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The environment in which physicians practice and patients receive care continues to change. Increasing employment of physicians, changing practice models, new regulatory requirements, and market dynamics all affect medical practice; some changes may also place greater emphasis on the business of medicine. Fundamental ethical principles and professional values about the patient-physician relationship, the primacy of patient welfare over self-interest, and the role of medicine as a moral community and learned profession need to be applied to the changing environment, and physicians must consider the effect the practice environment has on their ethical and professional responsibilities. Recognizing that all health care delivery arrangements come with advantages, disadvantages, and salient questions for ethics and professionalism, this American College of Physicians policy paper examines the ethical implications of issues that are particularly relevant today, including incentives in the shift to value-based care, physician contract clauses that affect care, private equity ownership, clinical priority setting, and physician leadership. Physicians should take the lead in helping to ensure that relationships and practices are structured to explicitly recognize and support the commitments of the physician and the profession of medicine to patients and patient care.

Objectives The aims of this position paper are to (i) summarize research on precarious employment (PE) in the context of occupational health; (ii) develop a theoretical framework that distinguishes PE from related concepts and delineates important contextual factors; and (iii) identify key methodological challenges and directions for future research on PE and health. Methods This position paper is the result of a working group consisting of researchers from the EU, Turkey and the USA, who have discussed the issue over the course of six months (October 2018-April 2019), meeting both online and face-to-face on several occasions. Results The lack of a common theoretical framework of PE hinders it from becoming an established part of occupational and public health research. There are also issues regarding operationalization in surveys and registers. Further, previous research on PE and health suffers from methodological limitations including inadequate study designs and biased assessments of exposure and outcomes. PE is highly dependent on contextual factors and cross-country comparison has proven very difficult. We also point to the uneven social distribution of PE, ie, higher prevalence among women, immigrants, young and low educated. We propose a theoretical framework for understanding precarious employment as a multidimensional construct. Conclusions A generally accepted multidimensional definition of PE should be the highest priority. Future studies would benefit from improved exposure assessment, temporal resolution, and accounting for confounders, as well as testing possible mechanisms, eg, by adopting multi-level and intersectional analytical approaches in order to understand the complexity of PE and its relation to health.

Work-integrated learning (WIL) is crucial for the development of employability skills and has an influence on employment outcomes. Given the significance of WIL pedagogies for graduate preparedness and transitions into work, concerns have been raised on the barriers to access and participation in WIL for some cohorts of learners. Equity and inclusion in WIL, that is, considerations for diverse learners once enrolled into a subject or course with varying WIL components, is not a new concept with some guidelines purported over a decade ago. Designing WIL to accommodate for equity and inclusion, however, has presented challenges with few studies offering navigation for curriculum design. This paper draws on empirically sound curriculum design principles for inclusion for learner variability through Universal Design for Learning (UDL), to offer the UDL for WIL design framework. The paper presents conceptual and practical contributions for educators of WIL experiences to reduce barriers and integrate student voice to support all graduates' career transitions.

Is healthcare employment recession-proof? We examine the long-standing hypothesis that healthcare employment is stable across the business cycle. We explicitly distinguish between negative aggregate demand and supply shocks in studying how healthcare employment responds to recessions, and show that this response depends largely on the type of the exogenous shock triggering the recession. First, aggregate healthcare employment responds procyclically during demand-induced recessions but remains stable during supply-induced recessions. Second, healthcare utilization drops significantly during demand-induced recessions, explaining the decline in healthcare employment during these periods. Finally, there is significant heterogeneity in the employment responses of the healthcare sub-sectors. While healthcare employment in most sub-sectors responds procyclically during recessions caused by both negative demand and supply shocks, it responds countercyclically in nursing-dominant sectors. Importantly, by isolating the recessionary impact of negative aggregate demand shocks from supply shocks on healthcare employment, we provide new empirical evidence that healthcare employment, in general, is not recession-proof., (© 2024 John Wiley & Sons Ltd.)

Abstract Background Work participation is important for health and can be considered as engagement in a major area of life which is of significance for most people, but it can also be thought of as fulfilling or discharging a role. Currently, academic research lacks a comprehensive classification of work participation outcomes. The International Classification of Functioning is the foremost model in defining work functioning and its counterpart work disability, but it does not provide a critical (core) set of outcomes. Standardizing the definitions and nomenclature used in the research of work participation would ensure that the outcomes of studies are comparable, and practitioners and guideline developers can better decide what works best. As work participation is a broad umbrella term including outcome categories which need unambiguous differentiation, a framework needs to be developed first. Aim To propose a framework which can be used to develop a generic core outcome set for work participation. Methods First, we performed a systematic literature search on the concept of (work) participation, views on how to measure it, and on existing classifications for outcome measurements. Next, we derived criteria for the framework and proposed a framework based on the criteria. Last, we applied the framework to six case studies as a proof of concept. Results Our literature search provided 2106 hits and we selected 59 studies for full-text analysis. Based on the literature and the developed criteria we propose four overarching outcome categories: (1) initiating employment, (2) having employment, (3) increasing or maintaining productivity at work, and (4) return to employment. These categories appeared feasible in our proof-of-concept assessment with six different case studies. Conclusion We propose to use the framework for work participation outcomes to develop a core outcome set for intervention studies to improve work participation.

The purpose of this article is to examine two policies in an attempt to measure their impact and ascertain any potential trajectory from government-level agenda to borough-level contextualisation. Inspired by content analysis, but also taking into account the implementation of the documents, this study draws upon the Every Child Matters green paper (2003) as a government initiative and seeks to establish the progression route taken by one particular borough (Knowsley). Knowsley, a borough with high unemployment figures for school leavers, aims to address its problematic areas through policy implementation and strongly acknowledges the significance of Every Child Matters. The two policies looked at here are the government green paper "Every Child Matters" (2003) and "Knowsley's Children and Young People's Strategic Plan 2007-2010" (2007). Both policies concern themselves with progression routes for young people and problematic areas are identified at an early age. (Contains 2 tables.)

In response to the current era of rapid evolution of health care delivery and financing, radiologists are increasingly considering, as well as confronting, new practice models. Hospital employment is one such opportunity. Within this report to the ACR membership, the potential advantages and risks for radiologists considering hospital employment are examined., (Published by Elsevier Inc.)

Background: Health status, type of contract, education and age might affect labour force participation (LFP). We investigated possible factors associated with LFP among European countries., Methods: European Union Statistics on Income and Living Conditions (EU-SILC) data of 149,798 individuals were used and the odds ratios were calculated in logistic regression analyses., Results: LFP rates were higher among those in good health. Self-perceived poor health frequencies were higher in people with temporary contracts than in those with permanent contracts in Bulgaria, Finland, and Hungary, while they were lower in Republic of Serbia. Multivariate analyses revealed that having temporary contract, poor health, oldest age group, and lower educational level were associated with lower probability of being in paid employment in the total study population. Poor health was stronger driver of lower LFP than temporary contracts in Austria, Hungary, Iceland, Netherlands. Temporary contracts were stronger driver of lower LFP than poor health in Greece, Spain, Finland, Portugal, Serbia, Slovenia and total study population., Conclusion: Both poor health and temporary contracts were associated with lower LFP. The magnitude of these associations varied among countries. Worker's health status differed by type of contract in Bulgaria, Hungary, Finland and Serbia., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Involuntary non-regular employment is a severe inequity problem worldwide, and it may significantly affect the mental health of employees. The present study aimed to examine the relationship between employment type and mental health. Additionally, the characteristics of involuntary non-regularly employed workers were explored. An online-based cross-sectional study was conducted in Japan, and 1566 participants were included in the data analysis. The eligible participants were divided into four categories: regularly employed (n = 1092), voluntary (n = 134), average (n = 233) and involuntary (n = 107) non-regularly employed individuals, respectively. Involuntary non-regular employment was associated with greater lack of vigour, anger-irritability, fatigue, anxiety, and depression. It was higher among women, those who were single or had no childcare, and those who had lower personal income or shorter working hours, or who tended not to practice relaxation activities. Lower personal income was associated with a risk of anxiety and depressive symptoms. Those individuals experiencing involuntary non-regular employment had a higher risk of poor mental health; subgroup analysis showed that this was particularly true among men. Both encouragement of employment stability via policy reform and workplace mental health support for involuntary non-regularly employed individuals are urgent health concerns., (© 2023 International Union of Psychological Science.)

Drawing on the labour process theory and the job-demands resources model, this study challenges the assumption of beneficial effects of high-performance HR practices (HPHRP). The study argues that such practices lead to heightened work demands, which in turn compromise employees' well-being. The study also argues that the negative consequences associated with HPHRP can be ameliorated when employees receive support from their managers. To test the study's moderated mediation model, multisource matched employer-employee data from the Workplace Employment Relations Survey 2011 is used. Results of generalised multilevel structural equation modelling in STATA revealed that the relationship between HPHRP and well-being (anxiety and depression) is mediated by Job demands (JD). Furthermore, the relationship between JD and both anxiety and depression is moderated by Managerial support (MS), such that when the level of MS is high, the positive relationship between HPHRP and both anxiety and depression via JD is weaker. Taken together, the findings of the study advance our understanding of why and when HPHRP may impair employees' well-being., (© 2023 The Authors. Stress and Health published by John Wiley & Sons Ltd.)

Objective: The 19-item return-to-work self-efficacy (RTWSE-19) scale is a new self-report measure intended to assess workers' beliefs of their current ability to resume normal job responsibilities following pain onset. The aim of this study was to evaluate the factor structure, internal consistency, and predictive and concurrent validity of RTWSE-19 among workers with acute low-back pain., Methods: Patients (N=399, 59% male, mean age 37 years) consulting for acute, work-related low-back pain completed an original 28-item version of the new scale along with concurrent measures of pain, functional limitation, activity avoidance, workplace physical demands, and pain catastrophizing. The assessment was repeated at visit 2, and work limitations and duration of sickness absence were assessed by questionnaire at 3-month follow-up. Exploratory factor analysis (principal component analysis with varimax rotation) was used to assess content validity of the scale, and scores were compared to concurrent pain measures and with disability outcomes at 3 months., Results: The full response range (1-10) was utilized on all 28 items, and there were no ceiling or floor effects. Mean item scores ranged from 4.9 ("reducing physical workload") to 8.3 ("describing injury to supervisor"). The exploratory factor analysis supported three underlying factors (eigenvalue >1.0): (i) meeting job demands; (ii) modifying job tasks; and (iii) communicating needs to others. Internal consistency (alpha) for the three scales were 0.98, 0.92, and 0.81 respectively. At visit 2, self-efficacy scores improved for "meeting job demands" and "modifying job tasks", but not for "communicating needs to others". After controlling for pain and functional limitation, both sickness absence and persistent work limitations were predicted by self-efficacy assessed at visit 2 (P<0.05), but self-efficacy assessed at visit 1 did not predict sickness absence., Conclusions: The RTWSE-19 is a new measure with adequate reliability and validity to measure the confidence of workers to meet job demands, modify job tasks, and communicate needs to co-workers and supervisors. When assessed 1-2 weeks after pain onset, the scale is predictive of disability outcomes.

In this paper, the author explores the prospect of, and the rationale for, the "critical workplace information literacy" (CWIL) construct, by situating it at the junction of critical information literacy (CIL) and workplace information literacy (WIL), the two hitherto discrete frameworks and subdomains of information literacy (IL). This preliminary attempt at the conceptualisation of a new construct was guided by the question of what role CIL can play in empowering workers to attain decent work. The author frames the conceptualisation around the 'decent work' (DW) concept, as a normative goal of the critical workplace information literacy construct, and discusses the rationale for it in the framework of the discussion on the decent work deficits in the contemporary work and information environment. Freire's critical hermeneutics and dialectics of voice and empowerment are drawn upon. The paper argues positively for the role of CIL in attaining decent work and for the need for a new construct that would help fill the knowledge and discursive gap in IL and its subdomains and overcome the current silos in the IL community. The author concludes that developing a concept requires a broad deliberative process informed by both theoretical and empirical research, and gives suggestions for future research.

Abstract Background As yet, little is known about the effects of mental health stigma on sustainable employment. This is surprising, as mental health stigma is common, and because people with severe and common mental disorders are 7 and 3 times more likely to be unemployed, respectively, than people with no disorders. As the global lifetime prevalence of mental disorders is 29%, the high unemployment rates of people with these health problems constitute an important and urgent public health inequality problem that needs to be addressed. Main text The aim of this position paper is to illustrate the assumption that stigma contributes to the unemployment of people with mental illness and mental health issues with evidence from recent scientific studies on four problem areas, and to provide directions for future research. These four problem areas indicate that: (1) employers and line managers hold negative attitudes towards people with mental illness or mental health issues, which decreases the chances of people with these health problems being hired or supported; (2) both the disclosure and non-disclosure of mental illness or mental health issues can lead to job loss; (3) anticipated discrimination, self-stigma and the ‘Why Try’ effect can lead to insufficient motivation and effort to keep or find employment and can result in unemployment; and (4) stigma is a barrier to seeking healthcare, which can lead to untreated and worsened health conditions and subsequently to adverse occupational outcomes (e.g. sick leave, job loss). Conclusions The paper concludes that stigma in the work context is a considerable and complex problem, and that there is an important knowledge gap especially regarding the long-term effects of stigma on unemployment. To prevent and decrease adverse occupational outcomes in people with mental illness or mental health issues there is an urgent need for high quality and longitudinal research on stigma related consequences for employment. In addition, more validated measures specifically for the employment setting, as well as destigmatizing intervention studies are needed.

This paper addresses the question of why young Australians with intellectual disability (ID) remain underrepresented in open employment despite significant investment by various stakeholders. It uses the analogy of Whack-a-Mole (an arcade game) to draw attention to the complexity young people face during transition, and to illustrate how addressing one barrier in isolation is unlikely to result in successful transitions. In response to repeated calls for more holistic understandings of the transition process for young adults with ID, the paper draws upon the work of Urie Bronfenbrenner to present an adaptation of his model to map the ecologies of young people with ID's as they seek to transition from school to open employment. The model illustrates the complexity of transition, a proliferation of stakeholders, and traces how transition is contingent on much more than young adults with ID's capabilities. It invites further consideration of, and utility for, an ecological model as a basis for imagining possibilities to increase the number of people with ID in open employment and concludes by raising some questions that stakeholders might ask.

Describes a six-week project in a high school American literature class on Studs Terkel's book "Working" (which explores the work lives of a cross-section of Americans). Describes how students wrote about personal work futures, wove together dramatic scenes from their favorite parts of the book, and carried out their own extended interviews. (SR)

Objective: This study examined the relationship between precarious employment (PE) and mental well-being, focusing on age-specific interactions., Methods: Nationally representative Korean workers (N = 29,961) were surveyed between 2020 and 2021 to collect data on multidimensional PE (categorized as low, moderate, or high) and the WHO-5 well-being index. Workers' ages were classified as young (<35 years), middle-aged (35-54 years), and older (≥55 years). Logistic regression was performed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). The interaction between PE and age on well-being was examined by including interaction terms in the regression models., Results: The prevalence of poor well-being was 25%, 29%, and 39% for low, moderate, and high precariousness, respectively, whereas it was 26%, 30%, and 39% for young, middle-aged, and older workers, respectively. In the overall sample, the OR (95% CI) of the association between PE and poor well-being was 1.24 (1.17-1.32) for moderate and 1.54 (1.43-1.65) for high precariousness, compared with low precariousness. There was a significant interaction between old age and PE on the odds of poor well-being. Compared with young workers with low PE, middle-aged workers with high PE (OR: 1.85, 95% CI: 1.62-2.10) and older workers with high PE (OR: 2.10, 95% CI: 1.83-2.40) exhibited increased odds of having poor mental well-being., Conclusion: PE serves as a social determinant of older workers' psychological well-being. Policy interventions are required to protect older workers' psychological well-being., (© 2024 The Author(s). International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.)

To study hiring discrimination against cancer survivors, we conduct a vignette experiment in which American and British professionals recruited via Prolific evaluate fictitious job candidates. Candidates differed by periods of non-employment in their career, including non-employment due to suffering from cancer. We study the effect of cancer experiences on professionals' hirability ratings, as well as its effect on underlying candidate perceptions, related to various potential forms of stigma identified in the literature. We find that employment opportunities are lower for candidates with a history of cancer, compared to candidates without such a gap. This penalty is particularly explained by perceptions that these candidates will have higher sick leave probabilities and create additional costs. However, relative to candidates with a comparable gap due to depression or personal reasons, former cancer patients are less stigmatised, with relatively favourable assessments of their emotional abilities, social abilities, motivation and positive impact on workplace culture., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Research on the influence of family background on college graduates' earnings has not considered the importance of the match between parents' and children's field of study. Using a novel design based on within-family comparisons, I examine long-term earnings returns to reproducing parents' field of study in Denmark. I find that individuals whose field of study matches that of a parent have earnings that are 2 percent higher than those of their siblings with college degrees in different fields, on average. Earnings returns to field inheritance are highest in the fields of law (9 percent), medicine (6 percent), and engineering (4 percent) and are driven mainly by income from self-employment. I find no direct evidence of nepotism as the earnings advantage does not arise from inheritance of parents' firms or employment in parents' occupational network. My findings indicate that, although a college degree generally equalizes family background differences in economic outcomes, there are additional payoffs to field inheritance, particularly in traditional fields characterized by a high degree of social closure and self-employment., (© 2024 The Authors. The British Journal of Sociology published by John Wiley & Sons Ltd on behalf of London School of Economics and Political Science.)

There is a need for improved skills development within the UK's Higher Education Institutions (HEI) stemming from the disconnect between the expectations of employers of the skills graduates have and the skills graduates have gained during their degree. It is well-known now that there is a clear skills gap. The present study aims to explore the effect of graduates and students' perception of skills development in HEI in the UK. A total of 420 participants completed an online survey to explore their perception as well as their confidence of skills development by rating each skill on a Likert scale. The paper discusses the results in light of pedagogical strategies developed to teach soft skills in HE. The paper concludes with recommendations for teaching practice.

The career transitioning of students with specific learning disabilities (SLD) has not been commendable. This research paper discusses the career transitioning of students with SLD concerning existing research concerning knowledge, attitudes, and perceptions about these students. It examined ways of preparing and supporting students with SLD towards their transition into the world of work. Additionally, it looked at how important career transitioning is for SLD students. More robust social networks, improved self-esteem, avoidance of stigma, and potential lifetime advantages, including better incomes and independent living, are some of the relevance of career transitioning for students with SLD. The paper highlights the need for students with SLD to receive support and guidance from their parents, teachers, school administrators, peers, counselors, and other stakeholders to obtain stable careers. This paper contributes to the theoretical and practical implications for supporting young people with SLD in their transition to the world of work. Further research is required to strengthen the existing literature on this topic.