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PubMed1992

Perceived discrimination in education and employment by people with Crohn's disease: a case control study of educational achievement and employment.

Eighty three patients in whom the diagnosis of Crohn's disease had been made before the age of 40 years and who had been resident in the city of Cardiff were asked to complete a detailed questionnaire about their educational and employment experiences. Responses were obtained from 58 patients (response rate = 70%), 23 buddy controls, and 27 community controls. The mean (SD) age of patients at the time of the survey was 31 (5) years. Twenty four of the patients were diagnosed before leaving secondary education, at a mean age of 17 years. They had lost significantly more days' schooling than controls (chi 2 = 14.3 p less than 0.001) but had achieved similar academic success as measured by examination passes and attendance at tertiary institutes of education. Similar numbers of patients and controls were employed at the time of the survey, although significantly more patients had experienced long term unemployment (z = 2.6 p less than 0.01). As a result of their experiences up to 30% actively concealed their illness from employers.

Adult↗
PubMed2000

Italian urological manpower: employment prospects and future scenarios. A panorama of employment opportunities for young urologists.

INTRODUCTION: Italy delayed limiting access to the Faculty of Medicine and the reform of schools of specialization was not accompanied by programming the number of scholarships, so employment expectations are often disappointing. The aim of this study is to analyze the employment prospects of specialists in urology through the development of possible scenarios for the 5-year period 2000-2004. MATERIALS AND METHODS: We recorded data received from Italian Schools of Specialization in Urology on specialists in the 5-year period 1994-1998. We also tried to obtain a picture of the national distribution of urologists and urological units. Statistical processing was done with SPSS for Windows 5.0. RESULTS: In the last 5 years, 501 urologists were licensed at an average age of 37 years; 535 urological units exist; 2,332 doctors practice urology (2,235 males and 97 females) for a ratio of 1 urologist to 24,500 inhabitants. By comparing the 'entrance' forecast with the potential 'exit', we can hypothesize an annual excess of 80 units. There is no significant correlation between the number of urologists in each structure and the number of inhabitants for each urologist. CONCLUSIONS: The present government programme does not take into account continual changes in employment and many other variables when defining the actual need for specialists. For valid predictions, the data we obtain must be updated for at least 5 years.

Adult↗
PubMed1992

The employment connection: the application of an individual supported employment program for persons with chronic mental health problems.

An individual supported employment program for people with psychiatric disabilities is described. Specific program components are outlined as well as issues related to implementation of job placement and job training processes. Preliminary outcome data indicated a 50% competitive employment rate following the first year of the program. The importance of collaboration between mental health and vocational rehabilitation specialists was highlighted. Emphasis on maintaining a client-centred approach was also discussed along with the need for a comprehensive employer education program.

Adult↗
PubMed1991

At-will employment doctrine--are patient care employers vulnerable?

This article analyzes the importance of changes in the at-will rule of employment law to hospital and other health care employers. A survey of wrongful termination cases brought against health care defendants is presented, and recommendations as to employment procedures are made.

Civil Rights↗
PubMed1981

Employment discrimination: procedures for handling complaints--Equal Employment Opportunity Commission. Proposed rule.

This proposed rule sets forth procedures for the handling of complaints of employment discrimination which are filed with Federal fund granting agencies under Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972 and other provisions of Federal law which prohibit discrimination on grounds of race, color, religion, age, sex or national origin in programs or activities receiving Federal financial assistance. The regulations allow the fund granting agency to refer complaints to the Equal Employment Opportunity Commission (EEOC). For complaints covered both by Title VII of the Civil Rights Act of 1964, as amended, or other statutes within EEOC's jurisdiction and by Title VI of the Civil Rights Act or Title IX, the regulations contemplate that most complaints of individual acts of discrimination will be referred to EEOC for investigation and conciliation, while most complaints of systemic discrimination will be retained by the fund granting agency. Employment discrimination complaints which are not covered by Title VI or Title IX will be transferred to EEOC. This proposed rule is not a "major rule" as defined by Section 1(b) of Executive Order 12291.

Civil Rights↗
PubMed2005

Basics of employment law: understanding and dealing with adverse employment actions and discrimination in the workplace.

In the present setting of fiscal and other constraints placed upon the business world during economically challenging times, there exists both intentional and unintentional opportunities for unfair and illegal treatment of employees. Hospitals and other health care facilities or organizations are not immune. In fact, given the demographics of our field and the general "graying" of our colleagues, a disproportionately higher number of perfusionists reside within the age-protected guidelines established by both federal and state law. Not coincidentally, the pressures on hospitals to stay solvent in the presence of decreasing reimbursement and declining revenues may well create a prescription for unfair treatment of employees. This article will explain the basic concepts of the protections afforded employees by law with regard to freedom from harassment and discrimination in the workplace. Matters related to the hostile workplace environment; age, sex, and race discrimination; and adverse employment actions will be explained and illustrated by applicable case law. In this regard, it is intended that this article will enhance the opportunity for perfusionists to be cognizant of both the express and implied behaviors (both verbal and nonverbal) that may be detrimental to an employment situation, as well as to be cognizant of some of the remedies at law available regarding adverse employment circumstances.

Agonistic Behavior↗
PubMed1990

The relationship between caregiving and employment. A study of stress in employed and unemployed caregivers of elderly persons.

The need for persons to provide care on an informal basis to frail and dependent elderly persons has generated a "caregiving crisis" in this country. Middle age women, the traditional caregivers for most generations, are no longer readily available to provide informal care. Instead, they are likely to be struggling to cope with the dual demands of paid employment and family responsibilities. Significant differences exist between employed and unemployed caregivers in relation to age, marital status, gender, personal health status, and caregiver-care recipient relationships. However, no differences exist in relation to the amount of stress experienced as a consequence of caregiving responsibilities. Occupational health nurses have an ideal opportunity to help employed caregivers cope with their caregiving responsibilities both at the worksite and in their personal lives.

Adaptation, Psychological↗
PubMed1989

Employment choices and earnings of social workers: comparing private practice and salaried employment.

Direct recognition statutes, such as freedom of choice and vendorship laws, have the potential to increase the number of independent providers of psychotherapy, and thus to increase competition in the market for psychotherapy. These laws increase the economic return to private practice by requiring that third-party payers directly reimburse psychologists and social workers. There has been, however, little empirical investigation of the responsiveness of psychotherapists' employment choices to changes in the economic return to private practice. In this study, a structural model of social workers' earnings and employment choices between private practice and salaried employment is estimated. After correcting for the potential self selection bias, the results suggest that increasing the relative return to private practice does not increase the probability that a social worker will enter private practice.

Economic Competition↗
PubMed2000

Employer-sponsored health insurance: are employers good agents for their employees?

Employers in the United States provide many welfare-type benefits, such as life insurance, disability insurance, health insurance, and pensions, to their employees. Employers can be viewed as performing an agency role in purchasing pension, health, and other welfare benefits for their employees. An exploration of their competence in this role as agents for their employees indicates that large employers are very helpful to their employees in this arena. They seem to contribute to individual employees' welfare by providing them with valued services in purchasing health insurance.

Decision Making↗
PubMed1999

Positive employment service - facilitating employment for people living with HIV.

As treatments and therapies develop and improve, enhancing life expectancy, Human Immunodeficiency Virus (HIV) has been described by some as a long term chronic condition rather than an acute life threatening illness. As this change occurs, new issues become relevant for the person living with HIV, employment being one of these. In light of this, the Positive Employment Service was developed and implemented to explore and address some of the issues related to employment for people living with HIV. The original concept for the service was primarily focused on vocational rehabilitation; however, it soon became clear that there was a need for a prevocational service facilitating transition and adjustment to productivity roles. The service was developed using approaches from Vocational and Occupational Therapy Models of Practice. This article discusses the challenges of developing and implementing this service and explores the unique perspective that occupational therapy brings to a position of this kind.

Journal Article↗
PubMed2001

Balancing flexibility for the employer and the employee: a case study of the development of annualized hours employment contracts.

As with many forms of flexible working, Annualized Hours (AH) systems offer potential benefits to both the employer and the employee. However, the flexibility requirements of employers and employees often conflict. Therefore, when a large food manufacturing organization decided to redesign its AH system, it employed an independent consultancy to act as neutral third party. The consultancy provided technical expertise and assistance in developing an AH system that optimised productivity and was acceptable to the workforce. Data are presented, obtained from focus groups conducted throughout the organization, describing some of the potential difficulties of implementing an AH system. Drawing upon these data, a number of new AH systems were proposed and modelled using specialist software tools. The design process is described, together with the advantages and difficulties associated with use of the software tools. It is concluded that the key elements in the process of designing AH systems are centred around issues of trust and communication; the involvement of a broad range of interested parties, through a process of carefully managed group facilitation; and the need for adequate technical support in the development and evaluation of AH systems.

Computer Simulation↗
PubMed1988

Analysis of employment specialist intervention time in supported competitive employment.

Results of an initial analysis of the employment specialist intervention time provided to consumers in supported competitive employment programs operated by the Rehabilitation Research and Training Center (RRTC) at Virginia Commonwealth University over 8 years was described. Analyses focused on the amount of staff intervention time provided as a percentage of the total number of hours worked by a consumer each week and a comparison of the amount of intervention time provided to two subsamples. Results indicated that consumers previously classified moderately or severely mentally retarded did not require a significantly greater amount of intervention time than those previously classified as borderline or mildly retarded during the first year of employment.

Adult↗
PubMed1996

Maternal employment in Scandinavia: a comparison of the after-birth employment activity of Norwegian and Swedish women.

"A striking characteristic of recent Western labour market trends is the rise in employment among mothers of very young children. So far, few studies have analysed the impact of public policies on employment rates of young mothers. In this study we address this issue by comparing two similar countries, Norway and Sweden, which have the same set of policies with slight variations, using data sets with similar designs. We analyse rates of re-entry into paid work after first birth for mothers in 1968-88 by means of hazard regression. One important finding is that the right to paid maternity leave with job security greatly speeds up the return to work."

Developed Countries↗
PubMed2006

The economic impact of bipolar disorder in an employed population from an employer perspective.

OBJECTIVE: To determine the economic impact of bipolar disorder on health benefit costs and health-related work absences from an employer perspective. METHOD: Data on health benefit costs and health-related absences during 2001 and 2002 were retrieved from a database and retrospectively examined. Regression modeling measured the cost differences while controlling for potentially confounding factors. The study population consisted of employees at multiple large employers who were widely dispersed throughout the United States. These employees were grouped into 2 cohorts: (1) employees with a bipolar disorder diagnosis (primary, secondary, or tertiary ICD-9 code of 296.0x, 296.1x, 296.4x, 296.5x, 296.6x, 296.7x, or 296.8x) in 2001 and (2) employees with no bipolar disorder diagnosis during 2001 or 2002 (comparison cohort). Specific outcome measures included annual health benefit claim costs and salary-replacement payments for the following employee health benefits: health care insurance, prescription drug, sick leave, short- and long-term disability, and workers' compensation. Additional outcome measures included annual absence days due to workers' compensation, short- and long-term disability, and sick leave (separately). RESULTS: The analysis identified 761 employees (0.3%) with bipolar disorder and 229,145 eligible employees without bipolar disorder. Employees with bipolar disorder annually cost $6836 more than employees without bipolar disorder (p < .05) and were more costly in every health benefit cost category. Employees with bipolar disorder missed an average of 18.9 workdays annually, while employees without bipolar disorder missed 7.4 days annually (p < .05). CONCLUSION: The impact of bipolar disorder can be costly in the workplace, leading to increased health benefit costs and increased absenteeism.

Absenteeism↗
PubMed1997

Daily demands during pregnancy, gestational age, and birthweight: reviewing physical and psychological demands in employment and non-employment contexts.

Although much research has focused on whether the physical demands of employment during pregnancy affect birth outcomes, this article argues that psychological demands should also be considered. Research published since 1980 is reviewed to examine how physical and psychological demands of employment are related to birth outcomes. Evidence for the effect of specific types of physical activities (e.g., lifting, standing) is equivocal, in part due to methodological limitations. However, studies combining several types of physical activities tend to find an association with more adverse birth outcomes. Too few pregnancy outcome studies have examined psychological demands in the workplace to make conclusions about birth outcomes, but the theoretical basis for further research is discussed. This article also argues that physical and psychological demands occur outside of the workplace and must therefore be considered with respect to responsibilities all women face throughout the day. An integrative model for studying these relationships is proposed.

Birth Weight↗
PubMed2005

Domestic violence and women's employment: fixed effects models of three waves of women's employment study data.

Domestic violence can interfere with women's ability to work, and may result in loss of welfare benefits and poorer economic outcomes. Previous studies showing no effect of domestic violence on employment could be a result of the failure to control for some individual characteristics; therefore we use fixed-effects models with three waves of Women's Employment Study (WES) data to control for unobservable time-invariant individual-specific characteristics. Included in our analyses were 598 women, from an urban county in Michigan who were on the welfare rolls in February of 1997, all of whom completed 3 waves of interviews. Our fixed effects regression results show that domestic violence significantly reduced the annual work hours of a respondent. Mental and physical health problems do not completely mediate this relationship. Our results support efforts to address domestic violence within the welfare system.

Adult↗
PubMed2006

Performance-based funding of supported employment for persons with severe mental illness: vocational rehabilitation and employment staff perspectives.

Vocational rehabilitation (VR) supervisors and counselors (n = 35) as well as supported employment (SE) program managers and employment specialists (n = 26) were enrolled in a 12-month evaluation comparing two models of funding services for persons with severe mental illness: fee-for-service and results-based funding (RBF). Quantitative measures of job satisfaction and preference for funding method were obtained prospectively on a quarterly basis, and SE staff activity logs were collected monthly. Qualitative data were collected using a series of focus groups conducted at the conclusion of the study. Despite recording a substantial increase in semi-annualized VR billing charges when using RBF (45-49%), SE staff expressed less satisfaction with RBF over time. Staff raised concerns about increased financial risks and pressures to achieve job placements under RBF. Vocational rehabilitation staff were consistently more satisfied with RBF, expressing particular satisfaction with perceived effectiveness and the payment authorization process. Both VR and SE staff expressed some reservations about RBF, primarily concerning possible pressures for adverse client selection.

Employment, Supported↗
PubMed2006

[Predicting gainful employment in a population sample of 4225 statutory pension insurance members covering a prognostic period of five years using a brief subjective prognostic employment scale (SPE Scale)].

PURPOSE: Vocational (dis-)ability is a key concept in social medicine. It plays a major role in the realm of statutory pension funds (e. g. appraisal of applications for early retirement) as well as in epidemiologic or rehabilitation research. In a former population-based survey reliability of a short scale assessing the subjective prognosis of gainful employment (SPE-Scale, range = 0 - 3) had been tested. We now wanted to explore whether the SPE-Scale allows a prediction of vocational outcomes (early retirement) in the population sample over longer periods of time. METHODS: Statutory pension insurees from Luebeck and surroundings aged between 40 and 55 were surveyed by questionnaire in 1999/2000. For 4225 subjects (= 95% of the original cohort) we obtained the following outcome data from pension fund records: dates of any applications for early retirement and beginning of retirement, date of death. The follow-up period covers 4.75 years on average. During this period 323 applications for early retirement (= 7.6%) were filed, and 200 subjects (= 4.7%) actually retired. RESULTS: First analysis including age and sex as covariates showed a threefold (SPE = 2) and eightfold (SPE = 3) risk of early retirement. Multivariate analysis (covariates: overall health status, number of chronic conditions, approved disability, subjective vocational ability, and length of sick leave measured at study onset) yielded a twofold risk of filing an application for early retirement (SPE = 3). CONCLUSIONS: The SPE-Scale is an appropriate screening instrument for hazards regarding gainful employment. It also can be recommended for use in epidemiologic or rehabilitation surveys.

Adult↗