EFFECTS OF A FAMILY-ORIENTED TRAINING EXPERIENCE ON THE ROLE OF THE PHYSICAL THERAPIST

This article describes ways in which a family-oriented psychologist contributed to a reconceptualization of the appropriate role for the physical therapist in patient care. The article identifies aspects of the changing role of the physical therapist, specifically its expansion to include skilled psychosocial interaction with patient and family for the purposes of reassurance, support and instruction. A primary shift involved changing from focus on the individual and his or her disability to focus on the patient in the context of his or her family. The article briefly describes elements of appropriate psychological training which can be incorporated successfully in a physical therapy educational experience, and concludes with a case example illustrating the basic points relevant to this type of interdisciplinary collaboration.     

Social and health‐care priorities of local politicians in Finland: do the attitudes of politicians reflect the actual processes in municipalities?

The aim of this study was to find out whether elected politicians' attitudes influence policy-making processes in terms of social and health-care resource allocation. A preliminary hypothesis was developed on the basis of previous empirical findings on the attitudes of politicians. If health-care costs decreased during the period 1993–1999, then secondary care costs should have increased and vice versa; if the total amount of resources increased, then secondary care must have been allocated fewer resources. However, the results of this study showed that the actual resource-allocation processes did not reflect the attitudes of local politicians. Expenditure on secondary health care increased during this period, while primary health-care services were allocated fewer resources. Analysing the actual decision-making processes rather than investigating attitudes to priority setting may prove more useful in gaining a better understanding of priority-setting processes and the mechanisms used in different contexts.     

“Walking the Tightrope:” Clinical Social Workers’ Use of Diagnostic and Environmental Perspectives

The purpose of this study was to understand how clinical social workers think about and utilize two distinct worldviews: the psychiatric perspective of DSM diagnosis (Diagnostic and Statistical Manual of Mental Disorders) and the contextual person-in environment perspective. The former is a requirement for service and reimbursement in nearly every clinical setting, while the latter has always been the hallmark of a distinctively “social work” approach. Although there have been quantitative surveys of social workers’ use of the DSM, this is the first qualitative study to examine how social workers actually navigate these two worldviews. Thirty clinical social workers took part in individual interviews, and their responses were analyzed thematically using HyperRESEARCH, a qualitative data management program. Findings reveal an array of ethical and practical issues, including the central “tightrope” of balancing the need to “ramp up” problem formulation in order to access service with the desire to “damp down” in order to minimize stigma and avoid pathologizing problems in living. Implications are addressed for social work practice, policy, and education.     

Why me? The frog-pond effect,relative deprivation and individual outcomes in the face of budget cuts

Conservation of resources (COR) theory proposes that both individual characteristics and environmental factors predict stress reactions, but does not consider interactions between individual variables and the immediate social context. Using theories regarding the frog-pond effect, which relates to how an individual perceives themselves in relation to that of those around them, and relative deprivation, we tested the hypothesis that employees who were personally more affected by a potential stressor, yet were in an organizational unit less affected by that stressor, would report more negative outcomes than employees who were subjected to the same stress but were in more affected units. Utilizing multilevel modelling and departmental- and individual-level data from a university experiencing severe budget cuts, it was found that both individual perceived budget cut impacts and departmental impacts were related to less job satisfaction, reduced affective commitment, greater perceptions of psychological contract breach and increased turnover intentions, supporting COR theory. Interestingly, as predicted by the frog-pond effect and relative deprivation theory, affected academic staff within departments that were less affected by the cuts had more negative responses than equally impacted individuals in more affected departments. We concluded that the frog-pond effect is relevant to work stress research and practice.     

Stereological Modelling of Random Particles

Stochastic models for three-dimensional particles have many applications in applied sciences. Lévy–based particle models are a flexible approach to particle modelling. The structure of the random particles is given by a kernel smoothing of a Lévy basis. The models are easy to simulate but statistical inference procedures have not yet received much attention in the literature. The kernel is not always identifiable and we suggest one approach to remedy this problem. We propose a method to draw inference about the kernel from data often used in local stereology and study the performance of our approach in a simulation study.     

Longitudinal assessment of the impact of multiple switches between a biosimilar and its reference product on efficacy parameters

Patients, physicians, and health care providers in Europe have more than 10 years of experience with biosimilars. However, there are still debates if switching between a biosimilar and its reference product influences the efficacy of the treatment. In this paper, we address this uncertainty by developing a formal statistical test that can be used for showing that switching has no negative impact on the efficacy of biosimilars. For that, we first introduce a linear mixed‐effects model that is used for defining the null hypothesis (switching influences the efficacy) and the alternative hypothesis (switching has no influence on the efficacy). Using this as the foundation of our work, we propose several approaches for testing for changes in the efficacy of the treatment due to switching and discuss the properties of these tests in an extensive simulation study. It is shown that all these methods have advantages and disadvantages and the decision regarding which method is preferred depends on the expectation of a switching assessment. To demonstrate the applicability of the methods in practice, the approaches were applied to the data of the EGALITY study, which compares the reference product Enbrel® (Amgen) with the approved biosimilar Erelzi® (Sandoz).     

Occupational shifts across sex-type boundaries in the Swedish labour market

This study examines sex differences in employees’ patterns of mobility between occupations of different sex proportions between 2002 and 2003 and how occupational sex segregation in Sweden is influenced by employees’ occupational shifts. The empirical analysis is based on large-scale and nationwide data sets with a panel design. The results show that employees’ occupational shifts strengthen sex segregation across occupations, especially female ones. Moreover, when we compare employees who in 2002 were in occupations with a given sex proportion, employees shift towards more sex-typical occupations relative to employees of the opposite sex, and this is particularly true for women and older employees. The analysis also shows that whereas the outflow from occupations of certain sex proportions is sex-biased, the sex composition of the inflow of other employees is mostly equal in magnitude to the outflow, partly explaining why the level of overall occupational sex segregation remains almost unchanged between these 2 years.     

Does past life matter? Social workers' views on biographical approaches

The article discusses the application of biographical approaches in social work practice and aims to identify issues that may need to be taken into account when implementing these approaches. The essays of 16 Finnish social workers, working in psychiatry, addiction treatment, rehabilitation, gerontology, pre-adoption counselling and vocational education, were analyzed regarding the respondents’ views on the benefits of biographical approaches, especially biographical interviewing (BI). Qualitative content analysis was used. The results indicate that biographical approaches can create a space for user reflection and social worker listening as well as provide a better understanding of service users’ situation. However, concerns regarding limitations of the approach, ethics and necessary professional competencies were raised. The conclusions drawn are that social work practice can benefit from BI done with awareness and ethical sensitivity and that ‘biographical lenses’ as a metaphor for a general attitude can be applied in most practice situations. The paper draws on a wider literature on biographical approaches in the social sciences.     

Children Exposed to Intimate Partner Violence Describe Their Experiences: A Typology-Based Qualitative Analysis

Although much is known about the impact of intimate partner violence on children, few empirical studies have linked children’s experiences to typologies. This qualitative study, based on interviews with children 8–12 years of age living at women’s shelters in Sweden, explores how children describe the nature of the violence they have been exposed to with the aim of identifying patterns in the children’s experiences. The typologies developed by Johnson and colleagues and by Holtzworth-Munroe and colleagues are used as an analytical framework for analysis. Three main types of children’s experiences of intimate partner violence were identified: “Obedience-Demanding Violence,” “Chronic and Mean Violence,” and “Parenthood-Embedded Violence.” These the types can improve our understanding of the complex variety of children’s experiences of parental IPV by acknowledging how from children’s perspectives, experiences of IPV are closely connected to the perpetrator being their parent. The study provides examples of three different strategies that have implications for the factors that social workers may want to address when making judgments about custody, place of residence, and contact.