Gender equality and managers' work in elderly and social care: A structural equation modelling approach

AIM

The study explores whether, and how, gender equality is associated with key aspects related to operative managers' improvement work. We explore the possible associations between gender equality and; prioritization of social regulations in operative decision-making, engagement in operative improvement work, group dynamics challenges and collaboration between managers and subordinates.

BACKGROUND

Regarding organizational relations and preconditions for providing good care and developing operative work in the social and elderly care sector, the value of having organizational gender equality is unknown.

METHOD

Associations were analysed using structural equation modelling of questionnaire data. The questionnaire was distributed to first-line managers in a large city in Sweden (n = 598, response rate 56%).

RESULTS

Positive perceptions of organizations' gender equality were significantly associated with more engagement in operative improvement work, fewer group dynamics challenges and higher priority of social regulations in unit decision-making, also when controlling for confounders. Gender equality had no association with managers' collaboration with subordinates in this study.

CONCLUSION(S)

This study demonstrates that equal opportunities for male and female workers could benefit operative managers' improvement work.

IMPLICATIONS FOR NURSING MANAGEMENT

Organizations that strive to improve conditions for operative work, which strengthen preconditions for service development, should include values of gender equality.

Sex differences in dementia: on the potentially mediating effects of educational attainment and experiences of psychological distress

BACKGROUND

Old-age dementias are known to disproportionally affect women as well as individuals with low educational attainment. The higher lifetime risk of dementia among women is usually attributed to their longer life expectancy. However, the impact of sex, and subsequent gender inequity, is likely to be more multifaceted than this explanation implies. Not least because of historical inequities in access to education between the sexes and the gender and socio-economic gradients in risk factors such as stress, depression and social isolation. Consequently, the present study sought to test whether differences in educational attainment and experiences of general psychological distress mediate the association between female sex and dementia.

METHODS

The study utilizes data obtained through the Gothenburg H70 Birth Cohort Study and the Prospective Populations Study on Women (n = 892). Data were analysed using Confirmatory Factor Analysis (CFA) and Structural Equation Modelling (SEM) with Weighted Least Squares Means and Variance adjusted (WLSMV) estimation. General psychological distress was indicated by a latent variable and constructed from five manifest items (previous depression, stress, self-esteem, chronic loneliness and satisfaction with social situation) that were all measured at baseline.

RESULTS

While the results could not corroborate that education directly mediates the effect of sex on dementia, level of distress was predicted by both female sex (0.607, p < .001) and education (- 0.166, p < .01) and, in turn, shown to be significantly associated with dementia (0.167, p < .05), also after controlling for confounders. When time from baseline to diagnosis was increased through sequential exclusion of dementia cases, the effect of distress on dementia was no longer significant.

CONCLUSION

The overall findings suggest that social (dis) advantage predicts general psychological distress, which thereby constitutes a potential, and rarely acknowledged, pathway between female sex, education, and dementia. They further underline the importance of attending to both education and distress as 'gendered' phenomena when considering the nature of their associations with dementia. However, the possibility of reverse causality bias must be acknowledged and the need for longitudinal studies with longer follow-up stressed.

The impact of social networks and APOE ε4 on dementia among older adults: tests of possible interactions

Objectives: Emerging evidence suggests that social networks may protect against the development of dementia among older adults. In this study we analysed the association between social networks, the apolipoprotein E (APOE) ε4 allele, and dementia. We also investigated whether there were gender-specific patterns in this respect.Method: The analyses used population-based longitudinal data from Gothenburg, Sweden: the H70 Birth Cohort Study and the Prospective Population Study on Women (PPSW). A total of 580 individuals born in 1930 underwent semi-structured neuropsychiatric examinations in 2000-2001. Follow-up examinations were carried out in 2005-2006 and 2009-2010. The timing of dementia onset was analysed using Cox proportional hazards regression.Results: The presence of the APOE ε4 allele affected the risk of developing dementia in both genders. Among women, distant social networks had a protective effect on dementia, while among men the significant associations between close social networks and dementia did not remain after controlling for covariates. Significant interactions between social networks and the APOE ε4 allele were not found.Conclusion: Strong social networks do not seem to moderate the increased risk of dementia implied by the APOE ε4 allele. Nevertheless, our results underline the importance of strong social networks in postponing dementia onset and indicate that their impact may differ among men and women.

Socioeconomic status, gender and dementia: The influence of work environment exposures and their interactions with APOE ɛ4

It is a well-established fact that unfavourable social and economic conditions have a negative impact on health and longevity. Recent findings suggest that this is also true of age-related dementias. Yet most common indicators of socioeconomic status (SES) say very little about the actual mechanisms at play in disease development. The present paper explores five work exposure characteristics, all of which have a clear social gradient, that could potentially shed further light on the relationship between SES and dementia. Specifically, it investigates whether these exposures could moderate the impact of a well-known genetic risk factor: the APOE ɛ4 allele. The empirical analyses are based on data from a Swedish population study (n = 1019). Main occupation was linked to The Job Exposure Matrix to estimate the individuals’ exposure to the following work environment factors: work control, support, psychological demands, physical demands and job hazards. All analyses were conducted using binary logistic regression and focused specifically on gene-work exposure interactions. A significant main effect of work control on dementia risk was detected for males (OR = 0.68; p< 0.05), but not for females. However, control was found to significantly moderate the effect of APOE ɛ4 in both genders, albeit in different ways. These findings do not only underscore the importance of considering interactions between social and genetic risk factors to better understanding multifactorial diseases such as dementia. They also propose that gender- and class-based inequities interact, and hence must be considered simultaneously, also in relation to this particular disease.

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There are steep social gradients in exposure to various work environment conditions.

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Work control alters the effect of APOE ɛ4 in both genders, albeit in different ways.

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High work control protects male, but not female, APOE ɛ4-carriers.

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‘Male’ high control jobs differ greatly from ‘female’ high control jobs.

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Gender- and class-based inequities interact also in the development of dementia.

Estimation of Maximum Recommended Therapeutic Dose Using Predicted Promiscuity and Potency

We report a simple model that predicts the maximum recommended therapeutic dose (MRTD) of small molecule drugs based on an assessment of likely protein-drug interactions. Previously, we reported methods for computational estimation of drug promiscuity and potency. We used these concepts to build a linear model derived from 238 small molecular drugs to predict MRTD. We applied this model successfully to predict MRTDs for 16 nonsteroidal antiinflammatory drugs (NSAIDs) and 14 antiretroviral drugs. Of note, based on the estimated promiscuity of low-dose drugs (and active chemicals), we identified 83 proteins as "high-risk off-targets" (HROTs) that are often associated with low doses; the evaluation of interactions with HROTs may be useful during early phases of drug discovery. Our model helps explain the MRTD for drugs with severe adverse reactions caused by interactions with HROTs.

Metal ion binding and activation of Streptomyces griseus dinuclear aminopeptidase: cadmium(II) binding as a model

A detailed metal binding and activation of the dinuclear aminopeptidase from Streptomyces griseus (sAP) has been analyzed and modeled by means of metal titration as well as kinetic and thermodynamic techniques using Cd2+ as a probe. Cd2+ binds to the two metal-binding sites in a sequential manner to produce a very active Cd2+-substituted derivative, particularly in the presence of Ca2+ (53% and 90%, respectively, relative to the activities of the native form in terms of kcat/Km under the same conditions). The first stepwise formation constant for the binding of metal to the dinuclear site (to form M-sAP) was found to determine the metal-binding selectivity, regardless of the magnitude of the second stepwise formation constant (to form M,M-sAP from M-sAP). Interestingly, despite the seemingly very different binding profiles for different metal ions under different conditions, all of them can be well described and fitted by the sequential binding model. In addition, Ca2+ was found to significantly affect metal binding, inhibition, and entropy of activation of this enzyme, and its role in sAP action is re-evaluated.

Supramolecular assemblies of quaternary ammonium cations and halide anions in the gas phase: ESMS-FTICR data and computer modelling

Supramolecular aggregates of tetraalkylammonium halides (R4NX) are formed by electrospray out of acetonitrile solution. Mass spectrometry reveals 88 charged aggregates for R= Me, Et, Bu; X= Br, I, ranging up to [(Bu4N)39Br42]3- in size. With the objective of improving calculations of intermolecular energies for supramolecular aggregates of ions, calibrated semi-empirical potentials for inter-ion interactions have been developed and applied to these aggregates. The accuracy of the calculated energies is supported by the measured collisional dissociation energy of (Et4N+)4 (I-)5. Energy optimisations indicate that the probable structures have the halide ions dispersed in a matrix of cations, which, for Bu4N+, can be mutually attractive. The aggregates are structurally fluid, with multiple structures separated by 4-8 kJmol(-1). The energy calculations are entirely consistent with the observed formation of large aggregates, and of multiply charged anions. It is estimated that the cohesive energies of supramolecular assemblies of ions such as these reach about 40 kJmol(-1) per constituent ion.