1. Imaging predicts long-term effects in veterans with brain injury

    March 31, 2016 by Ashley

    From the Radiological Society of North America media release:

    regions of the brain correlated with more severe neurobehavioral symptomsDiffusion tensor imaging (DTI), a type of MRI, may be able to predict functional post-deployment outcomes for veterans who sustained mild traumatic brain injury (MTBI), or concussion, during combat, according to a new study published in the journal Radiology.

    MTBI is a public health problem of increasingly-recognized importance, particularly among military veterans. Recently, there has been a dramatic rise in the incidence of combat-related MTBI. More than 300,000 U.S. service members were diagnosed with MTBI between 2000 and 2015, according to the Armed Forces Health Surveillance Center.

    Current assessment of MTBI remains challenging due to the difficulties in establishing the diagnosis, predicting outcomes and separating the effects of MTBI from other conditions like post-traumatic stress disorder (PTSD).

    DTI uses measurements of water movement in the brain to detect abnormalities, particularly in white matter. Previous studies have linked DTI metrics to neurocognitive function and short-term functional outcomes in groups of patients. The desire to uncover possible long-term effects spurred Jeffrey B. Ware, M.D., from the Philadelphia VA Medical Center in Philadelphia, Pa., to evaluate combat veterans using this technique.

    Dr. Ware and colleagues used brain MRI and DTI to study 57 military veterans who had a clinical diagnosis of MTBI upon return from deployment. The average length of time between injury and post-deployment evaluation was 3.8 years with an average follow-up duration of 1.4 years.

    “All conventional MR images were interpreted as normal,” Dr. Ware said. “We retrospectively analyzed the data from the DTI sequence to derive measures of white matter integrity, which we compared to clinical measures and subsequent outcome measures 6 months to 2.5 years after the initial evaluation.”

    The results showed significant associations between initial post-deployment DTI measurements and neurobehavioral symptoms, timing of injury, and subsequent functional outcomes. The measurements also correlated with greater healthcare utilization among veterans with MTBI.

    Following initial post-deployment evaluation, 34 of the study participants returned to work. Veterans who did not return to work displayed significantly lower fractional anisotropy (FA) and higher diffusivity in a specific brain region, the left internal capsule. These measures imply less structural integrity in that area of the brain. As this region is known to contain important fibers providing motor stimulation to the typically dominant right side of the body, the results may provide a correlation between impairments in fine motor functioning and inability to return to work.

    “Our findings suggest that differences in white matter microstructure may partially account for the variance in functional outcomes among this population. In particular, loss of white matter integrity has a direct, measurable effect,” Dr. Ware said. “It was illuminating to see the association between measures of white matter integrity and important outcomes occurring months to years down the road in our study population.”


  2. Driving curfews may curb teen crime

    March 29, 2016 by Ashley

    From the University of Texas at Dallas media release:

    teens friends boysA new UT Dallas study found that teen driving curfews might do more than reduce car accidents. They also may prevent teens from committing crimes.

    Arrests among teens ages 16-17 fell by as much as 6 percent in states with laws that restrict nighttime driving hours for teens, according to the study.

    The research by Dr. Monica Deza, assistant professor of economics in the School of Economic, Political and Policy Sciences, and co-author Daniel Litwok of the firm Abt Associates, was published online by the Journal of Policy Analysis and Management.

    Most states’ graduated driver licensing programs have nighttime restrictions. The programs typically include supervised learning and intermediate stages before young drivers receive full-privileged licenses. They have proven successful at reducing risky behaviors that cause accidents. The new study is one of the first to examine the programs’ potential impact on crime.

    “Being able to drive or having friends who can drive is the difference between going out and staying home on a Saturday night,” Deza said. “It seemed intuitive to us that having a curfew on driving hours affected the probability that teenagers would get themselves into trouble.”

    Deza and Litwok, senior analyst and economist at Abt Associates in Maryland, analyzed the FBI’s Uniform Crime Report arrest data from 1995 to 2011. They compared arrests of 16- and 17-year-olds to arrests of young adults ages 18 and older in states with the nighttime driving curfew for new drivers.

    Overall, arrests of the younger teens decreased by 4 to 6 percent. The reduction was even higher in the states with the strictest laws. In those states, arrests of 16- and 17-year-olds declined 5 to 8 percent.

    The biggest crime reductions occurred in states that had graduated license programs in place the longest. The types of crimes most affected were manslaughter, murder and larceny. Arrests of 16- and 17-year-olds dropped 11 percent for manslaughter or murder, 5 percent for larceny, and 4 percent for aggravated assault.

    Driving restrictions keep teens off the roads, lessen the influence of peers and change teen behavior, which may have contributed to the reduction in arrests, Deza said.

    The researchers found that the laws were most effective when gasoline prices were at their lowest, when teens were likely to drive the most. The restrictions prevented those teen drivers from taking full advantage of the affordable gas prices, according to researchers.

    “As policymakers become concerned with how low gasoline prices affect risky behaviors among teens, they may want to take into account the role of graduated driving licensing in keeping teenagers off the streets, even in periods in which the cost of driving is particularly low,” Deza said.

    Deza said that analyses of the costs and benefits of graduated driving license programs should include the policy’s impact on crime. She said that previous analyses may have underestimated graduated licensing programs’ benefit by not factoring in crime.

    Deza and Litwok initially conducted separate studies. The authors combined their research after yielding identical results. Litwok received support from Abt Associates and an Institute of Education and Sciences Grant for his research.


  3. Spending on public higher education overlooks net benefits as investment in state’s future

    March 14, 2016 by Ashley

    From the University of Illinois at Urbana-Champaign media release:

    school busIn spite of the overwhelming evidence of a skills deficit, a depressed middle class and growing inequality, the state of Illinois continues to underinvest in public higher education. But considering higher education funding as an investment that lowers state welfare and prison costs, generates tax revenues and leads to economic growth in the future — and not as mere consumption spending — could reframe the debate, according to an article by a University of Illinois expert in the economics of education.

    In the face of recent dramatic examples, including the $300 million in cuts to the University of Wisconsin budget and, in Illinois, the failure to fund public universities and MAP grants for 2016 together with the governor’s proposed cuts for 2017, the investment-versus-spending distinction is a vital one, said Walter W. McMahon, an emeritus professor of economics and of educational organization and leadership at the University of Illinois.

    “Since this curtailed investment in human capital would otherwise contribute heavily not only to a state’s economic growth and development but also in ways estimated in the article — to higher state tax revenue and lower Medicaid, child care, welfare and criminal justice system costs — it’s disheartening to see this disinvestment trend by our public officials,” said McMahon, also the author of “Higher Learning, Greater Good: The Private & Social Benefits of Higher Education,” published by Johns Hopkins University Press.

    Published in the Journal of Education Finance, the article develops the total return of public education relative to the full costs to the state of Illinois, the key criteria for determining whether there is under- or over-investment for the most efficient statewide development.

    McMahon concluded that public education in Illinois contributes to investment returns of 9.5 percent for K-12; 15.3 percent for community college; and 13.4 percent for university, respectively, for every dollar that’s spent — returns that are well above the 7.2 percent the money would have earned if invested in an index fund that tracked returns of the S&P 500, McMahon noted.

    (Updated calculations based on the newest earnings data at each education level, corrected for dropouts and other factors, show returns relative to costs of 12.9 percent at two-year institutions and 12.3 percent at the four-year institutions.)

    “These earnings-based and total social rates of return both show that higher education is economically very efficient — in fact, more efficient than the average corporation in the S&P 500,” McMahon said.

    This measure of efficiency trumps any possible overspending on administrative costs cited by critics, so it’s not surprising that U.S. higher education is widely regarded as the best in the world, according to McMahon.

    The effects are not just on better-paying jobs but are also on many outcomes beyond earnings, from better health and child development to political stability and lower criminal justice costs,” he said. “Furthermore, the returns last for the 65 years or so remaining in the typical graduate’s lifecycle.

    “All told, the state of Illinois’ education investment pays for itself every 2.3 years in state budget savings alone.”

    The return to the state is considerably larger if nonmonetary outcomes are considered.

    “A major opportunity being missed is estimating the effects of higher education on state tax revenues and on budgeted state tax costs for health care, welfare, child support and the criminal justice system,” McMahon said. “Beyond these state budget savings, I also found about a 30 percent total return that includes these wider health and other benefits to statewide development.”

    The paper’s implications for the state’s fiscal health and human capital ought to be of immediate concern to Illinois legislators and policymakers.

    The disconnect with objective benefit-cost analysis suggests the need for a new strategy in making decisions about public education financing,” McMahon said. “Legislators are often focused on infrastructure issues like bridges and roads, to the extent that public education gets short shrift. Nobody likes taxes, which, if the funds are invested in education where there is a future return, are a form of forced saving. But this type of saving and investment has a huge payoff. And if done thoughtfully, it is crucial to the state’s growth, development and fiscal health.”

    Another way of looking at the issue is that “one can also look at the same numbers as estimating the damage to the state from cuts, if they are not restored,” McMahon said.

    “In Illinois, what is happening is not just a disaster for higher education but also a growing disaster for the state budget, as time passes,” he said. “It’s a disaster for economic growth and the business climate, and a disaster for broader development and well-being of the state. Allowing Chicago State to close and not funding MAP grants, which forces students to drop out of school without the necessary skills to succeed in the working world — all of that will have serious implications for the state of Illinois that should be fairly obvious.”