The Influence of Student Loan Debt on Financial Satisfaction

This research examined the influence of student loan debt on financial satisfaction using a sample of adults ages 18–54 from the 2015 National Financial Capability Study (NFCS). The study took advantage of the expanded set of variables related to student loan debt that was added to the 2015 wave of the NFCS survey. Results provided mixed evidence of student loan debt serving as an influential factor on consumer financial satisfaction. Whereas borrowing from multiple sources (federal and private) or private lenders only was associated with a lower likelihood of respondents indicating that they would make the same borrowing decisions, having student loan debt was not significantly associated with financial satisfaction. Implications for policy are considered

Does Cetuximab Reduce the Risk of Anemia in Patients Undergoing Radiation Therapy for Head and Neck Cancers?

Purpose/Objective(s): Epidermal growth factor receptor (EGFR) activation is associated with increased production of interleukin 6 (IL6), which is intensified by radiotherapy (RT) induced inflammatory response. Elevated IL6 levels promote RT-induced anemia by upregulating hepcidin causing functional iron deficiency. Cetuximab, an EGFR inhibitor, resulted in significantly lower rates of RT induced anemia for locally advanced head and neck squamous cell carcinoma (HNSCC) patients receiving definitive RT vs RT-alone according to Bonner et al; and other studies compared to concomitant chemotherapy. However, little is known for cases receiving cetuximab with RT in the adjuvant setting. Materials/Methods: We queried our institutional HNSCC database for surgically staged non-metastatic cases that received adjuvant RT with or without concomitant cetuximab between 2006-2018. Cetuximab was administered for some high-risk cases medically unfit for platinum agents per multidisciplinary team evaluation. All included patients need to have at least one complete blood count pre- and post-RT end. We compared RT-cetuximab vs RT-alone for prevalence of baseline and post-RT anemia, defined as Hb below 12g/dL in females and 13g/dL in males, and mean hemoglobin (Hb) levels. We also assessed the improvement in Hb level post-RT (resolution of baseline anemia or Hb increase of at least 1g/dL above baseline), in addition to overall survival (OS) in relation to anemia/Hb dynamics. Results: We were able to identify 66 patients who fit our inclusion criteria, of which 27 (41%) received RT-cetuximab, with the remaining receiving RT-alone (n=39, 59%). Median age was 62.5 years (range, 34-88 years), males 80%, black 29%, and 85% had a smoking history. The majority of cases (73%) were locally advanced. Oral cavity and oropharynx were the most common subsites (37.5% each), with HPV+ve cases representing 52% of the later. The study groups were well-balanced, except for higher rates of positive final surgical margins, and extracapsular space invasion and median RT dose (p\u3c0.05). Baseline anemia was diagnosed in 70.4% in RT-cetuximab vs 76.9% in the RT-alone, p=0.76; with similar mean Hb level (11.7g/dL in both). Meanwhile, baseline iron, vitamin-B12 and folate deficiencies, and chronic kidney disease were non-different. After completion of RT, mean Hb was significantly higher in the RT-alone (12.9±1.4 g/dL) compared to RT-Cetuximab (11.9±2.1 g/dL), p=0.02. Nevertheless, higher anemia levels (70% vs 51%) and lower improvement of Hb post-RT (81.5% vs 92.3%) were both non-significant for RT-cetuximab vs RT-alone respectively, p\u3e0.05 for both. On multivariate analysis, baseline anemia was associated with worse OS (p=0.0052), unlike improvement of Hb post-RT (p=0.14) with a corresponding better improvement of Hb (56.4% vs. 25.9%, p=0.014), albeit lower anemia levels (70% vs. 51%), was non significant (p=0.195). On multivariate analysis, lack of baseline anemia was associated with better OS (p=0.0052), whereas improvement of Hb post-RT was only marginal (p=0.068). Conclusion: In a homogenous cohort of HNSCC patients treated postoperatively, concomitant cetuximab was not associated with lower RT-induced anemia, in contrast to previous studies

Consumption and life satisfaction: The Korean evidence

This study examines the association between consumption expenditure and life satisfaction among older Koreans (aged 50 or older). We estimate a series of individual fixed effects regressions that link life satisfaction to various types of household consumption using data drawn from the Korean Longitudinal Study of Aging. The results show that leisure consumption is positively related to life satisfaction and that this association is driven largely by uncommon and infrequent leisure activities, like travel and entertainment. Expenditures for leisure that provides more ordinary experiences, such as recreation and self-development programs, were generally uncorrelated with life satisfaction, despite being consumed by a large fraction of older Koreans. Finally, the evidence on whether material purchases or status-enhancing purchases were positively correlated with life satisfaction is mixed. On the one hand, our findings reaffirm the conventional wisdom that people feel more satisfied when spending money on experiences than on material possessions. On the other hand, we provide the novel finding that consumption directed toward extraordinary and memorable experiences that go beyond everyday life tends to generate greater future life satisfaction