs of individuals with FASD who are involved in the homeless-serving sector. In this paper, we present a mixed method, exploratory research study in Calgary, Alberta (2014- 2015), which examines the intersection of individuals with FASD and the phenomenon of housing insecurity and homelessness.

BACKGROUND

FASD, referred to as the ‘invisible disability’, is caused by prenatal alcohol exposure during pregnancy and comes with a significant degree of central nervous system damage, cognitive functioning and secondary disabilities [11]. In the absence of routine, structure, and consistency, individuals with FASD struggle. Despite resiliency factors in individuals with FASD, the underlying cognitive impairment caused by prenatal alcohol exposure contributes to their marginalization. As a consequence of their disability, individuals living with FASD often cycle through multiple systems, including homelessness, health [12] and corrections [13].

The primary cognitive issues of FASD contribute to the difficulties of finding sustainable housing and effective supports within the homeless-serving sector. These issues may include difficulties managing time and money, planning, attention deficits, memory issues, and difficulties understanding the consequences of behaviors [14,15]. These issues may all contribute to housing instability as individuals with FASD may not be able to budget their money appropriately or even have funds available and thus may be unable to pay their rent on time. They may miss meetings with their caseworkers or be evicted because of complex behavioral issues.

The relationship between homelessness and the primary and secondary disabilities of FASD is complex. Individual environmental factors associated with increased risk of homelessness include adverse childhood experiences; history of foster care/child welfare involvement; low education levels; young parenting; chronic health problems; lack of job skills; family breakdown or violence; mental health issues; trauma; substance abuse; and poor social support [9,16]. Secondary disabilities or problems associated with a primary FASD diagnosis have been identified as mental health problems, disrupted school experiences, trouble with the law, incarceration, limited or disrupted education, difficulty finding or maintaining employment, and substance abuse issues [17]. Thus, the secondary disabilities or conditions of FASD mirror many of the factors that place individuals at risk of homelessness and, with the existing primary cognitive disability of FASD, may instigate many challenges to obtaining residential stability.

Understanding and identifying the needs of individuals with FASD who experience homelessness, as well as the extent and nature of FASD within the homeless population, is necessary to determine allocation of resources, funding and effective housing models, and best practices for service delivery. In developing this project, we were concerned about particular vulnerabilities for men and women who have FASD and are homeless including specific concerns such as limited support systems, historical trauma, addictions, mental health problems, and becoming parents. All these factors contribute to the portrait of a complex population with high needs. In order to effectively serve individuals with FASD, a need exists to provide education to frontline workers on specific approaches that can be both supportive and effective. It is anticipated that this research will contribute to a deeper understanding of adults with FASD who experience homelessness and contribute, over time, to the development of a supportive and effective case management model.

The goal of this project is to create awareness of the different service and social support needs of individuals with FASD, as this understanding is foundational in our efforts to end homelessness and to ensure a continuum of care reflective of the different needs of the diverse homeless population. This goal is driven by concerns that we do not have a good understanding of this population in the homeless-serving sector. Participants in this study are referred by case managers or clinicians and have selfreported a diagnosis of FASD to a particular agency during intake and assessment. In cases where no formal diagnosis exists and FASD is suspected, these individuals may also be referred to this study through their case manager. We recognize there are challenges in identification of a population that is somewhat invisible and not subject to universal screening for FASD. A limitation of this study is that we do not have access to diagnostic or medical records as this is not possible. Our intent however, in this research is to identify through multiple sources, the concerns and needs for this population that experience homelessness and to identify gaps within the system. Through this research we can potentially build promising practices for delivering housing and support services to homeless individuals with FASD. Without recognizing the specific care needs and supports for individuals our interventions will not be effective and may, in fact, lead to further negative outcomes. Thus, the purpose of this project is to better understand the concerns and challenges associated with FASD within the single adult episodically and chronically homeless population in order to more effectively address their housing and associated support needs.

MATERIALS AND METHODS

This study was approved by the Conjoint Faculties Research Ethics Board at the University of Calgary on April 23, 2014.

We adopted a mixed methods approach [18] using both qualitative and quantitative components to address the following three questions:

1. What is the prevalence of FASD among the single chronic and episodic homeless population in Calgary (as reported in the Homeless Management Information System [HMIS] CHF database)?

2. How does FASD impact service utilization and client outcomes for people experiencing homelessness?

3. What are the experiences of individuals with FASD in the homeless serving sector?

4. What are promising practices to addressing FASD and supporting individuals with FASD in housing systems?

The mixed method approach for this research study includes the following six components:

• A comprehensive narrative literature review of promising practices for delivering FASD-informed care to people experiencing homelessness, include an analysis of the relationship between FASD, homelessness, and systems involvement;

• An environmental scan of local service providers supporting adults with FASD and support services offered to chronically homeless considered “hard to house”, who may have FASD;

• Quantitative analysis of HMIS data to assess the number of individuals reporting a diagnosis under the spectrum of FASD as well as analysis of system (health, child welfare, and justice) utilization to assess potential cases of FASD;

• Qualitative interviews with 30 chronically homeless adults with diagnosed or suspected FASD, identified by program case managers and/or clinicians and referred to the study;

• Qualitative interviews with 10 service providers to assess housing and support needs for homeless adults with FASD, or suspected FASD, and identify/assess community needs and gaps based on the interview data. Interviews with frontline service providers will also be used to assess the level of awareness and competency in the homeless sector related to FASD, including access to adult diagnostic centres;

• Needs assessment survey regarding the educational and training needs on FASD within the sector.

DISCUSSION

Although research in the area of FASD consistently recognizes that housing is a challenge for individuals with FASD and their families, it rarely identifies homelessness as an issue or explores how to support individuals with FASD into stable housing. As a disability, FASD is seldom recognized by those working in the homeless-serving sector to provide housing and support. This may be due to the “invisibility” of the disability and the difficulty that frontline workers face when dealing with the vast range of disabilities and conditions present in the homeless population with few resources, long wait times for referrals, and continually high staff turnover. Frontline workers also strive to get their clients into housing and to address their immediate and visible needs. This may lead to the oversight of FASD and the misinterpretation of an individual’s behaviors. In Canada, FASD Diagnosis has relied on the Canadian Guidelines for Diagnosis, which were published in 2005 [19] and are currently under revision.

The high social and economic costs of FASD are related to the health of individuals, the impact on community, and the cost of a lifetime of interventions across multiple systems, including unstable housing [20]. Recognizing the needs of individuals with FASD, particularly in relation to health and well-being, is critical in efforts to bring about change in order to more effectively support individuals who have a disability. When FASD goes unrecognized, the risks increase for individuals because supports are often ineffective. From a case management perspective, the need exists for an applied, structured decision making model that is somewhat flexible. The construct of FASD-informed practice has been gaining ground in child welfare practice [21-22]. Another focus of this research is to consider practices and policies that may serve as barriers to individuals experiencing homelessness who live with FASD. It is anticipated that disseminating this research will support those working in the sector to become sensitized to issues and concerns for persons with FASD, leading to a deeper understanding of FASD-informed practice.

CONCLUSION

The aim of this project is to create awareness through gathering information from individuals living with FASD, and those working on the frontlines of ending homelessness. The results from this research will be carefully reviewed with a goal in mind of presenting a symposium of the findings to the CHF and homeless-serving agencies within the region. It is anticipated that recommendations, supported by findings from this research, will be aligned with developing policy and practice recommendations aimed towards advocacy for diagnosis as needed and provision of clinical support for homeless individuals with suspected FASD. It is anticipated that this research will inform the development of strategic decision making regarding resourcing of community supports and housing need for homeless individuals with FASD. Additionally, it is important to bridge gaps between knowledge and the application of promising practices to support and create local and provincial strategies for an FASD informed service delivery for episodic and chronic homeless individuals. Ultimately, the developments of promising practices to support individuals with FASD who experience homelessness are the rationale driving this research. The disadvantages associated with FASD are multiple, and are particularly severe amongst those experiencing homelessness. Thus a goal of this research is to find a beginning place to work with and support a complex population who may be the most vulnerable in the homeless sector.

REFERENCES

1. Canadian Homelessness Research Network. Canadian definition of homelessness: Homeless Hub. 2012.

2. Gaetz S. The struggle to end homelessness in Canada: How we created the crisis, and how we can end it. The Open Health Services and Policy Journal. 2010; 3: 21-26.

3. Calgary Homeless Foundation. Summer 2012 point-in-time count report. Calgary, AB: Calgary Homeless Foundation. 2012.

4. Calgary Homeless Foundation. Alberta point-in-time homeless count: Calgary preliminary report. Calgary, AB: Calgary Homeless Foundation. 2014.

5. Gaetz S, Grady B, Buccieri K, Karabanow J, Marsolais A, editors. Youth homelessness in Canada: Implications for policy and practice. Toronto, ON: Canadian Homelessness Research Network Press. 2013.

6. Canadian Mortgage and Housing Corporation. Family homelessness: Causes and solutions. Ottawa, ON: CMHC. 2003.

7. Strangeland J, Walsh CA. Defining permanency and Aboriginal youth in foster care. First Peoples Child & Family Review. 2013; 8: 24-39.

8. Walsh CA, Krieg B, Rutherford GE, Bell M. Aboriginal women’s voices: Breaking the cycle of homelessness and incarceration. Pimatisiwin: A Journal of Aboriginal and Indigenous Community Health. 2014; 11: 377-394.

9. Walsh CA, Rutherford G, Kuzmak N. Characteristics of home: Perspectives of women who are homeless. The Qualitative Report. 2009; 14: 299-317.

10. Fotheringham S, Walsh CA, Burrows A. “A place to rest”: The role of transitional housing in ending homelessness for women. Gender, Place, and Culture: A Journal of Feminist Geography. 2013; 21.

11. Solliday-McRoy C, Campbell TC, Melchert TP, Young TJ, Cisler RA. Neuropsychological functioning of homeless men. J Nerv Ment Dis. 2004; 192: 471-478.

12. Hwang SW. Homelessness and health. CMAJ. 2001; 164: 229-233.

13. Fast DK, Conry J. Fetal alcohol spectrum disorders and the criminal justice system. Dev Disabil Res Rev. 2009; 15: 250-257.

14. Rutman D, La Berge C, Wheway D. Parenting with FASD – Challenges, strategies, and supports: A research and video production project. Victoria, BC: University of Victoria, 2005.

15. Grant T, Huggins J, Connor P, Pederson J, Whitney N, Streissguth A. A pilot community intervention for young women with Fetal Alcohol Spectrum Disorders. Community Mental Health Journal. 2004; 40: 499-511.

16. Frankish C, Hwang S, Quantz D. The relationship between homelessness and health: An overview of research in Canada. In Hulchanski D, Campsie P, Chau S, Hwang S, Paradis E, editors. Finding home: Policy options for addressing homelessness in Canada. Toronto: University of Toronto. 2005.

17. Streissguth AP, Malley K. Neuropsychiatric implications and long-term consequences of fetal alcohol spectrum disorders. Semin Clin Neuropsychiatry. 2000; 5: 177-190.

18. Creswell JW, Plano Clark VL. Designing and conducting mixed methods research. Thousand Oaks, CA: Sage Publications. 2010.

19. Chudley AE, Conry J, Cook JL, Loock C, Rosales T, LeBlanc N. Public Health Agency of Canada’s National Advisory Committee on Fetal Alcohol Spectrum Disorder . Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis. CMAJ. 2005; 172: S1-1S21.

20. Institute of Health Economics. Consensus Statement on Fetal Alcohol Spectrum Disorder (FASD) – Across the Lifespan. Edmonton, AB: 2009.

21. Badry D. The FASD (Fetal Alcohol Spectrum Disorder) Community of Practice in Alberta Human Services: Leading from Within Initiative. Calgary, AB: 2013.

22. Badry D. The FASD Community of Practice: Leading from Within Initiative, Advanced Case consultations. 2014. Unpublished report.

Received : 05 Dec 2014
Accepted : 13 Jan 2015
Published : 15 Jan 2015
Journals
Annals of Otolaryngology and Rhinology
ISSN : 2379-948X
Launched : 2014
JSM Schizophrenia
Launched : 2016
Journal of Nausea
Launched : 2020
JSM Internal Medicine
Launched : 2016
JSM Hepatitis
Launched : 2016
JSM Oro Facial Surgeries
ISSN : 2578-3211
Launched : 2016
Journal of Human Nutrition and Food Science
ISSN : 2333-6706
Launched : 2013
JSM Regenerative Medicine and Bioengineering
ISSN : 2379-0490
Launched : 2013
JSM Spine
ISSN : 2578-3181
Launched : 2016
Archives of Palliative Care
ISSN : 2573-1165
Launched : 2016
JSM Nutritional Disorders
ISSN : 2578-3203
Launched : 2017
Annals of Neurodegenerative Disorders
ISSN : 2476-2032
Launched : 2016
Journal of Fever
ISSN : 2641-7782
Launched : 2017
JSM Bone Marrow Research
ISSN : 2578-3351
Launched : 2016
JSM Mathematics and Statistics
ISSN : 2578-3173
Launched : 2014
Journal of Autoimmunity and Research
ISSN : 2573-1173
Launched : 2014
JSM Arthritis
ISSN : 2475-9155
Launched : 2016
JSM Head and Neck Cancer-Cases and Reviews
ISSN : 2573-1610
Launched : 2016
JSM General Surgery Cases and Images
ISSN : 2573-1564
Launched : 2016
JSM Anatomy and Physiology
ISSN : 2573-1262
Launched : 2016
JSM Dental Surgery
ISSN : 2573-1548
Launched : 2016
Annals of Emergency Surgery
ISSN : 2573-1017
Launched : 2016
Annals of Mens Health and Wellness
ISSN : 2641-7707
Launched : 2017
Journal of Preventive Medicine and Health Care
ISSN : 2576-0084
Launched : 2018
Journal of Chronic Diseases and Management
ISSN : 2573-1300
Launched : 2016
Annals of Vaccines and Immunization
ISSN : 2378-9379
Launched : 2014
JSM Heart Surgery Cases and Images
ISSN : 2578-3157
Launched : 2016
Annals of Reproductive Medicine and Treatment
ISSN : 2573-1092
Launched : 2016
JSM Brain Science
ISSN : 2573-1289
Launched : 2016
JSM Biomarkers
ISSN : 2578-3815
Launched : 2014
JSM Biology
ISSN : 2475-9392
Launched : 2016
Archives of Stem Cell and Research
ISSN : 2578-3580
Launched : 2014
Annals of Clinical and Medical Microbiology
ISSN : 2578-3629
Launched : 2014
JSM Pediatric Surgery
ISSN : 2578-3149
Launched : 2017
Journal of Memory Disorder and Rehabilitation
ISSN : 2578-319X
Launched : 2016
JSM Tropical Medicine and Research
ISSN : 2578-3165
Launched : 2016
JSM Head and Face Medicine
ISSN : 2578-3793
Launched : 2016
JSM Cardiothoracic Surgery
ISSN : 2573-1297
Launched : 2016
JSM Bone and Joint Diseases
ISSN : 2578-3351
Launched : 2017
JSM Bioavailability and Bioequivalence
ISSN : 2641-7812
Launched : 2017
JSM Atherosclerosis
ISSN : 2573-1270
Launched : 2016
Journal of Genitourinary Disorders
ISSN : 2641-7790
Launched : 2017
Journal of Fractures and Sprains
ISSN : 2578-3831
Launched : 2016
Journal of Autism and Epilepsy
ISSN : 2641-7774
Launched : 2016
Annals of Marine Biology and Research
ISSN : 2573-105X
Launched : 2014
JSM Health Education & Primary Health Care
ISSN : 2578-3777
Launched : 2016
JSM Communication Disorders
ISSN : 2578-3807
Launched : 2016
Annals of Musculoskeletal Disorders
ISSN : 2578-3599
Launched : 2016
Annals of Virology and Research
ISSN : 2573-1122
Launched : 2014
JSM Renal Medicine
ISSN : 2573-1637
Launched : 2016
Journal of Muscle Health
ISSN : 2578-3823
Launched : 2016
JSM Genetics and Genomics
ISSN : 2334-1823
Launched : 2013
JSM Anxiety and Depression
ISSN : 2475-9139
Launched : 2016
Clinical Journal of Heart Diseases
ISSN : 2641-7766
Launched : 2016
Annals of Medicinal Chemistry and Research
ISSN : 2378-9336
Launched : 2014
JSM Pain and Management
ISSN : 2578-3378
Launched : 2016
JSM Women's Health
ISSN : 2578-3696
Launched : 2016
Clinical Research in HIV or AIDS
ISSN : 2374-0094
Launched : 2013
Journal of Endocrinology, Diabetes and Obesity
ISSN : 2333-6692
Launched : 2013
JSM Neurosurgery and Spine
ISSN : 2373-9479
Launched : 2013
Journal of Liver and Clinical Research
ISSN : 2379-0830
Launched : 2014
Journal of Drug Design and Research
ISSN : 2379-089X
Launched : 2014
JSM Clinical Oncology and Research
ISSN : 2373-938X
Launched : 2013
JSM Bioinformatics, Genomics and Proteomics
ISSN : 2576-1102
Launched : 2014
JSM Chemistry
ISSN : 2334-1831
Launched : 2013
Journal of Trauma and Care
ISSN : 2573-1246
Launched : 2014
JSM Surgical Oncology and Research
ISSN : 2578-3688
Launched : 2016
Annals of Food Processing and Preservation
ISSN : 2573-1033
Launched : 2016
Journal of Radiology and Radiation Therapy
ISSN : 2333-7095
Launched : 2013
JSM Physical Medicine and Rehabilitation
ISSN : 2578-3572
Launched : 2016
Annals of Clinical Pathology
ISSN : 2373-9282
Launched : 2013
Annals of Cardiovascular Diseases
ISSN : 2641-7731
Launched : 2016
Journal of Behavior
ISSN : 2576-0076
Launched : 2016
Annals of Clinical and Experimental Metabolism
ISSN : 2572-2492
Launched : 2016
Clinical Research in Infectious Diseases
ISSN : 2379-0636
Launched : 2013
JSM Microbiology
ISSN : 2333-6455
Launched : 2013
Journal of Urology and Research
ISSN : 2379-951X
Launched : 2014
Journal of Family Medicine and Community Health
ISSN : 2379-0547
Launched : 2013
Annals of Pregnancy and Care
ISSN : 2578-336X
Launched : 2017
JSM Cell and Developmental Biology
ISSN : 2379-061X
Launched : 2013
Annals of Aquaculture and Research
ISSN : 2379-0881
Launched : 2014
Clinical Research in Pulmonology
ISSN : 2333-6625
Launched : 2013
Journal of Immunology and Clinical Research
ISSN : 2333-6714
Launched : 2013
Annals of Forensic Research and Analysis
ISSN : 2378-9476
Launched : 2014
JSM Biochemistry and Molecular Biology
ISSN : 2333-7109
Launched : 2013
Annals of Breast Cancer Research
ISSN : 2641-7685
Launched : 2016
Annals of Gerontology and Geriatric Research
ISSN : 2378-9409
Launched : 2014
Journal of Sleep Medicine and Disorders
ISSN : 2379-0822
Launched : 2014
JSM Burns and Trauma
ISSN : 2475-9406
Launched : 2016
Chemical Engineering and Process Techniques
ISSN : 2333-6633
Launched : 2013
Annals of Clinical Cytology and Pathology
ISSN : 2475-9430
Launched : 2014
JSM Allergy and Asthma
ISSN : 2573-1254
Launched : 2016
Journal of Neurological Disorders and Stroke
ISSN : 2334-2307
Launched : 2013
Annals of Sports Medicine and Research
ISSN : 2379-0571
Launched : 2014
JSM Sexual Medicine
ISSN : 2578-3718
Launched : 2016
Annals of Vascular Medicine and Research
ISSN : 2378-9344
Launched : 2014
JSM Biotechnology and Biomedical Engineering
ISSN : 2333-7117
Launched : 2013
Journal of Hematology and Transfusion
ISSN : 2333-6684
Launched : 2013
JSM Environmental Science and Ecology
ISSN : 2333-7141
Launched : 2013
Journal of Cardiology and Clinical Research
ISSN : 2333-6676
Launched : 2013
JSM Nanotechnology and Nanomedicine
ISSN : 2334-1815
Launched : 2013
Journal of Ear, Nose and Throat Disorders
ISSN : 2475-9473
Launched : 2016
JSM Ophthalmology
ISSN : 2333-6447
Launched : 2013
Journal of Pharmacology and Clinical Toxicology
ISSN : 2333-7079
Launched : 2013
Annals of Psychiatry and Mental Health
ISSN : 2374-0124
Launched : 2013
Medical Journal of Obstetrics and Gynecology
ISSN : 2333-6439
Launched : 2013
Annals of Pediatrics and Child Health
ISSN : 2373-9312
Launched : 2013
JSM Clinical Pharmaceutics
ISSN : 2379-9498
Launched : 2014
JSM Foot and Ankle
ISSN : 2475-9112
Launched : 2016
JSM Alzheimer's Disease and Related Dementia
ISSN : 2378-9565
Launched : 2014
Journal of Addiction Medicine and Therapy
ISSN : 2333-665X
Launched : 2013
Journal of Veterinary Medicine and Research
ISSN : 2378-931X
Launched : 2013
Annals of Public Health and Research
ISSN : 2378-9328
Launched : 2014
Annals of Orthopedics and Rheumatology
ISSN : 2373-9290
Launched : 2013
Journal of Clinical Nephrology and Research
ISSN : 2379-0652
Launched : 2014
Annals of Community Medicine and Practice
ISSN : 2475-9465
Launched : 2014
Annals of Biometrics and Biostatistics
ISSN : 2374-0116
Launched : 2013
JSM Clinical Case Reports
ISSN : 2373-9819
Launched : 2013
Journal of Cancer Biology and Research
ISSN : 2373-9436
Launched : 2013
Journal of Surgery and Transplantation Science
ISSN : 2379-0911
Launched : 2013
Journal of Dermatology and Clinical Research
ISSN : 2373-9371
Launched : 2013
JSM Gastroenterology and Hepatology
ISSN : 2373-9487
Launched : 2013
Annals of Nursing and Practice
ISSN : 2379-9501
Launched : 2014
JSM Dentistry
ISSN : 2333-7133
Launched : 2013
Author Information X