Improving partnerships with families and carers in in‐patient mental health services for older people: a staff training programme and family liaison service

In spite of policies advocating the involvement of families in the care of mental health service users in the UK, there are few examples of initiatives to develop staff confidence and skills in partnership working. This article describes a whole team training initiative and family liaison service to promote family inclusive working on in‐patient wards for older people in Somerset, UK. A three‐day staff‐training programme is described and training outcomes are reported. Staff report a substantial increase in confidence and family meetings held. A pre‐and post‐ training case note audit shows increased consideration of the needs of families. To further increase face to face meetings with families a family liaison service has been established, whereby a staff member with systemic family therapy training joins ward staff to hold family meetings as part of the assessment/admission process. Evaluation of this service has shown it to be effective with positive feedback from families and staff.     

对体胖者的社会性偏向：本土化视角的探索

通过三个研究从本土化视角探索人们对体胖者的社会性偏向特征。研究1采用访谈法和问卷法获得了被试对体胖者的刻板印象内容；研究2使用情感温度计和AMP范式对体胖者的外显与内隐偏见进行了测量；研究3通过情境测量对比人们在不同生活情境中对体胖者的行为反应。结果表明，中国被试对体胖者的刻板印象内容提名以高热情特质为主，刻板印象评价呈现低能力为主的特征；人们对体胖者没有外显偏见，但存在一定内隐偏见；社会生活情境中体胖者可能遭遇歧视，对女性体胖者的歧视程度更高。总体上，人们对体胖者的社会性偏向表现出复合性的本土化特征。     

Ageing Health Care and the Spiritual Imperative: A View from Scotland

SUMMARY

This paper, given as a keynote presentation at the third international conference on Ageing and Spirituality 2004 in Adelaide, Australia, offers a perspective on ageing that makes central and fundamental the spiritual journey. Ageing is not confined to the old. We are all ageing all the time and whilst the imperative of ego integration (Erikson, 1986, 1982) is more pressing in old age, the march of time makes no exceptions. The paper starts with a consideration of the Scottish context and the current interest in Scotland in spirituality and health. Borrowing from the human developmental ideas of Frankl, Jung, Erikson, and Klein, the paper takes the view that we are all spiritual beings, and we are all trying to be successful, integrated reconciled and mature individuals. Ageing and spirituality is relevant to every individual. Successful ageing is fundamentally concerned with the successful self. The spiritual journey is bound up with the search for meaning. Ageing is part of the task of being human and it involves decline and loss. The spiritual journey–search for meaning–is unique to each one of us. The spiritual journey is made evident in the search for the ultimate destination of giving up self, transcending self. Remembrance and routine are methods by which the ageing and the spiritual journey can be facilitated. A successful ageing, according to this perspective, is therefore one that embraces and self-consciously embarks upon a spiritual journey. To take it further–the spiritual journey is bound up with ageing–and further still–ageing is a spiritual journey (Bianchi, 1984). The primary task of ageing is spiritual development. Spiritual development is helped by an appropriate societal context in which ageing as spiritual journey can flourish. This has implications for health and social care services.     

‘Just Because I Can't Remember …’ Religiousness in Older People with Dementia

SUMMARY

This paper reports part of a pilot study that used spiritual reminiscence techniques to explore issues of religiosity, church attendance and meaning in life of a group of older people with dementia. The study used small groups, individual interviews and participant observation to examine the experience of dementia and the search for meaning used by people with dementia. There were 22 participants from three aged care facilities involved in the project. The majority of participants had been long-term church attendees and could describe how their religion and relationship with God had impacted on their lives. They had few fears for the future and derived considerable meaning in life from their relationships with family. Participants were able to describe early memories and also remember things happening recently in their aged care facility. This would seem to be the opposite of community expectations (and sometimes staff expectations) of older people with dementia.     

A Needs Assessment of Transgendered People of Color Living in Washington,DC

SUMMARY

A needs assessment (N = 248) conducted in Washington, DC, revealed that trans-gendered people of color are at high risk for HIV/AIDS, substance abuse, suicide and violence/crime victimization. Overall HIV prevalence was 25%, with 32% in natal males (MTFs, i.e., male-to-females). Four predictors for HIV positive status were identified through logistic regression-male sex at birth, a history of substance abuse, sexual assault, and unemployment. Substance abuse was found in nearly half the sample (48%) but only half of those (51%) had sought treatment for it. Thirty-eight percent reported experiencing suicidal ideation, with 63% of those attributing it to their gender issues. Of those with suicidal ideation, nearly half (49%, or 16% of the entire sample), went on to make attempt(s) to kill themselves. Forty-three percent had been victims of violence or crime, including 13% who had been sexually assaulted.

Knowledge of the Standards of Care of the Harry Benjamin International Gender Dysphoria Association was quite low (9%) and associated with white race, any higher education beyond high school, and access to sex reassignment surgery (SRS). Access to SRS, defined as obtaining vaginoplasties for natal males and chest surgeries for natal females, was just 4%. White race (versus all other races, p < .001) and female at birth (versus male, p < .01) were significantly associated with access to SRS.

Use of hormones at some point during their lives was reported by 51% of participants. Thirty-five percent were currently taking hormones, with 72% acquiring their hormones from friends or on the street. Among natal males, 25% had injected silicone.

Nineteen percent did not have their own living space, and employment, housing and job training were the most commonly-reported immediate needs of the sample. The results of this needs assessment provide evidence of an urgent need for increased medical and social services specific to transgendered people of color living in the District of Columbia.     

The “Transcendents” or “Trans” People

SUMMARY

This article was first published in Transvestia, vol. XVI, no. 95, 1978, pp. 81–92. Prince considers maleness and femaleness, and masculinity and femininity in human beings in terms of three dimensions: those of anatomy and physiology (the physical continuum), sex object choice (the psychological continuum), and the social and cultural continuum of masculinity and femininity. Socialisation traps us inside the two small permissible enclaves at the end of each continuum and in doing so produces “HALF HUMANS!” We accept this out of ignorance. As a humanist agitator, Prince advocates that we transcend the gender barrier and become free agents in regard to the transcended barrier. She distinguishes three types of trans people: transvestites (femmiphiles), transgenderists and transsexuals, and endorses the view that the woman most in need of liberation is the “woman” every man has locked in the dungeons of his own psyche.     

Religiosity and the mental health of adolescents in Great Britain

Most studies show that religion is a protective factor for mental health. A few argue that it is detrimental and the remainder conclude it makes no difference. We investigate the religiosity correlates of childhood psychopathology – strength of belief, importance of being able to practice one’s religion, and worship frequency. Questions on religiosity were included in the mental health survey of children in Great Britain administered to 2992 11–19-year-olds in 2007. The Development and Well-Being Assessment was used to generate rates of clinically recognisable mental disorders. Logistic regression analysis was used to establish the magnitude of the religiosity correlates of emotional and conduct disorders. Young people with a stated religion who had weakly held beliefs or who regarded religious practice as unimportant were those with the greater likelihood of having emotional disorders. Regular attendance at religious services or prayer meetings reduced the likelihood of having a conduct disorder.     

Aging of theory of mind: The influence of educational level and cognitive processing

Previous studies of theory of mind (ToM) in old age have provided mixed results. We predicted that educational level and cognitive processing are two factors influencing the pattern of the aging of ToM. To test this hypothesis, a younger group who received higher education (mean age 20.46 years), an older group with an education level equal to that of the young group (mean age 76.29 years), and an older group with less education (mean age 73.52 years) were recruited. ToM tasks included the following tests: the second‐order false‐belief task, the faux‐pas task, the eyes test, and tests of fundamental aspects of cognitive function that included two background tests (memory span and processing speed) and three subcomponents of executive function (inhibition, updating, and shifting). We found that the younger group and the older group with equally high education outperformed the older group with less education in false‐belief and faux‐pas tasks. However, there was no significant difference between the two former groups. The three groups of participants performed equivalently in the eyes test as well as in control tasks (false‐belief control question, faux‐pas control question, faux‐pas control story, and Eyes Test control task). The younger group outperformed the other two groups in the cognitive processing tasks. Mediation analyses showed that difficulties in inhibition, memory span, and processing speed mediated the age differences in false‐belief reasoning. Also, the variables of inhibition, updating, memory span, and processing speed mediated age‐related variance in faux‐pas. Discussion focused on the links between ToM aging, educational level, and cognitive processing.