Judith Harwin

Bio: Judith Harwin is an academic researcher from Lancaster University. The author has contributed to research in topics: Child protection & Child abuse. The author has an hindex of 16, co-authored 46 publications receiving 972 citations. Previous affiliations of Judith Harwin include University of Bedfordshire & Brunel University London.

Parental substance misuse and child care social work: findings from the first stage of a study of 100 families

Abstract: Parental misuse of drugs or alcohol is known to be a common issue for child care social workers, yet there has been surprisingly little British research on the topic. The study reported here attempts to address this gap. All files going for long-term allocation in four London boroughs over on average 1 year were examined (290 files). Parental substance misuse (PSM) emerged as a major feature of social work caseloads. Of the 290 cases, 100 (34%) involved concerns about parental substance misuse. The families involving substance misuse were more vulnerable on a variety of measures: the children were younger, the parents had more individual problems and the families lived in more difficult social situations. PSM cases tended to be ‘heavy end’ at the point of allocation: they accounted for 62% of all children subject to care proceedings and 40% of those placed on the child protection register. There was a fairly even spread between alcohol and drug misuse, and a number of cases involved both. Substance misuse specialists were rarely involved in working with families, primarily because parents said that they did not think that they had a problem. Suggestions for ways in which policy and practice with PSM might be improved are made in light of these findings.

What is ‘Substance Misuse’?

Abstract: This literature review concerned the end of life care needs of patients with drug and alcohol addiction, particularly in the UK, and to identify existing good practice guidance. Three themes emerged: » The need to improve recognition of substance misuse in patients receiving palliative care, and to meet the challenges palliative care teams face when caring for patients who have current or past opiate, benzodiazepine or alcohol addictions. » A lack of UK literature addressing the end of life care needs of patients with drug and alcohol addiction. There are articles in the US literature concerning a family-systems approach to the care of dying patients who have misused substances, and the role of social workers and counsellors in the care of dying patients receiving opiate-substitution treatment. » Inequitable access to end of life and palliative care services for homeless people, many of whom are addicted to substances or alcohol.

Parental Substance Misuse and Child Welfare: Outcomes for Children Two Years after Referral

Abstract: This paper reports on placement and welfare outcomes for children allocated a social worker where there was a concern about parental misuse of drugs or alcohol. All files going for allocation for long term work in four London boroughs over on average one year were examined (290 families). Of the 290, 100 families with 186 children involved concerns about parental substance misuse. File studies were carried out at allocation and two years post-referral for these children. At follow-up only 46% of the children remained with their main carer, with 26% living in the wider family and 27% in the formal care system. Logistic regression found the factors associated with children remaining at home were parental heroin misuse, violence and one or more parents being a first generation immigrant; factors associated with children moving were the child being a baby identified as at risk of harm and particular combinations who misused and family structure. A rating of welfare outcome was made based on educational, emotional/behavioural and health development. At follow-up, 47% of children had no problems, 31% had continuing problems and 22% had problems in more areas than at allocation. Regression analysis found the factors associated with poor welfare outcome were children remaining at home, domestic violence, alcohol misuse and being a boy. The combination of a high proportion of children moving carer and poor outcomes for those at home suggests that attention needs to be paid to improving outcomes in this area.

Social Relationships and Mortality Risk: A Meta-analytic Review

Abstract: Background The quality and quantity of individuals' social relationships has been linked not only to mental health but also to both morbidity and mortality. Objectives This meta-analytic review was conducted to determine the extent to which social relationships influence risk for mortality, which aspects of social relationships are most highly predictive, and which factors may moderate the risk. Data Extraction Data were extracted on several participant characteristics, including cause of mortality, initial health status, and pre-existing health conditions, as well as on study characteristics, including length of follow-up and type of assessment of social relationships. Results Across 148 studies (308,849 participants), the random effects weighted average effect size was OR = 1.50 (95% CI 1.42 to 1.59), indicating a 50% increased likelihood of survival for participants with stronger social relationships. This finding remained consistent across age, sex, initial health status, cause of death, and follow-up period. Significant differences were found across the type of social measurement evaluated (p<0.001); the association was strongest for complex measures of social integration (OR = 1.91; 95% CI 1.63 to 2.23) and lowest for binary indicators of residential status (living alone versus with others) (OR = 1.19; 95% CI 0.99 to 1.44). Conclusions The influence of social relationships on risk for mortality is comparable with well-established risk factors for mortality. Please see later in the article for the Editors' Summary

Nudge: Improving Decisions about Health, Wealth, and Happiness

Abstract: NUDGE: IMPROVING DECISIONS ABOUT HEALTH, WEALTH, AND HAPPINESS by Richard H. Thaler and Cass R. Sunstein Penguin Books, 2009, 312 pp, ISBN 978-0-14-311526-7This book is best described formally as a general explanation of and advocacy for libertarian paternalism, a term coined by the authors in earlier publications. Informally, it is about how leaders, systems, organizations, and governments can nudge people to do the things the nudgers want and need done for the betterment of the nudgees, or of society. It is paternalism in the sense that "it is legitimate for choice architects to try to influence people's behavior in order to make their lives longer, healthier, and better", (p. 5) It is libertarian in that "people should be free to do what they like - and to opt out of undesirable arrangements if they want to do so", (p. 5) The built-in possibility of opting out or making a different choice preserves freedom of choice even though people's behavior has been influenced by the nature of the presentation of the information or by the structure of the decisionmaking system. I had never heard of libertarian paternalism before reading this book, and I now find it fascinating.Written for a general audience, this book contains mostly social and behavioral science theory and models, but there is considerable discussion of structure and process that has roots in mathematical and quantitative modeling. One of the main applications of this social system is economic choice in investing, selecting and purchasing products and services, systems of taxes, banking (mortgages, borrowing, savings), and retirement systems. Other quantitative social choice systems discussed include environmental effects, health care plans, gambling, and organ donations. Softer issues that are also subject to a nudge-based approach are marriage, education, eating, drinking, smoking, influence, spread of information, and politics. There is something in this book for everyone.The basis for this libertarian paternalism concept is in the social theory called "science of choice", the study of the design and implementation of influence systems on various kinds of people. The terms Econs and Humans, are used to refer to people with either considerable or little rational decision-making talent, respectively. The various libertarian paternalism concepts and systems presented are tested and compared in light of these two types of people. Two foundational issues that this book has in common with another book, Network of Echoes: Imitation, Innovation and Invisible Leaders, that was also reviewed for this issue of the Journal are that 1 ) there are two modes of thinking (or components of the brain) - an automatic (intuitive) process and a reflective (rational) process and 2) the need for conformity and the desire for imitation are powerful forces in human behavior. …

Research Methods in Health. Investigating health and health services

Abstract: This new edition of Ann Bowling's well-known and highly respected text has been thoroughly revised and updated to reflect key methodological developments in health research. It is a comprehensive, easy to read, guide to the range of methods used to study and evaluate health and health services. It describes the concepts and methods used by the main disciplines involved in health research, including: demography, epidemiology, health economics, psychology and sociology.The research methods described cover the assessment of health needs, morbidity and mortality trends and rates, costing health services, sampling for survey research, cross-sectional and longitudinal survey design, experimental methods and techniques of group assignment, questionnaire design, interviewing techniques, coding and analysis of quantitative data, methods and analysis of qualitative observational studies, and types of unstructured interviewing. With new material on topics such as cluster randomization, utility analyses, patients' preferences, and perception of risk, the text is aimed at students and researchers of health and health services. It has also been designed for health professionals and policy makers who have responsibility for applying research findings in practice, and who need to know how to judge the value of that research.