Academic literature on the topic 'Delaware. Division of Social Services'

This article discusses the effect of the political division between Fatah and Hamas on the level of generalized trust in Palestine. It argues that the level of trust in Palestinian society has been shaped and influenced by the ongoing political division since 2007. As the level of trust has been declining since 2007, this research suggests that distrust in the political system, the deteriorated healthcare and education services, the high level of unemployment, corruption, and the violation of human rights in the Gaza Strip and the West Bank have led to the decline of the level of generalized trust in society at large. This study uses statistical test results to support the main argument. Data available from 2007, 2011, 2014, and 2017 from the Arab Barometer are used to examine how institutional and contextual factors affect the level of generalized trust in the Gaza Strip and the West Bank. The article discusses the results and how creating a hybrid society has contributed to lowering the level of trust generally. It seeks to understand the change in social trust among Palestinians over the years of the ongoing division, and examines how the political division, directly or indirectly, has led to the current low level of trust that has left remarkable changes and deep polarization in Palestinian society.

Objective: To examine the reasons contributing to the physician shortage in the country’s medically underserved areas using the state of Delaware as a focus state. Method: A literature review regarding the shortage of physicians with data compilation from Delaware Department of Public Health (DPH) and Delaware Health and Social services (DHSS) was performed. A review of the “Conrad 30 J1 VISA waiver program,” the most important and primary supplier of physicians to underserved areas of the state was performed. A survey interviewing the physicians recruited through this program to identify any challenges faced by them was designed and conducted. Results: The number of primary care physicians providing direct patient care in Delaware in 2018 had declined about 6% from 2013. The average wait time to see a PCP was 8.2 days in 1998 as compared to 23.5 days in 2018. Forty-six percent of physicians serving in HPSAs in Delaware are IMGs recruited through the J1 VISA waiver program. Eighty percent of these IMGs are actively considering leaving the United States due to anxieties around physician immigration policies, mainly “Immigration backlog.” Conclusion: The existing programs to recruit physicians to underserved areas seem to be inadequate. The state and the hospital systems should be able to utilize the J1 program to its full potential and focus on retaining these physicians after their assigned services. As the challenges of IMGs continue to worsen every day; the medical societies, hospitals, the state and federal government should advocate for policies that resolve these challenges.

An assertive community treatment (ACT) program was established in the Delaware correctional system in 1990, designed to ease the transition of drug-involved prison releasees into the community by providing both treatment and case management services. Studies to date, however, have found few direct outcome improvements for ACT clients. This article uses panel data collected from a sample of 300 drug-involved Delaware prison releasees, randomly assigned to either the ACT program or to regular probation/work release supervision. A multivariate path model predicts frequency of illegal drug use 18 months after release from prison. Analyses find no direct effects of the ACT program, but suggest indirect effects of ACT assignment on subsequent illegal drug use through intermediate outcomes. By looking at proximate outcomes of the ACT program in the context of other variables, this model suggests areas where case management with seriously drug-involved offenders can be most effective.

INTRODUCTION A major gap in US care for Sickle Cell Disease (SCD) is a dearth of healthcare providers with expertise in adult SCD management. In 2014 TOVA Community Health launched a community-based primary specialty care clinic in Delaware (DE). The Delaware Department of Health and Social Services found that 96 individual adults in DE with Sickle Cell Disease (SCD) utilized hospital services 99.5% of the time for sickle cell crisis (Anderson et al., 2014). The majority of those adults lived in New Castle County, DE. The dearth of sickle cell hematologist/oncologists for adults in this county may drive them to seek recurrent care through the hospital system. Recognizing this as a nationwide public health crisis, the Delaware Department of Health and Social Services (DHSS) partnered with TOVA Community Health in 2014 to establish an adult primary specialty care clinic medical home in New Castle County, DE. This report describes the progress/impact of an integrated primary specialty clinic for adults with SCD METHODS Prospective/ Retrospective tracking of best practices for SCD are featured in the NIH 2014 guidelines. The staff included a hematologist with expertise in SCD, a primary care provider, an advanced practice nurse, a Social Worker (MSW), a nurse care coordinator, and a community health worker, were funded by Sickle Cell Disease Association of America (SCDAA) and Health Resources and Services Administration (HRSA). From 2014 to 2018, integrated primary specialty care services were provided for 33 discrete patients. RESULTS This first cohort of patients was notable for health complications that may be attributed to the lack of coordinated primary specialty sickle cell care access. Therapeutic counseling, support groups and preventive health maintenance services were measured by: outpatient visits to the clinic, access to disease modifying therapies (hydroxyurea therapy or chronic transfusion therapy), immunizations (Pneumococcal), Depression Screens and Personalized Sickle Care Plans (Table). 21 % percent of the patients had no sickle cell provider and/or hematologist/oncologist other than ED or inpatient care for the 12 months preceding their first visit to our clinic. 48% of the patients received a pneumococcal vaccine (Pneumovax 23 val - n=16/33 and Prevnar 13 - n=7/33) and three (n=3/33) received both Pneumococcal vaccines. 30% percent of the patients (n=10/33 patients) seen were offered access to HU but were not on the drug and 42% (n=14) were prescribed HU. All patients did not have a Personalized Sickle Cell Care Plan prior to receiving services at the Primary Specialty Care clinic. 12% (n=4/33) patients had a diagnosis of Substance Abuse Disorder, 15% (n=5/33) had a diagnosis of Opioid Use Disorder and 3% (n=1/33) had both Substance Abuse and Opioid Use Disorder. 70% (n= 7/10) were male and 30% (n-3/10) were female with a diagnosis of Substance Abuse and/or Opioid Use Disorder. 45% (n=15/33) had a Pain Management Agreement established within the time period at the primary specialty clinic. CONCLUSION The creation of an integrated practice primary specialty care clinic for adults with SCD in New Castle County, Wilmington, DE demonstrates the successful leverage of regional networks that engages an academic institution for telehealth consultation, public health, and community-based organizations to develop an adult SCD primary specialty care model. This safety net clinic provides team based primary specialty care to adults whose only option previously was the hospital and/or emergency room. Unique challenges in managing adult SCD acute and chronic pain were addressed. Overall, this is one model for access to integrated primary specialty care and behavioral health services for persons with SCD across their lifespan. Figure 1. Disclosures No relevant conflicts of interest to declare.

Business development in the financial services sector improved competition among companies to give the best service to their customers. Having reliable services with a good communication network in the organization is the critical success of the company. This study aims to find the actors or people who influence organizations through formal and informal communication networks using Social Network Analysis (SNA). Information on casual and formal communication networks can be used by the HR department to measure the level of the social relationship of all employees that can improve their performance in the company. The author researched PT. BFI Salatiga. The results showed that tissue density was below 50% so that relationships were considered weak. The most dominant actor in degree centrality, closeness centrality, and betweenness centrality is the actor id#24 and id#29 from the collection division, actor id#27 from the operation division and actor id#30 from the credit division.

The College of Occupational Therapists' recent document, A Strategy for Modernising Occupational Therapy Services in Local Health and Social Care Communities - a Consultation (COT 2002), has provoked debate within the profession on the future delivery of occupational therapy services across health and social care. This seems an appropriate time to reflect on events of 30 years ago when, following the initial separation of health and social services, the profession was faced with the dilemma as to where occupational therapists should be located. This paper looks at the events and issues influencing the profession's decisions then, using a grounded theory approach and drawing on literature and documentation. At that time, discussions raised concerns about the division of skills, adherence to the ethical code and the status within the profession of occupational therapists working in local authorities. The profession's immaturity, lack of autonomy and medical orientation were key factors in influencing its response, which focused on drawing all occupational therapists into the health service. Despite lengthy discussions and consultations, the profession could not influence events and some local authority occupational therapists automatically became part of the newly set-up social services departments. Analysis reveals a possible missed opportunity to establish a firm foundation for occupational therapy in social services, the consequences of which are still evident today.

Before discussing the types of services that are required I would like to look, just briefly, at some of the recent history in the provision of services.Edith Bennett was the Director of the Family Welfare Division in what is now Community Services Victoria. Those of you who have been around for more than ten years will remember her. She once said that what we need is a range of flexible services. Being rather young and believing I knew it all I thought at the time that this was a load of simplistic rubbish. How could something so simple be true. The field likes to make these things complex. However, looking back I feel she had made a key point that is perfectly obvious now.

Erikson's theory of identity development and Marcia's model of identity statuses serve as a framework for this examination of the relationship between women's identity status and employment. The hypotheses of the study were that women with an achieved identity status would be more likely to obtain and retain employment and that interventions would increase their scores on identity-related subscales. Phase I of this study examined the relationship between identity development and employment among 203 women receiving public assistance. Subjects provided employment and public assistance histories and were categorized into three preferred cognitive styles according to responses to the Berzonsky Cognitive Style Inventory: Information Orientation (characterized by active searching and evaluation of relevant information prior to decision making/problem solving); Nonnative Orientation (characterized by a passive approach to decision making/problem solving which reties upon the opinions of significant others), and Diffuse Orientation (decision making/problem solving characterized by procrastination and avoidance). Information-and Nonnative-oriented respondents reported just over one year of public assistance ( 15 .05 and 14.21 months, respectively), while the Diffuse-oriented respondents had utilized public assistance in excess of three years (37.20 months). Diffuse-oriented respondents also reported changing jobs more frequently during the previous 12 months than Information- and Normative-oriented respondents, although no differences were found among the three groups in months employed. Phase 2 of this study used a quasi-experimental design to examine the effectiveness of interventions to affect employment and scores on the subscales of the Berzonsky Cognitive Style Inventory, as measured by the BCSI subscale scores. Results indicated that there were mixed differences in the pretest and 12-week followup scores of the intervention group on the subscales. However, there were more marked statistically significant differences in the number of hours worked per week and the percentage of the intervention group employed when comparing the pretest and the 12- week post intervention data. The results indicate that while the interventions were less effective in changing identity status than had been hypothesized, they were effective in assisting participants to obtain employment.

Walden University College of Social and Behavioral Sciences This is to certify that the doctoral dissertation by Santoria Lushell Williams has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Hilda Shepeard, Committee Chairperson, Public Policy and Administration Faculty Dr. Clarence Williamson, Committee Member, Public Policy and Administration Faculty Dr. Anne Hacker, University Reviewer, Public Policy and Administration Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2018 In Fulton County, Georgia, the Division of Family and Children Services (DFCS) child-welfare workers (CWWs) voluntarily separate from the agency at a rate higher than among other similar agencies in the state of Georgia. The problems of retention among CWWs in Fulton County have caused a subsequent problem in terms of the continued provision of quality services to foster children and families. This phenomenological study used McGregor's conceptualization of theory X-Y as the foundation for the exploration of the experiences of former Fulton County DFCS CWW workers related to their reasons for voluntary separation. Data were acquired through interviews with 10 CWWs who voluntarily separated from their positions with Fulton County between the years of 2013 and 2015. These interview data were transcribed and then coded and analyzed using a modified van Kaam procedure. Findings revealed that workers experienced what they perceived as a lack of administrative empathy, devaluation of workers, disrespect, and burnout, as well as the differences in knowledge between child welfare workers and management about the depth of CWW job duties. Two additional themes emerged regarding longevity that included motivation from peers and children safety. The positive social change implications of this study include recommendations to DFCS to engage CWWs in organizational decision making regarding child welfare policy and to seek opportunities to enhance feelings of value and inclusiveness among CWWs in strategic planning and policy making.

The purpose of this study was to develop and test an instrument to measure client satisfaction among families who are clients of a child protective services agency. With the growing numbers of families coming into contact with CPS agencies, the burgeoning numbers of children in foster care, and the increasing attention to the effectiveness of services within this population, client feedback is one approach that has been largely ignored by CSP administrators. The basic problem this dissertation addressed is the issue of obtaining feedback from the involuntary client, such as the family in a child abuse case. Specifically, this dissertation addressed the following four research questions: 1. Can a client satisfaction instrument be developed for CPS clients largely through the input of the clients? 2. What are the domains of satisfaction that are applicable to CPS families? 3. How much involvement do the CPS families feel that they have in the planning and decision-making in their cases? What impact does this have on their overall level of satisfaction? 4. What are the relationships among the various domains of satisfaction and the overall level of satisfaction? Two rounds of interviews were held with families who had been clients of the CPS agency serving the State of Oregon, Children's Services Division. These interviews served as the major source of information for the identification of satisfaction domains and for the development of a closed-ended instrument to measure these domains. The responses to the interviews were content analyzed and four specific domains of client satisfaction were identified. These were: (a) Helpfulness, (b) Partnership, (c) Choice, and (d) Information Sharing. Items were also developed to comprise a "General Satisfaction" domain. A closed-ended instrument was constructed and pre-tested in two large Branch offices of the agency. This instrument included five items to address the interest of the agency in the issue of "convenience." It also included seven items to gather information concerning the opinions of clients on the agency mission and goals. Results of the pre-test were analyzed and the instrument revised. The final instrument was mailed to a population of 4,337 CPS families. Surveys were returned by 489, or 11%, of the families. Analyses, including correlational analysis, factor analysis, and internal consistency reliability analysis, provided empirical support for the domains identified through the client interviews Analysis provided very little support for the "convenience" domain. Satisfaction on the four scales measuring the four domains of satisfaction was positively correlated with measure of overall satisfaction. The overall theme which ran through the entire client survey instrument was that of empowerment. Three of the four domains of satisfaction which were identified were: Ca) "Partnership," (b) "Choice," and (c) "Information Sharing." The challenge is for CPS agencies to incorporate these issues into their practice.

The aim of the study was to examine the background and prerequisites for social services responsibility for carers according to the carers’ section in the Social Services Act. How the legislation is perceived and implemented in practice was also studied. The study’s theoretical basis was jurisprudence and the sociology of law. Preparatory work and other sections of importance for the interpretation of the carers’ section in the Social Services Act were also scrutinized. Interviews with four municipal politicians and four local civil servants were conducted. Various factors which affect the prerequisites for the social services duty of care towards carers were identified in the study. By studying the direct effects of legislation various indirect effects were also highlighted. The results showed that legislation is a weak instrument of control in municipalities’ planning and implementation of support for carers. Therefore social services responsibility for carers is unclear and imprecise. For carers themselves it is difficult to know what support they can demand or ask for from social services – municipalities have to offer support for carers but the carers’ section does not give carers any legal right to support.

Abstract Amidst the worst disaster to impact a major U.S. city in one hundred years, New Orleans’ main trauma and safety net medical center, the Reverend Avery C. Alexander Charity Hospital, was permanently closed. Charity’s administrative operator, Louisiana State University (LSU), ordered an end to its attempted reopening by its workers and U.S. military personnel in the weeks following the August 29, 2005 storm. Drawing upon rigorous review of literature and an exhaustive analysis of primary and secondary data, this case study found that Charity Hospital was closed as a result of disaster capitalism. LSU, backed by Louisiana state officials, took advantage of the mass internal displacement of New Orleans’ populace in the aftermath of Hurricane Katrina in an attempt to abandon Charity Hospital’s iconic but neglected facility and to supplant its original safety net mission serving the poor and uninsured for its neoliberal transformation to favor LSU’s academic medical enterprise.

For many years, Sweden has had a reputation for having a comprehensive and women friendly welfare state. However, as in many other European countries during the past few decades, the organization and governing of welfare has undergone profound changes. Through interviews with social workers and the application of theories of governmentality, this thesis analyzes the expressions and consequences of such current organization and governing. One result is that the introduction of meticulous documentation practices of social workers contact with clients, regulate their interaction and constitute a control over both client and social worker. Another result is that the current organization fragments labor and awards more authority to managers, which functions to produce loyalty to the organization and management, rather than clients. This is expressed in demands not to voice protest, as it is said to create a bad mood. It is also expressed in demands to spend as little as possible on clients; short duration of treatment, preference for outpatient treatment and by making it difficult to receive financial support. This austerity is legitimized through the intermeshing of different ideals; budget awareness, evidence that supports short and outpatient treatment and that clients in order to change their course of life should to be allowed or coerced into taking individual responsibility. Another important finding is that the current governing and organization of social work produce distance and detachment, and thus discourage caring subjects. This is a complex process in which an assemblage of different techniques and rationalities undermines the cultivation of a relationship between social worker and client. 1) The ideal of evidence-based practice favors rigid methods over a flexible and holistic approach. 2) Ideals of rationality, closely connected to notions of masculinity and professionalism, value objectivity and devalue and deter the surfacing of emotions. 3) Meticulous practices of documentation reduce the amount of time available to meet clients. 4) Ideals and particular methods designed to promote individual responsibility in clients legitimize social workers distancing themselves from clients’ dependency and needs. 5) A division of labor, in either assessment or treatment, reduces time spent with clients for those who work with assessment and ultimately engage in the rationing of resources. 6) Standardized digital templates, installed to aid in assessments, regulate and proceduralize interactions with the client. 7) Austerity, heavy workloads, individualized responsibility and stress further accentuate distance, as detachment becomes a means to cope with arduous working conditions. The transformation of social work described above produces alienation and a fragmentation of social workers’ collective subjects. Simultaneously, an ethos of caring makes some social workers work extra hard to provide for clients, which ultimately covers for flaws in the system. Although such an ethos of caring allows for the further exploitation of social workers, it is also understood as a means of resistance, which in turn also forms the basis for organized resistance.
Sverige har ett internationellt rykte för att ha en omfattande och kvinnovänlig välfärd. Även om riktigheten i en sådan uppfattning sedan länge ifrågasatts har på senare år, likt i många andra Europeiska länder, det svenska välfärdssystemet genomgått en omfattande förändring i avseende på dess räckvidd, men också dess organisering och styrning. Fokus för denna studie är just denna organisering och styrning, och mer specifikt, hur detta påverkar ett av välfärdens kanske mest centrala område: socialt arbete. Genom att intervjua socialarbetare undersöks i denna studie uttryck för och konsekvenser av en sådan förändring, bland annat genom att undersöka hur könsbundna föreställningar och förväntningar är sammanflätade med det sociala arbetets organisering och styrning. I studien konstateras att socialarbetare erfar att deras arbete genomgått omfattande förändringar, vilket kopplas ihop med både organiseringen och styrningen av det sociala arbetet. Detta uttrycks både i de ideal som kringgärdar arbetet men också i dominerande arbetssätt. En sådan förändring är införandet av  omfattande dokumentationsprocedurer av socialarbetarens arbete och kontakt med klienter, vilket medför att kontakten med klienterna blir ytligare. Dokumentationsprocedurerna utgör också en sorts kontroll av både klienterna och socialarbetarna själva. En annan förändring som konstateras är att nya organisationsmodeller och en förändrad ledarskapskultur skapar förväntningar på socialarbetarna att vara lojala med organisationen och ledningen snarare än klienterna. Bland annat utrycks detta genom förväntningar att inte protestera och skapa dålig stämning på arbetsplatsen, men också genom uttalade krav att spendera så lite resurser som möjligt på klienterna; korta behandlingstider, öppenvårdsalternativ och orimligt hårda krav för att få ekonomiskt bistånd. Detta legitimeras genom sammanväxningen av flera olika ideal; budgetmedvetenhet, att klienter inte mår bra av långa institutionsvistelser, men också att klienterna ska tillåtas eller bör tvingas att klara att sig själva. Ett av studiens huvudresultat är att den nuvarande organiseringen och styrningen av socialt arbete skapar avstånd och likgiltighet. Genom flera sammankopplade ideal och arbetssätt styrs dagens socialarbetare till att bry sig mindre om de klienter de möter. På så sätt undermineras förutsättningarna för framväxten av en djup relation mellan socialarbetare och klient; 1) Idealet och kravet att socialarbetare ska arbeta utifrån evidens, det vill säga metoder och förhållningssätt som i speciellt utformade utvärderingsmodeller visat sig ha effekt, gör att väl strukturerade och rigida metoder ges företräde. Denna instrumentalisering underminerar ett flexibelt, relationsorienterat och helhetsfokuserat sätt att arbeta. Dessutom gör evidensidealets fokus på enskilda individer och avgränsade utvärderingstider att mer samhällsinriktat kritiskt och långsiktigt inriktat arbete undermineras. 2) Ett rationalitetsideal, tätt sammanbundet med föreställningar om professionalitet och maskulinitet, värderar objektivitet och förmågan att frikoppla socialarbetarens egna känslor från sitt arbete. Detta maskuliniserade professionsideal innebär att empati och solidaritet med klienten undergrävs. 3) Omfattande krav på olika former av dokumentation av det sociala arbetet gör att tiden som socialarbetaren har till sitt förfogande för att besöka och att ha möten med klienten blir knapp. 4) Ett allmänt samhällsideal kring individuellt ansvar och en särskild arbetsmetod (motiverande samtal) som många socialarbetare förväntas lära sig, framhäver klientens eget ansvar för och vilja till förändring. Detta legitimerar ett avståndstagande från klientens behov av hjälp och stöd enligt logiken  ”du måste klara detta själv”. 5) En vanligt förekommande uppdelning av socialarbetarnas arbetsuppgifter i en så kallad beställar-utförarmodell gör att vissa socialsekreterare arbetar med hjälp och stöd, medan andra arbetar med bedömningar av klienters behov. De senare, som också har inflytande över resurstilldelning, blir med en sådan organisering av arbetet alltmer frikopplade från den stödjande och hjälpande verksamheten och kontakten med klienten. 6) Standardiserade digitala bedömningsinstrument, skapade för att på ett likvärdigt sätt bedöma klienters behov och dokumentera det sociala arbetet, reglerar och instrumentaliserar kontakten med klienter. 7) Tunga arbetsbördor, individualiserat ansvar och stress, bidrar ytterligare till att skapa avstånd och likgiltighet eftersom det för vissa utgör ett sätt att genomleva en ohållbar arbetssituation. En allmän åtstramning av socialtjänstens resurstilldelning förstås som en viktig orsak till behovet av att skapa ovan distansmekanismer. Men distansen hänger också ihop med en tendens till ett återupplivande av en tidigare dominerande förståelse av marginalisering och sociala problem; där människors nöd ses som ett utslag av dålig karaktär och ett resultat av dåliga individuella val. De förändringar av det sociala arbetets premisser som beskrivits ovan gör att socialarbetarna alltmer görs främmande inför sitt arbete – de alieneras. Detta främmandegörande uttrycks genom att inte kunna identifiera sig med arbetet självt, sina kollegor eller med sig själv. Ett sådant främmandegörande underminerar, eller fragmentiserar, både relationen till klienten, men också en känsla av gemenskap med andra socialarbetare. En gemenskap som kan utgöra ett ”vi” och ligga till grund för att ställa krav, protestera och göra motstånd mot avhumaniserande ideal och reformer. På så vis är främmandegörandet inte bara en konsekvens av dagens organisering och styrning, utan också något som fyller en viktig funktion för en sådan styrning och organisering, och genomförandet av en allmän åtstramning i socialpolitiken. Samtidigt som dagens organisering och styrning av socialt arbete är främmandegörande, slår vissa socialarbetare knut på sig själva och arbetar extra hårt för att täcka upp för systemets brister och krympande resurser, för att trots det svåra läget ändå försöka ge det stöd som de upplever att klienten behöver. Ett sådant historiskt förankrat femininiserat omsorgsideal, dvs känslor av ansvar och empati inför behövande och en ilska inför oförrätter, utgör därmed på samma gång grund för en fördjupad exploatering av socialarbetarna, och ett vardagligt motstånd mot rådande system. I ett läge när flera upplever att kollegialiteten som grund för motstånd på arbetsplatserna underminerats, utgör ett sådant omsorgsideal samtidigt också grunden för organiserat motstånd utanför arbetsplatsen, bortom chefernas insyn, kontroll och härskartekniker. Medan nuvarande styrningssystem underminerar ett visst sorts motstånd, uppstår samtidigt grunden för nya.

The curriculum developed in this project was designed to meet the requirements of the Clay County gifted program. It provides a comprehensive American history curriculum, discovery through the Civil War, to promote mastery of the content area, increase involvement and interest of students in learning through the reduction of irrelevant and redundant material, and encourage individual initiative for one/sown investigations. The program consists of a series of independent studies in which the teacher is a facilitator who sets the stage and encourages students' endeavors. The study units developed for this project include objectives representing all levels in Bloom/s Taxonomy. The curriculum was evaluated by pilot-testing and surveying the students involved, as well as by surveying a team of teachers of the gifted and a university faculty member in social studies education.

L’expansion de l’organisation de la production des biens et services sous forme de réseau, découlant de la recherche de flexibilité face à une concurrence économique accrue, soulève des enjeux importants pour les relations industrielles. Notre thèse s’intéresse au processus de précarisation des emplois dans les segments externalisés des réseaux de production. Elle se base sur trois études de cas portant sur les réseaux de services publics et privés d’aide à domicile au Québec. Les études en droit critique ont montré que le droit du travail, fondé sur le modèle de l’entreprise intégrée et de la relation d’emploi bipartite, ne parvient pas à identifier comme employeurs certaines organisations dont l’action a pourtant un effet déterminant sur les conditions de travail dans les réseaux. Notre thèse visait donc à mettre en lumière la réalité empirique des relations de pouvoir qui traversent les réseaux et leurs effets et ce à partir d’un modèle analytique transdisciplinaire intégrant les dimensions juridiques et sociologiques. Les résultats nous amènent d’abord à constater que l’employeur juridique des travailleuses employées par les prestataires privés intégrés aux réseaux – une majorité de femmes – est le plus souvent une agence de location de personnel, une entreprise d’économie sociale ou même l’usager-ère des services d’aide à domicile. Cet employeur est rarement identifié aux organismes publics, donc sous l’égide de l’État, qui exercent un pouvoir prépondérant dans ces réseaux. Le décalage entre la régulation juridique du travail et la réalité empirique du pouvoir intra-réseau entraîne une précarisation de la protection sociale et des conditions de travail de ces travailleuses. Ainsi, la faible protection de leurs droits de représentation et de négociation collectives facilite l’imposition de la « disponibilité permanente juste-à-temps », combinant les logiques du lean et du travail domestique, ainsi qu’une déqualification sexuée et racialisée de leurs emplois par rapport à la situation dans le secteur public. Notre étude montre néanmoins que certaines pratiques innovatrices d’action collective réticulaire ont pu influencer la dynamique de pouvoir, en particulier celles portées par des associations locales de personnes handicapées recourant aux services et par un syndicat de travailleuses d’agence.
The increasing trend towards organizing the production of goods and services into networks as a result of the quest for flexibility in the face of fierce economic competition raises critical issues for industrial relations. Our thesis examines the precarization of jobs in the externalized segments of production networks. It is based on three case studies focusing on the networks of public and private homecare services in Quebec. Critical law studies have shown that labour law, based on the model of the integrated firm and the binary employment relationship, fails to identify as employers some organizations whose action nevertheless has a decisive impact on working conditions in these networks. Our thesis thus aimed to shed light on the empirical reality of the power relations prevailing throughout the networks and their effects, using an interdisciplinary analytical model that integrates the legal and sociological dimensions. Results indicate that the legal employer of workers – most of them women – employed by private service providers integrated into the networks is most often an employment agency, a social economy enterprise or the individual using the homecare services. This employer is rarely identified as being among the public organizations which, under the aegis of state, exercise predominant power over these networks. The gap between the legal regulation of labour and the empirical reality of intra-network power leads to a precarization of the social protection and working conditions of these women workers. Thus, the weak protection of their rights to collective representation and collective bargaining facilitates the imposition of “just-in-time permanent availability”, combining lean management logic with domestic work logic, and leads to a gendered and racialized deskilling of their jobs compared to the situation prevailing in the public sector. Our study nevertheless shows that some innovative practices involving reticular collective action – in particular practices implemented by local associations of disabled persons using the services and by a union of female agency workers – have had an influence on these power dynamics.

Ce mémoire propose une étude jurisprudentielle de la compétence constitutionnelle que peut exceptionnellement faire valoir le Parlement en matière de relations de travail lorsque les activités d’une entreprise sont intimement liées à la compétence que détient le Parlement sur les Indiens. La présente étude a pour objet de circonscrire les critères permettant de déterminer laquelle, de la législation provinciale ou fédérale du travail, est applicable à un employeur dont les activités, la mission ou encore la gestion se rattachent à la spécificité autochtone.
This Master’s thesis proposes a jurisprudential study of the exceptional constitutional jurisdiction that Parliament may have over labour relations where the employer’s activities are intimately related to the jurisdiction of the Parliament over “Indians”. The main objective of this study is to identify the criteria to be used to determine whether provincial or federal labour legislation applies to an employer whose activities, mission or management relates in any way to Aboriginal specificity.

AbstractThis chapter analyses socioeconomic segregation and segregation by migration background for Berlin, Germany. Berlin’s history of division and reunification affected suburbanization patterns and the unequal economic restructuring of the city over time. Within this historical context, we present our empirical results on segregation, and we reflect on the implications of segregation for the daily use of the city. Arguments that segregation affects access to amenities (as in the literature on ‘food deserts’) or reduces access to jobs (as in spatial mismatch theories) are not so useful for Berlin with its strong public transport infrastructure. We find that socioeconomic segregation was moderate and stable for the working-age population between 2007 and 2016, whereas segregation of poor children increased. At the same time, segregation of foreigners and segregation by migration background strongly declined. And yet, even though segregation levels are low and public services are present everywhere, the social use of the city, we argue, may be more segregated than statistical indicators suggest. Drawing on various case studies, we suggest that the use of the overall city reflects segregation patterns of the use of space for other reasons than commonly suggested.

This chapter looks at how some students of social policy see the development of ‘The Welfare State’ in historical perspective as part of a broad, ascending road of social betterment provided for the working classes since the nineteenth century and achieving its goal in the present time. This interpretation of change as a process of unilinear progression in collective benevolence for these classes led to the belief that in the year 1948 ‘The Welfare State’ was established. Since then, successive governments, Conservative and Labour, have busied themselves with the more effective operation of the various services. Both parties have also claimed the maintenance of ‘The Welfare State’ as an article of faith.

This chapter analyzes the issue of primary health care utilization in Hong Kong and introduces the case of Hong Kong where a special division between public and private sectors has developed in the field of primary health services. The chapter argues that in the foreseeable future, it is likely that the division of health care between the public and private sector will be maintained. In recent years, more and more individuals and families have purchased private health insurance so as to gain more options. The idea of universal health insurance was rejected by the public in recent consultations; the current alternative is government-regulated private insurance. Although private primary health services will continue as usual in the near future, public primary health services should be maintained or even expanded. Given the costliness of private services (especially specialist services), it is recommended that more resources should be invested in corresponding public health services.

This chapter discusses the issue of the gender division of housework, focusing on how formal childcare services and parental leave provisions are related to it. It comparatively studies the extent to which family policies are related to housework division in countries in East Asia and Europe. The chapter finds parental leave, which supports women as paid workers, is significant in Europe, but formal childcare services, which support women's deviant gender-roles, are significant when the examination is extended to East Asian countries. Gendered political power relations become significant only when Japan and Korea are added to the analysis. Neither gender-role ideology nor structural constraints, measured as gender wage gap, was an important macro-level factor. Ultimately, the chapter addresses how these results are related to the social investment approach to family and explains why the division of housework in East Asian countries remains highly gendered.

The primary objective of this chapter is about innovation within specific social organizations, which compacts with the division of labor, knowledge creation, and the use of technology such as e-enterprise in social economy aimed at improving productivity. A significant proportion of the world’s economy is organized to make profits not only for investors but to sustain the employment of many disadvantaged people throughout the world. It includes cooperative organizations, foundations, and many other social enterprises that provide a wide range of products and services across the globe and generate sustainable employment. Productivity tends to increase when the job is divided into manageable portions and then performed by adequately skilled personnel. In order to succeed in an environment in which other businesses fiercely compete along with social enterprises, it is imperative to take into account innovative systems such as e-enterprise to leverage competition and increase productivity.

The chapter claims that a profession progresses through interaction and conflict with adjacent professions. Using the professional development of physiotherapy in Norway as an example, the chapter illustrates how inter-professional disputes are central to the ways division of labour and responsibility are shaped. The chapter shows how the physiotherapists’ struggle to gain public authorisation, and to become a part of the national health services, were entwined with the medical professions aspirations to control and subordinate other professions working within the field of health and medicine. The chapter shows how physiotherapists battled the medical profession by seeking active support from the state.

Sport fans rarely attend sporting events alone. While traditional consumer and sport fan behavior research frequently segmented fans based on demographic characteristics, recent advances in understanding how sport fans co-create and co-consume sporting events provides substantial evidence that sports fans should be examined as tribal groups. In this chapter, seven dimensions of sport fan tribalism are proposed and tested (membership; geographic sense of community; social recognition; shared rivalry; and shared knowledge of symbols, rituals and traditions, and people) with samples from top-level American college football (Division I American football) and the top level of professional Portuguese soccer (Primeira Liga). The results provide reliability and validity evidence in support of the seven-dimension scale. In addition, the structural testing of the scale highlights differences between tribal fans and their teams (relative to other teams) in terms of five behavioral intentions and two commitment- related outcome variables. The implications of labeling sports fans at tribal, the use of the seven-dimension scale and the structural results are all discussed.

This chapter analyses the increasingly influential idea that healthcare systems, or health and social care systems more broadly, need to be better integrated—that both services and the experiences of individuals need to be less ‘fractured’ and that this depends upon attending to the overall architecture of systems. In order to approach the integration agenda, it is worth acknowledging the ‘problem’ that gives rise to it. The agenda is closely bound up with divisions and boundaries that are both necessary and a source of difficulties. The way in which health systems seek to provide diverse goods is through a division of labour that structures both services and roles. Yet the necessary division of labour inevitably and notoriously creates problems. Perhaps the central device through which health policy addresses and manages this tension—between differentiated provision and consolidated needs—is by supporting both specialism and generalism.

Scotland has some of the prerequisites for a social investment state. Yet the division of powers between the Scottish and UK levels in relation to taxation and welfare is not optimal. The Scottish Government has reformed its policy-making structures but still has shortcomings in planning for the long term. While public opinion in Scotland supports spending on public services from which citiziens benefit, it is only slightly more favourable to redistribution than in England. The experience of other counrties shows that citizens will support public spending and the resultant taxes if they know that they will get good services.

In the first part of the paper are analyzed different views of the rule of law: liberaldemocratic, then positivistic view and, finally, defining of the rule of law as the rule of positive-law order of particular properities. In addition to these the three theoretic orientations, one more classification was pointed out - formal and materaialistic aspect of the rule of law. Besides, the principles and institutions of the rule of law were analyzed: legitimacy of power, division of power, independent judiciary, legitimacy expressed in terms of the ideas of constitution and lawfulness, constitutional guarantees of human and civil rights, existence of free economy and economic activities. The subject of the second part of this paper are services. Nowadays, services are the motor of economic growth and include, especially in developed countries of EU, more then 70% of EDP, employees, new economic subjects, and service activities also make up over 70% of all the activities. The service sector includes different, heterogenic services the number of which is getting higher and higher. The service activities are numerous and performed in various sectors such as trading, communications, financing, government administration, health department, social welfare, media, education, tourism, catering, sport and others. We are all witness to the constant growth of service sector in view of continuous broadening of the range of services and the influence upon the economic development of the state. Law regulations of the services in the Republic of Serbia were analized as well as its harmonization with the law regulations at the level of EU and the need for its further upgrading and improvement.

The Division of Reproductive Health (DSR) of the Senegal Ministry of Health and Social Action, in partnership with the Population Council’s FRONTIERS in Reproductive Health program and Management Sciences for Health (MSH), conducted a study to test and compare three ways of providing reproductive health services to rural communities in the Kébémer district of Senegal in terms of their effectiveness, cost, and cost-effectiveness. FRONTIERS and MSH collaborated with the DSR to design the interventions, MSH supported the DSR in implementing the interventions, and FRONTIERS undertook the evaluation. This study, funded by USAID, responded to the recommendations of a 1999 workshop, organized by FRONTIERS and the DSR, on the community-based distribution (CBD) approach, which defined alternative CBD models appropriate for Senegal. The DSR sees the development of community-based service delivery models as essential for the future of health care in Senegal. As noted in this report, the general objective of the study was to contribute to the development of an integrated cost-effective program to increase the accessibility and availability of reproductive health information and services in rural areas of Senegal.