Combining Language Training and Work Experience for Refugees with Low-Literacy Levels: a Mixed-Methods Case Study.

Learning the host society's language and finding a job are important steps for the societal integration of refugees. Especially language proficiency is a key barrier for the integration of low literates. Often language training and gaining work skills are separated during the integration procedure. We investigated a 1-year pilot program for refugees with low-literacy levels in the Netherlands, which combined language training (daily classes, work-related language) with work experience in sheltered employment (second-hand shop) to facilitate language learning and prepare this group better for the labour market. Building on Ager and Strang's conceptual integration framework (2008), we expected that this combined program should improve agency (communication strategies, preparedness for the labour market) via intergroup contact at work. We used a mixed-method approach to follow the development of participants (N=10) longitudinally (baseline, after 6 months, after 11 months). We gathered questionnaire data, interviewed teachers and students, and observed interactions in classes and at work. Overall, use of communication strategies increased. Analyzing individual cases (profiles) offered nuanced insights into for whom and why the program seems to have differential impact, especially in terms of labour market preparation. We discuss results and the importance of creating intergroup contact to facilitate integration in a new society. Supplementary Information: The online version contains supplementary material available at 10.1007/s12134-023-01028-6.

Shared understanding and task-interdependence in nursing interns' collaborative relations: A social network study of vocational health care internships in the Netherlands.

Shared understanding among collaborators is a key element of delivering successful interprofessional care and a main challenge for professional education concerns nurturing such understanding among students. We assessed how nursing students perceived different levels of shared understanding in their collaborations with others in clinical internships. We analyse the collaborative networks of interns to examine whether individual factors (attitudes, perceptions of collaborative cultures, and motivation) or relational factors among collaborators (task-interdependence, cooperation frequency, and interprofessional and hierarchical roles) affect shared understanding among 150 Dutch nursing interns and their collaborators (n = 865). Theoretically, we stress the importance of focusing on collaborative relations in interprofessional care settings. Multilevel models distinguish two levels in explaining the variation in shared understanding, nesting collaborative relationships within individuals. Results indicate merely 37.4% of found variation of shared understanding could be attributed to individual-level factors (variation between interns), while 62.6% of variation is found within interns, showing that shared understanding differs substantially between the collaborations one intern engages in. Multilevel models reveal that task-interdependence strongly predicts shared understanding in inter- and intraprofessional collaborations. We conclude that focusing on collaborative relations is essential to foster shared understanding in vocational internship programmes, and that health care organisations should pay explicit attention to task-interdependence in interns' collaborations.

Community Health Center Efficiency. The Impact of Organization Design and Local Context: The Case of Indonesia.

BACKGROUND: The decentralization of the Indonesian healthcare system, launched in the year 2000, allowed the authorities of local community health centers (CHCs) to tailor their services to the needs of their clients. Many observers see this as an opportunity to increase CHC efficiency. Building on the Context Design Performance Framework, this paper assesses the extent to which efficiency variations between CHCs can be explained by the degree of fit between their organizational design characteristics and aspects of the communities in which they are embedded. METHODS: Data envelopment analysis (DEA) was applied to construct a measure of CHC efficiency for a sample of 598 CHCs in 2011, drawn from a publicly available Ministry of Health (MoH) dataset. Tobit regression analysis was applied to assess the impact of organization design and community characteristics and their interplay on efficiency. RESULTS: Large variations in CHC efficiency were discovered, suggesting that not all CHCs are equally capable of finding the optimal design to operate most efficiently. A significant inverted U-shape relationship was found for the organization design-efficiency link: efficiency is highest for CHCs with 1-2 horizontal units and decreases for CHCs exceeding or not reaching this number. No significant association was found between community characteristics (proportion of poor people, remote location of CHC) and CHC efficiency. CONCLUSION: Organizational design matters for CHC efficiency, but no evidence was found for the hypothesis that a better fit between community characteristics and CHC design increases efficiency. A potential reason for this might be that CHC management's main design challenge is how to cope with the scarce availability of well-trained health personnel.

Networks of reliable reputations and cooperation: a review.

Reputation has been shown to provide an informal solution to the problem of cooperation in human societies. After reviewing models that connect reputations and cooperation, we address how reputation results from information exchange embedded in a social network that changes endogenously itself. Theoretical studies highlight that network topologies have different effects on the extent of cooperation, since they can foster or hinder the flow of reputational information. Subsequently, we review models and empirical studies that intend to grasp the coevolution of reputations, cooperation and social networks. We identify open questions in the literature concerning how networks affect the accuracy of reputations, the honesty of shared information and the spread of reputational information. Certain network topologies may facilitate biased beliefs and intergroup competition or in-group identity formation that could lead to high cooperation within but conflicts between different subgroups of a network. Our review covers theoretical, experimental and field studies across various disciplines that target these questions and could explain how the dynamics of interactions and reputations help or prevent the establishment and sustainability of cooperation in small- and large-scale societies. This article is part of the theme issue 'The language of cooperation: reputation and honest signalling'.

Evaluator perceptions of NGO performance in disasters: meeting multiple institutional demands in humanitarian aid projects.

Providing aid in times of increasing humanitarian need, limited budgets, and mounting security risks is challenging. This paper explores in what organisational circumstances evaluators judge, positively and negatively, the performance of international non-governmental organisations (INGOs) in response to disasters triggered by natural hazards. It assesses whether and how, as perceived by expert evaluators, CARE and Oxfam successfully met multiple institutional requirements concerning beneficiary needs and organisational demands. It utilises the Competing Values Framework to analyse evaluator statements about project performance and organisational control and flexibility issues, using seven CARE and four Oxfam evaluation reports from 2005-11. The reports are compared using fuzzy-set Qualitative Comparative Analysis. The resulting configurations show that positive evaluations of an INGO's internal and external flexibility relate to satisfying beneficiary needs and organisational demands, whereas negative evaluations of external flexibility pertain to not meeting beneficiary needs and negative statements about internal control concerning not fulfilling organisational demands.

Social Network Characteristics and Their Associations With Stress in Older Adults: Closure and Balance in a Population-Based Sample.

OBJECTIVES: Integration into social networks reduces stress during adverse life events and improves coping with disability in late life. The aim was to investigate whether social network closure (frequent contact among ties) and balance (positive contact among ties) are associated with perceived stress. We expect lowest stress for older adults with highly closed and balanced networks. METHOD: Panel data on self-reported egocentric networks stem from the population-based Chicago Health, Aging, and Social Relations Study. Five waves were collected between 2002 and 2006, with 708 observations from 160 participants aged 50-68 years at baseline. Data include information on the participants' social relationships, that is, interaction frequency and relationship quality, for ego-alter ties and alter-alter ties, and participants' perceived stress. The analytical strategy used fixed- and random-effects models. RESULTS: Participants reporting the highest number of balanced relationships (positive ties among alters) experience least stress. This effect holds independently of sociodemographic confounders, loneliness, and network size. DISCUSSION: The absence of a stress-reducing effect from network closure suggests that balance matters more. Future research would benefit from considering balance when examining the characteristics of social networks that impinge on mental health outcomes in older adults.

Silence Is Golden. Six Reasons Inhibiting the Spread of Third-Party Gossip.

Most of the current literature on gossip describes gossipmongers as incessantly sharing evaluative and valuable information about an absent third party in teams, groups, communities, and organizations. However, potential gossipers can similarly decide not to share what they know, depending on the content, the context, or their relationship with the other actors in the gossip triad. We argue that understanding the reasons why people do not gossip may provide useful insights into individual motives, group dynamics, and collective behaviors. This theoretical contribution first critically surveys the existing gossip literature with the aim of highlighting the conditions under which people might refrain from sharing third party information. We then propose to apply Goal Framing theory as a way to bridge a theory of the micro-foundations of human behavior with an analytical model of the gossip triad that disentangles the various ways through which senders, receivers, and objects of gossip may be interrelated. From a goal framing perspective, most research on gossip illustrates the mechanisms in which the hedonic gratification derived from gossiping is reinforced by gain or normative goals. However, a normative or a gain goal frame can prevent the gossip monger from spreading the information, and we argue that depending on different configurations of frames and relations between actors the perceived costs of sending gossip may be far higher than much of the previous literature suggests.

"It's Not Always Possible to Live Your Life Openly or Honestly in the Same Way" - Workplace Inclusion of Lesbian and Gay Humanitarian Aid Workers in Doctors Without Borders.

In this exploratory study, we present findings from semi-structured interviews with 11 self-identified lesbian and gay (LG) humanitarian aid workers of Doctors without Borders (MSF). We investigate their perceptions of workplace inclusion in terms of perceived satisfaction of their needs for authenticity and belonging within two organizational settings, namely office and field. Through our combined deductive and inductive approach, based on grounded theory, we find that perceptions of their colleagues' and supervisors' attitudes and behaviors, as well as organizational inclusiveness practices play a role in LGs' perceived authenticity, but not belonging, in the workplace. However, these organization-level characteristics do not account for between-participant differences in perceived authenticity. Therefore, we inductively construct a typology of three groups, which we coined conscious first-missioners, authentic realists, and idealistic activists, based on how LG humanitarian aid workers assess and deal with not being able to be their authentic selves when they are in the field, because homosexuality is illegal in many project countries. Conscious first-missioners are separated from the other two groups based on having gone to the field once, whereby they felt in control over the decision on how to manage their sexuality. Alternatively, authentic realists and idealistic activists alike felt they did not really have a choice in how to manage their sexuality, but handled that differently. We find the importance of one's sexuality as well as adherence to the overarching organizational mission relevant individual-level factors herein. Furthermore, we find disclosure of sexual identity to be strongly context-dependent, as participants are 'out of the closet' in the office, but go back into the closet when they enter the field, with different country contexts even leading to different decisions concerning self-disclosure, thus demonstrating the importance of careful sexual identity management. This so-called disclosure dilemma, we find, may not be merely an individual choice, but rather a shared dilemma involving multiple stakeholders, such as the organization and fellow team members. We discuss the findings' contributions to existing literature on LGs' workplace experiences and implications for future research on inclusion of sexual and other invisible minorities in the workplace.

Combining informal care and paid work: The use of work arrangements by working adult-child caregivers in the Netherlands.

An increasing number of people combine paid work with the provision of informal care for a loved one. This combination of work and care may cause difficulties, necessitating adaptations at work, i.e. work arrangements. The present study explores what types of work arrangements are used by working caregivers, and which caregiver, care and work characteristics are associated with the use of these work arrangements. Within the Lifelines Informal Care Add-on Study (Lifelines ICAS), data on 965 Dutch informal caregivers in the North of the Netherlands were collected between May 2013 and July 2014 (response rate 48%), and data on 333 working adult-child caregivers (aged 26-68 years, 82% female) were used in this study. A small majority (56%) of the working caregivers used one or more work arrangement(s): taking time off (41%), individual agreements with supervisor (30%), formal care leave arrangement (13%), and reduction in paid work hours (6%). Logistic regression analyses showed that long working hours (OR 1.06, 95% CI 1.01-1.08), and the experience of more health problems (OR 2.54, 95% CI 1.56-4.05) or a disrupted schedule due to caregiving (OR 2.50, 95% CI 1.66-3.78) increased the chance to have used one or more work arrangements. Lower educated working caregivers were less likely to have used a formal care leave arrangement (tertiary vs. primary education OR 2.75, 95% CI 1.13-6.67; tertiary vs. secondary education OR 1.27, 95% CI 1.27-5.09). Policy makers should inform working caregivers about the availability of the different work arrangements, with specific attention for low educated working caregivers. Employers need to consider a more caregiver-friendly policy, as almost half of the working adult-child caregivers did not use any work arrangement.

The impact of older person's frailty on the care-related quality of life of their informal caregiver over time: results from the TOPICS-MDS project.

PURPOSE: To examine the impact of changes in an older person's frailty on the care-related quality of life of their informal caregiver. METHODS: Five research projects in the TOPICS-MDS database with data of both older person and informal caregiver at baseline and after 12 months follow-up were selected. Frailty was measured in five health domains (functional limitations, psychological well-being, social functioning, health-related quality of life, self-rated health). Care-related quality of life was measured with the Care-Related Quality of Life instrument (CarerQoL-7D), containing two positive (fulfilment, perceived support) and five negative dimensions (relational problems, mental health problems, physical health problems, financial problems, problems combining informal care with daily activities). RESULTS: 660 older person/caregiver couples were included. Older persons were on average 79 (SD 6.9) years of age, and 61% was female. Caregivers were on average 65 (SD 12.6) years of age, and 68% was female. Results of the multivariable linear and logistic regression analyses showed that an increase in older person's frailty over time was related to a lower total care-related quality of life of the caregiver, and to more mental and physical health problems, and problems with combining informal care with daily activities at follow-up. A change in the older person's psychological well-being was most important for the caregiver's care-related quality of life, compared to the other health domains. CONCLUSIONS: Health professionals observing decreasing psychological well-being of an older person and increasing hours of informal care provision should be aware of the considerable problems this may bring to their informal caregiver, and should tailor interventions to support informal caregivers according to their specific needs and problems.

Subjective burden among spousal and adult-child informal caregivers of older adults: results from a longitudinal cohort study.

BACKGROUND: Pressures on informal caregivers are likely to increase due to increasing life expectancy and health care costs, which stresses the importance of prevention of subjective burden. The present study examined the correlates of overall subjective burden and multiple burden dimensions among spousal and adult-child caregivers of Dutch older adults, both cross-sectional and longitudinal (12-months follow-up). METHODS: In 2010 and 2011 baseline and follow-up data was collected in a sample of informal caregivers and care recipients in the Northern provinces of the Netherlands. Subjective burden included 7 burden dimensions and a summary score for overall subjective burden, based on the Care-Related Quality of Life Instrument (CarerQoL-7D). Objective stressors were the time investment in caregiving (hours of household care, personal care, practical care) and the health situation of the care recipient, including multimorbidity, functional limitations (Katz Index of Independence Basic Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL), and cognitive functioning problems (EQ-5D + C). Correlates of subjective burden were evaluated with linear and logistic regression analyses. RESULTS: The sample consisted of 356 caregivers at baseline (43% spousal, 57% adult-child caregivers), and 158 caregivers at follow-up (45% spousal, 55% adult-child caregivers). At baseline and follow-up, spousal caregivers experienced a higher overall subjective burden, and reported more often mental health problems, physical health problems, and problems with combining daily activities, compared to adult-child caregivers. For spousal caregivers, a poorer health situation of the care recipient was associated with higher subjective burden, while adult-child caregivers reported higher levels of subjective burden when their time investment in caregiving was high. Subjective burden at follow-up was mainly explained by baseline subjective burden. CONCLUSIONS: These results indicate that for effective caregiver support, it is crucial to take the type of care relationship into account, since the level and correlates of overall subjective burden and burden dimensions varied for spousal and adult-child caregivers. In addition, reducing subjective burden will also positively impact the subjective burden over time.

Neighborhood income and major depressive disorder in a large Dutch population: results from the LifeLines Cohort study.

BACKGROUND: Previous studies are inconclusive on whether poor socioeconomic conditions in the neighborhood are associated with major depressive disorder. Furthermore, conceptual models that relate neighborhood conditions to depressive disorder have not been evaluated using empirical data. In this study, we investigated whether neighborhood income is associated with major depressive episodes. We evaluated three conceptual models. Conceptual model 1: The association between neighborhood income and major depressive episodes is explained by diseases, lifestyle factors, stress and social participation. Conceptual model 2: A low individual income relative to the mean income in the neighborhood is associated with major depressive episodes. Conceptual model 3: A high income of the neighborhood buffers the effect of a low individual income on major depressive disorder. METHODS: We used adult baseline data from the LifeLines Cohort Study (N = 71,058) linked with data on the participants' neighborhoods from Statistics Netherlands. The current presence of a major depressive episode was assessed using the MINI neuropsychiatric interview. The association between neighborhood income and major depressive episodes was assessed using a mixed effect logistic regression model adjusted for age, sex, marital status, education and individual (equalized) income. This regression model was sequentially adjusted for lifestyle factors, chronic diseases, stress, and social participation to evaluate conceptual model 1. To evaluate conceptual models 2 and 3, an interaction term for neighborhood income*individual income was included. RESULTS: Multivariate regression analysis showed that a low neighborhood income is associated with major depressive episodes (OR (95 % CI): 0.82 (0.73;0.93)). Adjustment for diseases, lifestyle factors, stress, and social participation attenuated this association (ORs (95 % CI): 0.90 (0.79;1.01)). Low individual income was also associated with major depressive episodes (OR (95 % CI): 0.72 (0.68;0.76)). The interaction of individual income*neighborhood income on major depressive episodes was not significant (p = 0.173). CONCLUSIONS: Living in a low-income neighborhood is associated with major depressive episodes. Our results suggest that this association is partly explained by chronic diseases, lifestyle factors, stress and poor social participation, and thereby partly confirm conceptual model 1. Our results do not support conceptual model 2 and 3.

Survey nonresponse among informal caregivers: effects on the presence and magnitude of associations with caregiver burden and satisfaction.

BACKGROUND: Informal caregiving is becoming more relevant with current trends such as population ageing. However, little is known about nonconsent and nonresponse bias in caregiving research. We investigated nonconsent and nonresponse bias in a sample of informal caregivers who participated in the LifeLines Cohort Study, and were invited for participation in an additional caregiving study. METHODS: We compared socio-demographic characteristics, caregiver health, caregiving situation, and caregiver outcomes of nonconsent and consent caregivers, and nonresponse and response caregivers, on LifeLines data, by using Chi-square tests, Independent Sample T-tests, and Mann-Whitney tests. Furthermore, we examined the influence of nonconsent and nonresponse on the presence and magnitude of the associations between caregiver characteristics and two commonly used caregiving outcomes (caregiver burden and satisfaction). We conducted multinomial logistic regression analyses, including interaction terms with nonconsent and nonresponse. RESULTS: Within a subcohort of 8443 caregivers, aged >18 years, 5095 caregivers (60 %) gave consent for participation in the caregiving study. Within the subgroup of 2002 caregivers who received the questionnaire, 965 (48 %) responded. Caregivers who were highly involved in caregiving (i.e. high time investment, high caregiver burden), gave more commonly consent to participate, and responded more often to the questionnaire. Nonconsent and nonresponse influenced the associations between caregiver characteristics and caregiver burden for only a few characteristics, mainly indicating the level of caregiving involvement (e.g. time investment, caregiving duration). Especially for caregiver burden, these indicators were stronger for consent and response caregivers than for nonconsent and nonresponse caregivers. CONCLUSIONS: Our findings are important for caregiving research, as they emphasized that participation might not be evenly distributed among caregivers, and that the possibility of nonconsent and nonresponse bias should be considered.

Subjective socioeconomic status and health in cross-national comparison.

Research has established a robust association between subjective socioeconomic status (SES) and health outcomes, which holds over and above the associations between objective markers of SES and health. Furthermore, comparative research on health inequalities has shown considerable variation in the relationship between different objective markers of SES and health across countries. Drawing on data from 29 countries, we present the first cross-national study on the subjective SES-health relationship. For two health outcomes, namely self-rated health (SRH) and psychological wellbeing, we are able to confirm that subjective SES is related to health in all countries under study, even when income, education, and occupational prestige are accounted for. Furthermore, we document considerable variation in the strength of the subjective SES-health association across countries. This variation however is largely independent of country differences in income inequality and country affluence. The health benefits of a high subjective SES appear to be slightly larger in more affluent countries, but only for SRH, not for psychological wellbeing.

Success and Failure of Parliamentary Motions: A Social Dilemma Approach.

Parliamentary motions are a vital and frequently used element of political control in democratic regimes. Despite their high incidence and potential impact on the political fate of a government and its policies, we know relatively little about the conditions under which parliamentary motions are likely to be accepted or rejected. Current collective decision-making models use a voting power framework in which power and influence of the involved parties are the main predictors. We propose an alternative, social dilemma approach, according to which a motion's likelihood to be accepted depends on the severity of the social dilemma underlying the decision issue. Actor- and dilemma-centered hypotheses are developed and tested with data from a stratified random sample of 822 motions that have been voted upon in the Dutch Parliament between September 2009 and February 2011. The social dilemma structure of each motion is extracted through content coding, applying a cognitive mapping technique developed by Anthony, Heckathorn and Maser. Logistic regression analyses are in line with both, actor-centered and social-dilemma centered approaches, though the latter show stronger effect sizes. Motions have a lower chance to be accepted if voting potential is low, the proposer is not from the voting party, and if the problem underlying the motion reflects a prisoner's dilemma or a pure competition game as compared to a coordination game. The number of proposing parties or a battle of the sexes structure does not significantly affect the outcome.

Personal networks and mortality risk in older adults: a twenty-year longitudinal study.

BACKGROUND: Research on aging has consistently demonstrated an increased chance of survival for older adults who are integrated into rich networks of social relationships. Theoretical explanations state that personal networks offer indirect psychosocial and direct physiological pathways. We investigate whether effects on and pathways to mortality risk differ between functional and structural characteristics of the personal network. The objective is to inquire which personal network characteristics are the best predictors of mortality risk after adjustment for mental, cognitive and physical health. METHODS AND FINDINGS: Empirical tests were carried out by combining official register information on mortality with data from the Longitudinal Aging Study Amsterdam (LASA). The sample included 2,911 Dutch respondents aged 54 to 85 at baseline in 1992 and six follow-ups covering a time span of twenty years. Four functional characteristics (emotional and social loneliness, emotional and instrumental support) and four structural characteristics (living arrangement, contact frequency, number of contacts, number of social roles) of the personal network as well as mental, cognitive and physical health were assessed at all LASA follow-ups. Statistical analyses comprised of Cox proportional hazard regression models. Findings suggest differential effects of personal network characteristics on survival, with only small gender differences. Mortality risk was initially reduced by functional characteristics, but disappeared after full adjustment for the various health variables. Mortality risk was lowest for older adults embedded in large (HR = 0.986, 95% CI 0.979-0.994) and diverse networks (HR = 0.948, 95% CI 0.917-0.981), and this effect continued to show in the fully adjusted models. CONCLUSIONS: Functional characteristics (i.e. emotional and social loneliness) are indirectly associated with a reduction in mortality risk, while structural characteristics (i.e. number of contacts and number of social roles) have direct protective effects. More research is needed to understand the causal mechanisms underlying these relations.

The impact of humanitarian context conditions and individual characteristics on aid worker retention.

High employee turnover rates constitute a major challenge to effective aid provision. This study examines how features of humanitarian work and aid workers' individual characteristics affect retention within one humanitarian organisation, Médecins Sans Frontières (MSF) Holland. The study extends existing research by providing new theoretical explanations of employment opportunities and constraints and by engaging in the first large-scale quantitative analysis of aid worker retention. Using a database of field staff (N=1,955), a logistic regression is performed of the likelihood of reenlistment after a first mission. The findings demonstrate that only 40 per cent of employees reenlist for a second mission with MSF Holland, and that workplace location and security situation, age, and gender have no significant effect. Individuals are less likely to reenlist if they returned early from the first mission for a personal reason, are in a relationship, are medical doctors, or if they come from highly developed countries. The paper reflects on the findings in the light of policy.

Receiving Instrumental Support in Late Parent-Child Relationships and Parental Depression.

OBJECTIVES: This study investigates the role of gender, functional limitations, and social interaction in the association between instrumental support from adult children and parental depression. We apply self-determination theory to hypothesize about the role of physical needs and social resources on parental depression in a European context. METHOD: A sample of 6,268 parents older than 65 who have nonresident children from the first wave of Survey of Health, Ageing and Retirement in Europe (2004) is analyzed. We estimate logistic regression models to test for the association between instrumental support and depression. Physical needs, gender, and social interaction are used as moderators. RESULTS: Net of core factors that contribute to depression, including previous history of depression, there is a U-shaped pattern between receiving instrumental support and depression that persists across country regimes. For respondents with medium physical limitations, too little or too frequent support from children is associated with higher depression. For respondents with severe limitations, receiving at least some support is better than receiving none at all. The receipt of too frequent support from children increases the level of depression more for women than men. All interaction effects are comparable across country regimes. DISCUSSION: Heterogeneity in physical needs and resources of older individuals must be taken into account when assessing the effects of instrumental support on mental health.

Population ageing research: a family of disciplines.

To study life course trajectories and ageing, scientific expertise is needed beyond epidemiology. More specifically, appropriate models of life course require a theoretical micro-foundation, need to incorporate multi-level context conditions and the interplay between them. It also requires the application of additional social scientific research methods that go beyond the application of statistical methods based on the multi-stage life table. These research theories and methods are available in disciplines like sociology, cultural anthropology, psychology, demography and economics. To effectively study healthy ageing of populations the individual approach of epidemiology has to be extended with the macro-population and socio-cultural approach of (social) demography and the institutional and network approaches of sociology.