Lower Occupational Attainment Research Articles

Modifiable risk factors for dementia in Indonesia: Results from STRiDE project

Background & Objective: Indonesia’s ageing population and increasing number of people living with dementia poses significant challenge to the health system. Better understanding of factors related to dementia prevalence is needed to mitigate risk, improve care, and ultimately reduce the incidence of dementia. In this study, we aimed to describe associations between potential risk factors and dementia in Indonesia. Methods: A cross-sectional study, part of the Strengthening Responses to Dementia in Developing Countries (STRiDE) project, was conducted in two provinces in Indonesia, Jakarta and North Sumatra between September and December 2021. A total of 2,110 older adults and their informants completed questionnaires covering cognitive and functional status, socioeconomic, medical and lifestyle factors. Models for each potential modifiable risk factor were created and then adjusted by age, sex and literacy. Prevalence ratios (PRs) were calculated for each risk factor. Results: In the adjusted models, lower education, lower occupational attainment, unmanaged diabetes, stroke, head trauma within the past 5 years, hearing loss, and chronic obstructive airway disease were all associated with higher prevalence of dementia in Indonesia. Current smoking, historic depression and high blood pressure were associated with higher dementia prevalence, but not statistically significant. Conclusion: Improving socioeconomic status (i.e., education and employment) and reducing health- related risk factors may be viable solutions to reduce the high prevalence rates of dementia in Indonesia. Further longitudinal research is needed to confirm direction of effect and causality.

Sex/gender and socioeconomic differences in modifiable risk factors for dementia

Both sex/gender and socioeconomic differences have been reported in the prevalence of modifiable risk factors for dementia. However, it remains unclear whether the associations between modifiable risk factors for dementia and incident dementia differ by sex/gender or socioeconomic status. This study aimed to investigate sex/gender and socioeconomic differences in the associations of modifiable risk factors with incident dementia using a life-course perspective. We used data from the English Longitudinal Study of Ageing (2008/2009 to 2018/2019). A total of 8,941 individuals were included [mean (standard deviation) age, 66.1 ± 9.8 years; 4,935 (55.2%) were women]. No overall sex/gender difference in dementia risk was found. Dementia risk was higher among those who experienced childhood deprivation [hazard ratio (HR) = 1.51 (1.17; 1.96)], lower occupational attainment [HR low versus high = 1.60 (1.23; 2.09) and HR medium versus high = 1.53 (1.15; 2.06)], and low wealth [HR low versus high = 1.63 (1.26; 2.12)]. Though different associations were found among the subgroups, there might be a sex/gender difference in dementia risk only for low cognitive activity, suggesting a higher risk for women [HR = 2.61 (1.89; 3.60)] compared to men [HR = 1.73 (1.20; 2.49)]. No consistent socioeconomic differences in modifiable dementia risk were found. A population-based approach that tackles inequalities in dementia risk profiles directly may be more effective than individual approaches in dementia prevention.

Dementia Prevalence, Comorbidities, and Lifestyle Among Jatinangor Elders.

Introduction: Research on dementia prevalence and the potentially related risk factors from Indonesia is scarce. We sought to identify the prevalence of dementia, health risk factors, and lifestyle in Jatinangor elders.Methods: A total of 686 participants completed questionnaires on lifestyle, health risk factors, and cognitive and functional tests from September 2013 to December 2013. We determined the prevalence of dementia; and the associations between health, leisure activities, dietary pattern, and dementia were analyzed using logistic regression.Results: The prevalence of dementia was 29.15%. The risk factors differed between age groups. Those aged 60–74 years and who have a lower education level, lower occupational attainment, and less active intellectual and recreational activities were associated with higher dementia risk. Those aged > 75 years living in a rural area and who take less fruit were associated with a higher risk of dementia.Conclusions: The prevalence of dementia in Jatinangor is high. The identified modifiable risk factors are a potential target for intervention and valuable for designing public health policies.

APOE e4-genotype and lifestyle interaction on cognitive performance: Results of the LIFE-Adult-study.

Previous studies have shown that the e4-allele of the APOE gene is associated with a higher risk of developing dementia. Our study investigated whether well-known associations between lifestyle factors and cognitive functioning may be stronger in individuals who carry the dementia risk variant of the APOE gene and whether this association is amplified with older age. Data analysis comprised 7,526 participants (aged 40- to 79-years-old) from the population-based LIFE-Adult-study. The effect of the APOE e4-allele on the association between lifestyle factors (smoking, physical activity, being overweight, occupational attainment) and cognitive performance (trail making test [TMT] B, verbal fluency test [VFT]) was analyzed via multivariate generalized linear modeling adjusted for APOE e2-allele, age, gender, education, stroke, and heart attack. Smoking, less physical activity, and lower occupational attainment was associated with a poorer performance in the TMT B and VFT. Neither the APOE e4-allele nor interactions with the APOE e4-allele were significantly associated with cognitive performance. The association between physical activity and occupational attainment on performance in the TMT B were stronger in older age, but the APOE gene did not modify those associations. Our findings suggest that the dementia risk variant of the APOE gene does not alter the association between lifestyle factors and cognitive performance in the general population aged 40- to 79-years-old. However, as lifestyle factors impact cognitive aging, research efforts should focus on establishing effective interventions promoting healthy lifestyle behaviors to counteract adverse cognitive aging processes. (PsycINFO Database Record

Mode of Migration, Age at Arrival, and Occupational Attainment of Immigrants from Mainland China to Hong Kong

This paper examines occupational attainment of Chinese immigrants in Hong Kong by comparing immigrants from Guangdong province with people who stayed in Guangdong and Hong Kong natives. Taking advantage of comparable data from the Hong Kong Panel Study of Social Dynamics (HKPSSD) and the China Family Panel Studies (CFPS), we find that Chinese immigrants have significantly lower occupational attainment, measured by International Socioeconomic Index (ISEI), than their counterparts in both the origin and the destination. We further examine whether immigrants’ occupational attainment differs by mode of migration and age at arrival. Results show that disadvantages exist for documented immigrants and those who arrived in Hong Kong at age 13 or older, whereas undocumented immigrants and those who arrived younger than 13 do not differ significantly from either Guangdong stayers or Hong Kong natives.

SU27. Cognitive Remediation, Cognitive Behavioral Therapy, and Occupational Outcome in Schizophrenia Spectrum Disorders: A 2-Year Follow-up Study

Background: Neurocognitive impairment is prominent in schizophrenia and significantly related to low occupational attainment and poor occupational outcomes (August et al, 2012). Vocational rehabilitation (VR) is frequently implemented to counteract high unemployment rates. Individuals with schizophrenia however face numerous challenges such as neurocognitive impairments and psychotic symptoms. Hence, augmenting VR to address illness-related factors may optimize occupational outcomes. The aim of this study was to examine the effects of Cognitive Remediation (CR)-augmented compared to Cognitive Behavioral Therapy (CBT)-augmented VR on neurocognition and occupational functioning over a 2-year period. Methods: One hundred and thirty-one participants underwent assessments at baseline, post-treatment (after 10 months), and follow-up (2 years after randomization). Performance on the MATRICS Consensus Cognitive Battery (MCCB), occupational status, and number of hours worked per week were recorded at all assessment points. Results: Both intervention groups improved on several neurocognitive domains, improvements were however in favor of the CR group with significant intervention-by-time interactions for working memory (P = .009) and the composite score (P = .03). There was a significant increase in number of participants working (79% vs 80% at post-treatment and 68% vs 58% at follow-up in CBT and CR, respectively) and hours worked throughout the project period, with no between-group differences. CBT participants were working 11.6 hours a week at post-treatment and 14 hours at follow-up, whereas CR participants worked 10.6 hours at post-treatment and 11.3 hours a week at follow-up. Separate multiple regression analyses with hours worked as criterion was not significant for CBT (P = .13), but for CR (P = .03) with education (P = .03) and positive change in Working Memory (P = .02) as significant predictors. Entering the composite change score as predictor instead of separate domains produced a significant model for CR (P = .02). Significant predictors were age (P = .04) and change in the composite score (P = .007). Conclusion: CR-augmented VR improved several neurocognitive domains, particularly Working Memory, which was central in the CR program as well as the MCCB Composite Score. Neurocognitive improvements may also be partially explained by additional strategy learning and bridging to work settings provided in the CR program perhaps reducing interference caused by neurocognitive impairments and leading to more sufficient allocation of neurocognitive resources in turn aiding in transfer of learning to vocational settings which consequently may have helped optimize occupational functioning. The major implication of these findings is that the combined effect of VR, organized collaboration between services and CBT/CR enabled a significant proportion of the participants to attain work and to increase the number of hours worked in the study.

Personality Development Within a Generational Context: Life Course Outcomes of Shy Children

Studies have shown that shy children born in the 1920s and 1950s had delayed marriage and parenthood, less stable careers, and lower occupational attainment as adults than other children. Do these effects still hold true? We examined demographic and social outcomes of children born between 1977 and 1982 in a prospective longitudinal study. We assessed shyness in childhood (age 8), adolescence (age 12-16), young adulthood (age 22-26), and adulthood (age 30-35), and derived three shyness trajectories (i.e., decreasing, increasing, and low-stable). Social and demographic outcomes for shy children who outgrew their shyness (i.e., decreasing trajectory) were indistinguishable from those who were consistently low on shyness measures. However, a shyness trajectory beginning in adolescence and increasing to adulthood was associated with poorer outcomes, similar to previous studies. These findings highlight the importance of multiple assessments in long-term longitudinal studies and the need to consider personality development within a generational context.

Interrelations between Environmental Exposures: Air Pollution, Noise and RF-EMF – Potential for Confounding?

Background If environmental radiofrequency electromagnetic field (RF-EMF) exposures are correlated with other environmental exposures, spurious results could be obtained if studied outcomes are associated with the respective exposures, but not with RF-EMF. The same accounts for socioeconomic position (SEP) which could provide the potential for confounding. Methods We used the Amsterdam Born Children and Development (ABCD) study to asses correlation between different environmental exposures, at the home address when children were 7yrs of age. Correlation between RF-EMF exposure from base stations was assessed with a geospatial model (NISMap) and from other indoor sources (DECT/WiFi) using parental self-reports. Traffic related air pollution (NO2) exposure was derived from land-use regression. Road/tram traffic noise and aircraft noise were extracted from corresponding noise maps. SEP indicators included maternal educational level, parental occupational attainment, and parental financial situation. Results We included 3,249 children in the analysis. Highest correlation between exposures was observed for RF-EMF from base stations with road/tram noise (Spearman correlation coefficient of 0.18, p<0.0001). Correlation of RF-EMF with air pollution and aircraft noise was low (all r <0.05, all p>0.7). There was a tendency of higher base-station exposure in children of mothers with lower educational level and lower occupational attainment (both r = 0.05, both p<0.01). For indoor RF-EMF sources, the associations were rather the opposite, with higher exposures in children of families in a better financial situation and of parents with higher educational level or occupational attainment (all r > -0.09, p<0.01). Conclusions All assessed correlations were low and potential for confounding therefore is expected to be weak. However, for outcomes where SEP and noise are important predictors, it is advisable to include these factors in future studies to assess the potential for confounding.

“Since Many of My Friends Were Working in the Restaurant”: the Dual Role of Immigrants’ Social Networks in Occupational Attainment in the Finnish Labour Market

This article considers the dual role of immigrants’ social networks in occupational attainment in the Finnish labour market. Drawing on the empirical observations gained from investigating the entire occupational careers of 40 immigrants, it argues that while ethnically dominated networks act as a crucial resource-opportunity structure to help get immigrants a foothold in the local economy and society, at the same time, they can also operate as constraining factors by confining them to low-prestige occupations in which the chances for occupational mobility are rather restricted. Overall, the article aims to suggest that although deficiency in locally gained human capital creates obstacles to better labour-market integration, the kinds of social networks in which immigrants are embedded can also significantly contribute to their low occupational attainment in their new country.

Forensic Assessment of Adults Reporting Childhood Sexualized Assault: Risk, Resilience, and Impacts

Though childhood sexualized assault (CSA) increases risk for varied psychological difficulties, no single condition, syndrome, or set of difficulties is reliably associated with such experiences. CSA likely disrupts or impairs normal development in complex ways that depend on the risk and resilience factors present before, during, and after CSA. CSA characteristics that increase risk for later difficulties include young age, trauma inflicted by another person, number of occurrences, violence or intrusiveness, betrayal of trust, adverse peri-traumatic reactions, negative reactions from others following disclosure, and a context of previous sexualized assault or maltreatment. Resilience increases with positive self-esteem, better intellectual functioning, good self-control, positive social support, and early therapeutic intervention. CSA is associated with impaired psychological development, mental health disorders, behavioural and relationship difficulties, physical health problems, reduced intellectual function, lower educational achievement, lower occupational attainment, and reduced lifetime income. Any particular difficulty may be problematic in its own right and may also contribute to other difficulties in the interlocking domains of individual abilities and attributes, relationships, and significant life activities. In individual forensic assessment cases, general evidence on CSA risk/resilience and impacts can be used in combination with the lifespan developmental analysis (Barnes & Josefowitz, Psychological Injury and Law, 2014), to determine whether and how CSA contributed to psychological injuries.

Occupational Attainment as a Marker of Cognitive Reserve in Multiple Sclerosis

Cognitive dysfunction affects half of MS patients. Although brain atrophy generally yields the most robust MRI correlations with cognition, significant variance in cognition between individual MS patients remains unexplained. Recently, markers of cognitive reserve such as premorbid intelligence have emerged as important predictors of neuropsychological performance in MS. In the present study, we aimed to extend the cognitive reserve construct by examining the potential contribution of occupational attainment to cognitive decline in MS patients. Brain atrophy, estimated premorbid IQ, and occupational attainment were assessed in 72 MS patients. The Minimal Assessment of Cognitive Functioning in MS was used to evaluate indices of information processing speed, memory, and executive function. Results showed that occupational attainment was a significant predictor of information processing speed, memory, and executive function in hierarchical linear regressions after accounting for brain atrophy and premorbid IQ. These data suggest that MS patients with low occupational attainment fare worse cognitively than those with high occupational attainment after controlling for brain atrophy and premorbid IQ. Occupation, like premorbid IQ, therefore may make an independent contribution to cognitive outcome in MS. Information regarding an individual's occupation is easily acquired and may serve as a useful proxy for cognitive reserve in clinical settings.

CONNECTING WITH WORK

ABSTRACT This study considers to what extent immigrants’ social networks have acted as important resources that have helped them to connect with employment opportunities during their entire occupational careers in Finland. Adopting a comprehensive job-acquisition model, it offers a detailed investigation into how job information that led to employment is acquired and transmitted, how the jobs themselves are applied for, and in which ways social contacts have played a direct or indirect role in obtaining them. Despite the presence of a well-established nationwide system of public employment agencies in Finland, reliance on predominantly ethnic networks was found to be pervasive among immigrants throughout their employment histories under loose as well as tight job-market conditions. The role of networks was especially vital in the immediate post-immigration period, because as newcomers to the host society, they lacked locally acquired human capital. The empirical observations also suggest, however, that extensive reliance on networks was also a means to circumvent discrimination prevailing in the labour market that discouraged immigrants from seeking employment through formal channels of job information. Discrimination had not only contributed to low occupational attainment of informants by confining them to low-prestige occupations but indirectly also may have led to the structuring of ethnically dominated networks among them. The study suggests that the efforts aimed at creating equal employment opportunities for immigrants are unlikely to bear fruit without successfully combating discrimination and a general change in attitudes towards immigrants in society.

Social Networks and Occupational Attainment in Australia

This article contributes to exploring the comparative effects of market mechanisms and social networks and the interplay of human capital and social networks in western labour markets. We examine social networks and occupational attainment by using data from the 2007 Australian Survey of Social Attitudes and provide three major findings: (1) as a job search method, social networks are associated with lower earnings and occupational status and a lower probability of entering a professional or managerial position than market-oriented job search methods; (2) jobs that are found using strong ties have lower occupational attainment than jobs found using weak ties; and (3) the poorer occupational attainment outcomes associated with social networks are only observed among those without university degrees.

Alcohol Consumption in Early Adulthood and Schooling Completed and Labor Market Outcomes at Midlife by Race and Gender

We assessed the relation of alcohol consumption in young adulthood to problem alcohol consumption 10 years later and to educational attainment and labor market outcomes at midlife. We considered whether these relations differ between Blacks and Whites. We classified individuals on the basis of their drinking frequency patterns with data from the 1982 to 1984 National Longitudinal Survey of Youth 1979 (respondents aged 19-27 years). We assessed alcohol consumption from the 1991 reinterview (respondents aged 26-34 years) and midlife outcomes from the 2006 reinterview (respondents aged 41-49 years). Black men who consumed 12 or more drinks per week at baseline had lower earnings at midlife, but no corresponding relation for Black women or Whites was found. Black men and Black women who consumed 12 or more drinks per week at baseline had lower occupational attainment than did White male non-drinkers and White female non-drinkers, respectively, but this result was not statistically significant. The relation between alcohol consumption in young adulthood and important outcomes at midlife differed between Blacks and Whites and between Black men and Black women, although Blacks' alcohol consumption at baseline was lower on average than was that of Whites.

Social Comparison 2.0: Examining the Effects of Online Profiles on Social-Networking Sites

Through their features--such as profile photographs or the personal vita--online profiles on social-networking sites offer a perfect basis for social comparison processes. By looking at the profile photograph, the user gains an impression of a person's physical attractiveness, and the user's vita shows which career path the person is pursuing. Against the background of Festinger's Social Comparison Theory, the focus of this research is on the effects of online profiles on their recipients. Therefore, qualitative interviews (N = 12) and two online experiments were conducted in which virtual online profiles of either physically attractive or unattractive persons (N = 93) and profiles of users with either high or low occupational attainment (N = 103) were presented to the participants. Although qualitative interviews did not initially give reason to expect online profiles to constitute a basis for comparison processes, results of the experiments proved otherwise. The first study indicates that recipients have a more negative body image after looking at beautiful users than persons who were shown the less attractive profile pictures. Male participants of the second study, who were confronted with profiles of successful males, showed a higher perceived discrepancy between their current career status and an ideal vita than male participants who looked at profiles of less successful persons.

Path dependence in social and psychological risk factors for dementia: A need for a targeted and active preventive policy

Background: Developing countries face the challenge of simultaneous development and population aging. In consideration of the rapid aging of society and the limited resources for long-term care, it is necessary to implement effective and efficient policies for preventing neurodegenerative disease. Previous studies found several psychosocial risk factors for Alzheimer’s disease, dementia, and cognitive impairment. Some studies indicated that such factors as educational and occupational attainment, income, and participation in social and mental activities were associated with the risk. Others identified psychological distress as a risk factor. According to the theory of path dependence, an earlier factor determines the successive ones. Education is one of the early experiences in life. Therefore, this study examines the association between education and the other risk factors and presents a suggestion for a preventive policy in developing countries. Methods: We conducted a self-administered questionnaire survey of 440 healthy older individuals who participated in activities at the Culture Centers or Clubs of the Third Age in three cities in Mexico. We used logistic regression models to assess the association between educational level and the other possible psychosocial risk factors for dementia. We measured the psychological status of older people with a composite of Philadelphia Geriatric Center Morale Scale, Rosenberg’s Self-Esteem Scale, and Life Satisfaction Index-A. Results: A low level of education was significantly associated with low occupational attainment as well as with having no income after adjusting for basic confounders such as age, gender, cohabitation status, and domestic role (p < 0.01). It was also significantly related to less frequent participation in mental activities after adjusting for the basic confounders, occupational attainment, and income (p < 0.01). The association between a low level of education and lower psychological status remained significant even after controlling for the basic confounders, income, and mental activities (p < 0.05). Conclusions: Education fixes a path that several psychosocial risk factors depend on. Therefore, resources for preventing dementia should be concentrated on those with a low level of education. In order to change the path of these people, it is necessary to implement active interventions, such as free programs that maintain their interest and motivate them to continue to participate in cognitively stimulating activities.

How Damaging is Part-Time Employment to a Woman's Occupational Prospects?

This paper investigates the causes of the well documented association between part-time employment and low occupational attainment amongst British women. In particular, the relative importance of structural factors and unobserved heterogeneity to the occupational attainment of women who choose to work part-time is investigated. The results indicate that there are significant structural impediments to women in part-time employment obtaining their true occupational potential. However, structural factors explain only part of the relatively low occupational attainment of women in part-time employment: differences in unobserved characteristics between part-time and full-time workers also contribute to the low occupational attainment of women in part-time employment.

Rural Transition: KNOW NO BOUNDS

In rural communities the aspirations of students to further educate themselves are often limited due to the geographical and economic boundaries (Burnell, 2003; Rojewski, 1989). Educators in these areas are also aware that when students from rural areas choose to continue their education after high school they are more likely than urban or suburban youth to drop out (Brecn & Quaglia, 1991; Burnell, 2003; McCracken & Barcinas, 1991). In spite of this, Parker (2001) points out in her opinion piece Rural 2000 and Beyond, that there is great hope for rural school survival. This survival depends, in part, on students leaving their rural community for a period of time, usually for college, and then returning to assist in the further development of the area. In rural communities, students with learning disabilities (LD) are faced with a limited number of local jobs and lower occupational attainment (Rojewski, 1999). With this realization, students with LD often decide that they must leave their rural communities, in order to expand career opportunities and further educate themselves. Parker (2001) states While they make contributions elsewhere, they represent yet another extraction of resources from rural areas very much like other resources such as grain, cattle, lumber, fish, minerals, and oil. To combat this loss of resources, rural schools need to use their assets to assist students with LD in making transition plans that include both post secondary and work components. The transition process for rural students with LD consists of a set of activities designed to assist in the preparation and understanding of the impact that geography and population distribution have on employment (Rojewski, 1989, p. 613) and new environments they will be entering. For these transition activities to occur successfully, a comprehensive process must be in place within the secondary educational setting. The overarching component within the transition process is the development of an individualized transition education plan (ITEP) that includes objectives to be followed for the student to reach their transition goals. The main goal of the ITEP is to prepare students to lead productive, independent lives after their secondary education experience. Rojewski (1989) suggests that for students with LD in rural areas, critical components must be in place. First, students must be integrated into normalized environments related to their secondary education. Second, paid work experiences are essential to provide the students with experiences needed to secure and hold a job. Third, students must be aware of how their disability will impact their performance on a job. Fourth, they must be able to relate strategies and knowledge gained in academic settings to educational or vocational goals. Finally, one individual is needed to oversee coordination of all services to ensure that all resources and information are being properly and consistently disseminated. Instruction on how to secure a job and assistance in locating a job might be necessary for certain students. Also imperative throughout this process is the support of family and friends. All of these components must be assessed and evaluated so educators can see the impact of the transition process. In rural settings the goal of transition as defined above is further influenced by narrow school curricula, restricted labor markets, and few college and professional role models (Rojewski, 1999). Often students from rural areas desire to remain in the area in which they grew up. This desire and its concurrent social reinforcement renders them place bound. As a result, it is essential to first form a realistic picture of their options within their own community setting, before developing a comprehensive transition education plan. Therefore, one transition model for students with LD from rural areas is represented by KNOW NO BOUNDS: K-Knowledge, N-Navigation, O-Ongoing, W-Well-informed, N-Niche, O- Observe, B-Background, O-Orchestrate, U-Utilize, N-Negotiate, D-Determination, S-Start. …

Sex Differences in the Educational-Occupational Expectation Process

This study presents a path analytic model of status expectations that focuses on how sex influences the educational and occupational expectations of a large sample of American adolescents. While female and male expectations can be predicted by the same model variables, the process is by no means identical for both sexes. Exogenous background variables have greater total effects for females, while intervening social-psychological and achievement related variables have substantially lesser effects for females than males. The same-sex parent is found to have a greater effect on adolescent expectations than the opposite-sex parent. No significant sex differences are found in the mean level of either expectation, but the distribution of occupational choices parallel the current sex segregation of the occupational sector. Further, relative to academic achievement, the females have lower expectations than the males. These results are interpreted as consequences of traditional sex role socialization. Research on social inequality has shown that women are underrepresented in the higher echelons of the American occupational structure. Women constitute approximately 40 percent of the labor force; more than half of all adult women work outside of the home. Yet only 8 percent of all physicians, dentists, and other related practicioners are women; the ratio of women to men in managerial and administrative positions is low (.20), and even lower (.05) among lawyers and judges (Featherman and Hauser; U.S. Bureau of the Census). Undoubtedly, the relatively low occupational attainment of women, given their large numbers in the labor force, reflects in large part the discrimination they encounter seeking work and on the job: among other things, discriminatory employment practices severely limit women's occupational choices and channel them into positions with highly restricted chances for promotion. But job discrimination does not tell the *This research was supported by a grant to the senior author from the National Institute of Mental Health (MH-23542).