Non-work Activities Research Articles

P-674. The Economic Burden of Infant RSV Among US Caregivers

Abstract Background Respiratory syncytial virus (RSV) is the most common cause of lower respiratory infections in infants and an important cause of infant hospitalization. The burden of RSV extends to infants’ caregivers (CGs) through increased expenses, reduced earnings, and work productivity loss. This study aimed to elucidate the economic impact of providing care for an infant with RSV on CGs.Figure 1.Work Productivity Loss and Non-Work Activity Impairment Methods A cross-sectional survey of primary CGs (aged ≥18 years, US residents) of infants aged ≤12 months who had a medically attended visit for RSV in the prior 6 months between October 2023-April 2024 was conducted. CGs self-reported on sociodemographic characteristics, work productivity loss, lost workdays, healthcare resource utilization (HCRU), income loss, and total household out-of-pocket (OOP) costs based on a 6-month recall during the infant’s RSV episode. Data collection commenced in March 2024 and is ongoing. An interim analysis restricted to the subset of currently employed CGs was performed, with results summarized via descriptive statistics for the total sample and by highest level of care setting that infants received during the RSV episode (Hospital Overnight [HO], Hospital No Overnight [HNO], Emergency Room [ER], Doctor’s Office [DO]).Figure 2.Income Loss and Total Household Out-of-Pocket Costs Results Employed CGs (N=209) were mostly white (91%), male (57%) and had a mean age of 34 (interquartile range [IQR]: 29, 36). Most CGs reported the RSV care setting as HO (51%), followed by HNO (23%), DO (16%) and ER (10%). CGs reported a median of 2 doctor visits, 1 ER visit, and 1 hospitalization during the RSV episode. A majority (57%) reduced working hours during the RSV episode; of these, 37% stopped working completely. CGs reported a mean of 8 (IQR: 3, 8) lost workdays, with the most lost workdays reported for HO (mean: 9 [IQR: 4,8]) and ER (mean: 8 [IQR: 4, 10]) care settings. Mean absenteeism, presenteeism, overall work productivity loss, and activity impairment, as well as median income loss, were highest for HO care setting; CGs incurred a median of $115 in total household OOP costs and $1200 in income loss (Figures 1-2). Conclusion Economic burden among CGs was substantial across care settings, with the highest burden among HO. Protecting infants from severe RSV illness can also reduce the economic burden for CGs. Disclosures Martine C. Maculaitis, PhD, Oracle Life Sciences: Employee of Oracle Life Sciences, which received funding from Pfizer to conduct the study. Cassandra Rene, PhD, MPH, Pfizer Inc.: Advisor/Consultant Joseph C. Cappelleri, PhD, Pfizer Inc.: Employee|Pfizer Inc.: Stocks/Bonds (Public Company) Sarah J. Pugh, PhD, MPH, Pfizer Inc.: Employee|Pfizer Inc.: Stocks/Bonds (Public Company) Ronika Alexander-Parrish, RN, MAEd, Pfizer, Inc.: Employee|Pfizer, Inc.: Ownership Interest|Pfizer, Inc.: Stocks/Bonds (Private Company) Jennifer Deese, PhD, MPH, Pfizer: Stocks/Bonds (Private Company) Michelle Vichnin, MD, Pfizer Inc.: Employee|Pfizer Inc.: Stocks/Bonds (Public Company) Monica F. Turiga, MD, Pfizer Inc.: Employee|Pfizer Inc.: Stocks/Bonds (Public Company) Nemin Chen, PhD, Pfizer: Advisor/Consultant Jessica E. Atwell, PhD, MPH, Pfizer Inc.: Employee|Pfizer Inc.: Stocks/Bonds (Public Company) Amy W. Law, PharmD, Pfizer Inc.: Employee|Pfizer Inc.: Stocks/Bonds (Public Company)

Evening recovery through nonwork creative activities: a diary study on well-being, self-expression, and absorption

ABSTRACT In this diary study, we examined whether creative activities during leisure are related to affective well-being at bedtime and work-related self-efficacy the next morning. We propose that these relationships are mediated by self-expression and moderated by absorption, with stronger relationships when absorption is high. Diary data were collected from 84 employes (N = 329 days) three times daily over five consecutive workweek days. We analyzed the data using multilevel modeling, controlling for other leisure activities. Results showed that nonwork creative activity was related to evening recovery, indicated by a change in affective well-being (higher positive activation, higher serenity, lower fatigue), but not with work-related self-efficacy. Self-expression mediated the relationship between nonwork creative activity and well-being, and absorption did not function as a moderator but as a mediator. Overall, these findings extend the research on nonwork creative activities and examine the underlying mechanisms between nonwork creative activity and affective well-being.

Meaningful Work, Post-Work, and Contemporary Aristotelianism

The paper explores the relation between a contemporary Aristotelian conception of human flourishing and two critical perspectives on work. The meaningful work perspective inquires what kind of work would be meaningful, by arguing that meaningful work is essential for human flourishing. The post-work perspective argues that good life lies outside work and workplaces and calls to eliminate work as much as possible. The paper suggests that it is possible to acknowledge the insights of both perspectives via contemporary Aristotelian notions of practice and human flourishing. The notion of practice incorporates the conception of meaningful work, yet it applies to nonwork activities as well. Conceptualization of human well-being via the notion of practice also responds to the post-work challenge of conceiving human flourishing without prioritizing work over other meaningful activities. In this way, a contemporary Aristotelian conception of human flourishing supports both the need for better work and less work.

Between obligations and leisure: an examination of non-work activities among the generation 55+ in Poland and Czechia

This article seeks to evaluate the non-work activities of the generation 55+ in Poland and the Czech Republic. The theoretical framework relies on Ronald Inglehart's theory of values, which is also applied in the research methodology. Following Inglehart's theory, the activities of the generation 55+ can be categorised into two groups. The first group aligns with materialist duty-related values, encompassing responsibilities such as caring for grandchildren, tending to elderly and disabled family members, and participating in religious observances. The second group aligns with postmaterialist values, emphasising personal development, self-expression, and quality of life. These activities encompass participation in classes offered by the University of the Third Age, volunteering, engaging in sports, and tourism. The research findings indicate a greater involvement of Poles in duty-related activities, particularly among women. This suggests a prevalence of materialist values in Poland. Conversely, Czechs, especially Czech women, exhibit more active involvement in leisure activities, pointing to the predominance of postmaterialist values. The conclusions present an integrated model of non-work activities for the generation 55+ that takes into account both materialist and post-materialist values.

Hypothetical mechanisms driving physical activity levels in ethnic minority groups living in Europe: a systematically identified evidence-based conceptual systems model

BackgroundIn Europe, physical activity levels tend to be lower in ethnic minority groups than the general population. Interventions and policies based on research examining isolated determinants of physical activity have had limited success in increasing physical activity levels. This study used systems dynamics theory and the capability approach theoretical framework to develop a conceptual model of how individual characteristics, institutional and physical environments and the migration context may interact to promote or hinder physical activity in ethnic minority groups living in Europe.MethodsA systematic update of Langøien et al.’s 2017 review of the determinants of physical activity in ethnic minority groups living in Europe was conducted. Our target population included individuals of all ages who reported a familial migration background from any low- and middle-income countries or belonging to minority indigenous population in Europe. Outcomes pertaining to non-work related physical activity of light, moderate or vigorous intensity performed in any setting were included. Included studies provided an evidence base from which to derive the causal loop diagrams comprising our conceptual model. Sub-system causal loop diagrams were interpreted in co-author review sessions to explicate non-linear system mechanisms, such as reinforcing and balancing feedback loops.ResultsForty-one studies were identified, of which the majority was qualitative. The conceptual model consisted of 4 causal loop diagrams relating to psychosocial constructs; sociocultural constructs; health and health communication and social and material resources, in interaction with environmental/migration context. Four hypothetical mechanisms were identified, e.g. hypothesizing that participation in organised activities leads to increased self-efficacy, thereby enabling further participation.ConclusionsThis study contributes an evidence-based conceptual systems model which elucidates how low levels of physical activity in ethnic minority groups in Europe could be supported by reinforcing and balancing mechanisms involving factors relating to physical and institutional environments, migration context and individuals. A pluralistic approach to literature review, integrating complexity methods such as CLDs into more conventional systematic literature review, supports novel insights into how factors could interact to support persistently low levels of activity, moving beyond the identification of potential relationships between isolated factors to indicating the ways in which these relationships are sustained and could be modified by intervention or policy.

Mitigating Workplace Burnout Through Transformational Leadership and Employee Participation in Recovery Experiences.

Description Burnout is a complex organizational phenomenon that diminishes employee well-being and overall organizational productivity. Researchers propose that leadership style contributes to employees' well-being, which impacts employee productivity. Organizations and leaders must address the causes of burnout and promote techniques employees can use to mitigate burnout, such as employee participation in recovery experiences. Recovery experiences are non-work activities that create positive outlooks and restore the energy needed to focus on one's work. This literature review examines current research in employee recovery experiences, conservation of resource theory (COR), burnout, and transformational leadership theory. Studying burnout through the lens of COR shows how important resource gain and recovery activities are to healthy employees and their job performance within the organization. The research reviewed suggests that transformational and transactional leadership styles have higher probabilities of promoting employee participation in recovery experiences than passive avoidant leadership style. The literature consistently showed burnout as a significant organizational phenomenon negatively affecting productivity, employee well-being, and turnover rates. The literature revealed that mitigating burnout happens through participation in recovery experiences. The literature on leadership styles supports the assumption that leaders play a significant role in employee well-being, group identity, and organizational climate. Leaders who desire to mitigate employee burnout will benefit from research that links transformational leadership style behaviors and employee participation in recovery activities.

Burden of Disease Associated with Refractory and Unexplained Chronic Cough in Canada: Results from a National Survey.

Chronic cough (persisting for ≥ 8weeks) is a common disorder that includes refractory chronic cough (RCC; cough that persists despite treatment of underlying disease) and unexplained chronic cough (UCC; cough with no identifiable cause). We evaluated self-reported health-related quality of life (HR-QoL) and work/activity impairment associated with RCC/UCC in Canada. Our exploratory study included Canadians in the Leger Opinion Panel with RCC or UCC. Key entry criteria were ≥ 18years of age, cough for ≥ 8weeks, not currently smoking/quit ≥ 1year ago, no serious respiratory disease or lung cancer, and not taking angiotensin-converting enzyme inhibitors. Respondents completed a 30-min online survey with general and cough-specific HR-QoL questionnaires, including the EuroQol (EQ) visual analogue scale (VAS), EQ-5-dimension 5-level (EQ-5D-5L), cough severity VAS, Leicester Cough Questionnaire (LCQ), and Work Productivity and Activity Impairment-Specific Health Problem (WPAI-SPH). Of 49,076 individuals who completed the chronic cough screening questionnaire (July 30-September 1, 2021), 1,620 (3.3%) met entry criteria for RCC/UCC and 1,046 (2.1%) completed the survey. The mean age of respondents was 45years and 61% were female. Respondents reported impairments in global HR-QoL (EQ-VAS 73.8, 61% with anxiety/depression on the EQ-5D-5L) and cough-specific HR-QoL (mean cough severity VAS score 29.7, LCQ index 15.2). Work and non-work activities were reduced by 34% and 30%, respectively, on the WPAI-SPH. RCC/UCC is prevalent in Canada and associated with impaired HR-QoL, particularly in mental health domains. Additional support and management options may be required to fully address this burden.

Level and limitations of physical activity in patients with excess body weight or diabetes

Physical activity (PA) is recommended to prevent or treat many diseases, but various factors may limit it. We analyse the level of PA and the barriers to undertaking it. Patients...

#254 PaCE CKD: examining health status and financial burden in patients with chronic kidney disease: assessing the non-clinical burden of disease

Abstract Background and Aims There is a detrimental effect of chronic kidney disease (CKD) on health states, with many patients worldwide experiencing considerable symptom burden and development of comorbidities, leading to frequent medical appointments and hospitalisations. Patients experience disease-associated financial strain as their ability to work is impaired. The aim of this multinational study was to characterise the non-clinical burden of CKD by quantifying the effect of CKD on health states and productivity in patients versus general population in several regions. Method Patients with early (stages 1-3) to advanced (stages 4-5) of CKD, including those receiving dialysis treatment, in Germany, Mexico, Taiwan, the UK, and the US were enrolled to a cross-sectional non-interventional survey measuring: Scores were compared with a general population cohort, matched 1:1 in sample size against patient cohorts and for demographic characteristics (e.g. age and area of residence). Results Across five countries, an average of 201 (range: 190–212) patients were enrolled, of whom 42% were receiving dialysis in Germany, 57% in Mexico, and 55% in the UK with smaller proportions of patients on dialysis cohorts in the US (32%) and Taiwan (15%). Haemodialysis was the most prevalent mode of dialysis in all countries, with most patients receiving dialysis in a clinic or hospital. Enrolled patients who had received a kidney transplant accounted for 11.5% on average across all countries. Compared with general population, people with CKD experienced a 24% reduction in mean [SD] EQ-5D utility scores, with patients in the US experiencing the greatest disparity in health states (0.64 [0.27] versus 0.95 [0.08]). Patients with CKD reported significantly more problems across all EQ-5D domains in Germany, Mexico, the US, and UK than general population cohorts. The highest percentage of patients reporting problems was in Mexico, with 81.4% reporting problems in usual activities compared with 4.4% in the general population. Patients receiving dialysis reported a mean EQ-VAS value of 70.3 compared with 91.8 in non-dialysis dependent patients, indicating that treatment burden negatively contributes towards patients perception of their health. In addition to impaired health states, patients reported elevated impairment across work and non-work activities in all countries. Patients reported increased rates of absenteeism, presenteeism, work impairment and non-work activity impairment, with the greatest impairment observed in the UK of 46.4% in non-work activity impairment compared with the general population. Conclusion These results indicate that people with CKD experience substantial burden of disease that extends beyond its clinical aspects. Decision makers should consider broader disease effects when addressing the burden of CKD.

#255 PaCE CKD: the impact of caregiving on health states and work productivity in chronic kidney disease: results from an international survey

Abstract Background and Aims Patients with chronic kidney disease (CKD) often rely on informal caregivers for support with their condition, but the effect of these responsibilities on caregivers’ lives is poorly understood. The aim of this study was to quantify the effect of CKD on caregivers’ health states and work productivity across five countries compared with the general population. Method Unpaid informal caregivers of patients with CKD, hereafter referred to as caregivers, in Germany, Mexico, Taiwan, the US, and the UK were enrolled to a non-interventional survey. Caregivers of patients with early (stages 1-3) to advanced (stages 4-5) CKD, including those receiving dialysis were enrolled in the study. A general population cohort was included, matched in sample size and demographic characteristics. The surveys assessed health states and work productivity with the following instruments: Results Across five countries, an average of 112 (range: 94–138) caregivers were enrolled to the study. Most respondents cared for a patient receiving dialysis—in Germany (65%), Mexico (65%), UK (67%), US (81%), though less than half (48%) of respondents in Taiwan cared for a dialysis dependent patient. Frequently reported caregiving duties were help with household duties and driving to medical appointments. Caregivers in Germany, Mexico, the US, and UK experienced significantly impaired health states compared with the general population, as demonstrated by lower EQ-5D-5L utility scores. The greatest difference was observed from respondents in Mexico, with 16% lower mean [SD] index scores compared with the general population (0.79 [0.18] versus 0.94 [0.07]). Caregivers of dialysis dependent patients had similar CarerQol utility scores as those caregiving for non-dialysis dependent patients. Caregivers for dialysis dependent patients reported more problems across all CarerQol domains than caregivers for non-dialysis dependent patients. Caregivers in the UK reported significantly more financial problems (33%) as a result of caregiving; caregivers in the US reported significantly more problems (30%) in combining daily activities with care tasks. Caregiving also had a negative effect on work productivity. Rates of absenteeism, presenteeism, work impairment and non-work activity impairment were worse in caregivers compared with the general population. The largest effects were observed in Mexico where a 40% increase in non-work activity impairment was reported. Conclusion This study highlights the global burden for caregivers of patients with CKD. The broader impact of disease on caregivers should be accounted for when considering interventions relating to CKD.

Examining the implications of work–nonwork demand congruence

AbstractExamining the implications of excessive work demands on employee well‐being is an important research area of occupational health psychology. Recovery during nonwork time has been emphasized as an important process for mitigating the negative implications of excessive work demands. However, this notion ignores the potential for nonwork activities to be comparably demanding to work activities. There has been a lack of attention paid to the potentially complex interrelationships between work and nonwork demands. Using the effort–recovery and challenge–hindrance stressor models, we developed a set of hypotheses for both the positive and negative implications of the interplay between employee work and nonwork cognitive demands. We collected information on cognitive workweek job demands (Friday) and nonwork cognitive weekend demands (Sunday) from a sample of workers (N = 146), and we used polynomial regression with response surface analysis to examine how different aspects of work–nonwork cognitive demand (in)congruence related to Monday work engagement. In general, higher cognitive workweek job demands promoted work engagement, even when nonwork cognitive demands were equally high. Cognitive demand incongruence that favoured higher cognitive work demands was also beneficial for employee work engagement. Theoretical and practical implications are discussed, along with directions for future research in this area.

Work Productivity and General Health Through 2 Years of Guselkumab Treatment in a Phase 3 Randomized Trial of Patients With Active Psoriatic Arthritis.

To evaluate the effect of guselkumab on work productivity and nonwork daily activity impairment and general health status through 2years in patients who were biologic-naïve with active psoriatic arthritis (PsA) in the phase 3 DISCOVER-2 clinical trial. Adult patients with PsA were randomized to subcutaneous injections of guselkumab 100mg every 4weeks (Q4W); at weeks 0, 4, then every 8 weeks (Q8W); or placebo (throughweek 24 with crossoverto guselkumab Q4W). Work productivity and nonwork daily activity impairment were assessed using the Work Productivity and Activity Impairment Questionnaire for PsA (WPAI-PsA) and patient-reported general health status using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) Index and EQ-Visual Analog Scale (EQ-VAS). Least-squares (LS) mean changes from baseline in WPAI-PsA domains and EQ-5D-5L/EQ-VAS were assessed through week 100. Changes in employment status were utilized to estimate potential indirect savings from improved work productivity. Of 739 randomized patients, 738 had available baseline data for the analyses (Q4W 245; Q8W 248; placebo 245). At week 24, greater improvements in work productivity, nonwork daily activity, and EQ-5D-5L/EQ-VAS were observed in the Q4W and Q8W groups versus the placebo group. At week 100, LS mean reductions in work productivity impairment (- 23.8% to - 28.0%) and nonwork daily activity impairment (- 26.6% to - 29.2%) and improvements in EQ-5D-5L/EQ-VAS (0.14 to 0.15/21.2 to 25.0) were maintained in patients receiving guselkumab. Among patients employed at baseline, 12.1-16.4% were not employed at week 100, and 20.0-25.3% shifted from not employed at baseline to employed at week 100. Potential yearly indirect cost savings (USD) from improved work productivity at week 100 ranged from $16,529 to $19,409. Patients with active PsA treated with guselkumab demonstrated reduced impairment in work productivity and nonwork daily activity, together with improvement in general health status and substantial potential cost savings, over a 2-year period. Clinicaltrials.gov identifier: NCT03158285.

A117 WORK PRODUCTIVITY IMPAIRMENT IN PERSONS WITH INFLAMMATORY BOWEL DISEASES: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract Background Inflammatory bowel diseases (IBD), which include Crohn’s disease (CD) and ulcerative colitis (UC), are chronic disorders that affect approximately 6.8 million people globally. IBD often develops at an early age and can have a significant impact on employment outcomes and work productivity. Individuals with IBD have higher rates of unemployment, sick leave, and work disability compared to the general population. Nevertheless, there remains a paucity of standardized reporting on work productivity impairment and the associated indirect costs in patients with IBD. Aims In this systematic review and meta-analysis, we evaluate work-related outcomes and employment data among patients with IBD. This may inform clinical and policy decisions to facilitate workplace accomodations for patients with IBD and improve their work productivity. Methods A systematic literature search was conducted in MEDLINE, EMBASE, and the Cochrane library, in addition to Scopus, ProQuest, and clinicaltrials.gov from inception to February 2023. We included full-texts and abstracts of observational and clinical trials that reported work-related outcomes in patients with IBD aged ampersand:003E18 years. We collected work-related data as described by the Work Productivity and Activity Impairment (WPAI) tool, in addition to other outcomes including employment, sick leaves, disability pensions, and indirect costs due to productivity loss. Pooled effect analysis was conducted using a random-effects model for pooled estimates of continuous and proportional data with 95% confidence intervals (CIs). Odds ratios (ORs) and mean differences were used to compare data between patients with active disease vs. remission. Results We included 134 studies (96 full-text articles and 38 abstracts). Among all patients with IBD, the pooled estimates were 16.41% [13.89-18.93] for absenteeism, 35.91% [31.11-40.72] for presenteeism, 39.41% [33.93-44.88] for overall productivity loss, and 45.96% [39.46-52.46] for non-work related activity impairment. Indirect costs were estimated at 1,813.9, 3,562.49, and 5,131.09 euros/patient/year for absenteeism, presenteeism, and overall work impairment respectively. For other non-WPAI outcomes, the pooled estimate for employment was 65.6%, 39.5% of patients reported sick days, 21.3% reported disability at work due to IBD directly, 12.3% received disability pensions, and 29.6% had lost jobs due to IBD. Overall, patients with active disease had worse WPAI and employment outcomes than those in remission. Conclusions IBD may result in significant work productivity impairment, lower employment, and significant indirect costs due to productivity loss. Larger studies with standardized definitions for work outcomes are needed to better evaluate the impact of IBD on work productivity. Funding Agencies Mount Sinai Resident Research Funding

The relationship between motivation and procrastination at work

This paper aims to examine the relationship between motivation and procrastination in the workplace. Motivation is addressed as a key factor in determining individual and organisational performanceand its impact on commitment, productivity and job satisfaction is investigated. The paper also focuses on various motivational theories and how they can be applied in the specific context of the work environment. In the organizational context, procrastination can lead to decreased workforce effectiveness and thus decreased organizational productivity focusing on the behaviors associated with procrastination in the work environment which can be classified into two main categories:the first involving engaging in non-work activities duringworking hours such as long discussions, prolonged breaks or cleaning the workspace and the second category of procrastination which refers to the extensive use of technology, especially the internet and mobile devices, known as „cyberslacking”.

Burden and Impact of Reactogenicity among Adults Receiving COVID-19 Vaccines in the United States and Canada: Results from a Prospective Observational Study.

As SARS-CoV-2 variants continue to emerge, vaccination remains a critical tool to reduce the COVID-19 burden. Vaccine reactogenicity and the impact on work productivity/daily activities are recognized as contributing factors to vaccine hesitancy. To encourage continued COVID-19 vaccination, a more complete understanding of the differences in reactogenicity and impairment due to vaccine-related side effects across currently available vaccines is necessary. The 2019nCoV-406 study (n = 1367) was a prospective observational study of reactogenicity and associated impairments in adults in the United States and Canada who received an approved/authorized COVID-19 vaccine. Compared with recipients of mRNA COVID-19 booster vaccines, a smaller percentage of NVX-CoV2373 booster recipients reported local and systemic reactogenicity. This study's primary endpoint (percentage of participants with ≥50% overall work impairment on ≥1 of the 6 days post-vaccination period) did not show significant differences. However, the data suggest that NVX-CoV2373 booster recipients trended toward being less impaired overall than recipients of an mRNA booster; further research is needed to confirm this observed trend. The results of this real-world study suggest that NVX-CoV2373 may be a beneficial vaccine option with limited impact on non-work activities, in part due to the few reactogenicity events after vaccination.

A modern approach to ergonomics: the study of work and non-work activities of employees

The purpose of the study is to determine how an employee's work and non-work activities are related. The relevance of after-work activities is covered in the introduction. The relationship between employees' work and non-work activities is illustrated in the section that follows. The last section addresses the effects of employees' unequal workloads and non-work activities as well as suggestions for personalized advice. An individual's general well-being depends on having a balanced ratio between work and non-work activities, which is why the article offers a more comprehensive answer to this issue.

The Burden of Pain Symptoms in Individuals with Uterine Fibroids-Results from a Prospective Observational Study in the USA.

To characterize the burden of uterine fibroids (UF) in individuals experiencing heavy menstrual bleeding (HMB) and moderate-to-severe UF-associated pain in terms of symptoms experienced, impact on work and activities, and pain medication use both on menstrual and non-menstrual days. This prospective, real-world, observational study enrolled 350 participants in the USA with a self-reported UF diagnosis, HMB, and moderate-to-severe pain due to UF. Data collection took place from February 9 to July 19, 2021. Over 4 months, participants used an online platform to self-report daily menstrual status, bleeding intensity, UF-associated pain severity, and pain medication use, and to complete weekly work and productivity questionnaires. Results were analyzed descriptively and are reported for the overall population, by pain medication subgroups-defined based on the most potent medication taken-and menstrual versus non-menstrual days/weeks. The analysis population consisted of 307 participants with ≤5 consecutive missing days of daily survey responses or ≥75% completion rate of the daily surveys. Mean age of participants (standard deviation; SD) was 37.2 (6.3) years. At baseline, 54.1% of participants reported not currently taking medication for treatment of HMB. Over the study period, mean UF-associated pain scores (SD; scale range 0-10) were higher on menstrual days (3.5 [2.7]) than non-menstrual days (1.0 [1.8]), and this was consistent across medication use subgroups. Pain medications were used more frequently on menstrual days than non-menstrual days (22.9% versus 3.7% days of pain medication use, respectively). Participants reported 31.5% work impairment on menstrual weeks versus a 12.7% work impairment on non-menstrual weeks. In this study, UF-associated pain symptoms coincided with a reduction in individuals' ability to take part in both work and non-work activities and an increase in pain medication use, particularly during menstrual weeks. These results highlight the need for improved diagnosis and pain management strategies in UF.

Does functional system segregation mediate the effects of lifestyle on cognition in older adults?

Healthy aging is typically accompanied by cognitive decline. Previous work has shown that engaging in multiple, non-work activities during midlife can have a protective effect on cognition several decades later, rendering it less dependent on brain structural health; the definition of “cognitive reserve”. Other work has shown that increasing age is associated with reduced segregation of large-scale brain functional networks. Here we tested the hypothesis that functional segregation (SyS) mediates this effect of middle-aged lifestyle on late-life cognition. We used fMRI data from three tasks in the CamCAN dataset, together with cognitive data on fluid intelligence, episodic memory, and retrospective lifestyle data from the Lifetime of Experiences Questionnaire (LEQ). In all three tasks, we showed that SyS related to fluid intelligence even after adjusting for the (nonlinear) age effects. However, we found no evidence that SyS in late-life mediated the relationship between non-specific (non-occupation) midlife activities and either measure of cognition in late-life. Thus, the brain correlates of cognitive reserve arising from mid-life activities remain to be discovered.

Return-to-work with long COVID: An Episodic Disability and Total Worker Health® analysis

A growing number of working individuals have developed long COVID (LC) after COVID-19 infection. Economic analyses indicate that workers' LC symptoms contribute to workforce shortages. However, factors that affect return-to-work from perspectives of people with LC remain largely underexplored. This qualitative study of people with LC conducted by researchers living with LC aimed to identify participants' return-to-work experiences using Total Worker Health® and Episodic Disability frameworks. 10% of participants who participated in a mixed-method global internet survey, had LC symptoms >3 months, and responded in English were randomly selected for thematic analysis using NVivo12. 15% of responses were independently double-coded to identify coding discrepancies. Participants (N = 510) were predominately white and had at least a baccalaureate degree. Four primary work-related themes emerged: 1) strong desire and need to return to work motivated by sense of purpose and financial precarity; 2) diverse and episodic LC symptoms intersect with organization of work and home life; 3) pervasiveness of LC disbelief and stigma at work and in medical settings; and 4) support of medical providers is key to successful return-to-work. Participants described how fluctuation of symptoms, exacerbated by work-related tasks, made returning to work challenging. Participants’ ability to work was often predicated on job accommodations and support. Non-work factors were also essential, especially being able to receive an LC medical diagnosis (key to accessing leave and accommodations) and help at home to manage non-work activities. Many participants described barriers accessing these supports, illuminating stigma and disbelief in LC as a medical condition. Qualitative findings indicate needs for workplace accommodations tailored to fluctuating symptoms, continuously re-evaluated by workers and supervisors together. Reductions in medical barriers to access work accommodations is also critical since many medical providers remain unaware of LC, and workers may lack a positive COVID test result.

Worker role perceptions and work participation among people with mental health issues taking part in interventions focusing on everyday life.

Knowing whether interventions addressing everyday life as a whole can affect work readiness for people with severe mental health issues would be important for how to develop support. To compare two groups of people with mental health problems, receiving either of two types of 16-week activity-based interventions, Balancing Everyday Life (BEL) or Care as Usual (CAU), regarding work readiness in terms of perceived worker role and satisfaction with recent work experience. Changes from baseline (T1) to completed intervention (T2) and a six-month follow-up (T3) and variables of potential importance to changes were also explored. This cluster RCT recruited participants for BEL (n = 133) and CAU (n = 93) from specialized and community-based psychiatry. Questionnaires addressing work readiness and potentially influencing variables (sociodemographic, clinical, type of intervention, work experience, non-work activity factors, social interaction and self-esteem) were used. Mixed model regression analyses were employed. Positive changes occurred for both groups in one worker role aspect (resources for a future worker role) and in satisfaction with recent work participation. Satisfaction with non-work everyday activities, having valued activities, and self-esteem were important for change in the work readiness variables, whereas intervention type, age, sex or general activity level were not. Both interventions yielded equally positive work readiness outcomes. Support that emphasizes engagement in satisfying and valued everyday activities and boosts self-esteem would be a potential way to help people with mental health issues develop work readiness in terms of the worker role and satisfaction with work participation.