Safety and health at work as fundamental rights: A comparative-historical study of the ILO's strategy of realistic vigilance

This article is a comparative-historical study of ILO action on occupational safety and health (OSH) as fundamental rights. In the two decades following the adoption of the International Covenant on Economic, Social and Cultural Rights, the ILO used a realist lens and prioritized the idea that OSH were dependent upon economic preconditions for their protection. This history is revisited in the light of the new complex of global health uncertainty and the addition of OSH to the framework of fundamental principles and rights at work. The analysis highlights the applicability of a realistic vigilance approach to the ILO's current work on OSH.     

Psychosocial interventions used to treat children with ADHD: safety and efficacy

Although stimulant therapy is the most common treatment for attention-deficit/hyperactivity disorder (ADHD) in children, it is not always effective in reducing behavioral symptoms. As a result, research on psychosocial interventions has progressed in recent years. This article provides a synopsis of psychosocial interventions for childhood ADHD, with an emphasis on basic behavior management principles, evidence-based interventions, and safety issues. Developmental issues that distinguish psychosocial interventions for children and adolescents are highlighted, and practical recommendations for collaborating with mental health professionals are provided.     

The mental health problems of mothers experiencing the child protection system: identifying needs and appropriate responses

This article presents the findings of a small pilot study which examined the needs of 13 mothers with severe mental health problems whose children were involved in the child protection system. The use of the diagnosis of ‘personality disorder’ in relation to this group of women is discussed and the finding that all these women had experience of domestic violence is considered in the context of other research findings. The extent to which child protection social workers and mental health professionals worked together on these cases was explored and only limited evidence of good communication and collaboration was found. The need for effective inter‐professional and inter‐agency coordination is argued, but differing conceptions of maternal mental health problems and their relationship to children's needs may make for difficulties in professional communication and decision‐making. The article seeks to identify the differing approaches to maternal mental health problems which appear to be developing out of different groups of research studies and argues that practitioners need to be explicit in identifying their perspectives on the associated issues of maternal mental health problems and child protection. Copyright © 1999 John Wiley & Sons, Ltd.     

Funneling Child Welfare Consumers into and through the Mental Health System: Assessment, Referral, and Quality Issues

This qualitative study explores how consumers of child welfare services reach nonpsychiatric mental health providers and the perceived quality of these services. It relies on iterative interviews with individuals and groups, as well as on court observations from one metropolitan area. Results suggest that, consistent with theories of street-level bureaucracy, efficiency issues drive mental health service use, as clients are routinely subjected to psychological evaluations and funneled into mental health services as a matter of course. Referral practices are shaped by child welfare professionals' routines, discretion, and desire to meet such system objectives as providing short turnaround times for reports. The results suggest that, despite stakeholders' best intentions, maltreated children are not benefiting from thoughtful processes geared to screen for, assess, and provide targeted treatment for unmet mental health needs.     

Preparing the school-age child for adoption.

The development of an adoptive relationship for children who have been in the limbo of foster care is a continuous process. It is unrealistic to expect these families to live happily ever after. Agencies must begin developing regular services to meet the special needs of the families being created. To a large extent the issues that will have to be worked through relate to the stages of preparation outlined in this paper. Each stage in the child's growth may activate unresolved issues around the grief at the biological parents' rejection, confusion about identity or difficulty in working through problems. Future adoptive home recruitment must take this into account by providing training and other supports to families considering adopting the older child.     

Challenges of Using Secondary Data to Study Rural Caregiving within the United States

When health fails, rural residents often turn to informal caregivers for assistance and are more likely to do so than those living in urban areas. Scholarship is clear in demonstrating the many burdens that accrue to those providing informal care. Furthermore, caregivers in rural areas face amplified health disparities and stressors, and limited access to resources and formalized supports. Yet, the study of informal caregiving within geographic context is made difficult by the limitations inherent in existing secondary data sources. In this report, we discuss three available data sources that provide information about US caregivers: the National Family Alliance Caregiving in the US Survey; Health and Retirement Survey; and National Survey of Midlife Development in the United States. These datasets illustrate common challenges of studying rural caregiving, including how to define rural residence, issues with data access, and difficulties attaining an adequate sample size. After reviewing these methodological issues, we identify two additional data sources that while promising, suffer from challenges of their own. We conclude by offering suggestions about how to capture the unique experiences of rural caregivers beyond the use of secondary data.     

Foster care and Medicaid managed care

Children in the foster care system are often dependent on Medicaid for health care. These children, however, have more complex health care needs than the typical child receiving Medicaid. States are implementing Medicaid managed care programs as a way to control escalating costs while providing necessary services. This article reviews the issues surrounding delivery of managed health care services to children in foster care and describes several solutions.     

Race and Marital History as Correlates of Women's Access to Family-Friendly Employee Benefits

Using a nationally representative sample of young women surveyed intermittently since 1968 (N = 2030), this study assessed the effects of race and marital history on access to family-friendly employee benefits between 1978 and 1995. Accounting for such factors as work history, total number of employers for whom the respondent has worked, education level, and number of children, race was found to act as a suppressor variable. White women were found to work for more years for employers providing family-friendly benefits even though Black women worked for more years in full-time jobs. Results suggested that systematic biases relegated Black women to lower-paying full-time jobs without family-friendly benefits more so than was the case for White women. Policy implications regarding affirmative action are discussed. No relationship was found between marital history and access to jobs with family-friendly benefits when taking into account other sociodemographic and employment-related characteristics.     

The effect of individually adjusted workstations on upper quadrant posture and muscle activity in school children

Evidence suggests there is increasing use of computers by children and poor workstation designs for children. This laboratory study investigated the effect of adjusting computer display height and desk height on upper quadrant posture and muscle activity. Thirty three children aged 4-17 years worked on a desktop computer at a standard school workstation and at a workstation adjusted to the individual, typically consisting of a lower display and desk height. The adjustments resulted in increased head tilt, neck flexion, gaze angle, cervical erector spinae activity and a trend for lower right upper trapezius activity. The recent evidence that suggests more head and neck flexion is not necessarily worse is discussed and normative values for children's head tilt and neck flexion presented. The role of forearm support in decreasing trapezius activity is also discussed.     

‘The Bad People Go and Speak to Her’: Young People’s Choice and Agency when Accessing Mental Health Support in School

Concerns about the mental health and well‐being of children and young people have been articulated in health and education policy fields as a call for closer working between schools and providers of mental health support services. Drawing from a Scottish study, this article explores issues of access, when mental health initiatives are sited in formal educational settings. In particular, it focuses on the implications for the agency of children and young people seeking support from those services when and how they choose. The study argues that over‐reliance on teachers as the main referral route to service influences what is deemed to be a problem, who is thought to need support and how the interventions are viewed by the children and young people. Alternative approaches are discussed, which offer opportunities for children and young people to explore the available services and make their own choices about their level of engagement.     

“Tell Me So That I Can Help You”: Private Information and Privacy Coordination Issues in the Context of Eldercare

In order to provide competent care to aging parents, adult children, and older parents must renegotiate long-standing privacy boundaries that allow caregivers access to parents’ private information. It is reasonable to surmise that caregivers encounter privacy coordination issues when attempting to care for their aging parent. This study utilizes Communication Privacy Management theory to explore what content is considered private and what privacy coordination issues arise in the context of eldercare. Results from 27 in-depth interviews with adult children caring for an aging parent suggest that information concerning parents’ future care, health and well-being, and (in)capabilities were marked private. The findings also detail three disruptions to privacy coordination, including parental caregivers’ ambivalence toward managing parents’ care-related information. Critical implications of the study are discussed, which include how privacy turbulence may be a functional catalyst for boundary recalibration.     

Media Studies 2.0? Binge Drinking and Why Audiences Still Matter

The idea of 'audience' no longer appears to suit media studies. Conceiving the public as sponges for information and entertainment may have worked in the television age. But not so the computer, mobile phone, iPod era. Increasingly, it appears that the public amuse and inform themselves, using media to create and circulate their own content. This presents media scholars with a considerable challenge, as outlined in David Gauntlett's announcement of 'Media Studies 2.0'. One goal of the new discipline is to dispense with 'audience' as a meaningful category. This essay will argue that this is a rhetorical shift only possible because of audience research. Additionally, in describing a study of young student drinkers, the essay will argue that traditional, 'receiver' definitions of audience offer an important means for the public to enter policy debates on binge culture. Abandoning audience thus also means ignoring media issues that the public feel are important.     

A new look at the health and homeless experience of a cohort of five-year olds

Homelessness is increasing and health workers and others need to be ever vigilant about the risk that this has on children's health. What is that risk and what are children's experiences of homelessness? A retrospective case note study was carried out to compare the health of a group of five-year olds who had experienced homelessness and compare them with matched ‘non-homeless’ controls. A home interview questionnaire was used to give a profile of the children's housing experience and the health issues faced during their time in temporary accommodation. Fifty-three cases when compared with 41 controls showed a statistically greater prevalence of child protection issues and an increased number of health needs identified at the school nurse health appraisal. The housing profile identified that the case children moved homes many times (37 per cent more than five times), were homeless much longer than the officially registered period (67 per cent more than 12 months) and 61 per cent were made homeless through domestic violence. The study reinforces the need for us to acknowledge important environmental stress and to continue to advocate for this group of disadvantaged children.     

Pediatrics: The emerging psychosocial challenges of the AIDS epidemic

HIV has a pervasive and profound effect on the psychological, social and neuropsychological functioning of infected infants, children and their families. This article discusses direct and indirect psychological manifestations of HIV in children. Direct effects are the outcome of the virus acting on the central nervous system and can result in compromised cognitive, language, motor, socio-emotional and motivational functioning. Indirect effects involve psychological responses to the stress of living with a life threatening illness, the social ostracism, disruption in life goals and undergoing frequent invasive and protracted medical procedures. A major focus of this article is to outline and describe a model comprehensive psychosocial support system developed within the Pediatric Branch of the National Cancer Institute. This includes early intervention issues and strategies for working with families during the introductory phase of the treatment program that also provides the framework for a care management approach, salient mental health problems that frequently occur in this group, and appropriate interventions for individuals and families. Attention is also given to dealing with anticipatory loss and bereavement, implementing traditional innovative intervention techniques, and for providing advocacy services concerning possible legal, financial, housing, and educational issues.     

The Ripple Effect: Lessons Learned About Secondary Traumatic Stress Among Clinicians Responding to the September 11th Terrorist Attacks

Secondary Traumatic Stress (STS) symptoms experienced by mental health clinicians who treated clients for issues related to the terrorist attacks of 9/11 were intense and unprecedented. An exploratory study, using qualitative techniques as the primary information gathering method, was conducted to gain a better understanding about “indirect” exposure to terrorism. Twenty-six mental health clinicians participated in this research effort. As part of this study, questions regarding STS were explored. STS levels among clinicians who provided care to victims of 9/11 were high 30?months after the attacks. Most clinicians lacked experience providing disaster relief mental health care. Availability of supervision and agency support was described as “weak;” however, peer support was deemed helpful. Over the past decade, progress has been made in addressing STS issues. Implications are included for social work practice, disaster mental health administration, funding sources and policy. Recommendations for future research are identified.     

The Contribution of Voluntary Organizations to the Care of Children with Life-limiting Incurable Disorders and their Families

A national postal survey of voluntay organizations providing for children with life-limiting incurable disorders (n = 147) is described. The majority of organizations originated from the motivation of parents or care workers in response to deficiencies in service provision from other agencies. A wide variety of services were available from the organizations with over half providing an information service, emotional support and counselling, patient and family support and a telephone helpline. The provision of some services, for example respite care, was, hoverer, associated with the size of annual budgets. Publicity, referral and funding arrangements are also discussed. The role of voluntary organizations as partners in care with statutory agencies is discussed in the light of instability of funding arrangements and the use of health and social work staff as the main source of information about voluntary services to parents. Areas of further research in this field are suggested.     

Effective inter-agency collaboration to safeguard children: Rising to the challenge through collective development

Multidisciplinary strategic collaborations are becoming increasingly commonplace. This is particularly evident in relation to safeguarding children. However, whilst there is a growing body of literature on both the effective leadership of collaborations and child protection there is little that combines the two. This means that senior managers, who are members of safeguarding partnerships, have a limited evidence-base to inform their collective learning and development. This paper seeks to add to the body of knowledge by first exploring both the literature on strategic collaboration and considering the implications for safeguarding partnerships. Second, by making an argument, that in order for members to engage in the effective joint leadership of collaborations they require opportunities for reflection and ongoing collective development. Third, providing an example of a way in which this can be achieved through the use of a self-assessment and improvement tool. Finally, considering the lessons learnt from the development of such a tool, focusing specifically on the implications for members of partnerships addressing complex problems such as the multifaceted issues associated with child maltreatment.     

Using the Personal Computer in Disaster Intervention

We describe in this paper the contributions of the personalcomputer to a rural mental health program designed to address disaster-induced psychological problems following a flood. The computer served a vital role in several areas. First, we were able to use the computer in desktop publication of pamphlets for disaster survivors. Second, we used the computer for managing data to assess the needs of survivors, evaluate effectiveness, and generate reports. And third, we used the computer to mail letters to all survivors, providing them with updated information regarding available services and continuing concerns. In evaluating the success of the program, we conclude that the computer enabled us to implement a program that was inexpensive, responsive, efficient and effective.