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Background: Small and medium-sized enterprises (SMEs) represent 95 % of businesses and are economically essential. When occupational injuries occur, scientific literature suggests that the return-to-work (RTW) success rate is proportional to the size of enterprises and the way RTW is managed may put workers in SMEs at risk. As most studies on RTW organizational practices have been conducted with large enterprises, little is known about how RTW is managed in SMEs., Objective: The aim of this study was to explore SME's organizational practices in the RTW process of workers having suffered an occupational injury., Methods: Semi-structured phone interviews were conducted with 15 participants from 3 different stakeholder categories (i.e., SME representatives, workers, and healthcare professionals) in order to explore their experiences regarding RTW in SMEs. Data were analyzed using a phenomenological analysis strategy., Results: SMEs' organisational practices evoked by participants gather in three themes: 1) Reducing the risks of occupational injuries (i.e., ensuring injury prevention), 2) Managing occupational injuries (i.e., dealing with the initial occupational injury, handling administrative aspects of work disability, and being actively involved in the RTW process), and 3) Preventing consequences of occupational injuries (i.e., adapting operations following injuries)., Conclusion: Organizational practices for RTW are used diversely in SMEs. Proposed lines of action adapted to the realities and needs of SMEs may be beneficial to hundreds of thousands of workers, enterprises and professionals involved in the RTW process.

Team-based work (TBW) plays a crucial role in the success and quality of public services. In the context of the Spanish public sector, our study evaluates if a low level of hierarchical distance (HD) in public organizations condition the public employees' commitment (EC) as well as TBW, assessed in terms of participation and consensus among team members. Simultaneously, we evaluated to what extent EC help to enhance TBW. Employing a sample of 213 government organizations from the south of Spain through a model of structural equations, we were able to answer the above questions. Our results revealed that team-based work functions more successfully within public organizations where there exists little verticality in their structures, norms, values and rules - in simplest terms, where there is minimal organizational HD. Such results also suggest that although regulations exist in the Spanish public sector, should public organizations attempt to be less vertical and more horizontal, they would perhaps have public servants that were more committed to their organizations. As a result, servants view the organization as their own and remain loyal. Finally, from an academic perspective, this study could be one of few to research and evaluate the hierarchical role and employees' commitment to the functioning of public employees based on participation and consensus in their work teams., (© 2021 The Authors. Scandinavian Journal of Psychology published by Scandinavian Psychological Associations and John Wiley & Sons Ltd.)

Aims: Women have much higher rates of sickness absence than men, but the causes of the difference are not well understood. This study examines whether managers have more lenient attitudes towards women's than towards men's absence, as this might contribute to higher rates of sickness absence among women. Differences between managers and other employees are also assessed. Methods: Vignettes were used to measure attitudes towards the legitimacy of sickness absence. The vignettes consisted of brief case descriptions of individuals considering asking their physicians for sick leave, with information about the medical condition (mainly taken from the descriptions in ICPC-2), occupation and gender. Respondents judged how appropriate sickness absence was in each case. Quota sampling was used, and the effective sample size was 899 managers and 1396 other employees, with each respondent evaluating either four or six vignettes. Generalised ordinal logistic regression was used. Results: The gender of the vignette person had no effect on the managers' evaluations of the appropriateness of sickness absence. Irrespective of the gender of the vignette person, however, managers were generally more restrictive than non-managers. Conclusions: Different attitudes on the part of managers towards sickness absence in men and women do not seem to contribute to gender differences in sickness absence, but managers are generally more restrictive compared to non-managerial employees.

Summary: Plastic surgeons are increasingly choosing to practice as employed physicians: either in an academic position, a single-specialty or multispecialty group, or within a franchise-type business. Employment offers advantages with regard to immediate income, minimal investment in practice start-up costs, and easier access to prospective patients. Surgeons considering such employment must perform due diligence to determine whether the position offered is a good fit. Once the decision is made to offer the plastic surgeon a position, an employment contract is negotiated. It is imperative that all parties understand the provisions of the contract, so that there are no misunderstandings between the employer and employee for the duration of the term. This article introduces physician recruitment offers and employment contracting. The key components of a contract are described, and compensation options are explained. Negotiation of the contract is critical so that all aspects are understood and agreed on, and the responsibilities of all parties are delineated., (Copyright © 2021 by the American Society of Plastic Surgeons.)

Este artículo propone intervenciones estructurales dirigidas a la reorganización del trabajo para evitar un repunte de casos de Covid-19, permitiendo la continuidad de la actividad económica. Se resume la evidencia disponible acerca de los ciclos de trabajo-confinamiento y la posible aplicación de ciclos de cuatro días de trabajo por tres de confinamiento (4x3) en el contexto mexicano. También se discuten otras intervenciones como la continuación del teletrabajo en algunos sectores y el escalonamiento de las jornadas de trabajo como medidas complementarias a los ciclos de trabajo-confinamiento. Esta discusión se da en el contexto de alta informalidad y escasos recursos para absorber una pérdida importante de la productividad por las empresas medianas y pequeñas en México. Se considera la necesidad de implementar apoyos para que personas y empresas puedan mitigar pérdidas en salarios y ganancias tanto del sector formal como informal.

The 2019 coronavirus (COVID-19), also known as SARS-CoV-2, is highly pathogenic and virulent, and it spreads very quickly through human-to-human contact. In response to the growing number of cases, governments across the spectrum of affected countries have adopted different strategies in implementing control measures, in a hope to reduce the number of new cases. However, 5 months after the first confirmed case, countries like the United States of America (US) seems to be heading towards a trajectory that indicates a health care crisis. This is in stark contrast to the downward trajectory in Europe, China, and elsewhere in Asia, where the number of new cases has seen a decline ahead of an anticipated second wave. A data-driven approach reveals three key strategies in tackling COVID-19. Our work here has definitively evaluated these strategies and serves as a warning to the US, and more importantly, a guide for tackling future pandemics. Also see the video abstract here https://youtu.be/gPkCi2_7tWo., (© 2020 Wiley Periodicals LLC.)

Abstract: This descriptive study investigated new NPs' job search experience including the job search process, employment negotiation, and compensation. The majority of new graduates found a job through networking within 3 months in a specialty practice or family medicine. Lack of experience and few available positions were employment obstacles., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

Although researchers have confirmed the relationship between positive leadership styles and work-family enrichment, benevolent leadership has received little attention. Drawing from the concept of mood contagion, this study explores the underlying mechanism between benevolent leadership and work-family enrichment. Using a survey of 459 employees, across 36 supervisors and their work groups, and multilevel structural equation modelling, this study revealed that benevolent leadership is positively associated with work-family enrichment via cross-level paths. The results indicated that benevolent leadership is associated with positive group affective tone, which further predicts subordinates' work-family enrichment. Moreover, work engagement mediates the relationship between positive group affective tone and work-family enrichment. Theoretical and practical implications are discussed., (© 2020 John Wiley & Sons, Ltd.)

Organizational effectiveness is contingent upon employees' contributions; however, the role of employee voice behavior as a critical component of employees' contribution to the organization has not been sufficiently acknowledged. Based on proactive behavior theory, we present a model to investigate employee voice behavior as an underlying mechanism in the relationship between supervisor delegation and perceived workplace inclusion. Using the SEM (structural equation modeling) method, we test our model's hypotheses with data from 271 employee-supervisor questionnaires administered in state-owned enterprises in the telecommunications industry. The results show that supervisor delegation is positively related to employees' promotive and prohibitive voice behavior. Promotive voice significantly influences perceived workplace inclusion, but prohibitive voice behavior was not found to have any impact on perceived workplace inclusion. Moreover, both dimensions of voice behavior, i.e., promotive and prohibitive voice behavior, significantly mediate the relationship between supervisor delegation and perceived workplace inclusion., Competing Interests: The authors have declared that no competing interests exist.

This study investigates the relationship between supervisory behavior, conflict management strategies, and sustainable employee performance and inquires the mediating effect of conflict management strategies. Data were collected from the SMEs of the manufacturing industry of Pakistan. The significance of the model was assessed using the PLS-SEM (structural equation modeling). The findings of the study revealed a positive and significant relationship between supervisory behavior and sustainable employee behavior. Similarly, conflict management strategies had a positive effect on the relationship between supervisory behavior and sustainable employee behavior. This study adds in the current literature of supervisory behavior as a critical predictor of sustainable employee performance in two ways. Firstly, this study validates Conflict management strategies as an influential mediator between the relationship of supervisory behavior and sustainable employee performance. Secondly, this study provides substantial practical implications for managers at SMEs to enhance sustainable employee performance through supervisory behavior, stimulated by conflict management strategies. This study is based on cross-sectional data; more longitudinal studies can further strengthen the generalizability of relationships between the constructs. The study adds in the current literature of PLS-SEM as an assessment model for direct and mediation relationships., Competing Interests: The authors have declared that no competing interests exist.

This paper proposes an optimization system for solving an NP-hard problem by using several new algorithms and application programs. This study aims to identify a suitable distribution of investment projects across several developed industrial regions. It is assumed that all industrial regions involved have the same economic and strategic characteristics. The problem involves a set of projects that are to be assigned across regions. Each project creates an estimated number of new jobs, and the distribution of projects can be guided by minimizing the maximum total number of newly created jobs. The problem is NP-hard one, and it is difficult to determine the most appropriate distribution. We apply scheduling algorithms in order to solve the analyzed problem. Severalheuristics are developedto obtain the appropriate distribution of newly created jobs across all regions. A branch-and-bound method is employed in order to obtain the exact solution. The performance of the algorithm is demonstrated by the experimental results for a total number of 1850 instances., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this paper., (Copyright © 2020 Mafawez Alharbi and Mahdi Jemmali.)

It has long been the goal of many gerontological social work scholars to increase the ability and opportunity for people to be engaged in paid and unpaid work throughout the life course. Yet the COVID-19 pandemic is revealing and exacerbating the financial insecurity of many older adults. In this paper, we review information related to older workers and how they might be affected by this pandemic and its aftermath, paying particular attention to the most socioeconomically and physically vulnerable older workers. We also offer first-hand experiences from our careers working with and conducting scholarship on older workers, paying particular attention to recent actions by many in the Senior Community Service Employment Program (SCSEP) network to provide paid sick leave to its low-income, older adult participants. We conclude with implications for social work scholarship and teaching, noting the uptick in technology use among older adults and the disparities that remain, as well as teaching that integrates discussions on the lifelong and cumulative effects of inequalities and marginalization and the need for additional researcher, student, and community collaborations.

Families and intergenerational relationships are important sources of risk for COVID-19 infection, especially for older adults who are at high risk of complications from the disease. If one family member is exposed to the virus they could serve as a source of transmission or, if they fall ill, the resources they provide to others could be severed. These risks may be especially heightened for family members who work outside the home and provide care, or for those family members who care for multiple generations. Policies have the potential to help families bear the burden of these decisions. This essay argues that policies that address health, employment, and other social issues have implications for families, and that policies aimed at families and caregivers can affect the health, employment, and the general well-being of the nation.

Purpose: In Kenya, the employment rate for persons with disabilities is about 1% compared to 73.8% for the general population, and the situation is even worse for persons with mental disabilities. Persons with mental disabilities are often regarded as "mad", and stand little or no chance of employment. We undertook an exploratory study with employers and potential employers to understand factors that hinder or facilitate their employment and to gain insight into employers' perceptions of mental disability. Materials and methods: We adopted a mixed method study design, including in-depth interviews ( n  = 10) and questionnaires ( n  = 158) with (potential) employers in Kenya to explore the barriers and facilitators of employment for persons with mental disabilities. Results: Out of the 158 employers who completed the questionnaire, only 15.4% had ever employed persons with mental disabilities. The perceptions that these persons are not productive and may be violent was associated with an unwillingness to employ them (OR: 10.11, 95%CI: 2.87-35.59 and OR: 3.6, 95%CI: 1.34-9.64, respectively). The possession of skills was the highest reported facilitator of employing persons with mental disabilities. Employers suggested that information about mental illness and the disclosure by prospective employees with mental disabilities are relevant for the provision of reasonable accommodation in the workplace. Conclusion: Possession of skills and disclosure by persons with mental disabilities could improve their employability. Information targeted at all actors including employers, employees, government, and policymakers is necessary for balancing employers and employees expectations.Implications for rehabilitationDisabled persons' organisations or mental disability programs that seek to improve the employment of persons with mental disabilities should incorporate methods that address employer expectations through dialogue to find mutual benefits.Employers require essential information about mental illness, and guidance and support in order to provide reasonable accommodation in the workplace for persons with mental disabilities.Disabled persons' organisations and inclusive employment programs should share the positive experiences of employers of persons with mental disabilities with employers who are unaware of the work abilities of persons with mental disabilities to stimulate adoption of inclusive practices.

Background: The new training allowance policy has been put in the Social Insurance Institution to bring back to employment workers with health problems unfit for their previous occupation. These people, following specific vocational training, may acquire new skills and competencies to stay on the labor market. The aim of this study was to assess the role of the Social Insurance Institution in the activation of persons with health problems, which was carried out by issuing opinions about the appropriateness of vocational retraining., Material and Methods: The analysis included 460 cases in which decisions on the appropriateness of vocational retraining, due to the inability to work in the current profession, were issued in 2009., Results: It was found that 40.9% of the analyzed cases were not in accordance with the principles of adjudicating on the incapacity for work and applicable law. The majority of the study group (72.4%) were people with basic vocational education. No significant changes were found as regards gender, age and the place of residence between the retrained (N = 89) and not retrained subjects (N = 252). In the retrained group including 89 persons, 13 subjects started to collect pension again within 6 months; and 1 person collected pension while working. In addition, 51 (57.3%) retrained subjects were unemployed. After 12 months, the number of unemployed subjects decreased to 31., Conclusions: The effectiveness of the training allowance as a tool for the activation of people with health problems, expressed as the number of retrained people who returned to the labor market, is low. More than 80% of the people fail to get retrained and some of them again submit pension applications. A large number of incorrect vocational retraining opinions, as well as the lack of cooperation between institutions conducting retraining (the Social Insurance Institution and labor offices) resulted in a limited effectiveness of the training allowance. In order to enhance the effectiveness of the training allowance, it is necessary to carry out organizational and legislative changes, with particular emphasis on expanding the knowledge of medical examiners representing the Social Insurance Institution and occupational health physicians, as well as to improve cooperation between all institutions involved in the occupational activation of people with health problems. Med Pr. 2020;71(3):309-23., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

This research builds on prior studies showing the role of employee emotion recognition in the stress process to be mixed and conflicting. As such, it was proposed that the extent to which employees' emotion recognition skills buffer or exacerbate emotional demands depends on the extent to which employees believe their supervisor also is skilled in emotion recognition. Two samples of Australian employees completed cross-sectional questionnaires. Sample 1 consisted of 149 employees in a medical research institution, and Sample 2 consisted of 161 government employees in an equipment supplies and logistics service. A three-way interaction among emotional demands, employee emotion recognition, and perceived supervisor emotion recognition was found on psychological strain in both samples and on job dissatisfaction in Sample 1. As predicted, when employee emotion recognition was high, those who perceived their supervisor to be high in emotion recognition were buffered from emotional demands. In contrast, stress-exacerbating effects were found when employees were high in emotion recognition, but supervisors were perceived to be low in emotion recognition. Overall, these results highlight the importance of emotion recognition in the stress process, and that the same skill set needs to be perceived in one's supervisor, an interpersonal resource, for this intrapersonal resource to be adaptive for employees., (© 2020 John Wiley & Sons, Ltd.)

Background: Hospitals utilize three ideal type models for governing relationships with their physicians: the traditional medical staff, strategic alliances, and employment. Little is known about how these models impact physician alignment., Purpose: The study compares the level of physician-hospital alignment across the three models., Approach: We used survey data from 1,895 physicians in all three models across 34 hospitals in eight systems to measure several dimensions of alignment. We used logistic equations to predict survey nonresponse and differential physician selection into the alliance and employment models. Controlling for these selection effects, we then used multiple regression to estimate the effects of alliance and employment models on alignment., Results: Physicians in employment models express greater alignment with their hospital on several dimensions, compared to physicians in alliances and the traditional medical staff. There were no differences in physician alignment between the latter two models., Conclusions: Employment models promote greater alignment on some (but not all) dimensions, controlling for physician selection. The impact of employment on alignment is not large, however., Practice Implications: Hospitals and accountable care organizations that rely on employment may achieve higher physician alignment compared to the other two models. It is not clear that the gain in alignment is worth the cost of employment. Given the small impact of employment on alignment, it is also clear that they are not identical. Hospitals may need to go beyond structural models of integration to achieve alignment with their physicians.

Over the past few decades, Quality Management System (QMS) and High Performance Work System (HPWS) have emerged as key concepts to enhance organizational effectiveness. All over the globe, majority of contemporary manufacturing and services organizations have applied at least one of these development strategies or even both. This study proposes an integrated framework of QMS and HPWS and empirically investigates the relationship between QMS and HPWS practices and their direct and indirect effects on organizational effectiveness using structural equation modelling (SEM). This research makes a number of significant contributions: (1) The black box of the conjoint implementation is opened up for better appreciation of the interplay of QMS and HPWS practices and their influence on organizational effectiveness (2) The key QMS practices recognized as contributing factor of performance have been classified and examined at two distinct levels i.e. QMS Top Level practices and QMS Core practices (3) The mediating and interaction effects of QMS Core practices and HPWS practices on the relationship of QMS-Top Level practices and organizational effectiveness have been thoroughly investigated. The proposed framework is tested through cross-sectional data from 90 Technical Services Organizations (TSO) operating in Pakistan. The research hypotheses are supported by the test results of the SEM. The findings and implications are discussed along with limitations and future research guidelines., Competing Interests: The authors have declared that no competing interests exist.

Background: Work and related exposures may play a role in suicide and there has been evidence in the literature that some occupational factors may be associated with suicide. The identification of occupational risk factors of suicide mortality among employees affiliated to the French special agricultural social security scheme (MSA), an understudied population, appears important. The objective of this study was to identify the occupational factors associated with suicide mortality among French employees from the MSA working between 2007 and 2013., Methods: The study population included all the employees affiliated to the MSA working between 1st January 2007 and 31st December 2013, i.e. 1,699,929 men and 1,201,017 women. The studied occupational factors included: economic activity, skill level, and work contract. Survival analyses (Cox models) stratified on gender were performed using age as time scale and region and year of contract as adjustment variables., Results: Among men, the factors associated with an elevated suicide risk were: economic activities of forestry, agriculture and related activities, and manufacture of food products and beverages (e.g. meat, wine), low-skilled level and working in the regions of Brittany, Burgundy Franche-Comté, Pays de la Loire, Normandy, Grand Est and Centre-Val-de-Loire. No association was observed among women., Conclusion: These results suggest that economic activity and low-skilled level may be associated with suicide among men affiliated to the MSA and may contribute to the implementation of prevention interventions. Further studies are needed to confirm and better understand these associations., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Context: Newly credentialed athletic trainers (ATs) have reported stress and role ambiguity during the transition to practice. Previous researchers focused on their qualitative experiences, yet no investigators have explored how characteristics such as the setting or type of educational program affect the transition to practice., Objective: To determine how newly credentialed ATs perceived their transition to practice., Design: Cross-sectional study., Setting: Online survey., Patients or Other Participants: Of 1835 newly credentialed ATs (18%) certified and employed between January and September, 332 completed the survey within 3 months of employment (129 men, 203 women; age = 23.58 ± 2.54 years)., Main Outcome Measure(s): The survey consisted of demographic information (eg, employment setting, job title) and 3 sections: (1) comfort level during the transition (CL), (2) feelings of mentorship and support (MS), and (3) feelings of organizational transition. Participants identified their feelings of nervousness, support, and understanding organizational values using a Likert scale (1 = strongly disagree , 4 = strongly agree ). Descriptive statistics were calculated for each survey item. Mann-Whitney U and Kruskal-Wallis (H) tests were used to determine associations between different demographic characteristics and responses regarding orientation and CL, MS, and feelings of organizational transition., Results: Most participants agreed or strongly agreed that they felt nervous (n = 264, 79.2%) and that the transition was stressful (n = 227, 68.1%) but they felt prepared for their job (n = 262, 78.7%). No differences in CL were present among settings (H = 5.64, P = .228), job titles (H = 4.88, P = .087), or types of professional program ( U = 6488, P = .279). Respondents who were assigned a mentor reported better perceptions of MS ( U = 6250, P < .001). Most participants felt that supervisors adequately explained administrative procedures during orientation (n = 169, 54.3%) and felt they were adequately oriented to organizational values (n = 252, 75.7%)., Conclusions: New ATs felt nervous when entering their new role, but having a mentor and receiving a detailed orientation helped alleviate stress during the transition to practice.

Through a brief historical recovery, the article seeks to describe the main trends in the world of work in Brazil. The emphasis of the article focuses on the current early transition to the service society, whose significant change can be observed in the operation of the labor market itself. Also, it considers the predominance of massive open unemployment, the expansion of the underutilization of the labor force and the generalization of precariousness in professions due to the absence of economic growth and the return of the neoliberal reforms. The result has been the increasing polarization within the world of work.

This paper discusses the importance of the Nursing to the Unified Health System, considering its presence in all organizational health structures, in the 27 units of the Federation and all municipalities of the country, essential, therefore, for the provision of high-quality health care. Nevertheless, the profession faces many challenges, both in the field of education and in the job market, that must be addressed, aiming at the valorization of these professionals who, despite all the difficulties they are subjected to, are committed to the health of the Brazilian population.

Background: The novel coronavirus (COVID-19) that emerged in late 2019, and later become a global pandemic, has unleashed an almost unprecedented global public health and economic crisis., Objective: In this perspective, we examine the effects of COVID-19 and identify a likely 'new normal' in terms of challenges and opportunities within the fields of disability, telework, and rehabilitation., Methods: We use a systems thinking lens informed by recent empirical evidence and peer-reviewed qualitative accounts regarding the pandemic to identify emerging challenges, and pinpoint opportunities related to health and changing employment infrastructure of people with disabilities and rehabilitation professionals., Results: From our interpretation, the key leverage points or opportunities include: (1) developing disability-inclusive public health responses and emergency preparedness; (2) enabling employment and telework opportunities for people with disabilities; (3) addressing the new requirements in rehabilitation service provision, including participating as essential team members in the care of people with infectious diseases such as COVID-19; (4) embracing the added emphasis on, and capacity for, telehealth; and (5) developing greater resilience, distance learning, and employability among the rehabilitation workforce., Conclusions: The COVID-19 pandemic has become increasingly challenging to the lives of people with disabilities and rehabilitation professionals; however, key challenges can be minimized and opportunities can be capitalized upon in order to 'build back better' after COVID-19.

Background: Because of demographic changes the nursing care sector is faced with a lack of qualified employees in the medium and long term. The shortage in the work force is caused by high workloads and unfavorable working conditions. In response to this shortage, there have been attempts to recruit qualified nursing staff from abroad and also to improve the integration of people with a migration background living in Germany into the job market., Methodology: Based on a quantitative cross-sectional study of 366 nurses, the psychosocial burden and strains among employees with a migration background (n = 112) and without a migration background (n = 254) were examined. For this purpose, 13 scales of the German version of the Copenhagen Psychosocial Questionnaire (COPSOQ) were used for the assessment of psychosocial factors at work. The results were compared with professional group-specific reference values (geriatric care) from the COPSOQ database., Results: The comparison of nursing staff with and without a migration background revealed that the emotional demands, work-privacy conflict and role conflicts factors received a significantly better rating among nursing staff with a migration background, while development opportunities were rated worse by this population group. The surveyed nursing staff exhibited higher stress values compared to the COPSOQ reference group in almost all scales., Conclusion: Nursing staff with a migration background need to be supported with respect to development opportunities. Suitable education and training measures may offer adequate career perspectives and may encourage employees to stay in their jobs.

Background.: Youth with Duchenne muscular dystrophy (DMD) and other neuromuscular disorders are living well into adulthood and often need help engaging in meaningful occupations., Purpose.: Our purpose was to explore enablers and barriers to engaging in meaningful occupations, from the perspectives of youth, parents, and practitioners., Method.: This qualitative study involved 26 participants (11 parents, eight youth ages 19 to 28 [mean = 22.3 years], seven practitioners). Data were obtained from semistructured interviews and analyzed using an interpretive descriptive approach., Findings.: Youth with DMD and neuromuscular disorders engage in meaningful occupations in a variety of ways. Occupational enablers were supports and accommodations and self-care skills and coping strategies, while occupational barriers involved societal expectations of a normative adulthood, discrimination and inaccessible environments, lack of supports and resources, medical challenges, fatigue, lack of motivation, and social isolation and depression., Implications.: Practitioners should work to uncover what youth consider important and connect them to appropriate resources so they can engage in meaningful occupations.

While community health workers (CHWs) are employed in various arrangements, little is known about the association between organizational structure and CHW experiences. Seventeen in-depth interviews were conducted with CHWs, supervisors, and leadership employed in one centrally organized setting to investigate organizational structure and perceptions of CHW effectiveness. A model that hired employees but assigned them to various settings offered support and unique career advancement opportunities. Coordinated education, ongoing trainings, and persistent supervision were perceived to improve the accuracy of resource information and facilitated collaboration across the health care system with increased health care team communication, offering insights into other organizational structures.

Young adults face unemployment-related challenges, particularly in low- and middle-income countries. Self-employment is encouraged by the Tanzanian government and international institutions such as the World Bank. It has been found that young adults who are employed or self-employed show more functional independence and less inequality and social polarization, as well as a decrease in deviant behaviour. However, limited knowledge and skills related to entrepreneurial activities contribute to lack of motivation towards self-employment among young adults. In order to examine these behaviours, an intervention study implementing an entrepreneurship and beekeeping training in Dar es Salaam, Tanzania was conducted. After completion of the intervention, a qualitative study was conducted that used focus group discussions (FGDs) to explore the experiences and changes in behaviour of young adults following the intervention. A total of 36 of the original 57 young adults from four camps who fully participated in the four arms of interventions were recruited. Qualitative content analysis was used to analyze the FGD data. Three themes emerged from the findings: establishment and maintenance of an entrepreneurial business, changes in behaviour, and perceived challenges. Improved entrepreneurial skills, customer care, and financial management were expressed as positive changes the participants attained relating to business management. Similarly, changes in the participants' behaviours, attitudes, and lifestyle practices led to improved health and increased recognition and respect in their communities. Insufficient start-up capital and long intervals between sessions were the main challenges. The study showed an improvement in the ability of the participants to generate the human, social, and financial capital prerequisite to business development. Increase in customer care, social capital and financial management are key factors for successful microbusiness activities for stable self-employment., Competing Interests: The authors have declared that no competing interest exist.

Background . Compared with other occupations, long-haul truck drivers (LHTD) engage in excessively unhealthy behaviors and experience disproportionately poor health outcomes. Health promotion efforts targeting LHTDs focus on improving individual-level behaviors; however, this occupation is replete with adverse work organization characteristics, high job stress, and compromised sleep health, which are hypothesized to cause poor health behaviors and outcomes among LHTDs. Therefore, the purpose of this study was to explore the connections between work characteristics, job stress, and sleep outcomes, and health behaviors and physical and mental health outcomes among LHTDs. Method . This was a cross-sectional study, using interviewer-administered surveys with LHTDs ( n = 260). Bivariate correlation analysis was used to explore the associations among work organization, job stress, sleep health, and health behaviors and outcomes. Logistic regression analyses were used to determine whether these work organization, job stress, and sleep factors predicted health behaviors and outcomes. Results . Long work hours of more than 11 hours daily (odds ratio [OR] = 2.34) resulted in increased odds of high caffeine consumption. High job stress (OR = 0.48) and poor sleep quality (OR = 0.42) led to decreased odds for spending at least 1 hour daily for cooking/eating. Low sleep duration, less than 7 hours daily (OR = 2.55), led to increased odds of a physical health diagnosis. Both high job stress (OR = 3.58) and poor sleep quality (OR = 2.22) resulted in increased odds of a mental health diagnosis. Conclusion . Health promotion efforts targeting LHTDs need to be coupled with upstream policy, environmental, and systems-level change, especially at the governmental and trucking industry levels.

In the years since the Great Recession, social scientists have anticipated that economic recovery in the United States, characterized by gains in employment and median household income, would augur a reversal of declining fertility trends. However, the expected post-recession rebound in fertility rates has yet to materialize. In this study, I propose an economic explanation for why fertility rates have continued to decline regardless of improvements in conventional economic indicators. I argue that ongoing structural changes in U.S. labor markets have prolonged the financial uncertainty that leads women and couples to delay or forgo childbearing. Combining statistical and survey data with restricted-use vital registration records, I examine how cyclical and structural changes in metropolitan-area labor markets were associated with changes in total fertility rates (TFRs) across racial/ethnic groups from the early 1990s to the present day, with a particular focus on the 2006-2014 period. The findings suggest that changes in industry composition-specifically, the loss of manufacturing and other goods-producing businesses-have a larger effect on TFRs than changes in the unemployment rate for all racial/ethnic groups. Because structural changes in labor markets are more likely to be sustained over time-in contrast to unemployment rates, which fluctuate with economic cycles-further reductions in unemployment are unlikely to reverse declining fertility trends.

This report explores the nature and quality of social ties of formerly homeless individuals in recovery from serious mental illness and substance abuse and how these ties relate to experiences of community. Using grounded theory and cross-case analysis techniques, we analyzed 34 qualitative interviews conducted with predominantly racial/ethnic minority individuals receiving mental health services. Participants described a range of involvement and experiences in the mental health service and mainstream communities indicating a combination of weak or strong ties in these communities. Across participants, two broad themes emerged: ties that bind and obstacles that "get in the way" of forming social ties. Salient subthemes included those related to family, cultural spaces, employment, substance abuse, stigma and mental health service providers and peers. The current study integrates our understanding of positive and negative aspects of social ties and provides a theoretical framework highlighting the complexity of social ties within mainstream and mental health service communities.

Objectives: To assess changes in work characteristics, socioeconomic status inequalities in changes in work characteristics, and whether US workplaces are becoming more stressful., Methods: We analyzed data from 5361 employed participants from the 2002, 2006, 2010, and 2014 NIOSH Quality of Work Life Surveys, based on representative samples of US workers. We used regression analyses to assess changes in job characteristics, adjusting for age, sex, race/ethnicity, education, work hours, and unemployment rate. For the regression analyses with continuous job characteristics, we created standardized variables allowing for the magnitude of changes to be directly compared between job characteristics., Results: Over the period 2002-2014, we observed statistically significant increases in job strain (+0.09 standard deviations (SD), P = 0.02), low job control (+0.10 SD, P = 0.03), and work-family conflict (+0.15 SD, P = 0.001). No significant changes were observed for high job demand, low social support, and low reward. The largest increase in low job control was seen among service workers., Conclusions: The increase in two cardiovascular disease risk factors, job strain, and low job control, might partially explain the slowing of the decline in US heart disease and stroke mortality rates., (© 2019 Wiley Periodicals, Inc.)

Background: The aim of this study is to estimate the prevalence of informal workers and their working conditions and employment precariousness in the EU-27; and to explore the association of different contract arrangements with health outcomes and how they are influenced by working and employment conditions., Methods: A sample of 27 245 working-age employees from the fifth European Working Condition Survey of 2010 was analysed. Logistic regression models were fitted to estimate the contribution of different contract arrangement (permanent, temporary and informal) and working and employment precariousness variables on health outcomes (psychosocial well-being and self-rated health)., Results: Prevalence of informal employees in the EU-27 is 4.1% among men and 5.1% among women. Although informal employees have the poorest working conditions and employment precariousness, they did not seem to reflect poorer health. Precariousness employment variables have a greater impact than working conditions variables in reducing the association between health outcomes and type of contract arrangement, especially in the case of informal employees., Conclusions: Informal employment in the EU-27 is characterized by worse working conditions and employment precariousness than the conditions for formal employees. There is no evidence at all that being in informal employment implies better health outcomes compared to permanent employees., (© The Author(s) 2018. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Context: Organizational policies for work-life balance exist, but little is known about athletic trainers' (ATs') awareness of and willingness to use them., Objective: To explore ATs' formal and informal work-life balance policies in the collegiate and university athletic training setting., Design: Sequential mixed-methods study., Setting: Web-based survey., Patients or Other Participants: We sent 4673 e-mails to National Athletic Trainers' Association ATs (full-time employment for at least 1 year, nonacademic appointment); 1221 participants began our survey (access rate = 26.1%), and 783 completed the survey (64.1% completion rate). Demographics were as follows: men = 375 (48.0%) and women = 404 (51.7%); age = 36 ± 10 years; experience = 13 ± 9 years; years at current place of employment = 8 ± 8 years; and participants with children or minor dependents = 262 (33.5%)., Main Outcome Measure(s): We created a 17-item instrument from an earlier qualitative study. A panel of experts (n = 3; employer, employee, and researcher) completed a content analysis. Variables of interest were confidence (scale = 1-4) and satisfaction (scale = 1-5) with policies. We used Pearson χ 2 analyses to compare the effect of undergoing an orientation and the presence or absence of children on the main outcome measures., Results: A majority of participants had experienced formal orientation through the human resources department (n = 522, 66.8%), the direct supervisor (n = 240, 30.7%), or a colleague (n = 114, 14.6%). However, many had received no orientation (n = 184, 23.6%). Those who had undergone orientation indicated greater confidence in knowing about ( P < .001) and greater satisfaction with ( P < .001) formal workplace policies and benefits. Those with children stated that they had greater confidence in knowing about ( P < .001) and greater satisfaction with ( P = .013) formal workplace policies and benefits. Those who had been oriented felt greater confidence in knowing about ( P = .009) but no difference in satisfaction with ( P = .060) informal workplace policies and benefits. We did not identify differences between those with and those without children regarding their confidence in knowing about ( P = .653) or satisfaction with ( P = .150) informal workplace policies and benefits., Conclusions: Athletic trainers in the collegiate and university setting were not confident in their knowledge of formal or informal work-life balance policies.

Demographic change has increased the need for elderly care. Training unemployed workers might be one way to increase the supply of elderly care nurses. This study analyzes the effectiveness of subsidized training for unemployed individuals in the elderly care professions in Germany over 11.5 years. We find that short further training and long retraining courses significantly increase workers' long-term employment. As approximately 25% to 50% of trained nurses have permanent jobs in the care sector, we estimate that approximately 5% of all employed nurses are formerly trained unemployed workers., (© 2019 The Authors Health Economics Published by John Wiley & Sons, Ltd.)

Public support of training in firms corresponds to the long-term importance of the quality of human capital in the competitiveness of firms and nations. Thus, the EU supports such training via the European Social Fund (ESF). The evaluation community evaluates the support by using either qualitative or quantitative methods. The simultaneous application of these two approaches is rare. The purpose of this paper is to combine quantitative (counterfactual impact evaluation) and qualitative (qualitative comparative analysis) methods in order to fill the methodological gap. Based on the combination of both approaches, it explores their strengths, complementarity and disadvantages to evaluate public support for employee training in the Czech Republic. The combination of methods makes it possible to identify not only the impacts but also their causes. Linking the ESF support to corporate competitiveness is crucial for demonstrating the effectiveness of public spending., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: Research is needed on how to optimize the return-to-work process for persons with mental health problems., Objective: To develop a model that explains how employer and rehabilitation professional mental health literacy may influence strategies used in the return-to-work of persons with mental health problems., Methods: A grounded theory study design was used to collect and analyse interview data from 23 employers and 22 rehabilitation professionals., Results: The analysis resulted in four categories, illustrated in a conceptual process model: 1) seeing mental health problems through past experiences; 2) separating understandable and incomprehensible mental health problems; 3) balancing safeguarding one's personal interest with providing adequate support; and 4) facing conflicts and uncertainty in employee/service user return-to-work. A positional map of employer/rehabilitation types was created based on level of negative attitudes and uncertainty in supporting employees/service users and the employer in relation to the level of comprehensive understanding of mental health problems., Conclusions: Professional mental health literacy needs to be increased. Interventions need to be developed that provide employers with targeted support and knowledge in mental health literacy. Education on how to prevent and detect common mental health problems in the workplace is needed.

Background: Students with autism spectrum disorder (ASD) typically struggle with post-school employment, post-secondary education, and independent living outcomes. This may be due to their limited input on the goals that are set for their future during the transition planning process., Aim: The aim of this systematic review was to investigate the extent of involvement of students in their IEP transition planning meetings in published research on the topic to date., Method and Procedures: The authors reviewed articles published between 1994 and 2016. Searches were performed in ERIC, ProQuest Education Journals, PsycINFO, and Scopus databases, resulting in 15 articles meeting the inclusion criteria., Outcomes and Results: Out of the 15 articles included in this review, five were survey research articles and ten were intervention studies. The overall results of the studies revealed that students with ASD had minimal active involvement in the transition planning process., Conclusions and Implications: It is essential for teachers to educate students about the transition planning process to increase their awareness of the purposes and procedures of the transition planning meeting. There is a pressing need for a more student-centred approach in transition planning to empower students and support them in becoming better self-advocates., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Purpose: The objective of this systematic review is to critically appraise the literature on disability disclosure and workplace accommodations for youth and young adults with disabilities., Methods: Systematic searches of nine international databases identified 27 studies meeting our inclusion criteria. These studies were analyzed with respect to the characteristics of the participants, methodology, results of the studies and the quality of the evidence., Results: Among the 27 studies, 18,419 participants (aged 14-33, mean 23.9 years) were represented across seven countries. Barriers to disability disclosure and requests for workplace accommodations were found at the individual (i.e., disability type, severity, poor self-concept, and advocacy skills), employment (i.e., type of industry, and working conditions, lack of supports), and societal levels (i.e., stigma/discrimination). Facilitators of disability disclosure included individual factors (i.e., knowledge of supports and workplace rights, self-advocacy skills), employment (i.e., training/supports, effective communication with employers, realizing the benefits of accommodations), and societal factors (i.e., positive attitudes toward people with disabilities). There was little consensus on the processes and timing of how disability should be discussed in the workplace among youth with disabilities., Conclusions: Our findings highlight the complexities of disability disclosure for youth with disabilities. More studies are needed to explore issues of workplace disclosure and accommodations for young people to improve disclosure strategies and the process of providing appropriate accommodations. Implications for Rehabilitation Clinicians, educators, and parents should support youth to become self-aware and build self-advocacy skills so they can make an informed decision about how and when to disclose their condition to employers. Clinicians, educators, and employers should help youth with disabilities to understand the benefits of disclosing their disability, and educate them on the supports available so they can remain healthy and productive in the workplace. Clinicians should advocate for employers to create a positive and supportive environment where youth feel comfortable disclosing their condition.

Introduction Timely and appropriate accommodations can help employees who experience disabilities stay at work instead of exiting the labor force. Employers can play a critical role in connecting such workers with the accommodations they need. This qualitative study seeks to inform policy makers who want to improve workforce retention outcomes by uncovering factors that affect whether employers provide accommodations to, and ultimately retain, employees with disabilities. Methods We conducted semistructured interviews with a convenience sample of human resources professionals in 14 Arkansas-based employers, yielding detailed information on 50 cases in which an employee developed or disclosed a disability. We analyzed the interviews using a grounded theory approach and compared cases to identify key themes emerging across subgroups of cases. Results Two organization-level factors and four employee-level factors influenced employers' efforts to accommodate and retain employees with disabilities: employer resources; employers' communication with the employee and other stakeholders; employee tenure; employee work performance; active/sedentary nature of employee role; and the severity and type of employees' health conditions. Conclusions Consistent with prior literature, employers with greater access to resources and better ability to communicate generally made greater effort to accommodate and retain employees with disabilities. However, employers in the study did not deploy these resources and processes consistently when making decisions about whether and how to provide accommodations to workers with disabilities; employee-level characteristics affected their actions. Policy makers should consider intervention approaches that reach workers who may be overlooked by employers with scarce resources.

People seeking asylum in high-income countries are vulnerable to food insecurity due to limited opportunities for social and economic participation. Given this vulnerability, nongovernment organisations are attempting to improve food security outcomes through targeted programmes. This study explored the role of a subsidised mobile fresh fruit and vegetable market (the Food Justice Truck-FJT) on the experience of food insecurity for people seeking asylum living in Melbourne, Australia. This research uses a mixed methods approach, employing surveys and semistructured interviews to explore the lived experiences of asylum seekers using the FJT, including their experiences of food insecurity. Half of the asylum seekers interviewed in this study were found to be experiencing food insecurity. Participants in this study sourced food from multiple locations, with the FJT providing a supplemental, but highly valued source of fresh produce. The FJT was identified as positive social setting for some participants included in this research. This research has identified the ability of programmes such as the FJT to act as positive social settings., (© 2018 John Wiley & Sons Ltd.)

Objective: The aim of this study was to investigate factors affecting turnover of Asian foreign-educated nurses (FENs), which may lead to improvements in retention strategies., Background: Asian FENs working in the United States have considerable rates of turnover. Little is known about which factors are related., Methods: A cross-sectional design was used. A convenience sample (n = 201) of Asian FENs completed surveys by regular mail and through a website. Backward multivariable logistic regression was performed to identify factors associated with turnover in their 1st year of employment., Results: Most participants were from the Philippines and Korea. Perceived quality of orientation predicted organizational-level turnover and trended toward predicting unit-level turnover., Conclusions: Healthcare institutions may benefit from developing organizational programs for FENs that are sensitive to their unique needs, in the interest of reducing rapid or early turnover and accompanying negative effects on hospital finances and patient care.

Objective: To compare workers with and without disabilities on their reported workplace hazard exposure and the presence of occupational health and safety vulnerability factors., Methods: Working-aged adults in Ontario or British Columbia were recruited to participate in a cross-sectional survey (n = 1988). Self-reported measures included demographic factors, work-related variables, perceived level of activity limitation at work, and presence of work safety vulnerability factors utilizing a novel framework., Results: Reporting a disability at work was significantly associated with greater hazard exposure than those without a disability. In addition, those reporting a disability at work were more likely to be employed in conditions where hazard exposure was combined with inadequate policies and procedures, or hazard exposures were combined with inadequate empowerment., Conclusions: Work safety vulnerability is one way that health inequalities can be perpetuated even among those with disabilities who have found work. Our results suggest that employers and policy makers need to focus on assessing and addressing hazard exposures and targeting occupational health and safety resources in the workplace in a way that includes workers with disabilities. Implications for Rehabilitation Workers with disabilities experience greater hazard exposure than those without a disability. Those with moderate and severe disabilities reported occupational health and safety vulnerability, suggesting that workplace accommodations should be available to a broader range of disability levels. It appears that, above and beyond standard safety procedures, providing workplace accommodations for people with disabilities may further reduce their hazard exposure and improve their safety.