eHealth interventions for family carers of people with long term illness: A promising approach?

Family carers of people who have long term illness often experience physical and mental health morbidities, and burden. While there is good evidence to suggest that carers benefit from psychosocial interventions, these have primarily been delivered via face-to-face individual or group-formats. eHealth interventions offer a novel, accessible and self-paced approach to care delivery. Whether these are effective for carers' wellbeing has been little explored. This paper reports the first comprehensive systematic review in this area. A total of 78 studies, describing 62 discrete interventions, were identified. Interventions commonly aimed to promote carers' knowledge, self-efficacy, caregiving appraisal, and reduce global health morbidities. Interventions were offered to carers of people with a wide range of long term illness; dementia has been the most researched area, as reported in 40% of studies. Clinical and methodological heterogeneity in interventions precluded meta-analyses, and so data were analysed narratively. The most popular approach has comprised psychoeducational interventions delivered via an enriched online environment with supplementary modes of communication, such as network support with professionals and peers. Overall, carers appreciate the flexibility and self-paced nature of eHealth interventions, with high rates of satisfaction and acceptability. More studies using robust designs are needed to extend the evidence base

The retirement pension system in the German Federal Republic. Historical changes and appropriateness within the context of social security policy.

Głównym tematem artykułu są świadczenia niemieckiego systemu zabezpieczeń emerytalnych i ich adekwatności na tle zmian od lat 50. XX w. Na początku przedstawiono powstawanie głównych założeń polityki emerytalnej od wprowadzenia „dynamicznej emerytury” w 1957 r. aż do najnowszych reform emerytalnych. Główny nacisk kładziony jest na podstawowe zasady normatywne dominujące w danym czasie w niemieckiej polityce emerytalnej. Następnie opisano budzące duże kontrowersje w bieżącej debacie kwestie adekwatności świadczeń niemieckiego systemu zabezpieczeń emerytalnych, które pokazano za pomocą wielowymiarowego podejścia. Analiza prowadzi do ambiwalentnych wniosków – rozwój zabezpieczeń emerytalnych oraz wzrost gospodarczy w ciągu ostatniego półwiecza doprowadziły do tego, że osoby starsze doświadczyły dużego awansu w ogólnospołecznej piramidzie dochodów. Jednakże reformy przeprowadzone na początku nowego tysiąclecia spowodowały, że powszechny system ubezpieczeń emerytalnych jest w coraz mniejszym stopniu w stanie spełniać swoje pierwotne podstawowe założenie, którym było zabezpieczenie standardu życia. Ogólnie rzecz biorąc, w ostatnich latach emerytury osób starszych nie nadążają za powszechnym rozwojem płac. Dzisiaj w Republice Federalnej Niemiec ubóstwo wśród osób w podeszłym wieku jeszcze nie jest palącym problemem, jednakże wiele przemawia za tym, że w przyszłości zdecydowanie się to zmieni.The main subject of the article are German retirement pension payments and amounts and their adequacy given the changes in force since the 1950s. Initially is presented the main premises of retirement policy from the introduction of the ‘dynamic retirement pension’ in 1957 right up until the very latest retirement pension reforms. The main emphasis is placed on the basic normative principles functioning at a given time within German retirement policy. Next described are the questions – highly controversial in the current debate, of the adequacy of German retirement pension payments: this being shown through a multidimensional approach. Analysis has resulted in ambivalent conclusions – the development of retirement insurance schemes as well as economic growth over the course of the last half a century has resulted in older people experiencing a noticeable improvement in their positioning within the general income pyramid of society. However, the reforms carried out at the beginning of the new millennium mean that the current system of retirement pensions is increasingly less able to fulfil its primary premise, which was to protect the standard of living. Generally speaking in recent years the retirement pension payments of old people are not keeping up with the general growth in pay levels. Although poverty amongst the old is not a grave problem at the moment in Germany a lot points to this situation changing in the future