Rights discourses in relation to education of people with intellectual disability: towards an ethics of care that enables participation

In this paper we argue that human rights approaches for intellectually disabled people have failed to recognise the complexity of rights claims made by and on behalf of this group. Drawing on a research project into discourses of education for intellectually disabled people in the Eastern Cape, South Africa we discern three rights discourses; namely, rights to full participation, rights to special services and rights to protection. These draw off a social model, a medical model and a protective model, respectively. We note that these discourses may be set up in contestation with each other. However, we argue that they can be seen as complementary if viewed within an ethics of care that enables participation. Within this conceptualisation, participation is viewed within relations of care but is subject to a critique that examines the role of context and disciplinary power in constructing dependency.     

Kinship Care and Transnational Parenting: The Intersection of Cultural Values and Practices

This study uses ethnographic research to examine the phenomenon of transnational parenting by migrant mothers from the African Caribbean community and their family who care for the mothers’ children. Twenty women’s narratives demonstrate the complexity of relationships between migrant mothers living and working in New York City and their extended family or kinship caretakers who coparent their children in their countries of origin. The study reveals three main factors that contribute to the success of transnational parenting: (1) informal kinship care-child fostering, (2) remittances, and (3) social networks. Policy and practice implications are explored.     

Policy advocacy for women's unpaid care work: comparing approaches and strategies in Nepal and Nigeria

This article focuses on policy advocacy programmes in Nepal and Nigeria, instigated by ActionAid International with local women's rights organisations and non-government organisations, and supported by the Institute of Development Studies, UK. These programmes aimed to challenge women's unequal responsibility for care work and to influence policymakers to understand the importance of providing services to support them. One of the main components of these programmes was child care, a responsibility which most women experience 24/7 for at least two decades of their lives, and which profoundly shapes their lives and opportunities. We examine the processes through which each of the country teams have engaged with public policies on this issue, focusing on the similarities and differences in each context. Although the programme of activities has been implemented in much the same way in both countries, and each chose to focus on early child-care provision as the main policy demand, the partnerships and policy processes chosen differ greatly. Specifically, we distinguish between ‘critical engagement’ (in the case of Nepal), as compared to ‘constructive engagement’ (in the case of Nigeria). The article ends with some reflections on the challenges facing the teams during their work, and the implications and lessons that can be drawn from these two case studies.     

Evaluation of a Training to Reduce Provider Bias Toward Pregnant Patients With Substance Abuse

The objective of this article is not to present a scientific or systematic study, but to provide an initial framework for designing a training workshop to enhance health practitioners’ (nurses, social workers, physicians, etc.) knowledge regarding substance abuse treatment and to decrease their bias toward substance-abusing women, particularly pregnant women in rural communities. We incorporated the 4 Transdisciplinary Foundations from the Substance Abuse and Mental Health Services Administration Competencies Model, with specific competencies targeted that related to provider bias. After the conference, 52 of the 70 participants completed a questionnaire to self-assess knowledge level and confidence in skill related to substance abuse management. Participant mean scores were statistically significantly higher following the conference than 1 week prior (p < .001) in the area of “gender difference with substance abuse,” moving from an average of 2.6 to 4.5 on a 5-point Likert scale. Our conference was successful in increasing attendees’ knowledge about gender difference and substance abuse among pregnant patients.     

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.     

城市农民工随迁子女义务教育政策及其完善：以广东为例

文章分析了广东省农民工随迁子女义务教育改革政策和实施情况。广东省基本实现了农民工随迁子女“人人有书读”,但是,农民工随迁子女入读民办学校的比例依然较高,入读公办学校的歧视依然存在,民办学校的教育质量问题依然存在。农民工随迁子女义务教育问题不能彻底消除,根本原因是没有建立起农民工随迁子女义务教育经费的投入保障机制。     

Qualitative exploration of supporting figures in the lives of emerging adults who left care compared with their noncare‐leaving peers

Studies on youth leaving care have emphasized their limited social support and their need for continuing support after emancipation. However, less is known about the nature of their existing social networks after emancipation and their roles during their transition to adulthood compared with their noncare‐leaving peers. With this in mind, 32 young adults aged 18 to 25 participated in semi‐structured interviews regarding their current support figures in order to learn whether they were congruent with their needs after emancipation. Thematic analysis revealed four main features of the two groups' social networks: (a) stability versus uncertainty as to the lasting presence of the supportive figure, (b) reliance on parents as main supportive figures versus relying on different supportive figures, (c) confidence versus uncertainty in the supportive figures' ability to help, and (d) holistic versus fragmented support of the young adults' needs. The discussion addresses the unique characteristics of care leavers in emerging adulthood and the implications of their social networks' features for their adjustment after emancipation. One of the study's recommendations is to proactively connect them to new supportive figures such as professionals or mentors by offering them mentoring programs cognizant of the instrumental and developmental tasks of emerging adulthood.     

Comfort with discussions about death,religiosity, and attitudes about end‐of‐life care

In end‐of‐life (EOL) care research, death anxiety and religiosity are often overlooked. Terror management theory (TMT) may provide a useful conceptual model with which to examine how comfort discussing death and religiosity influence attitudes related to EOL care. A telephone‐based survey was conducted among community‐dwelling adults in the Unites States. Via random sampling, with over‐sampling of Hispanics/African Americans, 123 completed survey interviews (response rate = 46%) were analyzed. Respondents were more likely to have better attitudes toward EOL care if they were older or white, religiously active, and comfortable with the subject of death. Religiosity and comfort discussing death were correlated with each other and remained significant predictors of attitudes about EOL care even without demographic covariates. Findings suggest that promoting an open dialogue about mortality may improve attitudes about EOL care and utilization of palliative care services. The study also provides evidence about the utility and applicability of TMT for EOL care.     

Key Determinants to using Telehealth Technology to Serve Medically Ill and Depressed Homebound Older Adults

Despite the increasing evidence for the effectiveness of telehealth technology in screening and treating chronic diseases, and comorbid depression among older adults, they have been slowly adopted by home health care (HHC) agencies. Therefore, this study aimed to identify factors that determine telehealth technology adoption. Twenty directors from the National Association for Homecare & Hospice member agencies completed a 45-min telephone interview. Questions were asked regarding their perceptions of telehealth, the key determinants of telehealth adoption and use, and recommendations they would give on telehealth adoption. The majority of the participants perceived telehealth as effective for managing symptoms and reducing cost. Meanwhile, some participants had a mixed feeling toward telehealth for depression care as they did not recognize their agency as equipped with the necessary resources and trained staff. Moreover, significant determinants of telehealth adoption included the agency-related characteristics, the patient-home environment, reimbursement and cost-related factors, and staff telehealth perception. Findings imply that there is a need for financial support both at the state and the federal levels to encourage telehealth adoption among HHC agencies. Future studies should consider exploring strategies used by successful programs to overcome barriers.     

Supporting foster and kinship carers to promote the mental health of children

The majority of children and young people removed from the care of their parents by the state of Victoria, Australia, reside in foster or kinship care. These children have experienced a broad range of adverse conditions and are up to 4 times more likely to experience problems with mental health than their mainstream peers. This paper draws on the perspectives of foster and kinship carers, describing the disconnection between their role as mental health advocates and their interest in early intervention in a field which is dominated by crisis and the historic marginalisation of foster and kinship carers. Thirty‐one foster and kinship carers across greater metropolitan Melbourne, Australia, contributed to this study through interviews and focus groups. Participants demonstrated a practical understanding of mental health and an ability to identify a range of conditions that have an adverse impact on the mental health of children and young people in their care. The paper concludes that there is a lack of systemic support and even a range of barriers that affect the capacity of foster and kinship carers to promote the mental health and well‐being of the children and young people in their care.