SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
We prospectively assessed whether providing social services with information on the immunisation status for a cohort of looked after children in the care of an urban unitary authority in England improved uptake rates. The provision of such information did not improve immunisation coverage in these children.
Homelessness, poverty, drug abuse and violent victimization faced by street-based women sex workers create needs for a variety of health and social services, yet simultaneously serve as barriers to accessing these very services. The present study utilized interview (n = 586) and focus group (n = 25) data to examine the service needs and associated barriers to access among women sex workers in Miami, Florida. Women most often reported acute service needs for shelter, fresh water, transportation, crisis intervention, and drug detoxification, as well as long-term needs for mental and physical health care, drug treatment, and legal and employment services. Barriers included both structural (e.g., program target population, travel costs, office hours, and social stigma) and individual (e.g., drug use, mental stability, and fear) factors. Bridging these gaps is tremendously important from a public health perspective given the disease burden among this population. Recommendations include service staff training, outreach, and promising research directions.
Explore the source record for details and available documents.
The Americans with Disabilities Act (ADA) of 1990 prohibits discrimination on the basis of disability in employment, state and local government services, public accommodations, and telecommunications. The act prohibits denying individuals with disabilities the opportunity to participate in a program or service or providing a service that is not equal to or that is different or separate from that given others. This article provides examples of possible barriers to full participation that might exist in social services and gives illustrations of reasonable modifications to increase access. Employers, private and government, profit and nonprofit, must make reasonable physical accommodations for disabled employees, unless such accommodation would cause undue hardship. This article gives examples of reasonable accommodations and undue hardship and discusses the ADA as a resource to clients with mental and physical disabilities and as a framework of protection for agencies serving them.
AIM: To explore the recent contact with health and social services by drug misusers who died of a fatal overdose and identify opportunities for preventive intervention. DESIGN: Retrospective case analysis. SUBJECTS: Eighty-seven residents of the Greater Glasgow area who died of a drug misuse-related overdose in 1999. METHODS: Analysis of matched data from several sources: Strathclyde Police; University of Glasgow Department of Forensic Medicine and Science; the Scottish Prison Service; general practitioners' medical notes, including records of accident and emergency attendances and psychiatric assessments; and five specialist agencies for drug misusers or the homeless. FINDINGS: Most of those who died of an overdose were males, long-standing heroin injectors and resident in a deprived area. Heroin caused most deaths, either alone or with other drugs. Twenty-three per cent died within 2 weeks of release from prison. For the 77 whose medical records were available, 90% had seen their general practitioner (32% in the month before death), 48% had attended accident and emergency services and 22% had received a psychiatric assessment in the year before death. Over 40% of the 87 used a drug agency in the year before death and 20% had used more than one agency. CONCLUSIONS: Previous suicidal ideation, attempted suicide and depression were common among those who died of an overdose, as was recent release from prison. Almost all had been in contact with and several were receiving specific treatment from health or specialist addiction services in their last weeks or months. The findings highlight both the numerous opportunities for intervention and the challenge of using them to prevent death.
The introduction of urine drug testing for this program has been considered a success by the social services agencies in Nova Scotia for the following reasons: 1. The results of urine drug testing have been accepted by the Family Courts of Nova Scotia because the urine collection and testing are performed with chain of custody procedures from collection to reporting and the analysis includes confirmation of all positive immunoassay screening tests. 2. Urine drug testing (with established screening and confirmation cut-offs) provides an objective indication of recent drug use compared with relying on self-reporting of drug use. 3. Urine drug testing is believed to be a deterrent to drug use because several individuals with a history of drug use have consistently tested negative for 6 to 12 months (30% of the clients). 4. Some clients with a history of substance abuse are successful in becoming drug free with the support of the social workers and the deterrent effect of random drug testing.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
During the past 20 years a network of services, including official state agencies and statewide grassroots domestic violence coalitions, has developed across the country to meet the problem of woman abuse. Although state agencies have gained access to diverse federal funds; have developed additional, more-creative ways to fund programs; and have established regulatory mechanisms to ensure quality of services, respondents agree that the existing services would not have been developed without the committed energy and effective lobbying of grassroots coalitions. However, these coalitions are now struggling with internal conflicts and are concerned that emerging social problems will eclipse them and capture the scant funds available. Without these coalitions, the network of social services may return the problem of woman abuse to the private arena of family life, where it is treated by therapy. This article surveys both state agencies and coalitions and discusses implications for services to abused women.
The purpose of this study was to identify social service needs and case management implications for homeless and marginally housed individuals accessing services at a suburban faith-based agency. The overall goal for the study was to provide data from the perspectives and experiences of clients that could be used to develop and/or revise services to more fully facilitate clients' movement toward self-sufficiency. The study used an exploratory qualitative design. Study participants consisted of 38 men and women currently using agency services who participated in one of four focus group sessions. Thematic analysis of the content of the audiotapes of the group sessions revealed that the overarching issue for participants was the ability to obtain and maintain employment. Related to this issue were six themes: job readiness and support; self-esteem issues; substance use and treatment; communications; women's issues; and transportation. Based on these client-generated themes, a multi-level case management program is presented.
As a consequence of the increasing number of elderly people, the proportion of people of working age (20-65) vs. the oldest-old (80+) will decrease considerably. Today, the total annual cost for the care of the elderly (health care and social services) in Sweden is about SEK 110 billion (about 6% of the GNP). The costs of health care are better correlated with the number of remaining years of life than with number of years from birth. The cost of health care during the last year in life is higher for the oldest-old than for the young-old. Informal care of demented persons is about 4-5 times more extensive than formal care. There is a strong correlation between GNP per citizen and resources spent on health care.
Explore the source record for details and available documents.
BACKGROUND AND AIMS: A large, national, long-term, longitudinal, multi-purpose study has been launched in Sweden--the Swedish National study on Aging and Care (SNAC). The study involves four research centers collecting data in four different areas of Sweden. METHODS: The study consists of two parts: the population part and the care and services part. In the population part, a large, representative panel of elders in different age cohorts is followed over time to record and describe the aging process from different aspects. In the care and services part, a systematic, longitudinal, individually-based collection of data is performed concerning provision of care and services together with functional ability, specific health care problems, and living conditions of the recipients living in the area. RESULTS: The data collection in the population part of the SNAC is not yet completed. In the present article, some preliminary results are reported from the care and services part. These pertain to comparisons between the participating areas with respect to the prevalence of disability among those receiving care and social services in their ordinary homes and those receiving care in special accommodation. A comparison is also presented with regard to the amount of home help provided to subjects with a given disability. CONCLUSIONS: This project has several advantages. It is expected to generate a rich data base relevant for future research on aging and care and to have a direct impact on the future Swedish system of care and services for the elderly.
BACKGROUND: The aim of this study was to investigate predictors of Quality of Life in a group of severely mentally ill substance abusers. These patients took part in a multi-centre study aimed at improving co-operation between psychiatric and social services in Sweden during the years 1995 to 1998. METHODS: Two hundred and eighty-eight patients, 62.4 % men, were included in the study. The criteria to enter the study were to have a diagnosis of severe mental illness and a diagnosis of substance dependence according to the DSM-III-R criteria. Quality of Life (QoL) was measured by a global assessment, Cantril's ladder (1965). Initially and after 18 months the following measurements were also used: Addiction Severity Index (ASI), Symptom Check List 90 (SCL-90) and The Clinical Rating Scale (CRS) for Alcohol Use (AUS) and Drug Use (DUS). RESULTS: Initially those who were older and those who had an apartment of their own or who lived in sheltered living had a higher QoL than the others. Those belonging to the borderline personality disorder subgroup had a lower QoL than those belonging to other psychiatric diagnostic subgroups. At follow-up QoL had improved significantly. Improvement in QoL was related to improvements in physical health, legal and family problems, psychiatric symptoms and a reduction of alcohol and drug problems (ASI), global functioning (GAF) and psychological problems (SCL-90). A multiple stepwise regression analysis showed that improvement in QoL primarily was predicted by improvements in psychiatric symptoms. Number of months without alcohol and drugs were positively associated with improvement in QoL. As a whole, at follow-up the QoL is still not high. CONCLUSIONS: In this group of severely mentally ill substance abusers, improvement in QoL was primarily predicted by improvements in psychiatric symptoms. Further, less alcohol and drug abuse seems to augment the subjective feeling of QoL.
This literature review examines current referral systems and processes used by community nurses when making referrals of children in need and children in need of protection to social services departments. The problems surrounding definitions of need, children in need and children in need of protection are considered. The ambiguity of the language used and the difficulties encountered by community nursing staff in trying to identify criteria and thresholds for referral are highlighted. The review focuses on research exploring the assessment and referral processes used by community nurse, in particular by health visitors, and draws attention to the lack of research concerning these areas. Government recognition of the problems encountered by agencies working in this field is acknowledged in recent Department of Health publications.
The objective of this study was to determine how the entry into long term care of people assessed by their local social services department (SSD) under the National Health Service and Community Care Act 1990 is predicted by the severity of their cognitive impairment, care provided by family members, and the receipt of community care services. The design involved a cohort study of people over one and a half years following referral (min-max: 1-2 years) from three SSDs (county council, metropolitan and inner London boroughs). Consecutive recruitment of 141 people with cognitive impairment aged 65 and over took place over a 4 month period. The main outcome measure was survival analysis of time taken from referral to entering long term care at follow-up. The receipt and intensity of community care services increased the probability of remaining at home. People with mild or moderate cognitive impairment were more likely to remain at home if they had a spouse or daughter carer. Analysis of the interaction between three main effects predicting entry to long term care (severity of cognitive impairment, access to a carer, and the receipt of home care or day care) suggests that while carers are central in determining whether older people with cognitive impairment are able to remain living in the community, there are limits to the care they can provide.
During the past thirty years a high proportion of all long stay hospital beds have been closed. The responsibility for those who would have occupied those beds previously has to a large extent been transferred from health to social services departments, or to family, voluntary and private care. The overall effect has been to prioritize acute medical care, and to expose the public provision and funding of long term residential care, whether medical or social, to the direct determination of political and economic forces. These policy changes have been introduced under the banner of community care, but are dependent on complex concepts which are morally contentious and often obscure. The purpose of this paper is to analyse these processes as a prerequisite to devising better policies in future.