Self-placement of the Unemployed in the Social Hierarchy. Evidence from European Countries

Unemployment has risen during the recent recession. However, the experience of unemployment varies considerably across European countries (Gallie 2013b). To study the unemployment experience in different European countries, a social exclusion approach was combined with a social stratification approach utilizing a measure of subjective social position which indicates how people perceive their relative position in the social hierarchy. In evaluating their social position people make comparisons within societal contexts. We hypothesize that the country-level economic and institutional context impacts the experience of unemployment, the way people interpret it, and thus affects the subjective social position of the unemployed. Our main goal was to study the impact of different macro-level economic and social characteristics on the subjective social position of the unemployed. We focused on a comparison of the subjective social position of unemployed persons against the remaining populations of 18 European countries using data from the International Social Survey Programme (ISSP) 2009 Social Inequality module

Eesti õpilaste probleemilahendusoskus: PISA 2012 arvutipõhise probleemilahendustesti tulemused

Tänapäeva ühiskonnale on omased kiired muutused ja pidev tehnoloogiline areng. Noorte edukat toimetulekut sellistes tingimustes toetab kohanemisvõime, valimisolek õppida ja julgus proovida uusi asju. OECD (2014) leiab, et noored peaksid kujunema elukestvateks õppijateks, kes suudavad mõelda paindlikult ja loominguliselt ning olema valmis lahendama keerukaid probleeme. PISA 2012 uuringus on probleemilahendusoskus määratletud kui õpilase võimekus mõista ja lahendada probleemolukordi, mille lahendusviis ei ole esmapilgul selge. Probleemi lahendamiseks on oluline tahe tegutseda ja leida vastus

Trapped in ‘Involuntary’ Work in the Late Career? Retirement Expectations versus the ‘Desire to Retire’ in Estonia

In light of recent policies aiming to promote the prolongation of working life, one of the key questions is how people have adjusted their retirement expectations (i.e., realistic plans) and preferences (i.e., wishes and desires). We explore which social groups plan to continue working after the statutory retirement age, and whether they wish to do it or whether it is a forced choice (‘involuntary’ work). Overall, almost all employed late career workers plan to work until or beyond retirement age in Estonia, especially men and those who have more educational and health resources. Still, results of a joint analysis of plans and wishes indicate that two groups have a higher risk of ‘involuntary’ work. First, a higher education combined with a low job satisfaction predicts staying longer in the labour despite the wish to retire as early as possible. Second, individuals who have poor health and a low job satisfaction often wish to retire as early as possible but stay in the labour market until reaching to the compulsory retirement age. Thus, policy measures increasing merely the statutory retirement age create tensions, especially among those not satisfied with their jobs. More analytical work and policy measures are needed to provide solutions at the workplace level that would enable a prolonged work career.

Kõrghariduse katkestajad Eestis: oskused ja positsioon tööturul

Käesoleva raporti keskseks uurimisteemaks on kõrghariduse lõpetamise olulisus edasisi tööturuvõimalusi silmas pidades. Täpsemalt kas lõpetanute ja katkestanute võimalused erinevad ning milline osa on selles mõlema grupi oskustel

Maintenance olaparib rechallenge in patients with platinum-sensitive relapsed ovarian cancer previously treated with a PARP inhibitor (OReO/ENGOT-ov38): a phase IIIb trial

PARP inhibitor; Ovarian cancer; RelapsedInhibidor de PARP; Càncer d'ovari; RecaigudaInhibidor de PARP; Cáncer de ovario; RecaídaBackground Poly(ADP-ribose) polymerase (PARP) inhibitor maintenance therapy is the standard of care for some patients with advanced ovarian cancer. We evaluated the efficacy and safety of PARP inhibitor rechallenge. Patients and methods This randomized, double-blind, multicenter trial (NCT03106987) enrolled patients with platinum-sensitive relapsed ovarian cancer who had received one prior PARP inhibitor therapy for ≥18 and ≥12 months in the BRCA-mutated and non-BRCA-mutated cohorts, respectively, following first-line chemotherapy or for ≥12 and ≥6 months, respectively, following a second or subsequent line of chemotherapy. Patients were in response following their last platinum-based chemotherapy regimen and were randomized 2 : 1 to maintenance olaparib tablets 300 mg twice daily or placebo. Investigator-assessed progression-free survival (PFS) was the primary endpoint. Results Seventy four patients in the BRCA-mutated cohort were randomized to olaparib and 38 to placebo, and 72 patients in the non-BRCA-mutated cohort were randomized to olaparib and 36 to placebo; >85% of patients in both cohorts had received ≥3 prior lines of chemotherapy. In the BRCA-mutated cohort, the median PFS was 4.3 months with olaparib versus 2.8 months with placebo [hazard ratio (HR) 0.57; 95% confidence interval (CI) 0.37-0.87; P = 0.022]; 1-year PFS rates were 19% versus 0% (Kaplan–Meier estimates). In the non-BRCA-mutated cohort, median PFS was 5.3 months for olaparib versus 2.8 months for placebo (HR 0.43; 95% CI 0.26-0.71; P = 0.0023); 1-year PFS rates were 14% versus 0% (Kaplan–Meier estimates). No new safety signals were identified with olaparib rechallenge. Conclusions In ovarian cancer patients previously treated with one prior PARP inhibitor and at least two lines of platinum-based chemotherapy, maintenance olaparib rechallenge provided a statistically significant, albeit modest, PFS improvement over placebo in both the BRCA-mutated and non-BRCA-mutated cohorts, with a proportion of patients in the maintenance olaparib rechallenge arm of both cohorts remaining progression free at 1 year.This work was funded by AstraZeneca and is part of an alliance between AstraZeneca and Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA (no grant number)

Preferences for follow up in long-term survivors after cervical cancer

Introduction An increasing number of cervical cancer survivors combined with lack of data on the efficacy of long-term surveillance, challenges existing follow-up models. However, before introducing new follow-up models, cervical cancer survivors’ own views on follow up are important. We aimed to explore preferences for follow up in long-term cervical cancer survivors and their associations with self-reported late-effects. Material and methods In 2013, we mailed 974 Norwegian long-term cervical cancer survivors treated during 2000-2007 a questionnaire with items covering preferences for follow up after treatment, clinical variables and validated questionnaires covering anxiety, neuroticism and depression. Results We included 471 cervical cancer survivors (response rate 57%) with a median follow up of 11 years. In all, 77% had FIGO stage I disease, and 35% were attending a follow-up program at the time of survey. Of the patients, 55% preferred more than 5 years of follow up. This was also preferred by 57% of cervical cancer survivors who were treated with conization only. In multivariable analyses, chemo-radiotherapy or surgery with radiation and/or chemotherapy (heavy treatment) and younger age were significantly associated with a preference for more than 5 years’ follow up. Late effects were reported by more than 70% of the cervical cancer survivors who had undergone heavy treatment. Conclusions Our study reveals the need for targeted patient education about the benefits and limitations of follow up. To meet increasing costs of cancer care, individualized follow-up procedures adjusted to risk of recurrence and late-effects in cervical cancer survivors are warranted.publishedVersio

Olaparib maintenance monotherapy in platinum-sensitive relapsed ovarian cancer patients without a germline BRCA1/BRCA2 mutation: OPINION primary analysis

Maintenance; Olaparib; Ovarian cancerManteniment; Olaparib; Càncer d'ovarisMantenimiento; Olaparib; Cáncer de ovariosObjective The phase IIIb OPINION trial (NCT03402841) investigated olaparib maintenance monotherapy in patients without a deleterious or suspected deleterious germline BRCA1/BRCA2 mutation (gBRCAm) who had platinum-sensitive relapsed ovarian cancer (PSROC) and had received ≥2 previous lines of platinum-based chemotherapy. Methods In this single-arm, open-label, international study, patients who had responded to platinum-based chemotherapy received maintenance olaparib tablets (300 mg twice daily) until disease progression or unacceptable toxicity. The primary endpoint was investigator-assessed progression-free survival (PFS) (modified RECIST version 1.1). A key secondary endpoint was PFS by homologous recombination deficiency (HRD) and somatic BRCAm (sBRCAm) status. The primary analysis of PFS was planned for 18 months after the last patient received their first dose. Results Two hundred and seventy-nine patients were enrolled and received olaparib. At data cutoff (October 2, 2020), 210 PFS events had occurred (75.3% maturity) and median PFS was 9.2 months (95% confidence interval [CI], 7.6–10.9) in the overall population. At 12 and 18 months, 38.5% and 24.3% of patients were progression-free, respectively. In the predefined biomarker subgroups, median PFS was 16.4, 11.1, 9.7, and 7.3 months in sBRCAm, HRD-positive including sBRCAm, HRD-positive excluding sBRCAm, and HRD-negative patients, respectively. The most common treatment-emergent adverse events (TEAEs) were nausea (48.4%) and fatigue/asthenia (44.1%). TEAEs led to dose interruption, dose reduction, and treatment discontinuation in 47.0%, 22.6%, and 7.5% of patients, respectively. Conclusion Maintenance olaparib demonstrated clinical benefit in patients without a gBRCAm, and across all subgroups, compared with historical placebo controls. There were no new safety signals.This study was funded by AstraZeneca and is part of an alliance between AstraZeneca and Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA

Täiskasvanud õppijad Eesti kõrgharidussüsteemis

Siinse uuringu ülesandeks oli analüüsida täiskasvanud õppijate kogemusi ja ootusi seoses kõrgkoolis õppimisega, õpikeskkonnaga, ning õpingute ja muu elu ühendamisega. Eestis on sarnast, spetsiaalselt täiskasvanud õppijate kogemusele keskenduvat uuringut varem läbi viidud 2007. aastal, mil Tallinna Ülikooli professor Ellu Saare juhtimisel töötati Euroopa Liidu 6. raamprogrammi rahvusvahelise uurimisprojekti „Elukestval õppel põhineva ühiskonna poole Euroopas: haridussüsteemi roll” ehk LLL2010 raames välja ja viidi kolmeteistkümnes Euroopa riigis läbi esimene formaalharidussüsteemis õppivate täiskasvanute uuring. Eestis küsitleti 2007. aastal toimunud uuringu raames 1000 õppijat, kellest 250 omandas kõrgharidust. Nende andmete põhjal on avaldatud mitmeid originaalseid uuringuid ja analüüse. Nüüdseks on toonased, veel majanduskasvu ajal kogutud andmed kaotanud oma aktuaalsuse – enamus siis õppinuid on juba kooli lõpetanud, uute õppijate kooli astumine on aga langenud globaalse majanduskriisi aega. Kuidas mõjutab see kontekst tänaseid täiskasvanud õppijaid? Mil moel erinevad eri tüüpi kõrgkoolides õppivad tudengid? Kas lastega ja lasteta tudengid pühendavad õpingutele ühepalju aega? Kui töötaval tudengil on samal ajal täita nii koolitöö kui palgatöö ülesandeid, siis kumma seab ta oma prioriteediks? Mida tähendab täiskasvanud õppijatele kõrgharidus – miks nad seda omandavad? Millised on nende ettepanekud kõrgkoolide õppijasõbralikumaks muutmiseks?http://primus.archimedes.ee/sites/default/files/Taiskasvanud_oppija_2.pd

Oskused ja elukestev õpe: Kellelt ja mida on Eestil oskuste parandamiseks õppida? PIAAC uuringu temaatiline aruanne nr 2

Arusaam õppimisest kui noorte kohustusest ja privileegist ei vasta tänapäeva kiiresti muutuva maailma nõudmistele. Euroopa Liit on aktiivselt asunud edendama täiskasvanute õppimist ja seadnud oluliseks prioriteediks suurendada elukestvas õppes osalemist. Selle taga on arusaam, et täiskasvanute õppes osalemine on kasulik nii sotsiaalses kui ka majanduslikus plaanis nii osalejatele endile kui ka ühiskonnale laiemalt, kuna see tõstab nii tootlikkust kui ka hõivet tööturul. Rahvusvaheline täiskasvanute oskuste uuring PIAAC (Programme for the International Assessment of Adult Competencies) pakub võrreldes varasemate andmebaasidega mitu täiendavat võimalust. Kuna uuring mõõtis lisaks haridustasemele ka kolme liiki oskusi (funktsionaalset lugemisoskust, matemaatilist kirjaoskust ja probleemilahendusoskust tehnoloogiarikkas kesk konnas), siis on võimalik uurida, kuivõrd mõjutavad elukestvas õppes osalemist oskused ja haridus eraldiseisvalt. Et PIAACi küsimustikus oli ka mahukas osa, mis mõõtis erinevate oskuste kasutamist tööl, annab see lisaks võimaluse analüüsida, kuivõrd mõjutavad elukestvas õppes osalemist nn pakkumise poole karakteristikud, st inimeste oskused ja haridustase, ning kuivõrd olulised on nn nõudlust iseloomustavad näitajad (eelkõige töö oskustemahukus)

Impact of hormonal biomarkers on response to hormonal therapy in advanced and recurrent endometrial cancer

Inhibidores de la aromatasa; Terapia de progestinaAromatase inhibitors; Progestin therapyInhibidors de l'aromatasa; Teràpia amb progestinaBackground Approximately 20% of women with endometrial cancer have advanced-stage disease or suffer from a recurrence. For these women, prognosis is poor, and palliative treatment options include hormonal therapy and chemotherapy. Lack of predictive biomarkers and suboptimal use of existing markers for response to hormonal therapy have resulted in overall limited efficacy. Objective This study aimed to improve the efficacy of hormonal therapy by relating immunohistochemical expression of estrogen and progesterone receptors and estrogen receptor pathway activity scores to response to hormonal therapy. Study Design Patients with advanced or recurrent endometrial cancer and available biopsies taken before the start of hormonal therapy were identified in 16 centers within the European Network for Individualized Treatment in Endometrial Cancer and the Dutch Gynecologic Oncology Group. Tumor tissue was analyzed for estrogen and progesterone receptor expressions and estrogen receptor pathway activity using a quantitative polymerase chain reaction–based messenger RNA model to measure the activity of estrogen receptor–related target genes in tumor RNA. The primary endpoint was response rate defined as complete and partial response using the Response Evaluation Criteria in Solid Tumors. The secondary endpoints were clinical benefit rate and progression-free survival. Results Pretreatment biopsies with sufficient endometrial cancer tissue and complete response evaluation were available in 81 of 105 eligible cases. Here, 22 of 81 patients (27.2%) with a response had estrogen and progesterone receptor expressions of >50%, resulting in a response rate of 32.3% (95% confidence interval, 20.9–43.7) for an estrogen receptor expression of >50% and 50.0% (95% confidence interval, 35.2–64.8) for a progesterone receptor expression of >50%. Clinical benefit rate was 56.9% for an estrogen receptor expression of >50% (95% confidence interval, 44.9–68.9) and 75.0% (95% confidence interval, 62.2–87.8) for a progesterone receptor expression of >50%. The application of the estrogen receptor pathway test to cases with a progesterone receptor expression of >50% resulted in a response rate of 57.6% (95% confidence interval, 42.1–73.1). After 2 years of follow-up, 34.3% of cases (95% confidence interval, 20–48) with a progesterone receptor expression of >50% and 35.8% of cases (95% confidence interval, 20–52) with an estrogen receptor pathway activity score of >15 had not progressed. Conclusion The prediction of response to hormonal treatment in endometrial cancer improves substantially with a 50% cutoff level for progesterone receptor immunohistochemical expression and by applying a sequential test algorithm using progesterone receptor immunohistochemical expression and estrogen receptor pathway activity scores. However, results need to be validated in the prospective Prediction of Response to Hormonal Therapy in Advanced and Recurrent Endometrial Cancer (PROMOTE) study