Unpaid Work Activities Research Articles

Health and Productivity Benefits with Early Intensified Treatment in Patients with Type 2 Diabetes: Results from Korea.

The available evidence suggests positive health outcomes associated with early treatment intensification in Type 2 diabetes mellitus (T2DM). Our study estimated the productivity effects arising from improved health correlated with early intensified treatment in T2DM in Korea. Using a recently published methodology and model, we investigated the association between early intensified treatment and the probability of experiencing fewer diabetes-related complication events. Treatment strategies leading to better health outcomes are expected to be associated with social value through increased participation in paid and unpaid work activities. Therefore, we translated the lower incidence of complications into monetary terms related to productivity for the Korean population. We quantified productivity by considering (a) absenteeism, (b) presenteeism, (c) permanent loss of labor force, and (d) activity restriction. Deterministic and probabilistic sensitivity analyses in the base case parameter were performed. Approximately, 1.7 thousand (standard deviation [SD] ±580 events) micro- and macrovascular complication events could potentially be avoided by early treatment intensification. This led to a societal gain attributed to increased productivity of 23 million USD (SD ± $8.2 million). This article demonstrates the likelihood of achieving better health and productivity through early intensified treatment in diabetes.

Informal Work and the Appropriation of Social Reproduction in Home-Based Work in India

Home-based work is among the largest forms of employment in the informal economy in India and is overwhelmingly represented by women. Employing a social reproduction framework that reframes what is counted as labor, this article asks how women’s unpaid work activities are appropriated as labor in subcontracted home-based work. Applying this analytical framework, it becomes clear that domestic work in the home, often completed by women, is needed and exploited in this production process as a result of gendered constructs of care. The contribution considers how unpaid work is directly appropriated by capital as surplus value. The context of informal work is key here because of the irregular and fragmented production process, the space where work occurs, and the use of unpaid family workers. The goal of this research is to offer empirical evidence that broadens analytical perspectives to account for the context of informality in the Global South. HIGHLIGHTS Subcontracted home-based work in India relies on a gendered, fragmented, and precarious labor force. Unpaid caregiving and household work directly contributes to profit-making. Western analytical concepts of the economy need to be reexamined in the context of the postcolonial informal economies. Research tools that measure economic participation need to capture how unpaid activities directly or indirectly contribute to economic processes.

Dietary Choices as Prevention Measure: Assessment of Societal Effects Related to Life Expectancy in Germany

Public health determines economic stability and growth. Inappropriate dietary behaviour induces a huge health burden across all age groups and geographical regions every year. Nutrition is one major driver to overcome non-communicable diseases and related costs. According to the World Health Organization, there is a gap in research considering the cost-effectiveness of policy nutrition interventions. The present modelling study is the first attempt to evaluate a potential nationwide shift towards healthy nutrition from a societal perspective. The scenario modelling builds on most recent findings from the research field and status quo food consumption according to national nutrition survey data. Potential age- and gender-specific gains in life expectancy due to diet improvement are evaluated for the 2019 population in Germany addressing different scenarios (optimal diet and feasible diet). Drawing on a human capital approach, the resulting health gains are translated into a societal value building on related gains in unpaid work productivity. The monetary evaluation of productivity increase is implemented according to the specialist’s approach. The potential gain in unpaid work activities related to improved nutrition, is estimated at € 5,046bn for the 2019 German population assuming an optimal diet scenario. In case of the more feasible diet scenario, additional life expectancy is lower but still valuable. Health gains are less for women as compared to men, but the societal value is higher for females due to higher societal contribution in terms of unpaid activities across all age groups. The potential health gains are highest for young age groups, but the monetary societal value for these individuals is lower due to discounting of future benefits. The study illustrates the societal value of nutrition as one dimension of preventing non-communicable diseases. Thereby, it provides valuable insights for policy decision makers to develop interventions on the population level that support transformation of the health care systems and economic structures towards a sustainable direction.

The impact of omalizumab on paid and unpaid work productivity among severe Japanese cedar pollinosis (JCP) patients

Aims Japanese cedar pollinosis (JCP) is a form of seasonal allergic rhinitis that affects 38.8% of the Japanese population. Particularly severe and most severe symptoms among JCP patients can lead to impairments of paid work productivity and unpaid work activities. Indeed, the current standard of care (SoC) is not always able to relieve these symptoms. Omalizumab, a novel JCP treatment recently approved in Japan, provides an effective add-on therapy to the SoC. This study estimates the effect of omalizumab on paid and unpaid work activities (i.e. its social impact) in patients with severe and most severe JCP symptoms in Japan. Methods The impact of omalizumab was estimated through a one-year static cohort model using the Work Productivity and Activity Impairment Allergy Specific (WPAI-AS) questionnaire derived from a clinical trial on omalizumab enrolling patients with severe and most severe JCP symptoms, which had been conducted in Japan. This effect was quantified using Japanese official statistics on employment and time use. The human capital approach and the proxy good approach were employed to monetize paid and unpaid work activities, respectively. A sensitivity analysis was implemented to account for modeling structural uncertainties. Results Our results show that the use of omalizumab might reduce the paid and unpaid work productivity losses due to severe and most severe JCP by nearly one-third. In the severe symptom period of three weeks, 36.6 million hours of lost paid and unpaid work hours could be avoided, which sums up to a monetized productivity loss of 728.3 million USD. Conclusions Omalizumab could provide substantial benefits in terms of paid and unpaid work activities in patients with severe and most severe JCP. Our results also highlight the importance of considering unpaid work in estimating productivity costs due to poor health.

TIME ALLOCATION AND FEELINGS OF HAPPINESS OF SELF-EMPLOYED PERSONS – A GENDERED PERSPECTIVE

This article focuses on the division of the daily activities of self-employed persons on entrepreneurial activities, unpaid work, leisure time and other activities, and their interconnection to the feelings of happiness (as part of subjective well-being). Modified Time Use Survey (TUS) methodology was used to gather data on division of time and to identify SWB. The 13 groups of activities and 161 self-employed persons were included in the analysis. The results suggest that both self-employed men and women dedicate more than 8 hours per day for paid work. Daily activities during which the highest part of self-employed men and women feel the happiest belong to leisure activities. Unpaid work activities bring the highest feeling of happiness to 12.5 % of self-employed women. Feelings of happiness of self-employed women are more fluctuating during the paid work than feelings of happiness of self-employed men. In the evening, the feelings of happiness of the self-employed women decrease significantly, which could be caused by double burden of self-employed women.

Measuring productivity loss in early relapsing-remitting multiple sclerosis

BackgroundMultiple sclerosis is one of the most common causes of neurological disability in young adults with major consequences for their autonomy and capacity to maintain employment. ObjectiveThe aim of this study was to assess the impact on work productivity in early-stage relapsing-remitting multiple sclerosis (RRMS). MethodsA multicenter, non-interventional study was conducted. Adult patients with a diagnosis of RRMS, a disease duration ≤ 3 years, and an Expanded Disability Status Scale (EDSS) score of 0–5.5 were included. Absenteeism, presenteeism, and unpaid work loss due to RRMS were measured using the Valuation of Lost Productivity (VOLP) questionnaire. The EDSS, SymptoMScreen, 5-item Modified Fatigue Impact Scale, Hospital Anxiety and Depression Scale, Symbol Digit Modalities Test, and Multiple Sclerosis Work Difficulties Questionnaire were used to gather information on disability, patients’ perception of symptom severity, fatigue, mood/anxiety, cognition, and problems in the workplace, respectively. Associations between the VOLP and clinical and work outcomes were analyzed using Spearman's rank correlations. ResultsA total of 189 patients were included. Mean age (SD) was 36.1 ± 9.4 years and 71.4% were female. Mean disease duration was 1.2 ± 0.8 years. Median EDSS score was 1.0 (IQR 0, 2.0). One hundred thirty patients (68.8%) were working for pay or self-employed. Fifty-three patients (40.8%) reported absence from work in the past 3 months with an average of 14.3 absent workdays. Their health problems resulted in the loss of 3.4% of their actual work time in the past 7 days. Thirty patients got help (11.8 h) with their unpaid work activities in the past 7 days. Absenteeism was significantly correlated with anxiety and depression (rho=0.298 and 0.291, p<0.001), fatigue (rho=0.214, p = 0.014), and symptom severity (rho=0.213, p = 0.015). Presenteeism was significantly correlated with fatigue (rho=0.375, p<0.001), symptom severity (rho=0.373, p<0.001), depression (rho=0.263, p = 0.008), and disability (rho=0.215, p = 0.031). ConclusionsProductivity loss even in a RRMS population with short disease duration stresses the need for more efficient treatment control of disease activity from earlier stages.

Gender and Social Institutions in the Labour Markets: An Analytical Perspective on the Covid-19 Disruptions in Northeast India

This article examines the trends and patterns of unpaid work performed by women in India’s North Eastern States and account for the factors that underlie these trends. It uses the two unit-level datasets from the National Sample Survey Office Employment and Unemployment Survey 2011–2012 and Periodic Labour Force Survey 2018–2019. The multinomial regression results found that illiterate and lower social stratum have more chances to engage in unpaid activities. It then explores the impact of COVID-19 on unpaid work activities among women in the northeast states. The telephonic conversation and informal interviews with different regional stakeholders have been substantiated along with the utilisation of the Centre for Monitoring Indian Economy report on employment and unemployment for the second quarter of 2020 for nuanced analysis. The study found that women are losing their livelihood very fast during the pandemic and the effects are likely to linger for a more extended period. JEL Codes: J16, J21, J22, R23

(Un)Sustainability of the Time Devoted to Selected Housework—Evidence from Slovakia

Domestic appliances play a vital role in modern households. Appliances help simplify domestic work, but individuals become dependent on them. The present paper aims to contribute to the long-standing dilemma among scholars whether domestic appliances help to shorten the time devoted to household chores or not. The paper focuses on the utilization of various domestic appliances in Slovak households and on the influence of their utilization on the time of men and women in partner households and in the single-person households devoted to routine unpaid work activities. The results of the paper are based on the data from original field research conducted in Slovakia in 2015. A total of 1179 partner households, 182 single-man households and 226 single-woman households were included in the analysis. The jamovi version 1.2 statistical program was used to verify the hypothesis by chi-squared goodness of fit test and nonparametric Mann–Whitney U-test. In partner households and in single-man households, usage of automatic washing machines significantly influences time devoted to preparation and maintenance of the clothes. In single-woman households, usage of dishwasher significantly influences time devoted to food preparation. In partner households, men devote less time to routine unpaid work activities than women, regardless of usage or non-usage of domestic appliances.

The socioeconomic burden of migraine: An evaluation of productivity losses due to migraine headaches based on a population study in Germany.

This study estimates the socioeconomic impact of migraine headaches on paid and unpaid work productivity in the adult German population in 1 year. We used data on headache frequency (days per month) from a longitudinal population-based study. Prevalence estimates of migraine were derived from the Global Burden of Disease Collaborative Network. Demography data were derived from official statistics in 2017. Aggregate headache days in 1 year were translated to losses in paid and unpaid productive hours based on estimates of presenteeism and absenteeism along with other socioeconomic parameters. Paid hours lost were distributed across the industry sectors. In this way, an age-, gender- and industry sector-specific monetary value was calculated for paid hours lost. Unpaid hours lost were valued by assigning the unpaid activities to their nearest market substitute. In a last step, value-added multipliers derived from input-output tables were used to calculate the economic value chain effects. A total of 15.5 million persons (20 years or older) suffer from migraine in Germany. Our analysis shows that 60% of those have three or fewer headache days per month, while patients suffering chronic migraine (15+ headache days per month) account for 5.4% of the adult migraine population. Females bear 65% of the total 836 million headache days per year. The socioeconomic losses due to migraine amount to €100.4 billion (€6493 on average per patient) in one year. In addition to time losses in paid work, migraine causes substantial socioeconomic losses to unpaid work activities due to its disproportionate prevalence among females. Economic value chain effects provide a novel perspective on losses beyond a patient's time loss. Overall, the elements of socioeconomic burden provide a strong rationale that innovative migraine therapies could be of high value to society.

Re-examining How Partner Co-presence and Multitasking Affect Parents’ Enjoyment of Childcare and Housework

Partner co-presence and multitasking are two contextual characteristics of time use that are commonly theorized to affect parental well-being. Although partner co-presence is often assumed to promote greater well-being, multitasking is frequently conceptualized as an indicator of time pressure. This study re-examines the relationship between these contextual characteristics and parents' enjoyment of childcare and housework. Using data from the U.K. Time Use Survey (2014–2015), our results indicate that associations between partner co-presence, multitasking, and enjoyment of unpaid work vary substantively depending on the type of task carried out. They also vary by gender of the parent. Mothers reported greater enjoyment of housework and interactive childcare with a partner present; however, this association did not extend to other types of childcare. Fathers' enjoyment varied little by partner co-presence. Similarly, multitasking was a varied experience depending on the types of activities parents combined. In some instances, combining unpaid work activities (e.g., housework with childcare) was associated with lower enjoyment; however, combining unpaid work with leisure was often associated with greater enjoyment. These results add nuance to prior research on how the contextual characteristics of time use relate to parental well-being and suggest that prior conceptualizations of partner co-presence and multitasking are incomplete.

The Unequal Burden of Poverty on Time Use in South Africa

This study aims to contribute to the research on poverty by analysing the association of income poverty with gender inequalities in time use patterns. Based on South Africa's first time-use data compiled in 2000, we explore whether household income poverty has any influence on the typical patterns of time use of women and men. Controlling for a variety of household and individual characteristics, we assess the extent to which living in income poverty produce long hours of work –-in particular unpaid work hours-- using bivariate and multivariate Tobit estimations. Our results show asymmetric impacts of income poverty on women's and men's time allocations controlling for the widely accepted determining factors. While women in poor households spend more time on unpaid work activities, we do not see any significant change in men's unpaid work time with poverty status. Women's total paid and unpaid work time is higher under poverty as the increase in their unpaid work time extends away from the decline in paid work time. Other findings obtained provide supporting evidence presented in previous research: being married/cohabiting with a partner has an increasing impact on women's unpaid work, whereas an opposite impact is observed for their male counterparts. Women's unpaid work time increases with the number of preschool children, whereas it is the paid work time which rises in case of men's work time.

Daily metabolic expenditures: estimates from US, UK and polish time-use data

BackgroundBehaviour has diverse economic, social and health consequences. Linking time spent in different daily activities to energy expenditure (EE) is one way of investigating the health and physiological consequences of behaviour and identifying targets to improve population health and well-being.MethodsWe estimated behaviour-related EE for respondents to time use surveys (TUS) from three countries: UK 2001, Poland 2012 and US 2003–13. The Harmonised Multinational Time Use Survey (MTUS) activity categories were matched to MET estimates from the 2011 Compendium of Physical Activities. We attach METs values to each successive activity in the TUS, together with both the original UK, Polish and US activity classifications and the 68-category MTUS activity classification. We used TUS estimates of activity durations across 24-h to estimate the Physical Activity Level (PAL) for respondents from the three countries and the average time spent and MET values for different activity categories.ResultsPAL values ranged from 1.59 in the US to 1.74 in Poland. The main sources of daily EE from PA were paid and unpaid work activities. Discretionary PA accounted for only a very small part (~ 3%) of adult daily energy expenditures. Using the harmonised MTUS 68-activity classification reduced the variability of the aggregate PAEE measure by ~ 20%, but the patterns of association between key demographics (age, sex, educational attainment) were unaffected. TUS data were further used to (1) identify sources of daily PA, and (2) assess adherence to physical activity guidelines (PAG) on a single-day basis. Estimated adherence levels were similar to those reported from other TUS as well as frequency based estimates.ConclusionsComparative studies of energy expenditure based on harmonised time use activity categories could provide insight into the relative importance of different activities for energy expenditure across different countries and demographic groups. However, new observational studies combining TUS data with accelerometer, direct observation and other measures of activity intensity are required for more accurate MET assignments to activity categories in TUS.

Economic status of women in India: paradox of paid–unpaid work and poverty

PurposeThe purpose of this paper is to understand the dynamics of women labor considering their unpaid work status. The intention is to understand the precise meaning of unpaid work and its magnitudes and trends in India. This study explores the causes of women to be engaged in unpaid work and the reason behind the non-reduction of unpaid labor as prophesied by the standard theories of economic development. Furthermore, this study aims to examine the nexus of the work status of women and its impact on poverty to give possible recommendations for promoting faster and more inclusive growth of the Indian economy.Design/methodology/approachFor addressing the above-mentioned issues, this study has used the data of 50th, 55th, 61st and 68th surveys conducted from 1993–1994 to 2011–2012 by National Sample Survey Office. In the first stage of analysis, the magnitude of unpaid work by women has been estimated. Subsequently, the relative contributions of socio-economic and demographics on the work status of women (paid and unpaid) in India have been assessed by using logistic regression model. In the second stage, the level of poverty among paid and unpaid women has been measured by using poverty estimation methodology. Furthermore, the incidence of poverty among unpaid women has been decomposed, and the contribution of socio-economic predictors has been measured.FindingsThe study reveals that the participation of women in paid activities has been consistently declined. During the study period, it is observed that the amount of unpaid work activities of women has significantly increased. Moreover, the increase of unpaid activities is more intense for those women who are less educated, marginalized and belong to the poorer household.Originality/valueThe key contributions of this study are to underpin the issue of low and declining participation of female labor force in India as well as to understand the dynamics of changing work status (paid to unpaid) of females in the neo-liberal development framework. Furthermore, this study explores the consequences of the increase in unpaid work on poverty, which has not been the focus of previous studies.

Modelling The Societal Impact Of Alirocumab In Patients With Severe Hypercholesterolemia Treated With Apheresis In Germany

Patients with severe hypercholesterolemia are at high risk of cardiovascular events. Many of them do not achieve recommended LDL-C target levels by maximal lipid lowering therapy and therefore have to undergo apheresis. This study was designed to estimate the long-term productivity gains and cost effects which come along by replacing apheresis treatments with alirocumab. A Markov model with 3-month cycles was developed to estimate the number of apheresis treatments which can be avoided over 6 years using alirocumab. The results of the ODYSSEY ESCAPE trial (NCT 02326220) were used to evaluate the effect of alirocumab on the frequency of apheresis treatments (in the trial 63.4% of patients on alirocumab avoided all and 92.7% avoided at least half of the apheresis treatments). To estimate the population wide reductions in apheresis treatments from 2017 to 2022, an open cohort population model was built. Avoided treatments were linked to productivity, through the average amount of time, patients spent on one apheresis treatment. Employment data and Time Use Surveys were used to allocate the total amount of lost time to paid and unpaid work activities. Paid work was valued according to average wages, unpaid work according to the proxy good approach. In addition, indirect and induced economic effects, resulting from additional productivity were looked at. Furthermore, the cost effects of the use of alirocumab in German apheresis patients were estimated using current prices. In a small population of 600-900 patients, 173,059 apheresis treatments could be avoided due to alirocumab in Germany within six years, corresponding to € 89 million in productivity gains and € 150 million of cost savings for the statutory health insurance (SHI). Replacing costly and time consuming apheresis treatments with alirocumab in patients with severe hypercholesterolemia leads to significant productivity gains and cost savings for the SHI.

Does Involved Fathering Produce a Larger Total Workload for Fathers Than for Mothers? Evidence from Norway

ObjectiveTo compare mothers' and fathers' total workloads within couples with different work‐time arrangements in a social democratic welfare state (Norway) and explore possible changes in the 1990s and 2000s.BackgroundWomen's double workload in families with two full‐time jobs has been well documented. However, some argue that fathers, too, may experience the double burden of market and domestic work as they become more involved in parenting.MethodThe data are from the Norwegian Time Use Surveys conducted in 1990, 2000, and 2010 among representative samples of the adult population. A subsample of coupled other‐sex‐parents with at least one child younger than age 20 years were used in the present study. Total workload is the sum of paid and unpaid work activities reported in a time diary. Standard multivariate ordinary least square regressions were used to explore gender differences.ResultsFull‐time work for both parents entailed approximately equal total workloads for fathers and mothers. However, fathers' total workload exceeded mothers' in full‐time and part‐time couples with school‐aged children.ConclusionDespite equal total workloads and reduced specialization, mothers still do less paid work and more family work than fathers in couples where both work full‐time in Norway. This is partly related to the gender‐segregated labor market. In full‐time and part‐time couples with school‐aged children, fathers' longer working hours are not fully offset by more family work for mothers.ImplicationsWork–family reconciliation policies promoting mothers' employment and fathers' family work may have the potential to reduce gender imbalances in parent's total workloads and moderate gendered specialization patterns.

Adolescent adaptation before, during and in the aftermath of the Great Recession in the USA.

This study examines the impact of the "Great Recession" (from December 2007 to June 2009) on 8th and 10th graders in the USA, using annual nationally representative data from the Monitoring the Future study. Historical changes in youth adjustment (self-esteem, depressed mood, risk taking, aggression and property crime), school achievement (grade point average [GPA], time spent on homework and educational expectations) and structured and unstructured activities (volunteering, employment, sports and evenings out for fun) were examined between 1991 and 2014. Overall, there were only slight changes in mean levels of adjustment, achievement and most youth activities. However, the percentage of youth working during the school year did decline during the Great Recession. Several longer-term trends were also evident, though not directly tied to the Great Recession. These include an increase in GPA, a decrease in time spent on homework, rising educational expectations and more time spent volunteering. Future work should assess how the shift to unpaid work activities (e.g. volunteering and internships) among youth is impacting the transition from school to work in the contemporary economy, and whether the Great Recession had deleterious impacts for younger children or among youth whose parents lost work or had their homes foreclosed.

Assigning Monetary Values to Unpaid Work in Slovakia

Abstract The article deals with unpaid work in Slovakia. Input-based approaches are used to assign a monetary value to unpaid work activities in Slovakia using the data from 2012 nation – wide survey conducted by the Faculty of Economics, Matej Bel University, Slovakia. This nation-wide survey contains representative data about 13 individual unpaid work activities based on Eurostat methodology. In this paper after taking into account the specific conditions of Slovakia, two input-based market replacement cost approaches, namely generalist and specialist are applied to calculate the monetary value of unpaid work. The results show that, depending on the chosen wage concept and activities, the monetary value of unpaid work ranges from approximately 18% to 25% of GDP in Slovakia. The paper concludes that in comparison with the other traditionally market economies the value is lower due to lower level of wages of corresponding market substitutes.

The Unequal Burden of Poverty on Time Use

This study uses the first time-use survey carried out in South Africa (2000) to examine women’s and men’s time use, with a focus on the impacts of income poverty. We empirically explore the determinants of time spent on different paid and unpaid work activities, including a variety of household and individual characteristics, using bivariate and multivariate Tobit estimations. Our results show asymmetric impacts of income poverty on women’s and men’s time use. Time-use patterns of South African women and men reveal the unequal burden of income poverty among household members. While being poor increases the amount of time women spend on unpaid work, we do not see any significant impact on men’s unpaid work time. For example, women in poor households spend more time than men collecting water and fuel, as well as maintaining their homes.

An Economic Evaluation of Rizatriptan in the Treatment of Migraine

Migraine is a common, chronic, neurovascular disorder, generally characterised by attacks of severe headache and autonomic nervous system dysfunction. Triptans are selective serotonin 5-HT(1B/1D) receptor agonists that represent effective therapeutic options for moderate-to-severe migraine attacks but with higher acquisition costs relative to usual care therapies. The objective of this study was to examine the cost effectiveness of rizatriptan treatment compared with 'Usual Care' or other triptans available in Canada for patients with moderate-to-severe migraine for whom other therapies (e.g. NSAIDs, simple analgesics) are insufficient or contraindicated. A decision-analysis model was created to estimate migraine treatment costs over a 24-hour period in patients with a diagnosis of moderate-to-severe migraine as defined by the International Headache Society criteria. Costs and clinical outcomes were observed over a 24-hour period from therapy initiation. Efficacy measures consisted of 'pain-free response at 2 hours' and 'sustained pain free for 2-24 hours'. Oral rizatriptan 10 mg was compared with other oral triptans (i.e. sumatriptan 50 or 100 mg), naratriptan 2.5 mg and zolmitriptan 2.5 mg, based on a meta-analysis and compared with 'Usual Care' based on a naturalistic study of people who experience migraine and who were similar to the target population. 'Usual Care' was defined as an aggregate of medications prescribed for the Canadian population for the indication of migraine, weighted by the relative frequency of use of prescriptions over a 1-year period. Analyses were conducted from the Ontario (Canada) Ministry of Health and Long-Term Care (MOH<C) perspective and the broader societal perspective. Results are presented as the cost per migraine attack aborted (i.e. pain free at 2 hours), as well as the cost per QALY. Several one-way sensitivity analyses were conducted to test the robustness of the model. All costs are expressed in 2002 $Can. Cost estimates are similar to previously published Canadian studies. Rizatriptan compared with 'Usual Care' produced an incremental cost per attack aborted of $Can49.82 and a cost per QALY gained of $Can31 845 from the MOH<C perspective. When a societal perspective was considered (which included time loss from paid and unpaid work activities), rizatriptan dominates 'Usual Care': that is, it is cost saving and more effective. All other triptans are also dominated by rizatriptan as they offer higher costs and lower efficacy. This study shows that rizatriptan treatment for patients who experience moderate-to-severe migraines may represent a cost-effective strategy for improving care of migraine patients in Canada.

Women Studies Conference in Puerto Rico

Conference Report Women Studies Conference in Puerto Rico Altagracia Ortiz On June 20,1989, women studies' scholars from Puerto Rico and the United States met at the University of Puerto Rico (UPR) to discuss issues of concern to Puerto Rican women on the island and in this country. The conference was sponsored by Antonio Lauria and Susana Cabanas of Intercambio, an academic exchange program between the City University of New York (CUNY) and UPR, and organized by Palmira RÃ-os of the Center for Immigrant and Population Studies of CUNY; and by Alice Colón and Margarita Mergal of the Centro de Estudio, Recursos, y Servicios a la Mujer (CERES) (Center for the Study, Resources, and Services to Women) of the Centro de Investigaciones Sociales (Center for Social Research) of UPR. The major focus of the conference was the different aspects of the work activities of Puerto Rican women today, but consideration was also given to the participation of women in the labor history of Puerto Rico and in the United States. Feminist scholars in Puerto Rico, Margarita Mergal noted in her keynote address, have begun to study women as an integral part of the historical processes that have affected the island in the 20th century. Some have studied women's role in the struggle for the suffrage and independence , in education and in the church; others have emphasized the relationship of women to population and migration programs. However, she believes that the most important research that has been done in recent decades has been the studies on women and work. Some of the topics that already have been investigated or which presently preoccupy scholars include women's contributions to the early trade-union movement; women's paid and unpaid work activities in and out of the home; the impact of industrialization on women's work; and the health of women in "toxic" worksites. Palmira RÃ-os, the CUNY keynote speaker, highlighted in her presentation the scholarly studies on Puerto Rican women workers that have emerged in the United States; she included among these the oral history projects of the Centro de Estudios Puertorriqueños (CEP) (Center for Puerto Rican Studies) of CUNY on Puerto Rican needleworkers in New York City, the research on working-class and professional women of Virginia Sánchez Korrol, and the work on the relationship between Puerto Rican female garment workers and the International Ladies' Garments Workers' Union of Altagracia Ortiz. RÃ-os also shared with the conference participants information about a symposium on Black women in the United States that she is helping to coordinate. ©1989 JOURNAL OF WOMEN'S HISTORY, VOL. 1 No. 2 (FALL)_________________________ 180 JOURNAL OF WOMEN'S HISTORY FALL One of the goals of this conference was to bring together scholars from various disciplines to formulate a research agenda that could lead to future collaborative efforts between UPR and CUNY women studies' investigators . There was, for example, interest in developing projects that would provide more ethnographic and analytical data on female workers in Puerto Rico in order for us to understand how the industrial division of labor and work processes have affected Puerto Rican women; how the spread of the feminization of work has impacted on the labor force there; how women have related as workers to the power structures on the island; and how they have coped with the health and stress problems they encounter in their jobs. The participants of the "Women, Work, and History Panel" proposed that an oral history task force be formed to initiate further discussions on the usage, application, and theoretical frameworks of this recent but valuable methodology in women labor studies. The members of this last panel all have been working on oral histories of Puerto Rican women, and the CUNY-UPR Women Studies Conference made it possible for us to share our experiences using this particular historical method. Yamila Azize, who has published several studies on the history of the participation of Puerto Rican women in the labor movement in Puerto Rico, has recently turned her attention to the history of women in the health field and in the tobacco industry. She is presently doing oral histories of elderly Puerto Rican...