Complex home care: challenges arising from the blurring of boundaries between family and professional care

Over the last 50 years, increasingly complex care (such as tracheostomy management, dialysis or enteral feeding) has shifted from hospital to home, with a concomitant rise in patient self-management and care given by family members. Recognition of the importance of the contribution of family care to the health system is also growing. This article reports the findings of a New Zealand study which explored the experiences of family carers who manage technical health procedures at home. It then draws attention to some broader issues raised by shifting complex care from professional management in hospital settings to family care at home, namely the ways in which complex home care blurs the boundaries between professional and family care (creating the ambiguous position of the expert carer) and questions of safety and responsibility in family care. We also discuss the implications for policy around family caregiving in New Zealand. Given the potential physical and mental health impacts of caring, it is time for renewed consideration of what family carers should be expected or allowed to manage and how the health system can support them in their important role.     

Strength matters: Tie strength as a causal driver of networks’ information benefits

Studies of social networks have often taken the existence of a social tie as a proxy for the transmission of information. However, other studies of social networks in the labor market propose that the likelihood of information transmission might depend on strength of the tie; and that tie strength is a potentially important source of the tie's value. After all, even if job seekers have social ties to those who have valuable job information, the seekers will gain little information benefit when the ties do not actually transmit the information. This paper clarifies the conditions under which social ties might provide information benefits. We use a survey vignette experiment and ask MBA students about their likelihood of relaying job information via strong ties (to friends) or weak ties (to acquaintances), holding constant the structural locations spanned by the tie and job seekers' fit with the job. The results support the claim that strength of tie has a causal effect on the chances of information transmission: potential referrers are more likely to relay job information to their friends than to acquaintances. The larger implication of these findings is that whatever benefits there might be to using weak ties to reach distant non-redundant information during job search, these benefits need to be considered against the likely fact that people connected via weak ties are less likely to actually share information about job opportunities than are people to whom the job seeker is strongly tied.     

The Conversational Model and Child and Family Counselling: Treating Chronic Complex Trauma in a Systemic Framework

Child and Family Counselling Teams in NSW Community Health Services are expected to provide therapeutic services to children who have experienced complex trauma. However, parental trauma is often overlooked or referred elsewhere. A systemic perspective informed by attachment theory and trauma theory provides the basis for addressing parental trauma in Child and Family Counselling Teams, thereby improving parenting. The Conversational Model is an evidence‐based intervention for chronic complex trauma. The foundations of the Conversational Model and its brief component, Short Term Intensive Psychodynamic Psychotherapy, are outlined and a case study is given to illustrate the usefulness of the intervention in Child and Family Counselling. Highlighted is the importance of addressing systemic trauma through parenting to improve attachment quality, family relationships, and children's function.     

Reconsidering “community liberated”: How class and the national context shape personal support networks

The “community liberated” thesis has been influential in describing contemporary social support systems. Specifically, “community liberated” argues that people do not seek support in their immediate neighborhood but rather entertain a network of far-flung ties to support-providing alters. This paper uses personal network data from six countries – Australia, Germany, the US, Austria, Hungary and Italy – to evaluate this argument and shows that the degree of liberation of one's community is strongly linked to one's socioeconomic status – specifically, one's education level. Additionally, we describe strong country-level heterogeneity in the spatial dynamics of personal support networks and find national contexts to be moderating the effect of education on community liberation, especially in Italy and Hungary, thus suggesting network geographic dispersion to be linked to national economic structures and labor markets. The paper thus elucidates the effect of two different, yet related social contexts on personal networks: the class context and the national context.     

The association between social support networks and maternal employment: a comparison of western German,eastern German,and migrant mothers of preschool-aged children

A lack of adequate childcare can delay mothers’ return to the labor market after childbirth. This paper examines whether social support with childcare by kin and friends facilitates maternal employment in the first 72 months after childbirth. Using data from the German Socio-Economic Panel (SOEP) 1993–2009, a comparison of natives (n?=?1409) and migrants (n?=?411) in corporative-conservative western Germany with mothers in former socialist eastern Germany (n?=?528) shows that kinship support is positively associated with maternal employment when public childcare is limited. Western German and migrant mothers return to work sooner if they are surrounded by kin. But kin do not provide support for maternal employment in eastern Germany, where public childcare is more easily accessible and continuous female employment is a prevalent social norm. Friendship networks, by contrast, are most valuable for maternal employment if they complement public childcare.     

What is gained and what is left to be done when content analysis is added to network analysis in the study of a social movement: Twitter use during Gezi Park

As social movements relying on the weak ties found in social networks have spread around the world, researchers have taken several approaches to understanding how networks function in such instances as the Arab Spring. While social scientists have primarily relied on survey or content analysis methodology, network scientists have used social network analysis. This research combines content analysis with the automated techniques of network analysis to determine the roles played by those using Twitter to communicate during the Turkish Gezi Park uprising. Based on a network analysis of nearly 2.4 million tweets and a content analysis of a subset of 5126 of those tweets, we found that information sharing was by far the most common use of the tweets and retweets, while tweets that indicated leadership of the movement constituted a small percentage of the overall number of tweets. Using automated techniques, we experimented with coded variables from content analysis to compute the most discriminative tokens and to predict values for each variable using only textual information. We achieved 0.61 precision on identifying types of shared information. Our results on detecting the position of user in the protest and purpose of the tweets achieved 0.42 and 0.33 precision, respectively, illustrating the necessity of user cooperation and the shortcomings of automated techniques. Based on annotated values of user tweets, we computed similarities between users considering their information production and consumption. User similarities are used to compute clusters of individuals with similar behaviors, and we interpreted average activities for those groups.     

Family Formation and Close Social Ties Within Religious Congregations

The study of family and religion has yet to elaborate on the social ties that connect these two important and changing institutions. Specifically, how does family formation (i.e., marriage and childrearing) impact social ties to religious communities? Using longitudinal data from the Portraits of American Life Study (2006–2012) and fixed effects regression models that control for time‐stable heterogeneity (N = 1,314), this study tests the effects of marriage and childrearing on changes in close congregational social ties. Fixed effects estimates suggest that marriage actually decreases close social ties to religious congregations, whereas rearing children within marital unions increases them. Thus, it is children, not marriage per se, that actually integrates married couples into religious communities. These contrasting effects tend to be the strongest among young adults, but they weaken with age as well as marital duration.     

Impact of support networks for breastfeeding: A multicentre study

Background

The rates of breastfeeding worldwide are slowly improving since 1996. Europe is still trailing behind the global breastfeeding incidence and prevalence rates. Thus, breastfeeding promotion, protection, prolongation and support have become an important challenge as breastfeeding sharply decreases in the first six months of life.

Disaster response on September 11, 2001 through the lens of statistical network analysis

The rescue and relief operations triggered by the September 11, 2001 attacks on the World Trade Center in New York City demanded collaboration among hundreds of organisations. To shed light on the response to the September 11, 2001 attacks and help to plan and prepare the response to future disasters, we study the inter-organisational network that emerged in response to the attacks. Studying the inter-organisational network can help to shed light on (1) whether some organisations dominated the inter-organisational network and facilitated communication and coordination of the disaster response; (2) whether the dominating organisations were supposed to coordinate disaster response or emerged as coordinators in the wake of the disaster; and (3) the degree of network redundancy and sensitivity of the inter-organisational network to disturbances following the initial disaster. We introduce a Bayesian framework which can answer the substantive questions of interest while being as simple and parsimonious as possible. The framework allows organisations to have varying propensities to collaborate, while taking covariates into account, and allows to assess whether the inter-organisational network had network redundancy—in the form of transitivity—by using a test which may be regarded as a Bayesian score test. We discuss implications in terms of disaster management.     

Norms,status and the dynamics of advice networks: A case study

The issue of the influence of norms on behavior is as old as sociology itself. This paper explores the effect of normative homophily (i.e. “sharing the same normative choices”) on the evolution of the advice network among lay judges in a courthouse. 0020 and 0025 social exchange theory suggests that members select advisors based on the status of the advisor. Additional research shows that members of an organization use similarities with others in ascribed, achieved or inherited characteristics, as well as other kinds of ties, to mitigate the potentially negative effects of this strong status rule. We elaborate and test these theories using data on advisor choice in the Commercial Court of Paris. We use a jurisprudential case about unfair competition (material and “moral” damages), a case that we submitted to all the judges of this court, to test the effect of normative homophily on the selection of advisors, controlling for status effects. Normative homophily is measured by the extent to which two judges are equally “punitive” in awarding damages to plaintiffs. Statistical analyses combine longitudinal advice network data collected among the judges with their normative dispositions. Contrary to what could be expected from conventional sociological theories, we find no pure effect of normative homophily on the choice of advisors. In this case, therefore, sharing the same norms and values does not have, by itself, a mitigating effect and does not contribute to the evolution of the network. We argue that status effects, conformity and alignments on positions of opinion leaders in controversies still provide the best insights into the relationship between norms, structure and behavior.