The future of refugee flows and policies

"The number of forced migrants...is estimated today to exceed 40 million [worldwide]. The changed international climate of the 1990s...has shifted the focus from the asylum and resettlement countries to the countries of origin: there is today a greater willingness to intervene in other countries' affairs either to avert the creation of new flows of focused migrants or to assist internally displaced populations, and there is the expectation of large-scale voluntary returns of refugees in asylum. This article discusses these and other policy issues concerning forced migration in this new international environment."     

Assessing right to die attitudes: a conceptually guided measurement model

This article discusses the current status of research regarding the assessment of attitudes toward euthanasia and other right to die constructs with a focus on conceptual and methodological issues hindering advancement in this area. Two models are presented: a conceptual model for differentiating the various right to die constructs, and a measurement model to guide scale development and refinement. The conceptual model defines the right to die constructs as a function of locus of decision and locus of action. Health status and age are hypothesized as important factors that in some instances are defining attributes in right to die constructs and in other instances are factors influencing people's attitudes toward the right to die. The measurement model considers the importance of construct specificity, individual characteristics, and conviction in the assessment of right to die attributes. An extant euthanasia attitude scale is presented and evaluated in terms of the models to demonstrate how they may be useful for advancing attitude research in this important area.     

Evaluating a private foundation's health program

Public policy decisions in health are increasingly difficult and expensive. Although there will never be enough information available, private foundations can help to bridge the most important gaps in knowledge. Larger foundations may also wish to respond to those who doubt the value of foundation activities. This article reviews the experiences over the past eight years of The Robert Wood Johnson Foundation in employing evaluation and related social research procedures in the planning and implementation of a major philanthropic effort to improve the health and medical care of Americans. Discussed are the still evolving Foundation evaluation framework, the unanticipated problems in undertaking specific evaluations, and the substantive findings of some of the studies.     

Culture and Organization: The Case of Transmanche-Link

The relationship between culture and organization has often been discussed, but rarely explored directly. This paper implements a cultural values instrument taken from Hofstede together with a behavioural instrument derived from Van de Ven to matched samples of British and French managers working on the Channel Tunnel project. The results largely replicate the findings of Hofstede regarding cultural values, but do not support the predicted implications for behaviour. In essence, the British were found to be more bureaucratic and more team-oriented than their French counterparts, who tended to be more fonceur and competitive. This indicates that the relationship between culture and behaviour might be more complicated than research to date suggests.     

Internalized Other Interviewing in Relational Therapy: Three Discursive Approaches to Understanding its Use and Outcomes

For over 20 years, family therapist Karl Tomm has been engaging families and couples with a therapeutic intervention he calls Internalized Other Interviewing (IOI). The IOI (cf. Emmerson‐Whyte, 2010; Hurley, 2006) entails interviewing clients, from the personal experiences of partners and family members as an internalized other. The IOI is based on the idea that through dialogues over time, one can internalize a sense of one's conversational partner responsiveness in reliably anticipated ways. Anyone who has thought in a conversation with a family member or partner, “Oh there s/he goes again,” or anticipates next words before they leave the other's mouth, has a sense of what we are calling an internalized other. For Tomm, the internalized anticipations partners and family members may have offers entry points into new dialogues with therapeutic potential—particularly, when their actual dialogues get stuck in dispreferred patterns.     

Comparison of Modes of Administration and Response Options in the Assessment of Subjective Health Using the First Question of SF-36

To compare two modes of administration (self-administered; by interviewer) and two response options format (using words; images of “facial-expressions”) of the first question of SF-36 (Q1SF-36), and to test its validity. We included 825 participants (20–90 years). Q1SF-36, using words or images, was included in a global questionnaire interview and at the end participants filled the SF-36. The agreement was tested by weighted kappa coefficients (WKappa). Classification Trees were used in the calibration of Q1SF-36 responses, with the physical (PDSF36) and mental dimensions of SF-36. Polyserial correlation coefficients and areas under the ROC curves (AUC) were used for validation. After categorization, using PDSF36 classification trees, the WKappa were 0.770 (self-administered vs. interviewer), 0.569 (self-administered vs. facial-expressions) and 0.566 (interviewer vs. facial-expressions). The WKappa between the PDSF36 and the modes (self-administered, interviewer and facial-expressions) were 0.784, 0.713 and 0.579 and the corresponding polyserial correlation coefficients were 0.784, 0.713 and 0.579. A good discriminatory power was found comparing the modes with the PDSF36 (AUC = 0.907, 0.923 and 0.827), but not with mental dimension (AUC = 0.538, 0.501 and 0.629). The Q1SF-36, by self-administration or interviewer, may be a valid alternative for assessment of subjective physical health, but not mental health.     

Nurses' working tasks and MSDs back symptoms: results from a national survey

Healthcare workers, namely registered nurses (RN), are frequently exposed to work-related musculoskeletal disorders (WRMSDs) risk factors. Identifying the symptoms of these disorders is one of the first epidemiological steps to managing them. This study aims to identify WRMSDs prevalence symptoms in Portuguese RN. During 8 months (2010-2011) the National Public Health School and the Portuguese Registered Nurses Board made a call to all RN to answer an online WRMSDs questionnaire. Respondents (n=2140) are mostly females (77.4%) and work mainly in hospitals (n=1396) and in primary healthcare centers (n=421). Results show high symptoms prevalence (last 12 months) in the lower back (60.6%), the upper back (44.5%), and the neck (48.6%). Nurses' activity, especially patient hygiene in bed, is a strong contributor (p>0.05) to pain in the upper back (OR=1.39 [1.09-1.80]) and lower back (OR=1.4 [1.08-1.84]). Patient holdup without mechanical support has the highest relationship (p>0.05) between work tasks and symptoms in the last 12 months in the upper back (OR=1.50 [1.19-1.90]). Prevalence rates of WRMSDs symptoms in Portuguese nurses are no different from other studies with Swedish, Italian and Greek nurses. Maybe changes in healthcare systems didn't change the way care is delivered and we must rethink how to prevent nurses WRMSDs.     

Dual experiences of teenage parenting and homelessness among Native Hawaiian youth: A critical interpretative phenomenological analysis

Teenage parenting is a challenging venture—particularly when parenting while homeless. The present study explores in‐depth through case‐based analysis the lived experiences of three young homeless and parenting teens (one mother and two fathers). It is the first known study of teenage parenting and homelessness among Native Hawaiian youth, a key affected population. Interpretative phenomenological analysis of participants' individual interviews revealed three themes that characterize the experience of parenting as a teen while homeless: (a) They never raised me up (childhood experiences); (b) becoming mommy and daddy (early experiences of teen pregnancy and parenting while homeless); and (c) finding our place (current experiences of teen parenting and perspectives on teen pregnancy and homelessness). Implications for direct practice, social policy, and future research are discussed in the context of this complex reality.