Factors impacting access to community services by people with intellectual disabilities

Background: People with intellectual disabilities increasingly live in smaller community settings rather than institutional settings. Home- and community-based services (HCBS) are a type of long-term care in which services and supports are provided in people’s homes and communities. HCBS are essential for people with disabilities to remain in the community. Method: The 2015-2016 National Core Indicators survey data, along with other datasets, were used to determine how factors impacted service utilization and additional services needed for adults with intellectual and development disabilities (I/DD) in the US. Three groups of factors were used: individual, interpersonal, and public policy factors. Results: Variables within each of the three groups of factors affected access to HCBS. Of significant note within individual factors, older adults received more services and had fewer additional services needed. Black respondents received fewer services and had more additional services needed. A higher problem behaviors score and use of mobility aids were associated with greater utilization and more additional services needed. Better health was associated with significantly fewer additional services needed. Within interpersonal factors, results indicated that people who lived in group homes received more services than people living in their own or family homes. Additionally, individuals with community jobs received more services. A notable public policy finding indicated people who lived in a state with a Balancing Incentive Program (BIP) got more services but also had additional services needed. Conclusion: This study examined factors not studied previously and indicates that future research should look at different factors to better understand their impacts on access to HCBS for people with I/DD

Social Ecology of Supervised Communal Facilities for Mentally Disabled Adults: VI. Initial Social Adaption

The social adaptation of mentally disabled adults introduced to two new vocational rehabilitation settings was investigated. Client behavior was observed for 8 weeks in subsequent workshop settings. During the evaluation period, clients\u27 sociability increased with time in the program. In the later workshop placements, the social milieu rather than time in the program influenced the degree of client sociability. Specifically, in the first 2 weeks of workshop placement, clients placed in Workshop A, which had more sociable milieu, remained at the high levels of sociability, similar to the last weeks in the evaluation phase. In contrast, clients placed in Workshop B showed a decline in sociability, which was related to environmental variables. Clients initially affiliated more with other clients they knew during evaluation, but this tendency decreased as they became integrated into the workshop program

Upper-Level Courses: Three Exemplars

This Article presents three exemplars of upper-level law school classes, and is divided into three parts. Part I discusses Securitization and Asset-Backed Securities ; Part II discusses Using Transactions to Teach Secured Transactions ; and Part III discusses Teaching Deals Through a Focus on the Entertainment Industry

Upper-Level Courses: Three Examplars

I\u27m Mark Fagan, and I co-teach a course on securitization with Tamar Frankel at Boston University School of Law. We have come together to teach several interdisciplinary courses that combine law, business and public policy. Our course on securitization is a wonderful exemplar because it touches so many aspects of law as well as business and public policy. We spent quite a bit of time wrestling with how to teach it. Do you teach it in a process fashion? Do you teach it by legal topic? Do you take examples and examine them? After much debate and discussion, we actually went with the linear, process path. We begin with the borrower and show the students how the originator of the loan fits in, how they take and create a Special Purpose Vehicle ( SPV ), and the SPV in turn takes the assets and turns them into securities. We walk through this process and explain how the assets can move in one direction, and the cash in the other, and then the repayment. On the surface, this seems quite straightforward. Basically, we\u27re taking the illiquid assets and turning them into tradable securities. But, when you unbundle it, you find a level of complexity, because in addition to our primarily players, many of whom they\u27ve already had some exposure to, we get our additional players: the rating agencies, the appraisers, the security brokers, and the servicers, which layer on a very interesting dynamic into this process, because they\u27re actually not part of the core process yet have a significant impact on the outcome of the securitization process

A Powerful Statistical Framework for Generalization Testing in GWAS, with Application to the HCHS/SOL

In GWAS, “generalization” is the replication of genotype-phenotype association in a population with different ancestry than the population in which it was first identified. The standard for reporting findings from a GWAS requires a two-stage design, in which discovered associations are replicated in an independent follow-up study. Current practices for declaring generalizations rely on testing associations while controlling the Family Wise Error Rate (FWER) in the discovery study, then separately controlling error measures in the follow-up study. While this approach limits false generalizations, we show that it does not guarantee control over the FWER or False Discovery Rate (FDR) of the generalization null hypotheses. In addition, it fails to leverage the two-stage design to increase power for detecting generalized associations. We develop a formal statistical framework for quantifying the evidence of generalization that accounts for the (in)consistency between the directions of associations in the discovery and follow-up studies. We develop the directional generalization FWER (FWERg) and FDR (FDRg) controlling r-values, which are used to declare associations as generalized. This framework extends to generalization testing when applied to a published list of SNP-trait associations. We show that our framework accommodates various SNP selection rules for generalization testing based on p-values in the discovery study, and still control FWERg or FDRg. A key finding is that it is often beneficial to use a more lenient p-value threshold then the genome-wide significance threshold. For instance, in a GWAS of Total Cholesterol (TC) in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), when testing all SNPs with p-values\u3c 5 × 10−8 (15 genomic regions) for generalization in a large GWAS of whites, we generalized SNPs from 15 regions. But when testing all SNPs with p-values\u3c 6.6×10−5 (89 regions), we generalized SNPs from 27 regions

The psychological science accelerator’s COVID-19 rapid-response dataset

In response to the COVID-19 pandemic, the Psychological Science Accelerator coordinated three large-scale psychological studies to examine the effects of loss-gain framing, cognitive reappraisals, and autonomy framing manipulations on behavioral intentions and affective measures. The data collected (April to October 2020) included specific measures for each experimental study, a general questionnaire examining health prevention behaviors and COVID-19 experience, geographical and cultural context characterization, and demographic information for each participant. Each participant started the study with the same general questions and then was randomized to complete either one longer experiment or two shorter experiments. Data were provided by 73,223 participants with varying completion rates. Participants completed the survey from 111 geopolitical regions in 44 unique languages/dialects. The anonymized dataset described here is provided in both raw and processed formats to facilitate re-use and further analyses. The dataset offers secondary analytic opportunities to explore coping, framing, and self-determination across a diverse, global sample obtained at the onset of the COVID-19 pandemic, which can be merged with other time-sampled or geographic data

New insights into the genetic etiology of Alzheimer's disease and related dementias

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele