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Multiple biomolecular condensates coexist at the pre- and post- synapse to enable vesicle dynamics and controlled neurotransmitter release in the brain. In pre-synapses, intrinsically disordered regions (IDRs) of synaptic proteins are drivers of condensation that enable clustering of synaptic vesicles (SVs). Using computational analysis, we show that the IDRs of SV proteins feature evolutionarily conserved non-random compositional biases and sequence patterns. Synapsin-1 is essential for condensation of SVs, and its C-terminal IDR has been shown to be a key driver of condensation. Focusing on this IDR, we dissected the contributions of two conserved features namely the segregation of polar and proline residues along the linear sequence, and the compositional preference for arginine over lysine. Scrambling the blocks of polar and proline residues weakens the driving forces for forming micron-scale condensates. However, the extent of clustering in subsaturated solutions remains equivalent to that of the wild-type synapsin-1. In contrast, substituting arginine with lysine significantly weakens both the driving forces for condensation and the extent of clustering in subsaturated solutions. Co-expression of the scrambled variant of synapsin-1 with synaptophysin results in a gain-of-function phenotype in cells, whereas arginine to lysine substitutions eliminate condensation. We report an emergent consequence of synapsin-1 condensation, which is the generation of interphase pH gradients realized via differential partitioning of protons between coexisting phases. This pH gradient is likely to be directly relevant for vesicular ATPase functions and the loading of neurotransmitters. Our study highlights how conserved IDR grammars serve as drivers of synapsin-1 condensation.

Importance: Unstable housing and homelessness can exacerbate adverse health outcomes leading to increased risk of chronic disease, injury, and disability. However, emergency departments (EDs) have no universal method to identify those at risk of or currently experiencing homelessness., Objective: To describe the extent of housing insecurity among patients who seek care in an urban ED, including chief concerns, demographics, and patterns of health care utilization., Design, Setting, and Participants: This cross-sectional study included all adult patients presenting to the ED at Vanderbilt University Medical Center (VUMC), an urban tertiary care, level I trauma center in the Southeast US, from January 5 to May 16, 2023., Main Outcomes and Measures: The primary outcome was the proportion of ED visits at which patients screened positive for housing insecurity. Secondary outcomes included prevalence of insecurity by chief concerns, demographics, and patterns of health care utilization., Results: Of all 23 795 VUMC ED visits with screenings for housing insecurity (12 465 visits among women [52%]; median age, 47 years [IQR, 32-48 years]), in 1185 (5%), patients screened positive for current homelessness or housing insecurity (660 unique patients); at 22 610 visits (95%), the screening result was negative. Of visits with positive results, the median age of patients was 46 years (IQR, 36-55 years) and 829 (70%) were among male patients. Suicide and intoxication were more common chief concerns among visits at which patients screened positive (132 [11%] and 118 [10%], respectively) than among those at which patients screened negative (220 [1%] and 335 [2%], respectively). Visits with positive results were more likely to be among patients who were uninsured (395 [33%] vs 2272 [10%]) and had multiple visits during the study period. A higher proportion of positive screening results occurred between 8 pm and 6 am. The social work team assessed patients at 919 visits (78%) with positive screening results., Conclusions and Relevance: In this cross-sectional study of 23 795 ED visits, at 5% of visits, patients screened positive for housing insecurity and were more likely to present with a chief concern of suicide, to be uninsured, and to have multiple visits during the study period. This analysis provides a call for other institutions to introduce screening and create tailored care plans for patients experiencing housing insecurity to achieve equitable health care.

Principal component analysis (PCA) is a dimensionality reduction method that is known for being simple and easy to interpret. Principal components are often interpreted as low-dimensional patterns in high-dimensional space. However, this simple interpretation fails for timeseries, spatial maps, and other continuous data. In these cases, nonoscillatory data may have oscillatory principal components. Here, we show that two common properties of data cause oscillatory principal components: smoothness and shifts in time or space. These two properties implicate almost all neuroscience data. We show how the oscillations produced by PCA, which we call "phantom oscillations," impact data analysis. We also show that traditional cross-validation does not detect phantom oscillations, so we suggest procedures that do. Our findings are supported by a collection of mathematical proofs. Collectively, our work demonstrates that patterns which emerge from high-dimensional data analysis may not faithfully represent the underlying data., Competing Interests: Competing interests statement:The author declares no competing interest.

High-throughput experimental methods in neuroscience have led to an explosion of techniques for measuring complex interactions and multi-dimensional patterns. However, whether sophisticated measures of emergent phenomena can be traced back to simpler, low-dimensional statistics is largely unknown. To explore this question, we examined resting-state functional magnetic resonance imaging (rs-fMRI) data using complex topology measures from network neuroscience. Here we show that spatial and temporal autocorrelation are reliable statistics that explain numerous measures of network topology. Surrogate time series with subject-matched spatial and temporal autocorrelation capture nearly all reliable individual and regional variation in these topology measures. Network topology changes during aging are driven by spatial autocorrelation, and multiple serotonergic drugs causally induce the same topographic change in temporal autocorrelation. This reductionistic interpretation of widely used complexity measures may help link them to neurobiology., (© 2023. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Children who experience homelessness display substantial variation in outcomes, but little attention has been given to potential mechanisms linking their housing experiences to their functioning. This study explores these mechanisms using qualitative coding of 80 interviews with parents participating in a randomized control trial of housing interventions for families experiencing homelessness. Interviews were conducted an average of 7 months after families entered a homeless shelter, when most families had exited shelters to a variety of other housing options. Many parents described children as faring poorly on behavioral and educational outcomes while in shelters but displaying improvement after leaving the shelter. Parents commonly viewed shelters as contributing to behavioral disruptions, with restored autonomy and routines after exiting shelters contributing to recovery in functioning. Parents offered long-term rental subsidies viewed having a stable, adequate place of their own as helping their children fare better from reduced family stress, improved routines, and changes in children's expectations about stability. Findings indicate the importance of understanding differences in housing stability and quality among families who experience homelessness for how children fare-including differences in how housing interventions affect stability and quality. Policies expanding access to long-term rental subsidies could help improve outcomes for children. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Background: Housing insecurity is prevalent among emergency department (ED) patients. Despite a surge of interest in screening for patients' social needs including housing insecurity, little research has examined ED social needs interventions. We worked together with government and community partners to develop and pilot test a homelessness prevention intervention targeted to ED patients with drug or unhealthy alcohol use., Methods: We approached randomly sampled patients at an urban public hospital ED, May to August 2019. Adult patients were eligible if they were medically stable, not incarcerated, spoke English, had unhealthy alcohol or any drug use, and were not currently homeless but screened positive for risk of future homelessness using a previously developed risk screening tool. Participants received a three-part intervention: (1) brief counseling and referral to treatment for substance use delivered through a preexisting ED program; (2) referral to Homebase, an evidence-based community homelessness prevention program; and (3) up to three troubleshooting phone calls by study staff. Participants completed surveys at baseline and 6 months., Results: Of 2183 patients screened, 51 were eligible and 40 (78.4%) participated; one later withdrew, leaving 39 participants. Participants were diverse in age, gender, race, and ethnicity. Of the 32 participants reached at 6 months, most said it was very or extremely helpful to talk to someone about their housing situation (n = 23, 71.9%) at the baseline ED visit. Thirteen (40.6%) said their housing situation had improved in the past 6 months and 16 (50.0%) said it had not changed. Twenty participants (62.5%) had made contact with a Homebase office. Participants shared ideas of how to improve the intervention., Conclusions: This pilot intervention was feasible and well received by participants though it required a large amount of screening to identify potentially eligible patients. Our findings will inform a larger future trial and may be informative for others seeking to develop similar interventions., (© 2022 Society for Academic Emergency Medicine.)

This study proposes an innovative use of a modified version of photovoice for cross-national qualitative research that allows participants to express their ideas, experiences, and emotions about a topic through photographic language. We examine factors affecting social service providers' work on people experiencing homelessness in Europe. We highlight five advantages of using photovoice in cross-national research: visual language, methodological flexibility, participatory data analysis, the bottom-up process, and the promotion of social change. Moreover, we identify key stages of the process: writing a detailed protocol for the implementation and fidelity of the projects, using two levels of data analysis, and disseminating the results. This study provides lessons learned for others who may want to use photovoice in cross-national research., (© 2022 The Authors. American Journal of Community Psychology published by Wiley Periodicals LLC on behalf of Society for Community Research and Action.)

Importance: Despite increasing interest in assessing patient social needs in health care settings, there has been little research examining the performance of housing-related screening questions., Objective: To examine the performance of 2 single-item screening questions assessing emergency department (ED) patients' self-perceived risk of future homelessness., Design, Setting, and Participants: This prospective cohort study was conducted among a randomly selected sample of adult ED patients from 2016 to 2017 in a public hospital ED in New York City. Data were analyzed from September 2019 through October 2021., Exposures: Responses on patient surveys conducted at the baseline ED visit for 2 single-item screening questions on self-perceived risk for future housing instability and homelessness were collected. One question asked patients if they were worried about having stable housing in the next 2 months, and the other question asked them to rate the likelihood that they would enter a homeless shelter in the next 6 months., Outcomes: Homeless shelter entry 2, 6, and 12 months after an ED visit, assessed using shelter administrative data in the study city, which was linked with participant baseline survey responses., Results: There were 1919 study participants (976 [51.0%] men and 931 [48.6%] women among 1915 individuals with gender data; 700 individuals aged 31-50 years [36.5%] among 1918 individuals with age data; 1126 Hispanic or Latinx individuals [59.0%], 368 non-Hispanic Black individuals [19.3%], and 225 non-Hispanic White individuals [11.8%] among 1908 individuals with race and ethnicity data). Within 2, 6, and 12 months of the ED visit, 45 patients (2.3%), 66 patients (3.4%), and 95 patients (5.0%) had entered shelter, respectively. For both single-item screening questions, participants who answered affirmatively had significantly higher likelihood of future shelter entry at each time point examined (eg, at 2 months: 31 participants responding yes [6.5%] vs 14 participants responding no [1.0%] to the question concerning being worried about having stable housing in the next 2 months). Sensitivity of the screening questions ranged from 0.27 to 0.69, specificity from 0.76 to 0.97, positive predictive value from 0.07 to 0.27, and area under the receiver operating characteristic curve from 0.62 to 0.72., Conclusions and Relevance: This study found that 2 single-item screening questions assessing ED patient self-perceived risk of future housing instability and homelessness had adequate to good performance in identifying risk for future shelter entry. Such single-item screening questions should be further tested before broad adoption.

Transcriptomics has revealed that cortical inhibitory neurons exhibit a great diversity of fine molecular subtypes 1-6 , but it is not known whether these subtypes have correspondingly diverse patterns of activity in the living brain. Here we show that inhibitory subtypes in primary visual cortex (V1) have diverse correlates with brain state, which are organized by a single factor: position along the main axis of transcriptomic variation. We combined in vivo two-photon calcium imaging of mouse V1 with a transcriptomic method to identify mRNA for 72 selected genes in ex vivo slices. We classified inhibitory neurons imaged in layers 1-3 into a three-level hierarchy of 5 subclasses, 11 types and 35 subtypes using previously defined transcriptomic clusters 3 . Responses to visual stimuli differed significantly only between subclasses, with cells in the Sncg subclass uniformly suppressed, and cells in the other subclasses predominantly excited. Modulation by brain state differed at all hierarchical levels but could be largely predicted from the first transcriptomic principal component, which also predicted correlations with simultaneously recorded cells. Inhibitory subtypes that fired more in resting, oscillatory brain states had a smaller fraction of their axonal projections in layer 1, narrower spikes, lower input resistance and weaker adaptation as determined in vitro 7 , and expressed more inhibitory cholinergic receptors. Subtypes that fired more during arousal had the opposite properties. Thus, a simple principle may largely explain how diverse inhibitory V1 subtypes shape state-dependent cortical processing., (© 2022. The Author(s).)

Objective: To develop a screening tool to identify emergency department (ED) patients at risk of entering a homeless shelter, which could inform targeting of interventions to prevent future homelessness episodes., Data Sources: Linked data from (1) ED patient baseline questionnaires and (2) citywide administrative homeless shelter database., Study Design: Stakeholder-informed predictive modeling utilizing ED patient questionnaires linked with prospective shelter administrative data. The outcome was shelter entry documented in administrative data within 6 months following the baseline ED visit. Exposures were responses to questions on homelessness risk factors from baseline questionnaires., Data Collection/extraction Methods: Research assistants completed questionnaires with randomly sampled ED patients who were medically stable, not in police/prison custody, and spoke English or Spanish. Questionnaires were linked to administrative data using deterministic and probabilistic matching., Principal Findings: Of 1993 ED patients who were not homeless at baseline, 5.6% entered a shelter in the next 6 months. A screening tool consisting of two measures of past shelter use and one of past criminal justice involvement had 83.0% sensitivity and 20.4% positive predictive value for future shelter entry., Conclusions: Our study demonstrates the potential of using cross-sector data to improve hospital initiatives to address patients' social needs., (© 2021 Health Research and Educational Trust.)

In noisy but stationary environments, decisions should be based on the temporal integration of sequentially sampled evidence. This strategy has been supported by many behavioral studies and is qualitatively consistent with neural activity in multiple brain areas. By contrast, decision-making in the face of non-stationary sensory evidence remains poorly understood. Here, we trained monkeys to identify and respond via saccade to the dominant color of a dynamically refreshed bicolor patch that becomes informative after a variable delay. Animals' behavioral responses were briefly suppressed after evidence changes, and many neurons in the frontal eye field displayed a corresponding dip in activity at this time, similar to that frequently observed after stimulus onset but sensitive to stimulus strength. Generalized drift-diffusion models revealed consistency of behavior and neural activity with brief suppression of motor output, but not with pausing or resetting of evidence accumulation. These results suggest that momentary arrest of motor preparation is important for dynamic perceptual decision making., (© 2022. The Author(s).)

Integration is one of the main goals of homeless services. Despite the growing research on integration and homelessness, few studies start with the perspective of people experiencing homelessness. Integration is often measured as participation in a list of standard behaviours. This process assesses behaviour in accordance with social norms but ignores people's own feelings and understanding of integration. The main aim of this study is to explore the meaning of integration from the perspective of people experiencing homelessness. Data were collected through semi-structured interviews involving 26 people in homeless service programmes. Five main themes regarding the meanings of integration were generated: work, housing, respectful relationships, family and personal dignity. Moreover, two themes of obstacles and facilitators affecting integration were identified. A new conceptualisation of integration is generated that captures the participants' sense of personal dignity, respect and recognition from others and a sense of utility within their living environments (work, house and family). Implications of the results are discussed with respect to homeless services and research on homelessness., (© 2021 John Wiley & Sons Ltd.)

The complexity of homeless service users' characteristics and the contextual challenges faced by services can make the experience of working with people in homelessness stressful and can put providers' well-being at risk. In the current study, we investigated the association between service characteristics (i.e., the availability of training and supervision and the capability-fostering approach) and social service providers' work engagement and burnout. The study involved 497 social service providers working in homeless services in eight different European countries (62% women; mean age = 40.73, SD = 10.45) and was part of the Horizon 2020 European study "Homelessness as Unfairness (HOME_EU)." Using hierarchical linear modeling (HLM), findings showed that the availability of training and supervision were positively associated with providers' work engagement and negatively associated with burnout. However, results varied based on the perceived usefulness of the training and supervision provided within the service and the specific outcome considered. The most consistent finding was the association between the degree to which a service promotes users' capabilities and all the aspects of providers' well-being analyzed. Results are discussed in relation to their implications for how configuration of homeless services can promote social service providers' well-being and high-quality care., (© 2020 Society for Community Research and Action.)

There is growing evidence that pre-exposure prophylaxis (PrEP) prevents HIV acquisition. However, in the United States, approximately only 4% of people who could benefit from PrEP are currently receiving it, and it is estimated only 1 in 5 physicians has ever prescribed PrEP. We conducted a scoping review to gain an understanding of physician-identified barriers to PrEP provision. Four overarching barriers presented in the literature: Purview Paradox, Patient Financial Constraints, Risk Compensation, and Concern for ART Resistance. Considering the physician-identified barriers, we make recommendations for how physicians and students may work to increase PrEP knowledge and competence along each stage of the PrEP cascade. We recommend adopting HIV risk assessment as a standard of care, improving physician ability to identify PrEP candidates, improving physician interest and ability in encouraging PrEP uptake, and increasing utilization of continuous care management to ensure retention and adherence to PrEP.

Pre-Exposure Prophylaxis (PrEP) has been shown to be an effective method of HIV prevention for men who have sex with-men (MSM) and -transgender women (MSTGWs), serodiscordant couples, and injection drug users; however fewer than 50 000 individuals currently take this regimen. Knowledge of PrEP is low among healthcare providers and much of this lack of knowledge stems from the lack or exposure to PrEP in medical school. We conducted a cross sectional survey of medical schools in the United States to assess the degree to which PrEP for HIV prevention is taught. The survey consisted Likert scale questions assessing how well the students were prepared to perform each skill associated with PrEP delivery, as well as how PrEP education was delivered to students. We contacted 141 medical schools and 71 responded to the survey (50.4%). PrEP education was only reported to be offered at 38% of schools, and only 15.4% reported specific training for Lesbian, Gay, Bisexual, and Transgender (LGBT) patients. The most common delivery methods of PrEP content were didactic sessions with 11 schools reporting this method followed by problem-based learning, direct patient contact, workshops, and small group discussions. Students were more prepared to provide PrEP to MSM compared to other high-risk patients. Few medical schools are preparing their students to prescribe PrEP upon graduation. Further, there is a need to increase the number of direct patient contacts or simulations for students to be better prepared.

Studies of large-scale brain organization have revealed interesting relationships between spatial gradients in brain maps across multiple modalities. Evaluating the significance of these findings requires establishing statistical expectations under a null hypothesis of interest. Through generative modeling of synthetic data that instantiate a specific null hypothesis, quantitative benchmarks can be derived for arbitrarily complex statistical measures. Here, we present a generative null model, provided as an open-access software platform, that generates surrogate maps with spatial autocorrelation (SA) matched to SA of a target brain map. SA is a prominent and ubiquitous property of brain maps that violates assumptions of independence in conventional statistical tests. Our method can simulate surrogate brain maps, constrained by empirical data, that preserve the SA of cortical, subcortical, parcellated, and dense brain maps. We characterize how SA impacts p-values in pairwise brain map comparisons. Furthermore, we demonstrate how SA-preserving surrogate maps can be used in gene set enrichment analyses to test hypotheses of interest related to brain map topography. Our findings demonstrate the utility of SA-preserving surrogate maps for hypothesis testing in complex statistical analyses, and underscore the need to disambiguate meaningful relationships from chance associations in studies of large-scale brain organization., Competing Interests: Declaration of competing interest M.H. and M.S. declare no competing interests. J.B.B. consults for Blackthorn Therapeutics. A.A. and J.D.M. consult for and hold equity with Blackthorn Therapeutics., (Copyright © 2020. Published by Elsevier Inc.)

Study Objective: Housing instability is prevalent among emergency department (ED) patients and is known to adversely affect health. We aim to determine the incidence and timing of homeless shelter entry after an ED visit among patients who are not currently homeless., Methods: We conducted a random-sample survey of ED patients at an urban public hospital from November 2016 to September 2017. Patients provided identifying information and gave informed consent for us to link their survey data with the New York City Department of Homeless Services shelter database. Shelter use was followed prospectively for 12 months after the baseline ED visit. We examined timing of shelter entry in the 12 months after the ED visit, excluding patients who were homeless at baseline., Results: Of 1,929 unique study participants who were not currently homeless, 96 (5.0%) entered a shelter within 12 months of their baseline ED visit. Much of the shelter entry occurred in the first month after the ED visit, with continued yet slower rates of entry in subsequent months. Patients in our sample who entered a shelter were predominantly men and non-Hispanic black, and commonly had past shelter and frequent ED use., Conclusion: In this single-center study, 5.0% of urban ED patients who were not currently homeless entered a homeless shelter within the year after their ED visit. Particularly if replicated elsewhere, this finding suggests that ED patients may benefit from efforts to identify housing instability and direct them to homelessness prevention programs., (Copyright © 2020 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.)

Although the decisions of our daily lives often occur in the context of temporal and reward structures, the impact of such regularities on decision-making strategy is poorly understood. Here, to explore how temporal and reward context modulate strategy, we trained 2 male rhesus monkeys to perform a novel perceptual decision-making task with asymmetric rewards and time-varying evidence reliability. To model the choice and response time patterns, we developed a computational framework for fitting generalized drift-diffusion models, which flexibly accommodate diverse evidence accumulation strategies. We found that a dynamic urgency signal and leaky integration, in combination with two independent forms of reward biases, best capture behavior. We also tested how temporal structure influences urgency by systematically manipulating the temporal structure of sensory evidence, and found that the time course of urgency was affected by temporal context. Overall, our approach identified key components of cognitive mechanisms for incorporating temporal and reward structure into decisions. SIGNIFICANCE STATEMENT In everyday life, decisions are influenced by many factors, including reward structures and stimulus timing. While reward and timing have been characterized in isolation, ecologically valid decision-making involves a multiplicity of factors acting simultaneously. This raises questions about whether the same decision-making strategy is used when these two factors are concurrently manipulated. To address these questions, we trained rhesus monkeys to perform a novel decision-making task with both reward asymmetry and temporal uncertainty. In order to understand their strategy and hint at its neural mechanisms, we used the new generalized drift diffusion modeling framework to model both reward and timing mechanisms. We found two of each reward and timing mechanisms are necessary to explain our data., (Copyright © 2020 the authors.)

Background: Homelessness is a risk factor for family involvement with child welfare services (CWS). Housing interventions are promising-but reasons for this are not well understood, and housing resources could be better targeted to families at risk of increased CWS involvement., Objective: We sought to better understand the relationship between homelessness and CWS involvement and examine whether homeless shelter data could combine with CWS data to enhance intervention targeting., Participants and Setting: For 4 years, we followed 2063 families investigated by the San Francisco Human Services Agency in 2011., Methods: Matching CWS data to homeless shelter data, we fit Cox models to examine the relationship between shelter use and subsequent CWS outcomes and produced ROC curves to judge model accuracy with and without shelter information., Results: Absent CWS covariates (family demographics, CWS history, and family safety and risk), past shelter entry predicted repeat maltreatment referral (HR = 1.92, p < .001), in-home case opening (HR = 1.51, p < .05), and child removal (HR = 1.95, p < .01), but not child reunification. With CWS covariates, past shelter use no longer predicted case opening and child removal, but still predicted referral (HR = 1.58, p < .01). Shelter data did not contribute to models' predictive accuracy., Conclusions: We find mixed evidence that shelter use independently leads to CWS involvement. Housing interventions might help by addressing present housing problems and family experiences correlated with past shelter use. However, we find no evidence that data matches with shelter systems could enhance targeting., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

The drift-diffusion model (DDM) is an important decision-making model in cognitive neuroscience. However, innovations in model form have been limited by methodological challenges. Here, we introduce the generalized drift-diffusion model (GDDM) framework for building and fitting DDM extensions, and provide a software package which implements the framework. The GDDM framework augments traditional DDM parameters through arbitrary user-defined functions. Models are solved numerically by directly solving the Fokker-Planck equation using efficient numerical methods, yielding a 100-fold or greater speedup over standard methodology. This speed allows GDDMs to be fit to data using maximum likelihood on the full response time (RT) distribution. We demonstrate fitting of GDDMs within our framework to both animal and human datasets from perceptual decision-making tasks, with better accuracy and fewer parameters than several DDMs implemented using the latest methodology, to test hypothesized decision-making mechanisms. Overall, our framework will allow for decision-making model innovation and novel experimental designs., Competing Interests: MS, NL, JM No competing interests declared, (© 2020, Shinn et al.)

Little is known about how medical students are trained to identify and reduce their own biases toward vulnerable patient groups. A survey was conducted among US medical schools to determine whether their curricula addressed physician implicit biases toward three vulnerable patient groups: lesbian, gay, bisexual, transgender, and questioning (LGBTQ) individuals, persons experiencing homelessness, and migrant farmworkers. Of 141 US medical schools, 71 (50%) responded. Survey respondents indicated that implicit bias is not routinely addressed in medical education, and training specific to vulnerable populations is infrequent. Recommendations for incorporating implicit bias training in medical school curricula are discussed., Competing Interests: Conflict of InterestThe authors declare that they have no conflicts of interest., (© International Association of Medical Science Educators 2020.)

Purpose: Interpersonal violence (IV) is a leading cause of morbidity, disability, adverse mental health conditions, and mortality. Without additional training, physicians are likely to limit their attention to the presenting trauma without recognizing or addressing potential long-term effects., Methods: A systematic review of the literature was conducted using PRISMA guidelines to identify original studies that focused on how medical students are taught to address IV across the life course., Results: Twenty-nine (29) articles were identified that sought to teach medical students how to respond to IV at different stages of the patient's life course., Conclusions: Research findings suggest that teaching medical students about IV can have a positive impact on their knowledge, attitudes, and skills. Despite the near universal support by medical and professional associations to address it, the evidence base for how to address IV effectively in the medical curriculum is still lacking.

Scientific evidence is accumulating about the range of adverse health, mental health, and risky behavioral sequelae across the life continuum arising from exposure to Adverse Childhood Experiences (ACEs). Research findings show a clear relationship between the number of ACEs experienced by a person during childhood and the adverse health outcomes of adulthood. The purpose of this systematic review was to assess the extent to which medical schools are teaching medical students about ACEs. Published articles were identified through searches of several databases using a combination of major and minor MeSH terms. Out of a total of 715 publications screened, 13 studies were identified that focused on medical education efforts to address ACEs. Educational interventions were conducted in a variety of formats, including lectures, perspective-taking exercises, and small group discussions. Our systematic review found little evidence to suggest that medical schools are teaching students how to address ACEs among their patients.

Background: Lesbian, gay, bisexual, transgender and questioning (LGBTQ) individuals experience higher rates of health disparities. These disparities may be driven, in part, by biases of medical providers encountered in health care settings. Little is known about how medical, nursing, or dental students are trained to identify and reduce the effects of their own biases toward LGBTQ individuals. Therefore, a systematic review was conducted to determine the effectiveness of programs to reduce health care student or provider bias towards these LGBTQ patients., Methods: The authors performed searches of online databases (MEDLINE/PubMed, PsycINFO, Web of Science, Scopus, Ingenta, Science Direct, and Google Scholar) for original articles, published in English, between March 2005 and February 2017, describing intervention studies focused on reducing health care student or provider bias towards LGBTQ individuals. Data extracted included sample characteristics (i.e., medical, nursing, or dental students or providers), study design (i.e., pre-post intervention tests, qualitative), program format, program target (i.e., knowledge, comfort level, attitudes, implicit bias), and relevant outcomes. Study quality was assessed using a five-point scale., Results: The search identified 639 abstracts addressing bias among medical, nursing, and dental students or providers; from these abstracts, 60 articles were identified as medical education programs to reduce bias; of these articles, 13 described programs to reduce bias towards LGBTQ patients. Bias-focused educational interventions were effective at increasing knowledge of LGBTQ health care issues. Experiential learning interventions were effective at increasing comfort levels working with LGBTQ patients. Intergroup contact was effective at promoting more tolerant attitudes toward LGBTQ patients. Despite promising support for bias education in increasing knowledge and comfort levels among medical, nursing, and dental students or providers towards LGBTQ persons, this systematic review did not identify any interventions that assessed changes in implicit bias among students or providers., Conclusions: Strategies for assessing and mitigating implicit bias towards LGBTQ patients are discussed and recommendations for medical, nursing, and dental school curricula are presented.

Introduction: Objective: we found a black precipitate during the infusion of a parenteral nutrition without lipids. The objective of this study is to check the composition of the precipitate and the influence of the type of amino acids in its formation. Methods: four PN bags were prepared with the following composition: 1 l of amino acids solution, 150 g glucose, 60 mEq potassium, 217 mEq chloride, 105 mEq sodium, 15 mEq magnesium, 15 mEq calcium, 18.63 mmol phosphorus and trace elements (Addamel®). Each bag was prepared using a different type of amino acids solution with different amount of cysteine per litre: Tauramin® 10% (0.5 g/l), Primene® 10% (1.89 g/l), Tauramin® 12.6% (0.62 g/l) or Synthamin® 10% (0 g/l). Tauramin® 10% and Primene® 10% were packaged in glass containers whereas Tauramin® 12.6% and Synthamin® 10%, in plastic. The contents of each bag were filtered using Pall NEO96E 0.2 micron filters. A 2.25% area of each filter was observed by scanning electron microscopy at 100x magnification. The analysis by energy dispersive spectroscopy (EDS) was performed at 1,000x magnification. Results: in the Primene® 10% and Tauramin® 10% filters, a greater amount of precipitate was observed than with Tauramin® 12.6% and Synthamin® 10%. The percentage of copper and sulphur in each area of the filters studied was, respectively, 22.9% and 11.5% (Primene® 10%), 19.3% and 9.6% (Tauramin® 10%), 3.7% and 0% (Tauramin® 12.6%), 2.5% y 0% (Synthamin® 10%). Conclusions: the observed precipitate contains copper and sulphur. Precipitate formation occurs in high cysteine content amino acids solutions packaged in glass containers. It is important to use filters in the administration of PN to ensure that this type of precipitates are retained and do not pass to the patient. Key words.

The implementation and adaptation of the Housing First (HF) model represented profound changes the structure and delivery, goals, and principles of homeless services. These features of homeless services directly influence providers, their work performance and the clients' outcomes. The present research, conducted in eight European countries, investigated how social providers working in HF or TS (Traditional Staircase) describe and conceptualize the goals and the principles of their services. Data were collected through 29 focus group discussions involving 121 providers. The results showed that HF and TS had similar and different goals for their clients in the following areas: support, social integration, satisfaction of needs, housing, and well-being. HF providers emphasized clients' autonomy and ability to determine their personal goals, with housing being considered a start on the path of recovery, while TS were more focused on individual clients' basic needs with respect to food, health and finding temporary accommodations. HF providers privileged the person-centered approach and housing as a right, while TS providers were more focused on helping everyone. Implications of the results are discussed as suggestions both for practice and for research.

Objective: to determine if precipitation processes occur in parenteral nutrition solutions (PNs) with calcium gluconate and sodium glycerophosphate in the precipitation threshold limits of the Spanish SENPE/SEGHNP/SEFH 2008 consensus document of PN preparation., Methods: seven PNs with different composition were prepared in triplicate: five 100 ml PNs with different concentrations of amino acids, calcium and phosphorus similar to consensus document maximum concentrations for precipitation, and two control PNs: one without calcium and phosphorus and other with high calcium and phosphorus content and low concentration of amino acids. All PNs did not contain lipids to allow correct detection of precipitates. The no lipid PNs were stored at room temperature for 20 hours, and at 35 °C for four hours. Subsequently, they filtered through a 0.2 μm filter, which was observed by electron microscopy. Because a large amount of not expected precipitates was observed, complementary studies were carried out., Results: precipitates were observed in all PNs except in the control solution without calcium and phosphorus; many of them were greater than 10 μm. However, according to our studies, these crystals were produced after filtration and calcium was found in their composition, but not phosphorus. Particles from the preparation of parenteral nutrition were also observed., Conclusions: in our study we did not find calcium phosphate precipitates in the limits included in the consensus document SENPE/SEGHNP/ SEFH. However, it is possible that micro precipitates with calcium are formed. It is important to filter PNs prior to their administration.

Complex network topology is characteristic of many biological systems, including anatomical and functional brain networks (connectomes). Here, we first constructed a structural covariance network from MRI measures of cortical thickness on 296 healthy volunteers, aged 14-24 years. Next, we designed a new algorithm for matching sample locations from the Allen Brain Atlas to the nodes of the SCN. Subsequently we used this to define, transcriptomic brain networks by estimating gene co-expression between pairs of cortical regions. Finally, we explored the hypothesis that transcriptional networks and structural MRI connectomes are coupled. A transcriptional brain network (TBN) and a structural covariance network (SCN) were correlated across connection weights and showed qualitatively similar complex topological properties: assortativity, small-worldness, modularity, and a rich-club. In both networks, the weight of an edge was inversely related to the anatomical (Euclidean) distance between regions. There were differences between networks in degree and distance distributions: the transcriptional network had a less fat-tailed degree distribution and a less positively skewed distance distribution than the SCN. However, cortical areas connected to each other within modules of the SCN had significantly higher levels of whole genome co-expression than expected by chance. Nodes connected in the SCN had especially high levels of expression and co-expression of a human supragranular enriched (HSE) gene set that has been specifically located to supragranular layers of human cerebral cortex and is known to be important for large-scale, long-distance cortico-cortical connectivity. This coupling of brain transcriptome and connectome topologies was largely but not entirely accounted for by the common constraint of physical distance on both networks., (Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Though disability and housing instability are discussed separately in public health literature, few studies address families at their intersection. As a result, little is known about families who experience both homelessness and disability, how many receive disability benefits like SSI and SSDI, or the influence of those benefits on health-promoting outcomes like housing stability and self-sufficiency. Moreover, no previous research compares the ability of different housing and service interventions to increase disability benefit access., Objective: We examine relationships between disabilities and SSI/SSDI income reported when families enter emergency shelters and later health-promoting outcomes (housing stability and self-sufficiency) and how housing interventions affect SSI/SSDI receipt., Methods: Families in the (name removed) Study (N = 1857) were interviewed in emergency shelters, randomly offered of one of three housing interventions or usual care (i.e., no immediate referral to any intervention beyond shelter), and re-interviewed 20 months later., Results: A third of families reported a disability at shelter entry. SSI/SSDI coverage of these families increased nearly 10% points over 20 months but never exceeded 40%. Disabilities predicted greater housing instability, food insecurity, and economic stress and less work and income. Among families reporting disabilities, SSI/SSDI receipt predicted fewer returns to emergency shelter, and more income despite less work. Offers of long-term housing subsidies increased SSI/SSDI receipt., Conclusions: Many families experiencing homelessness have disabilities; those receiving SSI/SSDI benefits have better housing and income outcomes. Providing families experiencing homelessness with long-term housing subsidies and SSI/SSDI could improve public health., (Copyright © 2017 Elsevier Inc. All rights reserved.)

The capabilities approach provides a rich evaluative framework to guide transformative change in the community mental health system. This study reports the content and construct validity and psychometric properties of a contextualized measure of the extent to which mental health programs foster achieved capabilities. The Achieved Capabilities Questionnaire for Community Mental Health (ACQ-CMH), adapted from Nussbaum's capabilities framework, was developed previously with consumer collaboration. Content validity was assessed through a collaborative process, involving a panel of eight consumers, staff members, and senior researchers. The resulting shorter version (ACQ-CMH-98) was completed by 332 community mental health consumers sampled throughout Portugal. Factor (PCA) analysis, internal consistency reliability, and test-retest reliability over 2 weeks (N = 33) showed good psychometric properties. The resulting six-factor structure with 48 items explains 48.88% of the total variance (KMO = 0.89; Bartlett p = .00). Internal consistency of the obtained dimensions ranges from .91 to .76. Associations of the measure with recovery, quality of life, and psychological distress scales add further evidence of construct validity. The adaptation of Nussbaum's framework stressed specific components that may enhance understanding and change within the community mental health system., (© Society for Community Research and Action 2018.)

Macroscopic cortical networks are important for cognitive function, but it remains challenging to construct anatomically plausible individual structural connectomes from human neuroimaging. We introduce a new technique for cortical network mapping based on inter-regional similarity of multiple morphometric parameters measured using multimodal MRI. In three cohorts (two human, one macaque), we find that the resulting morphometric similarity networks (MSNs) have a complex topological organization comprising modules and high-degree hubs. Human MSN modules recapitulate known cortical cytoarchitectonic divisions, and greater inter-regional morphometric similarity was associated with stronger inter-regional co-expression of genes enriched for neuronal terms. Comparing macaque MSNs with tract-tracing data confirmed that morphometric similarity was related to axonal connectivity. Finally, variation in the degree of human MSN nodes accounted for about 40% of between-subject variability in IQ. Morphometric similarity mapping provides a novel, robust, and biologically plausible approach to understanding how human cortical networks underpin individual differences in psychological functions., (Copyright © 2017 Elsevier Inc. All rights reserved.)

What housing and service interventions work best to reduce homelessness for families in the United States? The Family Options Study randomly assigned 2,282 families recruited in homeless shelters across 12 sites to priority access to one of three active interventions or to usual care in their communities. The interventions were long-term rent subsidies, short-term rent subsidies, and transitional housing in supervised programs with intensive psychosocial services. In two waves of follow-up data collected 20and 37 months later, priority access to long-term rent subsidies reduced homelessness sand food insecurity and improved other aspects of adult and child well-being relative to usual care, at a cost 9 percent higher. The other interventions had little effect. The study provides support for the view that homelessness for most families is an economic problem that long-term rent subsidies resolve and does not support the view that families must address psychosocial problems to succeed in housing. It has implications for focusing government resources on this important social problem.

Motivated by prior data on local cortical shrinkage and intracortical myelination, we predicted age-related changes in topological organization of cortical structural networks during adolescence. We estimated structural correlation from magnetic resonance imaging measures of cortical thickness at 308 regions in a sample of N = 297 healthy participants, aged 14-24 years. We used a novel sliding-window analysis to measure age-related changes in network attributes globally, locally and in the context of several community partitions of the network. We found that the strength of structural correlation generally decreased as a function of age. Association cortical regions demonstrated a sharp decrease in nodal degree (hubness) from 14 years, reaching a minimum at approximately 19 years, and then levelling off or even slightly increasing until 24 years. Greater and more prolonged age-related changes in degree of cortical regions within the brain network were associated with faster rates of adolescent cortical myelination and shrinkage. The brain regions that demonstrated the greatest age-related changes were concentrated within prefrontal modules. We conclude that human adolescence is associated with biologically plausible changes in structural imaging markers of brain network organization, consistent with the concept of tuning or consolidating anatomical connectivity between frontal cortex and the rest of the connectome., (© The Author 2017. Published by Oxford University Press.)

Family break-up is common in families experiencing homelessness. This paper examines the extent of separations of children from parents and of partners from each other and whether housing and service interventions reduced separations and their precursors among 1,857 families across 12 sites who participated in the Family Options Study. Families in shelters were randomized to offers of one of three interventions: permanent housing subsidies that reduce expenditures for rent to 30% of families' income, temporary rapid re-housing subsidies with some services directed at housing and employment, and transitional housing in supervised facilities with extensive psychosocial services. Each group was compared to usual care families who were eligible for that intervention but received no special offer. Twenty months later, permanent housing subsidies almost halved rates of child separation and more than halved rates of foster care placements; the other interventions did not affect separations significantly. Predictors of separation were primarily homelessness and drug abuse (all comparisons), and alcohol dependence (one comparison). Although housing subsidies reduced homelessness, alcohol dependence, intimate partner violence, and economic stressors, the last three variables had no association with child separations in the subsidy comparison; thus subsidies had indirect effects via reductions in homelessness. No intervention reduced partner separations., (© Society for Community Research and Action 2016.)

Graph theoretical analysis of the community structure of networks attempts to identify the communities (or modules) to which each node affiliates. However, this is in most cases an ill-posed problem, as the affiliation of a node to a single community is often ambiguous. Previous solutions have attempted to identify all of the communities to which each node affiliates. Instead of taking this approach, we introduce versatility, V, as a novel metric of nodal affiliation: V ≈ 0 means that a node is consistently assigned to a specific community; V >> 0 means it is inconsistently assigned to different communities. Versatility works in conjunction with existing community detection algorithms, and it satisfies many theoretically desirable properties in idealised networks designed to maximise ambiguity of modular decomposition. The local minima of global mean versatility identified the resolution parameters of a hierarchical community detection algorithm that least ambiguously decomposed the community structure of a social (karate club) network and the mouse brain connectome. Our results suggest that nodal versatility is useful in quantifying the inherent ambiguity of modular decomposition.

The emergent dynamics in networks of recurrently coupled spiking neurons depends on the interplay between single-cell dynamics and network topology. Most theoretical studies on network dynamics have assumed simple topologies, such as connections that are made randomly and independently with a fixed probability (Erdös-Rényi network) (ER) or all-to-all connected networks. However, recent findings from slice experiments suggest that the actual patterns of connectivity between cortical neurons are more structured than in the ER random network. Here we explore how introducing additional higher-order statistical structure into the connectivity can affect the dynamics in neuronal networks. Specifically, we consider networks in which the number of presynaptic and postsynaptic contacts for each neuron, the degrees, are drawn from a joint degree distribution. We derive mean-field equations for a single population of homogeneous neurons and for a network of excitatory and inhibitory neurons, where the neurons can have arbitrary degree distributions. Through analysis of the mean-field equations and simulation of networks of integrate-and-fire neurons, we show that such networks have potentially much richer dynamics than an equivalent ER network. Finally, we relate the degree distributions to so-called cortical motifs.

This study examined experiences of doubling up among families after episodes of homelessness. Doubling up refers to two or more adults or families residing in the same housing unit, which has been an increasing trend in the United States in recent decades. Within the past 14 years, the number of households containing more than one family, related or unrelated, has more than tripled. Although doubling up is increasingly common among families at all income levels, this study seeks to understand the experiences of doubling up among families who have been homeless. Through qualitative interviews with caregivers of 29 families, we analyzed advantages and disadvantages of doubling up with the caregiver's parent, other family, and nonfamily. Experiences were rated on a four-point scale-(1) mostly negative, (2) negative mixed, (3) positive mixed, and (4) mostly positive-and coded for various positive and negative themes. Overall, we found that doubling up was a generally negative experience for families in our sample, regardless of their relationship to their hosts. Common themes included negative effects on children, undesirable environments, interpersonal tension, and feelings of impermanence and instability. For formerly sheltered families in this study, doubling up after shelter did not resolve their period of housing instability and may be only another stop in an ongoing cycle of homelessness.

This study developed risk models for returns to housing instability (that is, homelessness and unstable doubling-up situations) among families exiting emergency shelter. Participants included 446 families randomly assigned to receive priority offers of long-term housing subsidies and 578 families randomly assigned to usual care in the Family Options Study, a multisite experiment designed to test the impact of various housing and service interventions for homeless families. Relationships between family features recorded at shelter entry and returns to housing instability 20 months later were examined empirically. Correlation, hierarchical logistic regression, and receiver operating characteristic curves were used to combine family features into predictive risk models. Results indicated that few observable family features beyond previous housing instability offered predictive utility. Access to long-term housing subsidies appears to reduce housing instability. Further research should examine whether disability benefits, reliable employment, or effective substance dependence treatment reduce housing instability.

The enrollment phase of the Family Options Study provides information about the mismatch of the homeless service system and the needs and desires of families experiencing homelessness in 12 communities. One-fourth (25.8 percent) of the 2,490 families screened for the study after shelter stays of a week were deemed ineligible for one or more of the interventions at initial screening, with ineligibility highest for those screened for transitional housing programs (28.9 percent) and lower for short- and long-term rental subsidies (9.2 and 4.1 percent). Families given priority offers of housing and service interventions for which they appeared eligible faced additional screening by programs and made decisions about whether to enroll. Considering all stages of this process, families were least likely to be eligible for and subsequently choose to enroll (within 9 months) in transitional housing programs (32.5 percent of those initially screened) and most likely to be eligible for and subsequently lease up with long-term subsidies (73.4 percent) with short-term subsidies in between (51.0 percent). Homeless system interventions systematically screen out families with housing and employment barriers, despite the presumption that these families are the families who need interventions in order to achieve housing and economic stability.

Research methods in community psychology have grown more diverse since the Swampscott conference, but rigorous social experiments maintain a place among the multiplicity of methods that can promote community psychology values. They are particularly influential in policy circles. Two examples of social experiments to end homelessness for different populations illustrate their role. Both studies show that offering extremely poor and disenfranchised people autonomy and the resources they seek works better than "helping" them to overcome deficits in ways designed by well-meaning service providers. Experiments are neither the first nor the last method community psychologists should employ, but are a critical part of the field's armamentarium for systems change., (© Society for Community Research and Action 2016.)

We propose a novel, closed-loop approach to tuning deep brain stimulation (DBS) for Parkinson's disease (PD). The approach, termed Phasic Burst Stimulation (PhaBS), applies a burst of stimulus pulses over a range of phases predicted to disrupt pathological oscillations seen in PD. Stimulation parameters are optimized based on phase response curves (PRCs), which would be measured from each patient. This approach is tested in a computational model of PD with an emergent population oscillation. We show that the stimulus phase can be optimized using the PRC, and that PhaBS is more effective at suppressing the pathological oscillation than a single phasic stimulus pulse. PhaBS provides a closed-loop approach to DBS that can be optimized for each patient.

The homelessness and child protective services (CPS) systems are closely linked. This study examines the patterns and sequence of families' involvement with homeless shelters and CPS, as well as whether involvement in each system predicts involvement in the other using linked administrative records for 258 families recruited in emergency shelters in Alameda County, California. More than half of families were reported to CPS at some point, but less than one-fifth ever had a report substantiated. Reports that were uninvestigated or unfounded increased in the months leading up to shelter entry and spiked immediately afterward, but substantiations and child removals increased only later. Shelter use before study entry was associated with CPS referrals and investigations after study entry, although not with substantiated cases or child removals. However, CPS involvement before study entry was not associated with returns to shelter after study entry. These results imply that an unsubstantiated report of neglect or abuse may serve as an early warning signal for homelessness and that preventive strategies aiming to affect both homeless and child protective systems should focus on reducing homelessness. CPS workers should evaluate families' housing needs and attempt to link families to appropriate resources. Black families were disproportionately referred to CPS after shelter entry after controlling for other family characteristics, but race was not associated with substantiations of neglect or abuse or with child removals. Findings lend modest support to human decision-making and institutional explanations of racial disproportionalities in CPS involvement, especially for reporters outside of the CPS system., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

This paper examines the housing and service interventions that work best to end family homelessness and to promote housing stability, adult and child well-being, family and self-sufficiency in the United States. It is based on the short-term (20-month) results of the Family Options Study, which recruited 2,282 families in emergency homeless shelters across 12 sites and randomized them to one of three housing and service interventions or to usual care in their communities. The approaches test both theoretical propositions about the nature of family homelessness and practical efforts to end it. Permanent housing subsidies were most successful at ending homelessness and promoting housing stability and had radiating impacts on all the other domains, suggesting that homelessness among families in the United States is centrally a problem of housing affordability. Project-based transitional housing, which attempts to address families' psychosocial needs in supervised settings, and temporary 'rapid re-housing' subsidies had little effect.

A randomized trial compared effects of a Family Critical Time Intervention (FCTI) to usual care for children in 200 newly homeless families in which mothers had diagnosable mental illness or substance problems. Adapted from an evidence-based practice to prevent chronic homelessness for adults with mental illnesses, FCTI combines housing and structured, time-limited case management to connect families leaving shelter with community services. Families were followed at five time points over 24 months. Data on 311 children-99 ages 1.5-5 years, 113 ages 6-10 years, and 99 ages 11-16 years-included mother-, teacher-, and child-reports of mental health, school experiences, and psychosocial well-being. Analyses used hierarchical linear modeling to investigate intervention effects and changes in child functioning over time. Referral to FCTI reduced internalizing and externalizing problems in preschool-aged children and externalizing for adolescents 11-16. The intervention led to declines in self-reported school troubles for children 6-10 and 11-16. Both experimental and control children in all age groups showed reductions in symptoms over time. Although experimental results were scattered, they suggest that FCTI has the potential to improve mental health and school outcomes for children experiencing homelessness.

In an effort to optimize magnetic field detection sensitivities, the Faraday responsivity vector, which determines the relationship between the Faraday rotation angle and an externally applied magnetic field, was investigated in magneto-optic sensors based on bismuth-doped iron-garnet films. Under externally applied fields, Faraday rotation is produced principally by domain rotation and domain wall motion, whose relative contributions depend on the domain geometry and the direction of laser propagation. When optically probed along a principal magnetization axis, Faraday rotation is driven by a single magnetization mechanism, and the responsivity is linearized (reduced to an effective Verdet constant). When the films are probed along an oblique angle to the principal axes, the relationship between the Faraday rotation and the external field becomes tensorial and much more complex. Although this may lead to more complicated phenomena, the interplay of domain rotation and domain wall bowing can be exploited to improve responsivity or bandwidth. A generalized model for the magnitude and direction of the responsivity vector is formulated, which gives predictions that are consistent with the experimental data. Applications to arrayed sensors and three-axis field measurements are discussed.

What makes for a good life? The capabilities approach to this question has much to offer community psychology, particularly with respect to marginalized groups. Capabilities are freedoms to engage in valued social activities and roles-what people can do and be given both their capacities, and environmental opportunities and constraints. Economist Amartya Sen's focus on freedoms and agency resonates with psychological calls for empowerment, and philosopher Martha Nussbaum's specification of requirements for a life that is fully human provides an important guide for social programs. Community psychology's focus on mediating structures has much to offer the capabilities approach. Parallels between capabilities, as enumerated by Nussbaum, and settings that foster positive youth development, as described in a National Research Council Report (Eccles and Gootman (Eds) in Community programs to promote youth development. National Academy Press, Washington, 2002) suggest extensions of the approach to children. Community psychologists can contribute to theory about ways to create and modify settings to enhance capabilities as well as empowerment and positive youth development. Finally, capabilities are difficult to measure, because they involve freedoms to choose but only choices actually made or enacted can be observed. The variation in activities or goals across members of a setting provides a measure of the capabilities that the setting fosters.

This study examines the extent and correlates of family separations in families experiencing homelessness. Of 2,307 parents recruited in family shelters across 12 sites, a tenth were separated from partners and a quarter from one or more children. Additional separations before and after shelter entry and reasons, from parents' perspectives, were documented in qualitative interviews with a subsample of 80 parents. Separations were associated with economic hardship, shelter conditions, and family characteristics.

Because homelessness assistance programs are designed to help families, it is important for policymakers and practitioners to understand how families experiencing homelessness make housing decisions, particularly when they decide not to use available services. This study explores those decisions using in-depth qualitative interviews with 80 families recruited in shelters across four sites approximately six months after they were assigned to one of four conditions (permanent housing subsidies, project-based transitional housing, community-based rapid re-housing, and usual care). Familiar neighborhoods near children's schools, transportation, family and friends, and stability were important to families across conditions. Program restrictions on eligibility constrained family choices. Subsidized housing was the most desired intervention and families leased up at higher rates than in other studies of poor families. Respondents were least comfortable in and most likely to leave transitional housing. Uncertainty associated with community-based rapid re-housing generated considerable anxiety. Across interventions, many families had to make unhappy compromises, often leading to further moves. Policy recommendations are offered.