Clinical social work education in palliative and end-of-life care: relational approaches for advanced practitioners

This paper describes the first post-Master's program in the US in end-of-life care for social workers. Developed at the Smith College School for Social Work, this program used innovative relational methods in student recruitment, curricular design, supervision, and leadership development, based upon input from the faculty, students, and field supervisors. Collaborations emerged with funders, agencies, and programs nationally. The program was based on a pedagogical stance that clinical work with dying people requires the capacity to be fully present- in individual, group, and family work; in interdisciplinary meetings; and in advocating for quality and equity of care-while attending to diverse and at-risk populations. Students deepened their clinical skills and took leadership in the field of end-of-life care.     

The existence of waiting time moments for single server queues with mixed renewal and poisson inputs

The following queuing system is considered: Two independent recurrent input streams (streams 1 and 2) arrive at a server. It is assumed that stream 1 is of Poisson type. Three priority disciplines are studied in case that customers of type 1 have priority: head-of-the-line, preemptive-resume, and preemptive-repeat discipline. For all three cases, the limiting distribution function of actual waiting times of low-priority customers is considered, and conditions are given for the existence of moments related to these limiting distributions.     

Insight into Informant Discrepancies Regarding Psychosexual Functioning of Adolescents with and without Autism Spectrum Disorder

The private nature of psychosexual functioning leads adolescents and their parents to have different perspectives, which highlights studying parent–child informant discrepancies in this domain. We investigated informant discrepancy in psychosexual functioning, using the self‐report and parent report versions of the Teen Transition Inventory (TTI), of adolescents with autism spectrum disorder (ASD; 136 parent–child dyads) compared to adolescents from the general population (GP; 70 parent–child dyads). Significantly larger informant discrepancies exist in ASD dyads than GP dyads in most domains of psychosexual functioning, except for Body image, Sexual behavior, and Confidence in the future. It is important to use and pay attention to both informants, as discrepancies are relevant for both research and clinical practice regarding psychosexual functioning.     

Implementing the Power to Kids programme in home-based (foster) care: Identifying the SAFETY approach

Sexual abuse and dating violence are chronic problems for children and young people in out-of-home care. This study explored the impact of a prevention and response programme Power to Kids, which targets harmful sexual behaviour (HSB), child sexual exploitation (CSE) and dating violence (DV) for children and young people in home-based (foster) care. Twenty-eight case managers, 25 foster carers and 13 children and young people participated in a mixed methods study in Victoria, Australia informed by the research question: How does the Power to Kids programme impact the sexual health and safety of children and young people in home-based (foster) care? The data analysis revealed a SAFETY approach whereby the sexual health and safety knowledge of carers and case managers was enhanced, and carers were given permission to have Brave Conversations with children and young people, who could then apply the new knowledge to their lives. Case managers were upskilled in identifying indicators of sexual abuse and empowered to escalate stalled therapeutic and disruption practice when children and young people were identified as experiencing HSB, CSE or DV.     

Eliciting expert judgements about a set of proportions

Eliciting expert knowledge about several uncertain quantities is a complex task when those quantities exhibit associations. A well-known example of such a problem is eliciting knowledge about a set of uncertain proportions which must sum to 1. The usual approach is to assume that the expert's knowledge can be adequately represented by a Dirichlet distribution, since this is by far the simplest multivariate distribution that is appropriate for such a set of proportions. It is also the most convenient, particularly when the expert's prior knowledge is to be combined with a multinomial sample since then the Dirichlet is the conjugate prior family. Several methods have been described in the literature for eliciting beliefs in the form of a Dirichlet distribution, which typically involve eliciting from the expert enough judgements to identify uniquely the Dirichlet hyperparameters. We describe here a new method which employs the device of over-fitting, i.e. eliciting more than the minimal number of judgements, in order to (a) produce a more carefully considered Dirichlet distribution and (b) ensure that the Dirichlet distribution is indeed a reasonable fit to the expert's knowledge. The method has been implemented in a software extension of the Sheffield elicitation framework (SHELF) to facilitate the multivariate elicitation process.     

Hitting the target without missing the point: New Zealand’s immunisation health target for two year olds

ABSTRACT

The use of health targets as a form of performance measurement has become more prominent internationally as governments have sought to control public expenditure, produce greater efficiency and improve accountability. However, health targets have faced criticism for their potential to produce negative outcomes within a health system. This paper examines how a health target was used as a policy instrument within the New Zealand health system to improve immunisation coverage at two years of age. It explores how the immunisation health target was implemented within four case study sites and discusses the effectiveness of the health target as a policy instrument for improving immunisation coverage and addressing persistent immunisation inequities. Measuring and monitoring performance towards the immunisation health target improved accountability for immunisation coverage within the New Zealand health system and focused attention on improving immunisation coverage in a way that previous policy attempts had failed to do. Health targets may be an effective policy instrument for creating change within specific areas of a health system if their potential for dysfunctional consequences are taken into consideration at the outset.     

The same and the other: male childcare workers managing identity dissonance

As childcare workers, men are in a contested position. On the one hand, they are in danger of being depicted as the pedophile; on the other hand, they are expected to bring something new and innovative to the thus-far female-dominated field. These men are experiencing ‘identity dissonance’ and have to find ways to manage and facilitate legitimate subject positions as both childcare workers and as men. Applying a perspective of discursive positioning, this article discusses men's positioning practices in nine qualitative interviews conducted with male childcare workers in German-speaking Switzerland. We identified a total of six discursive practices that men engage in to manage identity dissonance and construct a legitimate subject position. We found that men are engaging in a greater variety of practices than have been discussed so far. Unlike findings from other studies of men in female-dominated occupations, ours do not point to a clear-cut typology with regards to hegemonic and alternative masculinities; instead they show a variety of practices that are mobilized throughout all interviews.