Care services for frail older people in South Korea

This paper examines the changed social circumstances of older people in South Korea and specifically the increased need for formal health and social services for those who are frail and have no informal carers. The article begins with a summary account of the country's exceptionally rapid demographic, economic and social transformations, which demonstrates a widening gap between the population's expectations and needs, and health and social service provision. It then examines the recently initiated and now burgeoning welfare programmes, with particular attention to health and social services for sick and frail older people. Most extant care services are accessed mainly by two minorities: the very poor and the rich. The dominant policy influence of physicians and a history of conflict between traditional and western medicine probably underlies the low current priority for ‘care’ as opposed to ‘cure’, as also for the management of chronic conditions and rehabilitation. Neither long-term care services nor personal social services are well developed. There is a marked disparity between the acute services, which are predominantly provided by private sector organisations in a highly competitive market and broadly achieve high standards, and public primary care and rudimentary residential services. The latter are weakly regulated and there are many instances of low standards of care

HYDRA: a Java library for Markov Chain Monte Carlo

Hydra is an open-source, platform-neutral library for performing Markov Chain Monte Carlo. It implements the logic of standard MCMC samplers within a framework designed to be easy to use, extend, and integrate with other software tools. In this paper, we describe the problem that motivated our work, outline our goals for the Hydra pro ject, and describe the current features of the Hydra library. We then provide a step-by-step example of using Hydra to simulate from a mixture model drawn from cancer genetics, first using a variable-at-a-time Metropolis sampler and then a Normal Kernel Coupler. We conclude with a discussion of future directions for Hydra.

Policy and service responses to rough sleeping among older people

Rough sleeping in Britain has a long history, and interventions have alternated between legal sanctions and humanitarian concern. This paper critically examines recent changes in homeless policies and services, with particular reference to the needs of older people who sleep rough. The characteristics and problems of the group are first described. Single homeless people were formerly accommodated in direct-access hostels but, from the 1970s, individualised rehabilitation and resettlement have spread. Most recently, services dedicated to older people have begun (although remain few and are unevenly provided). Their achievements are reviewed and drawn upon in formulating normative proposals of the appropriate service mix. The 1990s ‘Rough Sleepers Initiative’ and related programmes promoted a ‘social care market’ of not-for-profit organisations that compete for increased (but short-term) funds to provide services, and the new Labour government will build upon these changes and increase funds. Low tolerance towards the ‘social exclusion’ of homelessness is promised but unerringly constructed as exclusion from work; while rough sleeping is dubbed as anti-social, coercive approaches to achieve a two-thirds reduction are foreseen. The proposed target might stall the development of diverse and effective services, or reduce providers' capacity to combat the perversities of resource allocation. The overall prospects for the improvement and expansion of services to provide significant help to single older homeless people are uncertain

The well-being of British expatriate retirees in southern Europe

This article examines the personal outcomes of overseas residence in later life, by analysing some findings from the first large-scale, comparative study of the retirement of British citizens to southern Europe. Four study areas are compared: Tuscany in Italy, Malta, the Costa del Sol of Spain, and the Algarve region of Portugal. The analysis focuses on the expressed reasons for moving to and residing in the areas, the reported advantages and disadvantages, and the respondents' predictions of whether they would stay or leave in response to adverse and beneficial events. Overall the subjects give very positive reports, but there are considerable differences among the four areas. The associations of individual variation in well-being with both a person's ‘temporal commitment’ to the area and to facets of their social integration are analysed. The onset of severe incapacity, sufficient to prevent the continued running of a home, is the event most likely to cause people to leave their adopted areas of residence

The diversity and welfare of older migrants in Europe

This paper sets the scene and provides a conceptual framework for the articles in this special issue. They present the findings of research on European residents who have reached or are on the threshold of old age and whose current circumstances have been strongly influenced by a migration across an international border. Such ‘older migrants’ are scattered throughout Europe and they have especially diverse characteristics. They include some of the most deprived and socially excluded, and some of the most affluent and accomplished, but all to a greater or lesser extent are disadvantaged through an interaction between social policies and their ‘otherness’ by living in a foreign country. Some claim attention through the severity of their unmet health and welfare needs and poor capacity to access advice and treatment, while the affluent groups are of great interest to social gerontology because of their enterprising, developmental and positive approaches to old age. They include among the most innovative of the latest generation of older people, who pursue new combinations of family responsibilities, leisure pursuits and income generation. The paper proposes that the concept ‘human capital’ summarises variations in preparedness for old age, that is, the resources by which people cope with demands for income, roles, treatment, care and support. A typology of the ‘welfare position’ of international migrants in contemporary Europe is presented

Inactivation of murine norovirus on a range of copper alloy surfaces is accompanied by loss of capsid integrity

Norovirus is one of the most common causes of acute viral gastroenteritis. The virus is spread via the fecal-oral route, most commonly from infected food and water, but several outbreaks have originated from contamination of surfaces with infectious virus. In this study, a close surrogate of human norovirus causing gastrointestinal disease in mice, murine norovirus type 1 (MNV-1), retained infectivity for more than 2 weeks following contact with a range of surface materials, including Teflon (polytetrafluoroethylene [PTFE]), polyvinyl chloride (PVC), ceramic tiles, glass, silicone rubber, and stainless steel. Persistence was slightly prolonged on ceramic surfaces. A previous study in our laboratory observed that dry copper and copper alloy surfaces rapidly inactivated MNV-1 and destroyed the viral genome. In this new study, we have observed that a relatively small change in the percentage of copper, between 70 and 80% in copper nickels and 60 and 70% in brasses, had a significant influence on the ability of the alloy to inactivate norovirus. Nickel alone did not affect virus, but zinc did have some antiviral effect, which was synergistic with copper and resulted in an increased efficacy of brasses with lower percentages of copper. Electron microscopy of purified MNV-1 that had been exposed to copper and stainless steel surfaces suggested that a massive breakdown of the viral capsid had occurred on copper. In addition, MNV-1 that had been exposed to copper and treated with RNase demonstrated a reduction in viral gene copy number. This suggests that capsid integrity is compromised upon contact with copper, allowing copper ion access to the viral genome

Exploring Pronatalism and Assisted Reproduction in UK Medicine

Globally, procreation is highly valued, and motherhood has long been seen as the normative role for women. Production of a biologically-related family in keeping with social norms is a key driver of the growing demand for assisted reproductive technologies as a ‘cure’ for infertility, which includes the provision of in vitro fertilisation (IVF) within the UK’s National Health Service (NHS). In this paper I argue that pronatalism – a social bias in favour of biological motherhood – entrenches harmful social norms for women as a group. I will question whether assisted reproductive technologies in the form of IVF bring radical change to women, or whether radical change is in fact required before assisted reproductive technologies can be considered to be liberating. I will explore whether the NHS access criteria for IVF are enabling or restrictive of women’s reproductive autonomy, paying particular attention to how the restrictions on sexuality and age contribute to this debate. I argue that despite the social harms of pronatalist bias, eliminating public funding of IVF would wrongfully target those women who are reproductively marginalised, for example, same-sex couples, trans groups, women of advanced maternal age and women who are unable to pay for treatment. Instead, I argue that access to IVF within the NHS should be maintained, but I propose amendments that ensure that the service is more equitably distributed to those in same-sex couplings. Further, I suggest ways that IVF can be included in a wider range of measures that tackle the social issues of infertility in women of advanced maternal age. Finally, I make recommendations for the medical profession to help reduce pronatalist bias, ensuring maximum autonomy for women when they are considering their reproductive futures