Sex differences in the development of mild cognitive impairment and probable Alzheimer’s disease as predicted by hippocampal volume or white matter hyperintensities

This study examined biological sex differences in the development of mild cognitive impairment (MCI) and probable Alzheimer’s disease (AD) development as predicted by changes in the hippocampus or white matter hyperintensities. A secondary data analysis of the National Alzheimer’s Coordinating Center Uniform Data Set was conducted. We selected samples of participants with normal cognition at baseline who progressed to MCI (n = 483) and those who progressed to probable AD (n = 211) to determine if hippocampal volume or white matter hyperintensities (WMH) at baseline predicted progression to probable AD or MCI and whether the rate of progression differed between men and women. The survival analyses indicated that changes in hippocampal volumes affected the progression to probable AD (HR = 0.535, 95% CI [0.300–0.953]) only among women. White men had an increased rate of progression to AD (HR = 4.396, CI [1.012–19.08]; HR = 4.665, 95% CI [1.072–20.29]) compared to men in other race and ethnic groups. Among women, increases in hippocampal volume ratio led to decreased rates of progressing to MCI (HR = 0.386, 95% CI [0.166–0.901]). Increased WMH among men led to faster progression to MCI (HR = 1.048. 95% CI [1.011–1.086]). Women and men who were older at baseline were more likely to progress to MCI. In addition, results from longitudinal analyses showed that women with a higher CDR global score, older age at baseline, or more disinhibition symptoms experienced higher odds of MCI development. Changes in hippocampal volumes affect the progression to or odds of probable AD (and MCI) more so among women than men, while changes in WMH affected the progression to MCI only among men.     

People with disability and new disaster communications: access and the social media mash-up

This article explores how a lack of access to increasingly complex and overlapping digital communications platforms in times of disaster for people with disabilities has the potential to make already life-threatening situations considerably more dangerous. As we are increasingly coming to rely on a social media mash-up of digital platforms to assist in communications during disaster situations, the issue of accessibility for people with disabilities is as dire as if it was high ground during a tsunami or transport during a typhoon. The contemporary social media environment is characterised by a complex and overlapping network of complementary platforms, populated by user-generated content, where people communicate and exchange ideas. In this environment, YouTube videos are posted to Facebook and embedded in blogs, and Twitter is used to link to these other sites and is itself embedded in other platforms. These networks are increasingly supplementing and supplanting more traditional communication platforms, such as the television and radio, particularly in times of disaster. The concern of this paper is that the elements from which this mash-up of communications channels is made are not always accessible to people with disabilities. This evolving network of social media-based communication exposes the limits of existing Internet-based universal design.     

Family violence in gambling help-seeking populations

Elevated rates of family violence among treatment-seeking problem gamblers compared to general population estimates have been reported in Spain, Canada and Australia. This study examined the occurrence of family violence among 454 problem gambling help-seeking clients (370 gamblers, 84 affected others) recruited through 3 national gambling treatment services in New Zealand. Measures used were the Problem Gambling Severity Index, and a modified version of the HITS Scale which assessed physical, emotional, verbal and sexual abuse. Past-year family violence among gamblers in this sample was 46.8% for victimization, 41.2% for perpetration and 55.0% for any form of family violence. Among affected others the occurrence was 65.5% for victimization, 57.1% for perpetration and 71.4% for any form of violence. The most common type of violence was verbal intimate partner violence. Affected others and women gamblers reported higher rates of violence victimization and perpetration. These findings underscore the importance of screening gambling help-seeking clients for family violence, and the development of prevention and treatment programmes to address violence in this population, with particular attention to affected others and women gamblers. Future research should assess coercive control and the gendered nature of family violence among problem gambling help-seekers.     

Relearning to Live Life Without Substances: A Grounded Theory of the Impact of Group Physical Exercise on Sobriety

Research has found significant benefits in using exercise as an adjunct treatment for substance use. This study used a qualitative grounded theory approach to explore the role of group exercise on maintaining sobriety. Sixteen persons (13 White men and 3 White women, age M = 31.81, SD = 8.23), recruited from a substance use recovery group that meets at a gym in an urban area in the Southeast part of the United States, were individually interviewed. Data were analyzed using Charmaz’s (2006) constructivist grounded theory strategies. Central themes revealed a parallel process between the steps taken to seek sobriety and those taken to maintain sobriety. The driving forces of sobriety success in both was 12 steps and group exercise programming that included elements of mentorship, structure, accountability, and fellowship or community. This study supported the use of physical group exercise as an adjunct treatment option for substance use treatment.     

Thinking Through Affect and Psychoanalysis: Introducing Papers from the Conference “Worldings,Tensions, Futures”

This is an introduction to the panel of papers collected from the affect theory conference “Worldings, Tensions, Futures,” comprising the stream focusing on psychoanalysis, affect and time.     

Whose ‘wee country’?: identity politics and sport in Northern Ireland

This article responds to calls in this journal for increased attention to identity, culture, power and sport. It explores, for the first time, the lived realities of identity politics in a divided society, through interviews with 12 self-declared Irish nationalists and republicans that represented Northern Ireland. Important insights are revealed into national eligibility decisions for either Irish team, motivated mainly by ‘shop window’ visibility and being seen as the best of a peer group. Political and sporting nationalisms were not necessarily analogous. A significant original finding is that the lived experiences of being closer to ‘the other’ resulted in an overall reinforcement rather than dissolution of difference. Visual and oral ‘national’ symbols such as flag, and especially anthem, delineated such difference, being symbolic walls of the mind. ‘Our wee country’ was thus a polarised and polarising fantasy shield. The article concludes by reconsidering the role of sport as a lens through which to examine identity and its’ place as part of the ‘problem’ and ‘solution’.     

The Role of Self-Conscious Emotions in the Sexual Health of Gay and Bisexual Men: Psychometric Properties and Theoretical Validation of the Sexual Shame and Pride Scale

Researchers have theorized about the role of sexual shame as a mechanism through which sexual minority stress manifests into mental health difficulties, such as sexual compulsivity for gay and bisexual men (GBM), and about the resilience-promoting effects of sexual pride. However, no validated measures to date have directly tapped into these constructs rather than using proxies for them, such as internalized homonegativity. We developed the Sexual Shame and Pride Scale (SSPS) and conducted a psychometric evaluation of it using a sample of 260 highly sexually active GBM. The scale had the expected structure in factor analysis and showed evidence of internal consistency and test–retest reliability. Correlational analyses demonstrated the convergent validity of sexual shame and sexual pride with relevant constructs. Regression analyses demonstrated the predictive validity of sexual shame in relation to sexual compulsivity, accounting for unique variability even after adjusting for previously demonstrated etiological factors, and the predictive validity of both shame and pride, which interacted to consistently predict four sexual behavior outcomes. Findings suggest the SSPS is a psychometrically valid and reliable measure that may be useful in future empirical work and highlight preliminary evidence for the role of these constructs in the sexual health of GBM.     

What might Normalisation Process Theory bring to policy implementation studies? Learning lessons and uncovering questions through a case study of the profound implementation failure of a new policing policy

Normalisation Process Theory (NPT), used nationally and internationally to explore implementation within health services research, is used for the first time within policing to understand profound policy implementation failure and to generate broader discussion of policy implementation theory. The policy in question (Police to Primary Care [P2PC]) was an intervention designed to notify GPs when women are assessed by police as at high risk of future domestic abuse. Designed to improve interagency communication, it took place amidst radical organisational change. Using qualitative interviews with domestic abuse specialist and frontline officers, this paper addresses how NPT helps to explain the (non)implementation of P2PC, how such an analysis differs from other policy implementation approaches, and what this means for our understandings of policy implementation more broadly. NPT proved useful in understanding mechanisms leading to (non)implementation of the intervention: fuzzy alignment with existing practice, faulty communication of purpose, and inattention to discretionary implementation spaces. It helped us understand why the intervention came to be invisible. Dwarfed by its organisational context, made institutionally hard to read by a lack of formal protocols, and given restricted view to police officers, it was compromised by a failure to instigate systems of organisational learning. More broadly, NPT helped reveal practices intersecting top‐down and bottom‐up implementation theory. The paper concludes by asking how NPT and theories of street‐level bureaucracy might be better used in tandem and, particularly, how this might help explorations of policy implementation where human actors are joined by technological actors in interpreting and making policy in vivo.