Decision‐Making in Paediatric Rehabilitation: Exploring Professionals' and Children's Views on Decision‐Making Involvement

The article explores the distinction that professionals make between difficult and less difficult decisions in paediatric rehabilitation interventions. This distinction is explored by looking at the involvement of two children in decisions regarding paediatric rehabilitation interventions. The article argues for a clinical practice where children's experiences are extensively used to improve practice and to accommodate the child's right to participate in medical decisions concerning their own body and life. The different ways the children and the professional describe their experiences provide an avenue for a discussion on how medical reasoning can curtail children's involvement in decisions.     

Social security reforms and early retirement

Many reform proposals of the social security systems in various OECD economies suggest to scale down the non-actuarial parts of the pension systems. These reforms have a flavor of increased efficiency at the costs of welfare losses for low-income individuals. Assessing the economic effects, we investigate five different reform proposals by means of a numerical overlapping generations model for the Norwegian economy. The model features an endogenous retirement age and heterogeneous individuals within generations. It turns out that the various reforms, which scale down the public non-actuarial pension system, lead to increases in the retirement age and steady-state welfare gains for all income classes. Received: 7 December 2000/Accepted: 29 January 2002 All correspondence to ?ystein Th?gersen. Financial support from the Research Council of Norway (The Economic Research Program on Taxation) is gratefully acknowledged. We are indebted to Lans Bovenberg, John Ermisch, Erling Steigum and two referees for valuable comments and useful discussion. Responsible editor: John F. Ermisch.     

The process of evaluating a capacity-building support initiative for HIV positive South Africans

This paper describes the process of evaluating a capacity-building initiative involving HIV positive South Africans. The evaluation was conducted within a participatory evaluation framework, which aims at empowering participants through social action. The rationale is that an understanding and acceptance of evaluation results promotes commitment to act. Forty four members of the Kudu Support Group and 23 non-members participated in the evaluation. Methods included in-depth interviews, a survey, repeated measures of the General Health Questionnaire-28 (GHQ-28), a SWOT analysis, interviews with health workers, field notes, and participatory observation. The capacity-building initiative resulted in empowerment through paid employment for support group members, the establishment of a vegetable garden, increased skills and efficacy, access to resources and networks, a perceived reduction of stigma, perceived improvement of social relations, and improved scores on the GHQ-28. Lessons that emerge out of this study are the importance of integrating evaluation as a part of ongoing activities throughout the research project; to ensure that methods and results are understandable and useful to for the participants; that the evaluator has an in-depth understanding of the project and context; and to introduce frequent and simple internal evaluation tools to guide efforts to improve community-based groups’ functioning and activities.     

Exploring the mechanisms explaining the quality of sibling relationships when children are taken into care: A qualitative study of Norwegian children

Sibling relationships are potentially central in children's and young people's lives. Research has shown that the quality of sibling relationships changes in a variety of ways when a sibling(s) moves into care. There is limited understanding of the mechanisms that cause these changes. This study addresses this gap by reanalysing a dataset of 25 semistructured interviews with young people (16 to 23 years) drawn from a municipality in Southern Norway. The original study explored the changes in sibling relationships when the young person moved into care. This reanalysis of the data set explores specifically, using a template analysis, the mechanisms that children describe when exploring why these changes occur. Findings show the intricacies of the young person's social identification with the biological and/or foster family and how sharing a common identity may be key to the development of the sibling relationship when the young person(s) is taken into care. Our findings also show how key adults, such as foster parents and social workers, influence the relationship. The paper concludes with recommendations for social workers on how they may strengthen sibling relationships in families where children have been taken into care.