Educational differences in the influence of health on early work exit among older workers

Objectives Previous research has shown that poor physical and mental health are important risk factors for early work exit. We examined potential differences in this association in older workers (50+) across educational levels. Methods Coordinated analyses were carried out in longitudinal data sets from four European countries: the Netherlands (Longitudinal Aging Study Amsterdam), Denmark (Danish Longitudinal Study of Ageing), England (English Longitudinal Study of Ageing) and Germany (German Ageing Survey). The effect of poor self-rated health (SRH), functional limitations and depression on different types of early work exit (early retirement, economic inactivity, disability and unemployment) was examined using Cox regression analysis. We examined educational differences in these effects by testing interaction terms. Results Poor physical and mental health were more common among the lower educated. Poor SRH, functional limitations, and depression were all associated with a higher risk of early work exit. These health effects were strongest for the disability exit routes (poor SRH: HRs 5.77 to 8.14; functional limitations: HRs 6.65 to 10.42; depression: HRs 3.30 to 5.56). In the Netherlands (functional limitations) and England (functional limitations and SRH), effects were stronger in the lower educated. Conclusions The prevalence of health problems, that is, poor SRH, functional limitations and depression, was higher in the lower educated workers. All three health indicators increase the risk of early work exit. In some countries, health effects on early exit were stronger in the lower educated. Thus, lower educated older workers are an important target group for health policy and intervention

Inflammatory bowel disease at a young age – implications for achieving upper secondary education

BACKGROUND: The incidence of inflammatory bowel disease (IBD) among children and adolescence is increasing worldwide. Having a chronic condition at a young age may affect educational achievement and later employment and self-support. The study aims to examine the impact of being diagnosed with IBD before 18 years of age on achieving an upper secondary education before 25 years of age. METHODS: Using the Danish National Patient Register (1980-2018) all patients (born 1970-1994) diagnosed with IBD at a young age (<18 years) were identified. The IBD-patients were matched on age and sex with 10 references without IBD at the index date (date of diagnosis of IBD). The outcome was achieving an upper secondary education using data from Danish Education Registers. The association between IBD diagnosis and achieving an upper secondary education was analyzed using Cox regression with robust variance estimation adjusting for parents’ highest educational level. Furthermore, stratified analyses were performed on parental socioeconomic status (education and income). RESULTS: We identified 3,178 patients with IBD: Crohn’s disease (CD) n = 1,344, Ulcerative colitis (UC) n = 1,834. Reference n = 28,220. The median age at diagnosis was 15.3 years (IQR: [13.0;16.9]). At the age of 25 74.0% (CI: 71.6-76.4) for CD, 75.8% (CI: 73.8-77.8) for UC, and 69.7% (CI: 69.2-70.3) for references had achieved an upper secondary education. The adjusted Hazard ratio (HR) of achieving an upper secondary education was 1.05 (CI: 1.00 -1.11) for CD and 1.09 (CI: 1.04 -1.15) for UC. When stratifying the IBD-patient with the lowest socioeconomic status performed better than their peers. CONCLUSIONS: Being diagnosed with IBD before 18 years of age did not reduce the chance of achieving an upper secondary education. Patients with low socioeconomic status performed better than their peers, however the study gives no explanation of this. KEY MESSAGES: • Children diagnosed with IBD before 18 years of age had at least the same chance of achieving an upper secondary education compared to references. • IBD patients with low social economic status performed better than their peers

Solvent contribution to the stability of a physical gel characterized by quasi-elastic neutron scattering

The dynamics of a physical gel, namely the Low Molecular Mass Organic Gelator {\textit Methyl-4,6-O-benzylidene-$\alpha$ -D-mannopyranoside ($\alpha$-manno)} in water and toluene are probed by neutron scattering. Using high gelator concentrations, we were able to determine, on a timescale from a few ps to 1 ns, the number of solvent molecules that are immobilised by the rigid network formed by the gelators. We found that only few toluene molecules per gelator participate to the network which is formed by hydrogen bonding between the gelators' sugar moieties. In water, however, the interactions leading to the gel formations are weaker, involving dipolar, hydrophobic or $\pi-\pi$ interactions and hydrogen bonds are formed between the gelators and the surrounding water. Therefore, around 10 to 14 water molecules per gelator are immobilised by the presence of the network. This study shows that neutron scattering can give valuable information about the behaviour of solvent confined in a molecular gel.Comment: Langmuir (2015

Water Dynamics at Protein Interfaces: Ultrafast Optical Kerr Effect Study

The behavior of water molecules surrounding a protein can have an important bearing on its structure and function. Consequently, a great deal of attention has been focused on changes in the relaxation dynamics of water when it is located at the protein surface. Here we use the ultrafast optical Kerr effect to study the H-bond structure and dynamics of aqueous solutions of proteins. Measurements are made for three proteins as a function of concentration. We find that the water dynamics in the first solvation layer of the proteins are slowed by up to a factor of 8 in comparison to those in bulk water. The most marked slowdown was observed for the most hydrophilic protein studied, bovine serum albumin, whereas the most hydrophobic protein, trypsin, had a slightly smaller effect. The terahertz Raman spectra of these protein solutions resemble those of pure water up to 5 wt % of protein, above which a new feature appears at 80 cm–1, which is assigned to a bending of the protein amide chain

Educational inequalities in health after work exit : the role of work characteristics

Background Educational inequalities in health have been widely reported. A low educational level is associated with more adverse working conditions. Working conditions, in turn, are associated with health and there is evidence that this association remains after work exit. Because many countries are raising the statutory retirement age, lower educated workers have to spend more years working under adverse conditions. Therefore, educational health inequalities may increase in the future. This study examined (1) whether there were educational differences over time in health after work exit and (2) whether work characteristics mediate these educational inequalities in health. Methods Data from five prospective cohort studies were used: The Netherlands (Longitudinal Aging Study Amsterdam), Denmark (Danish Longitudinal Study of Aging), England (English Longitudinal Study of Ageing), Germany (German Aging Study), and Finland (Finnish Longitudinal Study on Municipal Employees). In each dataset we used Generalized Estimating Equations to examine the relationship between education and self-rated health after work exit with a maximum follow-up of 15 years and possible mediation of work characteristics, including physical demands, psychosocial demands, autonomy, and variation in activities. Results The low educated reported significantly poorer health after work exit than the higher educated. Lower educated workers had a higher risk of high physical demands and a lower risk of high psychosocial demands, high variation in tasks, and high autonomy at work, compared to higher educated workers. These work characteristics were found to be mediators of the relationship between education and health after work exit, consistent across countries. Conclusion Educational inequalities in health are still present after work exit. If workers are to spend an extended part of their lives at work due to an increase in the statutory retirement age, these health inequalities may increase. Improving working conditions will likely reduce these inequalities in health

Comparing the harmful effects of nontuberculous mycobacteria and Gram negative bacteria on lung function in patients with cystic fibrosis

BACKGROUND: To better understand the relative effects of infection with nontuberculous mycobacteria and Gram negative bacteria on lung function decline in cystic fibrosis, we assessed the impact of each infection in a Danish setting. METHODS: Longitudinal registry study of 432 patients with cystic fibrosis contributing 53,771 lung function measures between 1974 and 2014. We used a mixed effects model with longitudinally structured correlation, while adjusting for clinically important covariates. RESULTS: Infections with a significant impact on rate of decline in %FEV1 were Mycobacterium abscessus complex with -2.22% points per year (95% CI -3.21 to -1.23), Burkholderia cepacia complex -1.95% (95% CI -2.51 to -1.39), Achromobacterxylosoxidans -1.55% (95% CI -2.21 to -0.90), and Pseudomonas aeruginosa -0.95% (95% CI -1.24 to -0.66). Clearing M. abscessus complex was associated with a change to a slower decline, similar in magnitude to the pre-infection slope. CONCLUSIONS: In a national population we have demonstrated the impact on lung function of each chronic CF pathogen. M. abscessus complex was associated with the worst impact on lung function. Eradication of M. abscessus complex may significantly improve lung function