School choice in Spain

Flip Klijn writes:

"Hey Al,
Recently, a letter in the Spanish newspaper "La Vanguardia" questions the new mechanism to assign students to universities in Spain.

Link to the letter in Catalan:http://www.lavanguardia.es/lv24h/20100623/53951521785.html

The writer of the letter (a high school student) wonders whether the introduction of *multiple* access grades (the novelty) is desirable. He discusses a hypothetical scenario in which multiples access grades may in fact lead to an undesirable assignment.

I was happily surprised with his analysis. Basically, he implicitly describes the deferred acceptance mechanism through a simple but very nice example that has a priority structure with a cycle (as in Ergin, Econometrica 2002). Then, he makes the point that the assignment is fair (or stable) but not very desirable (since it is inefficient).

It was impossible for me to not react to the letter. My response (in Spanish) was published in the Blog section of the same newspaper:http://www.lavanguardia.es/lv24h/20100624/53951867284.html

In my response, I first mention that with a single access grade there is indeed no incompatibility between stability and efficiency. Next, I argue that in certain situations it might be convenient, however, to have multiple access grades in which case the deferred accepted mechanism is a natural candidate mechanism (referring to the original work of Gale and Shapley, 1962, and the application in the National Resident Matching Program). I also point out that the incompatibility between stability and efficiency in the situation with multiple access grades cannot be solved by using some other mechanism. Finally, I mention that the deferred acceptance mechanism is "hassle-free" (i.e., strategy-proof) and that the experience in Boston and New York (high schools) has been very positive. Therefore, there are reasons to believe that the deferred acceptance mechanism with multiple access grades will work satisfactorily in the assignment of students to Spanish universities."

Heads of government for and against same-sex marriage

Two of yesterday's news stories from very different parts of the world caught my eye.

Icelandic Leader in Milestone Gay Marriage
"Iceland's prime minister made history last week when she wed her longtime girlfriend, becoming the world's first head of government to enter a gay marriage. But fellow Nordic nations hardly noticed when 67-year-old Johanna Sigurdardottir tied the knot with her longtime partner -- a milestone that would still, despite advances in gay rights, be all but inconceivable elsewhere. Scandinavia has had a long tradition of tolerance for alternative lifestyles -- and cross-dressing lawmakers and homosexual bishops have become part of the landscape. ''There is some kind of passion for social justice here,'' respected cross-dressing Swedish lawmaker Fredrick Federley said. ''That everybody should be treated the same.'' "

While in Australia, this from the new prime minister:
Gillard against gay marriage
"Prime Minister Julia Gillard says she does not support legalising gay marriage in Australia.Labor policy on gay marriage will remain the same under her prime ministership, Ms Gillard told Austereo show today."We believe the marriage act is appropriate in its current form, that is recognising that marriage is between a man and a woman, but we have as a government taken steps to equalise treatment for gay couples," Ms Gillard said."

The market for kidneys in Iran

The Iranian economist Farshad Fatemi at the Sharif University of Technology sent me this link to his very interesting working paper The Regulated Market for Kidneys in Iran.

Among other things, it is full of institutional detail and comparisons. Here are a few things that caught my eye.

Comparing total (live plus deceased) kidney donation across countries, per million population, the most recent figures (from 2007) are Iran 27.1%; UK 33.5%; Spain 49.5%; US 54.7%. (His source is the Barcelona-based Transplant Procurement Management Organization, whose international database I have yet to fully explore.)

His description of the market for kidneys in Iran includes the following

"After the donor passes the initial tests, the administrators contact the first patient in the same waiting list as the donor’s blood type [and other components of a match]...
If the patient who is on the top of the waiting list at the moment is not ready for the transplant ..., the next patient will be called... until a ready patient will be found. Then a meeting between the two parties is arranged (they are provided with a private area within the foundation building if they want to reach a private agreement) and they will be sent for tissue tests. If the tissue test gives the favourable result, a contract between the patient and the donor will be signed and they will be provided with a list of the transplant centres and doctors who perform surgery.
When the patient and the donor are referred to transplant centre, a cheque from the patient will be kept at the centre to be paid to the donor after the transplant takes place. The guide price has been 25m Rials (≈ $2660) until March 2007 for 3 years and at this time18 it has been raised to 30m Rials (≈ $3190). This decision has been made because the foundation was worried of a decreasing trend in number of donors.

"In some cases, the recipient will agree to make an additional payment to the donor outside the system; it is not certain how common this practice is, but according to the foundation staff the amount of this payment is not usually big and is thought to be about 5m to 10m Rials (≈ $530 to $1060). The recipient also pays for the cost of tests, two operations, after surgery cares, and other associated costs (like accommodation and travel costs if the patient travels from another city). Insurance companies cover the medical costs of the transplant and the operations are also performed free of charge in state-owned hospitals.
"In addition, the government pays a monetary gift to the donor for appreciation of her altruism (currently, 10m Rials), as well as automatic provision of one year free health insurance, and the opportunity to attend the annual appreciation event dedicated to donors...
"The minimum monthly legal wage for 2007 was Rials 1,830k (later raised to 2,200k for 2008). The minimum payment of Rials 45m is around 2 years of minimum wage. "
...
"[T]o prevent international kidney trade, the donor and recipient are required to have the same nationality. That means an Afghan patient, who is referred to the foundation, should wait until an Afghan donor with appropriate characteristics turns up. This is to avoid transplant tourism. "
...
"the donors are mostly men (Table 7). This can be because of the two facts. Firstly, the ages between 22 and 35; when the donation is accepted; is the fertility age; and women are less likely to be considered as potential donors. Secondly, as we mentioned before since men are supposed as the main breadwinner of the family, it is more likely that they sell their kidneys in order to overcome financial difficulties. Female donors count for around 18% of traded kidneys in our data; it is in contrary with the Indian case where 71% of the sold kidneys were from female donors (Goyal et al. 2002)."

In his sample of 598 transplants (Table 6), 539 were "traded kidneys," 10 "non-traded" and 49 "Cadaver", i.e. the vast majority of kidney transplants were live donor transplants with compensation to the donor.

Market for prayers in Iran

It's not just kidneys; selling prayers in Iran isn't repugnant either.

In Islamic Iran prayer sellers' trade is booming
"TEHRAN (Reuters Life!) - In Islamic Iran where clerics rule, unofficial "prayer sellers," who promise to intercede with the divine to solve all manner of life's problems, are seeing their business boom."
...
"Iran's clerics also believe in the power of prayer but they advise people against using prayers that lack a religious basis. Magic and superstition are both illegal under Islamic law.

"Writing prayers quoting Shia's immaculate Imams and receiving money for that has no legal obstacle," said Grand Ayatollah Lotfollah Safi Golpaygani when asked about the religious legitimacy of the prayer sellers. "

"But referring to prayers written by hustlers without reliable sources is not permitted, and getting money for those kinds of prayers is (religiously) forbidden," he told news website hawzah.net.

"Despite what Iranian clerics say, none of YaAli's customers ask him about the basis of his knowledge, which he says is founded on the Koran.

"It is not important where his knowledge comes from, I just want my problems to be solved," said Marjan, 24, who complains it is getting harder to see YaAli as customer demand increases."

A degree is a degree

"A degree is a degree! Whether fake or genuine, it's a degree! It makes no difference!" Baluchistan province chief minister Nawab Aslam Raisani, who claims a master's in political science, shouted at a gaggle of reporters Tuesday.

This insight is from the news report Fake degree scandal roils Pakistani politics.

(See my earlier post on the Market for bogus colleges.)

Espionage: the market for secret information

The newspapers this morning are full of stories about the arrest of eleven accused Russian spies, e.g. the NY Times reports In Ordinary Lives, U.S. Sees the Work of Russian Agents.
"They had lived for more than a decade in American cities and suburbs from Seattle to New York, where they seemed to be ordinary couples working ordinary jobs, chatting to the neighbors about schools and apologizing for noisy teenagers.
"But on Monday, federal prosecutors accused 11 people of being part of a Russian espionage ring, living under false names and deep cover in a patient scheme to penetrate what one coded message called American “policy making circles.” "

The story in the Harvard Crimson adds an interesting detail: Kennedy School Grad Arrested in Russian Spy Raid.
"Called the “Boston Conspirators” in a complaint filed in the U.S. District Court for the Southern District of New York, Heathfield and Foley are alleged to have met with a “former legislative counsel for US Congress” and a “member of faculty in economics.” The documents redacted the affiliation of the faculty member."

It's true that the publication process in Economics is ridiculously slow, but I thought the internet had removed the need for cells of long term sleeper spies to find out what's in our working papers...

Live kidney donation: how to ask in Chicago

Harvey Mysel, a kidney recipient who went on to found the Living Kidney Donor Network, writes to ask me to let readers know of two workshops he is offering in Chicago in July on Having your donor find you

Signaling you're not 'overqualified' in a recession

The Globe reports on Deflating credentials to land a job.

"As the tight job market forces the unemployed to apply for lower-level positions, more job seekers are “dumbing down’’ credentials, wiping graduate degrees and high-level experience off their resumes, recruiters say. Applicants say the idea is to get hiring managers to at least look at their resumes, instead of figuring someone with extra qualifications will demand a bigger salary or leave for a higher-level opportunity once the economy turns around."

...

“Somebody finds out you know that much more than they do, they get nervous,’’ Carroll said.

"That’s true, says Robert Akerlof, a post-doctoral associate at the MIT Sloan School of Management, who is working on a theory about how it can be difficult to maintain authority over overqualified workers if they think a job, or a boss, is beneath them.

"Dumbing down a resume is a way for job seekers to show that they are going to be respectful, said Akerlof, citing the “20 percent rule,’’ which states that bosses should be 20 percent smarter than their employees.

“I think it’s not so much that you’re lying about what your resume is, it’s that you’re trying to convey an appropriate attitude,’’ he said."

Misc. organ transplant links

A Review of Organ and Tissue Donation Procedures by the Royal Australasian College of Physicians nicely summarizes some of the different ways deceased donor organs are dealt with around the world.

The ‘blood group O problem’ in kidney transplantation—time to change? discusses the Eurotransplant Kidney Allocation System, which apparently allows some O kidneys to go to patients who aren't type O.

Mike Rees' revolution of non-simultaneous non-directed donor chains continues to bear fruit in unexpected ways: LOYOLA PROGRAM A RADICAL SHIFT IN LIVING DONOR KIDNEY TRANSPLANTS
"In a first, four people step forward to donate kidneys to complete strangers across the country with no strings attached."...
"It's extremely rare when someone asking for nothing in return steps forward at a hospital and offers to donate a kidney to a complete stranger.
What's rarer still is what has happened at Loyola University Medical Center -- four people have stepped forward and offered to donate kidneys to four complete strangers and none have asked for a thing in return.
"This is completely unique and totally unheard of," said Garet Hill, founder of the nonprofit National Kidney Registry, which coordinated the donations. "We have never had four donors from one institution come forward at one time to offer up kidneys for donation with no strings attached."
The selfless acts by the four have helped Loyola launch its Pay-it-Forward Kidney Transplant Program, the first of its kind in the Midwest, and the largest number of altruistic donors to ever begin such a program in the United States."

Here's a collection of kidney exchange stories and videos from MSNBC, some rather old: http://article.wn.com/view/2010/05/04/Kidney_swap_program_posts_high_success_rate/

And here's a live donor story: From Fear To Elation: Prepping To Be An Organ Donor

Deceased donor allocation policies are also a very big deal. Alex Tabarrok at MR has a thought provoking post on one aspect of the debate: Optimizing Kidney Allocation: LYFT for LIFE which touches on the issue of how it's often difficult to make changes in health care policy that aren't Pareto improvements, even if they are improvements by other measures.

Decent work research prize

When I read that the International Labour Organization had a Decent Work Research Prize, my initial thought was "finally, a research prize for the rest of us." (It's hard to do exceptional work, but doing decent work seems like an achievable goal...)

But that turns out to be a mis-reading: here's the beginning of the prize description.

"The ILO’s International Institute for Labour Studies has created a research prize to annually reward outstanding contributions to the advancement of knowledge on the ILO’s central goal of decent work for all."

That seems like a good goal too:)

Changing sexual mores in China

Swinger Tests China’s Sex Morals
"On Thursday, a court sentenced Mr. Ma to three-and-a-half years in prison, a severe penalty for a crime that the Chinese government calls “crowd licentiousness.” Mr. Ma, now China’s most famous swinger, remains defiant and plans to appeal, saying his sex life is his own business, not subject to the law as long as he causes no social disturbance, according to his lawyer, Yao Yong’an. "
...
"The case of Mr. Ma, who was arrested last August and went on trial last month, has drawn attention across China not only for its titillating details, but also because it also raises questions about an authoritarian government’s attempts to curb sexual freedom and limit privacy in a society where rapid economic growth and the ubiquity of the Internet have upended traditional values. "
...
"The Communist Party no longer maintains the kind of tight control over people’s private lives that it did decades ago. Yet, some officials still try to prosecute citizens based on laws that seem increasingly out of step with social mores. One example is criminal law 301, under which Mr. Ma and 21 fellow swingers were prosecuted, and which can result in a five-year prison term.
Chinese Internet users and even some official news organizations have debated the case."
...
"The law against group sex, generally interpreted by judges as involving three or more people, is left over from an earlier law against “hooliganism” that was used to prosecute people who had sex outside of marriage, Ms. Li said. The hooliganism law was scrapped in 1997. One notable swingers case took place in the early 1980s, when the leader of a swingers club involving four middle-aged couples was executed, she added.
At least three recent surveys have shown that prosecution of group sex does not enjoy widespread support today.
Several Chinese news Web sites posted editorials echoing that sentiment after the verdict was announced. "

Couples match

The University of Alabama at Birmingham magazine (June 2010) writes about the couples match: Match Making--Software Helps Medical Couples Stay Together

(Here's a paper with a more technical description of how the couples match works...

Roth, A. E. and Elliott Peranson, "The Redesign of the Matching Market for American Physicians: Some Engineering Aspects of Economic Design," American Economic Review, 89, 4, September, 1999, 748-780.,

and here's a paper that's about why it works as well as it does...

Kojima, Fuhito, Parag A. Pathak, and Alvin E. Roth, " Matching with Couples: Stability and Incentives in Large Markets," working paper, April 8 2010.)

NYU in Abu Dhabi

I've blogged before about the problems of establishing and maintaining universities in places whose culture may be antagonistic to university culture.

NYU seems to be attacking that from an interesting angle in it's Abu Dhabi venture, the modal student will be an American: N.Y.U. Abu Dhabi Scours Globe for Top Students

Abu Dhabi "...is where N.Y.U. will open a campus in September with an inaugural freshman class of 150 students from 39 countries."..."Although the students come from 39 countries, with 43 languages, about a third are from the United States. The next four biggest sources are the United Arab Emirates, China, Hungary and Russia. "
...
"Backed by the open checkbook of the Abu Dhabi government, the wealthiest of the seven United Arab Emirates, N.Y.U. Abu Dhabi scoured the planet for candidates. It called on the Institute of International Education, which administers the Fulbright scholarships, to help it identify 900 of the world’s top high schools, and then pressed the schools for their best students.
Though based in Abu Dhabi, students will be encouraged to spend time at some of N.Y.U.’s 16 other sites, on five continents — more traditional study-abroad centers with short-term or narrowly focused programs. In a promotional booklet, the university sketched out a hypothetical plan for film and media majors, with sojourns in Berlin, Buenos Aires, Prague and New York.
The project carries risks. While Abu Dhabi is a relatively modern, multicultural Muslim state, homosexual acts are illegal and the Internet is censored. And there is no guarantee that the seemingly limitless resources of its oil-rich government will remain so, given the precarious global economy and Middle East politics.
But the Abu Dhabi government has agreed to pay for the entire N.Y.U. project, though neither it nor the university has detailed a price. And the emirate has embraced N.Y.U.’s vision of a liberal arts institution with full access to ideas, books and the Internet. "
...
"Some in the new freshman class, including Mr. Aqel, have already used Facebook to discuss a possible civil rights club. “In a way, it’s almost a challenge because we can’t hold protests,” Mr. Aqel said. “But I think we’ll be able to find creative ways to circumvent restrictions while maintaining respect for our host country.” "

You can pick up the thread of previous posts here: Universities and culture.

Debra Satz on noxious markets

The Stanford class day speech: Satz to graduates: Some goods should never be for sale by Stanford philosopher Debra Satz, whose interests extend to sales of kidneys

Debra Satz (2008). The Moral Limits of Markets: The Case of Human Kidneys. Proceedings of the Aristotelian Society 108 (1pt3):269-288.

From the news story on her class day address:

"What are the different characteristics of markets? Why do some exchanges prompt "extreme revulsion"? Among the examples Satz raised: child labor, body parts, reproductive services, international arms, addictive drugs.
"What makes particular markets appear undesirable or, in my terminology, noxious?" she asked. The intrinsic nature of certain goods – friendship, a person's good name, various prizes and honor – can immediately diminish their value when they are sold.
There are also extrinsic reasons that make markets noxious, and this was Satz's focus. Is the agent fully aware of the consequences of his or her actions? Do all agents have the same information? Does the market cause extreme harm to individuals? And how extreme does it have to be to make it noxious? Does it cause harm to society?
As Satz said – with a nod to Tolstoy's line about unhappy families – "Each noxious market is noxious in its own way," and there will not be agreement on these issues. For example, the sale of kidneys is among one of the most difficult questions. Sales are illegal in every developed society, she said. Kidneys can be donated altruistically while the donor is alive or after death, but no society makes donation mandatory, even in death. Some would argue that with two kidneys people have more than they need. As of June 10, more than 80,000 Americans were on the waiting list for a kidney, and many of them will die waiting, Satz said. "...

"In closing, Satz threw up two final challenges: "Noxious markets" reflect some of the most fundamental problems of our globe, and they will not go away unless and until the underlying problems are addressed. That will require public debate and a willingness to confront hard issues."

HT: Michael Ostrovsky

And here's Megan McArdle on Satz: What We Should Feel and What We Should Not Sell

She quotes Satz's book Why Some Things Should Not Be for Sale: The Moral Limits of Markets on the following juxtaposition of moral positions:

"[T]here is a dilemma for those who wish to use the mother-fetus bond to condemn pregnancy contracts while endorsing a woman's right to choose an abortion. They must hold it acceptable to abort a fetus but not to sell it."

Lotteries for private schools

Over at the Education Sector, there's a movie review about school choice.

Analysis and Perspectives » What We're Watching » Tough Luck
A review of the film 'The Lottery'
Authors:
Chad Aldeman
Erin Dillon
Publication Date:
June 8, 2010

"The Lottery" (2010), directed by Madeleine Sackler. The film opens to a wider audience on June 8. For theater listings, visit: http://www.screenvision.com/s/showing/TheLottery/.


"Newark, N.J., Mayor Cory Booker supports charter schools. But he might hesitate before encouraging everyone to see the new documentary "The Lottery," which follows four young children and their families as they vie for a spot at Harlem Success Academy, a coveted charter school across the river in New York City. In the film, Booker says he no longer attends the lotteries that over-subscribed charter schools like Harlem Success Academy use to select students because they break his heart, and because "a child's destiny should not be determined on the pull of a draw."


"Many who see "The Lottery" will likely share Booker's conflicted feelings. The film does an excellent job of showing both the promise and the limits of charter schools and public school choice. When Booker uses the word "destiny," he's not exaggerating; the families feel that winning or losing this lottery will go a long way to determine their child's future. As one prospective Harlem Success parent says in the film, "They instill in those kids from the beginning that 'my goal is to become a college graduate.' I think that if I had had that type of setting ... I think that would have made a big difference in my life."


"And yet, it's no spoiler to alert audience members that some of the families profiled will lose the lottery; more than 3,000 families apply for 475 seats. Those who stay to attend a neighborhood school will be assigned to one of 23 elementary schools. At 19 of these schools, fewer than half of the students are reading on grade level. In contrast, at Harlem Success Academy, 95 percent of third-graders read at grade level, and 100 percent score proficient on the state math exam. Thus, the stakes for these four particular families are high.


""The Lottery's" strength is in showing the audience the school choice process through the eyes of these families..."

Misc. non-simultaneous kidney exchange chains

Allegheny General part of multistate kidney exchange
Wednesday, April 14, 2010, By Jill Daly, Pittsburgh Post-Gazette
"Twelve donors and 12 recipients with advanced renal disease will be part of the chain when it is completed."

A discussion in the Student BMJ of kidney exchange in England: Would you donate your kidney to a stranger? Donors give a kidney to strangers in paired, pooled, and chain kidney transplants

A big kidney exchange involving four DC area hospitals, organized at Georgetown U. Hospital, including a June 15 video on the Early Show with the crowd of patients and donors.

The National Kidney Registry, a private organization, has generated a report about some of their successful activities in organizing kidney exchanges in partnership with a number of hospitals, including many nonsimultaneous chaings: The National Kidney Registry: transplant chains--beyond paired kidney donation by Veale J, and Hil G., Clinical Transplants. 2009:253-64. [I haven't been able to find the whole article yet: Pub Med lists it as "in process," but here's the abstract:]
"Abstract: The National Kidney Registry (NKR) has facilitated more than 100 transplants at 24 centers in the past 2 years and the numbers are rapidly increasing. The NKR has inherent capability for rapid change as innovations are developed and incorporated in the approach to matching donors and recipients in transplant chains. Kidneys are shipped with geotracking devices utilizing existing OPO procedures whenever patients are willing to accept them. This reduces the need for donor travel and increases the geographic area where matches can be made. Out-of-sequence transplants can be performed to improve logistics. Matching software is designed to facilitate chain transplantation and incorporates metrics that help transplant centers develop strategies to improve the chances that their patients can be transplanted. Daily match runs and close attention to repairing broken chains have been critical to growing the number of transplants that can be facilitated. A number of new innovations are expected to increase the opportunities for patients and their potential living donors."

See a chain of stories on chains here.

Father's day

Father's Day is a great academic holiday, if you think of academics as being concerned not just with ideas and institutions, but with their whole history and earliest conception. Other kinds of coauthors sometimes have difficulty figuring out who did what. But my wife agrees that my contributions were seminal. She was the biggest contributor in the subsequent, germinal stages. The division of labor has been less clear in the happy, fast decades since.

Happy Fathers' Day to all you fathers and children out there.

Indian weddings in New England: the hotel market

The Boston Globe reports: For hotels, a perfect match--Recession-hit hosts embrace Indian weddings.

"On a hot, sunny Saturday in early May, a raucous wedding procession of women in bright, shimmery saris and men in long embroidered kurtas and sunglasses danced through a hotel parking lot behind a van blaring bhangra beats. The groom brought up the rear on a dappled white horse.

"It was the first time the Marlborough Best Western had hosted a traditional Indian wedding and, in keeping with Indian culture, it was an elaborate, all-day affair, with 450 guests.

"Best Western is among the many hotels actively pursuing this lucrative market as they struggle to make up for last year’s recession-diminished revenues.

"The InterContinental Hotel, the Ritz-Carlton, the Taj Boston, and the Westin in Waltham have all hosted Indian wedding expos in the past year. Hyatt Hotels Corp. developed an Indian wedding webinar to educate staff about ceremonial customs, cuisine, even popular brands of alcohol.

"And India New England, a newspaper published in Waltham, has had so much demand from advertisers that it put out two wedding supplements instead of one last year and plans to do the same this year.

“Literally, this market is just exploding,’’ said publisher Upendra Mishra."

..."The weddings, [wedding planner and decorator Shobha Shastry] said, typically range from $50,000 to $150,000 and can go as high as $300,000.

"The average cost of a wedding in Massachusetts, by comparison, is closer to $30,000, according to the research company the Wedding Report Inc."

..."There are about 1,500 Indian weddings a year in the region, according to India New England — more than double the number 10 years ago."

Unraveling of day care

The WSJ reports on the increasingly early reservations being made for day care:Day Care? Take a Number, Baby

"These days, many parents are so intent on getting high-quality care for their kids, that they are signing up at popular child-care centers at the moment they know they are expecting a baby—or before. Some child-care centers don't even offer applications, but merely hand parents a wait-list form. That means some kids spend the first two years of their lives on a day-care wait list.

"With more women than ever in the work force, many of the country's roughly 11,000 nationally accredited child-care centers are full to capacity. The rules governing wait lists are roughly the same for all of them: Slots are assigned on a first-come, first-served basis. Infant care usually has the longest wait lists. Siblings of children who are already enrolled typically get first dibs on openings, to keep families together.

"Even so, the decision-making process behind filling these coveted slots is complex.

"Directors must match up age groupings so classmates' napping and eating routines are similar. And they must coordinate children's admission to match the unpredictable "graduation" dates of older children.

"To secure a slot, directors advise wait-listing your child at least a year or more before you expect to need care. Jessica Cavens put her baby-to-be on a child-care wait list last August, as soon as she got the results of her home-pregnancy test. The child-care center director got the good news even before the baby's grandparents. Now, one year later, Ms. Cavens's baby, Peyton, has been promised a coveted slot in August in the infant-care room at Primrose School at Stapleton, Colo.

"Some child-care centers allow parents to wait-list children not yet conceived. At centers franchised by Goddard Systems Inc., with 362 schools in 37 states, directors generally accept a wait-list entry before conception as long as parents pay a refundable deposit, usually of about $200, says Joseph Schumacher, chief executive of the King of Prussia, Pa., company.

"Other directors accept wait-list entries with no questions asked. "I can't do a pregnancy test," says Vallerie Tribble, director of Innovation Station Child Development Center, Alexandria, Va., owned by Bright Horizons Family Solutions, Watertown, Mass.

"Alyssa Soper, director of Bright Horizons at the Prudential Center in Boston, where wait lists are about a year long, says she gets wait-list requests from families who say "they're trying or thinking about" having a baby.

"It pays to enroll all your kids at the same center. Even signing up an older sibling for after-school care or summer camp at your target center may be enough to earn his or her younger sib a slot."

HT: Benjamin Kay at UCSD

Misc. kidney exchange news

A May 17, 2010 story: Innovative Transplant Procedure at Emory Opens Door to More Patients in Need

"The Emory Transplant Center at Emory University Hospital in Atlanta has recently opened its innovative Paired Donor Kidney Exchange Program, providing greater hope for patients in need of kidney transplants."
...
"Dr. Newell and his team this past month completed the third paired donor exchange surgeries involving a total of six patients - three donors and three recipients - from Texas, Colorado and Georgia. As part of this, as well as one of the two previous exchanges, Emory partnered with the Texas Transplant Institute in San Antonio, the largest independent paired donor program in the country. The program is led by Adam Bingaman, MD, a former Emory trainee who completed both his residency in general surgery and his PhD work at Emory School of Medicine. "To get the ball rolling initially on our program here at Emory, one of the first things we did was partner with the Alliance for Paired Donation," says Dr. Newell. "APD maintains a database of patients who have incompatible donors from over 50 other transplant centers, and the Alliance runs a computer program once a month to find matches between them.
"After about a year, we decided to focus on developing our own database rather than depending on APD's, and we naturally approached Dr. Bingaman about collaborating," says Newell. "Now, building our own listing of donor-recipient pairs remains paramount, an effort expedited by weekly meetings and consultations. Whenever new candidates are added, the data is shared with Dr. Bingaman's program, further increasing each patient's chance of receiving a compatible kidney from a living donor.""

Here's a paper in the June 2010 American Journal of Transplantation:
Ethical Considerations for Participation of Nondirected Living Donors in Kidney Exchange Programs
E.S. Woodle, J. A. Daller, M. Aeder, R. Shapiro, T. Sandholm, V. Casingal, D. Goldfarb, R. M. Lewis, J. Goebel and M. Siegler ; for the Paired Donation Network

ABSTRACT Kidneys from nondirected donors (NDDs) have historically been allocated directly to the deceased donor wait list (DDWL). Recently, however, NDDs have participated in kidney exchange (KE) procedures, including KE 'chains', which have received considerable media attention. This increasing application of KE chains with NDD participation has occurred with limited ethical analysis and without ethical guidelines. This article aims to provide a rigorous ethical evaluation of NDDs and chain KEs. NDDs and bridge donors (BDs) (i.e. living donors who link KE procedures within KE chains) raise several ethical concerns including coercion, privacy, confidentiality, exploitation and commercialization. In addition, although NDD participation in KE procedures may increase transplant numbers, it may also reduce NDD kidney allocation to the DDWL, and disadvantage vulnerable populations, particularly O blood group candidates. Open KE chains (also termed 'never-ending' chains) result in a permanent diversion of NDD kidneys from the DDWL. The concept of limited KE chains is discussed as an ethically preferable means for protecting NDDs and BDs from coercion and minimizing 'backing out', whereas 'honor systems' are rejected because they are coercive and override autonomy. Recent occurrences of BDs backing out argue for adoption of ethically based protective measures for NDD participation in KE.

Paying It Forward
Tulane surgeons performed what is believed to be the first “domino” paired-donor kidney exchange in Louisiana at Tulane Medical Center. Three patients in dire need of a kidney transplant received new organs from people they had never met.