During the 1990s, the federal government dramatically changed its policy on housing the poor. Under the HOPE VI (Housing Opportunities for People Everywhere) Program, the U.S. Department of Housing and Urban Development intended to address the concentration of troubled low-income households in public housing by moving away from its reliance on project-based assistance and promoting instead the construction of mixed-income housing and the use of housing subsidies.This article presents important evidence from two systematic, multicity studies on how the original residents of HOPE VI developments have been affected by this radical new approach to public housing. While many residents have clearly benefited, the findings raise critical questions about whether the transformation of public housing will achieve its potential as a powerful force for improving the lives of low-income families.

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The purpose of this study is to provide new data on the relationship between housing quality and health status for people in five HOPE VI public housing developments around the country. HOPE VI is a federal program to replace or redevelop some of the poorest quality public housing in the country. A special survey of residents of these developments was conducted while they lived in HOPE VI housing before its redevelopment. Data for these individuals provides a profile of the quality of housing and the health status of people in HOPE VI housing before its renovation, of residents of publicly assisted housing across the nation, of other people living below the federal poverty level, and of non-poor people. Previously, the lack of data sets that included both housing quality and health status measures has prevented such an analysis. We examined two indicators of health status-perceived overall health status and medically diagnosed asthma. The health status of HOPE VI residents is decidedly worse than that of others in assisted housing and other poor people, despite their similarity in terms of economic deprivation. The difference in the level of asthma prevalence, a condition that has been tied to various measures of housing quality, is especially pronounced. Our analysis indicates that one major benefit of improving housing quality may be improved health status.

The serpin mechanism of protease inhibition involves the rapid and stable incorporation of the reactive center loop (RCL) into central ␤-sheet A. Serpins therefore require a folding mechanism that bypasses the most stable "loop-inserted" conformation to trap the RCL in an exposed and metastable state. This unusual feature of serpins renders them highly susceptible to point mutations that lead to the accumulation of hyperstable misfolded polymers in the endoplasmic reticulum of secretory cells. The ordered and stable protomer-protomer association in serpin polymers has led to the acceptance of the "loop-sheet" hypothesis of polymerization, where a portion of the RCL of one protomer incorporates in register into sheet A of another. Although this mechanism was proposed 20 years ago, no study has ever been conducted to test its validity. Here, we describe the properties of a variant of ␣ 1 -antitrypsin with a critical hydrophobic section of the RCL substituted with aspartic acid (P8 -P6). In contrast to the control, the variant was unable to polymerize when incubated with small peptides or when cleaved in the middle of the RCL (accepted models of loop-sheet polymerization). However, when induced by guanidine HCl or heat, the variant polymerized in a manner indistinguishable from the control. Importantly, the Asp mutations did not affect the ability of the Z or Siiyama ␣ 1 -antitrypsin variants to polymerize in COS-7 cells. These results argue strongly against the loop-sheet hypothesis and suggest that, in serpin polymers, the P8 -P6 region is only a small part of an extensive domain swap.

Prescribed antibiotic dosing regimens varied substantially and under-dosing was common. There is a need to further define appropriate dosing regimens for antibiotics administered during SLED and determine how pharmacists may help to ensure appropriate therapy.