Child protection assessment practices in Estonia
After the Soviet Union era and decades of forced interruption, the social work profession development started again in Estonia in 1991. Social work in re-independent Estonia has not had a long tradition, therefore there is a strong need to develop an effective child protection system that responds to adequate satisfaction of children’s needs. The author of this article sought to understand how Estonian child protection workers assess cases where child protection concerns have been identified. The article is based on the case vignette findings from twenty child protection workers from different regions in Estonia. The study indicated that child protection workers’ level of skills and/or commitment to engaging families constructively in the assessment process differs. The assessment practices indicate that assessments are done for the client rather than with the client .
What Is Next for Policy Design and Social Construction Theory?1
The study of policy design has made great progress over the past decade in leading scholars to understand why the American political system produces certain kinds of designs rather than others, and the consequences that policy designs have for democracy. This article outlines the distinctive and important elements of policy design theory—the centrality of policy design, the attention to social constructions, the attention to policy consequences (or feed-forward effects), and the integration of normative and empirical research and theory. It then suggests how policy design theory can complement other policy theories in guiding research and evaluating the conditions of U.S. democracy, and how in its own right it can be further developed and used to guide important inquiry about public policy's politics and social impacts.
Familial Cortical Myoclonic Tremor and Epilepsy, an Enigmatic Disorder: From Phenotypes to Pathophysiology and Genetics. A Systematic Review
Background Autosomal dominant familial cortical myoclonic tremor and epilepsy (FCMTE) is characterized by distal tremulous myoclonus, generalized seizures, and signs of cortical reflex myoclonus. FCMTE has been described in over 100 pedigrees worldwide, under several different names and acronyms. Pathological changes have been located in the cerebellum. This systematic review discusses the clinical spectrum, treatment, pathophysiology, and genetic findings. Methods We carried out a PubMed search, using a combination of the following search terms: cortical tremor, myoclonus, epilepsy, benign course, adult onset, familial, and autosomal dominant; this resulted in a total of 77 studies (761 patients; 126 pedigrees) fulfilling the inclusion and exclusion criteria. Results Phenotypic differences across pedigrees exist, possibly related to underlying genetic differences. A “benign” phenotype has been described in several Japanese families and pedigrees linked to 8q (FCMTE1). French patients (5p linkage; FCMTE3) exhibit more severe progression, and in Japanese/Chinese pedigrees (with unknown linkage) anticipation has been suggested. Preferred treatment is with valproate (mind teratogenicity), levetiracetam, and/or clonazepam. Several genes have been identified, which differ in potential pathogenicity. Discussion Based on the core features (above), the syndrome can be considered a distinct clinical entity. Clinical features may also include proximal myoclonus and mild progression with aging. Valproate or levetiracetam, with or without clonazepam, reduces symptoms. FCMTE is a heterogeneous disorder, and likely to include a variety of different conditions with mutations of different genes. Distinct phenotypic traits might reflect different genetic mutations. Genes involved in Purkinje cell outgrowth or those encoding for ion channels or neurotransmitters seem good candidate genes.