scholarly journals Adult social work and high-risk domestic violence cases

2016 ◽  
Vol 18 (3) ◽  
pp. 288-306 ◽  
Author(s):  
Hugh McLaughlin ◽  
Rachel Robbins ◽  
Claire Bellamy ◽  
Concetta Banks ◽  
Debbie Thackray
Keyword(s):  
Domestic Violence ◽  
High Risk ◽  
Social Workers ◽  
Child Protection ◽  
Service Users ◽  
Adult Service ◽  
Fit For Purpose ◽  
Agency Risk

Summary This article focuses on adult social work’s response in England to high-risk domestic violence cases and the role of adult social workers in multi-agency risk and assessment conferences. The research was undertaken between 2013 and 2014 and focused on one city in England and involved the research team attending multi-agency risk and assessment conferences. Interviews with 20 adult social workers, 24 multi-agency risk and assessment conferences attendees, 14 adult service users at time T1 (including follow-up interviews after six months, T2), focus groups with independent domestic violence advocates and Women’s Aid and an interview with a Women’s Aid service user. Findings The findings suggest that although adult social workers accept the need to be involved in domestic violence cases they are uncertain of what their role is and are confused with the need to operate a parallel domestic violence and adult safeguarding approach, which is further, complicated by issues of mental capacity. Multi-agency risk and assessment conferences are identified as overburdened, under-represented meetings staffed by committed managers. However, they are in danger of becoming managerial processes neglecting the service users they are meant to protect. Applications The article argues for a re-engagement of adult social workers with domestic violence that has increasingly become over identified with child protection. It also raises the issue whether multi-agency risk and assessment conferences remain fit for purpose and whether they still represent the best possible response to multi-agency coordination and practice in domestic violence.

Locally, together and close to the child - how the citizenship of school employees leads to the implementation of global standards of child protection

2021 ◽  
Vol 601 (7) ◽  
pp. 51-67
Author(s):  
Monika Czyżewska
Keyword(s):  
Domestic Violence ◽  
Child Protection ◽  
Interdisciplinary Teams ◽  
Legal Responsibility ◽  
Second Phase ◽  
School Employees ◽  
Social Pedagogy ◽  
Global Standards

For social pedagogy, it is important to answer the question whether the school and its surroundings are today a place where adults, aware of social and legal responsibility, adequately respond to suspicions of domestic violence against schoolchildren, and whether there is a dissemination of child protection standards, which are emphasized in international documents. Using the case study method, in Warsaw's Praga district (which was the Polish "cradle" of interdisciplinary work in the 1990s) I conducted two research (using an interview technique) on the role of schools in preventing child abuse. 10 respondents took part in the first phase of the study in 2009, while in the second phase (in the years 2019–2020) – 15 respondents. The aim of the study (in both phases) was to identify experiences regarding the quality of cooperation among school employees as members of interdisciplinary teams, in two periods of teams’ activity: before the introduction of the amendment to the Act on Counteracting Domestic Violence in 2010, and after its introduction – from 2011 (the aim of the article is to compare these experiences from both periods). The results of the research show that cooperation within the interdisciplinary teams established by the amendment is generally perceived positively by the members of these teams, although those who cooperated before the amendment, i.e., not obligatorily, define today's cooperation as too formalized and bureaucratic. The respondents' statements prove that currently interdisciplinary teams (from the perspective of a school employee in the Praga-Południe district) are less effective, and participation in their work, although obligatory, is relatively less frequent than when the meetings were voluntary.

scholarly journals Weight Loss Predicts Inferior Outcome in Polycythemia Vera Patients

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 22-23
Author(s):  
Albert Jang ◽  
Hussein Hamad ◽  
Sarvari Venkata Yellapragada ◽  
Iberia R. Sosa ◽  
Gustavo A. Rivero
Keyword(s):  
Weight Loss ◽  
High Risk ◽  
Blood Cell ◽  
Polycythemia Vera ◽  
Board Of Directors ◽  
Clinical Variable ◽  
Advisory Committees ◽  
Wbc Count

Background: Conventional risk factors for inferior outcomes in polycythemia vera (PV) include elevated hematocrit, white blood cell (WBC) count, age, and abnormal karyotype. Weight loss adversely impacts survival in cancer patients. JAK2 myeloproliferative neoplasms (MPN) upregulate tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), and IL-8 and induce decreased leptin levels leading to weight loss. The impact of weight loss in PV patients receiving best supportive care (i.e. frontline hydroxyurea [HU] therapy, phlebotomy) on overall survival (OS) is largely unknown. In this study, we seek to investigate: (1) differential effect on survival for weight loss, and (2) variables with predictive value for weight loss among JAK2 inhibitor-naïve PV patients. Methods: After IRB approval, 46 patients at the Michael E. DeBakey VA Medical Center diagnosed with PV between 2000 and 2016 were selected for analysis. Our outcome of interest was OS among PV patients exhibiting weight loss versus patients who maintained, gained weight or had minor weight loss. To objectively estimate weight changes overtime, the difference between baseline BMI [BMI-B] at the time of diagnosis and BMI at last follow-up (BMI-L) was obtained for each patient. Survival analysis was performed for PV patients exhibiting more than 10% weight loss (>10%) versus all other patients (less than 10% loss, stable and increased weight) (<10%) over time. Kaplan-Meier (KM) method was used to determine OS. Cox regression model was performed to assess independent role of different variables including age, blood cell counts and ferritin level Statistical analysis was performed using SAS software. Results: Median BMI loss was 10% (0.03-36.72%); 33/46 (71.7%) and 13/46 (28.2%) patients developed <10% and >10% BMI loss, respectively. Baseline characteristics are summarized in Table 1. Median BMI at last follow up was 21 for PV patients exhibiting >10% BMI loss and 27.7 for PV patients exhibiting <10% BMI loss (p<0.01). Median age was higher among patients exhibiting >10% BMI loss (68 vs 56 y, respectively, p=0.006). A non-significant clinical trend for higher WBC was observed among patients losing >10% BMI (10.9 vs 7.6 K/uL, p=0.08). Median Hemoglobin (Hb), hematocrit (Hct) and ferritin were intriguingly lower in the >10% loss group at 16 vs 18.3 g/dL (p=0.01), 49.3 vs 54.2% (p=0.04) and 29.8 vs 50.6 ng/mL (p=0.09) respectively, while median RDW was higher at 18 vs 15.1% (p=0.01). OS was 9125 days vs 5364 days, in patients with <10% and >10% BMI loss, respectively (p=0.02, HR=0.20; CI 95% 0.04-0.84) (Figure 1). On multivariate analysis, age (hazard ratio [HR], 1.34; p<0.02) and WBC count (HR, 1.57; p<0.01), were predictive of OS. Conclusions: A subgroup of PV patients exhibit progressive weight loss. Over 10% BMI reduction is associated with decreased survival, suggesting that "early weight loss" is an independent clinical variable that predicts high risk PV. While a larger study is needed to validate this observation, this small study highlights the role of leukocytosis, advanced age and weight loss in PV. Confirmation of the observations reported here could unveil an important role for pharmacologic and/or dietary interventions to improve survival among high-risk PV patients. Disclosures Rivero: agios: Membership on an entity's Board of Directors or advisory committees; celgene: Membership on an entity's Board of Directors or advisory committees; Incyte: Membership on an entity's Board of Directors or advisory committees.

Abstract 19763: Role of HAS-BLED Score on Major Bleeding in Atrial Fibrillation Undergoing Percutaneous Coronary Intervention With Drug-eluting Stents

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yoshitaka Ito ◽  
Kazuhiro Naito ◽  
Katsuhisa Waseda ◽  
Hiroaki Takashima ◽  
Akiyoshi Kurita ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
High Risk ◽  
Anticoagulant Therapy ◽  
Major Bleeding ◽  
Stent Implantation ◽  
Risk Group ◽  
High Risk Group ◽  
Low Risk

Background: While anticoagulant therapy is standard management for atrial fibrillation (Af), dual antiplatelet therapy (DAPT) is needed after stent implantation for coronary artery disease. HAS-BLED score estimates risk of major bleeding for patients on anticoagulation to assess risk-benefit in Af care. However, it is little known about usefulness of HAS-BLED score in Af patient treated with coronary stents requiring DAPT or DAPT plus warfarin (triple therapy: TT). The aim of this study was to evaluate the role of HAS-BLED score on major bleeding in Af patients undergoing DAPT or TT. Methods: A total of 837 consecutive patients were received PCI in our hospital from Jan. 2007 to Dec. 2010, and 66 patients had Af or paroxysmal Af at the time of PCI. Clinical events including major bleeding (cerebral or gastrointestinal bleeding) were investigated up to 3 years. Patients were divided into 2 groups based on HAS-BLED score (High-risk group: HAS-BLED score≥4, n=19 and Low-risk group: HAS-BLED score<4, n=47). DAPT therapy was required for a minimum 12 months after stent implantation and warfarin was prescribed based on physicians’ discretion. Management/change of antiplatelet and anticoagulant therapy during follow-up periods were also up to physicians’ discretion. Results: Baseline characteristics were not different between High-risk and Low-risk group except for age. Overall incidence of major bleeding was observed in 8 cases (12.1%) at 3 years follow-up. Major bleeding event was significantly higher in High-risk group compared with Low-risk group (31.6% vs. 4.3%, p=0.002). However, management of DAPT and TT was not different between the 2 groups. Among component of HAS-BLED score, renal dysfunction and bleeding contributed with increased number of the score. Conclusion: High-risk group was more frequently observed major bleeding events compared with Low-risk group in patients with Af following DES implantation regardless of antiplatelet/anticoagulant therapy.

scholarly journals Social workers’ views about children’s and parents’ competence in child protection decision-making

2020 ◽  
pp. 146801732094063 ◽  
Author(s):  
Johanna Korpinen ◽  
Tarja Pösö
Keyword(s):  
Decision Making ◽  
Social Workers ◽  
Child Protection ◽  
Service Users ◽  
Parents And Children ◽  
Children And Parents ◽  
The Social ◽  
Strength Based ◽  
Professional Ethos ◽  
Controversial Nature

Summary Competence is an essential part of any decision-making process. In child protection, it is challenged by the controversial nature of child removals and the vulnerable situations which children and parents experience therein. This article examines how and on what grounds social workers view parents and children to be competent to give their informed view in care order proceedings and what they do if doubts about competence arise. The analysis is based on 30 interviews with social workers in Finland. Findings The professional ethos and ethics of social work were embedded in the social workers’ descriptions of children’s and parents’ competence. The social workers were confident that the parents and children (of certain age) were competent to give their informed view about whether to consent to the care order proposal and the proposed substitute home. When they spoke about competence ascribed with hesitation, they described the vulnerability of service users, as well as their attitudes and withdrawal from contact. In the cases, social workers emphasized a strength-based view of children and parents and aimed to ‘talk more’ with them and to ‘give them more time’ to support their right to give an informed view. Applications Social vulnerability and competence should be explored reflectively in relation to decision-making in child protection. A better understanding of their interrelation makes social workers more competent to support the service users’ right to be included in decision-making. Critical awareness is needed to recognize when ‘more talk’ is not enough to realize children’s and parents’ rights.

scholarly journals Embodied Social Work Practice Within Risk Society

2019 ◽  
Vol 20 (5) ◽  
pp. 673-691 ◽  
Author(s):  
Joe Smeeton ◽  
Patrick O’Connor
Keyword(s):  
Decision Making ◽  
Social Work ◽  
Lived Experience ◽  
Social Workers ◽  
Child Protection ◽  
Work Practice ◽  
Social Work Practice ◽  
Risk Society ◽  
Service Users ◽  
Extreme Risk

This paper critically discusses the limitations of theorising social work from psychological and sociological perspectives and argues that phenomenology offers more opportunity to understand the embodied experiences of service users and social workers themselves. The paper argues that psychology and sociology have a limited analysis of being-in-the-world, which ought to be social work’s primary consideration. The paper offers an overview of the sociology of risk before embarking on an extensive description and discussion of Heidegger’s and Merleau-Ponty’s phenomenology applied to the lived experience of child protection social workers working within risk society. The argument is put that phenomenology is a useful tool for understanding the lived experience of social work practitioners. Findings: The authors conclude that embodied social work practice containing fear and anxiety can be thought of as akin to taking part in extreme risk sports and that this is an unhealthy experience that is likely to skew decision-making and adversely affect the lives of social workers and service users. Applications: The authors argue that phenomenology can enhance understanding of practice and decision-making and offers insights into the lived experience of social workers. Phenomenology is useful for helping social workers negotiate risk-saturated environments, through a focus on meaning.

Child sexual abuse: A critical analysis of social workers' role in recognising and responding to it

2020 ◽  
Vol 1 (1) ◽  
pp. 26-33
Author(s):  
Gary Wade
Keyword(s):  
Sexual Abuse ◽  
Child Sexual Abuse ◽  
Social Workers ◽  
Child Protection ◽  
Sexual Exploitation ◽  
Critical Evaluation ◽  
It Services ◽  
Policy And Practice ◽  
Critical Attention

The role of social workers in safeguarding and child protection has received much critical attention in recent years, in an evolving political and social arena, where policy and practice has shifted following both public outcry of serious case reviews and subsequent policy and practice changes concerning the profession and how it services the needs of the most vulnerable in society. This article seeks to critically examine the current methodology for identifying suspected child sexual abuse signs and indicators, the evolving spectrum of abuse, including critical evaluation of current perspectives on child sexual exploitation.

scholarly journals Linking abuse and recovery through advocacy: an observational study

2013 ◽  
Vol 23 (1) ◽  
pp. 99-113 ◽  
Author(s):  
K. Trevillion ◽  
S. Byford ◽  
M. Cary ◽  
D. Rose ◽  
S. Oram ◽  
...  
Keyword(s):  
Mental Health ◽  
Domestic Violence ◽  
Community Mental Health ◽  
Unmet Needs ◽  
Controlled Trial ◽  
Psychiatric Service ◽  
Community Mental Health Services ◽  
Service Users ◽  
Quasi Experimental

Aims.High numbers of psychiatric service users experience domestic violence, yet limited interventions exist for these victims. We piloted a domestic violence intervention for community mental health services to explore the feasibility of a future cluster randomized controlled trial.Methods.Quasi-experimental controlled design within five Community Mental Health Teams (three intervention and two control teams). The intervention comprised domestic violence training for clinicians' and referral to domestic violence advocacy for service users. Clinicians' (n = 29) domestic violence knowledge, attitudes and behaviours were assessed before and 6 months post-training. Service users' (n = 34) safety behaviours, unmet needs, quality of life and frequency/severity of abuse were examined at baseline and 3 months follow-up. Process evaluation data were also collected.Results.Clinicians receiving the intervention reported significant improvements in domestic violence knowledge, attitudes and behaviours at follow-up (p < 0.05). Service users receiving the intervention reported significant reductions in violence (p < 0.001) and unmet needs at follow-up (p < 0.05).Conclusions.Interventions comprising domestic violence training for clinicians and referral to domestic violence advocacy may improve responses of psychiatric services. Low rates of identification among teams not receiving training suggest that future trials using service user outcomes are unlikely to be feasible. Therefore, other methods of evaluation are needed.

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