Optimal management of post-traumatic radioulnar synostosis

Post-traumatic radioulnar synostosis is a rare complication after forearm or elbow injury that can result in loss of motion and significant disability. Risk factors include aspects of the initial trauma and of the surgical treatment of that trauma. Surgical intervention for synostosis is the standard of care and is determined based on the location of the bony bridge. Surgical timing is recommended between 6 months and 2 years with recent advocacy for the 6- to 12-month period after radiographs demonstrate bony maturation but early enough to prevent further stiffness and contractures. For most types of synostosis, surgical resection with interposition graft is recommended. The types of materials used include synthetic, allograft, and vascularized and non-vascularized materials, but currently there is no consensus on which is the most preferable. Adjuvant therapy is not considered necessary for all cases but can be beneficial in patients with high risk factors such as recurrence or traumatic brain injury. Postoperative rehabilitation should be performed early to maintain range of motion. © 2017 Osterman and Arief

How Would the President's Fiscal Commission's Social Security Proposals Affect Future Beneficiaries?

Estimates how proposed changes to Social Security, including raising the cap on earnings subject to the payroll tax, would affect benefits over time and by income and lifetime payroll tax contributions

Lucky Stores, Gambling, and Addiction: Empirical Evidence from State Lottery Sales

There is a large body of literature in both psychology and economics documenting mistaken perceptions of randomness. In this paper we demonstrate that people appear to believe that "lightning will strike twice" when it comes to lottery jackpots. First, we show that in the week following the sale of a winning ticket, retailers that sell a winning jackpot ticket experience relative increases in game-specific ticket sales of between 12 and 38 percent, with the sales response increasing in the size of the jackpot. In addition, the increase in sales experienced by the winning vendor increases with the proportion of the local population comprised of high school dropouts, elderly adults, and households receiving public assistance. We further show that this increase in retail-game sales initially reflects an increase in total sales at the retail and zip code level. Second, we show that the increase in sales is persistent at the winning retailer. However, the data no not provide clear evidence that the increase in sales at the zip code level is persistent. It thus appears that in the long run, consumers are persistent in their habit of buying lottery tickets at the "lucky" store; however, as the shock to total gambling dissipates, there is no evidence that lottery gambling itself is habit forming or addictive.

Socioeconomic Disadvantage and Early Childbearing

We examine the empirical relationship between socioeconomic disadvantage and rates of early childbearing. First, we use data from the Panel Study of Income Dynamics (PSID) to confirm a strong correlation at the individual level - women who grow up "disadvantaged" are much more likely to give birth as teens. Then we aggregate Vital Statistics microdata from 1968 through 2003 to conduct a cohort-based analysis of the relationship between rates of socioeconomic disadvantage of a birth cohort and the cohort's subsequent early childbearing experiences. Our cohort level analysis implies an even tighter intergenerational correlation between rates of background disadvantage and early childbearing. But, when our analysis econometrically controls for fixed state and year of birth effects in the model to account for cultural and other differences across cohorts, the relationship between rates of disadvantage and early childbearing is found to be quite modest. For example, the elasticity of early childbearing rates by age 18 with respect to the probability of being born to a mother under age 18 is only 0.05. This suggests that broader, societal forces are far more important in determining rates of early childbearing than rates of socioeconomic disadvantage per se.

Subsidized Contraception, Fertility, and Sexual Behavior

This paper examines the impact of recent state-level Medicaid policy changes that expanded eligibility for family planning services to higher income women and to Medicaid clients whose benefits would expire otherwise. We begin by establishing that the income-based policy change led to a substantial increase in the number of program recipients. We then examine Vital Statistics birth data from 1990 to 2003 and determine that it also reduced overall births to non-teens by about two percent and to teens by over four percent. Our estimates suggest a nearly nine percent reduction in births to women age 20-44 made eligible by the policy change. We supplement our state-level analysis with an investigation of individual-level data from the 1988, 1995, and 2002 National Surveys of Family Growth (NSFG) to examine the impact of these policies on sexual behavior and contraceptive use. Evidence from this analysis suggests that the reduction in fertility associated with raising income thresholds for eligibility was accomplished via greater use of contraception. Our calculations indicate that allowing higher income women to receive federally-funded family planning cost on the order of $6,800 for each averted birth.

Longitudinal-control design approach for high-angle-of-attack aircraft

This paper describes a control synthesis methodology that emphasizes a variable-gain output feedback technique that is applied to the longitudinal channel of a high-angle-of-attack aircraft. The aircraft is a modified F/A-18 aircraft with thrust-vectored controls. The flight regime covers a range up to a Mach number of 0.7; an altitude range from 15,000 to 35,000 ft; and an angle-of-attack (alpha) range up to 70 deg, which is deep into the poststall region. A brief overview is given of the variable-gain mathematical formulation as well as a description of the discrete control structure used for the feedback controller. This paper also presents an approximate design procedure with relationships for the optimal weights for the selected feedback control structure. These weights are selected to meet control design guidelines for high-alpha flight controls. Those guidelines that apply to the longitudinal-control design are also summarized. A unique approach is presented for the feed-forward command generator to obtain smooth transitions between load factor and alpha commands. Finally, representative linear analysis results and nonlinear batch simulation results are provided

Employee Health Insurance Decisions In a Flexible Benefits Environment

Empirical investigations of flexible benefits plans, an increasingly popular type of plan that allows employees to choose among multiple benefits options, have been limited. This study investigates hypotheses relating to the determinants of employees\u27 choices among six different health insurance options under a flexible benefits plan. Using employee-specific selection and demographic data provided by a large firm, we estimate a logistic regression model to analyze the effects of employee and plan characteristics on choice of health care plan. Results suggest that health plan decisions are significantly influenced by option premium, deductible and coinsurance amounts, and by employees\u27 age, gender, salary, and marital status. The results are considered within an expected utility maximization model

Ten Economic Facts About Crime and Incarceration in the United States

Crime and high rates of incarceration impose tremendous costs on society, with lasting negative effects on individuals, families, and communities. Rates of crime in the United States have been falling steadily, but still constitute a serious economic and social challenge. At the same time, the incarceration rate in the United States is so high -- more than 700 out of every 100,000 people are incarcerated -- that both crime scholars and policymakers alike question whether, for nonviolent criminals in particular, the social costs of incarceration exceed the social benefits