Socioeconomic,psychological and demographic determinants of Australian baby boomers' financial planning for retirement

Aim: Research from around the Western World has shown that psychological, socioeconomic and demographic factors can influence levels of financial planning. This study aims to determine how these factors interrelate to predict planning outcomes. Method: Data from the Ageing Baby Boomers in Australia Study were used to examine the effects of multiple factors on financial planning for 709 employed Australians nearing retirement. Results: The results showed that higher income, future time perspective (FTP) and financial knowledge independently predicted levels of retirement planning. The effects of FTP and financial knowledge on financial planning were consistent across levels of socioeconomic status. Conclusions: While similar issues in financial planning appeared across socioeconomic status, a ‘one size fits all’ approach to retirement policy may not be effective. Instead, policy should be targeted towards the diverse needs of different groups. Raising public awareness of FTP and financial knowledge may provide a useful starting point.     

Differences between hospitals in attainment of parathyroid hormone treatment targets in chronic kidney disease do not reflect differences in quality of care

ABSTRACT: BACKGROUND: Transparency in quality of care (QoC) is stimulated and hospitals are compared and judged on the basis of indicators of performance on specific treatment targets. In patients with chronic kidney disease, QoC differed significantly between hospitals. In this analysis we explored additional parameters to explain differences between centers in attainment of parathyroid hormone (PTH) treatment targets. METHODS: Using MASTERPLAN baseline data, we selected one of the worst (center A) and one of the best (center B) performing hospitals. Differences between the two centers were analyzed from the year prior to start of the MASTERPLAN study until the baseline evaluation. Determinants of PTH were assessed. RESULTS: 101 patients from center A (median PTH 9.9 pmol/l, in 63 patients exceeding recommended levels) and 100 patients from center B (median PTH 6.5 pmol/l, in 32 patients exceeding recommended levels), were included. Analysis of clinical practice did not reveal differences in PTH management between the centers. Notably, hyperparathyroidism resulted in a change in therapy in less than 25% of patients. In multivariate analysis kidney transplant status, MDRD-4, and treatment center were independent predictors of PTH. However, when MDRD-6 (which accounts for serum urea and albumin) was used instead of MDRD-4, the center effect was reduced. Moreover, after calibration of the serum creatinine assays treatment center no longer influenced PTH. CONCLUSIONS: We show that differences in PTH control between centers are not explained by differences in treatment, but depend on incomparable patient populations and laboratory techniques. Therefore, results of hospital performance comparisons should be interpreted with great caution.     

UNDERSTANDING WOMEN'S ANGER: A DESCRIPTION OF RELATIONAL PATTERNS

Sixty women's narratives about their anger were coded for elements of anger expression. Their decisions regarding how and where to express anger are most strongly influenced by the anticipated reactions of others. Six patterns of bringing anger into relationships or keeping it out were identified. Women bring anger into relationship: (1) positively and directly, with the goal of removing barriers to relationship; (2) aggressively, with the goal of hurting another; and (3) indirectly, through disguising anger with the goal of remaining safe from interpersonal consequences, using strategies of (a) quiet sabotage, (b) hostile distance, (c) deflection, and (d) loss of control. Women keep anger out of relationship (1) consciously and constructively, choosing to express it in positive ways; (2) explosively expressing anger, but not in the presence of another; and (3) through self-silencing, which ranges from conscious to lessconscious awareness of anger and its suppression. Implications of differing patterns for women's health are discussed.