Differences in Life Expectancy and Disability Free Life Expectancy in Italy. A Challenge to Health Systems

Background Measures of health expectancy such as Disability Free Life Expectancy are used to evaluate and compare regional/national health statuses. These indicators are useful for understanding changes in the health status and defining health policies and decisions on the provision of services because provide useful information on possible areas needing interventions and burden of care to health systems. Methods Two databases have been used for the analysis: the Italian Health Interview Survey and the European Community Household Panel. The data were analyzed by gender and geographic area. DFLE was calculated by the Sullivan method. Results In 2005 in Italy women have a longer life expectancy than men: 84 and 78 years, respectively. But if we consider life without disability in Italy the male disadvantage reduces: men live 85% of their years without disability, women only 75%. Geographic differences do exist because Disability Free Life Expectancy is longer in Northern and in Central regions; shorter in the South. At a European level similar data can be found: on average women live longer but they have a longer time of life with disability. Conclusion In Italy women live longer but have a worse quality of health than men; in the South there is a worse quality of health. Similar findings can be identified at a European level. The Italian situation with the highest percentage of DFLE at 65 out of the total LE at 65 and one of the longest LE witnesses ageing is not necessarily associated to a worsening of health.     

Measuring Stability and Change: Methodological Issues in Quality of Life studies

The aim of the paper is to show how the variety of approaches to study social change may result in a challenging complexity for the social scientist, starting from the difficulty of defining the concept of “change” itself and managing it through observed data. This is particularly true in presence of complex phenomena, such as those defining and composing the quality of life. What should be pointed out is that quality of life studies not only are focused on the present time but have also long term perspectives. This represents the link between studies on quality of life and forecasting. When applied to the field of quality of life, the typical logical approach to forecasts, based upon inferential statistics, could reveal its limits. Those limits are related to different aspects: e.g., the forms of relationships between different aspects of the phenomenon, which can be linear and non-linear; the dimensionality of phenomenon, which can turn out to be very complex; the causality, which could be direct or indirect; the entity of change, which implies the idea that also small change can have great impact; the perspective of observation, which can be internal or external and local or global. Consequently, the study of change related to quality of life needs, in addition to the traditional statistical tools as well as the tradition of social indicators, a different approach. Although the Futures Studies are not a proper science, nevertheless their approach to social research may ensure the requested accuracy of a scientific forecasting process.     

Comparative Examination of Self-Perceived Health and Other Measures of the Quality of Life Across the EU-27

In various fields of research self-perceived health has been defined and analysed as a significant measure of the health-related quality of life, and also as a predictor of health status. This paper examines the determinants of self-perceived health in the EU-27 area in order to find whether a common set of governmental policies could improve the self-perceived health and whether this positive effect would remain positive and significant on other measures of the quality of life as well as across the quintiles of income distribution. A number of panel regression models using the first-difference GMM estimator are applied to comparatively examine self-perceived health together with other measures of health status and quality of life, based on Eurostat data from 2003 to 2012. The empirical results of the paper could provide useful insights for the European health policy and other common actions and policies in the field of the quality of life.     

What Aspects of Society Matter for the Quality of Life of a Minority? Global Evidence from the New Gay Happiness Index

There is great variation in views on and treatment of minorities such as gay men across the world. We are the first to pinpoint what features of societies are beneficial to gay men’s quality of life by using a unique new cross-country dataset covering 110 countries, the Gay Happiness Index. It covers how gays perceive public opinion about them, how they experience behavior towards them and how satisfied they are with their lives. Our study is based on the premise that it is important to look at minority-specific effects of policies and institutions and not solely at the effects for the average citizen, as well as the transmission mechanisms through which policies and institutions affect life satisfaction. We find that factors such as equal legal rights for gay people, GDP per capita, democracy and globalization relate positively to the quality of life of gay men, primarily by shaping public opinion and behavior in a pro-gay direction. Religion (the shares of Muslims and Orthodox Christians) and living in a post-communist country tend to relate negatively to our quality of life indicators. Most of these factors have been shown to matter for the well-being of people in general as well, which may be taken to suggest that gay people benefit from being included in society—legally, socially and economically—on the same terms as others.     

Theory and Validity of Life Satisfaction Scales

National accounts of subjective well-being are being considered and adopted by nations. In order to be useful for policy deliberations, the measures of life satisfaction must be psychometrically sound. The reliability, validity, and sensitivity to change of life satisfaction measures are reviewed. The scales are stable under unchanging conditions, but are sensitive to changes in circumstances in people’s lives. Several types of data indicate that the scales validly reflect the quality of respondents’ lives: (1) Differences between nations in life satisfaction associated with differences in objective conditions, (2) Differences between groups who live in different circumstances, (3) Correlations with nonself-report measures of life satisfaction, (4) Genetic and physiological associations with life satisfaction, (5) Systematic patterns of change in the scales before, during, and after significant life events, and (6) Prediction by life satisfaction scores of future behaviors such as suicide. The life satisfaction scales can be influenced by factors such as question order, current mood, and mode of presentation, but in most cases these can be controlled. Our model of life satisfaction judgments points to the importance of attention, values, standards, and top-down effects. Although the scales are useful in research on individual well-being, there are policy questions that need more analysis and research, such as which types of subjective well-being measures are most relevant to which types of policies, how standards influence scores, and how best to associate the scores with current policy deliberations.     

Rethinking productivity: The perspective of the Earth as the primary corporation

Productivity and its consequences touch everything. Its comprehensive embrace includes Wall Street and rain forests, automobile output, diminishing Earth stocks, satisfying insatiable consumerism, chemical toxins, increasing population, and loss of topsoil. We ride the postindustrial roller coaster with its upside and downside. Thus, economically, we can cheer as the stock market goes up, up, up. Ecologically, we can lament this trajectory as sending a message that the life systems of the planet are going down, down, down.A rising environmental awareness is recognizing that the Earth is in a deficit position. Hence, the logical warrant for rethinking productivity. Here, our metaphors become a powerful communication system; specifically, the justification for rethinking productivity from the normative perspective of the Earth as the primary corporation. Wearing such an accountability lens, the business person understands the language and the judgment that, if the Earth falls to bankruptcy, then everything else collapses.To explore this critical issue positively, a framework is used setting forth ten guiding principles toward an ecological consciousness. Immediately following each principle, specific connections are made to initiate the process of rethinking productivity. The purpose is to offer not only concrete thinking and creative alternatives but actionable ideas or applications in the workplace and in our industrial and commercial settings; and to stimulate the beginnings of dialogue with the business community. The proposal builds toward a potential commitment worth the full investment of our human energies.The guiding principles emphasize the shamanic attitude which sees all things swayed by sacred meanings; shifting from object-domination to the experience of a subject radiating an interior richness; experiencing the infinitely differentiated splendor of the Earth; taking time to listen to the voices of divine presence; recovering insights of the mind and insounds of the heart to live in compassionate harmony with the Earth; becoming passionately engaged with life as an experience of celebration, with human happiness rescaled to Earth needs; becoming educated to the genius of the Earth and the human as its most original mode of expressiveness; with the full substance of our humanity, relating in mutually enhancing ways to the entire Earth community; inspired by the Dream of the Earth, finding enterprises worthy of our human energy; in the unfolding of this New Story, putting on a new imagination, Re-VISION-ing the human and being shaped by an ecological consciousness as a way into the future.Corresponding to each of these guiding principles, actionable ideas and applications are offered: choosing appropriate quality of life indicators; energizing people in organizations through the systematic elimination of all forms of waste; building upon the George Winter model for installing an environmental business management system; addressing three strategic levels of listening; enlarging lessons of world-class manufacturing organizations to planetary scope; extending the insights of a "geologian" to Earth dynamics; drawing upon the power of storytelling; contrasting the Dominant Social Paradigm and the New Environmental Paradigm. In summary, an extraordinary future awaits business leaders whose vision of this new productivity paradigm is inspired by a Dream of the Earth.     

Does family policy affect fertility?

From the mid-1960s to around 1980, Sweden extended its family policies that provide financial and in-kind support to families with children very quickly. The benefits were closely tied to previous work experience. Thus, women born in the 1950s faced markedly different incentives when making fertility choices compared to women born only 15–20 years earlier. This paper examines the evolution of completed fertility patterns for Swedish women born in 1925–1958 and makes comparisons to women in neighbouring countries where the policies were not extended as much as in Sweden. The results suggest that the extension of the policy raised the level of fertility, shortened the spacing of births, and induced fluctuations in the period fertility rates, but it did not change the negative relationship between women’s educational level and completed fertility.     

Nausea and vomiting in pregnancy: Blooming or bloomin’ awful? A review of the literature

BackgroundNausea and vomiting in pregnancy (NVP) is a normal, commonly experienced affliction of early pregnancy. Despite this, its impact on women's lives is not necessarily minimal. For some women, the implications of NVP are substantial with multi-faceted effects, hindering their ability to maintain usual life activities, and particularly their ability to work. In an effort to understand the effect of NVP, several researchers have developed NVP measurement tools, which enable an understanding of NVP's effect on quality of life (QOL).ProblemThis paper seeks to provide a review of the literature to explore the impact of NVP on women's quality of life, particularly their ability to maintain social and professional commitments.MethodMedline, CINAHL, PsychINFO, Ebsco, Science Direct, Health Source, Academic Search Premiere, Cochrane databases were extensively searched using Boolean operators with various combinations of relevant terms: nausea, vomiting, pregnancy, emesis, quality of life, QOL, NVPQOL, PUQE, SF-12, SF-36 and limited to those published from 1999 onwards. Papers were scrutinised to include those discussing the impact of normal NVP on women's lives, particularly their QOL with careful exclusion of those addressing hyperemesis gravidarum (HG).FindingsNVP has a significant effect on women's QOL and therefore their ability to maintain day-to-day activities as well as work capacity. This has implications for the woman, her partner, her family and her employers.ConclusionIt is important that all maternity care workers consider the impact of NVP on the woman's QOL and that care is given not to minimise this experience. Further research is warranted which considers ways in which women can best manage this experience in relation to social and professional commitments. Given the authors were able to identify only one Australian study in this area, published in 2000 and utilising non-NVP specific QOL measurement tools, there exists scope for additional local studies using NVP-specific QOL tools to determine the impact of QOL for Australian women and therefore Australian society.     

Work status and the quality of life

The general thesis from which this paper derived is that objective conditions are related to perceptions and evaluations of those conditions, but that such relationships are mediated by personal characteristics such as expectation and aspiration levels, and other motivational factors. The specific relationship examined is that between work status and overall life satisfaction among women. Although there is little difference in average levels of life satisfaction expressed by housewives and by women working outside the home, substantial differences emerge when women are distinguished by their motivation with respect to paid work: among women who want jobs, working women are more satisfied with their lives than are housewives; while among those who would prefer not to work, housewives are more satisfied. Evidence is also found in support of a hypothesis that work tends to be less central to the overall quality of women's lives than is true for men.     

A Sociological Review of the Reflections and Dimensions of Quality of Life of the Widows in Tehran

The article explores some of the theoretical perspectives on widows, followed by empirical findings on the issue in Tehran. Widowhood transition being pursued by drop in relations, is observed and examined from various dimensions, with the hope of improving the quality of life of the widows. Some of the socio-economic effects of widowhood as appraised by various thinkers and scientists, are reflected in the context. The phenomenon being in existence as long as socially regulated marriage continues under the cause-and-effect laws, needs probing with special reference to the modern time. That is, being subject to emotional crises, they need to be multi-dimensionally studied. Through a multi-method strategy, and with the use of questionnaire tool, data were collected. Widowhood as a common problem in old age is followed by the isolation, a period of change and new challenges, i.e., reflection of a major stressful life event. However, widows as a vulnerable social group are seen worldwide with commonalities. In other words, about half of the women householders in the world are widowed. The author reflects a clear and tangible picture of the widows’ quality of life, and their satisfaction with life through the tabulated data. Nevertheless, government and relevant agencies in Iran, need to work and plan hard to provide the widows with necessary security and support.     

Gender and Aging in the Developing World: Where Are the Men?

In recent years, both population aging and gender issues have gained prominence in international forums concerned with population. It is frequently asserted or implied that older women are universally more vulnerable to social, economic, and health disadvantages than older men. The most significant manifestation of this exclusive concern with women when considering gender and aging is the Plan of Action adopted by the Second World Assembly on Aging in 2002. The assumed relative disadvantage of elderly women is commonly attributed to gender differences in earlier life experiences. But are older women truly disadvantaged globally with respect to all or most essential aspects of well‐being? The authors provide empirical evidence that clearly shows that older women are not invariably disadvantaged vis‐à‐vis men. In particular, they call into question the wisdom and equity of a virtually exclusive emphasis on the needs of women when incorporating gender concerns into policies and programs related to aging. A more balanced perspective that recognizes gender as a potential, but not necessarily central, marker of vulnerability for various aspects of well‐being in specific settings and times, and that allows for male as well as female disadvantage, would serve the current and future elderly generations far better.     

Work-family conflict in comparative perspective: The role of social policies

This study focuses on the role of social policies in mitigating work-family incompatibilities in 27 countries. We ask whether work-family conflict is reduced in countries that provide family-friendly policies and flexible employment arrangements, and whether women and men are similarly affected by such policies. The study, based on the ISSP 2002, demonstrates considerable variation among countries in the perceived work-family conflict. In all but two countries, women report higher levels of conflict than men. At the individual level, working hours, the presence of children and work characteristics affect the perception of conflict. At the macro level, childcare availability and to a certain extent maternity leave reduce women's and men's sense of conflict. Additionally, the availability of childcare facilities alleviates the adverse effect of children on work-family balance for mothers while flexible job arrangements intensify this effect.     

On constructing and implementing an extended goal variable for economic policy

Multidimensional objective concepts, such as ‘quality of working life’ (‘quality of environment’ etc.), have gained increased importance in politico-economic programs, but much less in practical economic policy. Conventionally, ‘hard’ quantities of market-related monetary success, such as national product, predominate. These are supposed to be developing parallel to all other life areas. A condition for becoming relevant to policy-making is that extended objective concepts can be defined exactly, operationalized, and measured. Hence, theoretical, methodological, and empirical work is required. A possible method for devising an index of quality of working life together with some empirical results are presented in this paper. By employing the results, the decision basis of labor market and employment policies could be improved.     

What women want and why. Women's preferences for induction of labour or expectant management in late-term pregnancy

BackgroundBoth induction of labour at 41 weeks and expectant management until 42 weeks are common management strategies in low-risk pregnancy since there is no consensus on the optimal timing of induction in late-term pregnancy for the prevention of adverse outcomes. Our aim was to explore maternal preference for either strategy and the influence on quality of life and maternal anxiety on this preference.MethodsObstetrical low-risk women with an uncomplicated pregnancy were eligible when they reached a gestational age of 41 weeks. They were asked to fill in questionnaires on quality of life (EQ6D) and anxiety (STAI-state). Reasons of women's preferences for either induction or expectant management were explored in a semi-structured questionnaire containing open ended questions.ResultsOf 782 invited women 604 (77.2%) responded. Induction at 41 weeks was preferred by 44.7% (270/604) women, 42.1% (254/604) preferred expectant management until 42 weeks, while 12.2% (74/604) of women did not have a preference. Women preferring induction reported significantly more problems regarding quality of life and were more anxious than women preferring expectant management (p < 0.001). Main reasons for preferring induction of labour were: “safe feeling” (41.2%), “pregnancy taking too long” (35.4%) and “knowing what to expect” (18.6%). For women preferring expectant management, the main reason was “wish to give birth as natural as possible” (80.3%).ConclusionWomen's preference for induction of labour or a policy of expectant management in late-term pregnancy is influenced by anxiety, quality of life problems (induction), the presence of a wish for natural birth (expectant management), and a variety of additional reasons. This variation in preferences and motivations suggests that there is room for shared decision making in the management of late-term pregnancy.     

Using Changes in Life Satisfaction and Health to Predict the Survival Status Among Older Men and Women in Taiwan

Despite policies aimed at decreasing old-age income inequality, such as Social Security and Supplemental Security Income, research consistently finds that later-life poverty is highly concentrated among women. While the early-life economic disadvantages of motherhood are well established, little work has examined whether these disadvantages persist into later life. Life course research consistently demonstrates the relationship between early-life choices and later-life inequality, but few studies have examined whether the reproductive phase of a woman's life is associated with her later-life income. Using data from the 2003 wave of the National Longitudinal Survey of Mature Women cohort, this research examines whether women's age at first birth and parity are associated with her later-life income within the context of marriage. From a set of multivariate analyses, I find that despite a marginal statistically significant effect, substantively for the women in this cohort the effects of childbearing are not particularly consequential for later-life income. The results suggest that as women age the economic penalties associated with motherhood are less important to financial well-being than are other factors.     

The future of world population

Analysis of future population trends reveals a regional pattern of continued growth, dependent upon basic assumptions about demographic factors and the priority given to human rights, socioeconomic development, and global interdependence. Developing countries will account for 85-87% of world population growth, and the most rapid increase will occur in Africa. The optimum size of population remains debatable. Ecologist argue for a reduction to 1-2 billion people in order to be in balance with nature and maintain a high quality of life. A rapid, but plausible, fertility decline would result in a population of 10 billion by 2070. The lowest feasible UN projection is 8 billion. A 1-2 billion world population would not be feasible without drastic mortality increases and fertility declines. Population control is a highly charged and complex issue; feminists are not about to place responsibility for environmental degradation on women's excess fertility. The spirit of the UN Universal Declaration of Human Rights is that women have the right to determine family size with personal integrity and freedom rather than suffer coercion for the rights of society. Family planning is a necessary ingredient for achieving the goal of desired family size. The quality of life may be undermined by upholding human rights, without recognition of the context of socioeconomic development and global interdependencies. Global economic conditions, political crises, and environmental degradation can undermine even the best national development efforts. The most difficult task ahead is addressing priorities and forming a consensus. Human rights, socioeconomic conditions, and global interdependencies must be satisfied in a mutually beneficial way. When national and global goals conflict, a compromise must be reached. There are many unknowns. The challenge is to "identify a set of policies that will stabilize world climatic conditions, promote economic development, enhance the quality of life, and respect human rights." Investment in human capital, such as education and health, will help women to avoid unwanted pregnancies. Improving the status of women is key to socioeconomic development, human rights, and global interdependencies.     

The Development of Official Social Statistics in Italy with a Life Quality Approach

The article covers the main steps of official statistics in the second half of the Nineties through the illustration of the transition from economic oriented official statistics to the quality of life approach. The system of the Multipurpose Surveys introduced in 1993 to give an answer to questions at social level and to provide indicators for social policies, has been developed with a quality of life approach that combines the objective dimension to the subjective one. All dimensions of the social sphere have been analyzed with this approach: health, crime, leisure, work, poverty and deprivation. Sometimes the subjective questions were proxy of the objective situation, such as health and sometimes subjective aspects complemented the objective as in the case of crime and poverty. The history of the Italian official statistics is an example of how it is possible to realize a qualitative leap in social statistics integrating the objective and the subjective dimension.     

Working in caseload midwifery care: The experience of midwives working in a birth centre in North Queensland

BackgroundPregnancy, birth and child rearing are significant life events for women and their families. The demand for services that are family friendly, women focused, safe and accessible is increasing. These demands and rights of women have led to increased government and consumer interest in continuity of care and the establishment in Australia of birth centres, and the introduction of caseload midwifery models of care.AimThe aim of this research project was to uncover how birth centre midwives working within a caseload model care constructed their midwifery role in order to maintain a positive work–life balance.MethodsA Grounded Theory study using semi-structured individual interviews was undertaken with seven midwives who work at a regional hospital birth centre to ascertain their views as to how they construct their midwifery role while working in a caseload model of care.FindingsThe results showed that caseload midwifery care enabled the midwives to practice autonomously within hospital policies and guidelines for birth centre midwifery practice and that they did not feel too restricted in regards to the eligibility of women who could give birth at the centre. Work relationships were found to be a key component in being able to construct their birth centre midwifery role. The midwives valued the flexibility that came with working in supportive partnerships with many feeling this enabled them to achieve a good work–life balance.ConclusionThe research contributes to the current body of knowledge surrounding working in a caseload model of care as it shows how the birth centre midwives construct their midwifery role. It provides information for development and improvement of these models of care to ensure that sustainability and quality of care is provided to women and their families.     

Transforming Retirement: New Definitions of Life After Work

This quantitative research study uses survey data of women born between 1946 and 1951 in Australia. It follows earlier work that identified the importance of transitions from work for women of the baby boomer generation. We provide important insights into the lives of women who have partially or fully retired and the changing nature of women's work and retirement. For many women, retirement is characterized by newfound freedoms, opportunities, career change, and evolving identities, yet others view retirement as a continuation of previous occupational and gendered roles and commitments. This study has important implications for retirement policies for women.     

Change,Resources and Self-Esteem in a Community of Women Religious

The effect of change and resources to cope with that change on self-esteem is explored in a study of a community of Catholic women religious. These middle-aged and elderly women are highly educated with life long attachment to the workforce. In addition, they have all experienced a high degree of change in their lives. The amount of change was found to be related to self-esteem as were specific social and psychological coping resources. A sense of being in control of one's life was an important predictor of selfesteem, and was itself affected by the amount of change experienced. The number of close friends that could be identified was related to self-esteem. Age and physical disability were not directly related to self-esteem when other variables were controlled, but rather affected self-esteem indirectly throu h feelings of control over one's life. Similarities between these f indings and studies of elderly women in the general population are emphasized and implications for the future are presented.