Elements of Success in Welfare to Work Programs: Programmatic and Policy Recommendations

An analysis of eight welfare-to-work programs between 1998 and 2000 in Chicago to identify successful program elements, isolate barriers to employment presented by participants, and make recommendations for welfare reform policy. The programs were both large and small, of both long and short duration, and provided a variety of services, from vocational training to shorter job placement-focused activities. By reviewing quantitative findings within the context of qualitative data gathered through staff and participant interviews, we have identified elements of successful programming and welfare policy recommendations that flow from them.Sample Demographics: Our sample consisted of 843 participants in these eight programs over the two-year period.-- The mean number of children across the sample was 2.57.-- 46.7% had earned a high school diploma or GED.-- Average reading levels were 7.70 and 6.46 for math.-- 81.5% of the sample had been employed at some point prior to entering the program.-- The average length of time on welfare was 6.97 years.Employment Rates and Drop Rates: Analyzing all those participants who showed up at the programs after intake, the employment rate was 56.1% and the drop rate was 43.9%. Those who found employment were younger, had a slightly lower average number of children, and slightly more had been ever employed prior to entering the program.Reasons for Program Drop Outs: The four most commonly cited reasons for drop were child care, health, substance abuse, and low literacy.Child care drop outs were on average older, more poorly educated, and less likely to have been employed in the past. Almost half the child care drop outs had school age children in addition to younger children, giving rise to the hypothesis that they had difficulty in finding child care for so many different age groups.Nearly 80% of the health problems involved the health of the participant rather than other family members. Women who dropped out due to health problems had higher literacy and numeracy levels than the overall sample, as well as a much longer average time on welfare (11.95 years versus 6.97 years). Fewer participants with health problems had ever been employed (75.6%) compared to the overall sample (81.7%), indicating that these health problems have and continue to be employment barriers. Substance abusers dropped out later in the program than other drop outs. They too have been on welfare for a longer time than the overall sample- 8.67 years versus 6.97 years. Since their average employment history was about the same as the overall sample, it is likely that substance abuse causes participants to lose successive jobs, a factor that is associated with longer stays on welfare. Participants who dropped out due to low literacy had average reading scores of 4.54 and math scores of 3.96, considerably lower than the overall sample, and had longer years on welfare (8.34 compared to 6.46 for the entire sample). In addition, they had been employed far less than the sample (55% compared to 81.7%), indicating that their low literacy presented a significant barrier to employment

Roundtable on the sociology of religion: Twenty-three theses on the status of religion in American sociology-A mellon working-group reflection

[Extract] American sociology has not taken and does not take religion as seriously as it needs to in order to do the best sociology possible. Despite religion being an important and distinctive kind of practice in human social life, both historically and in the world today, American sociologists often neglect religion or treat it redtionistically. We explore several reasons for this negligence, focusing on key historical, conceptual, methodological, and institutional factors. We then turn to offer a number of proposais to help remedy American sociology’s negligence of religion, advance the study of religion in particular, and enhance sociology’s broader disciplinary capacity to improve our understanding and explanation of human social life. Our purpose in this analysis is to stimulate critical and constructive discussion about the significance of religion in human life and scholarly research on it

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial

Background: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor. Methods: The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population). Findings: Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI. Interpretation: In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk