Eligible Applicants Research Articles

Smoking Cessation in the WIC Program

To the Editor, In their recent paper, Yunzal-Butler et al. [1] report an analysis of the association between the timing of enrollment in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and cigarette smoking among prenatal WIC participants. Based on the finding that women who enroll in WIC early during pregnancy experience only modestly higher quit rates than women who enroll late, Yunzal-Butler et al. conclude that there ‘‘is ample room to improve WIC’s performance,’’ suggesting the WIC program consider intensifying its role in smoking cessation, perhaps through ‘‘more frequent and more focused’’ counseling. The purpose of this letter is twofold: first, we wanted to clarify the goals and approach of WIC in an effort to better contextualize smoking cessation efforts in the program. Second, we wanted to comment on issues that were not raised or adequately discussed by the authors, namely statistical issues regarding the smoking data and covariates utilized in the analysis. WIC is the only federally sponsored public health nutrition program whose mission is ‘‘to safeguard the health of low-income women, infants, and children up to age 5 who are at nutrition risk by providing nutritious foods to supplement diets, information on healthy eating, and referrals to health care’’ services [2]. Contrary to popular belief, WIC is not an entitlement program. This means that available funds do not cover all eligible applicants. With the funds that are available, and the recognition that the epidemic of obesity leads to numerous poor health outcomes, the primary goal of the WIC program is to provide nutritional education, counseling and nutritious foods to supplement participants’ diets. The WIC program provides grants to states to administer the program. States, in turn, fund contracts to local agencies to deliver WIC nutrition services. The scope of services provided by WIC local agencies is broad and includes nutrition education, nutrition risk assessment, breastfeeding support and promotion, immunization screening, referrals to health care and drug and substance abuse services and programs, and promotion of good nutrition for good health, including promotion of physical activity. Participation in nutrition education is voluntary; referrals to health care and other services are offered but not enforced. The positive results presented by Yunzal-Butler et al. suggest that WIC successfully goes beyond its primary goal of improving participants’ nutritional status and education by encouraging healthier lifestyle changes, in this case impacting smoking quit rates. While the authors are correct that the quit rates are modest compared to targeted smoking cessation programs, we believe this comparison is quite inappropriate, due to the aforementioned primary goal of the WIC program as a public health nutrition and education program. Although the WIC program offers participants referrals to smoking cessation programs, it is unrealistic to expect this public health nutrition program to achieve quit rates as high as a focused tobacco cessation program. In C. F. Davis (&) School of Public Health, Department of Epidemiology and Biostatistics, George Education Center 125, University at Albany SUNY, One University Place, Rensselaer, NY 12144, USA e-mail: cd5341@albany.edu

A Time for Change: An Exploration of Attitudes Toward Part-Time Work in Academia Among Women Internists and Their Division Chiefs

Increasing numbers of clinicians desire part-time work, and many will opt out of academic medicine if the barriers to part-time work are too great. Purposeful sampling was used to investigate the experiences of part-time academic physicians and their division leaders to understand (1) how each identified the negative and positive consequences of part-time work, and (2) how each conceptualize part-time work. In 2004, the authors interviewed the Society of General Medicine Horn Scholars Program applicants and their division chiefs from the 2001 and 2004 award cycles and performed a qualitative analysis of the one- to two-hour audiotaped interviews. Seven out of nine eligible applicants and six of seven division chiefs participated. All applicants were female junior faculty clinician educators in academic internal medicine from seven institutions. All division chiefs were male full-time faculty members. Both applicants and division chiefs identified multiple specific negative and positive consequences of part-time work. Analysis of interviews suggested that both groups tended to frame part-time work as a decision to "work less" or to "work differently." Self-reflection and articulation of values helped some faculty determine where they derive the greatest happiness and fulfillment personally and professionally. As more academics seek work-life balance and consider part-time work as a tool to achieve that balance, academic medicine will be challenged to develop creative models for integrating successful part-time physicians, or it will lose that segment of the workforce. This study's findings suggest that one such model may require that physicians and their leaders reconceptualize work altogether.

Re-Entry to Recovery

A demonstration project being designed by the Social Security Administration (SSA) and Rutgers University may provide an effective option for assisting eligible offenders with mental illness in obtaining employment during re-entry to their communities. The project, Early Intervention (EI), will provide temporary cash stipends, immediate Medicare, and innovative employment services and supports to eligible applicants for Social Security disability insurance (DI). The EI project is a broad departure from previous SSA employment initiatives in both philosophy and structure, addressing a host of commonly cited barriers to employment for persons with disabilities in new and different ways. Should the demonstration project prove successful and be adopted into a national program, EI has the potential to provide an important source of support to eligible offenders with mental illness who are transitioning back to their communities.

Learning But Not Earning? The Value of Job Corps Training for Hispanics

The National Job Corps Study (NJCS) was a four-year longitudinal social experiment in which over 15,000 Job Corps eligible applicants were randomized into treatment and control groups. Using experimental estimators, Job Corps was found to have positive impacts in the weekly earnings of white and black youths 48 months after randomization, but not for Hispanic youths, a puzzling outcome that eluded explanation in the NJCS. This study considers explanations for why Job Corps does not increase the earnings of Hispanics in the NJCS. First, we show that the randomization in the NJCS did not create comparable treatment and control groups for Hispanics, possibly because Hispanics represent 20% of the entire randomized sample and are more concentrated in metropolitan areas. We then apply alternative estimators that adjust for systematic differences in observable and time-invariant characteristics of the Hispanic subsample, but still find statistically insignificant effects of Job Corps 48 months after randomization. Finally, we estimate the net treatment effect controlling for post-treatment experience to advance an explanation for why Job Corps fails to benefit Hispanics 48 months after randomization: non-treated Hispanics earn a significant amount of labor market experience during the study compared to treated Hispanics (and non-treated blacks and whites). This higher level of experience translates into higher earnings that Hispanic treated individuals are not able to overcome by the end of the study, despite having higher earnings growth in the 48-month period compared to whites and blacks (either treated or non-treated).

Analysis of Profiles of Students Applying for Entrance to Universities

Applicants to universities present profiles of performance in a variety of relevant content areas as evidence for selection. Even though profiles of different applicants may involve different content areas, the applicants may be competing for places to the same university and even to the same program of study. In that case, and if there are more eligible applicants than there are places, universities must reconcile these different profiles in order to make comparisons among them. When there is a small number of applicants, then these comparisons may be camed out qualitatively; when the number of applicants runs into the order of thousands and there is a short time in which to make the offers, some quantitative analysis is required. This quantitative analysis usually involves aggregating the components of each profile in order to form a single score from which comparisons among applicants can be made readily. Legitimate concerns can be raised regarding forming simple aggregates from diverse components of profiles, but despite these concerns, the practical problem of making relatively rapid decisions means that these concerns are generally not addressed. The premise of this article is that profiles will be more or less consistent among the components and that although some profiles may not be, a great number of others may be, summarized adequately by a single score. It is shown that by applying the principles of latent trait test theory at the level of tests, it is possible to rank order a set of profiles in terms of the adequacy with which they are summarized by a single score, and that as a result, only a subset of the original profiles may require a qualitative analysis. The application of the procedure is illustrated with a random sample of 577 profiles from a population of 12,314, which were presented for selection into universities in Western Australia in 1986.

Accelerated versus traditional nursing students: a comparison of stress, critical thinking ability and performance

A high demand for graduate nurses and a dwindling pool of nursing school applicants have led several collegiate nursing programs to adopt innovative programs to increase the number of eligible applicants. One option is the development of accelerated nursing program. Because of the relative newness of these programs, the need to ascertain data about accelerated students and their success in these programs is vital. This prospective study examines the differences in stress levels, critical thinking ability, and performance of traditional and accelerated nursing students. A voluntary convenient sample ( n = 94) was used from nursing students enrolled in the Associate Degree Nursing (ADN) program. The State-Trait Anxiety Inventory and the Scale of Judgmental Abilities were used to measure the two independent variables. The grade point average in nursing courses and the National Council Licensure Exam scores were employed to measure performance of students. Results revealed that accelerated students showed consistently higher stress levels than those of the traditional students. Moreover, the accelerated group had significantly higher grade averages in nursing courses than traditional students. Implications for nurse educators and recommendations for further studies were made.

The Use of Biodata in Admissions to Teacher Education

Teaching is an attractive profession in Canada. Eligible applicants to teacher education programs typically outnumber available places by 4 to 1. In Canada, teaching confers high occupational status, professional salaries and working conditions, near certainty of graduation once enrolled in a program, and a generally favorable job market. Admission to a teacher education program confers a significant, desirable benefit, but the process of admission to teacher education programs is rather arbitrary. In the analysis, the AA. focus on admissions criteria intended to predict success as a student in the teacher education program or as a classroom teacher

Social work delivery of hospital-based financial assistance services.

Although the United States spends more than $800 billion, or 12 percent of its gross national product, on health care, an estimated 37 million Americans at or below the poverty level experience health risks associated with an inability to afford needed health care (Rowland, Lyons, Salganicoff, & Long, 1994). Between 1980 and 1990 uncompensated care grew from 4.6 percent to 17.8 percent of hospital expenses, reaching nearly $18 billion in revenue deductions and forcing hospitals to re-examine their ability to provide indigent or charity care (Davis & Roland, 1990; Letsch, Lazenby, Levit, & Cowan, 1993). Pursuit of all potential reimbursement options is now a fundamental health care industry fiscal policy. Social workers can be of strategic assistance in facilitating delivery of health care services to needy individuals and contributing to the fiscal bottom line of provider organizations. Although needs assessment and resource provision have long been regarded as integral components of health care social work practice (Becker & Becker, 1986; Bracht, 1978; Cabot, 1909; Cannon, 1923; Holosio & Taylor, 1989; Hubschman, 1983), limited examples of systematic delivery of financial services by hospital-based social workers exist. This article discusses a university hospital program in which the social work department facilitated access to health care for large numbers of needy patients and their families, increased facility reimbursement for services, reduced nonsponsored patient volumes, increased social work visibility, and enhanced the perception of the role social workers have in making patient care and fiscal contributions to the health care provider. The program serves as an operational model and has been adopted by other hospitals. UNMET PATIENT FINANCIAL NEEDS Oregon Health Sciences University (OHSU) is one of the principal teaching, research, and medical care centers in the Northwest, with more than 232,000 patient visits per year. Consistent with most public tertiary health care institutions, a high percentage of patients are either potential or actual Medicaid recipients or nonsponsored private pay (indigent) patients. With government coverage of uncompensated care reaching nearly one-third of OHSU gross patient revenues and growing concerns about maximized reimbursement, accurate patient financial eligibility determinations became crucial. Despite the extensive need, no systematic mechanism existed for providing information and application assistance to OHSU inpatients and outpatients potentially eligible for Medicaid or general assistance. Although the admitting department frequently identified eligible patients to the social work department, time constraints, other patient care needs, and lack of familiarity with complex and ever-changing public assistance program stipulations limited staff response to financial referrals. Such requests were given lower priority than crisis intervention, immediate discharge planning, comprehensive evaluations, counseling, and other interventions perceived as urgent. Relationships with Medicaid agency personnel were limited, updated policies were unavailable, and there was insufficient opportunity to follow through on complex applications. As a result, patients did not receive the detailed, accurate, and timely information they needed to initiate Medicaid applications, and OHSU lost potential reimbursement when discharged patients failed to complete eligibility determination interviews. SOCIAL WORK FINANCIAL ASSISTANCE PROGRAM Recognizing these deficiencies, the social work and admitting departments collaborated on a new rapid, focused intervention to assess patient financial resources, determine potential eligibility for public assistance, provide information about program benefits, assist initiation of applications, and provide follow-through to maximize the likelihood of eligible applicants receiving financial assistance. …

Dual Office Holding and the Constitution: A View From Hayburn’s Case

Dual Office Holding and the Constitution A View From Hayburn’s Case Mark Tushnet Editor’s Note: This article will appear in The JudiciaryAct of1789, to bepublishedby Oxford University Press in the spring of1991. The book is a compendium of thepapers delivered at a conference held at Georgetown University to mark the bicentennial of the Judiciary Act. Maeva Marcus, who organized the conference, is the editor. The Supreme Court’s January 1989 decision in Mistretta v. United States rejected a constitutional challenge to the manner inwhich the United States Sentencing Commission was composed.1 The constitutional challenge, prem­ ised on the principle of separation of powers, had several elements. As Justice Blackmun’s opinion for the Court noted, one of these ele­ ments recalled the arrangements brought into question early in the history of the federal judiciary, for the Sentencing Commission, de­ scribedas an independent agency located in the judicial branch, used the talents of sitting fed­ eral judges by making three of them members of the Commission. Because the Commission was not a court but was instead an agency ofthe United States, the federal judges who serve on the Commission hold two positions under the United States, one as judges and the other as Commissioners. This dual office holding was challenged as a violation of the Constitution. Justice Blackmun’s opinionnoted that a similar issue had arisen in connection with Hayburn’s Case, 2 U.S. 409 (1792), in which Congress asked judges of the Circuit Courts to serve as commissionersfor the determinationofcertain questions regarding entitlements to pensions for service during the Revolutionary War. Al­ though the Justices of the Supreme Court, sittingascircuitjudges, held thatthe underlying statute was unconstitutional, most ofthem agreed that Congress could require them to serve as commissioners, not as judges. Thispaper examinesthe constitutional terrain in which the Justices located the prob­ lem in Hayburn’s Case, in an attempt to under­ stand the distinction they drew between their constitutionallylimited duties asjudges and the more expansive possibilities for action in their individual capacities. At the outset, though, it should be noted that what we are dealing with may perhaps best be described as a 500-piece jigsaw puzzle, of which we have before us only a handful ofpieces from which we are to deter­ minewhat the overall picture is like. Under the circumstances, the best I can hope to do is identify certain aspects of the conceptual uni­ verse inwhichthe federaljudiciarywas located, which shed some light on the problem of dual office holding and therefore some light on the conception of judging embedded in the Constitution. I. The Invalid Pensions Act in the Circuit Courts A. The Constitutional Issues Addressed HAYBURN’S CASE 45 The story behind Haybum’s Case is well-known.2 The Invalid Pensions Act of 1792 was a public assistance program3 designed to help the families of soldiers injured in the Revolutionary War adjust to the dislocations caused both by their injuries and by the eco­ nomic disruption that occurred in the war’s af­ termath.4 TheAct suspended a previous statute oflimitations on claims by soldiers’ widows and orphans for two years, and allowed disabled soldiers and seamen to receive a pension. The applicant had to present the circuit court ofhis residence with a certificate or affidavits attest­ ing to his disability. The circuit court, whichwas required to sit for at least five days to receive pension applications, would, after receiving the required documents, certify the degree of dis­ ability to the Secretary ofWar, along with a de­ termination of the appropriate pension. The Secretary could then determine whether there had been “imposition or mistake” and withhold the pension recommended by the circuit court. Finally, the Secretary of War would report the list of applicants he found ineligible to ConIn 1989, Justice Harry Blackmun led the Court in reject­ ing a constitutional challenge to the manner in which the U.S. Sentencing Commissionwas composed. Because the Commisssion was designed as an agency of the United States, federal judges who serve on it were perceived as dual office holders, but not in violation of the Constitution. gress, which then would appropriate money for the pensions of the eligible applicants. Con­ gress apparently...

Enrollment demand with constrained supply in a higher education institution

Studies of enrollment demand typically assume that public institutions accept all eligible applicants. In that case the coefficients of a regression equation that explains enrollment as a function of variables that affect student demand are properly interpreted as unknown demand function parameters. However, if enrollments are limited by institutional constraints on the supply of places, another approach to estimating student demand behavior is needed. In this paper we develop a model that explains the determination of enrollments in these cases and a way to estimate the coefficients of a student demand equation that is part of the model. The results are much better than those obtained from a conventional model of enrollment demand estimated using ordinary least squares.

Aspects of Housing Allocation in Soweto

Abstract In Soweto, local authorities allocate housing to eligible applicants in terms of language grouping. This practice is in line with national location policy for Blacks in South Africa, is- designed to produce a linguistically homogeneous residential pattern in Soweto's townships. Allocation guidelines, and data concerning allocation practices are examined. The policy of spatial linguistic homogeneity is shown to be violated. This may be due to informal arrangements between applicants and authorities, housing shortages in the appropriate language reserves and intermarriage between ethnic groups.

Motivation to enter nursing: Eligible applicants to nursing schools in Israel—1968

Any study which includes cultural origins of the respondents tempts one to wander into fields not directly in the paths laid down. In this study of a selected group of young persons who were highly interested in entering nursing (as evidenced by their being accepted to discuss the practical aspects of entering a school), was given a questionnaire asking about motivation for wanting to be a nurse, information relevant to age, origins, and similar data to determine future recruitment plans. The hypotheses that the latter years of high school were the best time to start recruitment, and that all news media were good for propaganda purposes were disproved. Findings showed that young people began thinking seriously about a nursing career before they completed elementary school, and that the recruitment material they most used was factual information about entrance requirements and the actual work of nurses. The hypotheses that parents and other authority figures play a major role in career selection, and that cultural and ethnic background influence career choice were proven, and were most tempting to use as a basis for other hypotheses based on presonceptions of cultural types. It would seem, however, that the results of this study—made independently of others referred to—indicate that recruitment should begin earlier in the schooling of the young child, and that it should be realistic and factual, but geared to the idealism of the young adolescent.

Anti-Poverty Programs and Delinquency

The author is Director of the Social Science Department of National Analysts Inc., having joined the professional staff of this research organization in 1965 as a Study Director. He holds a B.A. in psychology from Temple University and a Ph.D. in sociology from the University of Pennsylvania. While pursuing graduate studies at the University of Pennsylvania, Dr. Robin was an instructor in sociology, and he was awarded the Finnegan Prize for the best piece of original research in the area of deviant behavior. Dr. Robin has served as a Research Assistant in the Department of Psychiatry of the University of Pennsylvania in connection with a study of indices of depression among psychotic patients, and as Research Assistant with the Center for Criminological Research, and Senior Research Assistant at the same university's School of Social Research Center. The author served as consultant to the President's Commission on Law Enforcement and Administration of Justice, and his study Member Delinquency in Philadelphia appeared as the lead article in the recently published Juvenile Gangs in Context. This Journal has published the following of his works: Gang Member Delinquency: Its Extent, Sequence and Typology, Vol. 55, at 59; Pioneers in Criminology: William Douglas Morrison, Vol. 55, at 48; and Justil5;sble Homicide by Police OffiRcers, Vol. 54, at 225. The effect of anti-poverty efforts on delinquency is explored in the present paper within the context of the in-school Neighborhood Youth Corps, one of the largest, best known, and most favorably received Federal programs of its kind. A control group of eligible applicants who were not admitted to the program was randomly and specifically established for research purposes, thus eliminating the self-selection factor. An extensive analysis of the police contact histories of the control and NYC enrollees disclosed no evidence that working in the program reduced their encounters with the police.