Continuity of Mental Health Care Across Military Transitions

Multiple deployments, a prominent characteristic of operations Enduring Freedom, Iraqi Freedom, and New Dawn, have been linked to increased risk for various mental health conditions. It is also well known that military transitions, such as a change of duty station or discharge, are an inevitable part of military life. While military transitions can be stressful for any service member or veteran, those with mental health conditions face additional challenges. Transition stress can exacerbate a mental health condition that in turn hinders ability to manage the transition, resulting in a cycle of stress. As a result, those receiving mental health care while transitioning often experience difficulty continuing treatment post-transition. This article describes a unique and innovative transition coaching program designed to address this emerging issue.     

Affective practices,care and bioscience: a study of two laboratories

Scientific knowledge‐making is not just a matter of experiments, modelling and fieldwork. It also involves affective, embodied and material practices (Wetherell, 2012) which can be understood together as ‘matters of care’ (Puig de la Bellacasa, 2011). In this paper we explore how affect spans and connects material, subjective and organizational practices, focusing in particular on the patterns of care we encountered in an observational study of two bioscience laboratories. We explore the preferred emotional subjectivities of each lab and their relation to material practice. We go on to consider flows and clots in the circulation of affect and their relation to care through an exploration of belonging and humour in the labs. We show how being a successful scientist or group of researchers involves a careful choreography of affect in relation to materials, colleagues and others to produce scientific results, subjects and workplaces. We end by considering how thinking with care troubles dominant constructions of scientific practice, successful scientific selves and collectives.     

The embeddedness of organizational performance: Multiple Membership Multiple Classification Models for the analysis of multilevel networks

We present a Multiple Membership Multiple Classification (MMMC) model for analysing variation in the performance of organizational sub-units embedded in a multilevel network. The model postulates that the performance of organizational sub-units varies across network levels defined in terms of: (i) direct relations between organizational sub-units; (ii) relations between organizations containing the sub-units, and (iii) cross-level relations between sub-units and organizations. We demonstrate the empirical merits of the model in an analysis of inter-hospital patient mobility within a regional community of health care organizations. In the empirical case study we develop, organizational sub-units are departments of emergency medicine (EDs) located within hospitals (organizations). Networks within and across levels are delineated in terms of patient transfer relations between EDs (lower-level, emergency transfers), hospitals (higher-level, elective transfers), and between EDs and hospitals (cross-level, non-emergency transfers). Our main analytical objective is to examine the association of these interdependent and partially nested levels of action with variation in waiting time among EDs – one of the most commonly adopted and accepted measures of ED performance. We find evidence that variation in ED waiting time is associated with various components of the multilevel network in which the EDs are embedded. Before allowing for various characteristics of EDs and the hospitals in which they are located, we find, for the null models, that most of the network variation is at the hospital level. After adding these characteristics to the model, we find that hospital capacity and ED uncertainty are significantly associated with ED waiting time. We also find that the overall variation in ED waiting time is reduced to less than a half of its estimated value from the null models, and that a greater share of the residual network variation for these models is at the ED level and cross level, rather than the hospital level. This suggests that the covariates explain some of the network variation, and shift the relative share of residual variation away from hospital networks. We discuss further extensions to the model for more general analyses of multilevel network dependencies in variables of interest for the lower level nodes of these social structures.     

Specialization and the Survival of Self‐Help Organizations

This article examines the survival rates of 589 self‐help organizations in order to understand how self‐help niches, organizations specializing in biomedical, human services, and behavioral health, differentially impact longevity. Drawing on a study of the self‐help movement, we examine how the various mechanisms by which specialization impacts self‐help movement organizations' chances of survival. Extending the concepts of embeddedness, countervailing powers, and organizational specialization to self‐help organizations, we investigate how formal structures and professional alliances differentially promote longevity. Results show how formalization enhances self‐help organizations' longevity, and serves as a mechanism by which specialization impacts organizational viability. While formalization has a robust and beneficial impact on longevity, some professional linkages are negatively associated with survival and others are positively associated with it.     

Hesitant Madams in a Global City: Japanese Expat Wives and their Global Householding in Hong Kong

Care work, once a sanctioned labor of love, is increasingly commodified in transnational contexts. The picture of migrant women shouldering the housework and child care of local professonal women may seem like a mutually beneficial arrangement—matching the “needs” of the haves and have-nots—, but the global care chain ultimately works to maintain the traditional gendered division of labor as well as global inequality. To this trend of globalization of care work, Japan has been an exception; however, how much longer it will be so is now in a question, as the government paves the way for importing domestic labor from abroad. This article focuses on Japanese expat wives in Hong Kong in order to locate Japanese women vis-à-vis the global care chain. The narrative analysis on how they decide whether to hire a domestic worker in their home away from home highlights the sociopolitical nature of their supposedly private choices. Some drew on cultural ideal of wifehood and motherhood to rationalize their choice while others referred to racialized or even overtly racist and classist images of foreign domestic workers. A few women spoke against the system itself, showing awareness of its inherent social injustice. All such narratives are never purely personal; their decisions and the rationalization behind them sustain the prevailing discourses of gender, race, ethnicity, culture, and class, which, in turn, envelop their attempts at global householding.     

Making Sense of After‐School Care Dilemmas in Mothers' Stories of After‐School Care in Finland and Sweden

The study focuses on dilemmas in storied experiences of everyday after‐school care arrangements among Swedish and Finnish mothers. Finland and Sweden, which share a history of strong labour market attachment among women, arrange institutional after‐school care in similar ways. The data consist of interviews with three Swedish and six Finnish mothers. A positioning analysis of four stories shows how decisions related to children's after‐school hours were allocated among different actors. Two reoccurring dilemmas, Competent‐dependent child stories and Unburdened‐deficient mother stories, emerged from the data analysis as related to prevailing moral discourses on childhood and motherhood.     

Learning from Japanese Experience in Aged Care Policy

Like Singapore, Japan is projected to age rapidly. Japan is the first country in the world where more than 20% of the total population is over 65. Even as Japan adapts from western Europe and America where population ageing is more advanced up till now, it has been pioneering its own aged care policy, given the differences in sociocultural and political contexts. Of particular interest is its introduction of long-term care insurance and its effectiveness in meeting the needs of the long-term care of the aged and their family caregivers. In this article I seek to compare and contrast Singapore and Japan in terms of their demographic changes leading to rapid ageing, and their respective policy and program responses to a rapidly ageing population, drawing lessons from the Japanese experience.     

The physical restraint of young people

Children and young people who are in residential care sometimes behave aggressively towards themselves and others, and they may need to be physically restrained by staff. This paper describes a small-scale study which examines the use of physical restraint in one Scottish region. It explores the circumstances surrounding the restraint and the feelings of staff about the use of the restraint. The study shows that many of the factors that have been shown to be associated with violence and aggression were present in the incidents described.     

Using complexity theory in kinship practice

This reflective discussion draws on data from a collaborative enquiry into kinship or family and friends practice. It introduces perspectives from complexity and chaos theory as a way of re‐examining the challenges of kinship practice. The discussion highlights the enduring challenges for practitioners, not least, managing anxiety and uncertainty, sustaining continuity and containment, becoming experienced and taking account of the complex developmental needs of the children and their families. The discussion particularly raises questions about appropriate settings for practitioners to undertake such a demanding area of child and family social work.