Employment Status Research Articles

Work Engagement and Performance of Romanian School Teachers During the COVID-19 Pandemic: The Impact of Sociodemographic and Contextual Factors

The pandemic has led to significant changes in teaching environments, which may have affected teacher engagement and performance. The aim of the paper is to investigate the levels of work engagement (WE) and work performance (WP) during the pandemic among teachers in primary and lower secondary schools in Romania and to identify if the dimensions of these two concepts differ according to gender, age, residence, status, teaching degree, and course profile, filling a gap in the specialized literature regarding these variables in Romanian education. We conducted a survey between February and March 2022 on a sample of 1051 teachers using the Utrecht Work Engagement Scale (UWES) and the Individual Work Performance Questionnaire (IWPQ 0.3). Teachers reported a high level of engagement and work performance, higher levels of WE being identified among female teachers and those teaching in rural areas. Younger teachers showed the lowest work engagement, despite their familiarity with the digital tools used during the COVID-19 pandemic. Interestingly, while gender and employment status did not have a significant impact on job performance, contextual performance was higher among tenured teaching staff and women. In addition, the profile of subjects taught significantly affected engagement and performance. The results of this research can contribute to a more dynamic and supportive educational system, ultimately leading to improved outcomes for teachers and students.

Frequency and clinical associations of common mental disorders in adults with high-grade glioma-A multicenter study.

One third of adults with cancer suffer from common mental disorders in addition to their malignant disease. However, it is unknown whether this proportion is the same in patients who have brain tumors and which factors modulate the risk for psychiatric comorbidity. In a multicenter study, patients with high-grade glioma at 13 neurooncology clinics were enrolled consecutively and interviewed with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (SCID) to diagnose common mental disorders. Predictors of psychiatric comorbidity were investigated using binary logistic regression. Six hundred ninety-one patients were interviewed. The proportion of patients who had mental disorders was 31% (95% confidence interval [CI], 28%-35%). There was evidence for an association of psychiatric comorbidity with the following factors: younger age (odds ratio [OR], 1.9; 95% CI, 1.1-3.4; p = .04), stable disease versus complete remission (OR, 1.7; 95% CI, 1.1-2.8; p = .04), lower income (OR, 1.7; 95% CI, 1.0-2.8; p = .04), living alone (OR, 1.6; 95% CI, 1.0-2.6; p = .05), fatigue (OR, 1.6; 95% CI, 1.1-2.4; p = .03), and impaired cognitive functioning (OR, 2.3; 95% CI, 1.5-3.6; p < .01). There was no evidence for independent effects of gender, histology, affected lobe, time since diagnosis, or employment status. Approximately one third of adult patients with high-grade glioma may suffer from a clinically relevant common mental disorder, without notable disparity between the genders. In particular, clinicians should pay attention to possible comorbidities for cases in which patients exhibit compromised subjective cognitive function, are younger than 50 years, maintain a state of stable disease, or live alone.

A Prospective Evaluation of Health Literacy Levels of Pregnant Women in Antenatal Classes: Impact on Delivery Outcomes in Nulliparous and Multiparous Women

Backgrounds/Objectives: Modern technology and educational activities, such as antenatal classes (ACs), increase patient informedness in medicine and improve collaboration between physicians and patients. The present study aimed to evaluate and compare the impact of maternal health literacy (HL) on delivery outcomes between nulliparous and multiparous women who attended antenatal classes. Methods: This prospective study recruited 281 pregnant women who regularly attended ACs, but only 188 who gave birth at our academic tertiary hospital were included in the final analysis. Socio-demographic characteristics, peripartum data (cervical dilatation at the time of admission to the hospital, duration of labor, and mode of delivery), and obstetric interventions (cesarean section (C/S) rate and rate of instrumental vaginal birth and episiotomy) were recorded, and the level of HL was assessed using the European Health Literacy Survey Questionnaire (HLS-EU-Q16). HL levels did not significantly affect peripartum and postpartum outcomes. Results: The study results showed that HL levels did not impact labor duration and newborn Apgar scores (p &gt; 0.05). Patient education levels and employment status affected the peripartum duration of labor (p = 0.048 and p = 0.001, respectively). There were no differences in the HL total score and subscale scores (p &gt; 0.05) between nulliparous and multiparous patients, and the rate of primary C/S was similar in both groups. Conclusions: HL levels did not impact delivery (peripartum) outcomes in pregnant women who attended antenatal classes. However, the primary C/S rate was similar between the nulliparous and multiparous groups, which may indicate that antenatal education services can correct the negative impact of low HL levels on the primary C/S rate.

Character strengths and employment in persons with disabilities: a national survey study

ABSTRACT This study explores the latent classes of character strengths within individuals with disabilities, seeks to understand the unique characteristics of each class, and examines the relationship between their class membership and employment status. Our data consisted of 11,699 people with disabilities. The results showed that five profiles best met the criteria. Of the 11,669 participants with disabilities, 1,947 (16.69%) were classified in Latent Profile 1 (Compassionate CS Utilizers), 1,422 (12.19%) were classified in Latent Profile 2 (Profound CS Utilizers), 2,704 (23.17%) in Latent Profile 3 (Creative CS Utilizers), 1,606 (13.76%) in Latent Profile 4 (Discerning CS Utilizers), and 3,990 (34.19%) in Latent Profile 5 (Minimalist CS Utilizers). Controlling for other predictors, Latent Profile 5 (Minimalist CS Utilizers) was associated with a 15.3% decrease in the odds of employment compared to Latent Profile 1 (Compassionate CS Utilizers). Clinical and research implications are discussed.

Determining the Relationship Between Sleep Problems, Shock Pain, and Shock Anxiety in Patients With ICD.

This study aimed to determine the relationship between sleep problems, shock pain, and shock anxiety in patients with implantable cardioverter defibrillator (ICD) and the affecting factors. The population of this descriptive cross-sectional study consisted of all patients who underwent ICD implantation in university hospital (N = 200), and the sample consisted of patients who met the inclusion criteria of the study (n = 132). Data were obtained using a "General Information Form", the "Florida Shock Anxiety Scale (FSAS)", the "Epworth Sleepiness Scale (ESS)", the "Pittsburgh Sleep Quality Index (PSQI)", and the "Visual Pain Scale (VPS)". The mean age of the patients was 66.13 years. The VPS was 6.40±3.36; the mean FSAS score was 29.98±8.46; the mean PSQI score was 8.02±3.81; the mean ESS score was 7.59±4.10. PSQI had a statistically significant correlation with the total FSAS score (p<0.001) and a statistically insignificant correlation with ESS (p>0.001). Age, sex, marital status, smoking status, cohabitants, previous ICD shocks, the status of lying on ICD, and fear of dislocation of ICD affected the total FSAS score; sex, employment status, history of heart attack, defined sleep disorder, awakening from sleep due to nightmares, and cessation of breathing during sleep affected the total PSQI score; history of previously defined sleep disorder, history of heart attack, use of medication for a sleep disorder, the pain felt when lying on ICD, and pain experienced during ICD shocks affected the total ESS score. The mean shock VPS scores differed between patients who received an ICD shock during sleep and those who were awakened by nightmares. It was found that the shock anxiety and shock pain scores of ICD patients were above average, that they had poor sleep quality, and that their sleepiness was at the level of "normal but increased daytime sleepiness".

Association Between Employment Status and Mental Health of People: An Evidence-Based Analysis in The Post Covid-19 Era

The COVID-19 pandemic has inflated many megacities in the world and petrified the mental health of people. Mental health complications of people during this pandemic were spread at different levels. This situation created the ground for this study to see whether the employment status of people was in line with fluctuating mental health conditions in Dhaka City Corporation during this invasion or in the&amp;nbsp;immediate past. It was a cross-sectional study that applied a multistage sampling method to define sample size. It selected the participants randomly and collected data through a self-administered structured questionnaire. This questionnaire was based on the DASS-21 to measure the conditions of mental health stability. Different statistical tools, including cross-tabulation, were used to reveal the association between the variables, and a chi-square test was conducted to examine the significance of such association. The findings of the study exposed the stern predisposition of mental health situations to employment status in the Dhaka City Corporation during and immediately after the COVID-19 invasion, which was at different levels depending on their demographic attributes. Thus, the findings have a significant conclusion that taking preventive measures for the employment security of people is essential to maintaining their mental health in the future. However, it could also be said that keeping this study only in urban areas and among educated people is a limitation, though such a limitation has opened further sites for potential studies.

Over-education rates and predictors of entry-level jobs in Türkiye

This research aims to determine the proportion of overeducated individuals with higher education levels compared to their colleagues who are graduates of associate, undergraduate, and postgraduate education but work at the same status in entry-level jobs. Overeducation rates in entry-level jobs in Türkiye were determined using the Turkish Statistical Institute (TUIK) Household Labor Force Surveys (2014-2019) microdata set. The job analyst measure was used to determine the rate of overeducation. Logistic regression data analysis was conducted to classify the variables that predict the state of being overeducated with the TUIK 2019 Household Labor Force Survey. According to the findings, overeducation rates increased gradually over the years by 8.02% in 2014, 8.98% in 2015, 9.78% in 2016, 10.43% in 2017, 11.00% in 2018, and 12.5% in 2019. For the state of being overeducated, various demographic variables were analyzed and predicted, such as income, age, region, gender, ISCED, marital status, firm size, place of work, additional job searches, ISCO 08 classification, and employment status.

Associations of non-employment with common mental disorder subcomponents among working age population: analysis of national data from 1993, 2000, 2007 and 2014.

Associations between employment status and mental health are well-recognised and such associations may have multiple modifying factors which may also contribute to variations in results. We aimed to investigate associations between non-employment and CMD subcomponents and the extent of their variation across age groups using nationally representative data in Britain. We used a series of national mental health surveys of adults living in private households: the British National Surveys of Psychiatric Morbidity of 1993, 2000, 2007 and 2014. Employment status was the primary exposure of interest. Presence or absence of each fourteen symptoms of common mental disorder (CMD), as the primary outcome, was ascertained identically in all surveys from the revised Clinical Interview Schedule (CIS-R). Odds ratio for the association between exposure and outcome and population attributional fractions (PAFs) for each association was calculated. Within the highest-risk 45 to 54 years age group, all odds ratios were statistically significant and strongest associations were observed with panic symptoms (OR = 2.33), followed by depressive symptoms (1.90), worry about physical health (1.84), depression (1.82), forgetfulness (1.82) and somatic symptoms (1.70). In the 55 to 64 years age group, highest population attributable fractions were observed for non-employment as a hypothetical risk factor for panic symptoms (51.7%), phobias (44.2%), forgetfulness (39.5%), depressive symptoms (38.5%), worries about physical health (37.9%) and somatic symptoms (36.0%). The particularly high impact in middle-aged, pre-retirement groups of non-employment on CMD suggests a policy focus on alleviating stressors and providing support for those made redundant and/or compelled to take unwanted early retirement.

Correlations between Sociodemographic Status, Attitude, Cultural Belief, and Family Support towards Complementary Feeding Practices

Introduction: Proper nutrition is crucial during the first two years of life, as this period is a "critical window" for promoting optimal growth, health, and behavioral development. Complementary feeding refers to the introduction of additional foods and liquids when breast milk alone no longer meets an infant's nutritional needs. Providing adequate and appropriate complementary foods, along with proper feeding practices, can help prevent stunting and promote healthy eating habits. Objective: This study aimed to identify the factors correlated with complementary feeding practices (i.e., MDD, MMF, MAD, and SSSFs) among children aged 6–23 months in Surakarta City. Method: This cross-sectional study involved 110 mothers with children aged 6-23 months. Data were collected through questionnaires interviewed directly to the respondents. The variables in this study included the child’s age, the mother’s age, parity, maternal education level, maternal employment status, attitude, cultural beliefs, and family support. Complementary feeding practices were assessed using the composite indicators such as MDD, MMF, MAD, SSSFs as recommended by the WHO. Result: This study identified that child's age (0.012 (OR: 3.71, CI: 1.28-10.75)), mother's age (0.001 (OR: 9.35, CI: 2.06-42.37)), parity (0.003 (OR: 4.16, CI: 1.54-11.21)), mother's education (0.018 (OR: 3.06, CI: 1.18-7.90)), attitude (0.028 (OR: 4.93, CI: 1.05-23.0)), cultural belief (0.000 (OR: 9.00, CI: 2.52-32.0)), and family support (0.000 (OR: 5.39, CI: 2.17-13.35)) were determinant factors of complementary feeding practice. There was no statistically significant correlation between the mother’s employment status and complementary feeding practices. Conclusion: It is essential to educate mothers on the correct timing and process of transitioning to complementary feeding. Nutrition education should aim to enhance and correct knowledge and beliefs about these practices. Mothers should receive practical guidance on making informed decisions, considering factors such as affordability, availability, access, and the preparation of nutrient-dense foods

Association of unemployment and increased depressive symptoms with all-cause mortality: follow-up study of a cardiovascular prevention programme.

Unemployment has been associated with increased risk of cardiovascular disease (CVD) and all-cause mortality. However, factors behind this association remain unsettled. A primary care CVD prevention programme was conducted in two Finnish towns in 2005-07. Of the participants (n = 4450), a cohort of apparently healthy CVD risk subjects belonging to the labour force (n = 1487) was identified. Baseline depressive symptoms were assessed by Beck's Depression Inventory. Data on employment status and mortality were obtained from official statistics. The effect of employment status and depressive symptoms on all-cause mortality after a median follow-up of 15 years was estimated in models adjusted for age, sex, body mass index, non-high-density lipoprotein cholesterol, physical activity, alcohol use, current smoking, glucose metabolism, and hypertension. In comparison to employed non-depressive subjects, fully adjusted hazard ratio (HR) for all-cause mortality was 3.53 (1.90-6.57) in unemployed subjects with increased depressive symptoms, 1.26 (0.68-2.34) in unemployed non-depressive subjects, and 1.09 (0.63-1.90) in employed depressive subjects. Factors independently associated with mortality were unemployment with increased depressive symptoms [HR 3.56 (95% CI 1.92-6.61)], screen-detected diabetes [HR 2.71 (95% CI 1.59-4.63)], current smoking [HR 1.77 (95% CI 1.19-2.65)], and higher age [HR 1.10 (95% CI 1.05-1.15)]. Unemployment in itself was not associated with all-cause mortality. If unemployment was accompanied with increased depressive symptoms, risk of death was significantly elevated.

“Sweeten the (i)-deal”: unveiling power and influence dynamics in family small and medium-sized enterprises

PurposeFamily small and medium-sized enterprises (SMEs) represent a substantial part of many economies. In these organizations, close and informal relationships between employers and employees often foster a mutual understanding of each other’s needs, facilitating the negotiation of idiosyncratic deals (i-deals), special employment conditions tailored for individual employees. However, research on how i-deals are negotiated in family SMEs, especially regarding power dynamics and influence, remains limited. This study aims to identify the types of i-deals negotiated in family SMEs and explore the role of power and influence in these negotiations.Design/methodology/approachSemi-structured interviews were conducted with 45 employees and 15 employers from Spanish family SMEs. Data were analyzed using ATLAS.ti 8, and thematic analysis was performed.FindingsThe study concludes that task, flexibility, financial and development i-deals are particularly negotiated in family SMEs. It identifies that referent and expert power play an important role in initiating these negotiations. Furthermore, rational tactics are generally employed for negotiating work performance, soft tactics for employment-related aspects and hard tactics for work flexibility. Additionally, the study identified gender differences in the negotiation of i-deals.Research limitations/implicationsThis study enhances i-deal literature by highlighting the distinct characteristics of family SMEs and their impact on i-deal negotiations. The findings suggest that power dynamics and influence tactics in family SMEs differ from those in larger firms. Moreover, certain i-deals may encounter resistance due to concerns about organizational performance and economic implications. Understanding these factors is essential for developing effective negotiation strategies in family SMEs.Originality/valueThis study offers a dual perspective, analyzing the power and influence tactics used by both employees and employers in family SME i-deal negotiations and highlighting gendered dynamics in these processes.

The effect of energy poverty on gender inequality in Southern Asian countries

Purpose The purpose of this study is to explore the relationship between gender inequality and energy poverty in Southeast Asian countries from 2000 to 2020. The study aims to assess the long-term impact of gender inequality on energy poverty by considering factors such as per capita gross domestic production (GDP), population growth and gross capital formation. By analyzing these variables, the research seeks to shed light on the disproportionate burden women face in energy-poor regions and to provide insights into how addressing energy poverty can promote gender equality and sustainable development in the region. Design/methodology/approach This study uses a dynamic generalized method of moments (GMM) model to analyze the long-term cointegration between gender inequality and energy poverty in Southeast Asian countries. The data, sourced from World Data Indicators, spans from 2000 to 2020, including variables such as GDP, population growth and gross capital formation. Proxy measures for energy poverty and gender inequality were developed using access to electricity, clean cooking technologies and female employment statistics. Stationarity tests and cointegration analyses were conducted to ensure the validity of the results, confirming the relationships among the variables for the region studied. Findings The study finds a significant positive relationship between gender inequality and energy poverty in Southeast Asian countries. Higher levels of gender inequality are associated with increased energy poverty, with women disproportionately affected due to reliance on traditional cooking methods. The dynamic GMM model confirms this long-term cointegration, showing that economic growth initially increases energy poverty but reduces it as nations invest in sustainable energy. Population growth has a negative association with energy poverty, suggesting that development and infrastructure improvements mitigate its effects. These findings highlight the need for gender-sensitive energy policies in the region. Originality/value This study offers a novel contribution by empirically examining the long-term relationship between gender inequality and energy poverty in Southeast Asian countries, an underexplored area in existing literature. Using a dynamic GMM approach, it highlights the disproportionate burden women face due to energy poverty, particularly through traditional cooking methods. The research provides valuable insights into how addressing energy poverty can promote gender equality, offering practical policy recommendations for sustainable development. Its findings serve as a foundation for policymakers to craft gender-sensitive energy interventions that enhance both social equity and economic growth in developing regions.

Parental experiences and perspectives of healthcare providers' genetic testing recommendations for their children diagnosed with autism spectrum disorder in the United States.

Although genetic testing is recommended for all children diagnosed with autism spectrum disorder (ASD) in the United States, it remains unclear how many parents have received and followed these recommendations. This study aimed to assess parental experiences and perspectives of healthcare providers' genetic testing recommendations. A total of 1043 parents of children with ASD from Simons Foundation Powering Autism Research for Knowledge completed an online survey. Only about one-third of the parents (34.2%) reported that their children's providers had recommended genetic testing. Factors associated with whether parents received these recommendations included the type of healthcare providers diagnosing ASD, parents' knowledge of genetic testing, the age of their children's diagnosis, and the presence of certain co-occurring medical conditions in their children. Our study also revealed that most parents (76.9%) who received recommendations had pursued genetic testing for their children. Adherence to the recommendations was associated with the characteristics of the parents (i.e., age and employment status) and children (i.e., gender), and their trust in the information from providers. The findings highlight the critical role of healthcare providers in facilitating genetic testing among families of children with ASD. Healthcare providers are recommended to increase their competencies and practice in providing genetic testing recommendations for ASD, assist parents in navigating testing challenges, and support parents through the testing process.

The Association of Hospital-Cardiologist Integration With Patient Outcomes, CareQuality, and Utilization.

Cardiologists are increasingly moving from independent practice to direct employment by hospitals. Hospital employment has the potential to improve care coordination and delivery, but little is known about its effect on care quality and outcomes. In this study, we sought to assess the association between hospital employment of cardiologists and patient outcomes, care quality, and utilization among patients hospitalized with incident acute myocardial infarction (AMI) or heart failure (HF). We used a sample of Medicare fee-for-service beneficiaries hospitalized with incident AMI or HF from 2008 to 2019. We identified the accountable cardiologists that cared for these patients and determined their employment status by means of tax identification numbers. We used difference-in-differences methods to compare clinical outcomes, quality measures, and utilization for patients treated by hospital-employed cardiologists after switching from independent to hospital-employed practice, to outcomes for patients treated by cardiologists who remained independent. Models were adjusted for time trends and patient, hospital, and cardiologist characteristics. Patient outcomes were in-hospital mortality, 30-day mortality, and 30-day readmission. Quality measures were receipt of: 1) a guideline-recommended test to assess cardiac function; and 2) a 30-day follow-up clinic visit. Utilization measures were length of stay and, for AMI patients, the proportion receiving coronary revascularization. The proportion of U.S. cardiologists employed by hospitals increased from 26% in 2008 to 63% in 2019. We identified 186,052 AMI and 259,849 HF patients cared for by cardiologists who switched to hospital employment and 168,052 AMI and 245,769 HF patients cared for by independent cardiologists. Patient characteristics were similar (mean age 80.8 years; 47% men). We found no significant differences in outcomes (eg, adjusted difference in 30-day mortality 0.03% [95%CI:-0.39% to 0.45%] for AMI patients and-0.05% [95%CI:-0.37% to 0.27%] for HF patients); no differences in most quality metrics except a small increase in the proportion of HF patients with 30-day follow-up (adjusted difference: 1.04%; 95%CI: 0.46%-1.62%); and no differences in utilization between patients treated by hospital-employed cardiologists (postswitch) vs independent cardiologists. Among U.S. cardiologists, there has been a large shift from independent practice to direct employment by hospitals. We found minimal evidence that cardiologist employment by hospitals improves care quality or outcomes.

Information communication technologies and intimate partner violence among women in sub-Saharan African countries

Intimate partner violence is widespread in sub-Saharan Africa with women the usual victims. Efforts to address intimate partner violence (IPV) include interventions with information communication technologies (ICT) that are being used to raise awareness and promote the empowerment of women. Thus, there is a need to examine the relationship between ICT ownership and IPV among women in sub-Saharan Africa. We conducted a cross-sectional study of four countries in sub-Saharan Africa using the Demographic and Health Survey data. Ownership of ICT was the main predictor variable that was measured by ownership of a radio, television, mobile phones, and access to the Internet. The outcome variable was IPV, which was measured in two forms: physical and sexual violence. A multivariable analysis using binary logistic regression was used to examine the association between ownership of ICT devices and intimate partner violence (IPV) among women. In Zambia and Mali, women who own ICT devices were significantly less likely to experience sexual violence than those who did not own ICT devices. Predictors such as age, place of residence, education, wealth status, employment status, number of children and age at first marriage were significantly associated with experiences of IPV, even though the strength of this relationship varied across countries and types of IPV. Access to ICT should be promoted among women because ICT can raise awareness and offer women a platform for receiving social support and advice about coping with intimate partner violence.

Precarious and vulnerable work: The experiences of applied sport psychologists

This article analyzes the vulnerable and precarious nature of applied sport psychology practice. Adopting a longitudinal approach over an 18-month period, data were collected through 41 semi-structured interviews with six applied sport psychologists working across soccer, swimming, and athletics. Interviews took place at 6–8 week intervals, and transcripts were iteratively analyzed with Kalleberg’s theorization of precarity and Kelchtermans’ writings around vulnerability adopted as the primary heuristic devices. Four themes were identified, highlighting how: (a) “precarious employment conditions”; (b) “constrained decision making”; (c) “challenges to demonstrating impact”; and (d) “contrasting beliefs of appropriate practice” typified practitioners’ applied experiences. Our findings and analysis advance discussions about the precarious nature of applied sport psychology work by recognizing some of the inherent structural vulnerabilities that characterize the role. Insights developed from this research have important implications for the profession, including the preparation, development, employment and ongoing support of its workforce.

HPB SO53 - Implementation of High Volume-Low Complexity 'GIRFT' lists for laparoscopic cholecystectomy

Abstract Background Waiting times for elective surgery have risen steadily since 2010, with particularly sharp increases after the Covid pandemic. There have been several initiatives to improve theatre productivity and increase operative numbers and these are broadly encompassed within GIRFT standards and the development of the concept of a High Volume-Low Complexity list. Current GIRFT standards recommend six laparoscopic cholecystectomies on an all-day operating list. This study aimed to describe the development and implementation of these lists within out district general hospital setting and outline the key barriers and solutions for other units to learn from. Method All patients on the waiting list for laparoscopic cholecystectomy were assessed and screened by a panel of consultant surgeons to assess suitability for a HVLC list. Theatre staff, anaesthetists and surgeons were widely consulted within local focus groups and a novel method of remuneration for additional work was developed: a 'cost-per-case (CPC)' remuneration structure was introduced (in contrast to standard remuneration by session time) to ensure productivity and high quality surgery. Operations were carried out on weekend lists in a dedicated accredited Elective Surgical Hub and staff were able to finish the day when all operations were completed. Results CPC lists took place from August 2023 to May 2024. All lists had six laparoscopic cholecystectomies or eight hernia repairs (or a combination) in line with GIRFT standards. Overall 124 cholecystectomies were performed and 119 were completed on a day case basis. The remaining 5 patients had a single night stay. There were no returns-to-theatre or major morbidity. All lists had started by 830AM and the latest finish time throughout the study period was 1525PM. The utilisation of CPC lists contributed to waiting times falling dramatically from over 52 weeks to 28 weeks by the end of the study period. Conclusion By utilising a novel form of remuneration, based on volume of work completed rather than time, we were able to maximise productivity without compromising safety whilst developing employment conditions that encouraged colleagues to perform additional work. Key facets to successful implementation include appropriate screening of cases, allowing staff to leave when the work is completed (rather than have to wait till the end of the day) and standardising equipment and kit to reduce wastage and turnaround time between cases. These lessons can be implemented in any surgical unit to improve productivity and increase volume of cases performed.

Abstract 4128698: Mental Health and Sleep Quality as Determinants of Physical Activity Levels in Depressed Rural Patients with Coronary Heart Disease

Background: Disparities in coronary heart disease (CHD) and other chronic related conditions, such as poor sleep quality and psychological distress, have been observed in rural areas. Both conditions can negatively affect disease progression, possibly through their impact on physical activity. The relationships, however, among sleep quality, psychological distress, and physical activity among depressed rural CHD patients have not been examined. Purpose: The purpose of this study was to determine the association of sleep quality (i.e., sleep fragmentation [frequent sleep interruption] and nocturnal/sleep movement [increased rates of movement, ‘tossing and turning’ during sleep]) and psychological distress (i.e., anxiety and perceived stress) with levels of physical activity (i.e., sedentary, light, and moderate to vigorous) in depressed rural patients with CHD. Methods: A total of 142 depressed rural CHD patients (aged 57.0±11.9 years, 97% White) completed surveys on demographic characteristics, anxiety (Brief Symptom Inventory), and stress (Perceived Stress Scale-4). Participants also wore accelerometer activity monitors for seven days (ActiGraph GT9X Link) to capture physical activity levels and sleep quality. Three different hierarchical regression models were conducted to predict each level of physical activity (sedentary, light, and moderate-vigorous) with predictor variables entered in blocks. Block 1 included demographic variables (i.e., age, sex, marital status, employment status). Block 2 included sleep quality measures, and Block 3 included psychological distress. Results: Participants spent 466±126.0 min/day while awake being sedentary, 483±119.9 min/day in light activity, and 90±65.9 min/day in moderate to vigorous activity. We found that stress was significantly associated with greater sedentary time (B = 6.56, p = .043) and less time in light activity (B = -7.99, p = .024). Nocturnal/sleep movement was significantly associated with increased sedentary time (B = 3.14, p &lt; .001) and decreased time in light (B = -5.29, p =.002) and moderate-vigorous activity (B = -2.58, p = .003). Anxiety was not associated with physical activity. Conclusions: Poor sleep quality and greater perceived stress are associated with a more sedentary lifestyle, a major risk factor for CHD. Addressing both stress and sleep management may play a role in reducing CHD risks associated with inactivity among depressed rural patients with CHD.

Within-person relationship between employment insecurity and mental health: a longitudinal analysis of the Understanding America Study

BackgroundEmployment insecurity is a socioeconomic factor influencing mental health, yet the empirical evidence supporting this claim has important limitations. The fluctuations in employment insecurity throughout the COVID-19 pandemic offered a...

Navigating Parenthood in the Pandemic: Revealing the Trade-offs of Childcare Choices Through Conjoint Analysis

Inequalities that emerged during COVID-19 pandemic highlight the need to examine parent constraints in their decision-making around work and early childhood education and care (ECEC). This paper draws on conjoint survey data from a representative sample of 976 parents from the four largest Canadian provinces to examine the trade-offs parents made regarding their child’s care during the pandemic. Demographic differences in parental income, employment status, and having a child with special needs shaped childcare preferences in different ways. Our analysis finds that the most important factor in parent decision-making was type of ECEC (with a strong preference for licensed arrangements), followed by choices related to health and safety during the pandemic. The conclusion considers policy implications, including the need for more targeted and inclusive approaches that address the varying needs and circumstances of parents to enhance the overall quality and accessibility of care services post-pandemic and beyond.