Growing Challenges to Youth Employment

31 Background: Reports of financial distress (FD) among older adults with cancer are limited. Geriatric assessments (GA) have been shown to identify impairments using patient-reported outcome data; we sought to identify GA identified impairments associated with FD among older adults with NSCLC. Methods: This was a retrospective study of patients aged ≥65 with NSCLC who completed a GA and were enrolled in the Cancer and Aging Resilience Evaluation (CARE) from 2018-2021 or Web-enabled CARE (WeCARE) from 2024-2025 registries at the University of Alabama at Birmingham. Examined GA domains included functional status, physical function, and health related quality of life (HRQOL) including both global physical and mental health. FD was assessed using a single-item question (“Do you have to pay for more medical care than you can afford?”) in the CARE cohort, and using a score ≤26 from the comprehensive score for Financial Toxicity (COST-FACIT) in the WeCARE cohort. The relationship between FD and GA impairments was assessed using odds ratios (OR) and 95% confidence intervals (CIs) from multivariable logistic regression models adjusted for patient age, sex, race, education and employment status. Results: Of 116 older adults with NSCLC who completed a CARE (n = 59) or WeCARE (n = 57) survey, median age was 71 years (range: 65-86), 61% were male, 79% were white, 38% had college or higher education, and 72% were disabled, retired, or unemployed. Overall, 34% of patients reported FD. Patients with higher odds of FD were African American (v White; OR = 3.11; 95% CI, 1.06 to 9.19), and had less than high school education (v a college or above degree; OR = 6.7; 95% CI, 1.43 to 33.3). Patients with higher odds of FD also reported GA impairments in physical function: ≥ one fall (v none; OR = 3.12, 95% CI 1.21-8.04), limitations in walking one block (v none; OR = 2.60, 95% CI 1.05-6.48; and impaired HRQOL in physical (OR = 2.39, 95% CI 1.03-5.53), and mental health (OR = 2.46, 95% CI 1.00-6.12). Conclusions: Almost a third of older adults with NSCLC reported FD at time of presentation to a medical oncologist visit. Sociodemographic factors, physical and mental health related impairments were associated with higher reporting of FD.With recent therapeutic developments in cancer care, cost of cancer care continues to rise thus proper allocation of resources is needed to manage FD in this vulnerable population.

Financing private higher education and the possible means of relieving the chronic financial distress that has characterized private colleges over the past ten years or so have been the subjects of study by the Carnegie Commission, the National Commission on the Financing of Postsecondary Education, and the Association of American Colleges. In discussing and describing financial distress, these groups have in general compiled a catalog of specific events, which, taken together, are assumed to signal distress. Their work has not been directed toward providing analytical and empirical descriptions of financial distress; rather, it has been largely policy oriented, addressing such issues as the proper role of the federal government in financing private higher education and the question of whether distress in the private sector of higher -education ought to be alleviated by external agents. ' The purpose of this study is to address the problem of providing an analytical description of financial distress in private colleges that will serve as a basis for an empirical description by presenting a model of the financial condition of a private college and by using this model to find and test presently produced accounting measures that will describe financial distress empirically. More specifically, the study will undertake to answer the following questions: What model will analytically describe the financial operations of a private college in a way that allows for the separation of distressed condition behavior from

Cancer patients may experience financial distress as a side effect of their care. Little is known about which patients are at greatest risk for altering their care or lifestyle due to treatment-related financial distress. We conducted a cross-sectional survey study to determine which patients are at greatest risk for altering their care or lifestyle due to treatment-related financial distress. Eligible patients were adults receiving cancer treatment enrolled between June 2010 and May 2011. We grouped coping strategies as lifestyle altering or care altering. We assessed coping strategies and relationships between covariates using descriptive statistics and analysis of variance. Among 174 participants, 89% used at least one lifestyle-altering coping strategy, while 39% used a care-altering strategy. Care-altering coping strategies adopted by patients included the following: not filling a prescription (28%) and taking less medication than prescribed (23%). Lifestyle-altering strategies included the following: spending less on leisure activities (77%), spending less on basics like food and clothing (57%), borrowing money (54%), and spending savings (50%). Younger patients were more likely than older patients to use coping strategies (p < 0.001). Lower-income patients adopted care-altering strategies more than higher-income patients (p = 0.03). Participants with more education and shorter duration of chemotherapy used lifestyle-altering strategies more than their counterparts (both p < 0.05). As a means of coping with treatment-related financial distress, patients were more likely to use lifestyle-altering approaches, but more than one-third adopted potentially harmful care-altering strategies. Younger age, lower income, higher education, and shorter duration of chemotherapy were characteristics associated with greater use of coping strategies. Copyright © 2015 John Wiley & Sons, Ltd.

ABSTRACTThis study offers critical insights into the experiences of First‐Generation College Students (FGCS) in Ghana. This phenomenological study included 18 undergraduate FGCS at a large public university in Ghana. By examining the challenges and coping mechanisms of FGCS, the research provides a holistic view of FGCS experiences in West Africa using evidence from Ghana's higher education. These contributions enhance our understanding of FGCS experiences in non‐Western contexts and offer valuable insights for improving support mechanisms. The study findings revealed numerous challenges for FGCS that impede their advancement in university settings. The study identifies various challenges faced by FGCS, such as financial distress, limited social capital, isolation, and psychological distress, thereby contributing to a nuanced understanding of FGCS experiences in non‐Western settings. The study highlights these students' unsustainable and potentially harmful coping strategies, addressing an under‐researched aspect of their experiences. The findings emphasise the need for higher education institutions to address FGCS's unique circumstances, offering insights into policies and practices to improve access, retention, and graduation rates. Practical strategies for supporting FGCS, such as providing logistical support, improving the social environment for FGCS, and collaboratively examining existing processes for impediments, are proposed to guide institutions in developing targeted interventions to simplify the higher education process and journey toward FGCS.

Mental health is an essential component of total health at all stages of life. It affects a person’s personal and social life, including regulating their emotions and thoughts, coping with stress, engaging with people and making sensible decisions. In recent decades, mental health has been a prevalent health issue among students. Therefore, the purpose of this study is: (1) to identify the possible factors influencing student mental health in public universities, (2) to determine the most influential factor that affects mental health among public university students, and (3) to analyze relationship between identified factors with student mental health. This study employed a quantitative approach using survey questionnaires. A sample of 200 students from public universities in Malaysia returned and usable for data analysis. The data was analysed using Version 27 of the Statistical Package for the Social Sciences (SPSS). The results of this study found that the scores for the three factors indicated a tendency towards agreement on student mental health factors with academic pressure (Mean=3.20), financial distress (Mean=2.69), and social support (Mean=3.48). The findings of the study showed that academic pressure (r=.495, p p&lt;.001), financial distress (r=.348, p&lt;.001) and social support (r=−.235, p&lt;.001) had a significant relationship between student mental health. Furthermore, multiple linear regression analysis was employed to predict students’ mental health using the three independent variables. The findings revealed that the three factors accounted for 29.7% of the variance in predicting student mental health. Also, academic pressure found to be the most influential factor on mental health among public university students, followed by social support while financial distress had no relative influence. These findings suggest that educators and higher education institutions should establish standards to reduce excessive academic stress, such as offering flexible deadlines and a balanced workload distribution in order to improve student mental well-being.

Public Purpose in the Evolution of American Higher Education

This chapter offers a necessary summary of the key concepts of the financial conditions in the higher education (HE) sector, through a close examination of different approaches. Focusing on a review of current literature, the chapter provides an overview of the transformation and main uses of performance information in the HE sector as the result of public policy changes. The chapter also defines some of the key theoretical and practical elements to describe the financial conditions and distress of public universities, while also clarifying the distinctive features of financial sustainability. The authors highlight in their closing remarks the implications for future research developments. These issues touch the core of the financial challenges in the HE sector and require thought and resolution to ensure the long-term success of public universities worldwide.

Higher education has been in a financially precarious position for many years – facing either a total transformation or elimination. Tuition increases and fewer college-age students from shifting demographics are primary reasons for the financial distress. Alternative financial stability models have assumed linear variable relationships and improperly calculate the probability of default. Stakeholders have historically relied upon models such as those developed by Edmit and the Department of Education which are inadequate at separating financially sound from unsound universities. We used an Automated Machine Learning approach utilizing multiple models to explain the relationship between metrics and the probability of default/closure allowing for more informed managerial decisions. This research, although applied to the homogeneous group of small liberal arts universities, can be applied to online and state universities and will allow the opportunity to take preventive steps to mitigate the likelihood of closing due to financial distress.

Do optimal scale and efficiency matter in Taiwan's higher education reform? A stochastic cost frontier approach

Bankrupting Higher Education

Background: Endometriosis is a chronic condition associated with substantial healthcare costs, diagnostic delays and long-term impairment in quality of life. Despite the recognized economic burden, patient-reported financial distress remains insufficiently studied. The aim of this study was to adapt and validate the Polish version of the Comprehensive Score for Financial Toxicity (COST-FACIT) for use in women with endometriosis, as well as to examine demographic and clinical factors associated with financial toxicity. Methods: A cross-sectional study was conducted among Polish women with endometriosis using an online survey. The COST-FACIT was adapted following standard forward–backward translation procedures, with FACIT approval. Psychometric evaluation included internal consistency, construct validity, convergent validity with the Financial Well-Being Scale, and test–retest reliability. Exploratory and confirmatory factor analyses were performed, and multivariable models were used to identify factors associated with financial toxicity. Results: The adapted scale demonstrated good psychometric properties, with excellent internal consistency (Cronbach’s α = 0.92; McDonald’s ω = 0.92) and strong test–retest reliability (r = 0.87). Exploratory factor analysis supported a two-factor structure of the instrument. COST-FACIT scores were strongly correlated with financial well-being (r = 0.78). Higher education, stable employment and higher income were associated with better financial well-being, whereas longer symptom duration, greater distance to care and higher healthcare expenditures were associated with worse scores. Conclusions: The Polish COST-FACIT demonstrated good psychometric properties and may serve as a useful instrument for assessing financial toxicity in women with endometriosis. The results highlight the financial burden of the disease and support the use of patient-reported measures to identify individuals at risk of financial distress and reduced quality of life. This tool may facilitate clinical research and improve patient-centered care.

We assessed the mental health effects of Australia's 2019-2020 bushfires 12-18 months later, predicting psychological distress and positive psychological outcomes from bushfire exposure and a range of demographic variables, and seeking insights to enhance disaster preparedness and resilience planning for different profiles of people. We surveyed 3083 bushfire-affected and non-affected Australian residents about their experiences of bushfire, COVID-19, psychological distress (depression, anxiety, stress, post-traumatic stress disorder) and positive psychological outcomes (resilient coping, wellbeing). We found high rates of distress across all participants, exacerbated by severity of bushfire exposure. For people who were bushfire-affected, being older, having less financial stress, and having no or fewer pre-existing mental disorders predicted both lower distress and higher positive outcomes. Being male or having less income loss also predicted positive outcomes. Severity of exposure, higher education and higher COVID-19-related stressors predicted both higher distress and higher positive outcomes. Pre-existing physical health diagnosis and previous bushfire experience did not significantly predict distress or positive outcomes. To promote disaster resilience, we recommend investment in mental health, particularly for younger adults and for those in rural and remote areas. We also recommend investment in mechanisms to protect against financial distress and the development of a broader definition of bushfire-related impacts than is currently used to capture brushfires' far-reaching effects.

From the High School Journal Editorial Board:Living in an Anti-globalization era: A Call for Promoting Critical Multiculturalism and Multicultural Education for Immigrant Teachers and Students in Secondary Education Xinxin Wang and Linyu Yu Since the beginning of 2020, the outbreak of coronavirus disease has challenged fundamental ways of living, including the economy and social structures. The world has been experiencing economic recessions, job market losses, health and safety concerns, and school closures. In the United States (U.S.), most schools at all educational levels were forced to shut down or pivot to distance learning immediately in Spring 2020. Insecurity and fear arose among people due to the quick spread of the pandemic and have created discriminatory responses and social exclusion disproportionately against people of color and immigrants (Devakumar et al, 2020). This increasing racism and othering has disrupted the education system's commitment to social justice. Few studies as of yet have examined the impact of the pandemic and anti-globalism against immigrant teachers and students in secondary education. With the previous U.S. administration's stringent immigration policy, restricted international travels, and rising anti-Asian hate crimes worldwide, it is a critical time to re-examine the educational conditions that immigrant teachers and students, particularly Asian American and international students, are experiencing during the anti-globalization era. Globalization has indeed been a phenomenon that cannot be avoided or denied. Knight (1997) conceptualized globalization as "the flow of technology; economy, knowledge, people, values, ideas...across borders" (p.6). Economy, education, politics, culture and every aspect of family life, particularly in the U.S. (e.g., food, clothing, transportation, and social media), are impacted by globalization. The sentiments and actions of anti-globalization are in response to globalization as a contributor to a higher global mobility across borders with no barriers in that globalization might indirectly boost the spread of the coronavirus. The rise of anti-globalization and nationalism during the pandemic has manifested in many aspects of life from "the closure of borders and the difficulty of mobilizing support and solidarity across them, to the fear [of illness, financial distress, social instability that] many people experience...[T]he response appears to make nationalism more salient as people look to support their own communities" (Bieber, 2020b, p. 1). Nationalism is argued to be a predominating ideology and practice in the U.S. and the world that values membership in a nation and downplays the uniqueness of other cultures (Bieber, 2020a). The pandemic and the voices of anti-globalization and nationalism impact every community and school and its teachers and students. However, more attention needs to be on the intersectionality of (post)pandemic anti-globalization and nationalism and its consequences on [End Page 79] immigrant teachers and students who represent the movement of people and ideas across borders. Immigrants accounted for about 13.7% of the U.S. population in 2018 (Budiman, 2020). Immigrant teachers in this editorial are defined as those who are foreign-born and came to the U.S. after receiving a majority of K-12 education in their home countries (Ndukwe, 2019). These teachers came to the U.S. for a variety of reasons such as higher education, family, refugee status, and job opportunities; and they hold citizenship, permanent resident status or temporary work visas. States on the eastern and western coast along with Alaska and Hawaii see the higher percentage of immigrant teachers in their teaching workforce compared to the Midwest (Starz, 2017). With regard to subjects, immigrant teachers are teaching in high-need areas such as mathematics, science, and special education as well as foreign language, English to speakers of other languages (ESOL), and bilingual education. The rise of immigrant teachers is seen as a response to the increase of linguistically and culturally diverse students in the U.S. (Ross & Ahmed, 2016) as well as a critical shortage of new teachers in the teacher preparation pipeline (U.S. Department of Education, 2011). Many efforts have been made in the U.S. educational system to recruit immigrant teachers. For example, many states develop alternative routes to teaching careers and there has also been federal support for alternative teacher certification (Gross, 2018). Within school districts and...

The COVID-19 pandemic poses financial challenges for students worldwide, especially for those in higher education where free and universal access is not guaranteed. Students in developed economies, a long-neglected group for pandemic studies, are not exceptions. The motivation of this study is to examine subjective financial well-being of undergraduate students during the COVID-19 pandemic. Accordingly, we conducted a self-administered survey composed of 31 questions that assesses students&amp;rsquo; demographic information and impact of COVID-19 on their financial status. The sample includes 655 students enrolled at the University of Toronto Mississauga during the academic year 2020-2021.The survey results show that most students are concerned about the impact of COVID-19 on the ability to meet overall financial obligations or essential needs. Using factor analysis, we further identified relevant matters of subject associated with this concern on subjective financial well-being: 1) concern on tuition costs and financial obligation; and 2) concern on living and traveling costs. The result clearly identifies the associations between university students&amp;rsquo; perceptions of financial well-being and its associated matters, and how these relations differ by students&amp;rsquo; demographic information. We conclude that educational leadership, local community, and the government should use their judgement to reduce students&amp;rsquo; financial distress by offering different types of financial supports with regards to student demographics.

Purpose– The purpose of the paper is to identify the determinants of the probability of living beyond one’s means. The paper also explores the coping mechanisms of those financially distressed as well as the debt taking behaviour of consumers.Design/methodology/approach– The study uses data obtained from the OECD International Network on Financial Education pilot study on Measuring Financial Literacy in 2010 for the case of Malaysia. A logistic regression model is used to identify the main determinants of the probability that a consumer will live beyond his/her means. The analysis is carried out by using a set of socio-economic factors and the individual’s financial behaviour and attitudinal characteristics as explanatory variables.Findings– The findings indicate that low income and seasonal income earners are more vulnerable to financial distress. Furthermore, having a higher education, higher financial knowledge and prudent financial behaviour and attitude do not necessarily translate into better financial management. Family and friends provide the main source of financial assistance in times of need.Research limitations/implications– The assessment of financial knowledge should go beyond individual’s knowledge on financial concepts and theories. Practical knowledge on financial and cash flow management should be assessed.Practical implications– The study reiterates the importance of financial education. It is imperative to include financial education as part of the schools’ curriculum and also to be incorporated as part of the Continuous Professional Development modules for working adults.Originality/value– The study is based on the first nationwide study of consumer finances in Malaysia. It contributes to the literature by integrating financial behaviour and attitudinal factors into the analysis of the ability of individuals to live within their means. The findings also show the limitations of the existing self-assessment of financial behaviour and attitude and the assessment of financial knowledge.