The concept of informal care: ambiguities and controversies on its scientific and political uses

Starting from an analysis of the scientific and political uses of the concept of informal care, this paper raises questions and launches the debate on the causes and effects of its uses. Recognizing the diversity and the contradictions found across the use of the term, it explains how its predominant use in Europe can be problematic. First, although it is widely recognized that care is provided primarily by women, this gender dimension is not emphasized in a concept that obscures the sexual division. Second, it does not render explicit that informal care is work, despite being unpaid. Third, the allusion to informality is likely to generate confusion with informal employment of care workers. Finally, studies often focus exclusively on care provided by family members, without distinguishing the spaces in which the work takes place and the social relationships it involves, namely the family or community. In Europe, where documents from (non)governmental organizations focus mainly on long-term care related to demographic aging, it is the care crisis of formal care provision systems, faced with financial fragility, reduction in funds and insufficient supply to meet the demand, that brings informal care to the political and scientific agendas. This paper argues that it is necessary to define conceptual boundaries that allow international studies on the dimension and value of this care work to be compared. It also advocates the importance of making visible that this is work, unpaid and female-dominated, since this view supports action guidelines more focused on social transformation and empowerment.

El aporte de las familias y las mujeres a los cuidados no remunerados en salud en Uruguay

Resumen: Considerando el creciente protagonismo de los cuidados en la agenda pública y de investigación en Uruguay, el presente artículo se enfoca en un tipo de cuidado prestado en forma no remunerada que requiere mayor visualización: el cuidado no remunerado en salud. Se propone responder a las siguientes interrogantes: ¿Quiénes asumen los costos del cuidado no remunerado en salud en Uruguay?, ¿Qué perfil tienen las personas cuidadoras no remuneradas en salud?, ¿A quiénes cuidan? ¿Cuál es el vínculo que mantienen con el sistema institucional de salud? Para ello, utiliza información proveniente de la Encuesta Nacional de Cuidados No Remunerados en Salud, realizada por el Grupo de Investigación Sociología de Género, de la cual las autoras son integrantes. Dicha Encuesta es representativa de la población uruguaya, está basada en una muestra bietápica y estratificada por nivel socioeconómico en la que se consultó a 1198 hogares sobre la realización de cuidados no remunerados en salud. Se demuestra que el cuidado en salud es mayormente realizado por integrantes del hogar, y de forma no remunerada. Las mujeres son las principales cuidadoras en salud, lo que da cuenta de la división sexual del trabajo existente en estas tareas. Por su parte, son las mujeres de mayor edad las que se dedican principalmente a proporcionar este cuidado, y esto es un rasgo distintivo de los cuidados en salud que los diferencia de los cuidados no remunerados cotidianos.

The Putative Chemosignal Androstadienone Makes Women More Generous

Putative human chemosignals have been shown to influence mood states and emotional processing, but the connection between these effects and higher-order cognitive processing is not well established. This study utilized an economic game (Dictator Game) to test whether androstadienone (AND), an odorous compound derived from testosterone, impacts on altruistic behavior. We predicted that the female participants would act more generously in the AND condition, exhibiting a significant interaction effect between gender and AND on Dictator Game contributions. We also expected that the presence of AND should increase the positive mood of the female participants, compared to a control odor condition and also compared to the mood of the male participants. The results confirm our hypotheses: for women the subliminal perception of AND led to larger monetary donations, compared to a control odor, and also increased positive mood. These effects were absent or significantly weaker in men. Our findings highlight the capacity of human putative chemosignals to influence emotions and higher cognitive processes - in particular the processes used in the context of economic decisions - in a gender-specific way.

Una mirada de género a las representaciones sociales del cuidado de las personas mayores

El artículo presenta los principales resultados del proyecto “Hacia un Sistema Nacional de Cuidados: representaciones sociales de la población y propuestas para el cuidado de dependientes”, cuyo objetivo general fue conocer las representaciones sociales de la población uruguaya sobre el cuidado, de modo de avanzar en la comprensión del mismo como elemento constitutivo del bienestar social desde una perspectiva de género y derechos. Los resultados de la encuesta representativa realizada muestran la fuerte presencia del “familismo” en dichas representaciones: se revela que la situación más deseable para el cuidado de las personas mayores es la que se brinda en el domicilio, y especialmente a través de los miembros de las familias. Además, se constata la fuerza del mandato de género en el rol cuidador de la identidad femenina, que trasciende las distintas posiciones sociales: las mujeres manifiestan mayor disposición que los varones a flexibilizar o abandonar el empleo en caso de necesidad de cuidados de sus familiares mayores.

Vertebroplasty and kyphoplasty: friends or foes?

PURPOSE

This paper aims to compare vertebroplasty and kyphoplasty by illustrating the two techniques, analysing the results and discussing the indications in relation to the type of fracture.

MATERIALS AND METHODS

Vertebroplasty was performed on 805 vertebral bodies in 485 patients affected by osteoporosis (310), metastasis (160) and vertebral haemangioma (15). The approach was unipedicular in 365 patients and bipedicular in 120 patients. Biopsies were obtained in patients with no known primary cancer (75). Kyphoplasty was performed in 39 patients with Magerl type A1 and A3 fractures within 3 months from the trauma. A bipedicular approach was used in all cases.

RESULTS

Outcomes were assessed on the basis of the visual analogue scale and the Oswestry Disability Index. In patients treated with vertebroplasty, success rates at 24-72 h were 90% for osteoporotic fractures, 100% for vertebral haemangiomas and 77% for metastatic fractures. Extravertebral vascular or discal leakage of cement occurred in 39 patients, but only two of them reported radicular pain due to epidural involvement. Osteoporotic patients developed new vertebral fractures at adjacent levels in 25 cases and at distal levels in 19 cases. In patients treated with kyphoplasty, pain relief was achieved within one month after treatment in 90% of cases. None of the patients wore orthotic braces after treatment, and no vertebral collapse was observed.

CONCLUSIONS

Vertebroplasty and kyphoplasty are both useful in the management of vertebral pain. In light of our experience, vertebroplasty is better indicated for vertebral fractures due to osteoporosis, haemangioma or metastasis on account of its simplicity and minimal invasiveness. Kyphoplasty is suggested in acute traumatic fractures of type A1 and A3 according to Magerl, as it allows recovery of vertebral stability and a better distribution of the cement.

Diet treatment of branched chain ketoaciduria studied by proton magnetic resonance spectroscopy

A novel nuclear magnetic resonance method is proposed for the diagnosis and follow-up of patients affected by branched chain ketoaciduria. The method allows quantitation of the branched chain amino acids (BCAA's) such as leucine, isoleucine and valine and of related keto- and hydroxy acids by means of a single spectrum. The method implies short time of analysis, as opposed to the very long time required by the techniques currently in use (amino acid analyzer combined with gaschromatography/mass spectrometry of keto- and hydroxyacids), it is easy and suitable for adjustements of the dietary treatment even on a daily basis. The case of a 15 days old newborn child, presenting muscular hypertonicity was unambiguously diagnosed in few minutes by means of one single NMR spectrum of urine. More interestingly, NMR spectra of serum in the following days were suitable for quantitating amino-, and keto acids as well as other metabolites of relevance in the follow up of the dietary treatment of the disease. After a diet lacking of BCAA's, to eliminate keto acids, a low BCAA diet was introduced, that succeeded in keeping the serum levels of the three amino acids within the normal range, while dropping the related keto acids.

[Posterior cranial fossa hemorrhage in term newborn infants: clinical and ultrasonographic aspects in 2 cases]

Haemorrhages of the posterior cranial fossa were diagnosed by cerebral sonography, sometimes these lesions were misinterpreted by the examination. We report two cases of posterior fossa haemorrhages in the term newborn without ultrasonography signs of this pathology. In a case some days after haemorrhagical damage, the signs of past haemorrhage were demonstrated.