Chapter Five

This chapter briefly discusses the development of Adult Protective Services (APS) programs in the United States in relation to federal law and policy, depicting the variety in such programs among the states. The chapter then describes ethical values and protocols as well as systemic constraints in pulic agency practice. These concepts and issues are applied to the three case examples, illustrating the need for multidisciplinary cooperation and coordination to gather the information and resources necessary to resolve the presenting problems.     

The Needs of Older Persons at Risk of Housing Loss

This chapter explores the implications of some of the earlier findings about elders at risk, especially the significance of social support, mental competence, and income. There is need for research exploring consumer perspectives and preferences, as well as agency constraints and flexibility. Services needed include health and mental health outreach, home maintenance and creative matching of natural helpers and formal care. Fundamentally, a national commitment is needed to "housing for all."     

Ethics and Elder Mistreatment:

This chapter focuses on the meaning of ethics in elder mistreatment. More specifically, ethical issues are distinguished from non-ethical issues and ethical dilemmas. The primary objective is to demystify ethics for elder-serving practitioners and to show how ethics can be a part of the treatment decision-making process. This process details "doing" ethics in the practice setting. It proposes a method for developing ethical practice in the multidisciplinary level. The multidisciplinary level starts with the client and professional ends with the community-based multidisciplinary team. The latter include human services professionals who have the important task of transforming ethical protocols into practice.     

Models for theory-based M.A. and Ph.D. programs

In response to growing demand for advanced public relations education, this article suggests integrated models of outcomes, curriculum, pedagogy and assessment for theory-based M.A. and Ph.D. programs. Because public relations has commonly been approached as a professional rather than theoretical subject, this article begins with a short explanation of why theoretical education is becoming an increasingly important part of public relations education. It then reports the integration team's recommendations for a flexible educational framework allowing for practical constraints and providing for institutional individuality at both the M.A. and Ph.D. levels. Assumptions underlying efforts of the team are outlined and specifics that might be included in M.A. and Ph.D. programs are presented with rationales for each.     

Educational differences in parents’ time with children: Cross‐national variations

We analyze time diary data from 24,546 married mothers and married fathers in Canada, Germany, Italy, and Norway to determine whether the effect of education on child‐care time varies cross‐nationally. Our results indicate that more educated mothers spend more time with children than less educated mothers in each country, despite substantial cross‐national variation in levels of economic support and services for families. This suggests that better educated mothers may have different parental values and behaviors than less educated mothers. Among fathers, however, education has no effect on child‐care time in Norway, and only weak effects in Germany. This suggests that family policies that provide economic support to families may reduce time constraints on fathers, thus ameliorating educational effects.     

BPD and the Need for Community

SUMMARY

This chapter emphasizes the importance of a community/systems approach in managing the treatment of individuals with borderline personality disorder. The natural systems existing around patient, clinician and family are recognized, and we examine how working teams are built from these systems. The Borderline Center at McLean Hospital is used as an illustration of an organizational model that utilizes the concept of the “holding environment” (Winnicott, 1965) to provide comprehensive services to borderline patients and their families. As patients move through various levels of care and exhibit typical borderline symptomatology, the importance of communication and coordination on the part of the treatment team is highlighted. This chapter also will illustrate the essential ways in which patients, clinicians and families are able to join together in the treatment of this disorder, with special emphasis on the necessity of family involvement. We also will examine how the treatment teams provide the foundation for larger communities, which are critical to sustaining the ongoing work of its members.     

Local realities: a frontier perspective on child protection team practice

This article presents a case study of a child protection team in a frontier county in Montana. Narratives from individual and group interviews highlight team members' experiences and the structuring of team practice in their frontier community, the power and challenge of community culture and history, and the interplay of constructions of children and child abuse as key elements that influence and shape team practice. This exploration suggests a framework for rethinking child protection team practice in diverse locations.     

Chapter 11. Caregivers of Children with Cancer

SUMMARY

When a child is diagnosed with cancer, families experience a devastating life event with immediate and long-term impact on quality of life, actvities of daily living, family dynamics, self identity, parental role, and sense of meaning in the world. However, despite the trauma, more recent studies are highlighting the resilience and functioning of families facing cancer in childhood. This chapter explores these family dynamics.     

LEVIATHAN AT BAY: CONSTITUTIONAL VERSUS POLITICAL CONTROLS ON GOVERNMENT

I integrate constitutional constraints in a model of electoral control of politicians. Two types of politicians compete for office: angels, who never misuse power, and knaves, who abuse delegated power. Political theory suggests that constitutional constraints and elections are substitutes; I find a more complicated relationship. Elections sometimes substitute for constraints, while constraints complement and strengthen electoral controls based on politicians' payoffs. Elections must work perfectly to generally allow constraints to be dispensed with. Knaves might self-select out of politics with constitutional constraints, which consequently appear inconsistent with the observed character of politicians. ( JEL H1, D72)     

Precaution and liquidity in the demand for housing

We exploit cross-sectional mortgage data to investigate the importance of liquidity constraints and a precautionary motive in the demand for housing. Households that are not liquidity constrained consume housing services essentially as the life cycle hypothesis suggests but with a significant precautionary component. Households that are liquidity constrained, in terms of not meeting standard loan-to-value or payments-to-income constraints, are similar to unconstrained households in most respects, including the precautionary motive, but they respond somewhat less to fluctuations in their lifetime income - suggesting some influence of bank-induced liquidity constraints. We additionally find, however, that banks enforce liquidity constraints only weakly.     

Sensing the Bike: Creating a Collaborative Understanding of a Multi‐Sensorial Experience in MotoGP Racing

This article concerns the analysis of work interaction of a motorcycle racing team during pre‐season tests, drawing on ethnomethodology, and conversation analysis to explicate the ways in which the manager and the driver collaborate, through everyday gestures and language, to create a shared understanding of the bike's mechanical issues and disambiguate the driver's accounts of the bike's performance. We report on a set of video‐recorded encounters between the manger and the driver, examining how the multi‐sensorial experience of the driver is recollected and understood by team members, while overcoming interactional constraints imposed by the unique professional setting.     

Does team lifting increase the variability in peak lumbar compression in ironworkers?

Ironworkers frequently perform heavy lifting tasks in teams of two or four workers. Team lifting could potentially lead to a higher variation in peak lumbar compression forces than lifts performed by one worker, resulting in higher maximal peak lumbar compression forces. This study compared single-worker lifts (25-kg, iron bar) to two-worker lifts (50-kg, two iron bars) and to four-worker lifts (100-kg, iron lattice). Inverse dynamics was used to calculate peak lumbar compression forces. To assess the variability in peak lumbar loading, all three lifting tasks were performed six times. Results showed that the variability in peak lumbar loading was somewhat higher in the team lifts compared to the single-worker lifts. However, despite this increased variability, team lifts did not result in larger maximum peak lumbar compression forces. Therefore, it was concluded that, from a biomechanical point of view, team lifting does not result in an additional risk for low back complaints in ironworkers.     

LEARNING ABOUT EDUCATION

Limited human capital investment is a common characteristic of low‐income countries despite the fact that estimated returns to educational investment in low‐income countries are generally higher than those in high‐income countries. Empirical evidence suggests that income and credit constraints can only account for a part of this underinvestment. Recent experimental evidence shows that families' misperceptions about the returns to education play a role in their low‐investment levels. This paper builds a heterogeneous‐agent model of human capital and growth that incorporates an adaptive learning mechanism to capture the way agents form perceptions about returns to education. We find natural conditions guaranteeing existence of stable equilibria. Along transition paths, agents' misperceptions about returns to education depress realized returns, which serves to reenforce and perpetuate low human‐capital investment. If human capital investments have both private and public returns, we find multiple stable equilibria, including those which are characterized by low investment and low returns. (JEL D83, O10, I25)     

Environmental education evaluation: Time to reflect,time for change

Evaluation in environmental education is fairly nascent despite decades-long attention to its importance. In setting the context for future chapters appearing in this special issue of the Journal of Evaluation and Program Planning, attention is devoted to the political circumstances associated with retrenchment in the public sector and increased involvement of citizens in environmental issues in their regions. It further is nested in the context of potential political reforms in a stable market democracy where education is but one strategy that can be bundled with regulations and taxes/subsidies. Additional attention is directed to explaining many of the key evaluation theories – utilization-focused evaluation, evaluative capacity building, and program-theory driven evaluation. The final section of this chapter situates the subsequent chapters of this volume based on the demographic target (youth or adult) as well as connection to a particular evaluation theory.     

‘Somebody Watching You’: Impact of Reflecting Teams on Hope in Couple Relationships

Reflecting teams (RTs) represent both an epistemological stance and a therapeutic technique. Most commonly associated with narrative and systemic approaches to therapy, RTs offer an outsider perspective that can bring hope and alternative narratives and perspectives for therapists and clients to explore. Relational hope is a little researched concept in the field of couple therapy research. This study explores the experience of RTs in couple relationships and the aspects of the experience that couples describe as connected to a sense of hope for their relationship. The study also considers whether difference in attachment style shows any relationship with hope in couple relationships before and after the clients’ session with a reflecting team. Couples completed questionnaires about their attachment style, demographics, and relational hope and were given the option to complete an interview about their experience with the reflecting team within 1 month of their therapy session. Our findings suggest that RTs contribute positively to hope in couple relationships particularly for clients who present with an anxious attachment style. This direction for research is important because there is very little research about hope in couple relationships despite its importance (Merolla, 2014; Snyder, 2002) and there is no research about what aspects of a reflecting team contribute to hope in couple relationships. Analysis of interviews indicates a number of features of the reflecting team feedback that were valued by clients.     

Therapeutic Alliance; A View Constructed by a Family Therapy Team

Therapeutic Alliance is a construct which may have value for a family therapy team and influence its day to day practice. This paper discusses whether family therapeutic alliance can be observed, described and measured, and gives an account of the development of the Family Therapeutic Alliance Scale (FTAS) by a brief strategic family therapy team. Our focus is on the use of statistical technique as a means of clarifying the team's construct of therapeutic alliance, informing the team process without being the final arbiter in development of the scale. The second stage outlines the investigation of the usefulness of the construct with a wider group of family therapists. In individual psychotherapies measures of therapeutic alliance have been shown to predict outcome. Our early work suggests this is also true for family therapies and the FTAS may be a predictor for outcome in family work.     

Status differences in cross-functional teams: effects on individual member participation, job satisfaction, and intent to quit

Cross-functional teams (CFTs) play an increasingly important role in health care. However, despite their potential, CFTs often fail to function effectively. This paper contributes to the literature in medical sociology by examining how the steep and well-defined hierarchy characteristic of the health occupations proves to be dysfunctional in the CFT setting. Previous research has shown that status differences among members of work teams negatively affect their functioning. Yet the specific mechanisms that connect variations in status to poor team functioning remain unclear. We hypothesize that it is the suppression of participation among low status team members that leads to poor CFT functioning. Our theoretical model integrates status characteristics theory and the value attainment theory of job satisfaction to link team members' statuses to participation in team decision-making and, ultimately, to their attitudes about the job. We use causal modeling to test our hypotheses. Our results indicate that relationships between health professionals defined in broader social contexts affect status, roles, and functions within CFTs, and these, in turn, affect the team's interpersonal processes. We suggest changes in organizational structure and in team leadership styles that might make CFTs more effective.     

PROFESSIONAL AUTONOMY AND ORGANIZATIONAL CONSTRAINT

Recent discussions of the professions agree on the centrality of autonomy to professionalism but disagree whether organizational employment is consistent with the maintenance of professionals' traditional autonomy. This article analyzes autonomy in the engineering profession with a view to discovering both whether engineers are able to maintain high levels of autonomy in an organizational context and whether autonomy is as central to job satisfaction among engineers as the literature suggests. The data used are drawn from a survey questionnaire mailed to a sample of 800 engineers in the Rochester, New York area in 1986. Two major findings are discussed. First, although engineers are subject to certain constraints, they do appear to maintain relatively high levels of professional autonomy, especially concerning how their jobs are actually carried out. Second, despite the high value engineers place on autonomy, its relationship to job satisfaction is not a simple one. The strong effect on job satisfaction of one type of autonomy (the ability to choose the projects on which one works) may be the result not of autonomy per se but whether engineers find their work interesting.     

Primary care teams

SUMMARY. Northern Ireland has a health and social services structure which should lead to the easier establishment of effective primary care teams. Following an analysis of constraints on interprofessional collaboration, various models of practice in Northern Ireland and in England and Wales are discussed to demonstrate potential solutions. Child abuse in particular is used to identify both problems and ways forward, especially concerning the general practitioner's key role in the primary care team