Working after retirement:Determinants and consequences of bridge employment

Steeds meer ouderen keren na hun pensioen terug op de arbeidsmarkt. In Nederland werkt één op de vier (vervroegd) gepensioneerden door op de arbeidsmarkt na pensionering. In vergelijking met andere Europese landen telt Nederland relatief veel herintredende gepensioneerden. Dit blijkt uit onderzoek van Ellen Dingemans verbonden aan het Nederlands Interdisciplinair Demografisch Instituut (NIDI-KNAW). Zij promoveert 9 maart aan de Rijksuniversiteit Groningen. Om inzicht te krijgen in wie er doorwerken na pensioen en wat daarvan de gevolgen zijn voor het welzijn van ouderen analyseerde Dingemans survey gegevens voor Nederland en voor 15 andere Europese landen. Het Nederlandse onderzoek was gebaseerd op gegevens die tussen 2001 en 2011 zijn verzameld door het Nederlands Interdisciplinair Demografisch Instituut (NIDI-KNAW) onder ruim 2400 oudere werknemers. Daarnaast werden gegevens gebruikt van een grootschalig Europees survey project – de ‘Survey of Health, Ageing and Retirement in Europe’ studie. Doorwerkende gepensioneerden zijn vaak relatief vroeg met pensioen gegaan, zijn hoog opgeleid en verkeren in goede gezondheid. Het onderzoek laat echter ook zien dat herintreding zeker niet aan deze groepen is voorbehouden. Ook onder lager opgeleiden en mensen die kampen met gezondheidsproblemen maakt een kleine, maar substantiële groep gepensioneerden een doorstart. Het belangrijkste motief om door te werken na pensionering is plezier in het werk. Slechts vijftien procent van de ondervraagden gaf aan vooral vanwege financiële motieven door te werken en voor één op de tien is het verlies aan sociale contacten het belangrijkste motief. Daarnaast bestaat er een groep die zoekt naar een betaalde baan na pensioen, maar die deze niet kan vinden; tegenover iedere drie à vier doorwerkers, staat één gepensioneerde ongewild aan de zijlijn. Het onderzoek van Dingemans laat verder zien dat vooral ouderen die onvrijwillig met pensioen zijn gegaan door druk vanuit de organisatie, ontevreden zijn over hun pensionering. Voor hen blijkt een terugkeer naar werk – al is het maar enkele dagen per week – het welzijn sterk te verhogen. Maar herintreding op de arbeidsmarkt is juist voor deze groep onvrijwillig gepensioneerden vaak lastig. Hun zoektocht naar een nieuwe baan is in veel gevallen niet succesvol

Access to Bridge Employment:Who Finds and Who Does Not Find Work After Retirement?

Purpose of the Study: Empirical studies on the determinants of bridge employment have often neglected the fact that some retirees may be unsuccessful in finding a bridge job. We present an integrative framework that emphasizes socioeconomic factors, health status, social context, and psychological factors to explain why some people fully retired after career exit, some participated in bridge jobs, while others unsuccessfully searched for one. Design and Methods: Using Dutch panel data for 1,221 retirees, we estimated a multinomial logit model to explain participation in, and unsuccessful searches for, bridge employment. Results: About 1 in 4 retirees participated in bridge employment after retirement, while 7% searched unsuccessfully for such work. Particularly those who experienced involuntary career exit were found to have a higher probability of being unsuccessful at finding bridge employment. Implications: The current study provides evidence for the impact of the social context on postretirement work and suggests a cumulative disadvantage in the work domain in later life

Prevalence and Predictors of Physician-Patient Discordance in Prognostic Perceptions in Advanced Cancer

BACKGROUND: Discordance between physicians' and patients' prognostic perceptions in advanced cancer care threatens informed medical decision-making and end-of-life preparation, yet this phenomenon is poorly understood. We sought to: (1) describe the extent and direction of prognostic discordance, patients' prognostic information preferences in cases of prognostic discordance, and physicians' awareness of prognostic discordance; and (2) examine which patient, physician, and caregiver factors predict prognostic discordance. MATERIALS AND METHODS: Oncologists and advanced cancer patients (median survival ≤12 months; n = 515) from 7 Dutch hospitals completed structured surveys in a cross-sectional study. Prognostic discordance was operationalized by comparing physicians' and patients' perceptions of the likelihood of cure, 2-year mortality risk, and 1-year mortality risk. RESULTS: Prognostic discordance occurred in 20% (likelihood of cure), 24%, and 35% (2-year and 1-year mortality risk) of physician-patient dyads, most often involving patients with more optimistic perceptions than their physician. Among patients demonstrating prognostic discordance, the proportion who preferred not knowing prognosis varied from 7% (likelihood of cure) to 37% (1-year mortality risk), and 45% (2-year mortality risk). Agreement between physician-perceived and observed prognostic discordance or concordance was poor (kappa = 0.186). Prognostic discordance was associated with several patient factors (stronger fighting spirit, self-reported absence of prognostic discussions, an information source other than the healthcare provider), and greater physician-reported uncertainty about prognosis. CONCLUSION: Up to one-third of the patients perceive prognosis discordantly from their physician, among whom a substantial proportion prefers not knowing prognosis. Most physicians lack awareness of prognostic discordance, raising the need to explore patients' prognostic information preferences and perceptions, and to tailor prognostic communication

Truncating SRCAP variants outside the Floating-Harbor syndrome locus cause a distinct neurodevelopmental disorder with a specific DNA methylation signature

Truncating variants in exons 33 and 34 of the SNF2-related CREBBP activator protein (SRCAP) gene cause the neurodevelopmental disorder (NDD) Floating-Harbor syndrome (FLHS), characterized by short stature, speech delay, and facial dysmorphism. Here, we present a cohort of 33 individuals with clinical features distinct from FLHS and truncating (mostly de novo) SRCAP variants either proximal (n = 28) or distal (n = 5) to the FLHS locus. Detailed clinical characterization of the proximal SRCAP individuals identified shared characteristics: developmental delay with or without intellectual disability, behavioral and psychiatric problems, non-specific facial features, musculoskeletal issues, and hypotonia. Because FLHS is known to be associated with a unique set of DNA methylation (DNAm) changes in blood, a DNAm signature, we investigated whether there was a distinct signature associated with our affected individuals. A machine-learning model, based on the FLHS DNAm signature, negatively classified all our tested subjects. Comparing proximal variants with typically developing controls, we identified a DNAm signature distinct from the FLHS signature. Based on the DNAm and clinical data, we refer to the condition as "non-FLHS SRCAP-related NDD.'' All five distal variants classified negatively using the FLHS DNAm model while two classified positively using the proximal model. This suggests divergent pathogenicity of these variants, though clinically the distal group presented with NDD, similar to the proximal SRCAP group. In summary, for SRCAP, there is a clear relationship between variant location, DNAm profile, and clinical phenotype. These results highlight the power of combined epigenetic, molecular, and clinical studies to identify and characterize genotype-epigenotype-phenotype correlations