Journey towards independent living: a grounded theory investigation of leaving the care of Girls & Boys Town,South Africa

The journey out of care and towards independent living is a challenge for many care-leavers. There has been little research into the social processes involved in this care-leaving journey. This paper presents the results of a grounded theory investigation into the care-leaving journeys of nine young men who had, several years previously, been in the care of Girls & Boys Town in South Africa. Working from a resilience perspective, with an ecological emphasis, four central social processes emerged that together explain the care-leaving experiences of the participants. These processes are striving for authentic belonging; networking people for goal attainment; contextualised responsiveness and building hopeful and tenacious self-confidence. These four processes are located within contextual boundaries and at the social environmental interface. The paper presents these processes in detail, drawing on selected narratives of the participants and integrated with additional theory. It is hoped that this paper may contribute to theory building concerning care-leaving processes and enhance youth care practices for youth in care and leaving care.     

Open Road or Blind Alley? Welfare Reform, Mothers, and Children with Disabilities

Welfare reform was examined for 39 Michigan families whose children have significant health or intellectual and behavioral disabilities. As a group, these families received little specialized assistance or services to address their unique needs. Family-cited barriers to self-sufficiency included poorly trained welfare caseworkers, limited public transportation, and inadequate child care. Having an older child was the only discriminating variable between working and non-working mothers. However, working mothers only had temporary positions with no benefits and low pay. All families, whether employed or not, lived below the poverty line.     

农村居民看病难、看病贵原因实证分析

利用扩展的线性支出系统模型(ELES),采用最小二乘法估计计算了我国农村居民的短期医疗服务需求价格弹性。研究结果表明:农村居民的短期医疗服务需求价格缺乏弹性。由于农村居民的短期医疗服务需求价格缺乏弹性,加上我国目前医疗体制存在的以药养医和医疗机构的逐利行为以及医疗市场缺乏有效的监管等问题,导致农村居民看病难、看病贵。解决这个问题,需要国家增加对卫生领域的投入,降低农民看病时自费的比例,增强卫生市场的竞争性,适当使医疗卫生资源向农村地区倾斜,并逐渐把医疗机构办成非盈利机构。     

Dementia Problem Behavior and the Production of Informal Caregiving Services

Informal caregivers of individuals with Alzheimer's disease spend a considerable amount of time providing care. In this paper, we use Grossman's health production and Becker's time allocation models to develop a model of informal care provision to elderly dementia patients. In our model, time inputs produce caregiving services, which provides utility to the caregiver, but reduces leisure. We assume that time is less productive of services on the margin as the disease progresses. In this framework, an increase in patients' disease severity does not necessarily increase informal caregiver time input. The cost of formal care establishes a reservation price for informal caregiving. When the costs of informal caregiving rise above this reservation level, the patient is institutionalized. We test empirically the effect of deterioration in the patients' condition, proxied by both disease severity and dementia problem behavior, on informal caregiving time. We find that dementia-related problem behaviors and functional limitations significantly increase inputs of informal caregiving time. Patients' problem behavior exerts a modifying effect on functional limitations, and patients' comorbidities have no effect on informal caregiving time.     

Efe fathers: one among many? A comparison of forager children's involvement with fathers and other males

The study reported describes Efe (pygmy) forager one-, two-, and three-year-olds' involvement with males. The Efe of northeastern Zaïre were chosen because their social organization allows us to examine hypotheses based on studies in Western, technologically complex societies about the distinctive role fathers play in the lives of their young children. Behavioral observations of Efe children's day-to-day activities with fathers, men and boys were recorded using a focal subject sampling technique (Altmann, 1974). Two behavioral measures were created to capture the extent to which males were involved with children: Social engagement describes males' involvement with children and social attention describes eavesdropping by children on males' everyday activities. Eight one-year-olds, 7 two-year-olds and 8 three-year-olds were each observed for six, one-hour observation sessions that were distributed evenly over the daylight hours. Data were analyzed using the traditional measure of involvement (e.g., adult males) and using a newly developed measure of the involvement of the average individual (e.g., average adult mate). Comparisons at each of the ages showed that fathers were consistently like other men in the extent to which children participated in social activities with them and watched their activities. Only fathers' level of social engagement declined significantly as children grew older. Boys' role relative to other males became increasingly distinctive as children aged. The findings suggest that Efe fathers may not be unique in the same sense assumed by Western study ideals, and raise questions about the special status given to fathers in Western theory and data. The patterning of mate involvement with children is discussed in terms of Efe community life, and in terms of Efe children's developing understanding of their relationship with fathers and other males.     

辩证地认识政府预算收支的平衡原则

政府预算收支原则 ,是政府组织预算收入 ,按排预算支出的指导思想。平衡原则是我国预算收支的支配性原则。本文辩证的分析了非均衡原则的缺陷 ,平衡原则对经济的调节功能及存在的局限性 ,从理念论述了政府预算平衡应选择的辩证方式     

Trade-Offs Between Formal Home Health Care and Informal Family CareGiving

Using 1994 National Long Term Care Survey data, we estimated logistic regressions of formal and informal home health care use and hours. Home health care use and intensity were differentially impacted by chronic conditions, are higher for Medicaid enrollees and rural or small town residents, but lower for HMO enrollees. Decreases in the probability of home health care use increased informal instrumental activities of daily living (IADL) support four hours and decreased informal activities of daily living (ADL) support eight hours weekly. IADL caregiving substituted for formal care, but ADL caregiving declined with reductions in formal care. Public policy reducing formal home health care access may reduce informal ADL caregiving and increase informal IADL caregiving, producing net declines in support.     

The State of Care Management in Learning Disability and Mental Health Services 12 Years into Community Care

This paper reports on the organization of care management froma longitudinal study of community care for people resettledfrom long-stay learning disability and psychiatric hospitals.The findings from a 12-year follow-up of care management arrangementsin 12 learning disability and eight mental health study siteservices are described. The diversity of care management arrangementsfound at earlier points in the evaluation remained evident.Also, many of the former ‘care in the community’service users were excluded from mainstream care managementarrangements in their localities. The difficulty of developingperson-centred arrangements in learning disability and the lackof integration of the Care Programme Approach and care managementwere evident. The findings and observations are placed in thewider policy and practice context, with suggestions for takingcare management forward nationally and locally.     

延边地方财政对区域经济增长的影响

在延边地方财政支出结构中,生产性支出的比重相对低,这对区域经济增长会产生短期效果影响。利用区域经济增长与地方财政支出之间因果关系模型实证分析延边地区的结果,证实了这一结论。为了区域经济的稳定增长,延边地区应适当提高生产性支出的比重。     

Can we remember differently? A case study of the new culture of memory in voluntary organisations

This article analyses the positive contribution that Slovenian voluntary, non–governmental organisations, users' organisations and community–based services in the field of mental health have made to the 'new culture of memory' of helpers and users. The conceptual differences between Slovenian psychiatric (institutional) treatment and voluntary community care are presented through the case study of Clare, a young woman who was diagnosed as a chronic schizophrenic. This example shows the importance of community care in voluntary organisations for the reduction of disability associated with mental disorders. The development of the new culture of memory in voluntary organisations and community–based services is not only the 'narrative turn' within social welfare, but also symbolises the 'implicit turn' in the relationship between the helper and the user. The real challenge of the new culture of memory in the process of help to disabled people (in respect of individuals working through traumatic memories) is that the helper can bear and support the user on a daily basis. During the process of their relationship, the deep implicit relational memories of both become activated and influence the change within the user as well as the helper.