Who Cares? Sociodemographic and Health Characteristics of Carers of Older Persons in Jamaica / ¿Quién cuida? Características Sociodemográficas y de Salud de los Cuidadores de Personas Mayores en Jamaica

ABSTRACT Objective: To describe the sociodemographic and health characteristics and implied needs of caregivers to older persons in Jamaica. Method: This was a community-based, nationally representative study in which a sample of 180 caregivers to older persons was interviewed. Findings: Caregivers were aged between 18 and 88 years (mean 50.5; s = 14.7) and most (77%) were informal compared to 23% who were paid to care. There were no differences between urban and rural caregivers with respect to gender, union status, residing with care recipients and holding a regular job while giving care. Urban caregivers were significantly more likely to report attaining secondary education than those in rural communities (χ2 (2) = 7.40, p < 0.05). Over 90% reported they had not received any formal training in caregiving and those ≤ 45 years were more likely than those in age groups ≥ 46 years to say they want to get caregiver training (χ2 (4) = 27.1, p < 0.001). Male caregivers were significantly more likely to report being the 'child/grandchild/in-law' of care recipients than female caregivers, among whom almost one in four reported their relationship as employee (Fisher's Exact test: p = 0.002). Most caregivers (51.7%) reported being diagnosed with one or more medical condition and 89% of those diagnosed reported being prescribed medications for their illnesses. Forty-five per cent of caregivers reported that they performed one or more activity of daily living (ADL) for their care recipients daily. Conclusion: Carers of older persons in Jamaica are predominantly family members, most have not received caregiving training and most have been diagnosed with a medical condition.

RESUMEN Objetivo: Describir las características sociodemográficas y de salud, así como las necesidades implícitas de los cuidadores de las personas mayores en Jamaica. Método: Se trata de un estudio comunitario representativo a nivel nacional, en el que se entrevista una muestra de 180 cuidadores de personas de edad. Resultados: Los cuidadores tenían entre 18 y 88 años (media 50.5; s.d. = 14.7) y la mayoría (77%) eran informales en comparación con el 23% que recibían pago por el cuidado. No hubo diferencias entre los cuidadores urbanos y rurales con respecto a género, estado civil, residir con las personas objeto del cuidado, y mantener un trabajo regular a la par con la atención a los ancianos. Los cuidadores urbanos presentaban una probabilidad significativamente mayor de haber alcanzado educación secundaria en comparación con aquellos de las comunidades rurales (χ2 (2) = 7.40, p < 0.05). Más del 90% reportó no haber recibido ninguna capacitación formal en cuidados, y aquellos con ≤ 45 años eran más propensos que los de los grupos de edad ≥ 46 años a decir que deseaban recibir entrenamiento como cuidadores (χ2 (4) = 27.1, p < 0.001). Los cuidadores hombres presentaban una probabilidad significativamente mayor de ser "hijo/nieto/yerno" de personas receptoras de cuidados, que las mujeres cuidadoras, entre las cuales casi una de cada cuatro reportó su relación como empleado (Prueba exacta de Fisher: p = 0.002). La mayoría de los cuidadores (51.7%) reportaron estar diagnosticados con una o más condiciones médicas, y el 89% de los diagnosticados reportaron recibir prescripciones de medicamentos para sus enfermedades. Cuarenta y cinco por ciento de los cuidadores informó realizar una o más actividades de la vida diaria (AVD) para las personas bajo su cuidado diariamente. Conclusión: Los cuidadores de personas mayores en Jamaica son en su mayoría miembros de la familia; la mayor parte de ellos no ha recibido capacitación como cuidadores; y la mayoría han sido diagnosticados con alguna condición médica.

Approaches And Future Direction Of Social Security System: Malaysian Perspective

Social security traditionally means a social insurance program providing social protection, or protection against socially recognized conditions, including poverty, old age, disability, unemployment and others. It also hovers around the subject of social insurance, where people receive benefits or services in recognition of contributions to an insurance scheme. Providing services for medical care, aspects of social work and even industrial relations may be included as part of social security services. Lately, the term is also used to refer to basic security, a term roughly equivalent to access to basic necessities. The 1 World Conference on Social Security organised by the Brazilian Government on 1st to 5th of December 2010 stimulates the countries to adopt universal, comprehensive and equitable social security systems as a valid, ethical and feasible option in the process of national reforms and regional integration. The main challenge to achieving the noble objective of universal social security system is financial sustainability and social cohesion supported by political will. As seen in a number of countries, Malaysia has a mixed social security schemes comprising state and private schemes, statutory obligatory requirements on the part of employers as well as state social assistance programmes. Maintaining the quality of life of the individuals and their dependents has become the primary focus of policies and programmes in providing social security. Among the critical pressures on the population’s standard of living is the provision of health care. Extension of the coverage for social security is critical in ensuring social inclusion.

Experiencias de la instauración de normas relativas al contenido de plomo en aire y el agua, en los Estados Unidos de América / Establishing lead in air and water standards in the United States of America

En los Estados Unidos de América se ha logrado una disminución de la exposición a plomo de la población en general, gracias al establecimiento de diversas normas. En este artículo se destaca parte de los conocimientos adquiridos a través de la experiencia obtenida en este país en materia de plomo, en particular respecto al aire y al agua. Uno de los aspectos fundamentales es la posibilidad de contar con una base científica sólidamente establecida y claramente entendida, a partir de la cual se tomarán las medidas correspondientes. Los efectos secundarios de ciertas normas concernientes al aire ponen de manifiesto de qué manera los esfuerzos orientados a solucionar un problema pueden aportar beneficios en otras áreas, si bien pueden surgir consecuencias no deseadas, debido a la falta de previsión y de evaluación. Asimismo, en este documento se discuten las diferencias entre los enfoques centralizados y los descentralizados para el manejo de la exposición a plomo.

Thrombocytopenia in malaria.

The relationship between platelet counts and platelet bound (direct) or platelet directed (indirect) serum antibody concentrations was studied in 17 patients with Plasmodium falciparum malaria and 12 patients with P. vivax malaria. Platelet counts rose with recovery from infection from 196 +/- 84 x 10(9)/l (mean +/- SD) and 195 +/- 34 x 10(9)/l to 319 +/- 99 and 283 +/- 62 x 10(9)/l respectively (p less than 0.002), but there was no relationship between either absolute platelet count or changes in counts and either indirect or direct platelet antibody levels. These findings suggest that a non-immunologically mediated mechanism is involved in the pathogenesis of thrombocytopenia in malaria.