Predicting Daily Sheltering Arrangements among Youth Experiencing Homelessness Using Diary Measurements Collected by Ecological Momentary Assessment.

Youths experiencing homelessness (YEH) often cycle between various sheltering locations including spending nights on the streets, in shelters and with others. Few studies have explored the patterns of daily sheltering over time. A total of 66 participants completed 724 ecological momentary assessments that assessed daily sleeping arrangements. Analyses applied a hypothesis-generating machine learning algorithm (component-wise gradient boosting) to build interpretable models that would select only the best predictors of daily sheltering from a large set of 92 variables while accounting for the correlated nature of the data. Sheltering was examined as a three-category outcome comparing nights spent literally homeless, unstably housed or at a shelter. The final model retained 15 predictors. These predictors included (among others) specific stressors (e.g., not having a place to stay, parenting and hunger), discrimination (by a friend or nonspecified other; due to race or homelessness), being arrested and synthetic cannabinoids use (a.k.a., "kush"). The final model demonstrated success in classifying the categorical outcome. These results have implications for developing just-in-time adaptive interventions for improving the lives of YEH.

Clinical and demographic predictors of concussion resolution in adolescents: A retrospective study.

Concussions in adolescents are a growing public health concern. The aim of this study was to identify clinical (e.g., concussion history, migraine history, learning disabilities/ADHD) and demographic factors (e.g., age, sex, race, health insurance status, mechanism of injury, education) that predict concussion recovery times. In a retrospective cohort study of 118 adolescents 13-19 years old who were evaluated for an acute concussion (≤10 days from injury), recovery times were calculated from the date of concussive injury to the date of clearance to return to play and/or normal activities. The median time to recovery was 17 days. Predictors of longer recovery included ADHD (HR = .221, 95% CI = .095 - .514, p < .001) and prior concussion (HR = .564, 95% CI = .332 - .959, p = .03). Student athletic insurance and public insurance were predictors of shorter recovery times (HR = 3.98, 95% CI = 1.25 - 12.65, p = .02 and HR = 3.33, 95% CI = 1.09 - 10.15, p = .03, respectively). In adolescents with prior concussion or ADHD, clearance to return to play/ normal activities may be delayed. Further research is needed to validate the impact of SES/health insurance on concussion recovery time.

Longitudinal assessment of heart rate variability in very low birth weight infants during their NICU stay.

BACKGROUND: Maturation of the autonomic nervous system has not been studied in high-risk very low birth weight (VLBW) infants in the first few weeks of life. AIM: To characterize developmental changes in autonomic nervous system activity of high-risk VLBW infants from 23 to 38 weeks post-menstrual age by measuring heart rate variability (HRV). STUDY DESIGN AND SUBJECTS: In this prospective cohort study 38 infants admitted to Children's Memorial Hermann Hospital NICU were longitudinally followed weekly or biweekly. Heart period data were recorded while infants were resting in active sleep. OUTCOME MEASURES: Growth of spectral power of HRV in low-frequency (0.05-0.25 Hz) and high-frequency (0.25-1.00 Hz) bands was modeled with linear mixed-effects models. The high-frequency power provides a measure of respiratory sinus arrhythmia (RSA). RESULTS: Low-frequency power increases with post-menstrual age, and intubated infants have lower HRV. The increase in low-frequency power is faster (0.50+/-0.12 dB/week) than the increase in RSA (0.17+/-0.09 dB/week). CONCLUSION: This longitudinal data exhibits developmental maturation of the RSA and of the low-frequency power of HRV in high-risk VLBW infants.