Improving health with programmatic, legal, and policy approaches to reduce gender inequality and change restrictive gender norms.

Evidence that gender inequalities and restrictive norms adversely affect health is extensive; however, far less research has focused on testing solutions. We first comprehensively reviewed the peer-reviewed and grey literature for rigorously evaluated programmes that aimed to reduce gender inequality and restrictive gender norms and improve health. We identified four mutually reinforcing factors underpinning change: (1) multisectoral action, (2) multilevel, multistakeholder involvement, (3) diversified programming, and (4) social participation and empowerment. Following this review, because little research has investigated the effects of national-level law and policy reforms, we conducted original quasi-experimental studies on laws and policies related to education, work, and income, all social determinants of health in which deep gender inequalities exist. We examined whether the laws and policies significantly affected health outcomes and gender norms, and whether law-induced and policy-induced changes in gender norms mediated the health effects, in areas for which longitudinal data existed. Laws and policies that made primary education tuition-free (13 intervention countries with the law and/or policy and ten control countries without) and that provided paid maternity and parental leave (seven intervention and 15 control countries) significantly improved women's and their children's health (odds ratios [OR] of 1·16-2·10, depending on health outcome) and gender equality in household decision making (OR 1·46 for tuition-free and 1·45 for paid maternity and parental leave) as a proxy indicator of gender norms. Increased equality partially mediated the positive effects on health outcomes. We conclude by discussing examples of how improved governance can support gender-equitable laws, policies, and programmes, immediate next steps, and future research needs.

Regulatory Considerations for Physiological Closed-Loop Controlled Medical Devices Used for Automated Critical Care: Food and Drug Administration Workshop Discussion Topics.

Part of the mission of the Center for Devices and Radiological Health (CDRH) at the US Food and Drug Administration is to facilitate medical device innovation. Therefore, CDRH plays an important role in helping its stakeholders such as manufacturers, health care professionals, patients, patient advocates, academia, and other government agencies navigate the regulatory landscape for medical devices. This is particularly important for innovative physiological closed-loop controlled (PCLC) devices used in critical care environments, such as intensive care units, emergency settings, and battlefield environments. CDRH's current working definition of a PCLC medical device is a medical device that incorporates physiological sensor(s) for automatic manipulation of a physiological variable through actuation of therapy that is conventionally made by a clinician. These emerging devices enable automatic therapy delivery and may have the potential to revolutionize the standard of care by ensuring adequate and timely therapy delivery with improved performance in high workload and high-stress environments. For emergency response and military applications, automatic PCLC devices may play an important role in reducing cognitive overload, minimizing human error, and enhancing medical care during surge scenarios (ie, events that exceed the capability of the normal medical infrastructure). CDRH held an open public workshop on October 13 and 14, 2015 with the aim of fostering an open discussion on design, implementation, and evaluation considerations associated with PCLC devices used in critical care environments. CDRH is currently developing regulatory recommendations and guidelines that will facilitate innovation for PCLC devices. This article highlights the contents of the white paper that was central to the workshop and focuses on the ensuing discussions regarding the engineering, clinical, and human factors considerations.

The Fallacy of Choice: the Destructive Effect of School Vouchers on Children With Disabilities.

This Article addresses the impact of school voucher programs on students with disabilities. We show that for children with disabilities, the price of admission into so-called "school choice" programs is so high that it is effectively no real choice at all. School voucher programs require students with disabilities to sign away their robust federal rights and protections in the public school system. Under the Individuals with Disabilities Education Act (IDEA)--the preeminent legislative safeguard for students with disabilities--these rights include the right to a "free and appropriate public education" delivered through an "individualized education plan." By giving up these protections, children with disabilities are left at the mercy of private schools that have no legal obligation to provide them with an appropriate education, and, in the vast majority of cases, are not legally prohibited from discriminating against them on the basis of their disability. We argue that school voucher programs--including a proposed federal voucher program--put the education of students with disabilities back decades, and likely constitute a violation of the Equal Protection Clause of the U.S. Constitution.

Getting a Sporting Chance: Title IX and the Intergenerational Transmission of Health.

We know that healthier mothers tend to have healthier infants, but we do not know how much of that relationship reflects the intergenerational transmission of genetic attributes versus environmental influences. From a policy perspective, it is crucial to understand which environmental influences are important and whether investments in one generation affect outcomes for the next. I use variation in the implementation of Title IX to measure the effects of increased athletic opportunities on the health of infants. Babies born to women with greater athletic opportunities as teenagers have babies that are healthier at birth. They are less likely to be born of low or very low birthweight and have higher Apgar scores. Copyright © 2016 John Wiley & Sons, Ltd.

Compulsory Schooling Laws and Migration Across European Countries.

Educational attainment is a key factor for understanding why some individuals migrate and others do not. Compulsory schooling laws, which determine an individual's minimum level of education, can potentially affect migration. We test whether and how increasing the length of compulsory schooling influences migration of affected cohorts across European countries, a context where labor mobility is essentially free. We construct a novel database that includes information for 31 European countries on compulsory education reforms passed between 1950 and 1990. Combining this data with information on recent migration flows by cohorts, we find that an additional year of compulsory education reduces the number of individuals from affected cohorts who migrate in a given year by 9 %. Our results rely on the exogeneity of compulsory schooling laws. A variety of empirical tests indicate that European legislators did not pass compulsory education reforms as a reaction to changes in emigration rates or educational attainment.

Boosting Social and Emotional Development In and Out of School.

(1) Illinois' state ESSA plan reflects the state's whole-child approach, adding references to the social, emotional and behavioral needs of students, along with high expectations for student achievement. (2) Massachusetts' state ESSA plan lists supporting socialemotional learning, health and safety as among the state's core educational strategies. (3) South Carolina's ESSA plan develops a framework identifying self-direction, perseverance, global perspective and interpersonal skills to be among the characteristics that every student should have when he or she graduates from high school.

THE COGNITIVE COMPETENCES OF IMMIGRANT AND NATIVE STUDENTS ACROSS THE WORLD: AN ANALYSIS OF GAPS, POSSIBLE CAUSES AND IMPACT.

Immigration, immigration policies and education of immigrants alter competence levels. This study analysed their effects using PISA, TIMSS and PIRLS data (1995 to 2012, N=93 nations) for natives' and immigrants' competences, competence gaps and their population proportions. The mean gap is equivalent to 4.71 IQ points. There are large differences across countries in these gaps ranging from around +12 to -10 IQ points. Migrants' proportions grow roughly 4% per decade. The largest immigrant-based 'brain gains' are observed for Arabian oil-based economies, and the largest 'brain losses' for Central Europe. Regarding causes of native-immigrant gaps, language problems do not seem to explain them. However, English-speaking countries show an advantage. Acculturation within one generation and intermarriage usually reduce native-immigrant gaps (≅1 IQ point). National educational quality reduces gaps, especially school enrolment at a young age, the use of tests and school autonomy. A one standard deviation increase in school quality represents a closing of around 1 IQ point in the native-immigrant gap. A new Greenwich IQ estimation based on UK natives' cognitive ability mean is recommended. An analysis of the first adult OECD study PIAAC revealed that larger proportions of immigrants among adults reduce average competence levels and positive Flynn effects. The effects on economic development and suggestions for immigration and educational policy are discussed.

Final Priority--Training of Interpreters for Individuals Who Are Deaf or Hard of Hearing and Individuals Who Are Deaf-Blind Program. Final priority.

The Assistant Secretary for Special Education and Rehabilitative Services announces a final priority under the Training of Interpreters for Individuals Who Are Deaf or Hard of Hearing and Individuals Who Are Deaf-Blind Program. The Assistant Secretary may use this priority for competitions in fiscal year 2016 and later years. We take this action to provide training and technical assistance to better prepare novice interpreters to become highly qualified, nationally certified sign language interpreters.

Effects of Early U.S. Compulsory Schooling Laws on Educational Assortative Mating: The Importance of Context.

Modernization theory predicts that rising education should increase assortative mating by education and decrease sorting by race. Recent research suggests that effects of educational expansion depend on contextual factors, such as economic development. Using log-linear and log-multiplicative models of male household heads ages 36 to 75 in the 1940 U.S. census data--the first U.S. census with educational attainment information--I investigate how educational assortative mating changed with one instance of educational expansion: early U.S. compulsory school attendance laws. To improve on existing research and distinguish effects of expansion from changes due to particular years or cohorts, I capitalize on state variation in the timing of these compulsory laws (ranging from 1852 to 1918). Aggregate results suggest that compulsory laws had minimal impact on assortative mating. However, separate analyses by region (and supplemental analyses by race) reveal that assortative mating by education decreased with the laws in the South but increased in the North. Whether due to economic, legal, political, or other differences, results suggest that the implications of educational expansion for marital sorting depend on context. Contemporary implications are discussed in light of President Obama's 2012 suggested extension of compulsory schooling to age 18.

Schooling in adolescence raises IQ scores.

Although some scholars maintain that education has little effect on intelligence quotient (IQ) scores, others claim that IQ scores are indeed malleable, primarily through intervention in early childhood. The causal effect of education on IQ at later ages is often difficult to uncover because analyses based on observational data are plagued by problems of reverse causation and self-selection into further education. We exploit a reform that increased compulsory schooling from 7 to 9 y in Norway in the 1960s to estimate the effect of education on IQ. We find that this schooling reform, which primarily affected education in the middle teenage years, had a substantial effect on IQ scores measured at the age of 19 y.

Bilingualism: research and policy.

Bilingualism, commonplace throughout the world, is not well accepted or supported in many parts of the United States. Education policies and practices regarding bilingualism are often based on myths and attitudes rather than facts, despite scientific evidence on both the disadvantages and advantages of bilingualism. Based on a brief overview of this evidence, I assert that we should embrace more informed policies and practice. Researchers should also work toward new and more complex research approaches to delve more deeply into how the brain organizes and reorganizes with language learning. Despite the continuing need for more research, we know enough to put in place (and study) informed policies and practices that can benefit all children. Now is the time for evidence-based practice, evidence-based policies, and integrative research on bilingualism and education.

Education increases patience: Evidence from a change in a compulsory schooling law.

I investigate the causal effect of education on time preferences. To deal with the endogeneity of education, I exploit exogenous variation in education imposed by a Turkish school reform that raised compulsory education from five to eight years. I find that education causes individuals to make more patient inter-temporal choices but does not induce them to report being more patient. I also provide evidence that the effect of education on patient inter-temporal choices does not operate through changes in financial well-being.