Parents' Views on Child Welfare's Response to Addiction

This is the publisher's version, also available electronically from http://alliance1.metapress.com/home/main.mpx.The helping system often responds to parents recovering from addiction in a way that reinforces their powerlessness and may perpetuate their addiction. This study identified worker and agency qualities that contribute to parents' recovery and family reunification. The authors conducted a qualitative study of successful clients of the child welfare system who regained their children after recovering from addiction. These parents describe the importance of workers' understanding the context of addiction from the parent's perspective

Predictors of Foster Care Exits to Permanency: A Competing Risks Analysis of Reunification, Guardianship, and Adoption

Nearly 800,000 children spend time in foster care each year, with many children experiencing lengthy stays and exiting without a permanent family. The main objective of this study was to identify which child and placement characteristics were significant predictors of foster care exit to three types of permanency: reunification, guardianship, and adoption. A nonexperimental longitudinal design was used to observe an annual entry cohort of 3,351 children who entered Kansas foster care in state fiscal year 2006. The sample was observed for 30 to 42 months. Data sources were two state administrative databases, one which tracks all children in foster care and one on mental health services. The primary data analysis was competing risks survival analysis. Study findings showed that children in foster care exit to different types of permanency at different rates. Reunification occurs the most quickly, followed by guardianship, and then adoption. While patterns of predictors varied by type of permanency, three major categories of important permanency predictors were identified: 1) demographic characteristics of age at entry and race, 2) clinical needs related to child disabilities and mental health problems, and 3) continuity and connections represented by kin placements, sibling placements, early stability, and absence of runaway events. Implications suggested that social work practice be age-differentiated and culturally appropriate, and that children's needs related to disabilities and mental health problems be addressed with thorough assessment and evidence-based services. Social work practices should also strive to keep children connected to family and in stable placements. The major social work theory implication suggested that permanency theory balance the primordial solidarities principle that stresses family connections with the bureaucratic institutions principle that emphasizes structures for ensuring stability. In addition, this study's findings indicated the need to improve and expand timely permanency for more children. Policy implications included: using guardianship as a viable permanency option for more children; revising federal policy to promote the discovery and implementation of new, creative approaches to permanency; and, reforming the current financing structure to be more flexible and better aligned with the promotion of permanency outcomes

Trust in Media, Institutions, and Health Information in Metropolitan Nebraska: 2021 Nebraska Metro Poll Results

Overall, most metropolitan Nebraskans have confidence in their local institutions (public safety agencies in their community, public schools in their community, and voting and election systems in their county). However, many have very little confidence in many national institutions (the U.S. Senate, the U.S. House of Representatives and the Presidency) as well as the Governor. Metropolitan Nebraskans most trust information received from friends/family/ acquaintances, local news sources (TV and newspapers), public sources (PBS and public radio) and state newspapers. They least trust information from social networking sites, Internet blogs, and Fox News. Most metropolitan Nebraskans trust local health professionals for reliable information on the coronavirus. Over nine in ten trust their doctor or other health care professional either some or a lot and just over three-quarters trust their local health department for reliable information on the coronavirus. At least seven in ten trust the U.S. Centers for Disease Control (CDC) and state public health officials. Most metropolitan Nebraskans favor having health professionals being the primary authority for public health decisions. Just over four in ten support having local health departments being the primary authority for public health decisions while one-third favor having state health departments as the primary authority. Less than one in ten metropolitan Nebraskans think either local or state government should be the primary authority for public health decisions

Life in Nonmetropolitan Nebraskan Communities: 2021 Nebraska Rural Poll Results

Rural Nebraskans are less positive about the current change and expected future change in their communities this year. The proportion believing their community has changed for the better has typically been greater than the proportion believing it has changed for the worse. However, this year the proportion believing their community changed for the worse was slightly more than the proportion believing it had changed for the better (similar to what occurred in 2003 and 2009). The proportion viewing positive change in their community sharply declined from last year. The proportion believing their community has stayed the same increased sharply. Despite that, rural Nebraskans are positive about their community by many different measures. Most rural Nebraskans rate their community favorably on its social dimensions, as friendly, trusting and supportive. Most rural Nebraskans also say it would be difficult to leave their community and have a positive attachment to their community. Finally, most rural Nebraskans disagree that their community is powerless to control its future. Differences in perceptions of their community are evident by community size. Residents of larger communities are more likely than residents of smaller communities to say their community has changed for the better during the past year and will be a better place to live ten years from now. However, persons living in or near the smallest communities are more likely than persons living in or near larger communities to rate their community as friendly, trusting and supportive. And, persons living in or near larger communities are more likely than persons living in or near smaller communities to get what they need in their community. However, persons living in or near the smallest communities are more likely than persons living in or near larger communities to have an attachment to their community. Except for some services that are largely unavailable in rural communities, rural Nebraskans are generally satisfied with basic community services and amenities. However, the proportion of rural Nebraskans satisfied with many social services and entertainment services has decreased during the past 20 years. Declines in satisfaction levels across the past 20 years occur with nursing home care, medical care services, senior centers, mental health services and retail shopping. Some rural Nebraskans say that transgender people, gays and lesbians, recent immigrants to the U.S. and liberals are discriminated against in their community

Impacts of the Pandemic in Nonmetropolitan Nebraska: 2021 Nebraska Rural Poll Results

Most rural Nebraskans felt various impacts from the pandemic. While many rural Nebraskans had someone in their household that quarantined because of possible coronavirus exposure or who contracted COVID-19, most have friends or family in their community that quarantined or contracted the virus. Many rural Nebraskans also have friends or family both inside and outside their community who were hospitalized as a result of COVID-19 or who died as a result of it. Most rural Nebraskans say the following were affected a fair amount or a great deal by the pandemic: their socialization with others, their life overall, and their company/workplace. Conversely, most rural Nebraskans say their physical health, their financial health and their mental health were either not at all impacted or not much. Some groups were more likely to report having these aspects of their lives affected by the pandemic. Residents of the Northeast region are more likely than persons living in other regions of the state to say the following aspects have been impacted at least a fair amount by the pandemic: their life overall, their mental health, and their physical health. And, persons living in or near larger communities are more likely than persons living in or near smaller communities to say the following items were affected at least a fair amount by the pandemic: their life overall, their mental health, their physical health, their financial health and their socialization with others. Work patterns were also impacted. While 16 percent of employed rural Nebraskans worked from home some of the time before the coronavirus outbreak, this increased to 28 percent when they took the survey in the spring and early summer. If they had a choice after the outbreak, just over one-third would like to work from home at least some of the time. Various economic impacts were also felt by rural Nebraskans. Two out of ten rural Nebraskans say someone in their household had a loss of income during the past year, 16 percent said someone in the household had their hours reduced and 16 percent had someone receive paid time off from their employer if a person in the household was infected with COVID-19. More of these impacts were seen in their community. Almost one-third of rural Nebraskans had friends or family in their community who had a loss of income or had their hours reduced. Almost three in ten had friends or family in their community that reduced the hours of operation of their business and just over one-quarter had friends or family in their community that were temporarily laid off. Certain groups are more likely to have experienced these economic impacts. Persons with the lowest household incomes are more likely than persons with higher incomes to say someone in their household experienced the following in the past year: were temporarily laid off, lost their job, and had hours reduced. And, persons living in or near larger communities are more likely than persons living in or near smaller communities to say friends or family in their community experienced many of the items listed: were temporarily laid off, lost their job, changed jobs, retired early, had hours reduced, had a loss of income and returned to work after being laid off temporarily. However, persons living in or near the smallest communities are the group most likely to say friends or family in their community closed a business. Consumer habits were also impacted. Many rural Nebraskans engaged in the following activities more often during the pandemic: had food from a restaurant delivered or used curbside pickup (44%), used videoconferencing to visit with friends or relatives (44%), shopped online (other than groceries) (38%), and had groceries delivered or used curbside pickup (34%). And, most rural Nebraskans report being likely to shop online (other than groceries) and use self-service banking options going forward. Many also say it will be likely for them to videoconference with friends/relatives, order food from a restaurant for delivery or curbside pickup and to order groceries by delivery or curbside pickup. Not many rural Nebraskans report significant limitations from their home Internet service on their ability to do various activities, such as work at home or participate in online K – 12 learning. Less than one in ten report being limited significantly or not being able to do each of the activities listed

Impacts of the Pandemic for Metropolitan and Nonmetropolitan Nebraskans [Research Brief]

Provides a synopsis of the report on impacts of the pandemic for metropolitan and nonmetropolitan Nebraskans by Nebraska Rural Poll researchers. Includes details about the impacts of the COVID-19 pandemic, health and economic impacts experienced during the pandemic from the 2021 metro and rural polls, the extent elements of life were affected or disrupted by the pandemic, frequency of working from home, changes in consumer habits during the pandemic, the likelihood of making consumer choices going forward, and the limitations of home internet service. The Nebraska Rural Poll sampled residents from non-metropolitan counties and regional trade centers in the state. The Nebraska Metro Poll sampled the seven counties that comprise the Lincoln and Omaha metropolitan areas. Both polls sent four mailings regarding or containing the surveys in the spring of 2021 and had an online response option

Life in Metropolitan and Nonmetropolitan Nebraskan Communities [Research Brief]

Provides a synopsis of the report on life in metropolitan and nonmetropolitan Nebraskan communities by Nebraska Rural Poll researchers. Includes details about community change, community social attributes, community powerlessness, satisfaction with community services and amenities, attachment to the community, discrimination in the community, plans to leave the community, and individual and community political views. The Nebraska Rural Poll sampled residents from non-metropolitan counties and regional trade centers in the state. The Nebraska Metro Poll sampled the seven counties that comprise the Lincoln and Omaha metropolitan areas. Both polls sent four mailings regarding or containing the surveys in the spring of 2021 and had an online response option

Impacts of the Pandemic in Metropolitan Nebraska: 2021 Nebraska Metro Poll Results

Most metropolitan Nebraskans felt various impacts from the pandemic. While many metropolitan Nebraskans had someone in their household that quarantined because of possible coronavirus exposure or who contracted COVID-19, most have friends or family in their community that quarantined or contracted the virus. Many metropolitan Nebraskans also have friends or family both inside and outside their community who were hospitalized as a result of COVID-19. Most metropolitan Nebraskans say the following were affected a fair amount or a great deal by the pandemic: their socialization with others, their life overall, their company/ workplace and their mental health. Conversely, most rural Nebraskans say their physical health and their financial health were either not at all impacted or not much. Some groups were more likely to report having these aspects of their lives affected by the pandemic. Persons living in or near larger communities are more likely than persons living in or near smaller communities to say the following items were affected at least a fair amount by the pandemic: their life overall, their mental health and their socialization with others. Work patterns were also impacted. While 14 percent of employed metropolitan Nebraskans worked from home some of the time before the coronavirus outbreak, this increased to 53 percent when they took the survey in the spring and early summer. If they had a choice after the outbreak, almost six in ten would like to work from home at least some of the time. Various economic impacts were also felt by metropolitan Nebraskans. Just over two in ten metropolitan Nebraskans say someone in their household had a loss of income during the past year, 19 percent had someone receive paid time off from their employer if a person in the household was infected with COVID-19, 17 percent said someone in the household had their hours reduced and 16 percent said someone in the household increased their income. More of these impacts were seen in their community. Almost four in ten metropolitan Nebraskans had friends or family in their community who had a loss of income, had their hours reduced or were temporarily laid off. Just over one-quarter had friends or family in their community that changed jobs. Certain groups are more likely to have experienced these economic impacts. Persons with the lowest household incomes are more likely than persons with higher incomes to say someone in their household experienced a loss of income in the past year. And, the youngest persons were the age group most likely to say someone in their household lost their job, changed jobs and increased their income. Consumer habits were also impacted. Many metropolitan Nebraskans did the following items more often during the pandemic: used videoconferencing to visit with friends or relatives (67%), had food from a restaurant delivered or used curbside pickup (66%), shopped online (other than groceries) (48%), had groceries delivered or used curbside pickup (42%) and used curbside pickup at a store (other than groceries) (41%). And, most metropolitan Nebraskans report being likely to order food from a restaurant for delivery or curbside pickup, shop online (other than groceries), use self-service banking options and use videoconferencing to visit with friends or relatives going forward . Many also say it will be likely for them to order groceries by delivery or curbside pickup, use curbside pickup at a store (other than groceries) and to have a virtual visit with a doctor. Not many metropolitan Nebraskans report significant limitations from their home Internet service on their ability to do various activities, such as work at home or participate in online K – 12 learning. Less than one in ten report being limited significantly or not being able to do each of the activities listed. However, persons living in or near smaller communities are more likely than persons living in or near larger communities to say their Internet service at least significantly limits their ability to engage in each of the activities listed

Nonmetropolitan Nebraskans’ Opinions about Water, Climate, and Energy: 2022 Nebraska Rural Poll Results

Most rural Nebraskans receive their home tap water from city water or municipal water systems. Just over two-thirds of rural Nebraskans receive their drinking water from a municipal system. One-quarter have private well water and seven percent are on a rural water system. Many rural Nebraskans have tested their home tap water for nitrates. However, a similar proportion indicated they have not tested their water or are unsure. Persons with higher household incomes are more likely than persons with lower incomes to have tested their home water for each of the items listed. Many persons with the lowest household incomes unsure if their water has been tested. Most rural Nebraskans do not treat their home tap water before drinking it. Persons living in or near the smallest communities (who were more likely to have private well water) are more likely than persons living in or near larger communities to not treat their home tap water. Rural Nebraskans have mixed opinions about various water problems. At least three in ten are concerned or very concerned about the following: contaminants in their water supply, water quality affecting their or their family’s health, water quality affecting wildlife or environment, water quality affecting the cost of water bills, and water will be too polluted. However, either the same or larger proportions indicate they are not concerned or not very concerned about these same items. Rural Nebraskans’ concerns about severe weather events have fluctuated over time. Concerns over extreme temperatures and more severe droughts declined between 2015 and 2020 but then increased again this year. The level of concern for these weather events this year is the highest over the three periods. Concerns about more severe droughts declined from 48 percent in 2015 to 21 percent in 2020 before increasing to 55 percent this year. However, when asked about more frequent extreme rains or floods, the level of concern was highest in 2020. Just under three in ten were concerned about extreme rains or floods in 2020, compared to just under one-quarter this year and 15 percent in 2015. In 2020, the flooding of 2019 was fresh in respondents’ minds. In 2015 parts of the state had been in drought the previous year and in 2022 most of the state is experiencing drought. These likely account for the differing levels of concerns between those years. This year, at least one-half of rural Nebraskans are concerned or very concerned about more severe droughts or dry periods (55%) and more extreme summer temperatures (50%). The Panhandle residents are more likely than residents of other regions to be concerned about more severe droughts or dry periods and more extreme summer temperatures. Rural Nebraskans are less likely to agree that we will learn to live with and adapt to climate change this year as they were in both 2013 and 2008. Just over six in ten agree with the statement this year, compared to just over seven in ten respondents in both 2013 and 2008. This year, most rural Nebraskans agree that we will learn to live with and adapt to climate change and that we have a responsibility to future generations to reduce the effects of climate change. A slight majority of rural Nebraskans agree that human activity is contributing to climate change. However, many rural Nebraskans agree that too much attention is paid to global climate change. This opinion was particularly apparent among persons with occupations in agriculture. Many rural Nebraskans favor proposals to reduce the effects of climate change that use tax credits or taxing corporations based on the carbon emissions they produce. Opinions are mixed on tougher carbon emission standards and tougher fuel-efficiency standards. Many rural Nebraskans oppose tax credits for electric vehicles

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London