In the design of social insurance programs, policy makers face the complex trade-off between providing income security to those in need and maintaining incentives that reduce the risk of... Show moreIn the design of social insurance programs, policy makers face the complex trade-off between providing income security to those in need and maintaining incentives that reduce the risk of unemployment. The impact of incentives driving these effects may differ vastly among groups of individuals, and may be influenced by contextual factors or program design differences. Given this complexity, it is crucial to continuously investigate the impact of incentives in the labor market and in social insurance programs through empirics. This evidence increases the overall knowledge on these topics and can then assist policy makers in making evidence-based and welfare-improving decisions.This thesis contains four studies that provide empirical evidence on the relationship between social insurance and the labor market in the context of the Netherlands. The studies investigate which groups of individuals are more responsive to (changes in) social insurance program parameters and how this relates to the targeting and welfare-maximizing objectives of the programs. The findings presented in this thesis have direct and important implications for the design of policies related to income inequalities, social insurance programs, and active labor market policies. Show less
Zwaan, K.F. van der; Mentink, M.D.C.; Jacobs, M.; Roos, R.A.C.; Bot, S.T. de 2022
Huntington's disease (HD) is an inherited neurodegenerative disease. People at risk for HD can choose to get predictive testing years before the clinical onset. HD is characterized by motor,... Show moreHuntington's disease (HD) is an inherited neurodegenerative disease. People at risk for HD can choose to get predictive testing years before the clinical onset. HD is characterized by motor, cognitive and psychiatric symptoms and has a mean age at onset between 30 and 50 years, an age at which people are usually still working. This systematic review focuses on summarizing which disease-specific characteristics influence employment and working capacity in HD.Twenty-three studies were identified and showed that while employment and working capacity in HD are negatively influenced by cognitive decline and motor impairments, apathy already plays a role in the prodromal stage. Moreover, the influence of HD transcends the clinical manifestation of the disease, as some people at risk are already experiencing the impact of HD on employment through fear of or actual genetic discrimination. Employment and working capacity are not influenced by predictive testing for HD in and of itself. Show less
Neve, O.M.; Jansen, J.C.; Mey, A.G.L. van der; Koot, R.W.; Ridder, M. de; Benthem, P.P.G. van; ... ; Hensen, E.F. 2021
Background Employment is an important factor in quality of life. For vestibular schwannoma (VS) patients, employment is not self-evident, because of the sequelae of the disease or its treatment and... Show moreBackground Employment is an important factor in quality of life. For vestibular schwannoma (VS) patients, employment is not self-evident, because of the sequelae of the disease or its treatment and their effects on daily life. Objectives This study assessed employment status, sick leave (absenteeism) and being less productive at work (presenteeism) in the long-term follow-up of VS patients, and evaluated the impact of treatment strategy (active surveillance, surgery or radiotherapy). Methods A cross-sectional survey study was performed in a tertiary university hospital in the Netherlands. Patients completed the iMTA-post productivity questionnaire (iPCQ). Employment status was compared to that of the general Dutch population. Employment, absenteeism and presenteeism were compared between patients under active surveillance, patients after radiotherapy and post-surgical patients. Result In total 239 patients participated, of which 67% were employed at the time of the study. Only 14% had a disability pension, which was comparable to the age-matched general Dutch population. The proportion of patients with absenteeism was 8%, resulting in a 4% reduction of working hours. Presenteeism was reported by 14% of patients, resulting in a 2% reduction of working hours. The median number of working hours per week was 36, and since the diagnosis, these hours had been reduced by 6%. There were no significant differences between treatment modalities. Conclusion On average, long-term employment status and working hours of VS patients are comparable to the age-matched general population. Treatment strategies do not seem to differentially impact on long-term employment of VS patients. Show less
Vorselaars, V.M.M.; Heijden, A.C. van der; Joustra, R.; Berger, W.R.; Hout, G.P.J. van; Kapel, G.F.L.; ... ; Piers, S.R.D. 2021
Background There are nationwide concerns about the unemployment rate among young Dutch cardiologists and the increase in temporary positions. Therefore, the aim of this study was to investigate the... Show moreBackground There are nationwide concerns about the unemployment rate among young Dutch cardiologists and the increase in temporary positions. Therefore, the aim of this study was to investigate the unemployment rate in this subgroup as well as the length of time between the end of their training and the acquisition of a permanent position. Methods All cardiologists who completed their training between January 2015 and December 2018 were invited to fill in an online questionnaire about their demographic characteristics, professional profile and employment status. The unemployment rate was calculated and Kaplan-Meier curves were used to determine the time between the end of training and the first permanent contract. Results In total, 174 participants were included (mean age 35 +/- 3 years, 64% male, median follow-up 2.3 years (interquartile range 1.4-3.2 years)). The unemployment rate was 0.6% (n = 1). Only 12 participants (7%) started their career with a permanent position. The percentage of cardiologists with a temporary position was 82%, 61% and 33% at 1, 2 and 3 years, respectively. The percentage of cardiologists with a temporary position did not differ with regard to age, gender, holding a PhD degree or type of teaching institution attended (academic vs non-academic). Forty-four per cent of participants perceived the current job market to be problematic. Conclusions The unemployment rate among young cardiologists in the Netherlands was low between 2015 and 2018. The vast majority of cardiologists start their career on a temporary contract. Three years later, 33% still hold temporary positions. Due to the resultant job insecurity, many young cardiologists describe the job market as problematic. Show less
Gorp, D.A.M. van; Hiele, K. van der; Middelkoop, H.A.M.; Visser, L.H. 2019
Background: Cognitive dysfunction is increasingly being recognized as an important limiting factor in work participation in patients with multiple sclerosis. This literature review provides a... Show moreBackground: Cognitive dysfunction is increasingly being recognized as an important limiting factor in work participation in patients with multiple sclerosis. This literature review provides a description, synthesis and interpretation of the existing literature and identifies gaps in current knowledge.Methods: Papers published between 1970 and April 2017 were included. Clinical trials, randomized controlled trials or observational quantitative studies in which data on cognitive factors associated with employment, work functioning or work-related problems were reported. Papers were manually double checked by two blinded reviewers.Results: A total of 41 papers were included of which 4 described prospective, longitudinal studies. The majority of studies reported positive associations between cognitive functioning and work outcomes (38/41 studies; 93%). Positive associations were found between work outcomes and global cognitive functioning (8/9 studies; 89%), language (8/17 studies; 47%), processing speed/ working memory (23/26 studies; 88%),new learning and memory (12/22 studies; 55%), executive functioning (10/17; 59%), intelligence (1/6; 17%) and self-reported cognitive functioning (14/15; 93%). None of the reviewed studies found a relation between visuospatial processing and work outcomes (0/8; 0%). Models including cognitive measures as well as demographic (age, education), neurological (disability, fine motor coordination, disease course), and psychological variables (depression, personality, fatigue) best predicted work outcomes.Conclusion: By conducting this review we found ample evidence that objective cognitive functioning (specifically processing speed/ working memory and executive functioning) and self-reported cognitive functioning are important independent associates of work outcomes and these factors should be addressed by healthcare professionals. Future research could benefit from a focus on longitudinal changes in cognition and its relation to work outcomes. Show less
Lobatto, D.J.; Steffens, A.N.V.; Najafabadi, A.H.Z.; Andela, C.D.; Pereira, A.M.; Hout, W.B. van den; ... ; Furth, W.R. van 2018
This study examined impacts of large-scale farming in Ethiopia on local economic development, household food security, incomes, employment, and the environment. The study adopted a mixed research... Show moreThis study examined impacts of large-scale farming in Ethiopia on local economic development, household food security, incomes, employment, and the environment. The study adopted a mixed research approach in which both qualitative and quantitative data were generated from secondary and primary sources. Three large-scale farms (two foreign and one domestic) operating in Oromia, Gambella, and Benshanguel Gumuz regional states were selected as case studies. The result of the study indicated that large-scale farms generally undermined local level food security and incomes, generated little employment opportunities for the local population, deteriorated the local environment, especially in terms of vegetation cover and soil quality, and contributed little to local economic development, such as infrastructure construction, technology transfer, and generating fiscal revenue and foreign currency. The study concluded that the approach of large-scale mechanized farming contributes little to the economic and agricultural transformation of the nation. Local people generally lose out in respect of land transactions and investments, and they are expropriated from their customary land rights to the benefit of national goals. The outcome contradicts with the ethno-linguistic federal state arrangement of the country in which federated states manage their resources to improve their local development. Show less