中国五保失能老人长期照护服务的困境与解困

失去生活自理能力的五保老人是社会最弱势的群体.随着五保供养制度的不断完善,其基本生活得到了保障.但是,由于五保供养制度多年来锁定在吃、穿、住、医、葬五个方面,理念上难以突破,制度上缺乏创新,致使针对五保失能老人的照护服务严重缺失,现有社会救助制度不能回应他们关于照护的特殊诉求,其生存状况令人堪忧.破解长期照护服务的困境,应从完善五保供养制度的法律法规、拓宽供养范围等角度出发,建立多层次筹资机制,确保他们获得长期照护服务以提高生活质量.     

社区居家养老的社会支持系统研究——以南京市雨花区为例

随着我国人口老龄化的加剧和家庭保障功能的弱化,社区居家养老服务已经成为社会发展的必然选择?文章基于南京市雨花区的实践,从主体?客体?内容等方面构建多元?互动的社区居家养老社会支持体系,其积极探索居家养老新模式的举措具有一定的借鉴意义?     

Migrants' regular army of labour: gender dimensions of the impact of the global economic crisis on migrant labor in Western Europe

The purpose of this article is to remedy the lack of explanatory endeavours concerning the positive performance of female migrant workers during the recent economic crisis in Western Europe. This phenomenon both interrogates the established association between economic downturns and their negative impact on migrant labour in low‐skilled jobs and enriches the theory of the reserve army of labour, which has been applied to understanding the fragile status of migrant workers in Western economies. Secondary analysis of Labor Force Survey (LFS) and OECD data concerning the impact of the crisis on migrant labour shows that women employed in the care‐domestic sector have been affected significantly less than men employed in manufacture and constructions. To explain this evidence, the article proposes a theoretical framework that draws on key concepts and debates in different strands of sociology: the increasing demand for paid care‐domestic work due to the ageing population and the growth of native‐born women's rates of activity; the commodification of care and the state management of migration; the affectivity and spatial fixity of care‐domestic labour. All these factors contribute to configure female migrant labour, mostly employed in the reproductive sector, as a ‘regular’ rather than a reserve army of labour.     

Keeping open by re‐imagining laughter and fear

Speaking to the debate on the nature of critique, this article is about the struggle to produce an account when listening to and retelling stories. It begins with the disconcertment over listening to a coherent story that emerges in interviews about the development of performance indicators for Dutch hospital care. The indicators are presented as solutions to the problem of unruliness in the healthcare world. Drawing on Helen Verran's work on generative critique I slow down the ‘problem‐solution‐found’ plot. Instead of contrasting the apparently coherent stories with the complexities of an ‘underlying’ practice of healthcare, I hold on to my initial disconcertment so that ‘fleetingly subtle’ interruptions become entry points for generative critique. Taking Eduardo Viveiros de Castro's understanding of the relation that fear and laughter have to alterity, I show how fear and laughter permit generative critique within seemingly coherent stories. In the case of indicator development, the interviewees ‘laugh away’ what they consider alter from quality and safety in healthcare: having no control over what is going on, polyglotism instead of a common language, and inaction as opposed to taking one's time. Paying attention to disconcerting interruptions generates sensitivity and questions rather than yet another set of (critical) problem‐solution‐found answers. How can ridiculed (laughed away) subjectivity be acknowledged as important entry points for including alterity in supervision? And how to position the acknowledgement, not as an antidote, but as a way of rendering the fear of alterity generative? Nurturing sensitivities is crucial for keeping open, which means resisting both the sticky tendency of normalizing accounts and the fallacy of misplaced concreteness. I conclude that keeping open by re‐imagining critique resonates with the creativity of collective life in actual times and places. Thereby it offers a promising potential for doing worlds differently.     

Running Away from Out‐of‐Home Care: A Multilevel Analysis

Previous research suggests that the likelihood of runaway episodes among children in out‐of‐home care varies across different communities/regions. However, the potential regional variation has rarely been reflected in attempts to understand runaway episodes in out‐of‐home care systems. The current study examines the effects of child characteristics, family characteristics and child welfare system‐related characteristics on the likelihood of runaway episodes among children in out‐of‐home care, while accounting for county‐level variations in the risk of runaway behaviours. The authors employed multilevel analyses using data on children aged 12–17 from the 2009 AFCARS database. Results demonstrate that the likelihood of runaway episodes varied across counties. Accounting for county variation, children's ages, gender, diagnosed clinical conditions, family structures, number of removals, number of placements, removal manner, and case plan goals significantly predicted runaway status. Implications are discussed.     

女性主义关怀伦理视野下的《接骨师之女》

谭恩美的《接骨师之女》描绘了在男权社会阴影下祖孙三代女性的生活故事。从女性主义伦理学的重要理论———关怀伦理学切入文本,从女性声音、女性关怀、伦理诉求三个方面探讨作者建构两性和谐社会的女性主义伦理愿望。     

The Effects of Childhood Sexual Abuse and Other Trauma on Drug Court Participants

Within the context of a larger study of drug court participants, this study examined the impact of traumatic experiences on psychiatric distress and on court outcomes. In the analyses, the participants (n = 229) were separated into 3 groups: childhood sexual abuse (CSA; n = 18), other trauma (n = 134), and no trauma (n = 77). The CSA group had higher mean scores on depression, anxiety, panic disorder, social phobia, somatization, and posttraumatic stress disorder than the other trauma group. Path analyses suggest that a history of trauma is a positive predictor of psychiatric distress and negative court events (positive urine screens, sanctions, etc.), with indirect effects on substance abuse severity, and failure in the drug court. These results suggest a need for the initial assessment procedure in drug courts to include a screening for trauma history, including CSA. They also suggest a need for trauma-informed care within drug courts.     

全额保障老年患者在基层公平享有合理使用基本药物政策研究

目的:为实施全额保障老年患者在基层公平享有、合理使用基本药物费用政策提供可行的管理策略。方法:以南京市江宁区参加职工医保的65岁以上老年患者就诊的数据为来源,分析其基本药物使用的状况和主要疾病病种的构成。结果:老年患者主要以抗微生物药、调节水、电解质及酸碱平衡药、内科用药(中成药)和心血管系统用药为主;主要是心脑血管疾病、呼吸系统疾病、消化系统疾病以及损伤骨折等;用药经济负担较重。结论:应加强老年人常用基本药物的配备,提高可获得性;实施分类管控,最大程度地减轻使用基本药物的经济负担;规范医师用药行为,提高基层医疗机构合理用药的水平;加强用药知识宣教,发挥社区药学服务的作用。     

Elderly Parents’ Need for Help and Adult Children's Moving Decisions

Recent changes in Finnish welfare policies have increased the need for family involvement in eldercare. This article uses qualitative interviews to study working adult daughters’ reasons for moving in with their parent(s). Coresidence was linked to the parents’ need for support, but also to the daughters’ life situations, family histories, the availability of welfare services, and cultural norms and values. The interviewees used the “familist” and “independent life” discourses in their speech. The familist discourse was used to argue for coresidence as a natural continuation of family traditions and life history, whereas the independent life discourse was used to legitimize the need for alternative care options and having a home of their own.     

Gender,migration and care deficits: what role for the sustainable development goals?

ABSTRACT

This article explores migration to higher income countries in light of collective commitments to the Sustainable Development Goals (SDGs) and argues that domestic social protection and labour market policy will need to be modified to meet these commitments. We look primarily at women in care work, using a broad definition of care that includes home help, domestic work and health care. We argue that the failure to recognise and value unpaid care work has created a sustained labour demand for women migrant care workers in many of these labour-importing countries. Increasingly, immigrant women are being imported into host economies to care, often in informal settings, and frequently engaged by private households, without full access to social protection and labour rights. The consistent application of SDG goals 5 and 8 and their linking to existing labour rights norms and conventions could simultaneously address care deficits in home and host countries and protect the rights of care workers in labour-importing countries and ensure that migrant workers are able to claim these rights.