Predictors of Adoption and Guardianship Dissolution: The Role of Race, Age, and Gender Among Children in Foster Care

Adoption and guardianship are meant to provide permanency to foster children when reunification is not a viable option. Unfortunately, sometimes adoption and guardianship placements dissolve resulting in children returning to care. Currently, there is limited research on the prevalence and predictors of adoption and guardianship dissolutions. This study investigated rates of guardianship and adoption dissolution using a complete entry cohort from a large state foster care system and the associations between child characteristics and risk factors with dissolution. Drawing on a complete entry cohort of foster children in Texas that exited to either adoption or guardianship placements, results demonstrated that over 2% of adoptive placements and 7% of guardianship placements were dissolved. Compared with White and Hispanic children, Black children had a higher risk of guardianship, but not adoption, dissolution. Older age was associated with a higher risk of adoption dissolution, and females had a higher risk of guardianship dissolution than males. Behavior problems, cognitive disability status, and mental health issues were all associated with a higher risk of dissolution. These findings have important implications for caseworkers and policymakers on permanency for children in adoptive or guardianship placements.

Timing of multikinase inhibitor initiation in differentiated thyroid cancer

There are limited treatment options for patients with radioactive iodine refractory, progressive differentiated thyroid cancer. Although there is consensus that multikinase inhibitor therapy should be considered in patients with progressive disease with considerable tumor load or symptomatic disease, uncertainty exists on the optimal timing to treat with a multikinase inhibitor, especially for asymptomatic patients. RIFTOS MKI is an international, prospective, open-label, multicenter, noninterventional study with the primary objective to compare the time to symptomatic progression from study entry in asymptomatic patients with radioactive iodine refractory, progressive differentiated thyroid cancer for whom there is a decision to initiate multikinase inhibitors at study entry (cohort 1) with those for whom there is a decision to not initiate multikinase inhibitors at study entry (cohort 2). Secondary endpoints are overall survival and progression-free survival, which will be compared between cohorts 1 and 2. Additional secondary endpoints are postprogression survival from time of symptomatic progression, duration of and response to each systemic treatment regimen and dosing of sorafenib throughout the treatment period. Asymptomatic, multikinase inhibitor-naive patients aged ≥18 years with histologically/cytologically documented differentiated thyroid cancer that is radioactive iodine refractory are eligible. Patients may receive any therapy for differentiated thyroid cancer, including sorafenib or other multikinase inhibitors if indicated and decided on by the treating physician. In total, 700 patients are estimated to be enrolled from >20 countries. Final analysis will be performed once the last enrolled patient has been followed up with for 24 months (ClinicalTrials.gov identifier: Nbib2303444).

Increased Sensitivity of the European Medicines Agency Algorithm for Classification of Childhood Granulomatosis with Polyangiitis

Objective.Granulomatosis with polyangiitis (Wegener’s; GPA) and other antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are rare in childhood and are sometimes difficult to discriminate. We compared use of adult-derived classification schemes for GPA against validated pediatric criteria in the ARChiVe (A Registry for Childhood Vasculitis e-entry) cohort, a Childhood Arthritis and Rheumatology Research Alliance initiative.Methods.Time-of-diagnosis data for children with physician (MD) diagnosis of AAV and unclassified vasculitis (UCV) from 33 US/Canadian centers were analyzed. The European Medicines Agency (EMA) classification algorithm and European League Against Rheumatism/Paediatric Rheumatology International Trials Organisation/Paediatric Rheumatology European Society (EULAR/PRINTO/PRES) and American College of Rheumatology (ACR) criteria for GPA were applied to all patients. Sensitivity and specificity were calculated (MD-diagnosis as reference).Results.MD-diagnoses for 155 children were 100 GPA, 25 microscopic polyangiitis (MPA), 6 ANCA-positive pauciimmune glomerulonephritis, 3 Churg-Strauss syndrome, and 21 UCV. Of these, 114 had GPA as defined by EMA, 98 by EULAR/PRINTO/PRES, and 87 by ACR. Fourteen patients were identified as GPA by EULAR/PRINTO/PRES but not by ACR; 3 were identified as GPA by ACR but not EULAR/PRINTO/PRES. Using the EMA algorithm, 135 (87%) children were classifiable. The sensitivity of the EMA algorithm, the EULAR/PRINTO/PRES, and ACR criteria for classifying GPA was 90%, 77%, and 69%, respectively, with specificities of 56%, 62%, and 67%. The relatively poor sensitivity of the 2 criteria related to their inability to discriminate patients with MPA.Conclusion.EULAR/PRINTO/PRES was more sensitive than ACR criteria in classifying pediatric GPA. Neither classification system has criteria for MPA; therefore usefulness in discriminating patients in ARChiVe was limited. Even when using the most sensitive EMA algorithm, many children remained unclassified.

Intergenerational risk sharing within funded pension schemes

Is intergenerational risk sharing desirable and feasible in funded pension schemes? Using a multi-period OLG model, we study risk sharing between generations for a variety of realistic collective funded pension schemes, where pension benefits and contributions may depend on the funding ratio and the asset returns. We find that well-structured intergenerational risk sharing via collective schemes can be welfare-enhancing vis-à-vis the optimal individual benchmark. Moreover, from an ex ante perspective the expected welfare gain of the current entry cohort is not at the cost of the older and future cohorts.

Entry, Exit and Productivity: Empirical Results for German Manufacturing Industries

From a model by Hopenhayn, three hypotheses can be derived: (H1) Firms that exit in year t were less productive in t -1 than firms that continue to produce in t. (H2) Firms that enter in year t are less productive than incumbent firms in year t. (H3) Surviving firms from an entry cohort were more productive than nonsurviving firms from this cohort in the start year. This paper uses unique newly available panel datasets for all manufacturing plants from Germany (1995-2002) to test these hypotheses. All three hypotheses are supported empirically for West and East Germany.

Are survival rates for northern spotted owls biased?

The northern spotted owl (Strix occidentalis caurina (Merriam, 1898)) is listed as threatened in both Canada and the United States. As part of a 1998–2004 study of habitat usage, we attached radio tags to 197 northern spotted owls. Owls that died or emigrated from the study areas could be identified with high certainty. The long-term data we obtained enabled us to estimate survivorship using multiple statistical methods. Using a pooled data set, we estimated annual survivorship at 0.927. Using a year-by-year analysis, we obtained some variation in survival by year, but the same overall mean. Using a staggered-entry cohort approach, we obtained an estimate of 0.934. Mean annual survival estimated by program MARK was 0.927. These estimates are outside the confidence intervals of prior studies that used capture–recapture methods. Capture–recapture methods are based on the assumption that birds remain within a demographic study area, but our data suggest that owls may disperse or remain undetected within a study area often enough that capture–recapture methods may overestimate mortality. Our results imply that the true finite population growth rate, λ, may be higher than estimated in prior studies that used capture–recapture methods.