Equivalization of incomes for household composition is accepted practice when measuring poverty but other variations in needs are rarely acknowledged. This paper uses data from two U.K. household surveys to quantify the extra costs of living associated with disability. The extra costs of disability are derived by comparing the "standard of living" of households with and without disabled members at a given income, having controlled for other sources of variation. Logit and ordered logit regressions are used to estimate the relationship between a range of standard of living indicators, income, and disability. The extra costs of disability derived are substantial and rise with severity of disability. Unadjusted incomes significantly understate the problem of low income amongst disabled people, and thereby in the population as a whole. Copyright 2005 Blackwell Publishing Ltd.
The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma and rhinitis and (3) to develop guidelines with all stakeholders that could be used globally for all countries and populations. ARIA—disseminated and implemented in over 70 countries globally—is now focusing on the implementation of emerging technologies for individualized and predictive medicine. MASK [MACVIA (Contre les Maladies Chroniques pour un Vieillissement Actif)-ARIA Sentinel NetworK] uses mobile technology to develop care pathways for the management of rhinitis and asthma by a multi-disciplinary group and by patients themselves. An app (Android and iOS) is available in 20 countries and 15 languages. It uses a visual analogue scale to assess symptom control and work productivity as well as a clinical decision support system. It is associated with an inter-operable tablet for physicians and other health care professionals. The scaling up strategy uses the recommendations of the European Innovation Partnership on Active and Healthy Ageing. The aim of the novel ARIA approach is to provide an active and healthy life to rhinitis sufferers, whatever their age, sex or socio-economic status, in order to reduce health and social inequalities incurred by the disease.
The active and healthy ageing measure reported here is calculated for the 28 European Union countries, with a specific focus on the current generation of older people and by using the latest data from multiple surveys. It covers diverse aspects of active and healthy ageing, by measuring older people’s contribution with respect to not just employment but also their unpaid familial, social and cultural contributions and their independent, healthy and secure living. The article presents the first-of-its-kind quantitative measure of active and healthy ageing in the literature on active and healthy ageing which hitherto has focused largely on concepts, definitions and public policy strategies. In this pursuit, an important contribution of this measure, referred to as the Active Ageing Index (‘AAI’), is that it also captures how countries differ with respect to capacity and enabling environments for active and healthy ageing. The AAI offers a breakdown not just by four domains of active and healthy ageing but also by gender. Key findings are that Sweden comes at the top of the country ranking, followed closely by Denmark, the United Kingdom, Finland, the Netherlands and Ireland. The four southern European countries (Italy, Portugal, Spain and Malta) are middle-ranked countries. Greece and many of the Central European countries are at the bottom, highlighting much greater untapped potentials of active and healthy ageing among older people in these countries and a need for greater policy efforts. Women fare worse than men in most countries, identifying a need for an emphasis on reducing gender disparity in experiences of active and healthy ageing. The AAI tool developed has the potential to identify the social policy mechanisms behind the differential achievements of active and healthy ageing, for example, what active and healthy ageing strategies have driven top performers, and in what respect the bottom-ranked countries have lagged behind.
The COVID-19 pandemic has affected about 210 countries with more than 67 million confirmed cases and over 1.5 million deaths across the globe including Pakistan. Considering the population density, health care capacity, existing poverty and environmental factors with more than 420,000 infected people and about 8300 plus mortalities, community transmission of the coronavirus happened rapidly in Pakistan. This paper analyses the short-and long-term effects of COVID-19 peak on the socio-economic and environmental aspects of Pakistan. According to the estimates, an economic loss of about 10%, i.e. 1.1 trillion PKR, will be observed in the FY 2021. Certain pandemic impediment measures like lockdowns, social distancing and travel restrictions taken by the Government have been thoroughly analysed to determine how they impacted the livelihoods of nearly 7.15 million workers. Consequently, a rise of 33.7% of poverty level is projected. While many negative impacts on primary, secondary and tertiary sectors of the economy such as agriculture, education and health care are observed, a drastic improvement in air quality index of urban centres of the country has been recorded amid lockdowns. With current economic crisis, fragile health care system and critical health literacy, a well-managed and coordinated action plan is required from all segments of the society led by the public authorities. Thorough assessment of COVID-19 scenario, management and control measures presented in this study can be assistive for the provision of policy guidelines to governments and think tanks of countries with similar socio-economic and cultural structure.
Large differences in COVID‐19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage were associated with low death rates in European countries. SARS‐CoV‐2 binds to its receptor, the angiotensin converting enzyme 2 (ACE2). As a result of SARS‐Cov‐2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT 1 R) axis associated with oxidative stress. This leads to insulin resistanceas well as lung and endothelial damage, two severe outcomes of COVID‐19. The nuclear factor (erythroid‐derived 2)‐like 2 (Nrf2) is the most potent antioxidant in humans and can block the AT 1 R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are given: Kimchi in Korea, westernized foods and the slum paradox. It is proposed that fermented cabbage is a proof‐of‐concept of dietary manipulations that may enhance Nrf2‐associated antioxidant effects helpful in mitigating COVID‐19 severity.
Health is a multi-dimensional concept, capturing how people feel and function. The broad concept of Active and Healthy Ageing was proposed by the World Health Organisation (WHO) as the process of optimizing opportunities for health to enhance quality of life as people age. It applies to both individuals and population groups. A universal Active and Healthy Ageing definition is not available and it may differ depending on the purpose of the definition and/or the questions raised. While the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) has had a major impact, a definition of Active and Healthy Ageing is urgently needed. A meeting was organised in Montpellier, France, October 20-21, 2014 as the annual conference of the EIP on AHA Reference Site MACVIA-LR (Contre les Maladies Chroniques pour un Vieillissement Actif en Languedoc Roussillon) to propose an operational definition of Active and Healthy Ageing including tools that may be used for this. The current paper describes the rationale and the process by which the aims of the meeting will be reached.
Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases as a model. The chronic respiratory disease action plan includes (1) AIRWAYS integrated care pathways (ICPs), (2) the joint initiative between the Reference site MACVIA-LR (Contre les MAladies Chroniques pour un VIeillissement Actif) and ARIA (Allergic Rhinitis and its Impact on Asthma), (3) Commitments for Action to the European Innovation Partnership on Active and Healthy Ageing and the AIRWAYS ICPs network. It is deployed in collaboration with the World Health Organization Global Alliance against Chronic Respiratory Diseases (GARD). The European Innovation Partnership on Active and Healthy Ageing has proposed a 5-step framework for developing an individual scaling up strategy: (1) what to scale up: (1-a) databases of good practices, (1-b) assessment of viability of the scaling up of good practices, (1-c) classification of good practices for local replication and (2) how to scale up: (2-a) facilitating partnerships for scaling up, (2-b) implementation of key success factors and lessons learnt, including emerging technologies for individualised and predictive medicine. This strategy has already been applied to the chronic respiratory disease action plan of the European Innovation Partnership on Active and Healthy Ageing. Electronic supplementary materialThe online version of this article (doi:10.1186/s13601-016-0116-9) contains supplementary material, which is available to authorized users.
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