Contribution and presentation at the International Conference on Population Geographies - Groningen, June 2013.
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The so called Second Demographic Transition (Lesthaeghe and Van der Kaa, 1986), which surfaced in the sixties of the twentieth century in Western Europe and North America, resulted from a significant change in the pattern of norms and values. This again resulted in delayed fertility, a declining population when there was no replenishment through "replacement migration” and an increasing variety of household structures (with a rising number of one-person households). The rise in life expectancy coupled with a declining fertility, evolved into a gradual ageing of the population.The concept of ‘unbalanced population decline’ (Van Nimwegen and Heering 2009) enables us, while studying population decline, to take into account different motives underlying the decision to migrate during the life course; young people migrating in search of higher education and job opportunities and elderly clustering in places with a high facility level. This unbalanced population decline is taking place in some rural parts and smaller towns in the Netherlands. Especially the two migration flows mentioned above determine the structure of the population and the possibilities for effective family, kin and other social support systems for the elderly.Method:Analysis using amongst others recent demographic data from de community of Oldambt (Netherlands)Results:It will be shown that the effects of the demographic transition in the North of the Netherlands are accelerated because of unbalanced population decline. Furthermore it will be argued that because of this combination in parts of the Northern Netherlands family, kin and social support systems for the elderly are deteriorating more rapidly than in other parts of the county.Conclusion:Combined effects of demographic transition and unbalanced population decline urge for a reconsideration of the possibilities to rely on family, kin and other social support systems in different regions in the Netherlands.
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In this contribution to the book “Human rights and social equality: challenges for social work" Nol Reverda is creating a society in which the quality of life experienced by seniors is improved by asking them to continue contributing their qualities and talents to society. The focus is then no longer on their shortcomings and their needs for care but rather on seniors ’capacities and contribution to society – in short, a grey society without waste.
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Thirty to sixty per cent of older patients experience functional decline after hospitalisation, associated with an increase in dependence, readmission, nursing home placement and mortality. First step in prevention is the identification of patients at risk. The objective of this study is to develop and validate a prediction model to assess the risk of functional decline in older hospitalised patients.
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The structure and financing of collective long-term care and support in the Netherlands changed dramatically with the introduction of the Social Support Act (WMO) the 1st of January 2015. This act arranged that municipalities assist people to live in their homes for as long as possible by providing various forms of aid and support. This aid and support however, is in addition to the help that people arrange for themselves and / or receive in the form of volunteer aid (mantelzorg) by family, friends and neighbours. Furthermore under this Act people only become eligible for state financed sheltered accommodation in the exceptional case of severe physical or mental illness. The fact that under the new regime of the Social Support Act municipal support is made additional to volunteer aid, it is important to understand what role family, friends and neighbours potentially can play and in fact do play. This is especially important in regions were unbalanced population decline through out-migration of young people, effectively changes social structures and accelerates the ageing of the population. For this reason we designed a limited pilot-study to test the possibilities and the necessity of a broader study focussing on potential and every day practice concerning volunteer aid for elderly in regions characterized by unbalanced population decline. In this pilot study we will focus on a rural municipality in the north of the Netherlands: Oldambt.Within the framework of this pilot-study we focussed on living arrangements and social network of two groups of senior citizens; one group of men and women aged 65-79 and one group aged 80 years and over. Based on demographic data kindly made available by the municipal office of Oldambt, in this paper we will draw a picture of these citizens living in the municipality. Going deeper into the material and the municipality’s structure we will than focus on one of the municipality’s communities, Finsterwolde, with its village, hamlets and surrounding rural area. For the purpose of this pilot-study we constructed a sample of 30 men and women aged 80+-elderly and asked them to fill in a questionnaire. Based on the outcomes of these questionnaires we than had five in-depth interviews with some of them. Finally, on the basis of the gathered material, we will draw some general conclusions while presenting some new questions for further research into the living conditions and social support systems for elderly in a region with unbalanced population decline and accelerated ageing.
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A growing number of older patients undergo cardiac surgery. Some of these patients are at increased risk of post-operative functional decline, potentially leading to reduced quality of life and autonomy, and other negative health outcomes. First step in prevention is to identify patients at risk of functional decline. There are no current published tools available to predict functional decline following cardiac surgery. The objective was to validate the identification of seniors at risk—hospitalised patients (ISAR-HP), in older patients undergoing cardiac surgery. A multicenter cohort study was performed in cardiac surgery wards of two university hospitals with follow-up 3 months after hospital admission. Inclusion criteria: consecutive cardiac surgery patients, aged ≥65. Functional decline was defined as a decline of at least one point on the Katz ADL Index at follow-up compared with preadmission status.
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Maintaining independence is the most important goal of the majority of older people. The onset of disability in activities of daily living is one of the greatest threats to the ability of older people to live independently. Older people with a low socioeconomic status (SES) are at high risk of functional decline. It is unclear what predicts functional decline in older people with a low SES. The aim of this study was to determine predictors of 12-month functional decline in community-living older people with low SES in the Netherlands. Functional decline was defined as the inability to perform (instrumental) activities of daily living. A prognostic multicentre study was conducted, using data from The Dutch Older Persons and Informal Caregivers Survey Minimum DataSet. A multivariable logistic regression model was fitted, using a stepwise backward selection process. Performance of the model was expressed by discrimination, calibration and accuracy. A total of 4.370 participants were included. The mean age of the participants was 80 years and 58.9% were female. Functional decline was present in 1486 participants (34.0%). Ten predictors were independently associated with the outcome. Dementia was the strongest predictor (OR 1.83, 95% CI 1.04–3.23). Other predictors were age, education, poor health, quality of life rate, arthrosis/arthritis, hearing problems, anxiety/panic disorder, pain and less social activities. The final model showed an acceptable discrimination (C-statistic 0.69, 95% CI 0.67–0.70), calibration (Hosmer-Lemeshow p-value 0.33) and accuracy (Brier score 0.20). Further research is needed to examine how functional decline can be ameliorated in this population.
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Purpose: Intellectual capital theory and practice predominantly focus on measuring and managing intangible assets. However, if we want to balance the intellectual capital books (Harvey and Lusch, 1999), we should recognize both intellectual assets and intellectual liabilities (Caddy, 2000). Therefore, the purpose of this article is to present a theoretical framework for measuring intellectual liabilities. Design: Identifying intangible liabilities is identifying the risk of decline and fall of organizations. One of the first extensive studies related to causes of decline and fall is Gibbon‟s Decline and Fall of the Roman Empire (Gibbon, 2003 [original publication 1776]). It seems as if the main lessons that were drawn from this study are also applicable to today‟s business environment. Therefore, the framework that is developed in this article is not only based on intellectual capital literature, but also on Gibbon‟s study into the causes of decline and fall of the Roman Empire. Findings: The findings are combined in a framework for measuring intellectual liabilities. The main distinction within the proposed framework is the distinction between internal and external liabilities. Internal liabilities refer to the causes of deterioration that arise from the sources of value creation within the organization. External liabilities refer to the causes of deterioration that come from outside and are beyond control of the organization. Originality: This article explores a relatively new topic (intellectual liabilities) from a perspective (historical sciences) that is hardly used in management science.
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Aims and objectives: To determine a valid, reliable and clinical userfriendly instrument, based on predictors of functional decline, to identify older patients at risk for functional decline. The predictors of functional decline are initially considered and, subsequently, the characteristics and psychometric qualities of existing screening instruments are investigated. Background: Functional decline is a common and serious problem in older hospitalized patients, resulting in a change in quality of life and lifestyle. Studies have shown that 3060% of older people develop new dependencies in activities of daily living (ADL) during their hospital stay. Adverse health outcomes such as mortality, a prolonged hospital stay, nursing home placement and increased dependency of older people at home are the results. Not only are the personal costs high but also, in a rapidly growing older population, the impact on health-care costs is also high. Results: Age, lower functional status, cognitive impairment, preadmission disability in instrumental activities of daily life (IADL), depression and length of hospital stay were identified as predictors of functional decline. Three screening instruments to identify hospitalized patients at risk for functional decline were found in the literature: the Hospital Admission Risk Profile, the Identification of Seniors at Risk and the Care Complexity Prediction Instrument. The reported validity was moderate. Reliability and the ease of use in the clinical setting were not well described. Conclusion.: These three instruments should be further tested in a hospitalized older population. Relevance to clinical practice. Screening is a first step to identify patients at risk for functional decline and this will make it possible to treat patients who are identified so as to prevent functional decline. Because of their ability to observe and to guide the patients and the overall view they have, nurses play a key role in this process.
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Due to a number of factors outlined in this article, the issue of population growth is excluded from the sustainability discussion. In this article, we explore some of the ethical presumptions that underlie the issues linking population growth and sustainability. Critics argue that action to address population creates social and economic segregation, and portray overpopulation concerns as being “anti-poor,” “anti-developing country,” or even “antihuman.” Yet, de-linking demographic factors from sustainability concerns ignores significant global realities and trends, such as the ecological limits of the Earth, the welfare and long-term livelihood of the most vulnerable groups, future prospects of humanity, as well as the ecosystems that support society. https://doi.org/10.1080/10042857.2016.1149296 LinkedIn: https://www.linkedin.com/in/helenkopnina/
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