“What About Lesbians?”: CFP Resolution 01/1999 between Silences, Disputes and Care Policies

Severe pre-eclampsia can cause significant mortality and morbidity for both mother and child, particularly when it occurs well before term. The only known cure for this disease is delivery. Some obstetricians advocate early delivery to prevent the development of serious maternal complications, such as eclampsia (fits) and kidney failure. Others prefer a more expectant approach in an attempt to delay delivery and, hopefully, reduce the mortality and morbidity for the child associated with being born too early. The objective of the review was to compare the effects of a policy of interventionist care and early delivery with a policy of expectant care and delayed delivery for women with early onset severe pre-eclampsia. We search the register of trials maintained by the Cochrane Pregnancy and Childbirth Group (April 2002) and the Cochrane Controlled Trials Register (The Cochrane Library, Issue 2, 2002). Randomised trials comparing the two intervention strategies for women with early onset severe pre-eclampsia. Trial quality was assessed using the criteria set out in the Cochrane Reviewers' Handbook. Data were extracted and checked independently by both reviewers. Two trials (133 women) are included in this review. There are insufficient data for reliable conclusions about the comparative effects on outcome for the mother. For the baby, there is insufficient evidence for reliable conclusions about the effects on stillbirth or death after delivery (relative risk (RR) 1.50, 95% confidence interval (CI) 0.42 to 5.41). Babies whose mothers had been allocated to the interventionist group had more hyaline membrane disease (RR 2.3, 95% CI 1.39 to 3.81), more necrotising enterocolitis (RR 5.5, 95% CI 1.04 to 29.56) and were more likely to need admission to neonatal intensive care (RR 1.32, 95% CI 1.13 to 1.55) than those allocated an expectant policy. Nevertheless, babies allocated to the interventionist policy were less likely to be small for gestational age (RR 0.36, 95% CI 0.14 to 0.90). There were no statistically significant differences between the two strategies for any other outcomes. There are insufficient data for any reliable recommendation about which policy of care should be used for women with severe early onset pre-eclampsia. Further large trials are needed.

Preconception health and care policies and guidelines in the UK and Ireland: a scoping review

Changes in care policies for children and older people are evident across Europe, reflecting changes in need, structures and available resources, such as demographic pressures and changing family structures and employment patterns, which have triggered a new recognition of the need for providing and receiving social care across generations. This has stimulated a new interest in the development of Early Childhood Education and Care (ECEC) policies and interventions for children, as well as interest in the development of long-term care (LTC) policies and interventions for older people. However, care policies are also affected by changing discourses and policy agendas, which shape the identification of the need for policy change as well as the direction of policy changes. This chapter has as an overall goal to present how Denmark as a representative of the Nordic public service model has institutionally approached social care for children and older people, what policies are presently in place or pursued, and how effective these policies have been for the constitution of care and care work. The chapter will more specifically focus on how policymaking in social care in Denmark has been influenced by new ideas, what these ideas have consisted of and how successfully they have influenced new policy direction. The chapter will conclude with a focus on what consequences policy changes have had for the user in terms of accessibility to and quality of care, as well as for the informal and formal care provider in terms of quality of care work.KeywordsChild CareHome CareGender EqualityNordic CountryIdeational FactorThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

This paper investigates new directions in the evolution of Latin American welfare regimes by focusing on the extension of early childhood education and care (ECEC) policies in Argentina and Mexico, particularly in the last decade. Both states have paid increased attention to ECEC policies for several reasons: the failure of first-generation structural adjustment reforms to address problems of poverty; women's increased participation in the paid labor force and the adoption of a new investment social paradigm which emphasizes human capital formation. We argue that these factors play out in different ways in the two countries, as a result of different ideologies and political agendas of the governments and their different degrees of openness to the influence of international ideas. When looking at gender dimensions of their welfare regimes, Argentina and Mexico show very similar patterns of gender stratification, and both states display similarities between their policies in the area of early education. In the area of day care, however, Mexico encourages women to work via defamilialization of services, while Argentina reveals preference for low-income mothers to stay at home and work in the informal sector.

Japan and Italy are the most aging societies in the developed countries and they both face the rapid increase of the social cost and the demand in manpower for long-term care. Both countries have the common welfare state trajectories and characteristics. In contrast, both the care and migration policies and the role of migrant care workers between Italy and Japan are consistently different. The paper compares the welfare state characteristics, care configurations, and the care-migration policies in 2000s, and reveals how the role of migrant care workers in Italy and Japan would be influenced by the migrant and care policies reciprocally. The paper concludes that the combination of the restricted migrant policies for unskilled migrant care workers and the in-kind-based national care policies is significant in efforts to maintain a qualified and regulated care work. Conversely, it verifies that the in-cash-based national care policy with the weak migration control for unskilled migrant workers brings the spread of marketized care with weak control and low professional skills, mostly in the gray market.

Individuals with dual enrollment in Medicare and Medicaid have become the focus of heightened US federal and state policy interest in recent years. These beneficiaries are among the most vulnerable and costly persons served by either program. This analysis uses a reduced-form econometric model and a unique survey of community-resident dual enrollees to take a critical step toward understanding the relationships and combinations of state long-term care (LTC) policies and their relative effectiveness in achieving their intended effects: increasing access to care, improving activities of daily living/instrumental activities of daily living (ADL/IADL) assistance, and reducing unmet needs. We then simulate the effects of alternative policies to determine the most effective combination.The combination of policies that was most effective in reducing the percentage of individuals receiving low levels of assistance was high spending in the community relative to nursing home and low community LTC spending per recipient; that is, spending more on community care and spreading it across more people. Overall, this analysis confirms that Medicaid LTC policy decisions by states, and the combinations of policies that are implemented, result in important variations in levels of assistance to elderly persons with disabilities.

A critical examination of home care: End of life care as an illustrative case

Care and education have deep historical divisions in the Canadian policy landscape: care is traditionally situated as a private, gendered, and a welfare problem, whereas education is seen as a universal public good. Since the early 2000s, the entrenched divide between private care and public education has been challenged by academic, applied and political settings mainly through human capital investment arguments. This perspective allocates scarce public funds to early childhood education and care through a lens narrowly focused on child development outcomes. From the investment perspective, care remains a prerequisite to education rather than a public good in its own right. This chapter seeks to disrupt this neoliberal, human capital discourse that has justified and continues to position care as subordinate to education. Drawing upon the feminist ethics of care scholarship of philosopher Virginia Held, political scientist Joan Tronto, and sociologist Marian Barnes, this chapter reconceptualizes the care in early childhood education and care rooted through four key ideas: (1) Care is a universal and fundamental aspect of all human life. In early childhood settings, young children’s dependency on care is negatively regarded as a limitation, deficit and a burden. In contrast, in educational settings, older children’s growing abilities to engage in self-care and self-regulate is viewed positively. We challenge this dependence/independence dichotomy. (2) Care is more than basic custodial activities. The premise that care is focused on activities concerned with the child’s body and emotions, while education involves activities concerned with the mind, permeates early childhood education and care policy. Drawing on Held’s definition of care as value and practice, we discuss why this mind-body dualism is false. (3) Care in early childhood settings can be evaluated as promoting well-being or, in contradiction to the meaning of care, as delivering poor services that result in harm to young children. We will explore the relevancy of Barnes’s contention that parallel to theorizing about good care in social policy, “we need to be able to recognize care and its absence” through the cultivation of “ethics sensibilities and skills applied in different practices in different contexts.” (4) Care must be central to early childhood education and care policy deliberation. Using Tronto’s concept of a “caring democracy,” we discuss how such deliberation can promote care and the caring responsibilities of educators in early childhood settings, thereby redressing long standing gendered injustices. We argue that these four ideas can be framed in advocacy messages, in ways that bridge the silos of care and education as separate domains and which open up the vision of an integrated early childhood education and care system. A feminist ethics of care perspective offers new possibilities for practitioners, advocates, researchers, and decision-makers to reposition and reclaim care as integral to the politics and policies of early childhood education and care.

This article explores how far the concepts of de-familialisation/familialisation are adequate to the classification of long-term care (LTC) policies for older people. In the theoretical debate over LTC policies, de-familialising and familialising policies are often treated as opposites. We propose re-conceptualising the relation between de-familialisation and familialisation, arguing that they represent substantially different types of policy that, in theory, can vary relatively autonomously. In order to evaluate this theoretical assumption, this article investigates the relation between the generosity level of LTC policies on extra-familial care, and the generosity level of LTC policies on paid family care, introducing a new multi-dimensional approach to measuring the generosity of LTC policy for older persons. It also explores the consequences of this for gender equality. The empirical study is based on a cross-national comparison of LTC policies in five European welfare states which show significant differences in their welfare state tradition. Data used are from document analysis of care policy law, the Mutual Information System on Social Protection, the European Quality of Life Survey and the Organisation for Economic Co-operation and Development. The findings support the argument that de-familialising and familialising LTC policies can vary relatively independently of each other in theory. It turns out that we get a better understanding of the relationship between LTC policy and gender equality if we analyse the role of different combinations of extra-familial and familial LTC policies for gender equality. The paper brings new insights into the ways welfare states act in regard to their LTC policies. It helps to clarify how the concept of de-familialisation/familialisation can be understood, and what this means for the relationship between LTC policies and gender equality.

The Evidence Synthesis Programme (ESP) is part of the National Institute for Health and Care Research (NIHR). As such, it aims to contribute to the NIHR's mission of improving the health and wealth of the nation by generating high-quality evidence syntheses (ES) to support evidence-informed health and care policy and practice. More information about the programme can be found on the NIHR website. A logic model is a graphical way to show how an activity, programme or intervention is expected to work and bring about the benefits and changes it intends to achieve. By summarising the core elements, a logic model can then be used to support programme planning, implementation and evaluation. NIHR logic models represent in a linear flow diagram the key activities, outputs, outcomes and impacts of each funding programme as a series of logical steps. This logic model sets out the essential elements of, and pathway to, impact for the NIHR ESP. Evidence syntheses are research projects that use formal techniques to bring together, evaluate and combine data from multiple studies to summarise and make sense of the existing body of research evidence on a particular topic.

* INTRODUCTION * Family and Aging Policy (Francis G. Caro) * INTERNATIONAL VIEW * Policies and Practices in Support of Family Caregivers--Filial Obligations Redefined in Sweden (Lennarth Johansson and Gerdt Sundstrom) * Danish Home Care Policy and the Family: Implications for the United States (Mary Stuart and Eigil Boll Hansen) * A Critical Review of Singapore's Policies Aimed at Supporting Families Caring for Older Members (Kalyani K. Mehta) * Families' Values and Attitudes Regarding Responsibility for the Frail Elderly: Implications for Aging Policy (Nancy Guberman, Jean-Pierre Lavoie, Michel Fournier, Lise Grenier, Eric Gagnon, Helene Belleau, and Aline Vezina) * THE UNITED STATES * Commentary: What Role for the Family and Medical Leave Act in Long-Term Care Policy? (Steven K. Wisensale) * Preliminary Experiences of the States in Implementing the National Family Caregiver Support Program: A 50-State Study (Lynn Friss Feinberg and Sandra L. Newman) * Families, Work, and an Aging Population: Developing a Formula That Works for the Workers (Donna L. Wagner). * Family and Friends as Respite Providers (Carol J. Whitlatch and Lynn Friss Feinberg) * The Family Caregiving Career: Implications for Community-Based Long-Term Care Practice and Policy (Joseph E. Gaugler and Pamela Teaster) * Zoning, Accessory Dwelling Units, and Family Caregiving: Issues, Trends, and Recommendations (Phoebe S. Liebig, Teresa Koenig, and Jon Pynoos) * Resident and Family Perspectives on Assisted Living (Carrie A. Levin and Rosalie A. Kane) * Welfare Reform: Challenges for Grandparents Raising Grandchildren (Casey E. Copen) * State Policy Decisions in the 1990s with Implications for the Financial Well-Being of Later-Life Families (Gretchen J. Hill) * Index * Reference Notes Included

How much, and in what ways, do cultural ideas contribute to understanding cross‐national differences in the extent of long‐term care (LTC) policy marketisation? We argue that differences in cultural ideas in the political sphere about ‘ideal’ ways of organising the provision of care shed light on these differences, relatively independently of the governing parties' positions on the left/right spectrum. Our comparative case study of two conservative welfare states, Germany and Austria, supports this argument. LTC policy marketisation in the mid‐1990s was, in both cases, based on left‐libertarian ideas. While these ideas gained strong political support from parties across the left/right spectrum in Austria, they were combined with etatist ideas in Germany, resulting in a substantially lower potential for marketisation in Germany's LTC policy. Our study also shows that, by contrast with neo‐liberal ideas, left‐libertarian ideas address care recipients' self‐determination and divert attention away from social problems associated with LTC marketisation.

We argue that the long‐term care (LTC) policy reform in France results from a long‐lasting evolution process that began in the 1980s and has led to the so‐called ‘French compromise’. This combines elements of different types of a fragmented care system including health insurance schemes, domiciliary and residential social care providers, tax deductions and an important private insurance sector, not to mention the crucial contribution of informal caregivers in families. This article concentrates on policies in both the public and the private sectors, as well as their overall cost. We focus on the core of the LTC policy, namely the creation and then the reforms of the cash‐for‐care allowance (Allocation personnalisée à l'autonomie). The evolution of the policy process concluded, after the 2007 Presidential election, with the announcement of a new direction, which has not been implemented yet, but which has raised professional and social concerns. Evidence from France suggests that LTC reform can only take place from a new compromise between three poles of protection: the family, the market and the state.

To understand the effect of current and future long-term care (LTC) policies on family eldercare hours for older adults (60years of age and older) in Singapore. The Social Isolation Health and Lifestyles Survey, the Survey on Informal Caregiving, and the Singapore Government's Ministry of Health and Department of Statistics. An LTC Model was created using system dynamics methodology and parameterized using available reports and data as well as informal consultation with LTC experts. In the absence of policy change, among the elderly living at home with limitations in their activities of daily living (ADLs), the proportion of those with greater ADL limitations will increase. In addition, by 2030, average family eldercare hours per week are projected to increase by 41 percent from 29 to 41hours. All policy levers considered would moderate or significantly reduce family eldercare hours. System dynamics modeling was useful in providing policy makers with an overview of the levers available to them and in demonstrating the interdependence of policies and system components.

IntroductionPreconception care can significantly improve maternal and infant outcomes, and thus optimise intergenerational health. The aims of this scoping review are to (1) provide an up-to-date summary of preconception health...