Explaining happiness trends in Europe.

In Europe, differences among countries in the overall change in happiness since the early 1980s have been due chiefly to the generosity of welfare state programs-increasing happiness going with increasing generosity and declining happiness with declining generosity. This is the principal conclusion from a time-series study of 10 Northern, Western, and Southern European countries with the requisite data. In the present study, cross-section analysis of recent data gives a misleading impression that economic growth, social capital, and/or quality of the environment are driving happiness trends, but in the long-term, time-series data, these variables have no relation to happiness.

Retirement Trajectories in Countries with Flexible Retirement Policies but Different Welfare Regimes.

We examine how both the welfare regime and health affect retirement trajectories in countries with flexible retirement policies using longitudinal methods and harmonized panel data from two social-democratic (Sweden and Denmark) and two liberal welfare regimes (Chile and the United States). An early retirement trajectory, which represents retirement in the early 60s, is the most frequent in all countries, although it is less prevalent in liberal than in social-democratic regimes. Adverse health conditions are more frequent among early retirees in liberal but not in social-democratic regimes. Overall, we do not find evidence for an inciting effect of flexible retirement policies on working life extension. However, welfare regimes substantially affect late-life labor force participation.

Evolución de la estructura de clases y el bienestar material en la Ciudad Autónoma de Buenos Aires contemporánea (2004-2015) / Evolution of class structure and material well-being in the contemporary City of Buenos Aires (2004-2015)

En este artículo analizamos los rasgos que asumió la estructura de clases de la Ciudad Autónoma de Buenos Aires (CABA) en el período 2004-2015. Utilizando como fuente de datos, principalmente, la Encuesta Anual de Hogares (EAH) relevada anualmente por la Dirección General de Estadística y Censos del Gobierno de la CABA, nos preguntamos acerca de cómo han evolucionado las clases sociales en términos de tamaño y composición, y cuánto se han distanciado o acercado respecto al bienestar material de los hogares que las conforman. Del análisis de los datos se desprende que la estructura de clases mantiene la configuración signada durante los años noventa, aunque con una relativa composición de la clase obrera calificada y la clase directivo-profesional. Por otro lado, el estudio de los ingresos y el acceso a la vivienda, en tanto dos activos del bienestar material de los hogares, muestra cierta reducción de la desigualdad respecto al primero, pero un fortalecimiento en las brechas respecto a la propiedad de la vivienda. (AU)

Family homelessness, subsequent CWS involvement, and implications for targeting housing interventions to CWS-involved families.

BACKGROUND: Homelessness is a risk factor for family involvement with child welfare services (CWS). Housing interventions are promising-but reasons for this are not well understood, and housing resources could be better targeted to families at risk of increased CWS involvement. OBJECTIVE: We sought to better understand the relationship between homelessness and CWS involvement and examine whether homeless shelter data could combine with CWS data to enhance intervention targeting. PARTICIPANTS AND SETTING: For 4 years, we followed 2063 families investigated by the San Francisco Human Services Agency in 2011. METHODS: Matching CWS data to homeless shelter data, we fit Cox models to examine the relationship between shelter use and subsequent CWS outcomes and produced ROC curves to judge model accuracy with and without shelter information. RESULTS: Absent CWS covariates (family demographics, CWS history, and family safety and risk), past shelter entry predicted repeat maltreatment referral (HR = 1.92, p < .001), in-home case opening (HR = 1.51, p < .05), and child removal (HR = 1.95, p < .01), but not child reunification. With CWS covariates, past shelter use no longer predicted case opening and child removal, but still predicted referral (HR = 1.58, p < .01). Shelter data did not contribute to models' predictive accuracy. CONCLUSIONS: We find mixed evidence that shelter use independently leads to CWS involvement. Housing interventions might help by addressing present housing problems and family experiences correlated with past shelter use. However, we find no evidence that data matches with shelter systems could enhance targeting.

History Matters: Racialized Motherhoods and Neoliberalism.

Neoliberal political reasoning is remaking the state's democratic character and its governing rules to reflect those of the market. The most prominent legislative example, Temporary Assistance for Needy Families, dictates work requirements, time limits, and monitoring and sanctioning of clients. Through such policies, the primary aims of government assistance changed from aiding needy citizens to transforming individuals into paid workers, regardless of continued poverty or care obligations. Although scholarship of related policy and governance tools has grown, less study has centered on understanding the historic events and ways in which race-based, gendered, and poverty narratives facilitated adoption of such austere policies. This article compares circumstances of African American and White mothers in the United States from the Revolutionary War to the postwelfare era. It describes what neoliberalism is, discusses the role of ideological discourses in policy and governance, presents the history and historical racialized portrayals of White and African American motherhood during this period, and analyzes the differential impact of ideological discourses using a lens of intersectionality. The conclusion discusses how discriminatory discourses subvert a democratic ethos for all and suggests ways for social workers to contest the impacts of neoliberalism.

Building Community Partnership to Sustain the Minnesota Student Parent Support Initiative.

PURPOSE: Considerable attention has been given to the sustainability of adolescent health programs as federal funds have become limited. This article describes important steps and lessons learned in seeking buy-in from stakeholders to promote sustainability and secure non-federal funds to maintain the Minnesota Student Parent Support Initiative (MSPSI) after federal funding ended. DESCRIPTION: MSPSI was established in 2010 to address the academic and health needs of expectant and parenting postsecondary students. MSPSI provided coordinated case management and referrals to health, education, and social services for expectant and parenting adolescents, as well as for their children, through Student Parent Centers (SPCs). Six important actions sustained the SPCs after the Office of Population Affairs (OPA) grant funds ended in November 2017: (1) preparing and planning for sustainability, (2) creating and engaging a sustainability committee, (3) assessing sustainability needs and creating a sustainability plan, (4) creating a data system to collect relevant data, (5) building capacity to support communication with decision makers, and (6) sharing data and success stories. ASSESSMENT: The implementation of the sustainability plan resulted in ongoing communications and data sharing with key partners that helped secure additional funds for continuing the program after OPA funding ended. CONCLUSION: Implementing the MSPSI sustainability plan developed from OPA's sustainability framework was effective in sustaining the SPCs after federal funding ended. The sustainability planning, the ability to secure funds, the attempt at passing legislation, and the lessons shared in this article provide valuable guidance to organizations seeking strategies to sustain adolescent health programs.

Introducing a Future-Oriented Approach to Health-Care Technologies and Welfare Policies: An Innovative Ethics Project in Sweden.

This article is a description of a 2-year program (May 2017-April 2019) intended to introduce new approaches to addressing ethical issues resulting from the introduction of new health-care technologies and welfare policies. In contrast to the traditional retrospective approach in addressing ethical issues after they occur, this program intended to address ethical issues proactively, before they occurred. This future-focused approach is one way to better keep up with the acceleration of change that society confronts. This project introduced innovative approaches in dealing with unintended consequences and ethical issues resulting from the implementation of new health-care technologies and welfare policies in the Halland region of Sweden.

The future incidence, prevalence and costs of stroke in the UK.

BACKGROUND: we project incidence and prevalence of stroke in the UK and associated costs to society to 2035. We include future costs of health care, social care, unpaid care and lost productivity, drawing on recent estimates that there are almost 1 million people living with stroke and the current cost of their care is £26 billion. METHODS: we developed a model to produce projections, building on earlier work to estimate the costs of stroke care by age, gender and other characteristics. Our cell-based simulation model uses the 2014-based Office for National Statistics population projections; future trends in incidence and prevalence rates of stroke derived from an expert consultation exercise; and data from the Office for Budget Responsibility on expected future changes in productivity and average earnings. RESULTS: between 2015 and 2035, the number of strokes in the UK per year is projected to increase by 60% and the number of stroke survivors is projected to more than double. Under current patterns of care, the societal cost is projected to almost treble in constant prices over the period. The greatest increase is projected to be in social care costs-both public and private-which we anticipate will rise by as much as 250% between 2015 and 2035. CONCLUSION: the costs of stroke care in the UK are expected to rise rapidly over the next two decades unless measures to prevent strokes and to reduce the disabling effects of strokes can be successfully developed and implemented.

Effectiveness of community organizing interventions on social activities among older residents in Japan: A JAGES quasi-experimental study.

Social activities in the community help older adults maintain functional ability. Community organizing, based on the assessment of health risks, community assets, and fostering intersectoral organizational partnerships, could increase participation opportunities. Supporting municipality staff members in building their capacity to take those actions might benefit them. Nevertheless, the effectiveness of such support remains unclear. This real-world-setting study evaluated the effectiveness of providing support for municipality health sectors in relation to older residents' social activities. Based on the Japan Gerontological Evaluation Study (JAGES), a nationwide study of community-dwelling older adults, from 2013 to 2016 researchers collaborated with health sector staff members in 13 participating municipalities (intervention group) in utilizing the JAGES-based community assessment data and building organizational partnerships. The remaining 12 municipalities (control) obtained the data only. We analyzed the longitudinal data of 47,106 older residents, performing a difference-in-differences (DID) analysis, weighted by the inverse of propensity to be selected for the intervention group, allowing for a multilevel (municipality/individual) data structure. In the intervention group, the estimated group participation prevalence in men increased by 10.4 percentage points from 47.5% to 57.9%, while in the control group, participation increased by 7.9 percentage points from 47.2% to 55.0% (DID estimated = 0.025, P = 0.011). No statistically significant difference between the two groups was observed among women (P = 0.131). Support for community organizing may improve group participation among older male residents. The community-attributable impact could be large, given that the intervention has the potential to work for all older residents in the municipality.

Nurse graduates' experiences and support needs: A qualitative systematic review of South Africa's community service programme.

BACKGROUND: The student-to-nurse graduate transition is a pivotal phase in the professional development of nurses. In South Africa, this transition is part of a compulsory community service programme, which requires newly graduated nurses to work in rural and/or underserved areas for a period of 1 year. OBJECTIVES: The aim of this study was to review nurse graduates' experiences and support needs during their transition in the compulsory community service programme. METHODS: A qualitative systematic review of experiences was conducted. Qualitative research studies that addressed nurses' experience in South Africa (2008-2017) were identified in Cochrane, Joanna Briggs Institute (JBI), Academic Search Complete, CINAHL, PubMed, SABINET, Science Direct, SCOPUS and Google Scholar databases. The systematic review methods included searching, sifting, abstracting and quality assessment of relevant qualitative studies by two reviewers and cross-checking by a third reviewer. Two reviewers independently performed blinded data extraction and quality assessment using the confidence in qualitative synthesis findings (ConQual) approach. RESULTS: A total of 1257 studies were identified of which 12 met the inclusion criteria. Seven of the 12 studies were published articles and six were theses. The quality of the studies was found to be of high standard based on the ConQual rating. Four main themes emerged from the analysis: (1) rich developmental experiences through practice exposure, (2) difficulties in reconciling theory and practice, (3) contextual challenges in the workplace and (4) need for professional support structures, educational measures and public guidelines. CONCLUSION: Although positive experiences were reported, various challenges emerged, indicating the need for more systematic support mechanisms during transition.

The influence of welfare state factors on nursing professionalization and nursing human resources: A time-series cross-sectional analysis, 2000-2015.

AIM: The aim of this study was to examine the relationship between welfare states and nursing professionalization indicators. DESIGN: We used a time-series, cross-sectional design. The analysis covered 16 years and 22 countries: Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Japan, Netherlands, New Zealand, Norway, Portugal, South Korea, Spain, Sweden, Switzerland, United Kingdom, and the United States, allocated to five welfare state regimes: Social Democratic, Christian Democratic, Liberal, Authoritarian Conservative, and Confucian. METHODS: We used fixed-effects linear regression models and conducted Prais-Winsten regressions with panel-corrected standard errors, including a first-order autocorrelation correction. We applied the Amelia II multiple imputation strategy to replace missing observations. Data were collected from March-December 2017 and subsequently updated from August-September 2018. RESULTS: Our findings highlight positive connections between the regulated nurse and nurse graduate ratios and welfare state measures of education, health, and family policy. In addition, both outcome variables had averages that differed among welfare state regimes, the lowest being in Authoritarian Conservative regimes. CONCLUSION: Additional country-level and international comparative research is needed to further study the impact of a wide range of structural political and economic determinants of nursing professionalization. IMPACT: We examined the effects of welfare state characteristics on nursing professionalization indicators and found support for the claim that such features affect both the regulated nurse and nurse graduate ratios. These findings could be used to strengthen nursing and the nursing workforce through healthy public policies and increase the accuracy of health human resources forecasting tools.

Home and Community-based Services and Life Satisfaction among Homebound and Poor Older Adults.

Little evidence exists regarding the role of Home and Community-Based Services (HCBS) utilization on life satisfaction among older people who are both homebound and low-income. Guided by the personal-environment (P-E) fit perspective, this study aims to: (1) describe characteristics of older people with homebound and low-income status; (2) investigate how the combination of homebound and low-income status is associated with life satisfaction; and (3) examine whether HCBS utilization moderates the association between homebound and low-income status and life satisfaction. Data were drawn from the 2012 Health and Retirement Study, and the sample included respondents who were 51+ years who completed a questionnaire for HCBS utilization (n= 1,662). Results describe sociodemographic, health-related, and environmental characteristics of older adults. Combined homebound and low-income status was a significant predictor of lower life satisfaction (ß = -0.15, p< .05), but better life satisfaction when they used HCBS (ß = 0.33, p <.10). These findings suggest that promoting HCBS utilization is a promising strategy to enhance well-being among those homebound and poor. Further studies are needed to test the effectiveness of HCBS with longitudinal data and to investigate the details of effective HCBS utilization such as frequency of use and types of services.

Welfare consequences for people diagnosed with nonepileptic seizures: A matched nationwide study in Denmark.

OBJECTIVE: We aimed to evaluate the excess direct and indirect costs associated with nonepileptic seizures. METHODS: From the Danish National Patient Registry (2011-2016), we identified 1057 people of any age with a diagnosis of psychogenic nonepileptic seizures (PNESs) and matched them with 2113 control individuals. Additionally, 239 partners of patients with PNES aged ≥18 years were identified and compared with 471 control partners. Direct costs included frequencies and costs of hospitalizations and outpatient use weighted by diagnosis-related group, and specific outpatient costs based on data from the Danish Ministry of Health. The use and costs of drugs were based on data from the Danish Medicines Agency. The frequencies of visits and hospitalizations and costs of general practice were derived from National Health Security data. Indirect costs included labor supply-based income data, and all social transfer payments were obtained from Coherent Social Statistics. RESULTS: A higher percentage of people with PNES and their partners compared with respective control subjects received welfare benefits (sick pay, disability pension, home care). Those with PNES had a lower employment rate than did controls for equivalent periods up to three years before the diagnosis was made. The additional direct and indirect annual costs for those aged ≥18 years, including transfers to patients with PNES, compared with controls, were €33,697 for people with PNES and €15,121 for their partners. SIGNIFICANCE: Psychogenic nonepileptic seizures have substantial socioeconomic consequences for individual patients, their partners, and society.

How and How Much: Combined Services for Domestic Violence and Substance Abuse.

This study generates practice-based evidence about organizational strategies for addressing co-occurring domestic violence (DV) and substance abuse (SA) using a survey of organizations working on both issues (N = 204). How (the strategies) and how much (the extensiveness) organizations attend to both issues vary by organizational type (DV, SA, or multiservice) and populations served. While most SA and multiservice organizations address DV internally, most DV organizations use external collaborations; all offer services to DV perpetrators at similar rates. Findings underscore the importance of including multiple, nuanced measures of organizational activities related to co-occurring DV and SA in future research.