Lower Likelihood Of Employment Research Articles

Improving Bowel Management in Children With Spina Bifida.

In individuals with spina bifida (SB), bowel incontinence is associated with lower quality of life and lower likelihood of employment. In an effort to maximize bowel continence in children and adolescents, we created a bowel management assessment and follow-up protocol in a multidisciplinary clinic. Here we report the results of this protocol using quality-improvement methodology. Continence was defined as no unplanned bowel movements. Our protocol involved: (1) a standardized 4-item questionnaire about bowel continence and consistency; (2) if the patient was not achieving continence, an intervention starting with oral medication (stimulant and/or osmotic laxatives), and/or suppositories (glycerin or bisacodyl) followed by an escalation to trans-anal irrigation, or continence surgery; and (3) follow-up phone calls at regular intervals to monitor progress and make changes as needed. Results are summarized with descriptive statistics. We screened 178 eligible patients in the SB clinic. Eighty-eight agreed to participate in the bowel management program. Of those who did not participate, the majority (68/90, 76%) were already achieving continence with their bowel regimen. Of children in the program, most (68/88, 77%) had a diagnosis of meningomyelocoele. At 1 year, the proportion of patients who were bowel accident free improved to 46% (vs 22% initially, P = 0.0007). A standardized bowel management protocol, primarily the use of suppositories and trans-anal irrigation to achieve social continence, as well as frequent telephone follow-up, can reduce bowel incontinence in children and adolescents with SB.

Return to Work Among Young Adult Survivors of Allogeneic Hematopoietic Cell Transplantation in the United States

Young adult (YA) survivors of allogeneic hematopoietic cell transplantation (HCT) are at risk for late psychosocial challenges, including the inability to return to work post-HCT. Work-related outcomes in this population remain understudied, however. We conducted this study to assess the post-HCT work status of survivors of allogeneic HCT who underwent HCT as YAs and to analyze the patient-, disease-, and HCT-related factors associated with their work status at 1 year post-HCT. Using Center for International Blood and Marrow Transplant Research data, we evaluated the post-HCT work status (full-time, part-time work, unemployed, or medical disability) of 1365 YA HCT survivors who underwent HCT between 2008 and 2015. Percentages of work status categories were reported at 4 time points: 6 months, 1 year, 2 years, and 3 years post-HCT. Percentages of post-HCT work status categories at the 1-year time point were also described in relation to survivors' pre-HCT work status categories. Factors associated with 1-year post-HCT work status (full-time or part-time work) were examined using logistic regression. From 6 months to 3 years post-HCT, the percentage of survivors working full-time increased from 18.3% to 50.7% and the percentage working part-time increased from 6.9% to 10.5%. Of patients in full-time work pre-HCT, 50% were unemployed or on medical disability at 1 year post-HCT. Female sex (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.40 to 0.77), HCT Comorbidity Index score ≥3 (OR, 0.57; 95% CI, 0.39 to 0.82), pre-HCT unemployment (OR, 0.37; 95% CI, 0.24 to 0.56), medical disability (OR, 0.44; 95% CI, 0.28 to 0.70), development of grade III-IV acute graft-versus-host disease (OR, 0.52; 95% CI, 0.34 to 0.80), and relapse within 1 year post-HCT (OR, 0.34; 95% CI, 0.21 to 0.56) were associated with a lower likelihood of employment at 1 year post-HCT. Compared with myeloablative conditioning (MAC) with total body irradiation (TBI), MAC without TBI (OR, 1.71; 95% CI, 1.16 to 2.53) was associated with a greater likelihood of employment at 1 year post-HCT. Graduate school-level education (OR, 2.47; 95% CI, 1.49 to 4.10) was also associated with a greater likelihood of employment at 1 year post-HCT. Although the work status among YA HCT survivors continued to improve over time, a substantial subset became or remained unemployed or on medical disability. These findings underscore the need for effective interventions to support return to work in this population.

Boys don’t cry (or do the dishes): Family size and the housework gender gap

We here use data from the British Cohort Study (BCS) to link family size to age-16 children’s contribution to household chores and the adult housework gender gap. Assuming that home production is an increasing function of family size and using an instrument to account for the endogeneity of fertility, we show that larger families have a different effect on boys and girls at age 16: girls in large families are significantly more likely to contribute to housework, with no effect for boys. We then show that childhood family size affects the housework gender gap between the cohort members and their partners at age 34. Women who grew up in larger families are more likely to carry out a greater share of household tasks in adulthood, as compared to women from smaller families. In addition, growing up in a large family makes cohort members more likely to sort into households with a wider housework gender gap as adults. We show that the persistent effect of family size is due to the adoption of behaviours in line with traditional gender roles: a lower likelihood of employment and shorter commutes for women, along with a higher employment probability for their partners.

Impact of Comorbid Conditions on Healthcare Expenditure and Work-related Outcomes in Patients With Rheumatoid Arthritis.

To evaluate the effect of comorbid conditions on direct healthcare expenditure and work-related outcomes in patients with rheumatoid arthritis (RA). This is a retrospective analysis of the Medical Expenditure Panel Survey from 2006 to 2015 in 4967 adults with RA in the United States. Generalized linear models were used for healthcare expenditure and income, logistic models for employment status, and zero-inflated negative binomial models for absenteeism. Thirteen comorbid conditions were included as potential predictors of direct cost- and work-related outcomes. The models were adjusted for sociodemographic factors including sex, age, region, marital status, race/ethnicity, income, education, and smoking status. Patients with RA with heart failure (HF) had the highest incremental annual healthcare expenditure (US$8205, 95% CI $3683-$12,726) compared to those without the condition. Many comorbid conditions including hypertension (HTN), diabetes, depression, chronic obstructive pulmonary disease, cancer, stroke, and HF reduced the chance of patients with RA aged between 18-64 years being employed. Absenteeism of employed patients with RA was significantly affected by HTN, depression, disorders of the eye and adnexa, or stroke. On average, RA patients with HF earned US$15,833 (95% CI $4435-$27,231) per year less than RA patients without HF. Comorbid conditions in patients with RA were associated with higher annual healthcare expenditure, lower likelihood of employment, higher rates of absenteeism, and lower income. Despite its low prevalence, HF was associated with the highest incremental healthcare expenditure and the lowest likelihood of being employed compared to other common comorbid conditions.

Psychological distress among refugees in Germany: a cross-sectional analysis of individual and contextual risk factors and potential consequences for integration using a nationally representative survey

ObjectivesResponding to the mental health needs of refugees remains a pressing challenge worldwide. We estimated the prevalence of psychological distress in a large refugee population in Germany and assessed its...

The impact of discharge contracture on return to work after burn injury: A Burn Model System investigation.

Despite many advances in burn care, the development of extremity contracture remains a common and vexing problem. Extremity contractures have been documented in up to one third of severely burned patients at discharge. However, little is known about the long-term impact of these contractures. The purpose of this study was to examine the association of extremity contractures with employment after burn injury. We obtained data from the Burn Model System database from 1994 to 2003. We included in the study cohort all adult patients who were working prior to injury and identified those discharged with and without a contracture in one of the major extremity joints (shoulder, elbow, wrist, hip, knee and ankle). We classified contracture severity according to mild, moderate and severe categories. We performed descriptive analyses and predictive modeling to identify injury and patient factors associated with return to work (RTW) at 6, 12, and 24 months. A total of 1,203 participant records met criteria for study inclusion. Of these, 415 (35%) had developed a contracture at discharge; 9% mild, 12% moderate, and 14% severe. Among 801 (67%) participants who had complete data at 6 months after discharge, 70% of patients without contracture had returned to work compared to 45% of patients with contractures (p < 0.001). RTW increased at each subsequent follow-up time point for the contracture group, however, it remained significantly lower than in no-contracture group (both p < 0.01). In multivariable analyses, female sex, non-Caucasian ethnicity, larger burn size, alcohol abuse, number of in-hospital operations, amputation, and in-hospital complications were associated with a lower likelihood of employment. In adjusted analyses, discharge contracture was associated with a lower probability of RTW at all 3 time points, although its impact significantly diminished at 24 months. This study indicates an association between discharge contracture and reduced employment 6, 12 and 24 months after burn injury. Among many other identified patient, injury, and hospitalization related factors that are barriers to RTW, the presence of a contracture at discharge adds a significant reintegration burden for working-age burn patients.

Post-Transplant Work Status of Young Adult Survivors of Allogeneic Hematopoietic Cell Transplant: A Report from the Center for International Blood and Marrow Transplant Research (CIBMTR)

Background: Return to full-time work after hematopoietic cell transplant (HCT) is an important indicator of health recovery and overall function of survivors. Because young adult (YA) HCT patients are at a critical personal and professional developmental phase at the time of their illness, they face unique challenges potentially impacting their ability to work post-HCT. We aimed to assess the post-HCT work status of YA patients undergoing allogeneic HCT and examine pre-HCT factors associated with their work status at the 1-year time-point post-HCT. Methods: Using data from the Center for International Blood and Marrow Transplant Research (CIBMTR), we studied YA (18-39 years of age at HCT) survivors (alive ≥1-year post-HCT) of allogeneic HCT performed between 2008 and 2015 for malignant or non-malignant conditions. All conditioning regimens, stem cell sources, and donor types were included. Work status [full-time (FT), part-time (PT), unemployed, medical disability] was assessed at 6-months, 1-, 2-, and 3-years post-HCT. We performed a multivariable logistic regression to study the pre-HCT patient and disease related [patient age at HCT, sex, race/ ethnicity, pre-HCT education, pre-HCT work status, disease diagnosis, Karnofsky/ Lansky performance score, hematopoietic cell transplant comorbidity index (HCT-CI), marital status], and HCT-related (year of transplant, stem cell source, donor type, conditioning regimen) factors associated with post-HCT work status at the 1-year time-point [dichotomized as employed (in FT/PT work) vs unemployed (unemployed, medical disability)]. Results: A total of 1,365 allogeneic HCT recipients met the selection criteria. Median age at HCT was 30.8 years (range 18-39; interquartile range 9.3). Forty-four percent were females; 89% received HCT for malignant diseases (myeloid diseases: 62%, lymphoid diseases: 35%) and the remainder for non-malignant diseases (severe aplastic anemia, inherited abnormalities of erythrocyte differentiation/ function, and disorders of the immune system). Forty three percent received total body irradiation (TBI) based myeloablative conditioning regimens. Median follow-up time from HCT was 60.6 months (range: 12-121). From 6-months to 3-years post-HCT, the percentage of survivors employed FT (18% to 51%) and PT (7% to 11%) increased, and unemployed (38% to 18%) and on medical disability (37% to 20%) decreased (Figure 1). Of patients in FT work pre-HCT, 50% were either unemployed or had medical disability status at the 1-year time-point (Figure 2). Of those unemployed pre-HCT, 19% were working at 1-year post-HCT. In the multivariable logistic regression, survivors' pre-HCT work status was significantly associated with the post-HCT work status at 1-year time-point. Compared to patients working FT pre-HCT, patients who were unemployed and on medical disability were significantly less likely to be employed at 1-year post-HCT [pre-HCT unemployment: odds ratio (OR) of FT/PT employment 0.30; 95% confidence interval (CI) 0.20-0.48; pre-HCT medical disability: OR 0.46; 95% CI 0.30-0.71]. Females (OR 0.51; 95% CI 0.37-0.69) and patients with an HCT-CI score of 2 (OR 0.61; 95% CI 0.39-0.95), and ≥3 (OR 0.53; 95% CI 0.36-0.76) also had a lower likelihood of employment. Compared to patients with high school or lower education, patients with graduate school level education had significantly higher likelihood of employment (OR 2.53; 95% CI 1.72-3.71). Compared to patients treated with total body irradiation (TBI) based myeloablative conditioning, significantly higher odds of employment were seen in chemotherapy-based myeloablative conditioning (OR 1.81; 95% CI 1.28-2.56) (Table). Conclusions: In YA HCT survivors, the full-time and part-time work rates steadily improved post-HCT. Nonetheless, nearly 40% were still either unemployed or on medical disability even at 3 years post-HCT. Although there were limitations of the study including lack of post-HCT time-dependent covariates for the analysis and direct patient report for work status, our study findings provide an insight into the factors impinging on YA survivors' ability of returning to work and points to a need for return to work interventions. Disclosures Shaw: Therakos: Other: Speaker Engagement.

When leaving is normal and staying is novel: Men's labor migration and women's employment in rural Mozambique.

Considerable cross-national research has examined the impact of international labor migration on livelihoods in sending households and communities. Although findings vary across contexts, the general underlying assumption of this research is that migration represents a novel income-generating alternative to local employment. While engaging with this assumption, we also argue that in many sending communities where labor migration has been going on for generations, it is the decision not to migrate and instead to pursue local livelihood opportunities that might constitute a true departure from the expected behavior. Importantly, both the decisions to migrate and not to migrate are part of a household strategy shaped by gendered negotiation and bargaining. Building on these propositions, we use rich survey data from rural Mozambique, a typical setting of long-established large-scale international male labor out-migration, to examine married women's gainful employment outside subsistence agriculture as it relates to their husbands' migration or local work. We find a somewhat lower likelihood of employment among migrants' wives, compared with nonmigrants' wives, and this pattern strengthens with increased duration of migration. However, we also find substantial differences among nonmigrants' wives: women married to locally employed men have themselves by far the highest probability of employment, while wives of nonemployed men are no different from migrants' wives, net of other factors. These findings are discussed in light of interconnected gendered complexities of both migration-related and local labor market constraints and choices.

PSY13 IMPACT OF COMORBID CONDITIONS ON HEALTH CARE EXPENDITURE AND WORK-RELATED OUTCOMES IN PATIENTS WITH RHEUMATOID ARTHRITIS: A RETROSPECTIVE ANALYSIS USING THE MEDICAL EXPENDITURE PANEL SURVEY IN THE PERIOD 2006-2015

In this study we evaluated the impact of comorbid conditions and other sociodemographic factors on direct healthcare expenditure and work-related outcomes (employment status, absenteeism and income) in patients with rheumatoid arthritis (RA). This was a retrospective analysis of the Medical Expenditure Panel Survey (MEPS) from 2006 to 2015 in RA adult patients in the United States (US). Generalised linear models with a log-link function and a gamma distribution were used for total healthcare expenditure and income, logistic regression models for employment status and negative binomial models for absenteeism. Thirteen comorbid conditions were included as potential predictors of direct cost and work-related outcomes. Sociodemographic predictors were sex, age, region, marital status, race, income, education and smoking status. After adjusting for covariates, RA patients with heart failure had an incremental healthcare expenditure of $8,205 (95% CI, $3,683-$12,726) per patient per year compared to RA patients without heart failure, the highest increment of all comorbid conditions considered in this study. Many comorbid conditions such as hypertension, diabetes, depression, COPD, cancer, stroke and heart failure reduced the chance of RA patients being employed. RA patients with stroke were 2.4 times (95% CI, 1.41-4.10) more likely to miss a day of work due to illness/injury. On average, an RA patient with heart failure earned $16,671 (95% CI, $5,846-$27,497) per year less than an RA patient without heart failure. RA patients with comorbid conditions have higher annual healthcare expenditure, lower likelihood of employment, higher rates of absenteeism and lower income. Heart failure, despite its low prevalence in RA patients, was associated with the highest incremental healthcare expenditure and the lowest likelihood of being employed compared to other common comorbid conditions in RA such as hypertension, diabetes and depression.

Linking local labour market conditions across the life course to retirement age: Pathways of health, employment status, occupational class and educational achievement, using 60 years of the 1946 British Birth Cohort

Several studies have documented that older workers who live in areas with higher unemployment rates are more likely to leave work for health and non-health reasons. Due to tracking of area disadvantage over the life course, and because negative individual health and socioeconomic factors are more likely to develop in individuals from disadvantaged areas, we do not know at what specific ages, and through which specific pathways, area unemployment may be influencing retirement age.Using data from the MRC National Survey of Health and Development, we use structural equation modelling to investigate pathways linking local authority unemployment at three ages (4y, 26y and 53y) to age of retirement (right-censored). We explored five hypothesized pathways: (1) residential tracking, (2) health, (3) employment status, (4) occupational class, and (5) education. Initially, pathways between life course area unemployment, each pathway and retirement age were assessed individually. Mediation pathways were tested in the full model.Our results showed that area unemployment tracked across the life course. Higher area unemployment at ages 4 and 53 were independently associated with earlier retirement age [1% increase = mean −0.64 (95% CI: −1.12, −0.16) and −0.25 (95% CI: −0.43, −0.06) years]. Both were explained by adjustment for individual employment status at ages 26 and 53 years. Higher area unemployment at age 26 was associated with poorer health and lower likelihood of employment at aged 53; and these 2 individual pathways were identified as the key mediators between area unemployment and retirement age.In conclusion, these results suggest that interventions designed to create local employment opportunities for young adults should lead to extended working through improved employment and health at mid-life.

The Hijab and Muslim women’s employment in the United States

A substantial body of empirical evidence suggests that employment benefits women, yet Muslim women consistently work for pay less than other women. This article extends the question of religion differences in employment to the United States, where—due to a paucity of data—we know little about Muslim women and their economic outcomes. The analysis uses the only known probability-sample surveys of Muslims in the U.S., conducted by the Pew Research Center in 2007 and 2011. These are pooled with the 2010 General Social Survey to provide the first comparative analysis of employment among Muslim and nonMuslim women using probability samples. I assess whether Muslim women in the United States work for pay less than their nonMuslim counterparts, and whether socio-demographic characteristics explain these differences. I find that the likelihood of employment for Muslim women who do not wear the hijab does not differ significantly from the likelihood of employment for nonMuslim women. However, women who wear the hijab have a much lower likelihood of employment than nonMuslim women or non-veiling Muslim women. The remainder of the analysis focuses on intra-Muslim differences, exploring what factors mediate “the hijab effect” on women’s employment. I find that demographic, human capital, and household composition variables mediate about one third of the effect, while the rest remains unexplained.

Early Adult Offending and Employment among Serious Adolescent Offenders: An Examination of Adolescent Service Receipt, Attachments, and Perceptions

This study examines whether service experiences, attachments, and perceptions of the legal system are related to early adult outcomes for serious adolescent offenders. This study also examines how individual and social contextual factors are related to previous service experiences among these adolescent offenders. Data from the Pathways to Desistance study, a longitudinal study following 1354 serious adolescent offenders from two geographic locations, were used to identify factors related to youth service experiences, and to test whether these service experiences, youth attachments, and youth perceptions were related to adult self-reported offending and employment outcomes. Youth from more disadvantaged social contexts were more likely to report previous service receipt at baseline. While group service receipt was related to a higher likelihood of adult offending, residential service receipt was related to a lower likelihood of employment. Youth attachments were positively related to employment in adulthood, whereas youth perceptions (cynicism) were positively related to self-reported offending in adulthood. Positive attachments were related to positive adult outcomes (i.e., employment), while negative perceptions were related to negative outcomes (i.e., offending). Serious adolescent offenders have a complex set of needs across social contexts. This may suggest that a holistic approach to studying and serving juvenile delinquents would include a broad range of outcomes, and that effective services should also be complex in addressing not only the individual, but also the challenges within their social contexts.

The Effect of Land Access on Youth Employment and Migration Decisions: Evidence from Rural Ethiopia

AbstractHow does the amount of land that youth expect to inherit affect their migration and employment decisions? We explore this question in the context of rural Ethiopia using a 2014 cross‐sectional dataset indicating whether or not youth household members from a previous 2010 survey had migrated by 2014, and in which sector they worked in 2014. We estimate a household fixed effects model and exploit exogenous variation in the timing of land redistributions to overcome endogenous household decisions about how much land to bequeath to descendants. We find that larger expected land inheritances significantly lower the likelihood of long‐distance permanent migration and of permanent migration to urban areas. Inheriting more land also leads to a significantly higher likelihood of employment in agriculture and a lower likelihood of employment in the non‐agricultural sector. Conversely, the decision to attend school is unaffected. These results appear to be most heavily‐driven by males and by the older half of our youth sample. We also find suggestive evidence that several mediating factors matter. Land inheritance is a much stronger predictor of rural‐to‐urban permanent migration and non‐agricultural‐sector employment in areas with less vibrant land markets, in relatively remote areas (those far from major urban centers), and in areas with lower soil quality. Overall, these results affirm the importance of push factors in dictating occupation and migration decisions in Ethiopia.

The Perfect Storm: Graduating during a Recession in a Segmented Labor Market

Using Spanish Social Security data merged with Labor Force Survey data, this article analyzes the effects of entry labor market conditions on workers’ careers two to three decades after graduating in Spain, a country well known for its highly segmented labor market and rigid labor market institutions. In contrast to more flexible labor markets such as in the United States or Canada, the authors find that following a recession the annual earnings losses of individuals without a university degree are greater and more persistent than those of college graduates. For workers without a college degree, the effect is driven by a lower likelihood of employment. For college graduates, the negative impact on earnings is driven by both a higher probability of non-employment and employment in jobs with fixed-term contracts. Although a negative shock increases mobility of college graduates across firms and industries, no earnings recovery occurs for the individual, just secondary labor market job churning. Results are consistent with the tight regulations of the Spanish labor market, such as binding minimum wages and downward wage rigidity caused by collective bargaining agreements.

The Perfect Storm: Graduating in a Recession in a Segmented Labor Market

This paper analyzes the effects of entry labor-market conditions on workers' career in Spain, a country well known for its highly segmented labor market and rigid labor-market institutions. In contrast with more flexible labor markets, we find that the annual earnings losses of individuals without a university degree are greater and more persistent than those of college graduates. For workers without a college degree, the effect is driven by a lower likelihood of employment. For college graduates, the negative impact on earnings is driven by both a higher probability of non-employment, and employment in jobs with fixed-term contracts. While a negative shock increases mobility of college graduates across firms and industries, there is no earnings recovery, just secondary labor-market job churning. Our results are consistent with tight regulations of the Spanish labor market such as binding minimum wages and downward wage rigidity caused by collective bargaining agreements.

Labor market effects of intrauterine exposure to nutritional deficiency: Evidence from administrative data on Muslim immigrants in Denmark

This paper examines whether nutritional disruptions experienced during the stage of fetal development impair an individual's labor market productivity later in life. We consider intrauterine exposure to the month of Ramadan as a natural experiment that might cause shocks to the inflow of nutrients essential for fetal development. Specifically, we use administrative data from Denmark to investigate the impact of exposure to Ramadan in utero on labor market outcomes of adult Muslim males, including employment status, annual salary, hourly wage rate, and hours of work. Our findings indicate that potential exposure to nutritional disruptions during a critical stage of fetal development is likely to have scarring effects on the fetus expressed as poor labor market outcomes later in life. Specifically, exposure to Ramadan around the 7th month of gestation results in a lower likelihood of employment and, to a lesser extent, a lower salary, and reduced labor supply. For example, the 7th month intrauterine exposure to Ramadan is associated with a 2.6 percentage points reduction in the likelihood of employment among Muslim males. We do not find an impact on the wage rate. Finally, we also document suggestive evidence that these results may partially be driven by increased disability and to a lesser extent by poor educational attainment among those who were exposed to Ramadan during this particular period in utero.

Employment status in peritoneal-dialysis patients

Background/PurposeThe employment status of peritoneal-dialysis patients could have been related to selection bias. This study examined the employment rate and associated factors in a population with peritoneal-dialysis-first policy. MethodsWe performed a single-center cross-sectional survey on the employment status of prevalent peritoneal-dialysis patients between January and September 2013 in Hong Kong. ResultsThe survey included 383 prevalent peritoneal-dialysis patients, with 128 of them in the labor force. Among the patients in the labor force, the employment rates were 65.8% and 18.9% for automated peritoneal-dialysis patients and continuous-ambulatory-peritoneal-dialysis patients, respectively, whereas 39.1% of patients in the labor force had expressed that they were able to work, but were unemployed. In adjusted analysis, the use of automated peritoneal dialysis (adjusted odds ratio of 7.93; 95% confidence interval 2.92–21.74) was independently associated with employment, whereas older age was associated with lower likelihood of employment (adjusted odds ratio of 0.53 for each 10 years old; 95% confidence interval 0.38–0.72). ConclusionThe employment rate in peritoneal-dialysis patients is very low when compared to that in the general population. Patients on automated peritoneal dialysis were more likely to be employed. 背景腹膜透析患者就業狀況的研究，有可能會受到選擇性偏倚的影響。這項調查 是在一個採納了 é腹膜透析第一û 政策的地區，進行就業率及其相關因素的研究。 方法在2013年1月至9月期間，我們在香港一個腹膜透析中心對現存的腹膜透析患者的就業狀況進行了一次橫斷面調查。 結果本次調查包括383名現存的腹膜透析患者，其中有128人被納入勞動力人口。在勞動力人口的患者中，自動腹膜透析的使用者就業率為65.8 %，連續性家居腹膜透析的使用者就業率為18.9 % 。另一方面，39.1%的勞動力人口患者，表示他們有能力工作，但並未受僱用。在調整後的分析，使用自動腹膜透析與就業率有獨立關聯，另外，較年長的患者與較低就業率有關聯。 結論相比一般香港人，腹膜透析患者的就業率非常低。自動腹膜透析的患用者較易就業。

Use of inpatient rehabilitation for cancer patients in Switzerland: who undergoes cancer rehabilitation?

Rehabilitation for cancer patients aims to reduce physical disability and mental distress resulting from the disease and its treatment. However, little is known about the use of cancer inpatient rehabilitation in Switzerland in relation to sociodemographic and medical characteristics. The main purpose of this study was to evaluate whether there are differences in sociodemographic and medical characteristics between patients who underwent inpatient rehabilitation (users) and those who did not (nonusers). A total of 238 cancer patients from the University Hospital Zurich were included. The sociodemographic and medical characteristics of inpatient rehabilitation users were assessed and compared with those of nonusers. We analysed the differences between inpatient rehabilitation users and nonusers. Of the patients included, 101 (42.4%) used inpatient rehabilitation. They were less likely to be employed (p = 0.029), stayed longer in hospital (p <0.001), and were more likely to have semiprivate or private supplementary health insurance (p = 0.030) than nonusers. There were differences in cancer site (p = 0.001). Patients with tumours of the digestive organs or of the thoracic organs were more likely to use rehabilitation, whereas breast cancer patients were less likely to use it. Stratified analyses showed that male patients with semiprivate or private supplementary health insurance (p = 0.037), lower education (p = 0.039), and lower likelihood of employment (p = 0.051) were more likely to use rehabilitation. Women with an advanced tumour stage used inpatient rehabilitation more often (p = 0.012). Findings show the influence of duration of hospitalisation, insurance type, cancer site, employment status, and gender on the use of inpatient cancer rehabilitation. The results indicate the need of structured standardised procedures for medical referral to be implemented based on screening.

Labor Market Effects of Intrauterine Exposure to Nutritional Deficiency: Evidence from Administrative Data on Muslim Immigrants in Denmark

This paper examines whether nutritional disruptions experienced during the stage of fetal development impair an individual's labor market productivity later in life. We consider intrauterine exposure to the month of Ramadan as a natural experiment that might cause shocks to the inflow of nutrients essential for fetal development. Specifically, we use administrative data from Denmark to investigate the impact of exposure to Ramadan in utero on labor market outcomes of adult Muslim males, including employment status, annual salary, hourly wage rate, and hours of work. Our findings indicate that potential exposure to nutritional disruptions during a critical stage of fetal development has scarring effects on the fetus expressed as poor labor market outcomes later in life. Specifically, exposure to Ramadan in the 7th month of gestation results in a lower likelihood of employment, a lower salary, and reduced labor supply, but not necessarily a lower wage rate. We also document suggestive evidence that these results may partially be driven by increased disability and to a lesser extent by poor educational attainment among those who were exposed to Ramadan during this particular period in utero.

Predictors of Employment Among Native Americans

Native Americans have higher rates of unemployment than other minority groups, and why this is so remains unclear. This study sought to determine demographic, physical health, mental health, and psychological symptoms predictive of employment for Native Americans in the Northeastern United States. The participants were 750 Native American men and women who ranged in age from 18 to 64 years. Using logistic regression, the findings indicated that Native Americans with greater education were more likely to be employed than those who were less educated (OR = 1.4, P &lt; .000). Native Americans who rated themselves in better physical health were more likely to be employed (OR = 1.3, P &lt; .003). Those who reported multiple psychiatric disorders were less likely to be employed (OR = 0.69, p &lt; .001). Pervasive sadness was related to a lower likelihood of employment (OR = 0.51, P &lt; .000). Recommendationsfor tribal leaders and rehabilitation practitioners are provided.