While the growing literature on HOPE VI emphasizes the presumed benefits of income mixing these benefits are most likely to occur if middle-income families with children are drawn to these sites. But is this feasible? Our comparative case study analysis of four HOPE VI sites in Cincinnati, Louisville, Baltimore, and Washington, DC, suggests that it will be difficult to achieve the mixing of lower-and middle-income families with children. None of the four developments explicitly sought middle-income families with children as part of their marketing. Louisville's HOPE VI site was the only one involving close collaboration between the school district, the housing authority, and city government from the beginning of the HOPE VI process. Moreover, the Louisville site was the only one successful in attracting middle-income (and not simply subsidized moderate-income) families with children. Strategies for making inner-city HOPE VI sites more attractive for middle-income families are discussed.In 1992, HOPE VI (originally known as the Urban Revitalization Demonstration Program) was enacted to transform the physical and social shape of distressed public housing. Under the current program this transformation includes: changing the physical shape of public housing by replacing the worst public housing developments with less dense developments, reducing concentrations of poverty by encouraging a
OBJECTIVE We explored longitudinal changes associated with switching to hybrid closed loop (HCL) insulin delivery systems in adults with type 1 diabetes and elevated HbA1c levels despite the use of intermittently scanned continuous glucose monitoring (isCGM) and insulin pump therapy. RESEARCH DESIGN AND METHODS We undertook a pragmatic, preplanned observational study of participants included in the National Health Service England closed loop pilot. Adults using isCGM and insulin pump across 31 diabetes centers in England with an HbA1c ≥8.5% who were willing to commence HCL therapy were included. Outcomes included change in HbA1c, sensor glucometrics, diabetes distress score, Gold score (hypoglycemia awareness), acute event rates, and user opinion of HCL. RESULTS In total, 570 HCL users were included (median age 40 [IQR 29–50] years, 67% female, and 85% White). Mean baseline HbA1c was 9.4 ± 0.9% (78.9 ± 9.1 mmol/mol) with a median follow-up of 5.1 (IQR 3.9–6.6) months. Of 520 users continuing HCL at follow-up, mean adjusted HbA1c reduced by 1.7% (95% CI 1.5, 1.8; P < 0.0001) (18.1 mmol/mol [95% CI 16.6, 19.6]; P < 0.0001). Time in range (70–180 mg/dL) increased from 34.2 to 61.9% (P < 0.001). Individuals with HbA1c of ≤58 mmol/mol rose from 0 to 39.4% (P < 0.0001), and those achieving ≥70% glucose time in range and <4% time below range increased from 0.8 to 28.2% (P < 0.0001). Almost all participants rated HCL therapy as having a positive impact on quality of life (94.7% [540 of 570]). CONCLUSIONS Use of HCL is associated with improvements in HbA1c, time in range, hypoglycemia, and diabetes-related distress and quality of life in people with type 1 diabetes in the real world.
Schools and Urban Revitalization is Volume One of a series, adapted from a recent issue of Community Development, geared toward empowerment through community engagement and an increase in grassroots leadership capacity. Published through a partnership between Routledge and the Community Development Society, the series seeks to provide timely research which can inform policy making and practice in the rapidly changing environment in which community development professionals operate. Patterson and Silverman ask us to reconsider the role of public schools in inner-city revitalization through a two-step process, first looking at the role of institutions, then at the role of schools in community planning.Schools and Urban Revitalization includes contributions from 18 scholars from various disciplines. Part I (Chapters 1 to 6) looks at the history of older, dying industrial cities and attempts to reincarnate them as centers for higher education and medicine; that is, the eds and meds model of anchoring development around large universities, hospitals, and other place-based institutions. As industry and other private businesses have weakened in declining cities, anchor institutions have replaced commerce and manufacturing as drivers of urban renewal. Kelly L. Patterson and Robert Mark Silverman argue that public schools should bridge the gap between the anchor institutions and the grassroots community organizations. Part II (Chapters 7 to 11) consists of case studies from five cities where public schools were involved in the community development process, and elaborates on how those efforts resulted in grassroots participation. The various contributors explore the potential for public schools to emerge as anchor institutions in their own right.In Chapter 1, Silverman and Patterson express their concern about the inequalities inherent in the relationship between urban social institutions and grassroots organizations of inner-city residents. Black, Latino and other disenfranchised groups have often suffered from a disadvantage in the development process, losing out to anchor institutions as they carry out expansion plans. The question is: How will it be possible to promote community control of the neighborhood revitalization process?Chapters 2 through 6 provide the history of anchor-based development. In Chapter 2 Silverman reviews revitalization driven by large public, private, and nonprofit organizations, and calls for a move from "institutional rape" to grassroots control. Silverman sees an opportunity to create a more meaningful grassroots voice in the development process by encouraging larger anchor institutions to participate in the improvement of the quality of public schools. This would help the anchor to attract a high-quality workforce.Janice Brockmeyer (Chapter 3) discusses the constraints affecting neighborhood revitalization in "shrinking cities." Rapid shrinkage in population threatens to diminish the role of community nonprofit organizations (CNPOs) as cities spatially and politically reconfigure themselves...
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