Work factors facilitating working beyond state pension age: Prospective cohort study with register follow-up

Objectives:The demographic changes in Europe underline the need for an extension of working lives. This study investigates the importance of physical work demands and psychosocial work factors for working beyond the state pension age (65 years).Methods:We combined data from three cohorts of the general working population in Denmark (DWECS 2005 and 2010, and DANES 2008), where actively employed workers aged 55–59 years replied to questionnaires about work environment and were followed until the age of 66 years in the Danish AMRun register of paid employment. Using logistic regression analyses, we calculated prevalence ratios (PR) and 95% confidence intervals (CI) for the association between physical and psychosocial work factors and working beyond state pension age, adjusted for age, sex, cohort, cohabiting, sector, income, vocational education, working hours, lifestyle, and previous sickness absence.Results:Of the 2884 workers aged 55–59 years, 1023 (35.5%) worked beyond the state pension age. Higher physical work demands was associated with a lower likelihood (PR 0.69, 95% CI 0.58–0.82) and a good psychosocial work environment was associated with higher likelihood (average of 7 items: PR 1.81, 95% CI 1.49–2.20) of working beyond state pension age. Stratified analyses did not change the overall pattern, ie, a good overall psychosocial work environment – as well as several specific psychosocial factors – increased the likelihood of working beyond state pension age, both for those with physically active and seated work.Conclusion:While high physical work demands was a barrier, a good psychosocial work environment seems to facilitate working beyond state pension age, also for those with physically active work.     

‘Underclassism’ and access to healthcare in urban centres

In this article, we draw on findings from an ethnographic study that explored experiences of healthcare access from the perspectives of Indigenous and non‐Indigenous patients seeking services at the non‐urgent division of an urban emergency department (ED) in Canada. Our aim is to critically examine the notion of ‘underclassism’ within the context of healthcare in urban centres. Specifically, we discuss some of the processes by which patients experiencing poverty and racialisation are constructed as ‘underclass’ patients, and how assumptions of those patients as social and economic Other (including being seen as ‘drug users’ and ‘welfare dependents’) subject them to marginalisation, discrimination, and inequitable treatment within the healthcare system. We contend that healthcare is not only a clinical space; it is also a social space in which unequal power relations along the intersecting axes of ‘race’ and class are negotiated. Given the largely invisible roles that healthcare plays in controlling access to resources and power for people who are marginalised, we argue that there is an urgent need to improve healthcare inequities by challenging the taken‐for‐granted assumption that healthcare is equally accessible for all Canadians irrespective of differences in social and economic positioning.     

Rethinking cultural safety while waiting to do fieldwork: methodological implications for nursing research

The concept of culture has been widely applied as an explanatory concept within health care, often within a framework representing culture as a fixed, reified entity, with cultural groups existing in a binary sense vis-;-vis mainstream culture. However, if our scholarship is to generate knowledge that addresses longstanding patterns of inclusion and exclusion along lines such as race, ethnicity, class, and gender, interpretive frames are needed that account for culture as embedded in fields of power relations; as mediated by social forces such as economics, politics, and historical patterns of oppression and colonization; and as being constantly renegotiated. In this article we trace a series of theoretical explorations, centered on the concept of cultural safety, with corresponding methodological implications, engaged in during preparation for an intensive period of fieldwork to study the hospitalization and help-seeking experiences of diverse ethnocultural populations.     

The association between psychosocial work environment,attitudes towards older workers (ageism) and planned retirement

Purpose  

The aim of this study was to examine the association between psychosocial factors (in particular ageism) at the workplace and older workers’ retirement plans, while taking health and workability of the employee into account.     

Psychopathology of adolescent detained versus psychiatric inpatient females

Several studies have shown high rates of psychopathology among female adolescents in detention. Although rates of mental health problems have been called alarming, it is unknown whether mental health needs in females in juvenile justice differ substantially from those of females in mental health care. Therefore, this study compared adolescent females in detention with inpatient adolescent females. For this purpose, a sample of 256 detained females (mean age 15.4 ± 1.3) was compared to 45 psychiatric inpatient females (mean age 15.8 ±1.4). Socio-demographic characteristics, mental health history and psychiatric problems were investigated using file-information and self-report questionnaires. Compared to detained females, inpatients more often showed internalizing problems and dissociation, whereas externalizing problems prevailed in girls in detention centers. Females in detention more often came from an ethnic minority group, while females in mental healthcare more often received mental healthcare previously and had parents with higher employment. This study confirms that mental health needs of girls in mental healthcare and in detention are high. However, non-mental health related factors were different as well - i.e. socio-economic factors - and are likely to influence the involvement with either service sector.     

Factors associated with glycaemic outcome of childhood diabetes care in Denmark.

AIMS: To study how structure and process of care is associated with outcome assessed by HbA(1c). METHODS: Data for this cross-sectional study originated from the nationwide Danish Registry for Childhood Diabetes and two questionnaires. One questionnaire was sent to all children under 16 years of age with Type 1 diabetes in the year 2000 (N = 1087, response rate 80%). Another questionnaire was sent to the 19 centres in Denmark treating these children (response rate 100%). Simultaneously the children were asked to take a blood sample for central HbA(1c) analysis. Linear mixed models were used for analysis of associations between structure and process indicators and HbA(1c). Age, diabetes duration, sex, ethnicity, family structure and parents' occupational status were included as patient factors possibly affecting HbA(1c). RESULTS: More visits to the outpatient clinic and higher insulin dosage were significantly associated with higher HbA(1c) (P = 0.002 and P = 0.0001, respectively). Increased frequency of blood glucose monitoring (BGM/week) and completed nephropathy screening were significantly associated with lower HbA(1c) value (estimates -0.008 and -0.49, P = 0.02, respectively). The structure indicators were not associated with HbA(1c), but telephone hot-line was positively associated with the process indicator BGM (estimate 4.02, P = 0.04). Children without Danish parents performed BGM significantly less frequently (-7.11, P = 0.0005) and had higher HbA(1c) (0.41, P = 0.06). CONCLUSIONS: Most process indicators were significantly associated with HbA(1c), indicating relevant action of staff on glucose regulation. The structure indicators were not associated with outcome, necessitating more detailed studies on the influence of staffing resources, treatment strategies and targets in childhood diabetes management.