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PubMed1985

The services provided during a child abuse and/or neglect case investigation and the barriers that exist to service provision.

More than one million cases of child abuse and neglect come to attention of child protection agencies each year. During the course of investigating these cases, social workers are charged with protecting the child while assessing whether or not abuse or neglect has actually occurred. Child welfare philosophy also dictates that at the same time the investigation is being conducted, the social worker strives to maintain the family intact, if at all possible. One way to address this dual responsibility of protecting the child while working towards family stability is through the provision of services during the investigation. The purpose of this paper is to identify the services that are provided during the course of a child abuse and/or neglect case investigation. The paper also identifies the barriers that exist both within an agency and within the external community that discourage the provision of services to children and families. The findings of this research show that in the majority of cases services are not provided during the investigation. In those case investigations where services are provided, a much broader range of services are considered for provision than are actually delivered. The research also found that placement is the most frequently provided service; however, only one-third of those children in placement receive any clinical services while in placement. Finally, this study found that the greatest barrier to service provision is a lack of evidence necessary to intervene in the home situation.

Child Abuse↗
PubMed2006

A good life environment for all through conceptual, technological and social innovations.

In conventional environmental protection the parallel development of advanced technical solutions alongside ever more stringent environmental standards increasingly conflicts with the moral and practical imperatives to ensure sustainability and drastically improve the life conditions of the world's poor. Such priorities are far better tackled by technological and social innovations based on relatively simple and highly sustainable concepts: e.g., applying Natural Biological Mineralization Routes (NBMR) for wastewater and waste treatment, implementing Decentralized Sanitation and Resource Recovery and Reuse (DESAR3) where transport of waste(water)s is kept to an optimum level and pollutants valorized, etc. With developing countries now taking a lead in applying these concepts in public sanitation, the more prosperous countries will gradually abandon the expensive, vulnerable and non-sustainable conventional approaches to wastes treatment and environmental protection.

Environmental Health↗
PubMed1995

Social relationships and abstinence from cocaine in an American treatment sample.

In an extension of earlier work relating social-relationship variables to post-treatment abstinence from abused drugs, 104 cocaine users were studied for 6 months after completing drug treatment. Social-relationship variables included social integration, perceived support and social-network cocaine use. The effects of social relationships on cocaine abstinence tended to be conditional on race. Greater social integration predicted abstinence for Caucasian Ss (n = 54), but not African-Americans (n = 50). Similar results occurred for perceived support. Social network drug-use data also showed race differences: the absence of current cocaine users and the presence of former users predicted abstinence only for Caucasians. Interpretation of these findings is complicated by the relationship we observed between race and route of cocaine administration, with African-American Ss far more likely than Caucasians to be crack smokers or injection users as compared to intranasal users. The effects of race could not be disentangled from the effects of route. Future studies of social relationships and cocaine abstinence should focus on identifying social factors that are protective for African-Americans and for smokers/injectors. Such studies are critical precursors to designing successful social-support interventions.

Adult↗
PubMed2004

Why young Dutch in-line skaters do (not) use protection equipment.

BACKGROUND: In-line skate injuries are highly preventable by the use of protective gear. We investigated how young Dutch skaters protect themselves and what factors predict the use of protective gear in order to develop campaigns to increase their safety behaviour. METHODS: A survey was conducted to study protection behaviour of 872 Dutch skaters and factors influencing the use of protective gear. Written questionnaires were used, measuring behaviour and social psychological determinants towards the use of protective behaviour. RESULTS: Protective gear was not often used: 36% used wrist guards, 28% used kneepads, 14% used elbow pads and 5% used helmets. The use of protective gear was influenced by social influences, self-efficacy expectations and intention (R2=54%). CONCLUSIONS: The present study shows that young Dutch skaters should improve their safety behaviour in order to prevent skate injuries. Furthermore, the study provides clear recommendations for developing prevention programmes.

Adolescent↗
PubMed1990

[Effects of health reform law on the handicapped from the viewpoint of social assistance].

In the legislator's intention, the recent health reform legislation is aimed at strengthening solidarity and self-responsibility, so that our statutory insurance-based health care system may continue to be efficient and financially viable. The essential steering mechanism introduced is a system of fixed amount benefits in the various benefit areas, among them medicaments, technical aids such as wheelchairs, hearing aids, glasses, and various orthopaedic aids. Only part of the guidelines, tables and regulations needed for implementation have however been made available so far. It is therefore impossible as yet to undertake appropriate, objective evaluation of the advantages and disadvantages of the reform for patients and health funds. It may however already be said that, in respect of dentures, transport, as well as burial costs, health fund insurants have to raise considerable extra means, partly touching on the financial substance of many insurants. A hardship/overcharge clause is intended to keep the additional burdens socially compatible. This device however is absolutely insufficient in the case of chronically ill and very severely disabled people, paying no regard to the considerable additional expenses these populations have to incur for participating in general community life. The inclusion of benefits for domiciliary nursing and care is viewed as only a first step. The financial resources for protection against the risk of nursing and care dependency, however, should not come from the statutory health insurance scheme, but be based on a common pool of funds to be financed by the various social protection branches.(ABSTRACT TRUNCATED AT 250 WORDS)

Cost Control↗
PubMed2004

Methamphetamine abuse and manufacture: the child welfare response.

Methamphetamine abuse is on the rise, particularly by women of childbearing age. This article describes the history and effects of methamphetamine use. The authors examine the ways exposure to the manufacture of this drug affects clients and social workers in the course of their work. Because children are frequently found at the scene of a manufacturing laboratory, the child welfare system often becomes involved, and child protective services and other social work agencies need protocols to address the needs of the children and their parents, as well as those of the legal system. In 1997 California created and implemented drug-endangered children's units in seven counties to address the needs of children from families that manufacture methamphetamine; these units involve collaborative efforts among child protective workers, district attorneys, physicians, and police officers. A case example provides information about the role of social workers and their collaboration with these multiple systems.

Adult↗
PubMed1988

Stress, salt and hypertension.

Reasons are given why calcium, obesity and genetics cannot be considered primary factors in the etiology of essential hypertension. This leaves the major protagonists as salt and neuroendocrine responses to the emotions aroused by the social environment. Most essential hypertension is renin dependent and associated with the physiological changes induced by arousal of the defence response. The psychosocial stimulation associated with this arousal induces an increase in salt appetite. This makes the salt consumption of society a measure of the social stress to which it is exposed. Primitive people whose blood pressure remains normal throughout their lives may lack modern societies' physically protective achievements but their religiously prescribed social solidarity may protect them from psychosocial stress. Our chronic suppression of awareness of emotional arousal together with loss of the ritualized support of affiliative behavior may result in repressed emotional responses which find somatic expression in diseases such as essential hypertension. Hypertensiologist George Pickering proposed that the primitive's ritual and taboo (the equivalent in our society might be the Alcoholic's Anonymous belief in a 'Higher Power') protect them from much anger and despair. He gave this precedence over salt as the primary factor in essential hypertension. New evidence supports this. Despite a high salt diet the blood pressure of socially adjusted rodents remains normal throughout their lifespan. On the other hand, the hypertension that develops when they are psychosocially stimulated is not abated by a low salt diet. In humans, the blood pressure of cloistered, secluded Italian nuns on a high salt diet has remained normal for 20 years while that of nearby village women has risen at a startling 2 mmHg/annum during the same period. On the other hand, in rapidly changing Malawi mature adult, rural and urban blood pressures are rising fast despite a low salt intake. Thus the evidence today argues that the most important factor in the etiology of essential hypertension is not salt but psychosocial stimulation.

Humans↗
PubMed1997

Accelerative changes in some anthropometric indices of newborn infants in Plovdiv during the period from 1939 to 1995.

Periodical observation and comparison of newborn infants' physical development indices gives an idea of the dynamics of accelerative changes and the efficacy of implemented health and social programs for maternity protection in a given country. The author performs a longitudinal study of the basic anthropometric--birth height and weight of newborn infants in Plovdiv for a 56 year period. Two periods are outlined. The first one, 46 years long, is characterized with a marked increase of the anthropometric values and lasts till 1975. After that the acceleration rate levels off and gradually slows down. In the second 10 year period an abrupt decrease of newborn infants' birth height and weight is recorded, as their values drop to the levels obtained in the 1946/47 study. The author relates this negative trend to the economic crisis in the country, the progressive impoverishment of the population, the unemployment and insecurity in the future. The existing social and health facilities for maternity protection in the country are estimated as inadequate for the present situation.

Anthropometry↗
PubMed1998

Health visitor understanding and rating of 28 health and social factors used as part of a health visitor caseload weighting system.

This paper reports the results of the first stage of an evaluation study of a health visitor caseload weighting system. In Bristol, health visitor caseloads are compiled annually to complete caseload weighting summaries based on 28 health and social factors known to reflect long-term health outcome. The main study aims to determine the validity and reliability of the caseload weighting system by assessing health visitor variation in interpretation of the health and social factors, the accuracy of caseload factor recording and methods of analysis used in interpreting their significance. This paper describes the exploratory phase of the study involving the distribution of a questionnaire to 252 health visitors in five Trust areas where no caseload weighting system operates. The purpose of the questionnaire and follow-up interviews with 28 health visitors was to develop a multiple-choice questionnaire to assess how health and social factors were being interpreted by health visitors using them in their everyday work. The study indicated that the 28 health and social factors were perceived to significantly influence the need for health visiting services. Some differences in perception of a small number of factors were identified according to the level of deprivation on the caseload. Health visitors' prioritization of child protection, and child protection related health and social factors, raised the possibility that caseload weighting might be used as a 'child protection check list' rather than as an overall measure of health visitor need. Interviews showed that a range of thresholds governs the health visitors' application of a particular factor to a family. Health visitor workload is also affected by other factors relating to practice location, which would need to be taken into account if these health and social factors were to be used for estimating workload. Health visitors not currently using the factors view them positively for the assessment of health needs in an area, and for planning work on an individual or management level, but the interviews identified a need for training in their use and suggested more work is needed to tighten and standardize definitions for use in the field.

Journal Article↗
PubMed1996

[The principles and methodology for assessing radiation risk: the medical and socioecological contradictions].

An effort has been made to evaluate the environmental and social contradictions as applied to radiation health. Consideration was given to the following issues: the principle of stochasticity and uncertainty of delayed radiation effects of low doses in evaluation of liquidators' health; economic approach to determination of radiation risk and radiation protection programme; risks (natural, domestic, technogenic) comparability principle; simulation of the "man-factor-population-external environment" system; regional and ethnic principles in evaluation of radiation risk; gnosiological approach to formation of a positive image of radiation factor, the principle of economic and social protection; evaluation of radiation health with allowance for specificity of pilot work in highly risky conditions.

Aerospace Medicine↗
PubMed1999

The new confidentiality for the 21st century in a managed care environment.

As society becomes more dependent on technology to store and obtain information quickly and effectively, there has been increasing concern in the social work community about protecting privacy and maintaining confidentiality, especially in a managed care environment. The concept of confidentiality is very different in a technologically advanced environment. This article reviews relevant social work, legal, and other professional literature on confidentiality, technology, and managed care. A three-level topology of client problems and behaviors is delineated and illustrated through practice examples, which demonstrate the different types of information that can be computer stored and retrieved and electronically transmitted. The articles discussed the levels of security, including log-on procedures, firewalls, and encryption, which can be used at each level to protect sensitive information, and presents guidelines to help professionals protect and promote confidentiality within the constraints of technology and managed care.

Computer Security↗
PubMed1998

Is schizophrenia a disorder of all ages? A comparison of first episodes and early course across the life-cycle.

BACKGROUND: The heterogeneity of schizophrenic and delusional syndromes by age of onset has frequently been discussed. METHODS: The age distribution of symptoms and 5 year course was studied in a population-based first-episode sample admitted to 10 psychiatric hospitals before the age of 60 (N = 232) and in a clinical sample without age limit of consecutive first admissions to a single hospital (N = 1109), both samples with broadly diagnosed schizophrenia. RESULTS: Early-onset patients, particularly men, presented more non-specific symptoms and higher PSE-CATEGO total scores than late-onset patients. In men, symptom severity decreased with increasing age of onset. In women, it remained stable except for an increase of negative symptoms with late-onset. Only a few symptoms changed markedly with age: disorganization decreased, while paranoid and systematic delusions increased steeply across the whole age of onset range. Pronounced age- and sex-differences emerged in illness behaviour, socially negative behaviour and substance abuse. Within the group of late-onset psychoses there were continuous transitions in symptom profiles and no discrimination between schizophrenia and paranoid psychosis or late paraphrenia. The main determinant of social course was onset level of social development. Early-onset patients did not improve in social status, while late-onset patients, prior to retirement, suffered considerable decline in social status. CONCLUSIONS: Gender differences in age at onset and in age trends in symptom severity support the hypothesis of a mild protective effect of oestrogen. Social course results from an interplay between biological factors (age at onset and functional impairment) and development factors (level of social development at onset and illness behaviour).

Adolescent↗
PubMed2001

Is German long-term care insurance a model for the United States?

German long-term care insurance, implemented in 1995, significantly extends the coverage of care-related risks. Given the similarities of German and U.S. institutional features, the German social insurance approach has been put forward as a possible model for long-term care in the United States. Using a political economy framework, the authors conducted a policy analysis that compares the main shortfalls of long-term care (LTC) provision in the United States and Germany, examines the responses provided by LTC insurance in Germany, and relates them to broader trends and proposals for change in welfare policy in both countries. German LTC insurance includes a high degree of consumer direction and compensation and protection for informal caregivers; it supports the extension of community-based services. Its shortfalls include the continued split between health and LTC insurance. In both countries, decentralization and institutional and financial fragmentation are some of the characteristics responsible for the failure to promote egalitarian social policy and substantially expand social protection to family- and care-related risks. The German LTC program is a good model for the United States. With a social insurance approach to LTC, costs are spread across the largest possible risk pool. Major goals that can be reached with such a program include establishment of universal entitlements to LTC benefits, consumer choice, and equitability and uniformity.

Activities of Daily Living↗
PubMed1999

Strengthening Social Security.

Social Security's core protections must be maintained, according to this author. He believes that by creating universal savings accounts and investing a small portion of the Social Security trust fund in equities, it is possible to secure the long-term future of Social Security without subjecting workers to the risks of individual, private accounts.

Aged↗
PubMed2006

The contribution of working conditions and social support to the onset of depressive and anxiety disorders among male and female employees.

Poor working conditions may be an important source of stress and may therefore contribute to the development of depressive and anxiety disorders. Social support may act as a buffer and protect against the development of depression or anxiety in the face of poor working conditions. With longitudinal data from the Netherlands Mental Health Survey and Incidence Study (NEMESIS), the effect of working conditions and social support on the incidence of depressive and anxiety disorders was examined among 2646 working men and women, aged 18 through 65 years. Three dimensions of self reported working conditions were assessed: psychological demands, decision latitude and job security. Social support was assessed through validated scales for daily emotional support. About 10.5% of working women and 4.6% among working men developed an incident depressive and/or anxiety disorder over 2 years. Psychological demands predicted the incidence of depressive and anxiety disorders in both men and women (RR per score increase=2.29, 95% CI: 1.44-3.63), whereas decision latitude and job security did not. Social support protected against the incidence of depressive and anxiety disorders. This effect was stronger for men compared to women. Social support did not buffer the unfavorable mental effect of working conditions. Women were more likely to report low levels of decision latitude, whereas men reported higher psychological demands. Working conditions did not explain sex differences in the incidence of depressive and anxiety disorders.

Adolescent↗
PubMed2006

A developmental study of heavy episodic drinking among college students: the role of psychosocial and behavioral protective and risk factors.

OBJECTIVE: A theory-based protection/risk model was applied to explain variation in college students' heavy episodic drinking. Key aims were (1) to establish that psychosocial and behavioral protective factors and risk factors can account for cross-sectional and developmental variation in heavy episodic drinking, and (2) to examine whether protection moderates the impact of risk on heavy episodic drinking. METHOD: Random- and fixed-effects maximum likelihood regression analyses were used to examine data from a three-wave longitudinal study. Data were collected in fall of 2002, spring of 2003, and spring of 2004 from college students (N=975; 548 men) who were first-semester freshmen at Wave 1. RESULTS: Psychosocial and behavioral protective and risk factors accounted for substantial variation in college-student heavy episodic drinking, and protection moderated the impact of risk. Findings held for both genders and were consistent across the three separate waves of data. Key predictors of heavy episodic drinking were social and individual controls protection (e.g., parental sanctions for transgression and attitudinal intolerance of deviance, respectively); models risk (peer models for substance use); behavioral protection (attendance at religious services); and behavioral risk (cigarette smoking and marijuana use). Changes in controls protection, models risk, and opportunity risk were associated with change in heavy episodic drinking. CONCLUSIONS: An explanatory model based on both psychosocial and behavioral protective and risk factors was effective in accounting for variation in college-student heavy episodic drinking. A useful heuristic was demonstrated through the articulation of models, controls, support, opportunity, and vulnerability to characterize the social context, and of controls, vulnerability, and other behaviors to characterize individuals.

Alcohol Drinking↗