The professional role of social work in a market environment

One argument often heard in garnering support for the reorganisation of the welfare state in the Netherlands is that the safety net which it was intended to form has become something of a hammock, whereas a genuine safety net ought to act more like a trampoline. Nowadays sometimes also known as the activating welfare state, it aims to reduce apathetic response and increase the participation of its citizens in society. More and more, social workers are enlisted to help achieve these goals. Activation, however, is also associated with the introduction of a market environment in the social sector.

In 1992, the management of the social work organisation in The Hague concluded a controversial agreement with the municipal social services. Under this contract, clients referred to the social work organisation by the municipal social services would be made eligible for regular jobs on the labour market. The clients who were referred had obligations of their own: their benefits would be reduced if they did not cooperate. The social work organisation guaranteed contractually a success rate of 60% within a pre-determined period. For this ‘product’, the municipal social services paid a fixed amount of money each year.

The article describes the professional manner in which the social workers in The Hague dealt with the contract.     

Theory-Based Policy Development for HIV Prevention in Racial/Ethnic Minority Midlife and Older Women

ABSTRACT

In 2008, there were more than a million persons with HIV/AIDS in the United States. The CDC (2007) estimates that 15% of persons with HIV/AIDS are over age 50. At greater risk are women of color. Most intervention efforts have focused on intrapersonal aspects of an individual and his or her sexual-risk behaviors, with little or no attention directed toward interpersonal and socioenvironmental considerations of risk and prevention. This paper considers the limitations of current national policies relating to HIV prevention in minority populations, especially among midlife and older women of color. In particular, this paper examines risk and prevention policies in light of ecological perspectives, social capital, and dialogical theories.     

A flexible marginal modelling strategy for non-monotone missing data

Summary.  Much research has been devoted to modelling strategies for longitudinal data with missingness, recently especially within the missingness not at random context. In this paper, the relatively unexplored but practically highly relevant domain of non-monotone missingness with multivariate ordinal responses is broached. For this, a dedicated version of the multivariate Dale model is formulated. Furthermore, we also assess the sensitivity of these models to their assumptions, by using the technique of global influence.     

Characterizing persistent disturbing behavior using longitudinal and multivariate techniques

Persistent disturbing behavior (PDB) refers to a chronic condition in therapy-resistant psychiatric patients. Since these patients are highly unstable and difficult to maintain in their natural living environment and even in hospital wards, it is important to properly characterize this group. Previous studies in the Belgian province of Limburg indicated that the size of this group was larger than anticipated. Here, using a score calculated from longitudinal psychiatric registration data in 611 patients, we characterize the difference between PDB patients and a set of control patients. These differences are studied both at a given point in time, using discriminant analysis, as well as in terms of the evolution of the score over time, using longitudinal data analysis methods. Further, using clustering techniques, the group of PDB patients is split into two subgroups, characterized in terms of a number of ordinal scores. Such findings are useful from a scientific as well as from an organizational point of view.     

Testing for Full Insurance Using Exogenous Information

We strongly reject the full-insurance hypothesis, using testing variables that are not decision variables for the households under investigation. We find that households are not insured against changes in the unemployment rate associated with the household head's occupational category. Using this exogenous information, we also investigate the appropriateness of exogeneity assumptions on idiosyncratic variables that have been used as testing variables in the full-insurance literature. It is shown that several exogeneity assumptions made in the existing literature are potentially problematic.     

Essay: On spirituality and social work practice

Abstract

Gradually, developments in both psychoanalytic theory and practice have pushed the psychoanalytic therapist from a position of presumed knowing and automatic authority towards a more full, complex and parallel participation in the therapeutic process. This dethroning corresponds to the more general undermining of the expert in the postmodern critique of established knowledge and power relations. It is argued that the shift has come about within psychoanalysis by the increasingly environmentalist tilt in theory, by the ascendance of countertransference thinking, and by the demise of the natural science model for psychoanalytic theory. Some implications for practice deriving from these changes are discussed.     

The Cost Effectiveness of Hepatitis Immunization for US College Students

Abstract

Hepatitis B immunization is recommended for all American children, and hepatitis A immunization is recommended for children who live in areas with elevated disease rates. Because hepatitis A and B occur most commonly in young adults, the authors examined the cost effectiveness of college-based vaccination. They developed epidemiologic models to consider infection risks and disease progression and then compared the cost of vaccination with economic, longevity, and quality of life benefits. Immunization of 100,000 students would prevent 1,403 acute cases of hepatitis A, 929 cases of hepatitis B, and 144 cases of chronic hepatitis B. Hepatitis B vaccination would cost the health system $7,600 per quality-adjusted life year (QALY) gained but would reduce societal costs by 6%. Hepatitis A/B vaccination would cost the health system $8,500 per QALY but would reduce societal costs by 12%. Until childhood and adolescent vaccination can produce immune cohorts of young adults, college-based hepatitis immunization can reduce disease transmission in a cost-effective manner.     

Hours of Paid Work in Dual-Earner Couples: The United States in Cross-National Perspective

Abstract

In this paper we examine the hours of paid work of husbands and wives in 10 industrialized countries, using data from the Luxembourg Income Study. We present results on the average hours of paid work put in jointly by couples, on the proportion working very long weekly hours, and on gender equality in working time within families. The United States ranks at or near the top on most indicators of working time for couples, because of (1) a high proportion of dual-earner couples; (2) long average work weeks, especially among women; and (3) a high proportion of individuals who work very long hours. In terms of gender equality, the United States ranks above average in paid working time among dual-earner couples with no children but fares less well among working parents. Finally, we discuss policies and institutions that may help explain the distinctive United States results, namely the long hours and moderate levels of gender equality, including the regulation of maximum hours, the demand for part-time work, and the public provision of child care.     

Towards Measurable and Auditable Efficiency Gains in the Flemish Public Sector

This article supports the Flemish Government’s efforts to improve the efficiency in the public sector, but points out that efficiency has to be considered in the broader context of a well-performing and well-functioning public sector. After describing the main motives for efficiency improvement, the article provides some insights into the concept of public sector efficiency gains. Within the discussion of their required characteristics, we focus mainly on the measurability and auditability conditions. We employ a phased approach for the measurement process of efficiency gains, going from the identification of potential savings to the reporting of the actual achieved results.