UNASSIGNED: Chagas disease is a neglected tropical disease with a chronic clinical course and high rates of morbidity and mortality. Despite a drastic reduction in the disease\'s incidence in Brazil in recent decades, older cases still impact the national social welfare system.
UNASSIGNED: To analyze the sociodemographic characteristics of Brazilian social welfare beneficiaries affected by the cardiac and digestive forms of chronic Chagas disease between 2004 and 2016.
UNASSIGNED: This cross-sectional study was based on data from the Brazilian Ministry of Labor and Social Security. Crude and adjusted odds ratios were estimated using logistic regression.
UNASSIGNED: Benefits were granted to 25,085 affected individuals, mostly men (15,812; 63%) with the cardiac form (20,424; 81.4%) who resided in urban areas (16,051; 64%). The highest relative frequency of benefits were granted in the Midwest macroregion (31.1/100,000 inhabitants). Male sex (odds ratios = 1.2; 95% CI 1.1-1.2), age 30-49 years (odds ratios = 1.8; 95% CI 1.4-2.1), residence in rural areas (odds ratios = 1.6; 95% CI 1.5-1.7) or the Southeast macroregion (odds ratios = 2.9; 95% CI 2.4-3.4) had the highest association with the cardiac form. Individuals with the cardiac form had a higher median age at disease onset (45 years; p < 0.001) but a lower age at work disability onset (50 years; p = 0.01).
UNASSIGNED: The impact of Chagas disease on Brazilian social welfare is mainly due to chronic Chagas cardiomyopathy, which was mainly associated with men in their productive years who live in rural areas in Southeastern Brazil.
UNASSIGNED: A doença de Chagas é uma doença tropical negligenciada, de evolução crônica e com elevada morbimortalidade. Apesar da drástica redução na incidência da doença nas últimas décadas no Brasil, casos infectados no passado ainda impactam o sistema de seguridade social brasileiro.
UNASSIGNED: Analisar as características sociodemográficas de beneficiários da seguridade social brasileira acometidos pela doença de Chagas crônica nas formas clínicas cardíaca e digestiva no período de 2004 a 2016.
UNASSIGNED: Estudo transversal com dados do Ministério do Trabalho e Previdência Social brasileiro. Empregou-se regressão logística para estimar odds ratio brutas e ajustadas.
UNASSIGNED: Houve concessão de 25.085 benefícios, a maioria relacionada à forma cardíaca da doença de Chagas (20.424; 81,4%), ao sexo masculino (15.812; 63%) e residentes em áreas urbanas (16.051; 64%). A macrorregião Centro-Oeste apresentou maior frequência relativa de benefícios (31,1/100.000 habitantes). Sexo masculino (odds ratio = 1,2; IC95% 1,1-1,2), faixa etária entre 30 e 49 anos (odds ratio = 1,8; IC95% 1,4-2,1), residência em áreas rurais (odds ratio = 1,6; IC95% 1,5-1,7) ou na macrorregião Sudeste (odds ratio = 2,9; IC95% 2,4-3,4) foram as categorias das variáveis mais associadas à forma cardíaca. Indivíduos com a forma cardíaca apresentaram idade mediana maior no início da doença (45 anos; p < 0,001), porém menor no início da incapacidade laboral (50 anos; p = 0,01).
UNASSIGNED: O impacto da doença de Chagas na seguridade social brasileira decorre principalmente por causa da cardiomiopatia chagásica crônica. Essa forma clínica esteve associada principalmente a pessoas do sexo masculino, em idade produtiva importante, residentes em áreas rurais e da macrorregião Sudeste do Brasil.

Economic welfare is essential in the modern economy since it directly reflects the standard of living, distribution of resources, and general social satisfaction, which influences individual and social well-being. This study aims to explore the relationship between national income accounting different attributes and the economic welfare in Pakistan. However, this study used data from 1950 to 2022, and data was downloaded from the World Bank data portal. Regression analysis is used to investigate the relationship between them and is very effective in measuring the relationship between endogenous and exogenous variables. Moreover, generalized methods of movement (GMM) are used as the robustness of the regression. Our results show that foreign direct investment outflow, Gross domestic product growth rate, GDP per capita, higher Interest, market capitalization, and population growth have a significant negative on the unemployment rate, indicating the rise in these factors leads to a decrease in the employment rate in Pakistan. Trade and savings have a significant positive impact on the unemployment rate, indicating the rise in these factors leads to an increase in the unemployment rate for various reasons. Moreover, all the factors of national income accounting have a significant positive relationship with life expectancy, indicating that an increase in these factors leads to an increase in economic welfare and life expectancy due to better health facilities, many resources, and correct economic policies. However, foreign direct investment, inflation rate, lending interest rate, and population growth have significant positive effects on age dependency, indicating these factors increase the age dependency. Moreover, GDP growth and GDP per capita negatively impact age dependency. Similarly, all the national income accounting factors have a significant negative relationship with legal rights that leads to decreased legal rights. Moreover, due to better health facilities and health planning, there is a negative significant relationship between national income accounting attributes and motility rate among children. Our study advocated the implications for the policymakers and the government to make policies for the welfare and increase the social factors.

Increased concern was raised globally at the outbreak of COVID-19 that victims of domestic violence would be even more at risk when isolated with a violent partner and out of reach of support due to restrictions. Swedish staff in violence against women services prepared for increased calls for help. Instead, a worrying silence arose in a time and place of high uncertainty. This article analyzes the narratology of risk, when staff members in violence against women services, reflect upon their accounts, responses, and experiences, during the pandemic. The analysis is based on three themes, accounting for expected increased influx, making sense of silence and accounting for mobilization. The findings are discussed by applying the relational theory of risk.

Suggesting there is an emerging and important focus on social welfare in inquests into death, this article argues that there is value for both social welfare and inquest scholarship in examination of links between the two. Emphasising the process of investigation, it aims to introduce the inquest to social welfare scholars, and proposes an agenda for research. The discussion examines a range of inquests in which questions of social welfare (understood broadly) were examined, including inquests into the death of Jackie Maguire in a care home (see R (Maguire) v. HM Senior Coroner for Blackpool & Fylde [2023] UKSC 20), the death of Jodey Whiting after her welfare benefits were stopped (in a case brought by her mother, Joy Dove, see Dove v. HM Assistant Coroner for Teesside and Hartlepool [2023] EWCA Civ 289), the death of Awaab Ishak due to mould in his housing association home, and the death of Ella Kissi-Debra which suggested a link between traffic, air pollution and asthma, as well as other cases, including the inquest into the death of Molly Russell which focused on the role of social media.

UNASSIGNED: Relieving the total pain of patients with cancer and supporting their well-being throughout their lives are important roles of palliative and supportive care. Poverty may inhibit patients from receiving dignified end-of-life care; however, using social welfare services may reduce its impact on patients\' end-of-life experiences. Nevertheless, no study has investigated which social welfare service could lead to favorable end-of-life experiences for patients living in poverty.
UNASSIGNED: This study aimed to describe the characteristics of users of palliative care among low-income patients and examine the difference in survival time among patients with cancer on social welfare services in a single center in Kyoto, Japan.
UNASSIGNED: We conducted a retrospective cohort study.
UNASSIGNED: We included 220 patients using Public Assistance (PA: aid minimum income and medical/long-term care), Free/Low-Cost Medical Care (FLCMC: aid only medical care), and nonwelfare-users who newly received palliative care in 2021.
UNASSIGNED: We calculated patients\' survival time from the initiation of palliative care to death. In addition, we identified patients who experienced home death.
UNASSIGNED: Compared with nonusers, FLCMC beneficiaries had shorter survival times (adjusted hazard ratio [aHR] 2.05, 95% confidence interval [CI] 0.80-5.22). No difference was observed among PA beneficiaries (aHR 1.19, 95% CI 0.49-2.87). No home death was observed among welfare service recipients.
UNASSIGNED: Social welfare benefits only for medical expenses may not sufficiently support dignified end-of-life care for low-income patients. Further studies are required to examine the robustness of this study considering various bio-psycho-social factors that can influence these findings, to support low-income patients with cancer on social welfare services.

UNASSIGNED: The digital finance era has reshaped young people\'s lifestyles, risk perceptions and insurance participation decisions. Modern youth have to constantly seek for rational social security support and construct individual protection barriers to adapt to new lifestyles and social structures. China\'s multi-tiered, universal health insurance system is urgently needed to satisfy young people\'s flexible needs and rational decision-making.
UNASSIGNED: Based on the micro data from 2011 ~ 2021 Chinese General Social Survey (CGSS), this paper uses macro data from Digital Inclusive Finance Index (DIFI) matching to construct probit and m-logit model to assess the impact of the development of digital finance on Chinese youth whether or not to participate in health insurance, and how they choose the concrete type of health insurance.
UNASSIGNED: (1) Baseline regression results shows that digital finance has a significant positive effect on Chinese youth\'s health insurance participation decisions, and has different effects on choices within health insurance types. Strong support for the conclusions is provided by endogeneity and robustness tests. (2) The results of the heterogeneity analysis reveal that the marginal effect of digital finance on young people\'s health insurance decisions shows urban-rural differences, divergence in levels of self-rated health. (3) The mechanism analysis results suggest that there are two mechanism paths of digital finance on youth health insurance decisions: the household income effect and the subjective well-being effect, and two moderating effects: employment type and family structure.
UNASSIGNED: Highlighting the positive value that digital finance brings to the perception of youth insurance participation and the construction of social security systems, it needs to pay close attention to the dynamic changes in employment security and family structure through data, and explore the socio-psychological fluctuation and demand for social security among modern youth. To provide a way forward to achieve the integration of the health insurance system in China and solve the current problem of health insurance equity.

In 2021, there were 11.7 million licensed young drivers in the U.S. This is 1.5 million fewer young drivers compared to 2007. The phenomenon of delay in driving licensure among teens has notable implications for opportunities positioning them for life success when transitioning into emerging adulthood and in later life.

Relations among democracy, citizenship and health have shaped the Unified Health System (SUS) over the past four decades. Until 2016, democracy was strengthened and social rights extended, despite structural difficulties, conflicts between projects, and unevenly over time. The SUS has allowed advances in access and improvements to health conditions. Between 2016 and 2022, there were significant reversals in economic, social, and health policies. Since 2020, the situation has been aggravated by the multidimensional crisis associated with the COVID-19 pandemic. The work of the SUS, universities and public scientific institutions was fundamental in tackling the crisis. From 2023 onwards, Brazil has faced enormous challenges in restoring a democratic national project focused on social welfare. Strengthening the SUS depends on the character of social policies and democracy, and on transforming relations among State, market and society, to overcome constraints that have persisted even during progressive governments. The SUS, a universal policy rooted in a broad concept of health and democratic values, is fundamental to establishing a pattern of development aimed at reducing inequalities and building a more just society.
As relações entre democracia, cidadania e saúde permearam a conformação e a trajetória do Sistema Único de Saúde (SUS) nas últimas quatro décadas. Em que pesem dificuldades estruturais, conflitos entre projetos e diferenças entre momentos, até 2016 observou-se o fortalecimento da democracia e a expansão de direitos sociais. O SUS permitiu avanços no acesso e melhorias nas condições de saúde. Entre 2016 e 2022, os retrocessos nas políticas econômicas, sociais e de saúde foram expressivos. A situação foi agravada pela crise multidimensional associada à pandemia de COVID-19 a partir de 2020. A atuação do SUS, de universidades e de instituições científicas públicas foi fundamental para o enfrentamento da crise. A partir de 2023, os desafios de retomada de um projeto nacional democrático e voltado ao bem-estar social são imensos. O fortalecimento do SUS depende do caráter das políticas sociais e da democracia, e de transformações nas relações Estado-mercados-sociedade, para superar limites que persistiram mesmo durante governos progressistas. O SUS, como política universal ancorada em uma concepção ampla de saúde e em valores democráticos, é um pilar fundamental para a consolidação de um padrão de desenvolvimento orientado para a redução das desigualdades e a construção de uma sociedade mais justa.

OBJECTIVE: This study assessed the effectiveness of Individual Placement and Support (IPS), Participatory Workplace Intervention (PWI), and IPS + PWI on work participation and health of people with work disabilities.
METHODS: A randomised controlled 2 × 2 factorial trial with 120 clients and an 18-month follow-up was performed. Differences between IPS and no-IPS and between PWI and no-PWI were assessed using log-rank tests and Cox proportional hazards models.
RESULTS: In the IPS group, restricted mean survival time (RMST) for sustainable paid employment was 352 days, compared to 394 in the no-IPS group (HR = 1.47, 95% CI = 0.81-2.63). In the PWI group the RMST was 378 days, compared to 367 in the no-PWI group (HR = 0.89, 95% CI = 0.48-1.64). For the secondary outcome \'starting any paid employment, a trial placement, or education\' RMST was significantly lower for the IPS group (222 days) than for the no-IPS group (335 days; HR = 1.85, 95% CI = 1.01-3.42). Mental health was significantly lower (worse) in the PWI group (difference -4.07, 95% CI = -7.93 to -0.22) than in the no-PWI group. For all other secondary outcomes, no statistically significant differences were found.
CONCLUSIONS: No statistically significant differences were observed in the duration until starting sustainable employment between IPS and no-IPS, and between PWI and no-PWI. The duration until starting any paid employment, a trial placement, or education was shorter in the IPS group than in the no-IPS group, but further research should explore whether this also increases sustainable employment in the longer term.

OBJECTIVE: This study is a process evaluation of the use of Individual Placement and Support (IPS) and Participatory Workplace Intervention (PWI) to increase the work participation of people with work disabilities. We ran the evaluation alongside a randomized controlled trial (RCT), to investigate whether and to what extent IPS and PWI were executed according to protocol.
METHODS: The study population consisted of clients with work disabilities, and their job coaches who were employed by the municipality of a large city in the Netherlands. Data were collected between September 2019 and November 2022 using registration forms, accompanied by researchers\' notes and logbooks.
RESULTS: For IPS the dose delivered was reasonable and the IPS fidelity measurement score was fair. The job search focused on paid work for almost all clients and was based on their wishes as indicated in the protocol, but integration of employment services with (health) care was often lacking. A minority of the clients who were assigned to PWI received the intervention, often because the client did not start work within the follow-up period and a workplace was a requirement to apply the intervention.
CONCLUSIONS: The results of this study show that IPS was executed reasonably and with a fair fidelity, which indicated implementation was sufficient to find an effect on work participation in the RCT. PWI was barely realized in practice and no conclusions regarding the fidelity could be drawn. We therefore conclude that we cannot expect PWI to have any effect on work participation in the RCT.