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.     

农民工子女健康危险行为思考

农民工子女健康危险行为日益增多,影响到社会安定。进行青少年健康危险行为的有关理论、概念、影响因素、预防和干预策略的阐述和总结,并为今后农民工子女健康危险行为研究提出建议。     

Client Personality,Working Alliance and Outcome

Abstract

The relationship of the five-factor model of personality to working alliance, symptoms and well-being was examined in a diverse community mental health sample (N = 103). Agreeableness, openness, extraversion and conscientiousness were associated with alliance. Neuroticism was strongly associated with symptoms, and negatively associated with well-being. Extraversion was moderately associated with well-being. Personality is deserving of further study as a potentially important influence on therapy process and outcome. Part of the much-replicated association of alliance with outcome may be accounted for by personality. Implications for social work practice and research are discussed.     

Examining Outpatient Health Care Utilization Among Adults with Severe or Profound Intellectual Disabilities Living in an Urban Setting

Abstract

The present study examined the health status and outpatient health care utilization among 52 adults with severe or profound intellectual disabilities (IDs) living with their families or in group homes in New York City. Bivariate and regression analyses among demographic variables, medical conditions, health care utilization, and type of living situation were conducted. Findings indicate that demographic factors andhealth statuses were similar regardless of living situation, except for ageand the presence of Down Syndrome, that is, younger people and people with Down Syndrome were more likely to live with family than in group homes. The results indicated that regardless of where they lived, individuals had high rates (70%) of overweight/obesity. The mean number of internal medicine, specialty medicine, nursing, and total clinic visits were significantly higher for those living in group homes compared to those living with their families. The findings and their implications are discussed with respect to social work policy and practice.     

Providing Mental Health Services to Older People Living in Rural Communities

Summary

Rural dwelling elders who experience mental health problems often have difficulty finding help since rural communities often lack adequate mental health service providers. This paper reports on the initial phase of a 5-year, interdisciplinary clinical research study that is testing the effectiveness of providing a home delivered, therapeutic psychosocial intervention, aimed at improving the emotional well-being and the quality of life of medically frail elders who live in rural communities. In the early phases of this study, the clinical research team encountered a number of interesting and often unanticipated challenges as it attempted to recruit study participants and provide services to them. In this article, we examine these challenges and share what we have learned so far about providing mental health services to elderly persons living in rural environments.     

Power To Our Journeys: Re‐membering Michael

The following personal reflections are in honour of Michael and all that he contributed to our lives. And, we honour Brigitte a key member of the group who died in 2006. Mem, Sue and Veronica, December 2008.     

Protection and Advocacy for Individuals with Mental Illness Act

Abstract

This study explored the perceptions of one state's policy stakeholders toward the implementation of the Protection and Advocacy for Individuals with Mental Illness Act (PAIMI Act). This congressional act established state programs authorized to investigate abuse, neglect, and civil rights violations against individuals with mental illness in residential facilities. A qualitative case study approach was selected to study the perceptions of the impact of this law. Participants were chosen using a maximum variation sampling of four diverse stakeholder groups. In-depth interview responses were developed into a series of proposed assertions regarding the impact of the PAIMI Act.     

The Culture of High-Risk Alcohol Use Among Club and Intramural Athletes

Abstract

Objective: The purpose of this study was to examine the drinking patterns of club and intramural college athletes and compare their alcohol consumption, perceived norms around the excessive use of alcohol, experience of negative consequences, and employment of protective strategies with those of campus varsity athletes. Participants: A total of 442 undergraduate students attending a private, suburban institution in the Northeast participated in the American College Health Association National College Health Assessment-II Web survey in spring 2011. Thirty-five students identified themselves as varsity athletes, 76 identified as club sport athletes, and 196 students identified themselves as intramural athletes. Methods: Survey responses were analyzed using Statistical Package for the Social Sciences. The Pearson's correlation coefficient and test for independence were applied to identify significant relationships between athlete status and identified variables related to alcohol use. Results: Results indicated that there were significant correlations between athlete status and all variables, to varying degrees. Conclusions: These findings have implications for campus health promotion professionals and athletics program coordinators seeking to address high-risk alcohol use among college athletes.     

The Eating Disorders NOS Diagnostic Profile Among College Women

Abstract

The authors examined a proposed profile of eating-related behaviors, associated features, developmental issues, and help-seeking behavior among college women, using an eating disorder response program. The most common symptom scenario was a pattern of regular binge eating, together with daily exercise and occasional purging. The most common associated features were distressing or dysfunctional overconcern about body image and self-esteem, usually with day-to-day stress and intermittent depression. The women who fit this pattern also presented developmental issues of perfectionism, conflictual relationships with parents, and struggles for independence; and they tended to be ambivalent about seeking services. Implications for practice, including the need to develop a framework for eating disorder responses on campus that includes preventive programs and developmental interventions to target emerging and moderate concerns are discussed; limitations and the preliminary nature of the findings are explicated.     

Social Connectedness,Self-Esteem,and Depression Symptomatology Among Collegiate Athletes Versus Nonathletes

Objective: The authors compared collegiate athletes and nonathletes to see whether there were significant differences in the perceived levels of social connectedness, self-esteem, and depression and if an interaction among the variables of athlete status, gender, GPA, BMI, and levels of weekly exercise and sleep were associated with depression symptomatology. Participants: Participants were 227 college students. Method: The authors surveyed students using the Center for Epidemiologic Studies Depression Scale, the Rosenberg Self-Esteem Scale, and the Social Connectedness Scale-Revised. Results: Athletes had significantly greater levels of self-esteem and social connectedness, as well as significantly lower levels of depression, than did nonathletes. However, the statistically strongest predictors of depression in this cohort were the variables of gender, self-esteem, social connectedness, and sleep. Conclusion: This study adds to the limited and inconsistent research in the empirical knowledge base regarding depression among collegiate athletes.