Investigating post-stroke fatigue: An individual participant data meta-analysis

The prevalence of post-stroke fatigue differs widely across studies, and reasons for such divergence are unclear. We aimed to collate individual data on post-stroke fatigue from multiple studies to facilitate high-powered meta-analysis, thus increasing our understanding of this complex phenomenon.Methods: We conducted an Individual Participant Data (IPD) meta-analysis on post-stroke fatigue and its associated factors. The starting point was our 2016 systematic review and meta-analysis of post-stroke fatigue prevalence, which included 24 studies that used the Fatigue Severity Scale (FSS). Study authors were asked to provide anonymised raw data on the following pre-identified variables: (i) FSS score, (ii) age, (iii) sex, (iv) time post-stroke, (v) depressive symptoms, (vi) stroke severity, (vii) disability, and (viii) stroke type. Linear regression analyses with FSS total score as the dependent variable, clustered by study, were conducted.Results: We obtained data from 14 of the 24 studies, and 12 datasets were suitable for IPD meta-analysis (total n = 2102). Higher levels of fatigue were independently associated with female sex (coeff. = 2.13, 95% CI 0.44–3.82, p = 0.023), depressive symptoms (coeff. = 7.90, 95% CI 1.76–14.04, p = 0.021), longer time since stroke (coeff. = 10.38, 95% CI 4.35–16.41, p = 0.007) and greater disability (coeff. = 4.16, 95% CI 1.52–6.81, p = 0.010). While there was no linear association between fatigue and age, a cubic relationship was identified (p < 0.001), with fatigue peaks in mid-life and the oldest old.Conclusion: Use of IPD meta-analysis gave us the power to identify novel factors associated with fatigue, such as longer time since stroke, as well as a non-linear relationship with age

The Weakening Position of University Graduates in Singapore's Labor Market: Causes and Consequences

Pulled along by global developments, Singapore is rapidly developing a "knowledge-based economy." Between 1990 and 2000, gross domestic product more than doubled (in constant dollars), and the number of managerial and professional jobs almost doubled. Such advances should be a boon to middle-class Singaporeans, but, instead, they find themselves under increasing economic pressure despite the increased need for educated labor and the surplus of manual labor. On the basis of analysis of available data, the article documents the deteriorating relative position of the well-educated in the labor market and explores the role of migration in that process. Copyright 2005 The Population Council, Inc..