Using Individual Development Accounts to Save for a Home: Are There Differences by Race?

Research indicates that homeownership is a key variable in wealth accumulation. Using data from the American Dream Demonstration, this study examines the performance of low-incomeblacks and whites saving for homeownership through Individual Development Accounts (IDAs), a matched saving program. Results show black IDA participants saved smaller amounts and less frequently. Furthermore, findings suggest institutional variables have different associations with savings for blacks and whites. Implications for policymakers and program administrators are discussed regarding differential targeting of race groups in the design and implementation of programs aimed toward increasing savings and assets accumulation for low-income and minority households

Diffusion of Policy Innovation: The Case of Individual Development Accounts (IDAs) as an Asset-Building Policy

Diffusion of a policy innovation from one state to another is an important component of social change. Several theories and models have been developed to explain how and under what circumstances policy innovation and diffusion occurs. This paper examines the policy diffusion process through the case of Individual Development Accounts (IDAs), a policy innovation designed to provide matched saving opportunities for low-income people to accumulate assets. While our examination supports several of the prominent theories of policy diffusion, we suggest that a fusion of policy theories may better guide policy makers in more adequately predicting and executing the diffusion of policy innovation. Furthermore, these theories appear to hold most relevance at distinct stages of the process

Saving and Asset Accumulation Among Low-Income Families With Children in IDAs

Research indicates that low-income families with children have many motives to save, however, the costs of raising children, low wage employment, means tested programs, and the need for child care make it difficult for them to save. Using data from the American Dream Demonstration (n=1,801), this study examines saving performances of low-income families with children in a matched savings program – Individual Development Accounts (IDAs). The results indicate that households with children in IDAs can save when they are provided structured opportunities. In addition, this study finds that institutional factors, not merely individual characteristics, are highly associated with IDA saving performance, and are important in explaining saving performances in IDAs. Implications for policy makers and program administrators to better assist low – income families to save and accumulate assets in IDAs are given

Prenatal Serum Concentrations of Brominated Flame Retardants and Autism Spectrum Disorder and Intellectual Disability in the Early Markers of Autism Study: A Population-Based Case-Control Study in California.

BackgroundPrior studies suggest neurodevelopmental impacts of polybrominated diphenyl ethers (PBDEs), but few have examined diagnosed developmental disorders.ObjectivesOur aim was to determine whether prenatal exposure to brominated flame retardants (BFRs) is associated with autism spectrum disorder (ASD) or intellectual disability without autism (ID).MethodsWe conducted a population-based case-control study including children with ASD (n=545) and ID (n=181) identified from the California Department of Developmental Services and general population (GP) controls (n=418) from state birth certificates. ASD cases were matched to controls by sex, birth month, and birth year. Concentrations of 10 BFRs were measured in maternal second trimester serum samples stored from routine screening. Logistic regression was used to calculate crude and adjusted odds ratios (AOR) for associations with ASD, and separately for ID, compared with GP controls, by quartiles of analyte concentrations in primary analyses.ResultsGeometric mean concentrations of five of the six congeners with ≥55% of samples above the limit of detection were lower in mothers of children with ASD or ID than in controls. In adjusted analyses, inverse associations with several congeners were found for ASD relative to GP (e.g., quartile 4 vs. 1, BDE-153: AOR=0.56, 95% CI: 0.38, 0.84). When stratified by child sex (including 99 females with ASD, 77 with ID, and 73 with GP), estimates were consistent with overall analyses in boys, but in the opposite direction among girls, particularly for BDE-28 and -47 (AOR=2.58, 95% CI: 0.86, 7.79 and AOR=2.64, 95% CI: 0.97, 7.19, respectively). Similar patterns overall and by sex were observed for ID.ConclusionsContrary to expectation, higher PBDE concentrations were associated with decreased odds of ASD and ID, though not in girls. These findings require confirmation but suggest potential sexual dimorphism in associations with prenatal exposure to BFRs. https://doi.org/10.1289/EHP1079

Pathways to Care of Maine Youth with Psychosis

Study clinicians conducted semi-structured interviews to identify the timing and steps of each person’s Pathway to Care (PtC).https://knowledgeconnection.mainehealth.org/lambrew-retreat-2023/1028/thumbnail.jp

Biomechanical investigation of a novel ratcheting arthrodesis nail

<p>Abstract</p> <p>Background</p> <p>Knee or tibiotalocalcaneal arthrodesis is a salvage procedure, often with unacceptable rates of nonunion. Basic science of fracture healing suggests that compression across a fusion site may decrease nonunion. A novel ratcheting arthrodesis nail designed to improve dynamic compression is mechanically tested in comparison to existing nails.</p> <p>Methods</p> <p>A novel ratcheting nail was designed and mechanically tested in comparison to a solid nail and a threaded nail using sawbones models (Pacific Research Laboratories, Inc.). Intramedullary nails (IM) were implanted with a load cell (Futek LTH 500) between fusion surfaces. Constructs were then placed into a servo-hydraulic test frame (Model 858 Mini-bionix, MTS Systems) for application of 3 mm and 6 mm dynamic axial displacement (n = 3/group). Load to failure was also measured.</p> <p>Results</p> <p>Mean percent of initial load after 3-mm and 6-mm displacement was 190.4% and 186.0% for the solid nail, 80.7% and 63.0% for the threaded nail, and 286.4% and 829.0% for the ratcheting nail, respectively. Stress-shielding (as percentage of maximum load per test) after 3-mm and 6-mm displacement averaged 34.8% and 28.7% (solid nail), 40.3% and 40.9% (threaded nail), and 18.5% and 11.5% (ratcheting nail), respectively. In the 6-mm trials, statistically significant increase in initial load and decrease in stress-shielding for the ratcheting vs. solid nail (<it>p </it>= 0.029, <it>p </it>= 0.001) and vs. threaded nail (<it>p </it>= 0.012, <it>p </it>= 0.002) was observed. Load to failure for the ratcheting nail; 599.0 lbs, threaded nail; 508.8 lbs, and solid nail; 688.1 lbs.</p> <p>Conclusion</p> <p>With significantly increase of compressive load while decreasing stress-shielding at 6-mm of dynamic displacement, the ratcheting mechanism in IM nails may clinically improve rates of fusion.</p

Characterizing and prognosticating chronic lymphocytic leukemia in the elderly: prospective evaluation on 455 patients treated in the United States.

BACKGROUND: Median age at diagnosis of patients with chronic lymphocytic leukemia (CLL) is \u3e 70 years. However, the majority of clinical trials do not reflect the demographics of CLL patients treated in the community. We examined treatment patterns, outcomes, and disease-related mortality in patients ≥ 75 years with CLL (E-CLL) in a real-world setting. METHODS: The Connect® CLL registry is a multicenter, prospective observational cohort study, which enrolled 1494 adult patients between 2010-2014, at 199 US sites. Patients with CLL were enrolled within 2 months of initiating first line of therapy (LOT1) or a subsequent LOT (LOT ≥ 2). Kaplan-Meier methods were used to evaluate overall survival. CLL- and infection-related mortality were assessed using cumulative incidence functions (CIF) and cause-specific hazards. Logistic regression was used to develop a classification model. RESULTS: A total of 455 E-CLL patients were enrolled; 259 were enrolled in LOT1 and 196 in LOT ≥ 2. E-CLL patients were more likely to receive rituximab monotherapy (19.3 vs. 8.6%; p \u3c 0.0001) and chemotherapy-alone regimens (p \u3c 0.0001) than younger patients. Overall and complete responses were lower in E-CLL patients than younger patients when given similar regimens. With a median follow-up of 3 years, CLL-related deaths were higher in E-CLL patients than younger patients in LOT1 (12.6 vs. 5.1% p = 0.0005) and LOT ≥ 2 (31.3 vs. 21.5%; p = 0.0277). Infection-related deaths were also higher in E-CLL patients than younger patients in LOT1 (7.4 vs. 2.7%; p = 0.0033) and in LOT ≥ 2 (16.2 vs. 11.2%; p = 0.0786). A prognostic score for E-CLL patients was developed: time from diagnosis to treatment \u3c 3 months, enrollment therapy other than bendamustine/rituximab, and anemia, identified patients at higher risk of inferior survival. Furthermore, higher-risk patients experienced an increased risk of CLL- or infection-related death (30.6 vs 10.3%; p = 0.0006). CONCLUSION: CLL- and infection-related mortality are higher in CLL patients aged ≥ 75 years than younger patients, underscoring the urgent need for alternative treatment strategies for these understudied patients. TRIAL REGISTRATION: The Connect CLL registry was registered at clinicaltrials.gov: NCT01081015 on March 4, 2010

Real-world clinical experience in the Connect® chronic lymphocytic leukaemia registry: a prospective cohort study of 1494 patients across 199 US centres.

The clinical course of chronic lymphocytic leukaemia (CLL) is heterogeneous, and treatment options vary considerably. The Connect® CLL registry is a multicentre, prospective observational cohort study that provides a real-world perspective on the management of, and outcomes for, patients with CLL. Between 2010 and 2014, 1494 patients with CLL and that initiated therapy, were enrolled from 199 centres throughout the USA (179 community-, 17 academic-, and 3 government-based centres). Patients were grouped by line of therapy at enrolment (LOT). We describe the clinical and demographic characteristics of, and practice patterns for, patients with CLL enrolled in this treatment registry, providing patient-level observational data that represent real-world experiences in the USA. Fluorescence in&nbsp;situ hybridization (FISH) analyses were performed on 49·3% of patients at enrolment. The most common genetic abnormalities detected by FISH were del(13q) and trisomy 12 (45·7% and 20·8%, respectively). Differences in disease characteristics and comorbidities were observed between patients enrolled in LOT1 and combined LOT2/≥3 cohorts. Important trends observed include the infrequent use of genetic prognostic testing, and differences in patient characteristics for patients receiving chemoimmunotherapy combinations. These data represent experiences of patients with CLL in the USA, which may inform treatment decisions in everyday practice

An ALMA Survey of Submillimeter Galaxies in the Extended Chandra Deep Field South : The Redshift Distribution and Evolution of Submillimeter Galaxies

Accepted by ApJ. 45 pages, 16 figuresWe present the first photometric redshift distribution for a large unbiased sample of 870um selected submillimeter galaxies (SMGs) with robust identifications based on observations with the Atacama Large Millimeter Array (ALMA). In our analysis we consider 96 SMGs in the Extended Chandra Deep Field South, 77 of which have 4-19 band, optical-near-infrared, photometry. We model the Spectral Energy Distributions (SEDs) for these 77 SMGs, deriving a median photometric redshift of z=2.3+/-0.1. The remaining 19 SMGs have insufficient optical or near-infrared photometry to derive photometric redshifts, but a stacking analysis of IRAC and Herschel observations confirms they are not spurious. Assuming these sources have an absolute H-band magnitude distribution comparable to that of a complete sample of z~1-2 SMGs, we demonstrate that the undetected SMGs lie at higher redshifts, raising the median redshift for SMGs to z=2.5+/-0.2. More critically we show that the proportion of galaxies undergoing an SMG phase at z>3 is 35+/-5% of the total population. We derive a median stellar mass for SMGs of Mstar=(8+/-1)x10^10Mo, but caution that there are significant systematic uncertainties in our stellar mass estimate, up to x5 for individual sources. We compare our sample of SMGs to a volume-limited, morphologically classified sample of ellipticals in the local Universe. Assuming the star formation activity in SMGs has a timescale of ~100Myr we show that their descendants at z~0 would have a space density and M_H distribution which are in good agreement with those of local ellipticals. In addition the inferred mass-weighted ages of the local ellipticals broadly agree with the look-back times of the SMG events. Taken together, these results are consistent with a simple model that identifies SMGs as events that form most of the stars seen in the majority of luminous elliptical galaxies at the present day.Peer reviewe

An ALMA Survey of Submillimeter Galaxies in the Extended Chandra Deep Field South : The Redshift Distribution and Evolution of Submillimeter Galaxies

Accepted by ApJ. 45 pages, 16 figuresWe present the first photometric redshift distribution for a large unbiased sample of 870um selected submillimeter galaxies (SMGs) with robust identifications based on observations with the Atacama Large Millimeter Array (ALMA). In our analysis we consider 96 SMGs in the Extended Chandra Deep Field South, 77 of which have 4-19 band, optical-near-infrared, photometry. We model the Spectral Energy Distributions (SEDs) for these 77 SMGs, deriving a median photometric redshift of z=2.3+/-0.1. The remaining 19 SMGs have insufficient optical or near-infrared photometry to derive photometric redshifts, but a stacking analysis of IRAC and Herschel observations confirms they are not spurious. Assuming these sources have an absolute H-band magnitude distribution comparable to that of a complete sample of z~1-2 SMGs, we demonstrate that the undetected SMGs lie at higher redshifts, raising the median redshift for SMGs to z=2.5+/-0.2. More critically we show that the proportion of galaxies undergoing an SMG phase at z>3 is 35+/-5% of the total population. We derive a median stellar mass for SMGs of Mstar=(8+/-1)x10^10Mo, but caution that there are significant systematic uncertainties in our stellar mass estimate, up to x5 for individual sources. We compare our sample of SMGs to a volume-limited, morphologically classified sample of ellipticals in the local Universe. Assuming the star formation activity in SMGs has a timescale of ~100Myr we show that their descendants at z~0 would have a space density and M_H distribution which are in good agreement with those of local ellipticals. In addition the inferred mass-weighted ages of the local ellipticals broadly agree with the look-back times of the SMG events. Taken together, these results are consistent with a simple model that identifies SMGs as events that form most of the stars seen in the majority of luminous elliptical galaxies at the present day.Peer reviewe