Search Results (22)

Background/Objective: Historically, immunization programs have focused on infants, children, and women of reproductive age. COVID-19 vaccination prompted countries to vaccinate adults. The objective of this manuscript is to provide a global overview of adult immunization policies post COVID-19 pandemic. Methods: We summarized WHO Strategic Advisory Group of Experts on Immunization (SAGE) recommendations by adult group and analyzed the data reported in 2024 (2023) by WHO Member States (MS) via the WHO/UNICEF electronic Joint Reporting Form on Immunization (eJRF) on national immunization schedules, and from other sources by WHO region and income group. Results: WHO policy recommendations exist for most of the licensed vaccines targeting adults; however, the inclusion in national immunization schedules is higher in high-income (HICs) and middle-income (MICs) countries. For pregnant women, 90% of MS reported vaccination against COVID-19 (65% in low-income countries [LICs]), 63% against tetanus-containing vaccines (73% in LICs), 57% against influenza (4% in LICs), and 21% against pertussis-containing vaccines (all MICs and HICs). For health workers, 91% against COVID-19 (92% in LICs), 59% against influenza (4% in LICs), and 25% against hepatitis B (10% in LICs). For adults with chronic diseases, COVID-19 vaccination data were not available, 58% against influenza, and 23% against pneumococcal disease. For older adults, more than 90% of MS across all income groups reported COVID-19 vaccination, 59% against influenza (8% of LICs versus 89% of HICs), 17% against pneumococcal, and 7% against herpes zoster (HZ). Conclusion: The disparities in adult immunization policies across income groups highlight the need to improve access and strengthen vaccination efforts. A life course approach is essential to maximize the full potential of immunization across all ages. Full article

Introduction: Food insecurity is a vital issue, especially in places such as Kinshasa. Additionally, food insecurity has been worsened by the COVID-19 pandemic, particularly in low- and middle-income countries. Thus, this study examined food insecurity in Kinshasa after the peak of the pandemic to understand the impact of post-pandemic recovery efforts as well as the heterogeneity of this problem according to the residence of respondent (slum vs. non-slum areas). Methods: Grounded in the four key dimensions of food security (availability, access, vulnerability, and utilization), this cross-sectional study was conducted in Kinshasa with a representative sample of 2170 households selected from 62 enumeration areas. We used a questionnaire to interview participants about their food situations. Interviews were conducted with the head of each household or their designated representative by 150 master’s students using tablets powered by the SurveyCTO application. Household food security status was evaluated using the Household Food Insecurity Access Scale. A logistic regression model was developed to assess household risk factors associated with food insecurity. Results: Most people we talked to were over 40 years old, and many lived in households with fewer than six people. About a third of the households were overcrowded. The prevalence of food insecurity was 76.5% (95%CI: 74.6–78.3). Factors associated with food insecurity included being a household head aged over 50 years, insufficient living space, lower socioeconomic status, and residing in slum areas (AOR: 1.38; 95% CI: 1.06–1.79). Conclusions: Vulnerable groups, such as slum residents, older adults, and informal workers are more likely to be affected by food insecurity. Addressing these challenges requires the government to develop targeted strategies that bolster resilience and mitigate household vulnerability during crises. Full article

Against the backdrop of Healthy China and an aging population, there is an urgent need to explore the effect of the Healthy Cities Pilot Policy (HCPP) on residents’ labor supply. This study integrates the HCPP, residents’ health, and labor supply time into a unified analytical framework. Using data from the China Health and Retirement Longitudinal Study (CHARLS) spanning the period 2011–2020 and leveraging the quasi-natural experiment provided by China’s 2016 HCPP, we empirically investigate its effects on labor supply time among middle-aged and elderly workers. Our findings indicate: (1) HCPP increases average weekly working hours by 2.834 h in pilot cities. (2) HCPP significantly enhances residents’ health status in pilot cities, extending their healthy time. (3) Middle-aged and elderly workers allocate more of their extended healthy time to labor rather than leisure, potentially influenced by traditional Chinese perceptions of “ceaseless toil”. (4) The impact of HCPP on labor supply time exhibits group heterogeneity, with stronger promotion effects observed among vulnerable middle-aged and elderly groups characterized by older age, rural household registration, lower educational attainment, and lower income levels. This research offers insights for policymakers aiming to optimize health policies and promote sustainable development within Chinese society. Full article

Mild cognitive impairment (MCI) is when brain function declines. MCI is the gray area transitioning from normal aging to the AD stage. Currently, the majority of early MCI diagnoses are processed through comprehensive neuropsychological tests. These tests may take the form of interviews, paper-and-pencil tests, or computer-based tests. There may be resistance from the subject if he/she has to undergo many screening tests simultaneously for multiple evaluation information, resulting in execution difficulty. The objectives of this study are to use 3D virtual reality to create an entertaining test scenario integrating the Mini-Cog, SPMSQ, MMSE, SLUMS, CDR, and CASI for middle-aged to older adults, furthermore, to employ fuzzy logic control (FLC) technology to develop a “MCI assessment system” for obtaining some pilot information for MCI assessment. There were 24 middle-aged to older adults aged from 50 to 65 years who participated in the evaluation experiment. The results showed that the MCI assessment system developed in this study is highly correlated with the traditional screening tests, including the Mini-Cog, SPMSQ, MMSE, SLUMS, and CASI. The assessment system can provide an integrated reference score for clinic workers in making judgments. In addition, the distribution of the System Usability Scale (SUS) evaluation scores for the MCI assessment system revealed that 87.5% were grade C (good to use) or above and 29.2% were grade B (extremely good to use) or above. The assessment system received positive feedback from the subjects. Full article

In the face of labour-force ageing, understanding labour-market characteristics and the health status of middle-aged and older workers is important for sustainable social and economic development. Self-rated health (SRH) is a widely-used instrument to detect health problems and predict mortality. This study investigated labour-market characteristics that may have an impact on the SRH among Chinese middle-aged and older workers, using data from the national baseline wave of the China Health and Retirement Longitudinal Study. The analytical sample included 3864 individuals who at the time held at least one non-agricultural job. Fourteen labour-market characteristics were clearly defined and investigated. Multiple logistic regression models of the associations of each labour-market characteristic with SRH were estimated. Seven labour-market characteristics were associated with higher odds of poor SRH when controlled for age and sex. Employment status and earned income remained significantly associated with poor SRH, when controlling for all the sociodemographic factors and health behaviours. Doing unpaid work in family businesses is associated with 2.07 (95% CI, 1.51–2.84) times probability of poor SRH, compared with employed individuals. Compared with more affluent individuals (highest quintile of earned income), people in the fourth and fifth quintiles had 1.92 (95% CI, 1.29–2.86) times and 2.72 (95% CI, 1.83–4.02) times higher chance, respectively, of poor SRH. In addition, residence type and region were important confounders. Measures improving adverse working conditions should be taken to prevent future risk of impaired health among the Chinese middle-aged and older workforce. Full article

Background: The COVID-19 pandemic transformed healthcare delivery with the expansive use of telemedicine. However, health disparities may result from lower adoption of telehealth among African Americans. This study examined how under-resourced, older African Americans with chronic illnesses use telehealth, including related sociodemographic and COVID-19 factors. Methods: Using a cross-sectional design, 150 middle-aged and older African Americans were recruited from faith-based centers from March 2021 to August 2022. Data collected included sociodemographics, comorbidities, technological device ownership, internet usage, and attitudes toward COVID-19 disease and vaccination. Descriptive statistics and multivariable regression models were conducted to identify factors associated with telehealth use. Results: Of the 150 participants, 32% had not used telehealth since the COVID-19 pandemic, with 75% reporting no home internet access and 38% having no cellular/internet network on their mobile device. Age, access to a cellular network on a mobile device, and wireless internet at home were significantly associated with the utilization of telehealth care. Higher anxiety and stress with an increased perceived threat of COVID-19 and positive attitudes toward COVID-19 vaccination were associated with telehealth utilization. Discussion: Access and integration of telehealth services were highlighted as challenges for this population of African Americans. To reduce disparities, expansion of subsidized wireless internet access in marginalized communities is necessitated. Education outreach and training by healthcare systems and community health workers to improve uptake of telehealth currently and post-COVID-19 should be considered. Full article

The evaluation of knowledge, attitude, and practices towards an emerging disease is an essential component of public health preventive measures during an outbreak. In October 2022, an outbreak of cholera was reported in Lebanon, which is the first to be reported in the Middle Eastern country for 30 years. This study aimed to explore the level of knowledge as well as attitude and practice of the general public in Lebanon towards cholera. A self-administered structured questionnaire was distributed via an online link to individuals living in Lebanon during October–November 2022. The survey instrument comprised items to assess the sociodemographic data; questions on knowledge about cholera symptoms, transmission, and prevention; as well as attitude and practice questions. Our study involved 553 participants, with a median age of 24 years and a majority of females (72.5%). The results showed that the majority of respondents correctly identified diarrhea as a symptom of cholera and recognized the spread via contaminated water and food. Having a university level education compared with secondary school or less (adjusted odds ratio (aOR) = 2.09), being married compared with single (aOR = 1.67), and working in the medical field compared with unemployed (aOR = 4.19) were significantly associated with higher odds of having good cholera knowledge. Having good knowledge compared with having a poor level of cholera knowledge (aOR = 1.83) and older age (aOR = 1.03) were significantly associated with higher odds of having a good attitude towards cholera. The current study showed an overall high knowledge score on cholera among the Lebanese population. Nevertheless, gaps in cholera knowledge were identified and should be addressed, particularly among workers in the medical field. Thus, we recommend targeted health education to the general population that aims to strengthen the health resilience in the community. Full article

Breast cancer is the most common tumor in middle-aged and older women. In 2003, the European Parliament recommended to Member States that all women with breast cancer should be treated by a multidisciplinary team and that a network of certified breast centers be organized (the centers have been called Breast Units (BUs)). With the present study, we aim to explore the impact of the introduction of the BU organizational model in the Liguria region, Italy, through different outcome indicators. An explorative retrospective analysis was conducted through the period from 2013 to 2019 to assess the impact of the introduction of the BU model in our region. We identified two periods: before (2014–2015) and after (2017–2018) the introduction of this organizational model to assess its value impact through the definition of six measurable outcome indicators. Length of hospitalization, repeated specialist outpatient diagnostic procedures and the rate of subjects who started radiotherapy treatment within 60 days improved after the introduction of BUs. The passive health migration rate only improved significantly for one local health unit (LHU), while reintervention and diagnosis–surgery time did not show any enhancement after the introduction of the BU model. The BU model seems to provide an increase in several aspects of the healthcare offered to breast cancer patients in Liguria, specifically in those areas where a shared guideline could assist healthcare workers. Future research, such as pilot studies, are needed to assess the impact of the introduction of the BU model in our reality. Full article

Due to the aging workforce, older workers, especially in the healthcare industry, must remain employable. However, older healthcare workers may face age discrimination that can limit their employability chances. In this study, we examined (a) the causal direction of the relationship between age discrimination and internal employability and (b) differences between age groups (young (≤30), middle-aged (31–44), and older (≥45) healthcare workers) in this relationship. Based on the Selection Optimization Compensation theory, we postulated that (i,ii) internal employability and age discrimination are inversely negatively related to one another over time and that (ii–iv) this relationship would be strongest for older employees compared to other age groups. We conducted a two-wave complete panel study among 1478 healthcare professionals to test these hypotheses. The results of our multi-group structural equation modeling analyses suggested that internal employability is a significant negative predictor of age discrimination. Moreover, results suggested that internal employability and age discrimination have a reciprocal relationship among older workers but are unrelated for younger and middle-aged workers. Theoretical and practical implications of our results are discussed. Full article

Changes in the regularity of working hours affect the cognitive function of middle-aged workers. This study investigated the association between alterations in the regularity of working hours and cognitive impairment in middle-aged and elderly Korean workers. The data from the Korean Longitudinal Study of Aging were analyzed and cognitive function was evaluated using the Korean version of the mini–mental state examination. A score of <23 points was defined as cognitive impairment. The effect of changes in the regularity of working hours on cognitive impairment development was assessed using the generalized estimating equation model. Compared with regular working hours group, the odds ratios (ORs; 95% confidence interval) of the “consistently irregular”, “regular to irregular”, and “irregular to regular” groups were 1.56 (1.30–1.88), 1.46 (1.20–1.77), and 1.24 (1.01–1.53), respectively. The risk of cognitive deterioration was found in the “consistently irregular” group. However, only workers with normal working hours in the “regular to irregular” group had a significant risk of cognitive deterioration (1.51 (1.21–1.89)). Altered working hours were associated with cognitive impairment in middle-aged and older workers. The study emphasizes the need to implement a standard work schedule that is suitable for middle-aged workers. Full article

Infection with COVID-19 could result in lockdown, quarantine of contacts, absenteeism from work, and temporary productivity loss. This research aims to calculate (1) how the pandemic affects on-the-job probability and earnings for the working population, and (2) how much productivity loss is associated with self or a family member sick with COVID-19. Based on data collected from the U.S Research and Development Survey (RANDS), this research projects the relationship between on-the-job possibility and age of the index group and calculates the employment possibilities of the index group relative to the healthy group, namely the employment ratio. The weekly loss of productivity, presented by earnings, associated with COVID-19 for groups aged 18–44 years and 45–64 years was calculated, since the 18- to 64-year-old population is an economy’s active workforce. Analytical results indicate that the older the age group, the lower the on-the-job possibility, and the higher the weekly productivity loss due to self or a family member being sick from COVID-19. For the group aged 45–64 years, the employment ratio of the index group relative to the healthy group dropped from 0.863 to 0.39, corresponding to a weekly productivity loss of 136–590 US dollars. The overall impact would be about a 9% loss in GDP. Infected or quarantined people would be confined to working in relatively isolated offices or places to allow for social distancing. Proactive health promotion in the workplace plus reactive work through telecommunication systems would reduce such losses. Such preparedness needs to be implemented early for more vulnerable workers who are of middle or old age and/or those comorbid with diabetes. Full article

Coronavirus disease 2019 (COVID-19) is a newly emerging infectious disease, and risk communication is one of several public health emergency responses. During the pandemic, many migrant workers in Thailand experienced barriers that hamper access to health information. This study aims to explore factors related to the outcomes of health risk communication, including awareness of public health measures and preventive practices. We conducted a cross-sectional survey on migrants between January and April 2021 using cluster sampling in Phuket, Ranong, and Samut Sakhon. In the descriptive analysis, we presented the median, proportion, and ratio, while in the inferential analysis, we employed a logistic regression with robust standard errors. Although a total of 303 participants were initially included in this study, the final number was narrowed down to 288 samples due to insufficient information required for the analysis. Frequent reception of health information and primary school education showed a statistically significant association with preventive practices. Middle-aged migrant workers demonstrated a significantly lower level of preventive practices than younger migrant workers. A longer stay in Thailand was significantly related to a lower degree of awareness toward public health measures. Thus, it is necessary to promote the accessibility of health information among migrant workers in Thailand, especially those who have lived in Thailand for more than eight years, are older, and have no formal education. Full article

Global agriculture is facing an aging workforce and successor crisis, while the degradation of rural youths’ agricultural skills, which is indeed a concrete manifestation of young agricultural labor loss, has received little attention. Based on data from 1902 questionnaires in rural Southwest China, this study draws on a qualitative and quantitative analysis of the degradation of their skills to deepen the insights into the relationship between rural youth and agriculture. We found that rural youth have much lower agricultural skills than rural middle-aged and elderly residents, and their agricultural skills vary depending on gender, age, and occupation. Rural young non-agricultural workers’ large proportion among rural youth and low skills are the main sources of the reduction in rural youths’ skills. According to ordered logistic regression analysis, rural young non-agricultural workers who are older, have less education per person in their household, and have a larger cultivated land size have higher skills. As for rural students, 65.44% of the rural students have no skills, age and family’s agricultural income are significant positive influencing factors of their agricultural skills, and female youth have higher agricultural skills. The results provide references for policymakers to formulate targeted policies to cultivate rural young agricultural successors. Full article

This study aimed to elucidate how career adaptability (CA) affects subjective well-being by focusing on the psychological adjustment of middle-aged and older workers. Two web-based surveys were conducted at 1-year and 3-month intervals with 3540 workers aged 40 to 64 years, including those eligible for both position-retirement and reemployment. Factor analysis of CA in the first wave extracted two factors “control and confidence” and “concern and curiosity”. Multiple regression analysis, adjusted for important covariates, was conducted with the overall CA and the two factors of CA as the independent variables, and scores of the Satisfaction with Life Scale (SWLS) as the dependent variable. For satisfaction with life, only concern and curiosity had a significant positive association, while control and confidence had no significant association. Analysis by employment stage indicated that only concern and curiosity had a significant positive association with satisfaction with life, while control and confidence had no significant association with any employment stage. The results suggest that the effect of CA on satisfaction with life remains the same, even among those who are position-retired or reemployed at the end of their vocational lives, which is a transition period in their lives. Full article

The aim of the study was twofold: (a) to examine the way in which professional social workers perceive and apply in their practice the concept of empathy; (b) to explore sociodemographic factors, education/special training and work characteristics associated with their empathic skills. This is a cross-sectional study with a purposive sample of 203 Greek social workers. For the assessment of empathy, the Empathy Scale for Social Workers (ESSW) was used. The sample consisted mainly of female social workers with a mean age of 43.8 years. More than 70% of them were practicing the profession for more than 10 years. Nearly one-third participated in psychotherapy courses, and only half of them have been certified. On average, they reported high levels of empathy. Initial univariate analyses showed that empathy scores were significantly higher for older social workers, married, the more experienced, those who referred to working experience with disabled people or people having problems with substance use and the professionals who had obtained a certification in psychotherapy. ‘Having a middle work experience of 10–19 years’ was a significant correlate in all scales and related negatively to empathy indicating a burnout effect. The implications for social work education and future training are discussed. Full article