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Recently married elderly people change attitude to hospital treatment and living in asylums; they prefer care rendered at home and hospital-substituting forms of care; hospitalization and ambulance care are less needed and permanent social workers are required less. All this promotes rational utilization of the potentialities of therapeutic institutions and saving of public health and social protection resources.
This article analyzes the evolution of public social expenditure in Spain from 1991 to 2000. It includes the analysis of the total public social expenditure as well as four of its components: sickness/health care, invalidity/old age, survivors, family/children. Expenditure is analyzed as a percentage of the GNP, and expenditure per capita in purchasing power units. This article shows that there has been an increase since 1993 in the deficit of the public expenditure on social protection in Spain representing a divergence from the average expenditure in the UE. The article also analyzes the development of care services (child care and services for dependent elderly), due their impact on gender inequalities.
A nationwide survey of county departments of social services revealed a need for medical services and consultation to child protection units. Over 92% of the 84 counties surveyed stated they had a problem meeting their medical needs and would be willing to hire a physician assistant as medical consultant to their county's child protection team. No county refused to consider a physician assistant, but 7% felt their medical requirements were being met. Needs the counties most commonly identified were providing parent education/anticipatory guidance (69%), interviewing (65.5%), interpreting medical information to a multidisciplinary child protection team (58.3%), review of medical records (45.8%), and physical examinations (42.9%). Over 17% of the counties had money to fund a full-time physician assistant, and over 60% of the counties could provide a partial salary, with 70.5% willing to share a salary with adjacent counties and 76.9% with the county's public health department.
In light of contemporary social legislation, jurisdiction, scientific publications as well as the great numbers of institutions and facilities, the field of rehabilitation has undergone profound, positive changes from the beginnings of social legislation till today. Lawmaker and social administration are equally concerned with the tasks at hand today and in the future. The legislator is responsible for closing legislational gaps and for creating definitional clarity. Inter alia because of the high expectations relative to quality and quantity of social services and benefits, it is not possible in the Federal Republic of Germany to achieve greater simplicity and at the same time greater social equity of rehabilitation law. One of the main problems is to determine what exactly is comprised by "social rehabilitation" as well as its relationships with other areas of rehabilitation, aside from integrating social rehabilitation in its entirety into the catalogue of tasks incumbent on the social insurance sector. The self-government bodies are called on to make even greater use of the rooms for action accorded under the applicable provisions. This includes the competence for undertaking research, which, in particular in the health insurance sector, emanates from art. 217 SGB 5 (Social Code, Book 5). The social protection administrations are called on to define the bases for rehabilitation programme standards relative to the various disability types, in view of safeguarding rehabilitation effectiveness and efficiency.(ABSTRACT TRUNCATED AT 250 WORDS)
In this paper we propose a social and health care model that offers alternatives to three problems arising in converging European welfare states, particularly in the southern nations: the rise in demand for services and features linked to the ageing process, the increase in dependency and the crisis of informal support. Development of the principles of social sustainability implies re-formulation of the regulatory, care, economic, administrative, cultural, and axiological framework enabling a response to the needs of long term care without compromising the welfare of future generations. Together with this principle, quality of life elevated to a subjective right directs attention towards the sphere closest to citizens, eliminating all barriers, which hamper exercise of this right. All of the above produces economic and social costs which must be accepted from a viewpoint of social co-responsibility, which brings with it the supply of welfare individually, without detriment to the exercise of state responsibility in guaranteeing a social protection system of a universal nature.
This analysis of the forms of social protection available in Argentina during 1935-48 pays special attention to the distinguishing aspects of infant mortality and birth rates in urbanized areas along the country's coastline. Different government public health institutions -- such as pediatric and maternity institutes -- undertook assistance work among single mothers, where moral teachings played an important role and where marriage was encouraged for its regulatory role in avoiding high rates of illegitimacy. In this task, physicians, visiting nurses, and social assistants from government institutions agreed with the church hierarchy and Catholic intellectuals, since both sectors considered matrimonial legitimacy vital to limiting a decline in the national birthrate.
Dental implants are used with increasing interest each day. This costly material, which is reimbursed neither by Public Social Protection Agencies nor by private health insurance companies, has become a cause for lawsuits. We analyzed the experts' conclusions regarding legal mementos and expert reports, wherein medical liability (4 cases) and repair of dental injury (2 cases) were put into question. The experts stress the need to regard this technique as surgical, and to have it necessarily yield results. Repair of damage caused by dental trauma using implants does not alter conventional approaches in terms of social security cover for maintenance and replacement of dental prosthesis. Difficulties encountered by experts in evaluating injuries sustained by bone-adapted implants are evoked.
For members of stigmatized groups, being confronted with highstatus outgroup members threatens social identity and undermines performance on status-relevant dimensions. Two experiments examined whether the negative effects of outgroup contexts are alleviated when value is expressed for a dimension on which the stigmatized ingroup excels. Specifically, the authors assessed whether ingroup versus outgroup context and contextual value for ingroup dimensions affects group members' reactions to failure on status-relevant dimensions and subsequent performance. Experiment 1 showed that in comparison to ingroup contexts, outgroup contexts induce stigmatized group members to protect social identity and to feel more agitated following negative performance feedback. Experiment 2 showed that when others in the context emphasize the importance of a dimension on which the ingroup excels, the negative effects of outgroup contexts are alleviated, stigmatized group members feel more cheerful concerning an upcoming task, and task performance is characterized by a focus on success.
The author critiques the expedient application of market valuation principles by the transnational corporations and other large firms in the Indian pharmaceutical industry on a number of issues like patents, pricing, irrational drugs, clinical trials, etc. He contends that ethics in business is chiseled and etched within the confines of particular social structures of accumulation. An ascendant neo-liberal social structure of accumulation has basically shaped these firms' sharp opposition to the Indian Patents Act, 1970, government administered pricing, etc. The author contents that the practice of neo-liberal economics is strongly associated with a "one-dimensional" ethics that privileges market valuation principles over all others. This seems to inevitably generate a social counter-movement that struggles for social protections. He critiques neo-liberal business practices from a perspective that derives from the work of the economic anthropologist Karl Polanyi. Before the present phase of liberalization in India, markets were "managed", but without a "welfare state" in place. Moving toward deregulation of the markets without a welfare state in place is unethical. Keeping the debilities of the institutional framework of public policy in mind, the author adopts a Polanyian perspective that places its trust and hope in the growing social legitimacy of the counter-movement in opposition to both neo-liberal business practices and the degenerate behavior of state agencies.
Convergence of policies and institutions across countries has been a recurrent theme within social sciences. 'Old' and 'new' convergence hypotheses have been associated with changing concepts and catchwords, such as modernization, logic of industrialism, post-industrialism, post-Fordism and globalization, but share some underlying theoretical perspectives. The purpose of this paper is to analyse tendencies towards convergence of social insurance systems in 18 OECD countries between 1930 and 1990, a period which has seen our sample of countries develop from predominantly agricultural societies to industrial or post-industrial market democracies. Data from the Social Citizenship Indicator Program (SCIP) are used to examine the development of institutional variables within the various national social insurance systems. Sub-samples of larger and smaller countries are examined separately, in order to test the open-economy hypothesis that smaller countries, being more exposed to international pressures than larger ones, could be expected to show higher degrees of social protection and also more convergence. Hypotheses on differentiated institutional barriers against pressures from the processes of transnationalization of the economy, as well as possible convergence effects of the supra-national policy making within the European Union, are discussed in the last section.
Most of the research and clinical reports concerning borderline personality disorder (BPD) come from highly developed countries. Although BPD can also be diagnosed in developing societies, it is likely that this form of pathology is more prevalent in North America and Europe. However, the personality traits and psychological risk factors underlying borderline personality may also be found in individuals from developing countries. The hypothesis of this paper is that social protective factors suppress the development of these traits into diagnosable personality disorders. This process is illustrated by cases in which borderline pathology emerged only after immigration.
Increased world trade has generally benefited industrialized or strong economies and marginalized those that are weak. This paper examines the impact of globalization on employment trends and occupational health, drawing on examples from southern Africa. While the share of world trade to the world's poorest countries has decreased, workers in these countries increasingly find themselves in insecure, poor-quality jobs, sometimes involving technologies which are obsolete or banned in industrialized countries. The occupational illness which results is generally less visible and not adequately recognized as a problem in low-income countries. Those outside the workplace can also be affected through, for example, work-related environmental pollution and poor living conditions. In order to reduce the adverse effects of global trade reforms on occupational health, stronger social protection measures must be built into production and trade activities, including improved recognition, prevention, and management of work-related ill-health. Furthermore, the success of production and trade systems should be judged on how well they satisfy both economic growth and population health.
Ratings of patient efficacy to manage illness, made by 191 congestive heart failure patients and their spouses, were examined as predictors of patients' survival over the next 4 years. When considered alone, both the patient's self-efficacy and the spouse's confidence ratings predicted survival, but only spouse confidence remained significant when both partners" efficacy ratings were included in the same Cox regression model. The overlapping prognostic significance of spouse confidence and a global, multicomponent measure of marital quality positioned the former as a proxy for the latter, reflecting a fundamentally social protective factor in patient survival. Successful adaptation to heart failure appears to involve more than the patient's personal agency, and psychosocial data from spouses can improve prediction of patient outcomes.
The paper examines the problems for social protection and economic growth that arise from the development of a dualistic labor force-- divided into a privileged core and a disadvantaged periphery--created by the dynamic interaction of labor supply rigidities and rapid technological growth. It concluded that reforms of labor market institutions have to be introduced in order to solve the existing problems.
A conceptual model for primary prevention is proposed. Its five elements are (1) Risk Factors that increase the likelihood of (2) eventual Mental Disorder contingent upon (3) intervening psychological stresses that promote Crises, which the individual may master more or less effectively dependent on (4) his current psychological Competence and (5) the powerful influence of Social Supports. The paper summarizes recent preventive intervention efforts and evaluative studies that focus on these elements in seeking to reduce psychiatric disorders in child populations: reduction of risk factors through mental health consultation and collaboration by mental health clinicians with child care workers and administrators; improvement of competence in children t risk by special educational programs with children and their parents that seek to enhance their cognitive and emotional programs with children and their parents that seek to enhance their cognitive and emotional problem-solving and coping skills; crisis intervention for children and their families by anticipatory guidance and preventive intervention; and fostering protective social supports by convening supportive groups for persons in need, and organizing mutual help groups, both of which seek to provide individuals under stress with help with emotional reequilibrium and cognitive guidance to compensate for capacities that are usually temporalily eroded by the upheaval of crisis.
The nature of the workplace continues to change as Europe adapts to the challenges of competing in a global marketplace. Across the European Union there is a trend of increasing absenteeism and early retirement due to mental health problems, particularly stress and depression. The social and economic costs of lost productivity in Europe are substantial. Moreover, the sustainability of social protection systems may be challenged further by increases in the levels of disability benefits paid to people who have left work on grounds of poor mental health. Yet despite these significant consequences, at both national and pan-European levels, decision-makers have been slow to recognise the importance of promoting mental health within the workplace, although recently there have been some positive developments. This paper outlines some of the socio-economic arguments for the promotion of good mental well-being in the labour force and identifies how they link with different national and European policy agendas around four key issues: economic growth and development, the promotion of a high level of public health, sustainability of social welfare systems and social inclusion. The role and activities to promote mental well-being in the workplace undertaken by both national and international organizations in Europe are outlined along with important gaps and challenges that need to be addressed.
The resources and instruments available to the office-practice physician fail to come up to the postulate of "rehabilitation of the person". The decentralized system of social protection administration has resulted in areas of competence of medically unclear definition, which is the background of frequent attempts to shift costs on to other institutions. Bureaucratic procedures are highly intricate and lacking in practicality, possibilities for community service provision, for improvement of the labour market situation and for comprehensive care of the disabled are not available to a sufficient degree in the present system.
Improvement of the living and working conditions of migrant workers as well as their free movement and social protection are among the major objectives of the European Community (laid down in the Treaty of Rome). In view of the forthcoming European internal market after 1993 and the related potential for increased sociopolitical integration also of disabled persons, an overview is presented of the policies adopted in the various member states in order to enhance employment of disabled people. The article gives an analysis of basic principles, without appraising the various provisions.