'More real than reality': a study of voice hearing

Hearing voices can be considered as elusive or illusory hallucinations in the sense that they are perceptions that have no external reason or even that they are divorced from reality. The aim of this article is to describe how participants in different focus groups account for and understand their voice-hearing experiences. The study shows that voice hearing can be such an overwhelming experience that it can even be experienced as 'more real than reality'. Voices are strong and powerful experiences that sometimes convey memories from the past or difficulties that the voice hearer would prefer to forget but in fact has had to confront. The voices also influence how the voice hearer sees his or her future. This study contributes to our knowledge of the world and language of voice hearers from the perspective of social work.     

Three estimators of the Mahalanobis distance in high-dimensional data

This paper treats the problem of estimating the Mahalanobis distance for the purpose of detecting outliers in high-dimensional data. Three ridge-type estimators are proposed and risk functions for deciding an appropriate value of the ridge coefficient are developed. It is argued that one of the ridge estimator has particularly tractable properties, which is demonstrated through outlier analysis of real and simulated data.     

Hearing voices in the archive

This essay is an attempt to fathom the performative and textual potential of historical sound recordings from the Lautarchiv in Berlin, along the available written files and a particular set of acoustic files spoken by an isiXhosa speaker. Read and listened to together, these files document the event and rationale of the recordings of the Phonographische Kommission with a man from the Eastern Cape, who was recorded while being interned as a foreign subject, in a German camp for British civilians in World War I. Following the acousmatic voice that speaks on several recordings, the essay explores the position of the speaker and the enunciation that speaks of the experience of war and displacement, and the complexities of audible traces of imperial knowledge production.     

Elderly People's Perceptions of a Telehealthcare System: Relative Advantage,Compatibility, Complexity and Observability

The use of telehealthcare systems to promote independent living for elderly people is growing. The results presented in this article, derived from an initial user lab test of a telecare system—GiraffPlus—indicate that the crucial factor for adoption of telehealthcare systems is not usability but the system's ability to support autonomy in everyday life. Eleven users tested the usability and reported what they perceived as possible benefits of having such a system at home. To support autonomy, customization is crucial for the system to be perceived as meaningful for the individual. Our analysis confirms previous research.     

‘Between heaven and hell’: Subjective well‐being of asylum seekers

Nearly 1.4 million asylum seekers arrived in Europe in 2015. With an unprecedented 822% increase in the number of asylum applicants, Finland experienced the largest increase in applicants than any other European country that year. In this study, we investigated asylum seekers’ experienced subjective well‐being (ExSWB) construct in comparison with their evaluated subjective well‐being (EvSWB) construct. A mixed methods approach with convergent design was adopted for the study, which combined quantitative data on asylum seekers’ (n = 181) ExSWB and EvSWB with qualitative data on the elements of ExSWB and EvSWB. The findings point at a limbus phase in asylum seekers’ livelihood transition between the borders for international protection in Finland. The Cantril self‐anchoring striving scale was used by the participants to describe this passage ritual of ambiguity. Furthermore, we also found gender differences related to coping and subjective well‐being, which supports previous findings on asylum seekers’ well‐being. Key Practitioner Message: ? The concept of the limbus phase of the asylum seeker livelihood transition is useful for describing asylum seekers’ experiences while waiting for an asylum decision; ? Asylum seeker SWB is closely related to status dissonance, separation and capitals, causing anxiety, worry and fear, and inflicting cognitive disruption; ? Equal, institutional‐level functions should be organised in the reception centre for easing the anxiety related to the asylum‐seeking process.     

Ambivalence and Living Apart Together in Later Life: A Critical Research Proposal

Most unattached older persons who would like an intimate partnership do not want to remarry or be in a marriage‐like relationship. A growing trend is to live apart together (LAT) in an ongoing intimate relationship that does not include a common home. We address the debate about whether LAT constitutes a new form of intimate relationship in a critical assessment of research on LAT relationships that applies ambivalence and concepts from the life course perspective. We conclude that among older but not younger adults, LAT relationships are generally a stable alternative to living with a partner, negotiated in the context of current social institutions and arrangements. We propose research questions that address later life living apart together as an innovative alternative intimate relationship. We encourage comparative work on the unique challenges of later life living apart together, their implications for other family ties, and their connection to social and cultural arrangements.     

Learning difficulties and academic competence among children in contact with the child welfare system

Children who have been in the welfare system tend to have poor social and health outcomes as adults. The aim of this study was to examine learning difficulties, as well as academic competence, among children in contact with child welfare service, and to compare this group to their same‐age peers. The material consisted of 4114 children in fifth to seventh grade, of which 101 were in contact with child welfare services. Information on learning difficulties and academic competence was obtained through questionnaires to teacher and parent/caregivers. As expected, there were significantly more children with learning difficulties in the child welfare group than the peer group; 12% of child welfare clients had general learning difficulties compared to only 0.4% of their peers, and 31% had specific learning difficulties in relation to mathematics and/or reading and writing, compared to 10% of their peers. The majority of child welfare children received assistance from pedagogical–psychological services. While more than every second child welfare client without general learning disability had low academic competence, there were also 15% who had high academic competence. The results show that although many of the children in contact with child welfare service have learning difficulties, there is also heterogeneity and potential for academic achievement.     

Children's agency in interprofessional collaborative meetings in child welfare work

The concept of children's agency can be used to understand how children actively shape their lives. While in social work there is a growing body of research on how children experience meetings that involve collaborating professionals, little is known about the ways in which they exert an influence. The purpose of the study is, in a Swedish context, to investigate children's perceptions of their agentic capacity in regulating participation and exerting an influence on outcomes in interprofessional collaborative meetings. Interviews were carried out with 28 children in receipt of social services support. Findings revealed that children perceive professionals' talk as restricting opportunities for input. They also perceive that they have the capacity to exercise agency by (i) conforming to expectations by feigning boredom and seeming disengaged, but at the same time paying close attention; (ii) by using exit strategies; and (iii) by developing ‘in‐situ’ strategies to end meetings. Rather than, as previously suggested, being powerless in such circumstances, the children tell how they carefully assess situations, and, from a position of apparent subordination, talk of ways of acting that reveal their agentic capacity. These insights are of importance for practitioners who are encouraged to look beyond behaviours that first meet the eye.     

Assessment of recovery in older patients hospitalized with different diagnoses and functional levels,evaluated with and without geriatric assessment

Background

The objective of the present study was to investigate 1) the role of different admission diagnoses and 2) the degree of functional loss, on the rate of recovery of older patients after acute hospitalization. Furthermore, to compare the predictive value of simple assessments that can be carried out in a hospital lacking geriatric service, with assessments including geriatric screening tests.

Methods

Prospective, observational cohort study, including 961community dwelling patients aged?≥?70 years, transferred from medical, cardiac, pulmonary and orthopedic acute hospital departments to intermediate care in nursing home. Functional assessment with Barthel index (BI) was performed at admission to the nursing home and further geriatric assessment tests was performed during the first week. Logistic regression models with and without geriatric assessment were compared concerning the patients having 1) slow recovery (nursing home stay up to 2 months before return home) or, 2) poor recovery (dead or still in nursing home at 2 months).

Results

Slow recovery was independently associated with a diagnosis of non-vertebral fracture, BI subgroups 50–79 and <50, and, in the model including geriatric assessment, also with cognitive impairment. Poor recovery was more complex, and independently associated both with BI?<?50, receiving home care before admission, higher age, admission with a non-vertebral fracture, and in the geriatric assessment model, cognitive impairment.

Conclusions

Geriatric assessment is optimal for determining the recovery potential of older patients after acute hospitalization. As some hospitals lack geriatric services and ability to perform geriatric screening tests, a simpler assessment based on admission diagnoses and ADL function (BI), gives good information regarding the possible rehabilitation time and possibility to return home.

     

Looking for elderly people´s needs: teaching critical reflection in Swedish social work education

ABSTRACT

This paper focuses on how to use critical reflection in social work education in order to encourage students to critically reflect on their standards regarding assessment, opinions and values about aging. Material, both oral and written, from needs assessments of older persons conducted by 106 social work students was analyzed. The result shows that the students initially interpreted needs based on prejudice and assumptions about aging. However, when using Schön´s three steps of reflection in the exercise, together with knowledge of critical social work theories, students became more concerned and reflected more critically on their assessments. This study shows the possibilities of working with pedagogical exercises in order to increase the awareness and critical knowledge of social work students in order to attempt to reduce discrimination. Educating students in critical social work enables them to learn how to comment on and transform the profession of social work and our unjust society, while questioning their own as well as society’s prejudice regarding the needs of elderly persons.