ABSTRACT
Prior studies have documented the pattern of decreased state funding for higher education in periods of economic contraction (i.e., the balance wheel phenomenon). This qualitative case study examines how policymakers in California and Texas made decisions about funding higher education at the onset of the COVID-19 pandemic, when policymakers faced an economic downturn. Data comprise 28 interviews with key state actors and 69 documents. The analysis expands prior understandings of how state policymakers make budgeting decisions that affect higher education by exploring how they perceive certain target populations as deserving or undeserving of state support. The study also sheds light on the tenuous relationship between policymakers' views of higher education and their funding decisions. © 2023 The Author(s).
ABSTRACT
Building on research examining state financing for higher education, our qualitative comparative case study investigates state policymakers’ decisions for funding public higher education during the COVID-19 crisis in California and Texas. These states were purposively selected based on the size of their postsecondary sector, state partisanship, and higher education funding responses during the pandemic. Moreover, these states represent two of the largest public postsecondary enrollments nationally and serve a racially and ethnically diverse student population. Guiding our study is the Hearn and Ness (2018) framework investigating the ecology of state higher education policymaking, which offers four contextual categories that influence state policy decisions: socioeconomic context, organizational and policy context, politico-institutional context, and external context. This framework suggests underlying factors influencing the state funding process, while also providing an opportunity to expand on this theory through the unique COVID-19 context. We used deductive and inductive techniques to analyze 28 interviews with a range of actors, including state elected officials, state government staff, and higher education officials. We also examined 69 documents (state budgets, news articles, and state executive orders) to triangulate and verify our interview data. Two areas served as key events that ultimately influenced higher education funding decisions in California and Texas: (1) the preference of certain higher education institutions and (2) the availability and application of federal dollars. Furthermore, the organizational and policy context and the politico-institutional context, as defined by the Hearn and Ness framework, provided additional state-level factors that resulted in distinct responses. This study offers practical and theoretical contributions to higher education policy and practice, including highlighting the decision-making and prioritization processes of state policymakers when facing an unprecedented pandemic and crisis, and discussing common and unique factors influencing higher education policymaking in two different state contexts. © 2022 SAGE Publications.
ABSTRACT
Background: The therapeutic landscape in metastatic NSCLC has dramatically changed with approvals of immunotherapy agents in both treatment-naïve and previously treated cancer patients (pts) and irrespective of histology. Pts with tumors that develop resistance is a significant area of unmet need. Vascular endothelial growth factor (VEGF) has been shown to modulate the tumor immune microenvironment and combination immune checkpoint and VEGF/VEGF receptor inhibition have shown benefit in multiple tumor types. Lung-MAP is a master protocol for pts with stage IV, previously treated NSCLC. Pts who were not eligible for a biomarker-matched substudy enrolled in S1800A. The adverse event profile will be presented. Methods: S1800A is a phase II randomized trial for pts who previously received PD-1 or PD-L1 inhibitor therapy for at least 84 days and platinum-based doublet therapy with ECOG 0-1 stratified by PD-L1 expression, histology and intent to receive ramucirumab in the standard of care (SOC) arm. Pts were randomized 1:1 to pembrolizumab and ramucirumab P+R or SOC (docetaxel +R [SOC w R];docetaxel, pemetrexed or gemcitabine [SOC wo R]). The primary endpoint was overall survival. Secondary endpoints included response, duration of response, investigator assessed-progression free survival and evaluation of toxicity. Results: From May 17, 2019 to November 16, 2020, 166 pts enrolled and 140 determined eligible [69 (49%) P+R;46 (33%) SOC w R;25 (18%) SOC wo R]. Treatments for those who received SOC wo R included 3 on docetaxel (19%);12 on gemcitabine (75%);and on 1 on pemetrexed (6%). 131 were eligible for adverse event (AE) assessment. The most common AE were fatigue (38%), proteinuria (28%), hypertension (23%), diarrhea (22%) and hypothyroidism (22%) on P+R;fatigue (61%), anemia (48%), diarrhea (41%) and neutropenia (39%) on SOC w R and anemia (56%), leukopenia (56%), fatigue (44%) and neutropenia (44%) on SOC wo R. Grade ≥ 3 treatment-related AEs occurred in 32% of pts on P+R, 54% of pts on SOC w R and 56% of pts on SOC wo R. Cardiac and thromboembolic events occurred in 12% of pts on P+R, 11% of pts on SOC w R and 0% of pts on SOC wo R. Grade 5 AE occurred in 2 pts on P+R (respiratory failure and cardiac arrest), 3 pts on SOC w R (2 respiratory failure and sepsis) and 1 pt on SOC wo R (sepsis). Four patients were diagnosed with COVID-19 (1 on P+R and 3 on SOC) and 3 died (1 on P+R and 2 on SOC). Conclusions: Grade 3 toxicities were lower in P+R compared to SOC arms with or without R. Cardiac and thromboembolic events were similar in arms that included R. P+R was generally well-tolerated. Efficacy outcomes will be presented when data matures.