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Inequalities relating to health and the life course : disability, mental Illness and older age

SAMMAN, Emma
RODRIGUEZ-TACKEUCHI, Laura
November 2012

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"Issues related to early childhood feature prominently in the MDG framework (as do malnutrition, HIV status and malaria), and data collection in these areas is fairly advanced. Other sources of inequality are notable by their virtual absence - among these, older age, disability and mental illness, although these issues each appear to affect sizeable numbers of particularly vulnerable people throughout the world. A clear obstacle to ‘mainstreaming’ these sources of inequality in a new post-2015 agreement is the widespread lack of nationally representative internationally comparable data. This could arise from definitional or technical issues (what to measure and/or how), operational issues (e.g., resource or capacity constraints), attitudinal issues (relating to stigma) and/or lack of demand from data users. Greater attention is needed to explore these constraints and how they might be overcome. To this end, this paper discusses currently available data and its limitations, constraints to better data collection and efforts needed to adjust key international survey instruments- the World Bank’s Core Welfare Indicator Questionnaire (CWIQ) and Living Standards and Measurement Survey (LSMS), Macro International’s Demographic and Health Survey (DHS) and the UNICEF Multiple Indicator Cluster Survey (MICS) - to collect reliable data on these sources of inequality, alongside other household indicators"
Note: Accepted under the "Addressing Inequalities" Global Thematic Consultation - Call for Proposals for Background Papers, Oct 2012

Common European guidelines on the transition from institutional to community based care|Guidance on implementing and supporting a sustained transition from institutional care to family-based and community-based alternatives for children, persons with dis

THE EUROPEAN EXPERT GROUP ON THE TRANSITION FROM INSTITUTIONAL TO COMMUNITY BASED CARE (EEG)
November 2012

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These guidelines "provide practical advice about how to make a sustained transition from institutional care to family-based and community based alternatives for individuals currently living in institutions and those living in the community, often without adequate support. The Guidelines are aimed primarily at policy and decision makers in the European Union and the neighbouring countries with responsibility for the provision of care and support services for children, people with disabilities and their families, people with mental health problems and older people"

Toolkit on the use of European Union funds for the transition from institutional to community based care

THE EUROPEAN EXPERT GROUP ON THE TRANSITION FROM INSTITUTIONAL TO COMMUNITY BASED CARE (EEG)
November 2012

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This toolkit "aims to explain how European Union funds can support national, regional and local authorities in designing and implementing structural reforms aimed at facilitating the development of quality family-based and community-based alternatives to institutional care. It addresses primarily the desk officers of the European Commission, managing authorities, intermediate bodies, monitoring committees and project promoters in the EU Member States and in acceding, candidate and potential candidate countries; and any other donors investing in services for children, people with disabilities, people with mental health problems or older people"

The voices of the marginalised

CAIN, Emma
October 2012

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"Drawing on the experience of four organizations (ADD International, Sightsavers, HelpAge International, Alzheimer’s Disease International), this paper argues the case for a greater focus on horizontal inequalities which relate to social factors of ‘difference’, and which contribute to marginalization. By focusing on the experience of persons with disabilities, older people and people with mental health issues, the paper explores the dynamics and mechanisms which marginalize individuals, and calls for a greater focus on these issues in current and future development frameworks. The paper highlights the importance of bringing the ‘lived experience’ in to the analysis and policymaking process through initiatives such as the ‘Voices of the Marginalized’ research project which promotes the voice and participation of persons with disabilities, older people and people with mental health issues"
Note: Accepted under the "Addressing Inequalities" Global Thematic Consultation - Call for Proposals for Background Papers, Oct 2012

Mainstreaming ageing into the post-2015 process

BEALES, Sylvia
March 2012

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This policy brief presents information supporting an accountable, rights-based and age-inclusive post-2015 policy framework that supports people across their life course, and across social, economic and environmental domains. It oulines the core issues, areas for action and related recommendations

Bridging aging and developmental disabilities service networks : challenges and best practices

FACTOR, Alan
HELLER, Tamar
JANICKI, Matthew
March 2012

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This reports aims to provide the "best practices guide to encourage the ‘bridging’ of the aging and developmental disabilities service networks that are both in need of including managed long-term, integrated care for people who are dually eligible for Medicaid and Medicare, and rebalancing initiatives that promote community living"

JSLU, JSPACA, PKSA, Cash and in-kind transfers for at-risk youth, the disabled, and vulnerable elderly social assistance programm and public expenditure review 7

WORLD BANK
February 2012

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Direct cash transfers for vulnerable elderly and disabled populations have been provided by the Indonesian Ministry of Social Welfare (Kementerian Sosial, Kemensos) since 2006; a similar cash transfer for at-risk youth was inaugurated in 2009. These programs Jaminan Sosial Lanjut Usia (JSLU), Jaminan Sosial Paca Berat (JSPACA), and program Kesejahteraan Sosial Anak (PKSA) for the elderly, disabled, and youth respectively transfer cash directly to beneficiaries. They account for increasing shares of the Kemensos overall budget, but subsidies directed to care and rehabilitation facilities as well as direct provision of institutional care still account for a noticeable portion of the Kemensos budget for these groups.  The report summarises quantitative and qualitative evidence in order to build a sound foundation for evaluating these cash transfer programs . Design features, efficiency and effectiveness of program implementation and operation, and impacts are analyzed. 

Constraint - Induced Movement Therapy: Determinants and Correlates of Duration of Adherence to Restraint use Among Stroke Survivors with Hemiparesis

OLASUNKANMI, D O
OLASUMBO, S A
2012

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Background: Constraint-Induced Movement Therapy (CIMT) was developed to improve purposeful movement of the stroke-affected extremity by restricting the use of the unaffected extremity. The two main components of CIMT are the training of the more-impaired arm to perform functional tasks, and the restraint of the less-impaired arm. One challenge that the application of CIMT faces is in ensuring adherence to the use of restraint.

 

Purpose: There is a need to determine the factors that may influence adherence, as this would allow CIMT to be delivered more effectively, and prevent situations where unrealistic expectations are placed on stroke–affected individuals.

 

Methods: Thirty stroke survivors with hemiparesis who met the inclusion criteria were consecutively recruited from the physiotherapy out-patient clinics, using a purposive sampling technique. A structured questionnaire was used to obtain information on clinical and socio-demographic parameters. The participants were given a restraint and an adherence time log-book, to make a daily record during the period they wore the restraint. The adherence time log- book was collected at the end of every week of the 3-week study. Motor function and functional use of the upper limb were measured using Motricity Index and Motor Activity Log respectively. Data was analysed using mean and standard deviations, independent t-test and Spearman rho; p was significant at 0.05.

 

Results: Gender (p=0.73) and side affected/handedness (p=0.79) had no significant influence on the percentage duration of adherence to restraint use (DARU). The influence of socio-economic status was seen, with the participants of middle socio-economic status adhering for longer duration (p=0.02). Age had weak and no significant correlation with percentage DARU (p=0.55). There was significantly fair correlation between motor function/functional use at any stage (p=0.55) and the corresponding percentage duration of adherence to restraint use, except the functional use in the first week (p=0.44).

 

Conclusion: Socio-economic status should be considered when applying CIMT.

Ageing in the twenty-first century : a celebration and a challenge

UNITED NATIONS POPULATION FUND (UNPF)
HELP AGE INTERNATIONAL
2012

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"This report, a collaborative effort of the United Nations and other major international organizations working in the area of population ageing, sheds light on progress towards implementing this Plan. It aims to raise awareness about the speed of population ageing and, more generally, about the experience of being old in our changing world. It recommends moving urgently to incorporate ageing issues into national development plans and poverty reduction strategies. It also shows that abuse, neglect and violence against older persons are much more prevalent than currently acknowledged, and points the way towards more effective prevention strategies and stronger legislation that can protect their human rights"

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