The societal impact of individual placement and support implementation on employment outcomes for young adults receiving temporary health-related welfare benefits: a difference-in-differences study

BACKGROUND

Individual placement and support (IPS) is an evidence-based practice that helps individuals with mental illness gain and retain employment. IPS was implemented for young adults at a municipality level through a cross-sectoral collaboration between specialist mental healthcare, primary mental healthcare, and the government funded employment service (NAV). We investigated whether IPS implementation had a causal effect on employment outcomes for all young adults in receipt of a temporary health-related rehabilitation (work assessment allowance, WAA) welfare benefit, measured at the societal level compared to municipalities that did not implement IPS.

METHOD

We used a difference in differences design to estimate the effects of IPS implementation on the outcome of workdays per year using longitudinal registry data. We estimate the average effect of being exposed to IPS implementation during four-years of implementation compared to ten control municipalities without IPS for all WAA recipients.

RESULTS

We found a significant, positive, causal effect on societal level employment outcomes of 5.6 (p = 0.001, 95% CI 2.7-8.4) increased workdays per year per individual, equivalent to 12.7 years of increased work in the municipality where IPS was implemented compared to municipalities without IPS. Three years after initial exposure to IPS implementation individuals worked, on average, 10.5 more days per year equating to 23.8 years of increased work.

CONCLUSIONS

Implementing IPS as a cross sectoral collaboration at a municipality level has a significant, positive, causal, societal impact on employment outcomes for all young adults in receipt of a temporary health-related rehabilitation welfare benefit.

AI and its consequences for the written word

The latest developments of chatbots driven by Large Language Models (LLMs), more specifically ChatGPT, have shaken the foundations of how text is created, and may drastically reduce and change the need, ability, and valuation of human writing. Furthermore, our trust in the written word is likely to decrease, as an increasing proportion of all written text will be AI-generated - and potentially incorrect. In this essay, I discuss these implications and possible scenarios for us humans, and for AI itself.

One size does not fit all: an exploratory interview study on how translational researchers navigate the current academic reward system

Introduction

Translational research is a subfield of the biomedical life sciences that focuses on clinically driven healthcare innovations. The workforce of this subfield, i.e., translational researchers, are diversely specialized and collaborate with a multitude of stakeholders from diverse disciplines in and outside academia in order to navigate the complex path of translating unmet clinical needs into research questions and ultimately into advancements for patient care. Translational researchers have varying responsibilities in the clinical, educational, and research domains requiring them to split their time two- or three-ways. Working between these domains and alongside peers who do not split their time as such, raises questions about the academic reward system used to recognize their performance, which mainly focuses on publication metrics within the research domain. What is unclear is how combining research tasks with tasks in the clinical and/or educational domains effects translational researchers and how they navigate the academic reward system.

Methods

In this exploratory interview study, semi-structured interviews were conducted to gain a deeper understanding of the current academic reward system for translational researchers. Stratified purposeful sampling was used to recruit 14 translational researchers from varying countries, subspecialties, and career stages. The interviews were coded after data collection was complete and arranged into three overarching result categories: intrinsic motivation, extrinsic factors, and ideal academic reward system and advice.

Results

We found that these 14 translational researchers were intrinsically motivated to achieve their translational goals while working in settings where clinical work was reported to take priority over teaching which in turn took priority over time for research. However, it is the latter that was explained to be essential in the academic reward system which currently measures scientific impact largely based on publications metrics.

Conclusion

In this study, translational researchers were asked about their thoughts regarding the current academic reward system. Participants shared possible structural improvements and ideas for specialized support on an individual, institutional, and also international level. Their recommendations focused on acknowledging all aspects of their work and led to the conclusion that traditional quantitative academic reward metrics do not fully align with their translational goals.

Can the introduction of an authentic learning exercise lead to the modulation of breakfast behavior in undergraduate students at University of La Réunion?

The authentic teaching and learning approach introduces real-world scenarios into the classroom to better engage Generation Z students. Considering this, we introduced an authentic learning practical exercise (breakfast meal and glycemic variation) to undergraduate biology students at the University of La Réunion (France). Here, students were initially briefed regarding the practical and subsequently determined their baseline glucose values (glucometer). They then consumed 200 mL of fruit juice together with a pain au chocolat (chocolate pastry) and subsequently recorded their glucose values at regular intervals. The last reading was done after 150 min, and they thereafter plotted such data to reveal temporal glycemic variations. During this time, the students also worked on a report to document information collected and began to supply responses to several listed questions. Three weeks after completion of the practical, we evaluated whether this intervention would lead to changes in their views regarding the nature and regularity of breakfast meal intake (employing survey questions). Our findings show that a reasonable proportion of the students indicated that the intervention did change their dietary habits, with 50% sometimes opting for an improved breakfast, whereas 10% also changed their habits albeit for only a small while. Of note, >60% of students indicated that they changed their breakfast intake habits by the end of the endocrinology module. These findings show that the beneficial effects of authentic teaching approaches may elicit relatively long-lasting changes in terms of breakfast behavioral patterns in young people and that such effects may also impact the broader society.NEW & NOTEWORTHY This study introduced an authentic learning exercise (endocrinology practical exercise) to undergraduate biology students and ascertained whether it changed their views regarding the nature and regularity of breakfast meals. Here, many altered their breakfast dietary habits, which persisted even after the completion of their module. Authentic teaching approaches can therefore trigger relatively long-lasting changes in terms of breakfast behavioral patterns in young people and may also impact the broader society.

The Societal Value of Vaccines: Expert-Based Conceptual Framework and Methods Using COVID-19 Vaccines as a Case Study

Health technology assessments (HTAs) of vaccines typically focus on the direct health benefits to individuals and healthcare systems. COVID-19 highlighted the widespread societal impact of infectious diseases and the value of vaccines in averting adverse clinical consequences and in maintaining or resuming social and economic activities. Using COVID-19 as a case study, this research work aimed to set forth a conceptual framework capturing the broader value elements of vaccines and to identify appropriate methods to quantify value elements not routinely considered in HTAs. A two-step approach was adopted, combining a targeted literature review and three rounds of expert elicitation based on a modified Delphi method, leading to a conceptual framework of 30 value elements related to broader health effects, societal and economic impact, public finances, and uncertainty value. When applying the framework to COVID-19 vaccines in post-pandemic settings, 13 value elements were consensually rated highly important by the experts for consideration in HTAs. The experts reviewed over 10 methods that could be leveraged to quantify broader value elements and provided technical forward-looking recommendations. Limitations of the framework and the identified methods were discussed. This study supplements ongoing efforts aimed towards a broader recognition of the full societal value of vaccines.

Predictors of Seeking Care for Influenza-Like Illness in a Novel Digital Study

Background

Previous research has estimated that >50% of individuals experiencing influenza-like illness (ILI) do not seek health care. Understanding factors influencing care-seeking behavior for viral respiratory infections may help inform policies to improve access to care and protect public health. We used person-generated health data (PGHD) to identify factors associated with seeking care for ILI.

Methods

Two observational studies (FluStudy2020, ISP) were conducted during the United States 2019-2020 influenza season. Participants self-reported ILI symptoms using the online Evidation platform. A log-binomial regression model was used to identify factors associated with seeking care.

Results

Of 1667 participants in FluStudy2020 and 47 480 participants in ISP eligible for analysis, 518 (31.1%) and 11 426 (24.1%), respectively, sought health care. Participants were mostly female (92.2% FluStudy2020, 80.6% ISP) and aged 18-49 years (89.6% FluStudy2020, 89.8% ISP). In FluStudy2020, factors associated with seeking care included having health insurance (risk ratio [RR], 2.14; 95% CI, 1.30-3.54), more severe respiratory symptoms (RR, 1.53; 95% CI, 1.37-1.71), and comorbidities (RR, 1.37; 95% CI, 1.20-1.58). In ISP, the strongest predictor of seeking care was high symptom number (RR for 6/7 symptoms, 2.14; 95% CI, 1.93-2.38).

Conclusions

Using PGHD, we confirmed low rates of health care-seeking behavior for ILI and show that having health insurance, comorbidities, and a high symptom burden were associated with seeking health care. Reducing barriers in access to care for viral respiratory infections may lead to better disease management and contribute to protecting public health.

The societal impact of early intensified treatment in patients with type 2 diabetes mellitus

Aim: The current study estimates the societal impact of early intensified treatment compared with initial monotherapy with subsequent treatment intensification in newly diagnosed adults with type 2 diabetes mellitus in Mexico. Methods: An individual patient-level simulation and a static cohort model were employed to simulate the treatment pathway and the probability of experiencing complications of diabetes. The avoided number of events was translated into avoided productivity losses, which were monetized using wages. Results: Patients on early intensified treatment experienced approximately 13,000 fewer complication events over 10 years. This was translated into a societal impact of $54 million (USD). Conclusion: Early treatment intensification is likely to be of particular benefit to health outcomes and productivity losses.

Title of "Ambassador of Clinical Psychology and Psychological Treatment" Awarded to Danutė Gailienė

The paper presents professional activities and the major works of an ambassador of the European Association of Clinical Psychology and Psychological Treatment (EACLIPT), Prof. Danutė Gailienė. Prof. Gailienė is among the most influential European clinical psychologists who contributed to clinical psychology training, research, and practice in former post-communist East European countries. Her entire career was dedicated to the development of clinical psychology, and through her work, Prof. Gailienė demonstrated how even in an oppressive and politically difficult environment, it is possible to keep the integrity and work up to higher standards.

Narrative review of the epidemiology, economic burden, and societal impact of metastatic bone disease

As the prevalence of cancer continues to rise in the United States due to a combination of both early detection and increased life expectancy, the number of clinically symptomatic skeletal metastases will continue to grow. Healthcare expenditures on cancer treatment have steadily increased each decade to our estimated level of approximately $200 billion in 2020. Metastatic bone disease is a significant driver of this cost, accounting for nearly one-fifth of the total cost of oncologic treatment. Understanding the impact of metastatic bone disease can help to identify the gaps between diagnosis and initiation of treatment in an effort to decrease the socioeconomic and psychosocial implications of the disease. In this paper, we review the epidemiology and economic burden of metastatic bone disease in addition to other sequelae that affect patients, including financial hardship, caregiver burden, diminished quality of life and psychological impact. Upon literature review of multiple studies investigating these factors, we found that advanced metastatic bone disease had overall poor outcomes with regards to the socioeconomic and psychosocial effects on not only patients and their families, but also society at large. These consequences may be improved by early referral to orthopedic specialists and establishment of a multi-disciplinary team.

Societal impact for patients with psoriasis: A nationwide Swedish register study

Background

Psoriasis is an immune-mediated chronic inflammatory disease having a significant negative health impact. Psoriasis has societal impact; loss of productivity has been estimated at approximately 10% and it may influence the patient's financial status. Relationships between quality of life, disease severity, and cost of care need exploration. Understanding the disease burden is important for health policy and research allocation. Few studies address the research gaps in socioeconomics, comorbidity, and medication use.

Objective

Observing differences in education, income, employment status, marital status, health care consumption, and drug utilization between patients with psoriasis and matched controls.

Methods

Cohort study following socioeconomics and health care consumption for all psoriasis patients from the Swedish patient register. All individuals with a first diagnosis of psoriasis in outpatient or inpatient care from 2002 to 2013 were followed until death, emigration, or end of the study.

Results

Overall, 109,803 patients were included (mean age 51.2 years, 53% women) and matched with 1.08 million controls. The levels of education and income were similar, but the proportion employed was significantly lower for patients with psoriasis. There was a tendency for fewer patients with psoriasis to be married.

Limitations

Generalizability, lack of primary care diagnoses, and lack of early treatments (available from 2005).

Conclusion

Understanding of the socioeconomic impact of psoriasis is extended by showing reductions in employment.

Boundaries Between Research Ethics and Ethical Research Use in Artificial Intelligence Health Research

The governance of ethically acceptable research in higher education institutions has been under scrutiny over the past half a century. Concomitantly, recently, decision makers have required researchers to acknowledge the societal impact of their research, as well as anticipate and respond to ethical dimensions of this societal impact through responsible research and innovation principles. Using artificial intelligence population health research in the United Kingdom and Canada as a case study, we combine a mapping study of journal publications with 18 interviews with researchers to explore how the ethical dimensions associated with this societal impact are incorporated into research agendas. Researchers separated the ethical responsibility of their research with its societal impact. We discuss the implications for both researchers and actors across the Ethics Ecosystem.

Breaking the COVID-19 Ice: Integrating Socioscientific Issues into Problem-Based Learning Lessons in Middle School

COVID-19 represents a socioscientific issue with many different facets and societal impacts for middle school in the 2020-2021 academic year. Socioscientific issues are socially significant, real-world issues that are culturally important and grounded in science. Using a socioscientific issues approach to engage middle school students in ill-structured problems in science and health issues affords teachers a motivational and scientific literacy teachable moment. Teachers face challenges when employing an SSI approach due to lack of time, lesson availability, and professional development. This brief paper and pre-recorded presentation describe problem-based learning modules related to COVID-19, such as vaccines, ventilators, and distribution of supplies that will be ready for middle school teachers at the beginning of the next school year. Lesson plans and related instructional tools will be available online at no charge. Research of the modules will use a qualitative approach to gather data from participating teachers.

European Academy of Cancer Sciences - position paper

The European Academy of Cancer Sciences (EACS) is an independent advisory body of well-recognised medical specialists and researchers striving to create a compelling interactive continuum of cancer research, from innovative basic research to implementation of state-of-the-art evidence-based cancer care and prevention. Achieving the above will entail bridging high-quality basic and preclinical cancer research to research on prevention, early detection and therapeutics as well as improving coordination of translational research efforts across Europe. The latter is expected to be expedited through quality assuring translational cancer research in Comprehensive Cancer Centres - entities that link research with the healthcare system - and networks of cancer research centres. Achieving a critical mass of expertise, resources and patients is crucial. Improving late translational research, which involves clinical studies to assess effectiveness, and added value for the health care is also a high priority. Both high-quality Big Data collections and the intelligent use of these data will promote innovation in cancer research and support outcomes research to assess clinical utility, quality of cancer care and long-term follow-up of treated patients. The EACS supports the mission-oriented approach recently proposed by the European Commission in Horizon Europe to deal with major challenges and would like to persuade the EU and its member states to formally launch a mission in cancer to boost and streamline the cancer research continuum in Europe. Building a coherent translational cancer research continuum with a focus on patients and individuals at risk will require, however, foresight as well as the extensive and continuous provision of evidence-based advice to inform policy.

Assessment of Perceived Attractiveness, Usability, and Societal Impact of a Multimodal Robotic Assistant for Aging Patients With Memory Impairments

The aim of the present study is to present the results of the assessment of clinical application of the robotic assistant for patients suffering from mild cognitive impairments (MCI) and Alzheimer Disease (AD). The human-robot interaction (HRI) evaluation approach taken within the study is a novelty in the field of social robotics. The proposed assessment of the robotic functionalities are based on end-user perception of attractiveness, usability and potential societal impact of the device. The methods of evaluation applied consist of User Experience Questionnaire (UEQ), AttrakDiff and the societal impact inventory tailored for the project purposes. The prototype version of the Robotic Assistant for MCI patients at Home (RAMCIP) was tested in a semi-controlled environment at the Department of Neurology (Lublin, Poland). Eighteen elderly participants, 10 healthy and 8 MCI, performed everyday tasks and functions facilitated by RAMCIP. The tasks consisted of semi-structuralized scenarios like: medication intake, hazardous events prevention, and social interaction. No differences between the groups of subjects were observed in terms of perceived attractiveness, usability nor-societal impact of the device. The robotic assistant societal impact and attractiveness were highly assessed. The usability of the device was reported as neutral due to the short time of interaction.

Modeling the fiscal costs and benefits of alternative treatment strategies in the United Kingdom for chronic hepatitis C

BACKGROUND

Hepatitis C (HCV) infection causes substantial direct health costs, but also impacts broader societal and governmental costs, such as tax revenue and social protection benefits. This study investigated the broader fiscal costs and benefits of curative interventions for chronic Hepatitis C (CHC) that allow individuals to avoid long-term HCV attributed health conditions.

METHODS

A prospective cohort model, assessing the long-term fiscal consequences of policy decisions, was developed for HCV infected individuals, following the generational accounting analytic framework that combines age-specific lifetime gross taxes paid and governmental transfers received (i.e. healthcare and social support costs). The analysis assessed the burden of a theoretical cohort of untreated HCV infected patients with the alternative of treating these patients with a highly efficacious curative intervention (ledipasvir/sofosbuvir [LDV/SOF]). It also compared treating patients at all fibrosis stages (Stages F0-F4) compared to late treatment (Stage F4).

RESULTS

Based on projected lifetime work activity and taxes paid, the treated cohort paid an additional £5,900 per patient compared to the untreated cohort. Lifetime government disability costs of £97,555 and £125,359 per patient for treated cohort vs no treatment cohort were estimated, respectively. Lifetime direct healthcare costs in the treated cohort were £32,235, compared to non-treated cohort of £26,424, with an incremental healthcare costs increase of £5,901 per patient. The benefit cost ratio (BCR) of total government benefits and savings relative to government treatment costs (including LDV/SOF) ranged from 1.8-5.6. Treating patients early resulted in 77% less disability costs, 43% lower healthcare costs, and 33% higher tax revenue.

CONCLUSION

The ability to cure Hepatitis C offers considerable fiscal benefits beyond direct medical costs and savings attributed to reduced disability costs, public allowances, and improved tax revenue. Changes in parameters, such as productivity, wage growth, and tax rates, can influence the conclusions described here.

Bringing ALife and Complex Systems Science to Population Health Research

Despite tremendous advancements in population health in recent history, human society currently faces significant challenges from wicked health problems. These are problems where the causal mechanisms at play are obscured and difficult to address, and consequently they have defied efforts to develop effective interventions and policy solutions using traditional population health methods. Systems-based perspectives are vital to the development of effective policy solutions to seemingly intractable health problems like obesity and population aging. ALife in particular is well placed to bring interdisciplinary modeling and simulation approaches to bear on these challenges. This article summarizes the current status of systems-based approaches in population health, and outlines the opportunities that are available for ALife to make a significant contribution to these critical issues.

Impact of eradicating hepatitis C virus on the work productivity of chronic hepatitis C (CH-C) patients: an economic model from five European countries

CH-C negatively affects work productivity (WP), creating a large economic burden. The aim of this study was to model the impact of sustained virologic response (SVR) on WP in CHC genotype 1 (GT1) patients in five European countries (EU5). Work Productivity and Activity Index-Specific Health Problem questionnaire was administered to patients across the ION clinical trials (n = 629 European patients). The analysis modelled a population of GT1 CHC patients over one year, who had been either not treated or treated with LDV/SOF. Sensitivity analyses assessed the possibility that CHC patients' labour costs were lower than the general population's and presented results by fibrosis stage. Before initiation of treatment, EU patients with CHC GT1 exhibited absenteeism and presenteeism impairments of 3.54% and 9.12%, respectively. About 91.8% of EU patients in the ION trials achieved SVR and improved absenteeism and presenteeism impairments by 16.3% and 19.5%, respectively. Monetizing these data, treatment with LDV/SOF resulted in an annual productivity gain of €435 million and a weighted average per-employed patient (PEP) gain of €900 in the EU5. PEP gains from treatment are projected to be higher in cirrhotic than in noncirrhotic patients. If CHC patients are assumed to earn 20% less than the general population, gains of €348 million (€720 PEP) annually are projected. CHC results in a significant economic burden to European society. Due to improvements in WP, SVR with treatment could provide substantial economic gains, partly offsetting the direct costs related to its widespread use.

Public optimism towards nanomedicine

BACKGROUND

Previous benefit-risk perception studies and social experiences have clearly demonstrated that any emerging technology platform that ignores benefit-risk perception by citizens might jeopardize its public acceptability and further development. The aim of this survey was to investigate the Italian judgment on nanotechnology and which demographic and heuristic variables were most influential in shaping public perceptions of the benefits and risks of nanotechnology.

METHODS

In this regard, we investigated the role of four demographic (age, gender, education, and religion) and one heuristic (knowledge) predisposing factors.

RESULTS

The present study shows that gender, education, and knowledge (but not age and religion) influenced the Italian perception of how nanotechnology will (positively or negatively) affect some areas of everyday life in the next twenty years. Furthermore, the picture that emerged from our study is that Italian citizens, despite minimal familiarity with nanotechnology, showed optimism towards nanotechnology applications, especially those related to health and medicine (nanomedicine). The high regard for nanomedicine was tied to the perception of risks associated with environmental and societal implications (division among social classes and increased public expenses) rather than health issues. However, more highly educated people showed greater concern for health issues but this did not decrease their strong belief about the benefits that nanotechnology would bring to medical fields.

CONCLUSION

The results reported here suggest that public optimism towards nanomedicine appears to justify increased scientific effort and funding for medical applications of nanotechnology. It also obligates toxicologists, politicians, journalists, entrepreneurs, and policymakers to establish a more responsible dialog with citizens regarding the nature and implications of this emerging technology platform.