The Australian Social Inclusion Agenda: A New Approach to Social Policy?

The Social Inclusion Agenda (‘SIA’) was introduced by the Australian Labor Party (‘ALP’) in the lead up to the 2007 federal election. The rhetoric was hopeful, proposing to reframe the government's approach to disadvantage. Rhetoric aside, what the then opposition meant when it talked of building social inclusion (‘SI’) was less clear than may have immediately met the eye. This paper offers an introductory analysis and review of the SIA. It first considers why Australia might benefit from a readjustment in its social policy direction, reflecting on the concepts of poverty and Amartya Sen's ‘capabilities approach‘. Second, it offers a critical overview of the main conceptions of SI/Social Exclusion. Third, it applies these first two parts of analysis to developments to date with the SIA. This part, whilst limited in scope and preliminary at best, offers some general comments as to the possibilities and pitfalls of the SIA and proposes the way forward from an analytical perspective in terms of guiding the SIA in a desirable direction.     

Speaking of art: Class code or historical residual?

Knowledge and consumption of the fine arts were once considered symbolic of upper class standing. As cultural production has expanded, fine art products in various guises have become accessible to more people across the socioeconomic spectrum. This article looks at how the New York Times covered the American art scene in the 1950s and between 2000 and 2009 to investigate whether reporting has maintained a knowledge-based approach that provides evidence for the continuation of class status as it relates to writing about the arts. We argue that critics and reporters have used fungibility, social hierarchies, and disinterested language during these two time periods to maintain the role of the fine arts as a marker of social distinction.     

Reflective Debriefing: A Social Work Intervention Addressing Moral Distress among ICU Nurses

ABSTRACT

Health-care workers may experience moral distress when they are unable to act as they believe is ethically appropriate in their clinical work. A social worker-facilitated protocol called Reflective Debriefing was developed and tested for alleviating moral distress through regular debriefings with nursing staff on an intensive care unit (ICU). Forty-two ICU nurses completed a Moral Distress Scale-Revised (MDS-R) at the beginning and end of a 6-month period, during which time regular debriefings were offered. The overall level of moral distress on the ICU surveyed was found to be low to moderate. The top three most frequent situations causing moral distress reported by most nurses in this study were related to the provision of nonbeneficial care in the ICU. Participants reported gaining the most benefit from feeling empowered to constructively confront other staff members about truth-telling in giving a prognosis. Nurses’ overall response to the intervention was positive, with 100% of participants requesting to continue the Reflective Debriefing sessions either on a monthly or on an as-needed basis. The response to the intervention emphasized the importance of interprofessional collaboration to successfully combat moral distress among health-care workers and may protect them from burnout, detachment, and even quitting their profession.     

Differential Relationships Between Religiosity,Cigarette Smoking,and Waterpipe Use: Implications for College Student Health

Abstract

Objective: Using a framework informed by problem behavior theory, ¹ Jessor, R and Jessor, S. 1977. Problem Behavior and Psychosocial Development: A Longitudinal Study of Youth, New York, NY: Academic Press.  [Google Scholar] the authors examined differential relationships between religiosity and the frequency of cigarette and waterpipe tobacco smoking. Participants: Six hundred fourteen individuals beginning their freshman year at a large, public, midwestern university. Methods: Paper-and-pencil surveys were administered to students who attended freshman orientation. Electronic surveys were sent to students who did not attend orientation. Results: Although a latent, generalized religiosity factor was negatively associated with frequency of cigarette smoking, there was no such relationship for frequency of waterpipe use. Conclusions: Conceptualizing waterpipe tobacco smoking in terms of problem behavior theory may be inappropriate, given its lack of association with religiosity. These results may reflect the perception that waterpipe use is a more socially acceptable form of tobacco use that is less harmful to health than cigarette smoking, despite medical evidence to the contrary. Implications for prevention and intervention are discussed.     

Medication Abortion Within a Student Health Care Clinic: A Review of the First 46 Consecutive Cases

Abstract

Objective: Medication abortion with mifepristone and misoprostol has been available in the United States since 2000. The authors reviewed the first 46 medication abortion cases conducted at a university-based student health care clinic to determine the safety and feasibility of medication abortion in this type of clinical setting. Participants: Female patients presenting for medication abortion at a student health care clinic between October 1, 2006, and April 1, 2009. Methods: Retrospective consecutive case review. Results: Successful completion not requiring uterine aspiration occurred in 85% of the cases that were not lost to follow-up. Six cases (15%) required uterine aspiration for completion: 3 underwent uterine aspiration only; 3 had aspiration after failing an additional dose of misoprostol. Only 1 patient visited the emergency room. There were no hospitalizations. Conclusions: Medication abortion services in a student health care clinic are safe and feasible. However, additional treatment may be required with some patients.     

Older Women's Perceptions of Elder Maltreatment and Ethical Dilemmas in Adult Protective Services: A Cross-Cultural,Exploratory Study

In this study, older African American, Latina, and Caucasian women from varying socioeconomic backgrounds participated in eight focus groups that examined their perceptions of elder maltreatment and three ethical dilemmas within adult protective service work: mandatory reporting, involuntary protective services, and criminalization of elder maltreatment. Participants espoused a broad and inclusive view of elder maltreatment. In responding to illustrative case scenarios, participants strongly favored protection over freedom by supporting mandatory reporting and involuntary protective services. Criminalization of elder maltreatment also was supported. This article presents results of each scenario and broad themes across the study, with attention paid to areas of consistency and difference across ethnicity and socioeconomic categories.     

Tracing Stigma in Long-Term Care Insurance in Israel: Stakeholders’ Views of Policy Implementation

A rapidly expanding number of baby boomers provide care to aging parents. This study examines associations between caregiver status and outcomes related to awareness and anticipation of future long-term care (LTC) needs using 2007 Connecticut Long-Term Care Needs Assessment survey data. Baby boomers who were adult child caregivers (n = 353) versus baby boomers who were not (n = 1242) were more likely to anticipate some future LTC needs and to have considered certain financing strategies. Although baby boomer adult child caregivers more readily anticipate some future LTC needs, they are not taking specific actions. It is important to address the need for public education directed toward those who are currently (or have recently completed) caring for aging parents.     

Multiple Disadvantages Among Older Citizens: What a Multidimensional Measure of Poverty Can Show

Using the newly created Freedom Poverty Measure, a multidimensional measure of poverty, it can be seen that there were 534,700 individuals who were in freedom poverty, who had either poor health or poor education in addition to having low incomes. This multidimensional disadvantage would not normally be captured by single measures of poverty, such as income poverty measures. Men were significantly less likely to be in freedom poverty than women (OR = 0.63, 95% CI: 0.54–0.74, p < .0001), and the proportion of individuals in freedom poverty increased with age, with those older than 85 being 2.3 times more likely to be in freedom poverty than those aged 65 to 69 years (95% CI: 1.73–3.11, p < .0001). Policy responses to address the marginalization of disadvantaged older people should take a multidisciplinary approach, addressing health inequalities in particular, not just low income.