Evaluation Strategies in Financial Education: Evaluation with Imperfect Instruments

Program evaluation often suffers due to time constraints, imperfect instruments, incomplete data, and the need to report standardized metrics. This article about the evaluation process for the Wi$eUp financial education program showcases the difficulties inherent in evaluation and suggests best practices for assessing program effectiveness. We analyzed the stated behaviors of 125 Wi$eUp survey respondents, finding that debt education produced a greater change in behavior than savings education did but that survey questions related to savings did not reflect the material in the associated module, potentially lowering scores. Longer evaluation periods and better matching of evaluation questions to the content delivered may improve the evaluation process

High Resolution Chandra Spectroscopy of Gamma Cassiopeia (B0.5IVe)

gamma Cas has long been famous for its unique hard X-ray characteristics. We report herein on a 53 ks Chandra HETGS observation of this target. An inspection of our spectrum shows that it is quite atypical for a massive star, with abnormally weak Fe XXV, XXVI lines, Ly-alpha lines of H-like species from Fe XVII, XXIII, XXIV, S XVI, Si XIV, Mg XII, Ne X, O VII, VIII, and N VII. Also, line ratios of the rif-triplet of for a few He-like ions XVII are consistent with the dominance of collisional atomic processes. Yet, the presence of Fe and Si fluorescence K features indicates that photoionization also occurs in nearby cold gas. The line profiles indicate a mean velocity at rest and a broadening of 500 km/s. A global fitting analysis of the line and continuum spectrum finds that there are 3-4 plasma emission components. The dominant hot (12 keV) component and has a Fe abundance of 0.22 solar. Some fraction of this component (10-30%) is heavily absorbed. The other 2-3 components, with temperatures 0.1, 0.4, 3 keV, are "warm," have a nearly solar composition, a lower column absorption, and are responsible for most other emission lines. The strength of the fluorescence features and the dual-column absorption model for the hot plasma component suggest the presence near the hot sites of a cold gas structure with a column density of 10^23 cm^-2. Since this value is consistent with theoretical estimates of the vertical disk column of this star, these attributes suggest that the X-rays originate near the star or disk. It is possible that the Fe anomaly in the hot component is related to the First Ionization Potential effect found in coronal structures around active cool stars. This would be yet another indication that the X-rays -rays are produced in the immediate vicinity of the Be star.Comment: 32 pages, 4 figures (Fig. 3 colorized.) To be published in 01/10/04 Astrophysical Journal, Main Journal; included figures and updated formattin

High Mass Triple Systems: The Classical Cepheid Y Car

We have obtained an HST STIS ultraviolet high dispersion Echelle mode spectrum the binary companion of the double mode classical Cepheid Y Car. The velocity measured for the hot companion from this spectrum is very different from reasonable predictions for binary motion, implying that the companion is itself a short period binary. The measured velocity changed by 7 km/ s during the 4 days between two segments of the observation confirming this interpretation. We summarize "binary" Cepheids which are in fact members of triple system and find at least 44% are triples. The summary of information on Cepheids with orbits makes it likely that the fraction is under-estimated.Comment: accepted by A

Low hemoglobin at hemodialysis initiation : an international study of anemia management and mortality in the early dialysis period

Background. Anemia at hemodialysis (HD) initiation is common. Correcting low hemoglobin (Hgb) before HD initiation may improve survival by avoiding potential harms of chronic anemia, high doses of erythropoiesis-stimulating agents (ESAs) and intravenous (IV) iron in the early HD period, and/or rapid Hgb rise. Methods. We included 4604 incident HD patients from 21 countries in the Dialysis Outcomes and Practice Patterns Study Phases 4-5 (2009-15). Because low Hgb at HD start may reflect comorbidity or ESA hyporesponse, we restricted our analysis to the 80% of patients who achieved Hgb >= 10 g/dL 91-120 days after HD start (Month 4). Results. About 53% of these patients had Hgb = 10 g/dL). Month 1 Hgb was associated with first-year HD mortality (adjusted hazard ratio for 1 g/dL higher Hgb was 0.89; 95% confidence interval: 0.81-0.97), despite minimal differences in Month 4 Hgb. Patients with lower Hgb in Month 1 received higher doses of ESA, but not IV iron, over the first 3 months of HD. Results were consistent when excluding catheter users or adjusting for IV iron and ESA dose over the first 3 months. Conclusions. Even among patients with Hgb >= 10 g/dL 3 months later, anemia at HD initiation was common and associated with elevated mortality. A more proactive approach to anemia management in advanced chronic kidney disease (CKD) may thus improve survival on HD, though long-term prospective studies of non-dialysis CKD patients are needed

Inflammation and erythropoiesis-stimulating agent response in hemodialysis patients : a self-matched longitudinal study of anemia management in the Dialysis Outcomes and Practice Patterns Study (DOPPS)

Rationale & objective: Previous studies of inflammation and anemia management in hemodialysis (HD) patients may be biased due to patient differences. We used a self-matched longitudinal design to test whether new inflammation, defined as an acute increase in C-reactive protein (CRP) level, reduces hemoglobin response to erythropoiesis-stimulating agent (ESA) treatment. Study design: Self-matched longitudinal design. Setting & participants: 3,568 new inflammation events, defined as CRP level > 10 mg/L following a 3-month period with CRP level ≤ 5 mg/L, were identified from 12,389 HD patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS) phases 4 to 6 (2009-2018) in 10 countries in which CRP is routinely measured. Predictor: "After" (vs "before") observing a high CRP level. Outcomes: Within-patient changes in hemoglobin level, ESA dose, and ESA hyporesponsiveness (hemoglobin 6,000 [Japan] or >8,000 [Europe] U/wk). Analytical approach: Linear mixed models and modified Poisson regression. Results: Comparing before with after periods, mean hemoglobin level decreased from 11.2 to 10.9 g/dL (adjusted mean change, -0.26 g/dL), while mean ESA dose increased from 6,320 to 6,960 U/wk (adjusted relative change, 8.4%). The prevalence of ESA hyporesponsiveness increased from 7.6% to 12.3%. Both the unadjusted and adjusted prevalence ratios of ESA hyporesponsiveness were 1.68 (95% CI, 1.48-1.91). These associations were consistent in sensitivity analyses varying CRP thresholds and were stronger when the CRP level increase was sustained over the 3-month after period. Limitations: Residual confounding by unmeasured time-varying risk factors for ESA hyporesponsiveness. Conclusions: In the 3 months after HD patients experienced an increase in CRP levels, hemoglobin levels declined quickly, ESA doses increased, and the prevalence of ESA hyporesponsiveness increased appreciably. Routine CRP measurement could identify inflammation as a cause of worsened anemia. In turn, these findings speak to a potentially important role for anemia therapies that are less susceptible to the effects of inflammation

Landscape, Memory, and the Shifting Regional Geographies of Northwest Bosnia-Herzegovina

Writing and arguing with older discourses that have informed the subdiscipline of regional geography and setting them against new ways of conceiving of the region, this article considers the northwest of Bosnia-Herzegovina as a site that calls for a newly animated form of regional study. Of particular concern here is the role that memory and commemorative practices play in such a spatial schema. The monumental landscapes of the Tito regime and its collective commemoration of World War II sit alongside and are troubled by the more recent traumas and spaces of unmarked death associated with the ethnic war in Bosnia during the early 1990s. Read together, northwest Bosnia-Herzegovina functions as a vivid exemplar for understanding traumatic historical mourning as a phenomenological process that is inseparable from the wider geopolitical landscape

Bodyweight Perceptions among Texas Women: The Effects of Religion, Race/Ethnicity, and Citizenship Status

Despite previous work exploring linkages between religious participation and health, little research has looked at the role of religion in affecting bodyweight perceptions. Using the theoretical model developed by Levin et al. (Sociol Q 36(1):157–173, 1995) on the multidimensionality of religious participation, we develop several hypotheses and test them by using data from the 2004 Survey of Texas Adults. We estimate multinomial logistic regression models to determine the relative risk of women perceiving themselves as overweight. Results indicate that religious attendance lowers risk of women perceiving themselves as very overweight. Citizenship status was an important factor for Latinas, with noncitizens being less likely to see themselves as overweight. We also test interaction effects between religion and race. Religious attendance and prayer have a moderating effect among Latina non-citizens so that among these women, attendance and prayer intensify perceptions of feeling less overweight when compared to their white counterparts. Among African American women, the effect of increased church attendance leads to perceptions of being overweight. Prayer is also a correlate of overweight perceptions but only among African American women. We close with a discussion that highlights key implications from our findings, note study limitations, and several promising avenues for future research

EMBASE search strategies for identifying methodologically sound diagnostic studies for use by clinicians and researchers

BACKGROUND: Accurate diagnosis by clinicians is the cornerstone of decision making for recommending clinical interventions. The current best evidence from research concerning diagnostic tests changes unpredictably as science advances. Both clinicians and researchers need dependable access to published evidence concerning diagnostic accuracy. Bibliographic databases such as EMBASE provide the most widely available entrée to this literature. The objective of this study was to develop search strategies that optimize the retrieval of methodologically sound diagnostic studies from EMBASE for use by clinicians. METHODS: An analytic survey was conducted, comparing hand searches of 55 journals with retrievals from EMBASE for 4,843 candidate search terms and 6,574 combinations. All articles were rated using purpose and quality indicators, and clinically relevant diagnostic accuracy articles were categorized as 'pass' or 'fail' according to explicit criteria for scientific merit. Candidate search strategies were run in EMBASE, the retrievals being compared with the hand search data. The proposed search strategies were treated as "diagnostic tests" for sound studies and the manual review of the literature was treated as the "gold standard." The sensitivity, specificity, precision and accuracy of the search strategies were calculated. RESULTS: Of the 433 articles about diagnostic tests, 97 (22.4%) met basic criteria for scientific merit. Combinations of search terms reached peak sensitivities of 100% with specificity at 70.4%. Compared with best single terms, best multiple terms increased sensitivity for sound studies by 8.2% (absolute increase), but decreased specificity (absolute decrease 6%) when sensitivity was maximized. When terms were combined to maximize specificity, the single term "specificity.tw." (specificity of 98.2%) outperformed combinations of terms. CONCLUSION: Empirically derived search strategies combining indexing terms and textwords can achieve high sensitivity and specificity for retrieving sound diagnostic studies from EMBASE. These search filters will enhance the searching efforts of clinicians