Financial Aid and Students' College Decisions: Evidence from the District of Columbia's Tuition Assistance Grant Program

The District of Columbia's Tuition Assistance Grant Program (DCTAG), instituted in 1999, allows DC residents to attend public colleges and universities throughout the country at considerably lower in-state tuition rates. We use the sharp decline in the price of public colleges and universities faced by residents of the District of Columbia under DCTAG to estimate the effects of price on students' college application and enrollment decisions. Using a sample of students from nearby large cities as a control group, we find that the number and share of DC residents applying to four-year colleges increased substantially under the program, and students were considerably more likely to apply to colleges that were eligible for the subsidy. Freshmen enrollments of DC residents also increased substantially at eligible institutions, although the effect on overall freshmen enrollments of DC residents was fairly modest, suggesting that in its first year the subsidy had more of an impact on where students chose to attend than on whether they chose to attend college at all.

Innovations for Vulnerable Populations in Massachusetts

This is the moderator\u27s introductory presentation for the mini-symposium entitled Innovations for Vulnerable Populations in Massachusetts, in which she places the session presentations in the context of an ongoing collaboration between Commonwealth Medicine, a division of the University of Massachusetts Medical School, and MassHealth

Impacts of the Teach For America Investing in Innovation Scale-Up

In 2010, Teach For America (TFA) launched a major expansion effort, funded in part by a five-year Investing in Innovation (i3) scale-up grant of $50 million from the U.S. Department of Education. Using a rigorous random assignment design to examine the effectiveness of TFA elementary school teachers in the second year of the i3 scale-up, Mathematica Policy Research found that first- and second-year corps members recruited and trained during the scale-up were as effective as other teachers in the same high-poverty schools in both reading and math. To estimate the effectiveness of TFA teachers relative to the comparison teachers, we compared end-of-year test scores of students assigned to the TFA teachers and those assigned to the comparison teachers. Because students in the study were randomly assigned to teachers, we can attribute systematic differences in achievement at the end of the study school year to the relative effectiveness of TFA and comparison teachers, rather than to the types of students taught by these two different groups of teachers. In addition to the impact analysis described in this report, the evaluation included an implementation analysis that describes key features of TFA's program model and its implementation of the i3 scale-up

Assessing the Effectiveness of Teach For America's Investing in Innovation Scale-Up

In 2010, TFA launched a major expansion effort, funded in part by a five-year Investing in Innovation (i3) scale-up grant of $50 million from the U.S. Department of Education. By the 2012 -- 2013 school year -- the second year of the scale-up -- TFA had expanded its placements of first- and second-year corps members by 25 percent. This study examines the effectiveness of TFA elementary school teachers hired during the first two years of the i3 scale-up, relative to other teachers in the same grades and school

Deviating from IDSA treatment guidelines for non-purulent skin infections increases the risk of treatment failure in emergency department patients

The Infectious Disease Society of America (IDSA) publishes guidelines regularly for the management of skin and soft tissue infections; however, the extent to which practice patterns follow these guidelines and if this can affect treatment failure rates is unknown. We observed the treatment failure rates from a multicentre retrospective ambulatory cohort of adult emergency department patients treated for a non-purulent skin infection. We used multivariable logistic regression to examine the role of IDSA classification and whether adherence to IDSA guidelines reduced treatment failure. A total of 759 ambulatory patients were included in the cohort with 17.4% failing treatment. Among all patients, 56.0% had received treatments matched to the IDSA guidelines with 29.1% over-treated, and 14.9% under-treated based on the guidelines. After adjustment for age, gender, infection location and medical comorbidities, patients with a moderate infection type had three times increased risk of treatment failure (adjusted risk ratio (aRR) 2.98; 95% confidence interval (CI) 1.15-7.74) and two times increased risk with a severe infection type (aRR 2.27; 95% CI 1.25-4.13) compared with mild infection types. Patients who were under-treated based on IDSA guidelines were over two times more likely to fail treatment (aRR 2.65; 95% CI 1.16-6.05) while over-treatment was not associated with treatment failure. Patients 70 years of age had a 56% increased risk of treatment failure (aRR 1.56; 95% CI 1.04-2.33) compared with those \u3c 70 years. Following the IDSA guidelines for non-purulent SSTIs may reduce the treatment failure rates; however, older adults still carry an increased risk of treatment failure

Patient Perspectives on Osseointegration: A National Survey of Veterans with Upper Limb Amputation

INTRODUCTION: Osseointegrated (OI) prostheses have a unique benefit-risk profile among prosthetic alternatives and have been marketed in the United States under a Humanitarian Device Exemption since 2015. Information about upper limb prosthesis user perspectives on benefits and risks, prosthesis-user subpopulations for whom OI is most acceptable, and outcomes that matter most to patients could help inform clinical and regulatory decision-making. Recent 21st Century Cures legislation expanded the role of patient experience data in the decision-making process of the U.S. Food and Drug Administration, recognizing that patient perspectives may be informative to regulators. OBJECTIVE: To better understand prosthesis user perspectives about the benefits and risks associated with upper limb OI prostheses. DESIGN: Patient perspective survey. SETTING: Telephone administration. PARTICIPANTS: National sample of veterans with upper limb loss. INTERVENTIONS: NA MAIN OUTCOME MEASURES: Benefit-risk survey developed for this study. RESULTS: Twenty-eight percent of unilateral and 13% of bilateral amputees were willing to consider osseointegration surgery. Multivariate logistic regression models [OR; 95% CI] showed that transhumeral amputation level [OR 1.40; 1.01-1.98] was associated with greater willingness to consider surgery, whereas older age [OR 0.17; 0.09-0.32] and higher VR-12 Mental Component Summary [OR 0.53; 0.35-0.81] were associated with less willingness. Having a durable/reliable device, the ability to do more activities, and having a comfortable device were rated as very important or somewhat important by 98% or more for every risk condition. CONCLUSIONS: Persons who were older, had transradial amputation (compared to transhumeral), and those who had better mental functioning were less willing to consider this surgery. Respondents who were willing to consider surgery indicated that the most important potential benefits were obtaining a durable/reliable device, the ability to do more activities, and having a comfortable device. Most were willing to accept one or more risks of surgery, with long-term risks including chronic pain, loss of nerve function, or device failure considered the most unacceptable. LEVEL OF EVIDENCE: III. has been contributed to by US Government employees and their work is in the public domain in the USA

Resident Wellness in US Ophthalmic Graduate Medical Education: The Resident Perspective

Importance: Wellness programs have become important strategies to combat burnout and depression among residents. However, the resident perspective on wellness in ophthalmic graduate medical education has not been solicited on a national level. Objectives: To report on residents\u27 views of wellness initiatives in ophthalmic graduate medical education and identify potential strategies for promoting resident wellness. Design, Setting, and Participants: In this national survey of ophthalmology residents in the United States, conducted from September 21 to November 3, 2017, all 1048 ophthalmology residents listed on the websites of ophthalmology residency programs accredited by the Accreditation Council for Graduate Medical Education were emailed an anonymous online survey consisting of 12 multiple-choice questions with options for free-text answers. Residents also received a mailed letter with a survey link and a $1 incentive, as well as 2 reminder emails. Survey responses were analyzed using descriptive statistics, and the free-text answers were categorized. Main Outcomes and Measures: Main outcomes include residents\u27 reports regarding their personal experiences with wellness during residency, support systems provided by their programs, and opportunities for improving wellness in ophthalmic graduate medical education. Results: Of 1048 residents, 241 (23.0%) responded to the survey. Most respondents (121 of 177 [68.4%]) reported that their programs faced an issue involving depression, burnout, or suicide among residents within the past year; 26.3% of respondents (61 of 232) reported being involved in a case when resident fatigue, burnout, or depression adversely affected a medical outcome or judgment. Fewer than half of the respondents (110 of 241 [45.6%]) reported that their residency programs placed moderate or major emphasis on promoting a culture of resident wellness, and only 26.7% (63 of 236) reported that their department had a formal resident wellness program. The most commonly cited barrier to resident wellness (59 of 236 [25.0%]) was a lack of time to attend wellness programs. Conclusions and Relevance: These results suggest that there is a substantial burden of burnout and depression among US ophthalmology residents and that there are opportunities to boost wellness in ophthalmic graduate medical education by making wellness curricula more accessible to residents and ensuring that residents have time to attend wellness programs

Strategic Players for Identifying Optimal Social Network Intervention Subjects

We present a method whereby social network ties are used to identify behavioral leaders who are situated in the network such that these individuals are: 1) able to influence other individuals who are in need of and most receptive to intervention, thereby optimizing the impact of the intervention; and 2) not embedded with ties to individuals that are likely to be behaviorally antagonistic to the intervention or that would compromise the optimal impact of intervention. In this study we developed a method that we call Strategic Players, which is a solution for identifying a set of players who are close to a target subset of the network (i.e., the target group), and far away from the subset we wish to avoid (i.e. the avoid group), where the proximity to either the target or avoid group may be facilitated by network members who are in neither group (i.e. the neutral group). This solution seeks to maximize the diffusion of the behavior to the target group while minimizing contact and influence to the avoid group. We apply this method to two different social networks, and one simulated social network