Have Welfare-To-Work Programs Improved Over Time In Putting Welfare Recipients To Work?

Data from 76 experimental welfare-to-work programs conducted in the United States between 1983 and 1998 are used to investigate whether the impacts of such programs on employment had been improving over time and whether specific program features influencing such changes can be identified. Over the period, an increasing percentage of control group members received services similar to those offered to program group members. As a result, differential participation in program service activities between program and control group members decreased steadily over time. This reduction in the net receipt of program services tended to reduce the impact of these programs on employment. However, the negative influence of the reduced incremental services was offset by other factors that resulted in program impacts remaining essentially constant from 1983 to 1998. Suggestions are made for possibly improving program impacts in future experiments.Welfare Programs; Program Evaluation; Employment Behavior of Low-Income Families; Meta Analysis

Rural Competitiveness: Results of the 1996 Rural Manufacturing Survey

Establishments in metropolitan and nonmetropolitan locations are surprisingly similar in their adoption of new technologies, worker skill requirements, use of government programs and technical assistance, exports, and sources of financing, according to the results of a nationwide survey of 3,909 manufacturing businesses. The most widespread concern of both metro and nonmetro businesses appears to be with quality of labor. Survey respondents report rapidly increasing skill requirements, and many report problems finding qualified workers. Quality of local labor is the most frequently cited problem associated with nonmetro business locations. Access to credit, transportation, and telecommunications infrastructure is a problem of secondary importance for both metro and nonmetro respondents. Rural communities face a considerable challenge in supplying workers with needed skills. The fastest-growing skill requirements -- computer, interpersonal/teamwork, and problem-solving skills -- are not central to traditional academic instruction.rural manufacturing, sample survey, worker skills, manufacturing location, credit availability, technology adoption, Community/Rural/Urban Development,

The Impact of Disability Benefits on Labor Supply: Evidence from the VA's Disability Compensation Program

Combining administrative data from the US Army, Department of Veterans Affairs, and Social Security Administration, we analyze the effect of the VA's Disability Compensation (DC) program on veterans' labor force participation and earnings. We study the 2001 Agent Orange decision, a unique policy change that expanded DC eligibility for Vietnam veterans who served in theater but did not expand eligibility to other veterans of this era, to assess the causal effects of DC enrollment. We estimate that benefits receipt reduced veterans' labor force participation by 18 percentage points, though measured income net of transfer income rose on average.United States. Social Security Administration (grant #10-P-98363-1-05 to the National Bureau of Economic Research as part of the SSA Retirement Research Consortium

Anharmonicity-induced isostructural phase transition of Zirconium under pressure

We have performed a detailed x-ray diffraction structural study of Zr under pressure and unambiguously identify the existence of a first-order isostructural bcc-to-bcc phase transition near 58 GPa. First-principles quantum molecular dynamics lattice dynamics calculations support the existence of this phase transition, in excellent agreement with experimental results, triggered by anharmonic effects. Our results highlight the potential ubiquity of anharmonically driven isostructural transitions within the periodic table under pressure and calls for follow-up experimental and theoretical studies

Individual prognosis at diagnosis in nonmetastatic prostate cancer: Development and external validation of the PREDICT Prostate multivariable model.

BACKGROUND: Prognostic stratification is the cornerstone of management in nonmetastatic prostate cancer (PCa). However, existing prognostic models are inadequate-often using treatment outcomes rather than survival, stratifying by broad heterogeneous groups and using heavily treated cohorts. To address this unmet need, we developed an individualised prognostic model that contextualises PCa-specific mortality (PCSM) against other cause mortality, and estimates the impact of treatment on survival. METHODS AND FINDINGS: Using records from the United Kingdom National Cancer Registration and Analysis Service (NCRAS), data were collated for 10,089 men diagnosed with nonmetastatic PCa between 2000 and 2010 in Eastern England. Median follow-up was 9.8 years with 3,829 deaths (1,202 PCa specific). Totals of 19.8%, 14.1%, 34.6%, and 31.5% of men underwent conservative management, prostatectomy, radiotherapy (RT), and androgen deprivation monotherapy, respectively. A total of 2,546 men diagnosed in Singapore over a similar time period represented an external validation cohort. Data were randomly split 70:30 into model development and validation cohorts. Fifteen-year PCSM and non-PCa mortality (NPCM) were explored using separate multivariable Cox models within a competing risks framework. Fractional polynomials (FPs) were utilised to fit continuous variables and baseline hazards. Model accuracy was assessed by discrimination and calibration using the Harrell C-index and chi-squared goodness of fit, respectively, within both validation cohorts. A multivariable model estimating individualised 10- and 15-year survival outcomes was constructed combining age, prostate-specific antigen (PSA), histological grade, biopsy core involvement, stage, and primary treatment, which were each independent prognostic factors for PCSM, and age and comorbidity, which were prognostic for NPCM. The model demonstrated good discrimination, with a C-index of 0.84 (95% CI: 0.82-0.86) and 0.84 (95% CI: 0.80-0.87) for 15-year PCSM in the UK and Singapore validation cohorts, respectively, comparing favourably to international risk-stratification criteria. Discrimination was maintained for overall mortality, with C-index 0.77 (95% CI: 0.75-0.78) and 0.76 (95% CI: 0.73-0.78). The model was well calibrated with no significant difference between predicted and observed PCa-specific (p = 0.19) or overall deaths (p = 0.43) in the UK cohort. Key study limitations were a relatively small external validation cohort, an inability to account for delayed changes to treatment beyond 12 months, and an absence of tumour-stage subclassifications. CONCLUSIONS: 'PREDICT Prostate' is an individualised multivariable PCa prognostic model built from baseline diagnostic information and the first to our knowledge that models potential treatment benefits on overall survival. Prognostic power is high despite using only routinely collected clinicopathological information.The Urology Foundatio

Patient satisfaction reported by in-visit and after-visit surveys

Patient experience measurement has become a basic requirement for every healthcare provider organization. Yet, when the timing and mode of survey administration are considered, there is skepticism about the usefulness of ‘after- visit’ patient experience surveys to measure satisfaction and identify opportunities to improve service or health care quality. The aim of this observational study was to compare patient satisfaction among those who rated the patient experience at the conclusion of their outpatient appointment while still in the office, to that among those who rated the patient experience up to one month after their outpatient appointment via a mailed survey. Two sampling strategies were used to collect patient experience data from patients of the University of Maryland Family and Community Medicine practice: a postal survey to collect data from patients approximately 30 days after their visit (the After-Visit survey), and a within-visit survey to collect data from patients during their visit (the In-Visit survey). Nineteen survey questions measured comparable constructs between the After-Visit and In-Visit. This study did not find any significant differences between the data sources for any of these questions. The study showed that patient satisfaction could be assessed within a visit or by mail 30 days later without a statistically significant effect on mean responses

Encouraging Evidence on a Sector-Focused Advancement Strategy: Two-Year Impacts from the WorkAdvance Demonstration

This report summarizes the two-year findings of a rigorous random assignment evaluation of the WorkAdvance model, a sectoral training and advancement initiative. Launched in 2011, WorkAd-vance goes beyond the previous generation of employment programs by introducing demand-driven skills training and a focus on jobs that have career pathways. The model is heavily influenced by the positive findings from the Sectoral Employment Impact Study (SEIS) completed in 2010. A major component of the WorkAdvance model, in common with the programs studied in the SEIS, is formal training offering industry-recognized certifications, reflecting the hypothesis that skills acquisition is necessary for advancement. The model also requires providers to be far more employer-facing than traditional training programs, taking into account multiple employers' changing skill requirements, employee assessment practices, and personnel needs. This report presents the imple-mentation, cost, participation, and two-year economic impacts of WorkAdvance. The economic results are based on unemployment insurance earnings records and a second-year follow-up survey.The WorkAdvance program operations and evaluation are funded through the federal Social Innovation Fund (SIF), a public-private partnership administered by the Corporation for National and Community Service. This SIF project is led by the Mayor's Fund to Advance New York City and the NYC Center for Economic Opportunity in collaboration with MDRC.Key Findings*All providers translated the WorkAdvance model into a set of concrete services, but it took time— more than a year for some components and providers -- and a substantial amount of tech-nical assistance and support. As a result, at some sites, later study enrollees were more likely than earlier ones to experience a fully implemented and "mature" WorkAdvance program.*Overall, WorkAdvance resulted in very large increases in participation in every category of services, as well as in training completion and credential acquisition, compared with what would have happened in the absence of the program. Expenditures for the operation of WorkAdvance fell between $5,200 and$6,700 per participant at the four providers delivering the program.*WorkAdvance providers increased earnings, with variation in results that closely matched the providers' experience in running sector-based programs and the extent to which the services they offered were demand driven. The most experienced sectoral provider, Per Scholas, had large and consistent impacts on both primary and secondary outcomes. Madison Strategies Group and Towards Employment, providers new to sectoral training, had promising but less consistent results that grew stronger for later enrollees. One provider, St. Nicks Alliance, did not produce positive impacts. The results did not differ dramatically across subgroups, though en-couragingly, WorkAdvance was able to increase earnings among the long-term unemployed.The evaluation as a whole provides important information for workforce development providers interested in pursuing a sector strategy. The analysis considers the role played by providers' sector-specific training and preparation and the role played by the nature of the sectors themselves. Future priorities that emerge from the results are (1) understanding how to help the more disadvantaged access the programs and (2) learning how to build service capacity, given how complex the model is to run

Seasonal variation in diagnosis of invasive cutaneous melanoma in Eastern England and Scotland.

BACKGROUND: Worldwide, the incidence of cutaneous melanoma has been reported to be highest in the summer and lowest in the winter. Northern Irish data suggested seasonal variation for women only, especially those with thinner melanomas, sited on limbs. We interrogated two larger UK cancer registries for temporal differences in melanoma diagnosis and associated patient characteristics. METHODS: Melanomas diagnosed from 2006 to 2010 in the Eastern England and Scottish cancer registries (n=11,611) were analysed by month of diagnosis, patient demographics and melanoma characteristics, using descriptive and multivariate modelling methods. RESULTS: More patients with melanoma were diagnosed in the summer months (June 9.9%, July 9.7%, August 9.8%) than the winter months (December 7.2%, January 7.2%, February 7.1%) and this pattern was consistent in both regions. There was evidence that the seasonal patterns varied by sex (p=0.015), melanoma thickness (p=0.002), body site (p=0.006), and type (superficial spreading melanomas p=0.005). The seasonal variation was greatest for diagnosis of melanomas occurring on the limbs. CONCLUSION: This study has confirmed seasonal variation in melanoma diagnosis in Eastern England and Scotland across almost all population demographics and melanoma characteristics studied, with higher numbers diagnosed in the summer months, particularly on the limbs. Seasonal patterns in skin awareness and related help-seeking are likely to be implicated. Targeted patient interventions to increase sun awareness and encourage year-long skin inspection are warranted.The paper was materially supported by the National Institute for Health Research (NIHR-CS-012-030), supporting FMW through a Clinician Scientist award. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health. During this project, GL was supported by a post-doctoral fellowship by the National Institute for Health Research (PDF-2011-04-047) to the end of 2014; and by a Cancer Research UK Clinician Scientist Fellowship award (A18180) from March 2015.This is the final version of the article. It first appeared from Elsevier via http://dx.doi.org/10.1016/j.canep.2015.06.00