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1.
Longit Life Course Stud ; 15(3): 322-347, 2024 May 16.
Artículo en Inglés | MEDLINE | ID: mdl-38954411

RESUMEN

Spain is one of the eight EU-27 countries that failed to reduce early school leaving (ESL) below 10% in 2020, and now faces the challenge of achieving a rate below 9% by 2030. The determinants of this phenomenon are usually studied using cross-sectional data at the micro level and without differentiation by gender. In this study, we analyse it for the first time for Spain using panel data (between 2002 and 2020), taking into account the high regional inequalities at the macroeconomic level and the masculinisation of the phenomenon. The results show a positive relationship between ESL and socio-economic variables such as the adolescent fertility rate, immigration, unemployment or the weight of the industrial and construction sectors in the regional economy, with significant gender differences that invite us to discuss educational policies. Surprisingly, youth unemployment has only small but significant impact on female ESL.


Asunto(s)
Factores Socioeconómicos , Humanos , España , Femenino , Masculino , Adolescente , Estudios Longitudinales , Factores Sexuales , Desempleo , Estudios Transversales , Instituciones Académicas , Abandono Escolar/estadística & datos numéricos , Adulto Joven
2.
Int J Rheum Dis ; 27(7): e15252, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38982887

RESUMEN

AIM: Existing studies on the cost of inflammatory arthritis (IA) and osteoarthritis (OA) are often cross-sectional and/or involve patients with various disease durations, thus not providing a comprehensive perspective on the cost of illness from the time of diagnosis. In this study, we therefore assessed the cost of lost productivity in an inception cohort of patients with IA and OA in the year before and after diagnosis. METHODS: Employment status, monthly income, days absent from work, and presenteeism were collected at diagnosis and 1 year later to estimate the annual costs of unemployment, absenteeism, and presenteeism using human capital approach. Non-parametric bootstrapping was performed to account for the uncertainty of the estimated costs. RESULTS: Compared to patients with OA (n = 64), patients with IA (n = 102, including 48 rheumatoid arthritis, 19 spondyloarthritis, 23 psoriatic arthritis, and 12 seronegative IA patients) were younger (mean age: 52.3 vs. 59.5 years) with a greater proportion receiving treatment (99.0% vs. 67.2%) and a greater decrease in presenteeism score (median: 15% vs 10%) 1 year after diagnosis. Annual costs of absenteeism and presenteeism were lower in patients with IA than those with OA both in the year before (USD566 vs. USD733 and USD8,472 vs. USD10,684, respectively) and after diagnosis (USD636 vs. USD1,035 and USD6,866 vs. USD9,362, respectively). CONCLUSION: Both IA and OA impose substantial cost of lost productivity in the year before and after diagnosis. The greater improvement in productivity seen in patients with IA suggests that treatment for IA improves work productivity.


Asunto(s)
Absentismo , Costo de Enfermedad , Eficiencia , Osteoartritis , Presentismo , Humanos , Persona de Mediana Edad , Masculino , Femenino , Osteoartritis/economía , Osteoartritis/diagnóstico , Osteoartritis/terapia , Presentismo/economía , Factores de Tiempo , Adulto , Anciano , Desempleo , Empleo/economía , Artritis/economía , Artritis/diagnóstico , Artritis/terapia , Artritis Reumatoide/economía , Artritis Reumatoide/diagnóstico , Artritis Reumatoide/tratamiento farmacológico , Renta
3.
RECIIS (Online) ; 18(2)abr.-jun. 2024.
Artículo en Portugués | LILACS, Coleciona SUS | ID: biblio-1561667

RESUMEN

A pandemia gerou impactos sociais e econômicos, como o trabalho informal dos que se ocupam do serviço de café de rua, ampliado na retomada pós-isolamento. O artigo analisa as significações construídas pelas instalações do serviço nas ruas de São Paulo (SP) e Vitória (ES), enquanto manifestações do empreendedo-rismo por necessidade. O corpus foi coletado em dias úteis, no início das manhãs, em diversos pontos das capitais. A semiótica discursiva sustentou a análise, e o seu método permitiu traçar isotopias conectoras de figuras e temas. Os resultados apontam para comunicação dos sentidos da informalidade, casualidade e familiaridade, marcados pela presença feminina, pela autonomia imposta aos sujeitos produtor/vendedor e consumidor e pela conexão entre a energia proporcionada pela bebida e o trabalho. Esses significadosvêm embebidos no risco vivido por esses sujeitos, aconchegados entre si e alijados da proteção de políticas públicas de trabalho, condições sanitárias, serviços de transporte e saúde.


The pandemic has generated social and economic impacts, such as the informal work of those who sell coffee on the streets, expanded in the post-isolation resumption. The article analyzes the meanings constructed by the service facilities in São Paulo (SP) and Vitória (ES), as demonstrations of the entrepreneurship by necessity. The corpus was collected on weekdays, in places of the state capitals. Discursive semiotics underpins the analysis, suggesting connective isotopies of figures and themes. The results point to the communication of the senses of informality, casualness and familiarity, marked by the female presence, by the autonomy imposed on the subjects producer/seller and consumer and by the connection between the energy given by the drink and the work. These meanings are embedded in the risk experienced by these subjects, snuggled among themselves and excluded from the protection of public policies of work, sanitary conditions, transportation and health services.


La pandemia generó impactos sociales y económicos, como el trabajo informal de quienes se ocupan del servicio de café en las calles, ampliado en la reanudación post-aislamiento. El artículo analiza los signifi-cados construidos por las instalaciones de servicios en las calles de São Paulo (SP) y Vitória (ES), como manifestaciones de emprendimiento por necesidad. El corpus fue recolectado entresemana, en puntos de las capitales. La semiótica discursiva sustenta el análisis y permitió trazar isotopías conectoras de figuras y temas. Los resultados apuntan para la comunicación de los significados de informalidad, marcados por la presencia femenina, por la autonomía impuesta a los sujetos productor/vendedor y consumidor, y por la conexión entre la energía dada por la bebida y el trabajo. Estos significados están incrustados en el riesgo vivido por estos sujetos, y excluidos de la protección de las políticas públicas laborales, las condiciones sanitarias, los servicios de transporte y salud.


Asunto(s)
Cambio Social , Factores Socioeconómicos , Emprendimiento , Café , Derecho al Trabajo , Desempleo , Perfiles Sanitarios , COVID-19
4.
Demography ; 61(3): 665-686, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38861667

RESUMEN

Adverse life events are major causes of declining health and well-being, but the effects vary across subpopulations. We analyze how the intersection of migration status and sex relates to two main adverse life events-job loss and divorce-thereby affecting individual health and well-being trajectories. Using data from the German Socio-Economic Panel (1984-2017), we apply descriptive techniques and individual fixed-effects regressions to analyze how job loss and divorce influence the health of immigrants and nonimmigrants. Our results support the hypothesis that immigrants suffer more from adverse life events than nonimmigrants in both the short and the long run. Relative to nonimmigrants, immigrants have a health advantage at younger ages, which becomes a disadvantage at older ages, and this faster decline at older ages is particularly steep among immigrants who experience adverse life events. These results help explain the vanishing health advantage of immigrants by showing that they are exposed to a double disadvantage over the life course: immigrants are more likely than nonimmigrants to suffer from adverse life events, such as job loss, and these events typically have a larger impact on their health. Our findings are the first to provide evidence regarding the consequences of different adverse life events and how they relate to the intersection of migration status and sex. Moreover, our results highlight the importance of intersectional analyses in research on immigrant health.


Asunto(s)
Divorcio , Emigrantes e Inmigrantes , Estado de Salud , Acontecimientos que Cambian la Vida , Factores Socioeconómicos , Humanos , Masculino , Femenino , Alemania , Persona de Mediana Edad , Emigrantes e Inmigrantes/estadística & datos numéricos , Adulto , Divorcio/estadística & datos numéricos , Anciano , Desempleo/estadística & datos numéricos , Factores Sexuales , Factores de Edad , Adulto Joven , Adolescente
5.
BMC Pediatr ; 24(1): 405, 2024 Jun 22.
Artículo en Inglés | MEDLINE | ID: mdl-38909207

RESUMEN

BACKGROUND: Nine in every thousand children born in the United Kingdom have congenital heart disease, and 250,000 adults are living with the condition. This study aims to investigate the associations between congenital heart disease and educational outcomes among school-aged children in Scotland. METHODS: Routine health and education databases were linked to produce a cohort of all singleton children born in Scotland and attending a local authority run primary, secondary, or special school in Scotland at some point between 2009 and 2013. Children with congenital heart disease within this cohort were compared with children unaffected by congenital conditions. Outcomes investigated were special educational need (SEN), absenteeism, exclusion, academic attainment, and unemployment. All analyses were adjusted for sociodemographic and maternity confounders. Absenteeism was investigated as a mediating factor in the associations with attainment and unemployment. RESULTS: Of the 715,850 children, 6,295 (0.9%) had congenital heart disease and 4,412 (6.1%) had isolated congenital heart disease. Congenital heart disease and isolated congenital heart disease were both significantly associated with subsequent special educational need (OR 3.45, 95% CI 3.26-3.65, p < 0.001 and OR 1.98, 95% CI 1.84-2.13, p < 0.001 respectively), absenteeism (IRR 1.13, 95% CI 1.10-1.16, p < 0.001 and IRR 1.10, 95% CI 1.06-1.13, p < 0.001 respectively), and low academic attainment (OR 1.69, 95% CI 1.39-2.07, p < 0.001 and OR 1.35, 95% CI 1.07-1.69, p = 0.011 respectively). Neither congenital heart disease nor isolated congenital heart disease were associated with school exclusion. Only congenital heart disease (OR 1.21, 95% CI 1.03-1.42, p = 0.022) but not isolated congenital heart disease was associated with unemployment. When days absent were included in the analyses investigating attainment and unemployment, the conclusions were not altered. CONCLUSION: Children with congenital heart disease have greater special educational need, lower school attendance, attain lower examination grades and have greater unemployment compared to peers. In addition to healthcare support, affected children need educational support to avoid additional impact on their long-term wellbeing.


Asunto(s)
Absentismo , Cardiopatías Congénitas , Humanos , Cardiopatías Congénitas/epidemiología , Escocia/epidemiología , Femenino , Masculino , Niño , Desempleo/estadística & datos numéricos , Adolescente , Educación Especial/estadística & datos numéricos , Éxito Académico , Escolaridad
6.
Am J Psychiatry ; 181(7): 620-629, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38859703

RESUMEN

OBJECTIVE: Many but not all persons with bipolar disorder require hospital care because of severe mood episodes. Likewise, some but not all patients experience long-term occupational dysfunction that extends beyond acute mood episodes. It is not known whether these dissimilar outcomes of bipolar disorder are driven by different polygenic profiles. Here, polygenic scores (PGSs) for major psychiatric disorders and educational attainment were assessed for associations with occupational functioning and psychiatric hospital admissions in bipolar disorder. METHODS: A total of 4,782 patients with bipolar disorder and 2,963 control subjects were genotyped and linked to Swedish national registers. Longitudinal measures from at least 10 years of registry data were used to derive percentage of years without employment, percentage of years with long-term sick leave, and mean number of psychiatric hospital admissions per year. Ordinal regression was used to test associations between outcomes and PGSs for bipolar disorder, schizophrenia, major depressive disorder, attention deficit hyperactivity disorder (ADHD), and educational attainment. Replication analyses of hospital admissions were conducted with data from the Bipolar Disorder Research Network cohort (N=4,219). RESULTS: Long-term sick leave and unemployment in bipolar disorder were significantly associated with PGSs for schizophrenia, ADHD, major depressive disorder, and educational attainment, but not with the PGS for bipolar disorder. By contrast, the number of hospital admissions per year was associated with higher PGSs for bipolar disorder and schizophrenia, but not with the other PGSs. CONCLUSIONS: Bipolar disorder severity (indexed by hospital admissions) was associated with a different polygenic profile than long-term occupational dysfunction. These findings have clinical implications, suggesting that mitigating occupational dysfunction requires interventions other than those deployed to prevent mood episodes.


Asunto(s)
Trastorno Bipolar , Trastorno Depresivo Mayor , Herencia Multifactorial , Sistema de Registros , Ausencia por Enfermedad , Humanos , Trastorno Bipolar/genética , Trastorno Bipolar/epidemiología , Masculino , Femenino , Herencia Multifactorial/genética , Adulto , Suecia/epidemiología , Ausencia por Enfermedad/estadística & datos numéricos , Persona de Mediana Edad , Trastorno Depresivo Mayor/genética , Trastorno Depresivo Mayor/epidemiología , Hospitalización/estadística & datos numéricos , Escolaridad , Desempleo/estadística & datos numéricos , Esquizofrenia/genética , Esquizofrenia/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/genética , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Estudios Longitudinales , Estudios de Casos y Controles
7.
Proc Natl Acad Sci U S A ; 121(27): e2316423121, 2024 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-38923986

RESUMEN

As disasters increase due to climate change, population density, epidemics, and technology, information is needed about postdisaster consequences for people's mental health and how stress-related mental disorders affect multiple spheres of life, including labor-market attachment. We tested the causal hypothesis that individuals who developed stress-related mental disorders as a consequence of their disaster exposure experienced subsequent weak labor-market attachment and poor work-related outcomes. We leveraged a natural experiment in an instrumental variables model, studying a 2004 fireworks factory explosion disaster that precipitated the onset of stress-related disorders (posttraumatic stress disorder, anxiety, and depression) among individuals in the local community (N = 86,726). We measured labor-market outcomes using longitudinal population-level administrative data: sick leave, unemployment benefits, early retirement pension, and income from wages from 2007 to 2010. We found that individuals who developed a stress-related disorder after the disaster were likely to go on sickness benefit, both in the short- and long-term, were likely to use unemployment benefits and to lose wage income in the long term. Stress-related disorders did not increase the likelihood of early retirement. The natural experiment design minimized the possibility that omitted confounders biased these effects of mental health on work outcomes. Addressing the mental health and employment needs of survivors after a traumatic experience may improve their labor-market outcomes and their nations' economic outputs.


Asunto(s)
Desastres , Trastornos por Estrés Postraumático , Humanos , Femenino , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/psicología , Trastornos por Estrés Postraumático/etiología , Masculino , Adulto , Salud Mental , Persona de Mediana Edad , Desempleo/psicología , Desempleo/estadística & datos numéricos , Empleo , Estrés Psicológico/epidemiología , Explosiones , Trastornos Mentales/epidemiología , Trastornos Mentales/etiología , Ausencia por Enfermedad/estadística & datos numéricos , Renta
8.
PLoS One ; 19(6): e0304991, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38900707

RESUMEN

Recent studies on classic psychedelics have suggested that their use is associated with psychological strengths and resilience, thereby conferring users a type of psychological protection relative to non-users. However, this idea has been brought into question by recent findings suggesting that lifetime users of lysergic acid diethylamide (LSD) report worse mental health during stressful experiences. The current study addresses these mixed findings by examining whether LSD use prior to a stressful experience buffers against the psychological distress experienced in the wake of the stressful experience. This study draws on openly-available data from the National Survey on Drug Use and Health (2008-2019) on 5,067,553 (weighted) unemployed, job seeking individuals experiencing job loss. Using purposeful respondent exclusion criteria to establish temporal precedence of the variables under investigation, this study offers a straightforward test of whether LSD use confers psychological resilience to naturalistic users. LSD use prior to job loss was associated with a higher likelihood of severe psychological distress following job loss, regardless of whether sociodemographic variables were controlled for or not. In sum, this study fails to find evidence for LSD-conferred psychological resilience in naturalistic users in the wake of a stressful experience.


Asunto(s)
Dietilamida del Ácido Lisérgico , Resiliencia Psicológica , Desempleo , Humanos , Masculino , Femenino , Adulto , Desempleo/psicología , Persona de Mediana Edad , Alucinógenos , Adulto Joven , Estrés Psicológico/psicología , Adolescente , Distrés Psicológico
9.
Cad Saude Publica ; 40(5): e00110523, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38896594

RESUMEN

This study aimed to evaluate the association between employment status and mental health, considering food insecurity as a mediator of this relation. A cross-sectional population-based study was conducted with adults (≥ 18 and < 60 years) during the COVID-19 outbreak in two cities from Southern Brazil. Employment status was categorized into working, not working, and lost job. The mental health outcomes evaluated were depressive symptoms, perceived stress, and sadness. Food insecurity was identified by the short-form version of the Brazilian Food Insecurity Scale. Adjusted analyses using Poisson regression were performed to assess the association between employment status and mental health. Mediation analysis was performed to investigate the direct and indirect effects of employment status on mental health outcomes. In total, 1,492 adults were analyzed. The not working status was associated with 53% and 74% higher odds of perceived stress and of sadness, respectively. Being dismissed during the pandemic increased the odds of depressive symptoms, perceived stress, and sadness by 68%, 123%, and 128%, respectively. Mediation analyses showed that food insecurity was an important mediator of the association between employment status and depressive symptoms and sadness, but not of perceived stress. The complexity of these results highlights economic and nutritional aspects involved in mental health outcomes.


Asunto(s)
COVID-19 , Depresión , Empleo , Inseguridad Alimentaria , Salud Mental , Pandemias , Estrés Psicológico , Humanos , COVID-19/psicología , COVID-19/epidemiología , Brasil/epidemiología , Adulto , Femenino , Estudios Transversales , Masculino , Depresión/epidemiología , Depresión/psicología , Persona de Mediana Edad , Salud Mental/estadística & datos numéricos , Adulto Joven , Empleo/psicología , Empleo/estadística & datos numéricos , Estrés Psicológico/epidemiología , Estrés Psicológico/psicología , Factores Socioeconómicos , SARS-CoV-2 , Desempleo/psicología , Desempleo/estadística & datos numéricos , Adolescente
10.
Front Public Health ; 12: 1324402, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38711763

RESUMEN

Background: Both overindebtedness and unemployment are critical life events that can result in or lead to poor mental health. What is less known is that the two partly interrelated events frequently go along with a feeling of loss or lack of control in life, which could be the main reason why they are associated with poor mental health. This has not been examined in previous research, particularly not in this combination. Methods: This study used and merged two cross-sectional data sets. Data collected in 2019 on 219 overindebted clients of the four official debt advisory centers in the Canton of Zurich were linked with a comparable subsample of 1,997 respondents from the Swiss Health Survey of 2017. The entire study population covered 2,216 adult individuals living in the Canton of Zurich. Results: The prevalence of no or low sense of control, medium to high psychological distress, and moderate to major depression was much higher among the 44 solely unemployed (36/30/12%), the 189 solely overindebted (73/83/53%), and particularly among the 30 unemployed and overindebted (93/97/60%) than among all 1,953 other survey participants (21/13/7%). Unemployment, overindebtedness, and a (resulting) lack or loss of control were all found to be strong risk factors for the two mental health outcomes under study. Associations, or rather negative health effects, were partly but not fully mediated by the sense of control. Overindebtedness much more strongly predicted psychological distress (ß = -0.37) and depression (ß = 0.17) than unemployment (ß = -0.05/0.01). The sense of control turned out to be an independent explanatory factor for poor mental health and even the strongest of all (ß = 0.49/-0.59). Conclusion: Improving a person's control beliefs could be a promising measure for preventing mental health disorders in general and in people who are unemployed and/or overindebted in particular.


Asunto(s)
Salud Mental , Desempleo , Humanos , Desempleo/estadística & datos numéricos , Desempleo/psicología , Suiza/epidemiología , Femenino , Masculino , Adulto , Estudios Transversales , Persona de Mediana Edad , Salud Mental/estadística & datos numéricos , Encuestas Epidemiológicas , Distrés Psicológico , Control Interno-Externo , Prevalencia , Encuestas y Cuestionarios
11.
Sci Rep ; 14(1): 10171, 2024 05 03.
Artículo en Inglés | MEDLINE | ID: mdl-38702409

RESUMEN

Mental health issues are intricately linked to socioeconomic background, employment and migration status. However, there remains a gap in understanding the mental health challenges faced by graduate youth in India, particularly in Kolkata City. This study aims to assess the prevalence and associated risk factors of depression, anxiety, and stress among higher-educated migrant youth. A survey was conducted on four hundred migrant graduate youths aged 21-35 residing in Kolkata. Measures included socio-demographics and the Depression Anxiety Stress Scale (DASS-21). Chi-square tests and binary logistic regression were employed to identify factors associated with mental health issues. The overall prevalence rates were 54.4% for depression, 61.8% for anxiety, and 47.9% for stress. Unemployed youths exhibited significantly more symptoms of depression and anxiety than their employed counter parts. The logistic regression model showed that unemployed youth, female sex, never married, and second- and third-time migrant youths were risk factors for high scores on the DASS-21. This study showed that mental health issues were alarming in the higher educated migrant youth. The study suggests the implementation of skill-based, job-oriented, and professional courses at the graduation level to prevent graduates from being rendered unproductive and jobless. Beside these, regular psychological support should be provided to the higher educated youth by the local governments.


Asunto(s)
Ansiedad , Depresión , Migrantes , Desempleo , Humanos , Femenino , Masculino , India/epidemiología , Migrantes/psicología , Migrantes/estadística & datos numéricos , Desempleo/psicología , Desempleo/estadística & datos numéricos , Adulto , Adulto Joven , Depresión/epidemiología , Depresión/psicología , Ansiedad/epidemiología , Ansiedad/psicología , Factores de Riesgo , Prevalencia , Salud Mental , Estrés Psicológico/epidemiología , Estrés Psicológico/psicología , Escolaridad
12.
JMIR Res Protoc ; 13: e55374, 2024 May 08.
Artículo en Inglés | MEDLINE | ID: mdl-38717812

RESUMEN

BACKGROUND: Unemployment affects millions of people worldwide and, beyond its economic impact, has severe implications for people's well-being and mental health. Different programs have been developed in response to this phenomenon, but to date, job-search interventions have proved to be most effective, especially the JOBS II program. The JOBS II program proved not only to be effective for re-employment but also has a positive impact on beneficiaries' mental health (ie, reduces anxiety or depression). However, by now, this evidence-based program has been delivered only on site in the various countries where it was implemented. In the digital era, web-based alternatives to such programs are highly needed because they have the advantages of scalability and cost-effectiveness. OBJECTIVE: In this context, we aim to investigate the efficacy of iJobs, the web-based adaptation of the JOBS II program, on job-search intensity and effort, the quality of job-search behaviors, and job-search self-efficacy. Further, 1 month after the intervention, we will also assess the employment status and the satisfaction with the job (if applicable). This study will also investigate the effect of iJobs on well-being and mental health (ie, anxiety and depression). METHODS: This study is a 2-arm randomized controlled trial. The 2 independent groups (intervention vs waiting list control group) will be crossed with 3 measurement times (ie, baseline, the postintervention time point, and 1-month follow-up). The design will be a 2 (intervention vs control) × 3 (baseline, the postintervention time point, and 1-month follow-up) factorial design. iJobs is a 2-week intervention consisting of 6 modules: an introductive module and 5 modules adapted from the original JOBS II program to the web-based setting and Romanian population. The web-based intervention also has a human component, as beneficiaries receive personalized written feedback after each module on the platform from a team of psychologists involved in the project. RESULTS: The enrollment of study participants started in June 2023 and is expected to end in May 2024. The data collection is expected to be completed by July 2024. The results are expected to be submitted for publication in the summer of 2024. CONCLUSIONS: This study is the first large-scale randomized controlled trial aiming to test the efficacy of a web-based adaptation of the JOBS II program. If our results support the efficacy of iJobs, they will offer the premise for it to become an evidence-based, accessible alternative for unemployed people in Romania and might be implemented in other countries. TRIAL REGISTRATION: ClinicalTrials.gov NCT05962554; https://clinicaltrials.gov/study/NCT05962554. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/55374.


Asunto(s)
Salud Mental , Desempleo , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Internet , Intervención basada en la Internet , Ensayos Clínicos Controlados Aleatorios como Asunto , Desempleo/psicología
13.
J Anxiety Disord ; 104: 102875, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38763062

RESUMEN

Individuals with Social Anxiety Disorder (SAD) are at risk for employment problems. This multi-site trial examined the efficacy of Work-Related Cognitive Behavioral Therapy provided alongside vocational services as usual (WCBT+VSAU), a group-based treatment designed to improve mental health and employment outcomes for individuals with SAD. Vocational service-seeking participants with SAD (N = 250) were randomized to either WCBT+VSAU or VSAU-alone. Hypotheses were that participants randomized to WCBT+VSAU would report less social anxiety, less depression, and more hours worked than participants randomized to VSAU-alone. WCBT+VSAU participants had significantly greater improvements on the Liebowitz Social Anxiety Scale (LSAS; d=-.25, CI=-0.49 to -0.02, p = .03) at post-assessment compared to VSAU-alone. The conditions did not differ on any variable at later time points or on secondary outcomes. Unexpectedly, participants randomized to VSAU-alone experienced LSAS improvements, similar to WCBT+VASU at later timepoints. Baseline psychological flexibility (beta=-.098 [-0.19-0.008]) and depression (beta=-0.18 [-0.34-0.009]) moderated change in social anxiety. Participants with lower psychological flexibility and higher depression responded more strongly to WCBT+VSAU than VSAU-alone over the duration of the study, suggesting that WCBT+VSAU may particularly benefit those with greater psychopathology. Results indicate that vocational centers are promising settings for treating SAD and employment-focused refinements are likely needed to improve work outcomes.


Asunto(s)
Terapia Cognitivo-Conductual , Fobia Social , Desempleo , Humanos , Terapia Cognitivo-Conductual/métodos , Masculino , Femenino , Adulto , Fobia Social/terapia , Fobia Social/psicología , Desempleo/psicología , Desempleo/estadística & datos numéricos , Persona de Mediana Edad , Resultado del Tratamiento , Depresión/terapia , Rehabilitación Vocacional/métodos
15.
BMC Public Health ; 24(1): 1315, 2024 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-38750531

RESUMEN

BACKGROUND: The aim of this study was to contribute to the theoretical development within the field of labour market effects on mental health during life by integrating Bronfenbrenner's ecological model with mainly earlier theoretical work on life-course theory. METHODS: An integrative review was performed of all 52 publications about labour market conditions in relation to mental health from the longitudinal Northern Swedish Cohort study. Inductive and deductive qualitative content analysis were performed in relation to Bronfenbrenner's ecological framework combined with life-course theories. RESULTS: The following nine themes were identified: 1. Macroeconomic recession impairs mental health among young people. 2. The mental health effects on individuals of youth unemployment seem rather insensitive to recession. 3. Small but consistent negative effect of neighbourhood unemployment and other work-related disadvantaged on individuals' mental health over life. 4. Youth unemployment becomes embodied as scars of mental ill-health over life. 5. Weak labour market attachment impairs mental health over life. 6. Bidirectional relations between health and weak labour market attachment over life. 7. Macrolevel structures are of importance for how labour market position cause poor health. 8. Unequal gender relations at work impacts negatively on mental health. 9. The agency to improve health over life in dyadic relations. Unemployment in society permeates from the macrolevel into the exolevel, defined by Bronfenbrenner as for example the labour market of parents or partners or the neighbourhood into the settings closest to the individual (the micro- and mesolevel) and affects the relations between the work, family, and leisure spheres of the individual. Neighbourhood unemployment leads to poor health among those who live there, independent of their employment status. Individuals' exposure to unemployment and temporary employment leads to poorer mental health over the life-course. Temporal dimensions were identified and combined with Bronfenbrenner levels into a contextual life-course model CONCLUSION: Combining the ecosocial theory with life-course theories provides a framework for understanding the embodiment of work-related mental health over life. The labour market conditions surrounding the individual are of crucial importance for the embodiment of mental health over life, at the same time as individual agency can be health promoting. Mental health can be improved by societal efforts in regulations of the labour market.


Asunto(s)
Salud Mental , Desempleo , Humanos , Suecia/epidemiología , Salud Mental/estadística & datos numéricos , Femenino , Masculino , Desempleo/psicología , Desempleo/estadística & datos numéricos , Adulto , Empleo/psicología , Empleo/estadística & datos numéricos , Adolescente , Estudios de Cohortes , Modelos Teóricos , Adulto Joven , Estudios Longitudinales , Recesión Económica , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología
16.
J Opioid Manag ; 20(2): 97-102, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38700390

RESUMEN

INTRODUCTION: Opioid use disorder (OUD) is a significant cause of opioid-related fatality, and while medications to treat OUD (MOUD) are effective, disparities remain in the access and uptake of such medications. This study investigated factors that may influence referral to and initiation of MOUD treatment. METHODS: Data from electronic medical records of 677 patients with a history of criminal legal system involvement in a recovery program were used to examine the flow of MOUD referral. RESULTS: Among patients identified as potentially eligible for MOUD treatment, about 38.0 percent were referred and 18.8 percent were confirmed to initiate MOUD treatment. Logistic regression analyses highlighted female gender and unemployment due to incarceration as positive and negative predictors of referral, respectively. The Chi-square test revealed that women and uninsured patients were more likely to initiate referred MOUD treatment. CONCLUSIONS: Data highlight the need for greater connection between referral agencies and MOUD treatment providers, considering factors that may influence referral.


Asunto(s)
Trastornos Relacionados con Opioides , Derivación y Consulta , Humanos , Femenino , Masculino , Trastornos Relacionados con Opioides/epidemiología , Adulto , Persona de Mediana Edad , Tratamiento de Sustitución de Opiáceos , Factores Sexuales , Desempleo/estadística & datos numéricos , Modelos Logísticos , Analgésicos Opioides/uso terapéutico , Registros Electrónicos de Salud
17.
BMC Public Health ; 24(1): 1375, 2024 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-38778320

RESUMEN

BACKGROUND: Not being in employment, education, or training (NEET) is associated with poor health (physical and mental) and social exclusion. We investigated whether England's statutory school readiness measure conducted at 4-5 years provides a risk signal for NEET in late adolescence. METHODS: We identified 8,118 individuals with school readiness measures at 4-5 years and NEET records at 16-17 years using Connected Bradford, a bank of linked routinely collected datasets. Children were categorised as 'school ready' if they reached a 'Good Level of Development' on the Early Years Foundation Stage Profile. We used probit regression and structural equation modelling to investigate the relationship between school readiness and NEET status and whether it primarily relates to academic attainment. RESULTS: School readiness was significantly associated with NEET status. A larger proportion of young people who were not school ready were later NEET (11%) compared to those who were school ready (4%). Most of this effect was attributable to shared relationships with academic attainment, but there was also a direct effect. Measures of deprivation and Special Educational Needs were also strong predictors of NEET status. CONCLUSIONS: NEET risk factors occur early in life. School readiness measures could be used as early indicators of risk, with interventions targeted to prevent the long-term physical and mental health problems associated with NEET, especially in disadvantaged areas. Primary schools are therefore well placed to be public health partners in early intervention strategies.


Asunto(s)
Instituciones Académicas , Humanos , Adolescente , Masculino , Femenino , Inglaterra/epidemiología , Preescolar , Factores de Riesgo , Empleo/estadística & datos numéricos , Escolaridad , Éxito Académico , Desempleo/estadística & datos numéricos , Desempleo/psicología
18.
Front Public Health ; 12: 1337859, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38784586

RESUMEN

Purpose: This study explores the intricate relationship between unemployment rates and emotional responses among Chinese university graduates, analyzing how these factors correlate with specific linguistic features on the popular social media platform Sina Weibo. The goal is to uncover patterns that elucidate the psychological and emotional dimensions of unemployment challenges among this demographic. Methods: The analysis utilized a dataset of 30,540 Sina Weibo posts containing specific keywords related to unemployment and anxiety, collected from January 2019 to June 2023. The posts were pre-processed to eliminate noise and refine the data quality. Linear regression and textual analyses were employed to identify correlations between unemployment rates for individuals aged 16-24 and the linguistic characteristics of the posts. Results: The study found significant fluctuations in urban youth unemployment rates, peaking at 21.3% in June 2023. A corresponding increase in anxiety-related expressions was noted in the social media posts, with peak expressions aligning with high unemployment rates. Linguistic analysis revealed that the category of "Affect" showed a strong positive correlation with unemployment rates, indicating increased emotional expression alongside rising unemployment. Other categories such as "Negative emotion" and "Sadness" also showed significant correlations, highlighting a robust relationship between economic challenges and emotional distress. Conclusion: The findings underscore the profound impact of unemployment on the emotional well-being of university students, suggesting that economic hardships are closely linked to psychological stress and heightened negative emotions. This study contributes to a holistic understanding of the socio-economic challenges faced by young adults, advocating for comprehensive support systems that address both the economic and psychological facets of unemployment.


Asunto(s)
Emociones , Salud Mental , Medios de Comunicación Sociales , Estudiantes , Desempleo , Humanos , Desempleo/psicología , Desempleo/estadística & datos numéricos , China , Universidades , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Adulto Joven , Medios de Comunicación Sociales/estadística & datos numéricos , Adolescente , Salud Mental/estadística & datos numéricos , Femenino , Masculino , Ansiedad/psicología , Ansiedad/epidemiología , Lingüística
19.
BMJ Open ; 14(5): e082773, 2024 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-38697760

RESUMEN

OBJECTIVE: To assess the prevalence and associated factors of neurocognitive disorder among people living with HIV/AIDS in South Gondar primary hospitals, North-West Ethiopia, 2023. DESIGN: Institution-based cross-sectional study design. SETTING: South Gondar primary hospitals, North-West Ethiopia. PARTICIPANTS: 608 participants were recruited using the systematic random sampling technique. MEASUREMENT: Data were collected using an interviewer-administered questionnaire and medical chart reviews. The International HIV Dementia Scale was used to screen for neurocognitive disorder. The data were entered through EPI-DATA V.4.6 and exported to SPSS V.21 statistical software for analysis. In the bivariable logistic regression analyses, variables with a value of p<0.25 were entered into a multivariable logistic regression analysis to identify factors independently associated with neurocognitive disorder. Statistical significance was declared at a value of p<0.05. RESULTS: The prevalence of neurocognitive disorder among HIV-positive participants was 39.1%. In multivariable logistic regression, lower level of education (adjusted OR (AOR)=2.94; 95% CI 1.29 to 6.82), unemployment (AOR=2.74; 95% CI 1.29 to 6.84) and comorbid medical illness (AOR=1.80; 95% CI 1.03 to 3.14) were significantly associated with neurocognitive disorder. CONCLUSION: HIV-associated neurocognitive problems affected over a third of the participants. According to the current study, comorbid medical conditions, unemployment and low educational attainment are associated with an increased risk of neurocognitive disorder. Therefore, early detection and treatment are essential.


Asunto(s)
Infecciones por VIH , Trastornos Neurocognitivos , Humanos , Etiopía/epidemiología , Estudios Transversales , Masculino , Femenino , Adulto , Prevalencia , Persona de Mediana Edad , Trastornos Neurocognitivos/epidemiología , Trastornos Neurocognitivos/etiología , Infecciones por VIH/epidemiología , Infecciones por VIH/complicaciones , Adulto Joven , Factores de Riesgo , Complejo SIDA Demencia/epidemiología , Modelos Logísticos , Adolescente , Escolaridad , Comorbilidad , Desempleo/estadística & datos numéricos
20.
Adv Life Course Res ; 60: 100607, 2024 06.
Artículo en Inglés | MEDLINE | ID: mdl-38569249

RESUMEN

Intra-family crossover effects triggered by job losses have received growing attention across scientific disciplines, but existing research has reached discrepant conclusions concerning if, and if so how, parental job losses affect child mental health. Drawing on sociological models of stress and life course epidemiology, we ask if parental job losses have long-term effects on child mental health, and if these effects are conditional on the timing of, or the cumulative exposure to, job losses. We use intergenerationally linked Swedish register data combined with entropy balance and structural nested mean models for the analyses. The data allow us to track 400,000 children over 14 years and thereby test different life-course models of cross-over effects. We identify involuntary job losses using information on workplace closures, thus reducing the risk of confounding. Results show that paternal but not maternal job loss significantly increases the risk of psychotropic drug use among children, that the average effects are modest in size (less than 4% in relative terms), that they may persist for up to five years, and that they are driven by children aged 6-10 years. Moreover, cumulative exposure to multiple job losses are more harmful than zero or one job loss.


Asunto(s)
Psicotrópicos , Humanos , Niño , Femenino , Suecia/epidemiología , Masculino , Psicotrópicos/efectos adversos , Desempleo/psicología , Desempleo/estadística & datos numéricos , Padres/psicología , Adolescente , Estrés Psicológico/psicología
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