Open access family centres and their users: positive results,some doubts and new departures

This article reports findings from a research study of two open access, multi-use, community-based family centres. Structured, qualitative interviews were conducted with 40 adult users and 40 local adult non-users of the two centres. Additionally, a profile of user characteristics was derived from a survey of users attending over a one-week period at both centres. The vast majority of users were women in their twenties, just over half of whom attended with their children. The benefits and limitations of the current functioning of open access centres are discussed, with a potential shift in emphasis along a social development model proposed. Copyright © 1999 John Wiley & Sons, Ltd.     

Alcohol and drug abuse: removing structural barriers to treatment for historically disadvantaged communities in Cape Town

The article reports on an exploratory study that examined access to alcohol and other drug treatment for historically disadvantaged communities in the Cape Town metropole. In-depth interviews were conducted with 20 key informants from various sectors of the alcohol and drug treatment system, including treatment service providers, members of local drug action committees and social workers from district social service offices. Findings highlighted three structural barriers to service delivery: (i) difficulties in developing and implementing a strategic plan relating to alcohol and drug problems due to poor capacity and other infrastructural issues, such as a lack of information, poor intersectoral collaboration and limited consultation with service providers; (ii) limited allocation of resources to alcohol and drug treatment which has restricted the availability of affordable services as well as the capacity of established services to meet increased demand for services in this area; and (iii) fragmented service delivery. The study highlighted the need for further transformation of the South African social welfare system responsible for alcohol and drug treatment service delivery through public–private partnership development and the introduction of a management information system.     

Barriers and facilitators to adherence to group exercise in institutionalized older people living with dementia: a systematic review

Objectives

Research suggests targeted exercise is important for people living with dementia, especially those living in residential care. The aim of this review was to collect and synthesize evidence on the known barriers and facilitators to adherence to group exercise of institutionalized older people living with dementia.

Methods

We searched all available electronic databases. Additionally, we searched trial registries (clinicaltrial.gov, and WHO ICTRP) for ongoing studies. We searched for and included papers from January 1990 until September 2017 in any language. We included randomized, non-randomized trials. Studies were not eligible if participants were either healthy older people or people suffering from dementia but not living in an institution. Studies were also excluded if they were not focused on barriers and facilitators to adherence to group exercise.

Results

Using narrative analysis, we identified the following themes for barriers: bio-medical reasons and mental wellbeing and physical ability, relationships dynamics, and socioeconomic reasons. The facilitators were grouped under the following thematic frames: bio-medical benefits and benefits related to physical ability, feelings and emotions and confidence improvements, therapist and group relationships dynamics and activity related reasons.

Conclusions

We conclude that institutionalized older people living with dementia, even those who are physically frail, incontinent and/or have mild dementia can demonstrate certain level of exercise adherence, and therefore can respond positively to exercise programs. Tailored, individually-adjusted and supported physical activity, led by a knowledgeable, engaging and well communicating therapist/facilitator improves the adherence to group exercise interventions of institutionalized older people living with dementia.

     

Coloniality and Intersectionality in Social Work Education and Practice

The history of social work education is deeply entangled with the structures of White supremacy and coloniality. Through an analysis of coloniality, the system from which social work operates, this article outlines an alternative framework of intersectionality, which decodes the dominant discourse in relation to power, privilege, White supremacy, and gender oppression. The framework of intersectionality moves professional social work pedagogy and practice from the trenches of coloniality toward decoloniality. The concepts of intersectionality and critical consciousness are operationalized to demonstrate how social work education can effect structural and transformational change through de-linking from its white supremacists roots.     

Robust regression using iteratively reweighted least-squares

The rapid development of the theory of robust estimation (Huber, 1973) has created a need for computational procedures to produce robust estimates. We will review a number of different computational approaches for robust linear regression but focus on one—iteratively reweighted least-squares (IRLS). The weight functions that we discuss are a part of a semi-portable subroutine library called ROSEPACK (RObust Statistical Estimation PACKage) that has been developed by the authors and Virginia Klema at the Computer Research Center of the National Bureau of Economic Research, Inc. in Cambridge, Mass. with the support of the National Science Foundation. This library (Klema, 1976) makes it relatively simple to implement an IRLS regression package.     

On O.L.S. estimation in singular linear models with general positive definite dispersion matrix

A condition in Graybill [1976] for the O.L.S.estimator to be B.L.U.E. in a linear model with positive definite dispersion not necessarily proportional to the identity matrix is extended to cover the case of a singular linear model.     

Balancing type I and type II error probabilities: further comments on proof of safety vs proof of hazard

This paper elaborates on earlier contributions of Bross (1985) and Millard (1987) who point out that when conducting conventional hypothesis tests in order to “prove” environmental hazard or environmental safety, unrealistically large sample sizes are required to achieve acceptable power with customarily-used values of Type I error probability. These authors also note that “proof of safety” typically requires much larger sample sizes than “proof of hazard”. When the sample has yet to be selected and it is feared that the sample size will be insufficient to conduct a reasonable.     

Patient-centered approach to building problem solving skills among older primary care patients: problems identified and resolved

This article describes problems identified by older primary care patients enrolled in Problem Solving Therapy (PST), and explores factors associated with successful problem resolution. PST patients received 1 to 8, 45-min sessions with a social worker. Patients identified problems in their lives and directed the focus of subsequent sessions as consistent with the steps of PST. The 107 patients identified 568 problems, 59% of which were resolved. Most commonly identified problems included health related issues such as need for exercise or weight loss activities, medical care and medical equipment needs, home and garden maintenance, and gathering information on their medical condition. Problems identified by patients were 2.2 times more likely to be solved than those identified by a health care professional. Using PST in primary care may facilitate patients in addressing key health and wellness issues.