My Home is Not My Castle: Follow-Up of Residents of Shelters for Homeless Youth

The paper presents a follow-up evaluation of Israel’s first two shelters for homeless youth. The main research questions were: (a) Did the youngsters achieve the shelters’ main goal of reaching a normative and suitable post-shelter residence? (b) How do the youngsters evaluate their stay at the shelter and its impact on them? (c) Is there a relationship between youngsters’ post-shelter residence and their evaluation of the shelter stay? Data on 345 youngsters were collected through follow-up telephone interviews with the youngsters, their parents, and community social workers. The findings indicate that the majority of these youngsters left the shelter to living arrangements that were normative but not necessarily fitting with their wishes and needs. Most of the youngsters were satisfied with the shelter, but no relationship was found between general satisfaction and achievement of the shelters’ declared goal. The discussion focuses on the significance of the findings with regard to the declared and operative goals of shelters.     

Social work in Israel: professional characteristics in an international comparative perspective

This article employs a comparative framework in the analysis of the professional characteristics of social work in Israel. Using the attributes and the power approaches to professions, Israeli social work is analysed according to eight variables: a protected 'trademark', monopoly over social care and delivery of services within state welfare systems, occupational autonomy, length of training and control over training, internal differentiation by levels of expertise and competence, professional organisation, a sanction-backed code of ethics, and material and symbolic rewards. The analysis reveals that Israeli social work has undergone an extensive professionalisation process and that it has characteristics that are not common in other countries. Initial explanations for this process are offered and discussed.     

Regulating social welfare services: Between compliance and learning

With the ongoing privatisation and marketisation of social welfare, the regulatory functions of governments have become much more important, necessitating careful attention. Yet there is little scholarly work on the goals and nature of regulating privatised social welfare services. To fill this gap, this study examined the regulatory process used by the Israeli Youth Protection Authority (YPA) to regulate homes for at‐risk youth. Based on 24 semi‐structured interviews with inspectors and staff, the article highlights the YPA's distinctive learning‐based and collaborative approach to regulating social welfare services. This approach puts the capacity‐building of professional skills, rather than compliance, at the centre of the regulatory mission and leaves room for professional discretion to the homes and the inspectors. The article outlines the distinctive features of this approach, considering its advantages and shortcomings in comparison with the more legalistic and audit‐based approaches currently dominating the field of social care inspection.     

Perioperative morbidity and mortality in 80 years and older undergoing elective urology surgery – A prospective study

Background and purpose. The number of octogenarians requiring surgery increases constantly. Data regarding perioperative morbidity and mortality in octogenarians is limited. Our aim was to assess surgery-related complications in octogenarians, undergoing urological surgery.

Patients and methods. We prospectively collected data from octogenarians and a control group of younger patients undergoing an elective urological surgery in our institution. Recorded data included: age, gender, American Society of Anesthesiologists (ASA) score, co-morbidities, number of medications, operation extent, anaesthesia type, surgery duration and perioperative morbidity and mortality.

Results. Forty-seven octogenarians and 80 patients with a median age of 59 years (range 19–75) enrolled prospectively. Gender ratio, surgeries extent and median operative time were similar among groups. General anaesthesia was more prevalent in the control group. ASA classification and duration of hospitalization were significantly higher in octogenarians. The rate of intra-operative complications was significantly higher in the octogenarians group 6.38% versus 3.75% (p = 0.007), there was no significant difference in immediate post-operative and post-discharge complications among groups. One octogenarian patient died 2 days post-surgery, no death occurred in the control group.

Conclusions. Octogenarians have higher rate of intra-operative morbidity, leading to longer hospital stay. More experienced surgeons and anaesthetists should be involved in the operation; and careful surgical technique, tapered anaesthesia and higher level of post-operative monitoring should be applied for patients in this age.