Curbing adult student attrition: Evidence from a field experiment

Roughly 20% of adults in the OECD lack basic numeracy and literacy skills. In the UK, many colleges offer fully government subsidized adult education programs to improve these skills. Constructing a unique dataset consisting of weekly attendance records for 1179 students, we find that approximately 25% of learners stop attending these programs in the first ten weeks and that average attendance rates deteriorate by 20% in that time. We implement a large‐scale field experiment in which we send encouraging text messages to students. Our initial results show that these simple text messages reduce the proportion of students that stop attending by 36% and lead to a 7% increase in average attendance relative to the control group. The effects on attendance rates persist through the three weeks of available data following the initial intervention

Impact of the HIV-1 genetic background and HIV-1 population size on the evolution of raltegravir resistance

Background: Emergence of resistance against integrase inhibitor raltegravir in human immunodeficiency virus type 1 (HIV-1) patients is generally associated with selection of one of three signature mutations: Y143C/R, Q148K/H/R or N155H, representing three distinct resistance pathways. The mechanisms that drive selection of a specific pathway are still poorly understood. We investigated the impact of the HIV-1 genetic background and population dynamics on the emergence of raltegravir resistance. Using deep sequencing we analyzed the integrase coding sequence (CDS) in longitudinal samples from five patients who initiated raltegravir plus optimized background therapy at viral loads > 5000 copies/ml. To investigate the role of the HIV-1 genetic background we created recombinant viruses containing the viral integrase coding region from pre-raltegravir samples from two patients in whom raltegravir resistance developed through different pathways. The in vitro selections performed with these recombinant viruses were designed to mimic natural population bottlenecks. Results: Deep sequencing analysis of the viral integrase CDS revealed that the virological response to raltegravir containing therapy inversely correlated with the relative amount of unique sequence variants that emerged suggesting diversifying selection during drug pressure. In 4/5 patients multiple signature mutations representing different resistance pathways were observed. Interestingly, the resistant population can consist of a single resistant variant that completely dominates the population but also of multiple variants from different resistance pathways that coexist in the viral population. We also found evidence for increased diversification after stronger bottlenecks. In vitro selections with low viral titers, mimicking population bottlenecks, revealed that both recombinant viruses and HXB2 reference virus were able to select mutations from different resistance pathways, although typically only one resistance pathway emerged in each individual culture. Conclusions: The generation of a specific raltegravir resistant variant is not predisposed in the genetic background of the viral integrase CDS. Typically, in the early phases of therapy failure the sequence space is explored and multiple resistance pathways emerge and then compete for dominance which frequently results in a switch of the dominant population over time towards the fittest variant or even multiple variants of similar fitness that can coexist in the viral population

Meat, eggs, dairy products, and risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

Background: A Western diet is associated with breast cancer risk. Objective: We investigated the relation of meat, egg, and dairy product consumption with breast cancer risk by using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). Design: Between 1992 and 2003, information on diet was collected from 319,826 women. Disease hazard ratios were estimated with multivariate Cox proportional hazard models. Results: Breast cancer cases (n = 7119) were observed during 8.8 y (median) of follow-up. No consistent association was found between breast cancer risk and the consumption of any of the food groups under study, when analyzed by both categorical and continuous exposure variable models. High processed meat consumption was associated with a modest increase in breast cancer risk in the categorical model (hazard ratio: 1.10; 95% CI: 1.00, 1.20; highest compared with lowest quintile: P for trend = 0.07). Subgroup analyses suggested an association with butter consumption, limited to premenopausal women (hazard ratio: 1.28; 95% CI: 1.06, 1.53; highest compared with lowest quintile: P for trend = 0.21). Between-country heterogeneity was found for red meat (Q statistic = 18.03; P = 0.05) and was significantly explained (P = 0.023) by the proportion of meat cooked at high temperature. Conclusions: We have not consistently identified intakes of meat, eggs, or dairy products as risk factors for breast cancer. Future studies should investigate the possible role of high-temperature cooking in the relation of red meat intake with breast cancer risk. Am J Clin Nutr 2009;90:602-12

Immunotherapy of pediatric brain tumor patients should include an immunoprevention strategy: a medical hypothesis paper

Adults diagnosed with Glioblastoma multiforme (GBM) are frequently faced with a 7% chance of surviving 2 years compared with pediatric patients with GBM who have a 26% survival rate. Our recent screen of possible glioma-associated antigen precursor protein (TAPP) profiles displayed from different types of pediatric brain tumors showed that pediatric patients contained a subset of the tumor antigens displayed by adult GBM patients. Adult GBM possess at least 27 tumor antigens that can potentially stimulate T cell immune responses, suggesting that these tumors are quite antigenic. In contrast, pediatric brain tumors only expressed nine tumor antigens with mRNA levels that were equivalent to those displayed by adult GBM. These tumor-associated antigens could be used as possible targets of therapeutic immunization for pediatric brain cancer patients. Children have developing immune systems that peak at puberty. An immune response mounted by these pediatric patients might account for their extended life spans, even though the pediatric brain tumors express far fewer total tumor-associated antigens. Here we present a hypothesis that pediatric brain tumor patients might be the best patients to show that immunotherapy can be used to successfully treat established cancers. We speculate that immunotherapy should include a panel of tumor antigens that might prevent the out-growth of more malignant tumor cells and thereby prevent the brain tumor relapse. Thus, pediatric brain tumor patients might provide an opportunity to prove the concept of immunoprevention

Intersectionality and gender mainstreaming in international health: Using a feminist participatory action research process to analyse voices and debates from the global south and north

Critiques of gender mainstreaming (GM) as the officially agreed strategy to promote gender equity in health internationally have reached a critical mass. There has been a notable lack of dialogue between gender advocates in the global north and south, from policy and practice, governments and nongovernmental organisations (NGOs). This paper contributes to the debate on the shape of future action for gender equity in health, by uniquely bringing together the voices of disparate actors, first heard in a series of four seminars held during 2008 and 2009, involving almost 200 participants from 15 different country contexts. The series used (Feminist) Participatory Action Research (FPAR) methodology to create a productive dialogue on the developing theory around GM and the at times disconnected empirical experience of policy and practice. We analyse the debates and experiences shared at the seminar series using concrete, context specific examples from research, advocacy, policy and programme development perspectives, as presented by participants from southern and northern settings, including Kenya, Mozambique, India, the Democratic Republic of Congo, Canada and Australia. Focussing on key discussions around sexualities and (dis)ability and their interactions with gender, we explore issues around intersectionality across the five key themes for research and action identified by participants: 1) Addressing the disconnect between gender mainstreaming praxis and contemporary feminist theory; 2) Developing appropriate analysis methodologies; 3) Developing a coherent theory of change; 4) Seeking resolution to the dilemmas and uncertainties around the ‘place’ of men and boys in GM as a feminist project; and 5) Developing a politics of intersectionality. We conclude that there needs to be a coherent and inclusive strategic direction to improve policy and practice for promoting gender equity in health which requires the full and equal participation of practitioners and policy makers working alongside their academic partners

Three Essays on Human Capital in the Public Sector

This dissertation presents three empirical studies on how to improve human capital in the public sector. In reverse chronological order, the essays ask who is attracted to public sector jobs (Paper 3); consider who can actually get a public sector job (Paper 2); and evaluate how current civil servants can be more effective at doing their job (Paper 1). In doing so, the dissertation presents tools that public managers can use to improve human capital within the constraints of government. Paper 1 focuses on the rising trend of teleworking options in the US federal government. Using eight years of rich administrative data on 10,000 employees at the United States Patent and Trademark Office (USPTO), I evaluate the impact of instituting a program that allows employees to work from home full time, not only on those who telework, but also on their peers who remain in the office. I find considerable impact on organizational effectiveness. Teleworkers display increased retention and two divergent effects on output: while productivity per hour of examination time goes down, teleworkers examine more applications per quarter because they spend more of their workday examining cases and fewer hours in meetings. Interestingly, having more teleworking peers increases productivity for those who stay in the office, but it also increases their sick leave and attrition, a proxy for burnout. I hypothesize that this is due to increased monitorability and task visibility in the office. This study shows that teleworking programs affect organizations beyond their direct impact on teleworkers and that these additional effects must be incorporated into the overall evaluation of whether teleworking works for organizations. Paper 2 considers how to improve diversity in the civil service, with a focus on the police. The paper reports the results of a randomized controlled trial (RCT) conducted in cooperation with a UK police force that was experiencing a disproportionate drop in minority applicants at one stage in its assessment process, the Situational Judgment Test (SJT). Drawing on insights from the literatures on stereotype threat (Steele & Aronson, 1995), belonging uncertainty (Walton & Cohen, 2007), and values affirmation exercises (Harackiewicz et al., 2014), we redesigned the wording on the email inviting applicants to participate in the SJT. The results show a 50 percent increase in the probability of passing the test for black and minority ethnic applicants in the treatment group; the intervention had no effect on white applicants. Therefore, the intervention closed the racial gap in the probability of passing the test without lowering the recruitment standard or changing the assessment questions. Paper 3 considers how to increase the number and diversity of people who are attracted to the police in the first place. The study presents the results of a field experiment that varied job advertisements on a postcard. The results suggest that, contrary to popular wisdom, public service motivation (PSM) messages are ineffective at attracting candidates that would not have applied anyway. Rather, messages that focus on the challenge of being a police officer are twice as effective at attracting new candidates, bringing in 16 out of the 70 new applicants compared to eight who received a PSM message. Non-white individuals disproportionately respond to messages that focus on the challenge and career advancement. Overall, messages that focus on the personal benefits of applying to a job are three times as effective at getting individuals to apply as messages that focus on serving the community, without an observable loss in applicant quality.Public Polic

Screening programme evaluation applied to airport security

Eleni Linos, Elizabeth Linos, and Graham Colditz investigate whether airport security screening would pass the National Screening Committee’s criteria for an effective screening tes

Institutional theory in behavioral public administration: a three-stage approach. In: The (missing?) role of institutions in behavioral public administration: a roundtable discourse

In this roundtable, the contributors discuss the role of institutions (or lack thereof) in behav-ioral public administration (BPA). In a multidisciplinary discourse, the contributors touch on the many ten-sions that exist between institutional and behavioral perspectives of public administration. This roundtable is intended to spark additional discourse on the role of institutions in how they parameterize behaviors within or how individual behaviors might, in the aggregate, influence the norms and rules that shape institutions. Here at JBPA, we encourage further dialogue on the role of institutions in behavioral studies and holding work from a macro-, meso-, and micro-lens accountable to each another (Jilke et al., 2019)