Uncounted care

Family care (care for dependent persons at home by family members and friends) is widely endorsed, politically and personally, as the chronic care option that is superior to institutionally-based, formal care services. Politicians, health planners, and analysts may be especially supportive of a preferred form of care which is also believed to be economical. But the full costs of family care, including the value of the unpaid work of caregivers, are rarely acknowledged. This article reviews studies of caregiving and its costs and acknowledges the gender bias inherent in caregiving which has been regarded as free before its costs were calculated. Policy and health care practice will benefit from examination of both the costs and benefits of family care.Debbie Ward is Assistant Professor in the Community Health Care Systems Department of the School of Nursing (mail stop SM-24) at the University of Washington, Seattle, WA 98195. She trained as a family nurse practitioner at Yale University in New Haven, Connecticut, and earned her Ph.D. in health policy from Boston University. Her research interests include women's paid and unpaid labor, and public health policy.     

The Impacts of Acculturative Stress and Social Competence on the Mental Health of Mainland Chinese Immigrant Youth in Hong Kong

Correspondence to Dr Daniel Fu Keung Wong, Associate Professor in the Department of Social Work and Social Adminstration, 1317 K K Leung Building, The University of Hong Kong, Pokfulam Road, Hong Kong.E-mail: dfkwong{at}hkucc.hku.hk Summary Attempts were made to examine migration stressors, social competence,and mental health status of immigrant youth in Hong Kong andto examine the effects of social competence on stress and themental health of immigrant youth. Data on 106 immigrant youth,which were collected through a structured questionnaire, wereanalysed. It was discovered that immigrant youth found survivalissues and losses, rather than cultural differences and unfulfilledexpectations, to be stressful. Male immigrant youth exhibitedmore psychological distress symptoms than female immigrant youth.Hierarchical regression analyses revealed that social competenceexerted moderating effects on stress and the mental health ofimmigrant youth. Immigrant youth who had a higher level of socialcompetence, in terms of self-control, empathy, assertivenessand the ability to read social cues, had less stress and enjoyedbetter mental health. In conclusion, personal and socio-culturalreasons are put forward to explain the findings. Practice andpolicy implications are also discussed.     

The empirical basis of risk assessment in child welfare: the accuracy of risk assessment and clinical judgment

The importance of risk assessment is juxtaposed with the lack of empirical support regarding the validity of risk inventories. This study compared risk ratings of one risk assessment tool to decisions made by case managers. The researchers sampled 450 children and compared predictive utility of risk assessment to child protection decisions. Risk assessment was consistent with clinical judgment in 74% to 81% of cases, more than previously reported in studies of risk assessment validity. Further analyses identified discriminate functions at the instrument's category and individual-item levels. The results have implications for the validity of the instrument and its utility in child welfare.     

Substance use during sexual and physical assault in HIV-infected persons

Data from the HIV-Alcohol Longitudinal Cohort was used to determine the prevalence of substance use by victims and assailants during physical and sexual assault against HIV-infected persons and whether these findings differed by gender. Of the sexually assaulted participants, 31% of victims and 70% of assailant(s) had used drugs/alcohol during sexual assault. Compared with men, women had higher odds of substance use during sexual assault (adjusted odds ratio [OR] 3.8, 95% confidence interval [CI] 1.6 to 8.7) and of substance use by their assailant(s) during sexual assault (adjusted OR 5.9, 95% CI 1.7 to 20.6) in adjusted analysis. Of the physically assaulted participants, 66% of victims and 85% of assailants used drugs/alcohol during physical assault; these results did not differ by gender.     

Maternal mortality in South Africa: lessons from a case study in the use of deaths reported by households in censuses and surveys

South Africa is unique in being a developing country which has asked questions on pregnancy-related deaths in both its 2001 census and 2007 household survey, and monitors maternal and pregnancy-related mortality through vital registration and a confidential enquiry into maternal deaths. These sources of data provide a wide range of estimates of maternal mortality for the country. This paper examines these estimates to assess to what extent the differences between them are due to data deficiencies, methodological deficiencies or definitional differences. The results show that since maternal deaths are relatively rare it is fairly difficult to establish the maternal mortality rate with a great degree of accuracy in a setting where data are less than perfect. They also show that to some extent the differences are due to differences and errors in processing of data but that pregnancy-related mortality should not be treated as synonymous with maternal mortality. However, after adjustment, pregnancy-related mortality from vital registration was comparable with the level that may be expected using several alternative approaches, while the rate reported by households in census and surveys was about double that from vital registration. Nonetheless, all the data indicate an upward trend in maternal mortality that is in keeping with the impact of the HIV/AIDS epidemic, which is likely to have contributed to the discrepancies.     

Constructing undesirables: A critical discourse analysis of ‘othering’ within the Protecting Canada's Immigration System Act

Immigration policy in Canada has recently shifted, reflecting changes in other Western countries. We studied the discursive constructions of forced migrants within Bill C‐31 “Protecting Canada's Immigration System Act” and its associated Backgrounder documents published by the Canadian Government. The documents were analysed using an approach to critical discourse analysis adapted from Bacchi's (2009) methodology and informed by a theoretical framework of “othering”. Particular groups of migrants were represented as posing threats to the economy, the integrity of the refugee system, and national security. The documents offered three solutions: the creation of specific categories of migrants, an emphasis upon efficiency of the system, and expanded powers to the government. The problematization of asylum seekers as posing multiple threats to Canadian society obfuscates governmental responsibilities to this population and reflects common strategies of neoliberal governance.     

Shared mobility in a Māori community

ABSTRACT

Shared mobility is being advanced as a novel, technologically sophisticated approach to reducing the environmental impacts of high levels of car ownership. However, communities have long shared modes of transport for reasons other than environmental quality. We describe the shared mobility practices undertaken in a Māori community in the East Cape region of New Zealand. They reveal long-established ways of sharing that are underpinned by, and support, cultural principles. Shared mobility provides an appropriate and comfortable environment for people to share vital and sacred information and to strengthen social bonds. It also reflects the desire of tribal members to retain cultural practices that benefit the collective. The findings make it clear that sharing transport has far more than economic and environmental benefits. We suggest that it is time for the social and cultural benefits of sharing transport to become part of the global narrative on twenty-first-century collaborative consumption.     

Blurring reality with fiction: Exploring the stories of women,madness, and infanticide

Problem

Often, there is a sense of shock and disbelief when a mother murders her child.

Changing things for the better: the use of children and young people’s reference groups in social research

The use of reference groups made up of members of the population being researched has been encouraged within the qualitative research literature. This paper describes the use of reference groups made up of children and young people and promotes them as a space within which co-reflexive activities can help researchers reconsider their research approaches and assumptions, their methodologies and methods and the new knowledge created. The paper uses three case studies to highlight the benefits the authors have encountered as well as those identified by children and young people themselves.