Aging in Asia: A cultural,socio-economical and historical perspective

Asia has about 60% of the world population and population aging is occurring more rapidly in Asia than in Western countries. The group aged 65 years and above will increase from 207 million in 2000 to 857 million in 2050, a staggering increase of 314%. The diversity in economic, demographic, religious, cultural and geo-political factors in Asia is unparalleled by any other continent, and is, in part, contributory to the rapid rise in population aging. By 2050, those under 15 years old will have shrunk from 30% in 2000 to 19%, while those aged 65 years and above will increase from 6% to 18%. In addition, the gender divide still persists with 100 elderly women to 70 elderly men. These projected demographic changes pose three major challenges: 1) how best to address the rising population of the group aged 65 years and above, 2) how to address the shrinking population of the young as well as the working adults, and 3) how to address the problems arising from the disproportionate increase in older women than men. From now to 2050, it will be expeditious for each country in Asia to look into ways of reversing the decline in total fertility rates (TFRs) and restore to replacement levels. If not, at least introduce measures to halt its free fall. Due to the complexity of factors that have influenced the fall in TFRs in Asia, it will be a daunting task to reverse this fall. There is no “single size fits all” solution to this complex problem. Research work in this short-term strategy in addressing the aging population is urgent. In the longer term, the East-West Centre have suggested four modalities, 1) establish policies and programmes that enhance traditional Asian systems of family support for the elderly; 2) introduce policy reform that encourages the elderly who are still capable of remaining in the work force; 3) create institutions and systems that support high levels of personal saving; and 4) formulate public programmes, including pension schemes and national healthcare systems. We need to work while there is time.     

Patient Rights: An Advocate's Perspective

Abstract

The current growing concern about patients' rights and the delivery of student health care precipitates an environment of fear, distrust, and uneasiness within university health services. This paper addresses several selected clinical, ethical, and legal issues which have come into conflict during recent years. Our examination surveys ethical and legal principles of confidentiality, defines areas in which breaches are most likely to occur, and suggests ways of preventing breaches of confidence between students and health services.

While the fundamental ethical principle underlying confidentiality is the individual's right of privacy, many issues of confidentiality are extremely difficult to resolve. University health services have expanded the concept of health care to encompass all the conditions — medical, emotional, social, economic and environmental — which affect the health of students. As a result, health service administrators should be fully aware of the laws and associated legal complexities in their own state which affect confidentiality. Furthermore, student health physicians, and particularly mental health therapists must be sensitive to needs for protecting the privacy of students.

Legal principles of confidentiality discussed in this paper with respect to specific problem situations which might arise in a student health center include: 1) right to privacy; 2) privileged communications; 3) releasing information from the medical record; 4) releasing information to the student; and 5) treating minors without parental consent. Finally, in addition to the responsibilities which must be assumed by the health professional, certain student responsibilities in the selection and utilization of health professionals are recommended.     

Humor and hostility: A neglected aspect of social movement analysis

Most research on social movements has focused on their chronology and structure, and on the social conflict generated by collective attempts to bring about or thwart change. The seriousness and intensity of such activity have led sociologists to ignore the lighter side of social movements. Humor is an important means of communication and in this article it is shown to be intimately related to conflict in social movements. A four-cell model of “conflict humor” is proposed. The relationship between humor and social movements is demonstrated in a brief case study of the Western Canadian separatist movement.     

"Flying by the seat of our pants": current processes to share best practices to deal with elder abuse

We examined current processes used to identify, communicate, and adopt "best practices" in the field of elder abuse using an iterative process involving literature and Internet reviews, surveys completed by stakeholders, and key informant interviews. Results indicate minimal research evidence exists to support current assessment and intervention strategies; there is an immediate need for more evaluation and research in this area and for improved knowledge exchange and translation. Two strategic directions are recommended: to (a) build capacity for research and program evaluation to advance knowledge of effective practices, and (b) build capacity for knowledge exchange to enhance professionals' efforts.     

What Kind of Self-Care Strategies Do People Report Using and is There an Association with Well-Being?

Objectives: The aim of this study was to describe what kind of self-care strategies people report using to improve or maintain their well-being. Furthermore, we also wanted to investigate whether reports of using self-care strategies were associated with well-being. Methods: A selected sample (n=871), aged between 20 and 64 years, living in Stockholm County, answered an open-ended question about self-care strategies. Well-being was assed using the WHO (Ten) well-being index. Results: Ten different categories were found. The most commonly reported self-care strategy was physical exercise, followed by social support and engaging in pleasurable activities. Physical exercise, social support, relaxation, and physical health were associated with a better well-being, social support being strongest correlated. Conclusion: The results suggest that reports of using certain self-care strategies are associated with a better well-being.     

Benevolence and authority as WEIRDly unfamiliar: A multi-language meta-analysis of paternalistic leadership behaviors from 152 studies

Based on a multi-language search, we qualitatively describe and meta-analytically summarize the growing but often ignored research literature on behaviors associated with paternalistic leadership (PL), a form of leadership that is considered to be acceptable and prevalent in many Non-WEIRD (Western, Educated, Industrialized, Rich, and Democratic) cultures. PL is conceptualized as the simultaneous enactment of two seemingly paradoxical leadership behaviors: 1) benevolence – the holistic and genuine care for followers' well-being even outside the workplace, and 2) authority – non-exploitative use of behaviors that emphasize power and control based on status and hierarchy. Results from 165 independent samples from 152 studies (total N?=?68,395) in fourteen countries demonstrate a consistently divergent pattern across the dimensions. Even in societies where PL is presumed to be more prevalent and acceptable, the strong control (authoritarianism) dimension is consistently negatively related to task performance, citizenship behaviors, creativity, attitudes towards the leader, and job attitudes. Conversely, the benevolence dimension demonstrates consistently positive relationships with leader effectiveness and follower performance, attitudes, and behaviors. The most commonly used measure of PL includes a morality dimension, which produces positive effects similar to the benevolence dimension. Collectively, PL dimensions (as well as a separate unitary measure of PL emphasizing benevolence) predict incremental variance beyond transformational leadership and beyond LMX. Based on conceptual and empirical grounds, it appears that PL (especially benevolence) is not fully captured in mainstream approaches to leadership and may add value to our understanding of the universe of ways leadership can be enacted. Several directions for future research are discussed, including the need to study the rarely-examined interactions between benevolence and authority, in line with the core of PL theory.