Long-term care in Spain: Difficulties in professionalizing services

The aim of this article is to analyze the difficulties in professionalizing the long-term care system in Spain. Since 2006, the new Spanish law has recognized care as a subjective right, and regulations are being designed to create a framework for its professionalization. Nowadays, family remains the most important group of providers who care for their elders, and women remain the main informal caregivers. Why do families resist using public long-term care services and professional carers included in the new law? The hypothesis highlights sociocultural factors as an obstacle to professionalization of long-term care services in addition to political and economic factors. The results show qualitative data about expectations, preferences, and discourses that women caregivers have in relation to their responsibility. The empirical material includes 25 interviews with different profiles of caregivers and six focus groups with family caregivers. The article suggests that the Spanish ideal of care is a problem for the professionalization of services because the family remains as the main provider of care—without specific skills, knowledge, and abilities.     

Building Health Insurance Literacy: Evidence from the Smart Choice Health Insurance™ Program

With the passage of the Patient Protection and Affordable Care Act (ACA) of 2010, the health insurance literacy of Americans became a critical issue. In response, a consumer education program was created and tested by university researchers and educators associated with Cooperative Extension. This article draws extensively on the emerging literature on health insurance literacy and on data from participants in the Smart Choice Health Insurance? program. The intent of the study was to understand socio-demographic and environmental variables that predict initial health insurance literacy and gains in health insurance literacy. A standardized instrument measuring health insurance literacy was used to collect the data. Multivariate analysis showed higher income consumers demonstrated greater initial health insurance literacy scores compared to middle income consumers, whereas younger, male and lower educated consumers reported lower initial health insurance literacy. After participating in the Smart Choice Health Insurance? program, consumers who made greater gains in their health insurance literacy tended to be female, higher income, and consumers residing in states that showed supportiveness of the ACA. The findings highlight the importance of considering sociodemographic characteristics in program design and delivery, as well as how contextual issues, such as the political environment, might impact the delivery of educational efforts. Findings from the analyses help inform ways to adapt and tailor educational opportunities that focus on health insurance literacy for a range of consumers.     

Time‐Space Distanciation: An Interdisciplinary Account of How Culture Shapes the Implicit and Explicit Psychology of Time and Space

The growing body of research on temporal and spatial experience lacks a comprehensive theoretical approach. Drawing on Giddens’ framework, we present time‐space distanciation (TSD) as a construct for theorizing the relations between culture, time, and space. TSD in a culture may be understood as the extent to which (1) time and space are abstracted as separate dimensions and (2) activities are extended and organized across time and space. After providing a historical account of its development, we outline a multi‐level conceptualization of TSD supported by research on cultural differences in the experience of time and space. We impact this conceptualization by examining two ethnographic case studies. We conclude by highlighting future research directions. TSD is an integrative, interdisciplinary, multi level construct with the potential to guide the burgeoning social science of time and space.     

Social Accountability in Diaspora Organizations Aiding Syrian Migrants

This article presents data from a study of Syrian diaspora organizations providing assistance to conflict‐affected Syrians in Europe, the Middle East, and North America. Using interview data from leaders in four Syrian diaspora non‐profit organizations, this article examines the social mechanisms used to ensure accountability within the challenging environments where the organizations operate. We find that Syrian diaspora organizations benefit from informal social accountability mechanisms that derive from individuals’ social network ties. Personal, social forms of accountability are particularly valuable to these organizations because these mechanisms help circumvent uncertainty and challenges in the operational environment. These findings reflect an important theme in the extant literature on diaspora philanthropy: diaspora members may have an advantage over other actors because of dense personal networks that make them adept at identifying dependable partners and enforcing agreements even in places where banking and legal systems are fragile.     

Strong convergence rates of probabilistic integrators for ordinary differential equations

Probabilistic integration of a continuous dynamical system is a way of systematically introducing discretisation error, at scales no larger than errors introduced by standard numerical discretisation, in order to enable thorough exploration of possible responses of the system to inputs. It is thus a potentially useful approach in a number of applications such as forward uncertainty quantification, inverse problems, and data assimilation. We extend the convergence analysis of probabilistic integrators for deterministic ordinary differential equations, as proposed by Conrad et al. (Stat Comput 27(4):1065–1082, 2017. https://doi.org/10.1007/s11222-016-9671-0), to establish mean-square convergence in the uniform norm on discrete- or continuous-time solutions under relaxed regularity assumptions on the driving vector fields and their induced flows. Specifically, we show that randomised high-order integrators for globally Lipschitz flows and randomised Euler integrators for dissipative vector fields with polynomially bounded local Lipschitz constants all have the same mean-square convergence rate as their deterministic counterparts, provided that the variance of the integration noise is not of higher order than the corresponding deterministic integrator. These and similar results are proven for probabilistic integrators where the random perturbations may be state-dependent, non-Gaussian, or non-centred random variables.

     

FamilyLive: Parental Skill Building for Caregivers with Interpersonal Trauma Exposures

Mental health treatments for emotionally traumatized children incorporate family and caregiver-child therapy sessions to promote child recovery and minimize developmental disruption. Such sessions require that caregivers regulate their emotions to remain productively engaged in the therapeutic process. However, caregivers with histories of unresolved interpersonal trauma have difficulty with emotional regulation. Interpersonal trauma also negatively affects the ability to reflect on one’s own and others’ feelings and intentions. This limitation interferes with caregiver engagement in psychotherapy relationships aimed at supporting child trauma work. FamilyLive is an innovative caregiver-focused family therapy model that uses a one-way mirror, a specially trained reflecting team, structured routines and individualized verbalizations to address this complex clinical phenomenon. Guided by the literature on attachment and trauma, FamilyLive has yielded anecdotal successes and positive pilot results. FamilyLive is a viable approach to engaging caregivers with histories of interpersonal trauma in trauma-focused child and family therapy relationships.     

OLS and IV estimation of regression models including endogenous interaction terms

We analyze a class of linear regression models including interactions of endogenous regressors and exogenous covariates. We show how to generate instrumental variables using the nonlinear functional form of the structural equation when traditional excluded instruments are unknown. We propose to use these instruments with identification robust IV inference. We furthermore show that, whenever functional form identification is not valid, the ordinary least squares (OLS) estimator of the coefficient of the interaction term is consistent and standard OLS inference applies. Using our alternative empirical methods we confirm recent empirical findings on the nonlinear causal relation between financial development and economic growth.     

“Everything That We Can Do”: A Content Analysis of the Protective Strategies Used by GLBTQ Parents

Despite increased access to parenting rights through legal marriage and adoption, U.S. gay, lesbian, bisexual, transgender, and queer (GLBTQ) parents continue to experience varying levels of support for their families. This study explored protective strategies, or actions taken to meet one's safety needs when vulnerable, that GLBTQ parents pursue. This study included 454 GLBTQ parents from a national survey. Participants' open-ended responses about protective strategies were extracted from the survey and analyzed using content analysis. Responses were coded into 10 categories capturing strategies GLBTQ parents used to protect their families. While strategies utilizing legal supports were common, the most cited strategies were symbolic strategies, including creating a family name and developing written statements of parent wishes. Exploratory analyses revealed no difference in mean number of strategies used between parents who reported having legal status as a parent through adoption or listing on the birth certificate and those without legal parenting status. These results suggest that GLBTQ parents, regardless of their legal parenting status, take intentional measures to achieve a sense of safety and increase social support. The findings reiterate the importance of both legal and social support of GLBTQ parents.