Infrequent Identity Signals, Multiple Correspondence, and Detection Risks in Audit Correspondence Studies.

Audit correspondence studies are field experiments that test for discriminatory behavior in active markets. Researchers measure discrimination by comparing how responsive individuals ("audited units") are to correspondences from different types of people. This paper elaborates on the tradeoffs researchers face between sending audited units only one correspondence and sending them multiple correspondences, especially when including less common identity signals in the correspondences. We argue that when researchers use audit correspondence studies to measure discrimination against individuals that infrequently interact with audited units, they raise the risk that these audited units become aware they are being studied or otherwise act differently. We also argue that sending multiple pieces of correspondence can increase detection risk. We present the result of an audit correspondence study that demonstrates how detection can occur for these reasons, leading to significantly attenuated (biased towards zero) estimates of discrimination.

How Did Colleges Disburse Emergency Aid During COVID-19? An Implementation Analysis of the Higher Education Emergency Relief Fund.

To address the unprecedented challenges of the COVID-19 pandemic, Congress authorized the Higher Education Emergency Relief Fund (HEERF I) in March 2020 with over $6 billion allocated for emergency financial aid. In this paper, we utilize the administrative burden framework to analyze HEERF I implementation for a stratified random sample of colleges, focusing on the implications for equity. We find that disbursement policies varied along two dimensions: (1) whether they imposed burdens on students by requiring applications and proof of hardship and (2) whether they targeted needy students and varied the amount of aid according to need. When we examine sectoral differences, we find that private for-profit colleges were more likely to place higher burden on students, whereas public and minority-serving institutions were more likely to reduce burden.

Efficacy of a brief intervention to improve emergency physicians' smoking cessation counseling skills, knowledge, and attitudes.

The objective of this study was to test whether a brief educational/administrative intervention could increase tobacco counseling by emergency physicians (EPs). Pre-/post-study at eight emergency departments (EDs) with residency programs were carried out. EPs received a 1-hour lecture on the health effects of smoking and strategies to counsel patients. After the lecture, cards promoting a national smokers' quitline were placed in EDs, to be distributed by providers. Providers completed pre-/ post-intervention questionnaires. Patients were interviewed pre-/post-intervention to assess provider behavior. Two hundred eighty-seven EPs were enrolled. Post-intervention, providers were more likely to consider tobacco counseling part of their role, and felt more confident in counseling. Data from 1168 patient interviews and chart reviews showed that, post-intervention, providers were more likely to ask patients about smoking, make a referral, and document smoking counseling. Post-intervention, 30% of smokers were given a Quitline referral card. An educational intervention improved ED-based tobacco interventions. Controlled trials are needed to establish these results' durability.

Nicotine dependence, motivation to quit, and diagnosis among adult emergency department patients who smoke: a national survey.

Patients in hospital emergency departments smoke more than the general population. Smoking profiles of these patients have largely been characterized in small, single-institution cohorts. Our objective was to survey adult smokers visiting a sample of U.S. emergency departments, as part of a study examining the efficacy of an educational intervention on physicians' knowledge, attitudes, and behavior regarding tobacco control. A convenience sample of patients in eight academic emergency departments was surveyed from May to July 2006. Eligible patients were aged 18 years or older, were every- or some-day smokers, spoke English or Spanish, were able to provide written informed consent, and were not actively psychotic. Descriptive statistics are reported using parametric and nonparametric measures. A total of 1,168 patients were interviewed (mean age = 40.7 years); 46.5% were female, 54.4% were uninsured or had Medicaid, and 29.9% had no usual source of care. Patients smoked a median of 10 cigarettes daily, with a median score on the Fagerstrom Test for Nicotine Dependence of 4, and a median score of 5 on the nine-point contemplation ladder, indicating a desire to quit within 6 months. Smokers with a diagnosis of cardiovascular, respiratory, or malignant disease were more interested in quitting than others (median ladder score = 4 vs. 6, p<.001), were more likely to believe they had a smoking-related illness, and were more likely to believe their emergency department visit was related to smoking. Smokers with a presenting complaint of chest pain or dyspnea were more interested in quitting than others (median ladder score = 4 vs. 6, p = .002). Emergency department patients smoked at moderate amounts, with moderate levels of addiction and interest in quitting. Smokers with tobacco-related diagnoses, or who believed their emergency department visit was related to smoking, were more interested in quitting. These findings suggest that the emergency department visit may provide a teachable moment to reach smokers who have tobacco-related problems.

The effect of etomidate on airway management practices of an air medical transport service.

OBJECTIVE: The authors studied the effect of introducing etomidate on the airway management practices of their air transport crew and specifically considered the need for paralytic agents during rapid-sequence intubation. METHODS: A prospective observational review of the transport records for all patients aged greater than 10 years who required intubation transported by the air medical crew before (PRE) and after (POST) the introduction of etomidate into the authors' rapid-sequence induction protocol was conducted. Data were collected, including the method of intubation, indications for intubation, and complications from the procedure. The following outcomes were measured: the method used for intubation (nasotracheal or orotracheal), oral intubation success rate, number of attempts for oral intubation, need for paralytic agents, and complications with the procedure. RESULTS: Comparing the PRE and POST periods, nasotracheal intubation was performed in 27 of 70 (38.6%) versus 33 of 71 (46.4%; p=0.237997). The overall success rate for intubation in the PRE period was 67 of 70 (95.7%), with 95.3% of orotracheal intubations being successful. In the POST period, the overall success rate was 65 of 71 (91.5%), with 94.7% of orotracheal intubations being successful. Complication rates were similar between the groups. Etomidate reduced the use of paralytic agents from 46 of 62 (74.6%) of patients receiving midazolam to 10 of 22 (45.5%) intubated with etomidate (p=0.02). CONCLUSIONS: Etomidate did not appear to have an impact on the selection of intubation methods by the air medical transport crew. Etomidate significantly reduced the need for administration of paralytic agents used in an RSI.