Suchergebnisse

It is not uncommon today to find aged and decrepit workers relegated to the industrial scrap-heap as useless and of no economic value. . . . The problem facing the aged today is largely the creation of the modern machine industry with its components of specialization, speed, and strain. . . . The introduction of new inventions and more specialized machinery, inevitable in the evolutionary process, while resulting in the ultimate good, always involves the replacing of men, which in the case of the aged, has an absolutely harmful effect, as it leaves them destitute [Epstein, 1972: 4–5, orig. 1922. Abraham Epstein was the founder of the American Association for Old Age Security].By the 1920s, social reformers believed that the requirements of modern industry created an increasing disadvantage for older people "in competition with those who have the greater quickness and adaptability of youth" (Nassau, 1915: 15). Old-age poverty resulting from unemployment was considered to be an urban problem because in rural communities "there is always work . . . and rent is negligible" (Nassau, 1915: 15).

The debate on old-age pensions in New York during the 1920s raised questions about traditional poor-law concepts concerning family responsibilityfor the aged and about the impact of industrialization and immigration on family security. The article examines these questions by analyzing a sample of families which included persons 65 years or older, in New York in 1925. The evidence consists of information on households collected from a state-wide sample of 1815 persons from the New York manuscript census of 1925. Low income among the employed may have forced the creation ofcro wded households among the new immigrants living in cities. But cultural expectations also contributed to different types of household structure. A west- European marriage pattern meant that American- and west-European-born elderly had fewer children to rely upon in old age, regardless of economic status. The immigrants from eastern and southern Europe stressed the value of children as insurance in old age. Family norms varied between cultural groups before industrial ization and continued even in post-industrial societies.

Background: COPD is among the leading causes of chronic morbidity and mortality in the European Union with an estimated annual economic burden of €25.1 billion. Various care pathways for COPD exist across Europe leading to different responses to similar problems. Determining these differences and the similarities may improve health and the functioning of health services. Objective: The aim of this study was to compare COPD patients' care pathway in five European Union countries including England, Ireland, the Netherlands, Greece, and Germany and to explore health care professionals' (HCPs) perceptions about the current pathways. Methods: HCPs were interviewed in two stages using a qualitative, semistructured email interview and a face-to-face semistructured interview. Results: Lack of communication among different health care providers managing COPD and comorbidities was a common feature of the studied care pathways. General practitioners/family doctors are responsible for liaising between different teams/services, except in Greece where this is done through pulmonologists. Ireland and the UK are the only countries with services for patients at home to shorten unnecessary hospital stay. HCPs emphasized lack of communication, limited resources, and poor patient engagement as issues in the current pathways. Furthermore, no specified role exists for pharmacists and informal carers. Conclusion: Service and professional integration between care settings using a unified system targeting COPD and comorbidities is a priority. Better communication between health care providers, establishing a clear role for informal carers, and enhancing patients' engagement could optimize current care pathways resulting in a better integrated system.