'They don't think I can do it': Experiences of self-advocates, employment specialists, and employers on employment of adults with intellectual disability.

BACKGROUND: A multi-phase Canadian study was conducted as part of a large-scale community and academic research partnership focused on understanding and improving the employment experiences of people with intellectual disabilities. METHOD: This multi-method study utilized a sequential approach, using findings from qualitative interviews (n = 28) to inform an online survey (n = 149). Participants were invited to share their experiences with paid employment or with persons with intellectual disabilities. RESULTS: Thematic analysis of data across interview and survey findings resulted in six themes: (1) assumptions and attitudes, (2) knowledge and awareness, (3) accessibility of processes, (4) use of accommodations, (5) workplace relationships, and (6) supports and resources. CONCLUSIONS: A holistic and systemic approach has the potential to improve inclusive employment experiences of people with intellectual disabilities. Action is needed mainly at the policy and employer level to reduce barriers and improve on facilitating measures reinforced by the themes shared in this study.

Drivers of employment dynamics of AI innovators.

Based on an analysis of companies developing artificial intelligence (AI) technologies, this study offers fresh evidence on the role of innovation as one of the drivers of employment growth. GMM-SYS estimates on a worldwide longitudinal dataset covering 4,184 firms that patented inventions involving AI technologies between 2000 and 2016 show a positive and significant impact of AI patent families on employment. The effect, presumably of product innovations, is small in magnitude and limited to service sectors and younger firms, which are at the forefront of the leaders of the AI revolution. We also detect some evidence of increasing returns, suggesting that innovative companies more focused on AI technologies are achieving larger impacts in terms of job creation.

K-12 Life Skills Education, Independence, and Employment of Autistic Individuals: Giving Voice to Autistic Adults.

Autistic adults are often challenged to engage in and complete life skill tasks independently and are underrepresented in employment. No prior study has explored the perceptions of autistic individuals regarding K-12 life skills experiences and postsecondary employment. As such, the purposes of this study were to explore the association between components of life skills instruction and employment for 12 autistic individuals, and to elicit the perspectives of and experiences in K-12 education and employment of six autistic adults. As this was a mixed methods study, surveys and semi-structured interviews were conducted. Results of Fisher's test indicated no statistically significant associations between employment and instructional components; however, the associations between employment and household chores [Cramer's V = .60]; cooking [Cramer's V = .66]; one-on-one instruction [Cramer's V = .63]; and field trips [Cramer's V = .41]) were large. The associations between employment and job site training [Cramer's V = .33] and token boards [Cramer's V = .33]) were moderate. Three themes and 10 subthemes emerged. Specifically, participants remembered Memorable Components from K-12 instruction: (a) job site training, (b) field trips, and (c) household chores. Participants perceived Beneficial Practices as: (a) job site training and (b) skills learned. Participants described shortcomings of K-12 instruction as need (a) for more skills training, (c) for social skills training, (d) to eliminate unnecessary instruction and (e) to carefully consider student placement. In conclusion, participants described experiences that helped them gain and attain post-secondary employment. More specific individualized programming in K-12 instruction would be beneficial to develop independence and post-secondary employment.

Barriers to and Facilitators for Finding and Keeping Competitive Employment: A Focus Group Study on Autistic Adults With and Without Paid Employment.

PURPOSE: The aim of the study was to gain more insight into barriers to and facilitators for finding and keeping competitive employment for autistic adults. Research questions were: (1) What barriers and facilitators do autistic adults report in finding and keeping competitive employment?; and (2) What are differences and similarities between autistic adults with and without paid employment regarding barriers and facilitators for sustainable employment? METHODS: Eight focus groups were conducted (N = 64 autistic adults). Four groups included only participants without paid employment (N = 24), and four groups consisted exclusively of participants with current paid employment (including part-time, N = 40). All discussions were audiotaped and transcribed verbatim to enable inductive thematic content analysis. Data were analyzed using ATLAS.ti 9. RESULTS: Ten themes and thirty-four subthemes were found. Many were interconnected. Themes facilitating sustainable employment included a positive workplace atmosphere, a supportive supervisor, being able to do work that aligns with interests and talents, favorable physical working conditions, coaching, higher self-insight, higher self-esteem, and proactivity. Most themes and subthemes emerged from both groups. Differences between the groups were that those with paid employment seemed to have experienced more friendly workplaces and supervisors, had received better coaching in finding and keeping employment, had higher self-insight and higher self-esteem, were more assertive and proactive. CONCLUSIONS: As many (sub-)themes were interrelated, the results suggest that to improve work participation, particularly two key areas are promising: (1) to realize more friendly, well-being oriented and inclusive workplaces, and (2) to increase autistic adults' self-insight into personal needs for positive wellbeing and self-knowledge regarding talents, wishes and well-being boundaries.

Disability day programs for people with intellectual disability: Characteristics and long-term perspectives.

There is limited knowledge regarding people with intellectual disability and their occupations in Sweden. The aim of the study was to examine young adults with intellectual disability who after secondary school participate in disability day programs (daily activity), with a focus on characteristics and longitudinal analyses of movements between occupations. The study used a national register of 26,908 people with intellectual disability, of which 13,128 individuals (48.8%) participated in daily activity. The group had slightly more men than women, many had attended individual programs in school, and significant associations were found between background factors and participating in daily activity. Proportions in daily activity remained stable over time; however, some individuals transitioned to employment or no known occupation. The study presents national and longitudinal understanding, highlighting the dominance of daily activity as an occupation. Further research is needed to increase knowledge on meaningful occupations for people with intellectual disability.

Predictors of Job Retention After Onset of Visual Impairment in Late Middle Age.

Objectives: We investigated factors associated with job retention after developing a visual impairment in late middle adulthood. Methods: Using longitudinal survey data from the Health and Retirement Study, we identified respondents who first reported poor eyesight or legal blindness at age 44-64 years in Waves 3-14 and who were employed in the previous wave. We conducted a multiple logistic regression analysis with job retention as the dependent variable and health and socioeconomic characteristics as independent variables. Results: Women, people who were married or partnered, and people with fair or better self-reported health were more likely to retain employment after vision loss, whereas people with more chronic health conditions were less likely to retain employment. Discussion: Poor health and chronic health conditions may prompt late middle-aged adults to leave the labor force after developing vision loss. Timely vocational rehabilitation services can help employed people with vision loss retain employment.

[Shortage of nurses in Spain: from the global case to particular situation. SESPAS Report 2024]. / Escasez de enfermeras en España: del caso global a la situación particular. Informe SESPAS 2024.

The nursing shortage is a multi-causal phenomenon that affects all countries and currently a global concern. The shortage of nurses jeopardizes the sustainability of health systems and the population health outcomes. Spain has historically had no difficulties in attracting new generations of nurses. The shortage of nurses is caused by the precarious working conditions and lack of professional development that have led to episodes of high international migration and abandonment of the profession. In this paper we focus on the evolution of different indicators of the working conditions of non-specialist nurses, who make up the bulk of the profession. These indicators allow us to analyse the abandonment of the profession, the duration of contracts, their full-time or part-time dedication and the excessive hiring. We have analysed the effect of COVID-19 and the labour reform on these indicators. COVID-19 reduced the abandonment of the profession and is currently at its lowest level, it has also accelerated the need to improve working conditions by increasing the percentage of permanent contracts and reducing the multiplicity of contracts in the same month. The labour reform has helped reduce the percentage of temporary contracts until reaching around 80% of the total contracts, and has reduced the number of nurses in Spain with more than one contract in the same month to below 3000 nurses on a sustained basis.

Relationship between employment and adaptive video gaming in individuals with physical disabilities.

PURPOSE: The purpose of this study was to assess employment characteristics of individuals with physical disabilities who currently participate in adaptive gaming and determine if there is a positive association between adaptive gaming and employment. MATERIALS AND METHODS: A survey was administered to individuals with disabilities who currently use adaptive video gaming equipment to gather information on demographics, gaming habits, employment characteristics, and subjective benefits of gaming on employment. RESULTS: The study included 606 participants. Over 57% of participants reported full-time or part-time employment. Nearly half of the participants reported using their equipment either most or all of the time to complete tasks related to work. Participants using their equipment to complete work tasks most or all of the time were more likely to be employed full-time (p = 0.0021). Over 75% of participants reported subjective benefits of adaptive video gaming on their employment. CONCLUSION: Participants in this study had higher rates of employment compared to national averages for individuals with physical disabilities. More frequent use of adaptive gaming equipment for work was associated with a higher likeliness of full-time employment. Most participants who were employed reported subjective benefits of adaptive gaming on employment through improvements in mental health, physical function, and cognition.

Participation in recreational activities has been shown to be associated with increased rates of employment for individuals with physical disabilities.Employment rates for those who participate in adaptive video gaming were found to be higher compared to individuals with disabilities in the general population.Adaptive video gaming may lead to increased rates of employment through improvement in mental health, physical function, and cognition.

Making Ends Meet: An Examination of Legal and Illegal Sources of Financial Support for Individuals Returning from Prison.

A fundamental challenge facing individuals returning from prison is securing income. Although there have been numerous studies on the relationship between post-release employment and reintegration, less is known about the extent to which returning individuals rely on other sources of financial support, such as the support from family members, public assistance, or earnings from illicit activities. There is also a knowledge gap around how these sources of financial support relate to one another. We use survey data from 385 men who were released from prison to two Chicago neighborhoods, collected as part of an evaluation of the Safer Return Demonstration. We found that 41% of men reported having a legal job since their release, 9% reported receiving income from illegal activities, 30% reported receiving monetary public assistance, 66% received non-monetary public assistance, and 60% were currently receiving financial support from their families. Results from logistic regression models indicate that individuals who were employed were less likely to be financially supported by their families or receive public benefits, but this had no impact on whether they received earning from illegal activities. We discuss the implications of these findings for policy, practice, and future research.

Work and self-rated memory among native Hawaiian and other Pacific Islander older adults.

OBJECTIVES: Engagement in work has an important association with cognitive health in later life, yet little is known about this association among Native Hawaiian and other Pacific Islander (NHPI) older adults. This study assesses the associations between various work characteristics and memory problems among this population. DESIGN: Using data from the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey (NHPI NHIS), the research question was explored among those who were aged 50+. RESULTS: Engagement in work, certain occupation types (e.g., clerical or professional occupations compared to blue-collar jobs), and the current/most recent job that is also the longest job held were associated with lower odds of having memory problems. CONCLUSION: The study's results suggest that work characteristics and opportunities to engage in work are important considerations in preventing memory problems in later life. As the NHPI population experiences cognitive health disparities earlier than other groups, timely interventions that focus on work engagement and a culturally relevant environment require further investigation.

The Trajectory of Agency-Employed Nurses in Ontario, Canada: A Longitudinal Analysis (2011-2021).

In Canada, reports of nursing staff shortages, job vacancies and the use of private agency nurses, especially in hospitals, have increased since the start of the COVID-19 pandemic. Media reports suggest the pandemic exacerbated nursing shortages among other issues, and nurses are leaving their traditional positions to work at such agencies. Public spending on agency nurses has increased appreciably. Using 2011 to 2021 regulatory college data on all registered nurses (RNs) and registered practical nurses (RPNs) in the province of Ontario, Canada, we investigated trends in the count and share of nurses working for employment agencies. We also examined the rate at which previously non-agency employed nurses transition to employment in at least one agency job. We found the prevalence of RNs and RPNs reporting agency employment was relatively stable from 2011 to 2019, and decreased slightly in 2020 and 2021. However, there was a small increase in transitions from non-agency employment to working at an agency job. We also found the mean hours of practice in all jobs reported by agency and non-agency nurses increased during the pandemic. Based on these findings, an increase in hours and/or prices for agency nurses may explain the increase in public funding for agency nurses, but it was not driven by an increasing share of nurses working for employment agencies. To fully understand employment agency activity, policymakers may need to monitor hours of work and hourly costs rather than only costs. Further research is required to investigate any long-term effects the pandemic may have had on agency-employment.

Return-to-employment for working-aged adults after burn injury: A mixed methods scoping review.

BACKGROUND: This scoping review aimed to identify the barriers, facilitators and benefits of returning to work following burn injury, outcome measures used, management strategies, and models of care. OBJECTIVE: To provide a comprehensive overview about working-aged adults returning to their preinjury employment after burn injury. METHODS: We followed a pre-determined scoping review protocol to search MEDLINE, CINAHL, Embase, PsycINFO, PubMed, Scopus, CCRCT and CDSR databases between 2000 to December 2023. Papers reporting primary data from previously employed adults with cutaneous burn injuries were included. RESULTS: In all, 90 articles met the review criteria. Return-to-work was both an outcome goal and process of recovery from burn injury. Physical and psychological impairments were identified barriers. Job accommodations and modifications were important for supporting the transition from hospital to workplace. Employment status and quality of life sub-scales were used to measure return-to-work. CONCLUSIONS: Consistent definitions of work and measurements of return-to-employment after burn injury are priorities for future research. Longitudinal studies are more likely to capture the complexity of the return-to-employment process, its impact on work participation and changes in employment over time. The social context of work may assist or hinder return-to-work more than physical environmental constraints. Equitable vocational support systems would help address disparities in vocational rehabilitation services available after burn injury.

Employment status in cancer patients the first five years after diagnosis-a register-based study.

PURPOSE: Work is important for identity formation, social status, and economic independency. Although some evidence within the field of work and cancer survivorship exists, no study has so far investigated employment status across all cancer diagnoses. Thus, the aim of the present study was to investigate the impact of all cancer diagnoses on employment status. METHODS: Danish cancer patients aged 20-60 years, diagnosed between 2000 and 2015, were identified through Danish registers and matched 1:5 with cancer-free controls. Logistic and linear regression was performed separately in 11 cancer types to assess and compare work status and work participation between cancer patients and cancer-free controls one, three, and five years after diagnosis. RESULTS: A total of 111,770 cancer patients and 507,003 cancer-free controls were included. All cancer types had lower chances of working one year after diagnosis (ORs between 0.05 and 0.76), with lung, colorectal, upper gastrointestinal, and blood cancer patients having the lowest chances. After three years, 10 of 11 cancer types had lower chances (ORs between 0.39 and 0.84). After five years, there were minimal differences between cancer patients and controls among most cancer types (ORs between 0.75 and 1.36). CONCLUSION: Most cancer patients had lower chances of working compared with the general population until five years after diagnosis. However, patients with certain cancer types experienced lower chances of working all years, despite improvement over time. IMPLICATIONS FOR CANCER SURVIVORS: The knowledge will help increase awareness on challenges regarding work-life after cancer. Furthermore, the distinguishing between diagnoses can inform to more targeted vocational rehabilitation.

The Impact of Formal Education, Specialized Training, and Offense Type on Perceptions of Employability: Can Bias Toward Hiring a Person With a Criminal History Be Mitigated?

Though hesitations to hire formerly incarcerated individuals are often related to assumptions about a person's dangerousness, there remain legitimate reasons, such as limited formal education and basic skills, that prevent returning residents from finding work. Previous research suggests that hiring decisions are confounded by offense type, even if an employer would otherwise consider a person with a criminal history. Thus, it is unclear whether returning residents' level of education or training can mitigate barriers related to their offense history. Using hypothetical case vignettes of a formerly incarcerated job applicant, this study examined whether hiring decisions were influenced by education and offense type. A between-subjects design with a sample of 223 individuals recruited via MTurk was conducted. Results of this study were largely consistent with prior research suggesting that criminal history presents an obstacle when trying to obtain employment. Implications and future directions are provided in the discussion.

Assessing the fidelity of supported education programs for first-episode psychosis to the supported employment guidelines adapted for education.

INTRODUCTION: Psychotic disorders are associated with academic difficulties. Supported Employment Program (SEP) guidelines have become the gold standard to improve occupational functioning in psychotic disorders. More recently, these guidelines have been adapted to education. In Canada, several community organizations and hospital programs offer supported education to young people with psychotic disorders. However, SEP guidelines are not systematically used. The objective of this study was to assess the fidelity of 6 Canadian (Quebec) organizations offering supported education services to young people with psychotic disorders to the SEP guidelines adapted to education. METHODS: Six sites offering educational services to young people with psychotic disorders were recruited. Semi-structured interviews were conducted with one supported education professional and one manager of each site, using the Quality of Supported Education Implementation Scale (QSEDIS). This new scale has been developed from the Quality of Supported Employment Implementation Scale. The QSEDIS assesses the fidelity of the quality of the implementation of supported education programs, using three subscales (Employees, Organization and Services). RESULTS: Acceptable fidelity scores were observed in the three QSEDIS subscales for all six sites combined. The Services subscale received the highest score of fidelity (4.4/5), followed by the Supported Education Employee (4.1/5) and the Organization (3.7/5). CONCLUSION: The results suggest that supported education services offered to young people with psychotic disorders in the six sites are generally consistent with SEP guidelines adapted to education. Further research is warranted to validate whether acceptable SEP guidelines fidelity according to the QSEDIS translates into educational outcomes.

Rehabilitation in patients with newly diagnosed epilepsy: A controlled, 1-year follow-up study on a specialized inpatient rehabilitation program.

OBJECTIVES: To evaluate the efficacy of a specialized inpatient rehabilitation program in patients with newly diagnosed epilepsy (NDE), who had been referred within 1 year after diagnosis. METHODS: We performed an open, prospective, controlled study comparing a 1-year follow-up assessment of patients with NDE after completing a rehabilitation program at an epilepsy center (rehabilitation group) with a control group of patients with similar epilepsy duration, but without rehabilitation in the first year after diagnosis. Primary outcome measures comprised emotional adaptation to epilepsy, depression and anxiety; and secondary outcome measures were overall quality of life (QoL), overall health, perceived restrictions because of epilepsy, level of information about epilepsy, and employment status. RESULTS: Comparison of the admission data of 74 rehabilitation group patients (mean age and SD 47.7 ± 13.0 years) with the pre-rehabilitation assessment of 56 control patients (45.5 ± 12.1 years) revealed no significant differences concerning sociodemographic and health data. Comparison of the follow-up assessment of the rehabilitation group and the pre-rehabilitation assessment of the control group showed significantly better values for the rehabilitation group on emotional adaptation to epilepsy (p = .003), overall QoL (p = .006) and overall health (p = .011), perceived restrictions because of epilepsy, and subjective level of information about epilepsy (both p's < .001). There were no statistically significant differences concerning depression and anxiety or employment status (all p's > .50). One year after rehabilitation, patients in the rehabilitation group were more often seizure-free and less often on sickness absence than control group patients (both p's < .001). SIGNIFICANCE: Since reduced QoL shortly after diagnosis of NDE is associated with seizure recurrence, an early identification of patients with a greater need for support seems important. This epilepsy-related rehabilitation program showed lasting effects on several aspects of adaptation to epilepsy and QoL.

Returning to Work Following Hematopoietic Cell Transplantation: The Survivor's Perspective.

While curing a patient's underlying disease is the primary goal of physicians performing hematopoietic cell transplantation (HCT), the ultimate objective is to provide patients with optimal post-HCT quality of life. For many survivors, this includes returning to work (RTW). We conducted a survey of 1- to 5-yr post-HCT survivors at our center to evaluate their perspective on facilitators and barriers to RTW as well as to gauge interest in potentially useful RTW support interventions. Survivors aged 18 to 65 yrs (n = 994) were sent an annual survey that included 36 supplementary questions about post-HCT RTW. Survey questions were selected from published national cancer survivor surveys and then modified specifically for HCT survivors. Three hundred forty-four (35%) survivors with a mean age of 53 yrs completed the survey, of whom 272 (79%) had worked prior to their diagnosis. Of those 272 patients, 145 (53%) were working currently and another 22 (8%) had attempted to go back to work following HCT but were not presently working. We found that having had an allogeneic versus autologous HCT (P = .006) was associated with a decreased likelihood of currently working, whereas frequent employer communication (>once a month) (P = .070) and having a more supportive employer (P = .036) were associated with a greater chance of currently working. Of survivors currently working, 45% reported that they had made one or more changes to their work schedule (e.g., flexible schedule or part-time work) or environment (e.g., work from home) upon RTW. Ninety-five percent of responders reported that they could have benefited from RTW support provided by the transplant center, but only 13% indicated that they had received it. Education on RTW challenges, information on disability benefits, and access to physical therapy were among the most requested support interventions. To improve post-HCT quality of life for survivors open to assistance, providers should address work status and goals, recognize barriers to successful return, and offer RTW support including working directly with employers. Allogeneic HCT survivors are particularly vulnerable to failing attempts to RTW and should be the target of retention interventions. A previously published manuscript on RTW guidance for providers of stem cell transplant patients endorsed by the American Society of Transplant and Cellular Therapy is available in Open Access and can be used as a tool to counsel and support these patients.

Understanding Australian pharmacy degree holders' job preferences through the lens of motivation-hygiene theory.

Increasing the contribution of pharmacists to primary care has been long discussed, particularly in the context of health workforce shortages and the push to better integrate all providers across primary care. This study examines the employment preferences of Australian pharmacy degree holders (PDHs) elicited through a discrete choice experiment (DCE), to better understand the drivers of current labour force choices. A labelled DCE was developed incorporating the six employment sectors: hospital pharmacy, community pharmacy, primary healthcare settings, pharmaceutical industry, government/academia, and non-pharmacy-related sector. Each alternative was described by five attributes using Herzberg's Two Factor Theory as a conceptual framework. They include motivators - role and career opportunities, and hygiene factors-flexible work schedule, geographic location, and salary. Unforced choice data were analysed using conditional logit and mixed logit models. Based on a sample of 678 PDHs in Australia, our findings indicated pharmaceutical industry is the least preferred sector, followed by non-pharmacy-related sector. Motivators in the form of role and career opportunities are the most important attributes in hospital pharmacy while hygiene factors - geographic location and salary significantly drive the choice of community pharmacy and primary care settings. We provided evidence of a willingness to adopt expanded roles in community pharmacy. This unique interpretation of the key drivers of employment preference in light of motivators and hygiene factors provides policy makers with important information when designing policies to attract and retain PDHs across employment sectors.

Diversity patterns in non-standard employment and their relationship with self-rated health in urban China from 2010 to 2021.

In recent decades, the rise of non-standard employment in China is thought to profoundly influence workers' health. Using data from the China General Social Survey 2010-2021, this study compares the self-rated health of workers engaged in various non-standard employment types with those in unemployment or standard employment in urban China. The research also investigates how these patterns have evolved over time among urban residents with different hukou types amid the expansion of China's welfare system and labor market shifts. We find that while unemployment is significantly related to worse self-rated health, the effects vary across different types of non-standard employment. Precarious employment has a more substantial adverse effect on health than part-time and self-employment, although the effect is less severe than that of unemployment. Between 2010 and 2018, the health impact of precarious employment declined, aligning with China's enhanced welfare system. However, its negative effect re-emerged in 2021. These patterns are particularly pronounced for urban residents holding agricultural hukou, highlighting the intersection of non-standard employment with the household registration system in shaping health outcomes within evolving labor markets.

Association of Geriatric Depressive Symptoms and Government-Initiated Senior Employment Program: A Population-Based Study.

OBJECTIVE: The impact of the government-initiated senior employment program (GSEP) on geriatric depressive symptoms is underexplored. Unearthing this connection could facilitate the planning of future senior employment programs and geriatric depression interventions. In the present study, we aimed to elucidate the possible association between geriatric depressive symptoms and GSEP in older adults. METHODS: This study employed data from 9,287 participants aged 65 or older, obtained from the 2020 Living Profiles of Older People Survey. We measured depressive symptoms using the Korean version of the 15-item Geriatric Depression Scale. The principal exposure of interest was employment status and GSEP involvement. Data analysis involved multiple linear regression. RESULTS: Employment, independent of income level, showed association with decreased depressive symptoms compared to unemployment (p<0.001). After adjustments for confounding variables, participation in GSEP jobs showed more significant reduction in depressive symptoms than non-GSEP jobs (ß=-0.968, 95% confidence interval [CI]=-1.197 to -0.739, p<0.001 for GSEP jobs, ß=-0.541, 95% CI=-0.681 to -0.401, p<0.001 for non-GSEP jobs). Notably, the lower income tertile in GSEP jobs showed a substantial reduction in depressive symptoms compared to all income tertiles in non-GSEP jobs. CONCLUSION: The lower-income GSEP group experienced lower depressive symptoms and life dissatisfaction compared to non-GSEP groups regardless of income. These findings may provide essential insights for the implementation of government policies and community-based interventions.