Furthering Productive Aging through Public-Private Sector Alliances: The Case of the Mexican Government and Starbucks Company.

This commentary focuses on the remunerated work dimension of productive aging in Mexico, specifically paid employment. The main purpose is to draw attention to productive aging policies and programs built on alliances between the Mexican government and private companies - e.g., Starbucks - and then to analyze the potential impacts of such alliances on the older population. We argue that although the Mexican government emphasizes the rights of older adults to engage in paid-employment programs through such alliances, it is not addressing the issues that underlie paid-employment activities in later life, such as conditions of inequality, lack of opportunities, and poverty. We also argue that the instrumentation of productive aging programs implemented by the government should consider the costs and benefits for older adults. Solid, research-based evidence is needed to better implement productive aging programs by accounting for the factors that influence older adults' decisions to continue working, the functional capacities of older workers, and their performance needs.

The relationships of job and family demands and job and family resources with family caregivers' strain.

BACKGROUND: Because of an expected increase in the number of family caregivers, there is a growing public and scientific interest in family caregiving and more specifically in the combination of family care with paid employment. It is important to gain insight in the family caregivers' strain and determining factors in the job and family domain. AIM: The aim of the study was to examine the associations of job and family demands and job and family resources with indicators of caregivers' psychological strain, that is caregiver burden, work-related emotional exhaustion and general ill mental health. In our research, we focused on individuals who combine paid employment with family caregiving. METHODS: A cross-sectional design was used. The study sample was derived in 2011 from a Dutch financial organisation and a healthcare organisation. A digital fully structured questionnaire was used. The sample consisted of 187 employees who identified themselves as family caregivers. Descriptive statistics and hierarchical linear regression analysis were performed. RESULTS: Job demands (i.e. workload, work-family conflict) and family demands (i.e. family care hours and family-work conflict) were significantly positively associated with all three domain-specific indicators of strain. The resources of work-family and family-work enrichment and autonomy did not contribute to less experienced strain. More supervisor and colleague support was associated with lower ill mental health. CONCLUSION: Our study showed that job demands (workload, work-family conflict) and family demands (family care hours, family-work conflict) were clearly associated with caregiver strain, while associations for job and family resources were not evident. It remains necessary to pay attention to the demanding aspects of dual roles of family caregivers but also to investigate the resources they have available at work as well as in their home situation and explore their potential reducing effect on family caregivers' strain.

Identifying social participation subgroups of individuals with severe mental illnesses: a latent class analysis.

PURPOSE: To investigate factors that influence participation in and needs for work and other daytime activities among individuals with severe mental illnesses (SMI). METHODS: A latent class analysis using routine outcome monitoring data from 1069 patients was conducted to investigate whether subgroups of individuals with SMI can be distinguished based on participation in work or other daytime activities, needs for care in these areas, and the differences between these subgroups. RESULTS: Four subgroups could be distinguished: (1) an inactive group without daytime activities or paid employment and many needs for care in these areas; (2) a moderately active group with some daytime activities, no paid employment, and few needs for care; (3) an active group with more daytime activities, no paid employment, and mainly met needs for care; and (4) a group engaged in paid employment without needs for care in this area. Groups differed significantly from each other in age, duration in MHC, living situation, educational level, having a life partner or not, needs for care regarding social contacts, quality of life, psychosocial functioning, and psychiatric symptoms. Differences were not found for clinical diagnosis or gender. CONCLUSIONS: Among individuals with SMI, different subgroups can be distinguished based on employment situation, daytime activities, and needs for care in these areas. Subgroups differ from each other on patient characteristics and each subgroup poses specific challenges, underlining the need for tailored rehabilitation interventions. Special attention is needed for individuals who are involuntarily inactive, with severe psychiatric symptoms and problems in psychosocial functioning.

An evaluation of an employment pilot to support forensic mental health service users into work and vocational activities.

BACKGROUND: Few employment programmes exist to support forensic service users with severe mental health problems and a criminal history. Little is known about how best to achieve this. The Employment and Social Inclusion Project (ESIP) was developed and piloted to support forensic service users into employment and vocational activities. AIMS: This pilot service evaluation aimed to assess the number of service users who secured employment/vocational activities and explored services users' and staff experiences. METHOD: Quantitative data were collected to record the characteristics of participating service users and how many secured employment and engaged in vocational activities. Eighteen qualitative interviews were conducted with service users and staff. RESULTS: Fifty-seven service users engaged with the project, most were men (93.0%) and previously employed (82.5%). Four service users (7.0%) secured paid competitive employment. Eight (14.0%) gained other paid employment. Tailored one-to-one support to increase skills and build confidence was an important feature of the project. Creation of a painting and decorating programme offered training and paid/flexible work. CONCLUSIONS: This exploratory project achieved some success in assisting forensic service users into paid employment. Further research to identify what works well for this important group will be of great value.

Employment in Adults with Down Syndrome in the United States: Results from a National Survey.

BACKGROUND: There is no current data about employment/unemployment of adults with Down syndrome in the United States. The data that exists includes adults with Down syndrome as part of the larger group of people with disabilities or people with intellectual disability. METHOD: This study used a survey to investigate paid and volunteer employment, unemployment, types of jobs, job training, job settings, job schedules and job satisfaction in adults with Down syndrome. There were 511 survey responses received. RESULTS: Findings were that there is high unemployment for adults with Down syndrome and that current employment is in a limited number of fields, primarily in the areas of food, janitorial work, landscaping, and office work. A small percentage of respondents have full time paid employment. A combination of part time paid employment and unpaid volunteer work is typical. CONCLUSIONS: Implications for educators, counselors, legislators and employers are discussed.

Meta-analysis of predictors of favorable employment outcomes among individuals with bipolar disorder.

OBJECTIVES: Although several studies have reported on predictors of employment in individuals with bipolar disorder (BD), the magnitude of the impact of these variables is unclear as no previous studies have estimated the collective effect sizes (ESs). The present meta-analysis estimated ESs and explored which of these variables are associated with positive employment outcomes. METHODS: We searched for articles published between 2000 and 2011 that reported associations between sociodemographic, clinical, psychosocial, and/or cognitive variables with employment outcomes in BD. Of the 781 articles identified, 22 met the inclusion criteria and were included in the final analysis (n = 6,301). Weighted correlation coefficients (r-index) were computed as ESs for each of the predictor variables, which were grouped into six categories: cognitive performance, symptomatology, sociodemographic factors, course of illness, clinical variables, and other personal factors. The overall ES (Rw) was estimated by assuming random-effect models. Sensitivity analyses were also performed to determine the robustness of the findings. RESULTS: Significant predictors of favorable employment outcomes included: cognitive performance (e.g., verbal memory, Rw = 0.33; executive function, Rw = 0.26), sociodemographic factors (e.g., years of education, Rw = 0.23), course of illness (e.g., number of lifetime psychiatric hospitalizations, Rw = -0.35), symptomatology (e.g., depression, Rw = -0.25), and other personal factors (e.g., personality disorder, Rw = -0.49). CONCLUSIONS: Overall, the cognitive performance and course of illness had larger average ESs than symptomatology or sociodemographic factors on favorable employment outcomes. These findings may help to guide the design of more effective work interventions for people with BD.

'You don't want to be seen as a burden' experiences of working with early inflammatory arthritis: a qualitative study.

PURPOSE: To describe the impact of early inflammatory arthritis on work participation. MATERIALS AND METHODS: Thirty individuals (24 women) of working age (age 18-69 years) with inflammatory arthritis (<2 years duration) who were in paid employment or fulltime education were interviewed using qualitative description methodology. Data was analysed using thematic analysis. RESULTS: Half of participants (n = 15) reported work disability within the first two-years of diagnosis. Five descriptive themes were identified that explained the early impact of IA on participation in paid employment. These themes were: (i) altered capacity for work; (ii) work comes first; (iii) the invisible burden; (iv) the disclosure effect; and (v) a reconstructed work future. CONCLUSION: The scale of early work disability appears to be higher than previously understood. Although early medical intervention has improved disease management, significant work-based restrictions requiring intervention remain. Internalised and invisible work-related anxieties present early in the disease and need to be acknowledged and addressed by healthcare providers.IMPLICATIONS FOR REHABILITATIONEarly inflammatory arthritis causes significant challenges in work ability, and early work-based participation restrictions are present despite early use of drug therapy.Assessment of the client's subjective experience, including understanding the invisible burden, is an important aspect in determining the types of work interventions required.Disclosure of diagnosis in the work environment is associated with anxiety and fear, however, disclosure is influential in supporting capacity to retain work participation and should be included in work interventions.Routine healthcare should include early interventions to address work-based restrictions and supporting work retention to avoid work disability.

The contribution of paid employment for students during their pre-registration nursing studies: An integrative review.

OBJECTIVE: This integrative review of the literature explores potential associations between paid employment during students' pre-registration study period and development of workplace capabilities. The capacity to demonstrate attainment of standards of practice upon registration as a nurse is essential for the delivery of safe, quality care. The increasing shift, internationally, to higher education, concerns have been raised about limited time in practice settings and consequently nurses' capability upon employment. Extensive research has been conducted into student clinical placement models and graduates transition programs, but employment during students' pre-registration study has received little consideration. DESIGN: An integrative approach of peer reviewed articles. DATA SOURCES: A systematic search of the literature published between 1996 and 2021 across five electronic data bases; including Cumulative Index to Nursing and Allied Health Literature, Scopus, Medline, American Psychological Association and Education Resource Information Centre was conducted. REVIEW METHODS: Data was analysed according to the Whittemore and Knafl (2005) framework to maintain a methodical and meticulous approach. RESULTS: Fourteen studies differentiated graduates employed during their studies. Employment contributed to developing capabilities across four domains, namely, personal growth and development, comprehensive nursing practice, organisational capability and professional values and behaviours upon employment. CONCLUSION: Employment during pre-registration studies is associated with developing workplace capabilities. Opportunities to develop the capability of graduates should focus on the possibility of 'learning' during employment rather than merely a recruitment strategy.

Do employers discriminate against obese employees? Evidence from individuals who are simultaneously self-employed and working for an employer.

We test whether the lower wages of obese employees result from employer discrimination using a novel empirical strategy. Using data from two nationally representative surveys from the US, we analyze the wages of individuals who are simultaneously self-employed and working for an employer. While lower productivity and customer discrimination against obese individuals may affect wages in both types of jobs, employer discrimination cannot affect the wages of solo entrepreneurs. Our estimates suggest that, even after controlling for productivity (proxied by their concurrent wage in self-employment), white women (men) who are obese earn 11.4% (9.7%) less than their healthy-weight counterparts in their paid employment jobs. We also find that white women (but not men) who are overweight earn 9.1% less than their healthy-weight counterparts. We do not find any evidence of significant bodyweight discrimination among black and Hispanic workers. These results suggest that white workers, especially white women, are likely to face bodyweight discrimination in their workplaces. We report the results for a series of robustness checks to rule out alternative explanations, such as reverse causality, differences in healthcare costs, and occupation-specific customer discrimination.

Caregivers' hopes, expectations and concerns surrounding the employment and future of young people with mental health conditions.

OBJECTIVE: Informal caregivers are often placed in a better position to understand and advocate for the vocational needs of young persons with mental health conditions. However, their opinions are largely ignored in the planning of vocational outcomes. This qualitative study had two broad aims: to explore (1) the perceptions of caregivers of young adults with mental health conditions on issues of paid employment and (2) their views and expectations of employment support services. METHODS: A total of 30 semi-structured interviews were conducted. Caregivers were 45 years old on average, the majority were women (73%) and were of Chinese ethnicity (53%). Most participants (60%) were parents of the young persons with psychotic disorders (57%), or affective and mood disorders, such as depression or anxiety disorders (43%). RESULTS: Thematic analyses of data revealed three superordinate themes: (1) caregiving roles, (2) caregivers' expectations and hopes, and (3) barriers to employmentof young persons with mental health conditions. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Caregivers strongly believed that employment support services should prioritise and advocate for recovery while securing employment. Local mental health employment support services should incorporate the views and expectations of caregivers of young persons with mental health conditions to foster better coordination between stakeholders, and enhance support for successful employment, reintegration into the community, and ultimately recovery for these individuals.

Does Work Disability Contribute to Trajectories of Work Participation before and after Vocational Labour Market Training for Job Seekers?

The contribution of ill-health to labour market participation in relation to vocational training is unclear. Using nationally representative Finnish register data on 42,691 vocational labour market trainees in 2008-2010, we constructed latent trajectory groups of work participation in the open labour market three years before and after training, identifying groups called "High-High", "High-Low", "Low-High", and "Low-Low". We plotted further patterns of labour market participation within these trajectory groups and, using multinomial logistic regression, examined assignment to these groups focusing on previous work disability status. Those with compared to those without previous work disability had previous employment more often and spent less time in economic inactivity within the two trajectory groups with low pre-training levels of work participation. Having a previous work disability was associated with assignment to the "High-Low" trajectory group of work participation instead of the "High-High" comparison group. The associations of other background factors with the assignment to the different trajectory groups were relatively similar amongst those with and without previous work disability. However, some of these associations were weaker amongst the former. Along with other key background factors, previous work disability should be accounted for when assessing the effects of vocational training.

Australia's Disability Employment Services Program: Participant Perspectives on Factors Influencing Access to Work.

Disability employment programs play a key role in supporting people with disability to overcome barriers to finding and maintaining work. Despite significant investment, ongoing reforms to Australia's Disability Employment Services (DES) are yet to lead to improved outcomes. This paper presents findings from the Improving Disability Employment Study (IDES): a two-wave survey of 197 DES participants that aims to understand their perspectives on factors that influence access to paid work. Analysis of employment status by type of barrier indicates many respondents experience multiple barriers across vocational (lack of qualifications), non-vocational (inaccessible transport) and structural (limited availability of jobs, insufficient resourcing) domains. The odds of gaining work decreased as the number of barriers across all domains increased with each unit of barrier reported (OR 1.22, 95% CI 1.07, 1.38). Unemployed respondents wanted more support from employment programs to navigate the welfare system and suggest suitable work, whereas employed respondents wanted support to maintain work, indicating the need to better tailor service provision according to the needs of job-seekers. Combined with our findings from the participant perspective, improving understanding of these relationships through in-depth analysis and reporting of DES program data would provide better evidence to support current DES reform and improve models of service delivery.

First year nursing students' perceptions of learning interpersonal communication skills in their paid work: A multi-site Australasian study.

Nursing students are increasingly undertaking paid work while studying and most choose paid work in health care or hospitality. This paper is drawn from a larger sequential exploratory mixed-method study which examined the relationship between students working while studying nursing and the impact on academic performance. In this paper, we explored first year nursing students' perceptions of communication skills gained through paid work. Using a qualitative exploratory design, 50 first year commencing nursing students from four nursing schools (3 Australia; 1 New Zealand) were interviewed. Inductive thematic analysis was used which identified two themes: (i) recognising the value of learning interpersonal communication skills and; (ii)opportunities to develop effective interpersonal communication skills. Paid work provides interpersonal communication skills; active listening, being present and interacting while multi-tasking and emotion management. Undergraduate education providers need to recognise the benefits of paid work for students, including enhancing interpersonal skills.

Effectiveness of the Boston University Approach to Psychiatric Rehabilitation in Improving Social Participation in People With Severe Mental Illnesses: A Randomized Controlled Trial.

BACKGROUND: People with severe mental illnesses (SMIs) have difficulty participating in society through work or other daily activities. AIMS: To establish the effectiveness with which the Boston University Approach to Psychiatric Rehabilitation (BPR) improves the level of social participation in people with SMIs, in the Netherlands. METHOD: In a randomized controlled trial involving 188 people with SMIs, we compared BPR (n = 98) with an Active Control Condition (ACC, n = 90) (Trial registration ISRCTN88987322). Multilevel modeling was used to study intervention effects over two six-month periods. The primary outcome measure was level of social participation, expressed as having participated in paid or unpaid employment over the past six months, as the total hours spent in paid or unpaid employment, and as the current level of social participation. Secondary outcome measures were clients' views on rehabilitation goal attainment, Quality of Life (QOL), personal recovery, self-efficacy, and psychosocial functioning. RESULTS: During the study, social participation, QOL, and psychosocial functioning improved in patients in both groups. However, BPR was not more effective than ACC on any of the outcomes. Better social participation was predicted by previous work experience and a lower intensity of psychiatric symptoms. CONCLUSIONS: While ACC was as effective as BPR in improving the social participation of individuals with SMIs, much higher percentages of participants in our sample found (paid) work or other meaningful activities than in observational studies without specific support for social participation. This suggests that focused rehabilitation efforts are beneficial, irrespective of the specific methodology used.

Employment pathways of individuals with spinal cord injury living in Switzerland: A qualitative study.

BACKGROUND: Labour market participation (LMP) represents a key goal of rehabilitation for individuals with spinal cord injury (SCI). To achieve this goal, Swiss SCI rehabilitation centres seek, together with their clients, viable follow-up solutions for returning to work after initial rehabilitation. However, the long-term outcomes of such vocational follow-up solutions have not been investigated so far, and there is a paucity of knowledge regarding the various types of employment pathways that persons with SCI living in Switzerland may experience. OBJECTIVE: To examine long-term employment pathways as experienced by individuals with SCI living in Switzerland. METHODS: A qualitative descriptive study design involving narrative interviews with individuals who completed vocational rehabilitation (VR) during their initial rehabilitation. Interviews were transcribed verbatim, and data analysed using an inductive thematic analysis approach. RESULTS: The analysis of the 15 interviews revealed four employment pathways: the pathway of no paid work, the pathway of retraining, the pathway of job adaptation and the pathway of continuing work. CONCLUSIONS: Apart from three pathways leading towards paid employment, our results revealed one pathway that was characterized by permanent unemployment. Individuals facing a pathway of no paid work may benefit from more custom-made vocational follow-up solutions and prolonged job coaching after initial VR.

Taken-for-granted assumptions about the clinical experience of newly graduated registered nurses from their pre-registration paid employment: A narrative inquiry.

Paid employment within clinical setting, such as externships for undergraduate student, are used locally and globally to better prepare and retain new graduates for actual practice and facilitate their transition into becoming registered nurses. However, the influence of paid employment on the post-registration experience of such nurses remains unclear. Through the use of narrative inquiry, this study explores how the experience of pre-registration paid employment shapes the post-registration experience of newly graduated registered nurses. Repeated individual interviews were conducted with 18 new graduates, and focus group interviews were conducted with 11 preceptors and 10 stakeholders recruited from 8 public hospitals in Hong Kong. The data were subjected to narrative and paradigmatic analyses. Taken-for-granted assumptions about the knowledge and performance of graduates who worked in the same unit for their undergraduate paid work experience were uncovered. These assumptions affected the quantity and quality of support and time that other senior nurses provided to these graduates for their further development into competent nurses and patient advocates, which could have implications for patient safety. It is our hope that this narrative inquiry will heighten awareness of taken-for-granted assumptions, so as to help graduates transition to their new role and provide quality patient care.

Cardiovascular disease, diabetes and early exit from paid employment in Europe; the impact of work-related factors.

BACKGROUND/OBJECTIVES: The aims of the study were to examine (i) the association between cardiovascular disease (CVD) or diabetes and exit from paid employment via disability benefits, unemployment, early retirement or other exit routes; and (ii) the impact of work-related factors on exit from paid employment among individuals with CVD or diabetes. METHODS: Respondents of the longitudinal Survey of Health and Retirement in Europe (SHARE) were included if they were aged >50years, had paid employment at baseline, and a known employment status after 2 or 6years (n=5182). A baseline-interview provided information on the presence of diagnosed CVD and diabetes, and physical and psychosocial work-related factors. During follow-up interviews information on work status was collected. Multinomial regression analyses were used to investigate the association between CVD, diabetes and exit from paid employment, and the impact of work-related factors. RESULTS: Workers with CVD or diabetes had significantly increased probabilities of disability benefits (OR 2.50, 95% CI 1.69-3.70) and early retirement (OR 1.34, 95% CI 1.05-1.74), but a comparable probability of unemployment (OR 1.10, 95% CI 0.71-1.71). Regarding disability benefits, individuals who had a stroke had the highest probability (OR 3.48, 95% CI 1.31-9.23). Perceived high job demands with low rewards or with low control at work further increased the probability of early exit among individuals with CVD or diabetes. CONCLUSIONS: Our study shows a prominent role of CVD and diabetes in premature losses to the workforce, and it shows that optimizing psychosocial work-related factors could be beneficial in people with CVD or diabetes.

Side by Side: a workplace engagement program for people with younger onset dementia.

This paper describes an innovative demonstration program called Side by Side that was initiated to assess the feasibility of supported workplace engagement for people with younger onset dementia. Seven people with mild dementia work one day per week beside a work-buddy in a large metropolitan hardware store. Work-buddies are store employees who have undergone dementia training. Work duties are negotiated at the start of each shift and include restocking, plant care, assembling display stock and serving customers. All participants have been able to adapt to the workplace environment and some now talk about 'their customers'. Family carers have reported a positive impact on self-esteem and life satisfaction as a result of the workplace experience. This evaluation of feasibility has exceeded all expectations and has demonstrated that it is possible to offer meaningful activities for people with mild dementia if an appropriate framework of support is provided.