Socioeconomic determinants of cognition among older adults in the Brazilian longitudinal study of aging (ELSI-Brazil): a life-course approach.

BACKGROUND: The prevalence of cognitive impairment no dementia (CIND) and dementia appears to be higher in low- and middle-income countries (LMICs) compared to high-income economies. Yet few nationally representative studies from Latin American LMICs have investigated life-course socioeconomic factors associated with the susceptibility to these two cognitive conditions. Hence, the present study aimed to examine the associations of early- (education and food insecurity), mid- (employment stability), and late-life (personal income and household per capita income) socioeconomic determinants of CIND and dementia among older adults from Brazil, while simultaneously exploring whether sex plays an effect-modifier role on these associations. METHODS: This population-based study comprised a nationally representative sample of older adults (N = 5,249) aged 60 years and over from the Brazilian Longitudinal Study of Aging (ELSI-Brazil). We fitted multinomial regressions and estimated odds ratios with the respective 95% confidence intervals (CIs). RESULTS: In multivariate analyses, participants with more years of early-life education (0.89, 95% CI [0.81, 0.97]) and mid-life employment stability (0.97, 95% CI [0.96, 0.99]) and higher late-life household per capita income (0.70, 95% CI [0.51, 0.95) were less likely to have dementia. Regarding CIND, more years of mid-life employment stability (0.97, 95% CI [0.96, 0.98]) was the only determinant to confer protection. Notably, secondary sex-based analyses showed the higher the early-life educational attainment, the lower the odds of dementia in women (0.81, 95% CI [0.75, 0.87]) but not in men (1.00, 95% CI [0.86, 1.16]). CONCLUSIONS: These findings may have implications for population health and health policy by advancing our understanding of socioeconomic determinants of CIND and dementia, especially in Latin America.

Long working hours and self-rated health in the national Brazilian working population: gender and employment status differences, 2019.

BACKGROUND: The regulation of working hours is governed by legal standards in formal employment. While the association between long working hours and various health outcomes has been extensively studied, there is limited evidence regarding Brazil. The objective of this study was to investigate the association among working hours, employment status, and self-rated health (SRH), taking into account differences between men and women in a national representative sample of the working population in Brazil. METHODS: A cross-sectional study was conducted among a representative sample of 33,713 workers in Brazil to assess self-rated health (SRH). We examined the associations between working hours and employment status, categorizing working hours as standard (40-44 h per week) or long (> 44 h per week), and employment status as formal or informal. Logistic regression models were employed, adjusting for sociodemographic, occupational characteristics, and health behaviors. Probabilities of negative SRH were calculated for men and women in different exposure profiles. Results were stratified by gender, and 95% confidence intervals (CIs) were applied to the findings. RESULTS: The prevalence of long working hours was higher among informal workers for both men and women. Adjusted odds ratio (AOR) results revealed that informal employment (AORwomen = 1.53; 95% CI: 1.13-2.07 and AORmen = 1.55; 95% CI: 1.22-1.96) and long working hours (AORwomen = 1.23; 95% CI: 1.06-1.43 and AORmen = 1.14; 95% CI: 1.00-1.30) were independently associated with negative SRH. Significant interactions between long working hours and informal employment were observed. Among individuals with the same exposure profile, women who engaged in long working hours had a higher probability of reporting negative SRH compared to men. CONCLUSIONS: The results of this study are in line with the literature, as differences between men and women in the likelihood of negative self-rated health were observed. The adverse health effects underscore the importance of implementing intersectoral actions to inform the revision of regulations concerning weekly working hours and the expansion of informal employment in low- and middle-income countries.

Risk Factors, Presentation, and Outcome in Acute Stroke according to Social Position Indicators in Patients Hospitalised in a Referral Centre in Bogotá 2011-2019.

INTRODUCTION: Treatment of stroke is time-dependent and it challenges patients' social and demographic context for timely consultation and effective access to reperfusion therapies. OBJECTIVE: The objective of this study was to relate indicators of social position to cardiovascular risk factors, time of arrival, access to reperfusion therapy, and mortality in the setting of acute stroke. METHODS: A retrospective analysis of patients with a diagnosis of ischaemic stroke in a referral hospital in Bogotá was performed. A simple random sample with a 5% margin of error and 95% confidence interval was selected. Patients were characterised according to educational level, place of origin, marital status, occupation, duration of symptoms before consultation, cardiovascular risk factors, access to reperfusion therapy, and mortality during hospitalisation. RESULTS: 558 patients were included with a slight predominance of women. Diagnosis of diabetes was more common in women and smoking in men (n = 68, 28.4% vs. n = 51, 15.9%; p = 0.0004). Rural origin was associated with higher prevalence of hypertension, diabetes, and dyslipidaemia (hypertension n = 45, 73.8% vs. n = 282, 57.4%; p = 0.007; diabetes n = 20, 33.3% vs. 109, 19.5%; p = 0.02; dyslipidaemia n = 19, 32.7% vs. n = 93, 18.9%; p = 0.02). Mortality was higher in rural patients (n = 8, 14.2% vs. n = 30, 6.1%; p = 0.03). Lower schooling was associated with higher frequency of hypertension and dyslipidaemia (hypertension n = 152, 76.0% vs. n = 94, 46.3%; p ≤ 0.0001; dyslipidaemia n = 56, 28% vs. n = 35, 17.0%; p = 0.009) as well as with late consultation (n = 30, 15% vs. n = 59, 28.7%; p = 0.0011) and lower probability of accessing reperfusion therapy (n = 12, 6% vs. n = 45, 22%; p ≤ 0.0001). Formal employment was associated with a visit to the emergency department in less than 3 h (n = 50, 25.2% vs. n = 58, 18%, p = 0.04 and a higher probability of accessing reperfusion therapy (n = 35, 17.6% vs. n = 33, 10.2%; p = 0.01). Finally, living in a household with a stratum higher than 3 was associated with a consultation before 3 h (n = 77, 25.5% vs. n = 39, 15.6%; p = 0.004) and a higher probability of reperfusion therapy (n = 57, 18.9% vs. n = 13, 5.2%; p ≤ 0.0001). CONCLUSION: Indicators of socio-economic status are related to mortality, consultation time, and access to reperfusion therapy. Mortality and reperfusion therapy are inequitably distributed and, therefore, more attention needs to be directed to the cause of these disparities in order to reduce the access gap in the context of acute stroke in Bogotá.

BICAMS in the Argentine population: Relationship with clinical and sociodemographic variables.

The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) was developed to provide valid assessment of cognitive impairment in multiple sclerosis (MS). The relationship between clinical and social variables and cognitive disorders has been extensively studied, but primarily in developed countries with a focus on other cognitive measures or batteries. The objectives of this study were to analyze the relationship between the BICAMS data and key clinical and sociodemographic variables in the Argentine MS population. A total of 50 MS patients were administered the Argentinean BICAMS Battery, comprised of the Symbol Digit Modalities Test (SDMT), the California Verbal Learning Test I (CVLT I), and the Brief Visuospatial Memory Test Revised (BVMTR). Disease progression, fatigue, depression, self-reported and informant report cognitive status, and employment status were assessed. Disease progression and employment status were most strongly associated with overall BICAMS performance (η2 effect size values ranging from .302 to .624, all comparisons statistically significant). Informant rating of patient cognition, age, depression, disease duration, fatigue, and work hours were significantly associated as well. Gender, years of education, and patient-reported cognitive status were nonpredictive. A similar pattern was seen at the individual test level, with more variables related to the SDMT and CVLT I than BVMTR. BICAMS is strongly associated with overall disease progression and employment status.

Entorno y cuidado: circunstancias que influyen en la calidad de la atención médica percibida por los colombianos / Environment and care: circumstances that influence the quality of healthcare perceived by the people in Colombia / Ambiente e cuidado: circunstâncias que influenciam a qualidade da atenção médica percebida pelos colombianos

Introducción. El análisis de las situaciones de salud, en el acto del cuidado de la enfermería, requiere de conocimientos, pues es el marco conceptual y la guía de esta labor. Aunque el cuidado integral de la salud, según Watson, depende del compromiso moral del enfermero de preservar la dignidad humana; son frecuentes los informes que muestran una mala percepción de la prestación de servicios de salud. En los informes, se indica que el 36% de los encuestados tienen una mala o muy mala percepción de la calidad de la atención médica. El objetivo es reflexionar sobre las circunstancias que influyen en la calidad de la atención médica percibida por los colombianos. Temas de reflexión. Se abordará el tema desde los patrones de conocimiento de la enfermería: el empírico, el estético, el ético, el sociocultural y el personal. Discusión. Las condiciones que influyen en la percepción de la calidad de la atención médica se agrupan en dos conceptos del metaparadigma de la enfermería. El primero es el entorno, en el que existen barreras de oferta y demanda, como la tecnificación, la infraestructura y los recursos del sistema de salud. El segundo es el cuidado, en el que la condición laboral tiene incidencia, ya que los profesionales de enfermería sienten culpabilidad, agotamiento y estrés, y comprometen la buena percepción del cuidado médico y el sentido de trascendencia profesional. Conclusiones. El acto del cuidado de la enfermería está rodeado de situaciones poco favorables, dadas las barreras en el sistema de salud colombiano, que comprometen la labor del enfermero. Por lo tanto, es necesario reflexionar y desarrollar conceptos relacionados con los patrones de conocimiento de la disciplina, que inciden en la formación de los nuevos profesionales. Esto, con el fin de cumplir a cabalidad el deber ser y el hacer de la enfermería en Colombia. [Duque-Castro JA, Ortiz-Urbano J, Rengifo-Arias DM. Entorno y cuidado: circunstancias que influyen en la calidad de la atención percibida por los colombianos. MedUNAB. 2018;21(2):60-68. doi:10.29375/01237047.2799].

Introduction. The analysis of health situations, in terms of nursing care, requires knowledge, since it is the conceptual framework and guide for this work. Although comprehensive healthcare, according to Watson, depends on the nurse's moral commitment to preserve human dignity, there are frequent reports that show a poor perception of the provision of healthcare services. The reports indicate that 36% of those surveyed had a poor or very poor perception of the quality of healthcare. The objective is to reflect on the circumstances that influence the quality of healthcare perceived by the people in Colombia. Topics of reflection. The topic will be addressed through the patterns of knowledge of nursing: empirical, aesthetic, ethical, sociocultural and personal. Discussion. The conditions that influence the perception of healthcare quality are grouped into two nursing metaparadigm concepts. The first is the environment, in which there are supply and demand barriers, such as technification, infrastructure and resources of the healthcare system. The second is the care, on which the employment status has an influence, since nursing professionals feel guilt, exhaustion and stress, and compromise the good perception of healthcare and the sense of professional importance. Conclusions. The act of caring in nursing is surrounded by unfavorable situations, given the barriers in the Colombian healthcare system that compromise the work of nurses. Therefore, it is necessary to reflect and develop concepts related to the patterns of knowledge of this discipline, which have an effect on the training of new professionals. This is in order to fully comply with the duty and practice of nursing in Colombia. [Duque-Castro JA, Ortiz-Urbano J, Rengifo-Arias DM. Environment and care: circumstances that influence the quality of medical care perceived by the people in Colombia. MedUNAB. 2018;21(2):60-68. doi:10.29375/01237047.2799].

Introdução. A análise das situações de saúde, no ato do cuidado da enfermagem, requer conhecimento, pois é o referencial conceitual e o guia desta atividade. Embora os cuidados integrais de saúde, segundo Watson, dependem do compromisso moral do enfermeiro para preservar a dignidade humana; há relatos frequentes que mostram uma má percepção da prestação de serviços de saúde. Nos relatórios, indica-se que 36% dos entrevistados têm uma percepção ruim ou muito ruim da qualidade do atendimento médico. O objetivo é refletir sobre as circunstâncias que influenciam a qualidade da atenção médica percebida pelos colombianos. Temas para reflexão. O tema será abordado a partir dos padrões de conhecimento da enfermagem: o empírico, o estético, o ético, o sociocultural e o pessoal. Discussão. As condições que influenciam a percepção da qualidade da atenção médica são agrupadas em dois conceitos do metaparadigma da enfermagem. O primeiro é o ambiente, no qual existem barreiras de oferta e demanda, como a tecnificação, a infraestrutura e os recursos do sistema de saúde. O segundo é o cuidado, no qual a condição de trabalho tem impacto, uma vez que os profissionais de enfermagem sentem-se culpados, exaustos e estressados, comprometendo a boa percepção do cuidado médico e o sentido de transcendência profissional. Conclusões. O ato do cuidado de enfermagem está cercado de situações desfavoráveis, dadas as barreiras no sistema de saúde colombiano, que comprometem o trabalho do enfermeiro. Portanto, é necessário refletir e desenvolver conceitos relacionados aos padrões de conhecimento da disciplina, que afetam a formação dos novos profissionais. Isso, a fim de cumprir integralmente o dever de ser e exercer a enfermagem na Colômbia. [Duque-Castro JA, Ortiz-Urbano J, Rengifo-Arias DM. Ambiente e cuidado: circunstâncias que influenciam a qualidade da atenção médica percebida pelos colombianos. MedUNAB. 2018;21(2):60-68. doi:10.29375/01237047.2799].

Análisis de la demanda laboral de profesionales en Psicología en Costa Rica durante el periodo 2012-2014 / Analysis of labor demand for Psychology professionals in Costa Rica during the period 2012-2014

Resumen: El tema de las condiciones y la demanda laboral en el campo de la Psicología ha sido objeto de varias in vestigaciones. En Costa Rica, tanto el Consejo Nacional de Rectores como otros grupos de investigación, han indagado acerca del tema. En este artículo se presentan los resultados de un análisis documental que tuvo como objetivo explorar las características recientes de la demanda de profesionales en Psicología en Costa Rica (e.g. número de puestos vacantes por año y requisitos solicitados). Para ello, se analizaron 1558 vacantes divulgadas por la Escuela de Psicología de la Universidad de Costa Rica en el periodo 2012-2014. Se encontró una tendencia decreciente en las vacantes anuales y un predominio de los puestos correspon dientes al área de Psicología Laboral (64.6%), a la empresa privada (47.5%) y localizados en la provincia de San José (41.0%). En la mayor parte de las vacantes (63.5%), se exigió entre uno y cinco años de experien cia. Lo más solicitado fue tres años (21.1%). En casi la mitad de los puestos (45.6%), se requirió el idioma inglés. Otros requisitos importantes fueron el dominio de programas informáticos (35.2%), programas de ofimática (27.7%), ser miembro del Colegio Profesional de Psicólogos (16.0%), el uso de hojas de cálculo (10.6%) y el manejo de pruebas psicológicas (7.4%). Finalmente, presentamos algunos de los requisitos solicitados más frecuentemente, segregados según área de la Psicología en la que se ubica la vacante, y desarrollamos algunas consideraciones sobre los resultados de este estudio.

Abstract: The issue of working conditions and labor demand in the field of Psychology has been the subject of several inves tigations. In Costa Rica, the National Council of Rectors and other research groups have inquired into this issue. In this article we present the results of a documentary analysis aimed at exploring the latest features of labor demand for professionals in Psychology in Costa Rica (e.g., number of vacant posts per year and prerequisites). For this pur pose, 1558 vacant posts reported by the Psychology Department at the University of Costa Rica in the period 2012-2014 were analyzed. We found a decreasing trend in job offers, and a predominance of vacant posts in industrial and organizational areas (64.6%), in private companies (47.5%), and located in the province of San José (41.0%). Most vacant posts (63.5%) required between one and five years of experience, with three years being the most com mon prerequisite (21.1%). In about half of the vacant posts (45.6%) English language was a requisite. Some other important requirements were software (35.2%) or office software (27.7%) knowledge, membership in the Costa Rican College of Psychologists (16.0%), spreadsheet management (10.6%) and psychological testing management (7.4%). Finally, we present some of the most frequently requested requirements, segregated by area of Psychology in which the vacant post is located, and we conclude with some considerations on the results of this study.

Employment Status, Depression, Drinking, and Alcohol Use Disorder in Puerto Rico.

BACKGROUND: Our aim was to examine the association between employment status, depression, drinking, binge drinking, and DSM-5 alcohol use disorder in Puerto Rico. METHODS: Data are from a 2013 to 2014 household random sample of individuals 18 to 64 years of age in San Juan, Puerto Rico. RESULTS: Bivariate analyses showed that depression was 5 times higher among unemployed males than among those employed full time (21% vs. 4%) and 2 times higher among unemployed females compared to those employed part time or full time (18% vs. 7% and 9%). Employment status was not associated with weekly volume of drinking, but nonparticipation in the workforce was protective against drinking (odds ratio [OR] = 2.17; 95% confidence interval [CI]: 1.03 to 4.57; p < 0.05) and binge drinking (OR = 0.62; 95% CI = 0.39 to 0.97; p < 0.05). This association could be due to the fact that those not in the work force may not be working due to sickness or disability. Male gender was a factor of risk for being a current drinker (OR = 2; 95% CI = 1.53 to 2.6; p < 0.001) and binge drinking (OR = 1.69; 95% CI = 1.29 to 2.2; p < 0.001). Male gender was protective against depression (OR = 0.32; 95% CI = 0.14 to 0.73; p < 0.01), but males employed only part time were almost 5 times more likely than females employed full time to be depressed (OR = 4.66; 95% CI = 1.25 to 17.38; p < 0.05). CONCLUSIONS: Employment status in Puerto Rico is associated with depression and with current drinking, but not with other alcohol-related outcomes. Perhaps Puerto Rico is a "wet" environment, where drinking is already at a relatively high level that is not affected by employment status. Perhaps the chronic high rate of unemployment in the island has also created familial (e.g., support) and personal level accommodations (e.g., participation in the informal economy) that do not include increased drinking.

Commentary on Caetano, Vaeth, Mills, and Canino (2016): Employment Status, Depression, Drinking, and Alcohol-Use Disorders in Puerto Rico.

BACKGROUND: In this commentary, we discuss a study by Caetano and colleagues (in press) that examines the relation between depression, employment status, and drinking behaviors among adults (aged 18 to 64) living in San Juan, Puerto Rico. METHODS: We discuss the contribution of Caetano and colleagues' (in press) study to the understanding of socioeconomic risk and protective factors associated with depression and drinking behaviors among Hispanics, specifically Puerto Ricans. We focus on 3 topics: (i) gender differences in the relation between depression and employment status, (ii) the relation between participation in the workforce and drinking behaviors, and (iii) the potential role of family and contextual factors mitigating the effects of unemployment on drinking behaviors. RESULTS: Findings suggest that in Puerto Rico, employment status, although associated with depression and drinking behaviors, was not associated with alcohol-related outcomes. CONCLUSIONS: Caetano and colleagues' (in press) article represents an important contribution to understanding differential effects in risk and protective factors associated with drinking behaviors and alcohol-related consequences among Hispanics. Future research should focus on examining the role of family and social support to mitigate the effects of unemployment, depression, and drinking behaviors among Puerto Ricans living in Puerto Rico.

Aborto voluntario y actividad laboral. Reflexiones para el debate / Induced abortion and labor activity. Reflections for discussion

El aborto voluntario es un fenómeno global que según distintos autores responde a patrones de comportamientos construidos socialmente y donde influyen las realidades sociales particulares de cada país. Este fenómeno requiere la información necesaria para comprender el complejo proceso que conduce a la decisión de la mujer para optar por la interrupción del embarazo y saber entender las circunstancias sociales, económicas y sanitarias que pueden explicar esta determinación. Con este propósito se presenta para el debate, algunas consideraciones sobre el aborto voluntario y la actividad laboral de las mujeres que optan por esta práctica, con especial mención la situación en España. Los argumentos están sustentados en el análisis de las estadísticas de interrupción Voluntaria del embarazo (IVE) reportadas por el Ministerio de Sanidad y Política Social, la participación de la mujer en el mercado laboral en España obtenidas del Instituto Nacional de Estadística (INE), los resultados de investigación sobre la asociación entre la situación laboral de la mujer y la Interrupción Voluntaria del embarazo y la revisión exhaustiva de las literatura científica sobre las distintas perspectivas del abordaje del aborto voluntario. Merece especial importancia el análisis de la actividad laboral de la mujer, como un posible determinante en la decisión de la mujer para interrumpir su embarazo, variable que ha sido identificada en la mayoría de las investigaciones como una de las condiciones socioeconómicas en las mujeres que optan por esa alternativa, al considerar que el embarazo interfiere con el empleo de las mujeres o, bien, les impide emplearse.

The induced abortion is a global phenomenon that according to various authors respond to socially constructed patterns of behavior and where they influence social realities of each country. This phenomenon requires the information necessary to understand the complex process leading to the decision of women to opt for abortion and able to understand the social, economic and health that can explain this requirement. For this purpose is presented for discussion, some considerations on voluntary abortion and labor activity of women who opt for this practice, with special mention of the situation in Spain. The arguments are supported by statistical analysis of the voluntary interruption of pregnancy (IVE) reported by the Ministry of Health and Social Policy, participation of women in the labor market in Spain obtained from the National Statistics Institute (INE), the research results on the association between employment status of women and voluntary termination of pregnancy and comprehensive review of scientific literature on the different perspectives of the approach of voluntary abortion. Analysis deserves special importance of women's work activity as a possible factor in the decision of women to terminate their pregnancies, a variable that has been identified in most of the investigations as a socioeconomic condition for women who choose for that alternative, considering that pregnancy interferes with the employment of women or, rather, prevents them from use.

Infections and inequalities: anemia in AIDS, the disadvantages of poverty.

OBJECTIVE: To study anemia in AIDS patients and its relation with socioeconomic, employment status and educational levels. METHODS: A total number of 442 patients who visited the Infectious Diseases University Hospital in Buenos Aires, Argentina were included in the study. Patients were dividied into two groups, i.e. one with anemia and the other without anemia. Anemia epidemiology and its relationship with educational level, housing, job situation, monthly income, total daily caloric intake and weekly intake of meat were evaluated. RESULTS: Anemia was found in 228 patients (54%). Comparing patients with or without anemia, a statistically significant difference was found (P<0.000 1) in those whose highest educational level reached was primary school, who lived in a precarious home, who had no stable job or were unable to work, whose income was less than 30 dollars per month, whose meat consumption was less than twice a week or received less than 8 000 calories per day. CONCLUSIONS: The high prevalence of anemia found in poor patients with AIDS suggests that poverty increases the risk to suffer from this hematological complication. The relationship between economic development policies and AIDS is complex. Our results seem to point to the fact that AIDS epidemic may affect economic development and in turn be affected by it. If we consider that AIDS affects the economically active adult population, despite recent medical progress it usually brings about fatal consequences, especially within the poorest sectors of society where the disease reduces the average life expectancy, increases health care demand and tends to exacerbate poverty and iniquity.

[Three modes of analysis in the incorporation of a gender perspective in socio-demographic studies of urban labor in Mexico]. / Tres ejes de analisis en la incorporacion de la perspectiva de genero en los estudios sociodemograficos sobre el trabajo urbano en Mexico.

PIP: This overview of sociodemographic research on the urban female labor force in Mexico from the 1970s to the mid-1990s traces the gradual development of a gender focus. One of the first problems examined was the insufficient visibility of female economic activity, resulting from underestimation of the productive contribution of women by information producers, analysts, and the women themselves. The next phases were documentation of existing differences between male and female economic activities, and analysis of the degree to which differences were transformed into inequalities. The process involved delving in greater depth into the causes and consequences of concentration or segregation of women in specific activities or occupations, as well as into the discrimination they experienced because of their gender. Some sociodemographic studies reconsidered the relation of extra-domestic and domestic work; a gender perspective on labor force analysis must take into account the essential fact that most women in the labor force also carry out domestic functions. Most studies of domestic work in Mexico, however, have been carried out separately from studies of extra-domestic work. This survey of the evolution of sociodemographic studies of work clearly demonstrates that the gender perspective is present or not from the moment of selecting a topic for research. The gender focus allows reconceptualization of well known themes, such as the subordination of working women.^ieng

Women's roles and family formation in Venezuela: new forms of consensual unions?

This paper assesses the effects of changes in women's education and labor force participation on nuptiality patterns and their implications for fertility decline in Venezuela. Results show that together with delays in union formation, changes in women's education and labor force participation produced a different, more "modern" type of consensual union, which coexists with "traditional" consensual unions. "Traditional" consensual unions remain a substitute for formal marriage among women from rural origins with low levels of education and higher levels of work experience. "Modern" consensual unions appear to be an option for well-educated women of urban origins. As in developed countries, these unions assume the form of a trial period before marriage or an alternative to singlehood. "Modern" consensual unions are more unstable than "traditional" consensual unions and they are associated with lower fertility.

Unauthorized Mexican workers in the 1990 Los Angeles County labour force.

"By analysing how unauthorized Mexicans compare with seven other ethno-racial groups in Los Angeles County, separately and collectively, by educational attainment and time spent in the U.S., we find that unauthorized Mexicans had relatively fewer years of formal education (either in the U.S. or in Mexico) and had been in the U.S. a relatively fewer number of years than in-migrants of other ethno-racial backgrounds in 1990. These findings are then used as proxies to compare the human capital endowments of different ethno-racial groups. We next estimate the number of unauthorized Mexicans by occupation, industry and class of worker, and compare these distributions with the total labour force and with the other ethno-racial groups in Los Angeles County.... Results show that amounts of human capital are positively related to the kinds of occupations filled." (SUMMARY IN FRE AND SPA)

[Day care and female employment in Mexico: descriptive evidence and policy considerations]. / Cuidado infantil y empleo femenino en Mexico: evidencia descriptiva y consideraciones sobre las politicas.

PIP: "This paper analyzes the supply and organization of public day care in Mexico and presents a series of considerations as to the formulation of future policy. The research concentrates on the evolution of public policies to provide day care to working women in the formal sector through the Mexican Social Security Institute (IMSS). Data on the evolution of female labor force participation, changes in family structure, the supply of day care and patterns of child care arrangements, suggest that access to formal facilities falls short of demand.... Innovative policies for the reorganization and expansion of the provision of day care are presently under consideration." (EXCERPT)^ieng

Patient satisfaction at health centres in Trinidad and Tobago.

The aim of this paper is to identify background characteristics of health centre users in Trinidad and Tobago and their perceptions of the services provided. Multi-staged sampling was used to select 1,500 health centre users throughout the country. Data were obtained using structured interviews conducted on regular clinic days. Results show that there is an overwhelmingly large percentage of unemployed persons (80.4%) and women (75.9%) among the users of health centres. The elderly is well represented, with 25.4 percent of the sample being over 60 years of age. Also, occupational status of family wage earners and educational attainment levels of respondents reflect a disproportionately higher number from lower socio-economic groupings among health centre users. On the other hand, proportions of different ethnic and religious groups among the respondents bear a striking similarity to the general population of Trinidad and Tobago. Respondents appear to be generally satisfied with the services of the health centres. When the categories for "satisfied' and "very satisfied' were combined, results show that 73.0% of respondents were satisfied with the comfort of the health centre, 81.7% with the ease and convenience of getting to the health centre and 67.4% with the medical care received at the health centre. According to respondents' opinions, the services in greatest need of improvement are the pharmacy and doctor services, especially through reducing the long waiting period. When the doctors, nurses and pharmacists were compared with respect to "courtesy and consideration', "Skills and Competence' and "advice provided', results show that the generally high levels of satisfaction are remarkably similar in all three cases.

PIP: A survey was conducted of 1500 health centers in Trinidad and Tobago to evaluate the impact of health centers on clients and characteristics of clients. Most clients belonged to disadvantaged groups: 80.4% were unemployed and 75.9% were women. 25.4% of clients were elderly. Among employed clients, the occupational status of the main wage earner tended to be low (e.g., 16.4% skilled manual, 15.6% unskilled manual, and 13.2% lower non-manual). Only 1.8% of clients had achieved a tertiary educational level. The ethnicity and religious affiliation of clients reflected that of the general population. 73% of clients considered the health centers to be comfortable. 81.7% were satisfied with the ease and convenience of visiting the health center. 67.4% considered the medical care received to be satisfactory. 74.2% spent 2-6 hours at the health center, largely due to insufficient health personnel, medical equipment, and pharmaceutical supplies. Thus, the lack of resources made it difficult to service the needs of the health center clientele. The long waiting period may have been inconvenient for employed persons. 47% of clients were unwilling to pay for health care. The services most in need of improvement were pharmacies (35.1%) and physicians' care (27.4%). Patients tended to rate physicians, nurses, and pharmacists equally high in terms of satisfaction with courtesy and consideration, skills and competence, and advice provided.

[Latin American women in Italy: a new reality of the international migration system]. / Mujeres latinoamericanas en Italia: una nueva realidad del sistema de migraciones internacionales.

PIP: The authors examine characteristics of female migration from Latin America to Italy. Aspects considered include country of origin, fertility behavior, age, employment status, household characteristics, and marriage patterns.^ieng

[Latin Americans in Spain (1981-1994). Estimation of a recent migratory phenomenon]. / Latinoamericanos en Espana (1981-1994). Aproximacion a un fenomeno migratorio reciente.

PIP: The author analyzes characteristics of Latin American migration to Spain during the period 1981-1994. Aspects considered include causes of the increase of Latin American migration to Spain; policies limiting migration to Spain; spatial distribution and sex of immigrants; labor force activity; and country of origin.^ieng

[Agrarian change and regional settling in Chile]. / Cambio agrario y poblamiento regional en Chile.

"This study analyzes the effect of agrarian change on regional settling dynamics in Chile during the last 35 years. The transformations of agrarian structure have produced important changes in the spatial configuration of country-city relations, particularly regarding the new features of rural-urban migration in regional contexts. Whereas until the sixties rural-urban migration was associated with an occupational shift from agriculture to urban employment, after the seventies this relation practically disappeared, leaving a virtual disassociation between the territorial mobility of the population and the occupational mobility of the labor force. This disassociation is a central trait of the current regional pattern of country-city relations." (SUMMARY IN ENG)

[International migration in Latin America]. / La migracion internacional en America Latina.

PIP: Trends in international migration in Latin America are reviewed using data from published sources. Aspects considered include historical views; migration according to occupational status and educational level; migration to the United States; migration characteristics in different regions of Latin America; and the crisis of the 1980s and its impact on population distribution.^ieng

Jobs: women's double burden.

PIP: Whereas international conventions and national laws provide equal opportunities for women in employment, the reality of women's lives keeps a disproportionate number of women unemployed, underemployed, and living in poverty. The UN itself, which officially is working toward equity among its employees, has a staff composed of just 32.6% women, and women comprise only 10.5% of the top end of the hierarchy. In areas where women's labor force participation has increased dramatically, women typically earn 30-40% less than men doing the same job or else their employment is limited to "traditional female" service positions. The fact that women and girls have received an inadequate education makes it extremely difficult to break the barriers of discrimination in developing countries. The empowerment of women will break the education barrier, and, when that falls, many other barriers will follow suit. Efforts are already underway to break structural barriers caused by economic and social policies. For example, a more flexible pattern of work has been proposed which will include the voluntary assumption of flexible hours, job-sharing, and part-time work. The concept of work is also being broadened to include the important human services that women traditionally provide on a volunteer basis. This will lead to a valuation of women's contribution to society which can be added to calculations of gross domestic product. Women also need protection as they attempt to eke out a living in the informal sector which has been the traditional avenue for women to earn money. This sector is not protected by law and is subject to extortion by officials and by male competitors. A variety of measures is under consideration to increase the protection of informal sector workers. Women also need protection in the conventional work place, especially as they enter fields traditionally reserved for men. These questions are important even in the context of global unemployment because these issues must be addressed or their resolution to women's disadvantage will gain the mantle of tradition.^ieng