Conditional Adjustment in a Markov Equivalence Class

We consider the problem of identifying a conditional causal effect through covariate adjustment. We focus on the setting where the causal graph is known up to one of two types of graphs: a maximally oriented partially directed acyclic graph (MPDAG) or a partial ancestral graph (PAG). Both MPDAGs and PAGs represent equivalence classes of possible underlying causal models. After defining adjustment sets in this setting, we provide a necessary and sufficient graphical criterion -- the conditional adjustment criterion -- for finding these sets under conditioning on variables unaffected by treatment. We further provide explicit sets from the graph that satisfy the conditional adjustment criterion, and therefore, can be used as adjustment sets for conditional causal effect identification.Comment: 29 pages, 6 figure

Justice Derailed: What Raids on Trains and Buses Reveal about Border Patrol's Interior Enforcement Practices

This report is the first-ever in-depth examination of the Border Patrol's transportation raids in upstate New York. It paints a disturbing picture of an agency resorting to aggressive policing tactics in order to increase arrest rates, without regard for the costs and consequences of its practices on New Yorkers' rights and freedoms. The report extends beyond transportation raids to other Border Patrol practices as well, raising serious concerns about an agency that appears to be driven by the belief that the regular rules of the Constitution do not apply to it

Chicago Recovery Partnership Evaluation of the American Recovery and Reinvestment Act

From 2009-2011, the City of Chicago and Cook County received a total of $2.35 billion in funding provided by the American Recovery and Reinvestment Act [ARRA]. The stimulus money was allocated to seven areas: education, basic needs, transportation and infrastructure, housing and energy, public safety, broadband and workforce development. The Chicago Recovery Partnership Evaluation of ARRA analyzes the impact of the stimulus spending using a costbenefit analysis framework. This report evaluated$1.09 billion of total spending in Chicago and Cook County, resulting in net benefits ranging from -$173.9 to$2,740.2 million. The wide range in net benefits is attributed largely to education, which received over half of ARRA funding

“You Can’t Record That!” Engaging American Indian Traditional Healers in Qualitative Research

Eliciting the serious illness-related traditions, beliefs, and values of historically and currently marginalized populations such as American Indian/Alaska Natives (AI/ANs) through Community-Based Participatory Research (CBPR) is a crucial initial step towards developing culturally-responsive interventions. While CBPR is the preferred methodology for research with AI/AN populations (1-2), it has rarely been used in palliative care (PC) research (3-4) specific to AI/AN spirituality. Moreover, few studies regarding AI/AN spirituality have included traditional healers’ voices in the research process (5-7); none were related to PC. To understand AI/AN spirituality in relation to PC requires cognizance of the historical trauma and cultural genocide experienced by many AI/ANs at the hands of the federal government and religious organizations. These entities focused on erasing traditional culture and resulted in AI/ANs being forced to practice traditional ceremonies, which are often highly valued at end-of- life, in secrecy (5-9). Thus, it is evident why collaborative partnerships between traditional healers and researchers are rare

Factors Influencing Palliative Care Access and Delivery for Great Plains American Indians

Context. Despite the known importance of culturally tailored palliative care (PC), American Indian people (AIs) in the Great Plains lack access to such services. While clinicians caring for AIs in the Great Plains have long acknowledged major barriers to serious illness care, there is a paucity of literature describing specific factors influencing PC access and delivery for AI patients living on reservation land. Objectives. This study aimed to explore factors influencing PC access and delivery on reservation land in the Great Plains to inform the development culturally tailored PC services for AIs. Methods. Three authors recorded and transcribed interviews with 21 specialty and 17 primary clinicians. A data analysis team of seven authors analyzed transcripts using conventional content analysis. The analysis team met over Zoom to engage in code negotiation, classify codes, and develop themes. Results. Qualitative analysis of interview data revealed four themes encompassing factors influencing palliative care delivery and access for Great Plains American Indians: health care system operations (e.g., hospice and home health availability, fragmented services), geography (e.g., weather, travel distances), workforce elements (e.g., care continuity, inadequate staffing, cultural familiarity), and historical trauma and racism. Conclusion. Our findings emphasize the importance of addressing the time and cost of travel for seriously ill patients, increasing home health and hospice availability on reservations, and improving trust in the medical system. Strengthening the AI medical workforce, increasing funding for the Indian Health Service, and transitioning the governance of reservation health care to Tribal entities may improve the trustworthiness of the medical system

Germline mutation of MDM4, a major p53 regulator, in a familial syndrome of defective telomere maintenance

International audienceDyskeratosis congenita is a cancer-prone inherited bone marrow failure syndrome caused by telomere dysfunction. A mouse model recently suggested that p53 regulates telomere metabolism, but the clinical relevance of this finding remained uncertain. Here, a germline missense mutation of MDM4, a negative regulator of p53, was found in a family with features suggestive of dyskeratosis congenita, e.g., bone marrow hypocellularity, short telomeres, tongue squamous cell carcinoma, and acute myeloid leukemia. Using a mouse model, we show that this mutation (p.T454M) leads to increased p53 activity, decreased telomere length, and bone marrow failure. Variations in p53 activity markedly altered the phenotype of Mdm4 mutant mice, suggesting an explanation for the variable expressivity of disease symptoms in the family. Our data indicate that a germline activation of the p53 pathway may cause telomere dysfunction and point to polymorphisms affecting this pathway as potential genetic modifiers of telomere biology and bone marrow function