Social Service Interventions Research Articles

برنامج مقترح للتدخل المهنی للخدمة الاجتماعیة من منظور نموذج الحیاة للتعامل مع الضغوط الأسریة لطالبات الدراسات العلیا المتزوجات حدیثا

ملخص البحث: استهدفت الدراسة التعرف على الضغوط الأسرية لطالبات الدراسات العليا المتزوجات حديثا، وتحقق هذا الهدف من خلال الإجابة على التساؤلات الفرعية التالية: ما الضغوط الأسرية التي تعاني منها طالبات الدراسات العليا المتزوجات حديثا المرتبطة بالزوج؟ ما الضغوط الأسرية التي تعاني منها طالبات الدراسات العليا المتزوجات حديثا المرتبطة بتدخل الأهل في شئون الحياة الزوجية؟ ما الضغوط الأسرية التي تعاني منها طالبات الدراسات العليا المتزوجات حديثا المرتبطة بتنشئة الأبناء؟ ما البرنامج المقترح للتدخل المهني للخدمة الاجتماعية من منظور نموذج الحياة للتعامل مع الضغوط الأسرية لطالبات الدراسات العليا المتزوجات حديثا؟ واشتملت الدراسة على مفهوم نموذج الحياة، الضغوط الأسرية، طالبات الدراسات العليا المتزوجات حديثا،اعتمدت الباحثة في إجراء الدراسة على مقياس موقفي بعنوان الضغوط الأسرية لطالبات الدراسات العليا المتزوجات حديثا من إعداد الباحثة ، استخدمت الباحثة المنهج المسح الاجتماعي بالعينة العمدية (القصدية) لطالبات الدراسات العليا المتزوجات حديثا بجامعة الفيوم بمرحلتي الدبلوم، الماجستير، الدکتوراه وعددهم (245) طالبة . وتوصلت نتائج الدراسة إلى أن طالبات الدراسات العليا المتزوجات حديثا يعانون من الضغوط الأسرية بنسبة متوسطة، وتوجد فروق ذات دلالة إحصائية عند مستوى معنوية اقل من (0.05) في مستوى استجابات المبحوثين طالبات الدراسات العليا المتزوجات حديثا عينة الدراسة على الضغوط الأسرية ترجع لاختلاف نوع السکن، العمر، عدد سنوات الزواج، المرحلة الدراسية، عدم وجود فروق ذات دلالة إحصائية في مستوى استجابات المبحوثات طالبات الدراسات العليا المتزوجات حديثا عينة الدراسة على الضغوط الأسرية، ترجع لاختلاف محل الاقامة, عدد الأبناء، الکلية، وتم التوصل لبرنامج مقترح للتدخل المهني للخدمة الاجتماعية من منظور نموذج الحياة للتعامل مع الضغوط الأسرية لطالبات الدراسات العليا المتزوجات حديثا. الکلمات المفتاحية: نموذج الحياة ، الضغوط الأسرية، طالبات الدراسات العليا المتزوجات حديثا Abstract The current study aims to identify the Stresses the family pressures of newly married graduate students, and this goal was achieved by answering the main question of the study, which is: What are the family pressures of newly married graduate students? And the answer to the following sub-questions: What are the family pressures that newly married postgraduate students suffer from, related to their husbands? What family pressures experienced by newly married postgraduate students related to parental interference in marital affairs? What are the family pressures of newly married graduate students related to raising children? What is the proposed program for professional social service intervention from a life model perspective to deal with family pressures for newly married postgraduate students? The study included the concept of life model, family pressures, newly married postgraduate students. In conducting the study, the researcher relied on an attitude scale titled family pressures for newly married postgraduate students, prepared by the researcher. The researcher used the method of social survey with the intentional (intentional) sample of married postgraduate students. Recently at Fayoum University in the diploma, master's, and doctoral stages, their number is (245) students. The results of the study reached that newly married postgraduate students suffer from family pressure at a rate of (66.1%) average, there are statistically significant differences at the level of significance less than (0.05) in the level of Respondents 'responses to newlywed postgraduate students, the study sample on family pressures due to the difference in housing type, age, number of years of marriage, school stage, the absence of statistically significant differences in the level of respondents' responses to newlywed graduate students, the study sample on family pressures, due to the difference in place Residence, number of children, college, and a Proposed Program for The Professional Intervention of Social Work from The Perspective Of The Life Model To Deal with Family Stress pressure Of Newly Married Female Graduate Students. key words: Life Model, Family Stress pressure, Newly Married Female Graduate Students The

Protection of social workers during the COVID-19 pandemic

The article examines the current challenges that life has posed to social workers in Ukraine and the world in their activities in the context of combating the effects of the COVID-19 pandemic. We are faced with the task of making every effort to support social workers, and provide them with opportunities for safe activities in the provision of services. The article considers the functions and principles on which the organization of social workers in counteracting the pandemic is based. Aspects related to problems and risks in their activities are also considered. It is also important to develop priority actions in the context of their protection against infection. Due to the fact that the pandemic situation is constantly changing, there are changes in the priorities of action, there are also changes in the protocols of organization and provision of social assistance. In addition, the availability of testing, the level of health risks and the ethical consequences of social services interventions in situations related to social problems in families affected by the pandemic are assessed. This is based on the International Declaration of Ethical Principles for Social Work of the International Federation of Social Workers (IFSW). The article considers the level of vulnerability of a social worker, client or population to severe clinical symptoms and increased risk of death from infection. The context of new challenges also considers models of remote service delivery and situations in which this is not possible. It is proposed for social workers to conduct training sessions and conduct regular remote supervision of their activities during their response to the COVID-19 pandemic. Social workers are invited to create plans for social and psychological protection and self-care.

Assessment of Psycho - Social Services Intervention Programmes for Internally Displaced Persons in Maiduguri, Nigeria

The study investigated the extent to which psychosocial services intervention programmes is being implemented for the internally displaced persons (IDPs) in the camps and to also find out how these programmes have been able to meet the needs of the affected persons. To achieve this objective, three research questions are generated. Subjects are 200 respondents that are selected from a target population of 1005 displaced persons in two camps in Borno state, through simple random sampling. A questionnaire titled “Psychosocial Services Intervention Programmes Questionnaire” (PSSIPQ) was used for data collection while interview and focus group discussions were used for additional information gathering. The study concludes that psychological support services are available in the various camps but require deepening and some improvement.

Analysis of Social Service Specialist Support in the Pediatric Emergency Department: A Single-center Descriptive Study

INTRODUCTION: Our main objective was to evaluate the demographic, epidemiological and clinical characteristics of patients aged 0-18 years who needed social service support in a pediatric emergency department. Our secondary aim was to remind the social service practices in emergency services and to describe the patient profile that frequently needed social service support. METHODS: Patients admitted to the pediatric emergency department between January 2010 and December 2018 were included in this descriptive and retrospective study. Age, gender, nationality, diagnosis at admission, consultations, reasons of social service consultation, problems determined by social service specialist and interventions were recorded via hospital information management system. RESULTS: Total number of patients consulted to social service during the study was 324. The mean age of the patient group was 11 ± 6 years, 206 (63.6%) were female, 118 (36.4%) were male; 283 (87.3%) were Turk, 41 (12.7%) were Syrian. The most common follow-up reasons were suicide with 133 patients (41%), trauma with 65 patients (20.1%), and substance abuse with 36 patients (11.1%). The most common social service consultation reason was suspected abuse-neglect (87.7%). As a result of social service evaluation, 116 (35.8%) had relationship problems, 73 (22.5%) had behavioral problems, 56 (17.3%) had abuse and/or neglect suspicion, 34 (10.5%) had either patient’s or family's adherence problem, 20 (6.2%) had environmental problems and 5 (1.5%) had legal problems. Only 20 patients (6.2%) had no problem. DISCUSSION AND CONCLUSION: In conclusion, social service support was needed the most for the patients who attempted suicide and consultation was requested the most due to suspicion of abuse and neglect. Thus, inclusion of social service specialists in pediatric emergency departments can play a key role in protection and safety of child health.

Social Connection and Self-perceived Depression Among Adolescents: A Path Analytic Model for Abu Dhabi

We examined how family and friendship connections of adolescents (15–19 years old) interrelate and how these interactions affect their self-perceived depression and stress. The data were collected through the Abu Dhabi Quality of Life Survey in 2018, which was completed by more than 51,000 respondents. Nine hundred and fifty-eight out of 3356 adolescents in the survey self-identified themselves as depressed. We developed a structural equation path model to explicate the relationships among the variables hypothesized to affect adolescents’ self-reported depression. The results produced an excellent fit of statistics of the model to the data. In general, social connections and relationships with family and friends directly affected adolescents’ self-perceived depressive feelings. More specifically, variables such as “often feeling isolated from people,” “the amount of quality time spent with family,” “the frequency of meeting with friends, relatives or colleagues,” and “involvement in informal activities with friends” had the greatest total effects on adolescents’ self-perceived depression. “The amount of quality time spent with family” also exerted indirect influence on feelings of isolation. Involvement in sports groups, involvement in religious and spiritual groups, and generalized trust did not exhibit any direct influence but had an indirect impact on self-perceived depression. The findings could contribute to the current understanding of theories of depression and yield implications for social policy, social service, and social work interventions for school-aged adolescents in Abu Dhabi.

Why Increased Focus on Aging With Disability Matters to Gerontology Research, Policy, and Practice

This symposium elaborates on the theme of the 2020 conference, “Why Age Matters”, to include aging with disability. We ask: “can an increased focus on aging with disability within gerontological research, policy, and practice advance our knowledge of disablement across the life cycle and improve our design and implementation of health and social service interventions’? Five experts will address this from differing perspectives (including gerontology and rehabilitation). One presentation draws on national/ regional data to illustrate the changing demographics of aging and disability and highlights the health consequences of aging with- and aging into, long-term physical disabilities. A second uses data from a mixed methods study to demonstrate the unique challenges experienced by adults aging with spinal cord injury with a focus on the impact of specific environmental barriers and facilitators to maintain health and participation in social roles. A third covers three reports on data from a scoping review to document the exclusion of middle-aged and older adults with disabilities from behavioral clinical trials and describes how translational research strategies can be used to help close this gap. A fourth presents examples of how technologies, such as videoconferencing and voice activation, are being used to deliver and enhance existing EB interventions to improve health, physical activity, and participation for individuals aging with mobility impairments. The last one draws on research and scholarly work from both gerontology and rehabilitation to highlight the co-occurring issues of ageism and ableism and describes how reducing ableism is central to successfully reframing aging. Lifelong Disabilities Interest Group Sponsored Symposium.

Shining Light and Creating Solutions: Health and Social Needs of Older Affordable Housing Residents

Aging within a community requires access to health and social services. This project lays the groundwork for an innovative, three-part health and social services intervention intended to improve the health and well-being of older affordable housing residents in a low-income, vulnerable Baltimore neighborhood. We will report on the first part, an assessment of residents’ unmet health and social service needs and their ideas for meeting these needs. With guidance from a community advisory group of older residents (a key program component), we are conducting structured interviews with 50 elders to identify residents’ needs and interests. These findings will inform the next project segments: Part 2- exploring how the Village model (in which neighbors identify and offer needed services to help their neighbors age within a community) can be adapted for an affordable housing setting, and Part 3- adapting an evidence-based housing-plus-services model to meet older residents’ unmet needs.

Adjustment Disorder Amongst Welfare Social Service Clients: The Role of Period of Service Receipt and Social Worker’s Alternation

AbstractAdjustment disorder is a maladaptive reaction to common life events. Levels of adjustment disorder can serve as one of the indicators of the effectiveness of social services interventions. Yet, the role of service receipt period and of social worker alternation in explaining levels of adjustment disorder remains unclear. In order to explore this issue, structured questionnaires were distributed to a random sample of 190 clients of a social services department in Israel. Whilst no significant differences were found between service receipt periods with regard to clients’ adjustment disorder, clients treated by a single social worker reported lower levels of adjustment disorder than those treated by alternating social workers. Furthermore, new and long-standing clients, treated by alternating social workers displayed higher levels of adjustment disorder than those treated by a single social worker. The importance of therapeutic alliance is discussed in light of the present findings.

Addressing elder abuse: service provider perspectives on the potential of restorative processes

ABSTRACT Older adults often rely on family and friends for care and support. Individuals providing support can take advantage of their vulnerabilities, resulting in neglect, physical, emotional, or sexual abuse, or financial exploitation. Conventional approaches, which older adults are often reluctant to pursue, utilize social service interventions, criminal justice responses, civil litigation, and case review multi-disciplinary teams. This project explored providers’ perspectives on using restorative processes, alternative approaches that bring together the person harmed, the person committing the harm, and the community to address the harm and repair relationships. Researchers recruited and interviewed providers working with abused older adults, as referred by a community-based elder justice working group. Providers perceived that restorative processes have the potential to address and prevent social isolation, which often leads to elder abuse. We recommend providers explore restorative processes to address elder abuse, paying attention to implementation barriers and identifying appropriate methods for supporting and maintaining outcomes.

Adapting a Complex, Integrated Health and Social Services Intervention in Two Communities

Research ObjectivePoor population health is not randomly distributed but follows a social gradient with adversity clustering in specific communities. Under the Alliance for Determinants of Health program, Intermountain Healthcare is leading a three‐year demonstration project designed to improve population health outcomes through integrating health care and social services. Recent federal policy efforts are testing interventions to address health inequities, yet little is known about how to effectively adapt these complex, highly contextual interventions to local settings.Study DesignA mixed methods analysis was used to adapt and deploy an integrated health and social services solution in two diverse communities using an intervention mapping approach. Specific steps taken to effectively adapt the intervention included the following: a needs assessment using local health needs and actuarial claims data, ethnographic field results, and key informant interviews; definition of change and performance objectives; theory and methods selection; program plan and production; and implementation and evaluation planning.Population StudiedKey national, state, and local government and community leaders, health departments, social service providers, health care providers, police/justice departments, education systems, advocacy organizations, and community members in two regionally and ethnically diverse communities in Utah.Principal FindingsThe needs assessment identified meaningful variation in local needs and available infrastructure across zip‐code‐based areas that guided selection of two communities. Program change objectives were defined, including improved local health and social services integration across sectors involving more than 50 service partners. Given the need for strong local program engagement, a multi‐ecological approach using theory‐informed methods was selected to guide local intervention development. An adapted Accountable Health Communities Model was developed including local community‐led steering committees to provide strategic oversight to local needs. Intermountain provided $6 million in funding to each community distributed by local community‐led finance committees to address local social service gaps. Weekly program huddles with Alliance partners are used to report results and to continuously improve and resolve local barriers. An external team was hired to conduct the evaluation. During the first year, 1321 eligible members underwent initial screening at an Alliance provider location; 139 members were navigated to one or more service partners demonstrating local integration feasibility. The most frequent navigation requests were for transportation (16%), dental care (15%), food (15%), clothing (9%), rent (9%), and mental health care (8%).ConclusionsLocal communities vary considerably in social service needs, capacity, and existing health care infrastructure. Intervention mapping provides a robust methodology for adapting complex integrated health and social services interventions that are responsive to the needs of diverse communities.Implications for Policy or PracticeImplementing programs that integrate health and social services is complex and multifaceted and should be designed with the local implementation in mind. Rigorous implementation science methods may reduce the risk of implementation failure and strengthen the potential generalizability of results.

Clinical Data Mining With the Listening Guide: An Approach to Narrative Big Qual

We developed a novel approach to narrative Big Qual research that combines Carol Gilligan and Lyn Mikel Brown’s Listening Guide with Irwin Epstein’s clinical data mining. We adapted the voice-based research methodology of the Listening Guide for use with a corpus of clinical case notes drawn from an integrated data system (IDS) of a social service intervention serving families in an immigrant enclave. This methodological innovation was inspired by the insight that the Listening Guide can be used to trace and name the layering of meaning within any narrative, whether that narrative reflects the experience of an individual person or, as in this case, the community and everyday life of a social service intervention. Critically, this approach pivots on theorizing the subject as the collective of the intervention itself, as narrated by case managers, who can be understood as narrating subjects within the cultural, figured world of the intervention. In the context of a larger process and outcome evaluation, marrying these two approaches provided context, texture, and depth to supplement existing data sources like self-report survey data and participant observation, and offered a glimpse inside the “black box” of the intervention. We adapted the Guide through three readings of the clinical case notes: once for stanza structure, once inspired by the I-Poem technique but modified for these third-person narratives, and once with an eye to the contrapuntal voices of the inner and outer worlds of the intervention. As a methodological innovation this approach represents an advance in Big Qual and a promising approach to conducting narrative research on large qualitative data sets within mixed methods studies.

Social services Interventions and the Mental Health and Mortality of care leavers: a population based data linkage study in Northern Ireland and Finland

BackgroundResearch has highlighted the poor mental health of looked after children compared to those never in care. However, little is known on what becomes of these children and their mental health trajectories after they leave the care of social services. In addition, previous studies are limited in their ability to differentiate between type of social care intervention received; kinship care, foster care or residential care.
 AimTo utilise nationwide social services data from two countries (Northern Ireland (NI) and Finland), with similar populations but different intervention policies, linked to a range of demographic and health datasets to examine the mental health outcomes of young adults in the years following leaving care.
 MethodsData from both countries on children born 1991-2000 were linked to social services data, hospital admissions, prescribed medication data and death records. Mental health outcomes were defined after the age of 18years (when statutory care provision ends) examined by care intervention and included admissions to psychiatric hospital, for self-harm and death by suicide.
 ResultsThe gender split in care in Finland is reflective of the population but more males are in care in NI. Initial results from Finnish data suggest those exposed to care in childhood have an increased risk of self-harm, psychiatric hospital admission and suicide after the age of 18years compared to those never in care. After adjusting for gender, age of entry to care and deprivation at birth those exposed to any care intervention had 3 times the risk of suicide (HR=3.06, 95% CI 1.18,7.98). Risk increased with duration in care but was equivalent across care intervention types. Analysis on the NI data is underway.
 ConclusionFull results will be available December 2019 and will explore which care pathways are most associated with poor mental health outcomes informing discussion around intervention opportunities and policy.

Opportunity or Burden? A Behavioral Framework for Patient Engagement.

Engaging patients as partners in their care is clinically appealing, yet challenging to implement, and we lack a measurement framework that is applicable to vulnerable populations. To address this gap, we conducted a qualitative study to refine a conceptual framework that reflects an individual's propensity to engage with care. Our objectives were to refine the framework's domains of engagement behavior; identify key behaviors within each domain that describe engagement with providers, health systems or settings; and illustrate examples for each behavior where higher self-efficacy describes an opportunity to enhance engagement, and lower self-efficacy describes difficulties with engagement that risk burden. We elicited patient perspectives by conducting individual semistructured interviews with veterans receiving care for mental health and/or chronic conditions from the Veterans Health Administration. Data were analyzed using the framework method. The resulting engagement framework encompassed 4 interrelated domains: Self-Management, Health Information Use, Collaborative Communication, and Healthcare Navigation. The propensity to engage with care was conceptualized as the cumulative self-efficacy to engage in behaviors across these domains. Results emphasize the collaborative nature of engagement behaviors and the impact of veteran cultural influences via perceptions of collective efficacy. This framework can be applied to judgments regarding a patient's propensity to engage in care. Because self-efficacy is an individual's context-specific judgment of their capabilities, this framework may inform health care and social service interventions that aim to engage patients. This maybe especially useful for public sector settings and populations with social risks.

Les demandes de placement d’enfants des familles juives du Maghreb : un révélateur des évolutions du travail social en France (1950-1970)

From the 1950s onwards, the question of placing children in institutions was constructed as a problem in the field of Jewish social services. This development is situated at the crossroads of a dynamic of transformation of social service intervention practices, the doctrine of casework, and the construction of the field of the medical-psychology of child services. This issue is of special relevance to the arrival of populations of urban North African Jews and the increase in demands for placement of these children by the OSE and the CASIP. This article looks at this critical moment in the history of child placement and highlights how the role of social workers has been reconfigured, both in terms of assessing requests for placement and the need to coordinate efforts with other child care professionals.

Experiences of social work intervention among mothers with perinatal mental health needs.

Perinatal mental health difficulties are prevalent among women, and the vulnerability of young infants makes this a time when families experiencing multiple adversities may be particularly likely to attract state intervention. However, very little is known about how mothers experience social work intervention during the perinatal period. This study explored experiences of social work intervention among women with perinatal mental health difficulties. Qualitative semi-structured interviews were carried out with 18 women with 6- to 9-month-old babies, who had been treated in England for a perinatal mental health difficulty and also had social services intervention. Interviews were analysed using thematic analysis. Findings suggested that mothers had a predominantly negative view of children's social services, especially when social workers had significant child protection concerns. The fear of being judged an unfit mother and having their babies taken away overshadowed their encounters. Mothers felt that social workers would not accept they could be good mothers in spite of their difficulties and set them up to fail. Some felt that social workers focused exclusively on the risks to the baby and did not acknowledge the mother's own needs or understand perinatal mental health. In some cases, social work intervention was described as intensifying pressure on mothers' mental health, leading to escalating difficulties and increased likelihood of care proceedings. At the same time, our study also included examples of mothers forming positive relationships with social workers, and of 'turning points' where initially negative interactions stabilised and child protection concerns lessened. Women's accounts highlighted the importance of feeling 'known' by social workers who understood and respected them. The findings also suggested there may be value in improving collaboration between social workers and mental health professionals to create more space for representation of women's needs as well as those of their babies.

Improving access to primary healthcare for vulnerable populations in Australia and Canada: protocol for a mixed-method evaluation of six complex interventions

IntroductionAccess to primary healthcare (PHC) has a fundamental influence on health outcomes, particularly for members of vulnerable populations. Innovative Models Promoting Access-to-Care Transformation (IMPACT) is a 5-year research programme built...

Can Justice System Interventions Prevent Intimate Partner Homicide? An Analysis of Rates of Help Seeking Prior to Fatality.

When women are killed, they are more likely to be killed by an intimate partner than anyone else, and a substantial number of women who are killed by an intimate were abused by that intimate partner before their death. The proportion of men killed by an intimate partner is much lower and prior research indicates that male intimate partner homicide victims are likely to abuse their partners prior to their deaths. However, limited research has examined the criminal and civil justice help seeking of intimate partner homicide victims. This study examines administrative data from one large urban police jurisdiction to understand rates of help seeking by homicide victims in the 1 to 3 years prior to the homicide. Over 4 years (2010-2014), 197 women and 776 men were killed. The proportion of women killed by an intimate or ex-intimate partner was 39.6%, and the proportion of men killed by an intimate or ex-intimate partner was 3.9%. Police had been in contact with the victim of intimate partner femicides for a domestic violence complaint in 91% of cases in the 3 years prior to the femicide (44.9% resulted in arrest), with an average of 6.2 visits per contacted victim. Among male intimate partner homicide victims, 73.3% had been the complainant on a domestic violence case (38.1% resulted in arrest). Few (<10%) victims sought protection orders before the homicide. Over the 3 years prior to their deaths, 36.7% of male homicide victims and 9.0% of femicide victims had been the suspect in a domestic violence case. Results indicate high rates of engagement of police officers with intimate partner homicide victims before their deaths, and highlight the opportunity for homicide prevention through integration of risk assessment (to identify high-risk cases) and enhanced criminal justice and social service interventions in high-risk cases.

Health Concerns and Access to Services: Female Sex Workers’ Experiences in Mumbai, India

Female sex workers (FSWs) in India experience unmet health‐care needs due to numerous barriers to care. The objectives of this study were to (i) explore the health concerns among FSWs in Kamathipura, a red‐light district of Mumbai, India; and (ii) understand their experiences using health‐related services and resources. This qualitative study used in‐depth, semi‐structured individual interviews with 15 FSWs recruited using snowball sampling. Data analysis consisted of reading transcriptions line by line, identifying themes, and coding categories. A matrix of health concerns and identified resources were created to examine relationships. Participants identified numerous health concerns. Six thematic categories emerged, encompassing all health concern codes: communicable disease, nutrition, substance abuse, reproductive health, mental health, and physical violence. Participants reported varying levels of availability of health services; additionally, their basic health needs exceeded resource availability. FSWs have vital health concerns that go untreated. Current health care and social service funding and interventions are insufficient to meet the needs. Health‐care services must be expanded across all identified health categories and FSWs informed of their existence. Furthermore, prevention and intervention programs, with support from both nonprofits and government, must be prioritized to address the basic food and safety needs of FSWs.

Illicit drug concentration in hair from children and their families. A two-year retrospective study in an Italian cohort

Children born or living in a familiar environment where illicit drugs are commonly used are exposed to severe health and social risk. The detection of drugs in children biofluids can indicate in utero exposure, systemic ingestion from mother's breast milk, passive or active exposure from caregivers. Hair analysis of children and their relatives is useful to estimate the exposure risk and may be useful in child neglect/child protection cases when contact with drugs of abuse is questioned. The aim of this study is to present and analyze the prevalence and the concentration of illicit drugs in hair samples of children with clinical signs or circumstantial stories of drug exposure, and in hair from their relatives. A retrospective observational study was performed on the hair samples collected in an obstetrician department at the moment of baby delivery, in cases of suspected prenatal drug exposure, and in a paediatric emergency department in cases of children exhibiting symptoms/signs of intoxication or child abuse. Hair samples were analysed at the local forensic toxicology laboratory. Hair samples of children (< 14 years old) and their relatives were collected. After washing, pulverization and solid phase extraction, samples were analyzed by high performance liquid chromatography – high-resolution mass spectrometry, screening for a wide class of psychotropic substances, including cocaine, opiates, opioids, amphetamines and amphetamine-like substances, cathinone and synthetic cathinones, cannabinoids, benzodiazepines, ketamine, Z-drugs. In 100 cases of suspected exposure to drugs, hair from children and their relatives were collected. Prevalence of children with hair positive for illicit drugs was 72%. Hair samples of mothers were collected in 66% of positive cases, with a concordance with child for most of drugs. Hair samples of other relatives were collected in 43% of positive cases. The most frequently detected drugs were cocaine, opiates and opioids, followed by cannabinoids, ketamine and amphetamine-like substances. According to the children age and the match with the drugs detected in the mother hair samples, the main part of cases can be referred to in utero or short-term exposure from the mother's breast milk, while cases due to exposure or ingestion in the family environment are fewer in the selected setting. The concentration of drugs and metabolites were higher in younger children than in their older siblings. Hair analysis is useful for the early identification of child exposure to illicit drugs, to estimate the risk of child neglect in families, and to monitor the outcome of social service interventions.

La DS-DIBA: Experiencia de la elaboración de una herramienta de valoración social y segmentación para los servicios sociales

La mejora de la eficacia y eficiencia del proceso de atención mediante la segmentación es uno de los retos principales de los servicios sociales básicos de Atención primaria. Para avanzar en este objetivo se ha desarrollado un proyecto de investigación-acción de rediseño y mejora continua, en 16 municipios de la provincia de Barcelona.El procedimento de segmentación se desarrolla mediante un instrumento de valoración social, denominado DS-DIBA, que proporciona confianza, seguridad y robustez en los diagnósticos sociales.El principal resultado es la identificación por profesionales expertos de las situaciones personales y familiares que causan las necesidades objeto de intervención de los servicios sociales; así como de los factores de contexto que inciden en ello. Esta herramienta describe cada situación a partir de evidencias objetivables, las clasifica según su gravedad y frecuencia. Finalmente segmenta cada caso en tres niveles de riesgo en función de la incidencia que presenta para la unidad de convivencia.La implementación del DS-DIBA aporta valor como soporte durante el proceso de intervención social: identificando perfiles comunes entre la población usuaria; avanzando en un lenguaje compartido y estructurado y en la integración horizontal y vertical; ayudando a la focalización del caso; y priorizando la intervención en términos de intensidad de atención y riesgo. El proyecto, además, supone una oportunidad para el análisis del impacto de las políticas sociales en la ciudadanía.