Receipt of Formal and Informal Help with Specific Care Tasks among Older People Living in their Own Home. National Trends over Two Decades

Sweden is seen as a typical example of a social democratic welfare regime, with universal and generous welfare policies. However, in the last decades, there have been substantial reductions in the Swedish provision of care for older people. This study aimed to examine trends in sources of care‐receipt in older people (77+) living in their own home and with a perceived need for help with two specific tasks: house cleaning and/or food shopping. Trends in care‐receipt were examined in relation to gender, living alone, having children and socio‐economic position. Data from the 1992, 2002 and 2011 data collection waves of the national study, Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD), were used. Response rates varied between 86 and 95 per cent, and the sample represents the population well. Trends and differences between groups were explored in bivariate and logistic regression analyses. There was a reduction in formal care‐receipt regarding house cleaning and food shopping over the study period. It was more common for women than men to receive formal care, and more common for men than women to receive informal care. Reductions in formal care have affected older women more than older men. Still, living alone was the most influential factor in care‐receipt, associated with a greater likelihood of formal care‐receipt and a lower likelihood of informal care‐receipt. It can be concluded that public responsibility for care is becoming more narrowly defined in Sweden, and that more responsibility for care is placed on persons in need of care and their families.     

The case of vegetovascular dystonia: inventing the most common Soviet disease

ABSTRACT

The paper considers the case of vegetovascular dystonia, one of the most typical and common “Soviet” diseases. This syndrome emerged in Soviet medicine after World War II, and very quickly become a popular diagnosis among physicians. The author describes how the construct of vegetovascular dystonia was formed and developed, what changes it underwent, and what affected those changes. The concept and history of vegetovascular dystonia can provide an understanding of Soviet medicine and health science in general.     

医院青年文化品牌塑造的路径探析

青年是医院的未来,引导青年医务人员树立坚定而充沛的文化自信是激发其积极性、主动性和创造性的重要方式。常州市第一人民医院以涵养文化自信为着力点打造青年文化品牌“青之源”,通过营造学习创新氛围、建设团日活动体系、搭建阅读分享平台、探索涵养青年文化自信的品牌塑造路径等方式,动力、活力、能力三源合流,为青年成长提供正向激励和人文滋养。     

Perceptions of transition-related health and mental health services among transgender adults

The opportunity to live authentically is critical for the well-being of transgender individuals. For many this requires accessing transition-related services. Current knowledge of transition-related care is limited. This study aims to elucidate experiences and needs of transgender individuals (N = 65) related to (a) therapeutic support, (b) medical care, and (c) aspects of living authentically in order to inform the development and delivery of trans-affirmative services. Findings reveal challenges accessing health care providers with trans-specific competency; gaps between critical aspects of transition-related care and receipt of services; and heterogeneity of experiences and needs. Recommendations for improving transgender-affirmative services are provided.     

Overcoming the ‘tyranny of the urgent’: integrating gender into disease outbreak preparedness and response

ABSTRACT

This article contributes to discussions on the gender dimensions of disease outbreaks, and preparedness policies and responses, by providing a multi-level analysis of gender-related gaps, particularly illustrating how the failure to challenge gender assumptions and incorporate gender as a priority at the global level has national and local impacts. The implications of neglecting gender dynamics, as well as the potential of equity-based approaches to disease outbreak responses, is illustrated through a case study of the Social Enterprise Network for Development (SEND) Sierra Leone, a non-government organisation (NGO) based in Kailahun, during the Ebola outbreak.     

The turn to optional familialism through the market: Long‐term care,cash‐for‐care,and caregiving policies in Europe

Cash‐for‐care (CfC) schemes are monetary transfers to people in need of care who can use them to organize their own care arrangements. Mostly introduced in the 1990s, these schemes combine different policy objectives, as they can aim at (implicitly or explicitly) supporting informal caregivers as well as increasing user choice in long‐term care or even foster the formalization of care relations and the creation of care markets. This article explores from a comparative perspective, how CfC schemes, within broader long‐term care policies, envision, frame, and aim to condition informal care, if different models of relationships between CfC and informal care exist and how these have persisted or changed over time and into which directions. Building on the scholarly debate on familialization vs. defamilialization policies, the paper proposes an analytical framework to investigate the trajectories of seven European countries over a period of 20 years. The results show that, far from being simply instruments of supported familialism, CfC schemes have contributed to a turn towards “optional familialism through the market,” according to which families are encouraged to provide family care and are (directly or indirectly) given alternatives through the provision of market care.     

Stillbirth in Australia 1: The road to now: Two decades of stillbirth research and advocacy in Australia

Stillbirth is a major public health problem with an enormous mortality burden and psychosocial impact on parents, families and the wider community both globally and in Australia. In 2015, Australia’s late gestation stillbirth rate was over 30% higher than that of the best-performing countries globally, highlighting the urgent need for action. We present an overview of the foundations which led to the establishment of Australia’s NHMRC Centre of Research Excellence in Stillbirth (Stillbirth CRE) in 2017 and highlight key activities in the following areas: Opportunities to expand and improve collaborations between research teams; Supporting the conduct and development of innovative, high quality, collaborative research that incorporates a strong parent voice; Promoting effective translation of research into health policy and/or practice; and the Regional and global work of the Stillbirth CRE. We highlight the first-ever Senate Inquiry into Stillbirth in Australia in 2018. These events ultimately led to the development of a National Stillbirth Action and Implementation Plan for Australia with the aims of reducing stillbirth rates by 20% over the next five years, reducing the disparity in stillbirth rates between advantaged and disadvantaged communities, and improving care for all families who experience this loss.     

Maternity waiting homes in times of crisis: Can current models meet women’s needs?

BackgroundMaternity waiting homes (MWHs) located close to birthing facilities are a conditional recommendation by the World Health Organisation, based on very low-quality evidence that they contribute to improvements in maternal or perinatal health outcomes. In addition, several studies suggest that more vulnerable women are less likely to use them. Yet significant investments continue to be made in building and running MWHs within conflict-affected and under-resourced health systems.AimsWe critically examine the literature to shed light on the challenges and opportunities provided by MWHs during health emergencies and in conflict situations.Findings and discussionMWHs are difficult to utilise during crises because they require women to be away from home, are often designed as dormitories, can lack security and be over-crowded. Some MWHs have been adapted during situations of political conflict to incorporate birthing and broader reproductive health care, thereby improving the availability of care away from over-burdened health facilities. How MWHs are adapted during times of crisis may provide insights into what systems of care are more appropriate in meeting women’s needs more broadly.ConclusionThe current global pandemic is an important time to reflect on whether MWHs are meeting the needs of a diverse range of women, in times of stability and during emergencies, and engage in genuine dialogue with women about the kinds of maternity care they want. We need to co-create those systems now so that they are more resilient during the inevitable crises we will face in the future.