Significant resources needed for return to work after sick leave

There are increasing numbers of people on long-term sick leave, especially with stress-related ill health and musculoskeletal disorders. The main purpose of this study is to, early on in the sick leave, find predictors of individual resources for a return to work. The study group consists of women and men on sick leave compared with reference groups of healthy persons. A questionnaire was used regarding diagnosis given on the doctor's certificate, self-reported symptoms, residential area, education, and kind of work. It also contained open questions about consequences in daily life and beliefs about future. Checklists concerning life satisfaction, sense of coherence, locus of control, coping resources and sick leave information over a four-year period have been used. Significant differences between the study group and the reference groups were found, relating to sense of coherence, locus of control, life satisfaction and coping resources. More than half of the study group were still on sick leave at a two-year follow-up. Important predictive factors turned out to be: previous sick leave, own belief about future and self-reported symptoms.     

Adults with dual eligibility for Medicaid and Medicare: access to substance abuse treatment

Access to substance abuse treatment is a noted concern for people with disabilities. Although much is known about elders with dual eligibility for Medicaid and Medicare regarding any care utilization and expenditures, little is known about their younger counterparts and how substance abuse might contribute. Drawing on national Medicaid claims, treatment utilization was explored for adults with and without dual eligibility for Medicare. People with dual eligibility were less likely to both initiate and engage in treatment as compared to those without dual eligibility. Implications relate to how existing systems provide substance abuse treatment to people with disabilities.     

The need to bring an end to the era of eligibility policies for a person-centred,financially sustainable future

Attention within the social care sector in England is moving away from consumerist notions of choice towards good professional practice as the route to personalisation. This demands a new focus on how to make practice that is person-centred the norm. The following sets out that this is unlikely to happen until the use of eligibility policies is ended. The lessons are relevant not only to England, but to other countries who may be looking to the United Kingdom as pioneering in the personalisation agenda.     

How to integrate digital media into a drop-in for homeless young people for deepening relationships between youth and adults

This paper reports on a curriculum called New Tech for Youth Sessions, designed for homeless young people, aged 13-25. Motivated by the ordinariness of digital media and its importance in communicating with society's institutions, the primary goal of the curriculum was to develop students' life skills for information technology and digital media. A crucial secondary goal was to position students to recognize their self-worth, through meeting challenges, positive communication with adults, and reciprocal peer support. The paper describes how these goals were addressed by incorporating a community technology center into a multi-purpose drop-in for homeless young people and by a curriculum that guides students through an integrated series of activities related to finding employment. The paper discusses the principles underlying the curriculum, the class processes, and the social structure that supports the learning environment. A far-reaching result, based on offering 13 classes to over 75 youth over 16 months, is the hypothesis that instruction in digital media can create visceral, life-affirming experiences of challenges overcome, which can help strengthen relationships between the youth and the drop-in staff. The paper concludes with a discussion of lessons learned for incorporating digital media into drop-ins for enabling access and for improving life skills.     

Ethical uneasiness and the need for open-ended reflexivity: the case of research into older people with a wish to die

This article focuses on research ethics in highly intimate research with possible impact on life and death. In order to stimulate an open-ended dialogue about research ethics, we reflect on four ethical challenges that came up during our research into older people with a wish to die. Drawing on our experiences, we discuss (1) the possibly confirming influence of our research on the death wish (moral experience of whether or not to disregard responsibility); (2) the suggested duty to intervene (moral experience of whether or not to compromise the person’s autonomy); (3) the researcher’s authority and power over the data (moral experience of threatening a person’s self-narrative) and (4) the dilemma of intimacy (moral experience of encountering the tragic). For guidance in addressing these challenges, we draw upon work on research ethics from phenomenological and care ethics scholars, as well as from those writing about relational ethics in health research. We suggest that being open about ethical uneasiness is important, because in most cases of a grey area, there are only open-ended answers needing an enquiring mind, rather than clear and fixed guidelines. Acknowledgement of ethical uneasiness and open-ended reflexivity are indispensable to constitute a morally good research practice.     

少数民族搬迁移民儿童社会融入何以可能——基于优势视角的融入机制与支持网络构建

在后扶阶段,影响我国少数民族搬迁移民儿童社会融合的主要因素已经由政府政策、资金等外部宏观因素转变为家庭、学校及社区等微观因素。研究少数民族移民儿童社会融合的关注点要由聚焦于政策、制度等宏观领域转至家庭、学校等微观场域,研究视角也理应由聚焦制度排斥的问题视角转向关注社会融入的优势视角。由此,根据优势视角理论及布朗芬·布伦纳的个体发展模型,在正视移民儿童社会融入问题和困难的前提下,剖析促进搬迁移民少数民族儿童社会融入的动力机制,挖掘移民儿童所具有的内外优势与资源,构建促进其社会融入的社会支持网络。     

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.