Conflicting Approaches to Addressing Ex-Offender Unemployment: The Work Opportunity Tax Credit and Ban the Box

Each year, roughly 700,000 prisoners are released from their six-by-eight-foot cells and back into society. Sadly, though, many of these ex-prisoners are not truly free. Upon returning to society, they often encounter several challenges that prevent them from resuming a normal, reintegrated lifestyle. For many, the difficulties associated with reentry prove to be too much, and within a short three years of their release, two-thirds of ex-offenders are rearrested, reconvicted, and thrown back into the familiar six-by-eight-foot cell. Recidivism might appear to be entirely the exoffenders’ fault, but ex-offenders are not solely responsible for these recidivism rates or the solution to this problem. Society must also understand and confront the challenges of the reentry process to “better serve prisoners, their families, their communities, and society at large.” The topic of ex-offender reentry is part of a much broader discussion of criminal justice reform. Many people are dedicated to reforming the criminal justice system as a whole. One example of criminal justice reform is the movement towards reducing mass incarceration and shifting away from the retributive focus of incarceration. There are also efforts to reduce the length of criminal sentences, as the recent reduction in sentences for some drug offenses demonstrates. The House Judiciary Committee is also involved in reform efforts in its work on several bipartisan bills aimed at reforming many aspects of the criminal justice system. However, these reform efforts will only truly work if ex-offender reentry works, and one key piece to successful reentry is the focus of this Note: ex-offender employment. Because an ex-offender’s unemployment status is the primary predictor of that individual’s likelihood of recidivating, this Note concentrates on the employment piece of the reentry picture. The majority of ex-offenders cannot find jobs after release from prison. The individuals returning to society face several barriers to employment, such as being less educated than the average adult, lacking work experience, and combating the stigma attached to having a criminal record. While the challenge of successful reintegration is multifaceted and not exclusively dependent on securing employment, strong policies directed at employing ex-offenders have the potential to make a meaningful difference, helping these individuals reenter society more effectively. This Note examines two current policies aimed at employing ex-offenders. First, this Note assesses the Work Opportunity Tax Credit (WOTC), a federal tax credit that private employers can claim for hiring individuals of certain target groups. One of these target groups is ex-felons released within the past year. This Note analyzes whether the WOTC is achieving its goal of encouraging employers to hire chronically unemployed individuals such as ex-felons and recommends how to improve the WOTC. The second policy this Note examines is “Ban the Box,” which aims to improve ex-offenders’ job prospects by requiring employers to remove the criminal history check box from job applications. Ban the Box legislation has recently received much attention in the press and in academic discussion because new research has reported that there are unintended negative consequences of the legislation. The research has found that while Ban the Box has successfully helped ex-offenders secure employment, the legislation has also led to increased discrimination of young men of color, including those without a criminal record. Given this negative research, this Note analyzes whether Ban the Box’s approach to the ex-offender unemployment problem is the correct one. Arguably, Ban the Box seeks to assist ex-offenders secure jobs by hiding their criminal history, whereas the WOTC seeks to assist chronically unemployed individuals by acknowledging their past. The two pieces of legislation appear to have contradicting ways of achieving the same goal. This Note attempts to begin the discussion on how to improve these policies in order to work together to serve the goal of employing ex-offenders. Accordingly, Part I explains the barriers that ex-offenders face when seeking employment and the consequences of not securing a job. This Note explains how being unemployed—and thus increasing the likelihood of recidivism—not only impacts the ex-offender himself but also his family and society in general. Part II evaluates one of two current policies focused on employment, the WOTC, and makes recommendations for improvement. Part III discusses the recent debate on Ban the Box legislation, and Part IV examines the interplay between Ban the Box and the WOTC. This Note explains how Ban the Box research further demonstrates the desperate need for changing employers’ hiring practices and argues that while the WOTC is not perfect, the WOTC’s overall approach is a better way of tackling this goal

Enhancing the Entrepreneurial Spirit in Apprenticeship Education to Develop Craft and Micro-enterprises

Micro, small and medium–sized enterprises are considered to be the mainstay of the economy of the European Union, since they represent 99% of all EU enterprises. They are socially and economically important in that they provide 65 million jobs and contribute to innovation and entrepreneurship. However, a 2002 Eurobarometer survey found that EU citizens are less inclined to become entrepreneurs, and tend to be more risk adverse. In recognising this, the EU made entrepreneurship one of the main objectives of the Lisbon Agenda in 2000. The European Commission in 2003 drafted the Green Paper on Entrepreneurship in Europe to stimulate debate on how to best promote the entrepreneurial spirit. In 2004, in adopting the conclusions from ‘Stimulating Entrepreneurship’ the European Council recognising that entrepreneurship is a major driver of employment, innovation and growth encouraged member states to stimulate the entrepreneurial mindset through training and education. The SENSibilisation des Apprentis à leSprit d’entreprendre (SENSAS) project is based around the notion of fostering entrepreneurship, or the entrepreneurial spirit, among young people, in line with the European Commission’s 2004 “Action Plan: The European Agenda for Entrepreneurship”. In this specific case the focus is on apprentices, who are in direct contact with both the worlds of work and training by virtue of their position in work-linked training programmes. As such, this project aims to target trainers, to enable them to imbue their students with the idea of entrepreneurship and to equip apprentices with an entrepreneurial spirit that they will employ in the real world. This partnership entrepreneurial project is located within the area of continuing education for teachers and trainers. It targets the following actors: trainers of apprentices and apprentices. In addition the outputs of this project can be broadened to reach regular third level students (of business or commerce for example) as well as secondary school pupils and their teachers or lecturers. There are two main products or outputs anticipated for this project. These are a pedagogical tool kit to raise awareness in entrepreneurial spirit and a computer software role playing tool. This working paper will seek to assess the outcome streams from each of the partner organisations implementation of the SENSAS products and subsequent evaluation of the emerging entrepreneurial spirit and channel them into conceptual frameworks that will signpost a continuing research paradigm

Developing an understanding of networks with a focus on LMIC health systems: how and why clinical and programmatic networks form and function to be able to change practices: a realist review

Networks are an increasingly employed approach to improve quality of care, service delivery, and health systems performance, particularly in low-and-middle income country (LMIC) health systems. The literature shows that networks can improve the provision and quality of services and health system functioning but there is limited evidence explaining how and why networks are established and work to achieve their reported results. We undertook a realist review to explore this. The objective of this realist review was to develop a programme theory outlining the underlying mechanisms and interactions of contexts that explain how and why a network’s set-up and function enable high-quality care and services and improved clinical outcomes in LMIC health systems. We followed Pawson’s five steps for realist reviews. The search strategy was based on a previously published scoping review with additional searches. Literature was selected based on its relevance to the programme theory and rigour. Context-mechanism-outcome configurations were developed from the extracted data to refine the initial programme theory with causal explanations. Theories on social movements and organisations supported the identification of mechanism and brought additional explanatory power to the programme theory. The programme theory explains how networks are initiated, formed, and function in a way that sets them up for network leadership and committed, engaged, and motivated network members to emerge and to change practices, which may lead to improved quality of care, service delivery, and clinical outcomes through the following phases: identify a problem, developing a collective vision, taking action to solve the problem, forming purposeful relationships, linkages, and partnerships, building a network identity and culture, and the creation of a psychological safe space. This deeper understanding of networks formation and functioning can lead to a more considered planning and implementation of networks, thereby improving health system functioning and performance

The role of DNA methylation in human pancreatic neuroendocrine tumours

Pancreatic neuroendocrine tumours (PNETs) are the second most common pancreatic tumour. However, relatively little is known about their tumourigenic drivers, other than mutations involving the multiple endocrine neoplasia 1 (MEN1), ATRX chromatin remodeler, and death domain-associated protein genes, which are found in ~40% of sporadic PNETs. PNETs have a low mutational burden, thereby suggesting that other factors likely contribute to their development, including epigenetic regulators. One such epigenetic process, DNA methylation, silences gene transcription via 5’methylcytosine (5mC), and this is usually facilitated by DNA methyltransferase enzymes at CpG-rich areas around gene promoters. However, 5’hydroxymethylcytosine, which is the first epigenetic mark during cytosine demethylation, and opposes the function of 5mC, is associated with gene transcription, although the significance of this remains unknown, as it is indistinguishable from 5mC when conventional bisulfite conversion techniques are solely used. Advances in array-based technologies have facilitated the investigation of PNET methylomes and enabled PNETs to be clustered by methylome signatures, which has assisted in prognosis and discovery of new aberrantly regulated genes contributing to tumourigenesis. This review will discuss the biology of DNA methylation, its role in PNET development, and impact on prognostication and discovery of epigenome-targeted therapies

Volleyball Overhead Swing Volume and Injury Frequency over the Course of a Season

Background: Overuse injuries are common in volleyball; however, few studies exist that quantify the workload of a volleyball athlete in a season. The relationship between workload and shoulder injury has not been extensively studied in women\u27s collegiate volleyball athletes. Hypothesis/Purpose: This study aims to quantify shoulder workloads by counting overhead swings during practice and matches. The purpose of the current study is to provide a complete depiction of typical overhead swings, serves, and hits, which occur in both practices and matches. The primary hypothesis was that significantly more swings will occur in practices compared to matches. The secondary hypothesis was that greater swing volume and greater musculoskeletal injury frequency will occur in the pre-season than during the season. Study Design: Prospective cohort. Methods: Researchers observed practice and match videos and counted overhead serves and attacks of 19 women\u27s collegiate volleyball players for two seasons. Serves, overhead hits, and total swings (serves + hits) were the dependent variables; event (matches and practice) along with position (defensive specialists, setter, outside hitter, and middle blocker) were the independent variables. Musculoskeletal injury frequency and swing volume workload were compared across pre-season and competitive season time periods. Results: Across all positions except outside hitters twice as many total swings occurred in practices compared to matches (p = .002) resulting in an average of 19 (CI95 16.5, 21.5) more swings in practice than in matches. The average number of total swings during the pre-season 47.1 (CI95 44.1, 50.1) was significantly greater than average swings per session during the competitive season 37.7 (CI95 36.4, 38.9) (p \u3c 0.001) resulting in a mean difference of 9.4 (CI95 6.1, 12.7) swings. The number of athletes limited in participation or out due to a musculoskeletal injury during the pre-season (2.9%) was greater than during the season (1.1%) (p = 0.042). Conclusion: These findings support the primary hypothesis that women\u27s collegiate volleyball athletes swing more during practices than in matches. The higher average number of serves in the pre-season and the greater frequency of musculoskeletal injuries requiring participation restriction or removal from participation suggest that a concordant relationship may exist between workload and injury variables. Level of Evidence: 2

Dockopathies: a Systematic Review of the Clinical Pathologies Associated With Human Dock Pathogenic Variants

The Dedicator of Cytokinesis (DOCK) family (DOCK1-11) of genes are essential mediators of cellular migration, growth, and fusion in a variety of cell types and tissues. Recent advances in whole-genome sequencing of patients with undiagnosed genetic disorders have identified several rare pathogenic variants in DOCK genes. We conducted a systematic review and performed a patient database and literature search of reported DOCK pathogenic variants that have been identified in association with clinical pathologies such as global developmental delay, immune cell dysfunction, muscle hypotonia, and muscle ataxia among other categories. We then categorized these pathogenic DOCK variants and their associated clinical phenotypes under several unique categories: developmental, cardiovascular, metabolic, cognitive, or neuromuscular. Our systematic review of DOCK variants aims to identify and analyze potential DOCK-regulated networks associated with neuromuscular diseases and other disease pathologies, which may identify novel therapeutic strategies and targets. This systematic analysis and categorization of human-associated pathologies with DOCK pathogenic variants is the first report to the best of our knowledge for a unique class in this understudied gene family that has important implications in furthering personalized genomic medicine, clinical diagnoses, and improve targeted therapeutic outcomes across many clinical pathologies

Incorporating comorbidity within risk adjustment for UK pediatric cardiac surgery

INTRODUCTION: When considering early survival rates after pediatric cardiac surgery it is essential to adjust for risk linked to case complexity. An important but previously less well understood component of case mix complexity is comorbidity. METHODS: National congenital heart diseases audit (NCHDA) data representing all pediatric cardiac surgery procedures undertaken in the United Kingdom and Ireland between 2009 and 2014 was used to develop and test groupings for comorbidity and additional non procedure based risk factors within a risk adjustment model for 30-day mortality. A mixture of expert consensus based opinion and empiric statistical analyses were used to define and test the new comorbidity groups. RESULTS: The study dataset consisted of 21,838 pediatric cardiac surgical procedure episodes in 18,834 patients with 539 deaths (raw 30-day mortality rate 2.5%). In addition to surgical procedure type, primary cardiac diagnosis, univentricular status, age, weight, procedure type (bypass, non-bypass or hybrid) and era, the new risk factor groups of: non Downs congenital anomalies, acquired comorbidities, increased severity of illness indicators (such as pre-operative mechanical ventilation or circulatory support) and additional cardiac risk factors (such as heart muscle conditions and raised pulmonary arterial pressure) all independently increased the risk of operative mortality. DISCUSSION: In an era of low mortality rates across a wide range of operations, non-procedure based risk factors form a vital element of risk adjustment and their presence leads to wide variations in the predicted risk of a given operation

Axillobifemoral Bypass: A Brief Surgical and Historical Review

Peripheral artery disease (PAD) occurs when plaque accumulates in the arterial system and obstructs blood flow. Narrowing of the abdominal aorta and the common iliac arteries due to atherosclerotic plaques restricts blood supply to the lower limbs. Clinically, the lower limb symptoms of PAD are intermittent claudication, discoloration of the toes, and skin ulcers, all due to arterial insufficiency. Surgical revascularization is the primary mode of treatment for patients with severe limb ischemia. The objective of the surgical procedure is to bypass a blockage in an occluded major vessel by constructing an alternate route for blood flow using an artificial graft. This article presents information on aortoiliac reconstruction, with an emphasis on axillobifemoral bypass grafting.

A Systematic Review of interventions to Promote Hpv Vaccination Globally

BACKGROUND: Despite the human papillomavirus (HPV) vaccine being a safe, effective cancer prevention method, its uptake is suboptimal in the United States (U.S.). Previous research has found a variety of intervention strategies (environmental and behavioral) to increase its uptake. The purpose of the study is to systematically review the literature on interventions that promote HPV vaccination from 2015 to 2020. METHODS: We updated a systematic review of interventions to promote HPV vaccine uptake globally. We ran keyword searches in six bibliographic databases. Target audience, design, level of intervention, components and outcomes were abstracted from the full-text articles in Excel databases. RESULTS: Of the 79 articles, most were conducted in the U.S. (72.2%) and in clinical (40.5%) or school settings (32.9%), and were directed at a single level (76.3%) of the socio-ecological model. Related to the intervention type, most were informational (n = 25, 31.6%) or patient-targeted decision support (n = 23, 29.1%). About 24% were multi-level interventions, with 16 (88.9%) combining two levels. Twenty-seven (33.8%) reported using theory in intervention development. Of those reporting HPV vaccine outcomes, post-intervention vaccine initiation ranged from 5% to 99.2%, while series completion ranged from 6.8% to 93.0%. Facilitators to implementation were the use of patient navigators and user-friendly resources, while barriers included costs, time to implement and difficulties of integrating interventions into the organizational workflow. CONCLUSIONS: There is a strong need to expand the implementation of HPV-vaccine promotion interventions beyond education alone and at a single level of intervention. Development and evaluation of effective strategies and multi-level interventions may increase the uptake of the HPV vaccine among adolescents and young adults