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PubMed1982

The case for integration of the investigator and helper roles in child protection.

Social workers who have both investigative and helping roles in child protective cases may find the roles to be in conflict and difficult to integrate. This problem has been exacerbated by recent changes in U.S. law and court procedure which place more emphasis on the quality of child abuse investigations. While it may not be easy for social workers to integrate the roles of investigator and helper, this paper draws on social work theory to show that it is possible and beneficial to their clients when they are able to do so. Social workers who are able to perform successfully in both roles are best prepared to help clients recognize and overcome problems. Division of the investigator and helper roles, on the other hand, may create significant difficulties including staff conflict, denial of problems by clients, and distortion of clients' expectations of the professional and the agency.

Child↗
PubMedDate not supplied

Reproductive health and blurred professional boundaries.

We recognize that many of the issues raised are not simple. Our proposal calls for the same thoughtful deliberation applied in other settings to be brought to bear on reproductive health care. Some have already tried alternative approaches. In Albuquerque, New Mexico, a university hospital neonatologist and the district attorney have collaborated to create an alternative to sentencing program for women who are arrested for drug-related crimes and found to be both pregnant and drug addicted. Rather than proceed with criminal sanctions, these women are offered entry into a drug treatment program that is geared to families with young children and run by the pediatrics department. Here, the physician and the district attorney collaboratively responded in ways congruent with the professional integrity of each. In another example in Portland, Oregon, physicians, drug treatment providers, and child protective social service representatives cooperatively defeated a legislative proposal to mandatorily test and report pregnant women for illicit drug use and, instead, formed a task force to jointly develop state policy regarding the issue. Drug use, HIV infection, child abuse, and poverty are all cause for alarm. Yet it is critical that our frustration about these difficult problems not be translated into blaming individuals for "deviance," or into short-term inadequate responses. In developing policy we should consider the impact on the legal and ethical rights and obligations of both patient and physician. For every course, we should evaluate both immediate and long-term efficacy, the consequences for the doctor-patient relationship, and the consequences for medical integrity. In the midst of the present regulatory and fiscal turmoil affecting health care, we urge physicians to be careful and deliberate in the policies they embrace and the actions they take.

Confidentiality↗
PubMed1992

The underrated benefits of oral contraception: consequences of pregnancy and induced abortion in teenagers.

If complications occur within a pregnancy planned and brought to term, they often can be dealt with and accepted. They are even more traumatic when they occur in an unwanted pregnancy that could have been prevented through contraception. Teenagers, because of their physical and psychological immaturity and also because of their social environment, seem to suffer with undue frequency from the complications of induced abortion. Its result, for the teenager, is a handicapped future in comparison to other women. Hence, access to contraception is important for all women, and especially for teenagers, in order to avoid such prejudicial situations. It is important, then, to prescribe oral contraception for its efficacy and its short- and long-term innocuousness. Because of her immaturity, the pregnant teenager is at risk: of spontaneous abortion, pre-eclampsia, anemia, hemorrhage, and prematurity. She is also at risk because of the social difficulties she will be facing. This is particularly true in families from developing countries. From birth, the child is also at risk: of low birth weight for the term, mortality in the first year of life, and all risks linked to abandonment, or education by a third party. In a proportion of 13 to 30% in western countries and in a proportion of 3% in East Asia or in Northwest Africa (Maghreb), induced abortions are a reflection of the following: early sexual activity without contraception even if fertility is still low in very young teenagers, absence of social protection or social independence, refusal of forced marriage, and presence or absence of liberal legislation.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Induced↗
PubMedDate not supplied

[From foreign worker to pensioner--selected aspects of financial security and social care of elderly foreigners in Germany].

There is evidence that many older migrants of foreign nationality remain permanently in the Federal Republic of Germany. Therefore the question of their social protection after retirement arises. This contribution discusses the financial protection via statutory pensions and social assistance, as well as the care provided by their families or on an inpatient or outpatient basis. Deficits in social protection of older immigrants are evident, which should be investigated more thoroughly and dealt with by social policy.

Aged↗
PubMed1986

Social skills and the stress-protective role of social support.

Cross-sectional analyses of data collected from a large sample of incoming college freshmen were used to determine whether the perceived availability of social support protects persons from stress-induced depressive affect; whether social competence, social anxiety, and self-disclosure are responsible for the stress-protective effect of perceived social support; and whether these social skill measures discriminate among persons for whom support will help, hinder, or be ineffective in the face of stress. Prospective analyses based on the original testing (beginning of school year) and 11- and 22-week follow-ups of a randomly selected subsample were used to determine how the same social skill factors influence the development and maintenance of support perceptions and of friendships. Evidence is provided for a stress-buffering role of the perceived availability of social support. The stress-buffering effect is unaffected by controls for the possible stress-protective influences of social anxiety, social competence, and self-disclosure. Although these social skill factors do not discriminate among persons for whom support will help, hinder, or be ineffective, they are prospectively predictive of the development of both social support and friendship formation. These prospective relations between social skills and the development of perceived availability of social support are only partly mediated by number of friends.

Adolescent↗
PubMed1988

Decree No. 88-737 setting the duties of the Minister of Social Affairs and concerning the reorganization of the Ministry, 31 August 1988.

This Decree sets forth the duties of the Minister of Social Affairs of the Ivory Coast. These include, among others, 1) organizing the social protection of the family, childhood, youth, and persons who are handicapped, maladjusted, and disadvantaged; 2) organizing, encouraging, and sensitizing individuals, families, and communities with a view towards promoting their psychological well-being, health, and social development; 3) studying and programming all new preventative or curative activities, leading to the betterment of individuals, families, and groups; 4) bringing assistance to individuals, families, and groups whose social situation requires state help; and 5) organizing the social protection of workers and their families. Among the departments of the Ministry of Social Affairs is the Directorate of Social Development, which is to create and ensure the application of national programs of family protection and social promotion of the population, through family and preschool education. Further provisions of the Decree describe the other departments and personnel of the Ministry.

Adolescent↗
PubMed2002

Social support protects against the negative effects of partner violence on mental health.

OBJECTIVES: Social support for abused women may reduce the impact of abuse on mental health, yet few studies have addressed this issue. We wish to determine associations between intimate partner violence (IPV) and mental health outcomes and to assess the protective role of abuse disclosure and support on mental health among abused women. METHODS: A cross-sectional survey was conducted of 1152 women, ages 18-65, recruited from family practice clinics from 1997 through 1999. They were screened for IPV during a brief in-clinic interview, and physical and mental health status was assessed in a follow-up interview. RESULTS: IPV, defined as sexual, physical, or psychological abuse, was associated with poor perceived mental and physical health, substance abuse, symptoms of posttraumatic stress disorder (PTSD), current depression, anxiety, and suicide ideation/actions. Among women experiencing IPV and controlling for IPV frequency, higher social support scores were associated with a significantly reduced risk of poor perceived mental health (adjusted relative risk [aRR] 0.5, 95% confidence interval [CI] 0.3, 0.6) and physical health (aRR 0.6, 95% CI 0.5, 0.8), anxiety (aRR 0.3, 95% CI 0.2, 0.4), current depression (aRR 0.6, 95% CI 0.5, 0.8), PTSD symptoms (aRR 0.5, 95% CI 0.4, 0.8), and suicide attempts (aRR 0.6, 95% CI 0.4, 0.9). CONCLUSIONS: Healthcare providers can be instrumental in identifying IPV and helping women develop skills, resources, and support networks to address IPV. Physicians, family, or friends may provide needed social support.

Adolescent↗
PubMed2003

[The challenge of health care provision politics for children and adolescents as part of equitable public policies].

The author analyzes the new social policy shaped by the assimilation of the notion of integral social protection with a view towards equity. The premises marked the social reform contained in the wording of the 1988 Constitution and in the laws regulating the respective rights during the 1990s, including public social assistance, health care, and education. The article demonstrates how, in the former context, Brazil's children and adolescents were subject to great vulnerability due to their position in the country's social structure, aggravated by differential access to public goods and services. An analysis of the health care policy for children and adolescents, emphasizing an inter-sectoral approach and redefining social and health programs and measures in the 1990s, was not intended to be conclusive but did point to some trends in the reorganization of public social assistance policy for low-income youth, in keeping with gains obtained in social indicators of vulnerability in the areas of health, education, and labor during the last decade. Still, the author concludes that this policy reorientation renewed the tension between targeting more vulnerable segments of the population with selective measures as compared to universal and comprehensive access to social protection.

Adolescent↗
PubMed2003

[Social policy and macro economic adjustment].

This paper analyzes responses by welfare states to globalization in some OECD countries in the 1980s and 90s, demonstrating that the hypothesis concerning the dismantling of social welfare systems cannot be proven due to lack of evidence of substantial changes in the funding and selection of beneficiaries. The paper also focuses on the effects of internationalization of the Brazilian economy on the country's social protection system. The conclusion is that restrictions imposed on public expenditures severely limited the capacity to promote broad coverage in social policies. During the decade the option was made for targeted, selective social policies based on the adoption of a diagnosis of low effectiveness in the Brazilian social protection system. The case of health policy was an exception, due to capacity for interest mediation in the social arena.

Brazil↗
PubMed1997

Perceived problems for self and others: self-protection by social downgrading throughout adulthood.

In this study the authors investigated social downgrading as reflected in the difference between perceptions about the self and about "most people my age." A large cross-national probability sample of adults at different age levels throughout adulthood provided ratings of perceived problems expected for the self and for "most other people my age" with regard to 12 domains of life (e.g., health, marriage, and job). Results showed that with regard to all domains, younger, middle-aged, and older adults believed other people's problems to be more serious than their own problems in these domains. Social downgrading was particularly pronounced for those domains for which a given participant experienced problems himself or herself. This self-protection tendency under threat was particularly pronounced in the older adults. The function and adaptive values for social downgrading across adulthood and old age are discussed.

Adaptation, Psychological↗
PubMed2007

[Old and new risks: In pursuit of other forms of protection].

Based on the concept of health as openness to risk, as outlined by Canguilhem in 1946, the authors seek to distinguish between risks that require social protection networks and those that should be tolerated as part of the human condition. To understand this issue, the article analyzes the historical emergence of the risk concept as viewed in early industrial society and its link to the idea of dangerousness and risk as analyzed by Robert Castel in his work From Dangerousness to Risk and L'Insegurité Sociale: Qu'est-ce Qu'etre Protegé? The authors discuss the continuities and discontinuities in these classical risks, with their social protection structures, and the emerging awareness of multiple hazards in late modernity.

Attitude to Health↗
PubMed2001

[From the "Rothenfelser Denkschrift" to book IX of the German social code - Milestones of governmental responsibility for integrating people with chronic illness and disabilities in occupation and society].

After World War II, further development of the social protection schemes in place seemed an urgent requirement given a rapidly unfolding industrial society. At the request of Federal Chancellor Konrad Adenauer, four renowned social scientists drafted the "Rothenfelser Denkschrift" published in 1955, which, on the basis of thorough analysis, presented concrete proposals for reshaping the field of social protection. Quite a few of these suggestions have since been incorporated in various books of the German social code, and some of their ideas are quite topical also in the context of the statutory health insurance reform to come. So, curative treatment and rehabilitation might both be considered indispensable constituents of health and social provision, with seamless transitions required in the interest of those affected as well as of meaningful utilization of resources.

Chronic Disease↗
PubMed2002

Financing systems of care for older persons in Europe.

The growing demand for long-term care is placing significant pressure on traditional funding for health and social services in the European Union. In countries where the social security system is based on the Beveridge model, dependency is essentially community-managed through local services; in some countries in which social protection is based on the Bismarck model, dependency has been recognized as a new risk; in southern Europe and Belgium, dependency leads to tax-funded social assistance. Related positions have been adopted: individual contributions are increasing, and while recourse to private insurance remains marginal but is developing, the need for public financing is not being questioned. The choices made regarding home-maintenance, local intervention levels and caregiver assistance will determine the degree of risk coverage in Europe. If the various European countries adopt similar policies, there can be a convergence of the models of social protection for dependency.

Aged↗
PubMedDate not supplied

[The medical service of sickness insurance: its future].

Since its creation, the Medical Service of Health Insurance has known an important evolution. Initially, its essential role was to control the allowances paid to the insured persons of the regimes of Health Insurance. Its aspect was rather coercive. But since 1960 a change has been outlined with the creation of the "Haut Comité Médical de la Sécurité Sociale": the Medical Control left its place to the Medical Service. With this denomination, its functions never stopped expanding. The Medical Service maintained its tasks of control devolved by the different regulations, and that is how it falls to it to express a view about long term diseases, disability occupational injuries, etc. It is also responsible for setting up "selective" controls with regard to some of medical or ancillary medical acts. But this taskwork is coupled with an important activity: the counsel. This responsibility is orientated in three directions: the Health Insurance Associations, the insured persons, and the Health Professions particularly as a part of the conventions binding them to the organizations of the French social protection system. During these last years new date intervened in health insurance matters in consequence of the economical crisis. Henceforward, it suits to find just a balance between a social protection of a high standard and adapted care of quality for the best cost. New opportunities are offered to the Medical Service to face this situation and gave it also a fresh impulse. This new evolution fits into an activity of public health considering the progress of the medicine. This activity must be orientated to a better knowledge of dispensed care and its good employment. Several orientations must be detained. In disease matters, informations in possession of the medical services are to be operated and, thanks to the data processing, a balance sheet of expenses will be drawn up, comparing them with diagnostic and therapeutic means. These studies, whose results will be published, must be guided with an exemplary scientific strictness and be supported by uncontested leading people in the medical world. Hospitalization is the other field where the role of the medical service must be essential. It certainly charges to continue the individual controls. But it must go further and be interested in the hospital working, as well as in the aggregate as by hospital service. This permits to get indispensable informations for useful decisions in view of a better hospitalisation.(ABSTRACT TRUNCATED AT 400 WORDS)

Costs and Cost Analysis↗
PubMed2005

Secondary traumatic stress and oncology social work: protecting compassion from fatigue and compromising the worker's worldview.

Secondary traumatic stress (STS) represents a disorder that has the same symptoms as post traumatic stress disorder, but results from vicariously experiencing trauma through association with those directly encountering the traumatic event(s). This exploratory study examined STS in 21 oncology social workers who were members of the Association of Oncology Social Workers. The results of this study revealed that oncology social workers experienced compassion fatigue and burnout and that these variables were inversely related to compassion satisfaction. Other relationships between emotional involvement, ability to separate work from home, level of licensure, personal loss, and empathetic responsiveness were also examined.

Adult↗