Sven Trygged

Income and education as predictors of return to working life among younger stroke patients.

BackgroundSocioeconomic conditions are not only related to poor health outcomes, they also contribute to the chances of recovery from stroke. This study examines whether income and education were predictors of return to work after a first stroke among persons aged 40-59.MethodsAll first-stroke survivors aged 40-59 who were discharged from a hospital in 1996-2000 and who had received income from work during the year prior to the stroke were sampled from the Swedish national register of in-patient care (n = 7,081). Income and education variables were included in hazard regressions, modelling the probability of returning to work from one to four years after discharge. Adjustments for age, sex, stroke subtype, and length of in-patient care were included in the models.ResultsBoth higher income and higher education were associated with higher probability of returning to work. While the association between education and return to work was attenuated by income, individuals with university education were 13 percent more likely to return than those who had completed only compulsory education, and individuals in the highest income quartile were about twice as likely to return as those in the lowest. The association between socioeconomic position and return to work was similar for different stroke subtypes. Income differences between men and women also accounted for womens lower probability of returning to work.ConclusionsThe study demonstrates that education and income were independent predictors of returning to work among stroke patients during the first post-stroke years. Taking the relative risk of return to work among those in the higher socioeconomic positions as the benchmark, there may be considerable room for improvement among patients in lower socioeconomic strata.

Balancing the global and the local : Some normative reflections on international social work

The main point of departure for international social work consists of the UN declarations on equal rights and opportunities. Important issues are globalization, global standards, universal as opposed to local contexts and the need for comparative studies. The article argues against particularism in favour of universalism and critical modernity.

Income and education as predictors of stroke mortality after the survival of a first stroke

Background. It is well known that socioeconomic indicators, such as income and education, predict both stroke incidence and stroke mortality. This means that persons in lower socioeconomic positions are less likely to survive their stroke, and there will be a selective survival in the group discharged from hospital after their first stroke. Question. Does socioeconomic position continue to predict mortality, stroke specific, or from other causes, among patients surviving their first stroke in spite of this selective survival? Methods. All persons in Sweden aged 40–59 years who were discharged after a first hospitalization for stroke in 1996–2000 were included (n = 10,487), then followed up until the end of the fourth calendar year after discharge. Data were analysed with Cox regressions controlling for age, sex, and stroke type. Results. Persons with high socioeconomic position, measured by education and income, have lower mortality than those of low position. Education was not significant when adjusted for income, however. The risk of dying was similar for stroke-specific mortality and all-cause mortality, for those with cerebral infarction as well as for all patients. Conclusions. Socioeconomic position predicted stroke-specific mortality also in the selective group of persons who survived their first stroke.

Social work with vulnerable families and children in 11 Russian regions

Purpose. The purpose of the study was to describe and analyse how key actors in the social sector in Russian regions identify problems, objectives and social work achievements in connection with vulnerable families and children. Methods. University personnel conducted 209 interviews using semi-structured questionnaires. Results. Family problems were reported to be related to poverty, parents’ alcohol abuse, the childs behaviour, the childs lack of social skills, domestic conflicts and problems getting adequate housing. The view of the majority of the respondents was that social orphanhood depends on poverty, alcohol abuse and the familys diminished role in society. Family incomes have improved but services have become more expensive. The social workers mostly put the child, not the family, in focus. Alcohol abuse was considered to be a greater problem in wealthier regions. Analyses between key groups showed that the respondents ranked problems differently, had similar ways of defining important objectives, but had divergent opinions on what social work could achieve concerning, for example, re-establishing the childs contacts with his/her biological parents. Conclusions. The respondents seem to be highly ambivalent toward alcohol abuse as a social problem and toward biological parents in vulnerable families. Social work in the regions is a profession in the process of formation.

Living in Danger: Previous Violence, Socioeconomic Position, and Mortality Risk among Women over a 10-Year Period

Violence against women has many negative consequences. In this short report the authors investigate patterns of mortality among women experiencing violence leading to inpatient care from 1992 to 2006. Do women who are victims of severe violence have an increased mortality risk (a) in general? (b) by violence? (c) by suicide? Does socioeconomic position have any bearing on the mortality risk? The study was based on Swedish national registers, where 6,085 women exposed to violence resulting in inpatient care were compared with a nonexposed population sample of 55,016 women. Women of all social strata previously exposed to severe violence and treated in hospital had a highly increased risk of premature death from all-cause mortality, violence, or suicide. Women previously exposed to severe violence continue to live a life in danger. There is need for a societal response to support and protect these women against further violence after discharge from hospital.

Education and post-stroke separation among couples with mutual children

The objective of this study based on Swedish registers is to examine the influence of socioeconomic position on poststroke divorce and separation using education as a marker. People aged 18 to 64 who suffered a first stroke between 1992 and 2005 were included if they were married or cohabiting and had mutual children. The material included 42,026 first stroke cases and 424,281 nonexposed persons, both populations divided into three different educational groups. Results show that the risk of separation is much higher in the incident year and in the first poststroke year, above all among people with only compulsory (elementary) education.

Beaten and Poor? A Study of the Long-Term Economic Situation of Women Victims of Severe Violence

This 10-year follow-up study based on Swedish national registers compares the economic situation of women victims of violence leading to hospitalization (n = 6,085) to nonexposed women (n = 55,016) in 1992 to 2005. Women exposed to severe violence had a poorer financial situation prior to the assault. Violence seems to heavily reinforce this pattern, indicating a continued need of support from the social work profession. Assaulted women had a worse income development, lower odds for being in employment, and higher odds for having low incomes and means tested social assistance during the 10-year follow-up, independent of having children or not.

How do students perceive the international dimension in social work education? : an enquiry among Swedish and German students

Globalization, internationalization, and regionalization affect domestic social work. This paper explores how undergraduate students perceive international aspects of their social work education. A questionnaire was distributed to social work undergraduates in Stockholm, Sweden (n=97), and Darmstadt, Germany (n=43). Results showed that a majority of students in Sweden were prepared to work with immigrants and refugees. A majority of students in both countries wanted more education about refugee social work and social work in other countries. The amount of exchange activities was modest, but many students could consider working abroad. Students related most strongly to international aspects of domestic social work such as work with immigrants and refugees.

A retrospective on care and denial of children with disabilities in Russia

In tsarist Russia, disability care was little developed, yet showed certain similarities with other European countries. Disabled children received support through charities and private philanthropy. The October revolution of 1917 proclaimed a better future for all the countrys citizens. Issues: How did the disability policy discussion change after the Russian revolution? Who took care of the so-called feeble-minded? What did this care consist of? Methodology: Study of political and scientific documentation of the period from the end of the 1800s to 1936, along with reflections on the ongoing situation found in the diaries of the head of one child institution, Ekaterina Gracheva. Outcomes: ‘Educable’ children received schooling, while ‘non-educable’ children were placed in separate institutions. This marginalisation was reinforced by the focus on the productive worker. Soviet Russia developed defectology as a science and increased the use of institutional solutions.

Embedded counselling in advisory work with clients in debt

This article addresses the potential for embedded counselling in social work with clients in debt. It is based on experiences from Sweden where budget and debt advisors employed by the municipalities give assistance to clients in financial difficulties. A distinction is made between advice and guidance on the one hand and counselling on the other. As the financial problems often have been long lasting, it is not enough with one-time advice that the client hopefully then follows. The purpose of the article, thus, is to explore the possibilities of incorporating counselling in the role of the advisor.