Intersectional impact of multiple identities on social work education in the UK

This document is the Accepted Manuscript version of the following article: Ben Chi-pun Liu, ‘Intersectional impact of multiple identities on social work education in the UK’, Journal of Social Work, Vol 17(2): 226-242, March 2017. © 2016 The Author(s). DOI to the published version: 10.1177/1468017316637220. Reprinted by permission of SAGE Publications.Summary: The study reviews the records of 671 social work students and graduates including the seven intakes from the first cohort in 2003/2004 to the intake in 2010/2011 to examine the interacting effect of learning difficulties, ethnicity and gender on the completion of social work training at a university in the South East of England. Findings: Among the students, 79.9% of them were female, 50.1% were black, 27.9% white, 10.7% Asian and 11.3% other ethnicities. A majority of students did not report any disability. Among those who did (n ¼ 84), 52.3% (n ¼ 44) reported a learning difficulty.The percentage of students who have successfully completed the training is 76.4%, a completion rate that is comparable to the UK’s national figure. Having controlled the confounding variables, hierarchical logistic regression identified the risk factor for dropoutfrom undergraduate social work programme as black female students with learning difficulties (odds ratio ¼ 0.100, 95% confidence interval ¼ 0.012–0.862, p < 0.05). Findings suggested that students with multiplicity of identities, i.e. being black and female and with a learning difficulty, have a lower probability to complete the programme successfully. Applications: Strategies for tackling the intersecting disadvantages of race, gender and disabilities in social work training should embrace three principles: providing continuous support, focusing on how the support is provided and addressing contextual and structural barriers.Peer reviewedFinal Accepted Versio

Increase in computed tomography in Australia driven mainly by practice change: A decomposition analysis

Background: Publicly funded computed tomography (CT) procedure descriptions in Australia often specify the body site, rather than indication for use. This study aimed to evaluate the relative contribution of demographic versus non-demographic factors in driving the increase in CT services in Australia. Methods: A decomposition analysis was conducted to assess the proportion of additional CT attributable to changing population structure, CT use on a per capita basis (CPC, a proxy for change in practice) and/or cost of CT. Aggregated Medicare usage and billing data were obtained for selected years between 1993/4 and 2012/3. Results: The number of billed CT scans rose from 33 per annum per 1000 of population in 1993/94 (total 572,925) to 112 per 1000 by 2012/13 (total 2,540,546). The respective cost to Medicare rose from $145.7 million to$790.7 million. Change in CPC was the most important factor accounting for changes in CT services (88%) and cost (65%) over the study period. Conclusions: While this study cannot conclude if the increase is appropriate, it does represent a shift in how CT is used, relative to when many CT services were listed for public funding. This ‘scope shift’ poses questions as to need for and frequency of retrospective/ongoing review of publicly funded services, as medical advances and other demand- or supply-side factors change the way health services are used

From design to operations: a process management life-cycle performance measurement system for Public-Private Partnerships

YesPublic–Private Partnerships (PPPs) have become a critical vehicle for delivering infrastructure worldwide. Yet, the use of such a procurement strategy has received considerable criticism, as they have been prone to experiencing time/cost overruns and during their operation poorly managed. A key issue contributing to the poor performance of PPPs is the paucity of an effective and comprehensive performance measurement system. There has been a tendency for the performance of PPPs to be measured based on their ex-post criteria of time, cost and quality. Such criteria do not accommodate the complexities and lifecycle of an asset. In addressing this problem, the methodology of sequential triangulation is used to develop and examine the effectiveness of a ‘Process Management Life Cycle Performance Measurement System’. The research provides public authorities and private-sector entities embarking on PPPs with a robust mechanism to effectively measure, control and manage their projects’ life cycle performances, ensuring the assets are ‘future proofed’

How provider organisations interpret regulation in the context of residential dementia aged care

Objective To explore how Australian residential dementia aged care providers respond to regulation via organisational culture, level, processes and interpretation. Methods Observation took place in three provider organisations. Qualitative, semi-structured in-depth interviews were conducted with aged care staff (n = 60) at three different levels of each organisation: senior management from three head offices (n = 17), facility management (n = 13) and personal care workers (n = 30) from eight residential care facilities. Results Orientations towards regulation included the following: "above and beyond;" "pushing back;" and "engineering out." Regulation was interpreted differently depending on the level of authority within an organisation where boundaries were managed according to strategic, operational and interactional priorities. Discussion Examining regulation within an organisational context and at different staff levels suggests ways to balance dementia care with regulatory control. Both generate stress, mitigated by culture and interdependent role differentiation.Peer reviewe