Cash Transfers and Children's Education and Labour among Malawi's Poor

This article examines the impact on children's education and labour of monthly cash grants targeted on ultra‐poor households and designed to reduce poverty and enable families to invest in human development. It conducts a randomised community trial, with baseline and endline surveys of intervention and control households; verifies school enrolment; and completes key‐informant interviews and focus‐group discussions. Compared with non‐beneficiaries, intervention children experienced a 5 percentage point difference in enrolment, higher educational expenditures, fewer absences, and a 10 percentage point decrease in labour outside the home. Qualitative data confirm the quantitative findings. Transfers to poor households had a positive impact. However, the Malawian educational system needs to be improved for short‐term impacts to lead to long‐term development in human capital.     

Heterogeneity in treatment effects across diverse populations

Differences in patient characteristics, including age, sex, and race influence the safety and effectiveness of drugs, biologic products, and medical devices. Here we provide a summary of the topics discussed during the opening panel at the 2018 Johns Hopkins Center for Excellence in Regulatory Science and Innovation symposium on Assessing and Communicating Heterogeneity of Treatment Effects for Patient Subpopulations: Challenges and Opportunities. The goal of this session was to provide a brief overview of FDA-regulated therapeutics, including drugs, biologics and medical devices, and some of the major sources of heterogeneity of treatment effects (HTE) related to patient demographics, such as age, sex and race. The panel discussed the US Food and Drug Administration's role in reviewing and regulating drugs, devices, and biologic products and the challenges associated with ensuring that diverse patient populations benefit from these therapeutics. Ultimately, ensuring diverse demographic inclusion in clinical trials, and designing basic and clinical research studies to account for the intended patient population's age, sex, race, and genetic factors among other characteristics, will lead to better, safer therapies for diverse patient populations.     

College students with congenital heart disease: A critical time for transition

As medical and surgical advances improve, more young adults with congenital heart disease (CHD) are attending college. This case study illustrates some of the issues that these young adults may face as they attend college and discusses the role that college health practitioners can play in easing that transition. Participants: A case of a male with CHD presenting to the college health clinic with a new onset headache. Methods: The authors discuss some of the unique challenges that college health practitioners may face when caring for students with CHD. In addition, they make recommendations on how best to care for these patients and how best to coordinate care with CHD students other care providers. Results: This student with a history of coarctation of the aorta presented with new onset headaches and was found to have high blood pressure. He was diagnosed with recurrent coarctation, underwent percutaneous treatment with stenting and quickly resumed classes. Conclusions: As more students with CHD enter college, college health providers will need to understand some of the health risks that CHD students face. In addition, understanding some of the optimal ways to coordinate care with CHD providers can ease the transition that CHD students face as they enter college.     

A Quantitative Analysis of the Effects of Postsecondary Institution Conversions from Not-For-Profit to For-Profit

This study highlights the changes that have occurred at postsecondary institutions after conversion from not-for-profit to for-profit control. Using Delta Cost Project Data and a pre-post study design with a control group of not-for-profit institutions that did not convert, comparisons are drawn. The findings suggest that institutions that convert experience greater enrollment growth, a decline in fulltime employment levels per full time equivalent (FTE) student, no change in average expenses per FTE student, a decrease in total revenue, a decrease in Pell Grants received, a decrease in tuition and fees revenue, and a decline in average subsidy per student post conversion. These findings are critical to the creation of informed policy decisions regarding institutional conversions.     

The Inability of Self-affirmations to Decrease Defensive Bias Toward an Alcohol-Related Risk Message Among High-Risk College Students

Abstract

Objective: To examine the efficacy of a self-affirmation task in deterring college alcohol misuse and the importance of preexisting beliefs in predicting subsequent behavior change. Participants: Heavy-drinking undergraduates (N = 110) participated during the 2011–2012 academic year. Methods: Participants were randomized to complete an affirmation or control task before reading an alcohol risk message. Alcohol-related beliefs and behaviors were assessed. Participants completed a 2-week online follow-up assessing alcohol-related behaviors. Results: Both groups reported increased perceived problem importance, but neither group displayed changes in personal risk. Follow-up assessment revealed similar, significant declines in peak consumption in both groups, with no significant between-group differences. Preexisting beliefs accounted for 5% to 10% of variance in drinking outcomes. Conclusions: An affirmation task does not seem to decrease defensive processing or alter high-risk drinking behaviors among college students and should not be utilized in lieu of more effective strategies.