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Who gets ongoing service and why? An exploration of assessment, judgments and decision making during initial assessments in child protection and welfare social work in Ireland
(University College Cork, 2022-10-07)
Background: Deciding whether or not to provide ongoing services following an Initial Assessment of alleged child abuse and or welfare concerns is one of the most important decisions that Social Workers make in Child Protection and Welfare. Despite this, very little is known about this practice or decisions at the conclusion of Initial Assessments or about the characteristics of children and families involved and their service needs. To fill these gaps, this thesis addresses the following issues: (i) current Irish policy for assessment and decision-making with reference to international developments; (ii) the organisational context for assessment practice; (iii) judgment and decision-making strategies that social workers use to determine eligibility for ongoing service; (iv) the characteristics of children and families who undergo Initial Assessment compared to the general population; (v) factors that are associated with the decision to provide ongoing service following an Initial Assessment; and (vi) comments on the efficacy of the current legislative and policy framework for assessment practice. Methods: Two empirical studies were informed by an extensive narrative literature review. A case study was designed to explore assessment practice in nine social work departments within a large administrative region of Tusla during the first quarter of 2016. Information collected from case file records (n=45) and interviews with SWs (n= 2 teams; n= 7 individuals) was thematically analysed to gain insight into the context for practice and into the sense-making and rationales provided for decisions. Secondly, a descriptive and analytic cross-sectional study was designed to profile children in Initial Assessments and to identify factors associated with the decision to provide ongoing service. Descriptive and multivariable analysis was applied to a complete sample of 480 children whose Initial Assessments concluded in seven social work departments in Tusla in the first quarter of 2016. That study also explored the use of the California Structured Decision Making© Family Risk Assessment (NCCD, 2017) to support decision-making. Results: The case study revealed that consistent with the literature, in situations of limited resources, a number of heuristic strategies were used to make decisions for ongoing service provision. Although social workers operate under a dual mandate of welfare and protection, in situations of high demand they prioritised caseload management over individual risk management leading to regret about judgments and decisions made in this specific practice context. The descriptive findings of the cross-sectional study revealed that families involved in Initial Assessments have greater burdens compared to the general population in addition to the specific child abuse and welfare-related difficulties investigated. The prevalence of exposures to risk factors is identified. Almost 2 in every 5 children (38.5%, n=185) remained open for ongoing service following Initial Assessment. In a multivariable model, several clinical and organizational factors were associated with ongoing service. In the analysis, the Irish model was compared to the California Structured Decision Making© Family Risk Assessment tool. The latter model would have allocated more children to ongoing service. Conclusions: The study makes many novel and important contributions to the literature. Through the originality of the study design, the research presents an in-depth exploration of the context for assessment practice and a detailed understanding of how SWs make decisions for ongoing service provision within this situated context. The findings are discussed in relation to their theoretical, practical, and research implications.
Cannabinoids on the brain
Cannabis has a long history of consumption both for recreational and medicinal uses. Recently there have been significant advances in our understanding of how cannabis and related compounds (cannabinoids) affect the brain and this review addresses the current state of knowledge of these effects. Cannabinoids act primarily via two types of receptor, CB1 and CB2, with CB1 receptors mediating most of the central actions of cannabinoids. The presence of a new type of brain cannabinoid receptor is also indicated. Important advances have been made in our understanding of cannabinoid receptor signaling pathways, their modulation of synaptic transmission and plasticity, the cellular targets of cannabinoids in different central nervous system (CNS) regions and, in particular, the role of the endogenous brain cannabinoid (endocannabinoid) system. Cannabinoids have widespread actions in the brain: in the hippocampus they influence learning and memory; in the basal ganglia they modulate locomotor activity and reward pathways; in the hypothalamus they have a role in the control of appetite. Cannabinoids may also be protective against neurodegeneration and brain damage and exhibit anticonvulsant activity. Some of the analgesic effects of cannabinoids also appear to involve sites within the brain. These advances in our understanding of the actions of cannabinoids and the brain endocannabinoid system have led to important new insights into neuronal function which are likely to result in the development of new therapeutic strategies for the treatment of a number of key CNS disorders.
The effect of superoxide dismutase enzyme inhibition on renal microcirculation of spontaneously hypertensive-stroke prone and Wistar rats
(Czech Academy of Sciences, 2018-01)
A significant factor in the development of hypertension may be excessive vasoconstriction within the renal medulla. This study therefore investigated the role of superoxide dismutase (SOD) in the regulation of renal medullary and cortical blood perfusion (MBP and CBP, respectively) in both stroke-prone spontaneously hypertensive rats (SHRSP) and normotensive Wistar rats. CBP and MBP were measured before and after intra-renal infusion of the SOD inhibitor, diethyldithio-carbamic acid (DETC). Under basal conditions, mean arterial pressure was significantly greater in SHRSP than Wistar rats, but both MBP and heart rate (HR) were significantly lower in SHRSP relative to Wistar rats (P<0.05, n=7 in both groups). Infusion of DETC (2 mg/kg/min) into the cortico-medullary border area of the kidney significantly decreased MBP in the SHRSPs (by 28+/-3 %, n=7, P<0.05), indicating a greater vasoconstriction within this vascular bed. However, DETC also significantly decreased MBP in Wistar rats to a similar extent (24+/-4 %, n=7, P<0.05). These results suggest that superoxide anions play a significant role in reducing renal vascular compliance within the renal medulla in both normotensive and hypertensive animals, although the responses are not greater in the hypertensive relative to the control animals.
One-to-one LEGO® SERIOUS PLAY® positive psychology coaching for emerging adults: a single-participant case study
Purpose: This study explores one-to-one LEGO® Serious Play® in positive psychology coaching (1-1 LSP in PPC) as an intervention to help emerging adults (EAs) in higher education develop a growth mindset. Design/methodology/approach: This is a qualitative single-participant case study of an EA undergraduate student's experience with 1-1 LSP in PPC to help him navigate uncertainty about making a decision that he felt would influence his future career. Findings: 1-1 LSP in PPC enabled the participant to create a metaphoric representation of how a growth mindset operated for him, promoting self-awareness and reflectivity. The LEGO® model that the participant built during his final session acted as a reminder of the resources and processes he developed during coaching, which helped him navigate future challenges. Research limitations/implications: This study contributes to the emerging literature on the impact of using LSP as a tool in one-to-one coaching in higher education. The participant's experience demonstrates that 1-1 LSP in PPC may be an effective way to support positive EA development. More research is needed to explore its potential. Practical implications: This study provides a possible roadmap to incorporate 1-1 LSP in PPC into coaching in higher education as a reflective tool to build a growth mindset in EA students. Originality/value: Because most undergraduates are EAs navigating the transition from adolescence into adulthood, universities would benefit from adopting developmentally informed coaching practices. 1-1 LSP in PPC may be an effective intervention that provides the structured and psychologically safe environment EAs need to develop lasting personal resources.
Reimagining care discourses through a feminist ethics of care: analysing Ireland’s Citizens’ Assembly on Gender Equality
(Bristol University Press, 2022-12-16)
The COVID-19 pandemic brought to the fore stark gendered care inequalities and the inadequacy of care provision across states. This article presents a feminist-ethics-of-care-informed discourse analysis of the representation of care that emerged at the Irish Citizens’ Assembly on Gender Equality – an innovative government-created citizen deliberation process. It identifies how care was represented as a ‘problem’ of both gender inequality and the market, and uncovers key silences, which ignored care as a universal need of all citizens and the significance of care networks to sustaining caring. We propose the necessity of ethics-of-care-based understandings to address post-pandemic care challenges.