Percentage Of Enrollment Research Articles

Thirty-five Years of Reporting of Sex and Race in Clinical Studies of U.S. FDA-Authorized Orthopaedic Devices.

At the U.S. Food and Drug Administration (FDA), the mission of the Center for Devices and Radiological Health (CDRH) is to ensure that all patients and providers have timely and continued access to safe, effective, and high-quality medical devices and safe radiation-emitting products. Although the CDRH has observed enrollment differences in some clinical trials, no systematic analysis has been conducted regarding enrollment differences in baseline demographics, to our knowledge. The CDRH has summarized information on study participants and their baseline demographics in public-facing documentation for all authorized medical devices that involved orthopaedic clinical studies from 1985 to 2020. Descriptive analyses and exploratory statistical testing have been conducted to investigate the reported percentages by sex and race compared with those reported in the U.S. National Census and the American Joint Replacement Registry (AJRR), respectively. We identified 94 submissions and corresponding combined clinical trials from 261 original clinical study arms with 34,193 participants. Most of the submissions reported age and sex, while only 36 submissions (38.3%) reported racial demographics. Among the 88 trials providing enrollment by sex, the female enrollment percentage ranged from 22.2% to 88.7%, with a mean of 55.0%. In the submissions that reported racial data (38.3%), White and Black patients had a mean enrollment of 89.2% (range, 64.8% to 98.7%) and 6.2% (range, 0.4% to 20.7%), respectively. The enrollment for other minority groups ranged from 0% to 3.0%. These clinical trials have shown numerically lower female representation (55.0%) but higher White representation (89.2%) than what has been reported in the AJRR. The other racial groups have participated much less than their corresponding percentages in the U.S. population, but they are similarly represented in the AJRR. The clinical trials supporting the FDA's authorization of orthopaedic devices had a wide range of sex and racial enrollments. It appears that female enrollment mirrors the percentage of women in the U.S. population. However, despite prior efforts, some racial groups are still underrepresented. The FDA has made a commitment to advancing health equity as part of the 2022-2025 Strategic Priorities of the CDRH. We hope that the results of this study will help health-care professionals make informed clinical decisions when using medical devices.

A prospective non-randomized feasibility study of an online membership-based fitness program for promoting physical activity in people with mobility impairments

BackgroundPeople with mobility limitations have a disproportionately higher rate of acquiring secondary conditions such as obesity, cardiovascular comorbidity, pain, fatigue, depression, deconditioning, and type 2 diabetes. These conditions often result from poor access to home and community-based health promotion/wellness programs. The aim of this project was to determine the feasibility of delivering an online community membership-based fitness program for individuals with mobility impairments.MethodsFor this prospective single-arm study, participants were recruited from members of a community fitness facility that serves people with physical disabilities and chronic health conditions. While all members had access to the online platform, individuals had to opt-in to participate in the research component. Activity options included 16 pre-recorded videos and 9 live exercise classes. During the 8-week program, participants had an opportunity to earn three exercise incentives for reaching certain activity milestones. Enrollment percentage, attendance, and attrition were tracked to assess program feasibility and acceptability. Changes in participant-reported outcomes including self-reported physical activity, psychosocial outcomes, and health-related quality of life (HRQOL) were examined using non-parametric analyses.ResultsA total of 146 eligible individuals were screened of which 33 enrolled (22.6%). Two participants withdrew from the study, so a total of 31 were used for analyses. Participants included 29 women and 12 Black people with an average age of 60 (± 15.9) years. Health conditions included stroke, post-polio, arthritis, neuropathy, cerebral palsy, and obesity. Ten participants used an assistive device to get around inside the home. Twenty-six participants (78.8%) completed the online program, and 5 participants earned all 3 participation incentives. The mean number of live Zoom exercise classes attended by the participants was 12.8 (range = 0–43) over 8 weeks; 3 of 31 participants did not attend any classes. On average, participants watched 128 min (range = 0–704 min) of pre-recorded videos; 6 of 31 participants did not view any pre-recorded videos. Self-reported physical activity showed the largest improvement (11.15 units; 95% CI, 3.08, 19.56) with an effect size of 0.51 (Cohen’s d).ConclusionsThis pilot study of an online membership-based fitness program for people with mobility impairments demonstrated preliminary effectiveness in increasing physical activity and was found to be feasible and acceptable. Feasibility endpoints do indicate potential to improve retention. These results suggest that online delivery of exercise programs can broaden the reach of specialized community fitness programs and is a promising direction for future work and fully powered trials are warranted to assess intervention efficacy.Trial registrationClinicalTrials.gov, NCT05138809. Registered September 2, 2021, ClinicalTrials.gov PRS: Record Summary NCT05138809.

Enrollment of Black, Indigenous and People of Color (BIPOC) and female participants in the US diabetes trials spanning 2000 to 2020: A chronological survey

AimsLittle is known about the enrollment practice of both Black, Indigenous and People of Color (BIPOC) and females in the US diabetes trials. We aimed to perform a chronological survey to evaluate the enrollment of BIPOC and female participants in the US diabetes randomized controlled trials (RCTs) over the past two decades. MethodsWe searched databases to systematically include the US diabetes RCTs from 2000 January 1st to 2020 December 31st. Primary outcome was the adequate enrollment of both BIPOC and females, defined by the participation to prevalence ratio (PPR) > 0.8. We tested the temporal trend in adequate enrollment over time and used logistic regression analysis to explore the relationship between adequate enrollment and trial characteristics. ResultsA total of 69 US diabetes trials were included for analyses, with a median BIPOC and female enrollment percentage of 29.0 % and 45.4 % respectively. There were 22 (31.9 %) trials with adequate enrollment of both BIPOC and females. No significant trend of adequate enrollment percentage of BIPOC and females over time was observed (P = 0.16). Of trial types, those with medication interventions were significantly related to decreased odds of adequate enrollment, when compared to trials with non-drug interventions (odds ratio = 0.29, 95 % confidence interval: 0.11–0.84). ConclusionsLess than one third of the US diabetes trials adequately enrolled both BIPOC and females over the past two decades, and no temporal improvement in BIPOC and female participant enrollment was observed. These results highlight the need for more endeavors to mitigate inadequate representation regarding BIPOC and female enrollment in diabetes trials.

A systematic review of racial disparity in pivotal poly (ADP-ribose) polymerase (PARP) inhibitor trials.

e13737 Background: Breast cancer is the most common cancer diagnosed worldwide. Breast cancer related mortality has decreased in the US, however this did not extend equally to African American women (AAW). According to CDC mortality rate from breast cancer in AAW is 20% higher than other ethnic groups. Younger age at diagnosis in AAW, higher incidence of triple negative breast cancer (TNBC), and higher incidence of AA males with breast cancer suggest genetic predisposition plays an important role in the disparate outcomes based on race. In an unbiased analysis of TNBC cases, the prevalence of pathogenic germline BRCA 1 & 2 mutations are twice as high as in breast cancer overall. Poly (ADP-ribose) polymerase (PARP) inhibitors have proven to be effective in germline BRCA 1 and BRCA 2 mutation associated breast cancer. However, data regarding the enrollment of racial and ethnic minorities in these pivotal trials that lead to the approval of these drugs is limited. Methods: We examined the demographic data reporting in Phase II/ III clinical trials of PARP inhibitors in breast cancer from 2016 to 2023. In order to highlight the disparities in the enrollment of minority groups we calculated an enrollment percentage of various racial groups in these trials. We conducted a systematic review of Phase II/III clinical trials of PARP inhibitors in BRCA 1 & 2 mutated breast cancer reported studies with sources from PubMed, Embase, Scopus, Clinicaltrials.gov, CENTRAL and Cochrane. 56 full text studies were identified, out of which 14 met inclusion criteria. The total number of patients included was N=5,067. Five trials did not include racial data. Results: Among trials that reported race and ethnicity (N=4004), the enrollment percentage was lowest for racial and ethnic minorities. AA: 3.4%, N=136. Non- Hispanic Whites were the most common to be enrolled: 71.05%, N=2845, Asians were 16.53% N= 662, Hispanics 2.03 %; N=83 and other 6.17%, N=247. Conclusions: Racial minorities are consistently underrepresented in all the pivotal PARP inhibitor trials and contributing to the race-based disparities in breast cancer. [Table: see text]

PENTAGON (Predicting Clinical Trials in Gynecologic Oncology): A retrospective study assessing study design factors that affect enrollment in gynecologic cancer trials.

e13647 Background: Obstacles to attaining a diverse clinical trial population contribute to poor representation in medicine, increasing health disparities by limiting generalizability and applicability of findings. Our objective is to evaluate trial enrollment trends according to patient and trial demographics for those who have sought care at our multi-center, mixed-setting Gynecologic Oncology practice. Additionally, we aim to determine specific trial criteria that promote or impede enrollment for patients and physicians. Methods: An IRB-approved, retrospective cohort study evaluating all patients who screened positive for a clinical trial through the Gyn Onc practice’s manual screening process was performed. Screening events were new neoplasms, recurrences or progressions, and changes in treatment. Data was collected from July 2022 to December 2023. Demographic information, trials for which each patient was considered, trials patients enrolled on, and trial characteristics were recorded. Results: After adjustment, there were no significant differences between patient factors (age, marital status, race, ethnicity, and number of screening events) and enrollment status. Of trials available, 9% require biopsy and 94.7% are in person. Most studies are interventional (78.9%) and pharmaceutical trials (73.7%). There was a drastic unadjusted estimated increase in enrollment for Medicaid patients compared to other insurances (55.2% vs 32%, p=.031). There was also an increase in enrollment for cervical cancer patients (18.4%, p=.106) compared to other cancer sites (56.5% vs 32.8%, p=.036). There was a positive relationship between distance traveled to the treatment site and clinical trial enrollment. Patients who lived within 20 miles of the clinical trial site had an enrollment percentage of 30.1% (n=93), compared to 46.55% enrollment for those who lived further (n=58). There was a significant increase in enrollment likelihood without an exclusion criterion of previous history of other cancer (50% vs 33.3%, p=.046). Trials that required no history of chemotherapy had an enrollment of 27.3% (compared to 44.1%). Conclusions: Unlike prior reports, we did not demonstrate differences in trial enrollment by race, socioeconomic or insurance status. This suggests that our objective manual screening process enhances equitable clinical trial offerings. It is possible that this objective manual screening process attenuates provider bias and offers clinical trials to historically marginalized and underrepresented groups.

Kanyashree Prakalpa as a catalyzer for development of women’s education in West Bengal, India

Kanyashree Prakalpa initiative in advancing women's education in West Bengal, India. This study investigates the enrolment among female students at undergraduate and postgraduate levels before and after the implementation of Kanyashree Prakalpa in West Bengal and makes a comparison between enrolment before and after the implementation of Kanyashree Prakalpa. The methodological techniques used in this study are qualitative and documentary. Documentary analysis addresses the goals of the study by reviewing the available reports from the Department of Higher Education, Government of India's All-India Survey on Higher Education. Results showed that before the implementation of Kanyashree Prakalpa, the percentage of female enrolment fluctuated from around 43.94% to 53.85% at the undergraduate level and after the implementation of Kanyashree Prakalpa, the percentage increased, reaching as high as 59.04% in 2019-2020. At the post-graduate level before the implementation, the percentage of female enrolment fluctuated around 43.94% to 53.85%. After the implementation, the percentage increased, reaching as high as 59.04% in 2019-2020 at the postgraduate level. In conclusion, this research highlights Kanyashree Prakalpas as a promising model for the development of women's education and empowerment.

Cost-Effectiveness and Budget Impact Analysis of the Implementation of Differentiated Service Delivery Models for HIV Treatment in Mozambique: a Modelling Study.

In 2018, the Mozambique Ministry of Health launched guidelines for implementing differentiated service delivery models (DSDMs) to optimize HIV service delivery, improve retention in care, and ultimately reduce HIV-associated mortality. The models were fast-track, 3-month antiretrovirals dispensing, community antiretroviral therapy groups, adherence clubs, family approach and three one-stop shop models: adolescent-friendly health services, maternal and child health, and tuberculosis. We conducted a cost-effectiveness analysis and budget impact analysis to compare these models to conventional services. We constructed a decision tree model based on the percentage of enrolment in each model and the probability of the outcome (12-month retention in treatment) for each year of the study period-three for the cost-effectiveness analysis (2019-2021) and three for the budget impact analysis (2022-2024). Costs for these analyses were primarily estimated per client-year from the health system perspective. A secondary cost-effectiveness analysis was conducted from the societal perspective. Budget impact analysis costs included antiretrovirals, laboratory tests and service provision interactions. Cost-effectiveness analysis additionally included start-up, training and clients' opportunity costs. Effectiveness was estimated using an uncontrolled interrupted time series analysis comparing the outcome before and after the implementation of the differentiated models. A one-way sensitivity analysis was conducted to identify drivers of uncertainty. After implementation of the DSDMs, there was a mean increase of 14.9 percentage points (95% CI: 12.2, 17.8) in 12-month retention, from 47.6% (95% CI, 44.9-50.2) to 62.5% (95% CI, 60.9-64.1). The mean cost difference comparing DSDMs and conventional care was US$ -6 million (173,391,277 vs. 179,461,668) and -32.5 million (394,705,618 vs. 433,232,289) from the health system and the societal perspective, respectively. Therefore, DSDMs dominated conventional care. Results were most sensitive to conventional care interaction costs in the one-way sensitivity analysis. For a population of 1.5 million, the base-case 3-year financial costs associated with the DSDMs was US$550 million, compared with US$564 million for conventional care. DSDMs were less expensive and more effective in retaining clients 12 months after antiretroviral therapy initiation and were estimated to save approximately US$14 million for the health system from 2022 to 2024.

A Statistical Analysis and Comparison of Hispanic and White Student Graduate School Enrollment Trends from 2002 to 2018

ABSTRACT Using national data from the US Department of Education, Integrated Postsecondary Education Data System (IPEDS) and the US Census Bureau, trends in graduate school enrollment percentages for Hispanic and White students from 2002 to 2018 were analyzed and compared. Major findings from three regression analyses included: (1) a strong, statistically significant positive linear trend for Hispanic students, (2) a small, yet statistically significant, negative linear trend for While students, and (3) statistically significant differences between the Hispanic and White student regression lines, in both y-intercepts and slopes. Additional calculations with the two student regression equations revealed that convergence or equality in graduate school enrollment percentages will not occur until 2051, if current trends continue.

In Which Schools Does Police Presence Most Exacerbate Racial Differentials in Arrest?

This study looks at racial disproportionalities in student arrests, particularly with school police presence. This study extends Homer and Fisher’s (2020) work, which finds higher arrest rates and stronger effects of police presence for Black than White students across schools, by investigating school racial compositions and context factors that are associated with the strongest relationships between police presence and higher arrest rates of Black than White students. Results show the largest within-school arrest rate differences between Black and White students in high schools with officers and that schools with lower Black student enrollment percentages show larger Black-White student arrest gaps.

Discrepancies in Gender Representation Between Integrated and Independent Plastic Surgery Programs.

Despite increasing female representation in integrated plastic surgery training programs, independent programs have lower representation and slow improvement in female enrollment. Self-reported resident data were used to investigate trends of female representation in integrated and independent programs. Data were collected from Accreditation Council of Graduate Medical Education resources of active residents' characteristics. Self-reported gender data were collected for integrated, independent, and general surgery programs from annual reports since 2009. χ2 analysis was conducted to compare female enrollment of integrated programs, independent programs, general surgery programs, and general surgery programs with matriculation-year adjustment. In 2008, 89 independent programs had nearly identical percentage of female enrollment with 30 integrated programs at 23.8% and 23.1%, respectively. Differences in representation between independent and integrated programs became significant in 2012, with independent programs demonstrating 25.1% female enrollment compared with 30.5% in integrated programs. This trend of higher female representation in integrated programs has persisted since 2012. To correct for preexisting disparity in general surgery programs, we compared female enrollment of independent programs with female enrollment of that class' general surgery matriculation-year 5 years earlier. In all examined years, general surgery still had proportionally higher female enrollment compared with independent programs, even with conservative 5-year matriculation adjustment. Dramatic differences in female enrollment were found between integrated and independent programs, with representation in integrated programs rising more quickly. Adjustments for previous rates of female enrollment in general surgery did not yield explanation for low independent program enrollment. Increasing female representation in independent training models will continue to create a more diverse workforce.

Vocational education and training systems in Europe: A cluster analysis

European countries differ widely in terms of vocational education and training (VET) tradition and the delivery of VET at the upper secondary level. A statistical approach to build a classification of VET systems in Europe is presented in the present article on the grounds of the size of the vocational enrollment, on the one hand, and the percentage of vocational enrollment in programs in which work and school are combined, on the other hand. Twenty-two European countries with full available information are considered in the study: 18 European Union (EU) countries, three Schengen Area (non-EU) countries (Iceland, Norway, and Switzerland), and the UK (non-EU state outside Schengen). Cluster analysis is a quantitative form of classification. The country groupings emerging from the K-means analysis performed in this paper allow us to distinguish mainly between vocational-oriented countries with high vocational specificity (e.g. Germany, Switzerland, and Austria), highly vocational-oriented countries with traditionally school-based VET programs (e.g. the Czech Republic and Slovakia), and less vocationally-oriented countries (general education-oriented countries such as Estonia and Spain).

Systematic Review of Enrollment of Students With Disabilities in Charters Compared to Traditional Public Schools

There is a perception that charter schools in the United States enroll students with disabilities at a lower rate than traditional public schools despite federal laws that require charter schools to provide the same services as traditional public schools. This systematic review answers the question: What research exists that explores the representation of students with disabilities in charter schools and the proportionality of that representation in comparison to traditional public schools? The methodology for this review was based on the PRISMA (Preferred Reporting Items for Systematic review and Meta-Analyses) statement for reporting systematic reviews. Conclusions from this review include the limited amount of research on the topic, the difficulty of comparing enrollment percentages between state systems, and the difficulty in determining factors affecting the enrollment of students with disabilities in charter schools.

Dual Mode of Education and Prospects in Tertiary Level: Perspective the Private Universities in Bangladesh

Due to the COVID-19 pandemic, many educational institutes in Bangladesh were forced to adopt online technologies for conducting their classes and examinations. Internet-based video conferencing applications, such as Zoom, google-meet, Facebook Messenger, etc., became especially useful during the quarantine days. Within a few months, almost all private and public universities started conducting online classes without much directive or pressure from the government. Within a short period, all stakeholders, including teachers, students, and management, get used to these new systems despite many challenges. This study aims to focus advantages of online education over classroom education for effective learning for university-level students. This study tries to identify the advantages and disadvantages of this online-based education system over the classroom-based system at the tertiary education level. Data was collected from 400 students from different private universities in Bangladesh using a Stratified sampling technique. Results show that the most crucial advantage is the participation of students in the class, i.e., students' attendance. Other benefits are reduced costs, systematic arrangement of study materials, and mental peace for working students as they could continue studying and doing jobs simultaneously. Vis-à-vis the study reveals disadvantages like 'conducting the fair examination,' availability, affordability, and internet reliability. Finally, the study suggests that “a combination of online-based education and classroom-based examination," i.e., dual mode of education, can increase the percentage of student enrollment in tertiary education without compromising quality.

Racial Difference in Part D Enrollment and Survival Among Older Patients with Multiple Myeloma

Introduction Multiple myeloma (MM) is the second most common hematologic malignancy in the United States. African Americans (AAs) are disproportionately affected by MM.Previous studies found that among patients with MM, when having equal access to treatment, AAs had better survival than Whites. Oral agents, e.g., immunomodulatory drugs, play an active role in the treatment of both newly diagnosed and relapsed or refractory MM. For Medicare patients, these oral agents are covered by Part D only. However, little is known about the potential role of Part D enrollment in racial difference among older patients with MM. Methods Using the Surveillance, Epidemiology, and End Results-Medicare linked database, we conducted a population-based cohort study to assess the role of part D enrollment and race in MM survival. The study included AA and White patients with first primary MM (International Classification of Diseases for Oncology-3rd edition, 9732) who 1) were diagnosed from 2007-2017, 2) ages ≥ 66 years at diagnosis, and 3) had continuous Parts A & B enrolment and were not a member of HMO from 12 months before diagnosis to end of follow-up (death or 12/31/2019, whichever came first). Patients were categorized as ever or never enrolled in Part D. We applied a published algorithm to define smoldering and symptomatic MM patients. Our outcome of interest is overall survival. Cochran-Armitage trend test was used to test trend of Part D enrollment by year of diagnosis. Kaplan-Meier curves were generated, and log-rank tests were used for comparisons across groups. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated from a multivariable Cox proportional hazards model, adjusting for demographics, comorbidities, and socioeconomic factors. All statistical tests were two-sided with a type I error of 0.05 and were performed with SAS Version 9.4. Results The final cohort included 17,097 patients with a median follow-up of 2.64 (interquartile range [IQR] 0.81-4.78) years for 3,315 AAs and 2.58 (IQR 0.70-4.72) years for 13,782 Whites. The median age of AAs was 75 ([IQR 70-80) and of Whites 76 (IQR 71-82) years. Compared with Whites, AAs were more likely to be female, younger, unmarried, diagnosed in more recent years, had a high Elixhauser score, be frail, have state buy-in, and reside in census tracts with 20-100% population below poverty (all ps<.01). However, AAs were less likely to have a diagnosis of symptomatic MM (69.0% vs 71.0%, p=0.02). During the follow-up, 85.7% AAs and 78.1% Whites were ever enrolled in Part D (p<.01). Among both races, Part D enrollment increased over years (ptrend<.01). AAs had higher Part D enrollment percentage than Whites in both smoldering MM (AAs 88.8%, Whites 84.7%, p<.01) and symptomatic MM groups (AA 84.3%, Whites 75.4%, p<.01). The median survival was 3.05 (95% CI 2.85-3.24) years for AAs and 2.86 (95% CI 2.75-2.97) years for Whites (p<.01). Smoldering MM patients who ever had Part D enrollment had highest median survival; among these patients, AA had higher median survival (5.76, 95% CI 5.39-6.62 years) than their White counterparts (4.94, 95% CI 4.71-5.15 years; Figure 1). In the multivariable models, Part D enrollees (vs non-enrollees) had better overall survival (p<.01), and the interaction term between race and Part D enrollment was statistically significant for all patients (p=0.04) and smoldering patients (p<.01). As shown in Figure 2, among patients who were ever enrolled in Part D, compared to Whites AAs had lower risk of death (HR=0.88, 95% CI 0.83-0.93, p <.01), especially among smoldering MM patients (HR=0.78, 95% CI 0.70-0.87, p<.01). However, among patients never enrolled Part D, no difference on survival (HR=0.99, 95% CI 0.89-1.11, p=0.92) was observed. Conclusions Among patients who ever enrolled in Part D, AAs, especially with smoldering MM, had better survival than Whites, yet there was no racial difference in survival among patients who never had Part D coverage. A higher percentage of Medicare Part D enrollment in AAs than that in Whites may help explain the racial difference in survival observed in MM patients. Future research is needed to evaluate patterns of MM care by both race and Part D enrollment. Acknowledgement This study was supported by grant 1U01CA265735-01. The contents are solely the responsibility of the authors and does not necessarily represent the official views of funding agency. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Racial/ethnic disparities in the enrollment of Medication Therapy Management programs among Medicare beneficiaries with Alzheimer’s disease and related dementias

Objective Previous analysis of policy scenarios reported potential disparities in eligibility in the Medicare Medication Therapy Management (MTM) program. With recently released MTM data, this study aimed to determine if racial/ethnic disparities exist in MTM enrollment among Medicare beneficiaries with Alzheimer’s disease and related dementias (ADRD). Methods Medicare claims/records (from 2013–2014 and 2016–2017) linked to the Area Health Resources File were examined. Included individuals were patients with ADRD and diabetes, hypertension or hyperlipidemia. The proportions of MTM enrollment were compared between non-Hispanic White (White) patients and racial/ethnic minority groups in descriptive analysis. Racial/ethnic disparities were then examined using a logistic regression adjusting for patient and community characteristics. Disparities across study periods were compared by estimating a logistic regression model with interaction terms between dummy variables for each racial/ethnic minority group and 2016–2017. Results In unadjusted analyses, minorities had higher enrollment proportions than Whites. In 2016–2017, for example, enrollment percentages for Whites, Blacks, Hispanics, Asian/Pacific Islanders (Asians) and Others were respectively 14.44%, 16.71%, 19.83%, 16.66%, and 17.78%. In adjusted analyses, Blacks had lower enrollment odds than Whites within all cohorts. In the entire study sample in 2016–2017, for example, Blacks with ADRD had 9% lower odds of MTM enrollment (odds ratio 0.91, 95% confidence interval [CI] = 0.86–0.97) than Whites. These disparities decreased over time among the ADRD sample and all sub-groups. The interaction term between Blacks and 2016–2017, for instance, indicated that disparities were lowered by 11% (odds ratio 1.11, 95% CI = 1.05–1.16) across study periods among those with ADRD. Conclusions Blacks with ADRD, and diabetes, hypertension or hyperlipidemia have lower likelihood of MTM enrollment than Whites. Racial disparities were reduced over time but not eliminated.

Affirmative Action Bans and Enrollment of Students From Underrepresented Racial and Ethnic Groups in U.S. Public Medical Schools.

The percentage of U.S. physicians who identify as being from an underrepresented racial or ethnic group remains low relative to their proportion in the U.S. population. How this percentage may have been affected by state bans on affirmative action in public postsecondary institutions has received relatively little attention. To examine the association between state affirmative action bans and percentage of enrollment in U.S. public medical schools from underrepresented racial and ethnic groups. Event study comparing public medical schools in states that implemented affirmative action bans with those in states without bans. U.S. public medical schools. 21 public medical schools in 8 states with affirmative action bans matched to 32 public medical schools in 24 states without bans from 1985 to 2019. Percentage of total enrollment from racial and ethnic groups underrepresented in medicine (Black, Hispanic, American Indian or Alaska Native, and Native Hawaiian or other Pacific Islander). The percentage of enrollment from underrepresented racial and ethnic groups was 14.8% in U.S. public medical schools in the year before ban implementation in states with bans. The adjusted percentage of underrepresented students in ban schools decreased by 4.8 percentage points (95% CI, -6.3 to -3.2 percentage points) 5 years after ban implementation relative to the year before implementation, whereas the adjusted percentage in control schools increased by 0.7 percentage point (CI, -0.1 to 1.6 percentage points), for a relative difference, or difference-in-differences estimate, of -5.5 percentage points (CI, -7.1 to -3.9 percentage points). Inability to account for the effect of these bans on undergraduate enrollment. State affirmative action bans were associated with significant reductions in the percentage of students in U.S. public medical schools from underrepresented racial and ethnic groups. None.

Middle School Music Uptake and Achievement: Evidence From the 2016 Arts National Assessment of Educational Progress

The purpose of this study was to examine the demographic characteristics and music achievement of eighth-grade students in the United States using evidence from the 2016 National Assessment of Educational Progress in the Arts (NAEP). Analyzing NAEP data from a nationally representative sample of 4,340 eighth graders attending public and private middle schools in the United States in 2016, The author estimated enrollment percentages in various kinds of music classes and compared Music NAEP scores across various individual characteristics. Results showed that 64% of eighth graders enrolled in a school music class, with 34% of eighth graders enrolling in an ensemble class. Among ensemble students, there was underrepresentation of Black and Latinx students and underrepresentation of students of lower socioeconomic status. Students who were enrolled in general music and not an ensemble did not follow this pattern: Black and Latinx students and students of lower socioeconomic means were overrepresented among general music students. Controlling for contextual and demographic characteristics, ensemble music students significantly outscored nonmusic students on the Music NAEP, but students enrolled in general music as their only music course scored statistically indistinguishably from their nonmusic peers.

OS PROFESSORES TEMPORÁRIOS NAS REDES MUNICIPAIS DO ESTADO DO PARÁ (2011-2020)

ABSTRACT: This study sought to analyze the presence of temporary teachers in the municipal public networks of Pará State between 2011 and 2020. This study employed a quantitative approach of exploratory nature with documentary analysis as the data collection procedure. The data were analyzed based on five variables: population size of the municipalities, GDP per capita, financing capacity of the networks, percentage of enrollment in rural schools, and the relationship between the number of teachers of the networks and wage earners in the municipalities. We found a generalized picture of non-compliance with the legislation that remained stable between 2011 and 2020, as well as a heterogeneous scenario, with the municipalities showing enormous diversity concerning the presence of temporary workers in their networks.

To be a STEM or not to be a STEM: Why do countries differ?

AbstractThis paper proposes a theoretical analysis and an empirical investigation on simultaneous choices of an enrolment and discipline field, comparing science, technology, engineering, and mathematics (STEM) to non‐STEM fields, to enlighten economic variables influencing students. The cross‐country analysis of 35 countries in the period 2013–2016 tries to disentangle factors shifting students from one choice to another and why countries differ in directing students toward specific disciplines. The results show that expenditures in R&amp;D convince more students to choose STEM disciplines, whereas population density and the expected years of schooling have a negative impact on the percentage of STEM enrolments. As a whole, it appears that STEM enrolments are chosen for investment motives, whereas non‐STEM enrolments are less guided by economic factors and more dependent on a consumption effect.

Administrative Tolerance and Tax Revenue: A Synergistic Desparity

Raising sufficient tax revenue is one of the main objectives of all governments at any given moment. Thus, any policy that goes in this direction and which does not undermine or compromise the rule of law and threatens the sustainability of the government is a welcome initiative. It is in this light that ‘administrative tolerance’ saw the light of the day in Cameroon’s public administrative land scape. The problem of this phenomenon today is that, the initial basis on which it was introduced, currently threatens its existence due to corruption and selfishness of some administrative officials in both public and private organizations. This study aimed at examining the effect of the synergy between administrative tolerance implementation and tax revenue, on a sectorial basis. The expo-facto research design was used since the data for the study were secondary, and a model was developed to suit the objective of the study. The data were analysed using SPSS Version 23.0 with the use of multiple regression model. The results revealed that Administrative Tolerance manifests a synergistic desparity with Tax Revenue over the period of the study, using the three proxies of Private Secondary School Enrolments as a percentage of Total Secondary School Enrolments, Commercial Services Exports measured at current US dollars and percentage Fuel Export as a percentage of Total Merchandise Exports. Therefore, it was observed from the study that Administrative Tolerance on the Private Secondary Education sector has a significant positive effect on Tax Revenue, while any such tolerance on Commercial Services Exports and Fuel Exports negatively affected Tax Revenue. This study recommends that the government should have a framework for Administrative Tolerance in which specifics on when and how or the extent of such tolerance to each particular sector. A blanket policy should not be used at any given period on all sectors as this may result in negative effects on Tax Revenue.