An agenda for future research regarding the mental health of young people with care experience

Young people who are currently or were previously in state care have consistently been found to have much higher rates of mental health and neurodevelopmental difficulties than the general youth population. While a number of high-quality reviews highlight what research has been undertaken in relation to the mental health of young people with care experience and the gaps in our knowledge and understanding, there is, until now, no consensus, so far as we aware, as to where our collective research efforts should be directed with this important group. Through a series of UK wide workshops, we undertook a consultative process to identify an agreed research agenda between those with lived experience of being in care (n = 15), practitioners, policy makers and researchers (n = 59), for future research regarding the mental health of young people with care experience, including those who are neurodiverse/have a neurodevelopmental difficulty. This consensus statement identified 21 foci within four broad categories: how we conceptualize mental health; under-studied populations; under-studied topics; and underused methodologies. We hope that those who commission, fund and undertake research will engage in this discussion about the future agenda for research regarding the mental health of young people with care experience.     

Coverage‐adjusted Confidence Intervals for a Binomial Proportion

We consider the classic problem of interval estimation of a proportion p based on binomial sampling. The ‘exact’ Clopper–Pearson confidence interval for p is known to be unnecessarily conservative. We propose coverage adjustments of the Clopper–Pearson interval that incorporate prior or posterior beliefs into the interval. Using heatmap‐type plots for comparing confidence intervals, we show that the coverage‐adjusted intervals have satisfying coverage and shorter expected lengths than competing intervals found in the literature.     

The potential power of social policy programmes: income redistribution,economic resources and health

Lundberg O, Fritzell J, Åberg Yngwe M, Kölegård ML. The potential power of social policy programmes: income redistribution, economic resources and health Int J Soc Welfare 2010: ??: ??–??© 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. This Supplement includes a number of articles dealing with the role of social policy schemes for public health across the life course. As a key social determinant of health, poverty and its consequences have historically been at the forefront of the public health discussion. But also in rich countries today, economic resources are likely to be important for health and survival, both on an individual and an aggregate level. This introductory article serves as a background for the more specific analyses that follow. The focus is on why income and income inequality could have an effect on individual and population health. We discuss relationships between the individual and population levels and between income and health, and some of the possible mechanisms involved. We also present arguments for why welfare state institutions may matter.     

Decision‐making in child welfare services: Professional discretion versus standardized templates

The article explores differences in the assessment and decision‐making processes, in child welfare services where a standardized template is implemented and in services where it is not. Child welfare services in several countries use different approaches to assess children's and families' need for intervention. In Norway, as in other European countries, there is a shortage of knowledge about decision‐making strategies. The article examines how 36 child welfare caseworkers in 6 different teams in Norway investigate, assess, and make decisions at the phase of an incoming referral. The analysed data were collected by focus group interviews. We use decision theory as a theoretical frame of reference. The analysis shows variation in the assessment procedure at different points of the process, depending on which approach was used. Despite such differences, the final decisions made were almost identical. Even though the data has its limitations because of the small number of informants, the results indicate that choice of approach is not decisive for decision‐making in the child welfare services.     

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.     

Comparing Long-Term Care Recipients in Urban and Rural Municipalities in Japan and Sweden

Japan and Sweden both have national systems of long-term care (LTC) and face similar challenges. This study compared various indicators of disability in LTC recipients in nine large urban, midsize urban, and rural municipalities in both countries. The aim was to establish whether urban-rural differences exist and whether they follow similar patterns in Japan and Sweden. It was found that LTC recipients in large urban municipalities in both countries were on average significantly less disabled than those from the other types of municipalities, regardless of the indicator for disability. Fewer persons in large urban municipalities live in extended families, which may increase the propensity to apply for LTC. The number of older people living alone in Japan is increasing, which means that the formal LTC system will come under increased pressure.     

Is the association between social capital and health robust across Nordic regions? Evidence from a cross‐sectional study of older adults

Nyqvist F, Nygård M. Is the association between social capital and health robust across Nordic regions? Evidence from a cross‐sectional study of older adults The study examined the association between structural and cognitive social capital and self‐rated health among 65‐ and 75‐year‐olds in Västerbotten in Sweden and Österbotten and Pohjanmaa in Finland. Data were retrieved from a cross‐sectional postal questionnaire survey conducted in 2005 and was answered by 3,370 persons, yielding a total response rate of 69 per cent. The association between self‐rated health and interpersonal trust and membership in organisations was tested by logistic regression analysis. The results showed that older adults in Västerbotten in Sweden experienced better self‐rated health than in Finland. Furthermore, interpersonal trust and active membership in organisations were associated with self‐rated health among 65‐ and 75‐year olds even after having controlled for the influence of region. We therefore conclude that the association between social capital and self‐rated health tends to be robust across contextually similar regions, but that further analyses are warranted in order to clarify the nature of this relationship. Key Practitioner Message: ?Health status can be indirectly strengthened through investments in social capital, such as group participation and active networks; ?When working with older adults, more focus needs to be put on how to develop trustful relationships; ?The Nordic welfare state, with its universal and subsidised social and health care services, has an indirect and positive effect on health among older adults.     

Gender Equality and Fertility: Which Equality Matters?

Does gender equality matter for fertility? Demographic findings on this issue are rather inconclusive. We argue that one reason for this is that the complexity of the concept of gender equality has received insufficient attention. Gender equality needs to be conceptualized in a manner that goes beyond perceiving it as mere “sameness of distribution”. It needs to include notions of gender equity and thus to allow for distinguishing between gender difference and gender inequality. We sketch three dimensions of gender equality related to employment, financial resources, and family work, which incorporate this understanding: (1) the ability to maintain a household; (2) agency and the capability to choose; and (3) gender equity in household and care work. We explore their impact on childbearing intentions of women and men using the European Generations and Gender Surveys. Our results confirm the need for a more nuanced notion of gender equality in studies on the relationship between gender equality on fertility. They show that there is no uniform effect of gender equality on childbearing intentions, but that the impact varies by gender and by parity.     

Methodological Considerations for Development of Research Support Systems

The article introduces the development of research support systems (RSS) as a special form of information systems (IS) development. Building on experiences from a concrete case several crucial differences between RSS development and development of conventional business support systems (BSS) are identified. So, development for RSS means less of mission and more of continues collaboration, less of producing and more of reciprocal learning and social change. It also involves an expanded universe of discourse that requires support more from an IS researcher and less of a conventional IS-developer. Further, there are issues of ethics and funding that makes RSS development extra challenging. All this represents a shift in focus away from How to do things, toward, What things to do. The article is closed with some tentative guidelines for RSS development. Those include preparing, learning, working arena, anticipatory acting, prototyping and stepwise improvement and scrutiny.