Kin Keeper

Abstract

Cancer mortality issues for African-American women are undeniably real. It is also apparent that to address the issue of this unequal burden, different intervention approaches are necessary. Employing a family systems approach for African-American women and their families holds benefits for both cancer prevention and cancer treatment. The Kin Keeper Modelis based on the premise that the natural ways African-American women communicate various health messages to females in their family can be used to influence their cancer prevention and screening behaviors. This paper reports empirical research that demonstrates significant familial influence on African-American women's cancer prevention screening behaviors. Findings indicated that family influence provides insight into the intersection of family altruism with cultural familial decision-making. In addition, the findings underscore the strong influence family has on African-American women's propensity to     

BPD and the Need for Community

SUMMARY

This chapter emphasizes the importance of a community/systems approach in managing the treatment of individuals with borderline personality disorder. The natural systems existing around patient, clinician and family are recognized, and we examine how working teams are built from these systems. The Borderline Center at McLean Hospital is used as an illustration of an organizational model that utilizes the concept of the “holding environment” (Winnicott, 1965) to provide comprehensive services to borderline patients and their families. As patients move through various levels of care and exhibit typical borderline symptomatology, the importance of communication and coordination on the part of the treatment team is highlighted. This chapter also will illustrate the essential ways in which patients, clinicians and families are able to join together in the treatment of this disorder, with special emphasis on the necessity of family involvement. We also will examine how the treatment teams provide the foundation for larger communities, which are critical to sustaining the ongoing work of its members.     

Deliberative democracy in the real world,the contribution of the capability approach

ABSTRACT

Drawing on Amartya Sen’s writings, this article presents the capability approach to democracy and shows its relevance for the sociological reflection and research on democratic processes conceived as ways to convert individual preferences into collective norms or decisions. Two moments are key in this respect: the formation of individual preferences and their translation into collective norms in the course of public debates. The initial sections present Sen’s conception of democracy, particularly emphasizing its articulation with the notions of ‘positional objectivity’ and ‘conversion’. Then, this conception is compared with two other mechanisms that may be used to coordinate individual decisions or preferences, namely the market and idealistic views on deliberative democracy. The article emphasizes how the capability approach departs from these two conceptions with regard to the two key concepts of capacity to aspire and capability for voice. The final section shows how Sen’s notion of democracy may open up a new field for research, namely the sociological investigation of the informational (or knowledge) basis of democracy.     

HMOs and the Future of Student Mental Health Services

Abstract

The health maintenance organization (HMO) is likely to have a prominent position under national health insurance, which will have a strong systematizing effect on the nation's health services. Over the past two years the University of Massachusetts mental health services have provided benefits at both the university and a private medical group practice. Experience has shown that a university which already provides broad services to a large student population can extend itself to the university community including its faculty and staff. Several advantages of this development, as well as some significant problems, are discussed. As the HMO grew and quality services were established, it became feasible for the private medical group to develop its own mental health component. Based on this and other experiences in mental health delivery systems, certain conclusions are drawn about the ways universities can develop HMOs and some recommendations are made for national mental health planning.     

Drug Addiction and Families

Abstract

Australia is experiencing a period of immense cultural change predicated on the use of Information and Communication Technology (ICT). New devices such as smartphones, tablet computers, and the social iterations of the internet are impacting on communication patterns and contributing to the merging of people's online and offline lives. Using Spanish sociologist Manuel Castells's theory of the Network Society as a theoretical foundation, this issues paper posits that social work must overcome its historical reluctance to embrace ICT if it is to remain relevant in the era of the network society. In particular, we argue that social work professionals need to begin a dialogue with IT developers, social service managers, and funding bodies about the need for practice-led ICT systems. This paper examines the turbulent history social work has had with technological change, and concludes that the adoption of a practice-led approach to ICT use in education, practice, and research provides a strong foundation for reimagining the relationship between social work and ICT.     

A Comparison of Biological and Adoptive Mothers and Fathers

ABSTRACT

While poverty is suspected to be the major reason for birth families relinquishing their children for international adoptions, little is known of the impact of the interplay among the economic, familial, and cultural aspects of a particular sending country which culminates in the adoption decision. In this study, the authors studied 73 birthmothers in the Republic of Marshall Islands, a small Western Pacific island nation with a total population of 68,000, to explore the influences that led to their adoption decision. Their findings reflect an environment of extreme poverty, the breakdown of traditional family support systems, and the exploitation of the cultural understanding of adoptions.     

Latino and African American Non-Custodial Fathers

Abstract

This study examines the perspectives of 30 Latino (n = 17) and African American (n = 13) low-income non-custodial fathers regarding their role as fathers and the child support system. Using an ethnographic approach, these non-custodial fathers (NCFs) were asked about their own childhood and background, their relationship with their own fathers, their relationship with their non-custodial child(ren), and their views of the child support system. The cultural portrait that emerges is one of a group of fathers who express a strong desire to be positive role models to their children and to play a significant role in their lives. Notwithstanding their negative feelings toward the child support enforcement system, they need to increase their knowledge regarding the process in order to clarify both their responsibilities and their rights. Implications for social work policy and research are included.     

Measuring the Effect of System Size on the Administrative Occupations of Macro Systems: A Reappraisal

Abstract

Organizational theory and empirical research suggests that the size of a system is an important determinant of its administrative sector. In this perspective, the key occupations that provide coordination and integration are as follows: (a) managers and administrators since they provide decision-making, (2) professional and technical experts because they evaluate information flows critical for decision-making, and (3) clerical workers since they contribute written messages resulting in communication. Recent research demonstrates that this approach may be successfully extended to more macro systems such as counties, cities, states and nations. In applying this theory, we argue that the size/administrative occupation relationships can be more completely understood than in previous studies by focusing on the detailed suboccupations found in each of the three broad occupation categories. Data from the fifty American states in 1970 indicate that the relationship between size and suboccupations may be positive, negative, or statistically non-significant depending on which suboccupation is examined. The paper concludes that administrative occupations are affected by size in a much more complex way than previously reported.     

Can we prevent deaths of homeless persons? Police led public health approach to prevent homeless deaths

Abstract

Research on homeless populations demonstrates that homelessness in itself is an independent risk factor for death. However, there is a dearth of detailed data on homeless decedents and the situations surrounding their deaths. This lack of knowledge, a desire to understand how and why homeless individuals were dying, and a sentinel event death led the Indianapolis Metropolitan Police Department Homelessness and Panhandling Unit to partner with a local researcher and begin conducting homeless death reviews. The approach is modeled after the evidence-based, public health approach of the Fetal and Infant Mortality Review process (FIMR). The FIMR model is a systematic approach to understanding system gaps and obtaining insights into the factors that resulted in homelessness and ultimately death. This article reports on the process to develop this unique multi-agency, police-led review of homeless deaths in Indianapolis, Indiana and resulting recommendations for action to decrease these deaths.     

Attitude Shifts: A Qualitative Analysis of Students' Awareness and Reaction to the Homeless

Abstract

Perceptions toward homelessness among 23 undergraduates were explored through individual, semi-structured interviews. Several higher-education institutions have incorporated non-traditional learning components to promote altruism and empathy among students toward the poor and homeless. We focused on one Midwestern university's experiential approach that had a “poverty-immersion” experience within a selected course. We explored how the poverty-immersion weekend altered undergraduates' perceptions of the poor and persons in homeless milieu. Students evidenced marked alterations in their understandings of the homeless: dispelling assumptions to consider individuals in light of personal and circumstantial situations that led to their states of homelessness, and the holistic nature of their needs. Students were challenged to reconsider the attitudes towards the homeless as expressed by those in the middle-class socioeconomic status.     

Grounding Twenty-first-Century Public Relations Praxis in Aristotelian Ethos

ABSTRACT

By grounding public relations praxis in Aristotelian ethos, practitioners can function as liaison officers with balanced perspectives, capable of co-creating meaning with both client organizations and their publics between whom experts are hired to facilitate mutually beneficial relationships. This approach locates persuasion at the nexus of speaker ethos in the public relations process. It allows practitioners to balance their commitment to the ethics of their profession with loyalty to clients, while empowering audiences (organizations and their publics) to function as the final arbiters of any courses of action proposed to them. Moreover, because the approach enables practitioners, based on their credible ethos, to participate in organizational decision-making, it has the potential to transfer their ethical worldview to client organizations. Ultimately, the central theoretical contribution of this essay is an alternative approach to public relations praxis founded on an analysis of Aristotle’s notion of phronesis, arête, and eunoia.     

Women Political Leaders

Abstract

This article thoroughly examines women prime ministers and presidents (also referred to as women executives) rigorously comparing nearly all cases of women executives from 1960 through 2002. The numbers of women executives, countries they have led, and the types of governmental systems in which they came to power are analyzed. A main focus is their political and educational backgrounds. Findings suggest that the number of women making it to executive office is few but varied geographically. Women executives have diverse education and political backgrounds. An important springboard to office in Asia and Latin America has been women's familial ties to important political leaders. Even these women are more diverse than expected in terms of background and, in particular, political experience.     

Evaluating the design and implementation fidelity of an adapted Plan-Do-Study-Act approach to improve health system performance in a Nigerian state

BackgroundThe Plan-Do-Study-Act (PDSA) cycle is fundamental to many quality improvement (QI) models. For the approach to be effective in the real-world, variants must align with standard elements of the PDSA. This study evaluates the alignment between theory, design and implementation fidelity of a PDSA variant adapted for Nigeria’s health system performance improvement.MethodsAn iterative consensus building approach was used to develop a scorecard evaluating new conceptual indices of design and implementation fidelity of QI interventions (design and implementation index, defects and gaps) based on Taylor’s theoretical framework.ResultsDesign (adaptation) scores were optimal across all standard features indicating that design was well adapted to the typical PDSA. Conversely, implementation fidelity scores were only optimal with two standard features: prediction-based test of change and the use of data over time. The other features, use of multiple iterative cycles and documentation had implementation gaps of 17 % and 50 % respectively.ConclusionThis study demonstrates how both adaptation and implementation fidelity are important for success of QI interventions. It also presents an approach for evaluating other QI models using Taylor’s PDSA assessment framework as a guide, which might serve to strengthen the theory behind future QI models and provide guidance on their appropriate use.     

In memory of C. West Churchman (1913–2004) Reminiscences,retrospectives, and reflections

Abstract

C. West Churchman, the grand old man of the ‘systems approach’, is dead. Born on 29 August 1913 in Philadelphia, Pennsylvania, he was 90 years of age. After a rich and significant life of scholarship, he died on 21 March 2004 in Bolinas, California. A former student and collaborator of Professor Churchman offers this commemorative essay. He looks back on his years with West (as everybody called him) at the University of California, Berkeley, and reflects on the way this changed his understanding of the systems approach. The paper also offers a sketch of some of the core concerns and concepts of Churchman’s philosophy of social systems design; a short summary of his professional career; an overview of his major publications; and a list of recommended readings.     

Providing context to the implementation of health promoting schools: A case study

PurposeIssues related to program context are important components of population health interventions and particularly among complex, adaptive initiatives in schools. Health Promoting Schools (HPS) is a global approach to support early development of healthy behaviors among children and youth. The purpose of this study was to explicate the practical and contextual processes that influenced implementation of HPS in schools in Nova Scotia (Canada).MethodsUsing a case-study approach, data was collected using interviews (n = 14) with principals, teachers and parents, observations collected during school visits and document review in five diverse schools.ResultsCase study schools reported a variety of HPS practices and three key themes emerged that provided context to the processes that facilitated their implementation. The results suggest that although school characteristics (theme 1), like staff allocation, physical location and resources, are important, these barriers can be mitigated by building organizational capacity (theme 2) and establishing a supportive school community culture (theme 3).ConclusionsThe study provided insight to the variability in implementation by describing how contextual barriers were experienced and mitigated by schools. Establishing a broad system to support HPS, with collaboration across health and education sectors, could help to progress adoption, implementation and sustainability of HPS.     

Energy propaganda: Channels for corporate hegemony

An approach is suggested to the study of corporate hegemony. By focusing on a single policy area (e.g., energy), selected elements of the hegemonic process can be examined in the concrete. The theoretical framework underlying this approach develops from Gramsci's (1971) concept of “ideological hegemony” (i.e., manufactured consent). To maintain their power positions in capitalist societies, dominant groups must disseminate and reinforce their views and prevent the spread of opposing perspectives. Propaganda campaigns by the energy industry are examined, focusing on corporate messages and their relationship to policy and on dissemination channels.     

The struggle of Batak Simalungun for their identity in Church organization in Simalungun,Medan, Indonesia

ABSTRACT

This research aims to find out the struggle of Batak Simalungun for their identity in church organization in Simalungun. This research uses a qualitative research approach, This qualitative research also uses an ethnographic approach. The qualitative research has at least five approaches and therefore can choose one of the five approaches. The results show about three demands of the Simalungun Batak movement over a special identity of Simalungun also include the church organization environment, where the entire Batak Church led by RMG touches on the original structures of Batak society and culture.     

Independent Mental Health Advocacy: A Model of Social Work Advocacy?

ABSTRACT

Advocacy has received less attention in social work research than other aspects of social work practice. This paper draws attention to two tensions in social work advocacy; between worker-led advocacy and person-led advocacy, and between individual advocacy and system level advocacy. We argue that human-rights-based social workers must choose a person-led approach over a worker-led approach while advocating with both systems and individuals. This argument is made by drawing on findings of an evaluation of Independent Mental Health Advocacy (IMHA) in Victoria, Australia. It is shown that social work training had not prepared social workers for rights-based, person-led advocacy and that social workers in public mental health services were struggling to maintain the rights of people in their services even with assistance from IMHA.

IMPLICATIONS

• Independent Mental Health Advocacy (IMHA) is a model of advocacy influenced by social work theory and delivered in part by social-work-trained advocates.

• Social work training is not preparing social workers for person-led, human-rights-based advocacy.

• Public mental health social workers are struggling to maintain the rights of people in mental health services even with the support of external advocacy services.

     

A Comprehensive Review and a Meta-Analysis of the Effectiveness of Internet-Based Psychotherapeutic Interventions

ABSTRACT

Internet-based psychotherapeutic interventions have been used for more than a decade, but no comprehensive review and no extensive meta-analysis of their effectiveness have been conducted. We have collected all of the empirical articles published up to March 2006 (n = 64) that examine the effectiveness of online therapy of different forms and performed a meta-analysis of all the studies reported in them (n = 92). These studies involved a total of 9,764 clients who were treated through various Internet-based psychological interventions for a variety of problems, whose effectiveness was assessed by different types of measures. The overall mean weighted effect size was found to be 0.53 (medium effect), which is quite similar to the average effect size of traditional, face-to-face therapy. Next, we examined interacting effects of various possible relevant moderators of the effects of online therapy, including type of therapy (self-help web-based therapy versus online communication-based etherapy), type of outcome measure, time of measurement of outcome (post-therapy or follow-up), type of problem treated, therapeutic approach, and communication modality, among others. A comparison between face-to-face and Internet intervention as reported on in 14 of the studies revealed no differences in effectiveness. The findings of this meta-analysis, and review of additional Internet therapy studies not included in the meta-analysis, provide strong support for the adoption of online psychological interventions as a legitimate therapeutic activity and suggest several insights in regard to its application. Limitations of the findings and recommendations concerning Internet-based therapy and future research are discussed.