Essays in policy evaluation

This dissertation consists of three empirical studies that aim at providing new evidence in the field of public policy evaluation. In particular, the first two chapters focus on the effects of the European cohesion policy, while the third chapter assesses the effectiveness of Italian labour market incentives in reducing long-term unemployment. The first study analyses the effect of EU funds on life satisfaction across European regions , under the assumption that projects financed by structural funds in the fields of employment, education, health and environment may affect the overall quality of life in recipient regions. Using regional data from the European Social Survey in 2002-2006, it resorts to a regression discontinuity design, where the discontinuity is provided by the institutional framework of the policy. The second study aims at estimating the impact of large transfers from a centralized authority to a local administration on the incidence of white collar crimes. It merges a unique dataset on crimes committed in Italian municipalities between 2007 and 2011 with information on the disbursement of EU structural funds in 2007-2013 programming period, employing an instrumental variable estimation strategy that exploits the variation in the electoral cycle at local level. The third study analyses the impact of an Italian labour market policy that allowed firms to cut their labour costs on open-ended job contracts when hiring long-term unemployed workers. It takes advantage of a unique dataset that draws information from the unemployment lists in Veneto region and it resorts to a regression discontinuity approach to estimate the effect of the policy on the job finding rate of long-term unemployed workers.

Einfluss einer indirekten pharmazeutischen Betreuung auf klinische und soziale Ergebnisse bei ambulant mit Chemotherapie behandelten Tumorpatienten

Krebspatienten, die eine Chemotherapie erhalten, leiden häufig an schwerwiegenden unerwünschten Arzneimittelwirkungen, wie z.B. Übelkeit und Erbrechen, welche nachweislich durch eine geeignete Supportivmedikation und durch eine direkte pharmazeutische Betreuung gesenkt werden können.rnIn dieser Arbeit wurde in einer prospektiven, nicht-interventionellen multizentrischen Studie untersucht, ob ambulant behandelte Mamma- und Colon-Carcinom-Patienten während der Chemotherapie Vorteile durch eine indirekte pharmazeutische Betreuung (Mitgabe einer schriftlichen Patienteninformation und der Begleitmedikamente) haben. Primäres Ziel der Studie war eine Reduktion von Häufigkeit und Schweregrad ausgewählter UAW, sekundäre Ziele waren die Verbesserung der Lebensqualität, der Patientenzufriedenheit und des Patientenwissens zur Therapie und Begleitmedikation. Die Daten wurden mittels vier verschiedener Patienten-Fragebögen in Form von Telefoninterviews zu drei verschiedenen Zeitpunkten der Chemotherapie erhoben.rnInsgesamt konnten 106 Patienten vom St.-Johannes-Hospital in Dortmund und von der Universitätsmedizin Mainz in die Studie eingeschlossen werden. Die UAW nach Häufigkeit und Schweregrad gemäß CTC konnten durch eine indirekte pharmazeutische Betreuung zu allen drei Zeitpunkten der Datenerfassung z.T. signifikant gesenkt werden. Eine Verbesserung konnte auch bei allen humanistischen Ergebnisparametern (Patientenwissen, Lebensqualität, Patientenzufriedenheit) beobachtet werden. Auf Grund der relativ kleinen, nicht vollständig rekrutierten Kontrollgruppe und den unterschiedlichen Rahmenbedingungen an den teilnehmenden Kliniken, sind weitere vergleichende Untersuchungen erforderlich, um den Nutzen einer indirekten pharmazeutischen Betreuung weiter zu belegen. rn

Comparative Study of Informal Health Care Networks and Elderly Health Status in Argentina and Cuba

The objective of this study is to evaluate the impact of informal care support networks on the health status, life satisfaction, happiness and anxiety of elderly individuals in Argentina and Cuba. Recent economic changes, demographic changes, the structure of families and changes in women?s labor participation have affected the availability of informal care. Additionally, the growing number of elderly as a percentage of total population has significant implications for both formal and informal care in Argentina and Cuba. Methods: The SABE - Survey on Health, Well-Being, and Aging in Latin America and the Caribbean, 2000 was used as the data source. The survey has a sample of 10,656 individuals aged 60 years and older residing in private households occupied by permanent dwellers in 7 cities in the Latin American and Caribbean region. My study will focus on the Buenos Aires and Havana samples in which there were 1043 individuals and 1905 individuals respectively. General sampling design was used to establish comparability between countries. Individuals requiring assistance are surveyed on their source of help and the relative impact of informal versus paid help is measured for this group. Other measures of social support (number of living children, companionship and number of individuals living in the same dwelling) are used to measure networks for the full sample. Multivariate probit regression analyses were run separately for Cuba and for Argentina to evaluate the marginal impacts of the types of social support on health status, life satisfaction, happiness and anxiety. Results: For Argentina, almost all of the family help variables positively impact good health. Getting help from most other members of the family negatively impacts satisfaction with life. Happiness is affected differently by each of the family help variables but community support increases the likelihood of being happy. Although none of the family or community help variables show statistical significance, most negatively affect anxiety levels. In Cuba, all of the social support variables have a positive marginal impact on the health status of the elderly. In this case, some of the family and community help variables have a negative marginal impact on life satisfaction; however, it appears that having those closest to the elderly, children, spouse, or other family, positively impacts life satisfaction. Most of the support variables negatively impact happiness. Receiving help from a child, spouse or parent is associated with a marginal increase in anxiety, whereas receiving help from a grandchild, another family member or a friend actually reduces anxiety. Discussion: The study highlights the necessity for enhancing the coordination of various care networks in order to provide adequate care and reduce the burdens of old age on the individual, family and society and the need for consistent support for the caregivers. More qualitative work should be done to identify how support is given and what comprises the support. The constant change and advancement of the world, and the growth of the Latin American and Caribbean region, suggests that more updates studies need to be done.

Zufriedenheit von Schülerinnen und Schülern und ihre soziale Integration

Eine gegenstandsbezogene Konzeption von Zufriedenheit geht davon aus, dass sich die Lebenszufriedenheit Jugendlicher von ihrer Zufriedenheit mit der Schule, mit der Klasse und der Lehrperson unterscheidet. Es wurde überprüft, ob sich diese Zufriedenheiten durch soziale Prozesse und Strukturen in der Schulklasse vorhersagen lassen. Im Rahmen einer Längsschnittuntersuchung mit 692 Schülerinnen und Schülern der siebten bis zwölften Klassenstufe aus 50 Schulklassen der Kantone Bern, Aargau und Solothurn (Schweiz) wurden diese Thesen anhand eines standardisierten Fragebogens analysiert. Wahrgenommene Klassenkohäsion und der subjektiv wahrgenommene Klassenstatus erklärten, im Gegensatz zum objektiven Klassenstatus, gemessen mit einem Soziogramm, einen beachtlichen Anteil der gegenstandsspeifischen Zufriedenheit, selbst nach Ablauf eines Jahres. Die Klassenstruktur und die Zufriedenheitsmasse waren sehr stabil. Klassenprozesse erlauben nicht nur Vorhersagen der Klassenzufriedenheit, sondern haben eine generalisierende Wirkung auch auf andere Zufriedenheitsbereiche.

Psychological adaptation to spousal loss in old age: The role of personality

Spousal loss is an inevitable critical life event for most individuals in old age, mostly associated with a negative impact on various well-being measures, ie. lower life satisfaction, higher rates of loneliness and depressive symptoms compared to married peers. While the negative effects on well-being are well documented in literature, the modifying factors accounting for the large variability in adaptation to loss are discussed controversially. The potential relevance of personality in the adaptation process has rarely been examined and findings regarding the role of time since loss are contradictory. Based on a vulnerability-stress-model this contribution aims a) to compare psychological well-being of bereaved individuals with married counterparts and b) to investigate the protective effects of different personality traits (Big Five, resilience), and the role of time since loss for adaptation in terms of life satisfaction, loneliness and depression. Data from a questionnaire study about the loss of a spouse in middle and old age in the German- and French-speaking parts of Switzerland are reported. The study is part of the Swiss National Centre of Competence in Research LIVES (Swiss National Science Foundation). The sample consists of 351 widowed persons (39% men, widowed since 0 - 5 years), and 605 married controls (50% men), aged 60 - 89 years. Group comparisons reveal the detrimental effect of spousal bereavement on all indicators of psychological adaptation. Results from hierarchical regression analyses show furthermore, that the effect of spousal loss on all psychological outcomes is moderated by personality traits. Separate analyses with the group of bereaved individuals suggest, that the protective effect of personality varies by the time passed since loss. Our results contribute to a better understanding of the variability in psychological adaptation to spousal loss in old age and give hints for counselling practice.

Time Heals Some Wounds: Psychological Adjustment To Marital Breakup

Marital breakup is among the most incisive stressors in adult life. While the negative effects of divorce on well-being are well documented in research literature, the large interindividual differences in psychological adaptation to this critical life event over time are still not well understood. Particularly the question, whether marital breakup represents a temporary crisis or rather a chronic strain is still controversially discussed. Against this empirical and theoretical background the aim of this study is to investigate the psychological adaptation (depression, perceived stress and life satisfaction) to marital breakup in a sample of 289 middle aged persons (M = 50.2 years) who were partnered at least 10 years (M = 23. 5 years). We compared two groups: one with a separation within the last 12 months (58 women, 25 men), another with a separation within the last 2-5 years (97 women, 38 men). A group of 441 age-matched married people served as control group. Findings from group comparison reveal that time passed since separation is indeed associated with better psychological adaptation (lower depression and perceived stress rates). Results from regression analyses show that differences in psychological adaptation are a function of neuroticism, resilience, new partnership and time passed since separation. These results provide support for the crisis approach and offer important insights into the process of adaptation to marital breakup, which in can be used for counselling.

Psychological adaptation to marital breakup in middle-aged persons: the role of gender and time

Marital breakup is among the most incisive stressors in adult life. While the negative effects of divorce on well-being are well documented in research literature, the large interindividual differences in psychological adaptation to marital dissolution are still not well understood. One major controversially discussed question is, whether marital dissolution represents a temporary crisis or rather a chronic strain. But also with regard of the role of gender results are mixed. The aim of the present study is to investigate the psychological adaptation (depression, perceived stress and life satisfaction) to marital breakup in a sample of 980 middle-aged persons (M = 51.8 years) who were partnered on average 19.4 years. We compared four time groups: one with a separation within the last 12 months (84 women, 36 men), another within the last 13-24 months (75 women, 19 men), a third within 25-60 months (121 women, 49 men), and one with a separation more than 60 months ago (189 women, 144 men). A group of 348 age-matched married people served as control group (189 women, 159 men). Findings from ANOVA with the outcome depression as well as with the outcome perceived stress yielded a significant main effect for both factors (gender and time). The group who had experienced a separation within the last 12 months differed significantly from all other groups (higher depression score and higher perceived stress). No significant main effect for the factor time was found for the outcome life satisfaction. Regarding gender differences, females from all time groups displayed higher depression scores and higher perceived stress but lower life satisfaction than males. These results give important insights into the process of adaptation to marital breakup, which can be used for counselling.

Effectiveness of integrated care including therapeutic assertive community treatment in severe schizophrenia spectrum and bipolar I disorders: the 24-month follow-up ACCESS II study

OBJECTIVE The ACCESS treatment model offers assertive community treatment embedded in an integrated care program to patients with psychoses. Compared to standard care and within a controlled study, it proved to be more effective in terms of service disengagement and illness outcomes in patients with schizophrenia spectrum disorders over 12 months. ACCESS was implemented into clinical routine and its effectiveness assessed over 24 months in severe schizophrenia spectrum disorders and bipolar I disorder with psychotic features (DSM-IV) in a cohort study. METHOD All 115 patients treated in ACCESS (from May 2007 to October 2009) were included in the ACCESS II study. The primary outcome was rate of service disengagement. Secondary outcomes were change of psychopathology, severity of illness, psychosocial functioning, quality of life, satisfaction with care, medication nonadherence, length of hospital stay, and rates of involuntary hospitalization. RESULTS Only 4 patients (3.4%) disengaged with the service. Another 11 (9.6%) left because they moved outside the catchment area. Patients received a mean of 1.6 outpatient contacts per week. Involuntary admissions decreased from 34.8% in the 2 previous years to 7.8% during ACCESS (P < .001). Mixed models repeated-measures analyses revealed significant improvements among all patients in psychopathology (effect size d = 0.64, P < .001), illness severity (d = 0.84, P = .03), functioning level (d = 0.65, P < .001), quality of life (d = 0.50, P < .001), and client satisfaction (d = 0.11, P < .001). At 24 months, 78.3% were fully adherent to medication, compared to 25.2% at baseline (P = .002). CONCLUSIONS ACCESS was successfully implemented in clinical routine and maintained excellent rates of service engagement and other outcomes in patients with schizophrenia spectrum disorders or bipolar I disorder with psychotic features over 24 months. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01888627.

Assessing Calling in Chinese College Students: Development of a Measure and Its Relation to Hope

Research suggests that perceiving a calling towards a particular career is relatively frequent among college students in Western cultures. However, little is known about how this applies to other cultural contexts. This study assessed the perception of career as a calling in the Chinese culture. Study 1 reports the development of the Chinese Calling Scale (CCS), based on a sample of 788 Chinese college students, and identifies three dimensions of a calling: Altruism, Guiding Force, and Meaning and Purpose. Measurement invariance across gender is supported by the CCS. In Study 2, the convergent and criterion validity of the CSS is examined based on a sample of 387 college students. The CCS is strongly related to an existing calling measure and moderately related to life meaning and life satisfaction. Study 3 examines the relation between calling, hope, life meaning, life satisfaction, and career decidedness among 518 college students. The findings reveal that hope significantly mediated the relation of calling with career decidedness, life meaning, and life satisfaction. In summary, this study provides a new scale to assess calling in Chinese culture and is the first to explore how calling relates to dispositional hope.

The positive effects of protean career attitude for self-initiated expatriates: Cultural adjustment as a mediator

Purpose – The authors sought to explain why and how protean career attitude might influence self‐initiated expatriates' (SIEs) experiences positively. A mediation model of cultural adjustment was proposed and empirically evaluated. Design/methodology/approach – Data from 132 SIEs in Germany containing measures of protean career attitude, cultural adjustment, career satisfaction, life satisfaction, and intention to stay in the host country were analysed using path analysis with a bootstrap method. Findings – Empirical results provide support for the authors' proposed model: the positive relations between protean career attitude and the three expatriation outcomes (career satisfaction, life satisfaction and intention to stay in the host country) were mediated by positive cross‐cultural adjustment of SIEs. Research limitations/implications – All data were cross‐sectional from a single source. The sample size was small and included a large portion of Chinese participants. The study should be replicated with samples in other destination countries, and longitudinal research is suggested. Practical implications – By fostering both a protean career attitude in skilled SIE employees and their cultural adjustment, corporations and receiving countries could be able to retain this international workforce better in times of talent shortage. Originality/value – This study contributes to the scarce research on the conceptual relatedness of protean career attitude and SIEs, as well as to acknowledging the cultural diversity of the SIE population.

Vocational identity trajectories: Differences in personality and development of well-being

This person-centred study investigated the longitudinal patterns of vocational identity development in relation to personality, the development of well-being, gender, nationality and the attended school track among two cohorts of Swiss adolescents in 8th or 9th grade (N = 269) and in 11th or 12th grade (N = 230). The results confirmed the existence of four identity statuses, namely, achievement, foreclosure, moratorium and diffusion. Forty-two per cent of students showed progressive patterns of identity development, while 37% remained in their identity status over time. Students with different statuses and status change patterns differed significantly in their personality traits. Higher neuroticism related to the emergence of identity exploration over time, while conscientiousness related to maintaining or achieving a sense of identity commitment in terms of achievement or foreclosure. Controlling for the effects of socio-demographics and personality traits, students who reached or maintained a state characterized by identity clarity and commitment showed a relative increase in life satisfaction, while those entering a state of identity crisis or exploration showed a decrease in life satisfaction. Copyright © 2011 John Wiley & Sons, Ltd.

Patterns of Psychological Adaptation to Spousal Bereavement in Old Age

Background: While the negative effects of spousal bereavement on well-being are well documented in empirical research, the large individual differences in psychological adaptation are still not well understood. Objective: This contribution aims to identify patterns of psychological adaptation to spousal loss in old age and to shed light on the role of intra- and interpersonal resources and contextual factors as discriminant variables among these patterns. Methods: The data stem from a cross-sectional questionnaire study of 402 widowed individuals (228 women, 174 men) aged between 60 and 89 years (mean age 74.41 years), who lost their partner within the last 5 years, and 618 married individuals, who served as controls (312 women, 306 men; mean age 73.82 years). Results: The exploratory latent profile analysis of the well-being outcomes of depressive symptoms, hopelessness, loneliness, life satisfaction and subjective health revealed three different groups in the widowed sample: ‘resilients' (54% of the sample), ‘copers' (39%) and ‘vulnerables' (7%). The most important variables for group allocation were intrapersonal resources - psychological resilience and the Big Five personality traits - but also the quality of the former relationship and how the loss was experienced. Conclusion: Successful adaptation to spousal loss is primarily associated with high scores in psychological resilience and extraversion and low scores in neuroticism. Our results shed light on the variability in psychological adaptation and underline the important role of intrapersonal resources in facing spousal loss in old age.

Marital split-up and widowhood in old age: Differential impact on psychological and social well-being

Marital split-up and spousal loss are among the most stressful critical life events. Numerous studies have documented their detrimental effects on well-being, yet the large individual differences in psychological adaptation are still not well understood. Whereas in old age bereavement is normative and can be anticipated, divorce is an “off-time” transition for this age group. In contrast to bereavement which has been amply studied, research on later life divorce is still missing despite the increasing relevance of the topic due to the significant increase of divorces in older age. Based on a modified and extended view of Amato’s divorce-stress-adjustment model (2000), the aim of this contribution is to explore the differential impact of marital split-up and widowhood in older age on psychological (life satisfaction) and social well-being (social loneliness), and the adaptation to these critical life events. Our analyses are based on data gathered in a questionnaire study, which is part of the Swiss National Centre of Competence in Research LIVES. In a first step we compared three groups of individuals aged 60 to 75 years: a sample of 251 persons with a marital split-up (127 women; 123 men), a sample of 270 widowed persons (170 women; 100 men), and a group of 221 continuously married people (110 women; 111 men), which served as control group. In a second step, we investigated the role of socio-demographic variables, intrapersonal and interpersonal resources and variables of the context of loss as predictors for the psychological adaptation to a marital break-up and loss in old age. First results by ANCOVA indicate significant differences with regard to life satisfaction among the three groups, with divorced persons with the lowest scores, followed by the bereaved ones, and the married controls with the highest. Regarding social loneliness, divorced individuals report higher social loneliness than the bereaved group and the married controls (no significant difference between widowed and the married). In both loss groups, financial and intrapersonal resources, as well as the emotional valence of the loss are the most important predictors for the psychological and social adaptation. However, happiness in the past relationship is an important resource regarding the indicators for adaptation for the widowers, but not for individuals with a marital dissolution.

Called and Burnout: Integrating career research with occupational health psychology

People are increasingly in search for meaning in their work and private life. They want to increase their self-awareness and reach personal fulfillment. People who are not able to cope with life‘s challenges often suffer from burnout, anxiety and depression. Consequently, the construct of calling becomes more and more important in the occupational context because of its positive consequences regarding numerous work (e.g. organizational commitment) and non-work-related outcomes (e.g. depression, life satisfaction) for individuals as well as for organizations. Building on first promising findings, the aim of the following chapter is to investigate the association of experiencing a calling in one‘s job and burnout (here defined as psychological phenomenon of prolonged exhaustion and disengagement at work, cf., Maslach, Schaufeli, & Leiter, 2001). Our findings suggest that experiencing one‘s work as a calling is negatively related to burnout. Especially with regard to the sub-dimension of disengagement, experiencing a calling turned out to be a protective factor. Further, the burnout sub-dimension of disengagement mediated the relationship between the experience of a calling and job satisfaction. Implications for further research and health-related preventive strategies are discussed.

Consistent estimation of the fixed effects ordered logit model

The paper considers panel data methods for estimating ordered logit models with individual-specific correlated unobserved heterogeneity. We show that a popular approach is inconsistent, whereas some consistent and efficient estimators are available, including minimum distance and generalized method-of-moment estimators. A Monte Carlo study reveals the good properties of an alternative estimator that has not been considered in econometric applications before, is simple to implement and almost as efficient. An illustrative application based on data from the German Socio-Economic Panel confirms the large negative effect of unemployment on life satisfaction that has been found in the previous literature.