Return to work still possible after several years as a disability pensioner due to musculoskeletal disorders: a population-based study after new legislation in Sweden permitting "resting disability pension"

Different strategies have been used to stimulate a return to work (RTW) among individuals suffering from long-term ailments. In Sweden a new law on "resting disability pension" permits disability pensioners to go back to work without jeopardising their benefits. In this study different variables related to RTW during 2000 by means of this legislation were identified among disability pensioners with musculoskeletal disorders. Individuals in the study group, when compared to a control group, had more often been disability pensioners for several years, had additional education, estimated their previous job to have been physically strenuous to a lesser degree, were more satisfied with the treatment at the social insurance office and had a more positive self-image. This study shows that it may be meaningful to continue/resume rehabilitation efforts and to try to motivate an individual suffering from musculoskeletal disorders to return to work even after several years as a disability pensioner.     

A gender-based incidence study of workplace violence in psychiatric and forensic settings

Limited data exist analyzing the role of gender in workplace violence in health care settings. This study examined whether different types of threatening incidents with patients (physical, verbal, sexual, or posturing) were salient to male versus female staff across psychiatric settings (inpatient forensic, inpatient acute/chronic psychiatric, and outpatient psychiatric). Results indicated that although women disproportionately experienced sexualized threats, they were not more likely to report such incidents as salient and threatening. The study also assessed the extent to which situational variables contributed to staff's feelings of threat. Results showed that rapport with the patient, quality of relationships with coworkers, and presence of coworkers in the area were not significantly related to how threatened staff felt in a recent threatening incident. Findings are discussed within the context of staff training and organizational benefits.     

Risk of disability pension in relation to gender and age in a Swedish county; a 12-year population based, prospective cohort study

Residents of the county of Osterg?tland, Sweden, who were 16-64 years of age in December 1984 and not pensioned (n=229,864), were followed in a prospective, cohort, study of data collected between 1985 and 1996. Using survival methods as the method of analysis, the likelihood of being granted a disability pension was 14% for women, 11% for men, and increased with age. Women less than 54 years of age were at higher risk than men (P<0.001), 69% of disability pensions granted were full-time and 31% were part-time, more women received part-time pensions (P<0.001). Whether the differences observed are due to gender bias in social insurance practices, to disease patterns, to occupational and work-related factors, or to a cohort effect has yet to be determined.     

Case management for people with psychiatric disabilities in rural Sweden; experiences from the implementation of a national policy

The aim is to analyse the implementation of a case manager-model in rural Sweden. A sample of 15 case management teams was selected. Written materials were collected and interviews on location were carried out. Results: rural case managers design their work methods themselves, which entail several deviations from the national policy guidelines in this field. The case management boards have a low capacity to direct and manage the activities of the case managers. Consequently, case managers develop into ‘welfare entrepreneurs’. One salient risk is that teams become isolated from the surrounding welfare system. In conclusion, the Swedish version of case management in rural areas is a result of local processes of adaptation and negotiation that result in services that differ from those envisaged in national policy guidelines.     

Prevalence,incidence and risk factors of testosterone deficiency in a population-based cohort of men: results from the study of health in Pomerania

Objective.?Low total testosterone levels (TT) have been associated with increased morbidity and mortality. However, the prevalence and incidence of testosterone deficiency (TD) in association with its risk has not been assessed systematically to date.

Methods.?Data from the prospective population-based Study of Health in Pomerania were used. From the 2117 men aged 20–79 years at baseline, 1490 men with complete TT data were analysed. Crude and age-specific prevalence and incidence rates of TD were estimated by TT levels below the age-specific 10th percentile. Analysis of covariance and Poisson regression models were used to assess the association of socio-demographic characteristics, health-related lifestyle, as well as somatometric, medical and laboratory measures with risk of incident TD.

Results.?TD baseline prevalence was 10.4% (N?=?155) and incidence 11.7 per 1000 person-years. TT levels showed a significant age-related decline with an unadjusted rate of 0.05 nmol/l per year. Obesity, metabolic syndrome, diabetes and dyslipidaemia were identified as risk factors of incident TD. Subpopulations of men without the revealed risk factors at both examinations maintained constant TT levels over time.

Conclusions.?Besides aging alone, lifestyle and different comorbidities were associated with TT level decline, suggesting that the age-related TT decline may be at least partly prevented through the management of potentially modifiable risk factors and health related behaviour.     

Community orientation of services for persons with a psychiatric disability. Comparison between Estonia,Hungary and the Netherlands

This article explores the way mental health services and social services are orientated on assisting people with a psychiatric disability to participate in different areas of community life. A large research project about community participation in three different countries (Estonia, Hungary and the Netherlands) confirms the findings of other studies that – regardless of geographical location – people with a psychiatric disability have difficulty fulfilling social roles in the community. They are often faced with fewer opportunities than other citizens, due to their health problems, stigma, discrimination and poverty [World Health Organisation. (2011). World report on disability. Geneva: WHO]. An important objective of social work is to help people find their way in society. Surprisingly enough, in all three countries, most social workers are mainly focused on solving individual problems, and not on community participation. Shifting the focus starts by having a clear awareness of the notion of community participation. Social workers have to work both on supporting individuals to find their way in the community (individual support), and on supporting social networks in the community to accommodate persons with a disability on the basis of equal and valued citizenship (community support).     

The morphogenesis of disability policies and the personalisation of social services. A case study from Italy.

Across Europe, and particularly since the 2008 Financial Crisis, new demands for tailor-made services came from different actors and perspectives: user-led organizations, intellectuals, policy makers, social workers, advocacy organizations, which call for a new way of programming, realizing and evaluating social policies. Personalization became a relevant part of the so called ‘welfare innovation narrative’, which concerns – to name but a few – English personalization agenda, Scottish self-directed support, Finnish education system, Norwegian cash-for-care policies. Even the European Commission is addressing new social services, reshaped through users’ capabilities. The aim of this paper is to critically explain, through a case study focused on the Sardinian disability policy, how social policy's morphogenetic cycles influence the governance of personalized disability plans and, consequently, the possibility of their implementation.     

A grounded theory of living a life with a physical disability in Taiwan

This study explores the experiences of disability for a number of Taiwanese adults with a physical disability. Using a grounded theory approach, their experiences of living a life with a physical disability were gained through in-depth interviews. The resulting grounded theory ‘it is more than just the impaired body’ presents the dynamic interactions between the participants and the context in which they were living their lives and how they managed their lives within that context. With its inclusion of the cultural dimension, a holistic way of understanding the daily lives of those who experience physical disability in Taiwan is provided.     

Cultural sensitivity in the delivery of disability services to children: A case study of Japanese education and socialization

This ethnographic study examined beliefs about disability and related socialization and educational practices at a Japanese elementary school. Disability is a universal issue affecting child welfare and educational systems around the world. Yet, relatively little sociocultural research has focused on non-Western children with disabilities. This limitation restricts our understanding of the extent to which and how cultures vary in their responses to disability, and the impact of these variations on children's development. Public schools in Japan recently implemented formal special education services for children with “developmental disabilities,” a new category used by educators to refer to “milder” difficulties in children's acquisition of social and academic skills, for example, learning disabilities, ADHD and Asperger's syndrome. This transition created a dilemma for educators: blending new requirements of providing individualized support with traditional Japanese socialization and educational practices of raising and educating children within peer groups. Participant observation, in-depth interviews, and longitudinal case studies of children with developmental disabilities addressed culturally- and developmentally-sensitive practices employed by educators. Educators were sensitive to stigma, involved peers in supporting one another, created home-like classrooms, guided children towards voluntary cooperation, and provided support and guidance to parents. Broad implications for the design of culturally-sensitive disability services are discussed.     

Gender Differences in Policy Preferences: A Summary of Trends from the 1960s to the 1980s

Using 267 repeated policy questions (962 time points), we examinegender differences in policy choices and how they have changedfrom the 1960s to the 1980s. The average gender difference inpreferences toward policies involving the use of force haveconsistently been moderately large. Sex differences in opiniontoward other policies—regulation and public protection,"compassion" issues, traditional values—have been approximatelyhalf as large but they also warrant more attention than in thepast. Our analysis suggests that the salience of issues hasincreased greatly for women, and as a result differences inpreferences have increased in ways consistent with the interestsof women and the intentions of the women's movement.     

Making a Statement: an exploratory study of barriers facing women with an intellectual disability when making a statement about sexual assault to police

Many women with intellectual disability become the victims of sexual assault. Despite this, anecdotal evidence suggests that few cases are prosecuted. This qualitative study looks at the barriers that arise at the crucial first step toward the prosecution of a complaint - making a statement to the police. In this study, sexual assault workers and members of the New South Wales police service in the greater Sydney area, Australia, were interviewed to identify the barriers that arise when women with intellectual disability decide to make a statement to police following sexual assault. The study's findings demonstrate a need for greater awareness within the police service of police policies and procedures, and legislation, as well as greater co-operation between the police service and other organisations, which have an impact on the lives of women with intellectual disability.     

Glorious Work: employment of adults with a learning disability in Guangzhou from the perspective of their parents

Promises and policies in ensuring employment opportunities for disabled people are stipulated in the State Laws and local regulations of the People's Republic of China. It is assumed that having a job implies better integration in society. However, the experience of young adults with learning disability in finding jobs tells a very different story. This article analyses the experience, perceptions and worries of parents of such young adults who are employed or have striven hard to obtain a job, comparing the ideal with a very different reality.     

Temporal stability of entries and predictors for entry into out-of-home care before the third birthday: A Danish population-based study of entries from 1981 to 2008

Objective

Placing a child in out-of-home care is one of the most radical measures a child protection system can decide to take. There is an essential interest in understanding the probability of entering care and what circumstances are related to the decision to place a child in out-of-home care. This study investigates the temporal stability of rates and predictors for entry into care.

Method

Data were obtained by linking several registration systems. The study population was defined as all children entering care before their third birthday from birth cohorts 1981–2008 (N = 11,034). Furthermore, a control population consisting of a randomly assigned quarter of the Danish child population from the same birth cohorts was used (N = 515,773). Rates of entry and Cox regression models from six periods from 1981 to 2008 were used to model co-variates associated with entry into out-of-home care.

Results

The overall likelihood for entering care is found to be decreasing over time. Furthermore, results reveal two trends: relative rates of entry are significantly decreasing for children whose mother has a psychiatric history prior to the child's birth; relative rates are significantly increasing for children whose mother or father was unemployed in the year prior to the child's birth.     

Predicting supportive behavior of parents and siblings to a family member with intellectual disability living in institutional care

This feasibility study examines whether the theory of planned behavior can predict supportive behavior provided by either parents to their offspring-or adult siblings to their brothers and sisters-with an intellectual disability living in 2 Israeli institutional care facilities. Participants were 67 parents and 63 siblings who were interviewed at baseline regarding their intentions to visit their offspring or sibling in the institutional care facility, to contact the caregiving staff, and to accept visits at home. Parents' and siblings' behavior regarding visitation and supportive behavior was examined after 6 months by caregiving staff. Core findings indicated that subjective norms in siblings and parents predicted frequency of home visits. Perceived behavioral control predicted frequency of contact between siblings and staff. Differences between parents and siblings regarding their supportive behaviors are discussed with respect to social work practice.     

Living on a knife edge: the responses of people with physical health conditions to changes in disability benefits

Abstract

This article documents the experiences of people with a physical health condition or disability who have experienced a loss of or change in disability benefits under the welfare reform programme in the United Kingdom. A theoretical model was constructed using in-depth interviews and grounded theory methods. The findings show that participants experienced the benefits system as dehumanising, and felt that they lived in a judgemental and invalidating society, where they were perceived as ‘scroungers’ and faced discrimination from others. These experiences negatively affected their mental and physical health and well-being. They also negatively affected participants’ identity, leading to experiences of shame, hopelessness and social isolation. However, many participants attempted to resist these negative impacts (e.g. through seeking support or taking political action). The findings demonstrate the significant impact of benefit changes on well-being and identity, thus highlighting important implications for claimants, and staff in healthcare, the benefits system and government.     

Transition from playing with simulated gambling games to gambling with real money: a longitudinal study in adolescence

Digital technology advances have supported an expansion of gambling activities, which is notable via the advent of simulated gambling games. Simulated gambling reproduces ‘real’ gambling activities, which enables the users to gamble without investing money. According to research evidence, a certain number of adolescents are playing with these games, but until now little has been known about how they could facilitate the migration to gambling with real money. Using a longitudinal design with a one-year interval period, the goal of this study was to assess the potential transition between playing with simulated gambling and the initiation to gambling with real money. The final sample was constituted of 1220 adolescents (age range = 14 to 18 y.o.) who had never played with real money at the first measurement time. At the second measurement time, 28.8% of the participants had gambled for the first time with real money. Logistic regressions revealed that the predictive association between simulated gambling and gambling with real money only holds for adolescents who transitioned from simulated poker to poker with real money. These findings highlight the need for regulation and monitoring on Internet gambling poker sites, as well as further research to assess the mechanisms at work.     

A new role for imaging in the diagnosis of physical elder abuse: results of a qualitative study with radiologists and frontline providers

Pediatric radiologists play a key role in the detection of child abuse through the identification of characteristic injury patterns. Emergency radiologists have the potential to play an equally important role in the detection of elder physical abuse; however, they currently play little to no part in this effort. We examine the reasons behind this limited role, and potential strategies to expand it, by interviewing attending faculty from Emergency Radiology, Geriatrics, Emergency Medicine, Pediatric Radiology, and Pediatrics. Our interviews revealed that radiologists’ contribution to elder abuse detection is currently limited by gaps in training, gaps in knowledge about imaging correlates, and gaps in inter-team clinical communication. Specifically, radiographic interpretation of elder trauma is severely restricted by lack of communication between frontline providers and radiologists about patients’ injury mechanism and functional status. Improving this communication and re-conceptualizing ED workflow is critical to expanding and optimizing radiologists’ role in elder abuse detection.