Skills Training Works: Examining the Evidence

In spite of public consensus that education and training lead to economic advancement, recent federal policies have made it harder for low-income Americans to get the education and training they need to succeed in today's economy. A number of recent federal policies, like the 1996 law that established the Temporary Assistance for Needy Families (TANF) welfare program, have in different ways adopted a "work first" approach that encourages or requires low-income adults to find employment immediately, rather than allowing them first to develop skills that might lead to better jobs with family-sustaining wages and benefits, and opportunities for steady work and advancement. This policy shift away from skills training and toward work first strategies has come about, in part, from a misconception that "training does not work." Many policymakers have heard that government-sponsored research -- such as the National Job Training Partnership Act (JTPA) Study, the Greater Avenues to Independence (GAIN) Evaluation and the National Evaluation of Welfare-to-Work Strategies (NEWWS) -- shows that low-income adults who receive training do no better in the job market than people who do not receive such services, or who receive only the less expensive job search assistance typical of many work first strategies. In fact, a more comprehensive look at the existing research reveals the documented effectiveness of skills training

The Effects of Virtual Reality on Symptom Distress in Patients Undergoing Hematopoietic Stem Cell Transplant

The purpose of this QI project was to evaluate the effects of virtual reality (VR) on symptom distress experienced by individuals receiving an allogenic stem cell transplant. Allogenic transplants are associated with a moderate to high risk for distressing symptoms such as depression, anxiety, and pain. VR targets multiple sensory modalities, including auditory, visual or haptic experiences, by using computer-generated scenarios, which can interact with an individual and possibly diminish unpleasant symptoms. Twenty individuals aged 19 to 70 years (median age of 56.5 years) who were hospitalized in an academic setting received VR up to two sessions a week for two weeks. Before and after each session, the participant completed the Edmonton Symptom Assessment Scale Revised (ESAS-r) to evaluate their symptom distress. Paired t-tests were conducted and showed significant improvement in eight out of the ten symptoms addressed in ESAS-r (depression, anxiety, tiredness, drowsiness, appetite, pain, quality of life, and wellbeing). Nausea and shortness of breath had no significant improvements. These findings suggest VR is a novel intervention to treat distressing symptoms in a hospital setting and warrant future investigations exploring VR’s impact on prolonged hospitalizations related to distressing symptoms

Gatsby's Gorgeous Car: Objects and the Outsider in F. Scott Fitzgerald's Fiction

Thesis advisor: Christopher P. WilsonGrowing up F. Scott Fitzgerald longed to be a part of the leisure class with whom he socialized and was educated. However, born into a middle class family and destined to be a writer, he never achieved that goal. This preoccupation with the leisure class continued into adulthood and was reflected in his works of fiction. In his writing he repeatedly depicts the outsider, a middle class character who by the means of monetary wealth hopes to rise in society. Through his relationship with the object, this outsider attempts to become a part of the elite and is rejected. Mannerisms and social codes that can only be learned by high birth restrict this individual from reaching social heights. The new wealth of the 1920's creates a paradox for the outsider. The object that the leisure class possesses is easily attainable, however, the upward movement it promises is still out of reach.Thesis (BA) — Boston College, 2004.Submitted to: Boston College. College of Arts and Sciences.Discipline: English.Discipline: College Honors Program

Social Determinants of Health: Underreported Heterogeneity in Systematic Reviews of Caregiver Interventions.

BACKGROUND AND OBJECTIVES:Although most people have some experience as caregivers, the nature and context of care are highly variable. Caregiving, socioeconomic factors, and health are all interrelated. For these reasons, caregiver interventions must consider these factors. This review examines the degree to which caregiver intervention research has reported and considered social determinants of health. RESEARCH DESIGN AND METHODS:We examined published systematic reviews and meta-analyses of interventions for older adults with age-related chronic conditions using the PRISMA and AMSTAR 2 checklists. From 2,707 papers meeting search criteria, we identified 197 potentially relevant systematic reviews, and selected 33 for the final analysis. RESULTS:We found scant information on the inclusion of social determinants; the papers lacked specificity regarding race/ethnicity, gender, sexual identity, socioeconomic status, and geographic location. The majority of studies focused on dementia, with other conditions common in later life vastly underrepresented. DISCUSSION AND IMPLICATIONS:Significant gaps in evidence persist, particularly for interventions targeting diverse conditions and populations. To advance health equity and improve the effectiveness of interventions, research should address caregiver heterogeneity and improve assessment, support, and instruction for diverse populations. Research must identify aspects of heterogeneity that matter in intervention design, while recognizing opportunities for common elements and strategies

A self-consistent model of Galactic stellar and dust infrared emission and the abundance of polycyclic aromatic hydrocarbons

We present a self-consistent three-dimensional Monte-Carlo radiative transfer model of the stellar and dust emission in the Milky-Way, and have computed synthetic observations of the 3.6 to 100 microns emission in the Galactic mid-plane. In order to compare the model to observations, we use the GLIMPSE, MIPSGAL, and IRAS surveys to construct total emission spectra, as well as longitude and latitude profiles for the emission. The distribution of stars and dust is taken from the SKY model, and the dust emissivities includes an approximation of the emission from polycyclic aromatic hydrocarbons in addition to thermal emission. The model emission is in broad agreement with the observations, but a few modifications are needed to obtain a good fit. Firstly, by adjusting the model to include two major and two minor spiral arms rather than four equal spiral arms, the fit to the longitude profiles for |l|>30 degrees can be improved. Secondly, introducing a deficit in the dust distribution in the inner Galaxy results in a better fit to the shape of the IRAS longitude profiles at 60 and 100 microns. With these modifications, the model fits the observed profiles well, although it systematically under-estimates the 5.8 and 8.0 microns fluxes. One way to resolve this discrepancy is to increase the abundance of PAH molecules by 50% compared to the original model, although we note that changes to the dust distribution or radiation field may provide alternative solutions. Finally, we use the model to quantify which stellar populations contribute the most to the heating of different dust types, and which stellar populations and dust types contribute the most to the emission at different wavelengths.Comment: Published in A&A. This version has been revised (compared to the published version) to include additional references to previous work. Scripts to reproduce the results in this paper can be found as supplementary material on the A&A site, or at https://github.com/hyperion-rt/paper-galaxy-rt-mode

Disparities in routine breast cancer screening for medicaid managed care members with a work-limiting disability

Objective: Examine disparities in routine mammography for women who qualify for Medicaid, because of a work-limiting disability. Methods: Individual-level data were obtained for women enrolled in Massachusetts Medicaid Managed Care plans who met the 2007 Healthcare Effectiveness Data and Information Set (HEDIS) criteria for the breast cancer screening measure (n=35,171). Disability status was determined from Medicaid eligibility records. Mammography screening was modeled using multivariate logistic regression. Separate models for women with and without a disability were also estimated. Results: Although unadjusted breast cancer screening rates were roughly equal for women with and without disability, after adjusting for confounders disability status had a significant negative association with screening mammography (OR=0.74; p Conclusion: Nationwide, rates of routine mammography for Medicaid managed care plans averaged below 50% in 2006. Given that a majority of eligible women served by Medicaid have disabilities, and studies have shown that women with disabilities are more likely to be diagnosed with late stage disease, a focus on improving rates of screening for women with disabilities is overdue

Sequencing of 16S rRNA Gene: A Rapid Tool for Identification of Bacillus anthracis

In a bioterrorism event, a tool is needed to rapidly differentiate Bacillus anthracis from other closely related spore-forming Bacillus species. During the recent outbreak of bioterrorism-associated anthrax, we sequenced the 16S rRNA generom these species to evaluate the potential of 16S rRNA gene sequencing as a diagnostic tool. We found eight distinct 16S types among all 107 16S rRNA gene seqs fuences that differed from each other at 1 to 8 positions (0.06% to 0.5%). All 86 B. anthracis had an identical 16S gene sequence, designated type 6; 16S type 10 was seen in all B. thuringiensis strains; six other 16S types were found among the 10 B. cereus strains. This report describes the first demonstration of an exclusive association of a distinct 16S sequence with B. anthracis. Consequently, we were able to rapidly identify suspected isolates and to detect the B. anthracis 16S rRNA gene directly from culture-negative clinical specimens from seven patients with laboratory-confirmed anthrax

Social Determinants of Health: Underreported Heterogeneity in Systematic Reviews of Caregiver Interventions

Background and Objectives: Although most people have some experience as caregivers, the nature and context of care are highly variable. Caregiving, socioeconomic factors, and health are all interrelated. For these reasons, caregiver interventions must consider these factors. This review examines the degree to which caregiver intervention research has reported and considered social determinants of health. Research Design and Methods: We examined published systematic reviews and meta-analyses of interventions for older adults with age-related chronic conditions using the PRISMA and AMSTAR 2 checklists. From 2,707 papers meeting search criteria, we identified 197 potentially relevant systematic reviews, and selected 33 for the final analysis. Results: We found scant information on the inclusion of social determinants; the papers lacked specificity regarding race/ethnicity, gender, sexual identity, socioeconomic status, and geographic location. The majority of studies focused on dementia, with other conditions common in later life vastly underrepresented. Discussion and Implications: Significant gaps in evidence persist, particularly for interventions targeting diverse conditions and populations. To advance health equity and improve the effectiveness of interventions, research should address caregiver heterogeneity and improve assessment, support, and instruction for diverse populations. Research must identify aspects of heterogeneity that matter in intervention design, while recognizing opportunities for common elements and strategies