Search Results for 'BMJ'

Age at retirement and long term survival of an industrial population BMJ

http://bmj.bmjjournals.com/cgi/content/abstract/bmj.38586.448704.E0v1?ecoll
BMJ, doi:10.1136/bmj.38586.448704.E0 (published 21 October 3005)

[But, why did early retirees retire early? feeling unwell?]

Age at retirement and long term survival of an industrial population: prospective cohort study
Shan P Tsai 1*, Judy K Wendt 1, Robin P Donnelly 1, Geert de Jong 2, Farah S Ahmed 1

1 Shell Health Services, Shell Oil Company, 910 Louisiana, Houston, TX 77002, USA
2 Shell International, Hague, Netherlands
* Correspondence to: shan.tsaiAT shell DOT com

Objective To assess whether early retirement is associated with better survival.
Design Long term prospective cohort study.
Setting Petroleum and petrochemical industry, United States.
Subjects Past employees of Shell Oil who retired at ages 55, 60, and 65 between 1 January 1973 and 31 December 2003.
Main outcome measure Hazard ratio of death adjusted for sex, year of entry to study, and socioeconomic status.

Results Subjects who retired early at 55 and who were still alive at 65 had a significantly higher mortality than those who retired at 65 (hazard ratio 1.37, 95% confidence interval 1.09 to 1.73). Mortality was also significantly higher for subjects in the first 10 years after retirement at 55 compared with those who continued working (1.89, 1.58 to 2.27). After adjustment, mortality was similar between those who retired at 60 and those who retired at 65 (1.06, 0.92 to 1.22). Mortality did not differ for the first five years after retirement at 60 compared with continuing work at 60 (1.04, 0.82 to 1.31).

Conclusions Retiring early at 55 or 60 was not associated with better survival than retiring at 65 in a cohort of past employees of the petrochemical industry. Mortality was higher in employees who retired at 55 than in those who continued working.

(Accepted 16 August 2005)

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Preventive health care in elderly people needs rethinking

This sounds like it could be an interesting think-piece. Unfortunately, BMJ no longer gives free access to articles the first year. [this article was subsequently made available to the public for discussion.]

I don’t know what they mean by elderly, the oldest olds? The age group was 70-82. See comments.

BMJ 2007;335:285-287 (11 August), doi:10.1136/bmj.39241.630741.BE1
Analysis by
Dee Mangin, senior lecturer in general practice1, Kieran Sweeney, honorary clinical senior lecturer in general practice2, Iona Heath, general practitioner3

1 Christchurch School of Medicine, University of Otago, Christchurch New Zealand, 2 Peninsula Medical School, Royal Devon and Exeter Hospital, Exeter EX2 5DW, 3 Caversham Group Practice, London NW5 2UP

Dee Mangin, Kieran Sweeney, and Iona Heath argue that, rather than prolonging life, preventive treatments in elderly people simply change the cause of death—the manner of our dying

The first 150 words of the full text of this article appear below.

Summary points

* Single disease models should not be applied to preventive treatments in elderly people
* Preventive treatments in elderly people may select cause of death without the patient’s informed consent
* Preventive use of statins shows no overall benefit in elderly people as cardiovascular mortality and morbidity are replaced by cancer
* A more sophisticated model is needed to assess the benefits and harms of preventive treatment in elderly people

Preventive health care aims to delay the onset of illness and disease and to prevent untimely and premature deaths. But the theory and rhetoric of prevention do not deal with the problem of how such health care applies to people who have already exceeded an average lifespan. In recent years, concerns about equity of access to treatments have focused on ageism. As a result, preventive interventions are encouraged regardless of age, and this can be harmful to the patient and expensive for the health . . .

[Full text of this article via paid subscription only] The full text is now available.
http://www.bmj.com/cgi/content/short/335/7614/285?etoc

O’Folks off their rocker Add this to Bookmarks:

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Alphabetical listing (mas o menos)

2003 what the City’s intentions are

2004 Nursing Homes: what LTC providers learned from battling four hurricanes

2004- Elderly in Florida at risk in every hurricane season

2006 AI/AN data report from US Census 2000

2006 National Adult Day Services Week

A push for stay-at-home healthcare

A say in one’s or other’s life?

AARP Bulletin: Blogosphere 101

AGS Foundation for Health in Aging

AMERICAN INDIAN AND ALASKA NATIVE LONG TERM CARE CONFERENCE 2006

Academic Geriatric Nursing Capacity Awards

Activism At All Ages

Activity and exercise

Administration on Aging Pandemic Preparation

Administration on Aging Region X: AK, ID, OR, WA

After Katrina, transplanted Creoles vow to keep culture alive

Age at retirement and long term survival of an industrial population BMJ

Age by decade

Continue reading ‘Alphabetical listing (mas o menos)’

Ethnic stereotyping and ageism

The post office box this week held an issue of the New Yorker which generated mixed feelings. Many New Yorker cartoons (http://www.cartoonbank.com/) are funny because they skewer our fallacies and foibles using the stereotypes we all have about each other. Most of the stereotypes protrayed are of rich white folk.

This recent cartoon is funny because it reveals the biased attitude many employers have towards older workers. Unfortunately, the medium of expressing a worthy idea is based upon an ethnic stereotype which is problematic, at the best.


by Lee Lorenz

Hold it—we almost forgot his benefits package.” (Two eskimos sending a third out to sea on a small slab of ice.)

ID: 122851, Published in The New Yorker September 11, 2006, http://tinyurl.com/fzgsq

The stereotype underlying the cartoon’s point about ageism is false. Recently we had a physician lie about just such a scenario, up north. People were quite hurt by the accusation.

JAMA falls foul of fabricated suicide story [JAMA is Journal of the American Medical Association]

by Deborah Josefson, San Francisco

An essay published in JAMA’s Piece of my Mind section, has stirred controversy after it was revealed that the events depicted in it were fictional.

The essay was written by a medical student, Shetal Shah, and appeared last October (JAMA 2000;284:1897-8). In his essay, Mr Shah described an encounter with a 97 year old Inuit [sic. Eskimo people live in Alaska and Inuit people live in Canada.] man, a toothless elderly member of the Siberian Yupik tribe, who, feeling useless, came to say goodbye to the young medical student before committing suicide by walking off into a frozen tundra in the morning fog.

In a letter to JAMA, Dr Michael Swenson, a physician with Norton Health Sound in Nome, Alaska, and Shah’s tutor during his elective, denied the existence of such a patient. Moreover, Dr Swenson charged that Mr Shah’s false account promulgates false stereotypes about the Inuit people and perpetuates ancient myths…. Dr Swenson said that he understood Mr Shah’s tweaking of events to make them more of a story but said that the account was entirely fictional and as such reflected more of our culture’s prejudices towards elderly people than those of the Siberian Yupik….

Read the story in the British Medical Journal, on-line here

http://bmj.bmjjournals.com/cgi/content/full/323/7311/472/a

I’m not sure there is any evidence for any such a scenario in the past, except maybe under extreme conditions of long ago.

Certainly, such a slur against a large group of US citizens should not have been printed in the New Yorker. As the response to the BMJ article said,

When will medical journals learn to leave anecdotes for Cosmopolitan and fictionalized accounts for the New Yorker? The author’s explanatory note is lame in the extreme. BMJ 2001;323:472 ( 1 September )

On the other hand, I am not as troubled by Sam Gross’ cartoon at the bottom, in part because he skewers every stereotype and in part because it highlights so well the predominant establishment attitude around here about caring and valuing older people.

This is 2006. We have no nursing home; we had an assisted living residence, which was never used as such. Another assisted living residence was promised to open September 2005. After several people inquired publicly, the health corp. finally announced it might open in 2008.

July 15, 2006, Assisted living home construction could begin soon

Construction on an Assisted Living Home in the YK Delta for elders and adults with disabilities may be just beyond the horizon.

“Establishing an assisted living home is important because we have an aging population in our region and we don’t have a facility where we can take care of them properly,” said Gene Peltola, CEO of the Yukon-Kuskokwim Health Corporation.

Despite the fact that the elderly make up one of the fastest growing populations in the YK Delta, the region remains as the only area in Alaska that has no long-term assisted living facility.

http://www.ykhc.org/1253.cfm

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~


by Danny Shanahan

“Remember, son, it’s never too early to start saving for retirement.” (Father talking to son as he pushes an elderly Eskimo out to sea on an ice floe.)

ID: 46757, Published in The New Yorker November 26, 2001, http://tinyurl.com/gqwvu

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~


by Christopher Weyant

“It’s your mother. She’s floated back.” (Two eskimos watch a third float back on his ice floe.)

ID: 122883, Published in The New Yorker September 18, 2006, http://tinyurl.com/znx2s

I have never appreciated mother-in-law jokes as they are inherently misogynist. The above is next week’s New Yorker take on Eskimos.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

by Sam Gross

“Are you sure this ice floe is going to pass by the nursing home?” (Elderly Eskimo on ice floe shouts back to family who are waving good-bye.)

ID: 42864, Published in The New Yorker November 22, 1999, http://tinyurl.com/j6soq

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Ann Fienup-Riordan, Ph.D. has explored Alaska Eskimo stereotypes and other portrayals in the movies—
Freeze Frame book jacket

http://www.washington.edu/uwpress/search/books/FIEFRP.html

“Freeze Frame, Alaska Eskimos in the Movies” by Ann Fienup-Riordan, Pub Date: August 2003,
ISBN:Paper: 0-295-98337-X


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Ageism in services for transient ischaemic attack and stroke

Unfortunately, British medical Journal is no longer available free on-line and the nearest medical library is either 400 miles or 1,500+ away.

2006;333:508-509 (9 September), doi:10.1136/bmj.38961.641400.BE

Editorial
Ageism in services for transient ischaemic attack and stroke could be cut by emulating successful efforts against ageism in heart disease care

Societies based on market driven economies have deeply embedded value systems that inherently favour economically productive younger citizens and marginalise non-productive older citizens. Health services reflect the societies they serve. One manifestationof institutionalised ageism is overt and covert rationing of health care that discriminates against older people. This might be acceptable if the clinical outcomes of treating older people were inferior. However, the notion of age based rationing of treatment has become unsustainable and unethical as robust evidence has accumulated that shows comparable outcomes for treatment of older and younger people.

In England, decades of health service underfunding have provided an environment in which ageism has flourished—it is endemic. Whenever a clinical stone is turned over, ageism is revealed—for example, in cancer services, coronary care units, prevention of vascular disease, and in mental health services. To this list we must now add the . . . [Full text of this article]

http://bmj.bmjjournals.com/cgi/content/short/333/7567/508?etoc

Press release here
“Ageism endemic in health services”

http://www.eurekalert.org/pub_releases/2006-09/bmj-aei090706.php

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