The evolving theory of occupational justice links the concept to social justice and to concerns for a justice of difference: a justice that recognizes occupational rights to inclusive participation in everyday occupations for all persons in society, regardless of age, ability, gender, social class, or other differences. The purpose of this descriptive paper is to inspire and empower health professionals to build a theoretical bridge to practice with an occupational justice lens. Using illustrations from a study of leisure and the use of everyday technology in the lives of very old people in Northern Sweden, the authors argue that an occupational justice lens may inspire and empower health professionals to engage in critical dialogue on occupational justice; use global thinking about occupation, health, justice, and the environment; and combine population and individualized approaches. The authors propose that taking these initiatives to bridge theory and practice will energize health professionals to enable inclusive participation in everyday occupations in diverse contexts.
Debates between refugee advocates, institutional actors and the wider public regarding refugee claimants often evoke anger, fear and sadness, as well as more positive emotions such as compassion, suggesting a complex societal emotional response toward refugee stories. This article analyses the emotional interactions surrounding refugee determination hearings, as reflected in the discourse of administrative judges and refugees. Our results show that the concepts of empathy and compassion are often used by judges to confirm the benevolent image that the administrative tribunal wants to project as a representative body of the host country. However, the very unequal power relations of the hearing setting structure the transmission of the refugee stories in a way that often prevents an emotional encounter between decision makers and refugees. Beyond the specific context of the refugee determination process, these results illustrate how prevalent psychological models of empathy and the transmission of trauma implicitly reveal a political dimension that validates representations of the helpless but potentially dangerous Other, representations that often underlie broader north-south power relations.
This paper tests the null hypothesis of no horizontal inequity in delivery of health care by use of count data hurdle models and Swedish micro data. It differs from most earlier work in three principal ways: First, the tests are carried out separately for physician and hospital care; second, the tests are carried out separately for the probability of seeking care and the amount of care received (given any use); and third, the tests are based on a model that includes several socioeconomic variables, e.g. income, education and size of community of residence. The paper rejects the hypothesis of no inequity because socioeconomic factors also have significant effects on utilization, e.g. income and size of community of residence. Size of community of residence has a positive significant effect on the frequency of physician visits but not on the probability of visiting a physician.
This paper analyzes the probability of a married couple getting divorced, based on the age difference between the husband and wife. To calculate such probabilities, the distribution of age differences of married couples was derived from the 1991 Census and the 1990 General Social Survey, and the distribution of age differences of divorcing couples was obtained from 1991 divorce data provided by the Department of Justice Canada. These distributions, the first based on data that are seldom available, are also analyzed in this paper. The results provide details about the expected significant imbalances that exist, both for married and divorcing couples, between the number of couples with older husbands and the number with older wives. A model is developed that shows that divorce rates are lowest when the husband is two to ten years older than the wife or when the magnitude of their age difference is extremely large. Furthermore, the chance of divorce is much higher when the wife is older than the husband than vice versa. The demands on a younger spouse--usually the wife--to provide informal health care for an older spouse are briefly discussed.
In this report, the results of interviews with sixty local health care politicians in southern Sweden will be presented. It is evident from the material that despite their formal responsibility, the politicians are of the opinion that other actors exert greater influence upon the allocation of resources. They do not think that health care expenditure need be extended, whereas fields such as care of the elderly and preventive medicine ought to receive extended contributions at the expense of other publicly financed activities such as general mammography and in vitro fertilization. Somewhat more than a third of the politicians hold that the goal stipulated in the Swedish Health Care Act, i.e. to provide good health and care on equal terms, has not been fulfilled. Their attitudes towards priority criteria such as personal responsibility, age, life expectancy, parenthood and productivity differ from case to case, and there is no clear-cut consensus. However, approximately half of the respondents agree wholly or partly that a person who promises to alter his or her unhealthy habits should be treated before someone who does not make such a promise. The same applies to the principle that those employed ought to be given priority in operating queues, and in consequence of this utility perspective there are also increased demands upon the physicians to take economy into consideration in treating an individual patient.
Summary.-Employees in three call centers were surveyed about their perceptions of organizational justice. Four factors were measured: distributive justice, procedural justice, interpersonal justice, and informational justice. Structural equation modeling was employed to test whether a two-, three-, or four-factor model best fit the call center data. A three-factor model of distributive, procedural, and informational justice provided the best fit to these data. The three-factor model that showed the best fit does not conform to any of the more traditional models identified in the organizational justice literature. This implies that the context in which organizational justice is measured may play a role in identifying which justice factors are relevant to employees. Findings add to the empirical evidence on the dimensionality of organizational justice and imply that dimensionality of organizational justice is more context-dependent than previously thought.
Organizational justice has attracted attention as a predictor of employees' mental and physical health as well as commitment and work outcomes. The lack of a Norwegian translation of an organizational justice scale has precluded its use in Norway. Four dimensions of the organizational justice construct were examined in a Norwegian military context, including facet measures of distributional, interpersonal, and informational justice developed by Colquitt in 2001, in addition to procedural justice developed by Moorman in 1991. Confirmatory factor analyses supported a four-dimensional structure with good internal consistency. Follow-up analyses have suggested that the four dimensions were nested beneath a general, latent organizational justice factor. A positive relationship between organizational justice and self-sacrificial behavior was found, indicating satisfactory construct validity. The results demonstrate that the Norwegian Organizational Justice Scale is a reliable and construct-valid measure of organizational justice in a Norwegian setting.
Fetal Alcohol Spectrum Disorder (FASD) has a significant impact on communities and systems such as health, education, justice and social services. FASD is a complex neurodevelopmental disorder that results in permanent disabilities and associated service needs that change across affected individuals' lifespans. There is a degree of interdependency among medical and non-medical providers across these systems that do not frequently meet or plan a coordinated continuum of care. Improving overall care integration will increase provider-specific and system capacity, satisfaction, quality of life and outcomes.
We conducted a consensus generating symposium comprised of 60 experts from different stakeholder groups: Allied & Mental Health, Education, First Nations & Métis Health, Advocates, Primary Care, Government Health Policy, Regional FASD Coordinators, Social Services, and Youth Justice. Research questions addressed barriers and solutions to integration across systems and group-specific and system-wide research priorities. Solutions and consensus on prioritized lists were generated by combining the Electronic Meeting System approach with a modified 'Nominal Group Technique'.
FASD capacity (e.g., training, education, awareness) needs to be increased in both medical and non-medical providers. Outcomes and integration will be improved by implementing: multidisciplinary primary care group practice models, FASD system navigators/advocates, and patient centred medical homes. Electronic medical records that are accessible to multiple medical and non-medical providers are a key tool to enhancing integration and quality. Eligibility criteria for services are a main barrier to integration across systems. There is a need for culturally and community-specific approaches for First Nations communities.
There is a need to better integrate care for individuals and families living with FASD. Primary Care is well positioned to play a central and important role in facilitating and supporting increased integration. Research is needed to better address best practices (e.g., interventions, supports and programs) and long-term individual and family outcomes following a diagnosis of FASD.
The authors investigate three hypotheses on the influence of labor market deregulation, decommodification, and investment in active labor market policies on the employment of chronically ill and disabled people. The study explores the interaction between employment, chronic illness, and educational level for men and women in Canada, Denmark, Norway, Sweden, and the United Kingdom, countries with advanced social welfare systems and universal health care but with varying types of active and passive labor market policies. People with chronic illness were found to fare better in employment terms in the Nordic countries than in Canada or the United Kingdom. Their employment chances also varied by educational level and country. The employment impact of having both chronic illness and low education was not just additive but synergistic. This amplification was strongest for British men and women, Norwegian men, and Danish women. Hypotheses on the disincentive effects of tighter employment regulation or more generous welfare benefits were not supported. The hypothesis that greater investments in active labor market policies may improve the employment of chronically ill people was partially supported. Attention must be paid to the differential impact of macro-level policies on the labor market participation of chronically ill and disabled people with low education, a group facing multiple barriers to gaining employment.