Changes in social inequalities in disability-free life expectancy in Southern Europe: the case of the Basque Country

Background: Health expectancy is a useful tool to monitor health inequalities. The evidence about the recent changes in social inequalities in healthy expectancy is relatively scarce and inconclusive, and most studies have focused on Anglo-Saxon and central or northern European countries. The objective of this study was to analyse the changes in socioeconomic inequalities in disability-free life expectancy in a Southern European population, the Basque Country, during the first decade of the 21st century. Methods: This was an ecological cross-sectional study of temporal trends on the Basque population in 1999-2003 and 2004-2008. All-cause mortality rate, life expectancy, prevalence of disability and disability free-life expectancy were calculated for each period according to the deprivation level of the area of residence. The slope index of inequality and the relative index of inequality were calculated to summarize and compare the inequalities in the two periods. Results: Disability free-life expectancy decreased as area deprivation increased both in men and in women. The difference between the most extreme groups in 2004-2008 was 6.7 years in men and 3.7 in women. Between 1999-2003 and 2004-2008, socioeconomic inequalities in life expectancy decreased, and inequalities in disability-free expectancy increased in men and decreased in women. Conclusions: This study found important socioeconomic inequalities in health expectancy in the Basque Country. These inequalities increased in men and decreased in women in the first decade of the 21st century, during which the Basque Country saw considerable economic growth.

South East London Palliative and End of Life Care Education and Training Strategy: Meeting the Education and Training Needs of the Health & Social Care Workforce Involved in the Care of Patients and Carers at the End of Life.

EXECUTIVE SUMMARY Aims 1. The aims of this strategy are • to ensure that a full range of education and training related to the adult end of life care pathway is available across South East London to meet the needs of our health and social care workforce • to enable those responsible for end of life care education and training commissioning to procure comprehensively from a full range of education providers in a systematic and strategic manner. Background 2. The work that underpins this strategy was begun by the South East London Cancer Network via its Palliative and End of Life Care Coordinating Group and then developed by way of the Marie Curie Delivering Choice Programme’s Education and Training work stream.

Choose Life not Economic Growth: Critical Social Theory for People, Planet and Flourishing in the ‘Age of Nature’

Choose a fucking big television Choose washing machines, cars, compact disc players, and electrical tin openers... Choose leisure wear and matching luggage. Choose a three piece suite on hire purchase in a range of fucking fabrics. Choose DIY and wondering who you are on a Sunday morning. Choose sitting on that couch watching mind-numbing sprit-crushing game shows Stuffing fucking junk food into your mouth. Choose your future. Choose life. (Irvine Welsh, Trainspotting, 1996) Anyone who believes exponential growth can go on forever in a finite world is either a madman or an economist (Kenneth Boulding)

Informalilty in the Social and Culture Life in the City Centre of Nairobi

We live in a world of advanced technology, stiff global competition and rapid transformation of all facets of life and as a result architecture has not been spared. These transformations affect the social relations, cultural consumption and political economy that have influenced the manner in which people perform in and out of space in the city centres. The residents have adopted strategies for negotiating through the spaces sanitized by authorities and other agents. The public spaces provide the background materials for informal urban practices that are sometimes deemed illegal yet are necessary for animating the city spaces. Cities market themselves ecstatically beyond the baroque with a more visible presence of the contending parties through trademarks, public relations invasively advertised in streets, monuments (signature buildings or projects), and language. This paper comes out of a research carried out in Nairobi in February and March 2007. It examined how the notions of globalisation are reflected in the life in the city centre; the impacts on the quality of life of users of the city centre and how informal urbanism has developed as copying strategy to deal with the transformations due to liberalization and globalization.

Work-life Conflict and Social Inequality in Western Europe

Recent debates on time-use suggest that there is an inverse relationship between time poverty and income poverty (Aguiar and Hurst in Q J Econ C(3):969-1006, 2007), with Hammermesh and Lee (Rev Econ Stat 89(2):374-383, 2007) suggesting much time poverty is 'yuppie kvetch' or 'complaining'. Gershuny (Soc Res Int Q Soc Sci 72(2):287-314, 2005) argues that busyness is the 'badge of honour': being busy is now a positive, privileged position and it is high status people who work long hours and feel busy. Is this also true of work-life conflict? This paper explores the relationship between work-life tension and social inequality, as measured by social class, drawing on evidence from the European Social Survey. To what extent is work-life conflict a problem of the (comparatively) rich and privileged professional/managerial classes, and is this true across European countries? The countries selected offer a range of institutional and policy configurations to maximise variation. Using regression modelling of an index of subjective work-life conflict, we find that in all the countries under study, work-life conflict is higher among professionals than non-professionals. Part of this is explained by the fact that professionals work longer hours and experience more work pressure than other social classes, though the effect remains even after accounting for these factors. While levels of work-life conflict vary across the countries studied, country variation in class differences is modest. We consider other explanations of why professionals report higher work-life conflict and the implications of our findings for debates on social inequality.

Association between participation in life situations of children with cerebral palsy and their physical, social, and attitudinal environment:A cross-sectional multicenter European study

Objective:
To evaluate how participation of children with cerebral palsy (CP) varied with their environment.

Design:
Home visits to children. Administration of Assessment of Life Habits and European Child Environment Questionnaires. Structural equation modeling of putative associations between specific domains of participation and environment, while allowing for severity of child's impairments and pain.

Setting:
European regions with population-based registries of children with CP.

Participants:
Children (n=1174) aged 8 to 12 years were randomly selected from 8 population-based registries of children with CP in 6 European countries. Of these, 743 (63%) agreed to participate; 1 further region recruited 75 children from multiple sources. Thus, there were 818 children in the study.

Interventions:
Not applicable.

Main Outcome Measure:
Participation in life situations.

Results:
For the hypothesized associations, the models confirmed that higher participation was associated with better availability of environmental items. Higher participation in daily activities—mealtimes, health hygiene, personal care, and home life—was significantly associated with a better physical environment at home (P<.01). Mobility was associated with transport and physical environment in the community. Participation in social roles (responsibilities, relationships, recreation) was associated with attitudes of classmates and social support at home. School participation was associated with attitudes of teachers and therapists. Environment explained between 14% and 52% of the variation in participation.

Conclusions:
The findings confirmed the social model of disability. The physical, social, and attitudinal environment of disabled children influences their participation in everyday activities and social roles.

Real-life Social Attention in Children with Autism Spectrum Disorders

Autism is a neuro-developmental disorder defined by atypical social behaviour, of which atypical social attention behaviours are among the earliest clinical markers (Volkmar et al., 1997). Eye tracking studies using still images and movie clips have provided a method for the precise quantification of atypical social attention in ASD. This is generally characterised by diminished viewing of the most socially pertinent regions (eyes), and increased viewing of less socially informative regions (body, background, objects) (Klin et al., 2002; Riby & Hancock, 2008, 2009). Ecological validity within eye tracking studies has become an increasingly important issue. As of yet, however, little is known about the precise nature of the atypicalities of social attention in ASD in real-life. Objectives: To capture and quantify gaze patterns for children with an ASD within a real life setting, compared to two Typically Developing (TD) comparison groups. Methods: Nine children with an ASD were compared to two age matched TD groups – a verbal (N=9) and a non-verbal (N=9) comparison group. A real-life scenario was created involving an experimenter posing as a magician, and consisted of 3 segments: a conversation segment; a magic trick segment; and a puppet segment. The first segment explored children’s attentional preferences during a real-life conversation; the magic trick segment explored children’s use of the eyes as a communicative cue, and the puppet segment explored attention capture. Finally, part of the puppet section explored children’s use of facial information in response to an unexpected event. Results: The most striking difference between the groups was the diminished viewing of the eyes by the ASD group in comparison to both control groups. This was found particularly during the conversation segment, but also during the magic trick segment, and during the puppet segment. When in conversation, participants with ASD were found to spend a greater proportion time looking off-screen, in comparison to TD participants. There was also a tendency for the ASD group to spend a greater proportion of time looking to the mouth of the experimenter. During the magic trick segment, despite the fact that the eyes were not predictive of a correct location, both TD comparison groups continued to use the eyes as a communicative cue, whereas the ASD group did not. In the puppet segment, all three groups spent a similar amount of time looking between the puppet and regions of the experimenter’s face. However, in response to an unexpected event, the ASD group were significantly slower to fixate back on the experimenter’s face. Conclusions: The results demonstrate the reduced salience of socially pertinent information for children with ASD in real life, and they provide support for the findings from previous eye tracking studies involving scene viewing. However, the results also highlight a pattern looking off-screen for both the TD and ASD groups. This eye movement behaviour is likely to be associated specifically with real-life interaction, as it has functional relevance (Doherty-Sneddon et al., 2002). However, the fact that it is significantly increased in the ASD group has implications for their understanding of real life social interactions.

Managing Island Life:Social, Economic and Political Dimensions of Formality and Informality in Island Life

"Managing Island Life: Social, Economic and Political Dimensions of Formality and Informality in Island Life" is a significant and timely contribution to the study of islands and island life. Wide-ranging in terms of both geographical and theoretical sweep, contributions consider the conceptualisation of the island as well as social, economic and political dimensions of island life and living. Showcasing the current state of island research, contributors cover diverse areas of island life such as: informal economies in the West Indies; the effects of natural convservation policies in the Highlands and Islands of Scotland; the role of internet sites in British Isles heritage tourism, and the impact of multicultural policies in the Indian Ocean. This volume will appeal to undergraduate social scientists as well as professional anthropologists, sociologists and geographers, policy makers and islands and regional specialists.

"New" and "Old" Social Risks: Life Cycle and Social Class Perspectives on Social Exclusion in Ireland

The life cycle concept has come to have considerable prominence in Irish social policy debate. However, this has occurred without any systematic effort to link its usage to the broader literature relating to the concept. Nor has there been any detailed consideration of how we should set about operationalising the concept. In this paper we argue the need for "macro" life cycle perspectives that have been influenced by recent challenges to the welfare state to be combined with "micro" perspectives focusing on the dynamic and multidimensional nature of social exclusion. We make use of Irish EU-SILC 2005 data in developing a life cycle schema and considering its relationship to a range of indicators of social exclusion. At the European level renewed interest in the life cycle concept is associated with the increasing emphasis on the distinction between "new" and "old" social risks and the notion that the former are more "individualised". Inequality and poverty rather than being differentially distributed between social classes are thought to vary between phases in the average work life. Our findings suggest the "death of social class" thesis is greatly overblown. A more accurate appreciation of the importance of new and old social risks requires that we systematically investigate the manner in which factors such as social class and the life cycle interact.

Late-stage, primary open-angle glaucoma in Europe:Social and health care maintenance costs and quality of life of patients from 4 countries

Objective: The purpose of this study was to estimate costs and quality of life (QoL) of late-stage glaucoma patients in 4 European countries. Methods: Retrospective review of medical charts of patients with POAG who were followed in a low-vision or vision rehabilitation center in one of 4 countries for at least 1 year was used to determine patient characteristics, health status, and health care resource use. Visual impairment was measured by best-corrected visual acuity (Snellen score). Patients were also interviewed over the telephone in order to assess their health-related QoL (using EuroQol EQ-5D) and use of resources including: the number of visits to rehabilitation centers, visits to hospital and non-hospital specialists, the use of low-vision devices, medication, tests, and the use of hired home help. The costs associated with resource use were calculated from the perspective of a third-party payer of health and social care based on resource usage and unit costs in each country. Results: Patients undergoing visual rehabilitation in France (n=21), Denmark (n=59), Germany (n=60), and the United Kingdom (n=22) were identified, interviewed and had their medical charts reviewed. Annual maintenance costs of late-stage glaucoma amounted to €830 (±445) on average. Average home help costs were more than 3 times higher. QoL, on average, was 0.65 (±0.28). QoL was positively correlated with the level of visual acuity in the patients' best eye. On the other hand, visual acuity was also positively correlated to health care costs, but negatively correlated to costs of home help. Conclusions: The study was limited by its observational, uncontrolled design. The finding that late-stage glaucoma is associated with higher home help costs than health care maintenance costs suggests that potential savings from a better preventive treatment are to be found for social care payers rather than health care payers. © 2008 Informa UK Ltd All rights reserved.

Developing and evaluating the integration of Life and Social Sciences teaching to first-year Nursing and Midwifery students

Title: Evaluating the integrating of life and social sciences teaching to first-year nursing and midwifery students

Objectives: To evaluate an integrated teaching and learning approach to first-year nursing students, combining the life, social sciences and public health with a more integrated and clinical focused approach to teaching delivery

Background: Historically within the School of Nursing and Midwifery the life sciences and social sciences had been taught as separate modules with separate teaching teams. This had reflected in a somewhat dis-integrated approach to student learning and understanding without clear clinical focus on application. With focus upon student learning the teaching teams engaged with a stepped, incremental and progressive movement towards developing and delivering a more integrated structure of learning, combining the life sciences, social sciences and public health teaching and learning within the one extended first-year module. The focus was particularly on integrated understanding and clinical relevance. This paper discusses both the approach to developing the integrated model of teaching and the evaluation of that teaching.

Results: The module, combining life, social science and Public health teaching was positively evaluated by the students. Evaluations are compared and contrasted from to nursing student intakes.