Family caregivers’ perceptions of maltreatment of older adults with dementia: findings from the northwest of Spain

Dementia is a neurocognitive disorder that implies a risk factor of maltreatment by family caregivers. In this study, we analyzed both informal caregiver’s perceptions of maltreatment and aspects of the caregiver and caregiving behavior that may be associated with maltreatment. We conducted five focus groups (FGs) in three Spanish cities: Segovia, Soria and León. The themes that were identified were related to two levels of maltreatment: (a) relational and (b) institutional. At the relational level, we observed the justification of maltreatment of Older Adults with Dementia (OAswD) by family caregivers during the occurrence of behavioral symptoms. At the institutional level, we noted that lack of support from the government was considered a type of maltreatment. These themes suggest that policy issues related to healthcare should be considered.     

Why Are So Many (If Not Really All) People and Families Disturbed?*

Many personal and family problems grow out of our not knowing how to process an intricate network of dualities, contradictions, dilemmas, paradoxes, and momentums that are intrinsic to the human condition rather than resulting from “disturbance” or pathology. What we have been learning in family therapy is that the processing of both “right” and “wrong” ways, or “good” and “bad” behaviors, is more likely to yield health and growth, whereas failures to process these dualities are far more the culprit of emotional disorders than bad or wrong behaviors as such. What really becomes important in family life is not the ability to stay out of trouble, but to get out of trouble, that is the ability to process conflicts and dilemmas and unfairness constructively. This way of looking at families helps us to account for and integrate many of the hard empirical findings that have been gathering now for twenty years in family therapy.     

Complexities in attracting and retaining direct support professionals

Recruiting and retaining direct support professionals (DSPs) remains essential to the full inclusion for persons with disabilities. Using a mixed-evaluation model, we measured DSPs' views versus those of their supervisors. DSPs expressed lower perceptions concerning their supervisors, satisfaction with their work situation, and environmental and safety factors. Focus groups provided insights into resolving issues related to compensation, work environment, and recruiting and retaining future DSPs. Motivating factors included wanting to be part of a helping community where all are valued. To improve their performance, DSPs stated their desire to understand the roles of managers and of the consumer. DSPs indicated that having career paths that provided advancement opportunities and direct contact with persons with disabilities were primary motivators.     

Toward 'good enough' services for inaptly served families and children: Barriers and opportunities

The present article draws attention to ways in which the goodness of fit between social services and their clients, both in the present and the past, determines the extent to which services are successful–in the sense that clients experience them as helpful and as furthering their well-being, and that there is objective evidence of improvement in their situation.

To provide an initial conceptual framework for exploration in this area, a number of terms are introduced and defined. These include ‘inapt service”, ‘inaptly served families’, and ‘good enough services’.

It is contended that biases that promote inaptness, in the areas of policy, organization, practice, and research and evaluation, have contributed to the proliferation and perpetuation of inapt services. As a basis for further reflection and for efforts to transform ‘inapt’ service systems into ones that are ‘good enough’, twelve such biases are discussed.

Finally, premises and directions for action that promote such transformative efforts are suggested.     

Effects of Aerobic Training on Primary Dysmenorrhea Symptomatology in College Females

Abstract

“Single-Dose Therapy for Cystitis in Women: A Comparison of Trimethoprim-Sulfamethoxazole, Amoxicillin, and Cyclacillin,” Thomas M. Hooton et al. We evaluated single-dose regimens of trimethoprim-sulfamethoxazole, amoxicillin, and cyclacillin as treatment for acute cystitis in 38 women. The trial was prematurely stopped because of frequent treatment failures. At two days after treatment, all 13 patients given trimethoprim-sulfamethoxazole were cured, while four (31%) of the 13 given amoxicillin and four (33%) of 12 given cyclacillin had persistent bacteriuria. At two weeks, 11 (85%) of 13 patients given trimethoprim-sulfamethoxazole, six (50%) of 12 given amoxicillin, and three (30%) of ten given cyclacillin were cured. One patient with positive results of antibody-coated bacteria testing who was treated with cyclacillin had signs and symptoms of acute pyelonephritis three days after treatment, and two patients treated with amoxicillin and one treated with trimethoprim-sulfamethoxazole converted antibody-coated bacteria test results from negative to positive after therapy. We conclude that single-dose treatment of cystitis in unselected women with cyclacillin and amoxicillin may result in low cure rates and that progression to acute pyelonephritis may occur following ineffective single-dose therapy. (Journal of the American Medical Association 1985;253:387-390.)     

Breaking free from siloes: intersectionality as a collective action frame to address toxic exposures and reproductive health

ABSTRACT

There has been increasing interest in collaborative approaches between the environmental justice (EJ) and reproductive justice (RJ) movements to address the higher burden of toxic exposures and associated reproductive health outcomes in vulnerable communities. This study examined the collective action frames (CAFs) of advocates at the EJ/RJ nexus. CAFs highlight how advocates identify problems and solutions, and motivate action. The use of intersectionality was identified as a main CAF used in three key ways: breaking free from identity-based, issue-based, and movement-based siloes. First, interviewees described breaking free from identity-based siloes by identifying risks of toxic exposures that result from intersecting social locations (e.g. gender, race/ethnicity, income, immigration status) and by equally prioritizing multiple aspects of their identities as they engage in advocacy. Second, they described breaking free from issue-based siloes by developing multi-issue agendas that address a complex web of interrelated problems impacting health. Third, they described breaking free from movement-based siloes by developing cross-movement collaborations to address issues of mutual concern. Among multiple reasons given for cross-movement collaborations, advocates perceived them as valuable in order to disrupt social, political, and economic power imbalances that shape environmental reproductive health inequities, as well as other health and social inequities. Based on these findings, we suggest that intersectionality is a master frame, and thus may be useful to advocates in other social movements addressing intersectional issues. Understanding an intersectionality frame can help to inform advocacy approaches to promote health and health equity, particularly those focused on policies and structural drivers of health.