Conference Addresses Problems of Reproduction and Women's Health Care

REPRODUCTION and health are important problems concerning women's progress and development. Since the 1960s the subjects have attracted the attention of the world. Awareness of these problems has gradually increased to the extent that some concepts have generally been agreed upon. They are:     

Togetherness—The Health Care Team

Abstract

In order to evaluate the progress of a health service, certain criteria (indices) should be established and monitored. If any health center wishes to compare its situation with others, a valid instrument for measuring morbidity is required, and the criteria must be in conformity with national and/or international standards. This paper details methods of producing health indices from medical diagnoses. It is based on experience in a health service for students. Three systems are offered to cover centers with and without computer facilities: 1) a minimum for student health services; 2) the “minima” requested by the World Health Organization; 3) a classification of conditions of special interest in student health. It is strongly recommended that the International Classification of Diseases (ICD-9) of the World Health Organization be accepted as the local and international basis for these diagnostic categories.

“Epidemic Non-A, Non-B Hepatitis in Nepal: Recovery of a Possible Etiologic Agent and Transmission Studies in Marmosets,” MARK A. KANE, et al. An epidemic of non-A, non-B hepatitis occurred in Kathmandu Valley, Nepal, during 1981–1982, with approximately 7.6% of households and 1.4% of individuals affected. Cases occurred preponderantly in the 15- to 34-year-old age group (70%), with most cases (75%) occurring in males. A high mortality rate (21%) occurred in pregnant women admitted to the hospital. No single water source was implicated, but epidemic peaks occurred during monsoon rains, and multiple opportunities for enteric transmission existed. One of eight patient stools examined by immune electron microscopy revealed aggregated, antibody-coated, 27-nm viruslike particles when convalescent serum samples were used as sources of antibody. Inoculation of two chimpanzees and four marmosets with a suspension of this stool resulted in elevated liver enzyme activity in three marmosets. Fecal excretion of 27-nm particles during the acute phase of disease (with temporally coincident antigen activity by radioimmunoassay) was observed in one marmoset, which also developed convalescent antibody against the particles in the original inoculum. (Journal of the American Medical Association 1984;252:3140–3145.)

“High-dose Vitamin C Versus Placebo in the Treatment of Patients with Advanced Cancer who Have Had No Prior Chemotherapy; A Randomized Double-Blind Comparison,” CHARLES G. MOERTEL, et al. It has been claimed that high-dose vitamin C is beneficial in the treatment of patients with advanced cancer, especially patients who have had no prior chemotherapy. In a double-blind study 100 patients with advanced colorectal cancer were randomly assigned to treatment with either high-dose vitamin C (10 g daily) or placebo. Overall, these patients were in very good general condition, with minimal symptoms. None had received any previous treatment with cytotoxic drugs. Vitamin C therapy showed no advantage over placebo therapy with regard to either the interval between the beginning of treatment and disease progression or patient survival. Among patients with measurable disease, none had objective improvement. On the basis of this and our previous randomized study, it can be concluded that high-dose vitamin C therapy is not effective against advanced malignant disease regardless of whether the patient has had any prior chemotherapy. (New England Journal of Medicine 1985;312:137–41.)     

Can Health Care Reform End Stigma Toward Mental Illness?

This article addresses the destigmatization of mental health through health care reform by incorporating antistigma efforts—a destaining of mental illness—through prevention and early intervention in community-based programs that would be mandated and funded through the auspices of Patient Protection and the Affordable Care Act (ACA). Mental health care policies under the ACA and the Mental Health Parity Act are briefly described, following a definition of mental health stigma and its impacts. Recommendations for statutory mandates in stigma reduction at the community and federal levels and guidelines for mental health/behavioral health providers form the article’s conclusion.     

Women and Children's Health Care in the Yimeng Mountain Area

The Yimeng Mountain area in the central and southern part of Shandong Province, is very poor.     

Worthy? Crowdfunding the Canadian Health Care and Education Sectors

Crowdfunding, the practice of asking for money from others using the Internet, is a major private means through which Canadians are funding their health care and education. Crowdfunding has proliferated in Canada during the 2010s and continues to grow, approaching the revenues of Canada's major traditional charities. Proponents describe it as an empowering practice from which anyone can benefit. If its gains are inequitably distributed, however, increasing reliance on this private funding mechanism, especially in core areas of welfare state provision, can further exacerbate inequalities of opportunity and income. This study asks why Canadians turn to health care and education crowdfunding and how equitably funds are raised using this novel method. Based on a mixed methods analysis of 319 campaigns conducted on two prominent crowdfunding platforms between 2012 and 2014, we find that crowdfunding users’ needs frequently correspond to known gaps in the contemporary social safety net, including in the area of cancer care, and that campaigns for older and visible minority Canadians face a disadvantage. We argue that health care and education crowdfunding is a response to the shortcomings of Canadian welfare state provision, but one that reproduces offline inequalities with potentially perilous consequences for democratic life and individual suffering.     

Households’ precautionary behaviors—the effects of the introduction of National Health Insurance in Taiwan

By reducing risk of large out-of-pocket medical expenses, comprehensive social health insurance may reduce households’ motivation to engage in precautionary behaviors such as saving, procurement of private insurance, and spousal labor-force participation. We use the natural experiment provided by the 1995 introduction of National Health Insurance in Taiwan to examine these effects, using pre-existing differences in access to health insurance (tied to the household head’s and spouse’s joint employment status) to identify the effects of increasing insurance coverage. We find that comprehensive health insurance has a statistically significant and large effect on household savings, but no significant effects on purchase of private accident insurance and spousal employment.

Educating Social Workers for Health Care’s Brave New World

A transforming health care system challenges educators to formulate curriculum that is relevant and anticipates evolving expectations and demands. This article reviews key features of the changing health care landscape, describes a Centers for Disease Control funded prototypical social work practice model designed to fit the contours of that landscape, and suggests five fundamental principles to guide successful adaptation of social work health care practice and educational preparation. Curricular implications of these principles are discussed.     

Health Care “As Usual”: The Insertion of Positive Psychology in Canadian Mental Health Discourse

The recent shift to a “positive psychological” approach that emphasizes a “health model,” rather than a “disease model,” in mental health discourses is intended both to reduce the stigma around mental health issues and to enable people to play a role in monitoring their own mental health. As a component of a larger study on access to and utilization of mental health services by immigrant women, and a partial reflection of the current ideological context of mental health policy and practice in Canada, this shift was examined by analyzing the Canadian Mental Health Association's mental health discourse as posted in Web-based text using features of critical discourse analysis. Although considered an improvement over previous approaches by some, the current mental health discourse continues to reflect ideologies that assume a universal psychology of individual mental health. Framing this research with aspects of sociocultural and postcolonial theories, this article seeks to identify the possibilities of this new discourse and expose its limitations in relation to immigrants to Canada.     

Does Health Insurance Premium Exemption Policy for Older People Increase Access to Health Care? Evidence from Ghana

Aging in Sub-Saharan Africa causes major challenges for policy makers in social protection. Our study focuses on Ghana, one of the few Sub-Saharan African countries that passed a National Policy on Aging in 2010. Ghana is also one of the first Sub-Saharan African countries that launched a National Health Insurance Scheme (NHIS; NHIS Act 650, 2003) with the aim to improve access to quality health care for all citizens, and as such can be considered as a means of poverty reduction. Our study assesses whether premium exemption policy under the NHIS that grants non-payments of annual health insurance premiums for older people increases access to health care. We assessed differences in enrollment coverage among four different age groups (18–49, 50–59, 60–69, and 70+). We found higher enrollment for the 70+ and 60–69 age groups. The likelihood of enrollment was 2.7 and 1.7 times higher for the 70+ and 60–69 age groups, respectively. Our results suggest the NHIS exemption policy increases insurance coverage of the aged and their utilization of health care services.     

Zhang Fang—a Student at the BBI

UNIVERSITY student Zhang Fang looks gentle and refined, but she is also frank and quick-witted. She was born in Chongqing of Sichuan Province. Her father is a comic dialogue performer and her mother was once a ballerina. Zhang Fang was imperceptibly influenced by     

What Explains Divorced Women's Poorer Health? The Mediating Role of Health Insurance and Access to Health Care in a Rural Iowan Sample

Economic restructuring in rural areas in recent decades has been accompanied by rising marital instability. To examine the implications of the increase in divorce for the health of rural women, we examine how marital status predicts adequacy of health insurance coverage and health care access, and whether these factors help to account for the documented association between divorce and later illness. Analyzing longitudinal data from a cohort of over 400 married and recently divorced rural Iowan women, we decompose the total effect of divorce on physical illness a decade later using structural equation modeling. Divorced women are less likely to report adequate health insurance in the years following divorce, inhibiting their access to medical care and threatening their physical health. Full‐time employment acts as a buffer against insurance loss for divorced women. The growth of marital instability in rural areas has had significant ramifications for women's health; the decline of adequate health insurance coverage following divorce explains a component of the association between divorced status and poorer long‐term health outcomes.     

Meeting the Needs of the Social Care and Health Care Workforce: Can a Duck Sleep with a Hippopotamus?

In a period when recruitment and retention are crucial issues in health and social care the focus of this paper is:

? Who are the workforce of health and social care?

? What are the needs of that workforce?

? How safe is it for the much smaller partner, social care, to work together with the much larger health care?

The latter point heads us back to the sub‐title of the paper: can a duck sleep with a hippopotamus?

This question comes from an advert used in the UK for a bed manufacturer, where our British sensitivities and fear of sex prevents us from showing a man and a woman in a double bed, what the Spanish charmingly call a ‘cama de matrimonio’, a marriage bed, and instead we show a hippopotamus and a duck sleeping, safely, in the same bed.

To follow this analogy, we have to show:

? that health and social care are in the same bed;

? that one is as large as a hippopotamus, and the other as small as a duck;

? what the dangers are of this;

and ask the question:

? What is there in the place of ‘spring technology’ which would permit both to sleep together, and for the duck not to end up flat?

In doing so, I hope to answer the first three questions I posed.     

The Seventh National Games—Success!

THE Seventh National Games held in Beijing in September 1993 was a great success. Its scale was unprecedented in Chinese sports history. Forty-five teams from provinces, municipalities, autonomous regions, the People's Liberation Army and athletics associations competed. All together over 6,000 athletes took part in 43 events. The tough competition brought magnificent results. Four world records were set, 21 broken and 3 equalled,     

The Effects of the State Children’s Health Insurance Program on Insurance Status and Health Care Utilization of Children

The State Children’s Health Insurance Program (SCHIP) of 1997 aimed to increase public insurance eligibility to children in families that were above the Medicaid income cutoff line, but were too poor to afford private coverage. This paper shows that SCHIP helped as many as 1.3 million children leave the ranks of the uninsured. However, almost 400,000 of these children came from families with two privately insured parents, and added approximately $300 million in health care expenses to federal and state budgets. This paper also presents estimates of health care consumption of children who switched to public insurance as a result of SCHIP.     

The Resilient Survivor—A Student Social Worker's Journey

This article is intended to bridge the gap between the literature on the service user perspective, essential to social work training, and the personal experiences student social workers bring to their training. It argues that there is a need to recognise the personal and sometimes painful experiences student social workers may bring to their training and the potential impact they have on their social work education and future practice. Sexually abused as a child, the author is in a unique position as a first year social work student to explore and share the impact of childhood sexual abuse (CSA) on her social work education and how this has been managed. This article will chart a parallel journey of personal and professional development by exploring the importance of reflective thought on one's own personal experiences and discussing how these experiences can inform the professional knowledge, skills and value base. This article concludes that during personal and professional development potential issues or themes may arise. These include the blurring of personal/professional boundaries, the need for heightened self-awareness skills, the ability to use supervision appropriately and the potential to misuse personal insights.     

Women In Higher Education——Half a Century

ZHOU Enru is a law professor at Chinese Women's College. In 1978, she took part in the school's reopening and renovation and then in 1995, she began collecting and compiling the school's history.