***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In this paper , we employ a classical experiment to determine if welfare reform causes poor women to experience increased levels of clinical anxiety and depression . We organize our analyses around the insights provided by lifestyle change and ecosocial theories of illness . Our data come from the New Jersey Family Development Program  ( FDP ) , one of the most highly publicized welfare experiments in the U.S. A sample of 8393 women was r and omly assigned into two groups , one which stressed welfare-to-work and the other which offered traditional welfare benefits . These women were followed from 1992 through 1996 and information on clinical diagnoses was collected quarterly from physician treatment cl aims to the government Medicaid program . Our intention-to-treat estimates show that for short-term welfare recipients FDP decreased the prevalence of anxiety by 40 % and increased depression by 8 % . For black women both anxiety and depression diagnoses declined while Hispanic women experienced a 68 % increase in depression . We discuss several public policy implication s which arise from our work OBJECTIVES We examined whether Jobs First , a multicenter r and omized trial of a  welfare reform  program conducted in Connecticut , demonstrated increases in employment , income , and health insurance relative to traditional welfare ( Aid to Families with Dependent Children ) . We also investigated if higher earnings and employment improved mortality of the participants . METHODS We revisited the  Jobs First r and omized trial , successfully linking 4612 participant identifiers to 15 years of prospect i ve mortality follow-up data through 2010 , producing 240 deaths . The analysis was powered to detect a 20 % change in mortality hazards . RESULTS Significant employment and income benefits were realized among Jobs First recipients relative to traditional welfare recipients , particularly for the most disadvantaged groups . However , although none of these reached statistical significance , all participants in Jobs First ( overall , across centers , and all subgroups ) experienced higher mortality hazards than traditional welfare recipients . CONCLUSIONS Increases in income and employment produced by Jobs First relative to traditional welfare improved socioeconomic status but did not improve survival Social scientists do not agree on the size and nature of the causal impacts of  parental income on children 's achievement . We revisit this issue using a set of welfare and antipoverty experiments conducted in the 1990s . We utilize an instrumental variables strategy to leverage the variation in income and achievement that arises from r and om assignment to the treatment group to estimate the causal effect of income on child achievement . Our estimates suggest that a $ 1,000 increase in annual income increases young children 's achievement by 5%-6 % of a st and ard deviation . As such , our results suggest that family  income has a policy-relevant , positive impact on the eventual school achievement of preschool children Background Participation in regular physical activity ( PA ) during the early years helps children achieve healthy body weight and can substantially improve motor development , bone health , psychosocial health and cognitive development . Despite common assumptions that young children are naturally active , evidence shows that they are insufficiently active for health and developmental benefits . Exploring strategies to increase physical activity in young children is a public health and research priority . Methods Jump Start is a multi-component , multi- setting PA and gross motor skill intervention for young children aged 3–5 years in disadvantaged areas of New South Wales , Australia . The intervention will be evaluated using a two-arm , parallel group , r and omised cluster trial . The Jump Start protocol was based on Social Cognitive Theory and includes five components : a structured gross motor skill lesson ( Jump In ) ; unstructured outdoor PA and gross motor skill time ( Jump Out ) ; energy breaks ( Jump Up ) ; activities connecting movement to learning experiences ( Jump Through ) ; and a home-based family component to promote PA and gross motor skill ( Jump Home ) . Early childhood education and care centres will be demographically matched and r and omised to Jump Start ( intervention ) or usual practice ( comparison ) group . The intervention group receive Jump Start professional development , program re sources , monthly newsletters and ongoing intervention support . Outcomes include change in total PA ( accelerometers ) within centre hours , gross motor skill development ( Test of Gross Motor Development-2 ) , weight status ( body mass index ) , bone strength ( Sunlight MiniOmni Ultrasound Bone Sonometer ) , self-regulation ( Heads-Toes-Knees-Shoulders , executive function tasks , and proxy-report Temperament and Approaches to learning scales ) , and educator and parent self-efficacy . Extensive quantitative and qualitative process evaluation and a cost-effectiveness evaluation will be conducted . Discussion The Jump Start intervention is a unique program to address low levels of PA and gross motor skill proficiency , and support healthy lifestyle behaviours among young children in disadvantaged communities . If shown to be efficacious , the Jump Start approach can be expected to have implication s for early childhood education and care policies and practice s , and ultimately a positive effect on the health and development across the life course . Trial registration Australian and New Zeal and Clinical Trials Registry No : ACTRN12614000597695 , first received : June 5 , 2014 Study objective : There is little guidance on how to select the best available evidence of health effects of social interventions . The aim of this paper was to assess the implication s of setting particular inclusion criteria for evidence synthesis . Design : Analysis of all relevant studies for one systematic review , followed by sensitivity analysis of the effects of selecting studies based on a two dimensional hierarchy of study design and study population . Setting : Case study of a systematic review of the effectiveness of interventions in promoting a population shift from using cars towards walking and cycling .  Main results : The distribution of available evidence was skewed . Population level interventions were less likely than individual level interventions to have been studied using the most rigorous study design s ; nearly all of the population level evidence would have been missed if only r and omised controlled trials had been included . Examining the studies that were excluded did not change the overall conclusions about effectiveness , but did identify additional categories of intervention such as health walks and parking charges that merit further research , and provided evidence to challenge assumptions about the actual effects of progressive urban transport policies . Conclusions : Unthinking adherence to a hierarchy of study design as a means of selecting studies may reduce the value of evidence synthesis and reinforce an “ inverse evidence law ” whereby the least is known about the effects of interventions most likely to influence whole population s. Producing generalisable estimates of effect sizes is only one possible objective of evidence synthesis . Mapping the available evidence and uncertainty about effects may also be important During the 1990s reforms to the US welfare system introduced new time limits on people 's eligibility to receive public assistance . These limits were developed to encourage welfare recipients to seek employment . Little is known about how such social policy programs may have affected participants ' health . We explored whether the Florida Family Transition Program r and omized trial , a welfare reform experiment , led to long-term changes in mortality among participants . The Florida program included a 24 - 36-month time limit for welfare participation , intensive job training , and placement assistance . We linked 3,224 participants from the experiment to 17 - 18 years of prospect i ve mortality follow-up data and found that participants in the program experienced a 16 percent higher mortality rate than recipients of traditional welfare . If our results are generalizable to national welfare reform efforts , they raise questions about whether the cost savings associated with welfare reform justify the additional loss of life We assess the impact of the New Hope Project , an antipoverty program tested in a r and om assignment experimental design , on family functioning and developmental outcomes for preschool- and school-aged children ( N = 913 ) .  New Hope offered wage supplements sufficient to raise family income above the poverty threshold and subsidies for child care and health insurance to adults who worked full-time .  New Hope had strong positive effects on boys ' academic achievement , classroom behavior skills , positive social behavior , and problem behaviors , as reported by teachers , and on boys ' own expectations for advanced education and occupational aspirations . There were not corresponding program effects for girls . The child outcomes may have result ed from a combination of the following : Children in New Hope families spent more time in formal child care programs and other structured activities away from home than did children in control families . New Hope parents were employed more , had more material re sources , reported more social support , and expressed less stress and more optimism about achieving their goals than did parents in the control sample . The results suggest that an anti-poverty program that provides support for combining work and family responsibilities can have beneficial effects on the development of school-age children This study examined the effect of a time-limited welfare program on school-age children using data on almost 3,000 children ( ages 5 - 17 at the four year follow up-point ) from the r and om assignment evaluation of Florida 's Family Transition Program ( FTP ) .  FTP was one of the first welfare reform initiatives to impose a time limit on the receipt of cash assistance , and it combined the time limit with a rich array of m and atory services . The effects of FTP on children were moderated by families ' risk of long-term welfare dependency . Contrary to predictions laid out at the outset , there were few effects of FTP on middle childhood and adolescent children for children of parents most likely to be long-term welfare dependent ( those most likely to hit the time limit ) . However , consistent negative effects on this same age group of children were found for children of parents least likely to be long-term welfare dependent -- parents who had the largest employment gains-- and effects of FTP  were most strongly negative for the oldest adolescent children . The findings suggest a different theoretical model for movements into employment than the one suggested in the previous literature for job loss . The findings are discussed in terms of their contribution to research and policy Background : The United Kingdom Employment Retention and Advancement ( U.K. ERA ) demonstration was the largest and most comprehensive social experiment ever conducted in the United Kingdom . It examined the extent to which a combination of postemployment advisory support and financial incentives could help lone parents on welfare to find sustained employment with prospect s for advancement . ERA was experimentally tested across more than 50 public employment service offices and , within each office , individuals were r and omly assigned to either a program ( or treatment ) group ( eligible for ERA ) or a control group ( not eligible ) .  Method : This article presents the results of a multilevel nonexperimental analysis that examines the variation in office-level impacts and attempts to underst and what services provided in the offices tend to be associated with impacts . Result : The analysis suggests that impacts were greater in offices that emphasized in-work advancement , support while working and financial bonuses for sustained employment , and also in those offices that assigned more caseworkers to ERA participants . Offices that encouraged further education had smaller employment impacts . Conclusion : Plausible results are obtained identifying those particular implementation features that tended to be linked to stronger impacts of ERA . The methodology employed also allows the identification of which services are associated with employment and welfare receipt of control families receiving benefits under the traditional New Deal for Lone Parent program OBJECTIVES We evaluated the economic benefits of  Temporary Assistance to Needy Families ( TANF )  relative to the previous program , Aid to Families with Dependent Children ( AFDC ) . METHODS We used pooled mortality hazard ratios from 2 r and omized controlled trials-Connecticut Jobs First and the Florida Transition Program , which had follow-up from the early and mid-1990s through December 2011- and previous estimates of health and economic benefits of TANF and AFDC .  We entered them into a Markov model to evaluate TANF 's economic benefits relative to AFDC and weigh them against the potential health threats of TANF . RESULTS Over the working life of the average cash assistance recipient , AFDC would cost approximately $ 28000 more than TANF from the societal perspective . However , it would also bring 0.44 additional years of life . The incremental cost effectiveness of AFDC would be approximately $ 64000 per life-year saved relative to TANF . CONCLUSIONS AFDC may provide more value as a health investment than TANF . Additional attention given to the neediest US families denied cash assistance could improve the value of TANF This study examines whether maternal employment affects the health status of low-income , elementary-school-aged children  using instrumental variables estimation and experimental data from a welfare-to-work program implemented in the early 1990s . Maternal report of child health status is predicted as a function of exogenous variation in maternal employment associated with r and om assignment to the experimental group . IV estimates show a modest adverse effect of maternal employment on children 's health . Making use of data from another welfare-to-work program we propose that any adverse effect on child health may be tempered by increased family income and access to public health insurance coverage , findings with direct relevance to a number of current policy discussion s. In a secondary analysis using fixed effects techniques on longitudinal survey data collected in 1998 and 2001 , we find a comparable adverse effect of maternal employment on child health that supports the external validity of our primary result BACKGROUND In this paper , data from the British National Survey of Psychiatric Morbidity are used to assess depressive disorders and markers of social disadvantage in women bringing up children on their own . METHOD The household component of the British National Surveys of Psychiatric Morbidity was based on a stratified r and om sample of > 10000 subjects . This paper reports on 5281 women interviewed in person . Psychiatric symptoms and ICD-10 diagnoses were established by lay interviewers using the CIS-R. Results are presented in terms of depressive episode and mixed anxiety/depressive disorder .  Housing tenure and access to a car were used as proxy measures of material status . The life event rate in the 6 months before interview was used to indicate overall exposure to stress , and subjects were asked in detail about perceived social support . Information was collected about various other sociodemographic attributes . Lone mothers were compared with supported mothers and with women not involved in care of children under 16 . RESULTS Lone mothers had prevalence rates of depressive episode of 7 % , about three times higher than any 
    Output:
    
The effects of  welfare‐to‐work interventions on health were generally positive but of a magnitude unlikely to have any tangible effects .
Authors ' conclusions The effects of WtW on health are largely of a magnitude that is unlikely to have tangible impacts .
Since income and employment are hypothesised to mediate effects on health , it is possible that these negligible health impacts result from the small effects on economic outcomes .
Even where employment and income were higher for the lone parents in WtW , poverty was still high for the majority of the lone parents in many of the studies .
Perhaps because of this , depression also remained very high for lone parents whether they were in WtW or not .
There is a lack of robust evidence on the health effects of WtW for lone parents outside North America