Work productivity loss among adults aged 18–64 years with Multiple Sclerosis in the United States: A propensity score matched study

BackgroundScarce data exists regarding United States (US) national-level work productivity loss among adults with Multiple Sclerosis (MS).ObjectiveTo address this significant knowledge gap, we examined the national-level productivity loss among adults (18≤ age ≤64 years) with MS compared to propensity score matched non-MS controls.MethodsWe adopted a retrospective, cross-sectional, matched cohort study design with pooled data from alternate years (2005/2007/2009/2011/2013/2015) of the Medical Expenditure Panel Survey (MEPS). We included adults who were employed and alive during the calendar year. Clinical Classification System code of “80” was used to identify individuals with MS. We matched adults with MS to non-MS adults utilizing propensity scores generated based on age, gender, and race/ethnicity using a greedy matching algorithm (8:1-digit matching). Missed workdays measured productivity loss of MEPS respondents. We selected Negative Binomial Regression (NBR) analysis as the count data model for this study. Analyses were conducted using SAS 9.4 and STATA 15.0 and accounted for the complex survey design of MEPS to generate US national-level estimates.ResultsThe final propensity-score matched sample consisted of 104 and 312 (unweighted) adults with and without MS, respectively. US national-level mean [Standard Error (SE)] annual missed workdays among individuals with MS [8.94 (SE:1.59)] was significantly higher (p = 0.001) compared to propensity score matched non-MS controls [3.15 (SE:0.40)]. After adjusting for several factors, NBR showed an approximately two-fold higher rate of missed work days among individuals with MS compared to propensity score matched non-MS controls (Incidence Rate Ratio: 1.98, 95% Confidence Interval: 1.18–3.33). Severity of pain, marital status, region, and hypertension also negatively impacted work productivity in this sample.ConclusionsIndividuals with MS in the US experience significantly higher productivity loss compared to propensity score matched non-MS controls. Interventions (e.g., improved management of MS symptoms) are warranted to reduce productivity loss among individuals with MS.     

IMPROVING ACCESS TO HEALTH SERVICES IS STRATEGIC PRIORITY OF PRODUCTIVITY DEVELOPMENT

As one of the basic human rights, health is an important guarantee for productivity. The authors introduce the Andersen's behavioral model of health service use,as well as the conception and classification of access to health services based on the model. Meanwhile,the relative guidelines and the impact on the health reform of China are discussed, compared with America's and China's. This paper propounds three strategic priority of productivity development.     

Health dynamics shape life-cycle incomes

This paper empirically investigates the long-run effects of major health improvements on income growth in the United States. To isolate exogenous changes in health, the econometric model uses quasi-experimental variation in cardiovascular disease mortality across states over time. Based on data for the white population, the results show that there is a causal link between health and income per person, and they provide novel evidence that health dynamics shape life-cycle incomes. Life-cycle income profiles slope more strongly at the beginning and at the end of work life in 2000 than in 1960, indicating that age becomes a more prominent determinant of income dynamics over this period. The channels for this transformation include better health, higher educational attainment, and changing labor supply.     

马克思关于人类社会阶段“跨越”发展的辩证法

马克思曾设想俄国农村公社有可能跨越资本主义制度“卡夫丁峡谷”而直接进入共产主义社会。本文运用马克思主义理论辩证地阐述了人类社会实现跨越发展所必备的条件内在因素、外在条件、动力以及跨越的内容。     

大蒜油蒸馏法提取条件的探讨

目的探讨蒸馏法提取大蒜油的适宜条件,对影响产率的重要因素进行多水平比较,优化组合,指导生产。方法按照大蒜油的生产步骤和影响因素,选择大蒜的破碎粒径,蒜酶激活剂—亚铁离子浓度,发酵温度和蒸馏提取时间这四个因素在三种水平下大蒜油的产率进行比较。结果大蒜破碎粒径为0.2mm、亚铁离子浓度为10mmol/L、发酵温度在33℃、蒸馏提取时间为120min时大蒜油的产率最高熏为0.49%。结论该实验结果能提高大蒜油产率一倍以上,在指导大蒜油生产中,应用效果良好。     

Level of work stress and factors associated with bruxism in the military crew of the Peruvian Air Force

BackgroundMilitary life leads to a great personal sacrifice and labor in the aircrew because they are constantly subjected to innumerable activities which have a great work pressure; therefore, the aim of this study was to determine the level of work stress associated with bruxism in the aircrew of the Peruvian Air Force.MethodsThis was a cross-sectional study. A total of 204 crew members of the Peruvian Air Force from the Air Group were surveyed, and the stomatological clinical inspection was carried out. Each crew member was evaluated using the validated International Labor Organization-World Health Organization (ILO-WHO) Work Stress Scale, and clinical records were used to diagnose bruxism using the Smith and Knight wear index.ResultsIt was found that 93.7% (n = 191) of the crew members were men and 6.3% (n = 13) were women; and the percentage of intermediate-level stress was found to be high in the grade of non-commissioned officers, whereas in the officer grade, the level of stress was low. There was also a statistically significant association between the variables military grade, sex, and age group. The sub-officers presented a higher percentage in the category "with bruxism", while in the rank of officers the category of "non-bruxism" was the most prevalent.ConclusionsThis study showed a statistically significant association between the variable bruxism and the level of work stress between the military aviators of the Peruvian Air Force (p<0.001).     

When do combinatorial mechanisms apply in the production of inflected words?

A central question for theories of inflected word processing is to determine under what circumstances compositional procedures apply. Some accounts (e.g., the dual-mechanism model; Clahsen, 1999 Clahsen, H. 1999. Lexical entries and rules of language: A multidisciplinary study of German inflections. Behavioral and Brain Sciences, 22: 991–1060. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) propose that compositional processes only apply to verbs that take productive affixes. For all other verbs, inflected forms are assumed to be stored in the lexicon in a nondecomposed manner. This account makes clear predictions about the consequences of disruption to the lexical access mechanisms involved in the spoken production of inflected forms. Briefly, it predicts that nonproductive forms (which require lexical access) should be more affected than productive forms (which, depending on the language task, may not). We tested these predictions through the detailed analysis of the spoken production of a German-speaking individual with an acquired lexical impairment resulting from a stroke. Analyses of response accuracy, error types, and frequency effects revealed that combinatorial processes are not restricted to verbs that take productive inflections. On this basis, we propose an alternative account, the stem-based assembly model (SAM), which posits that combinatorial processes may be available to all stems and not only to those that combine with productive affixes.     

Complementary medicine use and costs in patients with breast cancer who experienced treatment-related side effects: A cross-sectional survey in Korea

ObjectivesPopulation-based information on the costs of complementary medicine for treatment-related side effects in patients with breast cancer is scarce. We aimed to investigate the prevalence and expenditure on complementary medicine in patients with breast cancer who experienced treatment-related side effects.Design and settingTwo datasets were analyzed: 1) a 2017 survey on direct and indirect costs for treatment-related side effects, which was completed by 100 patients with stage 0-IV breast cancer, and 2) a Korean representative cross-sectional survey (Patient Survey 2014) that examined the prevalence of integrative medicine in 41 patients with breast cancer.Main outcome measuresThe direct and indirect costs for treatment-related side effects.ResultsIn the first dataset, the mean total direct medical cost for complementary medicine was US$1,584 and the mean indirect cost was US$6,988 per patient per year. Some patients (6%) visited non-medical institutions to utilize complementary medicine and additionally spent US$460 per patient per year. Approximately one-third of participants reported a substantial-to-heavy financial burden for using complementary medicine. However, only 17% of patients got information about complementary medicine through their physician. In the second dataset, 49% of patients with breast cancer who were discharged from Korean Medicine hospitals in Patient Survey 2014 data indicated that integrative medicine had been used.ConclusionsDespite some complementary medicine could be reimbursed by National Health Insurance in Korea, a considerable number of patients reported an economic burden associated with their use of complementary medicine. Strategies for guiding patients to receive evidence-based and cost-effective complementary medicine are needed.