Random samples of Temporary Assistance to Needy Families (TANF) recipients eligible for welfare-to-work activities (N = 632) were surveyed in two California

Jail recidivists with serious mental illness and substance use disorders were treated in an in-custody setting and then randomly assigned to either a high fidelity Integrated Dual Disorders Treatment program (103 participants) or to service as usual (79 participants). Outcomes were tracked an average of 18 months from program entry at the termination of the initial incarceration. A reduction in jail days from baseline to study period was significant for both groups. The pre to post reduction for arrests and total convictions was significant in the experimental group but not the control group. However, during the study period, differences between experimental and control groups in arrests, convictions and jail days were not statistically significant. Experimental participants had lower study period psychiatric inpatient and crisis utilization and greater outpatient utilization than did control group participants. The groups did not differ with regard to total institutional days. Experimental group attrition was relatively high.

Peer observation and feedback of resident teaching during work rounds is feasible and rewarding for the residents involved. Comfort with regards to being observed by peers, with receiving feedback from peers and with giving feedback to peers significantly increased after the study. Most residents reported changes in their teaching behaviour resulting from feedback. Residents felt that observing a peer teach on work rounds was one of the most useful activities to improve their own teaching on work rounds.

This article explores the cost implications of the capitated integrated service agency (ISA) model for persons with severe and persistent mental illness. Two demonstration sites in California were chosen for a randomized comparison between an ISA model and usual care under the existing county service system. Each ISA demonstration program assumed fiscal and service responsibility for approximately 100 clients. Cost information was collected during a 3-year study period. The capitated ISAs reduced the previously skewed distribution of resources to clients and reduced family economic burden (in one site). However, they did not reduce law enforcement, health, and other nontreatment public costs. Although capitated funding enabled programmatic effectiveness and the shifting of services toward rehabilitation, it did not itself ensure such results.

Executive summary• House prices have risen in real terms over time but have also been subject to some strong swings. According to the Nationwide index, real average house prices trebled between 1995-96 and 2007-08. In part, this represented a recovery following a fall of 40% during the early 1990s. However, by 2007-08, real house prices were 77% higher than their previous peak in 1989. They then fell by almost a quarter between 2007-08 and 2012-13, before starting to grow again from 2013-14. In 2014Q4, they remained 17% below their 2007Q3 peak.• In London, house prices grew faster than in the rest of the UK before the crisis and have since resumed growth more rapidly. Real house prices in London surpassed their previous peak during 2014.• In 2013-14, average UK house prices were 6.9 times the level of average earnings -about the same as a decade earlier and still below the 2007-08 peak of 8.1. Young adults are the most likely to be considering buying their first home. The ratio of average house prices to the average earnings of 25-to 34-year-olds peaked at 7.7 in 2007-08 and was 7.2 in 2013-14.• People's regular outgoings on housing can move differently from house prices, depending on trends in mortgage interest rates and rents. During the recent crisis, many homeowners were helped by the dramatic fall in interest rates. On average, real housing costs for owneroccupiers with a mortgage fell by 38% between 2007-08 and 2012-13, taking the proportion of their income spent on housing costs from 16% to 10%. Of course, renters have not experienced the same scale of relief, and the proportion of their income spent on housing costs rose from 25% to 27% over the same period. As homeowners tend to be further up the income distribution than renters, this has had predictable distributional consequences, with those towards the top of the distribution seeing the most favourable trends in housing costs.• Increases in house prices relative to incomes have probably been at least partly responsible for a significant decline in homeownership (and a rise in private renting) since the early 2000s, reversing the trend seen over the late 20 th century. This largely reflects differences between generations: the age-25 homeownership rate fell from 45% for the mid-1960s birth cohort to 20% for the mid-1980s cohort. By age 35, the homeownership rate of those born in the mid-1970s remained 10 percentage points lower than for those born in the mid1960s at the same age.1 The authors gratefully acknowledge funding from the Nuffield Foundation, which has provided generous support for ongoing IFS analysis relating to the 2015 general election. The Nuffield Foundation is an endowed charitable trust that aims to improve social well-being in the widest sense. It funds research and innovation in education and social policy and also works to build capacity in education, science and social science research. The Nuffield Foundation has funded this project, but the views expressed are those of the authors and not necessarily those of the Foundation. Mo...

The first part of this paper presents a vocational rehabili tation model for persons with severe and persistent psychiatric disabilities; the second part tests the model against 5-year outcomes. The Menu Approach to employment combines elements of other approaches under a new philosophi calframework. The philosophy has four principles: (1) work offers many bene fits besides a means to " pay the bills"; (2) virtually all consumers can participate in and benefitfrom meaningful paid work; (3) consumers should be able to choose from a "menu" of employment options, and; (4) multiple tri als of different kinds of paid work are an important part of developing long term employment in competitive settings. An empirical evaluation of the approach, analyzing 5 years of employment data from 102 participants in anACT-based program, found 74% tried paid work, half working competitively; the average number of jobs was 3.6, with an overall average tenure of 19.8 months for all jobs combined; workers earned $561,000 over 5 years, averag ing $2,054per job; those working at competitive jobs earned more and worked more hours per week than those working at jobs in agency-owned businesses.

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Social support, behavioral risk, and structural or demographic variables as well as acceptance of pregnancy were tested as determinants of late entry into prenatal care in a sample of 176 women in a rural county in California. The respondents were all those over age 18 served by four obstetric practices during a 4-month period ending in February 2000. One nurse-midwifery practice was included. Late entry into prenatal care during the first trimester occurred in 27.3% of the cases overall. Statistically significant independent variables in bivariate analyses were modeled in multivariate logistic regression. Stress, lack of family and friend support. Medicaid enrollment, age under 20 or over 34, low acceptance of pregnancy, and lack of a high school diploma were all predictors of late entry. Lack of family and friend support modified the effects of stress and Medicaid as payer. Although the determinants of late entry were remarkably complex in this sample, they have potential for public health intervention.