When Did Public Become the New Private? Grappling with Access to Postsecondary Education for Low-Income Students.

The shift to a knowledge economy has increased numbers of individuals pursuing postsecondary education. Low-income students do not access this process as high-income students do. Framed within a philosophy of justice, this three-study dissertation examines privatization and how one state increases postsecondary opportunity for low-income students. Fixed effects regression results from the first study (using public databases such as IPEDS, ICPSR, and Census) indicate that poverty rate is positively related to privatization, and per capita tax revenue and liberal ideologies are negatively associated with privatization. Indiana’s Twenty-first Century Scholars program guarantees financial aid and provides support services at regional centers if low-income students maintain a minimum high school GPA and satisfy other Scholar’s pledge components. Using data from the State Student Assistance Commission in Indiana and Student Information Systems on the 2004 high school cohort, two multinomial logits estimate academic preparation outcomes (honors or college preparatory versus a regular diploma) and college choice (four-year or research institutions versus two-year colleges), and a logit predicts college enrollment decisions. Compared to Pell recipients, Scholars whose parents participated in visits/events had higher odds of graduating with honors, and Scholars who visited regional centers increased their odds of completing the college preparation diploma. Logistic regression of all Scholars indicates that student counseling and parent participation in visits/events increase, and parent participation in academic preparation decreases, odds of enrolling. Compared to Pell recipients, the results of the college choice model demonstrate that Scholar participation in counseling decreases the odds of enrolling in four-year and research institutions. Parent participation in academic preparation increases the odds of enrolling in four-year and research institutions when adding academic preparation control variables; parent participation in visits/events and in career planning lose significance with those controls. Thus interventions (typically tax-supported) designed to build social capital increase academic preparation and college participation by low-income students. The three studies reveal a clash among the public and private goals of postsecondary education and equality of opportunity. Consequences of privatization include: reduced access, breakdown of the implied social contract, and increased social stratification. The dissertation concludes with recommendations for policymakers and future research.PHDHigher EducationUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/102467/1/asfisher_1.pd

Assessing the Gap in Adolescent Emergency Care Training for Emergency Medicine Residents: A Systematic Review.

Over 1.5 million U.S. adolescents rely on emergency services for the majority of their healthcare, with increasing presentations (particularly for mental health complaints) during the coronavirus disease 2019 (COVID-19) pandemic. However, a majority of physicians practicing emergency medicine report feeling unprepared to care for adolescent patients. In turn, adolescent patients often report feeling uncomfortable or unsafe when attempting to access emergency care. Despite this deficiency, the extent to which adolescent medicine is addressed during emergency residency medical training remains unclear. Our objective in this systematic review was to identify any existing, publicly available curriculum targeted to teach adolescent emergency care during emergency medicine residency. We conducted a keyword search within the Medline Ovid, Embase, Web of Science, and Cochrane databases to identify relevant literature published between the years of 1968 and 2021; publications meeting inclusion criteria were then analyzed for content. Despite an extensive review of the existing literature, we identified no systematized curriculum and only seven individual papers describing educational efforts to promote competency in adolescent care among emergency medicine residents. Of the resources available, none provide instruction on the management of multiple adolescent presentations, nor common conditions that should be included in a more comprehensive general emergency residency curriculum. No standardized curricula exist for the instruction of relevant adolescent care in an emergency medicine residency. We conclude that the available education for emergency medicine residents is lacking in the area of adolescent care and future work is needed to identify specific competencies to target with further intervention

Is stroke early supported discharge still effective in practice? A prospective comparative study

Objective: Randomised controlled trials have shown the benefits of Early Supported Discharge (ESD) of stroke survivors. Our aim was to evaluate whether ESD is still beneficial when operating in the complex context of frontline healthcare provision. Design: We conducted a cohort study with quasi experimental design. A total of 293 stroke survivors (transfer independently or with assistance of one, identified rehabilitation goals) within two naturally formed groups were recruited from two acute stroke units: ‘ESD’ n=135 and ‘Non ESD’ n=158 and 84 caregivers. The ‘ESD’ group accessed either of two ESD services operating in Nottinghamshire, UK. The ‘Non ESD’ group experienced standard practices for discharge and onward referral. Outcome measures (primary: Barthel Index) were administered at baseline, 6 weeks, 6 months and 12 months. Results: The ESD group had a significantly shorter length of hospital stay (P=0.029) and reported significantly higher levels of satisfaction with services received (P<0.001). Following adjustment for age differences at baseline, participants in the ESD group (n=71) had significantly higher odds (compared to the Non ESD group, n=85) of being in the ⩾90 Barthel Index category at 6 weeks (OR = 1.557, 95% CI 2.579 to 8.733), 6 months (OR = 1.541, 95% CI 2.617 to 8.340) and 12 months (OR 0.837, 95% CI 1.306 to 4.087) respectively in relation to baseline. Carers of patients accessing ESD services showed significant improvement in mental health scores (P<0.01). Conclusion: The health benefits of ESD are still evident when evidence based models of these services are implemented in practice

Formation and electronic structure of an atypical Cu A site

PmoD, a recently discovered protein from methane-oxidizing bacteria, forms a homodimer with a dicopper CuA center at the dimer interface. Although the optical and electron paramagnetic resonance (EPR) spectroscopic signatures of the PmoD CuA bear similarities to those of canonical CuA sites, there are also some puzzling differences. Here we have characterized the rapid formation (seconds) and slow decay (hours) of this homodimeric CuA site to two mononuclear Cu2+ sites, as well as its electronic and geometric structure, using stopped-flow optical and advanced paramagnetic resonance spectroscopies. PmoD CuA formation occurs rapidly and involves a short-lived intermediate with a max of 360 nm. Unlike other CuA sites, the PmoD CuA is unstable, decaying to two type 2 Cu2+ centers. Surprisingly, NMR data indicate that the PmoD CuA has a pure σu∗ ground state rather than the typical equilibrium between σu∗ and πu of all other CuA proteins. EPR, ENDOR, ESEEM, and HYSCORE data indicate the presence of two histidine and two cysteine ligands coordinating the CuA core in a highly symmetrical fashion. This report significantly expands the diversity and understanding of known CuA sites.Fil: Ross, Matthew O.. Northwestern University; Estados UnidosFil: Fisher, Oriana S.. Northwestern University; Estados UnidosFil: Morgada, Marcos Nicolás. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto de Biología Molecular y Celular de Rosario. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario; ArgentinaFil: Krzyaniak, Matthew D.. Northwestern University; Estados UnidosFil: Wasielewski, Michael R.. Northwestern University; Estados UnidosFil: Vila, Alejandro Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto de Biología Molecular y Celular de Rosario. Universidad Nacional de Rosario. Facultad de Ciencias Bioquímicas y Farmacéuticas. Instituto de Biología Molecular y Celular de Rosario; ArgentinaFil: Hoffman, Brian M.. Northwestern University; Estados UnidosFil: Rosenzweig, Amy C.. Northwestern University; Estados Unido