Sinking,swimming and sailing: experiences of job satisfaction and emotional exhaustion in child welfare employees

The authors conducted a mixed‐method study after a previous study of child welfare employees revealed a subgroup exhibiting surprisingly high levels of both emotional exhaustion (EE) and job satisfaction (JS). This subgroup included direct service workers, supervisors and managers. As these findings appeared to conflict with previous studies, we re‐reviewed the literature and undertook the current study to account for the co‐existence of EE and JS. We explored and compared this subgroup with two others: workers who found their work satisfying without experiencing high levels of EE and those whose high levels of EE were associated with low JS. Using a survey that included several standardized measures with 226 employees and semi‐structured interviews with a criteria‐based subsample of 25, we explored the role that personality, career expectations, coping styles, stage of life, education, gender and social networks play in outcomes for individual employees. Analyses of quantitative and qualitative data yielded a profile for each subgroup, offering insights into the subjective experiences of workers within individual, social and organizational contexts. These findings have implications for recruitment, training and support of child welfare workers.     

Personal Network Correlates and Predictors of Homelessness for Injection Drug Users in Baltimore, Maryland

Injection drug users are at high risk for homelessness and human immunodeficiency virus (HIV) infection. This study sought to examine incidence rates and the social and economic antecedents of homelessness of impoverished inner-city injection drug users. Of the 569 participants, from a nontreatment sample who participated HIV prevention study, interviewed at baseline, 324 (57%) were reinterviewed 5.2 months later. At baseline 48% of the participants reported that they had been homeless in the past 10 years. Of the 324, 18% reported that at both interviews they had been homeless within the prior 6 months, 12% reported homelessness at baseline but not at follow-up, and 8% reported homelessness at follow-up but not at baseline. At baseline personal social support network characteristic of size of material aid and size of sex network was found to be associated with self-reports of homelessness. Baseline reports of presence of mother in personal network, size of material aid network, and network density were found to be associated with reports of homelessness at follow-up. These result suggest the need for alternative approaches to addressing issues of homelessness injection drug users.     

Breaking free from siloes: intersectionality as a collective action frame to address toxic exposures and reproductive health

ABSTRACT

There has been increasing interest in collaborative approaches between the environmental justice (EJ) and reproductive justice (RJ) movements to address the higher burden of toxic exposures and associated reproductive health outcomes in vulnerable communities. This study examined the collective action frames (CAFs) of advocates at the EJ/RJ nexus. CAFs highlight how advocates identify problems and solutions, and motivate action. The use of intersectionality was identified as a main CAF used in three key ways: breaking free from identity-based, issue-based, and movement-based siloes. First, interviewees described breaking free from identity-based siloes by identifying risks of toxic exposures that result from intersecting social locations (e.g. gender, race/ethnicity, income, immigration status) and by equally prioritizing multiple aspects of their identities as they engage in advocacy. Second, they described breaking free from issue-based siloes by developing multi-issue agendas that address a complex web of interrelated problems impacting health. Third, they described breaking free from movement-based siloes by developing cross-movement collaborations to address issues of mutual concern. Among multiple reasons given for cross-movement collaborations, advocates perceived them as valuable in order to disrupt social, political, and economic power imbalances that shape environmental reproductive health inequities, as well as other health and social inequities. Based on these findings, we suggest that intersectionality is a master frame, and thus may be useful to advocates in other social movements addressing intersectional issues. Understanding an intersectionality frame can help to inform advocacy approaches to promote health and health equity, particularly those focused on policies and structural drivers of health.     

Measuring temporal stability in regression models of population estimation

This paper introduces an empirical indicator designed to measure the temporal stability of regression models used to produce subnational population estimates. Analysis of 67 counties in Florida centers on 1970 total population estimates generated from ratio-correlation and difference-correlation models. Comparisons are made between eight different regression specifications and employ a quantitative measure of relative estimate accuracy. The major findings of this study are that (a) variable measurement and type are important determinants of estimate accuracy, and (b) although temporal stability of the coefficients impacts estimation errors, the influence is not as pervasive as is suggested in the literature.     

Sometimes we're our own worst enemies

There is a sense of frustration among physicians involved in the decision and policy making processes within health care institutions. Because the endpoint is reached at glacial speed, too much time, money, and opportunity is lost. The decision making process can be repetitious and tedious because of unnecessary steps. By eliminating certain tactics and strategies employed by upper-level management in many health care institutions, the decision making process becomes more effective. This article focuses on the medical staff's role in the decision making process; explains why tactics to involve the medical staff are ineffective and why eliminating the medical staff from certain aspects of the process does not jeopardize the institution; and concludes that the hospital board and its delegates should be autonomous in the decision making process.     

Learning Stimulus‐Location Associations in 8‐ and 11‐Month‐Old Infants: Multimodal Versus Unimodal Information

Research on the influence of multimodal information on infants' learning is inconclusive. While one line of research finds that multimodal input has a negative effect on learning, another finds positive effects. The present study aims to shed some new light on this discussion by studying the influence of multimodal information and accompanying stimulus complexity on the learning process. We assessed the influence of multimodal input on the trial‐by‐trial learning of 8‐ and 11‐month‐old infants. Using an anticipatory eye movement paradigm, we measured how infants learn to anticipate the correct stimulus–location associations when exposed to visual‐only, auditory‐only (unimodal), or auditory and visual (multimodal) information. Our results show that infants in both the multimodal and visual‐only conditions learned the stimulus–location associations. Although infants in the visual‐only condition appeared to learn in fewer trials, infants in the multimodal condition showed better anticipating behavior: as a group, they had a higher chance of anticipating correctly on more consecutive trials than infants in the visual‐only condition. These findings suggest that effects of multimodal information on infant learning operate chiefly through effects on infants' attention.     

Homelessness and Children's Use of Mental Health Services: A Population-Based Study

This study examined whether children who become homeless differ from other low-income children in their mental health service use before and after their first homeless episode, and to what extent homelessness is associated with an increased likelihood of mental health service use. Differences between children with and without new onset of sheltered homelessness in the use of mental health services emerged following homelessness and widened over time. Sheltered homelessness and foster care placement history were associated with increased odds of receiving inpatient and ambulatory mental health services. Findings underscore the importance of collaborations between homeless assistance, foster care, and mental healthcare in efforts to mitigate family homelessness and collateral needs among homeless children.     

A comparison of population estimation methods: housing unit versus component II,ratio correlation,and administrative records

The authors present the case for the housing unit (HU) method as a technique for estimating the population of states and local areas in the United States. They "evaluate population estimates produced by the housing unit method and by three other commonly used methods: component II, ratio correlation, and administrative records. Basing [the] analysis on 1980 census data from 67 counties in Florida and testing for precision, bias, and the distribution of errors, [they find that] application of the HU method performs at least as well as the more highly acclaimed methods of local population estimation."     

An approach to the impaired physician

The 1988 California Administrative Code requiring all acute care medical staffs to provide assistance to impaired physicians has not resulted in an increase in the annual census in the Medical Board of California Diversion Program. In part, this lack of an increase is due to the failure of some hospitals to form physician aid committees and to the poor functioning of such committees in other hospitals. The common reasons for these deficiencies are that the medical staff leadership does not think there are any impaired physicians on staff and that they don't know what the committee would do if it were formed. This attitude demonstrates a lack of appreciation for the prevalence of impaired physicians and the tremendous amount of work required (establishing policies and procedures) to identify and help them. This article discusses the prevalence of the impaired physician, the types of impaired physicians, a "cookbook" approach to managing these physicians, and the success of intervention.     

The collaborative push: moving beyond rhetoric and gaining evidence

Collaboration has been enacted as a core strategy by both the government and nongovernment sectors to address many of the intractable issues confronting contemporary society. The cult of collaboration has become so pervasive that it is now an elastic term referring generally to any form of ‘working together’. The lack of specificity about collaboration and its practice means that it risks being reduced to mere rhetoric without sustained practice or action. Drawing on an extensive data set (qualitative, quantitative) of broadly collaborative endeavours gathered over 10 years in Queensland, Australia, this paper aims to fill out the black box of collaboration. Specifically it examines the drivers for collaboration, dominant structures and mechanisms adopted, what has worked and unintended consequences. In particular it investigates the skills and competencies required in an embedded collaborative endeavour within and across organisations. Social network analysis is applied to isolate the structural properties of collaborations over other forms of integration as well as highlighting key roles and tasks. Collaboration is found to be a distinctive form of working together, characterised by intense and interdependent relationships and exchanges, higher levels of cohesion (density) and requiring new ways of behaving, working, managing and leading. These elements are configured into a practice framework. Developing an empirical evidence base for collaboration structure, practice and strategy provides a useful foundation for theory extension. The paper concludes that for collaboration, to be successfully employed as a management strategy it must move beyond rhetoric and develop a coherent model for action.