Search Results (123)

We develop a continuous-time model of optimal consumption, portfolio allocation, and early retirement that, to our knowledge, is the first to incorporate an implementation delay —a fixed lag $\delta$ between the retirement decision and the actual cessation of labor and income. Using a dual-martingale approach, we obtain closed-form solutions and quantify how $\delta$ affects optimal behavior. For example, when $\delta$ increases from $0.5$ to 2 years (baseline parameters: $\beta =0.04$, $r=0.02$, $\mu =0.08$, $\sigma =0.2$, $\gamma =3$, $k_B=0.3$, and $\epsilon =1$), optimal pre-retirement consumption rises by approximately 7%, the risky asset share falls by about 5 percentage points, the expected retirement time increases by over 1 year, and the retirement wealth threshold $x_R$ grows by roughly 10%. These results provide policy-relevant insights for retirement systems where procedural lags can distort incentives and reduce welfare. Full article

Background: Femoroacetabular impingement (FAI) increasingly affects professional and amateur tennis players. Therefore, understanding the optimal approach to follow in specific cases plays an important role in the return to sports activity. Methods: This case report describes a two-stage functional recovery program implemented by two professional tennis players returning to practice. One player (a) underwent two arthroscopic surgeries for FAI and reconstruction of the damaged acetabulum labrum, while the other (b) took a stop period due to pain symptoms related to coxarthrosis and FAI. The subjects were monitored through pain perception questionnaires and mobility tests. An interview was conducted two years after the injury. Results: In both cases, at the end of the program, the subjects had no pain during tennis practice and gained more than 90% of range of motion in hip extension. However, both interrupted the program, experiencing painful symptoms again. At a two-year follow-up, the subjects were no longer involved in professional sports. The factors perceived by the two players were investigated and presented. Conclusions: The program proved beneficial, as both athletes returned to sports practice without pain symptoms and with hip mobility close to physiological. Nevertheless, the pain arose after the program ended and continued over time. Several aspects connected to the injury might have significantly affected early retirement from professional activity. Full article

Background/Objectives: Systemic sclerosis (SSc) is a multisystemic chronic autoimmune disease, which leads to disability and possibly early retirement. The objective of our study was to explore the associations between employment status (ES) and demographic, clinical and functional features in a single-center EUSTAR cohort. Methods: Consecutive patients with SSc examined between November 2011 and June 2023, who were under the age of retirement in our country (62 years for women, 65 for men at the time), were included. All patients underwent a comprehensive clinical assessment and filled in a work assessment questionnaire as well as two validated health-related questionnaires: the Scleroderma Health Assessment Questionnaire (SHAQ) and the Duruoz Hand Index (DHI). Associations between ES and potential predictors (education level, disease characteristics, work conditions, SHAQ and DHI) were tested using logistic regression adjusted for age and gender. Results: Ninety-one patients (mean ± SD age 53.7 ± 11.8 years, twenty-two with diffuse skin involvement, fifty-six with a history of digital of digital ulcers (DUs)), were included. Only 22 patients were still employed, while 69 were retired, of which 38 retired because of SSc. Among the employed, nine performed manual labor, nine spent many hours standing and three had to work in a cold environment. When potential predictors were tested separately, adjusted for age and sex, patients with higher education (OR (95% CI) 11.36 (2.03–63.36), p = 0.006) and no history of digital ulcers had higher odds of being employed. The presence of joint contractures and weightlifting as a work demand were associated with unemployment. In a multivariable model, higher education (OR 5.91, 95% CI 0.97–36.09, p = 0.054 and younger age (OR 0.90, 95% CI 0.85–0.96, p = 0.001) were independently associated with continued employment. High school education did not show a significant effect (OR 0.089, 95% CI 0.015–0.530, p = 0.008). Patients with a history of digital ulcers had the lowest employment rates compared to those with no digital ulcer history. No significant associations were found between employment status and SHAQ or DHI scores. Conclusions: SSc is associated with significant work disability and early retirement. Higher education, the lack of Dus and younger age were highly associated with staying employed. Given the rarity of SSc, we consider that our good sample size (n = 91) reflects disease prevalence, but results should be tested in other studies and the single center should be considered when interpreting generalizability. Full article

Background: Sarcopenia and buttock pain are highly prevalent in older adults and exert profound negative effects on quality of life. Little is known about the association between sarcopenia and buttock pain. Methods: This study performed cross-sectional and longitudinal analyses based on prospective cohort study data from the 2015 and 2020 waves of the China Health and Retirement Longitudinal Study (CHARLS). A total of 12,884 community-dwelling adults aged ≥45 years were included in the cross-sectional analysis, and 10,511 of these participants, free of buttock pain at baseline, were further investigated to assess incident buttock pain. Sarcopenia status was categorized as non-sarcopenia, possible sarcopenia, and sarcopenia according to the 2019 Asian Working Group for Sarcopenia and the 2021 Chinese consensus criteria. Logistic regression models adjusted for sociodemographic and health-related covariates were performed to estimate associations between sarcopenia status and buttock pain. Results: After adjusting for covariates, possible sarcopenia, but not sarcopenia, was associated with prevalent buttock pain (OR 1.23, 95% CI 1.03–1.48). After 5 years of follow-up, participants with sarcopenia were more likely to develop incident buttock pain (OR 1.37, 95% CI 1.03–1.81). Among sarcopenia components, poor physical performance was linked to prevalent pain (OR 1.25, 95% CI 1.05–1.50) and low handgrip strength predicted incident pain in males (OR 1.31, 95% CI 1.07–1.60). Appendicular muscle mass was not independently associated with either prevalent or incident buttock pain. Conclusions: In middle-aged and older Chinese adults, sarcopenia is an independent risk factor for incident buttock pain. Early screening and interventions of sarcopenia may help to mitigate the burden of buttock pain and its associated disability. Full article

Background: About 14,000 women develop cervical cancer each year in the United States. Human Papillomavirus (HPV) vaccination is an effective primary prevention measure for HPV infections and cervical cancer among adolescents and young adults. For middle-aged and older women, they rely on secondary prevention (i.e., cancer screening) for early detection of cervical cancer. The average age at which women receive a cervical cancer diagnosis is around 50, when most women are in the middle of perimenopause. In this study, we use data from a longitudinal survey to examine whether going through menopause is associated with cervical cancer screening behavior four or eight years later. Methods: Data were taken from 2012, 2016, and 2020 waves of the Health and Retirement Study (HRS), a longitudinal survey of middle-aged and older adults in America. Using the 2012 and 2016 waves as baselines, two four-year (n = 1011 and n = 1263) and one eight-year (n = 823) longitudinal analyses were conducted. The lost follow-ups and those who have had a hysterectomy were excluded. Hierarchical logistic regression models were used to compare women who had gone through menopause to those who were premenopausal or perimenopausal at each of the baselines in terms of their likelihood of having a pap smear test four or eight years later. Results: Results show that the women who had gone through menopause were less likely to have a pap smear test four or eight years later when compared to those who were still premenopausal or perimenopausal at baseline. Women who had gone through menopause at the baseline of 2016 were less likely to have a pap smear test by 2020 (Odds Ratio = 0.76, p < 0.05). A similar association was found among women who had gone through menopause at the baseline of 2012 after controlling for their previous pap smear behavior and other covariates. Conclusions: The American Cancer Society and other professional organizations recommend that women have cervical cancer screenings regularly until age 65. Our findings suggest that women seem less likely to have a pap smear test after menopause. More research is needed to have a comprehensive understanding of cervical screening behavior in this age group of women. Full article

Objectives: To evaluate the patient-reported impact of retinitis pigmentosa (RP) in a large patient cohort to identify relevant disease-related disadvantages as key aspects for the improvement of ophthalmic and social care. Methods: Consecutive patients with molecularly confirmed RP older than 18 years of age were identified in two tertiary care centers in Germany. Patients were contacted to participate in an anonymized patient query regarding the impact of RP on their vocational training, professional career, and social, familial, and personal life, as well as their experience with ophthalmologic care. Results: Out of 241 contacted patients, 162 responded (67.2%; 52.5% female, 67.3% younger than 50 years of age). While the impact of RP on vocational training was limited, professional careers were frequently disrupted with early retirement rates of 39.8% (≥40 years of age) to 50% (≥50 years of age). Most respondents felt restricted in their participation in public life (66.3%). One-fifth complained about financial restrictions; however, one-third of this number did not obtain financial help. A negative impact on familial life (21.4%) was less frequently reported compared to personal impairments, especially anxiety (74.5%) and depression (24.2%). Most respondents considered their ophthalmic care as adequate; however, a delayed diagnosis (≥two years: 28.6%) and initial misdiagnosis (24.0%) were frequent. Insufficient psychological support was the major complaint about professional care. Conclusions: RP affects the lives of patients in multiple aspects. Ophthalmic and social care providers should focus on the acceleration of the diagnostic process, as well as easy access to financial assistance and psychological support, as key areas for improvement. Improvements in these areas are expected to reduce challenges for patients. They should have an impact on rehabilitation, participation in public life, and quality of life. Full article

Background: Tennessee has one of the worst rankings for older adults’ oral health in the United States. This study aims to evaluate the oral health-related quality of life (OHRQoL) among older individuals (aged 60 and above) in Tennessee using the Oral Health Impact Profile-14 (OHIP-14) questionnaire. Methods: The data were collected from the 233 Tennessee Smile-on program participants in the early phase of the COVID-19 pandemic, between December 2019 and August 2021. The frequency and percentage for each subgroup were calculated. Cronbach’s alpha was used to measure the internal consistency or reliability of OHIP in this study. Factor Analysis (FA) with oblique rotation was conducted to explore the underlying factor structure of the OHIP questionnaire set. A p < 0.05 was considered statistically significant. Results: The majority of participants were retired (59.66%), and there was a significant difference in OHIP_sum scores among different employment statuses (p = 0.018). Cronbach’s alpha showed the domains of psychological discomfort, physical disability, and psychological disability were highly correlated with the total score (alpha = 0.8). Factor analysis identified three main dimensions: physical discomfort, psychological distress, and functional disability, and they can explain over 90% of the total variance. Individuals measure of sampling adequacy (MSA) and overall MSA are greater than 0.9, indicating excellent sampling adequacy. Conclusions: The study suggested that oral health can be assessed not only through examinations by dental professionals but also by considering emotional and social well-being. However, a limitation of the study is that it was conducted during the COVID-19 outbreak, which restricted participant involvement. Full article

Background/Objectives: Patient safety is directly linked with health and wellbeing of healthcare workers. In the UK, COVID-19 severely disrupted healthcare, with surgeons tackling prolonged waiting lists and working longer hours under high stress. This study explored the biomechanical and psychosocial demands on hospital surgeons, as well as their experience of pain and work-life balance post-pandemic. Methods: A questionnaire was developed combining validated tools assessing physical demands; modified job demand, control, and support; the WHO-5 wellbeing index; work–life balance from the Copenhagen Psychosocial Questionnaire; musculoskeletal pain; job satisfaction and retirement intentions. An online survey was developed using the Qualtrics© (Provo, UT, USA) platform and circulated through surgical networks using snowball sampling. Poisson regression modelling with robust confidence intervals was used to explore relationships between work-related factors and musculoskeletal pain, and associations with retirement intentions. Results: In total, 242 replies were received. Surgeons frequently reported strenuous occupational activities and work–life imbalance, and one in six reported job dissatisfaction. Only 17% reported no pain; the one-month prevalence of pain ranged from 46% at the lower back to 12% at the ankle, and pain was frequently disruptive. Better work–life balance had a protective effect for pain (PRR = 0.92, 95% CI = 0.85–0.99), while risk of pain increased with increasingly physically demanding activities at work (PRR = 1.04, 95% CI = 1.01–1.07) in the age- and sex-adjusted models. Job dissatisfaction was associated with intention to retire early (PRR = 1.83, 95% CI = 1.02–3.27). Conclusions: This study demonstrated high physical and mental demands among surgeons and poor work–life balance. Physical and emotional links to pain were identified. Fit surgeons ensure safe patient care. Our findings suggest that surgeons were facing health issues and work–life conflict post-pandemic, potentially limiting their job satisfaction and career span. A follow-up study is recommended. Full article

Indonesia’s commitment to the early retirement of coal-fired power plants (CFPPs) underscores the urgent need to transition to renewable energy due to coal’s significant contribution to environmental degradation and rising CO₂ emissions. Despite this urgency, several challenges impede the widespread adoption of renewable energy, including disparities in energy access, inadequate policy implementation, unreliable government financing mechanisms, and lack of education and awareness, especially due to the current incorporation of hydrogen and nuclear energy. To overcome these barriers, a robust policy framework is essential, complemented by progressive policy enactment. This study examines Indonesia’s evolving energy landscape, highlighting key challenges and opportunities for the implementation of renewable energy. The findings emphasize that a comprehensive and integrated roadmap is critical to unlocking Indonesia’s renewable energy potential. The roadmap includes strengthening governance, fostering public–private collaborations, and securing diverse financing channels, while offering targeted incentives, such as tax breaks and financial benefits. Furthermore, conducting pre-feasibility studies and regional assessments for emerging energy sources, like hydrogen and nuclear power, is crucial to accurately evaluate potential risks and opportunities. By addressing gaps in regulatory framework and enforcing effective policy measures, Indonesia can facilitate public–private partnerships, promote technology transfer, and develop skilled workforce as an effort to transition into a sustainable and diversified energy future. Full article

The construction industry is currently facing several challenges, such as increased complexity, rapid technological development, and early retirements of experts. The involvement of knowledgeable contractors during early design will provide significant benefits, resulting in good-quality design and enhanced construction performance, particularly in specialized areas like electrical disciplines. In this study, the authors conducted a survey with 82 industry experts to identify the benefits, barriers, and key selection criteria of Early Electrical Contractor Involvement (EECI) in construction projects. The survey results indicate that the benefits of EECI outweigh the barriers. Cost savings emerged as the most significant benefit of EECI for most participants, while the requirement for a high level of cooperation and transparency was identified as the most challenging barrier. This study also revealed the discrepancies in the assessment of benefits and barriers of EECI based on the participant’s role. Additionally, collaboration and teamwork were identified as essential factors for the successful implementation of EECI. However, companies remain reluctant to change contracting methods, as they tend to adhere to familiar practices despite the potential advantages of EECI. This study validates the importance and effectiveness of EECI with regard to construction projects and contributes to the existing body of knowledge in early contractor involvement, electrical subcontracting, and design quality improvement. Furthermore, the outcome of this study provides industry practitioners with a better understanding of EECI and can also be used for education purposes. Full article

Bridges are typically designed by reputable, specialized engineering and design companies with years of experience. In these firms, experienced engineers share and pass on their knowledge to younger colleagues. However, when these experts retire, some of the knowledge is lost forever. As a subset of artificial intelligence methods, artificial neural networks (ANNs) can solve the problem of acquiring, transferring, and preserving specialized expert knowledge. This article describes the possible application of CAE ANN to acquire knowledge and to assist in the design of incrementally launched prestressed concrete bridges. Therefore, multidimensional graphs in the form of iso-curves of equal values were created, allowing practicing engineers to understand complex relationships between design parameters. The graphs also contain information about the reliability of the results, which is defined by an estimated parameter. The general rule is that results based on a larger number of actual data points are more reliable. Finally, an ANN BD assistant is proposed as an application that assists engineers and designers in the early stages of design and/or established engineers and designers in variant studies and design parameter optimization. Full article

This study examines the problem of choosing optimal consumption, investment, early retirement, and effort levels for an economic agent who is unwilling to reduce their consumption over time. The agent’s income depends on a fixed wage rate, and varies proportionally with their level of effort, which incurs disutility due to labor. By applying the dual-martingale method, we reformulate the problem into its dual form, dividing it into two distinct sub-problems: one focuses on selecting a consumption path that does not decrease, while the other determines the optimal timing for early retirement. Using this method, we find optimal strategies in the form of explicit closed-form solutions. Full article

The objective of this study was to determine the association between acute and chronic pain and various economic and quality-of-life outcomes. The study sample was drawn from the World Trade Center Health Registry. Both acute and chronic pain were measured in 2020–2021. Logistic regression models were constructed to determine the odds of several economic and quality-of-life variables: early retirement, low household income, decline in household income, quality of life, and not working due to health. Those who had extreme pain in the last four weeks that interfered with normal work had 3.12 (95% confidence interval (CI): 2.36, 4.39) times the odds of early retirement, 5.34 (95% CI: 3.47, 8.21) times the odds of having a household income below USD 50,000, 2.56 (95% CI: 1.51, 4.33) times the odds of having an income decrease, and 14.4 (95% CI: 11.3, 18.3) times the rate of poor health days compared to those with no pain. Similar results were found for chronic pain. The detrimental effects of pain may influence multiple facets of a patient’s life, and both financial and overall well-being may diminish even several years after a pain diagnosis. Full article

Background: Low back pain (LBP) is the leading cause of lost productivity, absenteeism, disability, and early retirement worldwide. LBP treatment should be comprehensive, including prevention, education, diagnosis, and various treatment methods. Management can be divided into pharmacological and non-pharmacological. The role of physiotherapy in the comprehensive treatment of LBP is very important. Elastic therapeutic tape, also called kinesiology tape or therapeutic kinesiology tape, has been used for about 50 years. Purpose: The aim of this study was to evaluate the effectiveness of Kinesio taping in patients suffering from (LBP), and its possible effect on the swing of the center of pressure (COP), balance, gait, improvement of coordination, and pain reduction. Methods: A total of 60 patients aged 20 to 83 years (54% women) were examined, all of whom fulfilled the requirements for admission and rejection. The L1–L5 spine of the experimental group underwent Kinesio taping in addition to thorough rehabilitation. The control group underwent balance control training based on visual feedback (VFB). The research tools used included the Bohannon single-leg standing test, the FAC (Functional Ambulatory Category) scale, the Podsiadlo and Richardson Standing and Walking Test called “Timed Up and Go” (TUG), evaluation of lumbar spine movement, Lasegue’s test and examination of neurological deficit symptoms, and self-assessment of pain using the Visual Analog Scale (VAS). Results: The effects of Kinesio taping on pain, gait, coordination, postural control, and balance are statistically significant. The main parameter influencing the effects of Kinesio taping was age (below 55 years); this relationship was also observed in the control group. Conclusions: Kinesio taping is an effective method in the treatment of LBP. It improves postural control, balance, gait, coordination, and pain. Full article

This study investigates the spatial patterns of residential migration among older adults in the city center of Yancheng and the influencing factors using data on the home purchases of individuals aged 65 and older from 2016 to 2018, along with peripheral point of interest (POI) data, analyzed with ArcGIS and a decision tree model. The results indicated that persons aged 60–65 accounted for 42.8% of the total sample and primarily chose to migrate in the early stages of retirement. The intra-city migration of older adults exhibits both centripetal and centrifugal patterns, with a greater tendency toward the city center. House prices, floor levels, and commercial facilities significantly impact their choice of migration destinations. Among these, house prices were the most critical determinant, with the majority of older adults migrating to neighborhoods with lower house prices. This study contributes by integrating residential migration and location choice research and constructing an analytical framework based on facility accessibility. The findings provide insights into the key determinants of location choice for intra-city residential migration among older adults and the construction of livable neighborhoods for them. Full article