RESUMEN

PURPOSE: Strategies for preventing and ending homelessness are frequently measured by their effectiveness on indices of tenancy sustainment. To shift this narrative, we conducted research to identify what is needed to "thrive" following homelessness from the perspectives of persons with lived experience in Ontario, Canada. METHODS: Conducted in the context of a community-based participatory research study aimed at informing the development of intervention strategies, we interviewed 46 persons living with mental illness and/or substance use disorder [n = 25 (54.3%) unhoused; n = 21 (45.7%) housed following homelessness] using qualitative interviews. A subsample of 14 participants agreed to engage in photovoice interviews. We analysed these data abductively using thematic analysis informed by health equity and social justice. RESULTS: Participants described experiences of "living in a state of lack" following homelessness. This essence was expressed through four themes: 1) housing as part one of the journey to home; 2) finding and keeping "my people"; 3) meaningful activity as critical for thriving following homelessness; and 4) struggling to access mental health supports in the context of challenging circumstances. CONCLUSIONS: Individuals struggle to thrive following homelessness in the context of insufficient resources. There is a need to build on existing interventions to address outcomes beyond tenancy sustainment.

Asunto(s)

RESUMEN

Research aimed at identifying and evaluating approaches to homelessness has predominately focused on strategies for supporting tenancy sustainment. Fewer studies focus on strategies for enabling thriving following homelessness, and the perspectives of service providers and organisational leaders (SPOL) on this topic are rare. We conducted this study in the context of a community-based participatory research project in two cities in Ontario, Canada. This research was aimed at identifying the strengths and challenges of existing supports in enabling thriving following homelessness, followed by co-designing a novel intervention alongside persons with lived experience of homelessness (PWLEH) and SPOL. The current study presents the findings of interviews conducted in 2020-2021 with SPOL in organisations serving PWLEH. We interviewed 60 individuals including service providers (n = 38; 63.3%) and organisational leaders (n = 22; 36.7%) using semi-structured qualitative interviews. Interviews were conducted and recorded on Zoom to align with physical distancing protocols associated with the COVID-19 pandemic. Recordings were transcribed verbatim and analysed abductively informed by the lenses of social justice and health equity. The essence of our findings is represented by a quote from a research participant: 'We stick people in a house and say okay, you're housed. The problem is solved'. This essence was expressed through five themes: (1) stuck in a system that prevents thriving, (2) substance use as an important coping strategy that prevents tenancy sustainment and thriving, (3) the critical importance of targeting community integration following homelessness, (4) incorporating peer expertise as imperative and (5) people need to be afforded options in selecting housing and services following homelessness. Our findings indicate that SPOL envision possibilities of thriving following homelessness yet are embedded within a system that often prevents them from supporting individuals who are leaving homelessness to do so. Research, practice and policy implications are discussed.

Asunto(s)

RESUMEN

The organic glass-forming materials 1,3-bis(1-naphthyl)-5-(2-naphthyl)benzene (2) and its partially deuterated analogue, 1,3-bis(1-naphthyl-d(7))-5-(2-naphthyl)benzene (2-d(14)), have been synthesized on a gram scale using Suzuki coupling reactions. Detailed spectroscopic studies afford complete NMR assignments (1H, 2H, 13C) for both compounds. Modest energy barriers for the interconversion of atropisomers (ca. 15 kcal/mol) result in a propensity for these materials to form supercooled liquids and glasses, rather than undergoing crystallization. The preparation of these materials enables detailed studies of physical properties of organic glasses and molecular diffusion in condensed phases.

RESUMEN

A ditopic structure containing two heterocyclic DeAP units and programmed to self-assemble is used as an initiation unit for the synthesis of polylactide and polystyrene. The resultant polymers self-assemble into higher molecular weight structures with a lower molecular weight distribution. The largest discrete nanoscale polymeric assembly is proposed to be a hexameric star with a molecular weight of ca. 92.7 kDa. All polymeric assemblies generally exhibit PDI values of 1.3 to 1.5, which are lower than the PDI value of the corresponding polymeric arms. A hexameric assembly is stabilized by 30 hydrogen bonds, including six AADD.DDAA contacts. The hexameric star is formed under conditions that are at least partially controlled by kinetics.

Asunto(s)

RESUMEN

Until recently, the treatment of choice for noncommunicating hydrocephalus included the use of valve-regulated shunts such as the ventriculoperitoneal shunt. High failure rates and multiple complications have led neurosurgeons to use other techniques. Endoscopic third ventriculostomy (ETV) is becoming popular as treatment for noncommunicating hydrocephalus when standard shunts have failed.(1) We present 2 adolescents who developed exotropia, hypertropia, and diplopia after endoscopic third ventricle surgery.

Asunto(s)

RESUMEN

OBJECTIVE: To determine how professional characteristics and practices of physicians alter the selection of medical treatments involving multiple alternatives. Situations involving multiple alternatives can increase the difficulty of making a decision, resulting in more choice deferral than when fewer alternatives are available. DESIGN, SETTING, PARTICIPANTS: A survey and scenario were mailed to a random sample of 314 primary and emergency care physicians affiliated with the Indiana University Medical Center. Using a scenario involving treatment decisions for a patient with osteoarthritis, the effects of multiple treatment alternatives on decision making were explored. Other physician factors included experience, workload, fatigue, continuing education, and supervision. MAIN OUTCOME MEASURES: Physicians' treatment decisions. RESULTS: Physician response was 61% (n = 192). In contrast to previous studies, physicians in the present study were equally likely to prescribe a new medication, regardless of whether they were deciding about 1 medication or between 2 similar medications (54.5% v. 56.0%, P = 0.841). However, physicians who supervise medical students were far less influenced by the cognitive bias associated with multiple choices than those who did not supervise medical students. Supervising physicians were more likely to defer making a decision when there was only 1 treatment option than when there were 2 (49.3% v. 37%, P = 0.143), whereas the opposite was true for nonsupervising physicians (33.3% v. 63%, P = 0.040). The number of hours spent supervising medical students and the number of years as a physician were also important factors in the decision-making process. CONCLUSIONS: Multiple treatment alternatives may result in a deferral of choice. However, this cognitive bias is attenuated by experience and supervision, thus enhancing decision making. Implicit and explicit learning gained through experience and the supervisory process appears to be a central mechanism by which the physicians are protected from this cognitive bias.

Asunto(s)

RESUMEN

An exceptionally strong quadruply hydrogen-bonded complex is formed between 2,7-diamido-1,8-naphthyridine 3 (DAN) and the butylurea of guanosine 6 (UG) in chloroform. The UG unit can be prepared in four steps from guanosine on a 10 g scale in excellent yields without chromatographic purification. The association constant (Kassoc approximately 5 x 10(7) M(-1)) for the UG.DAN complex determined by fluorescence energy transfer from the naphthyridine unit of 3 to coumarin 343 covalently linked UG (18) is among the highest reported for a neutral DNA base-pair analogue. The weak self-association of DAN (Kdimer < 10 M(-1)) and UG (Kdimer ca. 200-300 M(-1)) means that the UG.DAN complex forms with unparalleled fidelity.

Asunto(s)

RESUMEN

On the basis of 3 experiments E. Wascher, U. Schatz, T. Kuder, and R. Verleger (2001) concluded, "The variety of tasks subsumed under the term Simon effect turned out to be heterogeneous" (p. 749). This comment critically evaluates the validity of their conclusion by considering their hypotheses methodology, specific conclusions, and proposed broader implications. Although the Simon effect is a behavioral phenomenon, E. Wascher et al. relied heavily on physiology in hypothesis generation, methodology, and interpretation of results. Moreover, methodological differences from most previous studies, combined with limited statistical support, nonreplication of previously reported behavioral phenomena inconsistencies in results across experiments, and evidence against a contribution of intrahemispherical activation by visuomotor pathways, strongly suggest that their conclusion should be viewed with caution.

Asunto(s)

RESUMEN

Numerous studies of two-choice reaction tasks, including auditory and visual Simon tasks (i.e., tasks in which stimulus location is irrelevant) and visual compatibility tasks, have found that only spatial stimulus-response (S-R) correspondence affected S-R compatibility. Their results provided no indication that stimulus-hand correspondence was a significant factor. However, Wascher et al. (2001) suggested that hand coding plays a role in visual and auditory Simon tasks when the instructions are in terms of the finger/hand used for responding. The present experiments examined whether instructing subjects in terms of response locations or fingers/hands influenced the Simon effect for visual and auditory tasks. In Experiments 1-3, only spatial S-R correspondence contributed significantly to the Simon effect, even when the instructions were in terms of the fingers/hands. However, in Experiment 4, which used auditory stimuli and finger/hand instructions, the contribution of stimulus-hand correspondence increased with practice.

Asunto(s)

RESUMEN

Irradiation (lambda = 670 or >613 nm) of 4,5-benzodiazocycloheptatriene (15), matrix isolated in argon at 10 K, produces primarily 2,3-benzobicyclo[4.1.0]hepta-2,4,6-triene (9) accompanied by small amounts of triplet 4,5-benzocycloheptatrienylidene (2) and 2-naphthylcarbene (10). A reversible photoequilibrium is established in which 9 is converted to 10 at lambda = 290 nm and then regenerated at lambda = 360 nm. Similarly, matrix-isolated 2,3-benzodiazocycloheptatriene (16) produces 4,5-benzobicyclo[4.1.0]hepta-2,4,6-triene (11) at lambda = 670 or >613 nm, but without detection of 2,3-benzocycloheptatrienylidene (4). Irradiation of 11 at lambda = 290 nm induces ring opening to triplet 1-naphthylcarbene (12), which, in turn, cyclizes back to 11 at lambda = 342 or >497 nm. The diazo compounds and photoproducts are characterized by IR, UV/visible, and ESR spectroscopy, where appropriate, and by comparison of the experimental and B3LYP/6-31G calculated IR spectra for each species. Alternate rearrangement products such as allenes 6, 7, and 8 are not detected in the photolysis of either diazo compound.