How Low-Paid Parents Navigate The Complex Financial Landscape Of Benefits Cliffs And Disincentive Deserts.

Policy makers are concerned that benefits cliffs-the phenomenon by which low-paid workers abruptly lose public benefits as their wages increase-may disincentivize work. The related concept of disincentive deserts refers to occasions when pay increases have little or no effect on a worker's financial well-being because of the resulting gradual reductions in public benefits. Little is known about how low-paid workers navigate this complex financial terrain. Based on in-depth interviews with twenty-five low-paid parents, this article reveals that parents' decisions about how much to work when facing benefits cliffs and disincentive deserts are based on their nuanced assessments of their currently available resources-financial, material, and emotional-of which public benefits are just one small piece. The primary driver of parents' decision making is their ability to care for their families. In no case did they base their decisions solely on a particular wage, income level, or ability to maintain public benefits. Thus, economic modeling, which draws conclusions about the impact of public benefits policies based solely on financial resources from work and benefits, is insufficient for understanding how parents make difficult choices when time, stress, and health are also relevant factors. The article concludes with recommendations for policy makers to expand and simplify public benefits.

Material Hardships, Perceived Stress, and Health among Low-Wage Hospital Workers.

Many service, clerical, and technical hospital workers deemed essential during the pandemic have wages that do not reflect the essential nature of their work and do not earn enough income to cover basic expenses. Thus, many experience material hardships related to food, housing, and medical care. Previous studies have shown strong relationships between material hardships and health; however, they do not fully explain the role of stress as an intervening mechanism. This cross-sectional study analyzes an online survey with 257 lower-wage hospital workers to examine the relationships between hardships and health, and how perceived stress mediates these relationships. Path analysis revealed that financial and food hardships were related to mental health through perceived stress, while medical hardship was directly associated with physical health. These findings add to the evidence that workers' hardships either directly or indirectly contribute to negative mental and physical health outcomes through perceived stress. Future investigations should further examine relationships among material hardships, stress, and health, and advocacy efforts should focus on raising wages for essential hospital workers.

Imaging of the Pes Cavus Deformity.

Direct-type cavus foot deformities are most commonly encountered and are primarily sagittal plane deformities. Direct deformities should be delineated from rarer triplane pes cavovarus deformities. The lateral weight-bearing radiograph is the cornerstone of imaging evaluation of direct pes cavus foot deformity. The apex of Meary talo-first metatarsal angle on the lateral radiograph represents the pinnacle of the cavus deformity and assists in subclassification of the deformity. With routine application, ancillary radiographic imaging techniques, such as the modified Saltzman view or the modified Coleman block test, can give valuable insight into deformity assessment and surgical planning.

From Child Welfare to Jail: Mediating Effects of Juvenile Justice Placement and Other System Involvement.

This study examines the effects of child welfare, mental health, and drug/alcohol system experiences on jail involvement, as mediated by juvenile justice placement, for Black and White youth/young adults. The sample was comprised of individuals born between 1985 and 1994 with child welfare involvement in an urban Pennsylvania county (N = 37,079) and an out-of-home placement (OOHP) subsample (n = 8,317). Four path models were estimated (two full samples, two subsamples; separate models for Black and White youth). For all models, juvenile justice placement was positively related to jail involvement. For the full samples, out-of-home child welfare placement was associated with an increase in juvenile justice placement. Within the Black placement sample, child welfare placement experiences had complex relationships with juvenile justice placement. Providing drug/alcohol services may be a protective factor for Black youth prior to juvenile justice contact. Articulating these relationships helps identify youth most at risk of justice system involvement and better targets services, especially mental health and drug/alcohol services.

Perioperative Understanding of Geriatric Patients.

Surgical treatment of the elderly can be a very difficult and complex endeavor. Appropriate and thorough evaluation of this group of patients is essential to identify surgical candidates who may be at increased risk for developing age-related problems, such as cognitive impairment or postoperative delirium. Involvement of family members and ancillary caregivers is ideal. In order to optimize surgical results, communication of goals of surgery and expectations of patients in order to achieve these goals is paramount. Physical therapy assessment of the elderly will give input on patients' capacity to perform needed changes in ambulatory status after surgery.

Social Justice for Crossover Youth: The Intersection of the Child Welfare and Juvenile Justice Systems.

Social workers are critical to promoting racial and social justice. "Crossover youth," a term used to describe youths who have contact with both the child welfare and juvenile justice systems, are an especially vulnerable but often overlooked population with whom social workers engage. A disproportionate number of crossover youth are African American. Empirical research on crossover youth is growing, but such scholarship rarely engages with a human rights and social justice perspective. African American children and youths have a distinct place within the history and current context of the child welfare and juvenile justice systems. These systems have historically excluded them or treated them differently; now, African American youths are overrepresented in each of them, and evidence suggests they are more likely to cross over. The purpose of this article is to describe the historical and current context of crossover youth, with a particular focus on African American youths, to provide the foundation for a discussion of what social workers can do to promote racial and social justice for crossover youth, including specific implications for practice and policy, as well as broader implications for human and civil rights.

A typology of drug selling among young adults in the United States.

BACKGROUND: Although studies have found that young adults who sell drugs are more likely to be involved in risky behaviors than those who do not sell drugs, there has been relatively little research that has explored heterogeneity among young adults who sell drugs. METHODS: Using a pooled sample of 18 to 25 year olds from the National Survey on Drug Use and Health (2006-2010) who report past-year drug selling (N = 5,373), this study employs latent profile analysis to specify latent groups and assess the correlates of group membership. RESULTS: Findings indicate substantial differences among young adults who sell drugs. In particular, the analysis found four groups of drug sellers: normative (49.6%), club drug users (23.6%), polysubstance users (16.0%), and criminal offenders (10.8%). Club drug users were characterized by high levels of ecstasy and hallucinogen use, polysubstance users were more likely to be depressed and anxious, White and female than the other groups. Criminal offenders were overwhelmingly male and more likely to be comprised of African-Americans and Hispanics. CONCLUSIONS: RESULTS indicate that drug selling in early adulthood varies substantially. Contrary to media and popular notions most drug sellers are not involved in crime and polysubstance using drug sellers are in clear need of mental health services. Further, most drug sellers in this age range are White. Findings suggest that policy efforts that operate under the assumption of homogeneity of drug selling may be misguided.

Looking back and thinking forward: examining the consequences of policies and practices that treat juveniles as adults.

This article examines the consequences of legislative changes that eased the process of treating juveniles as adults. Overall, it finds evidence that there has been an increase in the number of juveniles sent to the criminal court and the majority either remain in the community or return to the community shortly after serving a jail or prison sentence. In light of geographic and racial/ethnic disparities in transfer, differences in the programs and services offered to youth in the juvenile and criminal justice systems, and higher rates of recidivism among transferred offenders, the article supports the contention of many scholars and advocates that there is a need for policy and practice reform.

How different are their experiences and outcomes? Comparing aged out and other child welfare involved youth.

This paper adds to the growing body of research examining the experiences of youth aging out of the child welfare system. Through a comparison of youth aging out with two other groups of child welfare-involved youth-those whose families received child welfare services but were never placed out of home and those who were in out-of-home placement but did not age out-it presents a profile of their care careers and other system involvement (e.g., mental health, justice system). Analyses indicate that young people aging out of care have experienced significant amounts of time in out-of-home placement, a great deal of placement instability, and high levels of other system involvement. In general, their involvement is more extensive than that of the two comparison groups. However, the justice system involvement of youth who experienced out-of-home placement but did not age out is just as high as that of youth who have aged out. This finding highlights the importance of devoting resources not only to youth aging out of care but also to similarly-aged young people with prior child welfare involvement.

Patterns of mental health, substance abuse, and justice system involvement among youth aging out of child welfare.

Although research on youth aging out of the child welfare system has increased, there has been limited focus on how their experiences vary. In particular, there is a need to examine patterns in the involvement of these youth in other systems, which indicate constellations of challenges facing these young people as they transition out of care and into adulthood. Using administrative data from a large birth cohort of individuals born between 1985 and 1994 whose families have been involved in the child welfare system, this article presents an analysis of the mental health, substance abuse, juvenile justice, and criminal justice system involvement of youth who have aged out of child welfare. Using a 2-step cluster analysis, we identify 5 subgroups of youth. Two of these groups, accounting for almost half of the youth, have little other system involvement and have child welfare care careers of relative stability. The other 3 groups, consisting of just over half of the youth, have much more extensive other system involvement, as well as care careers marked by instability and a greater proportion of time spent in congregate care.

Patterns and correlates of illicit drug selling among youth in the USA.

PURPOSE: Despite the high rates of drug selling among youth in juvenile justice and youth residing in disadvantage neighborhoods, relatively little is known about the patterns of illicit drug selling among youth in the general population. METHODS: Using the public-use data file from the adolescent sample (N = 17 842) in the 2008 National Survey on Drug Use and Health (NSDUH), this study employed multiple logistic regression to compare the behavioral, parental involvement, and prevention experiences of youth who sold and did not sell illicit drugs in the past year. RESULTS: Findings from a series of logistic regression models indicated youth who sold drugs were far more likely to use a wide variety of drugs and engage in delinquent acts. Drug-selling youth were significantly less likely to report having a parent involved in their life and have someone to talk to about serious problems but were more likely to report exposure to drug prevention programming. CONCLUSION: Selling of drugs by youth appears to be a byproduct of substance abuse and deviance proneness, and the prevention programs these youth experience are likely a result of mandated exposure derived from contact with the criminal justice system. Assuming no major drug supply side reductions, policies, and practices associated with increasing drug abuse treatment, parental involvement and supervision, and school engagement are suggested.

Incarcerating juveniles in adult prisons as a factor in depression.

BACKGROUND: While existing research has shown higher prevalence of depression among incarcerated youths compared with non-incarcerated youths, none has studied incarceration as a cause of depression. AIMS/HYPOTHESIS: This study suggests that incarceration, in particular placement of youths in adult incarceration, is a factor in developing depression. METHOD: A records based comparison of depression among youths in different types of incarceration with non-incarcerated youths, controlling for other predictors of depression, namely offence type, family poverty, parents' history of incarceration and demographic profile. RESULTS: Youths in adult placements were significantly more likely to be depressed than youths in juvenile placements and community-based youths. CONCLUSION AND IMPLICATIONS: The findings suggest that there are mental health implications against incarcerating youths in adult prisons, a concern that current juvenile justice might not have considered adequately.

Are girls really becoming more delinquent? Testing the gender convergence hypothesis by race and ethnicity, 1976-2005.

Historically, girls have been less delinquent than boys. However, increased justice system involvement among girls and current portrayals of girls in the popular media and press suggest that girls' delinquency, particularly their violence and drug use, is becoming more similar to that of boys. Are girls really becoming more delinquent? To date, this question remains unresolved. Girls' increased system involvement might reflect actual changes in their behavior or changes in justice system policies and practices. Given that girls of color are overrepresented in the justice system, efforts to rigorously examine the gender convergence hypothesis must consider the role of race/ethnicity in girls' delinquency. This study uses self-report data from a large, nationally representative sample of youth to investigate the extent to which the magnitude of gender differences in violence and substance use varies across racial/ethnic groups and explore whether these differences have decreased over time. We find little support for the gender convergence hypothesis, because, with a few exceptions, the data do not show increases in girls' violence or drug use. Furthermore, even when girls' violent behavior or drug use has increased, the magnitude of the increase is not substantial enough to account for the dramatic increases in girls' arrests for violence and drug abuse violations.