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1.
Oral Health Prev Dent ; 22: 237-248, 2024 Jul 11.
Article in English | MEDLINE | ID: mdl-38989777

ABSTRACT

PURPOSE: To assess adherence to follow-up maintenance visits among patients who had previously undergone crown-lengthening surgery and investigate the different factors impacting their compliance. MATERIALS AND METHODS: A total of 314 patients were identified for follow-up appointments. Based on their responses, participants were categorised into four groups: attendees, non-attendees, refusals, and unreachable. Furthermore, data on sociodemographic factors (age, sex, nationality, marital status, education, occupation, and residential area), medical history, dental history (including missing teeth, implants, or orthodontic treatment history), and past appointment attendance (average yearly appointments, missed appointment percentage, and last appointment date) were collected and analysed to understand their influence on patient compliance. RESULTS: In a sample of 314 patients, 102 (32.5%) attended the appointments successfully. Improved attendance rates were significantly associated with being female, Saudi Arabian, married, and employed (p < 0.05). Moreover, patients with a high frequency of annual appointments and a recent history of appointments exhibited better compliance. None of the analysed dental factors affected the attendance rates. CONCLUSION: About one-third of patients who had undergone crown lengthening surgery were compliant with the follow-up visits. Different factors influenced this compliance pattern to varying extents, with more efforts needed to enhance patients' commitment to these visits.


Subject(s)
Crown Lengthening , Marital Status , Patient Compliance , Humans , Female , Male , Adult , Middle Aged , Sex Factors , Employment/statistics & numerical data , Young Adult , Age Factors , Educational Status , Follow-Up Studies , Appointments and Schedules , Occupations , Adolescent
2.
Front Public Health ; 12: 1421600, 2024.
Article in English | MEDLINE | ID: mdl-39005991

ABSTRACT

Introduction: How cognitive abilities affect financial and economic decision is an important issue that has attracted the attention of economics. Method: This paper uses the China Family Panel Studies (CFPS) 2010, 2014, and 2018 survey data to empirically test the impact of cognitive skills on the insurance participation decisions in rural China. Results and discussion: The results show that higher word ability is correlated to higher social health insurance participation and both word and math ability leads to higher social pension participation. Mechanism analysis reveals that individuals with higher cognitive skills are more likely to be affected by peers in insurance decision, and higher cognitive skills increase personal income that enables them to enroll in the social insurance. Further investigation of labor supply behavior suggests that while cognitive skills positively affect non-agricultural labor participation, cognitive skills amplify the negative effect of social security on labor supply.


Subject(s)
Cognition , Decision Making , Rural Population , Humans , China , Rural Population/statistics & numerical data , Female , Adult , Male , Middle Aged , Insurance, Health/statistics & numerical data , Employment/statistics & numerical data , Social Security/statistics & numerical data , Surveys and Questionnaires , Income/statistics & numerical data
3.
BMJ Open ; 14(7): e082903, 2024 Jul 09.
Article in English | MEDLINE | ID: mdl-38986552

ABSTRACT

INTRODUCTION: Persons with mild and moderate intellectual disability (MMID) have the right to participate in all aspects of society and be afforded equal opportunities to realise their full potential. However, it is a challenge for persons with MMID to find and maintain employment due to many different barriers. Currently, there is no contextually relevant framework in South Africa that considers the unique employment support needs and accommodation of persons with MMID, which can guide and inform the transition to employment interventions, strategies and national policy directives. METHODS AND ANALYSIS: The proposed scoping review will be guided by the methodological framework developed by a working group from the Joanna Briggs Institute (JBI) and the JBI Collaboration. The search for relevant studies will be conducted across 12 research databases. Reference mining of review studies will be conducted. A three-step search strategy will be used, including the use of information management software to manage the search results. Three independent reviewers will screen the full-text studies to finalise the list of included and excluded studies. Included studies will be assessed for methodological quality using a critical appraisal tool. Data will be charted by one independent reviewer and assessed by two independent reviewers, using a data charting instrument. The data chart will be presented using tables and charts describing the demographic features of the reviewed studies, with an explanation of the thematically analysed results. ETHICS AND DISSEMINATION: This scoping review has received ethical approval (BM22/10/11). A summary of the findings of the study will be published in a peer-reviewed journal. This scoping review will contribute to a better understanding of the key characteristics or factors underpinning the components of a multilevel transition to employment framework that will result in open labour market employment for persons with MMID.


Subject(s)
Employment , Intellectual Disability , Humans , Intellectual Disability/rehabilitation , Employment/statistics & numerical data , South Africa , Research Design , Review Literature as Topic , Employment, Supported
4.
PLoS One ; 19(7): e0303194, 2024.
Article in English | MEDLINE | ID: mdl-38990963

ABSTRACT

The impact of ill-health on labour force participation is a well-recognized concern in both developed and developing countries. However, previous studies have often overlooked age differentials in this relationship, assuming uniform effects across age groups. This study aims to fill this gap by examining how ill-health affects labour outcomes among different age segments in India. Utilizing data from the Longitudinal Ageing Study in India (LASI) Wave 1, which covers over 72,000 individuals aged 45 and above, this research investigates the linkage between health and labour force outcomes. The labour outcomes in this study includes labour force participation, labour earnings and hours worked. Present study used instrumental variable approach to mitigate endogeneity issues and establish causal relationships between health and labour outcomes. The Heckman selection model is utilized to address selection bias in analysing wage and hours worked. The study reveals several key findings. Firstly, ill-health consistently leads to a decline in labour force participation among both middle-aged (28 percent) and elderly (36 percent) individuals in India. This underscores the pervasive impact of health on workforce engagement, particularly in a context with limited social security measures. Secondly, the research identifies significant variations in the effects of ill-health on wages and hours worked based on age. Among elderly individuals, there is a pronounced reduction in both wages and hours worked due to ill-health. However, this effect is less pronounced among middle-aged adults. Furthermore, socioeconomic factors play a pivotal role in shaping how ill-health influences labour outcomes among different age groups. This study underscores the importance of considering age differentials in the impact of ill-health on labour outcomes, offering valuable insights for policymakers, practitioners, and researchers seeking to address this critical issue in India's dynamic socio-economic landscape.


Subject(s)
Employment , Humans , India , Middle Aged , Female , Aged , Employment/statistics & numerical data , Male , Longitudinal Studies , Health Status , Salaries and Fringe Benefits/statistics & numerical data , Age Factors , Socioeconomic Factors , Aging
5.
PLoS One ; 19(7): e0306458, 2024.
Article in English | MEDLINE | ID: mdl-38968175

ABSTRACT

BACKGROUND: Despite the importance of labour market participation and the high number of people with disabilities in rural Africa who rely on subsistence agriculture to survive, very few studies have documented labour market outcomes among farmers with and without disabilities in Africa. OBJECTIVE: We examined how labour market participation differed by disability and other factors among smallholder farmers in Western Kenya. METHODS: We use cross-sectional data collected between January and April 2022 from sorghum farmers enrolled in a trial evaluating the impact of a programme designed to improve labour market participation among sorghum farmers in rural Western Kenya. Disability and Labour market outcomes were assessed using questions from the Washington Group /ILO Labor Force Survey Disability Module the ILO Labour Force Survey module respectively. Univariate and multiple regression analyses were conducted to identify socio-demographic characteristics and other related factors associated with labour market participation. RESULTS: Among 4459 participants, disability was reported by 20.3% of women and 12.3% of men. Labour market participation was reported by 77.1% and 81.3% of women and men, respectively. Adjusting for demographic confounders, having a disability was associated with a lower likelihood of labour market participation (odds ratio 0.59, 95% confidence interval, 0.42-0.83, P = 0.001). These findings were similar in a modified model that looked at functional difficulties separately from anxiety and depression. Women, older participants, and those who were dependent on others were also more likely not to report participation in the labour market. CONCLUSIONS: Increased recognition and understanding of functional limitations among smallholder farmers is vital for the success of economic empowerment programmes aimed at increasing labour market participation among the most vulnerable populations.


Subject(s)
Disabled Persons , Farmers , Humans , Kenya , Female , Male , Farmers/psychology , Farmers/statistics & numerical data , Adult , Disabled Persons/statistics & numerical data , Middle Aged , Cross-Sectional Studies , Rural Population , Employment/statistics & numerical data , Agriculture , Young Adult , Adolescent
6.
Prev Med ; 185: 108062, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38972606

ABSTRACT

OBJECTIVE: Traumatic brain injuries (TBI), irrespective of severity, may have long-term social implications. This study explores the relationships between TBI severity and outcomes related to work stability, divorce, and academic achievement. METHODS: Using a Danish nationwide sample of persons with and without TBI, we employed case-control and longitudinal cohort designs. The case-control design utilized individuals aged 18 to 60 years and examined work stability. Each case, employed at time of TBI, was compared with 10 matched controls. The cohort design utilized individuals alive from 1980 to 2016 with and without TBI and assessed the likelihood of 1) divorce and 2) higher-level education. TBI exposures included concussion, skull fractures, or confirmed TBI. RESULTS: TBI cases exhibited higher odds ratios (OR) for work instability at all follow-ups compared to controls. Increased TBI severity was associated with a higher risk of work instability at 2-year follow-up (concussion: OR = 1.83; skull fracture: OR = 2.22; confirmed TBI: OR = 4.55), and with a higher risk of not working at 10-year follow-up (confirmed TBI: OR = 2.82; concussion: OR = 1.63). The divorce incidence rate ratio (IRR) was elevated in individuals with TBI (males: IRR = 1.52; females: IRR = 1.48) compared to those without TBI. Individuals with childhood TBI had reduced chances of attaining high school degree or higher (males: IRR = 0.79; females: IRR = 0.85) compared to those without TBI. CONCLUSION: TBI is associated with an increased long-term risk of social consequences, including work instability, divorce, and diminished chances of higher education, even in cases with concussion.


Subject(s)
Academic Success , Brain Injuries, Traumatic , Divorce , Humans , Female , Male , Divorce/statistics & numerical data , Brain Injuries, Traumatic/epidemiology , Adult , Denmark/epidemiology , Case-Control Studies , Middle Aged , Longitudinal Studies , Adolescent , Employment/statistics & numerical data , Young Adult
7.
JAMA Netw Open ; 7(7): e2421680, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-39023894

ABSTRACT

Importance: The US registered nurse (RN) workforce is in flux, with high rates of burnout, intention to leave, and vacancies. Rapid, repeated assessments of the nursing workforce can help hospital executives and policymakers enact effective recruitment and retention strategies. Objective: To identify changes in practicing RNs' employment plans and workplace assessments between the 2022 and 2023 surveys. Design, Setting, and Participants: This survey study compared data collected from the Michigan Nurses' Study at 2 time points: February 22 to March 1, 2022, and May 17 to June 1, 2023. Practicing RNs with an active, unrestricted license in Michigan and a valid individual email address were included. Main Outcome and Measures: The primary outcome was nurses' intention to leave their current position within 1 year. In the 2023 survey, nurses who planned to leave were queried on their next career step and the primary reason for their planned departure. Workplace assessments included questions about abusive or violent workplace events, emotional exhaustion, job satisfaction, the practice environment's delivery of high-quality care, and the clinical setting's safety rating. Regression analysis was used to examine workplace assessments and personal factors associated with planned departures. Results: This study obtained data on 9150 nurses (6495 females [71.0%]) and 7059 nurses (5134 females [72.7%]) responding to the 2022 (response rate, 8.3%) and 2023 (response rate, 7.4%) surveys, respectively. In the 2023 survey, 32.0% (2259) of nurses planned to leave their position, compared with 39.1% (3576) in the 2022 survey. Of these nurses, 957 (41.8%) planned to leave their current employer but remain in nursing, with workloads as the most frequently cited reason (29.4% [672]). Compared with the 2022 cohort, nurses in the 2023 sample reported less workplace abuse or violence (4591 [50.2%] vs 3063 [43.4%]; P < .001), fewer understaffed shifts (4407 [48.2%] vs 2898 [41.0%]; P < .001), and less frequent use of mandatory overtime (1709 [18.7%] vs 824 [11.7%]; P < .001). Factors associated with increased likelihood for planned departures included workplace abuse or violence (odds ratio [OR], 1.39; 95% CI, 1.05-1.82) and higher emotional exhaustion scores (OR, 3.05; 95% CI, 2.38-3.91). Favorable practice environments (OR, 0.37; 95% CI, 0.22-0.62) and excellent clinical setting safety ratings (OR, 0.28; 95% CI, 0.14-0.56) were associated with lower likelihood of planned departure. Conclusions and Relevance: Results of this study showed that nurses reported improved workplace conditions in the 2023 vs the 2022 survey; however, planned departure rates, abusive or violent events, and unsafe conditions remained high, and understaffing remained a primary concern for most nurses. Health system leaders and policymakers should prioritize initiatives that support nurse retention and reduce potential workforce instability.


Subject(s)
Job Satisfaction , Workplace , Humans , Female , Male , Adult , Workplace/psychology , Workplace/statistics & numerical data , Middle Aged , Employment/statistics & numerical data , Employment/psychology , Surveys and Questionnaires , Nurses/psychology , Nurses/statistics & numerical data , Personnel Turnover/statistics & numerical data , Michigan , Burnout, Professional/epidemiology , Burnout, Professional/psychology , Workplace Violence/statistics & numerical data , Workplace Violence/psychology , Nursing Staff, Hospital/statistics & numerical data , Nursing Staff, Hospital/psychology
8.
Int J Geriatr Psychiatry ; 39(6): e6106, 2024 Jun.
Article in English | MEDLINE | ID: mdl-39031830

ABSTRACT

OBJECTIVE: This study examined the relationship between precarious employment (PE) and mental well-being, focusing on age-specific interactions. METHODS: Nationally representative Korean workers (N = 29,961) were surveyed between 2020 and 2021 to collect data on multidimensional PE (categorized as low, moderate, or high) and the WHO-5 well-being index. Workers' ages were classified as young (<35 years), middle-aged (35-54 years), and older (≥55 years). Logistic regression was performed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). The interaction between PE and age on well-being was examined by including interaction terms in the regression models. RESULTS: The prevalence of poor well-being was 25%, 29%, and 39% for low, moderate, and high precariousness, respectively, whereas it was 26%, 30%, and 39% for young, middle-aged, and older workers, respectively. In the overall sample, the OR (95% CI) of the association between PE and poor well-being was 1.24 (1.17-1.32) for moderate and 1.54 (1.43-1.65) for high precariousness, compared with low precariousness. There was a significant interaction between old age and PE on the odds of poor well-being. Compared with young workers with low PE, middle-aged workers with high PE (OR: 1.85, 95% CI: 1.62-2.10) and older workers with high PE (OR: 2.10, 95% CI: 1.83-2.40) exhibited increased odds of having poor mental well-being. CONCLUSION: PE serves as a social determinant of older workers' psychological well-being. Policy interventions are required to protect older workers' psychological well-being.


Subject(s)
Employment , Mental Health , Humans , Republic of Korea/epidemiology , Middle Aged , Female , Male , Adult , Employment/statistics & numerical data , Employment/psychology , Mental Health/statistics & numerical data , Age Factors , Logistic Models , Aged , Job Security
9.
Afr J Reprod Health ; 28(6): 39-46, 2024 06 30.
Article in English | MEDLINE | ID: mdl-38979680

ABSTRACT

This study was designed to assess the connection between human capital development and the employment of women in China from 1990 to 2020. Data was collected from the World Development Indicators, after which it was subjected to Dynamic Ordinary Least Squares and Granger causality econometric analysis. The results from the study showed that human capital development and women employment had a negative but insignificant relationship. Similarly, a unidirectional relationship existed between female employment and government capital expenditure in China, while a bidirectional association ran between women employment and government expenditure on education in the country. Therefore, it is concluded that human capital development and government expenditure on education are the strong motivating factors that drive GDP growth rate and women employment in China. Consequently, we recommend that policymakers in China should consider massive investment in human capital development in order to enhance women employment in the country. Additionally, policymakers should embark on policies and programmes that foster the expansion of China`s GDP growth rate as a measure to increase employment opportunities for women.


Cette étude a été conçue pour évaluer le lien entre le développement du capital humain et l'emploi des femmes en Chine de 1990 à 2020. Les données ont été collectées à partir des indicateurs de développement mondial, après quoi elles ont été soumises à une analyse économétrique des moindres carrés ordinaires dynamiques et de la causalité de Granger. Les résultats de l'étude ont montré que le développement du capital humain et l'emploi des femmes entretenaient une relation négative mais insignifiante. De même, il existait une relation unidirectionnelle entre l'emploi des femmes et les dépenses publiques en capital en Chine, tandis qu'une association bidirectionnelle existait entre l'emploi des femmes et les dépenses publiques d'éducation dans le pays. Par conséquent, nous concluons que le développement du capital humain et les dépenses publiques consacrées à l'éducation sont les principaux facteurs de motivation qui déterminent le taux de croissance du PIB et l'emploi des femmes en Chine. Par conséquent, nous recommandons aux décideurs politiques chinois d'envisager des investissements massifs dans le développement du capital humain afin d'améliorer l'emploi des femmes dans le pays. En outre, les décideurs politiques devraient se lancer dans des politiques et des programmes qui favorisent l'expansion du taux de croissance du PIB chinois afin d'augmenter les opportunités d'emploi pour les femmes.


Subject(s)
Employment , Humans , China/epidemiology , Employment/statistics & numerical data , Female , Adult , Socioeconomic Factors , Economic Development , Women, Working/statistics & numerical data
10.
BMJ Open ; 14(7): e081509, 2024 Jul 20.
Article in English | MEDLINE | ID: mdl-39032930

ABSTRACT

INTRODUCTION: With demographic changes, there is increasing demand for individuals and governments to lengthen working lives. Jobs that are very physically demanding are likely to be more difficult to sustain at older ages. If workers at risk of mismatch of demand and capability could be identified early, there would be opportunities for intervention for health or lifestyle and/or re-training or redeployment. OBJECTIVE: To investigate whether self-reported walking speed (a good measure of function in elderly people) predicted health-related job loss (HRJL) longitudinally over 5 years of follow-up among middle-aged workers. DESIGN: Data came from the Health and Employment After Fifty (HEAF) prospective cohort study of middle-aged people (aged 50-64 years) in UK. SETTING: General population survey (sampling frame was 24 General Practice registers). PARTICIPANTS: The cohort included 8134 people recruited in 2013-2014. For the current analyses, 5217 people who ever worked and completed at least one follow-up questionnaire were eligible. PRIMARY OUTCOME: Exit from employment mainly or partly for health reasons (HRJL). RESULTS: At baseline, very slow walking speed was associated with: obesity, physical inactivity, smoking (men), financial hardship, lower educational attainment and not being in professional occupations. In total, 527 people (10%) reported at least one HRJL during follow-up. After adjustment, the HR for HRJL among men with very slow walking-speed was 4.32, 95% CI 2.72 to 6.87 and among women was 4.47, 95% CI 3.04 to 6.57. After further adjustment for 'difficulty coping with physical demands at work', hazards remained doubled in men and women. CONCLUSIONS: Self-reported walking speed could help identify older workers who are at increased risk of HRJL. This could provide opportunities for intervention through optimising health and lifestyle, restricting physical workload, retraining or redeployment. Early appropriate intervention could enable longer working lives and promote healthier, more equal ageing.


Subject(s)
Employment , Walking Speed , Humans , Male , Female , Middle Aged , Prospective Studies , Employment/statistics & numerical data , United Kingdom , Follow-Up Studies , Health Status , Self Report , Unemployment/statistics & numerical data
11.
BMC Psychiatry ; 24(1): 525, 2024 Jul 23.
Article in English | MEDLINE | ID: mdl-39044185

ABSTRACT

BACKGROUND: Stress-induced exhaustion disorder (SED) is the most common reason for long-term sick leave in Sweden and the recovery process may be long and troublesome. This study explores the symptoms of burnout, depression and anxiety among patients with SED 10 years after termination of a multimodal rehabilitation program. Another aim of the study was to investigate work situation, work functioning, and any remaining exhaustion and sleeping disorders among those who were gainfully employed at the 10-year follow-up. METHODS: This longitudinal study included 107 patients (91 women and 16 men), who had been diagnosed with SED 10 years prior to the study. After establishing the diagnosis they all underwent and completed an multimodal rehabilitation program. Data on symptoms of burnout, anxiety and depression were collected before and after the multimodal rehabilitation program, and at follow-ups after additional 1 year and an additional 10 years. At the 10-year follow-up, work situation, work functioning, and symptoms of exhaustion and sleep disorders were assessed in those who were gainfully employed (89 patients). RESULTS: Symptoms of burnout, anxiety, and depression remained stable from the 1- to the 10-year follow-up after completed rehabilitation. Among participants who were gainfully employed, 73% had changed workplaces, and 31.5% had reduced their working hours. Common reasons for these changes were lack of energy or because they had chosen to prioritise their lives differently. Work functioning was rated as moderate, one third self-reported SED to some extent, and one fifth reported moderate-to-severe insomnia. CONCLUSION: A relatively large proportion of former patients with SED have residual health problems 10 years after rehabilitation and some have not been able to return to full-time work. Preventive and early rehabilitative interventions with adjustments and measures at the organisational level are probably needed to achieve a more sustainable working life.


Subject(s)
Anxiety , Depression , Humans , Male , Female , Middle Aged , Adult , Longitudinal Studies , Depression/psychology , Sweden , Anxiety/psychology , Burnout, Psychological/psychology , Sick Leave/statistics & numerical data , Stress, Psychological/psychology , Fatigue/psychology , Employment/psychology , Employment/statistics & numerical data , Follow-Up Studies , Sleep Wake Disorders/psychology
12.
BMC Public Health ; 24(1): 1966, 2024 Jul 23.
Article in English | MEDLINE | ID: mdl-39044168

ABSTRACT

BACKGROUND: There is increasing awareness of the need to analyse symptoms of mental ill-health among early school leavers. Dropping out of compulsory education limits access to the labour market and education and could be related to deteriorating mental health over the course of a lifetime. The aim of this longitudinal study is to explore how early school leavers not in education, employment or training (NEET) narrate their working life trajectories linked to health, agency and gender relations. METHODS: Twelve early school leavers in the Swedish Northern Cohort (six women and six men) were interviewed over 40 years about their working life and health. Their life stories were analysed using structural narrative analysis to examine the evolution of their working life paths and to identify commonalities, variations and gendered patterns. RESULTS: All the participants started in the same position of "an unhealthy gendered working life in youth due to NEET status". Subsequently, three distinct working life paths evolved: "a precarious gendered working life with negative health implications", "a stable gendered working life in health challenging jobs" and "a self-realising gendered working life with improved health". Agency was negotiated through struggle narratives, survival narratives, coping narratives and redemption narratives. CONCLUSIONS: Even in a welfare regime like Sweden's in the early 1980s, early school leavers not in education, employment or training experienced class-related and gendered working and living conditions, which created unequal conditions for health. Despite Sweden's active labour market policies and their own practices of agency, the participants still ended up NEET and with precarious working life paths. Labour market policies should prioritise reducing unemployment, combating precarious employment, creating job opportunities, providing training and subsidised employment in healthy environments, and offering grants to re-enter further education. Our study highlights the need for further analyses of the contextual and gendered expressions of health among early school leavers throughout their lifetime, and of individual agency in various contexts for overcoming adversities.


Subject(s)
Student Dropouts , Humans , Female , Male , Sweden , Adult , Longitudinal Studies , Student Dropouts/psychology , Student Dropouts/statistics & numerical data , Health Status , Employment/psychology , Employment/statistics & numerical data , Middle Aged , Adolescent
13.
J Med Econ ; 27(1): 858-865, 2024.
Article in English | MEDLINE | ID: mdl-38904118

ABSTRACT

BACKGROUND: Triple Negative Breast Cancer (TNBC) is an aggressive subtype of breast cancer that can impact patients' employment and workforce participation. This study estimates how the employment effects of TNBC impact government tax revenue and public benefits expenditure in Switzerland, representing the fiscal burden of disease (FBoD), and likely consequences of introducing new treatment options. METHODS: A four-state cohort model was used to calculate fiscal effects for two treatments: Neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab monotherapy (P + C→P) and neoadjuvant chemotherapy alone (C). Lifetime present values of tax revenue, social benefit payments, and healthcare costs were calculated for the average population and those undergoing treatment to assess the FBoD. RESULTS: An average TNBC patient treated with C and P + C→P is expected to generate CHF128,999 and CHF97,008 less tax than the average population, respectively, and require increased social benefit payments. Compared to C, 75% of the incremental healthcare costs of P + C→P are estimated to be offset through tax revenue gains. CONCLUSIONS: This analysis demonstrates that 75% of the additional costs of a new TNBC treatment option can be offset by gains in tax revenue. Fiscal analysis can be a useful tool to complement existing methods for evaluating new treatments.


Subject(s)
Antibodies, Monoclonal, Humanized , Triple Negative Breast Neoplasms , Humans , Triple Negative Breast Neoplasms/drug therapy , Triple Negative Breast Neoplasms/economics , Switzerland , Female , Middle Aged , Antibodies, Monoclonal, Humanized/therapeutic use , Antibodies, Monoclonal, Humanized/economics , Health Expenditures/statistics & numerical data , Taxes , Neoadjuvant Therapy/economics , Adult , Cost of Illness , Aged , Chemotherapy, Adjuvant/economics , Employment/statistics & numerical data , Antineoplastic Agents/economics , Antineoplastic Agents/therapeutic use
14.
JAMA Netw Open ; 7(6): e2418468, 2024 Jun 03.
Article in English | MEDLINE | ID: mdl-38916890

ABSTRACT

Importance: Spinal cord injury (SCI) causes drastic changes to an individual's physical health that may be associated with the ability to work. Objective: To estimate the association of SCI with individual earnings and employment status using national administrative health databases linked to income tax data. Design, Setting, and Participants: This was a retrospective, national, population-based cohort study of adults who were hospitalized with cervical SCI in Canada between January 2005 and December 2017. All acute care hospitalizations for SCI of adults ages 18 to 64 years were included. A comparison group was constructed by sampling from individuals in the injured cohort. Fiscal information from their preinjury years was used for comparison. The injured cohort was matched with the comparison group based on age, sex, marital status, province of residence, self-employment status, earnings, and employment status in the year prior to injury. Data were analyzed from August 2022 to January 2023. Main outcomes and Measures: The first outcome was the change in individual annual earnings up to 5 years after injury. The change in mean yearly earnings was assessed using a linear mixed-effects differences-in-differences regression. Income values are reported in 2022 Canadian dollars (CAD $1.00 = US $0.73). The second outcome was the change in employment status up to 5 years after injury. A multivariable probit regression model was used to compare proportions of individuals employed among those who had experienced SCI and the paired comparison group of participants. Results: A total of 1630 patients with SCI (mean [SD] age, 47 [13] years; 1304 male [80.0%]) were matched to patients in a preinjury comparison group (resampled from the same 1630 patients in the SCI group). The mean (SD) of preinjury wage earnings was CAD $46 000 ($48 252). The annual decline in individual earnings was CAD $20 275 (95% CI, -$24 455 to -$16 095) in the first year after injury and CAD $20 348 (95% CI, -$24 710 to -$15 985) in the fifth year after injury. At 5 years after injury, 52% of individuals who had an injury were working compared with 79% individuals in the preinjury comparison group. SCI survivors had a decrease in employment of 17.1 percentage points (95% CI, 14.5 to 19.7 percentage points) in the first year after injury and 17.8 percentage points (14.5 to 21.1 percentage points) in the fifth year after injury. Conclusions and Relevance: In this study, SCI was associated with a decline in earnings and employment up to 5 years after injury for adults aged 18 to 64 years in Canada.


Subject(s)
Employment , Income , Spinal Cord Injuries , Humans , Spinal Cord Injuries/economics , Spinal Cord Injuries/epidemiology , Male , Female , Adult , Employment/statistics & numerical data , Middle Aged , Income/statistics & numerical data , Retrospective Studies , Canada/epidemiology , Young Adult , Adolescent , Cervical Cord/injuries
15.
Article in English | MEDLINE | ID: mdl-38837332

ABSTRACT

OBJECTIVES: Bridge employment and encore careers are 2 prevalent retirement pathways that have different goals and outcomes. Yet, "changing jobs in later life" is the shared prequel that blurs the distinction between them in empirical studies. This study proposes a set of criteria-voluntariness of career transition and the duration of work in the posttransition job-to distinguish various retirement pathways and investigates the predictors that distinguish the workers' choice of these pathways. METHODS: I conducted multinomial logistic regression to examine the predictors that distinguish between bridge employment, encore career, and direct workforce exit using the longitudinal sample of respondents with full-time career jobs in the Health and Retirement Study 1992-2020 (HRS, N = 2,038). To examine the predictors that distinguish between bridge employment and encore careers, I conducted logistic regression on the subsample of respondents who chose either bridge employment or encore careers (n = 927). RESULTS: The results show that the accumulated human capital from career jobs, physical and mental health conditions before leaving career jobs, and self-identified retirement status when transitioning to new jobs distinguish the workers' choices of taking on different retirement pathways. DISCUSSION: Maintaining the labor force participation of older workers is an important human resource agenda for policymakers. This study suggests that increasing the number of quality jobs for older workers would promote bridge employment and encore careers by raising the benefits of making career transitions as well as improving older workers' health.


Subject(s)
Employment , Retirement , Humans , Retirement/psychology , Retirement/statistics & numerical data , Female , Male , Employment/statistics & numerical data , Employment/psychology , Middle Aged , Aged , Longitudinal Studies , United States , Career Choice , Career Mobility , Health Status
16.
Neurology ; 103(2): e209532, 2024 Jul 23.
Article in English | MEDLINE | ID: mdl-38870454

ABSTRACT

BACKGROUND AND OBJECTIVES: Maternal stroke is a rare event with an increasing incidence. Data on the long-term prognosis after a maternal stroke are limited. We aimed to examine long-term mortality, recovery, vocational status and morbidity after a maternal stroke in a population-based setting including a comparison with matched, stroke-free controls. METHODS: In this register-based study with hospital chart validation, we included all women with a maternal stroke in Finland in 1987-2016 who survived the first year after the event. The recovery of the cases was assessed from the hospital charts by modified Rankin scale (mRS). Three controls matched by delivery year, age, and parity were selected for each case. All deaths until 2022 were identified from the Register for Causes of Death. Data on vocational status were obtained from Statistics Finland and morbidity from the Hospital Discharge Register and patient charts until year 2016. RESULTS: The study included 235 women with a maternal stroke and 694 matched controls. The median follow-up time was 17.5 years (interquartile range [IQR] 9.6-25.4) for mortality and 11.8 years (IQR 3.8-19.8) for vocational status and subsequent morbidity. Mortality among cases was 5.5% and among controls, 2.4% (age-adjusted odds ratio [OR] 2.3, 95% [CI] 1.1-4.9). At the end of the follow-up, 90.3% of the cases were independent in daily activities (mRS ≤2). In 2016, fewer women with a maternal stroke were working compared with controls (65.9% vs 79.1%, OR 0.5, 95% CI 0.4-0.7) and were more often receiving a pension (18.2% vs 4.9%, OR 4.4, 95% CI 2.7-7.3). Cerebrovascular events (age-adjusted OR 8.6 95% CI 4.4-17.1), cardiac diseases (age-adjusted OR 3.3, 95% CI 1.4-7.7), and major cardiovascular events were more common among cases during the follow-up (age-adjusted OR 7.6 95% CI 3.1-18.7). DISCUSSION: Despite having higher overall mortality and higher cardiovascular morbidity, the majority of the maternal stroke survivors recovered well. As expected, the vocational status of cases was inferior to that of controls, but most women were working at the end of the follow-up. Our study provides important information on the prognosis and sequalae after a maternal stroke to help in patient counseling and to improve secondary prevention.


Subject(s)
Registries , Stroke , Humans , Female , Stroke/mortality , Stroke/epidemiology , Case-Control Studies , Adult , Finland/epidemiology , Pregnancy , Recovery of Function , Employment/statistics & numerical data , Middle Aged , Pregnancy Complications, Cardiovascular/mortality , Pregnancy Complications, Cardiovascular/epidemiology
17.
Mult Scler Relat Disord ; 87: 105631, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38823313

ABSTRACT

BACKGROUND: Cognitive impairment can considerably impact the work life of people who have multiple sclerosis (MS). Cognitive symptoms are associated with an increased likelihood of unemployment, changes in employment and decreased working hours. This qualitative interview-based study aims to gather real-word experiences and perspectives from both people living with MS and healthcare professionals, to explore how cognitive symptoms are experienced in the workplace, how their impact is addressed, and what can be done to support people in managing and minimizing this impact on employment. METHODS: Semi-structured, one-to-one interviews were conducted with people living with MS who experience cognitive symptoms, and with healthcare professionals working in MS care. Participants were recruited from a healthcare market research agency based in the United States. The data obtained from the interviews were subsequently analysed using a Grounded Theory method, in order to identify the core themes that form the basis of this paper. RESULTS: A total of 20 participants (n = 10 people living with MS; n = 10 healthcare professionals) from the United States were interviewed. Overall, 9 themes were identified from the raw data, which were grouped into three core themes describing the perspectives and experiences reported by both people living with MS and healthcare professionals: (1) The implications of cognitive symptoms on work; (2) Challenges in addressing cognitive impairment and its impact on work in MS care; (3) Strategies and support for managing the impact of cognitive symptoms. CONCLUSION: The real-world insights of PwMS and HCPs gained from this qualitative study show that a multi-faceted approach to addressing cognitive impairment and its impact on the employment of PwMS is required. Workplace adjustments can range from self-implemented changes to changes put in place by employers to accommodate the various ways in which cognitive symptoms may impact a person's work. This study provides valuable information on how people living with MS can be affected by cognitive symptoms in the context of their employment; furthermore, that preparing early when possible and maintaining a proactive approach to managing their impacts on work are important for maintaining a good quality of life.


Subject(s)
Cognitive Dysfunction , Employment , Health Personnel , Multiple Sclerosis , Qualitative Research , Humans , Multiple Sclerosis/psychology , Female , Male , Cognitive Dysfunction/etiology , Adult , Middle Aged , Employment/statistics & numerical data , Health Personnel/psychology , Health Personnel/statistics & numerical data , Interviews as Topic
18.
Front Public Health ; 12: 1390055, 2024.
Article in English | MEDLINE | ID: mdl-38912265

ABSTRACT

The employment of college graduates has always been the focus issue of the whole society. Affected by the COVID-19, college graduates are facing a severe employment situation. In the present study, we explore the impacts of the COVID-19 on the employment of college graduates. We explore the employment promotion measures introduced by Chinese government and colleges and universities through a quick review and illustrate the difficulties that college graduates face. Furthermore, the present study explores the impacts of the COVID-19 on five aspects of the employment of college graduates: recruitment demand reduce, employment competition rise, employment channels change, psychological anxiety increase and employment structural contradiction intensify. In addition, we conclude that the employment promotion measures introduced by Chinese government and colleges and universities in respond to the impacts of the COVID-19 on the employment of college graduates have significantly promoted the employment of college graduates to a large extent and we provide implications based on the application of the study. The findings of the present study are of great significance for all countries worldwide to better cope with various similar emergency events, to alleviate employment pressure and to promote better and fuller employment of college graduates.


Subject(s)
COVID-19 , Employment , Humans , COVID-19/epidemiology , China/epidemiology , Employment/statistics & numerical data , Universities , SARS-CoV-2 , Pandemics
19.
Glob Health Res Policy ; 9(1): 21, 2024 Jun 20.
Article in English | MEDLINE | ID: mdl-38898516

ABSTRACT

BACKGROUND: Little is known regarding economic impacts of intimate partner violence (IPV) in humanitarian settings, especially the labor market burden. Examining costs of IPV beyond the health burden may provide new information to help with resource allocation for addressing IPV, including within conflict zones. This paper measures the incidence and prevalence of different types of IPV, the potential relationship between IPV and labor market activity, and estimating the cost of these IPV-associated labor market differentials. METHODS: The association between labor market outcomes, IPV experience, and conflict exposure among women ages 15-49 in Nigeria were studied using the 2018 Nigeria Demographic and Health Survey and 2013-17 Uppsala Conflict Data Program data. Descriptive analysis was used to identify patterns of IPV and labor outcomes by region. Based on this, multivariable logistic regression models were used to estimate the association between labor market participation and lifetime IPV exposure. These models were combined with earnings data from the United Nations Human Development Report 2021/2022 and a top-down costing approach to quantify the impacts in terms of lost productivity to the Nigerian economy. RESULTS: Substantial differences in IPV exposure and labor market outcomes were found between conflict and non-conflict-affected areas. Women with past year or lifetime exposure to physical, emotional, or "any" IPV were more likely to withdraw from the labor market in the past year, although no differences were found for sexual IPV or conflict-affected regions. We estimate an average reduction of 4.14% in the likelihood of working, resulting in nearly $3.0 billion USD of lost productivity, about 1% of Nigeria's total economic output. CONCLUSIONS: Increased odds of labor market withdraw were associated with several measures of IPV. Withdrawal from the formal labor market sector has a substantial associated economic cost for all of Nigerian society. If stronger prevention measures reduce the incidence of IPV against women in Nigeria, a substantial portion of lost economic costs likely could be reclaimed. These costs underscore the economic case, alongside the moral imperative, for stronger protections against IPV for girls and women in Nigeria.


Subject(s)
Intimate Partner Violence , Humans , Nigeria/epidemiology , Intimate Partner Violence/statistics & numerical data , Intimate Partner Violence/economics , Female , Adult , Adolescent , Young Adult , Middle Aged , Employment/statistics & numerical data , Prevalence , Incidence
20.
Front Public Health ; 12: 1357481, 2024.
Article in English | MEDLINE | ID: mdl-38903568

ABSTRACT

Introduction: Migrant workers in China are migrants from the rural to the urban areas who usually work in the cities and return to the countryside after a certain period. Due to China's strict household registration system, they differ significantly from urban residents' access to public services. However, at the same time, China's workers are facing a severe phenomenon of overwork, and the group of migrant workers is even more hard-hit by overwork, which will cause various adverse effects on workers and society and should attract the attention of all sectors of society. Methods: This paper focuses on the impact of digital financial inclusion on the overwork of migrant workers. This study considered cross-sectional data containing 98,047 samples based on the 2017 China Migrants Dynamic Survey 2017 (CMDS) and China Municipal Statistical Yearbook after robustness tests and heterogeneity analysis using probit models. Results: (1) digital financial inclusion can effectively alleviate overwork among migrant workers; (2) the impact of digital finance on overwork is more significant for the new generation, digitized industries, and self-employed migrant workers; it is also more significant for the South, East, and small and medium-sized cities than for the North, the Midwest, and large cities; (3) job quality and income are crucial factors in how digital financial inclusion affects overwork among migrant workers. Digital financial inclusion can improve the quality of employment for migrant workers and alleviate overwork. However, the income substitution effect partially reduces the inhibitory impact of digital financial inclusion on overwork. Conclusion: Continuously promote the development of digital inclusive finance, improve laws and regulations, and protect the labor rights and interests of migrant workers. At the same time, vocational training and skills upgrading for rural migrant workers should be strengthened to improve the quality of their employment so that they can leave the secondary labor market and enter the primary labor market.


Subject(s)
Transients and Migrants , Humans , China , Transients and Migrants/statistics & numerical data , Cross-Sectional Studies , Adult , Male , Female , Middle Aged , Surveys and Questionnaires , Employment/statistics & numerical data , Rural Population/statistics & numerical data
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