Survivors of pediatric brain tumors are at high risk of late complications that may affect their daily life in both short- and long-term perspectives.
In this nationwide registry-based study we explored the occupational outcomes, including employment, sickness or activity compensation and parental leave, in 452 individuals in Sweden, born 1988-1996, and diagnosed with a brain tumor before their 15th birthday. Their results were compared with 2188 matched controls.
There were significant differences between cases and controls for all assessed variables. The cases had benefitted from sickness or activity compensation 11 times more often than controls (CI 7.90-15.83; p < 0.001) between 2005 and 2016. Controls were almost three times more likely to have an employment (OR 0.36; CI 0.28-0.47; p < 0.001) and nearly twice as likely to have been on parental leave (OR 0.56; CI 0.39-0.80; p = 0.002). Although cases treated for high-grade tumors typically fared worse than those treated for low-grade tumors, significant differences for all assessed variables were also observed for cases treated for a low-grade tumor compared with controls.
Our findings emphasize the need for follow-up programs for all brain tumor diagnoses, not only those known to be at most risk. This is evident, for example, from the high number of cases who received sickness or activity compensation.

Frontline healthcare workers (FHCWs) responding to the COVID-19 pandemic develop posttraumatic stress disorder (PTSD), major depressive disorder (MDD) and generalized anxiety disorder (GAD) symptoms. Such symptoms are associated with burnout, occupational and relational difficulties. In the current study, we examined the prospective association between acute transdiagnostic COVID-19-related PTSD, MDD, and GAD symptoms at pandemic outset, and burnout and functional difficulties several months later in FHCWs in New York City.
Wave 1 symptoms of COVID-19-related PTSD, MDD, and GAD, were assessed in 787 FHCWs from April 14 to May 11th, 2020. Burnout and occupational difficulties were assessed at wave 1 and wave 2, approximately 7 months later.
After adjusting for wave 1 burnout, wave 1 MDD symptoms, particularly sleep difficulties, loss of interest, and feeling tired/having little energy, collectively explained 42% incremental variance in this outcome. After adjusting for wave 1 work difficulties, MDD and PTSD symptoms, particularly feeling tired/having little energy, loss of interest, and negative expectations of self/world, collectively explained 42% incremental variance in this outcome. After adjusting for wave 1 relationship difficulties, MDD, GAD, and PTSD symptoms, particularly depressed mood, irritability, and appetite disturbance, explained 26% incremental variance in this outcome.
Results highlight psychiatric symptoms assessed during the acute phase of the COVID-19 pandemic that may help predict burnout and work and relationship difficulties in FHCWs. Early interventions aimed at ameliorating transdiagnostic symptoms of MDD, PTSD, and GAD may help mitigate risk for burnout and functional difficulties in this population.

Medical assistants\' (MAs) working conditions have been characterized as precarious, and workplace-related intervention needs have been identified. However, strategies to change the MAs adverse working conditions are mostly seen on an individual level, including leaving the employer or even the profession. Since such intentions are antecedents of actual turnover, we aimed to quantify the potential link of reported unmet intervention needs with unfavorable occupational outcomes. Data were collected by means of a nationwide survey among medical assistants (n = 994) in Germany (September 2016-April 2017). The three subscales working conditions, reward from the supervisor, and task-related independence were derived from a 12-item instrument regarding work-related interventions needs (the independent variables). We used subscale-specific z-scores and a total needs z-score. The four outcome variables (i.e., intention to leave the employer, intention to leave the MA profession, choosing MA profession again, and recommending MA profession to young people) were dichotomized, and logistic regression analyses were performed and limited to MAs in employment (n = 887). We found that increasing needs according to the categorized total needs score were associated with increasing odds of all occupational outcomes. Needs pertaining to working conditions and reward from the supervisor were the strongest determinants of MAs\' consideration of leaving their employer or profession (Odds ratios: 1.55-2.61). In summary, our study identified unmet work-related intervention needs that are associated with unfavorable occupational outcomes. In light of staffing shortage in health care, the identified needs should be addressed to ensure that sufficient recruitment of junior staff in the profession of medical assistants remains feasible and that experienced staff is retained.