Why Do Some Students Fail to Receive Pell Grants?

IN PREVIOUS RESEARCH, we found that one in five California community college (CCC) students who are seemingly eligible for federal Pell Grant funds do not receive them.1 While the reasons students forgo these funds are not entirely understood, the consequences are quantifiable: Eligible CCC students pass up $130 million in financial aid in one semester alone. The amounts of forgone Pell Grants vary significantly by student characteristics and by college campus, suggesting that campus financial aid policies and practices may play an important role in whether or not students receive awards. Eligible students can receive as much as$6,095 in Pell funds each year. Because many low-income CCC students receive a state fee waiver that covers tuition, the Pell Grant can help them cover food, rent, transportation, and other expenses, thus allowing them to focus on school. To dive deeper into the phenomenon of forgone aid, we conducted a statewide survey of CCC campus financial aid directors. We sought to learn more about these administrators' perceptions of students' challenges in seeking aid, their general orientation as either conduits or gatekeepers of aid, and also about their institutions' policies and procedures, including methods of outreach to students who are flagged for a verification process that can pose significant challenges for students

Hydrodynamic modeling of San Elijo Lagoon, California

Decisions on where to concentrate management efforts need to be guided by an ability to accurately simulate and predict physical and ecological changes. Many restoration projects experience difficulties due to a lack of understanding of the ecological response and evolution of wetland systems (Goodwin et al., 2001). There are several approaches that can be taken in analyzing a system. The appropriate selection should be based on the available data, the spatial scale of the wetland, and the physical processes governing the system (Goodwin and Kamman, 2001). Predictive tools are essential for good long-term management (Goodwin et al., 2001). The objective of this thesis is to determine whether San Elijo Lagoon is a morphologically stable environment and to investigate the movement of water and sediment patterns within the estuary. This will be answered through analysis of field data and numerical modeling of the hydrodynamics of the system. A field campaign was conducted to collect a suite of hydrodynamic and sediment data in the estuary. The development of a conceptual model was further applied to a numerical model. The Danish Hydraulic Institute’s (DHI) Mike21 software package was used to develop a two-dimensional flexible mesh hydrodynamic model. This is a depth-averaged finite volume commercial program. The hydrodynamic model was calibrated with the data collected in May, and then verified with observed conditions from July and August. The lagoon has a net depositional environment. The inlet of the lagoon is unstable due to the enforced unnatural location and meandering morphology of the inlet channel; the force of the tide is not large enough to keep the inlet clear. MIKE21-FlexibleMesh model simulations confirm that San Elijo Lagoon’s hydrodynamics is dominated by tidal forcing and freshwater inflow. The freshwater inflow, as well as the morphology of the lagoon causes an attenuation of the tidal signal. In the coincidence of extremely low tides and extremely high runoff in the watersheds feeding the lagoon the freshwater inflow at the man-made dike can have a significant impact, but only for a short period of time

Disparate Impacts of COVID-19 Disruptions for California College Students

This paper documents the experience of California college students in the midst of the pandemic as their academic and home lives were disrupted. The analysis relies on a survey sent to all financial aid applicants statewide. Survey respondents include nearly 100,000 students enrolled in both two-year and four-year postsecondary institutions. Results reveal multiple stressors strained the educational experience and trajectories of many students. These stressors were not evenly distributed. In particular, students from low-income backgrounds were more likely to face increased financial stress, additional home responsibilities, and difficulty accessing the online learning environment, when compared to their higher-income peers

Recent Incarceration, Substance Use, Overdose, and Service Use Among People Who Use Drugs in Rural Communities

Importance: Drug use and incarceration have a substantial impact on rural communities, but factors associated with the incarceration of rural people who use drugs (PWUD) have not been thoroughly investigated. Objective: To characterize associations between recent incarceration, overdose, and substance use disorder (SUD) treatment access among rural PWUD. Design, setting, and participants: For this cross-sectional study, the Rural Opioid Initiative research consortium conducted a survey in geographically diverse rural counties with high rates of overdose across 10 US states (Illinois, Wisconsin, North Carolina, Oregon, Kentucky, West Virginia, Ohio, Massachusetts, New Hampshire, and Vermont) between January 25, 2018, and March 17, 2020, asking PWUD about their substance use, substance use treatment, and interactions with the criminal legal system. Participants were recruited through respondent-driven sampling in 8 rural US regions. Respondents who were willing to recruit additional respondents from their personal networks were enrolled at syringe service programs, community support organizations, and through direct community outreach; these so-called seed respondents then recruited others. Of 3044 respondents, 2935 included participants who resided in rural communities and reported past-30-day injection of any drug or use of opioids nonmedically via any route. Data were analyzed from February 8, 2022, to September 15, 2023. Exposure: Recent incarceration was the exposure of interest, defined as a report of incarceration in jail or prison for at least 1 day in the past 6 months. Main outcomes and measures: The associations between PWUD who were recently incarcerated and main outcomes of treatment use and overdose were examined using logistic regression. Results: Of 2935 participants, 1662 (56.6%) were male, 2496 (85.0%) were White; the mean (SD) age was 36 (10) years; and in the past 30 days, 2507 (85.4%) reported opioid use and 1663 (56.7%) reported injecting drugs daily. A total of 1224 participants (41.7%) reported recent incarceration, with a median (IQR) incarceration of 15 (3-60) days in the past 6 months. Recent incarceration was associated with past-6-month overdose (adjusted odds ratio [AOR], 1.38; 95% CI, 1.12-1.70) and recent SUD treatment (AOR, 1.62; 95% CI, 1.36-1.93) but not recent medication for opioid use disorder (MOUD; AOR, 1.03; 95% CI, 0.82-1.28) or currently carrying naloxone (AOR, 1.02; 95% CI, 0.86-1.21). Conclusions and relevance: In this cross-sectional study of PWUD in rural areas, participants commonly experienced recent incarceration, which was not associated with MOUD, an effective and lifesaving treatment. The criminal legal system should implement effective SUD treatment in rural areas, including MOUD and provision of naloxone, to fully align with evidence-based SUD health care policies.</p

Beta-lactam-induced immediate hypersensitivity reactions: A genome-wide association study of a deeply phenotyped cohort

Background β-lactam antibiotics are associated with a variety of immune-mediated or hypersensitivity reactions, including immediate (Type I) reactions mediated by antigen-specific IgE. Objective To identify genetic predisposing factors for immediate reactions to β-lactam antibiotics. Methods Patients with a clinical history of immediate hypersensitivity reactions to either penicillins or cephalosporins, which were immunologically confirmed, were recruited from allergy clinics. A genome-wide association study (GWAS) was conducted on 662 patients (the discovery cohort) with a diagnosis of immediate hypersensitivity and the main finding was replicated in a cohort of 98 Spanish cases, recruited using the same diagnostic criteria as the discovery cohort. Results GWAS identified rs71542416 within the Class II HLA region as the top hit (P = 2x10-14); this was in linkage disequilibrium with HLA-DRB1*10:01 (OR = 2.93 P = 5.4x10-7) and HLA-DQA1*01:05 (OR=2.93, P=5.4x10-7). Haplotype analysis identified that HLA-DRB1*10:01 was a risk factor even without the HLA-DQA1*01:05 allele. The association with HLA-DRB1*10:01 was replicated in another cohort, with the meta-analysis of the discovery and replication cohorts showing that HLA-DRB1*10:01 increased the risk of immediate hypersensitivity at a genome-wide level (OR = 2.96 P=4.1x10-9). No association with HLA-DRB1*10:01 was identified in 268 patients with delayed hypersensitivity reactions to β-lactams. Conclusion HLA-DRB1*10:01 predisposed to immediate hypersensitivity reactions to penicillins. Further work to identify other predisposing HLA and non-HLA loci is required. Clinical implications This novel insight into the mechanisms of immediate reactions associated with penicillins may be of use in risk stratifying patients where penicillin cannot be excluded as an etiological agent

Eligibility for interventions, co-occurrence and risk factors for unhealthy behaviours in patients consulting for routine primary care: results from the Pre-Empt study

Smoking, excessive drinking, lack of exercise and a poor diet remain key causes of premature morbidity and mortality globally, yet it is not clear what proportion of patients attending for routine primary care are eligible for interventions about these behaviours, the extent to which they co-occur within individuals, and which individuals are at greatest risk for multiple unhealthy behaviours. The aim of the trial was to examine 'intervention eligibility' and co-occurrence of the 'big four' risky health behaviours - lack of exercise, smoking, an unhealthy diet and excessive drinking - in a primary care population. Data were collected from adult patients consulting routinely in general practice across South Wales as part of the Pre-Empt study; a cluster randomised controlled trial. After giving consent, participants completed screening instruments, which included the following to assess eligibility for an intervention based on set thresholds: AUDIT-C (for alcohol), HSI (for smoking), IPAQ (for exercise) and a subset of DINE (for diet). The intervention following screening was based on which combination of risky behaviours the patient had. Descriptive statistics, χ2 tests for association and ordinal regressions were undertaken. Two thousand sixty seven patients were screened: mean age of 48.6 years, 61.9 % female and 42.8 % in a managerial or professional occupation. In terms of numbers of risky behaviours screened eligible for, two was the most common (43.6 %), with diet and exercise (27.2 %) being the most common combination. Insufficient exercise was the most common single risky behaviour (12.0 %). 21.8 % of patients would have been eligible for an intervention for three behaviours and 5.9 % for all four behaviours. Just 4.5 % of patients did not identify any risky behaviours. Women, older age groups and those in managerial or professional occupations were more likely to exhibit all four risky behaviours. Very few patients consulting for routine primary care screen ineligible for interventions about common unhealthy behaviours, and most engage in more than one of the major common unhealthy behaviours. Clinicians should be particularly alert to opportunities to engaging younger, non professional men and those with multi-morbidity about risky health behaviour. ISRCTN22495456. BACKGROUND METHODS RESULTS CONCLUSION TRIAL REGISTRATIO

Socio-demographic and clinical characteristics of re-presentation to an Australian inner-city emergency department: implications for service delivery

BACKGROUND: People who have complex health care needs frequently access emergency departments for treatment of acute illness and injury. In particular, evidence suggests that those who are homeless, or suffer mental illness, or have a history of substance misuse, are often repeat users of emergency departments. The aim of this study was to describe the socio-demographic and clinical characteristics of emergency department re-presentations. Re-presentation was defined as a return visit to the same emergency department within 28 days of discharge from hospital. METHODS: A retrospective cohort study was conducted of emergency department presentations occurring over a 24-month period to an Australian inner-city hospital. Characteristics were examined for their influence on the binary outcome of re-presentation within 28 days of discharge using logistic regression with the variable patient fitted as a random effect. RESULTS: From 64,147 presentations to the emergency department the re-presentation rate was 18.0% (n = 11,559) of visits and 14.4% (5,894/40,942) of all patients. Median time to re-presentation was 6 days, with more than half occurring within one week of discharge (60.8%; n = 6,873), and more than three-quarters within two weeks (80.9%; n = 9,151). The odds of re-presentation increased three-fold for people who were homeless compared to those living in stable accommodation (adjusted OR 3.09; 95% CI, 2.83 to 3.36). Similarly, the odds of re-presentation were significantly higher for patients receiving a government pension compared to those who did not (adjusted OR 1.73; 95% CI, 1.63 to 1.84), patients who left part-way through treatment compared to those who completed treatment and were discharged home (adjusted OR 1.64; 95% CI, 1.36 to 1.99), and those discharged to a residential-care facility compared to those who were discharged home (adjusted OR 1.46: 95% CI, 1.03 to 2.06). CONCLUSION: Emergency department re-presentation rates cluster around one week after discharge and rapidly decrease thereafter. Housing status and being a recipient of a government pension are the most significant risk factors. Early identification and appropriate referrals for those patients who are at risk of emergency department re-presentation will assist in the development of targeted strategies to improve health service delivery to this vulnerable group

Nano-electromechanical oscillators (NEMOs) for RF technologies.

Nano-electromechanical oscillators (NEMOs), capacitively-coupled radio frequency (RF) MEMS switches incorporating dissipative dielectrics, new processing technologies for tetrahedral amorphous carbon (ta-C) films, and scientific understanding of dissipation mechanisms in small mechanical structures were developed in this project. NEMOs are defined as mechanical oscillators with critical dimensions of 50 nm or less and resonance frequencies approaching 1 GHz. Target applications for these devices include simple, inexpensive clocks in electrical circuits, passive RF electrical filters, or platforms for sensor arrays. Ta-C NEMO arrays were used to demonstrate a novel optomechanical structure that shows remarkable sensitivity to small displacements (better than 160 fm/Hz {sup 1/2}) and suitability as an extremely sensitive accelerometer. The RF MEMS capacitively-coupled switches used ta-C as a dissipative dielectric. The devices showed a unipolar switching response to a unipolar stimulus, indicating the absence of significant dielectric charging, which has historically been the major reliability issue with these switches. This technology is promising for the development of reliable, low-power RF switches. An excimer laser annealing process was developed that permits full in-plane stress relaxation in ta-C films in air under ambient conditions, permitting the application of stress-reduced ta-C films in areas where low thermal budget is required, e.g. MEMS integration with pre-existing CMOS electronics. Studies of mechanical dissipation in micro- and nano-scale ta-C mechanical oscillators at room temperature revealed that mechanical losses are limited by dissipation associated with mechanical relaxation in a broad spectrum of defects with activation energies for mechanical relaxation ranging from 0.35 eV to over 0.55 eV. This work has established a foundation for the creation of devices based on nanomechanical structures, and outstanding critical research areas that need to be addressed for the successful application of these technologies have been identified