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Halim UA, Qureshi A, Dayaji S, Ahmad S, Qureshi MK, Hadi S, Younis F. Orthopaedics and the gender pay gap: A systematic review. Surgeon 2023; 21:301-307. [PMID: 36918303 DOI: 10.1016/j.surge.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/22/2022] [Accepted: 02/20/2023] [Indexed: 03/14/2023]
Abstract
AIMS Gender pay gaps are present in a wide range of industries, with the medical profession being no exception. The aim of this systematic review was to analyse the peer-reviewed literature to identify whether there is a gender pay gap in orthopaedics. METHODS A systematic review was conducted by searching the following databases: MEDLINE, Health & Medical Collection, Nursing & Allied Health Database, Publicly Available Content Database, Consumer Health Database and Healthcare Administration Database. Original research papers pertaining to the earnings of male and female orthopaedic surgeons were included for review. RESULTS Of 745 papers acquired through the database search, 12 were eligible for inclusion. These were published in the USA, Canada and Taiwan. 6 looked at the relationship between sex and annual income, 4 studied industry payments, one analysed hourly earnings and one compared payments per case between males and females. Men were found to earn significantly higher annual incomes than women, even when confounding factors such as rank, practice setting and subspeciality were accounted for. Men also receive significantly higher payments from industry, and earn more per hour than women. CONCLUSION This systematic review has demonstrated that there is a gender pay gap in orthopaedics, with women commonly earning significantly less than their male colleagues. The reasons for this, however, remain unclear, and deserve further investigation. It is incumbent upon orthopaedic departments, healthcare providers and orthopaedic associations to raise awareness and ensure that men and women are paid the same for equal work.
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Affiliation(s)
- Usman A Halim
- Department of Trauma & Orthopaedic Surgery, East Lancashire Hospitals NHS Trust, Blackburn, UK.
| | - Alham Qureshi
- Department of Trauma & Orthopaedic Surgery, East Lancashire Hospitals NHS Trust, Blackburn, UK
| | - Sa'ad Dayaji
- Department of Trauma & Orthopaedic Surgery, East Lancashire Hospitals NHS Trust, Blackburn, UK
| | - Shoaib Ahmad
- Department of Trauma & Orthopaedic Surgery, East Lancashire Hospitals NHS Trust, Blackburn, UK
| | - Mobeen K Qureshi
- Department of Trauma & Orthopaedic Surgery, Royal Bolton Hospital NHS Foundation Trust, Bolton, UK
| | - Saif Hadi
- Department of Trauma & Orthopaedic Surgery, East Lancashire Hospitals NHS Trust, Blackburn, UK
| | - Fizan Younis
- Department of Trauma & Orthopaedic Surgery, East Lancashire Hospitals NHS Trust, Blackburn, UK
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Militão JBDS, Maior JLS, Silva LF, Barbosa SDN, Machado MH, Gomes AMF, Barreto JCS, Aguiar Filho W. The legal precariousness of work relations in the health sector during the COVID-19 pandemic, as a factor of worker suffering. Cien Saude Colet 2023; 28:2797-2807. [PMID: 37878924 DOI: 10.1590/1413-812320232810.10212023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 06/01/2023] [Indexed: 10/27/2023] Open
Abstract
The present article analyzed the process of precarious work relations in the health sector, demonstrating how this situation generated illness and suffering among workers. The text sought to register how the institutional adoption of neoliberal economic conceptions, of the reduction of State social policies, coupled with a history of cultural rejection of labor rights, provided the attraction of mechanisms of precarious work for the public sector, notably, the outsourcing of labor and the provision of services. In a second moment, the text points out the legal improprieties committed, presenting the consequences of the weakening of the legal bond in the working conditions of these workers, mainly regarding working hours and remuneration, also highlighting how much the dissemination of these links represented a factor of a general reduction in wages and labor and social security rights in the sector. Data from Fiocruz surveys on working conditions during the pandemic were also presented. The article concludes by showing the urgency of rescuing the legal labor institutes that were abandoned in the historical path studied in order to guide the public health policies in a new direction.
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Affiliation(s)
- João Batista Dos Santos Militão
- Núcleo de Estudos e Pesquisas em Recursos Humanos em Saúde (NERHUS), Escola Nacional de Saúde Pública Sergio Arouca (ENSP), Fundação Oswaldo Cruz (Fiocruz). R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
| | | | - Luís Fernando Silva
- Núcleo de Estudos e Pesquisas em Recursos Humanos em Saúde (NERHUS), Escola Nacional de Saúde Pública Sergio Arouca (ENSP), Fundação Oswaldo Cruz (Fiocruz). R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
| | | | | | | | - José Cláudio Silva Barreto
- Núcleo de Estudos e Pesquisas em Recursos Humanos em Saúde (NERHUS), Escola Nacional de Saúde Pública Sergio Arouca (ENSP), Fundação Oswaldo Cruz (Fiocruz). R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
| | - Wilson Aguiar Filho
- Núcleo de Estudos e Pesquisas em Recursos Humanos em Saúde (NERHUS), Escola Nacional de Saúde Pública Sergio Arouca (ENSP), Fundação Oswaldo Cruz (Fiocruz). R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
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Howell CM, Myers J. Substance use disorder and treatment in healthcare providers. JAAPA 2023; 36:1-4. [PMID: 37751264 DOI: 10.1097/01.jaa.0000977732.74264.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
ABSTRACT Substance use disorder (SUD) is associated with innumerable risk factors and patient presentations, and is a leading cause of preventable disease. Research continues to explore the role of biochemical and social constructs that may play a role in the foundation, perpetuation, and progression of SUD in at-risk populations. Healthcare providers develop SUD at lifetime rates similar to those of the general population, but detecting common signs and symptoms may be challenging, often delaying treatment until the course becomes more complicated. Compounding this are tangible and intangible reservations to care, including clinician fear of the financial cost for treatment, lost wages, and damage to professional esteem. Nonetheless, all clinicians must be able to recognize SUD and be aware of treatments for afflicted colleagues.
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Affiliation(s)
- Christopher M Howell
- Christopher M. Howell is program director and an associate professor in the PA program, at Miami University in Oxford, Ohio. At the time this article was written, he was an associate professor in another PA program, where Jade Myers was a student. Ms. Myers now practices in primary care with Kettering (Ohio) Health Medical Group. The authors have disclosed no potential conflicts of interest, financial or otherwise
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104
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Roach M, Chapman C, Coleman PW. Racism Might Cause Prostate Cancer and Definitely Causes Excess Unemployment, Lost Wages, and Excess Cancer Deaths. J Clin Oncol 2023; 41:4595-4597. [PMID: 37428995 DOI: 10.1200/jco.23.00502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 03/11/2023] [Accepted: 03/31/2023] [Indexed: 07/12/2023] Open
Affiliation(s)
- Mack Roach
- Mack Roach III, MD, FACR, FASTRO, FASCO, Department of Radiation Oncology, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Christina Chapman, MD, MS, Department of Radiation Oncology, Section of Health Services Research, Baylor College of Medicine, Houston, TX Health Policy, Quality & Informatics Program, Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX; and Pamela W. Coleman, MD, FACS, FPMRS, Department of Surgery/OB GYN, Howard University College of Medicine, Washington, DC
| | - Christina Chapman
- Mack Roach III, MD, FACR, FASTRO, FASCO, Department of Radiation Oncology, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Christina Chapman, MD, MS, Department of Radiation Oncology, Section of Health Services Research, Baylor College of Medicine, Houston, TX Health Policy, Quality & Informatics Program, Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX; and Pamela W. Coleman, MD, FACS, FPMRS, Department of Surgery/OB GYN, Howard University College of Medicine, Washington, DC
| | - Pamela W Coleman
- Mack Roach III, MD, FACR, FASTRO, FASCO, Department of Radiation Oncology, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; Christina Chapman, MD, MS, Department of Radiation Oncology, Section of Health Services Research, Baylor College of Medicine, Houston, TX Health Policy, Quality & Informatics Program, Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX; and Pamela W. Coleman, MD, FACS, FPMRS, Department of Surgery/OB GYN, Howard University College of Medicine, Washington, DC
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105
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Lu X, Kim S. Weakly mutually uncorrelated codes with maximum run length constraint for DNA storage. Comput Biol Med 2023; 165:107439. [PMID: 37678135 DOI: 10.1016/j.compbiomed.2023.107439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/14/2023] [Accepted: 08/29/2023] [Indexed: 09/09/2023]
Abstract
DNA storage systems have begun to attract considerable attention as next-generation storage technologies due to their high densities and longevity. However, efficient primer design for random-access in synthesized DNA strands is still an issue that needs to be solved. Although previous studies have explored various constraints for primer design in DNA storage systems, there is no attention paid to the combination of weakly mutually uncorrelated codes with the maximum run length constraint. In this paper, we first propose a code design by combining weakly mutually uncorrelated codes with the maximum run length constraint. Moreover, we also explore the weakly mutually uncorrelated codes to satisfy combinations of maximum run length constraint with more constraints such as being almost-balanced and having large Hamming distance, which are also efficient constraints for random-access in DNA storage systems. To guarantee that the proposed codes can be adapted to primer design with variable length, we present modified code construction methods to achieve different lengths of the code. Then, we provide an analysis of the size of the proposed codes, which indicates the capacity to support primer design. Finally, we compare the codes with those of previous works to show that the proposed codes can always guarantee the maximum run length constraint, which is helpful for random-access for DNA storage.
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Affiliation(s)
- Xiaozhou Lu
- Department of Electrical, Electronic, and Computer Engineering, University of Ulsan, Ulsan, 44610, South Korea.
| | - Sunghwan Kim
- Department of Electrical, Electronic, and Computer Engineering, University of Ulsan, Ulsan, 44610, South Korea.
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106
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Postdocs are organizing to obtain better pay and working conditions - that can only be a good thing. Nature 2023; 622:670. [PMID: 37875623 DOI: 10.1038/d41586-023-03298-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
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107
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Gong SC, Park S. Increased risk of sleep problems according to employment precariousness among paid employees in Korea. Am J Ind Med 2023; 66:876-883. [PMID: 37545103 DOI: 10.1002/ajim.23523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/18/2023] [Accepted: 07/21/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND This study aimed to investigate the relationship between precarious employment (PE) and sleep problems among wage workers in Korea. METHODS Data from 29,437 wage workers were obtained from the 6th Korean Working Conditions Survey. PE was defined based on four dimensions: employment temporariness, irregularity, lack of protection, and economic vulnerability. A PE index indicating employment precariousness was derived. The outcome variables were three sleep problems experienced over the past year: difficulty initiating asleep; difficulty maintaining sleep' and fatigue upon waking. Multiple logistic regression was performed after adjusting for age, educational level, occupation, job tenure, company size, and working hours, to estimate the association between PE and sleep problems. RESULTS For both sexes, the risk of all sleep problems significantly increased as the precariousness of employment increased, showing a dose-response relationship. CONCLUSION An increased risk of sleep problems is evident as employment becomes more precarious. These findings could help improve the health of workers with PE by addressing sleep problems.
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Affiliation(s)
- Seong Chan Gong
- Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Sungjin Park
- Department of Occupational and Environmental Medicine, Gangnam Giein Hospital, Seoul, Republic of Korea
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108
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Mingyang Y, Hankun Y, Chen X, Zhida J. The impact of trade on employment: New evidence from a global value chains perspective. PLoS One 2023; 18:e0285681. [PMID: 37768986 PMCID: PMC10538729 DOI: 10.1371/journal.pone.0285681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 04/26/2023] [Indexed: 09/30/2023] Open
Abstract
Given the magnitude impact of global value chains (GVCs) in reconstructing the pattern of world trade, its employment implications deserve thorough study. In this paper we explore the impact of GVCs position on employment across countries and its heterogeneous mechanisms. We perform an in-depth theoretical analysis followed by an empirical test using panel data for 56 industries in 42 countries from 2000 to 2014. The results show that enhancing the GVCs position will significantly increase employment, with a more pronounced effect in developing countries. Mechanical tests demonstrate a positive wage effect for developed countries. For developing countries, there is a positive demand effect and a negative factor substitution effect. Heterogeneity tests show that developed countries promote employment primarily by improving the forward GVCs position. Developing countries boost employment mainly by reducing the backward GVCs position. Further research has revealed that employment in developed countries has a clear preference for industries with higher GVCs, crowding out employment in other industries. This paper has enriched research on the employment implications of GVCs position and exploring the possible crowding effect during the evolution of the position of GVCs, which has been informative and insightful for countries in formulating GVCs participation and employment policies.
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Affiliation(s)
- Yue Mingyang
- Department of Economics, Jiangsu Administration Institute, Nanjing, China
| | - Yuan Hankun
- Department of Economics, Jiangsu Administration Institute, Nanjing, China
| | - Xu Chen
- Post-Doctoral Research Center, Suzhou International Development Group, Suzhou, China
- Suzhou Financial Research Institute, Suzhou, China
| | - Jin Zhida
- School of Economics, Wuhan University of Technology, Wuhan, China
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Pereira MAD, Arroyo LH, Gallardo MDPS, Arcêncio RA, Gusmão JD, Amaral GG, de Oliveira VC, Guimarães EADA. Vaccination coverage in children under one year of age and associated socioeconomic factors: maps of spatial heterogeneity. Rev Bras Enferm 2023; 76:e20220734. [PMID: 37729269 PMCID: PMC10506597 DOI: 10.1590/0034-7167-2022-0734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/15/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE to analyze vaccination coverage spatial distribution in children under one year old and the socioeconomic factors associated with meeting the recommended goals in Minas Gerais. METHODS an ecological study, carried out in 853 municipalities in the state. Pentavalent, poliomyelitis, meningococcal conjugate, yellow fever, rotavirus, and 10-valent pneumococcal conjugate vaccination coverage were analyzed. Scan statistics and multiple logistic regression were performed to identify spatial clusters and factors associated with meeting coverage goals. RESULTS spatial analysis revealed clusters with risk of low coverage for all vaccines. Number of families with per capita income of up to 1/2 wage, Minas Gerais Social Responsibility Index and percentage of the poor or extremely poor population were associated with meeting the established goals. CONCLUSIONS the results are useful for designing interventions regarding the structuring of vaccination services and the implementation of actions to increase vaccination coverage in clusters with less propensity to vaccinate.
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Affiliation(s)
| | | | | | | | - Josianne Dias Gusmão
- Secretaria de Estado da Saúde de Minas Gerais. Belo Horizonte, Minas Gerais, Brazil
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A warm welcome to all our new vet student members. Vet Rec 2023; 193:218. [PMID: 37681608 DOI: 10.1002/vetr.3448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
Exam results day may seem a distant memory for some, but it marked the start of something special for all the new first-year vet students across the country. All the hard work has paid off - you did it! You're now a vet in the making and BVA is here to support you every step of the way.
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Alcusky MJ, Mick EO, Allison JJ, Kiefe CI, Sabatino MJ, Eanet FE, Ash AS. Paying for Medical and Social Complexity in Massachusetts Medicaid. JAMA Netw Open 2023; 6:e2332173. [PMID: 37669052 PMCID: PMC10481227 DOI: 10.1001/jamanetworkopen.2023.32173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 07/28/2023] [Indexed: 09/06/2023] Open
Abstract
Importance The first MassHealth Social Determinants of Health payment model boosted payments for groups with unstable housing and those living in socioeconomically stressed neighborhoods. Improvements were designed to address previously mispriced subgroups and promote equitable payments to MassHealth accountable care organizations (ACOs). Objective To develop a model that ensures payments largely follow observed costs for members with complex health and/or social risks. Design, Setting, and Participants This cross sectional study used administrative data for members of the Massachusetts Medicaid program MassHealth in 2016 or 2017. Participants included members who were eligible for MassHealth's managed care, aged 0 to 64 years, and enrolled for at least 183 days in 2017. A new total cost of care model was developed and its performance compared with 2 earlier models. All models were fit to 2017 data (most recent available) and validated on 2016 data. Analyses were begun in February 2019 and completed in January 2023. Exposures Model 1 used age-sex categories, a diagnosis-based morbidity relative risk score (RRS), disability, serious mental illness, substance use disorder, housing problems, and neighborhood stress. Model 2 added an interaction for unstable housing with RRS. Model 3 added rurality and updated diagnosis-based RRS, medication-based RRS, and interactions between sociodemographic characteristics and morbidity. Main Outcome and Measures Total 2017 annual cost was modeled and overall model performance (R2) and fair pricing of subgroups evaluated using observed-to-expected (O:E) ratios. Results Among 1 323 424 members, mean (SD) age was 26.4 (17.9) years, 53.4% were female (46.6% male), and mean (SD) 2017 cost was $5862 ($15 417). The R2 for models 1, 2, and 3 was 52.1%, 51.5%, and 60.3%, respectively. Earlier models overestimated costs for members without behavioral health conditions (O:E ratios 0.94 and 0.93 for models 1 and 2, respectively) and underestimated costs for those with behavioral health conditions (O:E ratio >1.10); model 3 O:E ratios were near 1.00. Model 3 was better calibrated for members with housing problems, those with children, and those with high morbidity scores. It reduced underpayments to ACOs whose members had high medical and social complexity. Absolute and relative model performance were similar in 2016 data. Conclusions and Relevance In this cross-sectional study of data from Massachusetts Medicaid, careful modeling of social and medical risk improved model performance and mitigated underpayments to safety-net systems.
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Affiliation(s)
- Matthew J. Alcusky
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester
| | - Eric O. Mick
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester
| | - Jeroan J. Allison
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester
| | - Catarina I. Kiefe
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester
| | - Meagan J. Sabatino
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester
| | - Frances E. Eanet
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester
| | - Arlene S. Ash
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester
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Bai Y, Kim C, Chum A. Impact of the minimum wage increase on smoking behaviour: A quasi-experimental study in South Korea. Soc Sci Med 2023; 333:116135. [PMID: 37562244 DOI: 10.1016/j.socscimed.2023.116135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/19/2023] [Accepted: 07/30/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND While there's a growing body of research studying the health effects of minimum wage increases, evidence of its impact on smoking is inconsistent. Using nationally representative statistics, our quasi-experimental study examines the impacts of South Korea's 2018 minimum wage increase on smoking patterns, offering a distinctive context due to the significant wage growth and the country's permissive smoking culture. METHODS Using the Korean Welfare Panel Study (KOWEPS), we conducted a difference-in-differences analysis using two-way fixed effect (TWFE) and Callaway and Sant'Anna Difference-in-differences (CSDID) methods. The study sample (n = 3494) included individuals aged 19-64 at baseline in 2016, and employed in the entire study period (2016-2019). RESULTS The model results suggest a roughly 2% increase in the probability of current smoking with an insignificant impact on average daily cigarette consumption following the 2018 minimum wage increase in Korea. These effects were most pronounced among men and age groups (45-64). We also found policy effects on those earning up to 150% of the minimum wage. CONCLUSION In a culture with widespread acceptance of smoking, an exogenous increase in disposable income due to elevated minimum wage might enhance vulnerability to societal pressure to smoke. Although TWFE and CSDID both suggest the same overall trend, the latter approach allows a more detailed examination by acknowledging heterogeneous treatment effects. These results could guide policymakers to contemplate the potential for increased smoking resulting from minimum wage hikes in societies where tobacco use is common, and accordingly strategize anti-smoking public health initiatives.
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Affiliation(s)
- Yihong Bai
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Chungah Kim
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Antony Chum
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
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Monfared AAT, Hummel N, Chandak A, Khachatryan A, Zhang Q. Assessing out-of-pocket expenses and indirect costs for the Alzheimer disease continuum in the United States. J Manag Care Spec Pharm 2023; 29:1065-1077. [PMID: 37307097 PMCID: PMC10510674 DOI: 10.18553/jmcp.2023.23013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND: The societal costs of Alzheimer disease (AD) are considerable. Cost data stratified by cost category (direct and indirect) and AD severity in the United States are limited. OBJECTIVE: To describe out-of-pocket (OOP) expenses and indirect costs from unpaid caregiving and work impairment among patients with AD by severity and among patients with mild cognitive impairment (MCI) in a representative sample of the US population. METHODS: Data from the Health and Retirement Study (HRS) were used. HRS respondents were included if they reported an AD diagnosis or were considered as having MCI based on their cognitive performance. MCI and AD severity staging was performed using a crosswalk from results of the modified Telephone Interview of Cognitive Status to the Mini-Mental State Examination. OOP expenses were assessed along with indirect costs (costs to caregivers from providing unpaid help and costs to employers). Sensitivity analyses were performed by varying assumptions of caregiver employment, missed workdays, and early retirement. Patients with AD were stratified by nursing home status, type of insurance, and income level. All cost calculations applied sampling weights. RESULTS: A total of 18,786 patients were analyzed. Patients with MCI (n = 17,885) and AD (n = 901) were aged 67.8 ± 10.7 and 80.9 ± 9.3 years, were 55.7% and 63.3% female, and were 28.3% and 0.9% employed, respectively. OOP expenses per patient per month increased with AD severity, ranging from $420 in mild to $903 in severe AD but were higher in MCI ($554) than in mild AD. Indirect costs to employers were similar across the AD continuum ($197-$242). Costs from unpaid caregiving generally increased by disease severity, from $72 (MCI) to $1,298 (severe AD). Total OOP and indirect costs increased by disease severity, from $869 (MCI) to $2,398 (severe AD). Sensitivity analysis assuming nonworking caregivers and zero costs to employers decreased the total OOP and indirect costs by 32%-53%. OOP expenses were higher for patients with AD who had private insurance (P < 0.01), had higher incomes (P < 0.01), or were in nursing homes (P < 0.01). Indirect costs to caregivers were lower for patients with AD in nursing homes ($600 vs $1,372, P < 0.01). Total indirect costs were higher for patients with AD with lower incomes ($1,498 vs $1,136, P < 0.01) and for those not in nursing homes ($1,571 vs $799, P < 0.01). CONCLUSIONS: This study shows that OOP expenses and indirect costs increase with AD severity, OOP expenses increase with higher income, subscription of private insurance, and nursing home residency, and total indirect costs decrease with higher income and nursing home residency in the United States. DISCLOSURES This study was financially sponsored by Eisai. Drs Zhang and Tahami are employees of Eisai. Drs Chandak, Khachatryan, and Hummel are employees of Certara; Certara is a paid consultant to Eisai. The views expressed here are those of the authors and are not to be attributed to their respective affiliations. Laura De Benedetti, BSc, provided medical writing support to the manuscript; she is an employee of Certara.
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Affiliation(s)
- Amir Abbas Tahami Monfared
- Eisai Inc., Nutley, NJ
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
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MacDougall H, Hanson S, Interrante JD, Eliason E. Rural-Urban Differences in Health Care Unaffordability During the Postpartum Period. Med Care 2023; 61:595-600. [PMID: 37561603 PMCID: PMC10421621 DOI: 10.1097/mlr.0000000000001888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
OBJECTIVE The objective of this study was to examine health care unaffordability for rural and urban residents and by postpartum status. METHODS We used cross-sectional survey data on female-identifying respondents ages 18-44 (n=17,800) from the 2019 to 2021 National Health Interview Study. Outcomes of interest were 3 measures of health care unaffordability. We conducted bivariate and multivariable regression models to assess the association between health care unaffordability, rurality, and postpartum status. RESULTS Bivariate analyses showed postpartum people reported statistically significantly higher rates of being unable to pay medical bills and having problems medical paying bills, as compared with nonpostpartum people. Rural residents also reported statistically significantly higher rates of being unable to pay their medical bills and having problems paying medical bills as compared with urban residents. In adjusted models, the predicted probability of being unable to pay medical bills among postpartum respondents was 12.8% (CI, 10.1-15.5), which was statistically significantly higher than among nonpostpartum respondents. Similarly, postpartum respondents had statistically significantly higher predicted probabilities of reporting problems paying medical bills (18.4%, CI, 15.4-21.4) as compared with nonpostpartum respondents. The rural residency was not significantly associated with the health care unaffordability outcome measures in adjusted models. CONCLUSIONS Both postpartum and rural respondents reported higher rates of being unable to pay medical bills and having problems paying medical bills; however, after adjusting for covariates, only postpartum respondents reported statistically significantly higher rates of these outcomes. These results suggest that postpartum status may present challenges to health care affordability that span the urban/rural context.
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Affiliation(s)
| | | | | | - Erica Eliason
- Brown University School of Public Health, Providence, Rhode Island
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Akhter M, Seda J, Stariha J, Slane V. Effect of Current (Virtual) vs. Future (Salary) Economics on the Residency Match. Acad Radiol 2023; 30:2095. [PMID: 37061449 PMCID: PMC10102691 DOI: 10.1016/j.acra.2023.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 04/17/2023]
Affiliation(s)
- Murtaza Akhter
- Department of Emergency Medicine, Penn State Hershey Medical Center, Hershey, PA 17033; Department of Emergency Medicine, HCA Florida Kendall Regional Medical Center, 11800 Sherry Ln, Miami, FL 33183.
| | - Jesus Seda
- Department of Emergency Medicine, HCA Florida Kendall Regional Medical Center, 11800 Sherry Ln, Miami, FL 33183
| | - Jillian Stariha
- Department of Emergency Medicine, HCA Florida Kendall Regional Medical Center, 11800 Sherry Ln, Miami, FL 33183
| | - Valori Slane
- Department of Emergency Medicine, HCA Florida Kendall Regional Medical Center, 11800 Sherry Ln, Miami, FL 33183
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Cooke EA, Huang J, Cole HA, Brenner E, Zhang A, Germaine P, Catanzano T. Author Response to "Effect of current (virtual) vs future (salary) economics on the residency Match". Acad Radiol 2023; 30:2096. [PMID: 37429781 DOI: 10.1016/j.acra.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 06/10/2023] [Indexed: 07/12/2023]
Affiliation(s)
- Erin A Cooke
- Vanderbilt University Medical Center, Department of Radiology, 1161 21st Ave. S., Nashville, TN 37232 (E.A.C., J.H., H.A.C.)
| | - Jennifer Huang
- Vanderbilt University Medical Center, Department of Radiology, 1161 21st Ave. S., Nashville, TN 37232 (E.A.C., J.H., H.A.C.).
| | - Heather A Cole
- Vanderbilt University Medical Center, Department of Radiology, 1161 21st Ave. S., Nashville, TN 37232 (E.A.C., J.H., H.A.C.).
| | - Emily Brenner
- Vanderbilt University School of Medicine, 1161 21st Ave. S., Nashville, TN 37232 (E.B., A.Z.).
| | - Alex Zhang
- Cooper Medical School of Rowan University, 1 Cooper Plaza, Ste.B23, Camden, NJ 08103 (P.G.).
| | - Pauline Germaine
- Cooper Medical School of Rowan University, 1 Cooper Plaza, Ste.B23, Camden, NJ 08103 (P.G.).
| | - Tara Catanzano
- Department of Radiology, University of Massachusetts Chan Medical School-Baystate, 759 Chestnut Street, Springfield, MA 01199 (T.C.).
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de Perio MA, Srivastav A, Razzaghi H, Laney AS, Black CL. Paid Sick Leave Among U.S. Healthcare Personnel, April 2022. Am J Prev Med 2023; 65:521-527. [PMID: 36878415 PMCID: PMC10440219 DOI: 10.1016/j.amepre.2023.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/22/2023] [Accepted: 02/22/2023] [Indexed: 03/07/2023]
Abstract
INTRODUCTION Healthcare personnel are at risk for acquiring and transmitting respiratory infections in the workplace. Paid sick leave benefits allow workers to stay home and visit a healthcare provider when ill. The objectives of this study were to quantify the percentage of healthcare personnel reporting paid sick leave, identify differences across occupations and settings, and determine the factors associated with having paid sick leave. METHODS In a national nonprobability Internet panel survey of healthcare personnel in April 2022, respondents were asked, Does your employer offer paid sick leave? Responses were weighted to the U.S. healthcare personnel population by age, sex, race/ethnicity, work setting, and census region. The weighted percentage of healthcare personnel who reported paid sick leave was calculated by occupation, work setting, and type of employment. Using multivariable logistic regression, the factors associated with having paid sick leave were identified. RESULTS In April 2022, 73.2% of 2,555 responding healthcare personnel reported having paid sick leave, similar to 2020 and 2021 estimates. The percentage of healthcare personnel reporting paid sick leave varied by occupation, ranging from 63.9% (assistants/aides) to 81.2% (nonclinical personnel). Female healthcare personnel and those working as licensed independent practitioners, in the Midwest, and in the South were less likely to report paid sick leave. CONCLUSIONS Most healthcare personnel from all occupational groups and healthcare settings reported having paid sick leave. However, differences by sex, occupation, type of work arrangement, and Census region exist and highlight disparities. Increasing healthcare personnel's access to paid sick leave may decrease presenteeism and subsequent transmission of infectious diseases in healthcare settings.
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Affiliation(s)
- Marie A de Perio
- Office of the Director, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio.
| | | | - Hilda Razzaghi
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - A Scott Laney
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia
| | - Carla L Black
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Han X, Yuan T, Wang D, Zhao Z, Gong B. How to understand high global food price? Using SHAP to interpret machine learning algorithm. PLoS One 2023; 18:e0290120. [PMID: 37585429 PMCID: PMC10431629 DOI: 10.1371/journal.pone.0290120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/02/2023] [Indexed: 08/18/2023] Open
Abstract
The global food prices have surged to historical highs, and there is no consensus on the reasons behind this round of price increases in academia. Based on theoretical analysis, this study uses monthly data from January 2000 to May 2022 and machine learning models to examine the root causes of that period's global food price surge and global food security situation. The results show that: Firstly, the increase in the supply of US dollars and the rise in oil prices during pandemic are the two most important variables affecting food prices. The unlimited quantitative easing monetary policy of the US dollar is the primary factor driving the global food price surge, and the alternating impact of oil prices and excessive US dollar liquidity are key features of the surge. Secondly, in the context of the global food shortage, the impact of food production reduction and demand growth expectations on food prices will further increase. Thirdly, attention should be paid to potential agricultural import supply chain risks arising from international uncertainty factors such as the ongoing Russia-Ukraine conflict. The Russian-Ukrainian conflict has profoundly impacted the global agricultural supply chain, and crude oil and fertilizers have gradually become the main driving force behind the rise in food prices.
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Affiliation(s)
- Xiao Han
- Agricultural Trade Promotion Center, Ministry of Agriculture and Rural Affairs of P.R. China, Beijing, P.R. China
| | - Tong Yuan
- Agricultural Trade Promotion Center, Ministry of Agriculture and Rural Affairs of P.R. China, Beijing, P.R. China
| | - Donghui Wang
- Agricultural Trade Promotion Center, Ministry of Agriculture and Rural Affairs of P.R. China, Beijing, P.R. China
| | - Zheng Zhao
- Agricultural Trade Promotion Center, Ministry of Agriculture and Rural Affairs of P.R. China, Beijing, P.R. China
| | - Bing Gong
- Agricultural Trade Promotion Center, Ministry of Agriculture and Rural Affairs of P.R. China, Beijing, P.R. China
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Abstract
BACKGROUND Many previous studies on the reasons behind unmet dental needs focus on economic issues. However, in this research, we aimed to investigate the relationship between long working hours and unmet dental needs while considering the influence of occupational factors in wage workers. METHODS This study used data from the Korea National Health and Nutrition Examination Survey (2012-2018) and analyzed a sample of 12,104 wage workers. Unmet dental needs were defined as cases in which individuals did not receive dental care, despite their need for examination or treatment, within the last year. Long working hours were defined as exceeding 52 h per week, based on the standard working hours stipulated by the Labor Standards Act. A binomial model was applied to calculate the prevalence ratio through multivariate logistic regression analysis. RESULTS The prevalence of unmet dental needs was observed in 3,948 cases (32.5%), among which 1,478 attributed their presence to lack of time. The prevalence of unmet dental needs showed an inverse relationship with the education level and household income. The wage workers who worked long hours had the highest prevalence of unmet dental needs. Long working hours were found to be 1.18 times (95% CI 1.07-1.29) more likely to result in unmet dental care compared to working less than 40 h. The relationship between long working hours and unmet dental needs were statistically significant only in men (PR 1.24, 95% CI 1.07-1.43). However, the relationship between long working hours and unmet dental needs owing to time were in both men and women (men: PR 1.59, 95% CI 1.20-2.11, women: PR 1.90, 95% CI 1.48-2.43). CONCLUSIONS This study confirmed that long working hours and unmet dental needs are related when occupational factors are taken into consideration, despite the absence of oral health indicators. Using this study as a reference, further research is necessary to identify the underlying causes of unmet dental care and to improve access to dental services in the future.
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Affiliation(s)
- Youngjin Choi
- Department of Public Health Sciences, Hanyang University Graduate School, Seoul, South Korea
| | - Inah Kim
- Department of Public Health Sciences, Hanyang University Graduate School, Seoul, South Korea.
- Hanyang University Graduate School of Public Health, Seoul, South Korea.
- Department of Occupational and Environmental Medicine, Hanyang University Medical Center, Seoul, South Korea.
| | - Jaechul Song
- Department of Public Health Sciences, Hanyang University Graduate School, Seoul, South Korea
- Hanyang University Graduate School of Public Health, Seoul, South Korea
- Department of Occupational and Environmental Medicine, Hanyang University Medical Center, Seoul, South Korea
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Abstract
Paid family medical leave (PFML) offers infants, parents, and society at large numerous health and economic benefits. It has been shown to improve neonatal and maternal outcomes, breastfeeding rates, familial relationships, and decrease gender inequalities in the workplace. Though the economic feasibility of PFML has been well established in many countries, the USA lacks a cohesive and comprehensive federal PFML policy. Neonatal healthcare providers play a critical role in impacting neonatal health and should actively advocate for the development and promotion of a federal PFML policy, particularly one that is inclusive of both mothers and fathers and is at least 12 weeks in duration.
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Affiliation(s)
- Tamara I Arnautovic
- Division of Newborn Medicine, Department of Pediatrics, Tufts Children's Hospital, Tufts University School of Medicine, Boston, MA, USA.
| | - Christiane E L Dammann
- Division of Newborn Medicine, Department of Pediatrics, Tufts Children's Hospital, Tufts University School of Medicine, Boston, MA, USA
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121
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Koevoet D, Strauch C, Naber M, der Stigchel SV. The Costs of Paying Overt and Covert Attention Assessed With Pupillometry. Psychol Sci 2023; 34:887-898. [PMID: 37314425 DOI: 10.1177/09567976231179378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
Attention can be shifted with or without an accompanying saccade (i.e., overtly or covertly, respectively). Thus far, it is unknown how cognitively costly these shifts are, yet such quantification is necessary to understand how and when attention is deployed overtly or covertly. In our first experiment (N = 24 adults), we used pupillometry to show that shifting attention overtly is more costly than shifting attention covertly, likely because planning saccades is more complex. We pose that these differential costs will, in part, determine whether attention is shifted overtly or covertly in a given context. A subsequent experiment (N = 24 adults) showed that relatively complex oblique saccades are more costly than relatively simple saccades in horizontal or vertical directions. This provides a possible explanation for the cardinal-direction bias of saccades. The utility of a cost perspective as presented here is vital to furthering our understanding of the multitude of decisions involved in processing and interacting with the external world efficiently.
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Affiliation(s)
- Damian Koevoet
- Experimental Psychology, Helmholtz Institute, Utrecht University
| | | | - Marnix Naber
- Experimental Psychology, Helmholtz Institute, Utrecht University
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Haro-Ramos AY, Bacong AM. Disparities in unmet needed paid leave across race, ethnicity and citizenship status among employed Californians: a cross-sectional study. Public Health 2023; 221:97-105. [PMID: 37441997 DOI: 10.1016/j.puhe.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 06/05/2023] [Accepted: 06/08/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVES Paid leave is essential for public health in order to prevent presenteeism (i.e., working while sick), provide an economic safety net for workers when ill, and promote family well-being through parental leave. While racial and ethnic disparities in unmet paid leave (or needing but not being able to take paid leave) are well documented, little evidence of the intersecting role of citizenship status exists. This study examined disparities in unmet paid leave across race, ethnicity and citizenship status. STUDY DESIGN This was a cross-sectional study of employed adults in California, USA. METHODS Weighted, multivariable logistic regressions were used to assess disparities in unmet needed paid leave across race, ethnicity and citizenship status categories, including non-citizen, naturalised, and citizen Latinx and Asian respondents, and naturalised and non-citizen White respondents, relative to US-born White respondents, controlling for demographic, familial, health-related and work-related covariates. This study examined a representative sample of Californian adults using the 2021 California Health Interview Survey (CHIS). A total of 24,453 people completed the CHIS from March to October 2021. This analysis was restricted to individuals who had complete data, were employed at the time of the survey and were part of the study race and ethnic groups of interest, leading to an analytical sample of 12,485 respondents. RESULTS While 16.9% of employed Californians reported forgoing needed paid leave, disparities across race, ethnicity and citizenship status were evident. Specifically, 31.8% of non-citizen Latinx respondents, compared to 11% of US-born White respondents, did not use paid leave when they needed it due to fear of job loss, fear of negative impacts on job advancement, employers denying it, lack of information or knowledge regarding the process or ineligibility. In the fully adjusted analyses, respondents identifying as non-citizen Latinx (adjusted odds ratio [aOR] = 2.57, 95% confidence interval [CI] = 1.94-3.40), naturalised Latinx (aOR = 1.90, 95% CI = 1.46-2.48), US-born Latinx (OR = 1.30, 95% CI = 1.06-1.60), non-citizen Asian (aOR = 2.34, 95% CI = 1.69-3.23) and naturalised Asian (aOR = 1.78, 95% CI = 1.35-2.34) had a statistically significantly higher likelihood of experiencing unmet needed paid leave compared to US-born White respondents. CONCLUSIONS Despite its importance for health, disparities across race, ethnicity and citizenship status exist in those who experience unmet paid leave. It is recommended that the administrative and enforcement agencies in California further communicate eligibility, facilitate the application process and enforce equitable access to paid leave for all workers.
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Affiliation(s)
- A Y Haro-Ramos
- Division of Health Policy and Management, School of Public Health, University of California, Berkeley, Berkeley, CA, USA.
| | - A M Bacong
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA
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Dalia AA, Vanneman MW, Bhatt HV, Troianos CA, Morewood GH, Klopman MA. Trends in Cardiac Anesthesiologist Compensation, Work Patterns, and Training From 2010 to 2020: A Longitudinal Analysis of the Society of Cardiovascular Anesthesiologists Salary Survey. Anesth Analg 2023; 137:293-302. [PMID: 36136075 DOI: 10.1213/ane.0000000000006191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Increasing cardiac procedural volume, a shortage of practicing cardiac anesthesiologists, and growth in specialist physician compensation would be expected to increase cardiac anesthesiologist compensation and work load. Additionally, more cardiac anesthesiologists are graduating from accredited fellowships and completing echocardiography certification. The Society of Cardiovascular Anesthesiologists (SCA) biannual salary survey longitudinally measures these data; we analyzed these data from 2010 to 2020 and hypothesized survey respondent inflation-adjusted total compensation, work load, and training would increase. For the primary outcome, we adjusted the median reported annual gross taxable income for inflation using the Consumer Price Index and then used linear regression to assess changes in inflation-adjusted median compensation. For the secondary outcomes, we analyzed the number of cardiac anesthetics managed annually and the most common care delivery staffing ratios. For the tertiary outcomes, we assessed changes in the proportion of respondents reporting transesophageal echocardiography (TEE) certification and completion of a 12-month cardiac anesthesia fellowship. We performed sensitivity analyses adjusting for yearly proportions of academic and private practice respondents. Annual survey response rates ranged from 8% to 17%. From 2010 to 2020, respondents reported a continuously compounded inflation-adjusted compensation decrease of 1.1% (95% confidence interval [CI], -1.6% to -0.6%; P = .003), equivalent to a total inflation-adjusted salary reduction of 10%. In sensitivity analysis, private practice respondents reported a continuously compounded compensation loss of -0.8% (95% CI, -1.4% to -0.2%; P = .022), while academic respondents reported no significant change (continuously compounded change, 0.4%; 95% CI, -0.4% to 1.1%; P = .23). The percentage of respondents managing more than 150 cardiac anesthetics per year increased from 26% in 2010 to 43% in 2020 (adjusted odds ratio [aOR], 1.03 per year; 95% CI, 1.03-1.04; P < .001). The proportion of respondents reporting high-ratio care models increased from 31% to 41% (aOR, 1.01 per year; 95% CI, 1.01-1.02; P < .001). Reported TEE certification increased from 69% to 90% (aOR, 1.10 per year; 95% CI, 1.10-1.11; P < .001); reported fellowship training increased from 63% to 82% (aOR, 1.15 per year; 95% CI, 1.14-1.16; P < .001). After adjusting for the proportion of academic or private practice survey respondents, SCA salary survey respondents reported decreasing inflation-adjusted compensation, rising volumes of cardiac anesthetics, and increasing levels of formal training in the 2010 to 2020 period. Future surveys measuring burnout and job satisfaction are needed to assess the association of increasing work and lower compensation with attrition in cardiac anesthesiologists.
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Affiliation(s)
- Adam A Dalia
- From the Division of Cardiac Anesthesiology, Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Matthew W Vanneman
- Division of Cardiovascular and Thoracic Anesthesia, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California
| | - Himani V Bhatt
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Gordon H Morewood
- Department of Anesthesiology, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - Matthew A Klopman
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia
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Tidman S. UK dentistry: a timeline of events 1920-2020 - Part 1: 1920-1946. Br Dent J 2023; 235:273-277. [PMID: 37620484 DOI: 10.1038/s41415-023-6180-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/20/2023] [Accepted: 05/02/2023] [Indexed: 08/26/2023]
Abstract
This is the first of a three-part series detailing significant developments in the delivery of dentistry in the UK between 1920-2020, covering the period following the establishment of the British Dental Association as a 'professional' organisation with a paid secretary and offices to the end of the Second World War.
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Kokorelias KM, Sinha SK. Commentary: Minding the Gap - Why Wage Parity Is Crucial for the Care of Older Canadians. Healthc Policy 2023; 19:32-39. [PMID: 37695704 PMCID: PMC10519331 DOI: 10.12927/hcpol.2023.27160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023] Open
Abstract
Zagrodney and colleagues (2023) have highlighted the pay differences that exist between those working in the home and community care (HCC) sector and other healthcare sectors. The authors argue that achieving wage parity could significantly mitigate the current HCC human resource crisis, support the overall sustainability of Ontario's healthcare system and improve patient outcomes. We build on their argument by highlighting issues that have contributed to wage disparities within healthcare systems and discuss how addressing them can create more equitable systems for both those receiving and those providing care. We further note how other healthcare systems that have wage parity have demonstrated that it is not a "nice to have" but an essential element of establishing a sustainable health human resources strategy. Finally, the new 10-year bilateral healthcare funding agreements that the federal, provincial and territorial governments are currently announcing will not only provide significant new funding but also an opportunity to decisively address the long-standing issue of wage parity in Canada, once and for all.
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Affiliation(s)
- Kristina M Kokorelias
- Assistant Professor Department of Occupational Science and Occupational Therapy Temerty Faculty of Medicine University of Toronto Associate Fellow National Institute on Ageing Toronto Metropolitan University Toronto, ON
| | - Samir K Sinha
- Professor Institute of Health Policy, Management and Evaluation Department of Medicine, Temerty Faculty of Medicine University of Toronto Director of Health Policy Research National Institute on Ageing Toronto Metropolitan University Toronto, ON
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Zagrodney KAP, King EC, Simon D, Nichol KA, McKay SM. Economic Evidence for Home and Community Care Investment: The Case for Ontario Personal Support Workers' Wage Parity. Healthc Policy 2023; 19:23-31. [PMID: 37695703 PMCID: PMC10519337 DOI: 10.12927/hcpol.2023.27161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023] Open
Abstract
The home and community care (HCC) sector is in a health human resource crisis. Particularly concerning is the shortage of personal support workers (PSWs) who provide the majority of HCC. This paper outlines a strategy to mitigate the HCC PSW shortage by applying appropriate funding to HCC and focusing on equal pay between HCC and institutional long-term care facilities' PSWs. Using publicly available data, our calculations estimate substantial government cost-savings from investing in HCC PSWs to increase HCC capacity. Beyond the economic evidence, how such investments would benefit those seeking care are also highlighted.
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Affiliation(s)
- Katherine A P Zagrodney
- Senior Research Associate - Quantitative Lead VHA Home HealthCare Toronto, ON Research Associate and Home and Community and Long-term Care Sector Co-Lead Canadian Health Workforce Network Ottawa, ON Assistant Professor (Status) Institute of Health Policy, Management and Evaluation University of Toronto Toronto, ON
| | - Emily C King
- Manager of Research VHA Home HealthCare Toronto, ON Assistant Professor (Status) Dalla Lana School of Public Health University of Toronto, Toronto, ON
| | - Deborah Simon
- Chief Executive Officer Ontario Community Support Association Toronto, ON
| | - Kathryn A Nichol
- Chief Executive Officer VHA Home HealthCare Assistant Professor (Status) Dalla Lana School of Public Health University of Toronto Toronto, ON
| | - Sandra M McKay
- Vice-President of Research and Innovation VHA Home HealthCare Assistant Professor (Status) Institute of Health Policy, Management and Evaluation University of Toronto Assistant Professor (Status) Ted Rogers School of Management Toronto Metropolitan University, Toronto, ON
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Abstract
Food prices spiked sharply in 2007-2008, in 2010-2011 and again in 2021-2022. However, the impacts of these spikes on poverty remain controversial; while food is a large expense for the poor, many poor people also earn income from producing or marketing food, and higher prices should incentivize greater food production. Short-run simulation models assume away production and wage adjustments, and probably underestimate food production by the poor. Here we analyse annual data on poverty rates, real food price changes and food production growth for 33 middle-income countries from 2000 to 2019 based on World Bank poverty measures. Panel regressions show that year-on-year increases in the real price of food predict reductions in the US$3.20-per-day poverty headcount, except in more urban or non-agrarian countries. A plausible explanation is that rising food prices stimulate short-run agricultural supply responses that induce increased demand for unskilled labour and increases in wages.
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Affiliation(s)
- Derek Headey
- International Food Policy Research Institute (IFPRI), Colombo, Sri Lanka.
| | - Kalle Hirvonen
- International Food Policy Research Institute (IFPRI), Colombo, Sri Lanka
- United Nations University World Institute for Development Economics Research (UNU-WIDER), Helsinki, Finland
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128
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Almond D, Cheng Y, Machado C. Large motherhood penalties in US administrative microdata. Proc Natl Acad Sci U S A 2023; 120:e2209740120. [PMID: 37428937 PMCID: PMC10629572 DOI: 10.1073/pnas.2209740120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 05/03/2023] [Indexed: 07/12/2023] Open
Abstract
Whereas previous research has described motherhood penalties in US survey data, we leverage administrative data on 811,000 quarterly earnings histories from the US Unemployment Insurance program. We analyze contexts where smaller motherhood penalties might be expected: couples where the woman outearns her male partner prior to childbearing, at firms that are headed by women, and at firms that are predominantly women. Our startling result is that none of these propitious contexts appear to diminish the motherhood penalty, and indeed, the gap often increases in magnitude over time following childbearing. We estimate one of the largest motherhood penalties in "female-breadwinner" families, where higher-earning women experience a 60% drop from their prechildbirth earnings relative to their male partners. Turning to proximate mechanisms, women are less likely to switch to a higher-paying firm postchildbearing than men and are substantially more likely to quit the labor force. On the whole, our findings are discouraging relative even to existing research on motherhood penalties.
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Affiliation(s)
- Douglas Almond
- Columbia University, New York, NY10027
- National Bureau of Economic Research, Cambridge, MA02138
| | - Yi Cheng
- Columbia University, New York, NY10027
| | - Cecilia Machado
- FGV EPGE, Fundação Getulio Vargas, Rio de Janeiro, RJ22250-900, Brazil
- Institute of Labor Economics, Schaumburg-Lippe-Straße 5-9, Bonn53113, Germany
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Lokanan M. The morality and tax avoidance: A sentiment and position taking analysis. PLoS One 2023; 18:e0287327. [PMID: 37459305 PMCID: PMC10351724 DOI: 10.1371/journal.pone.0287327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 06/02/2023] [Indexed: 07/20/2023] Open
Abstract
This paper examines the moral and legal underpinnings of corporate tax avoidance. Cast in terms of a totemic symbol that brand tax avoidance as within the purview of the law, the paper invokes the attributional frames of the new sociology of morality to examine the position of both the moral advocates and the amoral critics of aggressive tax avoidance. The paper uses the United Kingdom as a jurisdiction where complex tax planning by tax advisors serves as a measure of protection for corporations who may have already conceived that they are paying too much tax. Data for the paper came from semi-structured interviews conducted with tax accountants, consultants, parliamentarians, and government officials. To supplement the interviews, data from the Parliamentary Commission on Banking Standards were collected and analyzed to provide useful insights. The findings reveal that through effective tax planning, companies can reduce the present values of future tax payments. Given the singular justification of their actions within the contours of the tax rules, the moral culpability of organized tax avoidance is minimized, with very little liability attached. Tax avoidance is a morally charged area that is slowly drifting away from conventional social norms of what is right or wrong. It is hard not to see those in charge of tax regulation not using the findings of this paper to provide a more nuanced understanding of the intractable problems associated with corporate tax avoidance and use it as a reference point for regulatory reforms.
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Affiliation(s)
- Mark Lokanan
- Faculty of Management, Royal Roads University, Victoria, BC, Canada
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130
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Darabos K, Faust H. Assessing health, psychological distress and financial well-being in informal young adult caregivers compared to matched young adult non-caregivers. PSYCHOL HEALTH MED 2023; 28:2249-2260. [PMID: 36976715 DOI: 10.1080/13548506.2023.2195671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 03/20/2023] [Indexed: 03/29/2023]
Abstract
Young adult caregivers (YACs) are faced with the atypical challenge of providing informal (i.e. not paid) care to a family member, while simultaneously at a critical developmental stage in which many major life decisions and milestones are taking place. Adding the challenge of caring for a family member during this already complex time period may have a detrimental impact on young adults' (YAs) own overall health and well-being. The aim of this study was to examine differences in overall health, psychological distress, and financial strain among a propensity matched sample of YACs compared to young adult non-caregivers (YANCs) from a nationally representative database and to examine differences in these outcomes by caregiving role (caring for a child vs. other family member). YAs (aged 18-39, N = 178) identifying as a caregiver (n = 74) were matched with YANCs (n = 74) on age, gender, and race. Results revealed that YACs exhibited higher psychological distress, lower overall health and more sleep disturbance and higher financial strain compared to YANCs. YAs caring for family members other than children also reported higher anxiety and fewer hours spent caregiving compared to YAs caring for a child. YACs appear to be at risk for impairments in health and well-being compared to their matched peers. Longitudinal research is needed to understand how caregiving during young adulthood impacts health and well-being across time.
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Affiliation(s)
- Katie Darabos
- Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Haley Faust
- Department of Behavioral Oncology Children's Hospital of Philadelphia, Philadelphia, PA, USA
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131
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Sullivan DW, Gad SC. Eleventh Triennial Toxicology Salary Survey. Int J Toxicol 2023; 42:309-325. [PMID: 36946501 PMCID: PMC10354794 DOI: 10.1177/10915818231162914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
This is the eleventh in a series of salary surveys for toxicologists conducted at three-year intervals that began in 1988. Previous salary surveys were conducted in 1988, 1991, 1995, 1998, 2001, 2004, 2007 (which was posted electronically, but not published), 2012, 2016 and 2020. In addition to presenting the 2022 results, herein we are providing additional data and an analysis of the trends for employment and pay in toxicology over the last 35 years. The eleventh Triennial Toxicology Salary Survey was conducted as a joint project by the American College of Toxicology (ACT) and the Society of Toxicology (SOT). In addition to the two parent organizations, eight others (the Society for Birth Defects Research, the Society of Toxicologic Pathology, the Safety Pharmacology Society, the American Board of Toxicology (ABT), the Academy of Toxicological Sciences, the Roundtable of Toxicology Consultants, the Society of Environmental Toxicology and Chemistry (SETAC), and the Environmental Mutagenesis and Genomics Society) supported the effort by distributing the Survey Monkey-based instrument to their memberships. Surveys were not distributed to regional SOT chapters, causing there to be minimal responses below the doctorate and master's degree levels. It should be noted that there continues to be a significant increase in the number of individuals reporting six-figure incomes and in those receiving significant sums as bonuses.
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132
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Ash MJ, Livingston MD, Komro K, Spencer RA, Walker A, Woods-Jaeger B. The Impact of Increased Minimum Wage on Child Neglect Varies by Developmental Age of Child. J Interpers Violence 2023; 38:7893-7910. [PMID: 36710665 PMCID: PMC10238664 DOI: 10.1177/08862605221150458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Children in poverty are at significantly greater risk of experiencing child maltreatment. Family economic security policies, such as minimum wage laws, offer a promising prevention strategy to support low-income families. This study utilized data from the Fragile Families and Child Wellbeing Study, a longitudinal birth cohort study, to examine the effect of changes in state-specific minimum wage laws on maternal self-reported child maltreatment and material hardship as it varies by developmental age of the child. A series of fixed effects models with an interaction between the minimum wage and the age of the focal child were used to estimate if there was variation by developmental period of the impact of minimum wage laws on the following outcome variables: all domains of child maltreatment, maternal work-related stress, reported material hardship, aggravation in parenting, and maternal depression. Results revealed significant effects of increased minimum wage on maternal self-reported child neglect and material hardship when children are 3 years of age, and this relationship became non-significant as children aged. No effect was observed by age for other forms of child maltreatment nor any other outcome variables. Study findings suggest minimum wage laws may have differential effects on child neglect depending on the developmental period in which they are received.
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133
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Fisher E, Flynn MA, Pratap P, Vietas JA. Occupational Safety and Health Equity Impacts of Artificial Intelligence: A Scoping Review. Int J Environ Res Public Health 2023; 20:6221. [PMID: 37444068 PMCID: PMC10340692 DOI: 10.3390/ijerph20136221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/26/2023] [Accepted: 06/08/2023] [Indexed: 07/15/2023]
Abstract
Artificial intelligence (AI) has the potential to either reduce or exacerbate occupational safety and health (OSH) inequities in the workplace, and its impact will be mediated by numerous factors. This paper anticipates challenges to ensuring that the OSH benefits of technological advances are equitably distributed among social groups, industries, job arrangements, and geographical regions. A scoping review was completed to summarize the recent literature on AI's role in promoting OSH equity. The scoping review was designed around three concepts: artificial intelligence, OSH, and health equity. Scoping results revealed 113 articles relevant for inclusion. The ways in which AI presents barriers and facilitators to OSH equity are outlined along with priority focus areas and best practices in reducing OSH disparities and knowledge gaps. The scoping review uncovered priority focus areas. In conclusion, AI's role in OSH equity is vastly understudied. An urgent need exists for multidisciplinary research that addresses where and how AI is being adopted and evaluated and how its use is affecting OSH across industries, wage categories, and sociodemographic groups. OSH professionals can play a significant role in identifying strategies that ensure the benefits of AI in promoting workforce health and wellbeing are equitably distributed.
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Affiliation(s)
- Elizabeth Fisher
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA; (E.F.); (P.P.)
| | - Michael A. Flynn
- Division of Science Integration, National Institute for Occupational Safety and Health, Cincinnati, OH 45226, USA;
| | - Preethi Pratap
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, IL 60612, USA; (E.F.); (P.P.)
| | - Jay A. Vietas
- Division of Science Integration, National Institute for Occupational Safety and Health, Cincinnati, OH 45226, USA;
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Andersen M, Maclean JC, Pesko MF, Simon K. Does paid sick leave encourage staying at home? Evidence from the United States during a pandemic. Health Econ 2023; 32:1256-1283. [PMID: 36895154 DOI: 10.1002/hec.4665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 12/18/2022] [Accepted: 01/29/2023] [Indexed: 05/04/2023]
Abstract
We study the impact of a temporary U.S. paid sick leave mandate that became effective April 1st, 2020 on self-quarantining, proxied by physical mobility behaviors gleaned from cellular devices. We study this policy using generalized difference-in-differences methods, leveraging pre-policy county-level heterogeneity in the share of workers likely eligible for paid sick leave benefits. We find that the policy leads to increased self-quarantining as proxied by staying home. We also find that COVID-19 confirmed cases decline post-policy.
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Affiliation(s)
- Martin Andersen
- Department of Economics, University of North Carolina at Greensboro, North Carolina, Greensboro, USA
| | - Johanna Catherine Maclean
- Schar School of Policy and Government, George Mason University, Virginia, Arlington, USA
- Research Associate, National Bureau of Economic Research, Massachusetts, Cambridge, USA
- Research Affiliate, Institute of Labor Economics, Bonn, Germany
| | - Michael F Pesko
- Department of Economics, Andrew Young School of Policy Studies, Georgia State University, Research Affiliate, Institute of Labor Economics, Georgia, Atlanta, USA
| | - Kosali Simon
- Research Associate, National Bureau of Economic Research, Massachusetts, Cambridge, USA
- O'Neill School of Public and Environmental Affairs, Indiana University, Indiana, Bloomington, USA
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135
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Tellson A, Walker J, Woolverton S. RN Compensation Program: An innovative initiative for direct care nurses to drive outcomes. Nurs Manag (Harrow) 2023; 54:14-20. [PMID: 37253218 DOI: 10.1097/nmg.0000000000000018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Alaina Tellson
- At Baylor Scott & White Health in Dallas, Tex., Alaina Tellson is the system director of nursing professional development and the transition to practice program; Janice Walker is the system executive vice president and chief nurse executive; and Summer Woolverton is the director of compensation
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136
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Mensah MO, Ghanney Simons EC, Mangurian C, Ross JS. US Post-Graduate Residency Competitiveness, Trainee Diversity, and Future Salary Among 12 Clinical Specialties. J Gen Intern Med 2023; 38:1567-1569. [PMID: 36357730 PMCID: PMC10160250 DOI: 10.1007/s11606-022-07868-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 10/21/2022] [Indexed: 11/12/2022]
Affiliation(s)
- Michael O Mensah
- National Clinician Scholars Program, Department of Medicine, Yale University School of Medicine, New Haven, CT, USA.
| | - Efe C Ghanney Simons
- Department of Urology, David Geffen School of Medicine (DGSOM), University of California, Los Angeles (UCLA), Los Angeles, USA
| | - Christina Mangurian
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Center for Vulnerable Populations, University of California San Francisco, San Francisco, CA, USA
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
| | - Joseph S Ross
- Section of General Medicine and National Clinician Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
- Center for Outcomes Research and Evaluation, Yale-New Haven Health System, New Haven, CT, USA
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137
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Quadlin N, VanHeuvelen T, Ahearn CE. Higher education and high-wage gender inequality. Soc Sci Res 2023; 112:102873. [PMID: 37061326 PMCID: PMC10712336 DOI: 10.1016/j.ssresearch.2023.102873] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 02/20/2023] [Accepted: 03/02/2023] [Indexed: 06/19/2023]
Abstract
Over the past 60 years, we have witnessed a relocation of gender wage inequality. Whereas the largest wage gaps were once concentrated among lower-paid, lower-educated workers, today these wage gaps sit among the highest-paid, highly-educated workers. Given this reordering of gender wage inequality and the centrality of college graduates to total inequality trends, in this article, we assess the contribution of higher education mechanisms to top-end gender inequality. Specifically, we use Census and ACS data along with unique decomposition models to assess the extent to which two mechanisms rooted in higher education-bachelor's-level fields of study and the attainment of advanced degrees-can account for the gender wage gap across the wage distribution. Results from these decomposition models show that while these explanatory mechanisms fare well among bottom and middle wages, their explanatory power breaks down among the highest-paid college workers. We conclude that women's attainment of "different" education (via fields of study) or "more" education (via advanced degrees) would do little to close the gender wage gaps that are contributing most to contemporary wage inequality trends. We suggest some directions for future research, and we also take seriously the role of discriminatory pay-setting at the top of the wage distribution.
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138
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Düval S. Do men and women really have different gender role attitudes? Experimental insight on gender-specific attitudes toward paid and unpaid work in Germany. Soc Sci Res 2023; 112:102804. [PMID: 37061321 DOI: 10.1016/j.ssresearch.2022.102804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/10/2022] [Accepted: 10/01/2022] [Indexed: 06/19/2023]
Abstract
This article uses a novel experimental approach to measure whether men and women actually differ in their gender role attitudes. Recent research has shown that operationalizing gender role attitudes on a unidimensional scale ranging from "egalitarian" to "traditional" is problematic. Instead, their multidimensionality must to be taken into account. Similarly, an ideal measurement tool should consider that gender norms are applied conditionally, i.e., extensive information on the situational context must be provided. In this article, both preconditions are met by using a multifactorial survey experiment. The vignettes used in the survey experiment contain extensive contextual information on fictional couples' division of paid and unpaid work. In addition, the experimental variation of this information (e.g., the vignette persons' gender, the presence and age of children, and the partners' shares of paid and unpaid work) allows to disentangle the different dimensions that may influence (different) gender role attitudes of men and women. Results show no gender difference in attitudes: On average, men and women have "classical" egalitarian gender role attitudes.
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Affiliation(s)
- Sabine Düval
- Department of Sociology LMU Munich Konradstr, 680801, Munich, Germany.
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139
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Patel PA, Nahm WJ, Patel KK, Boyd CJ. Geographic Trends in General Surgery Resident Compensation Across the United States. J Surg Educ 2023; 80:639-645. [PMID: 36882340 DOI: 10.1016/j.jsurg.2023.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/11/2023] [Accepted: 02/05/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To examine the effect of cost of living on general surgery resident salaries and identify factors associated with greater incomes and availability of housing stipends. DESIGN Retrospective cross-sectional analysis of Fellowship and Residency Electronic Interactive Database (FREIDA), institutional websites, and Doximity. Program characteristics were compared through Kruskal-Wallis tests, ANOVA, and χ2 tests. Multivariable linear mixed modeling and multivariable logistic regression were utilized to determine factors associated with higher salary and availability of housing stipend, respectively. SETTING Three-hundred fifty-one general surgery residency programs in the United States. PARTICIPANTS Three-hundred-seven general surgery residency programs with available salary data for the 2022 to 2023 academic year. RESULTS The average postgraduate year 1 resident annual salary was $59,906.00 (standard deviation [SD] ± $5051.97). After adjustment for the cost of living, the average annual income surplus was $22,428.42 (SD ± $4848.64). Cost of living and resident remuneration varied substantially across regions (p < 0.001). Annual income surplus was the highest for programs in the Northeast when compared to other regions (p < 0.001). Resident annual income increased by $510 (95% confidence interval [CI] $430-$590) for each $1000 increase in the cost of living and $150 (95% CI $80-$210) for each 10-rank increase in Doximity general surgery program reputation ranking. An increased cost of living was associated with a higher likelihood of housing stipend availability (odds ratio 1.17, 95% CI 1.07-1.28). CONCLUSIONS General surgery residents are inadequately compensated for the cost of living, indicating the potential for increased compensation to alleviate economic strain of surgical trainees. As financial stress can have implications for mental and physical well-being, further discussion of current resident salaries and benefits is warranted.
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Affiliation(s)
- Parth A Patel
- Medical College of Georgia, Augusta University, Augusta, Georgia
| | - William J Nahm
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, New York
| | - Kajol K Patel
- Medical College of Georgia, Augusta University, Augusta, Georgia
| | - Carter J Boyd
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, New York.
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Abstract
BACKGROUND Research clearly demonstrates that income matters greatly to health. However, income distribution and its relationship to poverty risk is often misunderstood. METHODS We provide a structural account of income distribution and poverty risk in the U.S., rooted in the 'roles' that individuals inhabit with relation to the 'factor payment system' (market distribution of income to individuals through wages and asset ownership). Principal roles are child, older adult, and, among working-age adults, disabled individual, student, unemployed individual, caregiver, or paid laborer. Moreover, the roles of other members of an individual's household also influence an individual's income level. This account implies that 1) roles other than paid laborer will be associated with greater poverty risk, 2) household composition will be associated with poverty risk, and 3) income support policies for those not able to engage in paid labor are critical for avoiding poverty. We test hypotheses implied by this account using 2019 and 2022 U.S. Census Current Population Survey data. The exposure variables in our analyses relate to roles and household composition. The outcomes relate to income and poverty risk. RESULTS In 2019, 40.1 million individuals (12.7% of the population) experienced poverty under the U.S. Census' Supplemental Poverty Measure. All roles other than paid laborer were associated with greater poverty risk (p < .001 for all comparisons). Household composition, particularly more children and disabled working-age adults, and fewer paid laborers, was also associated with greater poverty risk (p < .001 for all comparisons). Five key policy areas-child benefits, older-age pensions, disability and sickness insurance, unemployment insurance, and out-of-pocket healthcare spending-represented gaps in the welfare state strongly associated with poverty risk. CONCLUSIONS The role one inhabits and household composition are associated with poverty risk. This understanding of income distribution and poverty risk may be useful for social policy.
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Affiliation(s)
- Seth A. Berkowitz
- Division of General Medicine and Clinical Epidemiology, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States of America
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Deepak Palakshappa
- Section of General Internal Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
- Section of General Pediatrics, Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
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141
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Garbin AJ, Stevens-Lapsley JE, Gritz RM, Tucker CA, Bade MJ. Long-Term Career Earnings in Academia Might Offset the Opportunity Cost of Full-Time PhD and Postdoctoral Education for Physical Therapists Who Hold a Doctor of Physical Therapy Degree. Phys Ther 2023; 103:pzad015. [PMID: 37128811 PMCID: PMC10152085 DOI: 10.1093/ptj/pzad015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 12/01/2022] [Accepted: 12/29/2022] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Rigorously trained physical therapy researchers are essential for the generation of knowledge that guides the profession. However, there is a current and projected dearth of physical therapy researchers capable of sustaining research programs in part due to perceived financial barriers associated with pursuit of a doctor of philosophy (PhD) degree, with and without postdoctoral training, following doctor of physical therapy (DPT) degree completion. This study aimed to evaluate the financial impact of PhD and postdoctoral training, including opportunity cost, years to break even, and long-term earnings. METHODS Clinical and academic salaries were obtained via the 2016 APTA Median Income of Physical Therapist Summary Report and 2019 CAPTE Annual Accreditation Report. Salaries were adjusted to total compensation to account for benefits and compared over a 30-year period starting after DPT education. Total compensations were also adjusted to the present value, placing greater weight on early career earnings due to inflation and potential investments. RESULTS Relative to work as a clinical physical therapist, 4 years of PhD training result in an earnings deficit of $264,854 rising to $357,065 after 2 years of additional postdoctoral training. These deficits do not persist as evidenced by a clinical physical therapist career earning $449,372 less than a nonmajority scholarship academic career (DPT to PhD to academia pathway) and $698,704 less than a majority scholarship academic career (DPT to PhD to postdoctoral training to academia pathway) over a 30-year period. Greater long-term earnings for PhD careers persist when adjusting to present value. CONCLUSIONS Although there is an initial opportunity cost of PhD and postdoctoral training represented by a relative earnings deficit, advanced research training results in greater long-term earnings. IMPACT The findings of this study allow physical therapists interested in pursuing PhD and postdoctoral training to be better informed about the associated financial ramifications.
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Affiliation(s)
- Alexander J Garbin
- VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), VA Eastern Colorado Health Care System, Aurora, Colorado, USA
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado, USA
| | - Jennifer E Stevens-Lapsley
- VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), VA Eastern Colorado Health Care System, Aurora, Colorado, USA
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado, USA
| | - R Mark Gritz
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado, Aurora, Colorado, USA
- Division of Health Care Policy and Research, University of Colorado, Aurora, Colorado, USA
| | - Carole A Tucker
- Nutrition, Metabolic & Rehabilitation Science Department, University of Texas Medical Branch - Galveston, Galveston, Texas, USA
| | - Michael J Bade
- VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), VA Eastern Colorado Health Care System, Aurora, Colorado, USA
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado, USA
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142
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Sargent MJ. Skin in the game: Race, ingroup identification, and attitudes toward paying college athletes. Cultur Divers Ethnic Minor Psychol 2023; 29:221-234. [PMID: 35025547 DOI: 10.1037/cdp0000520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES The present studies examined two dimensions of racial ingroup identification, using them as predictors of Black and White Americans' attitudes toward paying college athletes. Following Leach et al. (2008), the present work distinguished between ingroup self-investment and ingroup self-definition. The central prediction was that respondent race and self-investment would interact in predicting compensation support. METHOD In three studies (N = 352, N = 476, & N = 562), U.S. residents who were 18 or older and either Black or White completed an online survey in which they completed a self-report measure of racial identification, as well as reporting their opinion of paying college athletes. RESULTS The results supported the prediction, demonstrating that Black respondents' support was higher than that for Whites, but this was especially the case at high levels of self-investment. The third study suggests that these effects were driven by respondents who believed that Black athletes made up a larger percentage of the pool of likely beneficiaries of compensation. Ingroup self-definition played no role as a moderator. CONCLUSIONS Broadly speaking, it may be that, for policies whose likely beneficiaries are disproportionately Black, stronger racial self-investment serves to widen racial divides in support. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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143
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Gray A. City vets see big rise in salaries. Vet Rec 2023; 192:269. [PMID: 37000763 DOI: 10.1002/vetr.2897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
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144
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Hassan AYI, Cucculelli M, Lamura G. Caregivers' willingness to pay for digital support services: Comparative survey. Health Policy 2023; 130:104751. [PMID: 36857837 DOI: 10.1016/j.healthpol.2023.104751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 01/24/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Considering the substantial information needs experienced by informal caregivers, the increased availability of digital support services for caregivers as well as the potential they offer, further understanding of caregivers' willingness to pay for digital support services is needed. OBJECTIVE The aim of this study is to identify associations between informal caregiver's characteristics and their willingness to pay for digital support services in two countries: Italy and Sweden. METHODS A sample of 378 respondents participated in a cross-sectional survey. Respondents were recruited by the Italian National Institute of Health and Science on Ageing and the Swedish Family Care Competence Centre. A two-part regression model was used. In the first part, logistic regression analysis was applied to investigate the association between willingness to pay and sets of independent variables (caregiver's demographics, caregiver's socioeconomic resources and caregiving context). In the second part, a generalized linear model (log-link and gamma distribution) was applied to determine the adjusted mean willingness to pay. RESULTS More than half of the participants from both countries of our study were willing to pay out of pocket for digital support services. A recommendation by a healthcare professional was the top factor that may motivate caregivers' willingness to pay an additional amount for a paid version of a digital support service. In both countries, the majority of the respondents believe that the government should allocate more funds for digital support services and for improving digital infrastructures. Caregiver' s gender, care recipient relationship to the caregiver, care duration, the total household income and the amount spent per month on professional caregiving services are all associated with willingness to pay. For every additional 10 Euro increase in the amount spent per month on professional caregiving services, the odds of willingness to pay an additional Euro for a digital support service increased by 0.60 % in the Italian sample (p= 0.002, 95% CI: 1.002, 1.009) and 0.31% in the Swedish sample (p=0.015, 95% CI: 1.006, 1.057). CONCLUSIONS Factors such as demographics, socioeconomic resources and the caregiving context may play a role in caregivers' willingness to pay for digital support services. The digital and social divide may negatively affect caregivers' willingness to pay for digital support services. Policy makers and insurance providers should consider innovative policies to fund digital support services that have been shown to be effective at supporting and improving caregivers' health outcomes via subsidies or other incentives. Future research that evaluates the cost-effectiveness of digital support services is needed in a context of a growing number of informal caregivers and ever scarcer resources.
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Affiliation(s)
- Alhassan Yosri Ibrahim Hassan
- INRCA IRCCS - National Institute of Health and Science on Ageing, Centre for Socio-Economic Research on Ageing, Ancona, Italy; Department of Economics and Social Sciences, Faculty of Economics "Giorgio Fuà", Marche Polytechnic University, Ancona, Italy.
| | - Marco Cucculelli
- Department of Economics and Social Sciences, Faculty of Economics "Giorgio Fuà", Marche Polytechnic University, Ancona, Italy
| | - Giovanni Lamura
- INRCA IRCCS - National Institute of Health and Science on Ageing, Centre for Socio-Economic Research on Ageing, Ancona, Italy
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145
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Sweeney N. Postdoc unions can help secure a brighter future. Nature 2023; 616:249. [PMID: 37041249 DOI: 10.1038/d41586-023-01007-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
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146
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Callaghan JP, Freimane KZ, Kearney GP, Hart ND. (L)earning: Exploring the value of paid roles for medical students. Clin Teach 2023; 20:e13563. [PMID: 36808878 DOI: 10.1111/tct.13563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 01/06/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND The Medical Student Technician (MST) role is a paid position established in Northern Ireland in 2020. The Experience-Based Learning (ExBL) model is a contemporary medical education pedagogy advocating supported participation to develop capabilities important for doctors-to-be. In this study, we used the ExBL model to explore the experiences of MSTs and how the role contributed to students' professional development and preparedness for practice. METHODS A convenience sampling strategy was used to recruit a total of 17 MSTs in three focus groups. Semi-structured interviews were transcribed verbatim and analysed using the ExBL model as a framework. Transcripts were independently analysed and coded by two investigators and discrepancies resolved with the remaining investigators. RESULTS The MST experiences reflected the various components of the ExBL model. Students valued earning a salary; however, what students earned transcended the financial reward alone. This professional role enabled students to meaningfully contribute to patient care and have authentic interactions with patients and staff. This fostered a sense of feeling valued and increased self-efficacy amongst MSTs, helping them acquire various practical, intellectual and affective capabilities and subsequently demonstrate an increased confidence in their identities as future doctors. CONCLUSION Paid clinical roles for medical students could present useful adjuncts to traditional clinical placements, benefiting both students and potentially healthcare systems. The practice-based learning experiences described appear to be underpinned by a novel social context where students can add value, be and feel valued and gain valuable capabilities that better prepare them for starting work as a doctor.
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Affiliation(s)
| | | | - Grainne P Kearney
- Centre for Medical Education, Queen's University Belfast, Belfast, UK
| | - Nigel D Hart
- Centre for Medical Education, Queen's University Belfast, Belfast, UK
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147
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Leigh JP, Chakalov BT. Estimating Effects of Wages on Smoking Prevalence Using Labor Unions as Instrumental Variables. J Occup Environ Med 2023; 65:e234-e239. [PMID: 36662699 DOI: 10.1097/jom.0000000000002792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To test for the effects of wages on smoking using labor unions as instrumental variables. METHODS We analyzed four waves of the Panel Study of Income Dynamics (2013 to 2019 alternate years). The overall sample included workers aged 18 to 70 years in 2013 and subsamples within blue + clerical/white-collar and private/public sector jobs (N = 37,117 to 8446 person-years). We used two instrumental variables: worker's union membership and states' right-to-work laws. RESULTS $1 (2019 US dollars) increases in wages-per-hour resulted in 1.3 ( P < 0.001) percentage point decreases in smoking prevalence (8.2% decreases at the smoking mean). Larger effect sizes and strong statistical significance were found for blue-collar + clerical and private-sector subsamples; smaller sizes and insignificance were found for public-sector and white-collar subsamples. CONCLUSIONS Unions increase wages, and higher wages, in turn, reduce smoking. Wages and labor unions are underappreciated social determinants of health.
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Affiliation(s)
- J Paul Leigh
- From the Department of Public Health Sciences, University of California Davis School of Medicine, Davis, California (J.P.L., B.T.C.); Center for Healthcare Policy and Research, University of California Davis School of Medicine, Sacramento, California (J.P.L.); Center for Poverty & Inequality Research, University of California, Davis, California (J.P.L.)
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148
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Wild S. Leaving academia for industry? Here's how to handle salary negotiations. Nature 2023; 616:615-617. [PMID: 37069279 DOI: 10.1038/d41586-023-01299-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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149
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Buszkiewicz JH, Hajat A, Hill HD, Otten JJ, Drewnowski A. Racial, ethnic, and gender differences in the association between higher state minimum wages and health and mental well-being in US adults with low educational attainment. Soc Sci Med 2023; 322:115817. [PMID: 36905725 DOI: 10.1016/j.socscimed.2023.115817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/27/2023] [Accepted: 03/02/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND To date, research evaluating the association between minimum wage and health has been heterogenous and varies based on the specific subpopulation or health outcomes under evaluation while associations across racial, ethnic, and gender identities have been understudied. METHODS A triple difference-in-differences strategy using modified Poisson regression was used to evaluate the associations between minimum wage and obesity, hypertension, fair or poor general health, and moderate psychological distress in 25-64-year-old adults with a high school education/GED or less. Data from the 1999-2017 Panel Study of Income Dynamics was linked to state policies and characteristics to estimate the risk ratio (RR) associated with a $1 increase in current and 2-year lagged state minimum wages overall and by race, ethnicity, and gender (non-Hispanic or non-Latino (NH) White men, NH White women, Black, indigenous, or people of color (BIPOC) men, and BIPOC women) adjusting for individual and state-level confounding. RESULTS No associations between minimum wage and health were observed overall. Among NH White men 2-year lagged minimum wage was associated with reduced risk of obesity (RR = 0.82, 95% CI = 0.67, 0.99). Among NH White women, current minimum wage was associated lower risk of moderate psychological distress (RR = 0.73, 95% CI = 0.54, 1.00) while 2-year lagged minimum wage was associated with higher obesity risk (RR = 1.35, 95% CI = 1.12, 1.64) and lower risk of moderate psychological distress (RR = 0.75, 95% CI = 0.56, 1.00). Among BIPOC women, current minimum wage was associated with higher risk of fair or poor health (RR = 1.19, 95% CI = 1.02, 1.40). No associations were observed among BIPOC men. CONCLUSION While no associations were observed overall, heterogeneous associations between minimum wage, obesity, and psychological distress by racial, ethnic, and gender strata warrant further study and have implications for health equity research.
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Affiliation(s)
- James H Buszkiewicz
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| | - Anjum Hajat
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Heather D Hill
- Daniel J. Evans School of Public Policy and Governance, University of Washington, Seattle, WA, USA
| | - Jennifer J Otten
- Center for Public Health Nutrition, School of Public Health, University of Washington, Seattle, WA, USA; Nutritional Sciences Program, School of Public Health, University of Washington, Seattle, WA, USA; Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Adam Drewnowski
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA; Center for Public Health Nutrition, School of Public Health, University of Washington, Seattle, WA, USA; Nutritional Sciences Program, School of Public Health, University of Washington, Seattle, WA, USA
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150
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Wahidi MM, Lamb CR, Kovitz K, Keyes C, Bechara R, Giovacchini CX, French K, Shojaee S, Musani A, Eapen G, Ost DE. Interventional Pulmonology Productivity, Compensation, and Practice Benchmarks: The AABIP 2022 Report. J Bronchology Interv Pulmonol 2023; 30:129-134. [PMID: 36825802 DOI: 10.1097/lbr.0000000000000916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/08/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND Interventional pulmonology (IP) is a growing field that has not yet been recognized by the American Board of Medical Specialties or incorporated into national benchmark organizations. As a result, there is a lack of data on IP practice patterns, physicians' compensation and productivity targets. METHODS We sent an anonymous survey to 647 current or past physician members of the AABIP. Domains included demographics, training background, academic rank, practice settings, work relative value unit (wRVU) targets, salary, and career satisfaction. RESULTS The response rate to the survey was 28.3%; 17.8% were female. The median salary for IP faculty in academic institutions was $320,000 for assistant professors, $338,000 for associate professors, and $350,000 for full professors. Salaries were lower for women than for men in academic practice, even after adjusting for the number of years in practice (mean salary difference after adjustment $57,175, 95% CI: $19,585-$94,764, P =0.003). The median salary for private practice was higher at $428,000. Among respondents that used wRVU targets, the median targets for academic and private practice were 5500 and 6300, respectively. The majority of IP physicians are satisfied with their career choice. CONCLUSIONS Productivity targets in IP are used less than half the time, and when they are used, they are set in line with the lower wRVU of IP procedures. IP compensation is higher than that of general pulmonary medicine, as reported by national benchmark associations. In academic practices, gender differences in salaries were found.
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Affiliation(s)
- Momen M Wahidi
- Division of Pulmonary, Allergy and Critical Care, Department of Medicine, Duke University Medical Center, Durham, NC
| | - Carla R Lamb
- Division of Pulmonary and Critical Care, Department of Medicine, Lahey Hospital and Medical Center, Burlington, MA
| | - Kevin Kovitz
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois, Chicago, Chicago, IL and Chicago Chest Center, Elk Grove Village
| | - Colleen Keyes
- Division of Pulmonary and Critical Care, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Rabih Bechara
- Division of Pulmonary and Critical Care, Department of Medicine, Medical College of Georgia School of Medicine/Augusta University, Augusta, GA
| | - Coral X Giovacchini
- Division of Pulmonary, Allergy and Critical Care, Department of Medicine, Duke University Medical Center, Durham, NC
| | - Kim French
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, Elk Grove Village, IL
| | - Samira Shojaee
- Division of Allergy, Pulmonary and Critical Care, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Ali Musani
- Division of Pulmonary, Allergy and Critical Care, Department of Medicine, University of Colorado, Denver, CO
| | - George Eapen
- Division of Medicine, Pulmonary Department, MD Anderson Cancer Center, Houston, TX
| | - David E Ost
- Division of Medicine, Pulmonary Department, MD Anderson Cancer Center, Houston, TX
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