Service Coordination for Frail Elderly Individuals: An Analysis of Case Management Practices in Québec

The objective of this article is to understand coordination as it unfolds in case management practices in the context of integrated care networks devoted to frail elderly individuals. More specifically, my goal is to describe practical coordination processes. I conducted a qualitative exploratory study using an embedded case study design. My research covers three Health and Social Services Centres in Québec. I observed that case management is more frequently justified by a situation in which home care is precarious than by the intensity and multidimensionality present in a situation. In such instances, case management intervenes through a standby mode.     

Policy-making for immigration and integration in Québec: degenerative politics or business as usual?

Policy Design Theory (PDT) predicts that the distribution of the costs and benefits of governmental intervention depends on the social construction and level of power of target groups. The case of Québec, Canada, which recently went through acrimonious policy debates on immigration and integration issues, does not correspond to this pattern. Degenerative politics – that is, the stigmatization of powerless groups and an unequal distribution of the costs and benefits of governmental intervention to the detriment of the most vulnerable – did not occur even if the conditions were seemingly in place to produce it. Using Québec as a ‘most likely’ case, I show that the policy-making sphere remained immune to the degenerative dynamics that took hold in the media and the legislature. More precisely, I argue that three interrelated factors explain the results: past policies and their unintended consequences, an implementation structure committed to the needs of immigrants, and the specific incentive structure facing political actors. The results question the transferability of PDT outside of the institutional setting of the USA, where it was first developed and applied.     

Involvement of Ministries of Health in Health Service Coverage Decisions: Is England an Aberrant Case?

This article examines the involvement of ministries of health in making health service coverage decisions in Denmark, England, France and Germany. The study aims to inform debate in England about the feasibility of reducing perceived ministerial and bureaucratic ‘interference’ in decisions affecting the National Health Service, based on interviews with senior government officials and other health system stakeholders. Ministries of health differ in their involvement in health system governance and coverage decisions (‘the benefits package’), reflecting differences in institutional arrangements. In all four countries, organizations at arm's length or independent from government are either involved in providing technical advice to the ministry of health or have been mandated to take these decisions themselves. However, ministries of health occasionally intervene in the decision‐making process or ignore the advice of these organizations. The Department of Health in England is not an aberrant case, at least in relation to coverage decisions. Indeed, ministries of health in Denmark and France play a larger role in making these decisions. Public pressure, often amplified by the media, is a shared reason for ministerial and ministry involvement in all four countries. This dynamic may thus limit the feasibility of attempts to further separate the NHS from both the Department of Health and wider political pressures.     

Therapeutic management of violence in residential care for severely mentally ill clients: An application of intrapsychic humanism∗

The innovative psychology, intrapsychic humanism, is applied to formulate guidelines for effectively managing violent symptoms of severely mentally ill clients in residential settings, with the aims of: 1) helping staff reduce client violence; and 2) helping clients regulate their violent behavior. Using intrapsychic humanism, staff can understand, anticipate, and respond therapeutically to client violence. Triggers of violence, such as aversive reactions to pleasure and destructive reactions to real losses are described. Residential program structures that strengthen clients’ constructive motives and staff's caregiving motives are outlined.     

Development of minimum livelihood guarantee programmes in urban China: an empirical analysis based on 31 regions over 2003–2013

The Minimum Livelihood Guarantee (MLG) system in urban China is functioned as the last resort safety net for poor people and plays a substantial role in poverty reduction. This paper provides new empirical insights into the MLG development across 31 regions in urban China between 2003 and 2013. In addition to widely used indicators like benefit levels and number of benefit recipients, we construct two indicators of MLG replacement rates to measure the generosity of the benefits relative to income from work. The results show that the development of the urban MLG system in China has followed different tracks before and after 2008. Since 2008, the governments have made great efforts to increase the generosity of the MLG system while put more stringent conditions on MLG beneficiaries. Moreover, since 2008, the generosity levels of the MLG programmes began to converge across regions.     

The Diversification of Children’s Support for Their Parents in the Context of an Aging Society: Concepts and Behavior*

China’s aging society and the family-based model of basic aged care determine that children’s support for their parents directly affects the standard of living of the majority of the aging population. Existing theories indicate that in this era of social transition, the implications of filial piety have shifted from the traditional emphasis on the parent-child generational relationship and children’s duty to obey their parents to a dual mode in which family love coexists with the authority of the elders. Using data from the Chinese General Social Survey of 2006, we explore the ways in which the two basic dimensions of authoritarian filial piety and reciprocal filial piety connect with various types of filial behavior. The results of our multivariate linear model show that on average, authoritarian filial piety, which emphasizes authority relationships and children’s duty, increases children’s financial support for their parents, while reciprocal filial piety, stressing family love and generational equality, significantly increases children’s emotional support for their parents. A comparison of the basic dimensions of filial piety shows that neither significantly increases children’s physical support for their parents. Further analysis of the interaction effect indicates that the link between authoritarian filial piety and financial support is more significant among younger groups. In addition, for males, a marginally significant positive relation exists between authoritarian filial piety and physical support for their parents.     

A Model for Implementing an Evidence-Based Practice in Student Fieldwork Placements: Barriers and Facilitators to the Use of “SBIRT”

ABSTRACT

This article reports on focus group data analysis that was used to understand initial, largely positive outcomes from a university-based initiative to disseminate and implement an evidence-based practice (EBP)—Screening, Brief Intervention, and Referral to Treatment for Substance Use (SBIRT)—into student fieldwork placements, which are usual care social work settings. Focus groups were conducted with three groups of stakeholders involved in the ongoing project: social work department faculty (n = 10), bachelor- and master-level social work students (n = 8), and social work fieldwork instructors (n = 6). Dimensional analysis of the focus group data yielded results indicating that dissemination and implementation of SBIRT was influenced by agency- and school-level factors and perceived fit between the EBP and individual professional identity, intrapersonal characteristics, and timing. The resulting model, developed through the focus group analysis, is offered and shows how these factors interacted and affected training, supervision, and use of the EBP. The model provides social work educational programs and agencies a working tool for diagnosing and proactively addressing barriers and breakdowns in the EBP implementation process. Future research that tests the model as a diagnostic tool and generates knowledge about its influence in developing competent evidence-based practitioners is indicated. Future focus groups in relation to this initiative are needed to better understand these barriers and facilitators in the EBP implementation process and their critical roles in the process of translating SBIRT into standard social work practice.     

Systematic Innovation,Comprehensive Development and Going Global: Some Thoughts on the Construction of an Innovation System for Philosophy and Social Sciences in China during the “12th Five-year Plan” Period

Abstract

30多年来,中国思想解放、改革开放的伟大实践推动着哲学社会科学的创新取得了五大成就, 开启了理论创新的时代。“十二五” 时期, 中国哲学社会科学研究将步入系统创新的新阶段, 将从个别观点、个别结论的创新转换到基础理论、理论体系和方法论的创新; 从单一学科、单一视野的创新转换到综合创新、交叉创新和新学科群的崛起; 从无序竞争转换到有序推进。作为创新型国家建设的重要内容, 哲学社会科学创新体系、创新能力建设与自然科学同为 “鸟之两翼” 、“车之两轮” , 同样重要。中国哲学社会科学创新规划应当强化“国家意识”、建立“国家目标”、设立 “国工程” 。系统创新、全面发展、走向世界, 这是当代中国哲学社会科学的基本任务。关键词: 哲学社会科学 创新体系 创新能力 学科群

In the past three decades, the great practice of intellectual emancipation and reform and opening up in China has given rise to five achievements in philosophical and social science innovation, opening a new era of theoretical innovation. The 12^th Five-year Plan period (2011-2015) will witness the arrival of a new stage of systematic innovation in philosophical and social science research: innovation in individual opinions and conclusions will develop into innovation in fundamental theories, theoretical systems and methodologies; the innovation of individual disciplines and perspectives will give way to the rise of new groups of subjects and to innovation based on synthesized and interdisciplinary studies; and disorderly competition will be replaced by orderly progress. As an important component in the construction of an innovative nation, the building of an innovation system and innovation capacity is as important in philosophy and social sciences as in their counterpart, the natural sciences; they are like the two wings of a bird or two wheels of a cart. Our innovation plan for philosophy and social sciences should strengthen “national consciousness,” establish “national aims” and launch “national projects.” Systematic innovation, comprehensive development and going global constitute the basic tasks of contemporary Chinese philosophy and social sciences.