The Challenges of Rising Life Expectancy
Total Page：16
File Type：pdf, Size：1020Kb
ISSUE 113 2019 JANUARY ESPRIU FOUNDATION THE MAGAZINE OF HEALTHCARE CO-OPERATIVISM . THE CHALLENGES OF RISING LIFE EXPECTANCY HEALTH: The function of the thyroid glands HEALTH Smoking and breastfeeding CO-OPERATIVISM Health and solidarity in the Colombian cooperative movement CULTURE Cold War, a masterclass in staging Call us on 93 495 44 61 or visit www.asc.cat summary. health. issue 113 6 6 Smoking and breastfeeding. Dr. Adolf Cassan january, february and march de 2019 8 Barcelona Hospital Paediatrics Service and Neonatal Unit. Dr. Pere Sala 10 Respiratory illnesses: bronchitis and asthma. Dolors Borau The challenge of an 5 ageing population 12 A hospital admission for bronchiolitis. Dolors Borau health co-operativism. 16 16 Interview with Alfredo Arana Velasco, Executive President of the Coomeva co-operative group: “Health demands solidarity, and we co-operatives know all about that” 19 ASISA once again the insurer with the Best Customer Service 21 HLA Group hospitals improve their position in the main healthcare rankings 22 Barcelona Hospital marks World Prematurity Day 25 Assistència Sanitària allocates 30,000 euros to bursaries for health professionals 26 Espriu Foundation, world’s second-largest health co-operative network by turnover 29 CEPES and Social Economy Europe to present European social economy action plan monograph. 33 The challenges of rising life expectancy 34 Demographic ageing. Ignacio Romo and Meritxell Tizón 38 Interview with Isaura Leal, Government Commissioner for the Demographic Challenge: “The time has come to include the demographic impact in all public policy”. Meritxell Tizón 42 Do we live too long? José Manuel Ribera Casado, Emeritus Professor of Geriatrics and academician of the RANME. 45 Interview with Guillem López Casasanovas: “The active life of good professionals will last beyond the current restrictive retirement regulations”. Daniel Romaní culture. 49 Pause 49 50 Film criticism: A desolate fable. Enric Sòria 52 The World Turns: Beijing, bulwark of tradition 56 Remembering Salvador Espriu Call us on 93 495 44 61 or visit www.asc.cat Founded in 1989, the Espriu Foundation is made up of organisations that follow the co-operative healthcare model created by Dr Josep Espriu. These organisations are: Autogestió Sanitària, Scias, Lavinia and Asisa, which together form Grup Assistència and Grup ASISA Quarterly magazine. Third stage. Issue 113 january, february and march 2019 Health co-operatives magazine @ [email protected] Executive Board: president of Espriu Foundation & SCIAS Dr. Ignacio Orce, president of Autogestió Sanitària & Assistència Sanitària Dr Enrique de Porres, CEO of Asisa-Lavinia Dr Oriol Gras, Trustee of the Espriu Foundation Dr Carlos Zarco, CEO and Trustee of the Espriu Foundation readers’ letters. Executive Editor: Carles Torner Pifarré Editor-in-Chief: Paz Hernández Design and page layout:: ec.lluch Coordinator of the “Around the World” section Dr. Manuel Viola Thanks from Cuba Editorial Team: ILUNION Comunicación Social Proofreading and translation: Núria Sàbat (catalan Dear Sirs, and castilian) Jason Garner (english) We would like let you know that we still regularly receive Printing: ILUNION Retail y Comercialización your magazine. The teachers, researchers, students and Contributors to this edition: Dr. Carlos Zarco, other users at our institution continue to consult it with Dr. Adolf Cassan, Dr. Pere Sala, Dolors Borau, interest. We hope to maintain contact, and thank you for Núria Jané, Dra. Montserrat Montraveta, José Pérez, David Fernández, Oriol Conesa, Rafael sending us the most recent edition, number 112. Olea, Ignacio Romo, Meritxell Tizón, Daniel Romaní, Enric Sòria, Jordi Virallonga, Sam Abrams, Paz Hernández, Àngels Gregori, Dr. Jose Warm regards, Manuel Ribera Casado and Simona Škrabec. Photography and illustration: Keith Adams, Francisco Cruces, Joma, Jordi Negret and Pep Lic. Milagros Pérez Ortiz Herrero. Holguín University José de la Luz y Caballero University Site Registered publication: B-33773-2005 Miguel de Cervantes Saavedra University Library Fundació Espriu Collections Development Department Av. de Josep Tarradellas, 123-127, 4a planta Holguín. Cuba 08029 Barcelona. Juan Ignacio Luca de Tena, 12, 3ª. 28027 Madrid NIF: G-59117887 Tel.: 93 495 44 90 [email protected] www.fundacionespriu.coopw january 2019 05 editorial. The challenge of an ageing population Demographic ageing is a challenge that affects all countries like ours. Spain, with one of the highest life expectancies in the world, will, over the coming decades, head the world rankings according to a recent study produced by Wash- ington University and published in the prestigious medical journal The Lancet. Increased life expectancy at birth is a success for our society, our welfares state and our healthcare model as a number of the articles included in the Monograph section of this edition of compartir indicate. However, when an increase in the number of years we live coincides with a downward trend in birth rates, we then face the prospect of an ageing society in which the number of people more than 60 years old grows exponentially in comparison with younger generations of productive age. The challenges this raises are huge. And the questions are many. How will our healthcare system deal with a population with a high prevalence of chronic and Dr. Carlos Zarco degenerative illnesses? What will happen to the health budget? And what about Managing Director of the our current pensions system? Who will look after the elderly..? Espriu Foundation and It is a bewildering panorama. But, for most of the specialists who have contrib- President of the IHCO uted their accounts to make up the central section of this edition of compartir, the answer to these new social needs appearing on a not too distant horizon “The answer could open the way to new opportunities. All that it takes is for every agency involved, above all public authorities, to tackle the challenge with urgency, res- to these new olution and intelligence. social needs . appearing on a not too distant horizon could open the way to new opportunities”. health. prevent and cure Can a mother who smokes breastfeed her baby? There is no easy answer to this question, and it continues to generate debate. Smoking and breastfeeding Dr. Adolf Cassan What is undeniable is that smoking is a toxic habit which To begin with, smoking is harmful, but on the oth- is harmful both for the smoker and those around them er hand, breastfeeding offers considerable benefits to a who are exposed to the smoke from the burning ciga- newborn child: the mother’s milk is not only the perfect rette. Thousands of different substances have been iden- food during the early stage of life from a nutritional per- tified in tobacco smoke, some of which have been proven spective and also the immunity-enhancing elements it to be harmful to health. The most well-known substance contains, but also in terms of the emotional bond it rep- is nicotine, an alkaloid which has a stimulating effect on resents. The question, then, is apparently a simple one to the nervous system and is responsible for the clearest resolve: a mother opting to breastfeed her child should effects of tobacco on the body, such as the increase in not smoke. But what happens if the woman has no in- arterial blood pressure and faster heart rate, for example, tention of giving up smoking, or wants to, but is unable and which is also responsible for the addiction that to- to? Is it preferable, given the harm that smoking causes, bacco causes. Nonetheless, tobacco smoke contains other not to breastfeed, or , given the benefits of breastfeeding, more or less harmful substances, including in particular should she go ahead even if she smokes? a number that irritate the respiratory tracts, and others that are carcinogenic. HARM CAUSED BY SMOKING VERSUS BENEFITS OF BREAST- Tobacco smoke is harmful both for those who smoke FEEDING themselves, the “active smokers”, and those who are In order to address this issue it must first of all be borne exposed to the tobacco smoke of others, or “passive in mind that the nicotine from the tobacco smoke that smokers”. And according to the World Health Organisa- the woman’s lungs absorb enters the bloodstream and tion (WHO), passive smoking is particularly dangerous flows around her body, and during the period of breast- for younger children: experts assert, for example, that feeding also enters the composition of the milk produced breastfed-babies and children aged under six who are by the mammary glands. The levels of nicotine in a regularly exposed to tobacco smoke have a greater risk mother’s milk will, of course, depend on how many cig- of suffering infections of their lower respiratory system, arettes she smokes, and even the period of time between such as bronchitis and pneumonia, as well as any existing consuming tobacco and feeding her baby, but however respiratory conditions such as asthma being made worse. low they might be, it is entirely impossible to assert, as In the case of newborn babies the risk of sudden death is occasionally claimed in unreliable information, that syndrome is also increased. they are non-existent. Various studies have confirmed that a certain pro- THE DEBATE portion of the nicotine present in the mother’s blood- It would seem clear, then, that we should avoid expos- stream enters her milk. It has in fact been found that ing young babies to tobacco smoke in the atmosphere: the nicotine present in a mother’s milk has a stimulating you should never smoke anywhere there is a baby, and effect on the baby she feeds, as demonstrated by such wherever you do smoke should be well ventilated before objective factors as increased heart rate, and it has also a child enters. In this regard the recommendations are been claimed to cause a degree of anxiety or irritability, clear, and leave no room for doubt.