Breakdown of teenage placements in Danish out‐of‐home care

This study deals with the problem of breakdown in out‐of‐home placements for Danish teenagers. How often are these placements prematurely terminated against the requests and intentions of the child welfare authorities? Which factors seem to increase and decrease placement breakdown? The sample consists of 225 youths and 367 placements during the years 2004–2008. Among the 225 youths, 44% experienced a breakdown, and 33% of the 367 placements ended with a breakdown. A large proportion of the placement breakdowns (20%) occurred before 4 months, and within the first year, 62% of the placement breakdowns had taken place. Replacements took place in 61% of all placement breakdowns. The analysis showed that type of placement and number of youth at the same placement had significant association to placement breakdown, but variables based on the social worker's clinical assessment showed no association to breakdown. However, while the logistic regression model was significant, it explained only 6% of the variance. Earlier studies have indicated that breakdown is a substantial problem of child welfare in several other western countries, Denmark is no exception. These corresponding breakdown rates point out that no child welfare system yet have found a method to reduce breakdown substantially.     

Theory and social practice of agency in combining breastfeeding and employment: A qualitative study among health workers in New Delhi,India

BackgroundWomen's agency, or intentional actions, in combining breastfeeding and employment is significant for health and labour productivity. Previous research in India showed that mothers use various collaborative strategies to ensure a “good enough” combination of breastfeeding and employment. Bandura's theoretical agency constructs previously applied in various realms could facilitate the exploration of agency in an Indian context.AimTo explore manifestations of agency in combining breastfeeding and employment amongst Indian health workers using Bandura's theoretical constructs of agency and women's experiences.MethodsQualitative semi-structured interviews were conducted with ten women employees within the governmental health sector in New Delhi, India. Both deductive and inductive qualitative content analyses were used.FindingsBandura's features and modes of agency revealed that intentionality is underpinned by knowledge, forethought means being prepared, self-reactiveness includes collaboration and that self-reflectiveness gives perspective. Women's interviews revealed four approaches to agency entitled: ‘All within my stride or the knowledgeable navigator’; ‘Much harder than expected, but ok overall’; This is a very lonely job’; and ‘Out of my control’.ConclusionsAgency features and their elements are complex, dynamic and involve family members. Bandura's theoretical agency constructs are partially useful in this context, but additional social practice constructs of family structure and relationship quality are needed for better correspondence with women's experiences of agency. The variation in individual approaches to agency has implications for supportive health and workplace services.     

Gay Community Involvement: Its Interrelationships and Associations With Internet Use and HIV Risk Behaviors in Swedish Men Who Have Sex With Men

We measured aspects of “community involvement” chosen for men who have sex with men (MSM) in Sweden (gay places, media accessed, Internet, gay festivals, and social engagement, measured as proportion of gay friends) in two Swedish Internet-based samples from 2006 (n?=?3,202) and 2008 (n?=?4,715). Data showed low to moderate reliability with a moderate (0.57) alpha coefficient. While there is moderate internal consistency, as might be anticipated from measures of actual community involvement, they can be treated as scales. The Internet scale indicated the lowest reliability, perhaps due to respondents having Internet sites of primary choice, rather than a high level of usage across several sites. A hypothesized lack of correlation between traditional domains of the gay community and the Internet did not appear: correlations between the Internet measure and the other measures were positive and significant, but among the lowest correlations obtained between the community measures, ranging from 0.06 to 0.24. Those who use the Internet extensively are less likely to be involved in other aspects of the community. Sexual risk was associated with high social engagement at sexual meeting sites and with Internet use. Gay community involvement, including the Internet community, may be complex and associated with both increase in HIV sexual risk behaviors (by measuring use of sexual risk sites) and preventive measures (HIV testing).     

An evaluation paradox in social work? An empirical study of evaluation use in connection with temporary programmes in Swedish social work

This article contributes to the debate on evaluation use by analysing temporary national programmes in Swedish social work. Previous empirical research shows a gloomy picture of evaluation use, thus supporting an evaluation paradox: evaluations are not used for learning and development, but are continually prioritised. The aim of this article is to study, through interviews and document analysis, how evaluations of temporary programmes in social work are designed and used. The results support the paradox and we found that it has two dimensions. First, evaluations are prioritised, but they function as a ritual, characterised by routine and unclear intentions, with limited relevance for professional learning and improvement. The second dimension is about limited use by those commissioning the evaluations, but the evaluators are using data for new purposes and in new contexts. This is, at best, a form of conceptual use, hopefully contributing indirectly to social work practice. The article ends in a discussion on how evaluations could be designed for learning and improvement by focusing on three normative models: utilisation-focused evaluation, responsive evaluation and evidence-based practice approach (EBP).     

Modelling and simulation to improve decision‐making in clinical development

Modelling and simulation are buzz words in clinical drug development. But is clinical trial simulation (CTS) really a revolutionary technique? There is not much more to CTS than applying standard methods of modelling, statistics and decision theory. However, doing this in a systematic way can mean a significant improvement in pharmaceutical research. This paper describes in simple examples how modelling could be used in clinical development. Four steps are identified: gathering relevant information about a drug and the disease; building a mathematical model; predicting the results of potential future trials; and optimizing clinical trials and the entire clinical programme. We discuss these steps and give a number of examples of model components, demonstrating that relatively unsophisticated models may also prove useful. We stress that modelling and simulation are decision tools and point out the benefits of integrating them with decision analysis. Copyright © 2005 John Wiley & Sons, Ltd.     

Happiness and Satisfaction with Work Commute

Research suggests that for many people happiness is being able to make the routines of everyday life work, such that positive feelings dominate over negative feelings resulting from daily hassles. In line with this, a survey of work commuters in the three largest urban areas of Sweden show that satisfaction with the work commute contributes to overall happiness. It is also found that feelings during the commutes are predominantly positive or neutral. Possible explanatory factors include desirable physical exercise from walking and biking, as well as that short commutes provide a buffer between the work and private spheres. For longer work commutes, social and entertainment activities either increase positive affects or counteract stress and boredom. Satisfaction with being employed in a recession may also spill over to positive experiences of work commutes.     

Sense of coherence: definition and explanation

The present study is one of a few that have used 'sense of coherence' (SOC) as a dependent variable in an explanatory model. After studying three different samples – 680 students, 180 parents and 315 couples – we conclude that family relational and psychopathological variables contribute significantly to the explanation of SOC (explained variance between 10–27 and 26–50 per cent). In total, we obtained an explained variance of between 42 and 64 per cent. This leads us to the conclusion that in all three samples, SOC is multifaceted and thereby is more than simply an opposite state to depression. Context may play an important part in the explanation of SOC.     

Factor structure of the Mini-Maternal Behavior Q-Sort and associations with infant attachment: Informing precision in research and intervention

We examined the factor structure of parental sensitivity to infants as assessed by the Mini-Maternal Behavior Q-Sort (Mini-MBQS), a 25-item short-form of the original 90-item MBQS. We aimed to: (1) identify latent factors of the Mini-MBQS; and (2) validate each factor by testing associations with infant attachment classifications. Data on parent-infant dyads (n = 313; 222 mothers with 281 children, 29 fathers with 32 children) were drawn from a three-generation Australian cohort study. Exploratory Factor Analysis and Exploratory Structural Equation Modelling examined the structure of the Mini-MBQS. Two latent Mini-MBQS factors were identified, requiring 8 of 25 original items: (1) Attention and Responsiveness and (2) Contingency in Interactions. Infants with insecure attachment classifications had parents with lower sensitivity across both factors relative to infants classified secure. In particular, infants with resistant attachment classifications had parents with notably low Contingency in Interactions scores. Infants with disorganised attachment classifications had parents with the lowest relative sensitivity across both factors, and in these dyads Attention and Responsiveness scores were especially low. Results provide an empirically derived factor structure for the Mini-MBQS. Two subscales, each with significant infant attachment associations, may improve precision in clinical intervention and research translation.