RESUMEN
BACKGROUND: Our study focuses on the development of disease-free life years of two disease groups with high public health relevance: musculoskeletal diseases (MSD) and cardiovascular diseases (CVD). Against the backdrop of prolonged working lives, the development of disease-free life years in the working-age population is compared with the trend in the employed population. Differences between occupational groups are also examined. METHODS: The study is based on data from the statutory health insurance provider AOK Lower Saxony (Nâ¯= 2,001,225). Incident cases were identified based on the diagnosis data. The expected years free of MSD and CVD were calculated using multistate life table analysis for three periods between 2006 and 2018. The occupational group is identified via the occupational key. Three groups are distinguished: unskilled and semi-skilled workers, skilled workers and specialists, and highly skilled workers. RESULTS: Life years free of MSD clearly decreased in the general population and among the employed population. The decrease was strongest in the higher-skilled occupational groups. Life years free of CVD increased in the general population. The increase was weaker among the employed population. The only occupational group showing increases were men in unskilled and semi-skilled occupations. DISCUSSION: The study shows that disease-free life years among employed persons developed in some cases worse than in the general population. For the analysed disease groups MSD and CVD, there are clear inequalities between occupational groups, which decreased somewhat over time. The inequalities and the decrease in years free of MSD highlight the high public health relevance and the need for effective prevention strategies to prevent CVD and MSD in working age.
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Enfermedades Cardiovasculares , Enfermedades Musculoesqueléticas , Enfermedades Profesionales , Humanos , Enfermedades Musculoesqueléticas/epidemiología , Enfermedades Cardiovasculares/epidemiología , Alemania/epidemiología , Masculino , Femenino , Adulto , Persona de Mediana Edad , Enfermedades Profesionales/epidemiología , Adulto Joven , Anciano , Esperanza de Vida/tendencias , Empleo/estadística & datos numéricos , Empleo/tendencias , AdolescenteRESUMEN
INTRODUCTION: This study explored employment trends among working-age patients undergoing hemodialysis using 5-year surveys from 1996 to 2021. Policy changes affecting individuals with disabilities, the economic environment, and employment status among the general population in Japan were considered. Differences in trends by gender and health status were examined. METHODS: Employment status was categorized into employment and nonemployment; and regular, nonregular, and self. Analytical data with similar characteristics were generated over the six surveys using the propensity score method. RESULTS: The employment rate, especially among women, increased from 1996 to 2021. However, the employment rate ratio to the general population was approximately 80% for men and 50% for women, even in 2021. The employment rate increased with an expansion in nonregular employment. Women's employment trends could be explained by changes in real gross domestic product and employment quotas for individuals with disabilities. CONCLUSION: Employment trends differ by gender and by regular versus nonregular employment.
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Empleo , Diálisis Renal , Humanos , Masculino , Femenino , Diálisis Renal/economía , Diálisis Renal/estadística & datos numéricos , Diálisis Renal/tendencias , Empleo/estadística & datos numéricos , Empleo/tendencias , Japón , Persona de Mediana Edad , Adulto , Factores Sexuales , Encuestas y Cuestionarios , Personas con Discapacidad/estadística & datos numéricos , Estado de SaludRESUMEN
Evidence suggests that there are social inequalities in multimorbidity, with a recent review indicating that area levels of deprivation are consistently associated with greater levels of multimorbidity. Definitions of multimorbidity, the most common of which is the co-occurrence of more than one long term condition, can include long term physical conditions, mental health conditions or both. The most commonly used measure of deprivation in England and Wales is the Index of Multiple Deprivation (IMD), an index of seven different deprivation domains. It is unclear which features of IMD may be mediating associations with multimorbidity. Thus, there may be associations because of the individual characteristics of those living in deprived areas, characteristics of the areas themselves or overlap in definitions. Data from over 25,000 participants (aged 16+) of Understanding Society (Wave 10, 1/2018-3/2020) were used to understand the most salient features of multimorbidity associated with IMD and whether physical or mental conditions are differentially associated with the seven domains of IMD. 24% of participants report multimorbidity. There is an increased prevalence of multimorbidity composed of only long-term physical conditions in the most deprived decile of deprivation (22%, 95% CI[19,25]) compared to the least deprived decile (16%, 95% CI[14,18]). Mental health symptoms but not reporting of conditions vary by decile of IMD. Associations with multimorbidity are limited to the health, income, education and employment domains of IMD. We conclude that multimorbidity represents a substantial population burden, particularly in the most deprived areas in England and Wales.
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Escolaridad , Empleo , Renta , Multimorbilidad , Factores Socioeconómicos , Adulto , Empleo/tendencias , Humanos , Multimorbilidad/tendencias , Reino Unido/epidemiologíaRESUMEN
Automation and population aging are two major forces that will shape the nature of works in the future. However, it is not clear how these forces will interact with each other and affect the labor market. This paper examines the interaction effects of computerization and population aging on the labor market. We found that computerization and population aging have large and statistically significant effects on employment growth but not earnings growth. Also, their interaction terms are statistically significant only for employment growth but not for earnings growth.
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Automatización/economía , Empleo/tendencias , Dinámica Poblacional/tendencias , Automatización/ética , Automatización/estadística & datos numéricos , Empleo/economía , Humanos , Renta , Modelos Económicos , Modelos Teóricos , Ocupaciones , Dinámica Poblacional/estadística & datos numéricos , Clase Social , Factores Socioeconómicos , Factores de TiempoRESUMEN
BACKGROUND: Ongoing shifts in economic structure from automation and globalisation can affect employment and mortality, yet these relations are not well described. OBJECTIVE: We assess whether long-term employment and health outcomes relate systematically to structural change in the labour market, using the occupational Routine Task Intensity (RTI) score as indicator of exposure is to risks of outsourcing and technology-induced job loss. METHODS: Using a cohort design and administrative data with national population coverage, we categorise all Norwegian employees in 2003 by the RTI score of their occupation and examine how this score correlates with employment and health outcomes measured in 2018 and 2019. The study sample counts 416 003 men and 376 413 women aged 33-52 in 2003. RESULTS: The occupational RTI score at baseline is robustly associated with long-term employment, disability and mortality outcomes. Raw correlations are reduced after adjustment for potential confounders, but associations remain substantial in models controlling for individual covariates and in sibling comparisons. Working in an occupation with RTI score 1 SD above the mean in 2003 is associated with a raised probability of being deceased in 2019 of 0.24 percentage points (95% CI: 0.18 to 0.30) for men and 0.13 percentage points (95% CI: 0.02 to 0.24) for women, corresponding to raised mortality rates of 6.7% and 5.5%. CONCLUSIONS: Individuals in occupations characterised by high routine intensity are less likely to remain employed in the long term, and have higher rates of disability and mortality.
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Automatización , Empleo/estadística & datos numéricos , Desempleo/estadística & datos numéricos , Adulto , Empleo/tendencias , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mortalidad/tendencias , Noruega/epidemiología , Ocupaciones/tendencias , Pensiones/estadística & datos numéricos , Factores de Riesgo , Desempleo/tendenciasRESUMEN
Este artigo tem por objetivo geral debater o que é trabalhar no Brasil de 2020, a partir do processo de precarização em sua versão mais atualizada: a uberização. Em específico, nosso objetivo é discutir as estratégias e reinvenções desenvolvidas por uma categoria de trabalhadores uberizados para minimizar ou conter o avanço da precarização. Seguindo a tradição teórico-metodológica da psicologia social do trabalho, conduzimos uma análise temática a partir do perfil oficial do movimento dos Entregadores Antifascistas na rede social Instagram. O material para análise compreende postagens, entrevistas e reportagens em formato escrito e audiovisual, de acesso público. Nossa análise é apresentada a partir de três temas que emergem como fundamentais para o debate proposto: a precarização e seu aprofundamento na pandemia; o empreendedorismo funcionando para a precarização do trabalho; e o encontro da política com o trabalho dos entregadores. Concluímos que acompanhar a emergência e o desenvolvimento de movimentos de trabalhadores no enfrentamento à uberização nos mundos do trabalho permite identificar e compreender as implicações psicossociais dessas novas modalidades de organização do trabalho
This study aims to discuss the uberization of work as a more up-to-date version of the precarization of work. It also aims to show and debate the strategies and tactics which uberized workers developed to minimize its consequences and prevent the increase of precarious and insecure jobs. Following the theoretical-methodological perspective of the Latin American social psychology of work, we conducted a thematic analysis using documents from the official Instagram account of the movement of "Anti-Fascist Couriers." Publicly accessible written and audiovisual documents such as photos, interviews, documentaries, and magazine and newspaper articles compose our dataset. We show our analysis considering three main themes: the increase of precarious conditions at work after the outbreak of the COVID-19 pandemic; how entrepreneurialism enlarge precarious conditions at work; and delivery workers' political action. We conclude that monitoring the emergence and development of workers' movements in the fight against uberization in the world of work enabled us to identify and understand the psychosocial implications of these new forms of work organization
Asunto(s)
Humanos , Emprendimiento/economía , Empleo/tendencias , Grupos Profesionales , Política , Psicología Social , Brasil , Red Social , COVID-19/economía , SindicatosRESUMEN
BACKGROUND: Employment improves mental health and well-being by providing financial security, daily structure, a sense of identity and purpose, and social engagement. However, securing and sustaining employment is exceptionally challenging for vulnerable populations who experience persistent and multiple barriers, such as mental illness, homelessness, food and housing insecurity, and marginalization. Evidence-based supported employment programs, most notably individual placement and support (IPS) are becoming a more common approach for addressing the needs of these high-risk individuals. The aim of this paper is to outline the protocol for evaluating an IPS program in Vancouver's downtown and Downtown Eastside (DTES). METHODS AND DESIGN: This prospective quasi-experimental study of persons with persistent and multiple barriers to employment will use a mixed-methods approach for evaluating a novel IPS program. The evaluation will consist of survey packages and interviews that will capture outcomes related to employment and well-being, as well as the experiential process of receiving individualized and integrated supports through the IPS program. A mixed-methods approach is appropriate for this study as quantitative data will provide an objective assessment of program impacts on employment and well-being outcomes over time, while qualitative data will provide an in-depth understanding of continued barriers and experiences. DISCUSSION: The results from this evaluation will contribute evidence within a local British Columbian (BC) context that may increase access to meaningful employment for those with long-term experience of complex barriers to employment. Further, the findings will support continued improvements, and guide decision-making around practices and policy for future implementation of IPS and employment supports across BC.
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Educación/métodos , Rehabilitación Vocacional/métodos , Poblaciones Vulnerables/psicología , Colombia Británica , Educación/tendencias , Empleo/tendencias , Empleos Subvencionados/tendencias , Femenino , Personas con Mala Vivienda/estadística & datos numéricos , Inestabilidad de Vivienda , Humanos , Masculino , Trastornos Mentales/psicología , Salud Mental , Estudios Prospectivos , Rehabilitación Vocacional/tendencias , Encuestas y Cuestionarios , Poblaciones Vulnerables/educación , Poblaciones Vulnerables/estadística & datos numéricosRESUMEN
This paper analyzes the dynamics of the labor market in Latin America during the COVID-19 pandemic. After a decade of a virtuous circle of growth with the creation of formal jobs, the pandemic has had an considerable impact on the region's labor market, generating an unparalleled increase in the proportion of the inactive population, considerable reductions in informality, and, in contrast, smaller fluctuations in formal jobs. In this context, the formal sector, given its lower flexibility, became a "social safety net" that preserved the stability of employment and wages. Based on the findings presented in this paper, it is projected that, starting in 2021, informality will grow to levels higher than those of the pre-COVID-19 era-with 7.56 million additional informal jobs-as a result of the population returning to the labor market to compensate for the declines in incomes. According to the simulations presented, postponing or forgiving income tax payments and social security contributions conditional on the generation of formal jobs could reduce the growth of informality by 50 to 75 percent. Achieving educational improvements has the potential to reduce it by 50 percent.
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COVID-19 , Empleo/tendencias , Adolescente , Adulto , COVID-19/epidemiología , Empleo/estadística & datos numéricos , Composición Familiar , Femenino , Humanos , América Latina/epidemiología , Masculino , Persona de Mediana Edad , Ocupaciones , Política Pública , Salarios y Beneficios , Clase Social , Factores Socioeconómicos , Adulto JovenRESUMEN
We investigate the connection between the choice of transportation mode used by commuters and the probability of COVID-19 transmission. This interplay might influence the choice of transportation means for years to come. We present data on commuting, socioeconomic factors, and COVID-19 disease incidence for several US metropolitan areas. The data highlights important connections between population density and mobility, public transportation use, race, and increased likelihood of transmission. We use a transportation model to highlight the effect of uncertainty about transmission on the commuters' choice of transportation means. Using multiple estimation techniques, we found strong evidence that public transit ridership in several US metro areas has been considerably impacted by COVID-19 and by the policy responses to the pandemic. Concerns about disease transmission had a negative effect on ridership, which is over and above the adverse effect from the observed reduction in employment. The COVID-19 effect is likely to reduce the demand for public transport in favor of lower density alternatives. This change relative to the status quo will have implications for fuel use, congestion, accident frequency, and air quality. More vulnerable communities might be disproportionally affected as a result. We point to the need for additional studies to further quantify these effects and to assist policy in planning for the post-COVID-19 transportation future.
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COVID-19/transmisión , Transportes/economía , Transportes/estadística & datos numéricos , Ciudades , Empleo/tendencias , Humanos , Vehículos a Motor/economía , Vehículos a Motor/estadística & datos numéricos , Pandemias , Densidad de Población , Dinámica Poblacional/tendencias , SARS-CoV-2/patogenicidad , Factores Socioeconómicos , Transportes/métodos , Estados Unidos/epidemiologíaRESUMEN
Droughts are associated with several societal ills, especially in developing economies that rely on rainfed agriculture. Recently, researchers have begun to examine the effect of droughts on the risk of Intimate-Partner Violence (IPV), but so far this work has led to inconclusive results. For example, two large recent studies analyzed comparable data from multiple sub-Saharan African countries and drew opposite conclusions. We attempt to resolve this apparent paradox by replicating previous analyses with the largest data set yet assembled to study drought and IPV. Integrating the methods of previous studies and taking particular care to control for spatial autocorrelation, we find little association between drought and most forms of IPV, although we do find evidence of associations between drought and women's partners exhibiting controlling behaviors. Moreover, we do not find significant heterogeneous effects based on wealth, employment, household drinking water sources, or urban-rural locality.
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Sequías/estadística & datos numéricos , Violencia de Pareja/tendencias , Estudios Transversales , Bases de Datos Factuales , Empleo/tendencias , Composición Familiar , Encuestas Epidemiológicas , Humanos , Violencia de Pareja/psicología , Prevalencia , Factores de Riesgo , Parejas Sexuales/psicología , Tiempo (Meteorología)Asunto(s)
COVID-19 , Empleo/tendencias , Admisión y Programación de Personal/tendencias , Médicos/estadística & datos numéricos , Factores de Tiempo , Adulto , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Médicos Mujeres/estadística & datos numéricos , Análisis de Regresión , SARS-CoV-2 , Encuestas y Cuestionarios , Estados UnidosRESUMEN
OBJECTIVE: The COVID-19 pandemic has had considerable economic repercussions for young workers. The current study was undertaken to examine the impact of the pandemic on the employment of young adults with rheumatic disease and on perceptions of work and health. METHODS: Surveys were administered to young adults with rheumatic disease prior to and following the onset of the COVID-19 pandemic. Surveys asked about employment status and collected information on sociodemographic, disease/health, and work-context factors. Items also asked about the perceived impact of the COVID-19 pandemic on work and health. A generalized estimating equation model was fitted to examine the effect of the pandemic on employment. RESULTS: In total, 133 young adults completed the pre-COVID-19 pandemic survey (mean age 28.9 years, 82% women). When compared to the pre-COVID-19 pandemic period, employment decreased from 86% to 71% following the pandemic, but no other changes were identified in sociodemographic, disease/health, or work-context factors. The time period following the COVID-19 pandemic was associated with a 72% lower odds of employment compared to the pre-pandemic period (odds ratio 0.28 [95% confidence interval 0.11-0.71]). Those with a postsecondary education or who reported more mental job demands were more likely to be employed following the onset of the pandemic. Also, a majority of participants reported that the pandemic affected health care (83%), treatment access (54%), working conditions (92%), and occupational health and safety (74%). CONCLUSION: The onset of the COVID-19 pandemic had socioeconomic implications for young people with rheumatic disease. To support economic recovery for individuals with rheumatic disease, strategies to promote employment should be designed that account for the young adult life phase and occupational characteristics.
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COVID-19/epidemiología , Empleo/tendencias , Enfermedades Reumáticas/epidemiología , Encuestas y Cuestionarios , Adulto , COVID-19/diagnóstico , Canadá/epidemiología , Estudios de Cohortes , Estudios Transversales , Femenino , Humanos , Estudios Longitudinales , Masculino , Pandemias , Enfermedades Reumáticas/diagnósticoRESUMEN
Ethnic and gendered employment gaps are mainly explained by individual characteristics, while less attention is paid to occupational structures. Drawing on administrative data, this article analyses the impact of occupational characteristics on top of individual attributes in the urban labour market of Vienna. Both set of variables can explain observed employment gaps to a large extent, but persistent gaps remain, in particular among females. The article's main finding is that the occupational structure appears to have gendered effects. While men tend to benefit from ethnic segregation, women face difficulties when looking for jobs with high shares of immigrant workers. Looking for jobs in occupations that recruit from relatively few educational backgrounds (credentials) is beneficial for both sexes at the outset unemployment, but among females this competitive advantage diminishes over time. The article concludes by discussing potential strategies to avoid the traps of occupational segregation.
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Emigrantes e Inmigrantes/estadística & datos numéricos , Empleo/tendencias , Etnicidad/estadística & datos numéricos , Ocupaciones/tendencias , Salarios y Beneficios/tendencias , Adolescente , Adulto , Austria , Ciudades/economía , Escolaridad , Femenino , Humanos , Acontecimientos que Cambian la Vida , Masculino , Persona de Mediana Edad , Ocupaciones/economía , Ocupaciones/ética , Clase Social , Seguridad Social/estadística & datos numéricos , Población Urbana/tendenciasRESUMEN
RATIONALE & OBJECTIVE: Individuals faced with decisions regarding kidney replacement therapy options need information on how dialysis treatments might affect daily activities and quality of life, and what factors might influence the evolution over time of the impact of dialysis on daily activities and quality of life. STUDY DESIGN: Observational cohort study. SETTING & PARTICIPANTS: 7,771 hemodialysis (HD) and peritoneal dialysis (PD) participants from 6 countries participating in the Peritoneal and Dialysis Outcomes and Practice Patterns Studies (PDOPPS/DOPPS). PREDICTORS: Patient-reported functional status (based on daily living activities), country, demographic and clinical characteristics, and comorbidities. OUTCOME: Employment status and patient-reported outcomes (PROs) including Kidney Disease Quality of Life (KDQOL) instrument physical and mental component summary scores (PCS, MCS), kidney disease burden score, and depression symptoms (Center for Epidemiologic Studies Depression Scale [CES-D] score > 10). ANALYTICAL APPROACH: Linear regression (PCS, MCS, kidney disease burden score), logistic regression (depression symptoms), adjusted for predictors plus 12 additional comorbidities. RESULTS: In both dialysis modalities, patients in Japan had the highest PCS and employment (55% for HD and 68% for PD), whereas those in the United States had the highest MCS score, lowest kidney disease burden, and lowest employment (20% in HD and 42% in PD). After covariate adjustment, the association of age, sex, dialysis vintage, diabetes, and functional status with PROs was similar in both modalities, with women having lower PCS and kidney disease burden scores. Lower functional status (score <11) was strongly associated with lower PCS and MCS scores, a much greater burden of kidney disease, and greater likelihood of depression symptoms (CES-D, >10). The median change in KDQOL-based PROs was negligible over 1 year in participants who completed at least 2 annual questionnaires. LIMITATIONS: Selection bias due to incomplete survey responses. Generalizability was limited to the dialysis populations of the included countries. CONCLUSIONS: Variation exists in quality of life, burden of kidney disease, and depression across countries but did not appreciably change over time. Functional status remained one of the strongest predictors of all PROs. Routine assessment of functional status may provide valuable insights for patients and providers in anticipating outcomes and support needs for patients receiving either PD or HD.
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Costo de Enfermedad , Empleo/psicología , Diálisis Peritoneal/psicología , Calidad de Vida/psicología , Diálisis Renal/psicología , Insuficiencia Renal Crónica/psicología , Anciano , Estudios de Cohortes , Estudios Transversales , Empleo/tendencias , Femenino , Humanos , Internacionalidad , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Diálisis Peritoneal/tendencias , Estudios Prospectivos , Diálisis Renal/tendencias , Insuficiencia Renal Crónica/terapiaRESUMEN
Estimating the impact of child health investments on adult living standards entails multiple methodological challenges, including the lack of experimental variation in health status, an inability to track individuals over time, and accurately measuring living standards and productivity in low-income settings. This study exploits a randomized school health intervention that provided deworming treatment to Kenyan children, and uses longitudinal data to estimate impacts on economic outcomes up to 20 y later. The effective respondent tracking rate was 84%. Individuals who received two to three additional years of childhood deworming experienced a 14% gain in consumption expenditures and 13% increase in hourly earnings. There are also shifts in sectors of residence and employment: treatment group individuals are 9% more likely to live in urban areas, and experience a 9% increase in nonagricultural work hours. Most effects are concentrated among males and older individuals. The observed consumption and earnings benefits, together with deworming's low cost when distributed at scale, imply that a conservative estimate of its annualized social internal rate of return is 37%, a high return by any standard.
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Antihelmínticos/uso terapéutico , Costo de Enfermedad , Helmintiasis/prevención & control , Adolescente , Adulto , Antihelmínticos/administración & dosificación , Antihelmínticos/economía , Niño , Salud Infantil/economía , Salud Infantil/tendencias , Utilización de Medicamentos/tendencias , Empleo/tendencias , Helmintiasis/tratamiento farmacológico , Helmintiasis/economía , Helmintiasis/epidemiología , Humanos , Renta/tendencias , KeniaRESUMEN
RESUMEN Antecedentes: la formación en cirugía se mantuvo uniforme desde la instauración del modelo de re sidencias. El avance de la ciencia ha llevado a la superespecialización y un 70% de los cirujanos conti núan en formación con una especialidad posbásica. Objetivos: identificar la proporción de cirujanos que derivan horas a otra actividad y analizar la inser ción laboral del cirujano. Material y métodos: estudio prospectivo, descriptivo, de corte transversal. 1) Encuesta, 2) Registros de la Dirección General de Docencia e Investigación, 3) Concursos y Perfiles profesionales de acceso público. Resultados: sobre 435 encuestados, al finalizar la residencia, un 73,3% continuó su formación en una posbásica. Solamente un 24,7% se insertó inmediatamente en el mercado como cirujano general. En cuanto a la inserción laboral actual de aquellos que finalizaron la formación como cirujano general, apenas un 17,4% se desempeña de manera exclusiva como cirujano general. Conclusiones: la falta de confianza para actuar de manera independiente y la necesidad de completar 4 años de formación para ingresar en el campo de interés aparecen como las problemáticas para resol ver. Se propone un programa de 5 años con formato 2+3. El período de formación básica abordará en 24 meses las generalidades de la práctica quirúrgica. El segundo, de formación avanzada, desarrollará en profundidad la subespecialidad elegida. El quinto año otorgará a todos la posibilidad de actuar a modo de cirujano independiente. Planteada como una subespecialidad, la Cirugía General volvería a ser un fin en sí misma y no un medio para llegar a una subespecialidad.
ABSTRACT Background: Training in surgery has remained relatively uniform since the residency programs were introduced. The continuous advances in science have led to the progressive super-specialization of surgeons; 70% of them continue their training with a subspecialty. Objectives: The aim of this study was to identify the proportion of surgeons who dedicate hours of their practice in another activity and to analyze how surgeons enter the workforce. Material and methods: We conducted a prospective and descriptive cross-sectional study with data from a survey, records of the General Directorate of Teaching and Research, and records of competitive selection processes and professional profiles available online. Results: Of 435 survey respondents, 73.3% of the resident graduates continued postresidency training in a surgical subspecialty. Only 24.7% immediately started working in general surgery. Among the graduate trainees in general surgery, only 17.4% were exclusively dedicated to general surgery. Conclusions: The lack of confidence to perform procedures independently and the need for completing 4 years of training in the residency program in general surgery to start training in the professional field of interest, appear as the issued to be solved. We propose a 5-year program with a 2+3 model. The initial period comprises 24 months of basic training covering the general aspects of surgical practice. The second period of advanced training will provide thorough training in the subspecialty chosen. In the last year of the 5-year program trainees will have the opportunity to act as attending surgeons. General surgery, conceived as a subspecialty, would regain its status as an objective and no longer a pathway to become a subspecialist.
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Humanos , Cirugía General , Internado y Residencia , Encuestas y Cuestionarios , Empleo/tendencias , Cirujanos , MétodosRESUMEN
Human capital, broadly defined as the skills acquired through formal education, is acknowledged as one of the key drivers of economic growth and social development. However, its measurement for the working-age populations, on a global scale and over time, is still unsatisfactory. Most indicators either only consider the quantity dimension of education and disregard the actual skills or are demographically inconsistent by applying the skills of the young cohorts in school to represent the skills of the working-age population at the same time. In the case of rapidly expanding or changing school systems, this assumption is untenable. However, an increasing number of countries have started to assess the literacy skills of their adult populations by age and sex directly. Drawing on this literacy data, and by using demographic backprojection and statistical estimation techniques, we here present a demographically consistent indicator for adult literacy skills, the skills in literacy adjusted mean years of schooling (SLAMYS). The measure is given for the population aged 20 to 64 in 185 countries and for the period 1970 to 2015. Compared to the conventional mean years of schooling (MYS)-which has strongly increased for most countries over the past decades, and in particular among poor countries-the trends in SLAMYS exhibit a widening global skills gap between low- and high-performing countries.
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Demografía/estadística & datos numéricos , Países Desarrollados/estadística & datos numéricos , Países en Desarrollo/estadística & datos numéricos , Alfabetización/tendencias , Adulto , Países Desarrollados/economía , Países en Desarrollo/economía , Empleo/tendencias , Femenino , Humanos , Renta/tendencias , Masculino , Persona de Mediana Edad , Instituciones Académicas/tendenciasRESUMEN
Importance: After a decline in cardiovascular mortality for nonelderly US adults, recent stagnation has occurred alongside rising income inequality. Whether this is associated with underlying economic trends is unclear. Objective: To assess the association between changes in economic prosperity and trends in cardiovascular mortality in middle-aged US adults. Design, Setting, and Participants: Retrospective analysis of the association between change in 7 markers of economic prosperity in 3123 US counties and county-level cardiovascular mortality among 40- to 64-year-old adults (102â¯660â¯852 individuals in 2010). Exposures: Mean rank for change in 7 markers of economic prosperity between 2 time periods (baseline: 2007-2011 and follow-up: 2012-2016). A higher mean rank indicates a greater relative increase or lower relative decrease in prosperity (range, 5 to 92; mean [SD], 50 [14]). Main Outcomes and Measures: Mean annual percentage change (APC) in age-adjusted cardiovascular mortality rates. Generalized linear mixed-effects models were used to estimate the additional APC associated with a change in prosperity. Results: Among 102â¯660â¯852 residents aged 40 to 64 years living in these counties in 2010 (51% women), 979â¯228 cardiovascular deaths occurred between 2010 and 2017. Age-adjusted cardiovascular mortality rates did not change significantly between 2010 and 2017 in counties in the lowest tertile for change in economic prosperity (mean [SD], 114.1 [47.9] to 116.1 [52.7] deaths per 100â¯000 individuals; APC, 0.2% [95% CI, -0.3% to 0.7%]). Mortality decreased significantly in the intermediate tertile (mean [SD], 104.7 [38.8] to 101.9 [41.5] deaths per 100â¯000 individuals; APC, -0.4% [95% CI, -0.8% to -0.1%]) and highest tertile for change in prosperity (100.0 [37.9] to 95.1 [39.1] deaths per 100â¯000 individuals; APC, -0.5% [95% CI, -0.9% to -0.1%]). After accounting for baseline prosperity and demographic and health care-related variables, a 10-point higher mean rank for change in economic prosperity was associated with 0.4% (95% CI, 0.2% to 0.6%) additional decrease in mortality per year. Conclusions and Relevance: In this retrospective study of US county-level mortality data from 2010 to 2017, a relative increase in county-level economic prosperity was significantly associated with a small relative decrease in cardiovascular mortality among middle-aged adults. Individual-level inferences are limited by the ecological nature of the study.
Asunto(s)
Enfermedades Cardiovasculares/mortalidad , Empleo/tendencias , Renta/tendencias , Adulto , Empleo/economía , Empleo/estadística & datos numéricos , Femenino , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Mortalidad/tendencias , Estudios Retrospectivos , Estados Unidos/epidemiologíaRESUMEN
Despite numerous journalistic accounts, systematic quantitative evidence on economic conditions during the ongoing COVID-19 pandemic remains scarce for most low- and middle-income countries, partly due to limitations of official economic statistics in environments with large informal sectors and subsistence agriculture. We assemble evidence from over 30,000 respondents in 16 original household surveys from nine countries in Africa (Burkina Faso, Ghana, Kenya, Rwanda, Sierra Leone), Asia (Bangladesh, Nepal, Philippines), and Latin America (Colombia). We document declines in employment and income in all settings beginning March 2020. The share of households experiencing an income drop ranges from 8 to 87% (median, 68%). Household coping strategies and government assistance were insufficient to sustain precrisis living standards, resulting in widespread food insecurity and dire economic conditions even 3 months into the crisis. We discuss promising policy responses and speculate about the risk of persistent adverse effects, especially among children and other vulnerable groups.
Asunto(s)
COVID-19/economía , COVID-19/epidemiología , Países en Desarrollo/economía , Empleo/tendencias , Renta/tendencias , Pandemias/economía , SARS-CoV-2 , Adulto , África/epidemiología , Agricultura/economía , Asia/epidemiología , COVID-19/virología , Niño , Colombia/epidemiología , Violencia Doméstica , Recesión Económica , Composición Familiar , Femenino , Inseguridad Alimentaria/economía , Programas de Gobierno/economía , Humanos , Masculino , Estaciones del Año , Encuestas y CuestionariosRESUMEN
Our study aimed to assess the change in the sleep patterns during the Coronavirus lockdown in five regions (Austria/Germany, Ukraine, Greece, Cuba and Brazil), using online surveys, translated in each language. Part of the cohort (age 25-65, well-educated) was collected directly during lockdown, to which retrospective cross-sectional data from and after lockdown (retrospective) questionnaires were added. We investigated sleep times and sleep quality changes from before to during lockdown and found that, during lockdown, participants had (i) worse perceived sleep quality if worried by COVID-19, (ii) a shift of bedtimes to later hours during workdays, and (iii) a sleep loss on free days (resulting from more overall sleep during workdays in non-system relevant jobs), leading to (iv) a marked reduction of social jetlag across all cultures. For further analyses we directly compared system relevant and system irrelevant jobs, because it was assumed that the nature of the lockdown's consequences is dependent upon system relevance. System relevant jobs were found to have earlier wake-up times as well as shorter total sleep times on workdays, leading to higher social jetlag for people in system relevant jobs. Cultural differences revealed a general effect that participants from Greece and Ukraine had later bedtimes (on both work and free days) and wake-up times (on workdays) than Cuba, Brazil and Austria, irrespective of COVID-19 lockdown restrictions.