Differences In Employment Status Research Articles

Is South Africa being spared the global opioid crisis? A review of trends in drug treatment demand for heroin, nyaope and codeine-related medicines in South Africa (2012–2017)

IntroductionSouth Africa has seen a sharp increase in treatment admission trends for opioids despite beliefs that rates of opioid use remain low and do not represent a major problem. To advocate for the extension of Opioid Use Disorder (OUD) treatment and harm minimisation services in South Africa, better estimates of the extent of opioid use is needed. This paper responds to this need by describing (i) trends in treatment utilization for opioid-related problems in South Africa and (ii) differences in the profile of patients accessing treatment for different classes of opioids - heroin, ‘nyaope’ and codeine use. MethodsData were collected from 83 specialist treatment centres participating in the South African Community Epidemiology Network on Drug Use between 2012 and 2017. Descriptive analyses were conducted to describe the sociodemographic profile of patients and multiple logistic regression was used to explore socio-demographic and clinical factors associated with admission to treatment for opioid use disorders (OUD) . ResultsFrom January 2012 to December 2017, data from 11 2032 treatment episodes were collated. Of these, 20 319 (18.1%) were from patients admitted for an OUD. Over time, the proportion of overall opioid-related admissions increased significantly from 16.1% of all admissions in 2012 to 20.0% in 2017 (p <0.001). Data also suggests a significant increase in the overall proportion of patients reporting injection drug use, from 1.6% in 2013 to 3.5% in 2017 (p <0.001). Clear differences in employment status, referral sources between classes of opioids were also noted. ConclusionOver the last 5 years, South Africa has seen an increase in the proportion of opioid related disorders (OUD) treatment admissions. Public health interventions, evidence-based harm reduction approaches and improving access to treatment are among the interventions urgently needed to reduce the harms associated with the increased use of opioids in South Africa.

Long-Term Employment Outcomes among Female Cancer Survivors.

Advances in early detection and treatment have led to a growing population of female cancer survivors, many of whom are of working age. We examined the relationship between cancer and long-term (>5 years) employment outcomes in a nationally representative sample of working-age women in the United States. Data from nine waves of the Health and Retirement Study were used to examine employment status and weekly hours worked among cancer survivors (n = 483) and women without cancer (n = 6605). We used random slope regression models to estimate the impact of cancer and occupation type on employment outcomes. There was no difference in employment status between cancer survivors and women without cancer at baseline; however, during follow-up, cancer survivors were more likely to be employed than women without cancer (odds ratio (OR) = 1.33, 95% confidence interval (CI): 1.11–1.58). Among 6–10-year survivors, professional workers were less likely (OR = 0.40, 95% CI: 0.21–0.74) to be employed than manual workers. Among >10-year survivors, professional workers averaged fewer weekly hours worked (−2.4 h, 95% CI: −4.4–−0.47) than manual workers. The impact of cancer on long-term employment outcomes may differ by occupation type. Identifying the occupation-specific mechanisms associated with the return to work will be critical to developing targeted strategies to promote employment in the growing female cancer survivor population.

Marriage and fertility rates of Japanese women according to employment status: An age-period-cohort analysis

Objectives This study aimed to examine employment status differences in the marriage and fertility rates of Japanese women via an age-period-cohort (APC) analysis.Methods We used data collected from 1995 to 2015 in Japan based on the government's "Report of Vital Statistics: Occupational and Industrial Aspects," which recorded the marriage rates of unmarried adults and fertility rates of married adults-according to their employment status. A Bayesian APC analysis was performed to identify changes in marriage and fertility rates based on three effects: age, period, and cohort. Finally, we calculated the marriage and fertility rate ratios between non-employed and employed women for each age group, period, and cohort.Results The APC analyses showed that the period effect on marriage rates for non-employed women decreased during the periods analyzed, while that for employed women increased from 2005. Meanwhile, the period effect on fertility rates increased regardless of employment status, albeit to a larger degree for employed women. The cohort effect on marriage rates began to decrease from cohorts born in the 1960s for non-employed women, and from cohorts born in the 1970s for employed women. And the degree of the decrease was larger among non-employed women than those employed. Meanwhile, the marriage rate ratio increased from 0.46 (95% CI: 0.21, 0.90) in the cohort born between 1946 and 1950 to 1.00 (95% CI: 0.45, 1.92) in the cohort born between 1991 and 1995. Finally, the fertility rate ratio increased from 0.31 (95% CI: 0.12, 0.69) in the cohort born between 1946 and 1950 to 0.38 (95% CI: 0.14, 1.81) in the cohort born between 1991 and 1995.Conclusion Employment status differences in the marriage rates of unmarried adults and fertility rates of married adults decreased among younger Japanese cohorts and in recent years. By contrast, there were statistically significant differences in fertility rates of married adults based on employment status, even in cohorts born more recently.

Association between patient psychosocial characteristics and receipt of in-center nocturnal hemodialysis among prevalent dialysis patients.

Compared to traditional in-center hemodialysis (HD), in-center nocturnal dialysis (INHD) is characterized by longer sessions and nighttime administration, which may lead to better outcomes for some patients. Given the importance of patient choice in the decision to initiate INHD, we explored associations between patients' psychosocial characteristics and their receipt of INHD. Among hemodialysis patients at a medium-sized dialysis organization, we identified INHD patients as those for whom ≥80% of dialysis sessions were INHD sessions-starting at 6:30 pm or later and lasting ≥5 hours-over the 3 months (≥20 sessions total) after their first INHD session. We extracted dialysis session data from electronic medical records and psychosocial data from social worker assessments. We tested associations of patients' psychosocial characteristics-as well as demographic and clinical characteristics-with INHD receipt among all hemodialysis patients (INHD and HD) in bivariate analyses and multivariable logistic regression models. Among 759 patients with complete data, we identified 47 (6.2%) as INHD patients. On average, these patients were more likely than HD patients to be employed (full-time 10.6% vs. 5.2%; part-time 17.0% vs. 4.2%; P < 0.001), and they were significantly less likely to require ambulatory assistance (14.9% vs. 39.6%, P < 0.001). In multivariable regressions, we found that part-time employment (versus being unemployed) was associated with a 7.1 percentage-point higher likelihood of being an INHD patient (P = 0.01), and the negative association with ambulatory assistance needs approached statistical significance (P = 0.056). No other psychosocial factors included in this main regression analysis were statistically significantly associated with INHD patient status. Researchers comparing the outcomes of patients undergoing INHD versus other treatment modalities will need to account for differences in employment status-and other factors like requiring ambulatory assistance and age which may predict the ability to work-between INHD users and comparison patients to avoid bias in estimates.

Understanding Key Drivers of Staff and Manager Engagement: Linking Research to Leadership

Nurse managers, within a 33-bed pediatric intensive care unit, were concerned about decreased levels of frontline nurse engagement such as poor attendance at unit-based council meetings, slower adoption of unit initiatives, and fewer volunteers to fill vacancies in hospital-wide councils. A descriptive comparative research study was conducted to describe staff engagement and its association with demographic indicators. Research findings guided nurse managers toward development and implementation of action plans that included promotion of authentic leadership and application of leadership strategies toward understanding generational and employment status differences.

Employment pathways of cancer survivors-analysis from administrative data.

The incidence of cancer and its survival rate have been increasing worldwide, resulting in a greater number of cancer survivors. Since one's job often forms a central basis for self-esteem and provides financial security, knowing whether and how cancer can affect the employment of employed cancer survivors are important issues. While the past studies generally used survey data, this study utilizes pre-existing administrative data and employs the difference-in-differences model. We take newly diagnosed cancer patients in 2012, aged from 15 to 60years and employed upon diagnosis, as the study group (N = 12694) and the propensity-score matching-adjusted non-cancer employed population as the control group. Monthly employment information for 2011-2014 was retrieved for both groups. We define the pre-event period as the months before the diagnosis and the post-event period as the months from the diagnosis and afterwards. A pseudo-date symbolizing the index point for cancer diagnosis is assigned to the control group. The logistic regression results show that the impact of cancer on the employment status of cancer survivors is significantly negative for both genders. However, if the differences in employment status between the study and control groups prior to the incidence of cancer are significant, then some past research that used only post-period observations might have rendered biased estimates. The employment pathways indicate that 88% of female cancer survivors employed upon diagnosis continue to work during the full 12months after diagnosis. Further analyses on earnings demonstrate the possibility of cancer survivors retaining their job, but at lower pay.

The impact of vocational training on transition-aged adults

PurposeThe purpose of this paper is to examine the difference in attaining and maintaining employment between transition age youth (ages 19–22) with emotional and behavioral disorders (EBDs) completing and not completing vocational training.Design/methodology/approachA quantitative causal-comparative research design using existing data extracted from the National Longitudinal Transitional Study-2 (NLTS-2) via a restricted data use license issued by the National Center Special Education Research, Institution of Education Sciences, US Department of Education. One-way ANCOVA and multiple regression analysis with one independent variable and six control variables were used for the study.FindingsThe results showed there is a significant difference in employment status between transition age youth with EBDs completing vocational training as compared to non-completion of vocational training, controlling for gender, race, age, mental health services, academic achievement and prior work experience. Individuals who completed vocational training are more likely employed after two years, than those who had not completed vocational training.Originality/valueThe outcomes of the study showed that vocational training during the transitional period had a positive impact on outcomes such as employment status, participation in job skills programs and perceived preparedness for employment. These findings support the idea that vocational training during the secondary school period is an effective way to scaffold support for the transitional period. As a result, these findings justify the use of vocational training as part of the transitional preparation for students with emotional and behavioral disorders.

Influence of Employment on Quality of Life Outcomes Among People with HIV/AIDS in Rural Appalachia

The development of highly active antiretroviral therapy (HAART) has shifted human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) from an acute to a chronic condition. Due to reduced fatality, approximately 1.1 million people living with HIV/AIDS (PLWHA) are faced with increased longevity in conjunction with functional consequences associated with chronic disability. Employment has been associated with increased treatment adherence, quality of life (QoL), and mental and physical health for people living with HIV/AIDS. The purpose of this study was to determine the relationship between employment status and QoL for PLWHA. Participants included 115 patients receiving services from two Ryan White HIV/AIDS Program (RWHAP) clinics in a rural Mid Atlantic Appalachian region of the U.S. Findings revealed statistically significant differences in employment status on six domains of the World Health Organization’s Quality of Life scale for PLWHA (WHOQOL-HIV-Bref), except for spirituality/religion/personal beliefs. Implications for practice and research are discussed.

労働安全を脅かす因子としての正規・非正規という雇用形態の相違:－日米の事例からの探索的検討－

労働安全を脅かす因子としての正規・非正規という雇用形態の相違:－日米の事例からの探索的検討－

The health of single mothers and fathers in Germany.

In every fifth family in Germany, one parent lives alone with children in the household. Life as a single parent is often marked by challenges that include adopting sole responsibility for the child's education and care, alongside employment commitments, and the difficulties of reconciling work and family life. Moreover, despite comparatively high employment rates, single parents - and their children - are greatly affected by poverty. This paper compares the health of single parents and parents living in partnership and analyses the extent to which single parents' health varies according to their socio-economic and employment status, and social support. The analysis was conducted using data from the German Health Update (GEDA) study in 2009, 2010 and 2012 on fair or poor self-rated general health, as well as depression, back pain, obesity, smoking, sporting inactivity and the non-utilization of dental check-ups. The analyses are based on data from 9,806 women and 6,279 men living in a household with at least one child under the age of 18. The study identified a significantly higher prevalence for all health indicators (apart from obesity) among single mothers compared to mothers living with a partner. In the case of single fathers, higher prevalences were found for depression, smoking and the non-utilization of dental check-ups. On average, the lower socio-economic status of women can explain a certain proportion of the health impairment of single parents, but not for men. However, a lower socio-economic status or social support do not account for the health impairments of single parents. Therefore, the higher prevalence of health impairments among single parents cannot simply be attributed to differences in employment status or to lower levels of social support; rather, certain health indicators show a cumulative effect between single-parents status and the social factors mentioned above. The results presented here provide a differentiated view of the relationship between the health and social situation of single parents. Improving the financial position of one-parent families and making it easier to reconcile work and family life are important steps that would help improve the health of single parents.

Employment Status and Sick Leave After First-Time Implantable Cardioverter Defibrillator Implantation: Results From the COPE-ICD Trial.

In the Copenhagen Outpatient Programme-Implantable Cardioverter Defibrillator (COPE-ICD) Trial, a positive effect from a cost-saving, comprehensive cardiac rehabilitation program was found on physical and mental health in patients with ICDs. In the context of the COPE-ICD Trial, the aims of this study is to investigate (a) employment status after ICD implantation, (b) the number of sick days related to ICD implantation, (c) differences in employment status and sick days between rehabilitation and usual care groups, and (d) predictors of employment status and sick leave. Patients with first-time ICD implantation were randomized to comprehensive cardiac rehabilitation or usual care. One year after ICD implantation, patients answered questions about employment status and sick leave. Differences were tested using the Student t test and the χ test. Predictors of employment status and sick leave were tested using logistic regression and linear regression models. A total of 196 patients were randomized. The questionnaire was completed by 138 patients (70%). In total, 47% had worked before ICD implantation. After 1 year, 81% were still working and their mean (SD) number of sick days was 33.8 (58.3). Age 60 years or younger and secondary ICD indication were predictors of working after 1 year. Patients with secondary ICD indication had more sick days and patients who were not married had fewer sick days. Most patients who worked before ICD implantation returned to work after the ICD was placed. Those who were married and had an ICD for secondary prevention took more sick days after the ICD than did those without these characteristics. Those who were younger and have a secondary indication ICD were more likely to be working 1 year after ICD implantation.

Employment status five years after a randomised controlled trial comparing multidisciplinary and brief intervention in employees on sick leave due to low back pain.

To evaluate differences in employment status, during a five-year follow-up period in patients on sick leave due to low back pain who had participated in a trial comparing a brief and a multidisciplinary intervention. From 2004 to 2008, 535 patients were referred to the Spine Centre at the Regional Hospital in Silkeborg if they had been on sick leave for 3-16 weeks due to low back pain. All patients underwent a clinical examination by a rehabilitation physician and a physiotherapist, and were randomised to either the brief intervention or the multidisciplinary intervention. The outcome was employment status from randomisation to five years of follow-up and was measured by the mean number of weeks in four different groups of employment status (sequence analysis) and a fraction of the number of weeks working (work participation score) that were accumulated over the years. A total of 231 patients were randomised to the brief intervention and 233 patients to the multidisciplinary intervention. No statistically significant differences in the mean weeks spent within the different employment statuses were found between the two intervention groups. After five years of follow-up, participants in the multidisciplinary intervention had a 19% higher risk of not having a work participation score above 75% compared to participants in the brief intervention. After five years of follow-up no differences in employment status were found between participants in the brief and the multidisciplinary intervention.

Apprentice or Student? The Structures of Construction Industry Vocational Education and Training in Denmark and Sweden and their Possible Consequences for Safety Learning

There is a notable difference in occupational injury rates in the two Scandinavian countries, Sweden and Denmark, with the latter having a 40% higher rate of fatal occupational injuries in the construction industry. This study explored differences in the vocational education and training (VET) systems between Sweden and Denmark that may be important for students’ safety learning and practice during VET. In both countries, students participate in full-time education, and the curriculum includes school-based as well as company- based training. However, during company- based training Swedish students retain their student status, whereas Danish students are employed as apprentices. From a perspective of viewing safety as a social practice developed through interactions of different social and institutional bodies, the analysis points to this difference in employment status as important for their safety practices and also for the teachers’ position to influence safety learning and practices during company-based training. An analysis of interview and survey data focusing on how VET students enact safety ‘knowings’ across learning sites, suggest how different forms of connectivity models in VET promote various forms of safety learning among students.

A 6-year Follow-up survey of health status in middle-aged women with Turner syndrome.

Studies suggest younger women with Turner syndrome (TS) have good quality of life. Less is known about everyday functioning in adults with TS. In a 6-year follow-up study, multiple areas of functioning were compared between TS women and controls. Women with TS and controls were mailed a self-report survey 6 years after a baseline study. Fifty-seven women with TS (M age 40·6 ± 11·1 years) and 101 controls (M age 38·8 ± 10·6 years, ns) responded. Measures of background information, experienced life strain and presence/impact of health conditions were developed for this study. The QPS Nordic measured perceived workload challenges. The LiSat-9 measured life satisfaction. The Rosenberg Self-Esteem Scale measured self-esteem. More TS women lived alone, fewer had biological children, and more had adoptive children. TS women reported fewer sex partners and less sexual confidence. Controls had higher education. There was no difference in employment status. More TS women received disability pensions. TS women reported their work as more physically challenging, less positively challenging and requiring less knowledge skills. TS women experienced more life strain in school, adolescence and late working life. Controls reported higher overall life satisfaction, with no difference between samples on specific domains. TS women reported lower self-esteem. For TS women only, physical health at baseline predicted length of education and mental health at baseline predicted self-esteem. Women with TS face more challenges than controls on several domains of functioning. Early physical and mental health may influence later educational achievement and self-esteem for women with TS.

Challenges of Nikkei Peruvian Second Generation in Japan: An Overview of Their Employment Status after the Lehman Shock 2008

This article analyzes the second generation of Nikkei Peruvians who are residing in Japan to overcome their employment status from the first generation of Nikkei unskilled workers. Using the mix methodology (Qualitative & Quantitative) the paper describes the main characteristic of Nikkei Peruvian second generation after the financial crisis 2008, and focus in the main variables that influence their differences in employment status. The study involved the interview made since 2009 from the first generation Nikkei Peruvian to the second generation Nikkei Peruvian during 2015. They were asked to answer a socio-economic questionnaire and deep interview. Results of the study demonstrate that the main characteristics for Nikkei Peruvian second generation living in Japan are gender, civil status, place of birth, age group, study, social aid and employment status. Unlike the first generation unskilled workers the second generation employment status differs case by case due to their Japanese background. Even though some percentages of second generation continue as unskilled workers in Japanese factories even their social and human capital differs from the first generation of Nikkei Peruvian. The main differences between factory and no factory workers have to do with their civil status, age group, study status, and social aid. The second generation with background of two cultures and two languages who become unskilled workers means that their human and social capital as a bridge of two cultures will be devalued that would be consider by local government.

RURAL - URBAN DIFFERENCES IN HEALTH CARE QUALITY ASSESSMENT.

Aim:To determine the rural–urban differences in primary care practice, hospital inpatient care and total services.Methods:This cross-sectional study used data from Zenica-Doboj Canton in Federation of Bosnia and Herzegovina (FBiH). The overall sample size for the study was 1,995. Individual interviews were conducted in one randomly selected day of the week, except Monday and Friday, on the basis of EUROPEP (European Task Force on Patient Evaluations of General Practice Care) standardized questionnaire.Results:Out of total number (n=1 995), 47.9% was urban population and median of age was 42 years for both populations. The most of urban residents (81.4%) had finished high school or higher education compared with rural residents (58.5%) (p < 0.001). There are significant differences in employment status between rural and urban population (p < 0.001). Rural residents are more likely to travel more than 15 minutes to see their health facilities compared with urban residents (61.7% vs. 24.4%, respectively). Median of distance (kilometers) from residence location to the nearest hospital was statistically significantly higher in rural Me = 8.0 (5.0 do 14.5) km compared to urban population Me = 1.5 (1.0 to 3.0) km (p < 0.001). The rural population was more likely to buy drugs for medical treatment (p < 0.001) and parenteral injections in primary care practice (p < 0.001).Conclusion:There are significant differences in the overall health care assessment of rural populations as compared to urban populations.

Relation Analysis among the Discriminatory Experience, Job Satisfaction and Life Satisfaction of Disabled Workers: Focusing on Gender and Employment Status Differences

Relation Analysis among the Discriminatory Experience, Job Satisfaction and Life Satisfaction of Disabled Workers: Focusing on Gender and Employment Status Differences

Patients with persistent medically unexplained physical symptoms: a descriptive study from Norwegian general practice.

BackgroundFurther research on effective interventions for patients with peristent Medically Unexplained Physical Symptoms (MUPS) in general practice is needed. Prevalence estimates of such patients are conflicting, and other descriptive knowledge is needed for development and evaluation of effective future interventions. In this study, we aimed to estimate the consultation prevalence of patients with persistent MUPS in general practice, including patients’ characteristics and symptom pattern, employment status and use of social benefits, and the general practitioners’ (GPs) management strategy.MethodDuring a four-week period the participating Norwegian GPs (n = 84) registered all consultations with patients who met a strict definition of MUPS (>3 months duration and function loss), using a questionnaire with simple tick-off questions. Analyses were performed with descriptive statistics for all variables and split analysis on gender and age.ResultsThe GPs registered 526 patients among their total of 17 688 consultations, giving a consultation prevalence of persistent MUPS of 3%. The mean age of patients was 46 years, and 399 (76%) were women. The most frequent group of symptoms was musculoskeletal problems, followed by asthenia/fatigue. There was no significant gender difference in symptom pattern. Almost half of the patients were currently working (45%), significantly more men. The major GP management strategy was supportive counseling.ConclusionA consultation prevalence rate of 3% implies that patients with persistent MUPS are common in general practice. Our study disclosed heterogeneity among the patients such as differences in employment status, which emphasizes the importance of personalized focus rather than unsubstantiated stereotyping of “MUPS patients” as a group.

Gender Differences in Functional Health: Latent Curve Analysis Assessing Differential Exposure

To examine gender difference in trajectories of functional limitations among middle-aged and older adults using a comprehensive set of predictors and method not previously used to examine this topic. Two-part latent curve models were used to analyze data from the Health and Retirement Study. These models differentiate the occurrence of limitations from the number of limitations at both baseline and over time. Females had 3.70 times greater odds of having any limitations and had 28% more limitations at baseline compared with males, but there was no gender difference in the onset of limitations over time or in the number of limitations over time. Differences in employment status, income, wealth, depressive symptoms, arthritis, cancer, and eyesight partially explained the gender gap. Females are disadvantaged in terms of occurrence and number of limitations at baseline but the gender gap remains stable over time, suggesting differences occur before late-middle and old age. Females' lack of full-time employment, and lower levels of income and wealth translate into worse functional health. It is important to improve the socioeconomic status of females while also addressing the health conditions that contribute to functional limitations for males and females.

Sleep in remitted bipolar disorder: A naturalistic case-control study using actigraphy

IntroductionFindings from actigraphic studies suggesting that sleep and circadian rhythms are disrupted in bipolar disorder (BD) patients have been undermined by methodological heterogeneity and the failure to adequately address potential confounders. MethodTwenty-six euthymic BD cases and 29 healthy controls (HC), recruited from University Paris-Est and matched for age and gender, were compared on subjective (Pittsburgh Sleep Questionnaire Inventory; PQSI) and objective (mean scores and variability in actigraphy) measures of sleep as recorded by over 21 consecutive days. ResultsMultivariate generalized linear modelling (GLM) revealed significant differences between BD cases and HC for five PSQI items (total score and four subscales), four actigraphy variables (mean scores) and five actigraphy variability measures. Backward stepwise linear regression (BSLR) indicated that a combination of four variables (mean sleep duration, mean sleep latency, variability of the fragmentation index over 21 days, and mean score on PSQI daytime dysfunction sub-scale) correctly classified 89% of study participants as cases or controls (Chi-square=39.81; df=6; p=0.001). LimitationsThe sample size (although larger than most actigraphy studies) and incomplete matching of cases and controls may have influenced our findings. It was not possible to control for potential effects of psychotropic medication or differences in employment status between groups. ConclusionsWhen potential confounders of sleep and circadian profiles are adequately taken into account (particularly age, gender, daytime sleepiness, mood symptoms, body mass index, and risk of sleep apnoea), a selected subset of quantitative (mean scores) and qualitative (variability) features differentiated euthymic BD cases from HC.