Comparing precarious employment across countries: measurement invariance of the employment precariousness scale for europe (EPRES-E)

Comparing precarious employment (PE) across countries is essential to deepen the understanding of the phenomenon and to learn from country-specific experiences. However, this is hampered by the lack of internationally meaningful measures of PE. We aim to address this point by assessing the measurement invariance (MI) of the Employment Precariousness Scale for Europe (EPRES-E), an adaptation of the EPRES construct in the European Working Conditions Survey (EWCS). EPRES-E consists of 13 proxy-indicators sorted into six dimensions: temporariness, disempowerment, vulnerability, wages, exercise of rights, unpredictable working times. Drawing on EWCS-2015, MI of the second-order factor model was tested in a sample of 31,340 formal employees by means of (a) multi-group confirmatory factor analyses, and (b) the substantive exploration of EPRES-E mean scores in each country (...

Precarious Employment and Stress : The Biomedical Embodiment of Social Factors. PRESSED Project Study Protocol

Juan de la Cierva Incorporación fellowship (IJCI-2017-33999) ; ICREA Academia programThe PRESSED project aims to explain the links between a multidimensional measure of precarious employment and stress and health. Studies on social epidemiology have found a clear positive association between precarious employment and health, but the pathways and mechanisms to explain such a relationship are not well-understood. This project aims to fill this gap from an interdisciplinary perspective, integrating the social and biomedical standpoints to comprehensively address the complex web of consequences of precarious employment and its effects on workers' stress, health and well-being, including health inequalities. The project objectives are: (1) to analyze the association between multidimensional precarious employment and chronic stress among salaried workers in Barcelona, measured both subjectively and using biological indicators; (2) to improve our understanding of the pathways and mechanisms linking precarious employment with stress, health and well-being; and (3) to analyze health inequalities by gender, social class and place of origin for the first two objectives. The study follows a sequential mixed design. First, secondary data from the 2017 Survey on Workers and the Unemployed of Barcelona is analyzed (N = 1,264), yielding a social map of precarious employment in Barcelona that allows the contextualization of the scope and characteristics of this phenomenon. Drawing on these results, a second survey on a smaller sample (N = 255) on precarious employment, social precariousness and stress is envisaged. This study population is also asked to provide a hair sample to have their levels of cortisol and its related components, biomarkers of chronic stress, analyzed. Third, a sub-sample of the latter survey (n = 25) is selected to perform qualitative semi-structured interviews. This allows going into greater depth into how and why the experience of uncertainty, the precarization of living conditions, and the degradation of working conditions go hand-in-hand with precarious employment and have an impact on stress, as well as to explore the potential role of social support networks in mitigating these effects

Differentiating Acute Interstitial Nephritis From Immune Checkpoint Inhibitors From Other Causes

Immune checkpoint inhibitors (ICIs) have significantly improved outcomes for patients with neoplasms in advanced stages. On the other hand, ICIs have immune-related adverse events. These adverse events affect mostly other organs than the kidney, such as skin or gastrointestinal tract. The incidence of nephrotoxicity with monotherapy with any ICI is about 2%, which increases to 5% in combination therapy. Acute tubulointerstitial nephritis (AIN) is the most common pattern of kidney damage related to ICIs. Globally, without considering ICI nephrotoxicity, AIN is estimated to account for 15% to 20% of cases of acute kidney injury (AKI). This is crucial because patients who are treated with ICIs, may also be taking other drugs that potentially cause AIN, and therefore, knowing the particularities about ICI-related AIN could be helpful in clinical practice to better understand the phenotypic differences between the 2 types of AIN. In addition, several studies have now shown that being on proton pump inhibitors is a risk factor for AIN from ICI therapy

Comparing precarious employment across countries – measurement invariance of the employment precariousness scale for Europe

Comparing precarious employment (PE) across countries is essential to deepen the understanding of the phenomenon and to learn from country-specific experiences. However, this is hampered by the lack of internationally meaningful measures of PE. We aim to address this point by assessing the measurement invariance (MI) of the Employment Precariousness Scale for Europe (EPRES-E), an adaptation of the EPRES construct in the European Working Conditions Survey (EWCS). EPRES-E consists of 13 proxy-indicators sorted into six dimensions: temporariness, disempowerment, vulnerability, wages, exercise of rights, unpredictable working times. Drawing on EWCS-2015, MI of the second-order factor model was tested in a sample of 31,340 formal employees by means of (a) multi-group confirmatory factor analyses, and (b) the substantive exploration of EPRES-E mean scores in each country. The results demonstrate that threshold invariance holds for the first-order structure (dimensions) of 22 countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Lithuania, Luxembourg, the Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, Switzerland, UK), but only metric invariance is attained by the second-order structure. The latter is supported by the exploration of mean scores, where we found that different score patterns in each dimension lead to similar overall EPRES-E scores, suggesting that PE is configured by different sources within the six dimensions in each country according to their broader socio-political trajectories. We conclude that, although EPRES-E can be used for comparative purposes in 22 European countries, the scores of each dimension must be reported alongside the overall EPRES-E score.The research leading to these results has been supported by the Spanish Ministry of Science, Innovation and Universities under grant agreements No. CSO2016-79103R and No. CSO2017-89719-R (AEI/FEDER, UE)

Guix

Resumen basado en el de la publicaciónA partir de la conferencia titulada "La mejora de la convivencia. Todo aquello que uno quisiera saber y no se atreve a preguntar", pronunciada en septiembre de 2008 como actividad inaugural del PFZ de la comarca del Montsià, el centenar de docentes que asistieron pudieron hacer las aportaciones o las preguntas que creyeron oportunas respecto al tema planteado en la sesión. Se analizan y categorizan las opiniones que los maestros y los profesores expusieron en relación con la convivencia en los centros educativos.Universitat de Barcelona. Biblioteca del Campus de Mundet ; Passeig de la Vall d'Hebron 171; 08035 Barcelona; Tel. +34934021035; Fax +34934021034ES

Precarious employment and mental health across European welfare states: a gender perspective

Objective: The aim of this article was to examine the relationship between precarious employment (PE), welfare states (WS) and mental health in Europe from a gender perspective. Methods: Data were derived from the European Working Conditions Survey 2015. PE was measured through the Employment Precariousness Scale for Europe (EPRES-E), validated for comparative research in 22 European countries, and categorized into quartiles. Countries were classified into Continental, Anglo-Saxon, Scandinavian, Southern and Central-Eastern WS. Mental health was assessed through the WHO-5 Well-Being Index and dichotomized into poor and good mental health. In a sample of 22,555 formal employees, we performed gender-stratified multi-level logistic regression models. Results: Results showed greater prevalences of PE and poor mental health among women. However, the association between them was stronger among men. Cross-country differences were observed in multi-level regressions, but the interaction effect of WS was only significant among women. More precisely, Central-Eastern WS enhanced the likelihood of poor mental health among women in high precarious employment situations (quartiles 3 and 4). Conclusions: These findings suggest the interaction between contextual and individual factors in the production of mental health inequalities, both within and across countries. They also call for the incorporation of gender-sensitive welfare policies if equitable and healthy labor markets are to be achieved in Europe

Severe Immune-Related Adverse Events: A Case Series of Patients Needing Hospital Admission in a Spanish Oncology Referral Center and Review of the Literature

Immune checkpoint inhibitors (ICI) have revolutionized the landscape of cancer treatment. Although several studies have shown that ICIs have a better safety profile than chemotherapy, some patients develop immune-related adverse events (irAEs), which require specialized and multidisciplinary management. Since ICI indications are rapidly increasing, it is crucial that clinicians involved in cancer care learn to identify irAEs and manage them properly. Here, we report a case series of 23 patients with severe irAEs requiring hospitalization over a period of 12 months and seize the opportunity to review and update different general features related to irAEs along with the management of the most frequent severe irAEs in our series

Què es pot fer per millorar la convivencia?: la visió dels docents

A partir de la conferència titulada La millora de la convivència. Tot allò que hom voldria saber i no gosa preguntar, pronunciada el mes de setembre de 2008 com a activitat inaugural del PFZ de la comarca del Montsià, el centenar de docents que hi assistiren hi van poder fer les aportacions o les preguntes que van creure oportunes respecte al tema plantejat a la sessió. En aquest article, s'hi analitzen i s'hi categoritzen les opinions que els mestres i els professors van exposar en relació amb la convivència als centres educatiu

Precarious employment and stress: the biomedical embodiment of social factors. PRESSED Project Study Protocol

The PRESSED project aims to explain the links between a multidimensional measure of precarious employment and stress and health. Studies on social epidemiology have found a clear positive association between precarious employment and health, but the pathways and mechanisms to explain such a relationship are not well-understood. This project aims to fill this gap from an interdisciplinary perspective, integrating the social and biomedical standpoints to comprehensively address the complex web of consequences of precarious employment and its effects on workers' stress, health and well-being, including health inequalities. The project objectives are: (1) to analyze the association between multidimensional precarious employment and chronic stress among salaried workers in Barcelona, measured both subjectively and using biological indicators; (2) to improve our understanding of the pathways and mechanisms linking precarious employment with stress, health and well-being; and (3) to analyze health inequalities by gender, social class and place of origin for the first two objectives. The study follows a sequential mixed design. First, secondary data from the 2017 Survey on Workers and the Unemployed of Barcelona is analyzed (N = 1,264), yielding a social map of precarious employment in Barcelona that allows the contextualization of the scope and characteristics of this phenomenon. Drawing on these results, a second survey on a smaller sample (N = 255) on precarious employment, social precariousness and stress is envisaged. This study population is also asked to provide a hair sample to have their levels of cortisol and its related components, biomarkers of chronic stress, analyzed. Third, a sub-sample of the latter survey (n = 25) is selected to perform qualitative semi-structured interviews. This allows going into greater depth into how and why the experience of uncertainty, the precarization of living conditions, and the degradation of working conditions go hand-in-hand with precarious employment and have an impact on stress, as well as to explore the potential role of social support networks in mitigating these effects

Prevalence of ethical dilemmas in advanced cancer patients (secondary analysis of the PALCOM study)

Purpose: The main aim of this study was to determine the prevalence of ethical dilemmas in the end-of-life process in advanced cancer patients. Methods: We carried out a multicenter, cross-sectional, observational, prospective study in a cohort of cancer patients whose life expectancy was ≤ 6 months. We recorded sociodemographic characteristics, diagnosis of cancer, symptom burden, cognitive and functional status, emotional impact, and sociofamilial risk factors. The main outcome measure was the detection of ethical dilemmas, based on the following definition: conflict in decision-making during the end-of-life process that involves the need to choose between morally acceptable opposing options, where none is clearly preferable to another. Results: We included 324 patients (mean age, 69 years; 58% men). We identified 117 dilemmas in 90 patients (27.8%). The dilemmas detected were as follows: (a) conflicts of information (adaptive denial, conspiracy of silence, information exceeding patient's desired limit), 15.7%; (b) discrepancies in proportionality (discussion on futility, rejection of treatment, withdrawal of life support measures), 16.7%; (c) unrealistic expectations about the outcome of clinical trials, 2.5%; and (d) request for euthanasia or medically assisted suicide, 1.2%. We observed a greater prevalence of ethical dilemmas in men, in patients receiving active cancer treatment, and in patients with emotional distress (p < 0.05). Conclusions: The prevalence of ethical dilemmas during the end-of-life process in cancer patients is relevant. Most dilemmas were associated directly or indirectly with respect for patient autonomy. In this context, the communication skills of the health professionals and advanced care planning take on a key role