Gaps in social protection for health care and long‐term care in Europe: Are the elderly faced with financial ruin?

While public expenditure on health care and long‐term care (LTC) has been monitored for many years in European countries, far less attention has been paid to the financial consequences for older people of private out‐of‐pocket (OOP) expenditure necessary to access such care. Employing representative cross‐sectional data on the elderly populations of 11 European countries in 2004 from the Survey of Health, Ageing and Retirement in Europe (SHARE), we find that OOP payments for health care and LTC are very common among the elderly across European countries and such expenditures impact significantly on disposable income: up to 95 per cent of the elderly make OOP payments for health care and 5 per cent for LTC, resulting in income reductions of between 5 and 10 per cent, respectively. Failure to prevent financial ruin, as a consequence of excessive OOP payments, is evident in 0.7 per cent of elderly households utilizing health care and 0.5 per cent of elderly households utilizing LTC. Those particularly concerned are the poor, women and the very old.     

“Newsworthy” Victims?

More than 500 Aboriginal women have gone missing or been murdered in Canada since the 1980s yet press attention to this violence is relatively minimal. This paper compares local press coverage of matched cases: three missing/murdered Aboriginal women from Saskatchewan and three missing/murdered White women from Ontario. Quantitative and qualitative content analyses indicate stark disparities in the amount and content of coverage between groups. The Aboriginal women received three and a half times less coverage; their articles were shorter and less likely to appear on the front page. Depictions of the Aboriginal women were also more detached in tone and scant in detail in contrast to the more intimate portraits of the White women. Drawing on feminist media studies and theories of intersectionality, this paper argues that the simultaneous devaluation of Aboriginal womanhood and idealization of middle-class White womanhood contributes to broader systemic inequalities which re/produce racism, sexism, classism, and colonialism. This paper raises concerns about the broader implications of the relative invisibility of missing/murdered Aboriginal women in the press, and their symbolic annihilation from the Canadian social landscape.     

Reaching Isolated Older People

In the second part of a paper reporting a unique single day a week adult day program, the service methodologies developed in the program are described as well as a study of outcomes in four areas: success in reaching the target group, attendance, length of participation, and resolution of psychosocial and health related problems. Outcomes, illustrated by statistical and case material, indicate success in achieving the overall goal of maintenance and enhancement of the participant's life and functioning as a whole. Such a resource is recommended as a vital one for the target population of isolated older people described in the paper.     

Trajectories of Limitations with Activities of Daily Living Among Older Adults of Mexican Descent: The Role of Widowhood

Using seven waves of data from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1993–2011), this study applies multiphase growth models to examine changes in limitations with activities of daily living (ADL) across widowhood experience among 385 older adults of Mexican descent. This study also investigates the implications of demographic characteristics, health, socioeconomic status, living arrangements, and social involvement. ADL limitations increased pre-widowhood, were at higher levels immediately before and especially during the transition to widowhood, and increased at a steeper rate post-widowhood. Age and partially depressive symptoms accounted for these trends in ADL limitations pre-widowhood and to a lesser extent during the transition to widowhood and post-widowhood. Older age, being female, chronic conditions, financial strain, lower educational attainment, coresidence with children and others, and less frequent church attendance were risk factors for higher levels of and greater increases in these functional limitations throughout widowhood experience.     

Comparison on predictors of mental health service use among Asian older adults

Studies have mostly examined mental health service use of older Asian immigrant combining all Asian Americans into one group whereas immigration backgrounds and socioeconomic status of each Asian minority group are different. Therefore, this study aimed to identify predictors of mental health service use within specific ethnic groups among older Asian adults focusing on Chinese, Japanese, Korean, Filipino, and Vietnamese in California. The Behavioral Model for Vulnerable Populations (BMVP) is used to guide the secondary data analysis of a sample of 3,453 older Asian immigrants from the California Health Interview Survey (CHIS). Logistic and linear regression analyses are performed to examine predictors of mental health service use and the frequency of mental health service use, respectively. As results, mental health‐seeking patterns differ by ethnicity within the older Asian immigrant sample, not being married (Korean), higher levels of acculturation (Filipino), lower levels of neighborhood cohesion (Korean and Vietnamese), higher levels of perceived safety (Korean) and lower levels of perceived safety (Vietnamese), higher levels of mental distress (Korean and Filipino), and having perceived need (all) were related to more visits for mental health services. The study findings highlight the necessity of cultural competency services and programs for each Asian ethnicity.     

Agency and fatalism in older Appalachian women’s information seeking about gynecological cancer

Researchers consider older women in rural Appalachia to have low levels of agency and high levels of fatalism regarding decision making about cancer treatment. Using the life course perspective, we examined older women’s agency with information seeking about gynecological cancer. Semistructured interviews with 20 White women living in central Appalachia revealed four trajectories: Surrendering Control, Accepting Death, Self-Care, and Advocacy, each with its own forms of agency. Some women experienced personal transformation, increased self-efficacy, and a passion for community empowerment. Fatalism was not understood apart from placing trust in medical expertise. We implore researchers to further explore rural expressions of agency.     

Design of ISD-1: an instrument for social diagnosis in care homes for older persons*

This article describes the design process and main features of an instrument developed for use in the specialist area of intervention in care homes for older persons. The essential aim of ISD-1 (instrument for social diagnosis) is to permit the correct formulation of social diagnoses and to standardise and define the professional language used by social workers. Its content has been organised into 4 dimensions of social diagnosis, divided into 15 sub-dimensions containing 83 diagnostic categories. This work was performed in Spain, in the 24 care homes of the Madrid Social Care Agency of the Community of Madrid, involving the participation of the 40 social workers practising in these centres. ISD-1 is an easily understood and used tool, of potential use for social workers practising in care homes for older persons and capable of being adapted for use in other institutional environments, as well as being capable of adaptation and translation for its application in other countries.     

论我国刑事被害人的控告犯罪权之完善

刑事被害人在刑事诉讼中不能仅仅成为国家追诉犯罪的工具,而应该具有诉讼主体地位,其权利应当得到保障。控告犯罪是刑事诉讼的起点,我国被害人控告犯罪的权利存在着诸多缺陷,不能保障被害人的有效参与。应当完善被害人控告犯罪的权利,保障被害人对刑事诉讼程序的有效参与。     

保护女性性受害者应注意的几个问题

遭受性侵害的女性,其巨大的痛苦往往不仅仅来自直接的性侵害行为所造成的身体伤害本身,而且还来自侦查和诉讼过程中对女性人格权、隐私权的第二次侵害。文章就许多媒体纷纷报道的某地警方为抓获犯罪嫌疑人而设计“二次强奸”的抓捕方案,让被害人再次受辱一案为背景,论述了刑事警察在侦破女性性受害案中应注意的几个问题：要充分认识性侵害案的严重性及其特点;树立科学、人性的侦查理念;要及时立案和安抚受害人;在侦查过程中要注意对女性性受害人的保护;加大宣传力度和提高破案技术。