Accountability to Welfare Service Users: Challenges and Responses of Service Providers

Influenced by the consumerist sentiment in New Public Management,the last decades have witnessed a revival of the call for accountabilityto service users in the public service sector. As an act ofaccountability, social care and health care professionals areincreasingly obliged to involve their service users in the serviceplanning and monitoring process. Despite the popularity of thisaccountability and user involvement rhetoric, critics have,however, been skeptical of the prevailing user involvement initiativesas an effective measure of accountability to service users (Barnes and Wistow, 1994a,1994b; Bowl, 1996; Peck et al., 2002; Rea, 2004). Based on astudy of user involvement in the welfare sector of Hong Kong,this paper argues that the discourse of accountability to theservice users can be a source of unrest for welfare professionals,in the manifestation of accountability as a power relationship.Their ensuing response is to accommodate the ensuing challengearising from the demand for accountability to service usersby manoeuvring the accountability discourse. It is the contentionof this paper that the institutional inclusion of welfare serviceusers into a discursive space is a necessary but not sufficientcondition for the realization of a mandate of accountabilityto welfare service users.     

An EM Algorithm for Smoothing the Self-consistent Estimator of Survival Functions with Interval-censored Data

Interval-censored data arise in a wide variety of application and research areas such as, for example, AIDS studies (Kim et al ., 1993) and cancer research (Finkelstein, 1986; Becker & Melbye, 1991). Peto (1973) proposed a Newton–Raphson algorithm for obtaining a generalized maximum likelihood estimate (GMLE) of the survival function with interval-cen sored observations. Turnbull (1976) proposed a self-consistent algorithm for interval-censored data and obtained the same GMLE. Groeneboom & Wellner (1992) used the convex minorant algorithm for constructing an estimator of the survival function with "case 2" interval-censored data. However, as is known, the GMLE is not uniquely defined on the interval [0, ∞]. In addition, Turnbull's algorithm leads to a self-consistent equation which is not in the form of an integral equation. Large sample properties of the GMLE have not been previously examined because of, we believe, among other things, the lack of such an integral equation. In this paper, we present an EM algorithm for constructing a GMLE on [0, ∞]. The GMLE is expressed as a solution of an integral equation. More recently, with the help of this integral equation, Yu et al . (1997a, b) have shown that the GMLE is consistent and asymptotically normally distributed. An application of the proposed GMLE is presented     

The role of the gerontological social worker in assisted living

This qualitative study reports on thirteen assisted living (AL) administrators' perspectives of the role and the importance of the AL social worker in addressing the unmet needs of older adults as they move and transition into AL. Participant interviews were analyzed using the constant comparative method. Administrators described 5 AL social work roles: (a) decision-making and adjustment coordinator; (b) resident advocate; (c) mental health assessor and counselor; (d) family social worker; and (e) care planner. Implications include directly examining AL social workers' views, analyzing costs and benefits of employing AL social workers, and developing social work practicum sites within AL.     

Warehouses or Welfare?: Legislative Dispositions for Alcoholics

Skid row alcoholic offenders and the various legislative responses to this social problem are examined. Recent United States case law is discussed in the context of sociological explanations of societal intervention against this group. The validity of the medical model of alcoholism as a basis for planning social policy in respect of alcoholic offenders is questioned. Traditional justifications for civil commitment programmes are rejected as an infringement of civil liberty and human dignity. The effectiveness of criminal sanction on a cost benefit basis is analysed. Finally,. alternative policies are discussed and recommendations are made as to possible long-term solutions.     

Palliative sedation: an essential place for clinical excellence

The complexities that converge around palliative sedation invite clinicians to work together to differentiate the issues and come to recommendations and decisions that are humane, ethical, legal, and clinically sound. Whether a crisis or long-term situation exists, the work is essentially the same. It must include critical thinking, clinical expertise, multidimensional assessment, and an array of interventions to assist patients and families in situations where symptoms and suffering are sufficiently intense to warrant exploration of sedation. The many issues inherent in the discussion of sedation at end of life require not that we have the answers but rather that we work with our colleagues to raise relevant questions and integrate both expertise and compassion into end-of-life decisions and care.     

Measuring Mutual Help Willingness and Criteria among Hong Kong People: Confirmatory Factor Analyses

Mutual help has been often found to be beneficial for people’s well-being in clinical settings. Research in the general population, however, is relatively limited, partly due to the lack of applicable measurement tools. The present study attempted to develop two scales to measure mutual help willingness and criteria and test their psychometric properties among a community sample of Hong Kong people (n = 951). Confirmatory factor analyses suggested that the hypothetical models fitted the data very well. Results also indicated that though the willingness to seek help and to give help was significantly correlated, Hong Kong people were generally more willing to give help than to seek help. Age had a negative effect on help-seeking willingness, which can not be explained by education level. A set of criteria were applied similarly when people decided on help-giving and help-seeking. Agreement with the criteria was negatively correlated with age but the associations became negligible when education level was controlled. Research and practical implications of the findings are discussed.     

The Role of Coping Strategies in Understanding the Relationship Between Parental Support and Psychological Outcomes in Anxious Youth

The current study examined the moderating role of coping strategies on psychological outcomes at varying levels of parental support in a sample of clinically anxious youth. Youth (N?=?174, mean age 11.89) completed the Children’s Coping Strategies Checklist, Child and Adolescent Social Support Scale, Multidimensional Anxiety Scale for Children and Children’s Depression Inventory. Data was gathered at a large, university-based anxiety disorders treatment clinic. This nonexperimental design analyzed the use of active and avoidant coping strategies as a moderator of anxiety and depression, while controlling for parental support. Results revealed active coping strategies did moderate the relationship between parental support and anxiety, however, not as expected while the significant moderation role of avoidance coping was mixed. Findings showed that anxious youth with more parental support and more active coping were at risk for higher levels of anxiety, yet protected from higher depression. Avoidant coping strategies did moderate in a manner that was predicted for higher anxiety symptoms. Results suggest increased need for parental involvement in the treatment of anxiety disorders in youth.     

International Federation of Social Workers: International Policy on Refugees

The initiators and the advocates of the Australian Assistance Plan claim they are creating a new framework—a framework which is more sensitive to and aware of the needs of the individual and the community. As Knight and Wallace point out in the March issue of Australian Social Work, the key concept is participation.¹ The Social Welfare Commission, who initiated the A.A.P., describe it as:     

Consequences of work force reduction: Some employer and union evidence

Despite the popularity of workforce cutbacks in the 1990s, largescale empirical stud-ies at the bargaining unit level are rare. I explore some of the consequences of per-manent work force reduction using data from both employer and union respondents. About 56 percent of employer participants and 57 percent of local union officials reported a permanent reduction of bargaining unit employees. In comparing bargain-ing units that experienced a permanent reduction of union members, results obtained from both employers and union officials indicated a significant negative impact on over-all employee satisfaction and labor climate. Additional analyses with union respon-dents revealed that the reduction of bargaining unit employees was also associated with a higher rate of grievances and absenteeism and poorer relations between union members and their supervisors.