The VA Caregiver Support Line: A Gateway of Support for Caregivers of Veterans

In passing the Caregivers and Veterans Omnibus Health Services Act of 2010, Congress created a legislative mandate for the Veterans Administration (VA) to strengthen its program of support services for caregivers of veterans. As part of this expansion, the VA implemented a nationwide toll-free telephone Caregiver Support Line (CSL). The CSL is a single point of entry system to link caregivers to national and local services to support care of a veteran. This article describes the CSL and its role in supporting aging veterans and their caregivers, discusses social workers’ contributions to its development and implementation, and reports utilization data.     

Veterans’ Use of Programs and Services as They Transition to Civilian Life: Baseline Assessment for the Veteran Metrics Initiative

Abstract

A substantial minority of veterans struggle as they reintegrate into civilian life, reporting problems with vocational attainment, legal/financial/housing challenges, physical and mental health conditions, and social/interpersonal issues. While there are thousands of programs and services offered to veterans, little is known about which ones they use. In the current exploratory study, veterans separated from active duty in the prior three-months (48,965) were invited to complete a survey. Two primary questions were addressed: What programs/services did veterans use to assist in their reintegration to civilian life? What specific components/attributes of those programs did veterans report using? A total of 9566 veterans completed the survey. Approximately, two-thirds of veterans used at least one program to enhance their well-being, while one-third reported using multiple programs across multiple domains. Veterans primarily sought assistance for employment and educational advancement. Fewer veterans sought assistance for legal/financial/housing, health, and social functioning challenges. Social service providers and policy makers should be aware of the resources veterans use as they reintegrate into civilian life. Future research should examine factors that predict the use and nonuse of veteran reintegration programs, how use changes over time, and what factors predict program/service use, particularly among veterans at risk for poor transition outcomes.     

Hospice Use by Older Adults Knocking on the Door of the Nursing Facility

Abstract

Since 1983, federal funding has been available for hospice services. However, research studies have found that hospice is underutilized by people with terminal illnesses and their families. Low-income older adults are particularly at risk for underutilization. This study examined utilization of hospice services by nursing home applicants in one Midwestern state. Characteristics of users and non-users, and potential barriers to hospice use were examined. Findings further document that hospice is underutilized, especially by the Medicaid population, and point to barriers to hospice utilization. Specific recommendations are made to help practitioners increase hospice access.     

Aging,Depression, and Wisdom: A Pilot Study of Life-Review Intervention and PTSD Treatment With Two Groups of Vietnam Veterans

Vietnam War veterans are a sometimes overlooked subgroup of the aging baby boomer generation. Forty years after the war ended, war veterans still seek out VA or Vet Center counselors to assist with traumatic stress symptoms. However, there currently are no specific age-related protocols for treating older war veterans suffering from posttraumatic stress disorder (PTSD), nor have established PTSD interventions incorporated gerontology content for these older trauma survivors. This pilot study juxtaposed life review within regular PTSD group counseling for 12 Vietnam veterans at a community-based Vet Center using a partial crossover design. The Life Review and Experiencing Form (LREF) structured the delivery of the life review component. T-tests and repeated measures ANOVA were used to examine depression and self-assessed wisdom outcomes using measures previously tested with older adults. Findings suggest that life review prior to PTSD group therapy has clinical benefits for reducing symptoms of depression and increasing self-assessed wisdom. The study illuminates the possible relationship of traumatic stress symptom effects on the natural reminiscing process for older veterans and provides insights into methods for more age-appropriate treatment for trauma survivors participating in Vet Center and VA programs nationwide.     

Professionals’ decision‐making in cases of physical punishment reported to child welfare authorities: does family poverty matter?

The influence of family poverty on professionals’ decision‐making in cases of physical punishment reported to child welfare agencies was examined. The sample was drawn from the Canadian Incidence Study of Reported Child Abuse and Neglect. The influence of five indicators of poverty on six investigation outcomes was assessed. In addition, a Poverty Index was constructed from these five variables to assess whether the family's overall poverty status influenced investigation outcomes. The outcome variables examined were case substantiation, provision of ongoing child welfare services, referrals to child and family support programmes, out‐of‐home placement, applications to child welfare court and police involvement. Together, the poverty indicators did not account for more than 6% of the explained variation in any of the outcome variables, nor did the magnitude of the Poverty Index affect the likelihood of any of the investigation outcomes. These findings suggest that family poverty does not influence professionals’ decision‐making in cases of physical punishment reported to child welfare agencies in Canada. The findings have implications for the ongoing development of policy aimed at reducing parental use of physical punishment.     

Bridge Builders: A Qualitative Study Exploring the Experiences of Former Refugees Working as Caseworkers in the United States

ABSTRACT.

Individuals who come to the United States as refugees and work as resettlement caseworkers offer peer support, modeling, and assistance with integration to newly arriving refugees, despite often having limited training or experience in social service provision. A phenomenological approach was utilized to gain understanding about the experiences of refugee caseworkers. Nine caseworkers who came to the United States as refugees completed in-depth interviews. Thematic analysis was used to identify primary themes, including: a) the caseworker's bridge-building role with clients; b) their role in building bridges with others in the community, including the resettlement agency; and c) the caseworkers’ experience as bridge builders, including motivations, perspectives toward their role, and needed supports. Refugee service providers face unique challenges in negotiating boundaries with clients and meeting the expectations of their ethnolinguistic community members. Their strengths in understanding household experiences and in building agency and community understanding highlight their ability to contribute to positive resettlement outcomes. The findings from this study have implications for agencies serving refugees and for other social services that utilize peer-support strategies, particularly in regards to staff training and support. Findings highlight the need for research examining effective resettlement strategies and the perspectives of refugees toward resettlement approaches.     

Supporting the Labor Force Participation of Older Adults: An International Survey of Policy Options

The unprecedented aging of the world's population challenges many institutions, including labor markets and public pension programs. This study was conducted to survey expert opinions regarding conditions and policies that affect employment of older adults. Eighty-nine respondents from 26 nations responded to an Internet survey regarding their own experiences with the aging labor force; factors that encouraged or discouraged labor force participation of older adults; and government responses to these issues. Respondents identified barriers to employment of older adults and described their governments' responses. Findings illuminate a range of current policy options and suggest possible opportunities for innovation.     

A Tale of Two Cultures: Cross-Disciplinary Perspectives in the Care of Older Adults with Combined Visual and Medical Disabilities

A comparison of the vision rehabilitation and medical rehabilitation systems suggests that, despite the distinct professional cultures that have evolved around them over the past 50 years, their commonalities are more notable than their differences. The older adult, who frequently develops simultaneous visual and medical disabilities, demands a greater degree of cooperation between these systems, than that required for the younger client who was the primary focus of the rehabilitation paradigm in the years following World War II. This article includes guidelines for practitioners that should help them achieve a more comprehensive approach to their elderly visually impaired clients.     

新世纪中国后现代文化研究踪迹

新世纪初年,中国学者对后现代的研究从哲学、法学、政治学、心理学、文学艺术、文化产业等方面展开,拓展了"后学"研究空间.学术界对后现代性的意义有了新的认识,注意到后现代主义不是单纯地消解理性,而是剥离现代性的遮蔽,并对现代性的合法性根据加以质疑.本文从传统、现代与后现代多元问题中考察后现代研究中的争论,对后现代激进哲学--解构哲学思想、后女权主义思想、多元论思想等加以分析,进而透过后现代政治社会学心理学,考察后现代政治学、社会学、心理学、神学问题,并对后现代文学艺术之维的多元话语透视等几个方面,展示了中国"后学"研究的最新学术轨迹.     

Preliminary support for the use of narrative exposure therapy in a child protection context: Collective case-study narratives

The present paper attempts to provide preliminary support for the use of narrative exposure therapy (NET) in a child protection context. The prevalence of violence, abuse and neglect (VAN) within New South Wales is outlined as well as the current perspectives in trauma definition and symptomology, and the prevalence of trauma symptomology among birthparents and young people within child protection services. NET is introduced including its theoretical background, methodology, applications and research. Four applications of NET within a child protection context are presented, including lifelines and narrative excerpts. Specific themes presented included experiences of physical abuse, domestic and family violence, parental drug use, suicidal ideation and child removal. Statistical analysis including reliable change, clinical and statistical significance of pre- and post-PCL-5 outcomes measures are presented to infer preliminary support for NET within a child protection context. Limitations and future considerations for future research are discussed.     

Holes in the safety net: the strengths and weaknesses of child protection procedures

This paper uses findings from empirical research to demonstrate the strengths and weaknesses of the child protection procedures in the UK. Discontinuities in which child protection plans were not implemented arose because of limitations in the plans made, obstacles to implementation and weaknesses in the conduct of review meetings which rarely questioned the management of cases even when it was clearly deficient. The construction of risk made during the investigation carried over into the initial conference, fed into decisions about registration and had an enduring influence on the way in which later risks to children were interpreted. However, this meant that new information which challenged this view of risk was often ignored. Continuities were also evident between adequate plans for children's safety made at initial conferences and their subsequent protection. However, when children remained at home with an abusing parent, this remained true only when a new key worker had been allocated at the time of the conference. These initial plans also had an impact on the interventions provided, especially those for treatment. These findings emphasize the importance of adequate planning for children and families at initial child protection conferences and the need for an overhaul of the conduct of reviews if they are to be used more effectively.     

The Role of Pride,Shame, Guilt,and Humiliation in Social Service Organizations: A Conceptual Framework from a Qualitative Case Study

Emotions have become increasingly recognized as constitutive elements of organizations and organizational processes. While the emotions of pride, shame, guilt, and humiliation have long been considered to play a significant role in what people do and how they do it, they have received little theoretical and empirical attention within the literature on social service organizations. This paper responds to this research gap by outlining a conceptual framework for the role these emotions play, developed from an ethnographic case study of one English local authority child protection service. The framework outlines how these emotions influenced the wider institutional processes to construct an ideal form of practice, which was then used to evaluate the social workers’ actions and praise, shame, or humiliate the social workers accordingly. The threat of shame, and promise of praise, influenced most social workers to enact or conform to the standard, thereby regulating their identities. Some social workers, however, felt ashamed or guilty of what they were doing and sought to resist these attempts at control through acts of compromising, concealing, and influencing. This paper considers how this understanding contributes to our understanding of these emotions and how they are experienced in a modern social service context.     

诠释方法--通向法律的真理之路

通过反思以伽达默尔和利科为代表的哲学诠释学中关于要不要(科学)方法之争,可以肯定,在探索和寻求法律真理过程中方法不能缺席.诠释法律的方法在人类认识视野中具有多样性、独立性和自在性,在本体视野中是非自治、非独立的,而在实践视野中则具有实用功利性特征.     

Show Me the Way to go Home: A Narrative Review of the Literature on Delayed Hospital Discharges and Older People

Correspondence to Jon Glasby, Health Services Management Centre, University of Birmingham, Park House, 40 Edgbaston Park Road, Edgbaston, Birmingham B15 2RT, UK. E-mail J.Glasby{at}bham.ac.uk Summary This Research Note reports findings from a narrative reviewof the literature on the rate and cause of delayed hospitaldischarge in the UK. In addition to summarizing our knowledgeto date in this important area, the Research Note raises a seriesof questions about aspects of current hospital discharge policyand practice (and in particular, the recent reimbursement policyto charge social services departments for delayed discharges).     

Fairness, Equality and Legitimacy: A Qualitative Comparative Study of Germany and the UK

The pressures of globalization and shifts towards post‐industrialism are producing policies that increasingly emphasize the common themes of activation and of individual responsibility for outcomes. Such approaches suggest normative principles of equality of opportunity rather than of outcome, and of individual rather than collective responsibility for the outcomes achieved. Does this imply a shift towards a common normative framework for European welfare states, with implications for future policy developments? This article reports a recent qualitative study examining ideas about fairness and social provision in the very different regimes of Germany and the UK. The analysis shows that while respondents in both countries value equality of opportunity as a normative principle, those in Germany are much more likely to argue that an equal opportunity approach requires government to guarantee equal access to basic services. They are also more likely to express concerns about market freedoms which allow those who can afford it better access to health care and education. Real differences in welfare values remain, loosely following differences of regime type, despite the greater emphasis on activation and individual responsibility across European welfare states.     

收入差距测度及分解方法述评(英文)

本文按研究对象将收入差距划分为总体收入差距和组群收入差距两大类,从收入不平等、极化和组群收入差距三个层面梳理了收入差距的测度及其分解方法。其中,收入不平等侧重于对总体收入差距的刻画;极化着眼于收入分布中的“聚集”或“扎堆”现象,其衡量指标大体上可分为两极分化测度指标和多极分化测度指标。在收入差距的分解上,Shapley分解和组群收入差距的分布分解方法都是较为前沿的研究领域。文章还强调了各种收入差距衡量指标或分解方法的适用性和针对性,以便有的放矢地选用合适的相关指标和方法,更精准地探寻收入差距的成因。