A Multi-state model for the analysis of functional decline and mortality of frail elderly patients

L’objectiu d’aquest estudi, que correspon a un projecte de recerca sobre la pèrdua funcional i la mortalitat de persones grans fràgils, és construir un procés de supervivència predictiu que tingui en compte l’evolució funcional i nutricional dels pacients al llarg del temps. En aquest estudi ens enfrontem a l’anàlisi de dades de supervivència i mesures repetides però els mètodes estadístics habituals per al tractament conjunt d’aquest tipus de dades no són apropiats en aquest cas. Com a alternativa utilitzem els models de supervivència multi-estats per avaluar l’associació entre mortalitat i recuperació, o no, dels nivells funcionals i nutricionals considerats normals. Després d’estimar el model i d’identificar els factors pronòstics de mortalitat és possible obtenir un procés predictiu que permet fer prediccions de la supervivència dels pacients en funció de la seva història concreta fins a un determinat moment. Això permet realitzar un pronòstic més precís de cada grup de pacients, la qual cosa pot ser molt útil per als professionals sanitaris a l’hora de prendre decisions clíniques.

The Impact of prevention measures and organisational factors on occupational injuries

This paper analyses the impact of a series of managerial and organisational factors on occupational injuries. These consist of occupational safety measures, as regards both the intensity and the orientation of risk prevention in companies, and the adoption of certain work organisation practices, quality management and the use of flexible production technologies. We estimate a negative binomial regression based on a sample of 213 Spanish industrial establishments, defining a constant random parameter to take account of non-observable heterogeneity. Our results show that occupational safety measures, the intensive use of quality management tools and the empowerment of workers all help to reduce the number of injuries. We have also confirmed the presence of synergies between the organisational factors analysed and the development of an occupational safety strategy featuring participation and the extension of prevention to all levels of the organisation.

Old age mortality: a state of the art

This Phd research report aims to obtain a better understanding of the recent changes in mortality of the elderly population in developed countries. It’s essence will be a critical thinking, without performing empirical work, which means that the analysis and concepts of the actual demographic literature will form the main body of this work. There are two central questions: Which age and cause specific mortality trends caused these recent changes in the life expectancy?Did the increase in life expectancy of the elderly population accelerate, continue or decline in recent years?”

Health intervention and decline in infant mortality rates. Milk depots in Spain (1900-1936)

The role of public health has been a central topic on the classical debate about the historical mortality decline in Europe. One of these health initiatives were the Milk Depots. Spain set up those centres from the late 19th century until the beginning of the Civil War. The goal of this paper is to evaluate the effect of this health intervention on the infant mortality decline during this period. This study works out three kinds of sources: Statistical Yearbooks, Official documents and local records produced by the same Milk Depot. It analyses data available for all the country and one local case such as the Barcelona’s Milk Depot (1904-1935). The main methodological issue deals with the measurement of the effect of the Milk Depot activities on the pattern of changes of infant mortality. Results suggest that Milk Depots have a positive but quite moderate effect on the improving of overall levels of child survival.

Girls like pink: explaining sex-typed occupational aspirations amongst young children

There is a high degree of sex-typing in young children's occupational aspirations and this has consequences for subsequent occupational segregation. Sociologists typically attribute early sex-differences in occupational preferences to gender socialization. Yet we still know surprisingly little about the mechanisms involved in the intergenerational transmission of sex-typical preferences and there is considerable theoretical controversy regarding the role of individual agency in the process of preference formation. This study analyzes the determinants of sex-typed occupational aspirations amongst British children aged between 11 and 15. We specify different mechanisms involved in the transmission of sex-typical preferences and propose an innovative definition of individual agency that is anchored in observable psychological traits linked to self-direction. This allows us to perform a simultaneous test of socialization and agency predictors of occupational sex-typing. We find that parental influences on occupational preferences operate mainly through three distinctive channels: 1) the effect that parental socio-economic resources have on the scope of children's occupational aspirations, 2) children's direct imitation of parental occupations, and 3) children's learning of sex-typed roles via the observation of parental behavior. We also find a strong net effect of children's own psychological predispositions -self-esteem in particular- on the incidence of sex-typical occupational preferences. Yet large differences in the occupational aspirations of girls and boys remain unexplained.

Seeds of hope: Assessing the effect of development aid on the reduction of child mortality

The Millennium Declaration (2000) set as one of its targets a substantial reduction in child mortality. This paper studies whether the massive increase in development aid can account for part of the reduction in child mortality observed in developing countries since the year 2000. To do so, we analyze a panel of more than 130 developing countries over the 2000-2008 period. We use the time trend evolution of aid to identify an exogenous source of variation. Total aid has had no statistically significant effect on child mortality. However, a disaggregate analysis identifies certain sectors of aid that have had a significant impact. The effects have been larger in high mortality countries, including Sub-Saharan Africa. Projections based on our estimates strongly support the concern that most countries in that region will miss the Millennium Goals target on child mortality.

Relation between temperature and mortality in thirteen Spanish cities

In this study we examined the shape of the association between temperature and mortality in 13 Spanish cities representing a wide range of climatic and socio demographic conditions. The temperature value linked with minimum mortality (MMT) and the slopes before and after the turning point (MMT) were calculated. Most cities showed a V-shaped temperature-mortality relationship. MMTs were generally higher in cities with warmer climates. Cold and heat effects also depended on climate: effects were greater in hotter cities but lesser in cities with higher variability. The effect of heat was greater than the effect of cold. The effect of cold and MMT was, in general, greater for cardio-respiratory mortality than for total mortality, while the effect of heat was, in general, greater among the elderly

Measuring the child mortality impact of official aid for fighting infectious diseases, 2000-2010

Aid for fighting infectious and parasitic diseases has had a statistically significant role in the under-five mortality reduction in the last decade. Point estimates indicate a country average reduction of 1.4 deaths per thousand under fives live-born attributable to aid at its average level in 2000-2010. The effect would be an average drop of 3.3 in the under-five mortality rate at the aid levels of 2010. By components, a dollar per capita spent in fighting malaria has caused the largest average impact, statistically higher than a dollar per capita spent in STD/HIV control. We do not find statistically significant effects of other infectious disease aid, including aid for the control of tuberculosis.

(Endogenous) occupational choices and job satisfaction among recent PhD recipients: evidence from Catalonia

Drawing on data from two successive cohorts of PhD graduates, this paper analyses differences in overall job satisfaction and specific job domain satisfaction among PhDs employed in different sectors four years after completing their doctorate degrees. Covariate-adjusted job satisfaction differentials suggest that, compared to faculty members, PhD holders employed outside traditional academic and research jobs are more satisfied with the pecuniary facets of their work (principally, because of higher earnings), but significantly less satisfied with the content of their job and with how well the job matches their skills (and, in the case of public sector workers, with their prospects of promotion). The evidence regarding the overall job satisfaction of the PhD holders indicates that working in the public or private sectors is associated with less work well-being, which cannot be fully compensated by the better pecuniary facets of the job. It also appears that being employed in academia or in research centres provides almost the same perceived degree of satisfaction with the job and with its four specific domains. We also take into account the endogenous sorting of PhD holders into different occupations based on latent personal traits that might be related to job satisfaction. The selectivity-corrected job satisfaction differentials reveal the importance of self-selection based on unobservable traits, and confirm the existence of a certain penalisation for working in occupations other than academia or research, which is especially marked in the case of satisfaction with job content and job-skills match. The paper presents additional interesting evidence about the determinants of occupational choice among PhD holders, highlighting the relevance of certain academic attributes (especially PhD funding and pre-and-post-doc research mobility) in affecting the likelihood of being employed in academia, in a research centre or in other public or private sector job four years after completing their doctorate programme.

Exploring the conditions for a mortality crisis: bringing context back into the debate

This study engages with the debate over the mortality crises in the former Soviet Union and Central and Eastern Europe by 1) considering at length and as complementary to each other the two most prominent explanations for the post-communist mortality crisis, stress and alcohol consumption; 2) emphasizing the importance of context by exploiting systematic similarities and differences across the region. Differential mortality trajectories reveal three country groups that cluster both spatially and in terms of economic transition experiences. The first group are the countries furthest west in which mortality rates increased minimally after the transition began. The second group experienced a severe increase in mortality rates in the early 1990s, but recovered previous levels within a few years. These countries are located peripherally to Russia and its nearest neighbours. The final group consists of countries that experienced two mortality increases or in which mortality levels had not recovered to pre-transition levels well into the 21st century. Cross-sectional time-series data analyses of men’s and women’s age and cause-specific death rates reveal that the clustering of these countries and their mortality trajectories can be partially explained by the economic context, which is argued to be linked to stress and alcohol consumption. Above and beyond many basic differences in the country groups that are held constant—including geographically and historically shared cultural, lifestyle and social characteristics—poor economic conditions account for a remarkably consistent share of excess age-specific and cause-specific deaths.

Economic crisis and recovery: changes in second birth rates within occupational classes and educational groups

This study assesses the decline in second birth rates for men and women across different skill levels in transitional Russia. Changes within educational groups and occupational classes are observed over three distinct time periods: the Soviet era, economic crisis, and economic recovery. The most remarkable finding is the similarity in the extent second birth rates declined within educational groups and occupational classes during the economic crisis. Although further decline occurred in the recovery period, more variation emerged across groups.

Occupational choice and development

The rise in world trade since 1970 has been accompanied by a rise in the geographic span of control of management and, hence, also a rise in the e ective international mobility of labor services. We study the e ect of such a globalization of the world's labor markets. The world's welfare gains depend positively on the skill-heterogeneity of the world's labor force. We nd that when peoplecan choose between wage work and managerial work, the worldwide labor market raises output by more in the rich and the poor countries, and by less in the middle-income countries. This is because the middle-income countries experience the smallest change in the factor-price ratio, and where the option to choose between wage work and managerial work has the least value in the integratedeconomy. Our theory also establishes that after economic integration, the high skill countries see a disproportionate increase in managerial occupations. Using aggregate data on GDP, openness and occupations from 115 countries, we find evidence for these patterns of occupational choice.

The Effect of occupational sex-composition on earnings: job-specialisation, sex-role attitudes and the division of domestic-labour in Spain

Important theoretical controversies remain unresolved in the literatire on occupational sex-segregation and the gender wage-gap. A useful way of summarising these controversies is viewing them as a debate between - cultural -socialisation. The paper discusses these theories in detail and carries out a preliminary test of the relative explanatory performance of some of their most consequential predictions. This is done by drawing on the Spanish sample of the second wave of the European Social Survey, ESS. The empirical analysis of ESS data illustrates the notable analytical pay-offs that can stem from using rich individual-level indicators, but also exemplifies the statistical llimitations generated by small sample size and high rates of non-response. Empirical results should, therefore, be taken as preliminary. They seem to suggest that the effect of occupational sex-segregation on wages could be explicable by workers' sex-role attitutes, their relative input in domestic production and the job-specific human capital requirements of their jobs. Of these three factors, job-specialisation seeems clearly the most important one.

Upgrading or polarization? occupational change in Britain, Germany, Spain and Switzerland, 1990-2008

This paper analyzes the pattern of occupational change in four Western European countries over the last two decades: what kind of jobs have been expanding -- high-paid jobs, low-paid jobs or both? By addressing this issue, we also examine what theoretical account is consistent with the observed pattern of change: skill-biased technical change, skill supply evolution or wage-setting institutions? Our empirical findings show a picture of massive occupational upgrading that closely matches educational expansion. In all four countries, by far the strongest employment growth occurred at the top of the occupational hierarchy, among managers and professionals. Yet in parallel, in Britain and Switzerland, as well as in Germany and Spain after 1996 and 2002 respectively, relative employment declined more strongly in the middling occupations (among clerks and production workers) than at the bottom (among interpersonal service workers). This slightly polarized pattern of occupational upgrading is consistent with the "routinization" hypothesis that technology is a better substitute for average-paid jobs in production and the office that for low-paid jobs in interpersonal services. However, we find large cross-country differences in the employment evolution at the bottom of the occupational hierarchy, among low-paid services workers: sizeable growth in Britain and Spain, but stagnation in Germany and Switzerland. This results points towards the possibility that wage-setting institutions filter the pattern of occupational change.

Occupational sex-composition and earnings : individual and social effects

This paper investigates the micro and macro-level factors affecting the empirical association between occupational sex-composition and individual earnings. This is done in two analytical steps using data from the second round of the European Social Survey. In a first step, country-fixed-effects regressions are used to test the extent to which job-specialization, gender attitudes and the relative supply of domestic work can account for the impact of occupational sex-composition on earnings. In accordance with previous research, it is found that all these micro-level variables have a significant effect on the analyzed association, yet only job-specialization can explain it away by itself. In a second analytical step, macro-level interactions are tested under the hypothesis that defamilialization policies reduce the pay-offs of sphere specialization by sex, generating incentives for all types of women to invest in the labor market. Empirical results suggest that gender attitudes and the relative supply of housework are much more loosely associated to earning in social-democratic and former communist societies than in conservative or liberal regimes. This finding is interpreted as consistent with the defamilialization hypothesis.