Background: Glucocorticoid immunosuppressant therapy in pediatric kidney transplant (Tx) recipients does not allow the improvement of growth after Tx. Objective: To determine the effect of early steroid withdrawal (SW) on longitudinal growth, insulin sensitivity (IS), and body composition (BC). Methods: This was a prospective, randomized, multicenter study in Tx. Insulin-like growth factor (IGF)-I, IGF-binding protein 3 (IGFBP3), IS, and BC (DEXA/pQCT) were determined at baseline and up to 12 months after Tx. Results: A total of 30 patients were examined; 14 patients were assigned to the SW group (7 male, 7 female; 12 in Tanner stage I) and 16 patients were assigned to the steroid control (SC) group (10 male, 6 female;12 in Tanner stage I). Their chronological age was 7.8 ± 4.3 years, height was -2.3 ± 0.99 SD scores (SDS), and body mass index -0.3 ± 1.2 SDS. After 1 year, the SW group showed an increase in height SDS (+1.2 ± 0.22 vs. +0.60 ± 0.13 SDS in the SC group, p < 0.02), lower IGFBP3 (p < 0.05), cholesterol (p < 0.05), and higher high-density lipoprotein cholesterol (p < 0.05). SW patients had lower trunk fat with no differences in IS. Only in prepubertal patients, the SW group had lower glycemia (p < 0.05), very low-density lipoprotein cholesterol (p < 0.01), triglycerides (p < 0.05), triglycerides/glycemia index (TyG; p < 0.02), and better lean mass. Both groups showed an improvement in lean mass after kidney Tx. Conclusions: SW improved longitudinal growth, lipid profile, and trunk and lean fat in Tx patients. In prepubertal recipients, the decrease in TyG suggests better IS.

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We analyze the economic returns to different postsecondary degrees in Chile. We posit a schooling decision model with unobserved ability, observed test scores and labor market outcomes. We benefit from administrative records to carry out our empirical strategy. Our results show positive average returns to postsecondary degrees, especially for five-year degrees. However, we also uncover a large fraction of individuals with realized negative net returns. Although psychic benefits of postsecondary education could rationalize this result, we argue this might also suggest that individuals lack information at the time schooling decisions are made. Finally, our findings illustrate the importance of allowing for heterogeneous treatment effects when making policy recommendations.

This paper estimates the effect of early lead exposure on academic achievement and adult earnings. We analyze longitudinal information from individuals attending primary and secondary schools in the city of Arica (in northern Chile). Between 1984 and 1989, Arica received more than 20,000 tons of toxic chemicals containing high concentrations of lead. Initially, the chemical waste was located several kilometers from the city. However, Arica's rapid expansion, which included the construction of housing projects just meters away from the waste deposit, put a large number of families at risk. Our data include information on residential proximity to the polluted area, levels of lead exposure, comprehensive demographic information, nationally representative academic test scores and administrative data on adult earnings.We document a strong relationship between blood lead levels and student academic performance. We find that an increase of one microgram of lead per deciliter of blood reduces math and language scores by 0.15 and 0.21 standard deviations, respectively. For earnings, we estimate that for each extra microgram of lead, monthly earnings decrease by CLP 11,458 (or USD 22.92). This translates into a reduction of USD 6,000 in lifetime earnings per microgram of lead per deciliter of blood.

We use data from Chile's targeted voucher program to test the effects of vouchers on school results. Targeted vouchers have delivered extra resources to low-income, vulnerable students since 2008. Moreover, under this scheme, additional resources are contingent on the completion of specific education reforms. Using a differencein-differences approach and a market-level empirical analysis, we find a positive and significant effect of vouchers on standardized test scores. Additionally, our results highlight the importance of conditioning the delivery of resources to some specific academic goals in markets with institutional characteristics that prevent public schools from behaving as profit-maximizing firms.