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Design of the Project NetWork return-to-work experiment for persons with disabilities.

As the Nation's first rigorous large-scale evaluation of vocational rehabilitation (VR) assistance to persons with severe disabilities, the Project NetWork demonstration will provide a wide range of information to policy-makers, researchers, and other interest groups. The evaluation of Project NetWork addresses two key policy questions: Is it feasible to increase participation in VR services among Disability Insurance (DI) beneficiaries and Supplemental Security Income (SSI) applicants/recipients through a combination of intensive outreach, case management, and enhanced work incentives? Do the interventions tested produce net benefits from the perspective of participants, society, the DI Trust Fund, and the Federal Government, as a whole? The study utilizes a randomized field experiment design to evaluate the net impact of the demonstration on participant employment, earnings, receipt of transfer benefits, social and psychological well-being, and other variables of interest to policymakers. A combination of SSA administrative data, information from the demonstration's onsite management information system (MIS), and in-person interviews (containing a rich array of information on disability, health, and attitudes) supports the evaluation. This article summarizes three aspects of the evaluation: Its experimental and sample design; the methods and data to be used to analyze project benefits, costs, and participation; and the challenges faced during demonstration implementation. It also presents preliminary data on the characteristics of Project NetWork participants and eligibles.

Adult↗

Chemical dependency: helping a nurse return to work.

A co-worker is coming back to work after being treated for alcohol and drug problems. I don't want to have to watch or monitor her. How do we know that her patients will get their medications this time and good care? The last time she took the meds herself instead of giving them to her patients.

Employment↗

The development of a Pharmacy Student Work Values Inventory (PSWVI).

The purpose of this study was to develop an instrument that measures pharmacy student work values. The instrument was included in a questionnaire mailed to 1,820 pharmacy students who had just graduated or were in their last year of pharmacy school from 19 schools of pharmacy nationwide. A total of 738 questionnaires were deemed usable for a usable rate of 41.5 percent. After Varimax factor analysis, eleven reliable factors emerged: Quality Patient Care; Supervision and Company Policy; Work Creativity/Variety; Status; Management/Leadership; Economic Return; Work Schedule; Family Responsibilities; Job Security; Co-worker Relationships; and Policies and Procedures. "Job Security," "Family Responsibilities," and "Patient Care" were rated least and negatively important respectively. There were no differences between BS and PharmD degree aspirants on the eleven factors; however, there were some significant differences between sexes. Women rated "Supervision and Company Policy" and "Quality Patient Care" higher than men. Men did not negatively value "Work Schedule" as much as women did, i.e., women preferred to work traditional, weekday hours.

Education, Pharmacy↗

Effects of time-limited vs unlimited compensation on pain behavior and treatment outcome in low back pain patients.

A common theme in the pain literature is that worker's compensation reinforces pain behavior and adversely influences treatment outcome of chronic pain patients. This study compared 110 chronic low back pain males divided into three groups: 44 receiving no compensation, 27 receiving time-limited worker's compensation, and 39 receiving unlimited social security disability benefits. All patients participated in a multimodal treatment program (e.g. nerve blocks, transcutaneous electrical nerve stimulation, relaxation training, biofeedback). Physician ratings of pain behavior and self-report measures of pain characteristics, activity level, and medication intake were gathered pretreatment; self-report measures were collected again approximately one year following treatment. The results showed disability patients to have a higher percentage of physician rated symptom dramatization and pain behavior and a greater usage of medication compared with the non-compensation and time-limited worker's compensation patients. At follow-up, no between group differences were found on measures of pain intensity, medication usage and activity. In general, however, more worker's compensation and non-compensation patients who were initially not working had returned to work at the time of follow-up compared with the disability patients. These results suggest that time-limited compensation may not affect treatment outcome or interfere with return-to-work chances while unlimited compensation may adversely influence the probability that patients will return to work. These findings support the notion that worker's compensation patients receiving time-limited financial benefits do not necessarily represent a 'problem' subgroup of chronic pain patients.

Adult↗