Care Security Research Articles

Global Security in the 21st Century

Security is a central human concern that includes numerous sub-listings. We often think of economic security, national security, energy security, nuclear security, cyber security, democratic and civil rights security, personal security and health care security as some examples. However, what is becoming very clear is that we should all be concerned with global security of our common, shared biosphere. Global security encompasses all of the above, but even more importantly, it depends on our environmental/ecological security. It also requires the establishment of universal human rights and civil liberties. The achievement of global security will require a complex, interconnected network of humans and their activities in a rapidly changing world. The focus must be on global climate change and human population growth, which are rapidly emerging as the two most important threats. The threat of nuclear weapons is still with us, but its relative importance may decline as global climate change and human population growth continue to degrade our biosphere. We must also focus on the many types of pollution that contribute to ecosystem instability and species extinction. Wars contribute immensely to societal instability and environmental degradation. Wars represent a form of carelessness which we no longer can afford. Nuclear weapons should be disassembled and wars halted. Military disciplines must be regulated by an international force, and expenditure of large sums of money for military must be prevented. Such uses of our resources are archaic and obsolete. We have more important problems to face and conquer. To complicate the situation, we also need to consider existing and emerging infectious diseases. There is a paucity of global infrastructure that is required to combat them. No one will feel secure when global epidemics hit. Natural selection of humans via infectious diseases will be cruel with immense suffering and death. The situation is grave, but there are actions that can be taken that will ameliorate our plight. We need responsible governmental officials who respect and obey international law. They must recognize that the needs of the world community must supercede national interests. Those who refuse must be expelled from office. Impeachment followed by severe punishment must become a standard consequence of dishonesty, corruption and activities based on selfinterest rather than the public interest. If billions of dollars had not been spent on military, just think what we could have accomplished. Universal human rights, birth control, healthcare and education could have been guaranteed for the same cost. Only if dealt with Water Air Soil Pollut (2010) 205 (Suppl 1):S45–S46 DOI 10.1007/s11270-007-9522-x

The opinions of Finnish specialist physicians on social security system

Background: We can argue that opinions are considered to be part of the physician’s professional identity. Professional identity has been considered a result of learning. After graduation physicians usually continue to study to gain a specialisation, and we can assume that this process affects their opinions because every specialty has its own “cultural climate”. Also, specialists have different views towards the welfare state because, for example, of the fact that they work with different types of population groups. Aim of the study: In this article we will describe how specialists feel about the current level of social security in Finland. Methods: The empirical analysis in our study is based on postal survey. The 2000 working age physicians’ random survey sample was picked from the register of the Finnish Medical Association (n=1092, response rate 54,6 %). The whole questionnaire included questions dealing with social security, health policy and health care system. The data was analysed using means and multinomial logistic regression analysis. Results: This study shows that surgeons and radiologists are the most critical of social security. These groups often think that social security is excessive. In contrast, psychiatrists show a stronger tendency to support social security. All in all, Finnish specialists are more critical of the social security system than are nonspecialised physicians. Conclusions: There are many similarities between Nordic countries when we look at the historical role of medical profession. We can also assume that specialist physicians' opinions on social security are quite similar compared to those of other Nordic countries.

What comprises a good outcome in spinal surgery? A preliminary survey among spine surgeons of the SSE and European spine patients

Standardized and validated self-administered outcome-instruments are broadly used in spinal surgery. Despite a plethora of articles on outcome research, no systematic evaluation is available on what actually comprises a good outcome in spinal surgery from the patients' and surgeons' perspective, respectively. However, this is a prerequisite for improving outcome instruments. In performing a cross-sectional survey among spine patients from different European regions and spine surgeons of the SSE, the study attempted (1) to identify the most important domains determining a good outcome from a patients' as well as a surgeon's perspective, and (2) to explore regional differences in the identified domains. For this purpose, a structured interview was performed among 30 spine surgeons of the SSE and 353 spine surgery patients (representing Northern, Central and Southern Europe) to investigate their criteria for a good outcome. A qualitative and descriptive approach was used to evaluate the data. Results revealed a high agreement on what comprises a good outcome among surgeons and patients, respectively. The main parameters determining good outcome were achieving the patients' expectations/satisfaction, pain relief, improvement of disability and social reintegration. Younger patients more often expected a complete pain relief, an improved work capacity, and better social life participation. Patients in southern Europe more often wanted to improve work capacity compared to those from central and northern European countries. No substantial differences were found when patients' and surgeons' perspective were compared. However, age and differences in national social security and health care system ("black flags") have an impact on what is considered a good outcome in spinal surgery.

Long-Term Employment Trajectories Among Participants With Severe Mental Illness in Supported Employment

Long-Term Employment Trajectories Among Participants With Severe Mental Illness in Supported Employment

Long-Term Employment Trajectories Among Participants With Severe Mental Illness in Supported Employment

The long-term trajectories of participants in supported employment have not been clear. This exploratory study presents eight- to 12-year employment trajectories among adults with psychiatric disabilities who participated in supported employment. We reinterviewed 38 of 78 participants (49%) with severe mental illness eight to 12 years after they enrolled in supported employment studies in a small urban mental health center in New England. Data were analyzed by using quantitative and qualitative methods. All 38 participants worked during the follow-up period, a great majority (82%) in competitive jobs, and 71% worked for more than half of the follow-up years. Participants reported numerous benefits related to employment, including enhancements to self-esteem, relationships, and illness management. Psychiatric illness was the major barrier to work; part-time employment and long-term supports were the major facilitators. Three overlapping themes emerged from the qualitative analysis as significant perceived influences on participants' work-related behavior. First, the successful management of symptoms and the deployment of appropriate coping skills appeared to play an important role in finding and maintaining work. Second, participants generally preferred to work part-time because of the lesser demands of this type of job and because it was perceived to allow for the maintenance of Social Security and health care entitlements. Third, participants saw the importance of ongoing individual placement and support services. Participants stated that this was imperative in making successful transitions between jobs or from unemployment to employment and in helping negotiate pay raises or changes in conditions. The long-term trajectories of participants in supported employment programs, both vocational and nonvocational, appear to be positive.

Elderly destitution in Ile‐Ife community of Osun State, Nigeria

Many studies have been conducted on the elderly, but none has ever paid particular attention to the increasing rate of destitution in the rural communities, where the elderly serve as agents for sustenance and transmission of culture. This study is descriptive in nature and has adopted qualitative perspective in order to identify and examine the factors that have contributed to the state of elderly in destitution in Ile-Ife, Nigeria. It has also examined the feelings and reactions of the subjects of the study and has documented how their lifestyles affect their health status. Sixteen elderly people in destitution were traced and interviewed in Ile-Ife community. At each location, where an elderly in destitution was located, at least an elderly chief and a resident were located for interview. Data collected were analysed using Textbase Beta package for qualitative analysis. The study found that communal feud, violence and conflicts were factors that created unhappiness for the elderly, and the lack of adequate support from the immediate households consequently led to their homelessness. The study documented that the elderly in destitution lack good hygiene and nutrition, and equally suffer self-neglect and mental confusion. The study concludes that peaceful coexistence, communal security, and familial care and support are important factors that promote happiness and successful ageing. It also maintains that focused health education is highly essential for the households and caregivers of the elderly in rural community.

Quantitative Evaluation and Analysis on Human Health Risk

Health condition is related to the economic and social development of a country and the whole world. We concluded that the influencing factors of health risk include environment pollution, food security, disease threat and health care condition, and then an indicators system is put forward in the paper. Based on the foundation of the indicators system, 40 countries were chosen to evaluate the condition of human health risk. With the method of Hierarchical Cluster Analysis, 40 countries were divided into four groups, and we analyzed the characteristic of each group. Compared with other countries at the similar development level of economy, the human health risk of China is much higher. We analyzed the correlation between human health risk and the economy development level, and then we concluded that a country should attach importance to improving the condition of human health, when the GNI per capita is between $ 1000 and 3000 US dollars. The stage is vital for economy development, and also for the improvement of the human health condition. We found that countries with high human health risk are mostly in Africa and Asia. The developed countries should help the developing countries reduce the human health risk for a win-win situation of the development of the whole humanity.

Post‐Apartheid Social Movements and the Quest for the Elusive ‘New’ South Africa

The South African Constitution guarantees justiciable socio‐economic rights such as the rights to access to housing; to sufficient food and water; to social security and health care services. This ‘transformative constitution’ is meant to help rid the country of legacies of apartheid such as huge economic inequalities and entrenched poverty. The government's embrace of neoliberalism has, however, meant that these legacies have not only remained largely untreated but have also become entrenched. Poor communities have started organizing themselves in order to challenge the government's neoliberal policies as well as marginalization from structures of governance. This paper evaluates the nature of these 'social movements’ as well as their impact on democracy and development.

Does the World Really Need More Babies?

To see an article like “The baby deficit” (M. Balter, Special Section: Life Cycles, News, 30 June, p. 1894) in a magazine such as Business Week , or The Economist , or Sociology Today would not be surprising, but how could Science publish such an article? The thrust of this four-page article is captured in the sentence “Population losses could bring a raft of negative economic consequences in the industrialized world, as well as greater stresses on social security and health care systems as the proportion of older citizens increases.” The word “environment” never once appears in the article. With the biosphere on the brink of multiple disasters or even catastrophe, how can Science —the publisher of numerous reports on energy, climate change, and species extinction—write so extensively about “baby deficits” without mentioning overpopulation in an environmental context? Our species is presently responsible for the worst mass extinction event of the past 65 million years. If recent reports of imminent and rapid destruction of the entire Amazon rainforest—due to activities like logging, burning, and agriculture accompanied by prolonged drought from anthropogenically induced climate change—turn out to be accurate, then our species may ultimately become responsible for the worst mass extinction in the entire history of life on Earth. Viewed in this light, a rapid and massive decline in human numbers due to a “baby deficit,” although perhaps accompanied by some short-term economic and social pain for some people, would be a blessing for millions of species on Earth, including our own. ![Figure][1] CREDIT: STEVE KROPP/IMAGES.COM/CORBIS [1]: pending:yes

Low-income, Rural Elders' Perceptions of Financial Security and Health Care Costs

ABSTRACT Despite Medicare coverage, health care expenses consume a significant proportion of older Americans' incomes. These costs can be particularly difficult for low-income elders. Rural elders face some unique challenges including lower incomes and higher health care costs, on average. This study examines the perceptions of a sample of low-income rural elders (n = 66) regarding their employment history, current income, financial security, health status, level of health insurance, and ability to meet basic needs and health care costs. In general, study participants were happy to be living rurally, although many had had restricted employment opportunities throughout their lives with resulting low retirement incomes. Health care expenses were burdensome for many. The article concludes with advice to policy makers from the study participants and by examining how the recent Medicare reform might help or hurt these elders.

Advanced Asia's health systems in comparison

There is growing interest in comparing patterns of social and health service development in advanced Asian economies. Most publications concentrate broadly on a range of core social services such as education, housing, social security and health care. In terms of those solely focused on health, most discuss arrangements in specific countries and territories. Some take a comparative approach, but are focused on presentation and discussion of expenditure, resourcing and service utilization data. This article extends the comparative analysis of advanced Asian health systems, considering the cases of Japan, South Korea, Taiwan, Hong Kong and Singapore. The article provides basic background information, and delves into common concerns among the world's health systems today including primary care organization, rationing and cost containment, service quality, and system integration. Conclusions include that problems exist in ‘classifying’ the five diverse systems; that the systems face common pressures; and that there are considerable opportunities to enhance primary care, service quality and system integration.

La violencia en las mujeres usuarias de los servicios de salud en el IMSS y la SSA

To compare the prevalence of violence and determine its risk factors among women who use Mexican Social Services (IMSS) clinics and do not have access to social security services. Sociodemographic data linked to domestic violence reported by women attending the Mexican Institute of Social Security (IMSS) health services was analyzed. Bivariate and multivariate analysis was performed using STATAV.7. Psychological violence in IMSS women was 18% followed by physical violence (9.1%), sexual (6.7%) and economic (5%). Prevalence of violence in women with no social security care was psychological (21.4%), physical (10.5%), sexual (7.5%) and economical (5%). Women between 25 and 44 years of age with basic schooling and married and with family background of violence were the most affected. The daily consumption of alcohol by their partners was an important predictor of domestic violence. Violence in women with no social security is higher. Partner's alcohol intake pattern is an important risk factor. Detection of domestic violence in the clinical setting is necessary to recognize its real magnitude as a social problem.

Research Priorities for Gerontological Social Work: Researcher and Practitioner Perspectives

This article describes a Delphi study to identify research priorities of gerontological social work practitioners and to compare these priorities with those of social work academic researchers. A national expert panel of 52 gerontological social work practitioners completed questionnaires to delimit a set of high-priority research topics. Findings were compared with a similar Delphi study conducted with academic social work researchers. The researcher panel and the practitioner panel endorsed a need for intervention research. Practitioners also identified several unique priorities, including income security and long-term care policies, decision making, and planning for later life. The authors suggest four substantive areas (housing and transitions in living arrangements, family caregiving, health and mental health, and workforce) and four crosscutting themes (intervention research, social policy, service delivery, and capacity building) as a potential organizing framework for a research agenda for gerontological social work.

Long-Term Care over an Uncertain Future: What Can Current Retirees Expect?

The leading edge of the baby boom generation is nearing retirement and facing uncertainty about its need for long-term care (LTC). Using a microsimulation model, this analysis projected that people currently turning age 65 will need LTC for three years on average. An important share of needed care will be covered by public programs and some private insurance, but much of the care will be an uninsured private responsibility of individuals and their families--a responsibility that will be distributed unequally. While over a third of those now turning 65 are projected to never receive family care, three out of 10 will rely on family care for more than two years. Similarly, half of people turning 65 will have no private out-of-pocket expenditures for LTC, while more than one in 20 are projected to spend $100,000 or more of their own money (in present discounted value). Policy debate that focuses only on income security and acute care--and the corresponding Social Security and Medicare programs--misses the third, largely private, risk that retirees face: that of needing LTC.

Patients' Free Movement Rights and Cross-Border Access to Healthcare

As a result of the case-law of the Court of Justice, national systems of social security and health care can no longer neglect cross-border aspects as patients start behaving as consumers looking for the ‘best medical treatment’ at the ‘highest possible rate’ of reimbursement. A Member State cannot prevent its patients taking advantage of more advanced medical treatment or better organised care systems in another Member State unless it can justify such a limitation to patients' mobility rights on the basis of the need to maintain high-quality medical resources and a financially stable healthcare system. Authorisation for treatment abroad cannot be refused solely because there are waiting lists on the national territory. The Court's case law has prompted the Commission to include provisions on patient mobility in its proposed ‘Bolkestein’ Directive on services in the internal market. Whatever may be the fate of that Directive, a legislative codification of the principles outlined in the case law would certainly enhance transparency and legal certainty for all stakeholders.

Nutritional status of 1 – 3–year–old children and maternal care behaviours in the Orang Asli of Malaysia

It is estimated that worldwide there are at least 300 million indigenous people living in more than 70 countries on 5 continents. In Peninsular Malaysia the indigenous people known as Orang Asli (OA) in the Malay language or original people form the minority constituting less than 1% of the total population of the country. Despite continuous efforts by the government to integrate them into the mainstream economy the OA still live on the fringes of Malaysian society cut off from most social services; they are poorly educated and earn a meagre living. Described as the poorest of the poor the OA continue to have poor nutritional and health status (particularly the children) compared with other ethnic groups in Malaysia The World Declaration on the Survival Protection and Development of Children identified adequate maternal child care practices as important prerequisites to improved child nutrition. Care refers to the practices or behaviours performed by caregivers that affect nutrient intake health and the cognitive development of the child. Together with household food security a healthy environment and control of infections care is recognised at the policy level as a fundamental contributor to the nutritional well being of children. UNICEFs original conceptual model of child health identifies the role of care for the childs survival growth and development. In this model the immediate determinants of good nutrition and survival are adequate dietary intake and health. These are affected by underlying conditions which include household food security health services and care of women and children. Food health and care are in turn influenced by political ideological historical and economic structures. (excerpt)

Critical issues for homeland security and health care sector readiness

The "war on terrorism" and the nation's response to associated terrorist threats has created a significant challenge for health care risk management professionals. The Department of Homeland Security and initiation of the National Response Plan have set in motion a series of national requirements and obligations designed to protect and prepare the country to meet terrorist threats. These requirements and obligations have an impact on the health care industry with its ownership of critical infrastructure/key resources requiring protection from all-hazards events. Health care risk management professionals should be aware that the consequences of not meeting expectations during a future attack are significant.

The Quality of Homeland Security and Health Care Systems: The Texas Rangers Initiative

Healthcare facilities are an essential component of an emergency response system in case of nuclear, biological or chemical attack, but at the present time, are poorly prepared for an incident. Key elements of the healthcare facility response plan include prompt recognition of the incident, staff and facility protection, patient decontamination and triage, medical therapy, and coordination with external emergency response and public health agencies. Controversial aspects include the optimal choice of personnel protective equipment, establishment of patient decontamination procedures, the role of chemical and biological agent detectors and potential environment packs and water treatment systems. The medical profession must assume a central role in state and national organizations, such as the Texas Rangers Medical Corps. The Texas Rangers Medical Corps shows a possible system to set security plans, policies and systems in each state or region independently, but unified since they can join together to bring each experience to a national coordinated committee.

Joined-up government and privacy in the United Kingdom: managing tensions between data protection and social policy. Part I

The Labour government that came to power in the United Kingdom in 1997 made much of its commitment to ‘joined-up working’, by which it meant horizontal integration between policies and co-ordination across services. The particular manner in which it pursued this commitment has led to growing pressure for the sharing of citizens’ personal information among public service agencies. Yet at the same time, Parliament was engaged in implementing the European Data Protection Directive with a new Data Protection Act and the Government was honouring its manifesto commitment to bring the European Convention on Human Rights – including its enshrined right to private life – into domestic law. Government has therefore been obliged to find ways of managing the potential tension between these commitments. There are two analytically distinct dimensions to the arrangements through which this is being attempted. First, the horizontal dimension consists in initiatives that apply across all policy fields, and includes the establishment of cross-governmental guidelines for implementing data protection law as well as the development of national policy on sharing personal data between public services. In 2002, the government published a major policy paper on data sharing and privacy. By late 2003, its approach to the need for legislation had changed sharply. The second analytically distinct dimension, the vertical dimension, consists in the laws, codes and norms developed in specific policy fields to govern relationships between data sharing and privacy within those fields. This two-part article discusses these arrangements. Part I analyses the horizontal dimension of the governance of data sharing and privacy. Part II (published in the next issue) examines the vertical dimension in three fields in which tensions between data sharing and privacy have come to the fore: community safety, social security and NHS health care. Four options for the governance of data sharing and privacy are analytically distinguished: (1) seeking to make the two commitments consistent or even mutually reinforcing; (2) mitigating the tensions with detailed guidelines for implementation; (3) allowing data sharing to take precedence over privacy; and (4) allowing privacy to take precedence over data sharing. The article argues that, despite its strong assertion of (1), the government has, in practice, increasingly sought to pursue option (2) and that, in consequence, the vertical dimension has become much more important in shaping the relationship than the horizontal dimension. The articles argue, however, that option (2) is a potentially unstable strategy as well as being unsustainable.

Who and How Should Build the Trust in eCommerce? Research of Polish Internet Shops

Author described role of trust in the development of eCommerce. Role of state, NGO's and shops in the process of trust building was described. Author elaborated a quantitative method, based on the multi-parameter comparative analysis, which allowed comparison level of trust building in different shops. Method was used for the analysis of 30 polish shops. Main conclusion of the research is: lack of proper communication with clients, proper care for personal data and external trust transfer, as well as lack of care for payment comfort and security, has definitely negative influence on the client trust to make shopping with the Internet.