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Health inequalities during school-to-work transitions among young adults: Mapping the evidence
(2020)
Background
School-to-work transition is a sensitive period that can have a substantial impact on health over the life course. Previous studies suggest pronounced health inequalities during this period but little is known about the determinants at the individual, meso- and macro-levels. We aim to further elucidate possible health inequalities during school-to-work transitions with a focus on multilevel determinants, e.g. evidence on potential effects of contextual and compositional factors of specific institutions involved.
Methods
We are currently conducting a scoping review (funded by the German Research Foundation) to map the evidence on the above mentioned topic among young adults (aged 16-24 years), following the methodological framework proposed by Arksey and ÓMalley and PRISMA. The literature search was performed in Ovid MEDLINE, Web of Science, ILO and NIOSH, using sensitive search strategy developed by text-analysis. Only articles published between January 2000 - February 2020 and written in English or German are considered. The selection process is conducted following a two-step approach:1) screening of titles and abstracts 2) screening of full-texts by two independent reviewers. Any discrepancies in the selection process are resolved by a third researcher.
Preliminary Results
Following the five stages of the methodological framework, the scoping review is currently in stage 3 (study selection-screening phase). We found 25,069 potentially relevant articles in our primary search. 15,508 articles remained after the duplicates were removed. Up to now, 8,825 papers were screened of which 7,629 were excluded and 1,176 included which qualified for full-text reading. Complete results of the scoping review will be presented at the conference.
Conclusions
This scoping review will improve our knowledge about the emergence and development of health inequalities during school-to-work transitions by examining health of individuals in different institutional contexts.
Key messages
- Improving our knowledge of health inequalities during school-to-work transitions.
- the role of determinants at the individual, meso- and macro-levels during this stage will also be examined.
AlGaN/GaN heterostructure field effect transistors (HFETs) were irradiated with 2 MeV protons, carbon, oxygen, iron and krypton ions with fluences ranging from 1 × 109 cm−2 to 1 × 1013 cm−2. DC, pulsed I–V characteristics, loadpull and S-parameters of the AlGaN HFET devices were measured before and after irradiation. In parallel, a thick GaN reference layer was also irradiated with the same ions and was characterized by X-ray diffraction, photoluminescence, Hall measurements before and after irradiation. Small changes in the device performance were observed after irradiation with carbon and oxygen at a fluence of 5 × 1010 cm−2. Remarkable changes in device characteristics were seen at a fluence of 1 × 1012 cm−2 for carbon, oxygen, iron and krypton irradiation. Similarly, remarkable changes were also observed in the GaN layer for irradiations with fluence of 1 × 1012 cm−2. The results found on devices and on the GaN layer were compared and correlated.
AlGaN/GaN heterostructure field effect transistors (HFETs) were irradiated with protons as well as carbon, oxygen, iron and krypton ions of high (68 and 120 MeV) and low (2 MeV) energy with fluences in the range from 1x107 to 1x1013 cm-2. High energy irradiation with protons, carbon and oxygen produced no degradation in devices while krypton irradiation at the fluence of 1x1010 cm-2 resulted in a small reduction of 2% in the transconductance. Similarly, for GaN samples irradiated with protons, carbon and oxygen at high energy no changes were seen by XRD, PL and Hall effect, while changes in lattice constant and a reduction in PL intensity were observed after irradiation with high energy krypton. Low energy irradiation with carbon and oxygen at a fluence of 5x1010 cm-2 results in small change in the device performance while remarkable changes in device characteristics are seen at a fluence of 1x1012 cm-2 for carbon, oxygen, iron and krypton irradiation. Similarly changes are also observed by XRD, PL and Hall effect for the thick GaN layer irradiated at the fluence of 1x1012 cm-2. The device results and GaN layer properties are strongly correlated.
The effect of proton, carbon, oxygen and krypton irradiation on AlGaN HFET devices has been studied. Irradiation was performed at 68 and 120 MeV with fluences in the range from 1 × 10^7 to 1 × 10^13 cm2 . Before and after irradiation, dc and pulsed I – V characteristics, loadpull and S -parameters of the AlGaN HFET devices were measured. A thick GaN reference layer was characterized by x-ray diffraction, photoluminescence and Hall measurements before and after irradiation. Proton, carbon and oxygen irradiation show no degradation in devices while krypton irradiation shows a small change at a fluence of 1 × 10 10 cm2 in the device characteristics. The device results are correlated with the thick GaN results.
Concomitant microwave ablation for curative treatment of atrial fibrillation (AF) was performed in 18 patients with history of chronic atrial fibrillation and indication for open heart surgery, 11 patients with mitral valve replacement and 7 patients with coronary artery bypass grafting. There were no perioperative complications. During the postoperative period most of the patients had intermittent AF, they received low dose Sotalol therapy and electric cardio-versions. Up to now seven patients have reached follow-up day 90. One patient has persistent AF. Two patients had typical atrial flutter that was electrically converted to sinus rhythm (SR), isthmus ablation is planned. The other four patients have SR, one patient without cardioversions. These four patients show recovered atrial function with observed A-wave for transmitral flow. Under visual guidance the continuous atrial lesion lines could be induced effectively and safely by the intraoperative device Lynx.
Hintergrund: „Health Behaviour in School-aged Children (HBSC)“ ist eine der größten internationalen Kinder- und Jugendgesundheitsstudien und kooperiert mit der Weltgesundheitsorganisation (WHO). In Deutschland werden im vierjährigen Turnus jeweils Heranwachsende im Alter von 11, 13 und 15 Jahren zur Gesundheit, zum Gesundheitsverhalten und zu sozialen Rahmenbedingungen befragt. Der Beitrag widmet sich der Beschreibung der HBSC-Studie und speziell der Methodik des aktuellen Surveys 2022 sowie der vorherigen Erhebungen von 2009/10 bis 2017/18. Methode: Am Survey 2022 beteiligten sich 174 Schulen mit insgesamt 6.475 Schülerinnen und Schülern. Die Erhebung erfolgte mittels Fragebogen und erfasst ein breites Themenspektrum (u. a. mentale Gesundheit, Bewegungsverhalten, Mobbingerfahrungen, soziale Determinanten der Gesundheit sowie Erfahrungen im Zusammenhang mit COVID-19). Ergänzt wurde die Erhebung 2022 um eine Schulleitungsbefragung (N = 160). Neben der aktuellen Stichprobe werden auch die Stichproben der vorangegangenen drei Surveys mit repräsentativen Angaben für Deutschland vorgestellt: 2009/10 (N = 5.005), 2013/14 (N = 5.961) und 2017/18 (N = 4.347). Diskussion: Die Kinder- und Jugendgesundheit hat eine hohe Public-Health-Relevanz. Dazu leistet die HBSC-Studie einen elementaren Beitrag, denn sie liefert international vergleichbare Ergebnisse, ermöglicht die Analyse von
Trendentwicklungen und stellt umfangreiche, repräsentative Daten zum Gesundheitsmonitoring für Stakeholder bereit.
Background: Health Behaviour in School-aged Children (HBSC) is one of the largest international studies on child and adolescent health and cooperates with the World Health Organization (WHO). In Germany, adolescents aged 11, 13 and 15 are surveyed every four years about their health, health behaviour and social conditions. This article describes the HBSC study and in particular the methodology of the current 2022 survey and prior surveys conducted between 2009/10 and 2017/18.
Method: 174 schools with a total of 6,475 students participated in the 2022 survey. The survey was conducted using questionnaires and covered a wide range of topics (including mental health, physical activity, bullying experiences, social determinants of health and experiences related to COVID-19). The 2022 survey was complemented by a school principal survey (N = 160). In addition to the current sample, the samples of the three previous surveys with representative data for Germany are presented: 2009/10 (N = 5,005), 2013/14 (N = 5,961) and 2017/18 (N = 4,347).
Discussion: The health of children and adolescents is of great public health importance. The HBSC study makes a substantial contribution by providing internationally comparable results, analysing trends, and providing stakeholders with comprehensive and representative health monitoring data.
Diamond-like carbon (DLC) coatings are often utilized to change the base properties of raw materials, e. g. to gain robust or chemically inert surfaces. Here the deposition of hard DLC layers on soft polymers is tested. The common industrial polymers polyethylene (PE) and polyoxymethylene (POM) serve as model substrates in the present work. In order to examine the effect of the carbonaceous layers on PE and POM thin diamond-like carbon films were realized via PECVD. The topography of the different coatings was detected by AFM and SEM uncovering the different influence of the substrate material, e. g. interlayer formation for PE. The composition of the surface structures were analyzed in more detail by NEXAFS, showing the hybridization of carbon atoms in chemical different surroundings from the pure polymer to the carbon coating. The comparison of carbon coated PE- and POM-composites enables valuable insights into the interaction between soft substrates and hard coatings. For the chosen settings in PECVD, POM showed incomplete coating, while on PE a very stable and robust composite has formed.
Hintergrund:
Sozioökonomische Ungleichheiten in der gesundheitlichen Versorgung werden häufig krankheitsspezifisch untersucht, während die Evidenz zu Unterschieden in der Inanspruchnahme in der Gesamtbevölkerung bislang unzureichend ist. Ziel der Arbeit ist es, den internationalen Stand zum Zusammenhang zwischen dem Sozialstatus und der Inanspruchnahme von Haus- und Fachärzten systematisch aufzubereiten.
Methode:
In den Datenbanken Medline und Web of Science wurde eine systematische Literaturrecherche durchgeführt, um quantitative Studien aus den Jahren 2003 bis 2018 zu identifizieren. Von 1214 Treffern werden aktuell 69 Volltexte in Hinblick auf die Einschlusskriterien überprüft.
Ergebnisse:
Die Inanspruchnahme wird entweder als „Anzahl der Arztkontakte“ gemessen oder zwischen Nutzung und Nicht-Nutzung eines Haus- oder Facharztes in einem bestimmten Zeitraum unterschieden. Die bisher gesichteten Studien deuten darauf hin, dass sich die sozioökonomischen Ungleichheiten in der Inanspruchnahme der haus- und fachärztlichen Versorgung unterscheiden. Während Fachärzte seltener von Menschen mit niedrigem Sozialstatus aufgesucht werden, sind die Ungleichheiten bei Hausärzten geringer und die Studien konnten entweder keine sozioökonomischen Unterschiede aufzeigen oder fanden, dass Menschen mit niedrigem Sozialstatus häufiger eine Primärversorgung in Anspruch nehmen.
Diskussion:
Sozioökonomische Unterschiede zu Ungunsten der sozial benachteiligten Bevölkerung bestehen möglicherweise deutlicher bei Fachärzten im Vergleich zu Hausärzten. Gerade in der Inanspruchnahme von Fachärzten besteht daher Handlungsbedarf zur Verringerung der Ungleichheiten, um eine bedarfsgerechte Inanspruchnahme der Versorgung zu gewährleisten. Mögliche Gründe für die Unterschiede sollen bei einem Vergleich der Studien untersucht werden, um Implikationen für eine Verbesserung der Versorgung abzuleiten.
Treatment of Atrial Fibrillation in Open Heart Surgery. The Potential Role of Microwave Energy
(1999)
Background:
While health inequalities among young people are well described, the underlying mechanisms have been explored far less. Compositional and contextual characteristics of institutional contexts (e.g. kindergartens, schools) are likely to shape health inequalities among young people and may have an impact above and beyond individual-level determinants. The general research objectives of the research unit are to empirically study if characteristics of different institutional contexts are associated with the emergence of individual-level inequalities in health and c) to integrate findings from different life stages into a comprehensive theoretical model about the key mechanisms at individual and contextual levels.
Methods and analysis:
Building upon reviews of the existing evidence, each of the five subprojects of the research unit will analyse secondary data (cross-sectional and longitudinal surveys). The subprojects will focus on institutional contexts that serve as major socialization agents in society, such as the family, kindergarten, school, tertiary education/work, as well as the health care system. Linear or logistic multilevel modelling will be applied in order to examine the role of institutional characteristics for young people's health and health inequalities at the individual level.
Ethics and dissemination:
The dissemination activities include the publication of results in peer-reviewed journals, at international and national scientific conferences, as well as press releases in written and broadcast media to inform relevant stakeholders and the lay public. In the first funding stage, the research unit only uses secondary data of existing datasets. Therefore, ethical approval is not required.
Objectives The main objective was to systematically map evidence regarding the emergence of health inequalities in individuals aged 16–24 years during school-to-work and school-to-university transition (STWT). Second, we aimed to summarise the evidence on potential effects of contextual and compositional characteristics of specific institutional contexts entered during STWT on health and health behaviours.
Design Scoping review.
Study selection Relevant literature was systematically searched following the methodological framework proposed by Arksey and O’Malley. Ovid MEDLINE and Web of Science, and websites of the International Labour Organization and National Institute for Occupational Safety and Health were searched, using a predetermined search strategy. Articles in English or German published between 1 January 2000 and 3 February 2020 were considered.
Data extraction To collect the main information from the selected studies, a data extraction spreadsheet was created. Data were summarised and grouped into five health outcomes and five institutional contexts (school, vocational training, university, work, unemployment).
Results A total of 678 articles were screened for inclusion. To be able to draw a picture of the development of various health outcomes over time, we focused on longitudinal studies. Forty-six prospective studies mapping health-related outcomes during STWT were identified. Higher family socioeconomic position (SEP) was associated with higher levels of health behaviour and lower levels of health-damaging behaviour, but there was also some evidence pointing in the opposite direction. Disadvantaged family SEP negatively impacted on mental health and predicted an adverse weight development. There was limited evidence for the outcomes physical/somatic symptoms and self-rated health. Meso-level characteristics of the institutional contexts identified were not systematically assessed, only individual-level factors resulting from an exposure to these contexts, rendering an analysis of effects of contextual and compositional characteristics on health and health behaviours impossible.
Conclusions This scoping review demonstrated a wide range of health inequalities during STWT for various health outcomes. However, knowledge on the role of the core institutional contexts regarding the development of health inequalities is limited.
School-to-work/university transition is a sensitive period that can have a substantial impact on health and health behaviour over the life course. There is some indication that health and health behaviour is socially patterned in the age span of individuals in this transition (16–24 years) and that there are differences by socioeconomic position (SEP). However, evidence regarding this phenomenon has not been systematically mapped. In addition, little is known about the role of institutional characteristics (eg, of universities, workplaces) in the development of health and possible inequalities in health during this transition. Hence, the first objective of this scoping review is to systematically map the existing evidence regarding health and health behaviours (and possible health inequalities, for example, differences by SEP) in the age group of 16–24 years and during school-to-work transition noted in Germany and abroad. The second objective is to summarise the evidence on the potential effects of contextual and compositional characteristics of specific institutions entered during this life stage on health and health behaviours. Third, indicators and measures of these characteristics will be summarised.Methods and analysisWe will systematically map the evidence on health inequalities during school-to-work-transitions among young adults (aged 16–24 years), following the methodological framework proposed by Arksey and O’Malley. The literature search is performed in Ovid MEDLINE, Web of Science, International Labour Organization and National Institute for Occupational Safety and Health, using a predetermined search strategy. Articles published between January 2000 and February 2020 in English or German are considered for the review. The selection process follows a two-step approach: (1) screening of titles and abstracts, and (2) screening of full texts, both steps by two independent reviewers. Any discrepancies in the selection process are resolved by a third researcher. Data extraction will be performed using a customised data extraction sheet. The results will be presented in tabular and narrative form.Ethics and disseminationEthical approval is not required for this scoping review. The results will be published in a peer-reviewed scientific journal and presented at international conferences and project workshops.