Income distribution, weekly hours of work, and time for child rearing: The US experience in a cross-national context

Working-age Americans work longer hours than adults in other industrialized countries. At the same time, the United States. has one of the least equal income distributions of any rich country. This paper provides a cross-national analysis of the impact of the exceptional U.S. income distribution and labor supply patterns on time available for child caregiving by comparing the income distributions and work hours distributions of seven rich countries. Our analysis shows that Americans tend to work longer hours than Canadians and Western Europeans at both the top and bottom of the income distribution, but the proportional difference is largest at the bottom of the distribution. Americans at the bottom of the income distribution work longer hours than their counterparts in other rich countries but nonetheless achieve a relative standard of living that is below that enjoyed by working-age adults in other countries who hold a comparable position in their national income distributions. U.S. household heads responsible for rearing children are unusually time constrained. Parents in the middle and top part of the U.S. distribution derive an important advantage from devoting so much of their time to paid employment: They receive higher labor incomes and enjoy greater ability to purchase time-saving household services. Lowincome U.S. parents do not derive a comparable advantage from their long hours of work. They work more than parents in other industrial countries who have the same low rank in the income distribution, but their incomes are proportionately further below the median income in their country

Failure to launch: Cross-national trends in the transition to economic independence

We analyze trends in the age of economic independence in six industrialized countries, Belgium, Canada, Germany, Italy, the United Kingdom, and the United States. The paper compares trends in the household living arrangements, employment rates, earnings levels, and net incomes as young adults rise in age from 18 to 34 years old. Our results show a picture of generally declining independent living and economic self-sufficiency ('failure to launch') among 18-34 year-old men and women in their early 20s from the mid-1980s to 1995-2000. The exceptions are women in their late 20s and early 30s , who have somewhat improved prospects for economic independence, although from a starting level that was well below that observed among men of the same age. North America (the United States and Canada ) and to some extent the U.K. offer partial exceptions to this general pattern. Between the mid-1980s and 2000 employment rates improved among young Americans in their late 20s and early 30s, and earnings levels either remained stable or increased modestly. The stability of U.S. employment levels helped to offset an apparent reduction in male hourly wage rates for this group , giving 26-34 year-old American men either larger gains or smaller losses in economic self-sufficiency compared to those experienced by their counterparts in continental Europe. In addition, young women in the U.S. who were 26 and older saw bigger improvements in wage self-sufficiency than most of their counterparts in continental Europe. In the closing section we speculate on the possible causes for such changes

Temporal stimulated intersubband emission of photoexcited electrons

We have studied the transient evolution of electrons distributed over two levels in a wide quantum well, with the two levels below the optical phonon energy, after an ultrafast interband excitation and cascade emission of optical phonons. If electrons are distributed near the top of the passive region, a temporal negative absorption appears to be dominant in the intersubband response. This is due to the effective broadening of the upper level state under the optical phonon emission. We have then considered the amplification of the ground mode in a THz waveguide with a multiquantum well placed at the center of the cavity. A huge increase of the probe signal is obtained, which permits the temporal stimulated emission regime of the photoexcited electrons in the THz spectral region.Comment: 5 pages, 5 figures, brief repor

Estimating probability of germline mismatch repair mutations in colorectal cancer patients with microsatellite stable tumors

http://deepblue.lib.umich.edu/bitstream/2027.42/112938/1/13053_2011_Article_206.pd

Interpretations of the Term “Actionable” when Discussing Genetic Test Results: What you Mean Is Not What I Heard

In genomic medicine, the familiarity and inexactness of the term “actionable” can lead to multiple interpretations and mistaken beliefs about realistic treatment options. As part of a larger study focusing on public attitudes toward policies for the return of secondary genomic results, we looked at how members of the lay public interpret the term “medically actionable” in the context of genetic testing. We also surveyed a convenience sample of oncologists as part of a separate study and asked them to define the term “medically actionable.” After being provided with a definition of the term, 21 out of 60 (35%) layperson respondents wrote an additional action not specified in the provided definition (12 mentioned “cure” and 9 mentioned environment or behavioral change) and 17 (28%) indicated “something can be done” with no action specified. In contrast, 52 surveyed oncologists did not mention environment, behavioral change, or cure. Based on our findings, we propose that rather than using the term “actionable” alone, providers should also say “what they mean” to reduce miscommunication and confusion that could negatively impact medical decision‐making. Lastly, to guide clinicians during patient‐ provider discussion about genetic test results, we provide examples of phrasing to facilitate clearer communication and understanding of the term “actionable.”Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149289/1/jgc41064.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149289/2/jgc41064_am.pd

Next‐generation sequencing in precision oncology: Patient understanding and expectations

BackgroundImplementation of precision oncology interventions poses several challenges to informed consent and patient education. This study assessed cancer patients’ understanding, expectations, and outcomes regarding participation in research examining the impact of matched tumor and germline sequencing on their clinical care.MethodsA total of 297 patients (mean age: 59 years; 50% female; 96% white) with refractory, metastatic cancer were surveyed, including 217 who completed surveys both before and after undergoing integrated whole exome and transcriptome sequencing as part of a larger clinical research study.ResultsAt baseline, the vast majority of patients expected to receive several potential direct benefits from study participation, including written reports of sequencing findings (88%), greater understanding of the causes of their cancer (74%), and participation in clinical trials for which sequencing results would make them eligible (84%). In most cases, these benefits were not realized by study completion. Despite explanations from study personnel to the contrary, most participants (67%‐76%) presumed that incidental germline sequencing findings relevant to noncancerous health conditions (eg, diabetes) would automatically be disclosed to them. Patients reported low levels of concern about study risks at baseline and low levels of regret about study participation at follow‐up.ConclusionsFindings suggest that cancer patients participating in precision oncology intervention research have largely unfulfilled expectations of direct benefits related to their study participation. Increased focus on patient education to supplement the informed consent process may help manage patients’ expectations regarding the extent and likelihood of benefits received as a result of undergoing genomic sequencing.This study assessed cancer patients’ understanding and expectations regarding participation in research examining the impact of matched tumor and germline sequencing on their clinical care. Findings suggest that cancer patients participating in precision oncology intervention research have largely unfulfilled expectations of direct benefits related to their study participation. Increased focus on patient education to supplement the informed consent process may help manage patients’ expectations regarding the extent and likelihood of benefits received as a result of undergoing genomic sequencing.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147745/1/cam41947.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/147745/2/cam41947_am.pd

Older Babies - More Active Mothers? How Maternal Labor Supply Changes as the Child Grows

Female labor market activity is dependent on the presence and the age of a child, but how do the determinants develop in magnitude and significance with the child's age? Using German SOEP data from 1991 to 2006 for mothers with young children, the change in maternal labor supply when the child is one, two, and three years old is explicitly addressed. According to the tobit regression results for precise working hours, maternal labor supply becomes increasingly responsive to economic incentives - mainly to imputed wages - as the child grows

Blurred Boundaries: Gender and Work-Family Interference in Cross-National Context

Although well theorized at the individual level, previous research has neglected the role of national context in shaping overall levels of nonwork-work and work-nonwork interference. This study fills this gap by examining how a national context of gender empowerment affects the likelihood of experiencing nonwork-work and work-nonwork interference at the individual and national levels. Controlling for individual-level differences in the distribution of job demands and resources, results from our multilevel models indicate that women's empowerment has significant net gender and parenthood effects on nonwork-work interference. By contrast, gender empowerment equally structures work-nonwork interference for these groups. Our results highlight the need to investigate interference bidirectionally and in a multilevel context. © The Author(s) 2013

Effect of Public Deliberation on Attitudes toward Return of Secondary Results in Genomic Sequencing

The increased use of genomic sequencing in clinical diagnostics and therapeutics makes imperative the development of guidelines and policies about how to handle secondary findings. For reasons both practical and ethical, the creation of these guidelines must take into consideration the informed opinions of the lay public. As part of a larger Clinical Sequencing Exploratory Research (CSER) consortium project, we organized a deliberative democracy (DD) session that engaged 66 participants in dialogue about the benefits and risks associated with the return of secondary findings from clinical genomic sequencing. Participants were educated about the scientific and ethical aspects of the disclosure of secondary findings by experts in medical genetics and bioethics, and then engaged in facilitated discussion of policy options for the disclosure of three types of secondary findings: 1) medically actionable results; 2) adult onset disorders found in children; and 3) carrier status. Participants’ opinions were collected via surveys administered one month before, immediately following, and one month after the DD session. Post DD session, participants were significantly more willing to support policies that do not allow access to secondary findings related to adult onset conditions in children (Χ2 (2, N = 62) = 13.300, p = 0.001) or carrier status (Χ2 (2, N = 60) = 11.375, p = 0.003). After one month, the level of support for the policy denying access to secondary findings regarding adult‐onset conditions remained significantly higher than the pre‐DD level, although less than immediately post‐DD (Χ2 (1, N = 60) = 2.465, p = 0.041). Our findings suggest that education and deliberation enhance public appreciation of the scientific and ethical complexities of genome sequencing.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146892/1/jgc40122-sup-0006.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146892/2/jgc40122.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146892/3/jgc40122-sup-0005.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146892/4/jgc40122-sup-0007.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146892/5/jgc40122-sup-0002.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146892/6/jgc40122-sup-0001.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146892/7/jgc40122-sup-0003.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146892/8/jgc40122-sup-0004.pd

Comparison of breast and bowel cancer screening uptake patterns in a common cohort of South Asian women in England

Background: Inequalities in uptake of cancer screening by ethnic minority populations are well documented in a number of international studies. However, most studies to date have explored screening uptake for a single cancer only. This paper compares breast and bowel cancer screening uptake for a cohort of South Asian women invited to undertake both, and similarly investigates these women's breast cancer screening behaviour over a period of fifteen years. Methods: Screening data for rounds 1, 2 and 5 (1989-2004) of the NHS breast cancer screening programme and for round 1 of the NHS bowel screening pilot (2000-2002) were obtained for women aged 50-69 resident in the English bowel screening pilot site, Coventry and Warwickshire, who had been invited to undertake breast and bowel cancer screening in the period 2000-2002. Breast and bowel cancer screening uptake levels were calculated and compared using the chi-squared test. Results: 72,566 women were invited to breast and bowel cancer screening after exclusions. Of these, 3,539 were South Asian and 69,027 non-Asian; 18,730 had been invited to mammography over the previous fifteen years (rounds 1 to 5). South Asian women were significantly less likely to undertake both breast and bowel cancer screening; 29.9% (n = 1,057) compared to 59.4% (n = 40,969) for non-Asians (p < 0.001). Women in both groups who consistently chose to undertake breast cancer screening in rounds 1, 2 and 5 were more likely to complete round 1 bowel cancer screening. However, the likelihood of completion of bowel cancer screening was still significantly lower for South Asians; 49.5% vs. 82.3% for non-Asians, p < 0.001. South Asian women who undertook breast cancer screening in only one round were no more likely to complete bowel cancer screening than those who decided against breast cancer screening in all three rounds. In contrast, similar women in the non-Asian population had an increased likelihood of completing the new bowel cancer screening test. The likelihood of continued uptake of mammography after undertaking screening in round 1 differed between South Asian religio-linguistic groups. Noticeably, women in the Muslim population were less likely to continue to participate in mammography than those in other South Asian groups. Conclusions: Culturally appropriate targeted interventions are required to reduce observed disparities in cancer screening uptakes