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Healthcare Policy 16(1) August 2020 : 27-42.doi:10.12927/hcpol.2020.26292
The Role of Social Workers in Interprofessional Primary Healthcare Teams
Vela Tadic, Rachelle Ashcroft, Judith Belle Brown and Simone Dahrouge
Background: In Ontario, Canada, social workers are employed in a number of primary healthcare (PHC) settings such as Community Health Centres (CHCs) and Family Health Teams (FHTs). However, many aspects of social work practice within PHC settings are unknown.
Objectives: The objectives of our study are to determine the amount of social work services provided in CHCs and FHTs, identify the types of services that social workers provide in CHCs and FHTs and ascertain the methods social workers use to deliver services in CHCs and FHTs.
Method: An analysis of a cross-sectional data set obtained from a survey conducted in June 2016 in Ontario was performed.
Results: The majority of practices (84.2%) had a social worker, although several practices also hosted other types of mental health workers. In virtually all practices with social workers, they (and individuals designated as mental healthcare providers) were also involved in practice level efforts to support mental healthcare delivery. In several practices, the care they delivered extended beyond that related directly to mental healthcare, ranging from preventive care and health promotion (64.5%) to palliative care (16.8%). In several practices, these workers also offered group appointments related to healthy behaviour (43.6%) and self-management (~33%).
Interestingly, the role of social workers in practices where they were the sole designated mental healthcare worker was not meaningfully different from practices where other mental health professionals work.
Conclusions: In PHC, social workers deliver or support the delivery of mental healthcare, but their role extends beyond that domain to encompass a broader set of services that contribute to the individual's health and wellbeing.
Canada has a universal healthcare system that covers the majority of healthcare costs, such as physician costs, hospital care and tests, but that public insurance system does not include services by most non-physician healthcare professionals. This lack of insurance for services provided by non-physician healthcare professionals is especially detrimental for those with mental healthcare issues (found in 17% of the Canadian population), the costs for which are often prohibitive to those without private insurance (Corscadden et al. 2019; Sunderland and Findlay 2013). Improving access to mental health services in primary healthcare (PHC) settings can improve care quality, coordination of care and outcomes for patients struggling with mental illnesses (Rush 2014). Team-based care also improves the prevention and management of chronic diseases and is linked to lower costs (Beaulieu et al. 2013; Kates et al. 2011; Kiran et al. 2015).
In Canada, Ontario has led the way in funding interprofessional PHC teams with the introduction of Family Health Teams (FHTs) in 2005 (Brown and Ryan 2018) – which now serve approximately three million Ontarians (22% of the provincial population; Glazier et al. 2012) – and by investing in the expansion of Community Health Centres (CHCs), a PHC model established in the 1970s that serves the more vulnerable segments of the population (Collins et al. 2014; Hastings 1972). Different PHC models are intended to serve different patient populations, community needs and provider preferences (Ashcroft 2015; Glazier et al. 2012; Hutchison and Glazier 2013). In Ontario, FHTs are an example of a professional PHC model that has physicians as the main providers who hold a high level of responsibility; care is preventative, diagnostic and curative; and, historically, FHTs have little community involvement, serving a limited number of enrolled patients (Ashcroft 2015). CHCs are an example of a community PHC model aimed to meet broad health needs of the population from a social determinants perspective and serve their respective neighbourhood catchments (Collins et al. 2014).
Although both FHTs and CHCs are designed to meet local community needs, CHCs have distinct services that enable them to address the broad health needs of the more vulnerable segments of the population that they provide care for (Glazier et al. 2012). For example, compared with FHTs, CHCs typically offer a broader range of health promotion services to address the social determinants of health faced by the disadvantaged populations that they serve and are involved in a range of community engagement activities outside of their practice organization (Glazier et al. 2012). FHTs were established with the intention to improve access to comprehensive healthcare services, interdisciplinary team–based care, patient-centred care and mental health services, as well as to improve services' continuity across other parts of the healthcare system (Ashcroft 2015; Aggarwal 2009; Brown and Ryan 2018). The interprofessional composition within FHTs and CHCs varies from practice to practice, but it typically comprises family physicians, nurses and nurse practitioners, as well as other allied health professionals, such as social workers, pharmacists and dietitians, who provide a range of health and mental health services without the burden of direct costs assumed by the patient (Glazier et al. 2012; Gocan et al. 2014; Marchildon and Hutchison 2016).
Integration of social work in PHC
The absolute numbers of social workers practising in primary care settings across Ontario are currently unknown. Yet, the surge in the emergence of interprofessional teams since the early 2000s has significantly increased the availability of publicly funded social workers in Ontario PHC settings (Ashcroft et al. 2018). For example, social workers now represent the third largest group of interprofessional health professionals in FHTs, following physicians and nurses (Ashcroft et al. 2018). The number of publicly funded social workers in FHTs ranges from approximately 0.4 to 56.7 FTE (Ashcroft et al. 2018), which suggests that some smaller FHTs have one part-time social worker and larger FHTs have hired multiple social workers across multiple sites (Ashcroft et al. 2018). Moreover, the actual number of social workers employed in interprofessional PHC settings is even more difficult to ascertain because some social workers are hired into roles that are explicitly titled "social worker," whereas other similarly trained social workers are employed in PHC settings as a "mental health counsellor" (Kates et al. 2002).
Social work's scope of practice in PHC settings
The biopsychosocial approach, person-in-context philosophy and clinical expertise of social work align well with those of PHC (Ashcroft et al. 2018; Mann et al. 2016; Rabovsky et al. 2017), particularly because patients in PHC settings are increasingly confronted with complex psychosocial and mental health problems that benefit from social work interventions (Mitchell 2008; Van Hook 2003). Social workers assist a range of patient populations and provide services in areas including mental health conditions and addictions, chronic disease, children and youth illnesses, geriatrics illnesses, grief, trauma, parenting issues, palliative care, dementia and other neurological issues, financial stressors, housing issues and a broad range of other general psychosocial issues (Ashcroft et al. 2018; McGregor et al. 2018; Sverker et al. 2017).
Patient care activities of social workers in PHC settings include providing psychosocial assessments and interventions, completing comprehensive risk assessments, providing psychotherapy as well as other types of counselling, making referrals to community resources, supporting medical provider interventions, conducting health promotion activities, engaging in systems navigation and care coordination, providing ongoing case management, improving relationships between the medical provider and the patient, assisting in team building and, at times, assisting in the education and training of other healthcare providers (Ashcroft et al. 2018; Horevitz and Manoleas 2013; McGregor et al. 2018; Sverker et al. 2017). The typical length of appointments with social workers in PHC settings is unknown, although sessions tend to be shorter than sessions in other mental health specialty care contexts (Horevitz and Manoleas 2013).
The delivery of social work services in PHC settings may take on various forms. For example, patient care may occur in-office via direct face-to-face individual, couple and/or family appointments (Kates et al. 2002; Sverker et al. 2017). Social workers in PHC settings may conduct home visits for homebound patients as in the case of palliative and end-of-life care and other types of complex biomedical and psychosocial situations (Reckrey et al. 2014; Steketee et al. 2017). Group services are an alternate mode of care, in which social workers in PHC settings may facilitate a range of different types of psychoeducation or therapeutic group interventions (Ezhumalai et al. 2018; Kates et al. 2002; Steketee et al. 2017). Indirect interventions are also used, where the need for face-to-face contact, such as with completion of referrals and other types of documentation, is less (Horevitz and Manoleas 2013). Social workers may also lead a range of activities within PHC contexts that are not direct patient care interventions such as community development and outreach, some health promotion activities, education and training, supervision and taking on various formal and informal leadership roles (Ashcroft et al. 2018).
Despite the rapid increase of social work services, there is limited information and research conducted on social work in the current PHC context (Ashcroft et al. 2018; Dinh and Bounajm 2013; Mitchell 2008). The purpose of this study is to determine the extent to which social work services are integrated into the current PHC context in Ontario, Canada. The research question guiding our study is as follows: What social work services currently exist in CHCs and FHTs in Ontario, Canada? The objectives of our study are to (i) determine the number of social work services in CHCs and FHTs, (ii) identify the types of services that social workers provide in CHCs and FHTs, and (iii) ascertain the methods social workers use to deliver services in CHCs and FHTs.
Design and context
An analysis of a cross-sectional data set obtained from a primary care setting survey conducted in June 2016 in Ontario, Canada, was perfomed. In Ontario, the Ontario Health Insurance Plan covers most medical care facilities for the entire population, including the primary care services provided by family physicians, but it does not cover the services provided by allied health professionals, including mental health professionals, in the non-acute out-patient setting for most Ontarians. For this reason, and to determine the extent of services provided by allied health professionals, including social workers, a survey was considered as the appropriate method to reach a large number of primary care settings across Ontario. Only patients receiving care at a CHC or FHT may have free access to the services of a social worker or psychologist or other mental healthcare worker if that practice's team comprises such a professional. Thus, our survey targeted CHCs and FHTs because of the integration of allied health professionals within these PHC models.
The survey targeted all primary care settings that provide comprehensive care (i.e., excluding specialized and walk-in clinics) in the province of Ontario. Practice sites working together under a single organization across different geographical locations were considered unique practices and a questionnaire was sent to each. The survey was promoted through the Ontario College of Family Physicians, newsletter. Local Health Integration Network primary care leads were asked to promote the survey within their network of primary care providers. The survey was promoted by the INSPIRE PHC network through their e-mail listserv. Finally, the Ontario Association of Community Health Centres (now the Alliance for Healthier Communities [AOHC]) and the Association of Family Health Teams of Ontario (AFHTO) promoted the survey among their members each by way of membership listserv. The AOHC and AFHTO sent an invitation for their members to complete the survey on three separate occasions. This study is limited to the subset of practices in these interprofessional models. At that time, there were 184 and 73 CHCs and FHTs, respectively. One organization may have a single practice site or be composed of more than one practice site working collaboratively under the same management.
The research tool we relied on was an online survey developed to capture primary care attributes that could be studied for their relationship with the quality of care delivered. The survey was largely based on the "Measuring Organizational Attributes of Primary Health Care" survey developed by the Canadian Institute for Health Information and released in 2013 and the Evolution survey used in Quebec (Levesque et al. 2014; Pineault et al. 2012), and supplemented with additional questions to capture all required information.
Description of variables in the research tool
We assessed the practice's primary care model, team composition and services provided. For the last question, items were divided into services provided during individual appointments, group appointments and practice-level initiatives or programs. The respondent was asked to record whether that service was provided, and by whom. The options provided were doctor, registered nurse or registered nursing assistant, nurse practitioner, pharmacist, dietitian, mental health worker and other. These questions are provided in Appendix 1, available online at (here).
For the question that captured team composition, respondents could identify the presence of social workers and other mental health workers separately. No definition was provided for either term. The section that captured services provided six specified categories (MD, RN/RNA, Nurse Practitioner, Pharmacist, Dietitian and Mental Health Worker) and an Other category for which the respondent was asked to provide details. We created a Social Worker category to capture the sites that had identified that the service was provided by a social worker in the "Other" category. Because there was no Social Worker category available to the respondents, some practices likely recorded the work performed by these professional under the category "Mental Health Worker". PHC practices that included social workers were identified based on the proportion of practices having reported that an activity was performed by an "other mental health worker" yet did not check "mental health workers" in their team profile. Considering the three most commonly reported services for that group, the proportion was as follows: psychosocial services, 69%; primary mental health care, 71%; and prevention and health promotion, 76%. Given that the majority of services captured under Mental Health Worker were likely performed by a social worker, we describe activities having been reported as performed by a "Mental Health Worker" or a "Social Worker" under the "Other (specify)" together for all 101 practices eligible for that analysis. As a sensitivity analysis, we also report on these activities in the subset of 68 practices having indicated that no other mental health workers or psychologists were present in the practice.
Study size
In total, 68 CHCs and 77 FHTs completed at least a portion of the survey. Of these, 10 CHCs and 14 FHTs did not complete the principal section of interest and were excluded, resulting in 58 CHCs and 63 FHTs included in the analyses. The analyses pertaining to a social worker's role are limited to 43 CHCs and 58 FHTs having reported the presence of these professionals.
We reported on proportions and averages for various professionals or of activities performed. Although we provide the data by model, because the intent was to understand these practices' features in the different models, and not to identify differences, we did not conduct statistical comparisons between models.
The survey was completed primarily by an administrative or clinical manager (57.0%) or executive directors (34.7%), although a practice physician, other managerial health professionals, or junior administrative staff were also involved (18.5%) in completing the survey.
Practice description
Of the 121 CHCs and FHTs, 53.7% were part of a multisite organization. Most respondents were from academic sites (70.0%) involved in teaching medical students or residents, situated in the community (93.4%) rather than attached to a tertiary care centre and established at least five years earlier (88%).
The staffing profile in CHCs, FHTs and others is shown in Table 1. Family physicians, nurse practitioners and nurses were the most predominant health professionals at the sites. The majority of practices (83%) reported having at least one social worker on staff, and some practices (18%) had psychologists on staff. Social workers were slightly more common in FHTs, whereas other mental health workers were more common in CHCs. Thirty-one practice sites (approximately 25%) reported having an other mental health worker, a term the survey did not define in more depth. In total, 11 (35.5%) of these 31 practices did not report having a social worker on staff.
TABLE 1. Human resources
Human resources Practices with such a team member Number (%) Full-Time Equivalent Average (SD)
CHC FHTs Overall CHC FHTs Overall
Family Physicians 55 (96.5%) 63 (100%) 118 (98.3%) 3.0 (1.5) 7.8 (5.0) 5.6 (4.4)
Nurse Practitioners 57 (100%) 57 (90.5%) 114 (95.0%) 3.4 (1.8) 2.1 (1.2) 2.5 (1.5)
Registered Nurse 53 (93.0%) 63 (100%) 116 (96.7%) 4.1 (3.0) 3.8 (2.9) 3.9 (2.9)
Social Worker 43 (75.4%) 58 (92.1%) 101 (84.2%) 2.0 (1.5) 1.5 (1.0) 1.7 (1.3)
Psychologist 6 (10.5%) 16 (25.4%) 22 (18.3%) 0.5 (0.4) 0.6 (0.4) 0.6 (0.4)
Other Mental Health Worker 23 (40.4%) 8 (12.7%) 31 (25.8%) 1.7 (1.2) 0.8 (0.8) 1.5 (1.2)
Full-Time Equivalent is calculated for only practices where that team member is present. Registered Nurse includes registered practical nurses.
In the 101 sites that reported having a social worker on staff, the full-time equivalent ratio of social workers to primary care providers (i.e., family physicians or nurse practitioners) was 0.24, although this ratio was considerably lower in FHTs (0.16) than in CHCs (0.34).
Services provision
We limited our analyses to practices reporting having a social worker(s) on staff (n =101). Among these, only 20 practices reported having Other Mental Health Worker on staff. Survey results strongly suggested that, in the absence of a Social Worker category, respondents most likely codified some activities performed by the social worker into the Other Mental Health Worker category. We show the results of the respondents that selected Mental Health Worker or specified that the activity was performed by a social worker under "Other: specify" combined. When the data set is limited to practices without any mental health professional other than the social worker (n =68), the activities' profile is largely unchanged (Table 2). These professionals are commonly involved in direct, one-on-one patient service delivery, and they influenced the programs offered at the practice level. They were less likely to deliver group services.
TABLE 2. Services offered by social workers/mental health workers [practices with social worker(s)only]
Services Percentage of practices offering the service
All practices (N = 101) Practices (N = 68) without other mental health worker or psychologist
Overall CHC FHT Overall
Individual patient appointments
Psychosocial services 95.0 97.7 93.1 92.6
Primary mental healthcare services 90.1 88.4 91.4 85.3
Prevention and health promotion 76.2 65.1 84.5 72.1
Liaison with other healthcare organizations 64.4 65.1 63.8 69.1
Home visits 39.6 48.8 32.8 35.3
Lifestyle counseling 35.6 34.9 36.2 36.8
End-of-life/palliative care 16.8 18.6 15.5 16.2
Lifestyle and healthy living 43.6 39.5 46.6 41.2
Patient self-management plans 33.7 32.6 34.5 32.4
Chronic disease management 31.7 23.3 37.9 26.5
Practice-level initiatives/programs
For patients with mental disorders 93.1 90.7 94.8 89.7
Amount of social work in PHC practices
There is a variation in the amount of social work services integrated across CHCs and FHTs. Although more FHTs are likely to have social workers on site (92.1% vs. 74.1%); however, the FTE is somewhat higher in CHCs than FHTs (2.0 vs. 1.5 FTE). In these practices, the ratio of social worker to FTE primary care providers was 0.24. Given the existing wait-list for social work services in many FHTs and CHCs (Ashcroft et al. 2018), determining the recommended ratio of social work services per family physician or nurse practitioner may help to meet patient care demands (Keefe et al. 2009). Organizational features of a PHC setting have a profound effect on patient care, including the degree to which healthcare providers such as social workers are integrated into the team (Ashcroft et al. 2018; Hogg et al. 2008). Knowing the recommended amount of social work services considered optimal to meet patient care demands in a given PHC setting, and in relation to organizational variations, will aid policy and decision-makers make evidence-based decisions about future resource allocation to meet patient care demands.
Type of services provided by social workers
Social workers provide a broad range of services, including psychosocial care, mental health care, patient education and sometimes end-of-life care, in CHCs and FHTs, with little differences across models. Given that social workers were not involved in the survey completion, we suspect that these represent underestimates of the actual numbers of the types of social work services. For example, given that all of social work services fall under the umbrella of psychosocial care, we would anticipate that psychosocial care would likely be reported at 100% if social workers completed the survey (Ashcroft et al. 2018; Mann et al. 2016; Mitchell 2008; Rabovsky et al. 2017).
Contextual variables such as patient population characteristics, geographical setting and availability of community resources understandably influence the types of services offered in PHC settings (Hogg et al. 2008), including social workers' scope of practice (McGregor et al. 2018; Mitchell 2008; Sverker et al. 2017). Social workers in CHCs and FHTs are providing services to Ontarians with mental health care needs, yet the range of other types of patient populations who are recipients of social work's services such as prevention and health promotion, home visits, lifestyle counselling and chronic disease management remains unclear. Variations exist in the types of social work services provided in different PHC settings in Ontario (Ashcroft et al. 2018), yet the differences that exist between northern and southern regions remain unknown. In addition, it is unknown how the scope of practice of social workers in CHCs and FHTs is developed in relation to existing resources in different communities and the mechanisms in which social workers are liaising with other health organizations.
Methods of care delivery
A range of modalities help deliver social work services in PHC settings (Kates et al. 2002; Sverker et al. 2017). According to our data, a majority of a social work services are being provided via in-office appointments, with the emphasis more on individual appointments than on group appointments. The average length of social work appointment is unknown and was not asked in our survey. The data showed that home visits are being offered by some social workers, although the types of clinical situations and patient characteristics to benefit most from home visits by social workers in CHCs and FHTs remain unknown. Less than half of the practices having a social worker(s) reported that these professionals offered group appointments for lifestyle and healthy living, patient self-management plans and chronic disease management. There may be even more opportunities for social workers to apply their expertise in group appointments than in what currently exists (Ashcroft et al. 2018). Future investigations will help determine the optimal modalities for practice in PHC settings to meet the high demands for social work services, given the increasing patient complexity (Ashcroft et al. 2018; Ashcroft et al. 2019).
Challenges to optimizing integration of social work in PHC
The inclusion of social work in CHCs and FHTs has made a range of services available to PHC that can help improve individual and population health outcomes. However, more data are needed to help demonstrate the impact of social work services on care processes and patient outcomes (Ashcroft et al. 2018). For example, research has shown that patients of FHTs experienced considerable improvement in diabetes care over time compared to patients of primary care physicians who were not a part of an interprofessional team (Kiran et al. 2015); yet contributions of social work, if any, to these or other types of patient outcomes despite their involvement in providing lifestyle counselling, helping with patient self-management planning and engaging in chronic disease management activities, are unknown. One of the challenges is that it is difficult to capture social work's contributions to care in administrative databases that are used to determine the population-based impact of care. Only recently has CHC interprofessional team data, including data on social work and the patients they serve, become available. Outcome data was beyond the scope of this study, although we recommend that leaders and social workers in PHC settings integrate the collection of data within the practice setting to help highlight the impact social workers are having on patient care and health outcomes. We encourage academic FHTs and CHCs to make this integration a priority, given their capacity for research.
The integration of social work in PHC has expanded substantially because of a systematic pan-Canadian PHC reform that began in the early 2000s (Ashcroft et al. 2018). Considerable investments have been made, leading to the accelerated inclusion of social workers in PHC settings in Ontario and elsewhere across Canada (Ashcroft 2015; Ashcroft et al. 2018; Hutchison et al. 2011). Now that social workers are flourishing in numbers in PHC settings (Ashcroft 2015; Ashcroft et al. 2018), our study suggests that there is an opportunity for key stakeholders to determine how best to sustain the social workers currently embedded in PHC practices, to maximize their contributions in patient care. This suggestion is particularly timely, given the recent provincial policy priorities to enhance patient access to mental health services, which directly align with social workers' scope of practice in PHC settings (The Canadian Press 2020).
In a previous study, social workers indicated that some leaders have a limited understanding of social workers' roles in PHC settings (Ashcroft et al. 2018). Despite the limitation, we felt that it was important to carry out this study because the participants who completed our survey are the same leaders in PHC settings making influential decisions on the number of social workers to employ in a practice, the types of activities that fall within a social worker's role within their practice setting and the modes of service delivery that are permitted and encouraged. Despite the gaps of having non–social workers as respondents, our survey provides an opportunity to provide an understanding from a perspective that highly influences social work's role in PHC settings (Ambrose-Miller and Ashcroft 2016; Ashcroft et al. 2018).
There are two key limitations for consideration. Using a survey to answer our research question meant that the range of responses and the depth of understanding of social workers' roles are limited to categories within the survey itself. The second limitation is that the survey relied on participants who are non–social workers and who may not be able to fully articulate the amount, range or methods used to deliver social work services in PHC settings (Ashcroft et al. 2018).
Our study raises additional recommendations for social work practitioners, educators and researchers. Role clarity is essential for team collaboration and for ensuring that social workers in PHC settings are contributing to patient care at an optimal level by providing the most effective types of services (Ambrose-Miller and Ashcroft 2016). We encourage social workers to identify themselves as social workers even when not hired in the role that has the social work title (such as mental health counsellor). Doing so will help clarify the scope of practice to patients, other team members and administrators (Ambrose-Miller and Ashcroft 2016). We also encourage PHC leaders to hire social workers in roles using the formal title "Social Worker" instead of the general term "Mental Health Counsellor." Furthermore, where applicable, we advise that the job title of social worker be taken into consideration and included in collective agreements. Any person who uses the title "Social Worker" or "Registered Social Worker" is registered with a provincial social work regulatory body, which then provides some assurance for educational requirements and performance standards that guide scopes of practice (Collins et al. 2002). There is substantial value in having PHC professional organizations (e.g., AFHTO and the Ontario College of Family Physicians) and social work professional organizations (e.g., Ontario Association of Social Workers) collaborate to help determine how to maximize social workers' scope of practice in PHC settings. The reason for this is because healthcare is a complex system, and by effectively nurturing the ongoing integration of social work in PHC settings, local PHC leaders will benefit from ongoing direction and supportive infrastructure at a macro level (Corrigan et al. 2017; Sørensen et al. 2018).
Educators have a role to ensure that social workers are prepared to provide a range of services using multiple modalities that are required in comprehensive and fast-paced PHC settings (Horevitz and Manoleas 2013). Academic practice sites are well-positioned to facilitate educational opportunities for social work students, given their long history of training medical students and family medicine residents (Soklaridis et al. 2007). Early exposure to PHC teams, and learning in "real time" (with trainees from other disciplines), can increase the social work practice readiness in primary care settings (de Saxe Zerden et al. 2018). Further embedding social work within the training provided at academic practices will better prepare students from other disciplinary backgrounds for collaborative care practices inherent to PHC (de Saxe Zerden et al. 2018). When social work students are included in interprofessional training opportunities, students from other disciplinary perspectives gain a greater understanding of group process, improve communication skills for difficult conversations, feel more confident when encountering adversity and improve group decision-making abilities – which leads to better patient care outcomes (Charles et al. 2011; Reeves et al. 2017). We encourage the academic practice sites involved in our study to also prioritize education and training of social workers.
We recommend that researchers develop surveys in a way that can capture social workers' contributions in PHC settings. Complexities exist in doing so because of the many roles assumed by social workers in PHC settings. For example, many mental health worker positions are held by a social worker. It is challenging for surveys to capture person-centred, relational and multipronged approaches of social work unless these are designed from the outset with this particular intent. Future research can help determine the most optimal types of activities, approaches and delivery modalities for social workers to use, to best address the needs of increasingly complex patient issues within the current PHC context.
Rôle des travailleurs sociaux dans les équipes interprofessionnelles de soins primaires
Contexte : En Ontario, au Canada, des travailleurs sociaux sont employés dans nombre d'organismes de soins de santé primaires (SSP) tels que les centres de santé communautaire (CSC) et les équipes Santé familiale (ESF). Toutefois, plusieurs aspects du travail social au sein des organismes de SSP demeurent inconnus.
Objectif : L'objectif de notre étude est de déterminer la quantité de services en travail social proposé dans les CSC et les ESF, d'identifier le type de services offerts par les travailleurs sociaux et de connaître les méthodes employées par ceux-ci pour offrir leurs services.
Méthode : Nous avons procédé à l'analyse d'un ensemble de données transversales obtenues au moyen d'une enquête menée en Ontario, en juin 2016.
Résultats : Il y a un travailleur social dans la majorité des organismes (84,2 %), mais plusieurs organismes comptent aussi sur la présence d'autres types d'intervenants en santé mentale. Dans pratiquement tous les organismes qui offrent des services de travail social, ces derniers – et les personnes désignées comme prestataires de services en santé mentale – sont aussi impliqués dans les efforts de l'organisme pour appuyer la prestation de soins de santé mentale. Dans plusieurs organismes, les services qu'ils offrent débordent les soins directement liés à la santé mentale, allant d'activités de promotion de la santé et des soins préventifs (64,5 %) aux soins palliatifs (16,8 %). Dans plusieurs organismes, ces travailleurs animent aussi des groupes pour favoriser les comportements sains (43,6 %) et l'autogestion (~33 %).
Il est intéressant de constater que le rôle du travailleur social n'est pas significativement différent entre les organismes où il constitue le seul travailleur désigné pour les services de santé mentale et ceux où travaillent aussi d'autres professionnels de la santé mentale.
Conclusion : Dans les SSP, les travailleurs sociaux offrent des services de santé mentale ou y contribuent, mais leur rôle s'étend au-delà de ce domaine et comprend un plus large éventail de services qui favorisent le bien-être et la santé des individus.
Vela Tadic, MSW, Executive Director, Bruyère Academic Family Health Team, Ottawa, ON
Rachelle Ashcroft, PHD, Assistant Professor, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON
Judith Belle Brown, PHD, Professor, Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON
Simone Dahrouge, PHD, Scientist, Bruyère Research Institute, C.T. Lamont Primary Health Care Research Centre, University of Ottawa, Ottawa, ON
Correspondence may be directed to: Rachelle Ashcroft, PhD, Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4. She can be reached by phone at 416-978-6314 or by e-mail atrachelle.ashcroft@utoronto.ca
We are very grateful to Jennifer Rayner (Alliance for Healthier Communities) and Carol Mulder (formerly Association of Family Health Teams of Ontario [AFHTO]) for their invaluable support in the delivery of the survey, and to Laura Belsito (AFHTO) and Drs. Rayner and Mulder for reviewing the manuscript. Thank you to the Transdisciplinary Understanding and Training on Research Primary Health Care (TUTOR-PHC) program, which supported the involvement of Vela Tadic in this research as part of her TUTOR-PHC traineeship.
Aggarwal, M. 2009. Primary Care Reform: A Case Study of Ontario [doctoral dissertation]. Retrieved July 28, 2020. <https://tspace.library.utoronto.ca/bitstream/1807/17722/1/Aggarwal_Monica_200906_PhD_thesis.pdf>.
Ambrose-Miller, W. and R. Ashcroft. 2016. Challenges Faced by Social Workers as Members of Collaborative Health Care Teams.Health & Social Work41(2): 101–09. doi:10.1093/hsw/hlw006.
Ashcroft, R. 2015. Ontario's Family Health Teams: Politics Within the Model.Canadian Social Work Revie.32(1-2): 117–32. doi: 10.7202/1034146ar.
Ashcroft, R., C. McMillan, W. Ambrose-Miller, R. McKee and J.B. Brown. 2018. The Emerging Role of Social Work in Primary Health Care: A Survey of Social Workers in Ontario Family Health Teams.Health & Social Work43(2): 109–17. doi:10.1093/hsw/hly003.
Ashcroft, R., T. Kourgiantakis, G. Fearing, T. Robertson and J.B. Brown. 2019. Social Work's Scope of Practice in Primary Mental Health Care: A Scoping Review.British Journal of Social Wor.49(2): 318–34. doi:10.1093/bjsw/bcy051.
Beaulieu, M.D., J. Haggerty, P. Tousignant, J. Barnsley, W. Hogg, R. Geneau et al. 2013. Characteristics of Primary Care Practices Associated with High Quality of Care.CMAJ185(12): E590–96. doi:10.1503/cmaj.121802.
Brown, J.B. and B. Ryan. 2018. Processes that Influence the Evolution of Family Health Teams.Canadian Family Physicia.64(6): e283–e289.
Charles, G., C.V. Barring and S. Lake. 2011. What's In It for Us? Making the Case for Interprofessional Field Education Experiences for Social Work Students.Journal of Teaching in Social Work31(5): 579–93. doi:10.1080/08841233.2011.615265.
Collins, D., H. Coleman and P. Miller. 2002. Regulation of Social Work. A Confusing Landscape.Canadian Social Work Review/Revue canadienne de service social19(2): 205–25.
Collins, P., S. Resendes and J. Dunn. 2014. The Untold Story: Examining Ontario's Community Health Centres' Initiatives to Address Upstream Determinants of Health.Healthcare Policy10(1): 14–29. doi:10.12927/hcpol.2014.23977.
Corrigan, M.J., K. Krase and J.C. Reed. 2017. A Social Work Response to the Affordable Care Act: Prevention and Early Intervention.Journal of Psychoactive Drug.49(2): 169–73. doi:10.1080/02791072.2017.1295333.
Corscadden, L., E. Callander and S. Topp. 2019. Who Experiences Unmet Needs for Mental Health Services and What Other Barriers to Accessing Health Care Do They Face? Findings from Australia and Canada.The International Journal of Health Planning and Management34(2): 761–72. doi:10.1002/hpm.2733.
Dihn, T. and F. Bounajm. 2013.Improving Primary Health Care through Collaboration: Measuring the Missed Opportunity. The Conference Board of Canada. Retrieved July 27, 2020. <http://www.integrationresources.ca/wordpress/wp-content/uploads/2013/09/D43_PrimaryHealthCare_Briefing_3.pdf>.
de Saxe Zerden, L., M. Lombardi, M. Fraser, A. Jones and Y. Rico. 2018. Social Work: Integral to Interprofessional Education and Integrated Practice.Journal of Interprofessional Education and Practice10: 67–75. doi:10.1016/j.xjep.2017.12.011.
Ezhumalai, S., D. Muralidhar, R. Dhanasekarapandian and B. Nikketha. 2018. Group Interventions.Indian Journal of Psychiatry60(4): S514–21. doi:10.4103/psychiatry.IndianJPsychiatry_42_18.
Glazier, R., B. Zagorski and J. Rayner. 2012, March. Comparison of Primary Care Models in Ontario by Demographics, Case Mix and Emergency Department Use, 2008/09 to 2009/10. Institute for Clinical and Evaluative Sciences. Retrieved July 16, 2020. <https://www.ices.on.ca/Publications/Atlases-and-Reports/2012/Comparison-of-Primary-Care-Models>.
Gocan, S., M.A. Laplante and K. Woodend. 2014. Interprofessional Collaboration in Ontario's Family Health Teams: A Review of the Literature.Journal of Interprofessional Practice and Education3(3): 1–19. doi:10.22230/jripe.2014v3n3a131.
Hastings, J.E.F. 1972. The Community Health Centre in Canada. Information Canada.
Hogg, W., M. Rowan, G. Russell, R. Geneau and L. Muldoon. 2008. Framework for Primary Care Organizations: The Importance of a Structural Domain.International Journal for Quality in Health Car.20(5): 308–13. doi:10.1093/intqhc/mzm054.
Horevitz, E. and P. Manoleas. 2013. Professional Competencies and Training Needs of Professional Social Workers in Integrated Behavioral Health in Primary Care.Social Work in Health Car.52(8): 752–87. doi:10.1080/00981389.2013.791362.
Hutchison, B., J.F. Levesque, E. Strumpf and N. Coyle. 2011. Primary Health Care in Canada: Systems in Motion.The Milbank Quarterly89(2): 256–88. doi:10.1111/j.1468-0009.2011.00628.x.
Hutchison, B. and R. Glazier. 2013. Ontario's Primary Care Reforms Have Transformed the Local Care Landscape, But a Plan is Needed for Ongoing Improvement.Health Affair.32(4): 695–703. doi:10.1377/hlthaff.2012.1087.
Kates, N., A.M. Crustolo, S. Farrar and L. Nikolaou. 2002. Counsellors in Primary Care: Benefits and Lessons Learned.Canadian Journal of Psychiatr.47(9): 857–62. doi:10.1177/070674370204700907.
Kates, N., G. Mazowita, F. Lemire, A. Jayabarathan, R. Bland, P. Selby et al. 2011. The Evolution of Collaborative Mental Health Care in Canada: A Shared Vision for the Future.Canadian Journal of Psychiatry56(5): 1–10.
Keefe, B., S.M. Geron and S. Enguidanos. 2009. Integrating Social Workers into Primary Care: Physician and Nurse Perceptions of Roles, Benefits, and Challenges.Social Work in Health Car.48(6): 579–96. doi:10.1080/00981380902765592.
Kiran, T., A. Kopp, R. Moineddin and R. Glazier. 2015. Longitudinal Evaluation of Physician Payment Reform and Team-Based Care for Chronic Disease Management and Prevention.CMA.187(17): E494–502. doi:10.1503/cmaj.150579.
Levesque, J.F., S. Descôteaux, N. Demers and M. Benigeri. 2014, February.Measuring Organizational Attributes of Primary Healthcare: A Scanning Study of Measurement Items Used in International Questionnaires.Institut national de santé publique. Retrieved March 18, 2020. <https://www.inspq.qc.ca/pdf/publications/1857_Measuring_Organizational_Primary_HealthCare.pdf>.
Mann, C.C., J.H. Golden, N.J. Cronk, J.K. Gale, T. Hogan and K.T. Washington. 2016. Social Workers as Behavioral Health Consultants in the Primary Care Clinic.Health & Social Work41(3): 196–200. doi:10.1093/hsw/hlw027.
Marchildon, G.P. and B. Hutchison. 2016. Primary Care in Ontario, Canada: New Proposals After 15 Years of Reform.Health Policy120(7): 732–38. doi:10.1016/j.healthpol.2016.04.010.
McGregor, J., S.W. Mercer and F.M. Harris. 2018. Health Benefits of Primary Care Social Work for Adults with Complex Health and Social Needs: A Systematic Review.Health and Social Care26(1): 1–13. doi:10.1111/hsc.12337.
Mitchell, P. 2008. Mental Health Care Roles of Non-Medical Primary Health and Social Care Services.Health and Social Care in the Community17(1): 71–82. doi:10.1111/j.1365-2524.2008.00800.x.
Pineault, R., J.F. Levesque, M. Hamel, S. Provost, P. Tousignant, A. Couture et al. 2012. L'accessibilité et la continuité des services de santé : une étude sur la première ligne au québec rapport de recherche. Soumis aux instituts de recherche en santé du Canada (IRSC) et à la fondation canadienne de la recherché sur les services de santé (FCRSS). Retrieved July 7, 2020. <https://www.inspq.qc.ca/pdf/publications/777_ServicesPremLignes.pdf>.
Rabovsky, A., M. Rothberg, S. Rose, A. Brateanu, L. Kou and A. Misra-Hebert. 2017. Content and Outcomes of Social Work Consultation for Patients with Diabetes in Primary Care.Journal of the American Board of Family Medicine30(1): 35–43. doi:10.3122/jabfm.2017.01.160177.
Reckrey, J.M., G. Gettenberg, H. Ross, V. Kopke, T. Soriano and K. Ornstein. 2014. The Critical Role of Social Workers in Home Based Primary Care.Social Work Health Car.53(4): 330–43. doi:10.1080/00981389.2014.884041.
Reeves, S., F. Pelone, R. Harrison, J. Goldman and M. Zwarenstein. 2017. Interprofessional Collaboration to Improve Professional Practice and Healthcare Outcomes.Cochrane Database of Systematic Reviews6(6): CD000072. doi:10.1002/14651858.CD000072.pub3.
Rush, B. 2014. Evaluating the Complex: Alternative Models and Measures for Evaluating Collaboration among Substance Use Services with Mental Health, Primary Care and Other Services and Sectors.Nordic Studies on Alcohol and Drugs31(1): 27–44. doi:10.2478/nsad-2014-0003.
Soklaridis, S., I. Oandasan and S. Kimpton. 2007. Family Health Teams: Can Health Professionals Learn to Work Together?Canadian Family Physician53(7): 1198–99.
Sørensen, M., U. Stenberg and L. Garnweidner-Holme. 2018. A Scoping Review of Facilitators of Multi-professional Collaboration in Primary Care.International Journal of Integrated Car.18(3): 13. doi:10.5334/ijic.3959.
Steketee, G., A.M. Ross and M.K. Wachman. 2017. Health Outcomes and Costs of Social Work Services: A Systematic Review.American Journal of Public Health107(S3): S256–66. doi:10.2105/AJPH.2017.304004.
Sunderland, A. and L. Findlay. 2013. Perceived Need for Mental Health Care in Canada: Results from the 2012 Canadian Community Health Survey – Mental Health.Health Reports24(9): 3–9.
Sverker, A., G. Östlund, M. Börjeson, M. Hägerström and C. Gåfvels. 2017. The Importance of Social Work in Healthcare for Individuals with Rheumatoid Arthritis.Quality in Primary Care25(3): 138–47.
The Canadian Press. 2020, March 3. Ontario Revamping Mental Health Services.CityNews. Retrieved March 18, 2020. <https://toronto.citynews.ca/2020/03/03/ontario-mental-health-services/>.
Van Hook, M. 2003. Psychosocial Issues Within Primary Health Care Settings: Challenges and Opportunities for Social Work Practice.Social Work in Health Care38(1): 63–80. doi:10.1300/J010v38n01_04.
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Testing replacement of drives in hardware-based RAID systems
Hard disc drives are becoming more reliable, often achieving a Mean Time To Failure (MTTF) of up to 2.5 million hours and carrying a warranty of up to five years. In practice, this means that a storage system comprising 1000 identical hard drives should only expect two or three drives to fail during one year within the warranty period.
However, a few drives may still fail and once this occurs they must be replaced. If identical drives are available, either through inventory or a limited spares manufacturing program by the manufacturer then simple replacement is possible. Once it is no longer possible to source identical drives then drives with slightly different characteristics, such as later models must be used if possible. The challenge for IT managers is to understand which drives would work as suitable replacements in existing systems.
This challenge is more difficult for hardware controlled RAID systems. In order to promote a better understanding of the issue, Toshiba undertook some testing using some common RAID controllers including Broadcom's LSI "MegaRAID SAS 9380" and the new Microsemi Adaptec "SmartRAID 3154", which are considered functionally compatible with Adaptec's "Series7" and "Series8" models.
A total of ten tests were performed using a RAID5 configuration consisting of four identical hard drives connected to either the Broadcom or Adaptec RAID controller. To simulate the scenario where a replacement was necessary, one hard drive was then replaced. It was then checked as to whether this drive had been accepted by the controller, whether a rebuild had been successfully completed and whether system performance was maintained.
At the end of the testing, Toshiba concluded that there is some flexibility when replacing failed disk drives in a RAID set. It is possible to replace 512n drives with 512e models as well as larger capacity or third-party models. Additionally, outdated SAS 6Gbit/s hard drives can be replaced with new models featuring a 12Gbit/s interface as the 12Gbit/s model is backwards compatible with the 6Gbit/s standard. However, it should be noted that 512n/512e models are not compatible with 4kn models. In addition, certain RAID controllers even allow replacement of SATA drives with SAS models and replacement of hard drives with SSDs. However, just because these configurations are supported by the RAID controller this does not mean they should be implemented in practice.
Toshiba has authored a report with full details of each test and its outcome.
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« The Week Ahead. January 24 – 30, 2011.
When my silence gets read by others, their voice comes unstitched over mine.
This work was supported by Dance Theater Workshop's Studio Series Residency Program and David Hurwith/ Ritual and Research, which provided a residency for this work.
Taking this common practice, in this our Internet world, I want to approach, first, the question of what are we signing in for and what is involved in this one-click action, even if I don't use technology for this. The other side of it would be the old practice of a signature, which could be an identity, license, agreement, etc. So I will use this excuse and aesthetics image to work in a movement piece related with social conventions that I'm trying to deal with.
Renée Archibald's choreographic work has been presented at venues including Danspace Project, Dixon Place, The Brooklyn Museum, The Chocolate Factory, in Dance Theater Workshop's Fresh Tracks Series, The Kitchen's Dance and Process, and Sugar Salon at Abron's Art Center. She has performed with Christopher Williams, Ann Liv Young, Alex Escalante, and Rebecca Lazier among others and holds a BFA from University of North Carolina School of the Arts. Currently, Renée is a first year MFA candidate in the dance department at University of Illinois, Urbana-Champaign and is grateful for Movement Research's support.
Jillian Peña is a dance and video artist primarily concerned with confusion and desire between self and other. Her work is in dialogue with psychoanalysis, queer theory, pop media, and spirituality. She has been presented internationally, including at Dance Theater Workshop and The Kitchen in New York, Akademie der Kunste Berlin, Centre for Contemporary Arts Glasgow, and Mix Brazil Sao Paulo. As a dancer, Jillian has enjoyed performing with Jennifer Allen, Ann Liv Young, Beth Gill, and Eleanor Bauer. She has an MFA from the School of the Art Institute of Chicago, where she was a fellowship recipient, and a BA from Hollins University. Jillian is a Jack Kent Cooke Graduate Scholar and a Practice-based PhD candidate in Fine Art at Goldsmiths College, University of London. Her video work is distributed by Video Data Bank. She is a Movement Research Artist-in-Residence 2009, and a 2009 DanceWeb Fellow at Impulstanz in Vienna.
These works are supported by the Movement Research Artist-in-Residence Program funded, in part, by the Leonard and Sophie David Fund.
Bauer is super, I really wish they should hurry up with the final film if they're going to product it!


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Microsoft sends invites to a 'small' Surface event on May 20th
Josh Ong
Microsoft today sent out press invites to a private event for its Surface tablet line on May 20th in New York City.
The text of the invite says "Join us for a small gathering," hinting at the announcement of the rumored Surface Mini device.
Microsoft is said to have been working on a smaller-screened Surface for some time now in preparation for release this Spring. The tablet is expected to run on the ARM/Windows RT architecture and feature a screen that's between 7 to 8 inches.
In addition to its Surface event, Microsoft is gearing up to release Windows Phone 8.1 later this month.
Thumbnail credit: TIMOTHY A. CLARY/AFP/Getty Images
Published May 5, 2014 — 23:47 UTC
May 5, 2014 — 23:47 UTC


Make a statement with this modern artisan crafted pendant. Cast in high purity Argentium 960, 100% recycled silver, this pendant measures 22mm x 6mm (7/8" x 1/4") and is channel set with three beautiful 4mm Chatham Blue Sapphires.
My wife loves here new necklace. Shipping was prompt. I'm very happy.
This necklace is beautiful, even prettier than the picture!
It is wonderful and perfect!


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810 Memorial Dr #13,276 RSF, Cambridge, MA, 02139
Listing Agent: Patrick Verbeke | Agent phone: 617-230-3638
Courtesy of: Keller Williams Realty Boston Northwest | Office phone: 617-497-8900
Address: 810 Memorial Dr #13,276 RSF
City: Cambridge
Neighborhood: Cambridgeport
Property Taxes: $316,571
Tax Amount: $316,571
13,276 RSF (subdividable) office space for lease on the 2nd floor. Wheelchair accessible elevator building recently renovated (new cladding, windows, mechanicals, elevator, and lobby). Views of the Charles River. Easy access to I-90. 0.7 mile to Central Square T station o the MBTA red line ("brain line"). Bus stop in front of the building (70 and 64). On-site garage parking (2/1,000 SF) and bike storage. Zipcar locations nearby. 810 Memorial Drive offers 24-hour key card access and on-site property management, maintenance, and security. Amenities include a fitness center. Location at the crossroads of MIT, Harvard and Boston University. The property is surrounded by Whole Foods, Trader Joe's, Alive and Kicking Lobsters, Riverside Café, Dunkin', Sub Zero Nitrogen Ice Cream, and Micro Center. Nearby hotels include DoubleTree, Courtyard, and Sheraton. Reach the Charles River within a short walk and several parks, including Riverside Press Park, Alberico Park, and Magazine Beach Park.
Listing Agent: Patrick Verbeke Agent phone: 617-230-3638 Courtesy of: Keller Williams Realty Boston Northwest Office phone: 617-497-8900 The property listing data and information, or the Images, set forth herein were provided to MLS Property Information Network, Inc. from third party sources, including sellers, lessors, landlords and public records, and were compiled by MLS Property Information Network, Inc. The property listing data and information, and the Images, are for the personal, non commercial use of consumers having a good faith interest in purchasing, leasing or renting listed properties of the type displayed to them and may not be used for any purpose other than to identify prospective properties which such consumers may have a good faith interest in purchasing, leasing or renting. MLS Property Information Network, Inc. and its subscribers disclaim any and all representations and warranties as to the accuracy of the property listing data and information, or as to the accuracy of any of the Images, set forth herein. Privacy Policy Notice: All information collected voluntarily from you will be used to personalize your experience, improve our website and improve our customer service. This information will not be shared with any other third persons or entities. Updated: 31st January, 2023 7:47 PM (UTC)


When Is a Due Date Not Really a Due Date? Reviewing Indiana Medicaid Revalidations | CIPROMS, Inc.
Indiana Medicaid recently published a new list of providers who must revalidate their enrollment. The list, available for download from the Indiana Medicaid website, includes providers with due dates over the next several months, through December 2018 according to the file name, though many providers also are listed with dates beyond December 2018.
According to Indiana Health Coverage Programs (IHCP), when it is time to revalidate their enrollment, providers will receive notification letters at 90 days and 60 days in advance of the revalidation due date. Notices are sent to the mail-to address indicated on the provider's service location profile and also included as a reminder on the home page of their Provider Account on IHCP's Provider Healthcare Portal. Providers with multiple service locations must revalidate the enrollment of each service location and will receive notification for each separately.
Timing is everything when it comes to revalidating enrollment. Providers are not allowed to revalidate until they receive their notification letter, but providers who fail to revalidate in a timely manner will be disenrolled from participation in the IHCP.
Also, according to Denise O'Brien, CIPROMS Director of Provider Enrollment, the due date isn't really the due date.
As a result, providers should ensure their mail-to address is up-to-date on the Provider Healthcare Portal so they receive the revalidation notification letters in a timely manner. Additionally, providers should frequently check the list of Indiana Medicaid revalidation due dates to ensure they haven't missed receiving their notification letters. If the due date indicated on the published list is within 90 days, providers should assume a letter has been mailed and proceed with revalidating their enrollment.
Providers who find themselves disenrolled from Medicaid because of a failure to revalidate in a timely manner will need to re-enroll with the IHCP, which could result in a gap in eligibility.
Providers who wish to revalidate on paper must use the appropriate IHCP provider packet—the same as is required at initial enrollment. There is not a separate revalidation form, so providers will need to indicate "Revalidate Enrollment" in field 1 on Schedule A under Type of Request.
Only certain types of providers must pay a revalidation fee. Review the IHCP Provider Enrollment Risk Category and Application Fee Matrix to determine whether an application fee is required by your provider type, along with additional screening criteria that may apply to your provider specialty during revalidation.
Medicaid revalidation is mandated for most healthcare providers at least every five years by the Centers for Medicare and Medicaid Services (CMS). Durable medical equipment (DME) and home medical equipment (HME) providers, including pharmacy providers with DME or HME specialty enrollments, must revalidate enrollment at least every three years. For more information about provider enrollment revalidation, see the Provider Enrollment provider reference module or visit the Provider Enrollment Revalidation page on the Indiana Medicaid website.


text:
The Luxury Rebound — Brace, Brace, a New Era of Exuberance Has Started
Erwan Rambourg
The pandemic is far from over but luxury demand has already moved on to the next phase of growth, so expect to be surprised. Photo: Courtesy of Tiffany & Co.
Human nature — and some favorable macro-economic factors — have led to a rebound of luxury sales growth already towards the end of last year.
As we lap the early impacts of the pandemic spread from February-March 2020, growth should mechanically be very high, a counterintuitive reality given the world remains broadly restricted and travel still shut down.
Purchases could become more mindful, more skewed to bigger brands and bestselling items with more demanding consumers but expect exuberance of growth to take you by surprise.
A surprising late 2020 rebound
A year ago, I was happily meetings friends and clients, going out to restaurants, and enjoying life in the Big Apple. And then, mid-March, everything suddenly shutdown, and I have been working from home ever since and reading articles about the great New York exodus, how the city would never be the same again, and how maybe, according to one New York Post article, it is the case that "New York City is dead forever."
To be sure, the city is clearly not the lively one I grew up in, as friends flying in from less restrictive states (think Florida) always remind me, commenting on how dull it now feels. So all of this grim reality should tell us luxury demand has evaporated in New York, right? Wrong! Chanel, Dior, Louis Vuitton, and Tiffany are all still bustling. Why?
Human nature prevails, of course. Wealthy consumers, stuck at home, have come back to spend on luxury. True, they have been incentivized to do so, as they entered the pandemic being wealthy, plus a combination of favorable equity markets, secondary property markets and staycationing has enabled them to feel even more wealthy. But even before financial considerations, human nature has prevailed retailers talking to "a survival trade," i.e., "I've been through this, it's ok to reward myself." What happened in New York with local clienteles, and in parts of Europe with locals there as well, is not too dissimilar to what happened in mainland China a lot earlier on in 2020.
Even more surprising to the brands was the rebound of Western consumers given very few would have imagined them to be so engaged and motivated to purchase luxury goods while circumstances remain so dire. Sure, there are exceptions. The UK vaccination roll out, for instance, has been impressive. But in most of the Western world, restrictions are still painful (think France) and COVID-19 fatalities remain saddening high (think US). And yet the rebound has started.
Recommended ReadingAbsent Chinese Tourists Impact Western LuxuryBy Adina-Laura Achim
"Anniversarying" the shock
Go back to the pandemic timeline and you will remember that by last February, most of China's stores were shut and by mid-March both Europe and the US as well. You don't need to be a math guru to understand that if luxury sales for any given brand were halved in the March-May period last year, all things being equal this year, they should double. The media tends to sensationalize what otherwise should just be a logical outcome. Last April, the press was all about how an Hermès Guangzhou store beat record sales when it reopened post-pandemic.
Well, considering Chinese citizens had bought nothing for two months and, more importantly, that most sales to Chinese nationals used to take place abroad — but now going abroad was an impossibility with all borders being shut — what was optically incredible was just plain logical. Similarly, if brands double their sales in the March-May 2021 period year-over-year, the media will likely highlight "astonishing sales," when we will just have gone back to 2019 levels, plain and simple. And, as I just published my book, Future Luxe, discussing a strong decade of post COVID-19 growth for luxury, I could go around on a "I told you so" tour, but I won't…
Not just about the optics
All in, the optics will look good this year for the luxury industry. But beyond the optics, luxury has emerged as being way more important to wealthy individuals' lives than we could have imagined. Sure, big brands with iconic ranges are outperforming, while smaller, independent companies struggle. Sure, consumers are asking more questions and greenwashing is making way to ensure a proper conscience. But beyond the 2021 rebound, I remain confident that luxury demand can thrive. The crisis has improved the quality of management and sales staff in the sector, the level of knowledge and engagement to consumers and, as I discussed last week, a shift from product to purpose will make the relationship between brands and consumers that much stronger. Luxury is by definition something you don't need but it changes your perspective, puts a smile on your face, makes you hopeful and enthused and we still need that right now.
Erwan Rambourg has been a top-ranked analyst covering the luxury and sporting goods sectors. After eight years as a Marketing Manager in the luxury industry, notably for LVMH and Richemont, he is now a Managing Director and Global Head of Consumer & Retail equity research. He is also the author of Future Luxe: What's Ahead for the Business of Luxury (2020) and The Bling Dynasty: Why the Reign of Chinese Luxury Shoppers Has Only Just Begun (2014).
The Luxe Decade
Covid-19, dior, greenwashing, hermes, iconic products, louis vuitton, new york city, The Luxe Decade, Western rebound
Sky's the Limit — Why Size Is Really Not an Issue for the Big Luxury Brands
Faster, Higher, Stronger, Together — Why Luxury Records will be Broken in 2022
Brave New World: How 2021 Was a Useful Reset for Luxury
Talking About My Generation: What Virgil Abloh and Others Have Done to Connect Youth to Luxury


text:
Q: COALESCE mysql trigger returning wrong value I'm new to mysql triggers. just getting my head around things so I understand if something may not be coded correctly or the most efficient route :)
What i'm trying to do is after a database entry has been added to join the tables via values submitted to create a text string for fulltext search as I can't fulltext search across multiple tables. I can get the sentence I want by adding ,' ', after each IF statements to get the space in between values but I would prefer + space(1) because if the value is null then there would be an unnecessary space. However the + space(1) or + ' ' functions seems to throw a zero back rather than the value + a space.
The undefined action is to avoid the default value appearing in the sentence created.
Hope it makes sense, hard to explain!
my code is as follows:
CREATE TRIGGER `tz_search_term_update` AFTER INSERT
ON `live_db`.`tz_product`
FOR EACH ROW BEGIN
    INSERT into tz_search (listing_id) VALUES (NEW.id);
    UPDATE tz_search search
    INNER JOIN tz_product product ON search.listing_id = product.listing_id
    INNER JOIN product_data_make make ON product.make = make.id
    INNER JOIN product_data_model model ON product.model = model.id
    INNER JOIN product_data_colour colour ON product.colour = colour.id
    INNER JOIN product_data_condition cond ON product.cond = cond.id
    INNER JOIN product_data_simstatus sim ON product.sim = sim.id
    INNER JOIN product_data_spec spec ON product.spec = spec.id
    INNER JOIN product_data_capacity capacity ON product.capacity = capacity.id
    SET search.term = CONCAT(
        IF(make.make_name = 'Unspecified', '', COALESCE(make.make_name + space(1),'')),
        IF(model.model_name = 'Unspecified', '', COALESCE(model.model_name + space(1),'')),
        IF(colour.colour_name = 'Unspecified', '', COALESCE(colour.colour_name + space(1),'')),
        IF(sim.simstatus_name = 'Unspecified', '', COALESCE(sim.simstatus_name + space(1),'')),
        IF(spec.spec_name = 'Unspecified', '', COALESCE(spec.spec_name + space(1),'')),
        IF(cond.condition_name = 'Unspecified', '', COALESCE(cond.condition_name + space(1),'')),
        IF(capacity.capacity_name = 'Unspecified', '', COALESCE(capacity.capacity_name,'')))
    WHERE search.listing_id = NEW.listing_id;
END

A: Use CONCAT function for appending strings. Example:
COALESCE(CONCAT(make.make_name , space(1) ),'')

The operator + is for arithmetic operations ( 'a' + 'b' returns 0 ).

redpajama_set_name: RedPajamaStackExchange


text:
Democratic Divide Isn't Just Moderates Versus Progressives
Mary C. Curtis
February 14 | 2020
Are frightened Democrats in the middle of an ugly fight to the death between the so-called progressive and moderate wings of the party? To observe the weeping and gnashing of teeth after the New Hampshire primary, you might think so. Let's just say, that reaction is premature and missing the point.
Yet there are already calls from some in the Democratic establishment, such as it is, for consolidation of the moderates to fight a Bernie Sanders surge that would presumably cast the party into the electoral wilderness in 2020, when the main focus, the reasoning goes, is to beat Donald Trump. To be fair, that seems to be top of mind for all those who want Trump out of office. When I go to the market or gym, anyone of a certain political persuasion even vaguely familiar with what I do for a living asks me "who can beat Trump" before I get a "hello."
I get the urgency with each passing day, as an emboldened president interferes with career prosecutors at the Justice Department, gloats as a Purple Heart recipient with shrapnel in his body is marched out of the White House or floats the possibility of overhauling programs such as Medicare, breaking his own campaign promise.
But I'm honest when I answer: "I don't know, it's early and anything can happen. Remember 2016." Well, I guess they do remember, which is why they're so nervous.
Whose decision?
It's more than a little insulting, though, to a lot of voters to want to wrap everything up before the Nevada caucus, the South Carolina primary and Super Tuesday, before the diverse electorate that will determine who gets to stand onstage and accept that nomination has had a chance to weigh in. By the way, those are also the voters who could make the difference in November.
With 1,990 delegates needed to clinch the presidential nomination, and a neck-and-neck race with Pete Buttigieg at 22 and Sanders at 21, we should stop counting?
Especially after an Iowa caucus gone awry, the argument that Iowa and New Hampshire, with the power to make or break candidates, should not go first makes sense, despite being dismissed as sour grapes when former hopeful Julián Castro made it.
Before all the votes were cast in the New Hampshire primary, former Vice President Joe Biden was on the ground in South Carolina, perhaps anticipating his poor showing in the first-in-the-nation primary, and shoring up what has been called his "firewall." Primary winner Sanders was heading that way, with events planned in the Super Tuesday state of North Carolina, preceded by appearances from campaign surrogates Nina Turner and Susan Sarandon. In South Carolina, Tom Steyer was visible in ads and mailings, creeping up in the polls and picking verbal fights with a Biden supporter.
Michael Bloomberg was everywhere, or at least he seemed to be, with ads and staffing across the country and his own Southern swing in the works.
Note that Andrew Yang, the only candidate of color on the last debate stage, has suspended his campaign, squashing the hopes as well as the dreams of the Yang Gang. Former Massachusetts Gov. Deval Patrick, failing to gain traction, also bowed out, so, "poof," all the African American candidates have disappeared.
Though the winnowing down is necessary and expected, does anyone wonder if the first states had been shuffled to include, maybe, Georgia and Texas, or New Jersey and California, Castro and Sens. Cory Booker and Kamala Harris — and the issues they put front and center — might have drawn more attention and donor support, and survived to fight another day?
The question has been asked, why has it been so difficult for Buttigieg and Sen. Amy Klobuchar to gain support from African American and Latino voters? Why not turn that around to ask why white voters have been so eager to support candidates who have shown little traction among black and brown voters?
When I expressed that thought, someone who presumably has it all figured out, testily lectured: "They," meaning those black and brown voters, "will just have to suck it up."
Paternalism is an ugly look, for Democrats as well as Republicans. It does not and should not work that way, and newly crowned front-runners should be prepared.
Klobuchar, riding high after a praised debate showing gave her campaign a boost and a strong, third-place New Hampshire finish, is getting another look and stronger vetting, including on the prosecutor past that caused some of Harris' troubles. When a host on ABC's "The View" grilled her about her past failure to prosecute officers in police-involved killings and one case the AP has reported on and reviewed that resulted in a young man in jail and lots of questions, Klobuchar's answers leaned heavily on "systematic racism" boilerplate.
Based on Buttigieg's deer-in-the-headlights reaction in the last debate when asked about disparate rates of marijuana arrests, based on race, in his time as South Bend, Indiana, mayor and his nonscripted follow-up that linked pot possession to gangs and violence and "slaughtering," well, it will take more than the endorsement of South Carolina state Rep. JA Moore from Charleston, an African American, to move past his well-documented stumbles with voters of color and the word salad he offers when asked about them.
Guys, when you're polling lower than the poster child for stop-and-frisk with black voters, you've got work to do.
That doesn't let Bloomberg off the hook. He may have a raft of African American mayors, including Steve Benjamin of Columbia, South Carolina, on his side, and black voters who have been special targets of the current president are nothing if not practical. But as long as he's a candidate, expect to hear Bloomberg on a loop, saying, "The way you should get the guns out of the kids' hands is throw them against the wall and frisk them." As someone who has a black son who has been profiled (and multiply that by a lot of black and brown folks), believe me, those words never lose their sting.
All the breathless prognostication and punditry expended on Iowa and New Hampshire doesn't make it game over, as much as Democrats looking for unity might want to make it so.
Mary C. Curtis has worked at The New York Times, The Baltimore Sun, The Charlotte Observer, as national correspondent for Politics Daily, and is a senior facilitator with The OpEd Project. Follow her on Twitter @mcurtisnc3.


text:
Q: How to store Arabic Characters in Database I'm having a problem in a VB.NET application, i have a form that the user fills to store data in the database, the problem is that when i enter Arabic string, it gets stored in the database as question marks: ??????
The database field type is nvarchar, has anybody else come across this problem?

A: take a look here seach for Database-level collations.

A: You need to choose an Arabic collation for your varchar/char columns or use Unicode (nchar/nvarchar)
CREATE TABLE #test
(
col1 VARCHAR(100) COLLATE Latin1_General_100_CI_AI,
col2 VARCHAR(100) COLLATE Arabic_CI_AI_KS_WS,
col3 NVARCHAR(100)
)

INSERT INTO #test VALUES(N'لا أتكلم العربية',N'لا أتكلم العربية',N'لا أتكلم العربية')


text:
Kyllinga erecta är en halvgräsart som beskrevs av Heinrich Christian Friedrich Schumacher. Kyllinga erecta ingår i släktet Kyllinga och familjen halvgräs.

Underarter

Arten delas in i följande underarter:

 K. e. africana
 K. e. erecta

Källor

Externa länkar

Halvgräs
erecta

redpajama_set_name: RedPajamaWikipedia


Busy is too mild a word, but is the only one that comes to mind at the moment. That, and blessed.
Australia, Germany, South Africa, Netherlands and the United States were telling their travel adventures.
Monday. 38 of us began the first of four cleaning days picking up trash outside Jaffa Gate and working outward toward Ir David. We were not in our t-shirts that day but were still stopped multiple times with questions followed by amazed thank yous. One lady jumped in and helped for awhile. Another beautiful young Russian student asked for information as she wants to join us the next time we come.
The results are clear… this is exactly what we are supposed to be doing. Abba has put His fingerprints on this endeavor over and over. Here is a quick before and after of one spot on Monday. One person made this difference in ten minutes.
We were much better prepared on Tuesday when we stayed in Giv'at Ye'arim and cleaned as a gift to our hosts. Again, we collected a couple hundred bags while our hosts provided water and rolls of trash bags. Residents vascillated between watching from inside the house or out in the yard to coming and thanking us or even engaging in conversation. The most touching response was a lady who came out with a tray bearing three small cups of glorious fresh squeezed pomegranate juice from thevtree in her front yard.
We retired early on Tuesday in preparation for Yom Kippur observance.
As we began our evening service, six residents of the moshav showed up and asked if they could worship with us. We were stunned and honored. I know Adonai was happy.
Yom Kippur was a restful fast day that ended with a couple hour service.
Most of the service was individuals standing to pray and confess the sins of our fathers against the Jews and to ask Hashem for forgiveness. We ended with rejoicing, singing and dance. Bobby Bennie brought his worship flags and was especially excited as we sang James Block's version of Psalm 80. The evening was fellowship and rest.
Today, we are back in Jerusalem cleaning every terrace and stairwell all the way to the park. This time, our bright golden shirts, in stark contrast to the rosemary and olive trees, attracted many comments, questions and videographers. Again, the impact is visible.
Tomorrow we will clean around Mt. Herzl, Yad Vashem, and Jerusalem Forest to wrap up the cleaning portion of this trip. Sukkot awaits!
Due to lack of time and poor internet service in the building the larger group is staying in, most posts and pictures will have to wait for my return. My young photog son has taken a couple thousand pics, some amazing, that will have to wait until we get back.
Previous postA 'hurry-cane' and we're off!!
It's nice to have holy friends so you know who will be standing next to you when Geula comes.
I want to be standing with you, achi!
You can make a difference!! You may not be able to attend an Ani Yosef Trip, but you can help others serve in Israel. This fund is to help leaders and needy persons with the cost of travel to serve in Israel. Select in increments of 10 USD. Thank you!


Do I Need to Notify My Insurance Company When my Child Turns 16?
Quick answer, no, you do not need to inform your insurance agency until your child has obtained their drivers license.
Some insurance companies will ask the names and dates of birth of each family member and will follow up with you to see if they have obtained their drivers license; however it is always a good idea to check in with your insurance agent. In general most insurance companies do not charge for junior drivers who only hold a permit. Once the tests have been passed and someone holds a drivers license you need to report to your insurance company and add them to the policy.
If you have a licensed driver living in your home then by law the driver needs to be listed on your policy, or prove they have their own insurance. Many people believe that the insurance follows the car (i.e., if someone borrow's the car and gets into an accident it is okay because the car is insured). We do not recommend your take this stance. It is not helpful to your young driver, you, or someone that could potentially be involved in an accident with your teen driver.
Depending on number of cars you have registered under your policy you could sign your young driver on as a principal operator or occasional operator of the vehicles. Then the rate for having a young driver – if you have 3 cars they get ranked as a principal operator even if they are only driving occasionally.
A Good Student Discount for B average or 3.0 in college is a common practice for insurance companies.
In New York you can take Drivers Ed or Defensive Driving and those help reduce costs.
Once you have been licensed for 3 years insurance rates can go down. There is a surcharge for inexperienced license drivers, which is removed after three years, depending on carrier it could go down each year. Plan on first three years of having a license to pay 20-25% higher for insurance rates.
As always, please contact us at Kaplan Insurance if you have any questions about your auto insurance policy and your options for your teen drivers. It is our goal to make sure you have the best coverage at rates you can afford.


Our locations around the world continuously strive to further reduce waste volumes and emissions as well as the consumption of energy and water.
We consider it to be our most important task to harmonize the future of humanity with technical progress.
MAHLE strives to make its products as energy- and resource-efficient as possible.
Environmentally sound product design is an important consideration when developing new products. These basic principles also apply to our operational processes, which are designed to conserve energy and resources, following the ISO standards 14001 and 50001, as well as OHSAS 18001. By taking appropriate measures, MAHLE also ensures that environmentally harmful events are avoided and limited in the case of damage. To this end, we invest in environmentally friendly, state-of-the-art technologies and actively support global climate protection efforts. Species conservation and diversity considerations are also taken into account in planning measures. Fulfilling the general obligation of due diligence in protected areas is second nature to MAHLE.
Die Welt, one of the most important daily newspapers in Germany, and Accenture, one of the world's largest corporate consultancies, chose MAHLE as the winner of their prestigious TOP 500 Award for sustainable growth.


Pooled investment funds – also known as 'collective investment schemes' – are a way of combining sums of money from many people into a large fund spread across many investments and managed by a professional fund manager.
There are a diverse range of funds that invest in different things, with different strategies – high income, capital growth, income and growth, and so on.
Unit trusts and Open-Ended Investment Companies (OEICs) are professionally managed collective investment funds. Managers pool money from many investors and buy shares, bonds, property or cash assets, and other investments.
You buy shares (in an OEIC) or units (in a unit trust). The fund manager combines your money together with money from other investors and uses it to invest in the fund's underlying assets.
You own a share of the overall unit trust or OEIC – if the value of the underlying assets in the fund rises, the value of your units or shares will rise. Similarly, if the value of the underlying assets of the fund falls, the value of your units or shares falls. The overall fund size will grow and shrink as investors buy or sell.
The value of your investments can go down as well as up, and you might get back less than you invested. Some assets are riskier than others, but higher risk also gives you the potential to earn higher returns.
Before investing, make sure you understand what kind of assets the fund invests in and whether that's a good fit for your investment goals, financial situation and attitude to risk.
Most unit trusts and OEICs allow you to sell your shares or units at any time – although some funds will only deal on a monthly, quarterly or twice-yearly basis. This might be the case if they invest in assets such as property, which can take a longer time to sell.
However, bear in mind that the length of time you should invest for depends on your financial goals and what your fund invests in. If it invests in shares, bonds or property, you should plan to invest for five years or more. Money market funds can be suitable for shorter time frames.
If you own shares, you might get income in the form of dividends. Dividends are a portion of the profits made by the company that issued the shares you've invested in.
If you have an investment fund that is invested in shares, then you might get distributions that are taxed in the same way as dividends.
In April 2016, a new tax-free Dividend Allowance of £5,000 a year was introduced for all taxpayers (this tax-free allowance will fall to £2,000 in April 2018).
Any dividends received within a pension or Individual Savings Account (ISA) will remain effectively tax-efficient.
Basic-rate payers who receive dividends of more than £5,000 need to complete a self-assessment return.


text:
Q: Open a record, update it and insert as new record in MySQL I have a db with 10 fields, of which only a few change very often. I would like to open the current record, update it, and enter it back into the db with a new auto id while retaining the previous record.
If I INSERT a new record, I have to re-enter all the info even tho it may not have changed.
If I UPDATE a record, it overwrites the previous values.
Any suggestion would be greatly appreciated

A: You can do it via two different queries: SELECT and INSERT, or you can use INSERT INTO SELECT construction. Check documentation for complete reference http://dev.mysql.com/doc/refman/5.0/en/insert-select.html

A: How about a suitably modified version of
insert into table select * from table where id='current_id'

Sample query:Say i want to read first record ,lift student, subject but change marks and insert a new record
insert into score(student,subject,marks)
select student,subject,'30' from score where id=1;

Sample Data
+---------+---------+-------+----+
| student | subject | marks | id |
+---------+---------+-------+----+
| A1      | phy     |    20 |  1 |
| A1      | bio     |    87 |  2 |
| A2      | che     |    24 |  3 |
| A3      | che     |    50 |  4 |

Table structure:

+---------+-------------+------+-----+---------+----------------+
| Field   | Type        | Null | Key | Default | Extra          |
+---------+-------------+------+-----+---------+----------------+
| student | varchar(20) | YES  |     | NULL    |                |
| subject | varchar(20) | YES  |     | NULL    |                |
| marks   | int(1)      | YES  |     | NULL    |                |
| id      | int(10)     | NO   | PRI | NULL    | auto_increment |
+---------+-------------+------+-----+---------+----------------+


Wood is the material of choice for those looking for grace and elegance, for living spaces that are a pleasure to experience thanks to their natural, vibrant, living surfaces.
Stoneware is the technology that allows you to bring a splendidly warm allure to even the most critical of settings, such as the bathroom or kitchen, thanks to its frost-resistant, stainresistant surfaces. It is also easy to clean, so its beauty can be preserved forever.
Wood-effect porcelain stoneware combines the virtues of both materials, offering the contemporary construction industry an eco-friendly, sustainable option with a delicate, material appeal, perfect for delightfully natural, tasteful furnishing solutions.
Wood-effect porcelain stoneware offers endless furnishing opportunities, from classic combinations to more unusual pairings, ready to embody all the creativity of both the designer and home owner.
For a perfect blend of nature and technology, choose the Bark collection by FAP, in ceramic wood with a modern design, available in the contemporary colours Avana, Artico and Nebbia.
The contemporary appeal of this wood-effect stoneware is evident in its delicately irregular surfaces, with soft veining patterns, discreet nuances and extra-subtle gnarls that take the collection up a step from interior design trends.
Bark is composed of wood-effect flooring, skirting tiles, step and corner tiles, and woodeffect tiles that can be combined with FAP collections with other material inspirations, such as cotto, concrete, marble and stone. The collection comes with a soft-texture finish, ideal for elegant residential and contract settings.
A splendid finishing touch to the project is provided by the small-size tile with natural edges that gives the setting a personal style accent with the herringbone laying pattern, a contemporary take on a classic that's ideal for areas such as the bathroom, bedroom, sitting room and study, or public settings such as concept stores and classy restaurants.
Get inspired by Bark wood-effect stoneware!


text:
GuideStone trustees hear reports, honors Hawkins; Dilbeck calls 2022 the 'Year to Set a Stone'
Posted by Roy Hayhurst | Mar 5, 2022 | Feature, News
Above: O.S. Hawkins, right, prays for Hance Dilbeck during the GuideStone report at the 2021 Southern Baptist Convention Annual Meeting. Dilbeck is now president and chief executive officer of GuideStone, replacing Hawkins who will serve as president emeritus.
PLANO, Texas—GuideStone® Financial Resources continued its efforts to ensure pastors and other church and ministry workers could focus on their callings while also achieving and meeting their financial goals and needs.
Trustees met in regular session February 28–March 1 in Plano, Texas, a few miles north of GuideStone's offices. During their meeting, trustees elected John Hoychick, Jr. (La.) chairman and David Cox (Mich.) as vice chairman.
The gathering marked the 58th and final trustee meeting for O.S. Hawkins, who has served as president and chief executive officer since 1997. It also marked the official transition of D. Hance Dilbeck, Jr. as president and chief executive officer. Dilbeck joined the ministry in July 2021 and has served as president-elect.
In his final remarks to trustees, Hawkins indicated he has been captured by a verse, Job 12:9, which reads, "Who among all these does not know that the hand of the Lord has done this?" Hawkins told trustees it has indeed been God's hand at work over the last 25 years.
"What a privilege it's been for Susie and me over this quarter of a century," Hawkins said. "This whole journey has just been absolutely amazing."
Hawkins was celebrated by friends, family, current and former GuideStone trustees and staff during a dinner Monday night, Feb. 28 in his honor.
Outgoing trustee chair Renée Trewick (N.Y.) lauded O.S. and Susie Hawkins for their service and commitment to GuideStone participants.
"One of the greatest privileges of serving in this position has been the opportunity to get to know O.S. and Susie both personally and professionally," Trewick said. "Thank you both for all you have done — we love you and will miss you."
Trustees presented the couple with gifts, including a donation to further fund the O.S. Hawkins Outstanding Pastoral Ministry Graduate Award at Southwestern Seminary.
The evening featured comments from trustee Steve Dighton (Kan.-Neb.), who led the search committee that selected Dilbeck; Jack Graham, pastor of Plano, Texas, Prestonwood, and lifelong friend of Hawkins; Bob Sorrell, a longtime former trustee; and John R. Jones, who served as chief operating officer of GuideStone throughout Hawkins' tenure.
"I can give witness, as so many of you can, on how God has had His hand on O.S. Hawkins," Jones said, detailing much of the growth of the ministry over the last 25 years. "Everything starts with O.S.'s relationship with the Lord."
At Dilbeck's request, Hawkins will continue to serve GuideStone until an official retirement on July 31. Hawkins will continue to write and speak on behalf of Mission:Dignity® while also providing assistance to Dilbeck. The trustees bestowed on Hawkins the honorary title of President Emeritus to recognize his continued efforts on behalf of Mission:Dignity even after his official retirement.
"He understands the Kingdom of God is about relationships," Dilbeck said. "He cares for people, especially the pastor at the crossroads. O.S. has a pastor's heart."
Reflecting on the ministry's many accomplishments during his tenure—registering GuideStone's investment options in 2001, the name change in 2004 from the Annuity Board to GuideStone, Southern Baptists' approval to make GuideStone's retirement, investment and life and health products to like-minded ministries and churches, and to make those investments available to those in the pew — Hawkins noted that it was the continued faithful support of Mission:Dignity for which he was most grateful.
During ministry reports, Jones, chief operating officer, said the highlight of 2021 was the record year experienced by Mission:Dignity, which included the largest fundraising year ever, $11 million; more donors than ever before gave to Mission:Dignity, 10,000; and the greatest November fundraising, aided by matching donations on the nationwide #GivingTuesday emphasis.
"Most of that $11 million comes from Sunday School classes, churches and individuals who have been regular donors, giving $100 or $1,000 here and there," Jones told trustees.
Through Mission:Dignity, GuideStone helps more than 2,400 retirement-aged Southern Baptist ministers, workers and their widows, with extra money needed for housing, food and vital medications, ensuring a well-deserved dignity, independence and, often, the ability to continue serving the Lord. The neediest couples with at least 25 years of paid Southern Baptist service receive $750 each month under increased benefits approved by trustees last summer.
Following a Hawkins custom, Dilbeck established a theme to guide the ministry's work for 2022, calling it the "Year to Set a Stone."
The imagery comes from 1 Sam. 7:12, which reads, "Then Samuel took a stone and set it between Mizpah and Shen, and named it Ebenezer, saying, "thus far the Lord has helped us" (NASB 1995).
Dilbeck noted that the passage connotes both a backward look, remembering the past and celebrating what the Lord has done and a forward look, confident that the Lord will continue to be with us. Dilbeck said, like the Israelites, GuideStone is called to Look Backward, Look Upward, Look Inward and Look Forward.
Part of the next year will involve the executive team working together with trustees to develop a new strategic plan for the ministry, following a cycle Hawkins established with the formation of the GuideStone 100 long-range plan that guided the ministry for more than a decade. Dilbeck said, though, that strategic plans can fail without the Lord's hand.
"He has helped us, He will help us, and indeed He must help us, or our strategy is vanity," Dilbeck said.
Looking back on 25 years, Hawkins concluded his final remarks, committing to Dilbeck and trustees that he would be Dilbeck's greatest asset and his biggest supporter.
"We are looking backward with hearts so full of thanksgiving for 25 wonderful years, looking forward to passing the baton to Hance and Julie," Hawkins said. "I look forward to great days ahead."
Then echoing his own charge received from Ray Taylor, who led the trustee search committee that called Hawkins to GuideStone in 1997, Hawkins gave his charge to Dilbeck.
"You take something great and make it greater," Hawkins said. "I'll be your biggest fan and supporter."
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Roy Hayhurst
Roy Hayhurst is director of denominational and public relations for GuideStone Financial Resources of the Southern Baptist Convention.
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Small hole outside plate mark and printed area.
Bodiam Castle, Sussex Bonner / Stockdale c1810. Copper Engraving.
Steel Engraving size: 150 x 100 mm .
Brighton, Sussex Steel Engraving size: 150 x 210 mm .
Brighton (Top) Cheltenham (Bottom) .
Charles Knight 1850 Steel Engraving size: 170 x 230 mm .
mounted on backing paper for inclusion in a larger volume book.
Eridge. Eridge Castle & Eridge Park.
Clearly in the county of Sussex, but attributed to Kent in many old publications.
Even today, Eridge Park has a postal address of Eridge, Tunbridge Wells, Kent.
Prints of Eridge are located in the Kent section.
Steel Engraving size: 170 x 120 mm .
Hailsham Church, Sussex. Stockdale 1812.
Hastings Castle & Beach, Sussex. Stockdale 1813.
Hastings, Sussex Steel Engraving size: 210 x 160 mm .
Lithograph size: 180 x 120 mm .
Mayfield Place, Sussex Copper Engraving size: 270 x 200 mm .
Etching size: 170 x 130 mm .
Bartlett / Finden 1842 Steel Engraving size: 200 x 150 mm .