Saturday, June 25, 2022

San Francisco's Lowell High School admissions will return to merit-based system

 The SF Chronicle has the latest twist in this involved story over San Francisco's elite Lowell High School.

Lowell High School admissions will return to merit-based system after S.F. school board vote  by Jill Tucker

"After nearly two years of intense and bitter debate, test scores and grades will once again determine which San Francisco students are admitted to Lowell High School after the city’s school board decided to return to the merit-based admission system Wednesday.

"In a 4-3 vote, the school board decided to restore the previous merit process after two years of using a lottery-based system. The vote will now apply to freshman entering in the fall of 2023 as well as future classes, unless the board takes further action in the future to change the admission process.

...

"The board’s decision was the latest inflection point in the nearly two-year saga featuring feuding public officials, a lawsuit and accusations of racism over which students are eligible to attend Lowell, long considered one of the highest-performing public high schools in the country.

"The board first approved a switch to a lottery system in October 2020, citing a lack of academic data given the switch to distance learning earlier that year.

"A board majority then made that decision permanent four months later, citing a lack of diversity and racism at the elite academic schools. But the hurried vote sparked a lawsuit and then a judge’s ruling that the district violated laws related to the Brown Act, which regulate public meetings.

"The board then had to backpedal, reversing the decision before extending the lottery process for another year."

***********

Earlier:

Sunday, April 17, 2022

Friday, June 24, 2022

New York City school choice: increased use of lotteries in the news

The recent emphasis on lotteries in NYC school choice is discussed in the NY Times:

N.Y.C. Tried to Fix High School Admissions. Some Parents Are Furious. In an attempt to democratize schools, the city is focusing less on grades, attendance and test scores. Instead, it relies heavily on a lottery.  By Ginia Bellafante

"Some back story: Apart from what are known as the specialized high schools — hypercompetitive institutions like Stuyvesant and Bronx Science that, controversially, admit students on the basis of a single standardized test — the city gives eighth graders the option of applying to 160 screened high schools and programs that have their own criteria.

"Whether a student qualifies for one of these selective schools has typically depended on an opaque combination of grades, test scores (different from the ones used for the specialized high schools), essays, art portfolios and other work. The next step has students rank their preferences in descending order on a scale of one to 12, after which they are thrown into a lottery. A prizewinning algorithm developed to match medical students to residency programs then determines where a student is placed.

"Among high-achieving families in Manhattan, brownstone Brooklyn and many parts of Queens, the goal is not a spot in just any of the 160 schools but admission to eight or nine that are especially competitive, prestigious and largely dominated by white and Asian families. What has caused such ire in the current admissions cycle is that many parents discovered that their children — students with grade-point averages in the high 90s, for instance — were admitted to none of their ranked choices. Instead they would be funneled to schools they knew little about.

...

"The state exams, usually a determining factor in high school placements, had been abandoned during the pandemic. So, too, were attendance records. Students with grades in the mid-80s were now bundled with those who had much higher averages, meaning that an eighth-grader with an academically stellar record but a poor lottery number could easily lose out to a merely very good student with a great lottery assignation."

**********

Previous related posts:

Monday, April 18, 2022


Thursday, June 23, 2022

School Choice in Chile

 Here's a recent report on the implementation of centralized school choice in Chile.

School Choice in Chile by José Correa, Natalie Epstein,  Rafael Epstein, Juan Escobar, Ignacio Rios, Nicol ́as Aramayo, Basti ́an Bahamondes, Carlos Bonet, Martin Castillo, Andres Cristi, Boris Epstein, and Felipe Subiabre, OPERATIONS RESEARCH Vol. 70, No. 2, March–April 2022, pp. 1066–1087

Abstract. "Centralized school admission mechanisms are an attractive way of improving social welfare and fairness in large educational systems. In this paper, we report the design and implementation of the newly established school choice system in Chile, where over 274,000 students applied to more than 6,400 schools. The Chilean system presents unprecedented design challenges that make it unique. First, it is a simultaneous nationwide system, making it one of the largest school choice problems worldwide. Second, the system is used for all school grade levels, from prekindergarten to 12th grade. One of our primary goals is to favor the assignment of siblings to the same school. By adapting the standard notions of stability, we show that a stable assignment may not exist. Hence, we propose a heuristic approach that elicits preferences and breaks ties between students in the same priority group at the family level. In terms of implementation, we adapt the deferred acceptance algorithm as in other systems around the world."


"From a practical standpoint, a key lesson is that maintaining continuous communication and collaboration with policymakers is essential, as many practical issues arise and must be incorporated into the design. In addition, decomposing the implementation into a given number of steps allowed us to gain experience, solve unexpected problems, and continuously improve the system. "

Wednesday, June 22, 2022

Russian Journalist’s Nobel Medal Sells for $103.5 Million, with proceeds to UNICEF for Ukrainian refugees.

 The NYT has the story: it exemplifies quite a number of things (including jump bidding in a reserve price charity auction...)

Russian Journalist’s Nobel Medal Sells for $103.5 Million. Dmitri A. Muratov, the editor of the independent newspaper Novaya Gazeta, will donate proceeds to UNICEF to help Ukrainian child refugees.  By Kalia Richardson

"The Nobel Peace Prize put up for auction by the Russian journalist Dmitri A. Muratov to help Ukrainian refugees sold Monday night for $103.5 million to an anonymous buyer, obliterating the record for a Nobel medal.

"The proceeds from the auction will go to UNICEF to aid Ukrainian children and their families displaced by Russia’s invasion of their country.

"Mr. Muratov is the editor in chief of the independent newspaper Novaya Gazeta, which suspended publication in March in response to the Kremlin’s increasingly draconian press laws. In an interview with The New York Times last month, he said he was inspired to auction the award he won last year by the Danish physicist Niels Bohr, who sold his medal to help civilian relief in Finland following the Soviet invasion of that country in 1939.

...

"The previous record for auctioning off a Nobel medal came in 2014, when the prize belonging to James Watson, who shared in the discovery of the double-helix structure of DNA, sold for $4.1 million ($4.76 million, including the commission that goes to the auction house).

"Heritage Auctions, which handled the sale of Mr. Muratov’s medal, has sold five former Nobel Prizes, including the one awarded to Watson’s co-discoverer, Francis Crick. That medal sold for $2.27 million in 2013.

"Josh Benesh, the chief strategy officer for Heritage Auctions, which will not take a commission on the sale, said he was flabbergasted by the final price. The bidding had been mainly cruising along in increments of $100,000 or $200,000 when it suddenly spiked from $16.6 million to $103.5 million. Gasps filled the room when a Heritage Auctions employee manning the phone relayed the figure"

*********

Here's the Heritage Auction site:

 The Dmitry Muratov Nobel Peace Prize Charity Auction to Benefit UNICEF's Child Refugee Fund #790 / Lot #1

Here are some posts about earlier sales of Nobel prize medals, some by economists:

Saturday, October 26, 2019

Tuesday, June 21, 2022

Japanese court upholds ban on same sex marriage

 The Japan Times has the story:

In LGBTQ rights setback, Japan court says barring same-sex marriage not unconstitutional   June 20, 2022

"An Osaka court on Monday ruled that Japan's ban on same-sex marriage was not unconstitutional, dealing a blow to LGBTQ rights activists in the only Group of Seven nation that doesn't allow people of the same gender to marry.

"Three same-sex couples — two male, one female — had filed the case with the Osaka District Court, only the second case to be heard on the issue in Japan. In addition to rejecting their claim that being unable to marry was unconstitutional, the court dismissed their claim for ¥1 million per person in damages.

"The plaintiffs said they will appeal Monday's ruling to a higher court.

"The latest case revolved around the interpretation of marriage in Article 24 of the Constitution, which stipulates, "Marriage shall be based only on the mutual consent of both sexes and it shall be maintained through mutual cooperation with the equal rights of husband and wife as a basis."

Monday, June 20, 2022

Report of a SARS-CoV-2 human challenge trial. In Britain.

 The May issue of Nature Medicine reports what I am pretty sure was the first covid challenge trial. It was a small one, designed to track how the viral load develops after infection, to see how quickly tests detect infection, and to check procedures to pave the way for subsequent challenge trials.  Recall that a challenge trial, also called a human infection trial, is one in which the participants are deliberately exposed to the disease, and then reside in the hospital under close medical observation and care.

Killingley, B., Mann, A.J., Kalinova, M., Boyers, A., Goonawardane, N., Zhou, J., Lindsell, K., Hare, S.S., Brown, J., Frise, R. and Smith, E., 2022. Safety, tolerability and viral kinetics during SARS-CoV-2 human challenge in young adults. Nature Medicine, 28(5), May, 1031-1041.

"36 volunteers aged 18–29 years without evidence of previous infection or vaccination were inoculated with 10 TCID50 of a wild-type virus (SARS-CoV-2/human/GBR/484861/2020) intranasally in an open-label, non-randomized study (ClinicalTrials.gov identifier NCT04865237; funder, UK Vaccine Taskforce). After inoculation, participants were housed in a high-containment quarantine unit, with 24-hour close medical monitoring and full access to higher-level clinical care."

...

"Written informed consent was obtained from all volunteers before screening and study enrollment. Participants were given a donation of up to £4,565 to compensate for the time and inconvenience of taking part in the study (including at least a 17-day quarantine). This was calculated using the National Institute for Health Research (NIHR) formula and the UK national living wage."

Two of the volunteers were found to have previous antibodies, and of the remaining 34, 53% (18 people) were infected with the disease after 5 days.  

Here's a schematic of how the trial proceeded, starting with almost 27,000 people who volunteered online to participate in the trial, from which the final 36 participants were chosen.




In contrast, the Phase 3 clinical trial of the Pfizer vaccine had almost 22,000 people in the vaccine group and in the placebo group, and reported after four months that only 8  participants in the vaccinated group had contracted the disease, compared to 162 in the placebo group.  So the vaccine was 95% effective (only 5% of the 170 infections were in the vaccinated group).

Big (Phase 3) vaccine trials aren't comparable to small preliminary trials, so my point here is just that in the challenge trial the rate of infection of unvaccinated volunteers in 5 days is more than fifty times that rate over four months in the traditional clinical trial, in which participants go about their lives and get infected by chance.  That's one of the reasons that challenge trials offer the possibility of fast and efficient testing.

***********

When the study was completed, in 2021, the NY Times published a column with the headline

Britain Infected Volunteers With the Coronavirus. Why Won’t the U.S.?,  By Kate Murphy Oct. 14, 2021

It ended with the following paragraph:

"As one participant in Britain’s Covid human challenge trial put it: “You know the phrase ‘one interesting fact about yourself’ that strikes terror into everyone? That’s now solved forever. I did something that made a difference.”

***********

Of course challenge trials are controversial in lots of ways. See some discussion here of the ethics of paying challenge participants. 

Thursday, October 29, 2020

Paying participants in challenge trials of Covid-19 vaccines, by Ambuehl, Ockenfels, and Roth

"we note that increasing hourly pay by a risk-compensation percentage as proposed in the target article provides compensation proportional to risk only if the risk increases proportionally with the number of hours worked. (Some risky tasks take little time; imagine challenge trials to test bulletproof vests.) "

Sunday, June 19, 2022

Unraveling of MBA recruitment

 The WSJ has the story:

Some M.B.A.s Are Getting Job Offers Before They Step Onto Campus. Early recruiting—before students and prospective employers see how they take to business school—reflects the fierce competition for fresh talent in consulting.   By Lindsay Ellis

"Just getting accepted into business school is proving a career boost for some students, who are fielding offers from consulting firms before their M.B.A. programs even begin.

"Major consulting firms including Bain & Co. and McKinsey & Co. say they are offering some 2023 internships to students who don’t start business school until this fall. Some offers come with the promise of a full-time job after graduation in 2024.

...

"McKinsey began early recruiting last year after finding some of its recruiting prospects had already committed elsewhere, said Kristin Altenburg, an associate director of U.S. campus recruiting. "

Saturday, June 18, 2022

Conference on Mechanism and Institution Design July 11th to 15th, 2022 National U. of Singapore, online.

 Here's the announcement:

2022 Conference on Mechanism and Institution Design July 11th to 15th, 2022 

Department of Economics, National University of Singapore

Keynote Speakers: Fuhito Kojima, Dan Kovenock, Alessandro PavanRakesh Vohra

"The theme of the conference is on mechanism and institution design, interpreted in a general sense. The conference welcomes papers in all areas of economics, finance, information system, and politics, etc., which are related to mechanisms and institutions. The topics include but are not limited to game theory and foundations, asymmetric information, mechanism design, market design, information design, market and equilibrium, assignments, auctions, contests, bargaining, matching, college admission, election schemes, political institutions, sustainability, public good provision, nonlinear pricing, law and litigation, voting, sports, economic reform, comparative economics, regulation, taxation schemes, school choice, governance, corporate finance, cryptocurrency, financial institutions, capital structure, incentives in labor market, social choice, information and learning, decision theory, platform, network, etc. Papers can be theoretical, empirical, experimental, or historical. Young economists including senior PhD students are encouraged to submit their papers.

"Based on the feedback from the session organizers and individual submitters, we decide to hold the conference fully online this time."

Friday, June 17, 2022

ACM Conference on Economics and Computation (EC’22), June 28th through July 15th

 Nicole Immorlica sends this announcement:

The Twenty-Third ACM Conference on Economics and Computation (EC’22) is taking place virtually and physically from June 28th through July 15th and includes many events of interest, including some targeted to students and early-career researchers. Virtual registration is priced to make the conference broadly accessible (just $10 or free with ACM SIGecom membership for students). Register and join us for:

 

·  Virtual Conference Tutorials and Contributed Poster Session: June 28-July 1, 2022: tutorials on market design, search, crypto, and learning, as well as a selection of contributed research posters.

·  Virtual Preview Day, July 6, 2022: posters and lightning talks of accepted conference papers.

·  Virtual Mentoring Workshop: July 7, 2022: how-to talks, job market panels, and several small group and social activities.

·  In-Person Opening Reception: 6:00-8:30 PM MT, July 11, 2022

·  Hybrid In-Person & Virtual Conference Technical Program: July 12-July 14, 2022

·  Hybrid In-Person & Virtual Conference Workshops: July 15, 2022: workshops on contract design, market design, and revenue management.

 

We look forward to seeing you at EC’22! 

 Please reach out to sigecom-ge...@googlegroups.com with questions.


Thursday, June 16, 2022

Behavioral economics and market design are quite different -- Nick Chater and George Loewenstein reflect

 Experimental economics is one of the empirical foundations of what we now call behavioral economics.  Market design sometimes depends on experiments, and is sometimes behavioral.  And when behavioral economists talk about "choice architecture" there is a clear connection with market design, although market design focuses more directly on the 'rules of the game' than on the psychology of human behavior.  Despite the connections, the two fields always felt quite different.

Here's a new working paper by two eminent behavioral scientists, one trained as a psychologist and one as an economist, saying that behavioral economics is oriented to individual level behavior, which is quite different from system level design and behavior, and that it can be costly to mistake one for the other.

The i-Frame and the s-Frame: How Focusing on Individual-Level Solutions Has Led Behavioral Public Policy Astray  by Nick Chater and George Loewenstein

Abstract: An influential line of thinking in behavioral science, to which the two authors have long subscribed, is that many of society’s most pressing problems can be addressed cheaply and effectively at the level of the individual, without modifying the system in which individuals operate. Along with, we suspect, many colleagues in both academic and policy communities, we now believe this was a mistake. Results from such interventions have been disappointingly modest. But more importantly, they have guided many (though by no means all) behavioral scientists to frame policy problems in individual, not systemic, terms: to adopt what we call the “i-frame,” rather than the “s-frame.” The difference may be more consequential than those who have operated within the i-frame have understood, in deflecting attention and support away from s-frame policies. Indeed, highlighting the i-frame is a long-established objective of corporate opponents of concerted systemic action such as regulation and taxation. We illustrate our argument, in depth, with the examples of climate change, obesity, savings for retirement, and pollution from plastic waste, and more briefly for six other policy problems. We argue that behavioral and social scientists who focus on i-level change should consider the secondary effects that their research can have on s-level changes. In addition, more social and behavioral scientists should use their skills and insights to develop and implement value-creating system-level change.

**********

updated reference: Chater N, Loewenstein G. The i-frame and the s-frame: How focusing on individual-level solutions has led behavioral public policy astray. Behav Brain Sci. 2022 Sep 5:1-60. doi: 10.1017/S0140525X22002023. Epub ahead of print. PMID: 36059098.

**********

This is not the first time that G.L. has warned of this. Here's his 2010 NYT op-ed:

Economics Behaving Badly By GEORGE LOEWENSTEIN and PETER UBEL, July 14, 2010

"As policymakers use it to devise programs, it’s becoming clear that behavioral economics is being asked to solve problems it wasn’t meant to address. Indeed, it seems in some cases that behavioral economics is being used as a political expedient, allowing policymakers to avoid painful but more effective solutions rooted in traditional economics."

************

Here's a recent Social Science Bites podcast  in which GL is interviewed by David Edmonds. It touches on some of Loewenstein's vast accomplishments (he pioneered many of the most important topics in behavioral economics before they were widely recognized as important...). It focuses on the "empathy gap" that we exhibit when we fail to appreciate how we'll behave when we're in a different affective state. He also answers questions about where his ideas come from, and eclectic research methods.

George Loewenstein on Hot and Cold Affect

Wednesday, June 15, 2022

An unusual Argentine presidential candidate supports a monetary market for kidneys

 The right-wing Argentine politician,  Javier Milei, who describes himself as an anarcho-capitalist (but who the Washington Post thinks has a chance of becoming Argentina's next president, supports the sale of kidneys for transplantation. (The Buenos Aires Times describes him in general as an "outspoken provocateur.") While the election is only in 2023, this is the first time I have heard of this issue entering any sort of political campaign.

Here's the story in La Nacion, with some excerpts in rough translation by Google:

Javier Milei se manifestó a favor de la venta de órganos tras apoyar la compra libre de armas y denunciar a periodistas: “Es un mercado más”  2 de junio de 2022

"Javier Milei spoke out in favor of the sale of organs after supporting the free purchase of weapons and denouncing journalists: “It is one more market”

"In a week full of controversy for having denounced journalists and supported the free purchase of arms , the national deputy Javier Milei expressed another controversial opinion this morning: he declared himself in favor of the sale of organs . “It is one more market,” said the libertarian, who has already declared himself a presidential candidate for 2023.

"Asked about his position regarding this practice prohibited by law in Argentina, Milei said: “It is one more market and you could think of it as a market. The problem is why everything has to be regulated by the State.

...

"Later, he said that "there is probably something" that leads someone to decide to market their organs and under the assumption that this reason could be, for example, poverty, Milei indicated: "Then we are going to put it in other terms: if not you end up buying that organ, you end up starving and you don't even have a life."

*******

HT: Julio Elias

Tuesday, June 14, 2022

MR on repugnance for compensating blood donors, carried to an absurd conclusion

 Alex Tabarrock had a great post at MR the other day, via Peter Jaworski, called A Bloody Waste.

Here's how it began:

A Bloody Waste

"Hemochromatosis is a disorder in which extra iron builds up in the body. A potential treatment is phlebotomy so patients with hemochromatosis want to donate blood and donate regularly. The American Red Cross, however, does not permit people with hemochromatosis to donate blood. Why not? The blood is safe and effective. The blood of these patients doesn’t have much, if any, extra iron (the iron builds up in the body not so much in the blood per se). The “problem” is that people with hemochromatosis benefit themselves by giving blood and for this reason their blood is considered tainted by the American Red Cross."

Monday, June 13, 2022

Price gouging laws are unpopular with economists

 Chicago Booth's Initiative on Global Markets recently polled their panel of academic economists in the U.S. on whether a new law banning price gouging would be useful. Almost no one thought that would be a good idea:




Sunday, June 12, 2022

Who Benefits from Meritocracy? by Diana Moreira & Santiago Pérez

 Exams for U.S. civil service positions apparently started for some positions in 1883, and here's an NBER working paper that looks at the difference that made in the composition of people hired, by socioeconomic status.

Who Benefits from Meritocracy?  by Diana Moreira & Santiago Pérez

NBER WORKING PAPER 30113 DOI 10.3386/w30113 June 2022

Does screening applicants using exams help or hurt the chances of lower-SES candidates? Because individuals from lower socioeconomic backgrounds fare, on average, worse than those from richer backgrounds in standardized tests, a common concern with this "meritocratic" approach is that it might have a negative impact on the opportunities of lower-SES individuals. However, an alternative view is that, even if such applicants underperformed on exams, other (potentially more discretionary and less impersonal) selection criteria might put them at an even worse disadvantage. We investigate this question using evidence from the 1883 Pendleton Act, a landmark reform in American history which introduced competitive exams to select certain federal employees. Using newly assembled data on the socioeconomic backgrounds of government employees and a difference-in-differences strategy, we find that, although the reform increased the representation of "educated outsiders" (individuals with high education but limited connections), it reduced the share of lower-SES individuals. This decline was driven by a higher representation of the middle class, with little change in the representation of upper-class applicants. The drop in the representation of lower-SES workers was stronger among applicants from states with more unequal access to schooling as well as in offices that relied more heavily on connections prior to the reform. These findings suggest that, although using exams could help select more qualified candidates, these improvements can come with the cost of increased elitism.


From the conclusions:

"Our findings have implications for the broader debate on exams and meritocracy. Allocating opportunities based on exams is sometimes described as an equity-efficiency panacea, helping select the most qualified candidates while simultaneously increasing the representation of lower SES individuals. Our results challenge this view: although using exams could, in principle, help select more qualified candidates, we show that these improvements can also come with the cost of increased elitism. More generally, our findings show that adopting less discretionary selection criteria might not necessarily help the chances of lower-SES individuals.

...

"Importantly, while we investigate how exams shaped the social origins of government officials, an important question that remains unanswered is whether the poor themselves were on net made worse off by the reform. The answer to this question is not an obvious one for a variety of reasons. For instance, individuals from disadvantaged backgrounds might benefit the most from having a well-functioning state, even if achieving this efficiency implies that they might lose direct access to government jobs. "

***

This paper makes me think of an earlier paper, about the historical introduction and then abandonment of a national exam-based school choice system in Japan, where the result of national exams was that urban students filled more of the places...

Friday, February 21, 2020


Saturday, June 11, 2022

Harm reduction for drugs: an experiment in British Columbia

 Here's a news story in the Guardian, and the policy paper from British Columbia about the new efforts on harm reduction there.

Canada to decriminalize some drugs in British Columbia for three years. Policy aims to stem record number of overdose deaths by easing a fear of arrest by those who need help


Here's the official report of the Provincial Health Officer of British Columbia. I think the choice of cover picture does a good job of capturing the tension between treating drug users as criminals or as patients.

STOPPING THE HARM. DECRIMINALIZATION OF PEOPLE WHO USE DRUGS IN BC



Friday, June 10, 2022

Congratulations to Arthur Lee, on receiving the Anna Laura Myers Prize for Outstanding Honors Thesis

Arthur Lee received the Economics Department's Anna Laura Myers Prize for Outstanding Honors Thesis yesterday, for his thesis on school choice in Singapore:

A Multi-Phase School Choice Mechanism: Theory and Practice by Arthur Lee

Abstract: We study aspects of a multi-phase school choice system used to allocate students to primary schools (first to sixth grade) in Singapore. We first examine the institutional objectives and contextual constraints of the market. Using interviews and public sources, we then present evidence of strategic decision-making by parents, and outline common considerations they face. We then introduce a novel theoretical model of a sequential matching mechanism, and analyze its performance under uncertainty. We find that the sequential nature of the mechanism may permit equilibrium welfare improvements for students when compared to the static Boston Mechanism. However, we also find that in some important respects (e.g. stability of equilibrium outcomes), such a system may be less desirable than a slot-specific Deferred Acceptance mechanism, a variant of Deferred Acceptance that allows for quotas. We use empirical evidence to demonstrate, using a Regression Discontinuity Design (RDD) inspired approach, that many parents use prior year’s application information in strategic decision-making. We make partial progress towards additional empirical questions, such as explaining a spike in unassigned students in 2020. Finally, we use our data to provide recommendations for students and parents in their decision-making process.



Congratulations on a fine thesis, Arthur.

Thursday, June 9, 2022

What are (swim) tests for?

 Tests serve multiple purposes, they can be to screen, to certify, to incentivize.  In recent years we have seen concern about tests' differential predictive power for different groups of test takers lead to reduced use for screening, e.g. as SAT's have become optional for college admissions, or as the US Medical Licensing Exam (USMLE) step 1 is moving to pass/fail grades, to prevent its (over)use in screening medical students for residencies.

Here's a story in the Chronicle of Higher Ed on swimming tests being abandoned at colleges, most recently at Williams.  (It brought back memories of my own freshman swim test at Columbia in 1968... )

Race on Campus: Why Colleges Are Dropping Their Swim Tests by Adrienne Lu 

"Welcome to Race on Campus. At one point or another, about a quarter of American colleges required students to pass a swim test. Today, there are far fewer who do, but a few holdouts remain. One college dropped its requirement this month after examining data showing students of color were far more likely to need a remedial swim class. 

...

“Students expressed feeling shamed and punished for not knowing how to swim,” wrote D. Clinton Williams in an email to The Chronicle. Williams is director of the college’s Pathways for Inclusive Excellence and chairman of the Diversity Advisory Research Team, which studied the swimming requirement. “One student told her first-year adviser, ‘It’s like they are punishing the city kids.’

...

"Once common among American colleges, swimming requirements have been dwindling for decades. A 1997 survey by professors at North Carolina State University found only 5 percent of colleges had a swim-test requirement then, down from the 25 percent that once did.

...

"Concerns about how swim requirements affect students differently are not new. Hobart and William Smith Colleges dropped its requirement in 1994, calling it archaic, difficult to administer, and unfair to students who had no access to pools, according to a Chronicle article at the time. An op-ed in the student newspaper of Washington and Lee University last November argued that the university had “failed to consider racial, economic, and cultural barriers to swimming.”

"Jeff Wiltse, a professor of history at the University of Montana, who has published extensively on the history of swimming pools in the U.S., said Black Americans today are about half as likely to know how to swim as white Americans.

...

"According to the Centers for Disease Control and Prevention, drowning is one of the three leading causes of unintentional-injury death among Americans under 29 years old, and from 1999-2019, American Indian or Alaskan Native people died from drowning at twice the rate of non-Hispanic white people, while non-Hispanic Black people died from drowning at 1.5 times the rate."

*********

The Talmud (in a section that's not so easy to read, kiddushin 29a, concerned among other things with a father's obligations to a son) records this opinion: " And some say: A father is also obligated to teach his son to swim. "

Wednesday, June 8, 2022

What might the assisted reproduction gray market look like, post Roe?

 Yesterday I blogged about what might happen to the availability of abortion if it's constitutional protection is reversed so that individual states can ban it.  Today let's consider other medical issues involving conception, such as IVF, which involves creating embryos in Petri dishes. It may be at risk, state by state, if we find that embryos have legal rights.  But (like abortion), IVF is likely to remain legal in some states even if banned in others.

Here's an article in JAMA:

What Overturning Roe v Wade May Mean for Assisted Reproductive Technologies in the US, by I. Glenn Cohen, JD; Judith Daar, JD; Eli Y. Adashi, MD, MS, JAMA. Published online June 6, 2022. doi:10.1001/jama.2022.10163

"Across the US there exists a wide range of state laws (statutory and common law) regarding assisted reproductive technologies. For example, California courts essentially enforce agreements involving gestational surrogacy, whereas Nebraska treats such agreements as void and unenforceable and Michigan treats the creation of a commercial surrogacy agreement as a felony.

...

"The leaked opinion in the Dobbs case explicitly states that “to ensure that our decision is not misunderstood or mischaracterized, we emphasize that our decision concerns the constitutional right to abortion and no other right” and that “[n]othing in this opinion should be understood to cast doubt on precedents that do not concern abortion” after sentences that reference the Supreme Court’s pre-Roe constitutional cases regarding a constitutional right to use contraception.1 But on its face, the key piece of the reasoning of the Dobbs decision, that a “right to abortion is not deeply rooted in the Nation’s history and traditions,”1 would seem to apply with even more force to IVF, which was first used in the US in 1981, after Roe v Wade—and certainly was not present at the time of the framing of the Fourteenth Amendment (1868).

...

"A future Supreme Court opinion might easily group embryo destruction as more like abortion because of its involvement with the destruction of “potential life.” If anything, it is easier to see how the Supreme Court might reach such a decision because there is not a countervailing claim to a woman’s gestational bodily autonomy raised by, for example, a prohibition on IVF."

*********

States that make laws against IVF may have difficulty enforcing them if other U.S. states continue to have legal IVF.  Laws can of course claim to apply to their citizens wherever they are, but a woman who returns home, pregnant, from a jurisdiction with legal IVF will be very hard to distinguish from other pregnant women.  So it will be easier to shut down fertility clinics (or to ban the sale of contraceptives) within a state's boundaries than to prevent state residents who can afford it from going to a neighboring state to help them with family planning.  

Tuesday, June 7, 2022

What might the abortion gray market look like, post Roe?

 My favorite psychiatrist points out that, before abortions became generally legal except when the woman's life was at risk, psychiatrists were often called upon to make a decision.

The ‘Open Secret’ on Getting a Safe Abortion Before Roe v. Wade  By Sally L. Satel

"Dr. Satel is a visiting professor of psychiatry at Columbia and a senior fellow at the American Enterprise Institute."


"If the Supreme Court overturns Roe v. Wade, will psychiatrists resume their pre-Roe role as arbiters of abortion access? The law once compelled psychiatrists and pregnant women to perform dishonest rituals to get abortions. Will psychiatrists once again need to be complicit post-Roe?

"Before Roe v. Wade, a number of states allowed abortions if doctors could certify that the mother’s health, not solely her life, was at serious risk. A great number of those certifications were granted by psychiatrists, some of them by the professors who taught me as a resident in the mid-1980s in Connecticut.

"Through the 1940s and 1950s, medicine advanced to the point where health problems like heart disease and tuberculosis were generally no longer considered to be indications for therapeutic abortion. As a result, psychiatric justification became the primary rationale for therapeutic abortion before Roe.

...

"It was an “‘open secret,’” Dr. Richard A. Schwartz of the Cleveland Clinic observed in 1972, the year before Roe was decided, “that a woman can obtain a safe abortion in a licensed hospital if she can find a psychiatrist who will say she might commit suicide.

"To accommodate such women, psychiatrists used a combination of empathy and civil disobedience to declare them at risk unless they were allowed to terminate their pregnancies."

***

If the Supreme Court overturns Roe, laws about abortion will go back to the individual States. One difference from the pre-Roe environment is that there will now be probably around half of the states that will continue to allow legal (and hence safe) abortions.  So the gray market in states with abortion bans will also involve travel, for those who can afford it (and perhaps mail order pills for those well organized enough and for whom travel isn't a good option).


Monday, June 6, 2022

The return of convalescent plasma as a treatment for Covid

 As evidence accumulates, it appears that convalescent plasma helps some patients with Covid.  Here's an article from Medpage

COVID Convalescent Plasma Finds a Therapeutic Role. — Growing evidence shows benefits in the immunocompromised

by Arturo Casadevall, MD, PhD, Jeffrey P. Henderson MD, PhD, Brenda J. Grossman, MD, MPH, Michael J. Joyner, MD, Shmuel Shoham, MD, Nigel Paneth, MD, MPH, and Liise-anne Pirofski, MD June 19, 2022

"In the dark days of the early COVID-19 pandemic, when there was no known therapy, COVID-19 convalescent plasma (CCP) brought a ray of hope. COVID-19 survivors, community organizers, clinicians, regulators, and blood bankers collaborated to quickly bring CCP to patients. First used at the end of March 2020 in the U.S., 40% of all hospitalized patients were being treated with CCP by October 2020, considerable progress for a treatment without pharmaceutical industry support.

"Since those early days, CCP use has largely fallen off based on insufficient evidence of efficacy in hospitalized patients and the availability of other therapies. But growing evidence has shown benefits of CCP in a population with diminished treatment options and vaccine responses: the immunocompromised. This population encompasses about 3% of the population and their needs have been relatively neglected in treatment guidelines during the COVID-19 pandemic.

...

"As the pandemic progressed, further evidence showing that CCP was effective when used early and with high antibody content emerged, strengthening support for the FDA EUA in specific groups. However, with evidence of widespread benefit being considered insufficient in the broader patient population, CCP was largely branded as ineffective, collections dropped, and little or no CCP was available when Omicron surged in early 2022.

...

"The continued needs of immunocompromised patients and the discovery that CCP obtained from vaccinated convalescent donors possess extremely high levels of antibodies that neutralize all known variants to date, including Omicron, have promoted a CCP comeback. CCP use is now recommended for immunocompromised patients by multiple major professional organizations, including the Infectious Diseases Society of America (IDSA) and the Association for the Advancement of Blood and Biotherapies (AABB).

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Earlier:

Sunday, April 25, 2021