April 7, 2009

UK: Age-proofing Britain's Women Professionals

. FOLSOM, California / NewsBlaze / April 7, 2009 By Barbara Lewis, Womens Feature Service In her youth, British journalist and broadcaster Joan Bakewell was labelled "the thinking man's crumpet" on the strength that she had brains as well as looks and a propensity for short skirts (it was the 1960s, after all). Now in her more demurely-dressed seventies, Bakewell has accepted a government invitation to become the 'Voice of Older People' and, as she once advanced the cause of feisty young women journalists in a then very male-dominated milieu, she is now pressing for older people, especially, older women to be heard. The thrust of her arguments is severely practical. "Older women are disadvantaged in shops (no seats, for one thing), in there being no public toilets and in terms of how they are treated ... without respect or consideration," she said when asked about attitudes towards older women. "Women still do not have equal pay for equal work and that applies at all ages." Joan Bakewell. Photo: Telegraph, UK July 2007 The government's decision to make her the spokesperson for the elderly, announced late last year, coincides with a new Equality Bill. Drawn from more than 100 separate pieces of discrimination law, for the first time it brackets legal measures against ageism with those against the five other forms of discrimination - against gender, sexual orientation, race, religion and disability. In Britain, ageism is the biggest issue of them all. It is the most commonly-experienced form of discrimination, with 23 per cent of adults reporting that they have suffered from it (three times more than any other form of discrimination), according to figures provided by British charity, Age Concern. It looms especially large for women, who, on an average, live longer than men do and make up a bigger proportion of the elderly population. Women also run the greatest risk of curtailed professional careers and reduced pension rights. "They face the double whammy of discrimination for being female, but for being older as well," said a spokeswoman for Age Concern. Last year, television news reader Selina Scott was awarded an out-of-court settlement after she brought a case against Channel Five television, claiming she had been lined up for a maternity cover position but was discriminated against for being too old. "How many women are there on mainstream current affairs programmes who are over 50? ... Yet, you look around and see lots of men," Scott, who is in her late 50s, has been quoted as saying. Channel Five's only comment was a brief statement. "The proceedings brought by Selina Scott against Five under new age discrimination laws have been settled," it said. "Five has apologised for the offence it caused Ms Scott." The channel did not disclose the terms of the settlement. Other mature women broadcasters, Kate Adie and Anna Ford, have also accused television of favouring younger women and Bakewell herself has been quoted as saying the medium is dominated by the "hideously young". Ford, in an interview with the left-leaning 'Observer' newspaper, said the rejection of older women - whose experience should make them more highly-valued - was an especially British problem. "In America, there are women with white hair who are heads of banks, heads of corporations," she was quoted as saying in December. "Where are those women here?" US women are not without complaint, however. Actress Meryl Streep attracted media coverage across the world with her comment in January that "of course there is ageism in the film industry". To tackle the British problem, the government's new legislation is expected to begin making its way through parliament in April. Its purpose is to make Britain "a fairer place," according to a government statement, announcing its 2008-2009 draft legislative programme. It will introduce an integrated "Equality Duty", preventing discrimination in the provision of services and meaning employment practices will have to be "age-proofed". In theory, broadcasting and other professions will include women of all ages. Service providers, such as insurers, and those offering professional training - routinely complained about by older people - will no longer be able to withhold services on the grounds that those requesting them are too old. "Fairness and an absence of discrimination are the hallmarks of a modern, decent society, with a strong economy, which draws on the talents of all," the government commented further of its new law. It was speaking before anyone knew the full extent of the economic crisis, which has added to the challenge of ending discrimination of all kinds. Many arguing for the better use of women in the workplace have stressed their economic value. Similarly, in the face of an ageing population, employing older people for longer would mean they make a much bigger financial contribution and are a smaller drain on the tax payer. But now cash is short and unemployment is rising, many are focused primarily on short-term costs, such as that the new legislation could entail. The Department of Health has commissioned research, showing age discrimination in the provision of health services could be expensive to eradicate. Age Concern is also concerned that the new law could take time to implement. It still warmly welcomes the changes. It is only concerned that for some elderly people, who have already waited long enough, they will be too late. Copyright © 2009, NewsBlaze, Daily News

USA: Family reaches settlement in '03 death of Alzheimer's patient

. ORLANDO, Florida / Orlando Sentinel / News / April 7, 2009 By Rene Stutzman, Sentinel Staff Writer CASSELBERRY — Herbert Allen, 85, and Abraham Semchuck, 80, lived in the same locked-down facility for Alzheimer's patients. They spent their days together, ate meals together. They were nearly inseparable, according to court records. One evening, they had a disagreement. Allen either slapped or punched Semchuck, who fell and struck his head. He died of a brain injury four days later. The medical examiner ruled the death a homicide. The State Attorney's Office called it manslaughter. Allen didn't understand what happened. Because of their suspect's infirmity, prosecutors chose not to file charges. All this happened in 2003, but Semchuck's daughter, Rosa Silverstein of Sanford, kept the case alive, filing suit in Circuit Court accusing the facility, Eastbrooke Gardens, of failing to protect her father. She recently settled with Health Care Property Investors Inc., the company that owned the property at the time. Neither side would disclose its terms. "There's no dispute that Mr. Semchuck's death was unfortunate and very sad, and you can't help but have a lot of sympathy because of it," said Samuel Salario Jr., Health Care's Tampa attorney. Salario said his client was not responsible, however. Health Care owned the land and buildings, but a different company operated the facility. Still, it opted to settle rather than face the expense of a trial, he said. The facility has since been sold to another company and also has new management, according to state and Seminole County records. No one is sure what happened the night Semchuck was fatally injured. Staff members heard two men arguing, according to court records, and when they went to investigate, found Semchuck sitting on the floor, slumped against the wall. Allen was trying to help him to his feet. Semchuck had a swollen left eye — it would soon turn black — and a bloody nose. He could not talk. An ambulance took him away. Four days later, the day Semchuck died, Casselberry police Investigator Michael E. Johnson interviewed Allen. Semchuck had threatened to hit him, Allen told the officer, so he slapped Semchuck first — on the cheek "like this," said Allen, swatting himself. "I asked Allen if he thought that Semchuck was hurt when he fell down, and he told me, 'No. He wasn't hurt. He just fell,'" Johnson wrote in his report. The officer then added this about the suspect: "He had been looking for Semchuck all day but couldn't find him." Allen died two years ago at age 88. His family would not comment. Declining health Abraham Semchuck was a metalworker born in Buenos Aires, Argentina. He and his wife, Fanny, moved to Central Florida — a condo near Altamonte Mall — in 1998 to be closer to their grandchildren. He took a job as a bag boy at Publix, according to court records. By the time he was admitted to Eastbrooke Gardens in March 2003, he was a widower whose health was in decline. He suffered from dementia and was confused, according to facility records, but overall, he was pleasant, although very hard of hearing. History of falling He also wanted to go home. A few weeks after moving in, he was caught climbing out a window, according to facility records. Four days later, Casselberry police telephoned the facility: Semchuck had escaped without anyone noticing. Semchuck also had a history of falling, according to court records. One day, he was found sitting in the middle of the floor, having slid from a chair. Another time, he fell in the dining room, injuring a finger and arm. The staff gave him a walker, but he kept forgetting to use it. The staff put Semchuck and Herbert Allen in the same room, No. 42. The two men did everything together, according to employee Tamika Ordonez. "If they weren't together, they would be following each other," she told attorneys in a sworn statement. They stuck together They also argued, according to records. Semchuck's belongings turned up missing, and Silverstein one day saw Allen wearing her father's clothing. Another time, a staff member saw Allen push Semchuck, causing him to fall. The staff moved the men to separate rooms, but that didn't keep them apart. When staff members found Allen in Semchuck's bed one day, they sent him to his own room. Semchuck, though, went trailing after him. Semchuck, a staff member wrote on his chart, "wants to stay with him." Rene Stutzman can be reached at rstutzman@orlandosentinel.com Copyright © 2009, Orlando Sentinel

USA: Before and After: Aging process mostly beyond our control, experts say

. WINSTON-SALEM, North Carolina / Winston-Salem Journal / April 7, 2009 LIVING By Janice Gaston, Journal Reporter Journal Illustration by Nicholas Weir We know the most obvious signs of aging. Wrinkles. Gray hair. Sags and bags. But for some of us, entering into our later years means some surprises. Most women will grow thicker through the middle and flabbier in their thighs and arms. The hair on their head might thin while the fine, pale hair on their faces might grow heavier and darker. Men, too, tend to thicken through the middle with age. Many will lose hair on top of their heads and gain hair in their noses and ears. While men and women will shrink in height, their noses and ears will grow. Their eyelids will droop, their jowls will sag, and their skin will grow thin. They will develop freckles, age spots and spider veins on their faces. And their brains will actually shrink. Oh, joy. I talked to three doctors -- Dr. Chip Celestino, Dr. William Palmer Jr. and Dr. Suzanne Hess -- about what happens to people as they grow older. Frank "Chip" Celestino, MD Celestino is a professor of family and community medicine at Wake Forest University School of Medicine and the director of the department of geriatrics at Wake Forest University Baptist Medical Center. Palmer is a doctor of rehabilitation medicine at Whitaker Rehab Center. Hess is a dermatologist. Aging comes from internal forces, such as genetics, and external forces, such as smoking and sun exposure. We can slow the clock by maintaining good health habits, and we can also take advantage of cosmetic surgery to keep ourselves looking youthful. But some forces of nature simply cannot be denied. They are born within us. Take the loss of height, for example. Celestino said that the discs between our vertebrae contain a lot of water; the amount of water decreases as we age, and the vertebrae squeeze closer together, diminishing our height. Even if they do everything right, Celestino said, people at age 70 are not the same height that they were at age 25. Even people who exercise and eat well will have a hard time keeping the same hard body that they may have had when they were 30, he said. As men and women age, the fat content of their bodies goes up, and muscles atrophy. A while back, when photographs surfaced of Arnold Schwarzenegger, the governor of California, in a tiny swimsuit, it was obvious that his bodybuilding days were far behind him. He looked like a lot of men older than 50, with sagging skin and flab around his middle. It's the rare person who can work hard enough to keep a trim, muscular body into old age. Some people get lucky with genetics and stay slim. But most of us go at least a little to seed. Losing and Gaining Hair Many of us will lose hair on our heads and sprout hair where we don't want it. Fifty to 60 percent of men will undergo male-pattern baldness, Celestino said. "They will grow it extensively out of their noses and ears." Women don't usually go bald, but their hair can thin as they age. And they may notice dark, bristly hairs appearing on their chins and upper lips. The hairs aren't new, he said. But the changing balance of hormones that comes with aging cause the hair follicles to produce "terminal" hairs, thick, coarse and dark, rather than the soft, downy "vellus" hairs that were there before. Even as we are producing dark hairs on our faces, we are likely to be growing gray hair on our heads. People go gray because the pigment-producing cells in the hair stop their work, Celestino said. How soon and how much we gray is determined by genetics. We might begin to turn gray in our teens, as did Taylor Hicks, an American Idol winner. Or we might be able to hold on to our natural hair color well into middle age. Most people have developed at least some gray hair by their 40s and 50s. Now, on to the skin. Our skin starts to age while we are still young, Hess said. In our 20s, we start to slowly lose collagen, a fibrous protein that provides firmness and strength to our skin. In our 30s and 40s, gravity and repetitive movements, such as frowning and squinting, begin to affect the skin, causing lines and furrows. The decreased elasticity of the skin becomes more apparent when we reach our 50s. The older we get, the more saggy and fragile our skin becomes. We bruise more easily, Palmer said. We develop all sorts of unsightly things on our faces, such as freckles, age spots, spider veins and keratoses, thick, wart-like growths. The tips of our noses start to droop, and our ears elongate. Our eyelids sag and the fat pads beneath our eyes become more prominent. People who undergo cosmetic surgery on their eyes often look significantly younger, Celestino said, "just because eyes are such a window of youth." Invisible Changes But many of the issues of aging are not visible to the eye. Bone density and muscle strength decrease, as does our reaction time, Palmer said. The lenses of our eyes become more dense and less elastic, which makes it harder for our eyes to change focus quickly. That is where bifocals come in. As men and women lose hormones that affect the immune system, including testosterone and estrogen, their ability to fight infection decreases, they are sick more often, and they take longer to recover from illnesses. The gastrointestinal system slows down when we get old, Palmer said. "When you talk to old people, everyone focuses on their bowels." With age comes increased risk of hernias, reflux and constipation. We don't taste food, smell odors or sleep as well when we get old. And then there's that brain thing. The size of the brain shrinks, Palmer said, and the blood flow to the brain can be decreased by hardening of the arteries. Therefore we don't think or reason as well. When it comes to aging, Celestino said, we can't change our genes, "at least not now." What we can do is avoid the sun and cigarettes, exercise regularly, eat smart, maintain a good body weight and get enough sleep And grow old gracefully. ■ Janice Gaston jgaston@wsjournal.com © 2009 Media General Communications Holdings, LLC

CHINA: Health care reform aims at public interests

. BEIJING, China / People's Daily / Politics / April 7, 2009 The Central Committee of the Communist Party of China (CPC) and China's State Council jointly issued a guideline on fixing the ailing health care system on April 6 after over five months of debate and revision. It kicked off the long-anticipated reform to ensure health care service is more accessible and affordable to the country's 1.3 billion people. Innovative ideas employed to make the health care system accessible and affordable to both urban and rural residents It is the core principle to provide all Chinese people with basic health care as a public service, and to make the health care system more public oriented, says Liu Xinming, an official with the Ministry of Health in charge of medical policies and regulations. Establishing a public health system covering both urban and rural residents complies with the scientific outlook on development, and highlights the principle of equality and justice, Liu adds. Professor Huang Jianshi with the Chinese Academy of Medical Sciences says that most countries worldwide have placed the equality of health and medical service as a top priority. The core principle of a medical care system is to strengthen government responsibility, make medical care service affordable to urban and rural residents alike and promote social harmony and equality. Professor Li Ling with China Centre for Economic Research notes that basic medical and health care services, if regarded as public products, will cover the country's 1.3 billion people. It will serve as a milestone in China's medical and health cause. Major breakthrough planned to make health care service accessible to all Chinese people According to the new plan, the government will set up diversified medical insurance systems in order to have urban employees, urban residents who do not work or are self-employed, and rural residents covered by some sort of insurance plan in the next three years. Subsidies provided by fiscal authorities at various levels will be increased to 120 yuan per person in 2010. China plans to push forward the implementation of basic medical insurance for urban residents in 2009, particularly for the old, the disabled and children. The ratio of those covered by the basic medical insurance is expected to pass 90 percent by 2011. Many Chinese residents suffer enormous difficulties with rising medical bills and face medical debt due to lack of health insurance and soaring medical and health care costs. Professor Cai Jiangnan with Fudan University says that expanded coverage provided the basic medical care system in the new reform plan will put an end to the lack of the proper medical treatment for urban and rural residents and soaring medical bills. Major targets set to ensure urban and rural residents to enjoy equal public services It is one of the major targets for medical reform to ensure equality of public medical services for both urban and rural residents. Professor Ma Jin with Shanghai Jiao Tong University says that every citizen is entitled to enjoy basic medical services regardless of gender, age, race, profession, residence and income. Professor Wang Hufeng with the Renmin University of China notes that public medical service is a kind of public product, which needs financial support from the government. Government institutions can afford some of the services, and others can be achieved through purchase. Policies fermented to grant subsidies to public hospitals Reform of public hospitals is the top focus of the ongoing medical and health care reform. State-run hospitals have been heavily depending on profits from medical services and drug prescriptions for their operating expenses. The profit-driven method of management has resulted in heavy burdens on patients and led to a waste of medical resources. The plan calls for the government to provide subsides for medical equipment, and aims to cut the involvement of public hospitals with drug sales to cut drug prices, medical supply prices and medical checkup fees. The income of state-run hospitals will come from two channels: service fees and fiscal subsidies. The income from drug fees in the past will be made up by the newly added medical service fees and government investment. Copyright by People's Daily

USA: World's oldest person celebrates 115th in LA

. LOS ANGELES, California / Associated Press / April 7, 2009 The world's oldest known living person celebrated her 115th birthday Monday. Melvin Daignault, left, wishes Gertrude Baines a happy 115th birthday at Western Convalescent Hospital. When the Shellman, Ga., native was born, Grover Cleveland was president and the U.S. flag had only 44 stars. Ken Hively / Los Angeles Times Gertrude Baines was honored at Western Convalescent Hospital with music, a letter from the president, and two cakes. Baines said little during the celebration as friends sang to her and she received a proclamation from Guinness World Records acknowledging her as the world's oldest person. "Who would take Los Angeles for the place that would have the world's oldest person?" Robert Young, a scientist and senior consultant with Guinness, said later in an interview. "Living that long is like winning the genetic lottery." Born in 1894 in Shellman, Ga., Baines became the world's oldest living person when a 115-year-old woman, Maria de Jesus, died in Portugal in January. Baines' physician said she only has two complaints. "Number one, she doesn't like the bacon. It's not crisp enough," the doctor, Charles Witt Jr., told KCAL-TV. "And the other thing is she fusses about her ... arthritis of her knees. She told me that she owes her longevity to the Lord, that she never did drink, she never did smoke and she never did fool around." Baines father, born two years before the Civil War in 1863, was likely a slave, Young said. Baines has outlived her entire family. Her only daughter died of typhoid fever when she was a toddler. Featured on local television newscasts in November when she cast her ballot for Barack Obama for president, Baines said she backed him "because he's for the colored." She said she never thought she would live to see a black man become president. Baines received a letter from Obama, wishing her a happy birthday. Baines worked as a maid in Ohio State University dormitories until her retirement, and has lived at the Los Angeles convalescent hospital for more than 10 years. Since 1986, Young said, the world's oldest person title has been held by a woman for all but 44 days. Copyright © 2009 The Associated Press.

UK: Working to understand men's mental health

. LONDON, England / The Guardian / JoePublic Blog / April 7, 2009 More can be done to help men in this little studied area of wellbeing Posted by Michael Addis Men's mental health is a particularly salient issue in these troubled times. Worldwide, more than one million people kill themselves each year. In the UK, men are four times more likely than women to kill themselves and there have been over 6,500 male suicides in the past six years. Incidence data from the last century show suicide rates have peaked during past economic recessions. Gay men are two to three times more likely to have a mental health problem and 4.3 times more likely to attempt suicide than straight men, and have around double the rate of depression and anxiety. 94% of young offenders are male and 80-90% have mental health problems. Furthermore, while the rate of deliberate self-harm is higher in females (associated with problems in interpersonal relationships), it is four times more likely to lead to suicide in males, and is associated with alcohol, employment, financial and housing difficulties. One question is, will we see an escalation of distress and suicide in males during the current economic downturn? Men's mental health is a dramatically understudied and poorly understood area of human wellbeing. Men are half as likely as women to be diagnosed with depression, yet twice as likely to abuse alcohol and drugs. What's going on here? One compelling possibility is that what society teaches men about what it means to be a man leads us to express our pain in ways that differ from women. Among the more striking differences is that men are more likely to keep their problems to themselves. We frequently suffer in silence, and sometimes with dire consequences. Our research at Clark University in the US has shown that men who are more likely to value self-reliance and stoicism are more likely to have significant symptoms of depression; they are also more likely to report feeling ashamed of being depressed, and more likely to keep the problem to themselves. Factors that may lead to mental wellbeing or ill-health are multiple and have complex interrelationships. Comparatively little is understood about how these manifest in men differently to women. There is lack of public knowledge about mental health problems generally. During their lifetime, 25% of the population will experience a mental health difficulty. However, when asked, half of company bosses estimated levels at 0% in their workforce. Stigma is associated with mental health problems and their perceived effect on employment. In western cultures, boys are taught that it is better to express emotions such as anger than fear or pain and there are cultural sanctions for those who deviate from this. Depression and anxiety may get expressed as anger. Men are socialised to fix problems. As one service user put it "men deal with it – I'm not dealing with it, therefore I'm not a man". No wonder men may have a tendency to play down their problems, overestimate their ability to deal with them and have a reluctance to seek help. Nor is it surprising that it is commonly hard for those around them to spot the symptoms. So, what can be done? Men and women need educating in what symptoms to look out for in themselves and others. Signs may include inability to concentrate; being unable to engage with people; a change in appetite; feelings of worthlessness or hopelessness; change in sleeping patterns; and increase in use of alcohol or drugs. Some men have faulty perceptions about, and place low value on, therapy. As a society, we need to associate help-seeking with strength and courage. Media campaigns in the UK, such as Time to Change, aim to start addressing this. The effects of redundancy on men and women need consideration and employers need educating. At Clark University there are plans to establish the first centre devoted to the study of men's mental health. Half of people experiencing depression, after a relatively short course of therapy, go on to make a full and lasting recovery. However, sitting and talking about problems is not what many men are comfortable doing. Therapists need to develop more effective methods of engaging them. The national strategy, Increasing Access to Psychological Therapies (IAPT), is aimed at identifying and treating anxiety and depression more effectively in the general population. Early statistics show lower take-up of this service among men. While research indicates that higher numbers of women experience mental health difficulties than men, it is unclear whether this is because it is a hidden problem and self-referral to the new IAPT services might help. Linking commissioning of education, social care and health care services may lead to men's needs being more comprehensively addressed in future. • Michael Addis is professor of psychology at Clark University, Massachusetts © Guardian News and Media Limited 2009

USA: When it comes to healthcare, the U.S., Britain and Canada are hurting

. LOS ANGELES, California / The Los Angeles Times / Healthcare / Opinion / April 7, 2009 Healthcare in all three countries has the same problem. They just feel it in different places. By Ezra Klein When asked by the New England Journal of Medicine to detail his healthcare vision during the campaign, John McCain concluded with a rousing denunciation of "new government bureaucracies that will translate into higher taxes, reduced provider payments and long waiting lines." Long lines come up frequently in the American healthcare discussion, the symbol of all that is to be feared about a government-run system. And it's true that in Canada and Britain, the two countries most often cited in discussions of what nationalized healthcare might mean, some patients report having to wait months for some elective treatments. Sometimes. But we've got waiting lines too -- along with 50 million uninsured and a system that costs more than twice as much per person as that of any other country. We've just managed to hide our lines through clever statistical gimmickry. Britain and Canada control costs in a very specific fashion: The government sets a budget for how much will be spent on healthcare that year, and the system figures out how to spend that much and no more. One of the ways the British and Canadians save money is to punt elective surgeries to a lower priority level. A 2001 survey by the policy journal "Health Affairs" found that 38% of Britons and 27% of Canadians reported waiting four months or more for elective surgery. Among Americans, that number was only 5%. Score one of us! Well, sort of. American healthcare controls costs in another way. Rather than deciding as a society how much will be spent in the coming year and then figuring out how best to spend it, we abdicate collective responsibility and let individuals fend for themselves. So although Britain and Canada have decided that no one will go without, even if some must occasionally wait, the U.S. has decided that most of those who can't afford care simply won't get it. When that very same survey also looked at cost problems among residents of different countries, 24% of Americans reported that they did not get medical care because of cost. Twenty-six percent said they didn't fill a prescription. And 22% said they didn't get a test or treatment. Those latter numbers are probably artificially small: If you can't afford to see a doctor, you never know that you can't afford the treatment she would recommend. In Britain and Canada, only about 6% of respondents reported that costs had limited their access to care. Moreover, surveys conducted by the Organization for Economic Cooperation and Development have found that most countries don't have waiting lines or the uninsured. Not Germany or France or Japan or Sweden, all of which have more of a mix of public and private options. But Canada is next door, and Britain speaks our language, so we tend to spend a lot of time comparing our system with these systems and not a lot of time thinking through the full range of options. In light of the "Health Affairs" data, smugness about our speedy access to care seems a bit peculiar. If someone can't afford care, we record their waiting time as zero. You don't wait for what you can't have. But a more accurate accounting would record that wait as infinite, or it would record when the patient eventually ends up in the emergency room because the original ailment went untreated. Research like this raises a simple question: Would you rather wait four months for a surgery or be unable to get it altogether? Just last week, House Republicans expressed their preference for the latter. Their long-awaited budget document was admirably specific about changes to Medicare. They call for "a new Medicare program" in which enrollees are given a check "equal to 100% of the Medicare benefit," which they can then take to the private market to purchase their own care. This proposal has a purpose beyond dismantling a popular government entitlement program. Currently, Medicare does not abide by a budget. It is not run like the Canadian or British healthcare systems. Instead, it pays whatever is deemed "reasonable and necessary." Because of that, costs are shooting through the roof: The Congressional Budget Office estimates that Medicare spending will more than triple by 2050. The Republican plan gives Medicare a budget. Costs grow only as fast as the check grows. And because the check grows more slowly than health spending does, the program saves money. But this is, in effect, almost precisely the strategy of Britain and Canada: It is the government imposing an arbitrary budget on its healthcare spending. The difference is that the British and Canadian governments try to apportion that health spending so that the whole population gets care. That can mean, alongside other cost-saving measures, longer waits for services. The Republican budget simply would give individuals a fixed check. That will mean that patients who exceed that sum and don't have money of their own go without needed care. So Americans will continue to brag that no one waits, and Canadians and Britons will continue to brag that no one goes without. And somewhere, the French and the Germans and the Japanese and the Swiss and many others will wonder why we insist on choosing between such awful extremes. Ezra Klein is an associate editor at the American Prospect. He blogs at www.EzraKlein.com. Copyright 2009 Los Angeles Times

CANADA: When a house is not a home

. TORONTO, Ontario / The Star / Living / MortgageFraud/ Identity Theft/ April 7, 2009 'My sense of security in Canada is gone' says Paul Reviczky, who learned about identity theft the hard way Paul Reviczky, 89, stands outside his house. The property was sold out from under him, likely by “tenants” who forged his name on a power of attorney. “I think he was targeted because he is elderly,” his niece says. Michael Stuparyk/Toronto Star Harold Levy An 89-year-old man has been left both heartbroken and betrayed after his North York bungalow was stolen from him in the rising wave of title fraud. Paul Reviczky, who fled Hungary in 1957 to escape Communist persecution, is one of the latest homeowners to discover that Ontario law favours banks, mortgage companies and purchasers over victims of fraud. “I was shocked to learn that this could be the law in Canada,” Reviczky says. “I fled Hungary to escape lawlessness like this and now my sense of security in Canada is gone.” Gerry Phillips, Ontario's minister of government services, vowed yesterday to change the land-registry system to protect homeowners like Reviczky from title fraud. Reviczky purchased the property at 220 Sheppard Ave. W. in 1980 for $67,500 to generate a rental income that would help pay for the education of relatives back in Hungary. The retired tobacco farmer, who came to Canada 49 years ago with his wife Ilona and his then 3-year-old daughter Marietta, says he felt so strongly about his duty to help out the family he left behind that he specified in his will that the property could not be sold after his death because the income was to be used for their support. Since his wife's death in February 2005, he has lived alone in his home a few kilometres from the rental property. Reviczky could not believe his ears on June 26 when his neighbour, a real estate agent, told him she had noticed on the computer that he had sold his rental property in May. “So I went back to my office, got the record from the computer and showed it to him,” Vivian Ho told the Toronto Star. “His face turned red and I was worried that he was going to have a heart attack.” Police believe Reviczky's most recent “tenants” forged his name on a power of attorney that purported to give a grandson named “Aaron Paul Reviczky” authority to sell the home on his behalf. “I don't have a grandson named Aaron,” Reviczky says. “I don't have any grandsons.” On May 15, “Aaron Paul Reviczky” sold the property on his behalf for $450,000 to a purchaser named Pegman Meleknia, who took out a mortgage of $337,500. “I did not get the proceeds,” Reviczky says. Reviczky's lawyer, Tonu Toome, says it was “very painful” to have to break the news to Reviczky that he may lose his house forever — even though he was an innocent victim of fraud — because Ontario law recognizes the transaction as valid where the purchaser is unaware of the scam. “I had to tell him that although he would ultimately receive financial compensation for the loss of his home, this would entail legal fees and an application to Ontario's Land Titles Assurance Fund, which could take several years,” Toome says. Says Reviczky: “I want my home ... not just some money.” Phillips, who bears responsibility for the province's land titles registration system, says he met last week with 50 representatives of all the communities affected by title fraud — including police, real property and financial institutions — to get advice on how to stem this increasingly prevalent crime. “This is a high priority for our government and I want people to know that we are treating it seriously,” Phillips says. Earlier this summer, several other identity-theft victims in Toronto were also shocked to discover they weren't protected by the law. Click to read about more cases of IDENTITY THEFT © Copyright Toronto Star 1996-2009

CANADA: Calorie restricted diet helped elderly memory performance, shows study

. VANCOUVER, British Columbia / METRO CANADA / Vancouver / Mind & Body / April 7, 2009 Eat less, remember more By Celia Milne, Metro Canada Eating fewer calories may help fend off dementia, reported a recent German study. A German study has found that eating less may help improve memory in older people. The findings suggest that simply eating fewer calories could help fend off dementia, a benefit that has been shown in animal studies in the past. Researchers divided 50 healthy elderly people into three groups. They ranged in weight from normal to slightly overweight. The study took place over three months. The first group received 30 per cent calorie restriction; the second group received a higher amount of “good fats” found in olive oil and fish (but the same total fat intake); and the third group proceeded with a regular diet. Memory performance was measured before and after the three-month period, using standardized tests. The people who were on calorie restriction had a boost in memory of about 20 per cent, while those in the other two groups had no change. “They remembered more words on average from a word list, with an average of about a fifth more,” Dr. Agnes Flöel, a neurologist at the University of Münster in Germany, told Metro. PD Dr. med. Agnes Flöel Klinik und Poliklinik für Neurologie University of Münster “Our study provides some first evidence on the impact of calorie restriction on memory in the elderly, but this study has to be followed up now by us and hopefully others,” added Flöel, who led the study. The next step is to try to repeat the findings in a larger group of healthy elderly people and to try to figure out why calorie restriction can aid memory. Then, the group plans to study the use of calorie restriction in those with mild cognitive decline. Memory loss is quite common. A recent survey found that 58 per cent of Canadian baby boomers (ages 40 to 60) have had short-term memory loss over the past year. Much more serious is Alzheimer disease, which affects a small number of young people, and one in 20 Canadians over age 65 (one in four over age 85). The Alzheimer Society of Canada predicts that in the next 25 years, Alzheimer disease will more than double in the Canadian population. Flöel warned that people who already suffer from Alzheimer disease might not be good candidates for calorie restriction, since they tend to lose weight anyway, and become emaciated. “To implement calorie restriction at this stage might actually be too late for any brain-beneficial effects, and might be detrimental to them as far as their general health status is concerned,” she reported. Copyright 2001-2009, Free Daily News Group Inc.

UK: "I've a fulfilling life in London, but my children and grandchildren never want to see me"

. LONDON, England / Telegraph / Lifestyle / April 7, 2009 Lifeclass By Lesley Garner In Lifeclass this week, Lesley Garner advises a reader on how to see more of her children and grandchildren. Victim of your own success: you seem so independent that your children don't think you need them Photo: GETTY Dear Lesley, I am a 70-year-old widow, and will be spending Easter alone. I was alone at Christmas, too. I have three children in their thirties and forties. The youngest has refused to speak to me for more than 10 years, and even the death of his father five years ago didn't change that. His siblings don't know why he is like this, and it's probably one of the reasons I am being sidelined more and more. My children get together but leave me out. What can I do about it, if anything? My heart aches with the loss. It feels as if I am dead already in their eyes. I have a busy, fulfilling life in the heart of London with a studio flat, and I go to art classes. I cannot put anybody up because my flat is so small, but I choose to live here so that I can have a life on my own. If I tried to reason with my children, they would accuse me of emotional blackmail or self pity. I am not a bossy, controlling mother, but little and funny. The children all left home at 18 and went to university, and I am proud of them. I have two grandchildren, but I rarely see them and am not allowed to speak to them on the phone. About twice a year they come to London, as they live within easy reach, and I get a call from them every three months. Is it too late for us to get close, or at least a little closer than we are now? I have two friends of 78 and 82, whose children ignore them as well. We wonder if there are a lot of neglected grannies out there. As there are so many homes for oldies, it is obvious that not all children care for their elderly parents. Is that why mine stay away now, so that they can justify not looking after me later? Is it too late to have their friendship? When we are together, we never stop talking and laughing. But it's the lack of overall communication that is causing me pain. Hester Dear Hester, To answer one of your questions first, of course it is not too late to get close, or – more realistically – at least a little closer than you are now. But before I look at how you might help this happen, it's worth dismantling your letter for some clues as to how you arrived at your situation in the first place. You say that you have two friends who are in a similar situation to yours, ignored by their children. And you are not the only grandparent who has written to me complaining of loneliness and neglect by your children, so this is a situation worth addressing. And it is certainly one you can do something about. Unhappiness lies in the gap between our expectations and reality, so I would like to know what would make you happy? What contact would be enough for you? I once read about a study into happiness that found that Finnish mothers, isolated by dark winters, were actually happier than Italian mothers with big families. The reason was that in Finland, everybody knows that winter travel is difficult, and you don't expect to see your children. But in Italy, where big, cheerful families are the norm, a missed visit is a catastrophe. Communication is everything, and I don't just mean family visits. You sit alone in your little flat – and I'll come to that in a minute – and imagine that you are being excluded from your children's lives; and, as night follows day, that they don't like or love you any more. I imagine that your children, busy in their own lives, tell each other and their friends how wonderful you are. She's great, they probably say. Terribly independent, lives a life of her own, doesn't need us, always up to something new –­ she's taking art classes now. How wonderful, their friends say. And then they come to visit you and you have a lovely time, laughing and reminiscing, and they go away happy. They obviously think you don't need them yet. This doesn't mean that, should you fall ill, or need their care, they wouldn't rally round. I don't include the son who won't speak to you. You have given me no clues about him, but there is a story there to unravel. What strikes me is that you are a victim of your own success. Note your Freudian slip –­ you wrote of making not a life "of" your own, but a life "on" your own. Well, that is what you have got. You are quite a character, and you are giving out some strong messages. You describe yourself as "little and funny", which strikes me as slightly odd. That's just one step short of "cute", which is a description more appropriate to a child than a woman of wisdom. It sounds as though you have a persona that firmly denies your age and vulnerability; a woman who is at pains to be seen as little and funny is not being entirely honest about her feelings and her needs. There is a middle way between being needy and self-pitying, and being so bright and brisk that you make it hard for people to see the real you. And you have a flat that won't allow you to have visitors? I made this mistake a few years ago and then, despite the upheaval, after 18 months, I decided to move in order to get the extra bedroom. It's lovely to be able to offer friends a bed, and wouldn't it be nice to ask your grandchildren to sleep over? If one or other of your children spent the odd night with you, you would find that the visit was much more relaxed than a rushed, hectic lunch party. You complain about not being visited, but how much of a welcome do you offer? You are the one who wants the situation to change, and so you are the one who is going to have to make the initial moves. Don't give them a chance to call you self-pitying. Make positive suggestions for visits and calls. I think you also have to be honest with yourself about how much you have contributed to the way things are. And you need to be aware that your children's lives are much busier than yours. I am not excusing them but they need to be taught how to treat you. I remember a time when I only ever got calls from my children when there was a problem – until I pointed this out and said it would be nice to get a call just to say "Hello, how are you?". I also remember a time when my own parents reproached me for lack of contact, especially with their grandchildren. What they didn't realise was that their grandchildren were of an age when their own parents hardly saw them either. The thing is, families change shape all the time, and patterns of contact and visiting are up for renegotiation. Most people I know worry about their parents a lot, even if they don't see them regularly. Most people I know realise that there will come a time when their parents really need them. In the meantime, all signs of independence from healthy, active parents are welcome. You give out a lot of signs of independence, and your children have gone to sleep on you. It is time to be honest with them about your feelings. It's not that you want to become dependent on them but the pendulum has swung too far. Start with the one to whom you feel closest, and get your diaries out. • What do you think? Are you neglected by your children, do you feel guilty about your elderly parents or have you worked out the perfect relationship? Or do you have a completely different problem for me to look at? Write to me at lesley.garner@telegraph.co.uk Lesley Garner's Lifeclass Lesley Garner is a journalist, artist and author of three self-help memoirs. Her weekly Lifeclass column offers readers advice on everything from sexual dysfunction and money worries to family tensions and cyber bullying © Copyright of Telegraph Media Group Limited 2009

INDIA: 50% IT employees unwell, reports Assocham

. NEW DELHI, India / The Times of India / April 7, 2009 More than half of corporate India's workforce suffers from various chronic and lifestyle diseases, with those in the information technology (IT) and IT-enabled services (ITeS), media, knowledge process outsourcing (KPO) and financial services topping the list, says an industry group report. A study by the Associated Chambers of Commerce and Industry of India (Assocham), said 54 per cent of the workforce in the IT and ITeS sectors were afflicted with depression, severe headaches, obesity, chronic backache, spondylosis, diabetes and hypertension. It said of them, 23 per cent suffered from spondylosis, 20 per cent from sleeping disorder and 18 per cent from obesity. Other ailments were depression (16 per cent), fatigue (13 per cent) and high blood pressure (9 per cent). "Corporate employees have to survive the stiff global competitive environment to save their jobs, which affects their health," said Assocham secretary general D S Rawat. In the media sector, 51 per cent of respondents suffered from similar ailments, with about 36 per cent suffering from high blood pressure, 29 per cent from depression and 15 per cent afflicted with diabetes. Of the near 50 per cent of KPO employees who reported ailments, 24 per cent suffered from sleeping disorder, 17 per cent reported regular headaches and fatigue, 12 per cent suffered from depression and 9 per cent with diabetes and obesity. Financial Services emerged as the fourth hardest-hit sector, with 47 per cent of its workforce reporting various ailments. Of them, 24 per cent suffered from a high level of fatigue, 18 per cent from diabetes, 14 per cent had cardiovascular disorders and 12 per cent sleeping disorder. The Assocham survey covered companies from 18 broad sectors. Copyright © 2009 Times Internet Limited

NEW ZEALAND: Pensioners better off in NZ, reports study

. AUCKLAND, New Zealand / The New Zealand Herald / April 7, 2009 By Isaac Davison According to the OECD's survey, elderly Kiwis are among the best looked-after senior citizens in the world. Photo BOP Times New Zealand's older citizens are well looked after by the Government - in fact, better than in the world's richest nations. Only 2 per cent of New Zealand's retirement-age population were classed as below the poverty line in a 2008 OECD study. Just 13 of the 30 countries had poverty rates of less than 10 per cent among older people. The study of 30 OECD countries compared the income level of retirement-age New Zealanders to median disposable income levels. However, several organisations who work with older people said the study does not reflect the financial reality of New Zealand's retirees. A transtasman comparison found Australia's older population in far worse shape, with 27 per cent of over-65s below the poverty line. Michael Littlewood, co-director of the University of Auckland Retirement Policy and Research Centre, said: "There are several possible explanations for New Zealand's favourable international position but the most obvious difference between New Zealand and the other 29 OECD countries is the simple, generous New Zealand superannuation pension." However, social policy researcher Charles Waldegrave said if the study were to use the official New Zealand poverty threshold (60 per cent of disposable income levels), New Zealand would place last in the same study. "Most of our superannuants sit in the band between 50 and 60 per cent of median household income." Some organisations working with older people said the OECD study findings were misleading. Age Concern chief executive Ann Martin said: "They just don't match what older people are telling us. Common sense tells us you can't live on $12,500 - $16,000 per person [after tax] annually, but that's what most superannuitants have to do. "International comparisons of living standards and superannuation are notoriously unreliable. For example, in New Zealand there's none of the additional supports, like cold-weather power payments and free medical visits, that UK superannuitants get." Grey Power president Les Howard said that older people still struggled financially in New Zealand because of flaws in our superannuation system and the effect of the economic downturn. * Coping with life Which country's older people are best off? 1= NZ, Netherlands, Czech Rep 4: Luxembourg 5= Iceland, Hungary, Poland 15: United Kingdom 26: United States 27: Australia Source: OECD, Growing Unequal? Income Distribution and Poverty in OECD Countries

JAPAN: Why don't my parents count as members of the family?

. TOKYO, Japan / The Japan Times / Life in Japan / Features / April 7, 2009 HOTLINE TO NAGATACHO By Amit Chaturvedi Dear Ministry of Justice, "A beautiful country, the land of the rising sun, home of the most helpful people in this world . . ." If anyone ever asks me about Japan, that's what I tell them. I consider Japan to be the ideal country to live in — a perfect world, even with the language barriers. The next question from my friends or colleagues is inevitably: "Then why did you leave?" I often ask myself this question, and every time I can come up with only one answer: "In Japan, parents are not considered part of the family." Because of this, when I lived in Japan my parents couldn't stay with me for longer than three months. Obviously I chose my family over the country that I — and my family, including my parents — loved. Even now, I cannot understand why the idea of elderly parents being part of the family is so unimaginable in Japan. Whenever my parents came to visit, my colleagues were always surprised that they stayed with me in my house for three months. The expressions on their faces made me think that it was no wonder the Japanese Immigration Bureau does not count parents as dependents, and hence never grants them dependent visas or tourist visas of longer than three months. I have been to the immigration office in Shinagawa many times, and they are some of the most polite officials I have ever met. However, after they have listened to you carefully they will tell you in simple terms that they cannot extend your parents' tourist visa. They are "not part of your family," so they can't get dependent visas either. Coming from the Indian subcontinent, I had always counted even my uncles and my cousins as being to some extent dependent upon me as part of an extended family. But I think at the very least, parents are thought of as part of the family unit all over Asia. I thought the same would apply for Japan, which has historically been a closely knit society, but I guess things have changed. I don't see how it would negatively impact on the government, and in particular the Immigration Bureau, if they decided to allow parents of "aliens" to stay longer, for six months or a year. They could apply safeguards to prevent abuse, such as that they not be able to work during their stay, or have to go back home once a year, for example. For many of my friends this has become an important issue. Some opted to stay in Japan for a better future and others, like me, put priority on the family and left despite their professional and personal preference. The Immigration Bureau should think about this issue and help improve the lives of "alien" professionals working in and for Japan. Hotline to Nagatacho community@japantimes.co.jp (C) The Japan Times Ltd

PAKISTAN: Senior Citizens Not Required to Renew ID Cards

. ISLAMABAD, Pakistan / The News International / April 7, 2009 Senior citizens more than 65 years old are not required to renew their Computerized National Identity Card (CNIC), according to the instructions of Nadra. A spokesperson of National Data Base and Registration Authority (Nadra) has asked the citizens to renew the period of their computerized Identity Card as soon possible for their legal, businesses and other matters. Nadra spokesperson said that authorities always informed the citizen about developments through media. He said that computerized Identity Card period is in the favour of the citizen to keep the data update in the national database. Source: thenews.com.pk

UK: Pensioners' lives 'getting worse'

. LONDON, England / BBC News UK / Pensioners / April 7, 2009 One in four pensioners believe their lives have got worse in the last year A quarter of UK pensioners feel their lives are getting worse, a report by the merged charity Age Concern and Help the Aged has suggested. Of 1,000 people aged 65 and over questioned, 24% said their quality of life had deteriorated in the past year. The charity says that equates to more than two million people across the UK. The report, "One Voice" tracks progress on issues affecting older people. Of 30 indicators, 13 showed things had got worse, while 13 remained unchanged. Only four indicators had shown a year-on-year improvement. A random sample of 1,000 people aged over 65 were questioned across the UK and the results weighted to the profile of all adults in that age group. Researchers found that 60% of those questioned believed age discrimination exists in the everyday lives of older people - a rise of 7% on last year. Meanwhile, 52% believed that people planning services were not paying enough attention to pensioners - up 8%. Stuck in the past Michelle Mitchell from Age Concern and Help the Aged said: "Loneliness, depression, poverty and neglect blight the lives of millions of older people and for many, evidence shows the situation is getting worse, not better. "Attitudes to older people are stuck in the past, the care and support system for older people is on the brink of collapse and older people's experiences of isolation and exclusion have largely been ignored by successive governments. "Despite the economic conditions dominating the headlines, the current government and all political parties must not shy away from addressing the long term challenges of an ageing society. "Beneath the shocking statistics are real life human tragedies - avoiding the issues is no longer an option." According to Age Concern and Help the Aged, 19% of pensioners now live below the poverty line, which it says is the equivalent of more than two million people. It acknowledges that some progress was made last year, with the government committing to a ban on age discrimination, and preparing for a Green Paper to reform social care, but says much more needs to be done. The report sets out the charity's priorities for action in 2009 and calls on the government to spend between £1bn and £2bn extra on older people's social care as part of any fiscal stimulus. The charity also wants the government to outlaw mandatory retirement ages, and to roll out automatic payment of benefits. Pensions Minister Rosie Winterton said there needed to be a change in public attitudes towards older people and insisted their needs were "very much a priority" for the government. "Our commitment to help today's pensioners is resolute with the increase in state pension by 5% from this month and changes from 2010 that will mean women and carers will find it easier to get a full basic state pension," she added. Age Concern England and Help the Aged have joined together to form a single new charity. © BBC MMIX

CANADA: Dad's Stuff - Relics of a former life

. TORONTO, Ontario / Globe and Mail / Life / April 7, 2009 In an hour all I had thrown out were Dad's old bookends and a mug. Maybe we could just keep the apartment By Gail Kerbel When my father moved from his rambling house to a three-room apartment, my siblings and I were enlisted to help. Since we didn't know what to do with all the stuff from our childhood home, we crammed everything into his new digs. The silver and crystal that was brought out for company, the entire Encyclopedia Britannica, 1965 edition, the dusty boxes of report cards extolling our virtues as friendly, co-operative children, the massive dining room table with its 12 gold flocked chairs — we transferred all of it. "Have I told you how much I love this place?" my father would ask. "You have, Dad." "I come home from work, make a coffee and relax in the Florida room. I just love it." The Florida room was a narrow, enclosed porch overlooking a parking lot. I don't know what it had to do with Florida. "That's great, Dad." My father was telling me he had no intention of leaving his apartment and moving to a nursing home. Sorry, Dad. We put it off as long as we could, longer than we should have. But when his arms were too weak to hoist himself from his chair, when his legs were too feeble to carry his weight, we moved him to a home. We thought that if we brought some items from the apartment — a pink velvet loveseat, a blue ottoman — maybe that would cheer him up, maybe he would rally. As if upholstery had magical restorative powers. He was there for five days, and then he died. Once again, we had to pack up the stuff. My two brothers, my sister and I held a family meeting to figure out how to close the apartment. We sat in his living room with our coats on, four adult orphans wishing we were anywhere but there. It would have been more comfortable if we could have taken our coats off, but all the windows were open to let in fresh air. In the weeks before we had to move him, our father sealed up his apartment, sat in a chair and smoked, and a bitter stench still lingered in the place. We sorted through the items quickly because no one wanted much. We all had our own stuff, and our father had suggested the furniture might be worth an interesting sum. We spent the rest of the afternoon shivering and discussing what we would do with the proceeds from a sale. I was considering a trip to Andalusia. I arrived one morning to prepare for a meeting with a woman from a high-end consignment store. I displayed the crystal and silver on the dining room table, lit one of my father's stale cigarettes, sat on the pink loveseat and calculated what we'd make from this bounty. I figured we'd clear about $40,000. But I miscalculated. It turned out the woman wanted … nothing. Apparently, the furniture that I thought was so exquisite, that I used to sashay around pretending to be Scarlett O'Hara receiving gentlemen callers, was faux French Provençal from Eaton's. The market was flooded with the stuff and nobody wanted it. Adios Andalusia. I took a green garbage bag into my father's office, opened it wide and tossed in some old bookends. Then I sat at the desk, fired up another cigarette, opened the top drawer and nearly choked on my sadness. There was his handwriting on squares of white notepaper: reminders of doctor's appointments, shopping lists, little conversations with himself in script so familiar I could hear his voice. I closed the drawer and opened another. It contained a number of plaques honouring my mother's charitable work. One of them had her photo mounted between two acrylic plates. I already had the picture, but how do you throw out an item with your mother's face on it? You don't. I had been there for an hour, and all that I'd managed to throw out were the bookends and a chipped mug. My brother came by to pick up some documents and spied the mug in the garbage. "You're throwing that out?" he asked. "It's broken," I said. "But that's the mug that held the pencils on the shelf by the phone." I pulled it from the bag. It was becoming clear that we were never going to have the place cleaned out by the time the lease expired. There was only one thing to do: renew the lease. Just because my father couldn't stay in his beloved apartment didn't mean everything else had to go. I could keep the apartment and pay the rent on all the relics of a former life. And when my husband and I died, our sons could inherit the lease and stuff in the boxes of hockey trophies and Mother's Day cards and the old pine table around which we've spent so many happy hours. And then their children, if they were creative enough to make space, could cram in the mementos from their childhoods, and nobody would ever have to let go of anything again. Then I remembered the building was going to be turned into a condo. It's been a year since the furniture was trucked off to a flea market and the garbage collectors carted away the rest. Yet still when I think of the chipped mug, the acrylic plaque, the pink velvet loveseat, I want it all back. Gail Kerbel lives in Toronto. Click to download Podcast, view Illustration by Birgit Lang. © Copyright 2009 CTVglobemedia Publishing Inc

ITALY: Italy digs out earthquake dead in grim ritual of disaster

. Rescue workers pull an injured woman from her house in Onna, one of the towns severely affected by yesterday’s earthquake. Photograph: Massimiliano Schiazza/EPA ONNA, Italy / The Guardian / April 7, 2009 By John Hooper in Onna, Abruzzo There were twelve of them. Four of the bodies were in shiny new coffins. The rest were still in their improvised shrouds - quilts, sheets and even a gaily coloured curtain. All round the paddock in which the dead had been laid out under a line of trees, there were other signs of the unbearable lightness of modern disaster: a woman in a blush-pink dressing gown who stood at the end of the line of coffins making the sign of the cross as the tears gushed down her cheeks; a man in a souvenir cap advertising Radio 101 who sat on a rock with his head bowed, just a yard or two from the grimly swathed bodies of his neighbours; the woman in the spangled Playboy bunny top who was pleading with her half-delirious, tear-stained friend not to go back into the centre of the village where rescue workers were burrowing in the ruins of what until 3.30am yesterdayhad been a pretty little village under the snow-capped Apennines. Onna had about 300 inhabitants. One of the team of undertakers said they had already removed five. And within a half an hour another three corpses had been added to the sad line in the paddock, carried out of the centre by weary-looking rescue workers, their faces caked in powdery dust. Elderly women in the rubble-strewn L'Aquila street Photograph: Grillo/EPA In villages and towns nearby a similar ritual was being observed. By last night more than 150 people had been confirmed dead, 1,500 injured, in Italy's deadliest earthquake for nearly 30 years. Tens of thousands more had been left homeless - all struck by a random tragedy. In Onna, Pio Sbroglia's sister, Edwige, was one of the bundles of humanity pulled from the wreckage. "She thought she was all right at first and said she was going to make it. I was worried about the injuries to her head, but in the end the pressure of the bricks on her chest suffocated her", said the 62-year-old retired farm worker as he stood nearby, his arm in a sling and his hair matted with blood. Sbroglia was angry. "Why weren't we told to go?" he asked. The authorities insist that nothing could have been done to predict the earthquake. But, said Virgilio Collajani, his neighbour, the villagers had noticed tremors for the past three weeks. "And that isn't normal," he said. "This is a seismic area, sure. But no one alive here today has experienced an earthquake." Onna dates back to medieval times, as do some of its houses. Others were built later by families who moved up from Sicily in the days when the Abruzzo formed part of the Kingdom of the Two Sicilies. Collajani began to reel off their surnames, but when he got to that of yet another family devastated by what had just happened he broke down and wept. Minutes later, the ground shook. There was a dull, deep crack from underground - the latest in a long sequence of aftershocks that continued throughout the day and into the evening. Screams went up from a group of women huddled nearby and some of them began to run senselessly, if understandably, away from the safe, open ground. The really dangerous place to be was in the village centre where the buildings, many dating from the 16th and 17th centuries, had crumbled like piles of biscuits as the ground shook under the force of an earthquake felt as far away as Naples. Experts said the epicentre was just a few miles from Onna, on the road linking the city of L'Aquila to the hillside town of Paganica, where Angelo De Paolis, aged 57, and his friend had come to look at what was left of the convent. The neoclassical convent of Santa Chiara with its handsome, cream-coloured facade was the proudest building in town. When the earthquake struck, it did surprisingly little damage to the tallest part of the convent, in the middle. But it devastated the wings. The abbess, 61 year-old Mother Gemma Antoniucci, was apparently still asleep when the ceiling came crashing down on her. She was found dead. Another nun was pulled from the rubble but she, too, had died, according to a woman who drove up and wanted to know where the bodies had been taken. De Paolis said he had worked as a mechanic in France for 30 years to get together the money to buy the house where he lived with his wife and their two children before it was shaken to the ground in what the mayor of L'Aquila called "20 interminable seconds". "All that sacrifice," said De Paolis, shaking his head and giving a little half-smile of bewilderment. "All destroyed." Had he not taken out an insurance policy? "No," he said. "It's not something you do in these parts." Italians have a fatalistic disposition. "In any case", said his friend, Ettore Fiordigigli, "the insurance companies often don't cover you for natural disasters." The earthquake, he said, had left them "out on the streets". He and De Paolis and their families faced a night - perhaps the first of many- in a tent at the bottom of the hill where the emergency services had occupied the rugby ground and were busy turning it into a campsite. Yesterday was a clear, sunny day, but the snow on the mountains showed how cold it can get up here on the spine of Italy. Some of the survivors fled. The first petrol station on the road that leads from L'Aquila through the mountains to the Autostrada del Sole, and from there to Rome. was packed yesterday morning with cars laden with people and luggage. Along the road, people - mostly youngsters - sat, and in some cases slept, among their suitcases. Some were students made homeless when a hostel partially collapsed. Angelo Battani had come to the city with a friend who was there to sit an exam for entry into Italy's revenue guard. They had been told that the trains were not running because the track was unsafe and were both hoping that, sooner or later, a bus would come along to take them to the capital. "There were tremors on Sunday night at about 11," he said. "But I went to sleep and was woken by the earthquake just after 3.30. Our hotel held up well, but they brought out a lad from an older house nearby and I don't know whether he made it." Buildings dating from before 1980, when Italy brought in strict rules for construction in seismic areas, appeared to have fared worst. A few hundred yards away, beyond a roundabout, a block of flats possibly dating from the 1950s looked as though its front had been smashed off like brittle icing on a wedding cake. At Sant'Elia, on the outskirts of L'Aquila, Father Mauro Orru, the parish priest, stood looking at what was left of his church. His dog collar was unbuttoned and askew and his hair was dishevelled. The church of San Lorenzo had been thrown up in the dying years of Italy's "economic miracle" between 1968 and 1970, he said. Its reinforced concrete frame looked untouched, but the brickwork in between had collapsed, as had the rendering. Inside the church, a life-sized Saint Joseph leaned giddily at an angle, a baby Jesus lying in his arms, still intact but missing a finger. © Guardian News and Media Limited 2009

April 6, 2009

ITALY: Village of Mostly Elderly Residents Devastated by Quake

. ONNA, Italy / The Wall Street Journal, New York / April 6, 2009 By Stacy Meichtry For years Gabriele De Cata, the local physician, attended to this sleepy medieval village. Homes made of heavy stone walls that had stood for centuries kept Onna's 300 residents -- most of them elderly -- cool in the summer and warm in the winter, Mr. De Cata says. In the early hours of Monday morning, Mr. De Cata arrived in Onna to make his final housecall. "I ran from house to house, but there were just mountains of stones and screams," he says. At least 36 of Onna's residents were crushed to death when a 6.3 earthquake stuck the village, leaving most of it in ruin. Onna is just one of several villages around L'Aquila (7 km from L'Aquila), that were flattened during Monday's earthquake, which claimed more than 150 lives. In Onna, however, the devastation was particularly intense and its people were especially vulnerable. About 70% of the village's residents are elderly, Mr. De Cata says. Many of them lacked the strength to scramble to safety when the quake struck, he says.Mr. De Cata and other residents were able to save a few of his patients using Persian throw rugs to haul people out of their toppled homes. However, in the early hours of Tuesday, Mr. De Cata was still waiting for news on most of his patients as rescue workers sifted through the debris. Authorities had not released the names of the dead. "I had 25 patients in that town, and I don't know who made it out," Mr. De Cata says, surveying mounds of toppled stones, where homes once stood. Among the dead was 91 year-old Iole Pezzopane and her caretaker. "She's gone. The town is gone," said Pio Ludovici, her grandson, hours after pulling his grandmother's body from the rubble. Stacy Meichtry stacy.meichtry@wsj.com Copyright ©2009 Dow Jones & Company, Inc.

USA: Raising Grandchildren in a Recession

. NEW YORK, NY / The New York Times / FITNESS & NUTRITION / April 6, 2009 Every family struggles in a tough economy, but the recession poses unique problems for people raising their grandchildren. Some six million kids, representing about 8 percent of American children, live with their grandparents, according to the U.S. Census bureau. The recession is hitting these “grandfamilies” especially hard, The Wall Street Journal reports. Today, more and more children are being raised by their grandparents. These grandparents provide a crucial safety net, allowing children whose parents can’t provide for them to remain in families, instead of winding up as wards of the state. But as the recession hits “grandfamilies,” that safety net is under stress. The unemployment rate for older workers is lower than the overall rate. But once they become unemployed, older workers find it harder to land a job and they tend to remain out of work longer than younger workers, according to the Bureau of Labor Statistics. The unemployment rate for those 55 and over has been climbing significantly in recent months; in March, it rose to 6.2 percent — the highest it has been since September, 1949, according the bureau…. Many older workers who lose their jobs drop out of the work force, believing their efforts are hopeless. The number of people 55 and older classified by the federal government as “discouraged” — meaning they’ve given up looking for work because they don’t think there are any jobs for them — nearly tripled from December 2007 to December 2008, to 154,000 from 53,000, according to the AARP Public Policy Institute. The medical literature is mixed on the health effects of raising grandchildren. Some studies show that raising your grandchildren takes a toll on your health. Not only is the job physically tiring, but grandparents who are raising young children often suffer from less sleep and exposure to childhood colds and have less time to take care of themselves. At the same time, some grandparents enjoy raising their grandchildren and believe it makes them more active and connected. When grandma raises baby. Susan Farley for The New York Times To learn more about the recession and grandparents, read the full story, “‘Grandfamilies’ Come Under Pressure.” Copyright 2009 The New York Times Company

PHILIPPINES: Stiff penalties on buses, taxis not giving 20 pc cut to senior citizens

. MANILA, Philippines / Manila Bulletin / April 6, 2009 By JC Bello Ruiz All public utility vehicles, including taxis, should grant a 20-percent fare discount to Filipino senior citizens or else face stiff penalties, according to a new directive issued by the Land Transportation Franchising and Regulatory Board (LTFRB). The LTFRB has increased the penalty for non-granting of the 20 percent fare discount to the elderly to P2,500 for just the initial offense — P2,000 higher than the previous P500 fine. LTFRB Chairman Alberto Suansing said they have observed that only jeepneys and buses have been granting fare discounts to senior citizens, prompting them to issue LTFRB Memorandum Circular 2009-10 directing all public utility operators and drivers to grant a 20 percent fare discount to senior citizens who avail themselves of their services. The LTFRB noted that according to Article 7, Section XI of Republic Act No. 9257, otherwise known as “An Act Granting Additional Benefits and Privileges to Senior Citizens, “20 percent discount should be accorded to senior citizens in public railways including the Light Rail Transit, Metro Rail Transit, Philippine National Railways, Skyways, and fares in buses, jeepneys, taxi and shuttle services (Asian Utility Vehicles) shall be granted for the exclusive use and enjoyment of senior citizens.” The new directive signed by Suansing and Board Members Gerardo Pinili and Ma. Ellen Dirige-Cabatu last April 1 states that in the case of taxi service, “the full 20 percent discount on the total taxi fare shall be given to the senior citizen regardless of the number of his or her companions.” For jeepneys, buses, and GT Express vehicles (Asian Utility Vehicles), “the 20 percent discount shall be based on the amount of fare corresponding to the senior citizen.” “To avail (themselves) of the fare discount, all senior citizens should present identification documents such as ID cards issued by the City or Municipal Mayor/Office of Senior Citizens Affairs or of the barangay captain of the place where the senior citizen resides; passport; other documents that prove that the senior citizen is a Filipino who is at least 60 years old.” Copyright 2009. Manila Bulletin

USA: Retirement Ain’t Just For Senior Citizens, Anymore!

. BROOKLYN, NY / HOT INDIE NEWS / April 6, 2009 Expert Says Life After Work Should Be About Doing What You Love The word retirement conjures images of rocking chairs, sunsets and shuffleboard – and the big night out every week is a bus ride to the bingo hall. For young people and even those who are approaching the top of that hill, these ideas are about as attractive as a long, slow root canal without Novocain. But Mary Lloyd, author of Supercharged Retirement by Hankfritz Press (www.mining-silver.com), is out to change all that. Her view is that retirement doesn’t mean retreating from life, but rather, embracing it and all the things that drive our passions and fuel our fire. “The current version of retirement doesn’t work because we are living too long to be satisfied with a life that is focused primarily on leisure,” said Lloyd. “To make this stage of life meaningful, it needs to be shaped according to the values and preferences of each individual. That’s not as easy as it sounds and we need more resources to help us find the right things to create a satisfying life once we are old enough to retire.” Mary’s advice doesn’t come from studies or data, but rather, by walking the walk. By the time she was 47, she was working as a division manager for a Fortune 200 company, and found retirement a financially feasible option. So, in 1993, she left her job to embark on her “last” career as a fiction writer. Given the tough ladder she had climbed in the business world, she didn’t think this next phase of her life would be difficult. After trying everything from a multi-month world cruise to deploying to Texas with the Red Cross in the aftermath of Hurricane Rita – with a few adventures in between – Lloyd finds herself singing a different song in 2009. Her message is simple: the current approach of retirement doesn’t work. Her tips for her baby-boomer brethren include: The 100% leisure model of retirement (“the Golden Years”) is just a marketing spin for “get out of the way.” We need some kind of work to thrive once we retire, even if we don’t do it for pay. Retiring doesn’t mean we have to stop making a difference. By this time in our lives, each of us has a unique set of skills, talents and abilities. We need to mesh that with a personal sense of what’s important to define our own individual sense of purpose. Living through our sense of purpose is as essential as breathing. Once we lose that, we lose the ability to make the choices we need to thrive. Much of what we blame on aging is really the result of mindset and lifestyle decisions. It is within our capability to change and alter those elements of our ives, and master our destiny, rather than be a slave to circumstances. “The RV model might work for some, but most of us need a goal to work toward to feel worthwhile,” Lloyd said. “To retire well, we need learn how to include that and still relax and have fun.” About Mary Lloyd After more than 17 years as a management executive in the natural gas industry, Mary Lloyd decided to retire. That was in 1993, and since that time, she has accomplished more than many people do during their entire professional careers. At 62, she has more energy and drive than many people in their 30s and 40s. Her favorite activity is hiking — eight or more miles in the wilds of the Pacific Northwest whenever she has the chance. She does not believe you become “unable” once you have earned the financial freedom to retire. She hikes, skis, cycles and just took up tennis again — after ditching the erroneous assumption that she was “too old for that.” She feels she’s healthier than when she was in her 40s, and is eager to share the lessons of her experiences with others, young and not so young, so they can do more than just enjoy retirement, but rather, so they can master it. Source: hotindienews.com

USA: How To Stop Worrying About Aging

. NEW YORK, NY / Forbes Magazine / ForbesLife / April 6, 2009 Executive Health and Health Care How To Stop Worrying About Aging By Rebecca Ruiz A holistic approach to your health can help you obsess less about expensive products and procedures aimed at fixing flaws. In Depth: How To Stop Worrying About Aging Gone are the days when beauty treatments were considered recession-resistant. From skincare products to face-lifts, Americans are spending less on their looks. In the recent past, cosmetic surgery and anti-aging skincare markets had grown by double digits each year. The emphasis on products and procedures, however, often eclipsed a more balanced approach to aging and appearance that includes long-term goals like protecting the skin and staying healthy. But the recession might be just the catalyst consumers need to change their point of view. In Depth: How To Stop Worrying About Aging The markets for anti-aging skincare and cosmetic medicine are both contracting. The former, a $1.6 billion industry, is forecasted to shrink 0.7% in 2009, according to research company Mintel. And the $10 billion cosmetic surgery market has seen a 9% decline in 2008, according to the American Society of Plastic Surgeons. "People are starting to be more careful about where they spend their dollars," says Dr. Leslie Baumann, a dermatology professor and director of the University of Miami's Cosmetic Center. "They want things that really work." Trading Down Kat Fay, a senior beauty analyst at Mintel, also sees a shift in consumption patterns. In terms of skincare, consumers are trading down from pricey department store products to more affordable drug-store items. Fay expects some shoppers will stick with this tactic even when the country emerges from the recession. "Because these are emotional purchases, it boils down to how they feel about it when they have it on their skin," says Fay. "If it feels the same, they're probably not going to run back and buy the $200 version." Similarly, Baumann has noticed that her patients--in addition to choosing less expensive fillers and wrinkle-smoothing treatments instead of expensive surgeries--are asking more questions about how the results of a procedure or treatment compare to the cost. But Baumann encourages her patients to think not just about the procedures, but also the simple steps that go a long way toward slowing the aging process. Her typical patient often eschews these in favor of more aggressive treatments, including microdermabrasion and facials--neither of which has been shown to produce long-term results. The trifecta of anti-aging skincare, she says, is sun protection, antioxidants and retinoids, topical creams that have been shown to prevent and reverse wrinkles and lines. Sunscreen helps to shield the skin from ultraviolet rays, which hasten the effects of aging. Some studies have shown that antioxidants may protect cells from the effects of free radicals, molecules produced by the body when it's exposed to ultraviolet rays, pollution and smoke. Scientists have yet to determine the most effective way to deliver antioxidants to cells, but Baumann recommends eating fruits and vegetables. Retinoids, which the Food and Drug Administration has approved for anti-aging purposes, are a family of products that include retinol and Retin-A. They are available in over-the-counter and prescription forms. More Than Skin Deep While these strategies help conceal the effects of aging, Dr. Sherwin Nuland, author of The Art of Aging, urges consumers to look beyond the surface. The gradual breakdown of the body over time affects one's physical and mental abilities, a process that Nuland says can be stalled by intellectual engagement, social connectedness and exercise. Mental and social stimulation offers "a sense that you are a value to other people" says Dr. Nuland. That mentality is a powerful antidote to feelings of irrelevance that can accompany getting older. Exercise is also vital for preventing chronic diseases like cardiovascular disease and diabetes, which can easily subtract 10 years from one's visage and, most importantly, life. A holistic approach to getting older, says Dr. Baumann, can help foster less anxiety about its effects on the body. "The whole mindset needs to change about what really works," she says. "When [people] are doing all the right things, they're aging less and they feel more comfortable." In Depth: How To Stop Worrying About Aging 2009 Forbes.com LLC™

INDONESIA: Lifestyle linked to hike in Parkinson's Disease

. JAKARTA, Indonesia / The Jakarta Post / National / April 6, 2009 Indonesia will face an increasing number of people suffering from Parkinson’s disease (PD) in the future because of a growing elderly population and unhealthy lifestyles, a group of neurologists have warned. Parkinson's Disease is a degenerative-nerve disease with symptoms including tremors and slowed movement. The disease, which normally afflicts those aged over 60 but can occur at any time, also affects speech and other cognitive functions. “Research at Cipto Mangunkusumo Hospital, Jakarta, revealed that in 2005 as many as 8.5 percent of patients in the neurology section suffered from Parkinson’s disease. This was a significant increase from the previous 2.02 percent in the 2000-2004 period,” Neurologist Banon Suko said at a seminar on memory-loss diseases Saturday. She said the sudden surge could have to do with a greater public awareness of the disease, prompting people to seek treatment. “However, it is still a large number,” she said. Another neurologist Abdulbar Hamid said lifestyle played a major large role in maintaining neurological health. “People should pay extra attention nowadays to their diet and avoid unhealthy habits like smoking. Stress should also be avoided,” he said. Banon said between 1990 and 2025, the number of senior Indonesian citizens was expected to rise by over 400 percent. “From 2015 to 2020, life expectancy for Indonesians will reach more than 70 years,” she said. “This higher number of elderly people will prompt more neuro-degenerative diseases, such as Parkinson’s and Alzheimer’s disease,” she said. However, these diseases do not only threaten the elderly, Banon said. “According to the Cipto Mangunkusumo research, in 2006 almost a quarter of those suffering from Parkinson’s disease were under 50,” she said. Banon said research from the last decade showed the symptoms of PD began normally showing in an individual toward the end of their 40s. The country also still lacked proper PD treatment, she said. “Not enough people are aware of the disease, and its treatment is often poor.” For instance, many patients, along with their caretakers, rarely bother to remember the names, let alone contents, of medicines the patients should take,” Banon said. Caretakers and patients often fall into counterproductive habits that can worsen the disease’s effects, she said. “For example, patients choose to stay at home and reduce their activity rather than being active, which slows down the disease’s effects,” Banon said. Copyright © 2008 The Jakarta Post - PT Bina Media Tenggara

AUSTRALIA: Sparks fly over care for the aged

. SYDNEY, NSW / The Australian / April 6, 2009 By Patricia Karvelas, Political correspondent AGED-CARE providers are at war with Minister for Ageing Justine Elliot, with one prominent provider accusing her of "lying in the grass waiting to publicly execute a care provider as soon as they step a weary foot sideways". The aged-care sector is angry with Ms Elliot for deciding to "name and shame" them after the federal Government raised the stakes on substandard operators in the aged-care sector after pressure from consumer groups. From July, it will publish a list of all aged-care centres that have received a notice of non-compliance in the previous year or are the subject of one. Under present arrangements, centres issued a notice of non-compliance may continue to operate and are not required to disclose they have been warned. In the latest publication of aged-care journal Insight, Feros Care chief executive Jennene Buckley attacks Ms Elliot. Feros Care operates aged-care centres in NSW and Queensland. "The website appears to be another tool the minister's office has created to demoralise the hardworking, inspirational and committed people who work in aged care," Ms Buckley says. "There is too much regulation, not nearly enough resources to meet each new regulatory requirement that is thrown our way, and now we have the concern of a minister who is lying in the grass waiting to publicly execute a provider as soon as they step a weary foot sideways." Queensland's Sundale Garden Village chief executive Glenn Bunney asks: "Does the minister ever tire of beating up the industry in Australia ... Does she measure her success in her role by the number of failed aged-care facilities per annum, and the lack of confidence in the Australian system? Surely there must be some motivating factor behind the real policy vacuum under her stewardship." But Ms Elliot said she would not stop publishing incriminating data about them and was confident the aged-care sector would see the merit of publication of quality data. "I recognise that there is some hesitation, but this is about helping Australian families gain more access to information on the quality and compliance of Australia's 2830 aged-care homes," she said. "Let's work together to improve the care and quality in Australia's nursing home and hostel sector. We already have a world-class and world-leading sector, but there is always scope for improvement," she said. She has the support of National Seniors boss Michael O'Neil, who said it was crucial this information was provided. Ms Elliot said choosing an aged-care home could be very difficult and families deserved this information, especially when they were making one of the toughest decisions of their lives. "I completely reject claims that this is name and shame; this is about transparency, openness and information for families," she said. The Government has conducted almost 4200 unannounced visits to nursing homes and hostels since July 1: 2949 by the independent Aged Care Standards and Accreditation Agency and 1238 by the Department of Health and Ageing. "This is about ensuring proper care, including nutrition and hydration, in Australia's nursing homes and hostels," Ms Elliot said. Copyright 2009 News Limited Click to read "Justine Elliot's earlier press statement: Australian Government Supporting Carers and their Special Needs: $38 Million"