Risky Business: How Older 'At Risk' People in Denmark Evaluated Their Situated Risk During the COVID-19 Pandemic
In: Anthropology & Aging: journal of the Association for Anthropology & Gerontology, Volume 41, Issue 2, p. 167-176
ISSN: 2374-2267
n/a
4 results
Sort by:
In: Anthropology & Aging: journal of the Association for Anthropology & Gerontology, Volume 41, Issue 2, p. 167-176
ISSN: 2374-2267
n/a
In: Clotworthy , A & Westendorp , R GJ 2020 , ' Risky business : How older 'at risk' people in Denmark evaluated their situated risk during the COVID-19 pandemic ' , Anthropology & Aging , vol. 41 , no. 2 , pp. 167-176 . https://doi.org/10.5195/aa.2020.318
The COVID-19 pandemic has presented us with a unique opportunity to examine how societies manage urgent biological risk. While evaluating the available evidence is an important aspect of risk analysis, the resultant political decisions may contain certain biases and blind spots; thus, when they are experienced in everyday life, public-health measures may not consider the lived experience of those whom the decisions affect. As such, the pandemic has also provided us with an opportunity to learn how people experience risk-adverse public-health measures, and how they manage uncertainty. In Denmark, for example, the government's response included a risk-adverse approach that labelled people age 65+ as one of the population groups most 'at risk' for infection. But what are older people's (phenomenological) experiences of being categorised in a 'high-risk' group? This paper is based on telephone interviews with 32 people across Denmark, including 14 people (eight women and six men) between the ages of 65 and 83, which were conducted to gain insight into how the pandemic and the first months of the societal lockdown in Denmark affected their mental health, everyday behaviour, and social lives (both in person and on the internet/social media). We describe how, in response to unclear biopolitical discourses and decisions being made for 'their own good,' older people reclaimed their agency by evaluating their individual circumstances to determine their own situated risk and to manage this existential uncertainty on their own terms. Our reflections focus on the consequences of the current pandemic on older lives, and particularly how governments – when faced with future public-health crises – can implement fairer preventative measures that consider the societal value and capabilities of older people.
BASE
In: Clotworthy , A , Kusumastuti , S & Westendorp , R GJ 2021 , ' Reablement through time and space : A scoping review of how the concept of 'reablement' for older people has been defined and operationalised ' , BMC Geriatrics , vol. 21 , 61 . https://doi.org/10.1186/s12877-020-01958-1
Background: While the field of rehabilitation has determined a common definition of professional practice, legislators and healthcare professionals in various Western countries have struggled to reach consensus about how the newer offer of 'reablement' should be organised, operationalised, and understood as a health service for older adults. International research indicates that there is confusion, ambiguity, and disagreement about the terminology and the structure of these programmes, and they may not be adequately supporting older people's self-identified goals. Could an analysis of the concept's genealogy illuminate how reablement can be more effective and beneficial in theory and in practice? Methods: We conducted a qualitative and quantitative scoping review to determine how reablement has developed through time and space. Eligible articles (n=86) had to focus on any of the defined features of current reablement programmes; there were no restrictions on study designs or publication dates. In articles published from 1947–2019, we identified themes and patterns, commonalities, and differences in how various countries described and defined reablement. We also performed an analysis using computer software to construct and visualise term maps based on significant words extracted from the article abstracts. Results: The fundamental principles of reablement have a long history. However, these programmes have undergone a widespread expansion since the mid-2000s with an intention to reduce costs related to providing long-term care services and in-home assistance to growing older populations. Despite theoretical aspirations to offer person-centred and goal-directed reablement, few countries have been able to implement programmes that adequately promote older people's goals, social involvement, or participation in their local community in a safe, culturally sensitive and adaptable way. Conclusions: Reablement is meant to support older people in attaining their self-defined goals to be both more physically independent at home and socially involved in their communities. However, until legislators, health professionals, and older people can collectively reach consensus about how person-centred reablement can be more effectively implemented and supported in professional homecare practice, it will be difficult to determine a conceptual description of reablement as a service that is unique, separate, and distinct from standard rehabilitation.
BASE
BACKGROUND: A high circulating concentration of interleukin 6 is associated with increased risk of coronary heart disease. Blockade of the interleukin-6 receptor (IL6R) with a monoclonal antibody (tocilizumab) licensed for treatment of rheumatoid arthritis reduces systemic and articular inflammation. However, whether IL6R blockade also reduces risk of coronary heart disease is unknown. METHODS: Applying the mendelian randomisation principle, we used single nucleotide polymorphisms (SNPs) in the gene IL6R to evaluate the likely efficacy and safety of IL6R inhibition for primary prevention of coronary heart disease. We compared genetic findings with the effects of tocilizumab reported in randomised trials in patients with rheumatoid arthritis. FINDINGS: In 40 studies including up to 133,449 individuals, an IL6R SNP (rs7529229) marking a non-synonymous IL6R variant (rs8192284; p.Asp358Ala) was associated with increased circulating log interleukin-6 concentration (increase per allele 9·45%, 95% CI 8·34-10·57) as well as reduced C-reactive protein (decrease per allele 8·35%, 95% CI 7·31-9·38) and fibrinogen concentrations (decrease per allele 0·85%, 95% CI 0·60-1·10). This pattern of effects was consistent with IL6R blockade from infusions of tocilizumab (4-8 mg/kg every 4 weeks) in patients with rheumatoid arthritis studied in randomised trials. In 25,458 coronary heart disease cases and 100,740 controls, the IL6R rs7529229 SNP was associated with a decreased odds of coronary heart disease events (per allele odds ratio 0·95, 95% CI 0·93-0·97, p=1·53×10(-5)). INTERPRETATION: On the basis of genetic evidence in human beings, IL6R signalling seems to have a causal role in development of coronary heart disease. IL6R blockade could provide a novel therapeutic approach to prevention of coronary heart disease that warrants testing in suitably powered randomised trials. Genetic studies in populations could be used more widely to help to validate and prioritise novel drug targets or to repurpose existing agents and targets for new therapeutic uses. FUNDING: UK Medical Research Council; British Heart Foundation; Rosetrees Trust; US National Heart, Lung, and Blood Institute; Du Pont Pharma; Chest, Heart and Stroke Scotland; Wellcome Trust; Coronary Thrombosis Trust; Northwick Park Institute for Medical Research; UCLH/UCL Comprehensive Medical Research Centre; US National Institute on Aging; Academy of Finland; Netherlands Organisation for Health Research and Development; SANCO; Dutch Ministry of Public Health, Welfare and Sports; World Cancer Research Fund; Agentschap NL; European Commission; Swedish Heart-Lung Foundation; Swedish Research Council; Strategic Cardiovascular Programme of the Karolinska Institutet; Stockholm County Council; US National Institute of Neurological Disorders and Stroke; MedStar Health Research Institute; GlaxoSmithKline; Dutch Kidney Foundation; US National Institutes of Health; Netherlands Interuniversity Cardiology Institute of the Netherlands; Diabetes UK; European Union Seventh Framework Programme; National Institute for Healthy Ageing; Cancer Research UK; MacArthur Foundation.
BASE