Understanding mobility characteristics and needs of older persons in urban Pakistan with respect to use of public transport and self-driving

Since 1990, Pakistan's demographic transition has been increasing life spans with a steady rise in the number of older persons. Pakistan faces many challenges in caring for its older population. The proportion of the population aged 60 years and above is estimated to increase from 5.8% in 2000 to 12.4% in 2050. A study was conducted to understand the existing mobility characteristics of the elderly, their perceived needs and constraining factors. Data was collected using convenient sampling from 450 people aged 60 years or older in nine towns within Lahore City. Older people were approached around urban facilities (shops, banks, terminals) and asked to respond to survey questions. Within-residence interviews were also conducted, mainly for those women who declined interviews in public places. Descriptive and comparative analyses were performed, including Pearson's chi squared test for independence. The results are discussed in terms of mode choice, public transport preferences, self-driving issues and the relative benefits of formal and informal public transport options. The study found lower levels of weekly trip-making compared to those reported for older people in China, South Korea and USA. Vehicle ownership (mainly carsand motorcycles) and socio-demographic factors were found to significantly affect trip making. There were large gender differences in trip making and vehicle ownership, suggesting further research and policy action targeting the mobility needs of elderly women. Older persons were concerned about safety issues concerning public transport and self-driving, and also the behavior of transport crews, and this has informed several of the concluding policy recommendations

A randomised controlled trial of a physical activity and nutrition program targeting middle-aged adults at risk of metabolic syndrome in a disadvantaged rural community

Background: Approximately 70% of Australian adults aged over 50 are overweight or obese, with the prevalence significantly higher in regional/remote areas compared to cities. This study aims to determine if a low-cost, accessible lifestyle program targeting insufficiently active adults aged 50-69 y can be successfully implemented in a rural location, and whether its implementation will contribute to the reduction/prevention of metabolic syndrome, or other risk factors for type 2 diabetes, and cardiovascular disease.Methods/Design: This 6-month randomised controlled trial will consist of a nutrition, physical activity, and healthy weight intervention for 50–69 year-olds from a disadvantaged rural community. Five hundred participants with central obesity and at risk of metabolic syndrome will be recruited from Albany and surrounding areas in Western Australia (within a 50 kilometre radius of the town). They will be randomly assigned to either the intervention (n = 250) or wait-listed control group (n = 250). The theoretical concepts in the study utilise the Self-Determination Theory, complemented by Motivational Interviewing. The intervention will include a custom-designed booklet and interactive website that provides information, and encourages physical activity and nutrition goal setting, and healthy weight management. The booklet and website will be supplemented by an exercise chart, calendar, newsletters, resistance bands, accelerometers, and phone and email contact from program staff. Data will be collected at baseline and post-intervention.Discussion: This study aims to contribute to the prevention of metabolic syndrome and inter- related chronic illnesses: type 2 diabetes mellitus, cardiovascular disease, and some cancers; which are associated with overweight/obesity, physical inactivity, and poor diet. This large rural community-based trial will provide guidelines for recruitment, program development, implementation, and evaluation, and has the potential to translate findings into practice by expanding the program to other regional areas in Australia. Trial registration: Australian and New Zealand Clinical Trials Registry [ACTRN12614000512628, registration date 14th May 2014]

The current shortage and future surplus of doctors: a projection of the future growth of the Japanese medical workforce

<p>Abstract</p> <p>Background</p> <p>Starting in the late 1980s, the Japanese government decreased the number of students accepted into medical school each year in order to reduce healthcare spending. The result of this policy is a serious shortage of doctors in Japan today, which has become a social problem in recent years. In an attempt to solve this problem, the Japanese government decided in 2007 to increase the medical student quota from 7625 to 8848. Furthermore, the Democratic Party of Japan (DPJ), Japan's ruling party after the 2009 election, promised in their manifesto to increase the medical student quota to 1.5 times what it was in 2007, in order to raise the number of medical doctors to more than 3.0 per 1000 persons. It should be noted, however, that this rapid increase in the medical student quota may bring about a serious doctor surplus in the future, especially because the population of Japan is decreasing.</p> <p>The purpose of this research is to project the future growth of the Japanese medical doctor workforce from 2008 to 2050 and to forecast whether the proposed additional increase in the student quota will cause a doctor surplus.</p> <p>Methods</p> <p>Simulation modeling of the Japanese medical workforce.</p> <p>Results</p> <p>Even if the additional increase in the medical student quota promised by the DPJ fails, the number of practitioners is projected to increase from 286 699 (2.25 per 1000 persons) in 2008 to 365 533 (over the national numerical goal of 3.0 per 1000) in 2024. The number of practitioners per 1000 persons is projected to further increase to 3.10 in 2025, to 3.71 in 2035, and to 4.69 in 2050. If the additional increase in the medical student quota promised by the DPJ is realized, the total workforce is projected to rise to 392 331 (3.29 per 1000 persons) in 2025, 464 296 (4.20 per 1,000 persons) in 2035, and 545 230 (5.73 per 1000 persons) in 2050.</p> <p>Conclusions</p> <p>The plan to increase the medical student quota will bring about a serious doctor surplus in the long run.</p

A global corporate census: publicly traded and close companies in 1910

In 1910 the world had almost half a million corporations, only one-hundredth of today's total. About one-fifth—with over half of corporate capital—were publicly tradable, higher portions than today. Most publicly quoted corporations traded in Europe and the British Empire, but most close (private) corporations operated in the US, which, until the 1940s, had more corporations per capita than anywhere else. The 83 countries surveyed here differed markedly in company numbers, corporate capital/GDP ratios, and average corporate size. Enclave economies—dominated by quoted (and often foreign-owned) companies—had the largest average sizes, while other nations had more varied mixes of large quoted corporations and close company small and medium enterprises

Change and continuity in Japanese compensation practices: the case of occupational pensions since the early 2000s

This article analyses changes in the provision of Japanese occupational pensions since the early 2000s. It shows how Japanese companies have followed strategies of cost and risk reduction by creating multi-layered benefit systems that offer a combination of defined benefit (DB) and defined contribution (DC) plans whose benefits are becoming increasingly performance-oriented. Analysing the reasons behind the resilience of DB schemes in Japan, the article concludes that enterprise union behaviour has had less influence than regulatory issues and continued corporate commitment to long-standing employment practices for regular workers. These findings highlight the embeddedness of Japanese employment practices in their institutional context