Is It Enough? A Comparative Examination of 'Care Leaver's' Health Trajectories in Scotland and Ontario
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基本信息
- 批准号:2265240
- 负责人:
- 金额:--
- 依托单位:
- 依托单位国家:英国
- 项目类别:Studentship
- 财政年份:2019
- 资助国家:英国
- 起止时间:2019 至 无数据
- 项目状态:已结题
- 来源:
- 关键词:
项目摘要
Children placed in State care, either voluntarily or through legal orders, experience numerous challenges upon leaving care that include - but are not limited to - a lack of supportive housing and potential homelessness (Dixon 2008; Randall 1988, 1989), lower educational attainment and occupational status (O'Sullivan and Westerman 2007; Day et al. 2012), and greater likelihood of experiencing poverty (Tarren-Sweeney 2008; Dixon et al. 2006; Saunders and Broad 1997). These adverse outcomes - which are interrelated - shape children's present and future health status (Dixon 2008). Those in and leaving care are more likely to experience adverse physical and mental health outcomes such as premature mortality, drug abuse, depression, and anxiety (Akister et al. 2010; Hjern et al. 2004; Kerker and Dore 2006; Meltzer et al. 2003; National Audit Office 2015; Pilowsky and Wu 2006; Tarren-Sweeney 2008; Tine and Mette 2009). While some of this may be due to the characteristics of those entering care, as 6% of children with disabilities are located within care facilities (Gordon et al. 2000), most of this can be attributed to their exposure to social disadvantage and isolation prior to, during, and after leaving care. Whilst there exists a significant body of research illuminating the precarious position of this population of care experienced young adults, it fails to situate them within a wider public policy environment (Power and Raphael 2017). Current models linking care experience to later outcomes generally focus on individual behaviours/characteristics, the consolidation of positive identities though the development of supportive networks, and the effects of specific social policies germane to this group. Whilst informative, these models neglect key environmental and contextual factors that shape the living and working conditions of this vulnerable population. Accordingly, there is a need to revaluate existing models and insights which examine the poor health trajectories of those in and leaving care.Within their evaluation of poor health trajectories amongst young people in and leaving care, Power and Raphael (2017) incorporate insights from existing literature into a model that illuminates the implications of contextual characteristics on care leaver's health (Figure 1). This holistic model incorporates individual mechanisms, family and local area characteristics, social determinants of health, the public policy environment, and macro-structural concepts associated with power distribution. It incorporates a pathway model to show how stages in the life course interact with these factors to shape care leavers health.This project shall be a comparative of two policy environments: Edinburgh, Scotland and Toronto, Canada. The rationale for this is that the political economy of health literature groups these countries together under the banner 'liberal welfare state' (Esping-Andersen 1990, 1999). Whilst useful, this model fails to acknowledge complexity within these jurisdictions. Moreover, the role of devolutionary politics in Scotland and the federal system in Canada makes these interesting case studies. For while both have a level of autonomy in constructing social policies, the economic dominance of Westminster and Ottawa can be restricting.The proposed research project shall utilize a two-tier methodological approach that will reflect the model developed by Power and Raphael. The first stage will be a demographic profile survey alongside a health screening questionnaire (EQ-5D) and the second will be semi-structured, non-standardised interviews. Moreover, the project shall utilize a mixed-methods approach (Brewer and Hunter 2006) which will enable one to (1) illuminate associations between quantified variables and (2) qualitatively contextualize and understand these relations. This consequently has the potential to lead to the development of empirically informed policies that derive from the experiences of care leavers.
自愿或通过法律的命令置于国家照料之下的儿童在离开照料时会遇到许多挑战,包括-但不限于-缺乏支助性住房和可能无家可归(狄克逊,2008年;兰德尔,1988年,1989年),较低的教育程度和职业地位(O 'Sullivan and Westerman 2007; Day et al. 2012),以及经历贫困的可能性更大(Tarren-Sweeney 2008;狄克逊et al. 2006; Saunders and Broad 1997)。这些相互关联的不良后果影响着儿童现在和未来的健康状况(狄克逊,2008年)。接受和离开护理的患者更有可能经历不良的身心健康结局,如过早死亡、药物滥用、抑郁和焦虑(Akister et al. 2010; Hjern et al. 2004; Kerker and Dore 2006; Meltzer et al. 2003; National Audit Office 2015; Pilowsky and Wu 2006; Tarren-Sweeney 2008; Tine and Mette 2009)。虽然其中一些原因可能是由于进入照料机构的残疾儿童的特点,因为6%的残疾儿童在照料机构内(Gordon等人,2000年),但其中大部分原因可能是他们在离开照料机构之前、期间和之后处于社会不利地位和孤立状态。虽然有大量的研究揭示了这群有护理经验的年轻人的不稳定地位,但它未能在更广泛的公共政策环境中对他们进行评估(Power and Raphael 2017)。目前将护理经验与后来的结果联系起来的模式一般侧重于个人行为/特征、通过发展支持网络巩固积极的身份以及与这一群体密切相关的具体社会政策的影响。虽然这些模型提供了信息,但忽略了影响这一弱势群体生活和工作条件的关键环境和背景因素。因此,有必要重新评估现有的模型和见解,这些模型和见解研究了护理中和离开护理的年轻人的健康状况不佳的轨迹。在他们对护理中和离开护理的年轻人的健康状况不佳的轨迹进行评估时,Power和Raphael(2017)将现有文献的见解纳入一个模型,该模型阐明了环境特征对护理离开者健康的影响(图1)。这一整体模式结合了个人机制、家庭和地方特点、健康的社会决定因素、公共政策环境以及与权力分配有关的宏观结构概念。它结合了一个路径模型,以显示生命过程中的各个阶段如何与这些因素相互作用,以塑造护理离开者的健康。这个项目将是两个政策环境的比较:苏格兰爱丁堡和加拿大多伦多。这样做的理由是,卫生文献的政治经济学将这些国家归类在“自由福利国家”的旗帜下(Esping-Andersen 1990,1999)。虽然这一模式很有用,但它未能认识到这些司法管辖区的复杂性。而且,苏格兰的权力下放政治和加拿大的联邦制度的作用使这些有趣的案例研究。因为,虽然两者在构建社会政策方面都有一定程度的自主权,但威斯敏斯特和渥太华在经济上的主导地位可能会受到限制。拟议的研究项目将利用一种双层方法论,这种方法论将反映Power和Raphael开发的模型。第一阶段将是人口统计学概况调查以及健康筛查问卷(EQ-5D),第二阶段将是半结构化、非标准化访谈。此外,该项目应采用混合方法(Brewer和Hunter 2006),这将使人们能够(1)阐明量化变量之间的关联,(2)定性地了解和理解这些关系。因此,这有可能导致根据脱离照料者的经验制定有经验依据的政策。
项目成果
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其他文献
吉治仁志 他: "トランスジェニックマウスによるTIMP-1の線維化促進機序"最新医学. 55. 1781-1787 (2000)
Hitoshi Yoshiji 等:“转基因小鼠中 TIMP-1 的促纤维化机制”现代医学 55. 1781-1787 (2000)。
- DOI:
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LiDAR Implementations for Autonomous Vehicle Applications
- DOI:
- 发表时间:
2021 - 期刊:
- 影响因子:0
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吉治仁志 他: "イラスト医学&サイエンスシリーズ血管の分子医学"羊土社(渋谷正史編). 125 (2000)
Hitoshi Yoshiji 等人:“血管医学与科学系列分子医学图解”Yodosha(涉谷正志编辑)125(2000)。
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Effect of manidipine hydrochloride,a calcium antagonist,on isoproterenol-induced left ventricular hypertrophy: "Yoshiyama,M.,Takeuchi,K.,Kim,S.,Hanatani,A.,Omura,T.,Toda,I.,Akioka,K.,Teragaki,M.,Iwao,H.and Yoshikawa,J." Jpn Circ J. 62(1). 47-52 (1998)
钙拮抗剂盐酸马尼地平对异丙肾上腺素引起的左心室肥厚的影响:“Yoshiyama,M.,Takeuchi,K.,Kim,S.,Hanatani,A.,Omura,T.,Toda,I.,Akioka,
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