Impact of physical activity on activity of daily living in moderate to severe dementia: a critical review

The objectives of this study were to describe the different modalities of physical activity programs designed for moderate to severe dementia and to identify their impact on functional independence in activities of daily living (ADL). A critical review of randomized controlled trials related to the impact of physical activity programs in moderately to severely demented persons on ADL performance and meta-analysis of the identified studies were performed. Among the 303 identified articles, five responded to the selection criteria. Four out of the five studies demonstrated limited methodological quality. In one high-quality study, physical activity programs significantly delayed deterioration of ADL performance. The program components and ADL assessment tools vary widely across studies. Although the proposed treatments have not proven their efficiency in improving the ADL status of the patients, they were able to limit the decline in ADL functioning. Future research is warranted in order to identify clinically relevant modalities for physical activity programs for people with moderate to severe dementia.     

Improving Risk Management: From Lame Excuses to Principled Practice

The three classic pillars of risk analysis are risk assessment (how big is the risk and how sure can we be?), risk management (what shall we do about it?), and risk communication (what shall we say about it, to whom, when, and how?). We propose two complements as important parts of these three bases: risk attribution (who or what addressable conditions actually caused an accident or loss?) and learning from experience about risk reduction (what works, and how well?). Failures in complex systems usually evoke blame, often with insufficient attention to root causes of failure, including some aspects of the situation, design decisions, or social norms and culture. Focusing on blame, however, can inhibit effective learning, instead eliciting excuses to deflect attention and perceived culpability. Productive understanding of what went wrong, and how to do better, thus requires moving past recrimination and excuses. This article identifies common blame‐shifting “lame excuses” for poor risk management. These generally contribute little to effective improvements and may leave real risks and preventable causes unaddressed. We propose principles from risk and decision sciences and organizational design to improve results. These start with organizational leadership. More specifically, they include: deliberate testing and learning—especially from near‐misses and accident precursors; careful causal analysis of accidents; risk quantification; candid expression of uncertainties about costs and benefits of risk‐reduction options; optimization of tradeoffs between gathering additional information and immediate action; promotion of safety culture; and mindful allocation of people, responsibilities, and resources to reduce risks. We propose that these principles provide sound foundations for improving successful risk management.     

Female Perceptions of Organizational Justice

This study examines women's conceptualization of the pervasive construct of organizational justice. A comprehensive four factor model was used to represent organizational justice while outcome variables were the important employee attitudes of job satisfaction, organizational commitment and turnover intentions. Structural equation modelling was used to analyse responses from 301 male and 147 female respondents. Differences were found for procedural, interpersonal and informational justices. It would appear female and male employees have differing responses to perceptions of justice. Justice had a diffuse effect for males, but not for females. For men, interpersonal justice predicted an increase in organizational commitment while procedural justice predicted a decrease in turnover intentions. For female employees, informational justice was found to increase commitment and reduce turnover intentions. The study highlights the need for all justice factors to be considered and for sex differences to be considered in future justice research.     

When the Norwegian child-welfare services get involved: parents making sense of referrals

There is limited research exploring parents' views and understanding of referrals to the child-welfare services (CWS). This study explores parents' understanding of the circumstances leading to a child-welfare referral, and their understanding of the reporter's objectives in making the referral. Qualitative content analysis and frequency analysis was performed on open-ended survey responses from a sample of 683 Norwegian parents in contact with the CWS. The results showed that the majority (60.2%) of the parents perceived the referral to be initiated solely because of parental difficulties and multiple family life stressors. Some of the parents (22.8%) believed the referrals were initiated exclusively because of their children's problems, whereas a few (13.3%) perceived it to be a combination of parental/familial difficulties and children's problems. The findings reveal that close to half of the parents (46.4%) felt the objective of the person making the referral was to help the child, their parents and the family. Some (36.5%) saw it as a routine or mandated action by public or official services, while others (18.7%) reported that they did not know why referrals had been made, or gave no answer to the question. A small group of parents (6%) viewed the referral as an act of harassment. The main implications of these findings are discussed.     

A Telephone Intervention for Substance-Using Adult Male Perpetrators of Intimate Partner Violence

OBJECTIVE: To preliminarily evaluate telephone-delivered motivational enhancement therapy (MET) in motivating unadjudicated and nontreatment seeking intimate partner violence (IPV) perpetrators, who also use substances, to self-refer into treatment. METHOD: 124 adult men were recruited via a multimedia marketing campaign and were randomly assigned to the intervention (MET) or comparison group following a baseline assessment. Participants in the MET condition received a personalized feedback report on their IPV and substance-use behaviors, consequences, and social norms beliefs. RESULTS: Results supported the likely effectiveness of MET in short-term reduction of IPV behavior, increasing motivation for treatment seeking, and changing perceived norms for IPV and substance abuse (SA). CONCLUSIONS: Applications for brief MET interventions to facilitate voluntary treatment entry among substance-using IPV perpetrators are discussed.     

Effectively addressing mental health issues in child welfare practice: the family connection

Nonprofit family-run organizations, such as Tennessee Voices for Children (TVC), are providing leadership in advocating for and delivering services to children and families in need. Utilizing a family-driven approach and a staff partially comprised of parent-professionals, TVC's Nashville Connection and Family Connection programs have strengthened families by providing alternatives to state custody for children and families living with serious emotional or behavioral problems. TVC's Nashville Connection and Family Connection programs did this by coordinating support services, building community bridges, and providing comprehensive in-home services.     

Injunctive Norms and Problem Gambling among College Students

Two studies examined the relationships among injunctive norms and college student gambling. In study 1 we evaluated the accuracy of perceptions of other students’ approval of gambling and the relationship between perceived approval and gambling behavior. In study 2 we evaluated gambling behavior as a function of perceptions of approval of other students, friends, and family. In study 1, which included 2524 college students, perceptions of other students’ approval of gambling were found to be overestimated and were negatively associated with gambling behavior. The results of study 2, which included 565 college students, replicated the findings of study 1 and revealed positive associations between gambling behavior and perceived approval of friends and family. Results highlight the complexity of injunctive norms and the importance of considering the reference group (e.g., peers, friends, family members) in their evaluation. Results also encourage caution in considering the incorporation of injunctive norms in prevention and intervention approaches.     

Staying safe while consuming alcohol: a qualitative study of the protective strategies and informational needs of college freshmen

OBJECTIVE: In this qualitative study, the authors examined how students attempt to minimize harm to themselves and others when drinking. PARTICIPANTS: The authors recruited freshmen at a large, mid-Atlantic US public university during the fall semester of 2005 to participate in 8 focus groups. METHODS: The moderator's guide was developed through an iterative process that included input from experts and pilot testing. The researchers audiotaped focus group conversations, transcribed them, and subjected them to an interrater reliability check. Analysis was based on the framework of Information-Motivation-Behavioral Skills Model and a phenomenological approach. RESULTS: College students have a repertoire of coping strategies they use in an attempt to safeguard themselves and their friends from harm when drinking. Strategies encompass planning a safe context for drinking, using safety measures to minimize harm when drinking, and taking care of someone who has consumed too much alcohol. CONCLUSIONS: A harm-reduction focus that acknowledges and builds on existing protective strategies may be a promising avenue for alcohol interventions.     

The inner circle: Building bridges or boundaries between researchers and practitioners

An epistemological and methodological approach, The Change Laboratory, is analysed to determine which forms of distributing knowledge are apparent during cross-cultural research. Distributing knowledge is intricately related to methodological design, to researchers’ and practitioners’ life experiences and to roles of power. The article concludes that research conducted across cultures necessitates careful analysis of the power found within forms of distributing knowledge. This power is derived from a tacit belief that certain knowledge is only available to those within a given circle or that it is available to those outside a given circle without alteration.