Implementing Housing First Across Sites and Over Time: Later Fidelity and Implementation Evaluation of a Pan-Canadian Multi-site Housing First Program for Homeless People with Mental Illness

This article examines later fidelity and implementation of a five‐site pan‐Canadian Housing First research demonstration project. The average fidelity score across five Housing First domains and 10 programs was high in the first year of operation (3.47/4) and higher in the third year of operation (3.62/4). Qualitative interviews (36 key informant interviews and 17 focus groups) revealed that staff expertise, partnerships with other services, and leadership facilitated implementation, while staff turnover, rehousing participants, participant isolation, and limited vocational/educational supports impeded implementation. The findings shed light on important implementation “drivers” at the staff, program, and community levels.     

The Family Sanctum: The Promise of Love’s Continuing Enlargement Across the Lifespan

Humanistic psychology acknowledges that spirituality is woven into the very fabric of human existence; however, this article furthers the position that the human striving for love and connection is the very definition of human spirituality. By suggesting that the original human intention to connect re-emerges in each subsequent developmental stage, merely reconfiguring to fit the requirements of current developmental tasks, it argues that the early family is an important arbiter of human spirituality across the lifespan. Finally, this article posits that the experience and expression of spirituality in older age reflects either an unbroken link to the original affectionate connection to (biological or surrogate) family members, or the intentional vitalization of weakly formed early family ties.     

Design and Evaluation of a Decision Aid for Inviting Parents to Participate in a Fragile X Newborn Screening Pilot Study

The major objectives of this project were to develop and evaluate a brochure to help parents make an informed decision about participation in a fragile X newborn screening study. We used an iterative development process that drew on principles of Informed Decision Making (IDM), stakeholder input, design expertise, and expert evaluation. A simulation study with 118 women examined response to the brochure. An independent review rated the brochure high on informational content, guidance, and values. Mothers took an average of 6.5 min to read it and scored an average of 91.1 % correct on a knowledge test. Most women rated the brochure as high quality and trustworthy. When asked to make a hypothetical decision about study participation, 61.9 % would agree to screening. Structural equation modeling showed that agreement to screening and decisional confidence were associated with perceived quality and trust in the brochure. Minority and white mothers did not differ in perceptions of quality or trust. We demonstrate the application of IDM in developing a study brochure. The brochure was highly rated by experts and consumers, met high standards for IDM, and achieved stated goals in a simulation study. The IDM provides a model for consent in research disclosing complicated genetic information of uncertain value.     

Reaching beyond spatial perception: Effects of intended future actions on visually guided prehension

Three experiments examined whether manipulating actors' intentions, regarding forthcoming actions, influences the time course and kinematics of visually guided, reach‐to‐grasp movements. Subjects performed two‐step action sequences where the initial movement always involved reaching for and grasping cubes located at a constant distance. Demands of the second movement were systematically manipulated. Although the spatial parameters (cube size and distance) remained constant across all conditions, the durations of the initial movements differed substantially depending on the actions subjects intended to perform once the objects were in hand. Less time was required to engage a small (1 cm³) cube when the intention was to transport it to a new location on the workspace vs. a large (4 cm³) cube when the goal was to merely lift it above its current resting position (Experiment 1). This difference in duration of the initial movement reflects more time spent in the deceleration phase of the reach when the task does not require transporting the cube to a new location on the workspace. Further, this context effect is not related to accuracy demands (Experiment 2), or complexity (Experiment 3) of the intended second movement. These findings demonstrate that actions are determined both by the perceived spatial demands of the immediate movement as well as the intended goal of the entire action sequence.     

Understanding the Mental Health Travails of Custodial Grandparents

Grandcarers are at-risk of poor mental health outcomes. Current knowledge of the support needs of grandcarers is fragmented. To help fill this knowledge gap qualitative analysis was undertaken on 49 interviews conducted with custodial grandparents. The findings reveal that conflicted occupational roles coupled with the complexity of the stressors facing grandcarers both contribute to their social isolation and to their self-doubts about their ability to adequately attend to their grandchildren’s needs. Greater awareness among occupational therapists (OTs) of custodial grandparents’ mental health travails and an increased understanding of key occupational therapy (OT) practice initiatives are central to addressing grandcarers’ mental health travails.     

Interfering with remembering and knowing: effects of divided attention at retrieval

A Remember-Know paradigm was used to examine the cognitive resource requirements of recollection and familiarity memory processes at retrieval. Younger and older adults studied a list of words, and in a later auditory recognition test indicated whether each word was Remembered, Known, or New. Retrieval was performed under full or divided attention (DA) conditions, with either a digit task to numbers, or an animacy task to words, presented visually. Younger and older adults showed an increase in false Remember responses during both DA conditions, indicating a general effect of attention on illusory recollection. Both age groups also showed decreased accuracy in Know responses, but only during the word-based DA condition, indicating a material-specific effect on familiarity. Aging was associated with decreased accuracy in Remember, but not Know, responses, and with increased latency in distracting task responses under DA conditions. Results suggest that avoiding false recollective responses during retrieval requires attentional resources, whereas accurate familiarity responses require the reactivation of content-specific representations.     

One sound or two? Object-related negativity indexes echo perception

The ability to isolate a single sound source among concurrent sources and reverberant energy is necessary for understanding the auditory world. The precedence effect describes a related experimental finding, that when presented with identical sounds from two locations with a short onset asynchrony (on the order of milliseconds), listeners report a single source with a location dominated by the lead sound. Single-cell recordings in multiple animal models have indicated that there are low-level mechanisms that may contribute to the precedence effect, yet psychophysical studies in humans have provided evidence that top-down cognitive processes have a great deal of influence on the perception of simulated echoes. In the present study, event-related potentials evoked by click pairs at and around listeners' echo thresholds indicate that perception of the lead and lag sound as individual sources elicits a negativity between 100 and 250 msec, previously termed the object-related negativity (ORN). Even for physically identical stimuli, the ORN is evident when listeners report hearing, as compared with not hearing, a second sound source. These results define a neural mechanism related to the conscious perception of multiple auditory objects.     

How infants use perceptual information to guide action

When infants catch a rolling ball by intercepting its trajectory, the action is prospectively controlled to take account of the object's speed, direction and path. We complicated this task in two ways: by occluding a portion of the ball's path with a screen, and by sometimes placing a barrier that blocked the ball's path behind the screen. In two experiments we manipulated visual information about the barrier and the ball's trajectory to see how this would aid 9‐month‐olds’ performance. Anticipatory reaching was possible but difficult with a partially occluded trajectory; actually catching the ball was aided by full view of the trajectory although timing of reach onset was not affected. Full sight of the barrier and trajectory through a transparent screen prevented inappropriate reaching, whereas sight of the barrier alone through a ‘window’ in an opaque screen did not. We interpreted these results as evidence for decreased performance as cognitive load increased with the loss of visual information. In contrast to anticipatory reaching behavior, search for the ball after it disappeared behind the screen was facilitated by the opaque window condition, confirming previous studies that found superior search with opaque versus transparent screens.