ANCILLARY AND SPECIALIST HEALTH SERVICES: THE RELATIONSHIP BETWEEN INCOME,USER RATES AND EQUITY OF ACCESS

Australia's public health system currently provides substantial funding to, amongst its other objectives, ensure access to hospital, medical and pharmaceutical services by all families irrespective of income (McClelland, 1991, p. 6). However most ancillary services are not similarly subsidised and there is some evidence that income presents a barrier to the use of these services. There is also evidence that low income might also reduce access to specialist medical practitioner services which, while funded through Medicare, are less likely to be bulk billed than general practitioner services, and which therefore attract higher out-of pocket costs. In this study, the 1989–90 National Health Survey is used to examine whether there are indicators that low income reduces access to a range of ancillary services such as physiotherapy, optician services, chiropractic and dental services and to specialist medical practitioner services.     

Relationship Between Pain and Chronic Illness Among Seriously Ill Older Adults: Expanding Role for Palliative Social Work

Confronting the issue of pain among chronically ill older adults merits serious attention in light of mounting evidence that pain in this population is often undertreated or not treated at all (Institute of Medicine, 2011 Institute of Medicine . ( 2011 ). Relieving pain in America: A blueprint for transforming prevention, care, education and research . Washington, DC : National Academies Press . [Google Scholar]). The relationship between pain and chronic illness among adults age 50 and over was examined in this study through the use of longitudinal data from the University of Michigan Health and Retirement Study, sponsored by the National Institute on Aging and the Social Security Administration. Findings suggested positive associations between pain and chronic disease, pain and multimorbidity, as well as an inverse association between pain and education. Policy implications for workforce development and public health are many, and amplification of palliative social work roles to relieve pain and suffering among seriously ill older adults at all stages of the chronic illness trajectory is needed.     

Treatment at the end of life

End-of-life care has gained recognition as an important interdisciplinary clinical domain during the past three decades largely because scientific and medical advances have changed the nature of dying in the US. Advances in the treatment of life-limiting ilness have typically focused on medical issues and on treating the physical symptoms that accompany the final stage of a terminal illness. However, because the lengthening life span has made more choices available at the end of life, there is also greater need for evidence-based psychosocial treatment to diminish some of the prolonged emotional, psychological treatment to diminish some of the prolonged emotional, psychological, social, and spiritual distress that accompanies dying. Both terminally ill older adults and their caregivers can be helped by interventions that address the need for information, education, preparation, communication, emotional support, and advocacy. This paper preents a review of evidence-based psychosocial treatments at the end of life for both older adults and their caregivers.     

Rhythm in Mother‐Infant Interactions

Rhythmic behavior and the association of vocal rhythmic behavior with language development were studied in a sample of 30 mother‐infant dyads. Dyads were observed in 2 contexts (1 involved sharing pictures and the other sharing musical toys) when infants were 18 and 24 months of age. Vocal rhythmic behavior was seen in both contexts, and in both contexts mothers matched their infant's vocal rhythmic behavior at greater than chance rates. Greater matching tended to be associated with higher language scores whereas, counter to prediction, higher rates of maternal vocal rhythmic behavior tended to be associated with lower language scores. At 24 months of age, mother‐daughter dyads showed more matching than mother‐son dyads. These results suggest that differences in maternal production of vocal rhythmic behavior may foster different language learning strategies.     

Observed and Reported Psychological and Physical Aggression in Young, At-Risk Couples

The occurrence of observed and reported physical and psychological aggression was examined for young, at-risk mostly unmarried couples using reports from both partners and observational data. It was predicted that males higher in antisocial behavior would be more likely to have an antisocial partner and that antisocial behavior would predict aggression toward the partner. The prevalence of reported physical aggression was comparable to that found for prior studies and was generally higher for the young women than the young men. Observed aggression was significantly associated with reported aggression, and psychological aggression was associated with physical aggression. Assortative partnering by antisocial behavior was found. The young man's aggression toward his partner was predicted particularly by his antisocial behavior, whereas that of the young woman was predicted by depressive symptoms and low self-esteem. Relationship satisfaction was associated with the occurrence of psychological aggression but not of physical aggression.     

The impact of educational efforts on first-year university students' acceptance of meningococcal vaccine

The authors measured the impact of educational efforts on the number of college students who received meningococcal vaccine. First-year Brown University students from the classes of 2004 (n = 1,562) and 2005 (n = 1,518) received educational vaccine materials before they arrived on campus, whereas students from the class of 2003 (n = 1.441) did not. Students in the class of 2003, 13% (n = 184) of whom had received vaccine before their arrival on campus, served as the baseline. These educational efforts by the college health services before students arrived on campus increased the number of students immunized before campus arrival to 46% (n = 724) for the class of 2004, and 60% (n = 913) for the class of 2005. Education about the benefits of meningococcal vaccine before students' arrival on campus increased both the number of immunized students and the overall immunization rate among students.