Assessing the Oral Health Needs of Public Housing Residents

Objectives: “Tooth Smart Healthy Start” is a randomized clinical trial which aims to reduce the incidence of early childhood caries (ECC) in Boston public housing residents as part of the NIH funded Northeast Center for Research to Evaluate and Eliminate Dental Disparities. The purpose of this project was to assess public housing stakeholders' perception of the oral health needs of public housing residents and their interest in replicating “Tooth Smart Healthy Start” in other public housing sites across the nation. Methods: The target population was the 180 attendees of the 2010 meeting of the Health Care for Residents of Public Housing National Conference. A ten question survey which assessed conference attendees' beliefs about oral health and its importance to public housing residents was distributed. Data was analyzed using SAS 9.1. Descriptive statistics were calculated for each variable and results were stratified by participants' roles. Results: Thirty percent of conference attendees completed the survey. The participants consisted of residents, agency representatives, and housing authority personnel. When asked to rank health issues facing public housing residents, oral health was rated as most important (42%) or top three (16%) by residents. The agency representatives and housing authority personnel rated oral health among the top three (33% and 58% respectively) and top five (36% and 25% respectively). When participants ranked the three greatest resident health needs out of eight choices, oral health was the most common response. Majority of the participants expressed interest in replicating the “Tooth Smart Healthy Start” program at their sites. Conclusion: All stakeholder groups identified oral health as one of the greatest health needs of residents in public housing. Furthermore, if shown to reduce ECC, there is significant interest in implementing the program amongst key public housing stakeholders across the nation.

Systematic Review of Supported Housing Literature 1993 – 2008

Supported housing for individuals with severe mental illness strives to provide the services necessary to place and keep individuals in independent housing that is integrated into the community and in which the consumer has choice and control over his or her services and supports. Supported housing can be contrasted to an earlier model called the “linear residential approach” in which individuals are moved from the most restrictive settings (e.g., inpatient settings) through a series of more independent settings (e.g., group homes, supervised apartments) and then finally to independent housing. This approach has been criticized as punishing the client due to frequent moves, and as being less likely to result in independent housing. In the supported housing model (Anthony & Blanch, 1988) consumers have choice and control over their living environment, their treatment, and supports (e.g., case management, mental health and substance abuse services). Supports are flexible and faded in and out depending on needs. Results of this systematic review of supported housing suggest that there are several well-controlled studies of supported housing and several studies conducted with less rigorous designs. Overall, our synthesis suggests that supported housing can improve the living situation of individuals who are psychiatrically disabled, homeless and with substance abuse problems. Results show that supported housing can help people stay in apartments or homes up to about 80% of the time over an extended period. These results are contrary to concerns expressed by proponents of the linear residential model and housing models that espoused more restrictive environments. Results also show that housing subsidies or vouchers are helpful in getting and keeping individuals housed. Housing services appear to be cost effective and to reduce the costs of other social and clinical services. In order to be most effective, intensive case management services (rather than traditional case management) are needed and will generally lead to better housing outcomes. Having access to affordable housing and having a service system that is well-integrated is also important. Providing a person with supported housing reduces the likelihood that they will be re-hospitalized, although supported housing does not always lead to reduced psychiatric symptoms. Supported housing can improve clients’ quality of life and satisfaction with their living situation. Providing supported housing options that are of decent quality is important in order to keep people housed and satisfied with their housing. In addition, rapid entry into housing, with the provision of choices is critical. Program and clinical supports may be able to mitigate the social isolation that has sometimes been associated with supported housing.

Lightweight Formal Methods for the Development of High-Assurance Networking Systems

We survey several of the research efforts pursued by the iBench and snBench projects in the CS Department at Boston University over the last half dozen years. These activities use ideas and methodologies inspired by recent developments in other parts of computer science -- particularly in formal methods and in the foundations of programming languages -- but now specifically applied to the certification of safety-critical networking systems. This is research jointly led by Azer Bestavros and Assaf Kfoury with the participation of Adam Bradley, Andrei Lapets, and Michael Ocean.

Improving the Accessibility of Lightweight Formal Verification Systems

In research areas involving mathematical rigor, there are numerous benefits to adopting a formal representation of models and arguments: reusability, automatic evaluation of examples, and verification of consistency and correctness. However, broad accessibility has not been a priority in the design of formal verification tools that can provide these benefits. We propose a few design criteria to address these issues: a simple, familiar, and conventional concrete syntax that is independent of any environment, application, or verification strategy, and the possibility of reducing workload and entry costs by employing features selectively. We demonstrate the feasibility of satisfying such criteria by presenting our own formal representation and verification system. Our system’s concrete syntax overlaps with English, LATEX and MediaWiki markup wherever possible, and its verifier relies on heuristic search techniques that make the formal authoring process more manageable and consistent with prevailing practices. We employ techniques and algorithms that ensure a simple, uniform, and flexible definition and design for the system, so that it easy to augment, extend, and improve.

Safe Compositional Network Sketches: The Formal Framework

NetSketch is a tool for the specification of constrained-flow applications and the certification of desirable safety properties imposed thereon. NetSketch is conceived to assist system integrators in two types of activities: modeling and design. As a modeling tool, it enables the abstraction of an existing system while retaining sufficient information about it to carry out future analysis of safety properties. As a design tool, NetSketch enables the exploration of alternative safe designs as well as the identification of minimal requirements for outsourced subsystems. NetSketch embodies a lightweight formal verification philosophy, whereby the power (but not the heavy machinery) of a rigorous formalism is made accessible to users via a friendly interface. NetSketch does so by exposing tradeoffs between exactness of analysis and scalability, and by combining traditional whole-system analysis with a more flexible compositional analysis. The compositional analysis is based on a strongly-typed Domain-Specific Language (DSL) for describing and reasoning about constrained-flow networks at various levels of sketchiness along with invariants that need to be enforced thereupon. In this paper, we define the formal system underlying the operation of NetSketch, in particular the DSL behind NetSketch's user-interface when used in "sketch mode", and prove its soundness relative to appropriately-defined notions of validity. In a companion paper [6], we overview NetSketch, highlight its salient features, and illustrate how it could be used in two applications: the management/shaping of traffic flows in a vehicular network (as a proxy for CPS applications) and in a streaming media network (as a proxy for Internet applications).

Lightweight Formal Verification in Classroom Instruction of Reasoning about Functional Code

In college courses dealing with material that requires mathematical rigor, the adoption of a machine-readable representation for formal arguments can be advantageous. Students can focus on a specific collection of constructs that are represented consistently. Examples and counterexamples can be evaluated. Assignments can be assembled and checked with the help of an automated formal reasoning system. However, usability and accessibility do not have a high priority and are not addressed sufficiently well in the design of many existing machine-readable representations and corresponding formal reasoning systems. In earlier work [Lap09], we attempt to address this broad problem by proposing several specific design criteria organized around the notion of a natural context: the sphere of awareness a working human user maintains of the relevant constructs, arguments, experiences, and background materials necessary to accomplish the task at hand. We report on our attempt to evaluate our proposed design criteria by deploying within the classroom a lightweight formal verification system designed according to these criteria. The lightweight formal verification system was used within the instruction of a common application of formal reasoning: proving by induction formal propositions about functional code. We present all of the formal reasoning examples and assignments considered during this deployment, most of which are drawn directly from an introductory text on functional programming. We demonstrate how the design of the system improves the effectiveness and understandability of the examples, and how it aids in the instruction of basic formal reasoning techniques. We make brief remarks about the practical and administrative implications of the system’s design from the perspectives of the student, the instructor, and the grader.

Efficient Support for Common Relations in Lightweight Formal Reasoning Systems

In work that involves mathematical rigor, there are numerous benefits to adopting a representation of models and arguments that can be supplied to a formal reasoning or verification system: reusability, automatic evaluation of examples, and verification of consistency and correctness. However, accessibility has not been a priority in the design of formal verification tools that can provide these benefits. In earlier work [Lap09a], we attempt to address this broad problem by proposing several specific design criteria organized around the notion of a natural context: the sphere of awareness a working human user maintains of the relevant constructs, arguments, experiences, and background materials necessary to accomplish the task at hand. This work expands one aspect of the earlier work by considering more extensively an essential capability for any formal reasoning system whose design is oriented around simulating the natural context: native support for a collection of mathematical relations that deal with common constructs in arithmetic and set theory. We provide a formal definition for a context of relations that can be used to both validate and assist formal reasoning activities. We provide a proof that any algorithm that implements this formal structure faithfully will necessary converge. Finally, we consider the efficiency of an implementation of this formal structure that leverages modular implementations of well-known data structures: balanced search trees and transitive closures of hypergraphs.

A Formal Semantics for Weak References

A weak reference is a reference to an object that is not followed by the pointer tracer when garbage collection is called. That is, a weak reference cannot prevent the object it references from being garbage collected. Weak references remain a troublesome programming feature largely because there is not an accepted, precise semantics that describes their behavior (in fact, we are not aware of any formalization of their semantics). The trouble is that weak references allow reachable objects to be garbage collected, therefore allowing garbage collection to influence the result of a program. Despite this difficulty, weak references continue to be used in practice for reasons related to efficient storage management, and are included in many popular programming languages (Standard ML, Haskell, OCaml, and Java). We give a formal semantics for a calculus called λweak that includes weak references and is derived from Morrisett, Felleisen, and Harper’s λgc. λgc formalizes the notion of garbage collection by means of a rewrite rule. Such a formalization is required to precisely characterize the semantics of weak references. However, the inclusion of a garbage-collection rewrite-rule in a language with weak references introduces non-deterministic evaluation, even if the parameter-passing mechanism is deterministic (call-by-value in our case). This raises the question of confluence for our rewrite system. We discuss natural restrictions under which our rewrite system is confluent, thus guaranteeing uniqueness of program result. We define conditions that allow other garbage collection algorithms to co-exist with our semantics of weak references. We also introduce a polymorphic type system to prove the absence of erroneous program behavior (i.e., the absence of “stuck evaluation”) and a corresponding type inference algorithm. We prove the type system sound and the inference algorithm sound and complete.