A Comparative Study of Denmark and New Zealand’s National Health Targets

This paper investigates the influence of nationally imposed health targets on current management control practices in New Zealand and Denmark. It reveals how variants of New Public Management (NPM), arising from specific historical socio-political contexts, rise to the challenge of national differences. The study finds that both nations are challenged to ensure data registration procedures produce valid and comparable performance measures. Denmark’s reliance on a single efficiency measure of health sector performance reflects a historic socio-political context that reduces the feasibility of additional measures whereas New Zealand’s context enables the government to impose a more extensive range of health targets.     

转型期员工心理健康服务研究：工会模式- 以辽宁省为例

转型期员工面临较大的压力,心理健康问题比较突出。工会在提供心理健康服务方面兼备效率和效果的双重优势,采用分段购买方式与专业机构建立"委托—代理—共建"关系,以"心理健康服务共享中心"(PHSSC)为核心,将会费作为服务经费的主要来源,由专业人员提供服务并收集相关数据进行分析和趋势预测,制定相应的管理与监督机制,通过专业服务保障并提升员工心理健康水平。     

Self-rated health and barriers to healthcare in Ukraine: The pivotal role of gender and its intersections

The ongoing health crisis in the Ukraine has persisted for 48 years with a clear division of gender-based outcomes as seen in the decline of male life expectancy and stagnation of female longevity. The purpose of this paper is to investigate differences in self-rated health and system barriers to health care applicable to gender and its intersections because of the differing negative health outcomes for men and women. Intersectionality theory provides an analytic framework for interpreting our results. Utilizing a nationwide sample of the Ukrainian population (N = 1908), we found that low socioeconomic status (SES) women rate their health worse than men generally and any other socioeconomic group. Yet women also face the greatest barriers to health care until older ages when the ailments of men cause them to likewise face the obstacles. In reviewing the barrier to health care scale, one barrier—that of health care services being too expensive—dominated the responses with some 52.5 percent of the sample reporting it. Consequently, the greatest problem in Ukraine with respect to health reform reported by the population is the out-of-pocket costs for care in a system that is officially free. These costs, constituting some 40 percent of all national health expenditures, affect women and the aged the most.     

Resilience in the Face of Adversity: African Immigrants' Mental Health Needs and the American Transition

The aims of this qualitative study were to explore key sources of emotional distress and coping strategies among West African immigrants. Thirty-eight adult West African immigrants participated in six semistructured, open-ended focus group sessions. Focus group data were analyzed using a grounded theory approach. While participants reported high levels of psychological distress associated with racial/cultural discrimination, intimate partner violence, parenting, extended-family demands, and problematic immigration status, they demonstrated resilience and the ability to identify a range of coping strategies that draw on their cultural heritage. Only two of the participants reported having used psychological services; both outcomes were negative. The findings of this study are considered in terms of their clinical implications.     

An assessment of sexual health risk behaviors among female youth in juvenile detention

This study investigated the association between risky sexual behavior and drug use among female youth sentenced to a regional juvenile detention center. Preincarceration behavioral health risk data were collected from a modified version of the Youth Risk Behaviors Surveillance Survey completed by respondents. Almost all of the 105 participants had been detained before their current sentence, more than half of them were sexually active before the age of 13, and 70% had smoked marijuana or drank alcohol by age 14. A regression analysis was conducted to determine if preincarceration sexual health risk behaviors were significant enough to predict continued risk behaviors related to pregnancy, disease prevention, and substance use. Findings indicate that youth detention-based prevention programs should emphasize sexual and drug-risk reduction strategies as a means to reduce risky behaviors for this population.     

Similarities and Differences in Victimization Risk Factors for Nonoffending and Offending Substance Users

In this cross-sectional study of substance users in Norway, the authors describe the patterns of victimization and investigate the factors associated with victimization, for nonoffenders and offenders separately. Recent victimization was reported by 59%, and the victimization rate was higher among offenders compared with nonoffenders (69% and 43%, p < .001). Women, regardless of offender status, experienced more victimization. Unstable housing was associated with victimization among nonoffenders, whereas markers for more severe substance use and indicators for poor mental health were associated with victimization in both groups. Addressing these factors may be important in reducing victimization and its negative outcomes among substance users.     

Adolescent Co-occurring Disorders Treatment: Clinicians' Attitudes,Values, and Knowledge

This study examined community-based clinicians’ (N = 294) attitudes, background/experiences, values, and knowledge relating to issues of co-occurring disorders, which occur at a high rate among adolescents involved in the juvenile justice system. Study results reveal that clinicians self-rate their clinical values and attitudes at or above the expected level of competency, but they concede that their skill and knowledge levels are not adequate. Comparison measures reveal that employment setting conditions, geographic region, hours worked per week, and strongly held convictions about the importance of integrated mental health and substance use disorders service delivery distinguish clinicians’ co-occurring disorders knowledge levels. Implications are offered.     

The role of universities in the promotion of worker protection: UCLA labor occupational health and safety program as a model for countries with developing economies

ABSTRACT

Protection of the workers’ health in countries with developing economies is increasingly important because of the adverse effects of globalization, along with changing industrial relations, the rise of precarious work and outsourcing, and the decline in unionization. In this study, I examine whether the institutes created by universities might serve as an interface between workers, academia, and state agencies, and provide assistance for both improving workplace conditions and enforcing occupational health and safety rules. I describe the history of one such effort: The Labor Occupational Safety and Health Program (LOSH) at the University of California, Los Angeles (UCLA). Using a review of written sources along with participatory observation and interviews as methods, I found that the challenges faced by LOSH historically have important parallels in countries with developing economies today. Ultimately, university-based occupational health programs like LOSH need to be followed in other parts of the world and be supported by governments if the mission to reduce workplace injuries and diseases is going to be realized in the United States and in other countries.     

I'm Stuck as Far as Relationships Go

Abstract

This is a study of how heterosexual girls construct the meaning of their health issues within their dating relationships. We found that a number of barriers contributed to girls' difficulty with articulating their needs and desires in their romantic relationships. Adolescent girls who participated in our study blamed themselves for their boyfriends' abuse and lack of commitment and experienced their ability to speak in their own interests as compromised. Many of the girls experienced what researchers term an “impossible choice” between compromising self to maintain a relationship or compromising the relationship to maintain self. The dating relationship was predominantly determined by patriarchal and dualistic thinking that undercut healthy decision making. Assisting girls within supportive environments to reflect upon gendered power differentials in their relationships can facilitate their expression of authentic voice which in turn can enhance their own health behaviors.     

The politics of HIV/AIDS in South Africa: government action and public response

A decade ago it seemed likely that African governments would be destabilised by the impact of the HIV/AIDS epidemic. This article tests some of the presumptions in such forecasting with an examination of the South African case. It begins with an assessment of the effects on the public health system of the South African government’s efforts to cope with the illness. Efforts to implement universal treatment of people who are HIV-positive appear to have strengthened government, while the costs have been affordable. The efforts have extended the embrace of the public health system and prompted the engagement of civil society in policy formation and implementation. Survey evidence suggests that the government has gained public approval and that its health service delivery has become more socially accountable. Civil protest to engender political reforms in the treatment of AIDS patients has enhanced the role of constitutional checks on executive authority.