James E. Ryan

The Perverse Incentives of the No Child Left Behind Act

The No Child Left Behind Act, perhaps the most important federal education law in our nations history, is designed to boost achievement levels of all students and to close the achievement gap among students from different backgrounds. This article explains how the Act creates perverse incentives that work against the achievement of the Acts laudable goals, and it argues that these perverse incentives are an unavoidable aspect of any test-based accountability system that focuses on absolute achievement levels. It goes on to suggest some possible responses to the flaws in the Act, and it concludes with some tentative observations about the proper role of the federal government in education law and policy.

Occupational risks associated with cigarette smoking: a prospective study.

BACKGROUND Studies have indicated that cigarette smokers have more occupational accidents and injuries and use more sick time and health benefits than nonsmokers, thereby producing sizeable costs for employers. However, they usually have not controlled for other possible sources of these costs. We analyzed occupational costs associated with smoking while adjusting for a number of potential confounders. METHODS We conducted a prospective, controlled study of the association between smoking and employment outcomes in 2537 postal employees, adjusting for age, gender, race, drug use, job category, and exercise habits. RESULTS For smokers, the relative risk for turnover was 1.01 (95% confidence interval [CI], 0.83-1.21); for accidents 1.29 (CI, 1.07-1.55); for injuries 1.40 (CI, 1.11-1.77); for discipline 1.55 (CI, 1.19-2.02). Their mean absence rate was 5.43% compared with 4.06% for nonsmokers. CONCLUSIONS Our study shows that cigarette smoking is associated with adverse employment outcomes after controlling for a number of possible confounders. This finding has implications for companies formulating smoking policies and considering the establishment of smoking cessation programs.

Teaching and Social Support: Effects on Knowledge, Attitudes, and Behaviors to Prevent Low Back Injuries in Industry

This study was funded in part by NIH grant AR36308 The authors thank the employees of the United States Postal Service and the American Postal Workers Union (APWU), Boston Metro Area Local, and Maithandlers Local 301 for their help and cooperation; therapists from the Department of Rehabilitation Services, Bngham and Womens Hospital for help in training workers; and Ms Nancy Tanner for typing

A case-control study of risk factors for industrial low back injury. the utility of preplacement screening in defining high-risk groups

Using a cohort of 8183 postal workers, this study assesses the efficacy of preplacement medical examinations in defining the risk of occupational low back injuries. From this cohort, 154 subjects with occupational low back injuries between 1983 and 1988 and 942 control subjects who did not have low back injuries were identified. A multivariate logistic regression shows that a history of prior disability, odds ratio 2.90 (95% confidence interval 1.88-4.48), and a heavy lifting job, odds ratio 1.91 (1.32-276) are associated with occupational low back injuries. However, a history of previous back injury on screening examination is not associated with subsequent occupational injury. The association between a history of disability and occupational low back injury has not been previously noted and warrants further research.

Risk for Occupational Low-Back Injury after Lumbar Laminectomy for Degenerative Disc Disease

Thirty-two Postal Service applicants who had undergone laminectomies were classified as low risk for back injury after preplacement examinations and were subsequently hired for employment. Each was compared with six control subjects, who were matched by age, gender, date of hire, and job classification. The odds ratios for occupational back injury with 95% confidence intervals were 5.9 (1.9-18.8) overall and 9.1 (1.5-73.8) for letter carriers. Of subjects, 25% were injured, compared with 6% of controls. The median elapsed time between surgery and hire was 5.9 years for injured subjects and 6.8 years for uninjured subjects. A rank sum test comparing the elapsed times of the two groups was not significant (P = 0.30). Postal workers are at increased risk for back injury after laminectomy. The risk does not appear to decrease with increased time since surgery.

A Constitutional Right to Preschool

Currently, about twenty-five percent of all children ages three through five, who are not in kindergarten, attend a publicly-funded preschool. A bit more than twenty-five percent attend a private preschool. As for the public programs, the federal government traditionally played the leading role in providing access to preschool, but that is beginning to change. Forty states and the District of Columbia currently sponsor pre-school programs, up from ten in 1980. Both federal and state programs typically target poor children, but even then only serve a limited portion of the eligible group. As a result, millions of three- and four-year old children do not attend preschool, many because they have no access to public programs and cannot afford private ones. This article examines whether access to publicly-funded preschool ought to be expanded and, if so, whether courts - state or federal - should play a role in that expansion.

Justice Scalia’s Unoriginal Approach to Race and Gender in Education

Although Justice Scalia purported to be driven by originalism and precedent, his opinions in three education cases—Grutter v. Bollinger (2003), Parents Involved v. Seattle School District (2007), and United States v. Virginia (1996)—tell a different tale. In these cases, his arguments are difficult to defend on originalist grounds and, surprisingly, Justice Scalia himself makes no attempt to do so. Similarly, his views are difficult to square with precedent. It is hard to escape the conclusion that, in some of his most noteworthy cases related to education, Justice Scalia was as results-oriented as the justices and judges he loved to criticize.

Preventing low Back Injuries: A Controlled Trial of an Educational Program among U.S. Postal Workers

Lawren H. Daltroy, Dr. P.H., Brigham and Womens Hospital, Boston, MA MauraD. Iversen, B.S.P.T., S.D., Simmons College, Boston, MA Martin G. Larson S.D., Boston University, Boston, MA Robert Lew, Ph.D., Brigham and Womens Hospital, Boston, MA Elizabeth Wright, Ph.D., Brigham and Womens Hospital, Boston, MA James Ryan, M.D., M.P.H., Boston University, Boston, MA Craig Zwerling, M.D., Ph.D., The University ofIowa, Iowa City, IA Anne H. Fossel, Brigham and Womens Hospital, Boston, MA Matthew H. Liang, M.D., MPH., Brigham and Womens Hospital, Boston, MA

Severity of disability due to occupational low back injury after lumbar laminectomy for degenerative disc disease.

Thirty-two postal workers were rated low risk in preplacement examinations after lumbar laminectomies for degenerative disc disease. They demonstrated an odds ratio for occupational back injury of 5.9 when compared with 192 control subjects matched by age, gender, employment date, and job classification. Each injured employee was subsequently observed for 2 years after injury. Data were collected on time lost from work due to the injury and incidence of surgical treatment. Injured subjects lost a median of 66 and a mean of 292.8 days from work, whereas injured control subjects lost a median of 8.5 and a mean of 24.8 days. Mean time lost per person hired was 73.2 days for subjects compared with 1.6 days for control subjects. Three of eight injured subjects required repeat surgery and three remain totally disabled. No injured control subjects required surgery and all resumed work.