Pilot training for clinical research professionals in using empathy to recognize and respond to implicit bias in research recruitment and retention.

Recruiting and retaining research participants is challenging because it often requires overcoming structural barriers and addressing how histories of mistrust and individuals' lived experiences affect their research engagement. We describe a pilot workshop designed to educate clinical research professionals on using empathy skills to recognize and mitigate bias to improve recruitment and retention. In a post-workshop survey (22/31 participants completed), 94% agreed the workshop helped them practice perspective-taking, recognize implicit bias, and identify opportunities for empathy.

The development of a clinical research educational training for community health workers using the joint task force for clinical trial competency framework.

The NYU Clinical & Translational Science Institute, in collaboration with a number of community-engaged initiatives, developed a training for community health workers (CHWs) to enhance health literacy about clinical research. This innovative research training provides CHWs with a basic level of competency in clinical research to convey the importance of research to communities and better advocate for their health needs. CHWs are an underutilized resource to engage diverse populations in clinical research.

Early reading at first grade predicts adult reading at age 42 in typical and dyslexic readers.

Research indicates that the achievement gap in reading between typical and dyslexic readers is already evident in first grade and persists through adolescence. However, it is not known whether this reading gap persists into adult life. In this report we use an epidemiologic sample of 312 children (typical readers = 246; dyslexic readers = 66), followed longitudinally from age 5 through adulthood and examine two fundamental questions: 1) Is reading level in 1 grade predictive of reading proficiency in adulthood in typical and dyslexic readers? and 2) Are the trajectories of reading development from 1 through 5 grade predictive of reading proficiency in adulthood in typical and dyslexic readers? Our findings indicate that early reading levels in 1 grade as well as the trajectory of reading development through the first five years of school were associated with reading scores in adulthood.

Ten Years Later: Reflections on Critics' Worst-Case Scenarios for the Affordable Care Act.

The primary goals of the Affordable Care Act (ACA) were to increase the availability and affordability of health insurance coverage and thereby improve access to needed health care services. Numerous studies have overwhelmingly confirmed that the law has reduced uninsurance and improved affordability of coverage and care for millions of Americans. Not everyone believed that the ACA would lead to positive outcomes, however.

Developmental trajectories of white matter structure in children with and without reading impairments.

Left temporal-parietal white matter structure is consistently associated with reading abilities in children. A small number of longitudinal studies show that development of this area over time is altered in children with impaired reading. However, it remains unclear how brain developmental patterns relate to specific reading skills such as fluency, which is a critical part of reading comprehension.

Identifying atypical change at the individual level from childhood to adolescence.

Identifying change at the individual level is an important goal for researchers, educators, and clinicians. We present a set of statistical procedures for identifying individuals who depart from a normative change. Using Latent Change Scores models (LCS), we illustrate how the Individual Likelihood computed from a statistical model for change (IL) and from an alternative unrestricted model (ILsat) can be used to identify atypical trajectories in situations with several measurement occasions.

Accuracy of Reported Community Diagnosis of Autism Spectrum Disorder.

To compare community diagnoses of Autism Spectrum Disorder (ASD) reported by parents to consensus diagnoses made using standardized tools plus clinical observation. 87 participants (85% male, average age 7.4 years), with reported community diagnosis of ASD were evaluated using the Autism Diagnostic Observation Schedule) (ADOS-2), Differential Ability Scale (DAS-II), and Vineland Adaptive Behavior Scales (VABS-II).

Employer-Sponsored Insurance Stable For Low-Income Workers In Medicaid Expansion States.

We assessed rates of employer health insurance offer, take-up, and coverage in June 2013 and March 2017 among workers. Overall, offer rates remained stable, and take-up and coverage rates increased. In Medicaid expansion states, the share of workers with family incomes at or below 138 percent of the federal poverty level who had employer-based coverage held steady, while uninsurance rates declined.

Early Experience with the ACA: Coverage Gains, Pooling of Risk, and Medicaid Expansion.

We provide an overview of the characteristics of those who have gained insurance coverage due to the ACA as well as the characteristics of the remaining uninsured. We also describe the implications for the broader sharing of health care risks required under the law, and how they vary by individuals' health status. Finally, we assess the implications of state decisions to expand or not expand Medicaid eligibility under the law, how those decisions affect state finances, health care providers, residents, and how the effects may vary for those states using waivers to expand eligibility using strategies designed to be more broadly politically acceptable.

Estimating the Counterfactual: How Many Uninsured Adults Would There Be Today Without the ACA?

Time lags in receiving data from long-standing, large federal surveys complicate real-time estimation of the coverage effects of full Affordable Care Act (ACA) implementation. Fast-turnaround household surveys fill some of the void in data on recent changes to insurance coverage, but they lack the historical data that allow analysts to account for trends that predate the ACA, economic fluctuations, and earlier public program expansions when predicting how many people would be uninsured without comprehensive health care reform. Using data from the Current Population Survey (CPS) from 2000 to 2012 and the Health Reform Monitoring Survey (HRMS) data for 2013 and 2015, this article develops an approach to estimate the number of people who would be uninsured in the absence of the ACA and isolates the change in coverage as of March 2015 that can be attributed to the ACA.

Achievement Gap in Reading Is Present as Early as First Grade and Persists through Adolescence.

Objectives: To determine if differences between dyslexic and typical readers in their reading scores and verbal IQ are evident as early as first grade and whether the trajectory of these differences increases or decreases from childhood to adolescence.

Study Design: The subjects were the 414 participants comprising the Connecticut Longitudinal Study, a sample survey cohort, assessed yearly from 1st to 12th grade on measures of reading and IQ. Statistical analysis employed longitudinal models based on growth curves and multiple groups.

An early look at changes in employer-sponsored insurance under the Affordable Care Act.

Critics frequently characterize the Affordable Care Act (ACA) as a threat to the survival of employer-sponsored insurance. The Medicaid expansion and Marketplace subsidies could adversely affect employers' incentives to offer health insurance and workers' incentives to take up such offers. This article takes advantage of timely data from the Health Reform Monitoring Survey for June 2013 through September 2014 to examine, from the perspective of workers, early changes in offer, take-up, and coverage rates for employer-sponsored insurance under the ACA.

Phase I study of 30-minute infusion of carfilzomib as single agent or in combination with low-dose dexamethasone in patients with relapsed and/or refractory multiple myeloma.

Purpose: Carfilzomib is an irreversible inhibitor of the constitutive proteasome and immunoproteasome. This phase I study evaluated the maximum-tolerated dose (MTD), pharmacokinetics, and pharmacodynamics of carfilzomib administered as a 30-minute intravenous (IV) infusion. Safety and efficacy of carfilzomib as a single agent or in combination with low-dose dexamethasone were assessed.

An estimated $84.9 billion in uncompensated care was provided in 2013; ACA payment cuts could challenge providers.

Millions of uninsured people use health care services every year. We estimated providers' uncompensated care costs in 2013 to be between $74.9 billion and $84.

The health reform monitoring survey: addressing data gaps to provide timely insights into the affordable care act.

The Health Reform Monitoring Survey (HRMS) was launched in 2013 as a mechanism to obtain timely information on the Affordable Care Act (ACA) during the period before federal government survey data for 2013 and 2014 will be available. Based on a nationally representative, probability-based Internet panel, the HRMS provides quarterly data for approximately 7,400 nonelderly adults and 2,400 children on insurance coverage, access to health care, and health care affordability, along with special topics of relevance to current policy and program issues in each quarter. For example, HRMS data from summer 2013 show that more than 60 percent of those targeted by the health insurance exchanges struggle with understanding key health insurance concepts.

Disruption of functional networks in dyslexia: a whole-brain, data-driven analysis of connectivity.

Background: Functional connectivity analyses of functional magnetic resonance imaging data are a powerful tool for characterizing brain networks and how they are disrupted in neural disorders. However, many such analyses examine only one or a small number of a priori seed regions. Studies that consider the whole brain frequently rely on anatomic atlases to define network nodes, which might result in mixing distinct activation time-courses within a single node.

Diffusion tensor imaging correlates of reading ability in dysfluent and non-impaired readers.

Many children and adults have specific reading disabilities; insight into the brain structure underlying these difficulties is evolving from imaging. Previous research highlights the left temporal-parietal white matter as important in reading, yet the degree of involvement of other areas remains unclear. Diffusion tensor imaging (DTI) and voxel-based analysis were used to examine correlations between reading ability and tissue structure in healthy adolescents and young adults (n=136) with a range of reading ability.

Why employers will continue to provide health insurance: the impact of the Affordable Care Act.

The Congressional Budget Office, the Rand Corporation, and the Urban Institute have estimated that the Patient Protection and Affordable Care Act (ACA) will leave employer-sponsored coverage largely intact; in contrast, some economists and benefit consultants argue that the ACA encourages employers to drop coverage, thereby making both their workers and their firms better off (a "win-win" situation). This analysis shows that no such "win-win" situation exists and that employer-sponsored insurance will remain the primary source of coverage for most workers. Analysis of three issues-the terms of the ACA, worker characteristics, and the fundamental economics of competitive markets-supports this conclusion.

How choices in exchange design for states could affect insurance premiums and levels of coverage.

The Affordable Care Act gives states the option to create health insurance exchanges from which individuals and small employers can purchase health insurance. States have considerable flexibility in how they design and implement these exchanges. We analyze several key design options being considered, using the Urban Institute's Health Insurance Policy Simulation Model: creating separate versus merged small-group and nongroup markets, eliminating age rating in these markets, removing the small-employer credit, and setting the maximum number of employees for firms in the small-group market at 50 versus 100 workers.

The 2007-09 recession and health insurance coverage.

Loss of employment and declining incomes meant that five million Americans lost employment-based health insurance during the recent economic recession (2007-09). All groups of Americans were affected, but the growth in the number of uninsured people was particularly noticeable for whites, native-born citizens, and residents of the Midwest and South. Adults did not benefit nearly as much as children from public programs designed to offset the decline in employer-sponsored insurance and thus bore all of the burden of rising uninsurance.

Uncoupling of reading and IQ over time: empirical evidence for a definition of dyslexia.

Developmental dyslexia is defined as an unexpected difficulty in reading in individuals who otherwise possess the intelligence and motivation considered necessary for fluent reading, and who also have had reasonable reading instruction. Identifying factors associated with normative and impaired reading development has implications for diagnosis, intervention, and prevention. We show that in typical readers, reading and IQ development are dynamically linked over time.

Enrollment is driving Medicaid costs--but two targets can yield savings.

This paper examines various reasons for the growth in Medicaid spending in the current decade. Although Medicaid spending has grown faster than the rate of increase in national health spending, much of this is explained by increased enrollment. Per enrollee, Medicaid spending actually compares favorably to increases in medical care prices and gross domestic product.