Different countries, different needs: the role of private health insurance in developing countries

This article discusses the role of private health insurance (PHI) in developing countries. Three broad regional clusters are identified that share similar characteristics and policy challenges for the effective integration of private insurance into national health care systems: (1) Latin America and Eastern Europe, where there are already developed insurance industries facing important market and policy failures; (2) the Middle East/North Africa region and East Asia, where there is a projected strong growth of PHI that needs to be accompanied by efficient regulation; and finally, (3) South Asia and Sub-Saharan Africa, where PHI will only play a marginal role in the foreseeable future while the scaling up of small-scale, nonprofit insurance schemes appears to be of critical importance. Overall, this survey shows that the role of private insurance varies depending on the economic, social, and institutional settings in a country or region. Private health insurance schemes can be valuable tools to complement existing health-financing options only if they are carefully managed and adapted to local needs and preferences.     

Sexual offenders with learning disabilities: risk,recidivism and treatment

Abstract

While the literature on the assessment, treatment and management of non-learning disabled sexual offenders is well established, it is only in recent years that researchers and clinicians have focused on sexual offenders with learning disabilities. In contrast to mainstream sex offender treatment programmes, there are few evaluated community-based treatment programmes for sexual offenders with learning disabilities, and of the small number of published studies that describe treatment programmes, most are based on small samples and few have been validated empirically. Sexual offenders with learning disabilities differ from their non-disabled counterparts in several important ways, having implications for management and treatment. Due to methodological differences between studies, the prevalence of sexual offending by men with learning disabilities is not clear. However, in some studies, the sexual recidivism rate of offenders with learning disabilities is 6.8 times and 3.5 times that of non-disabled sexual offenders at 2- and 4-years’ follow-up, respectively. Sexual offenders with learning disabilities are also at greater risk of re-offending in a shorter time period. There remains an urgent need for further research into the assessment of risk and whether components from mainstream treatment programmes can be adapted to meet the needs of learning disabled sexual offenders. Approaches to working with sexual offenders with learning disabilities and programme development are discussed.     

On the relationships between gender, power control, self-control, and crime

This article bridges the gap between two theories that attempt to explain the gender - crime relationship. Power-control theory posits that power relationships of parents in the public sphere are reflected in their relationship at home. Different kinds of households are thus distinguished by degrees of patriarchy. Differential socialization generates gender differences in crime across households. Gottfredson and Hirschi's general theory purports that low self-control explains all crime across all groups, yet little research explored the link between low self-control and crime both among, as well as between, genders. Linking low self-control and power-control theories, this study examined the relationships gender, power-control, self-control, and crime. Results indicated that while low self-control explained both male and female criminality, the effect of parenting on the development of low self-control was complex; males and females differentially responded to parents' control. The gender-based processes that impact the development of self-control should further be explored.     

Adolescent Sexual Victimization, ADHD Symptoms, and Risky Sexual Behavior

This study examined the association between ADHD symptoms experienced before age 12 and sexual victimization during adolescence in a sample of 374 college women who had not been sexually victimized as children. The linkage with risky sexual behavior and the moderating effects of sociodemographic factors also were considered using structural equation modeling. ADHD symptoms were associated with greater sexual victimization during adolescence and were linked with sexual victimization through engagement in risky sexual behavior. Sociodemographic factors did not affect the overall model; however, sociodemographic factors were differentially related to certain paths in the model. In particular, the associations between ADHD symptoms and sexual victimization, as well as risky sexual behavior, were stronger for Black than White women. Also, the relation between ADHD risky sexual behaviors was stronger for young women who grew up with only their mother than with both parents, and for those whose primary caregiver was employed rather than unemployed.     

Sexual assaults in Geneva between 2006 and 2010

In Geneva, all sexual assault victims are examined both by a gynaecologist and a forensic pathologist with special training in clinical forensic medicine. Between 2006 and 2010, 473 victims were examined following such an assault. Over the years, the number of sexual assaults rose steadily. Most victims were aged between 15 and 30 years. The majority of the assaults occurred at night and on the weekend and often happened at the place where the perpetrator or the victim lived. Usually, the offender acted alone and was known to the victim. Many victims hesitate to present for an examination, which makes it difficult to collect evidence. Penetration was usually vaginal and without the use of a condom. Injuries on the body or genitals were seen in only half of the cases for the first ones and in less than one third for the second ones. Quite often (at least in 42 % of the cases), the victim consumed alcohol before the assault and the use of drugs--especially cannabis--was not uncommon either.     

Sexual Orientation,Race, and Trauma as Predictors of Sexual Assault Recovery

Sexual minorities and racial minorities experience greater negative impact following sexual assault. We examined recovery from sexual assault among women who identified as heterosexual and bisexual across racial groups. A community sample of women (N?=?905) completed three yearly surveys about sexual victimization, recovery outcomes, race group, and sexual minority status. Bisexual women and Black women reported greater recovery problems. However, Black women improved more quickly on depression symptoms than non-Black women. Finally, repeated adult victimization uniquely undermined survivors’ recovery, even when controlling for child sexual abuse. Sexual minority and race status variables and their intersections with revictimization play roles in recovery and should be considered in treatment protocols for sexual assault survivors.     

论紧急救治权与医疗欠费的矛盾及其对策

紧急救治权是我国卫生法规定的公民在患病急危时，有得到医师紧急抢救的权利。而在当前却存在日益增多的急诊欠费与紧急救治权之间发生矛盾的案例，严重妨害了患者的紧急救治权。如果仅依靠追究医师的法律责任来解决该矛盾，只是治表之策，而建立急诊欠费的补偿机制才是根本对策。因此，应当通过社会建立急诊“绿色通道”会员制度，医院共同参与建立“医疗欠费共担基金”，政府建立紧急救治欠费补偿基金，聘请律师对恶意欠费依法追缴等对策保障患者紧急救治权。     

Facing rejection: new relationships, broken relationships, shame, and stalking

This study provides a preliminary examination of the relationship among shame-proneness, emotions, and persistent, unwanted courting or pursuit behaviour. A total of 222 undergraduates completed a questionnaire measuring responses to the termination of a relationship or the declining of a date. The Test of Self-Conscious Affect was used to measure shame. Although shame was unrelated to types of intrusive behaviour, individuals who engaged more repetitively in covert pursuit tended to ruminate more over their love interest than did those who rarely engaged in such behaviour. Rumination was positively correlated with shame. Self-harm behaviours and harm toward others were associated with feelings of sadness and depression, and those who engaged more often in harm toward others also reported feelings of anger and jealousy. Conclusions are made regarding the function of shame and other emotions in intrusive behaviour and their potential relevance to treatment of stalkers.     

Sexual abuse in Canadian university and college dating relationships: The contribution of male peer support

Using data from a Canadian national representative sample survey of male university and college students, this study tested three hypotheses from a theoretical model which attempts to explain the relationship between male peer group dynamics and sexual assault in dating relationships. Consistent with previous research conducted in the United States, the findings reported here show that male peer support is a significant predictor of sexual abuse in post-secondary school courtship. This article concludes with several suggestions for further research.     

New perspectives on intersectoral relationships between manufacturing and services

This study advocates the explicit incorporation of the production of in-house information services into input-output tables in order to overcome the limitations imposed by conventional accounting frameworks which distort the relationship between manufacturing and services. This relationship is analysed using a well-known impact methodology. The importance of consumption induced multiplier effects, i.e. demand linkages, is also emphasised. The shift in perception of intersectoral relationships which adoption of our methodology provides is demonstrated using Japan in 1980 as a case study. It is shown that ‘conventional’ analysis seriously underestimates the importance of services for output and employment creation. Comparisons to a recent study by Park and Chan (1989) are drawn which provided the stimulus for this paper.     

Exploring the literature on relationships between gender roles, intimate partner violence, occupational status, and organizational benefits

Studies of intimate partner violence (IPV) and work have been primarily conducted with women in low-wage low-status (LWLS) positions, as much of this research has focused on poverty, welfare, and homelessness. Although women in LWLS positions represent a large percentage of working women in the United States, it is also important to investigate experiences of women in high-wage high-status (HWHS) positions because a growing number of women are employed within such jobs. We propose gender role theory can be used to explain occurrences of IPV among women in HWHS positions and their utilization of organizational benefits. We suggest those in HWHS positions may be likely to have access to organizational benefits (e.g., medical, vacation, and flexible work schedules) and the ability to utilize the Family and Medical Leave Act. However, prevailing gender roles existing in organizations may render women in HWHS positions unlikely to use benefits or to take leave.