A longitudinal study of depressiveness in children in public care

Rajhvajn Bulat L. A longitudinal study of depressiveness in children in public care Int J Soc Welfare 2010: 19: 412–423 © 2009 The Author, Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare. The aim of this article is to analyse the challenges involved when making longitudinal observations of depressiveness in children raised in public care. The first measurement comprised 375 children from children's homes and foster families; however, most of the results are based on an analysis of the 139 children who participated in both parts of the research. We used the Child Depression Inventory and the anxiety/depression subscales of Youth Self Report and Child Behaviour Checklist as measures of depressiveness. The comparison of results from the first and second measurements showed that depressiveness in children in public care decreased over time. Children who grew up in children homes were, in the first measurement, more depressed than those living in foster families, but after five years that difference had disappeared. Furthermore, decrease in depressiveness is predominantly associated with less frequent delinquent, aggressive or hyperactive behaviour, less withdrawal and better control over uncomfortable emotions.     

Palliative care patients' experiences of healthcare treatment

Kennett C, Payne M. Palliative care patients' experiences of healthcare treatment Int J Soc Welfare 2010: 19: 262–271 © 2009 The Author(s), Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare. This article reports on a thematic analysis of the opinions of 34 palliative care patients about medical and healthcare treatment expressed in comments, narratives and discussions during a series of facilitated group discussions undertaken as part of training events for medical students. Palliative care patients often have long healthcare careers, which enables them to compare different professionals and services, thus offering a more powerful and complex analysis of patient experience than that obtainable from analysis of complaints or satisfaction surveys, and permits some understanding to be obtained of the attitudes that condition evaluations of services. The patients balanced negative views with positive experiences. They appreciated open, listening, equal and friendly relationships with professionals in which careful explanation fostered their confidence in the overall service. They criticised inflexible services that did not consider their broad needs, and in which relationships with professionals were characterised by busy‐ness and professional distance.     

Efficacy of Statistical Outlier Analysis for Monitoring Quality of Care

Researchers have proposed that hospitals with excessive statistically unexplained mortality rates are more likely to have quality-of-care problems. The U.S. Health Care Financing Administration currently uses this statistical “outlier” approach to screen for poor quality in hospitals. Little is known, however, about the validity of this technique, since direct measures of quality are difficult to obtain. We use Monte Carlo methods to evaluate the performance of the outlier technique as parameters of the true mortality process are varied. Results indicate that the screening ability of the technique may be very sensitive to how widespread quality-related mortality is among hospitals but insensitive to other factors generally thought to be important.     

Overcoming the ‘tyranny of the urgent’: integrating gender into disease outbreak preparedness and response

ABSTRACT

This article contributes to discussions on the gender dimensions of disease outbreaks, and preparedness policies and responses, by providing a multi-level analysis of gender-related gaps, particularly illustrating how the failure to challenge gender assumptions and incorporate gender as a priority at the global level has national and local impacts. The implications of neglecting gender dynamics, as well as the potential of equity-based approaches to disease outbreak responses, is illustrated through a case study of the Social Enterprise Network for Development (SEND) Sierra Leone, a non-government organisation (NGO) based in Kailahun, during the Ebola outbreak.     

How Employed Mothers in Australia Find Time for Both Market Work and Childcare

Time use studies find that employed mothers reduce their parental childcare time by much less than an hour for every hour they spend in market work. This paper uses data from the Australian Bureau of Statistics Time Use Survey 1997 (4,059 randomly selected households) to investigate how employed mothers manage to avoid a one-for-one trade-off between work and childcare. It compares the time allocation of employed fathers, employed mothers and non-employed mothers and finds that parents use non-parental childcare to reschedule as well as to replace their own childcare, that employed mothers reschedule activities from weekdays to weekends or to earlier or later in the day, and spend less time than other mothers in housework, childfree leisure and personal care.

Pregnancy after loss during the COVID19 pandemic

BackgroundRapid changes to how maternity health care is delivered has occurred in many countries across the globe in response to the COVID-19 pandemic. Maternity care provisions have been challenged attempting to balance the needs and safety of pregnant women and their care providers. Women experiencing a pregnancy after loss (PAL) during these times face particularly difficult circumstances.AimIn this paper we highlight the situation in three high income countries (Australia, Ireland and USA) and point to the need to remember the unique and challenging circumstances of these PAL families. We suggest new practices may be deviating from established evidence-based guidelines and outline the potential ramifications of these changes.FindingsRecommendations for health care providers are suggested to bridge the gap between the necessary safety requirements due to the pandemic, the role of the health care provider, and the needs of families experiencing a pregnancy after loss.DiscussionChanges to practices i.e. limiting the number of antenatal appointments and access to a support person may have detrimental effects on both mother, baby, and their family. However, new guidelines in maternity care practices developed to account for the pandemic have not necessarily considered women experiencing pregnancy after loss.ConclusionBereaved mothers and their families experiencing a pregnancy after loss should continue to be supported during the COVID-19 pandemic to limit unintended consequences.     

Delaying factors for maternal health service utilization in eastern Ethiopia: A qualitative exploratory study

BackgroundIn Ethiopia, maternal health service utilization is still unacceptably low. The societal and cultural factors that constrain women from attending these services have not yet been sufficiently explored. Using qualitative methods, we aimed to explore the factors that delay maternal health service utilization in eastern Ethiopia.MethodA total of 13 audio-recorded focus group discussions were conducted comprising 88 participants. We conducted separate group discussions with reproductive aged women, mothers-in-law, traditional birth attendants, husbands, and Health Extension Workers to capture their knowledge, practices, feelings, thoughts and attitudes towards maternal health service utilization. The recorded sessions were transcribed into the local language and then translated into English for analysis.ResultThe study identified a number of factors that may delay maternal health service utilization. Factors were grouped using the Three Delays model as a framework. Low level of awareness regarding need, poor involvement of husband, perceived absence of health problems, social power, community misperceptions and cultural restrictions, negative attitudes towards male midwives, acceptance of traditional birth attendants and poor social networking were Delay One factors. Lack of physical accessibility and high transportation costs were categorised as Delay Two factors for skilled birth care attendance. Perceived or experienced poor quality of care were categorised as Delay Three factors for both skilled birth and postnatal care utilization.ConclusionDespite the ongoing government measures to improve maternal health service utilization in Ethiopia, numerous factors continue to contribute to delays in service use, which in turn contribute to high maternal mortality.     

Educational assortative mating and time use in the home

This study examines the association between individuals' educational assortative mating and time spent on child care and housework. Focus is put on hypogamous couples, or couples in which wives have more education than their husbands. Relative resources and gender revolution frameworks are considered as contexts to explain why hypogamous couples may share their time differently than other couples. A series of ordinary least squares regressions with population and sampling weights are employed using American Time Use Survey data from 2003 to 2018. Three, separate analyses using relative education, gender, and all educational pairings as the independent variables of interest are presented with child care and housework as the dependent variables. The current findings show that men in hypogamous marriages perform about 10 min more of child care per day on average than their peers in hypergamous and homogamous marriages, and that this comes primarily from basic care activities. This accounts for approximately 43% of the difference between men and women in the average amount of time spent on child care. No clear pattern of significance is apparent comparing individuals’ time spent on housework by relative education, suggesting that housework and child care have evolved differently in the context of gendered domestic responsibilities. Men in hypogamous marriages are more egalitarian in their sharing of child care. However, this is only true for couples in which men have at least a high school diploma and women are highly educated.     

Loss and grief: The experience of transition to residential aged care

There is growing recognition of the experience of non-death-related loss and grief. One unexplored area of non-death-related loss and grief is associated with older people’s transition from home to residential aged care (RAC). This paper reports findings from a qualitative study that explored the experiences of people living in RAC, carer-relatives of people living in RAC and RAC staff. Using theories of loss and grief, the paper identifies features of the transition to RAC that are associated with unresolved loss and maladaptation to changed circumstances, and the types of support that would mitigate these. Using a series of focus groups with both residents and carer-relatives, as well as staff, the study found that residents and their families need more support to negotiate the multiple, often necessarily hasty decisions and bureaucratic requirements associated with transitioning to RAC, while simultaneously experiencing loss and grief. The types of support that families would welcome from service providers include facilitating shared decision making, valuing family and community carer expertise and providing practical information and assistance to fulfil administrative obligations.