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PubMedDate not supplied

Productive work and employment for persons with traumatic brain injury: what have we learned after 20 years?

This article describes return to work outcomes for individuals with traumatic brain injury (TBI) through a selective review of the published literature and an examination of TBI labor force participation from the Rehabilitation Services Administration 91l and the Social Security Administration Benefits Planning, Assistance and Outreach databases. Implications and recommendations to further our understanding about the different parts of the work outcome profile of individuals with TBI are offered.

Brain Injuries↗
PubMed2004

Educating social workers to meet the challenge of an aging urban population: a promising model.

As Americans live longer, they will require more health and social services to address the onset of acute and chronic conditions. The persistent changes in health care delivery and the increasingly diverse older adult population in urban settings, coupled with the high expectation for families to be responsible for home care needs, challenge social workers, who work alongside physicians, nurses, and other health care professionals, to provide services effectively. Because social workers are becoming more essential, social work education must increase the numbers of social workers with the knowledge and skills necessary for practice in the current U.S. health, mental health, and social service systems, particularly in caring for the aging populations in urban settings. A New York Academy of Medicine study identified the need for increased synergy between the two components of graduate social work education: the field experience and classroom instruction. One educational model, the Practicum Partnership Program, which is designed to better integrate field and classroom, is being tested at six sites. Early results from over 300 graduates are encouraging, with evidence that students' knowledge and skills regarding aging adults have increased, their satisfaction with the experience was very high, and those who were trained reflect the diversity of the population of older adults. The early success of this program suggests that innovative educational models that expose graduate social work students to diverse populations across the continuum of care are possible. Such models will be essential for the nation to be successful in producing a social work labor force qualified to meet the challenge of an aging urban population.

Aged↗
PubMed1982

The economics of disabilities: international perspectives.

The impact of disability within a nation is mediated by the provisions which exist for impairment prevention, for rehabilitation of people who are disabled and for coordination of the various social benefit and labor market actions taken with regard to disabled people and their families. The paper reviews available international research on the socio-economic impact of disability prevention and rehabilitation measures based upon a Rehabilitation International analysis of literature in this field from 40 countries and studies of the United Nations. Key issues include: the cost of disability, the family impacts, displacement from the labor force, social benefit and disability policies, and the application of cost/benefit analysis to these processes-the tool and its limitations. Available research confirms the United Nation study finding that while disability will create a cost in every society regardless of whether or not rehabilitation services exist, "the more a society recognizes these costs, and the more it attempts to ameliorate them through provision of adequate disability prevention and rehabilitation services, the greater is the overall economic return that may be expected."

Cost-Benefit Analysis↗
PubMed1989

Gender and depression: assessing exposure and vulnerability to life events in a chronically strained population.

It has been suggested that higher levels of distress among women may be partially a function of their nurturant roles. Role-related differences in exposure and/or responsiveness to events occurring to network members are hypothesized to represent a "cost of caring" for women that translates into elevated levels of depressive symptoms. This paper examines the significance for depressive symptoms of gender differences in exposure and vulnerability to eventful stress among a sample of physically disabled subjects. This sample provides an opportunity to more fully assess the relevance of employment for understanding gender differences in depression. Our results indicate that men and women are equally exposed and equally vulnerable to life events occurring to themselves. However, we found women to be both more exposed and more vulnerable to events occurring to others. When labor force participation is taken into account, dramatic gender differences are revealed in the apparent significance of employment for exposure and vulnerability to various kinds of stressful events. The implications of these findings for public health interventions are discussed.

Adult↗
PubMed1986

The economics of informal care. Labor market effects in the National Hospice Study.

This article analyzes the labor market-related effects of informal care provision in the National Hospice Study on the individual providing this care. The results indicate that voluntary providers of patient care who were employed at the onset of the care-giving episode experienced considerable loss of earnings. These losses were partly caused by the fact that over one-fourth of initially employed caregivers left the labor force because of care obligations. This exit probability increased with the caregiver's age and female gender, and decreased with the caregiver's reported annual family income. Of the caregivers who continued in paid employment during the informal care episode, 60% reported losses of income because of care-related increased absenteeism from work. These two types of income loss are quantified using an indirect valuation method. This quantification indicates that some of the cost savings which have been attributed to the home-centered hospice modality in the National Hospice Study may have resulted from the shifting of costs from the formal health care sector to the informal care sector.

Absenteeism↗
PubMed1990

The competing demands of employment and informal caregiving to disabled elders.

The competing demands of work and elder care are the subject of this study. The employment decisions of the informal caregivers of a nationally representative sample of disabled elders were examined using a nested multinomial logit model. Findings from the work accommodation model demonstrated that primary caregivers and those caring for elders with greater care needs are more likely to take unpaid leave, reduce work hours, or rearrange their work schedules to assume elder care responsibilities. Being female, white, and in fair-to-poor health also increased the likelihood of work accommodation. The model predicting employment of a caregiver revealed that the prospect of having to accommodate work to the demands of caregiving keeps some people from work entirely. However, not all caregivers would choose to work in the absence of caregiving responsibilities. After controlling for the probability of work accommodation, need for care, and availability of others to care, it is more likely that younger, white and more highly educated caregivers will be employed. The self-selection of working caregivers observed in this study should be considered when forecasting changes in caregiving costs associated with changes in the labor force participation of caregivers as a result of deliberate policies or social and demographic trends.

Activities of Daily Living↗
PubMed1999

Prevalence of physical inactivity and its relation to social class in U.S. adults: results from the Third National Health and Nutrition Examination Survey, 1988-1994.

PURPOSE: This study examines the prevalence of physical inactivity during leisure time in a national representative sample of U.S. adults. METHODS: Data were obtained from the Third National Health and Nutrition Examination Survey, conducted between 1988 and 1994. A total of 18,825 adults aged 20 yr and older participated in a home interview where information about physical activity, education, income, occupation, employment, and labor force participation was obtained. RESULTS: The prevalence of physical inactivity among U.S. adults was 23%, with more women (28%) than men (17%) reporting being inactive during their leisure time. Additionally, inactivity is more common among in social class such as persons who are less educated, living below the poverty line, living in households with income below 20,000 dollars, and who are retired. In every category of social class, women experienced a higher prevalence of physical inactivity than men. CONCLUSIONS: We conclude that social class is associated with physical inactivity and that more research is needed to better understand the effect that other social and environmental factors have on sedentary behaviors in our society.

Adult↗
PubMed1984

Pediatricians' attitudes toward maternal employment and substitute child care.

In 1979 more than 54% of women with children less than 18 years old were in the labor force. The purpose of this study was to study the attitudes of pediatricians toward maternal employment and substitute child care arrangements. To survey their attitudes toward maternal employment and substitute child care, we sent a questionnaire to 476 North Carolina pediatricians. The response rate was 50%. On the issue of maternal employment the attitudes were 46% favorable, 35% neutral, and 19% unfavorable. Corresponding attitudes for substitute child care were 53%, 30%, and 17%.

Adult↗
PubMedDate not supplied

Slipping accidents causing low-back pain in a gearbox factory.

An accident model was used to analyze data in terms of the first event in all reported accidents occurring in a gearbox factory during 1974. The data were used to study the causes of lumbosacral injuries. A labor force of 2000 men sustained 99 lumbosacral injuries, 54 of which led to absence of one or more days. Twenty of the 54 were initiated by slipping, and 17 presented as a sudden onset of low-back pain without any preceding accidental event. A review of all patients who were absent following a slipping accident disclosed that the lumbosacral region was by far the commonest part of the body injured. Tripping was an infrequent cause of these injuries. Slipping rarely features in the literature as a cause of low-back pain. It is suggested that this is due to confusion between various contributory factors and events forming an accident.

Accidents, Occupational↗
PubMed1998

Asymptomatic grotesque deformities of the cervical spine. An occupational hazard in railway porters.

STUDY DESIGN: A case report. OBJECTIVE: To illustrate an extremely rare occurrence of chronic, occupational, low-grade trauma leading to asymptomatic grotesque cervical spine deformities in railroad station porters. SUMMARY OF BACKGROUND DATA: Occupational trauma causing spinal deformities has been described in relation to thoracic and lumbar spines in miners. To the authors' knowledge, this is the first reported case of asymptomatic cervical spinal deformity in railway porters as a result of chronic occupational trauma. METHODS: A magnetic resonance imaging study was performed on both patients. RESULTS: The magnetic resonance images showed advanced degenerative changes in the cervical spine causing obvious deformities, along with apparently normal cord signal intensity. CONCLUSIONS: Chronic, occupational, low-grade trauma of the cervical vertebral region is extremely unusual in industrialized countries. Nevertheless, in view of the increasing mobility of people in general and of the labor force in particular, this complication of an occupational exposure deserves attention as an unusual cause of cervical spinal deformity.

Adult↗
PubMed1981

A survey of working conditions in small-scale industries in Nigeria.

The working conditions in 225 small-scale industrial premises representing nine different trades with a labor force of 1,497 were studied. The provision of drinking water, hand washing and toilet facilities, eating places and cloakrooms was found to be generally unsatisfactory. The indoor workers were on the whole better provided for than those working outdoors except for the provision of cloakrooms and eating places where the reverse was the case. Sanitation was found to be inversely related to the size of the firms (p less than 0.05). Ways of improving the conditions of these people working in rather hazardous circumstances are discussed.

Developing Countries↗
PubMed1997

A descriptive analysis of nonfatal occupational injuries to older workers, using a national probability sample of hospital emergency departments.

An estimated 136,985 nonfatal, work-related injuries to workers 55 years of age and older were presented for treatment in hospital emergency departments across the United States during 1993. Men accounted for 63.7% of the injuries and had an injury rate of 1.06 per 100 workers, compared with a rate of 0.76 among women. Among the oldest workers (65+ years), injuries were more likely to be fractures or dislocations, to result from falls on the same level, or to involve hospitalization. The services industry had the largest number of injuries (31.9%), whereas the highest injury rate occurred in the agriculture/forestry/fishing industry (1.50 per 100 workers). The types of injuries most frequently requiring hospitalization were fractures or dislocations that resulted from a fall. Because older workers' employment demographics and injury patterns differ from the remainder of the labor force, interventions need to be developed which are specific to the workplace for this older working population.

Accidental Falls↗
PubMed2005

The education and employment status of patients with inflammatory bowel diseases.

Inflammatory bowel disease (IBD) has the propensity to affect patients who are in their late teens and early 20s, an age when most people decide on their educational and career directions. This review describes the effects that IBD has on the continuum of education and employment. Patients with Crohn's disease and ulcerative colitis attain a similar level of education as that of the general population. The quality of life of such patients in school, as measured by both patients' and teachers' perceptions, indicates that, despite the difficulties that students face in terms of missed school time and physical inconveniences, teachers are generally perceived by students to have favorable attitudes toward helping them. Even though earlier work in the area of employment has suggested that the occurrence of IBD is clustered among people in white-collar positions, recent data have suggested that certain environmental risks for IBD (i.e., sedentary or indoor jobs) may be associated with jobs classified as being white-collar, and therefore having a white-collar job may in itself not be a risk factor for the development of IBD. Patients with IBD have a higher rate of nonparticipation in the labor force, and the participation rate seems to maintain steady levels over time. A majority of patients with IBD continue in the same employment positions over a period of years. Patients with IBD, especially those who have undergone surgery, took more sick leave than their counterparts without IBD. A majority of patients with IBD favored the disclosure of their diagnosis to their employers and perceived little discrimination in the workplace. Furthermore, most employers were perceived by their employees with IBD as having fair attitudes toward the compensation provided for their employees with IBD.

Education↗
PubMed2005

The prevalence and effects of adult attention deficit/hyperactivity disorder on work performance in a nationally representative sample of workers.

OBJECTIVE: The prevalence and workplace consequences of adult attention deficit/hyperactivity disorder (ADHD) are unknown. METHODS: An ADHD screen was included in a national household survey (n = 3198, ages 18-44). Clinical re-interviews calibrated the screen to diagnoses of Diagnostic and Statistical Manual of Mental Disorders, 4th edition ADHD. Diagnoses among workers were compared with responses to the WHO Health and Work Performance Questionnaire (HPQ). RESULTS: A total of 4.2% of workers had ADHD. ADHD was associated with 35.0 days of annual lost work performance, with higher associations among blue collar (55.8 days) than professional (12.2 days), technical (19.8 days), or service (32.6 days) workers. These associations represent 120 million days of annual lost work in the U.S. labor force, equivalent to dollar 19.5 billion lost human capital. CONCLUSIONS: ADHD is a common and costly workplace condition. Effectiveness trials are needed to estimate the region of interest of workplace ADHD screening and treatment programs.

Adolescent↗
PubMed2002

Personality development and growth in women across 30 years: three perspectives.

This article addresses three questions about personality development in a 30-year longitudinal study of women (N = 78): (1) To what extent did the women maintain the same position in relation to each otheron personality characteristics over the 30 years, and what broad factors were related to the amount of change in their rank order? (2) Did the sample as a whole increase or decrease over time on indices of personality growth, and did they change in ways distinctive to women? (3) Were experiential factors associated with individual differences in the amount of change? Results showed that personality was quite consistent while also showing that time interval was positively related to rank-order change and age was negatively related to rank-order change. Over the period from age 21 to age 52, the women increased on measures of norm-orientation and complexity and showed changes on measures of Dominance and Femininity/Masculinity consistent with the hypothesis that changing sex roles would lead to increases in Dominance and increases, then decreases, in Femininity/Masculinity. A third set of results showed that changes in Dominance and Femininity/Masculinity were associated with life circumstances such as marital tension, divorce, and participation in the paid labor force. The implications of the findings for personality development and growth are discussed.

Adult↗
PubMedDate not supplied

Fatherhood in the twenty-first century.

The twentieth century has been characterized by four important social trends that have fundamentally changed the social cultural context in which children develop: women's increased labor force participation, increased absence of nonresidential fathers in the lives of their children, increased involvement of fathers in intact families, and increased cultural diversity in the U.S.. In this essay, we discuss how these trends are changing the nature of father involvement and family life, and in turn affecting children's and fathers' developmental trajectories. We end with an eye toward the twenty-first century by examining how the children of today will construct their expectations about the roles of fathers and mothers as they become the parents of tomorrow. This life-span approach to fatherhood considers the broader sociohistorical context in which fatherhood develops, and emphasizes the urgent need to consider mothers, fathers, and family structure in future research as we seek to understand and model the effects of parenting on children's development.

Child↗
PubMed1997

Emergent migration policy in a democratic South Africa.

This article sets recent debates on migration policy in South Africa against broader historical realities that have shaped patterns of population movement on the subcontinent since the end of the nineteenth century. During the course of the last century, most forms of population movement were the result of disjointed regional economic development which can be traced to two epochal events at the end of the nineteenth century: the creation of the modern African state system and the discovery of mineral wealth in Southern Africa. Although regulation of migrant labor was a fundamental feature of the colonial period, it was only after 1950, when independent states began to define specific migration priorities, that states began to restrict significantly the flow of transnational labor. From this point notions such as internally displaced person, refugee and illegal immigrant become increasingly appropriate to the study of regional migration. Particular attention is given to current debate on the definition of refugee which forms part of a broader international debate. A number of South African writers have argued that, given the structural imbalances contained in the regional economy, the term "refugee" should be redefined to included economic migrants. This position is not shared by the South African Government, and an analysis of current policy and legislation demonstrates a growing tendency to restrict the influx of undocumented migrants. This is due, in part, to the recent political transition and the institutional compromises that it produced as well as the growth of negative sentiment towards illegal immigrants at both mass and elite levels, as demonstrated by two recent research findings. The article concludes with a summation of recent trends in South African migration policy and an evaluation of the ambiguous position that South Africa occupies within Southern Africa.

Africa↗