From Hospital to Home with NDIS Funded Support: Examining Participant Pathway Timeframes Against Discharge Expectations

ABSTRACT

For patients with disability who require funded supports to leave hospital, the introduction of the National Disability Insurance Scheme (NDIS) represents opportunity and challenges. At a time of major reform, timely and supported discharge is reliant on overcoming interface complexities. The purpose of this study was to examine the NDIS participant pathway timeframes against discharge expectations for hospitalised adults with spinal cord injury (SCI) or acquired brain injury (ABI) and interrogate delays for the two groups. Administrative data on 54 participants (ABI?=?18 and SCI?=?36) were analysed. Both groups experienced delays to discharge and significant variability in timeframes between NDIS pathway processes and extent of delays. Group differences were identified regarding inefficiencies across the continuum, with type of support a factor to investigate further. This study has uncovered critical points in the NDIS pathway that could impact discharge of participants and where collaboration and adaptive strategies could be targeted to improve processes.

IMPLICATIONS

• Ensuring the National Disability Insurance Scheme (NDIS) pathway operates effectively in the hospital setting is critical to the timely discharge of people with complex needs who require funded supports.

• Monitoring implementation of the NDIS in the health setting is important to avert interface problems that impede timely discharge and access.

     

An exploration of social & emotional factors impacting well-being in women who have sex with women (WSW)

Abstract

“Women who have sex with women” or WSW have unique perspectives within the LBGTQ spectrum. The purpose of this study included documenting perceptions, feelings, and experiences among WSW. Thirty-seven women participated in six focus groups, ages ranged from 20–64 years. Responses were transcribed and thematically coded. Four themes emerged as influencing factors: shame and fear, community, gender roles, and normalcy. Each major theme produced minor themes providing a context within major themes. Results offer valuable insights that can assist community members, health professionals, and scientists to better appraise the disparities and stigma impacting social and emotional well-being among WSW.     

Children forever: The search for origins among Chilean adults who were adopted

There has been a global increase in the number of adults who were adopted 1 1 To make the text more readable, we use the term “adult adoptee” rather than our preferred term “people who were adopted.” We prefer the latter term because it does captures our understanding that adoption is a practice and a life experience and not necessarily a permanent fixture of the identities of people who were adopted.
searching for their origins. This trend has promoted the interest of social sciences researchers, as well as carry out the obligations of states to provide specialized services. In this article, we present some results from the first qualitative study that explores the experiences of some Chilean adults who were adopted and searched for their origins in Chile through the National Service of Minor's Search for Origins Program. The narratives of the participants show that, in spite of legislative changes, a series of barriers and contradictions continue to exist, which make it difficult to guarantee the right to know one's origins. The legal and technical frameworks and practices analysed show how difficult it is to dismantle the “clean break” principle. They also highlight the persistence of the image of adoptees as “minors” who need the “protection” of their parents or professionals. We discuss the different challenges to be considered by researchers, practitioners, and policy‐makers involved in adoption policies and practices.     

Children of prisoners: exploring the impact of families' reappraisal of the role and status of the imprisoned parent on children's coping strategies

Qualitative data from a larger study on the impact of parental imprisonment in four countries found that children of prisoners face fundamentally similar psychological and social challenges. The ways that children cope, however, are influenced by the interpretative frame adopted by the adults around them, and by how issues of parental imprisonment are talked about in their families. This article argues that families have to reappraise their view of the imprisoned parent and then decide on their policy for how to deal with this publicly. Their approach may be based on openness and honesty or may emphasise privacy and secrecy, or a combination of these. Children are likely to be influenced by their parents'/carers' views, although these may cause conflict for them. Where parents/carers retain a positive view of the imprisoned parent, children are likely to benefit; where parents/carers feel issues of shame and stigma acutely, this is likely to be transmitted to their children. This is important for social workers and practitioners involved in supporting prisoners' families and for parenting programmes.     

Juggling and Dealing: The Creative Work of Care Package Purchasing

In conventional diagrams of the new service delivery process, assessment of need is linked to purchase by a single line or arrow; the implication is that purchase follows more or less logically and directly from assessment. This paper focuses on the complex creative work that goes on in the "space" between assessment of need and purchase of service, and the changing influences on that work. "Purchase" is deconstructed to reveal the complex processes and calculations involved, and the ways in which budgets "free" resources and markets influence the final outcome. The paper describes the effects on care package construction and purchase of changing policies, budget arrangements and financial limits; it goes on to outline the difficulties and complications in using information on unit costs in purchasing. Unit costs are only part of a complex equation in which prices are negotiated and total cost juggled in the context of budgets, financial limits, real accessibility and balanced by quality considerations. It is suggested that talk of "playing shops" and use of "off-the-shelf" services underestimates the complexity of care package construction and purchase. Micro-purchase of care services has more in common with dealing and juggling than with lifting standardized, packaged, pre-priced goods off shelves in Sainsbury's.     

GENDER AND HEGEMONY IN FASHION MAGAZINES:

Women's responses in the context of focus groups to fashion photographs and clothing advertisements in Vogue magazine and to a brief questionnaire eliciting their attitudes toward clothing and fashion are used to examine the nature and extent of hegemonic influences in fashion. Participants' sources of information about fashion suggest that the authority of the fashion press is limited. The magazine's conceptions of women's roles as expressed in its fashion photography fit a model of "conflicted" hegemony characteristic of American media and popular culture in general. Empowered by the cultural context of conflicted hegemony, women were generally critical of fashion photographs. Their responses to photographs were influenced by their acceptance of traditional norms of feminine demeanor but varied by age and race. They rejected the magazine's orientation toward the use of fashionable clothing for postmodernist roleplaying in favor of a modernist outlook.     

Did Australia’s Baby Bonus Increase Fertility Intentions and Births?

In May 2004, the Australian government announced a “Baby Bonus” policy, paying women an initial A$3,000 per new child. We use household panel data from the Household, Income and Labour Dynamics in Australia Survey (N = 14,932) and a simultaneous equations approach to analyze the effects of this bonus on fertility intentions and ultimately births. The results indicate that opportunity costs influence intentions and births in predictable ways. Fertility intentions rose after the announcement of the Baby Bonus, and the birth rate is estimated to have risen modestly as a result. The marginal cost to the government for an additional birth is estimated to be at least A$3,000 per new child. We use household panel data from the Household, Income and Labour Dynamics in Australia Survey (N = 14,932) and a simultaneous equations approach to analyze the effects of this bonus on fertility intentions and ultimately births. The results indicate that opportunity costs influence intentions and births in predictable ways. Fertility intentions rose after the announcement of the Baby Bonus, and the birth rate is estimated to have risen modestly as a result. The marginal cost to the government for an additional birth is estimated to be at least A126,000.