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Access to higher education in the United States is increasingly on the public policy agenda as funding constraints affect the realization of college attendance for many middle and low-income students. We use the Pell Grant as a proxy for low-income participation, and the percent of undergraduate students receiving a Pell Grant (Pell Prevalence Ratio, or "PPR") in 2003-04 at 846 public and private universities as the variable of interest to address two questions. First, what factors contribute to the variation among universities in their PPR? Second, to what extent does an institution's actual PPR deviate from the PPR estimated from our empirical model? (Contains 1 figure, 4 tables and 6 footnotes.)

Oocyte cryopreservation (i.e., egg freezing) is one of the newest forms of assisted reproduction and is increasingly being used primarily by two groups of women: (1) young cancer patients at risk of losing their fertility through cytotoxic chemotherapy (i.e., medical egg freezing); and (2) single professionals in their late 30s who are facing age‐related fertility decline in the absence of reproductive partners (i.e., elective egg freezing). Based on a binational ethnographic study, this article examines the significance of egg freezing among Jewish women in Israel and the United States. As they face the Jewish maternal imperative, these women are turning to egg freezing to relieve both medical and marital uncertainties. In both secular and religious Jewish contexts, egg freezing is now becoming naturalized as acceptable and desirable precisely because it cryopreserves Jewish motherhood, keeping reproductive options open for Jewish women, and serving as a protective self‐preservation technology within their pronatalist social environments. [ABSTRACT FROM AUTHOR]

Asian American women are turning to oocyte cryopreservation (egg freezing) at rates higher than would be expected, given that Asian Americans make up less than six percent of the total United States population. Based on ethnographic interviews with 23 women of East, Southeast, and South Asian ancestry, we examine the "fertility paradox" faced by highly educated Asian American professional women. Despite achieving multiple "pillars of success," these women have difficulty finding educated partners with whom to pursue childbearing. Egg freezing offers feelings of empowerment and relief from pressure for Asian American women, holding open the possibility of future biogenetic motherhood. [ABSTRACT FROM AUTHOR]

Purpose: How can elective egg freezing (EEF) be made patient centered? This study asked women to reflect on their experiences of EEF, which included their insights and recommendations on the optimal delivery of patient-centered care. Methods: In this binational, qualitative study, 150 women (114 in the USA, 36 in Israel) who had completed at least one cycle of EEF were recruited from four American IVF clinics (two academic, two private) and three in Israel (one academic, two private) over a two-year period (June 2014–August 2016). Women who volunteered for the study were interviewed by two medical anthropologists. Interviews were audio recorded, transcribed, and entered into a qualitative data management program (Dedoose) for analysis. Results: The majority (85%) of women were without partners at the time of EEF, and thus were undertaking EEF alone in mostly couples-oriented IVF clinics. Following the conceptual framework known as "patient-centered infertility care," we identified two broad categories and eleven specific dimensions of patient-centered EEF care, including (1) system factors: information, competence of clinic and staff, coordination and integration, accessibility, physical comfort, continuity and transition, and cost and (2) human factors: attitude and relationship with staff, communication, patient involvement and privacy, and emotional support. Cost was a unique factor of importance in both countries, despite their different healthcare delivery systems. Conclusions: Single women who are pursuing EEF alone in the mostly couples-oriented world of IVF have distinct and multifaceted needs. IVF clinics should strive to make best practices for patient-centered EEF care a high priority. [ABSTRACT FROM AUTHOR]

Objective: To compare patient safety in major orthopedic procedures between an orthopedic hospital in Italy, and 26 US hospitals of similar size.Design: Retrospective analysis of administrative data from hospital discharge records in Italy and Florida, USA, 2011-13. Patient Safety Indicators (PSIs) developed by the Agency for Healthcare Quality and Research were used to identify inpatient adverse events (AEs). We examined the factors associated with the development of each different PSI, taking into account known confounders, using logistic regression.Setting: One Italian orthopedic hospital and 26 hospitals in Florida with ≥ 1000 major orthopedic procedures per year.Participants: Patients ≥ 18 years who underwent 1 of the 17 major orthopedic procedures, and with a length of stay (LOS) > 1 day.Intervention: Patient Safety management between Italy and the USA.Main Outcome Measure: Patient Safety Indicators.Results: A total of 14 393 patients in Italy (mean age = 59.8 years) and 131 371 in the USA (mean age = 65.4 years) were included. US patients had lower adjusted odds of developing a PSI compared to Italy for pressure ulcers (odds ratio [OR]: 0.21; 95% confidence interval [CI]: 0.10-0.45), hemorrhage or hematoma (OR: 0.42; CI 0.23-0.78), physiologic and metabolic derangement (OR: 0.08; CI 0.02-0.37). Italian patients had lower odds of pulmonary embolism/deep vein thrombosis (OR: 3.17; CI 2.16-4.67) compared to US patients.Conclusions: Important differences in patient safety events were identified across countries using US developed PSIs. Though caution about potential coding differences is wise when comparing PSIs internationally, other differences may explain AEs, and offer opportunities for cross-country learning about safe practices. [ABSTRACT FROM AUTHOR]

There is at best an emergent body of scholarship about the specific ways that the forces of globalization relate to the work of educators in the US, educational leadership programmes and their faculty. This research, structured with a four-tier model grounded in the self-study methodology, contributes to this body of literature. It explores our experiences teaching curriculum leadership courses in university-based preparation programmes, highlighting the intersection of globalization and our experiences in the educational leadership course room through the lenses of curriculum leadership and teaching practices. Our iterative analytic process draws on course syllabi, 75 pages of epistolary dialogue, 12 hours of teleconferences and 20 pages of meeting notes to make its assertions about the value of self-study research in educational leadership, the adaptive role of the leader educator in the twenty-first century, and the necessity of a glocalized, ideological course room in an era of globalization. Further, we submit that the reframing process inherent in self-study research surfaces awareness of the classroom as part of a larger global commons, thereby promoting empathy and counteracting the forces of isolation and dehumanization that can accompany globalization. [ABSTRACT FROM AUTHOR]

This study investigates the leadership tenets informing veterans' work as school leaders. Drawing on 15 interviews and surveys with military veterans working as educational leaders, the study relies on Stake's (2006) case study method to substantiate assertions that veterans: 1) come into education without the support of a transitional program, 2) are committed to taking care of their people, 3) have a strong belief in service, 4) are influenced by leadership that they have witnessed, and 5) are equipped to manage delegating and accountability by virtue of military experiences. [ABSTRACT FROM AUTHOR]

Study Question: What knowledge, attitudes and intentions do US obstetrics and gynecology (OB/GYN) residents have toward discussing age-related fertility decline and oocyte cryopreservation with their patients?Summary Answer: Most OB/GYN residents believe that age-related fertility decline, but not oocyte cryopreservation, should be discussed during well-woman annual exams; furthermore, nearly half of residents overestimated the age at which female fertility markedly declines.What Is Known Already: Oocyte cryopreservation can be utilized to preserve fertility potential. Currently, no studies of US OB/GYN residents exist that question their knowledge, attitudes, and intentions toward discussing age-related fertility decline and oocyte cryopreservation with patients.Study Design, Size, Duration: A cross-sectional online survey was conducted during the fall of 2014 among residents in American Council for Graduate (ACOG) Medical Education-approved OB/GYN residency programs. Program directors were emailed via the ACOG Council on Resident Education in Obstetrics and Gynecology server listing and asked to solicit resident participation.Participants/materials, Setting, Methods: Participants included 238 residents evenly distributed between post-graduate years 1-4 with varied post-residency plans; 90% of residents were women and 75% were 26-30 years old. The survey was divided into three sections: demographics, fertility awareness, and attitudes toward discussing fertility preservation options with patients. Descriptive and inferential statistics were conducted.Main Results and the Role Of Chance: A strong majority of residents (83%) believed an OB/GYN should initiate discussions about age-related fertility decline with patients (mean patient age 31.8), and 73% percent believed these discussions should be part of an annual exam. One third of residents overestimated the age at which there is a slight decline in female fertility, while nearly half of residents overestimated the age at which female fertility markedly declines. Over three-quarters of residents (78.4%) also overestimated the likelihood of success using assisted reproductive treatments (ARTs). Residents were likely to support oocyte cryopreservation in cancer patients irrespective of the woman's age, but much less likely to support elective oocyte cryopreservation. For elective oocyte cryopreservation, 40% believed OB/GYNs should initiate discussions with patients (mean age 31.1), while only 20% believed this topic should be part of an annual exam.Limitations, Reasons For Caution: Because the study invitation was sent through US OB/GYN residency program directors rather than directly to residents, it is possible that some residents did not receive the invitation to participate. This limits the generalizability of the findings.Wider Implications Of the Findings: Within the USA, there appears to be a critical need for improved education on fertility decline in OB/GYN residency programs. To promote informed reproductive decision-making among patients, efforts should be made to help OB/GYNs provide comprehensive fertility education to all women, while also respecting patient choices.Study Funding/competing Interests: None. [ABSTRACT FROM AUTHOR]

This paper offers a reinterpretation of the Fed's time-varying implicit inflation target, based on two considerations. The first is that the need to alleviate the burden of distortionary taxation may justify the choice of a positive inflation rate. The second is based on compelling evidence that the degree of price and wage indexation falls with trend inflation. In fact, we find that a proper characterization of the joint evolution of fiscal variables and nominal rigidities has a strong impact on the Ramsey optimal policies, implying optimal inflation dynamics that are consistent with the observed evolution of U.S. trend inflation. By contrast, tax policies have been too lax, especially at the time of the controversial Bush tax cuts. [ABSTRACT FROM AUTHOR]

The influence of managed care on internal medicine residents' attitudes and career choices has not yet been determined and could be substantial. In a survey of 1,390 third-year internal medicine residents, 21% believed that managed care was the best model of health care for the United States, and 31% stated they would be satisfied working in a managed care system. Those from high managed care communities (>30% penetration) were only slightly more accepting of managed care, but were more likely to choose general internal medicine as a career (54%, p = .0009) than those from communities with lower managed care penetration. [ABSTRACT FROM AUTHOR]

This article presents an international perspective of the proposed changes to the DSM-5 for learning disabilities (LD) and attention-deficit/hyperactivity disorders (ADHD) across ten countries: Australia, Germany, Greece, India, Israel, Italy, Spain, Taiwan, the United Kingdom, and the United States. We provide perspectives of the present situation for youth with LD and youth with ADHD and describe the legislation, prevalence rates, and educational systems that serve students with disabilities in the respective countries. We also present a discussion of the expected impact of the proposed changes for the diagnosis of LD and ADHD in each country. [ABSTRACT FROM PUBLISHER]

Purpose: The 2011 NCCN (National Comprehensive Cancer Network) guidelines for prostate cancer recommend pelvic lymph node dissection at radical prostatectomy in all individuals with a nomogram predicted lymph node invasion probability of 2% or greater. We examined the ability of these guidelines to correctly predict lymph node invasion in patients treated with extended pelvic lymph node dissection. Materials and Methods: We examined 3,064 consecutive patients treated with radical prostatectomy and extended pelvic lymph node dissection between 2000 and 2010. We formally validated the NCCN guideline nomogram using discrimination, calibration and decision curve analysis as benchmarks. Moreover the performance characteristics of the 2% nomogram cutoff as well as other cutoff values (range 1% to 10%) were tested. Results: Overall 10.0% of patients had lymph node invasion. The discrimination accuracy of the NCCN guideline nomogram was 79.8%, with a maximum underestimation of the lymph node invasion risk of 41.2%. On decision curve analysis the NCCN nomogram fared better than not performing pelvic lymph node dissection in all patients. However, in the prediction range between 0% and 9% the nomogram did not fare better than performing pelvic lymph node dissection in all patients. The use of the 2% cutoff would allow the avoidance of 49.3% of pelvic lymph node dissections, at the cost of missing 20.3% of patients with lymph node invasion. Conclusions: The NCCN nomogram tends to significantly underestimate the real lymph node invasion rate. Moreover the use of the currently recommended cutoff of 2% to trigger pelvic lymph node dissection might not be appropriate. [Copyright &y& Elsevier]

The article offers information on the usefulness of three-dimensional (3D) echocardiographic (3DE) imaging, representing a major innovation in cardiovascular ultrasound. It discusses the evaluation of cardiac chamber volumes and mass as well as the assessment of regional left ventricular (LV) wall motion and quantification of systolic dyssynchrony. It also discusses the transthoracic 3DE examination protocol.

This paper documents the existence of a significant forecast error on crude oil futures. We interpret it as a risk premium, which, in part, could have been explained by means of a real-time U.S. business cycle indicator, such as the degree of capacity utilization in manufacturing. This result is robust to the specification of the estimating equation and to the considered business cycle indicator. An out-of-the-sample prediction exercise reveals that futures adjusted to take into account this time-varying component produce significantly better forecasts than those of unadjusted futures, of futures adjusted for the average forecast error and of the random walk, particularly at horizons of more than 6 months. [ABSTRACT FROM AUTHOR]

Erectile dysfunction (ED) affects the sexual lives of millions of men. The first-line oral pharmacotherapy for most ED patients is phosphodiesterase type-5 (PDE-5) inhibitors, of which three are available. Sildenafil is the most widely prescribed oral agent for ED and has a very satisfactory efficacy–safety profile in all patient categories. Tadalafil and vardenafil were introduced in the European Union and in the United States in 2003 and 2004, respectively. The three PDE-5 inhibitors share many pharmacological and clinical characteristics, and each has unique features. This review, which is based on the contemporary literature on PDE-5 inhibitors, describes the chemical, pharmacological, and clinical features of sildenafil, vardenafil, and tadalafil. The first section reviews the pathophysiology of penile erection and PDE-5 inhibitor pharmacology. The second section summarizes data regarding efficacy and safety of the three drugs in treating ED in the general population as well as in selected patient categories. [ABSTRACT FROM AUTHOR]

Provides a model encompassing both partisan influences on monetary policy and the issue of central bank independence in the United States. Failure of central bank independence to affect the expected output level in election years; Partial independence and policy convergence; Explanation for the orthogonality between inflation and output variability.

In this paper we assess whether regional disparities in the euro area stimulate labour mobility, using migration behaviour in US states as a benchmark. Large regional disparities within European countries and size differences between them and US states led us to select regions as the appropriate unit of analysis for Europe. While the level of net immigration flows with respect to population is similar in the USA and the euro area, our study shows that its sensitivity to regional disparities differs considerably. Indeed, migration is much more significantly influenced by income disparities in the USA than it is in the Euro-11, both in the short and the long term. Furthermore, the responsiveness of net migration inflows to shocks to the relative unemployment rate is negative in the regions of the USA, but nil in those of the Euro-11. Finally, risk factors (identified in the theoretical model as the variance of income) are significant determinants of migration decisions in Europe but not in the USA. [ABSTRACT FROM AUTHOR]

The author discusses the contentious nature and continuous debate over the moral status of the human embryo. It is stressed that empirical information is having a perspicuous effect on key elements of the moral debate. He comments of the decision made by U.S. President Barack Obama to allow public funding of embryonic stem cell research. The Roman Catholic Church's stance on stem cell research is assessed. How embryo loss as a natural component of human reproduction has affected opinion is discussed.

Egg freezing (i.e., oocyte cryopreservation) is a new reproductive technology that allows women's eggs to be frozen and stored for future use. Over the past five years, so-called “medical egg freezing” (MEF) has begun to play a major role as a form of fertility preservation for young women with cancer and other fertility-threatening medical conditions. Indeed, women who are candidates for MEF are often facing the “double jeopardy” of fertility loss and potential death. In this article, we examine the experiences of the first generation of women to use MEF in the United States and Israel, two countries where experimental use of MEF began early, and where MEF is now offered clinically in many in vitro fertilization (IVF) clinics. Through an ethnographic, interview-based study carried out between June 2014 and August 2016 with 45 women (33 American, 12 Israeli) who had completed at least one cycle of MEF, we highlight women's reflections on their egg freezing experiences, and their considerable hopes for future recovery and motherhood. However, MEF is a Janus-faced new “hope technology.” On the one hand, it holds out the promise of life in terms of recovery and future childbearing. As such, women's reflections on MEF reveal hope and gratitude for the technology's existence. However, as with IVF itself, future motherhood can never be guaranteed. This is especially true for women facing death from advanced or aggressive forms of cancers. Three ethnographic case studies of cancer patients, two from the US and one from Israel, highlight how MEF offers hope for life among women confronted with a deadly disease. [ABSTRACT FROM AUTHOR]

Background: Pelvic fractures (PF) require high force mechanism and their severity have been linked with an increase in the incidence of associated injuries within the abdomen and chest. Our goal is to assess the impact of solid organ injury (SOI) on the outcome of patients with PF and to identify risk factors predictive of morbidity and mortality among these patients.Study Design: We conducted a single-center retrospective review of medical records of patients 16 years or older admitted to our level 1 trauma center with pelvic fracture with and without OI associated from blunt trauma between 1/1/2010-7/31/2015.Results: 979 patients with PF were identified. 261/979 (26.7%) had at least one associated SOI. The grade of the SOI ranged from I to III in 246 patients, grade IV in five patients and grade V in 10 patients with SOI sustained a higher pelvic AIS grade and required a statistically significant greater amount of blood products (BP). Thoracic and urogenital injuries were also more common. The mortality of patients with PF was not affected by the presence of SOI. Increasing age, Injury Severity Score, Glasgow Coma Scale, hypothermia and the amount of BP transfused were predictive of mortality.Conclusions: The presence of SOI did not affect the outcome of patients with pelvic fracture, although our results may be linked to the limited number of patients with high grade SOI. The degree of pelvic AIS is predictive of associated injuries within the abdomen and chest. [ABSTRACT FROM AUTHOR]

Objective: To compare the impact of mandated IVF insurance coverage on ET practices and resulting multiple pregnancy rates. Design: Retrospective analysis of all fresh, nondonor IVF cycles performed in the United States in 2006. Setting: United States. Patient(s): A total of 91,753 fresh, nondonor IVF cycles in the United States. Intervention(s): None. Main Outcome Measure(s): Pregnancy rate, live-birth rate, embryos transferred, multiple pregnancy rate. Result(s): Overall, nonmandated states had a significantly higher pregnancy rate (38.8% vs. 35%) and live-birth rate (32.2% vs. 29.1%) than mandated states. Nonmandated states also had a significantly higher twin rate (28.1% vs. 26%) and triplet rate (3.9% vs. 3.4%). The average number of embryos transferred was also significantly higher in nonmandated states (2.6 vs. 2.2). These findings were more pronounced in the <35 and 35–37 age groups. Conclusion(s): In the last 8 years, despite a reduction in the average number of embryos transferred and multiple pregnancy rates, there is a continued association between mandated IVF coverage, the transfer of fewer embryos, and lower rates of multiple pregnancies and births, particularly in the younger age groups. [Copyright &y& Elsevier]

In this article, we elucidate how elective egg freezing (EEF) has been received within the three Abrahamic traditions—Judaism, Christianity, and Islam—and how these religion-specific standpoints have affected the EEF experiences of women who self-identify as religiously observant. Through an analysis of religious women's narratives, the study explores the "local moral worlds" of religious women who chose to freeze their eggs for non-medical reasons. It draws on ethnographic interviews with 14 women in the United States and Israel who had completed at least one EEF cycle, and who were part of a large, binational study that interviewed, between 2014 and 2016, 150 women who pursued EEF. These religious women, who were all highly educated, faced a particular challenge in finding appropriate marriage partners. Feeling pressured but still hopeful to marry and create large families, the women used EEF to extend their reproductive timelines and reduce their anxieties. As the study showed, the women reinterpreted or reconciled religious restrictions on the use of EEF in various ways, believing that their ultimate pursuit of religiously sanctioned reproduction justified the means. This study, which is the first to compare Jewish, Christian, and Muslim women's experiences of EEF, illustrates how this novel technology is now shaping the local moral worlds of religious women. • Abrahamic religious traditions demonstrate support for elective egg freezing (EEF). • Catholicism is the exception, prohibiting EEF for fertility preservation. • Religious women are turning to EEF when they cannot find a marital partner. • EEF extends reproductive timelines and reduces religious women's anxieties. • Religious women transgress EEF restrictions to accomplish future motherhood goals. [ABSTRACT FROM AUTHOR]