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1.
Soc Work Public Health ; 35(7): 617-632, 2020 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-32970544

RESUMEN

The COVID-19 pandemic has been particularly overwhelming for communities of color in the United States. In addition to the higher levels of underlying health conditions, circumstances related to a history of oppression and unequal access to opportunities and services are apparent. Social service programs will need to be re-developed to accommodate a new reality, both in terms of how people connect with services and how social work professionals provide them. Professional social work organizations' codes of ethics are analyzed, along with the theoretical framework of structural competency. It is an ethical imperative that social welfare policy and practice advance as culturally competent, racial equity, and empowerment-based programs. Child welfare is portrayed as an example where the pandemic could provide an opportunity to learn from the past to construct a more compassionate, competent, and ethical future.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Política Pública , Racismo/ética , Bienestar Social/ética , Servicio Social/ética , Betacoronavirus , Competencia Cultural , Humanos , Pandemias , Estados Unidos/epidemiología
2.
Creat Nurs ; 26(1): e35-e39, 2020 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-32024746

RESUMEN

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.


Asunto(s)
Prestación de Atención de Salud/ética , Prestación de Atención de Salud/tendencias , Política de Salud/tendencias , Invenciones/ética , Invenciones/tendencias , Bienestar Social/ética , Bienestar Social/tendencias , Prestación de Atención de Salud/estadística & datos numéricos , Predicción , Humanos , Invenciones/estadística & datos numéricos , Estudios Retrospectivos , Bienestar Social/estadística & datos numéricos , Suecia
3.
Br J Sociol ; 71(1): 112-126, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31903605

RESUMEN

The increased comparative research on perceptions of public welfare deservingness studies the extent to which different subgroups of citizens are deemed worthy or unworthy of receiving help from the welfare state. The concept of deservingness criteria plays a crucial role in this research, as it theorizes a universal heuristic that citizens apply to rank people in terms of their welfare deservingness. Due to the mainly quantitative nature of the research and despite the indisputable progress it has made, the subjective existence and actual application of these deservingness criteria remain a bit of a black box. What criteria of deservingness do citizens actually apply, and how do they apply them? This article opens the black box of welfare deservingness and sheds light on the nature and practice of deservingness criteria. Empirically, the paper explores how the deservingness of immigrants is discussed and established within 20 focus groups conducted in Slovenia, Denmark, UK, and Norway in 2016 with a total of 160 participants. All 20 focus groups discussed the welfare deservingness of immigrants based on similar vignette stimuli. Our analysis shows that (1) deservingness criteria are used both to construct images of target groups and as normative yardsticks; (2) deservingness criteria do not work independently of each other, but rather co-function in specific hybridized discourses; and (3) the moral logic of deservingness is supplemented by alternative moral logics, at least in the case of migrants.


Asunto(s)
Emigrantes e Inmigrantes , Bienestar Social , Migrantes , Adulto , Anciano , Actitud , Dinamarca , Emigrantes e Inmigrantes/psicología , Femenino , Grupos Focales , Heurística , Humanos , Masculino , Persona de Mediana Edad , Principios Morales , Noruega , Eslovenia , Bienestar Social/ética , Migrantes/psicología , Reino Unido
4.
Soc Work ; 64(4): 321-328, 2019 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-31566240

RESUMEN

Modern technology threatens to dramatically alter the U.S. labor economy, but the crumbling social safety net may be insufficient for affected workers. Some advocates propose to address these converging problems through universal basic income (UBI). Authors conducted a preliminary review of social work perspectives on the topic of UBI. They found very little relevant literature, especially among American scholars. Existent social work literature frames UBI as an alternative to the neoliberal welfare state and mass unemployment. Social workers also contribute a critical social justice orientation to UBI scholarship in other disciplines. Grounded in the NASW Code of Ethics, authors argue that it is imperative for American social workers to seriously consider UBI as an answer to growing inequality and the unique expertise that social workers offer as allies of marginalized populations.


Asunto(s)
Renta , Pobreza/ética , Política Pública , Justicia Social/ética , Trabajadores Sociales/psicología , Humanos , Principios Morales , Pobreza/economía , Pobreza/prevención & control , Bienestar Social/economía , Bienestar Social/ética , Servicio Social/ética , Estados Unidos , Diseño Universal
6.
Rev. bioét. derecho ; (45): 59-71, mar. 2019.
Artículo en Español | IBECS | ID: ibc-177375

RESUMEN

Este artículo pretende contribuir al debate sobre la objetividad de la ciencia, la independencia y la libertad académica de quienes investigan. A partir de una breve panorámica sobre los factores que moldean la investigación en salud pública, se pretende iniciar una reflexión desde la perspectiva ética sobre la libertad de los y las investigadoras a la hora de realizar su investigación -las fuerzas externas e internas que la moldean- y el propósito social de su labor investigadora, que debe ser el avance del conocimiento para aumentar el bienestar social y la salud de las poblaciones


This article aims to contribute to the debate on the objectivity of science, independence and academic freedom of researchers. Based on a brief overview of the factors that shape public health research, we intend to initiate a reflection from the ethical perspective on the freedom of researchers when conducting their research -the external and internal forces that shape it- and the social purpose of their research work, which should be the advancement of knowledge to increase social welfare and the health of populations


Aquest article pretén contribuir al debat sobre l'objectivitat de la ciència, la independència i la llibertat acadèmica dels qui investiguen. A partir d'una breu panoràmica sobre els factors que modelen la recerca en salut pública, es pretén iniciar una reflexió des de la perspectiva ètica sobre la llibertat dels i les investigadores a l'hora de realitzar la seva recerca -les forces externes i internes que la modelen- i el propòsit social de la seva labor investigadora, que ha de ser el progrés del coneixement a fi d’augmentar el benestar social i la salut de les poblacions


Asunto(s)
Humanos , Apoyo a la Investigación como Asunto/ética , Ética en Investigación , Libertad , Salud Pública , Bienestar Social/ética , Responsabilidad Social , Comités de Ética en Investigación/ética , Política Pública , Ciencia/ética
7.
Br J Sociol ; 70(4): 1104-1127, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29785778

RESUMEN

This article examines the narrative strategies through which Polish migrants in the UK challenge the formal rights of political membership and attempt to redefine the boundaries of 'citizenship' along notions of deservedness. The analysed qualitative data originate from an online survey conducted in the months before the 2016 EU referendum, and the narratives emerge from the open-text answers to two survey questions concerning attitudes towards the referendum and the exclusion of resident EU nationals from the electoral process. The analysis identifies and describes three narrative strategies in reaction to the public discourses surrounding the EU referendum - namely discursive complicity, intergroup hostility and defensive assertiveness - which attempt to redefine the conditions of membership in Britain's 'ethical community' in respect to welfare practices. Examining these processes simultaneously 'from below' and 'from outside' the national political community, the paper argues, can reveal more of the transformation taking place in conceptions of citizenship at the sociological level, and the article aims to identify the contours of a 'neoliberal communitarian citizenship' as internalized by mobile EU citizens.


Asunto(s)
Actitud , Emigración e Inmigración , Política , Bienestar Social/psicología , Migrantes/psicología , Adulto , Unión Europea , Femenino , Humanos , Masculino , Persona de Mediana Edad , Narración , Polonia/etnología , Bienestar Social/ética , Participación de los Interesados , Encuestas y Cuestionarios , Reino Unido , Adulto Joven
8.
Nurs Ethics ; 26(7-8): 1955-1967, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30318993

RESUMEN

Appropriate and balanced decision-making is sentinel to goal setting and the provision of appropriate clinical care that are attuned to preserving the best interests of the patient. Current family-led decision-making in family-centric societies such as those in Singapore and other countries in East Asia are believed to compromise these objectives in favor of protecting familial interests. Redressing these skewed clinical practices employing autonomy-based patient-centric approaches however have been found wanting in their failure to contend with wider sociocultural considerations that impact care determinations. Evaluation of a number of alternative decision-making frameworks set out to address the shortcomings of prevailing atomistic and family-centric decision-making models within the confines of end-of-life care prove these alternative frameworks to be little better at protecting the best interests of vulnerable patients. As a result, we propose the Welfare Model that we believe is attentive to the relevant socio-culturally significant considerations of a particular case and better meets the needs of end-of-life care goals of preserving the welfare of patients. Employing a multi-professional team evaluation guided by regnant psychosocial, legal, and clinical standards and the prevailing practical and clinical realities of the particular patient's setting the Welfare Model provides a clinically relevant, culturally sensitive, transparent, and evidence-based approach to care determinations.


Asunto(s)
Bienestar Social/ética , Cuidado Terminal/métodos , Toma de Decisiones , Humanos , Defensa del Paciente , Autonomía Personal , Personeidad , Singapur , Bienestar Social/psicología , Cuidado Terminal/psicología , Cuidado Terminal/tendencias
9.
Bioethics ; 32(9): 562-568, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30450599

RESUMEN

Drawing on a conception of people as 'ecological subjects', creatures situated in specific social relations, locations, and material environments, I want to emphasize the importance of place and place-making for basing, demonstrating, and forging future solidarity. Solidarity, as I will define it here, involves reaching out through moral imagination and responsive action across social and/or geographic distance and asymmetry to assist other people who are vulnerable, and to advance justice. Contained in the practice of solidarity are two core 'enacted commitments', first, to engaging our moral imaginations and recognizing others in need and, second, to responsive action. Recognizing the suffering of displacement and responding through place-making should follow from even the most simplistic understanding of people as 'implaced'. Recognition, furthermore, that places are created and sustained, transformed, or neglected in ways that foster or perpetuate inequities, including health inequities, generates responsibilities concerning place-making. Place-based interventions, on either count, should be principal and, indeed, prioritized ways of showing solidarity for the vulnerable and promoting justice. Where solidaristic relations do not prevail, place-making can catalyze and nurture them, and over time advance justice. On the moral landscapes of bioethics, the terrain where care and health are or should be at the center of attention, an ethic of place and place-making for those who have been displaced - patients, the elderly, urban populations, and asylum-seekers, for instance - expresses and has rich potential for nurturing bonds of solidarity.


Asunto(s)
Bioética , Salud Global/ética , Accesibilidad a los Servicios de Salud/ética , Justicia Social/ética , Responsabilidad Social , Disparidades en el Estado de Salud , Humanos , Cooperación Internacional , Bienestar Social/ética
10.
Bioethics ; 32(9): 553-561, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30264873

RESUMEN

Many working in bioethics today are engaging in forms of normative interpretation concerning the meaningful contexts of relational agency and institutional structures of power. Using the framework of relational bioethics, this article focuses on two significant social practices that are significant for health policy and public health: the practices of solidarity and the practices of care. The main argument is that the affirming recognition of, and caring attention paid to, persons as moral subjects can politically motivate a society in three respects. The recognition of solidarity and the attention of care can prompt progressive change toward a democratic willingness: (a) to provide for equal respect for rights and dignity; (b) to provide the social resources and services needed for just health and well-being; and (c) to focus its creativity and wealth on the actualization of potential flourishing of each and all. Solidarity is discussed as a morally developmental stance that moves from standing up for another, standing up with another, and standing up as another. Care is discussed as a morally developmental stance that moves from the attentive rehabilitation of another, attentive companionship with and for another, and attentive commitment to another.


Asunto(s)
Salud Global/ética , Accesibilidad a los Servicios de Salud/ética , Justicia Social/ética , Responsabilidad Social , Bioética , Disparidades en el Estado de Salud , Humanidades/ética , Humanos , Cooperación Internacional , Salud Pública , Bienestar Social/ética
11.
Bioethics ; 32(9): 585-592, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30226284

RESUMEN

Designing the future of work is crucial to the health and well-being of people and societies. Experts predict that developments such as the advancement of digital technologies, automation, and the movement of manufacturing jobs to low-wage countries will lead to major transformations in the labour market, and some foresee significant job losses. Due to the close relationship between employment and health, major job losses would have significant negative impacts on the health and well-being of individuals and societies. Job losses would also pose a major challenge to solidaristic support within societies because they would negatively affect the recognition of similarities among people, which is vital for solidaristic practice and institutions. To prevent these negative effects, a fundamental redesign of the relationship between work and income is necessary. And for this project to succeed, we need to reconsider of the value of work. Building on definitions of flourishing people and societies, we argue that the value of work should not be determined by the labour market, but according to its importance for society. Using a solidarity-based framework we argue that such a re-valuation of work will help to ensure social cohesion and increase reciprocity in our societies. It will serve as a foundation upon which we can reconfigure the relationship between work and income without risking the loss of social cohesion and solidarity.


Asunto(s)
Empleo/ética , Política Pública , Bienestar Social/ética , Promoción de la Salud/ética , Humanos , Cambio Social , Justicia Social , Estados Unidos
12.
Bioethics ; 32(9): 541-552, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30044895

RESUMEN

The concept of solidarity has recently come to prominence in the healthcare literature, addressing the motivation for taking seriously the shared vulnerabilities and medical needs of compatriots and for acting to help them meet these needs. In a recent book, Prainsack and Buyx take solidarity as a commitment to bear costs to assist others regarded as similar, with implications for governing health databases, personalized medicine, and organ donation. More broadly, solidarity has been understood normatively to call for 'standing with' or assisting fellow community members and possibly also distant others in regard to their needs, whether for its own sake or in order to realize the demands of justice. I argue here that the understanding of solidarity in the existing bioethics literature is unduly restricted by not sufficiently theorizing the notion of structural (or systemic) injustice and its import for understanding solidarity. Extending traditional conceptions of labor and social movement solidarity, I contrast unitary solidarity within a given group with 'networking solidarities' across groups. I analyze the meaning of structural injustice and its significance for solidarity, including countering institutionally entrenched inequalities and economic exploitation. I then apply this broadened conception to healthcare, discussing structural problems with the U.S. insurance system and the solidarity movements addressing its deficiencies. I analyze some natural disasters and global health challenges that were aggravated by structural injustices, along with the solidarity movements they engendered. Finally, I revisit the questions of governing health databases and of personalized medicine with the enlarged conception of solidarity in view.


Asunto(s)
Salud Global/ética , Accesibilidad a los Servicios de Salud/ética , Justicia Social/ética , Responsabilidad Social , Bioética , Disparidades en el Estado de Salud , Humanos , Cooperación Internacional , Bienestar Social/ética
14.
Bioethics ; 32(9): 569-576, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-29741209

RESUMEN

Solidarity is commonly invoked in the justification of public health care. This is understandable, as calls for and appeals to solidarity are effective in the mobilization of unison action and the willingness to incur sacrifices for others. However, the reference to solidarity as a moral notion requires caution, as there is no agreement on the meaning of solidarity. The article argues that the reference to solidarity as a normative notion is relevant to health-related moral claims, but that it does not provide a convincing foundation of claims to universal health care. References to universal solidarity obliterate an important distinction between those moral demands that are founded on principles like justice, recognition, or humanity, and those demands that stem from partisan relations in communities. While there is no 'separate essence' of solidarity that could be referred to in order to argue for the conceptual necessity of solidarity's partiality, some features may reasonably be stipulated as being essential to solidarity with a view to its systematic function within moral philosophy. The normative and motivational force of the ties invoked by solidarity is particularly relevant when basic moral demands are not met, and societies are in need of significant forms of communal relatedness.


Asunto(s)
Autonomía Personal , Bienestar Social/ética , Cobertura Universal del Seguro de Salud/ética , Prestación de Atención de Salud/ética , Derechos Humanos , Humanos , Cooperación Internacional , Obligaciones Morales , Justicia Social/ética
15.
Cochrane Database Syst Rev ; 2: CD009820, 2018 02 26.
Artículo en Inglés | MEDLINE | ID: mdl-29480555

RESUMEN

BACKGROUND: Lone parents in high-income countries have high rates of poverty (including in-work poverty) and poor health. Employment requirements for these parents are increasingly common. 'Welfare-to-work' (WtW) interventions involving financial sanctions and incentives, training, childcare subsidies and lifetime limits on benefit receipt have been used to support or mandate employment among lone parents. These and other interventions that affect employment and income may also affect people's health, and it is important to understand the available evidence on these effects in lone parents. OBJECTIVES: To assess the effects of WtW interventions on mental and physical health in lone parents and their children living in high-income countries. The secondary objective is to assess the effects of welfare-to-work interventions on employment and income. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE Ovid, Embase Ovid, PsycINFO EBSCO, ERIC EBSCO, SocINDEX EBSCO, CINAHL EBSCO, Econlit EBSCO, Web of Science ISI, Applied Social Sciences Index and Abstracts (ASSIA) via Proquest, International Bibliography of the Social Sciences (IBSS) via ProQuest, Social Services Abstracts via Proquest, Sociological Abstracts via Proquest, Campbell Library, NHS Economic Evaluation Database (NHS EED) (CRD York), Turning Research into Practice (TRIP), OpenGrey and Planex. We also searched bibliographies of included publications and relevant reviews, in addition to many relevant websites. We identified many included publications by handsearching. We performed the searches in 2011, 2013 and April 2016. SELECTION CRITERIA: Randomised controlled trials (RCTs) of mandatory or voluntary WtW interventions for lone parents in high-income countries, reporting impacts on parental mental health, parental physical health, child mental health or child physical health. DATA COLLECTION AND ANALYSIS: One review author extracted data using a standardised extraction form, and another checked them. Two authors independently assessed risk of bias and the quality of the evidence. We contacted study authors to obtain measures of variance and conducted meta-analyses where possible. We synthesised data at three time points: 18 to 24 months (T1), 25 to 48 months (T2) and 49 to 72 months (T3). MAIN RESULTS: Twelve studies involving 27,482 participants met the inclusion criteria. Interventions were either mandatory or voluntary and included up to 10 discrete components in varying combinations. All but one study took place in North America. Although we searched for parental health outcomes, the vast majority of the sample in all included studies were female. Therefore, we describe adult health outcomes as 'maternal' throughout the results section. We downgraded the quality of all evidence at least one level because outcome assessors were not blinded. Follow-up ranged from 18 months to six years. The effects of welfare-to-work interventions on health were generally positive but of a magnitude unlikely to have any tangible effects.At T1 there was moderate-quality evidence of a very small negative impact on maternal mental health (standardised mean difference (SMD) 0.07, 95% Confidence Interval (CI) 0.00 to 0.14; N = 3352; studies = 2)); at T2, moderate-quality evidence of no effect (SMD 0.00, 95% CI 0.05 to 0.05; N = 7091; studies = 3); and at T3, low-quality evidence of a very small positive effect (SMD -0.07, 95% CI -0.15 to 0.00; N = 8873; studies = 4). There was evidence of very small positive effects on maternal physical health at T1 (risk ratio (RR) 0.85, 95% CI 0.54 to 1.36; N = 311; 1 study, low quality) and T2 (RR 1.06, 95% CI 0.95 to 1.18; N = 2551; 2 studies, moderate quality), and of a very small negative effect at T3 (RR 0.97, 95% CI 0.91 to 1.04; N = 1854; 1 study, low quality).At T1, there was moderate-quality evidence of a very small negative impact on child mental health (SMD 0.01, 95% CI -0.06 to 0.09; N = 2762; studies = 1); at T2, of a very small positive effect (SMD -0.04, 95% CI -0.08 to 0.01; N = 7560; studies = 5), and at T3, there was low-quality evidence of a very small positive effect (SMD -0.05, 95% CI -0.16 to 0.05; N = 3643; studies = 3). Moderate-quality evidence for effects on child physical health showed a very small negative effect at T1 (SMD -0.05, 95% CI -0.12 to 0.03; N = 2762; studies = 1), a very small positive effect at T2 (SMD 0.07, 95% CI 0.01 to 0.12; N = 7195; studies = 3), and a very small positive effect at T3 (SMD 0.01, 95% CI -0.04 to 0.06; N = 8083; studies = 5). There was some evidence of larger negative effects on health, but this was of low or very low quality.There were small positive effects on employment and income at 18 to 48 months (moderate-quality evidence), but these were largely absent at 49 to 72 months (very low to moderate-quality evidence), often due to control group members moving into work independently. Since the majority of the studies were conducted in North America before the year 2000, generalisabilty may be limited. However, all study sites were similar in that they were high-income countries with developed social welfare systems. AUTHORS' CONCLUSIONS: The effects of WtW on health are largely of a magnitude that is unlikely to have tangible impacts. Since income and employment are hypothesised to mediate effects on health, it is possible that these negligible health impacts result from the small effects on economic outcomes. Even where employment and income were higher for the lone parents in WtW, poverty was still high for the majority of the lone parents in many of the studies. Perhaps because of this, depression also remained very high for lone parents whether they were in WtW or not. There is a lack of robust evidence on the health effects of WtW for lone parents outside North America.


Asunto(s)
Salud del Niño , Empleo/psicología , Estado de Salud , Salud Materna , Salud Mental , Padres Solteros/psicología , Bienestar Social/psicología , Adolescente , Adulto , Niño , Salud del Niño/ética , Preescolar , Empleo/economía , Empleo/ética , Empleo/legislación & jurisprudencia , Femenino , Humanos , Renta , Lactante , Seguro de Salud/estadística & datos numéricos , Salud Materna/ética , Pobreza , Ensayos Clínicos Controlados Aleatorios como Asunto , Bienestar Social/ética , Bienestar Social/legislación & jurisprudencia
16.
Ann Acad Med Singap ; 46(9): 356-363, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29022038

RESUMEN

Amidst dramatic global change, there is a greater need than ever for principled and committed professionals. The sibling professions of law and medicine, in particular, serve crucial functions in contemporary society. To meet the challenges of the future, members of both professions must appreciate and commit to their shared calling to public service, and ensure that it is not overridden by the profit motive. Three further commitments follow from this: first, to nurture and mentor new entrants to the professions to ensure the continuance of that mission of public service; second, to improve accessibility and affordability through pro bono work and by other means, so that all who need professional assistance can receive it; and, thirdly, to serve with excellence in ethics as well as competence, so as not to betray the trust of the laypersons who rely on professionals to safeguard their interests and welfare. The medical and legal professions have much to learn and gain from working with each other toward those shared goals.


Asunto(s)
Comunicación Interdisciplinaria , Jurisprudencia , Medicina/normas , Bienestar Social/ética , Ética Profesional , Accesibilidad a los Servicios de Salud , Humanos , Objetivos Organizacionales , Avisos de Utilidad Pública como Asunto , Responsabilidad Social , Confianza
17.
Cochrane Database Syst Rev ; 8: CD009820, 2017 08 20.
Artículo en Inglés | MEDLINE | ID: mdl-28823111

RESUMEN

BACKGROUND: Lone parents in high-income countries have high rates of poverty (including in-work poverty) and poor health. Employment requirements for these parents are increasingly common. 'Welfare-to-work' (WtW) interventions involving financial sanctions and incentives, training, childcare subsidies and lifetime limits on benefit receipt have been used to support or mandate employment among lone parents. These and other interventions that affect employment and income may also affect people's health, and it is important to understand the available evidence on these effects in lone parents. OBJECTIVES: To assess the effects of WtW interventions on mental and physical health in lone parents and their children living in high-income countries. The secondary objective is to assess the effects of welfare-to-work interventions on employment and income. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE Ovid, Embase Ovid, PsycINFO EBSCO, ERIC EBSCO, SocINDEX EBSCO, CINAHL EBSCO, Econlit EBSCO, Web of Science ISI, Applied Social Sciences Index and Abstracts (ASSIA) via Proquest, International Bibliography of the Social Sciences (IBSS) via ProQuest, Social Services Abstracts via Proquest, Sociological Abstracts via Proquest, Campbell Library, NHS Economic Evaluation Database (NHS EED) (CRD York), Turning Research into Practice (TRIP), OpenGrey and Planex. We also searched bibliographies of included publications and relevant reviews, in addition to many relevant websites. We identified many included publications by handsearching. We performed the searches in 2011, 2013 and April 2016. SELECTION CRITERIA: Randomised controlled trials (RCTs) of mandatory or voluntary WtW interventions for lone parents in high-income countries, reporting impacts on parental mental health, parental physical health, child mental health or child physical health. DATA COLLECTION AND ANALYSIS: One review author extracted data using a standardised extraction form, and another checked them. Two authors independently assessed risk of bias and the quality of the evidence. We contacted study authors to obtain measures of variance and conducted meta-analyses where possible. We synthesised data at three time points: 18 to 24 months (T1), 25 to 48 months (T2) and 49 to 72 months (T3). MAIN RESULTS: Twelve studies involving 27,482 participants met the inclusion criteria. Interventions were either mandatory or voluntary and included up to 10 discrete components in varying combinations. All but one study took place in North America. Although we searched for parental health outcomes, the vast majority of the sample in all included studies were female. Therefore, we describe adult health outcomes as 'maternal' throughout the results section. We downgraded the quality of all evidence at least one level because outcome assessors were not blinded. Follow-up ranged from 18 months to six years. The effects of welfare-to-work interventions on health were generally positive but of a magnitude unlikely to have any tangible effects.At T1 there was moderate-quality evidence of a very small negative impact on maternal mental health (standardised mean difference (SMD) 0.07, 95% Confidence Interval (CI) 0.00 to 0.14; N = 3352; studies = 2)); at T2, moderate-quality evidence of no effect (SMD 0.00, 95% CI 0.05 to 0.05; N = 7091; studies = 3); and at T3, low-quality evidence of a very small positive effect (SMD -0.07, 95% CI -0.15 to 0.00; N = 8873; studies = 4). There was evidence of very small positive effects on maternal physical health at T1 (risk ratio (RR) 0.85, 95% CI 0.54 to 1.36; N = 311; 1 study, low quality) and T2 (RR 1.06, 95% CI 0.95 to 1.18; N = 2551; 2 studies, moderate quality), and of a very small negative effect at T3 (RR 0.97, 95% CI 0.91 to 1.04; N = 1854; 1 study, low quality).At T1, there was moderate-quality evidence of a very small negative impact on child mental health (SMD 0.01, 95% CI -0.06 to 0.09; N = 2762; studies = 1); at T2, of a very small positive effect (SMD -0.04, 95% CI -0.08 to 0.01; N = 7560; studies = 5), and at T3, there was low-quality evidence of a very small positive effect (SMD -0.05, 95% CI -0.16 to 0.05; N = 3643; studies = 3). Moderate-quality evidence for effects on child physical health showed a very small negative effect at T1 (SMD -0.05, 95% CI -0.12 to 0.03; N = 2762; studies = 1), a very small positive effect at T2 (SMD 0.07, 95% CI 0.01 to 0.12; N = 7195; studies = 3), and a very small positive effect at T3 (SMD 0.01, 95% CI -0.04 to 0.06; N = 8083; studies = 5). There was some evidence of larger negative effects on health, but this was of low or very low quality.There were small positive effects on employment and income at 18 to 48 months (moderate-quality evidence), but these were largely absent at 49 to 72 months (very low to moderate-quality evidence), often due to control group members moving into work independently. Since the majority of the studies were conducted in North America before the year 2000, generalisabilty may be limited. However, all study sites were similar in that they were high-income countries with developed social welfare systems. AUTHORS' CONCLUSIONS: The effects of WtW on health are largely of a magnitude that is unlikely to have tangible impacts. Since income and employment are hypothesised to mediate effects on health, it is possible that these negligible health impacts result from the small effects on economic outcomes. Even where employment and income were higher for the lone parents in WtW, poverty was still high for the majority of the lone parents in many of the studies. Perhaps because of this, depression also remained very high for lone parents whether they were in WtW or not. There is a lack of robust evidence on the health effects of WtW for lone parents outside North America.


Asunto(s)
Salud del Niño , Empleo/psicología , Estado de Salud , Salud Materna , Salud Mental , Padres Solteros/psicología , Bienestar Social/psicología , Adolescente , Adulto , Niño , Salud del Niño/ética , Preescolar , Empleo/economía , Empleo/ética , Empleo/legislación & jurisprudencia , Humanos , Renta , Lactante , Seguro de Salud/estadística & datos numéricos , Salud Materna/ética , Pobreza , Ensayos Clínicos Controlados Aleatorios como Asunto , Bienestar Social/ética , Bienestar Social/legislación & jurisprudencia
18.
Medisan ; 20(10)oct. 2016. tab
Artículo en Español | CUMED | ID: cum-63691

RESUMEN

Se realizó un estudio descriptivo y transversal de 10 ancianos institucionalizados en la Casa de Abuelos de Baracoa, en el período 2014-2015, para evaluar algunos de los factores biopsicosociales que influyen en su bienestar subjetivo. En la serie predominaron el grupo etario de 70-79 años, el nivel escolar primario, el estado civil divorciado, las enfermedades crónicas no trasmisibles, así como la ausencia de pareja y de apoyo social. Las dimensiones más afectadas fueron la autoaceptación, el apoyo social, el dominio del ambiente y el crecimiento personal(AU)


A descriptive and cross-sectional study of 10 institutionalized elderly in the senior citizens center in Baracoa, was carried out during 2014-2015, to evaluate some of the biopsychosocial factors that influenced in their subjective well-being. In the series the 70-79 age group, the primary school level, divorced marital status, the chronic non communicable diseases, as well as couple and social support absence prevailed. The most affected dimensions were the selfacceptance, social support, the environment control and personal growth(AU)


Asunto(s)
Humanos , Masculino , Femenino , Anciano , Impacto Psicosocial , Hogares para Ancianos , Bienestar Social/ética , Conformidad Social , Condiciones Sociales , Epidemiología Descriptiva , Estudios Transversales
19.
Acta bioeth ; 22(1): 27-36, jun. 2016. graf, tab
Artículo en Inglés | LILACS | ID: lil-788882

RESUMEN

After delimiting the concepts of moral and ethics the author makes a conceptual difference between psychiatry and mental health. He proposes that the former is a medical specialty while the latter is built in the health concept. Psychiatric problems correspond to mental disorders that affect individual persons while mental health problems, such as underdevelopment and poverty, generalized corruption and violence affect the whole society and interfere with human development and economic growth. To mix up both concepts as if they were synonymous, especially in third world countries, leads to scientific, economic and sociopolitical risks that attempt against their developments as nations.


Luego de deslindar los conceptos de moral y ética, el autor distingue conceptualmente psiquiatría de salud mental. Postula que la primera se refiere a una especialidad médica, mientras la segunda es ínsita al concepto de salud. Los problemas psiquiátricos corresponden a trastornos mentales que afectan a individuos, mientras que los de salud mental, tales como el subdesarrollo y la pobreza, la corrupción generalizada y la violencia,afectan a toda la sociedad e interfieren con el desarrollo humano y económico de los países. Confundir ambos conceptos como si fueran sinónimos, particularmente en países del tercer mundo, conduce a riesgos científicos, económicos y político-sociales que atentan contra su desarrollo como naciones.


Após deslindar os conceitos de moral e ética, o autor distingue conceitualmente psiquiatria de saúde mental. Postula que a primeira se refere a uma especialidade médica, enquanto a segunda é ínsita ao conceito de saúde. Os problemas psiquiátricos correspondem a transtornos mentais que afetam os indivíduos, enquanto os de saúde mental, tais como o subdesenvolvimento e a pobreza, a corrupção generalizada e a violência, afetam toda a sociedade e interferem no desenvolviento humano e econômico dos países. Confundir ambos conceitos como se fossem sinônimos, particularmente em países do terceiro mundo, conduz a riscos científicos, econômicos e político-sociais que atentam contra o seu desenvolvimento como nações.


Asunto(s)
Humanos , Psiquiatría/ética , Bienestar Social/ética , Salud Mental , Ética
20.
Br J Sociol ; 67(1): 97-117, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26948066

RESUMEN

This paper notes the contemporary emergence of 'morality' in both sociological argument and political rhetoric, and analyses its significance in relation to ongoing UK welfare reforms. It revisits the idea of 'moral economy' and identifies two strands in its contemporary application; that all economies depend on an internal moral schema, and that some external moral evaluation is desirable. UK welfare reform is analysed as an example of the former, with reference to three distinct orientations advanced in the work of Freeden (1996), Laclau (2014), and Lockwood (1996). In this light, the paper then considers challenges to the reform agenda, drawn from third sector and other public sources. It outlines the forms of argument present in these challenges, based respectively on rationality, legality, and morality, which together provide a basis for evaluation of the welfare reforms and for an alternative 'moral economy'.


Asunto(s)
Economía , Justicia Social/economía , Bienestar Social/economía , Economía/legislación & jurisprudencia , Humanos , Política , Bienestar Social/ética , Bienestar Social/legislación & jurisprudencia , Reino Unido
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