Racial Disparities in Welfare Dependence and Financial Independence: Links to Human Capital,Local Economy,and State Temporary Assistance for Needy Families Policies

This secondary data analysis examined racial disparities in associations betwen welfare dependence/financial independence and human capital, local economy, and state TANF policies. A sample of 6,737 parents was extracted from the public-use data set titled “National Longitudinal Survey of Youth.” Results showed that restrictive TANF policies reduced African Americans’ likelihood of welfare use and increased likelihood of their financial independence. Multinomial logistic results also showed that, among Hispanics, employment growth in neighboring counties promoted welfare use; whereas among Caucasians such growth promoted financial independence. County poverty increased (a) Caucasians’ likelihood of welfare use and (b) Hispanics’ likelihood of being working poor; it decreased Caucasians’ and African Americans’ likelihood of financial independence. Across ethnic groups, education reduced likelihood of welfare use and working poor status; across minority groups, education increased likelihood of financial independence, but among Caucasians it decreased such likelihood. Across ethnic groups, occupational skills hindered dependence and improved odds of employment (regardless of welfare or poverty status). This study concluded the studied TANF policies and job markets were not color-blind. Interventions this study implies include less-restrictive TANF policies, generous support services, TANF staff cultural-competence training, and antidiscrimination rules. Research investigating particular TANF policies’ and services’ effects by ethnicity might prove useful.     

“Better safe than sorry”—Reasons for consulting care due to decreased fetal movements

Background

Experience of reduced fetal movements is a common reason for consulting health care in late pregnancy. There is an association between reduced fetal movements and stillbirth.

Quantification of follow-up time in oncology clinical trials with a time-to-event endpoint: Asking the right questions

For the analysis of a time-to-event endpoint in a single-arm or randomized clinical trial it is generally perceived that interpretation of a given estimate of the survival function, or the comparison between two groups, hinges on some quantification of the amount of follow-up. Typically, a median of some loosely defined quantity is reported. However, whatever median is reported, is typically not answering the question(s) trialists actually have in terms of follow-up quantification. In this paper, inspired by the estimand framework, we formulate a comprehensive list of relevant scientific questions that trialists have when reporting time-to-event data. We illustrate how these questions should be answered, and that reference to an unclearly defined follow-up quantity is not needed at all. In drug development, key decisions are made based on randomized controlled trials, and we therefore also discuss relevant scientific questions not only when looking at a time-to-event endpoint in one group, but also for comparisons. We find that different thinking about some of the relevant scientific questions around follow-up is required depending on whether a proportional hazards assumption can be made or other patterns of survival functions are anticipated, for example, delayed separation, crossing survival functions, or the potential for cure. We conclude the paper with practical recommendations.     

Sexual risk behaviors among youth in the child welfare system

This study uses data from the National Survey of Child and Adolescent Well-Being (NSCAW) to provide estimates of sexual risk behaviors for 877 youth, age 11–14 at baseline, in the child welfare system. It examines the association between baseline psychosocial risk and protective factors on engagement in sexual risk behaviors after 36 months. It further compares rates of sexual risk behaviors between youth placed in out-of-home care and those who remained with their biological family. Key findings include a high rate of pregnancy, a high percentage of youth who initiated sexual activity at or before age 13 as well as a limited role of protective factors in moderating sexual risk behaviors. A history of placement into out-of-home care is not significantly associated with greater engagement in sexual risk behaviors. Implications for intervention development and child welfare policy for this population are discussed.     

Overtime and Undertime: An Analysis of Hours Worked*

Drawing on 1980 Public Use Microdata Samples (PUMS), this study compares the determinants of annual hours of work for whites, blacks, and mainland-born Puerto Ricans residing in the New York SMSA in 1979. Two theoretical approaches are tested; a neoclassical specification and an extended structural model. The analysis supports both approaches. Few differences in coefficients exist between white and minority men, but the hours of minority women are less sensitive to family demands than are those of white women. The implications of these and other findings are discussed.     

Unethical business practices in U.S. health care alarm physician leaders

Learn the results of ACPE's recent survey on ethical business practices and find out why physician executives are very concerned about the impact unethical behaviors appear to be having on health care.     

The dark side of P4P

Examine the pitfalls of pay for performance and learn why some physicians and others are deeply concerned about the idea of incentive pay and fear it will have a negative impact on patient care.     

Konfliktcoaching einer Schulleiterin

Conflict-coaching of a headmistressThe author describes the process of conflict coaching. A newly appointed headmistress encountered a high conflict-potential when taking over this position. During the process of coaching appropriate strategies for conflict will be developed and necessary preparations will be made. As an extension of management-competencies the executive receives support from the coach.