Mixing Apples and Oranges and Other Methodological Problems with a Meta-Analysis of Long Term Psychodynamic Psychotherapy

Current trends in mental health practice indicate that mental health practitioners, including clinical social workers, are tending to move away from psychodynamic approaches and are favoring short-term empirically supported approaches such as cognitive-behavioral therapy (CBT). Recently, the presumption that long-term psychodynamic psychotherapy (LTPP) approaches lack empirical support has been challenged, however, with the publication in major peer reviewed journals of meta-analyses that are claimed to demonstrate its equality to or superiority over empirically supported short-term therapies for some conditions. The present article examines the methodology employed in one particular meta-analysis which compared LTPP to short term therapies and the studies upon which the analysis was based. We found that major methodological and statistical flaws with the meta-analysis and with the individual studies preclude drawing any conclusions regarding the efficacy of LTPP.     

Losing a home through mortgage repossession: the views of children

In Britain between 1990 and 1998 454,280 households containing an estimated 1.32 million adults and children experienced mortgage repossession. The majority of households which are repossessed contained dependent children. Drawing on qualitative data derived from interviews with parents and children this paper aims to throw some light on how losing a family home in this way is experienced by children. The process of the repossession is often long and drawn out and is characterised by uncertainty; the change in tenure status from ‘owner’ to ‘renter’ is matched by a change in social status; and disruption in the children's social lives and circumstances. Copyright © 2001 John Wiley & Sons, Ltd.     

The Effects of First Occupation on Long Term Health Status: Evidence from the Wisconsin Longitudinal Study

In this paper, we use a longitudinal survey that has collected information for 50 years on a large cohort of Wisconsin high school graduates and their siblings to examine the long term impact of early occupational choice on health status. We find evidence that beginning a career in a blue collar occupation is correlated with several measures of poor health outcomes at ages 50–65. Since our dataset includes usually unobserved pre-labor market characteristics, including IQ and childhood health status, we can show that controlling for these variables is important for many results and suggests a high level of selection into occupation based on health and ability. We also provide evidence of gender differentials in the association between first occupation and later health. Then, we replace our basic measure of occupational categories with summary measures of job characteristics and find that employment at “bad jobs” at the beginning of an individual’s career predicts later health outcomes. Finally, we use sibling information in the dataset to show that unmeasured family background factors explain a large share of the effects of occupation on later health. Overall, the evidence points to limited, though heterogeneous, long term effects of health from blue collar employment.     

The Accessibility of Public Spaces for People with Dementia: a new priority for the 'open city'

The social model of disability de-medicalises disability and politicises it as an issue of universal rights. However, the rights of people with dementia have been less strongly advocated than those of people with physical disabilities. This is particularly the case with environmental planning and design. The needs of people with dementia are now informing the design of residential homes and day centres, but the issue of accessibility to public spaces and amenities has been almost completely neglected. Many outdoor environments such as shopping centres or parks may be inhospitable for people with dementia because they are disorientating, difficult to interpret and navigate, threatening or distressing. The article reviews the literature on indoor design for dementia, reports on research investigating the accessibility of outdoor environments, and describes a new approach using virtual reality technology to enable people with dementia to identify and test outdoor design and planning improvements themselves.     

Mind-loss in the African American community: Dementia as a normal part of aging

Dementia has been called a “silent epidemic” among African Americans. While there is a disproportionately high rate, little else is known. The purpose of this study was to begin to discover the cultural and linguistic variations in the definition, recognition, explanation of, and response to, dementia as it is experienced in the African American community. Participant observation was combined with guided conversations with 14 African American who knew persons who had, as they called it, lost their minds or whose minds had slipped. Analysis followed the structure of a grounded theory approach from looking at the phenomena of dementia through the consequences of its presence. Key findings included the lack of the recognition of formal language e.g. dementia, the attribution of normalcy of signs and symptoms and the importance of caregiving spontaneously provided to needy community members.     

Having the Last Word,but Losing the Culture Wars: Mainstream Press Coverage of a Canceled Evangelical Benediction

This study examines how mainstream news media reported the withdrawal of a popular pastor from the 2013 Obama inaugural ceremony. Louie Giglio was originally chosen for a role in the event but relinquished his position when focus was placed on a sermon he once delivered about homosexuality. Analysis of framing and sourcing of the stories raises serious questions about the role media played in reporting about this skirmish, which is clearly part of the larger culture wars.     

Dementia,disability rights and disablism: understanding the social position of people living with dementia

This article considers the recent history and consequences of positioning people living with dementia in the realms of disability, disablism and disability rights. The geo-political focus is the United Kingdom and neighbouring resource-rich nations in the Global North. The first section examines the growing trend of identifying ‘dementia’ with ‘disability’, a trend fuelled by the expansion of dementia-related activism and research. The second section focuses on how researchers who have published in Disability & Society and other journals have applied the social model of disability to individuals living with dementia. The third section discusses three conceptual challenges that lie ahead for those who choose to research and theorise the dementia/disability connection. These challenges concern: theorising dementia as disability; understanding intersectionality in dementia contexts; and understanding ‘abuse’ in dementia contexts.     

Bringing Disability into the Sociological Frame: a comparison of disability with race, sex, and sexual orientation statuses

Applying a social constructionist perspective, this paper explores the shared characteristics of American constructions of race, sex, sexual orientation, and disability. The discussion considers how each of these statuses is constructed through social processes in which categories of people are (1) named, (2) aggregated and disaggregated, (3) dichotomized and stigmatized, and (4) denied the attributes valued in the culture. The apparent utility of the social constructionist perspective - and its dominance in American sociology - is contrasted with its infrequent application to the study of disability.     

The Impact of the Physical Home Environment for Family Carers of People with Dementia: A Qualitative Study

Background: The majority of people with dementia are cared for by their families at home. This study aimed to elicit family carers' perceptions on home environmental aspects and strategies with the view to identify barriers and facilitators when caring for a person with dementia at home.

Design and methods: Thirteen co-resident family carers were engaged in semi-structured in-depth walking interviews. Interviews were recorded, transcribed and analysed using thematic analysis.

Results: Home environments can pose a number of challenges and opportunities. Aspects of the architectural and interior environment (e.g. size, condition, layout and accessibility, familiarity) are perceived as important (Theme 1) as well as a plethora of environmental strategies that encourage independence and comfort at home (Theme 2). Carers' scepticism, timing, costs, property characteristics and mistrust to services are some barriers to implementing environmental strategies (Theme 3).

Conclusions: Carers improvised solutions via trial and error and need further education on strategies to create an enabling and comfortable home environment.     

Suicide Prevention in the Dot Com Era: Technological Aspects of a University Suicide Prevention Program

Abstract

Western Michigan University's Suicide Prevention Program utilizes multiple technological components, including an online training course, a Web site, and 2 social networking Web site profiles, as integral aspects of a comprehensive program. This article discusses the development, maintenance, use, and impact of the technological aspects of this program, which complement other program activities in meeting program goals. The Web site and use of social networking Web sites have been very well received by members of the university and wider community. Although initial outcomes of each component are positive, low participation in the online training course has limited the usefulness of pretest–posttest comparisons. It is thought that other campus suicide prevention programs may benefit from using technology as a primary method in their suicide prevention programming efforts.     

Drop-off Detection with the Long Cane: Effects of Different Cane Techniques on Performance

This study compared the drop-off detection performance with the two-point touch and constant contact cane techniques using a repeated-measures design with a convenience sample of 15 cane users with visual impairments. The constant contact technique was superior to the two-point touch technique in the drop-off detection rate and the 50% detection threshold. The findings may help an orientation and mobility instructor select an appropriate technique for a particular client or training situation.     

From the New Ecological Paradigm to Total Liberation: The Emergence of a Social Movement Frame

Drawing on theories of social movements and environmental sociology, this article considers a frame transformation that is taking place within ecological social movements. This transformation produced a new frame: “total liberation.” We explore this phenomenon by analyzing interviews with activists, fieldwork observations, and documents from radical environmental and animal rights movement networks in the United States. Beyond introducing the total liberation frame, the article expands current understandings of how and why frame transformations occur through a consideration of how multiple frames, as well as intra‐ and intermovement tensions and influences, shape frame transformation.     

Disabling Spaces and Spatial Strategies: Feminist Approaches to the Home Environment of Family Caregivers of People with Dementia

ABSTRACT

The home environment becomes very important for family caregivers of people with dementia as a place of safety, retreat and care provision. Using a gender-based perspective, the authors analyzed thirteen interviews with family caregivers to understand how they perceived their home space. The data was analyzed thematically with the help of adjacency diagrams. Our analysis identified three main themes: compact layout, spatial flexibility, and the wider neighborhood. Given the gendered nature of caring, the findings are discussed drawing on the work of feminist architects regarding the home environment. The authors argue that feminist architectural approaches can usefully inform spatial strategies regarding dementia, ageing friendly housing, accessible living and the wellbeing of the caregiver. Different bodies and users’ needs should be at the epicenter of design, as opposed to conventional design and the current practices by developers, which may create a series of disabling spaces.     

Patient assertiveness in ethnically diverse older women with breast cancer: Challenging stereotypes of the elderly

Patients' views of patient-physician interactions—particularly the perspectives of older, ethnically diverse women—are poorly understood. The older patient's attitude toward and understanding of the medical encounter, however, are essential to the design of strategies to improve patient-physician communication. To date, investigations have primarily emphasised the ways in which the therapeutic relationship is influenced by immutable patient characteristics. This qualitative study extends previous research findings by looking beyond the effect of ascribed categories (such as age, race, and gender) and focusing on aspects of patient behavior, specifically assertiveness. Focus groups were conducted with older African-, Chinese-, European-, and Hispanic American breast cancer patients from sites in the eastern and western United States. The study explores the potential of a form of patient activation for challenging stereotypes of the elderly and changing health care practitioners' behavior.     

Dementia policy revisited: an analysis of the state laws targeted towards individuals with Alzheimer's disease and other forms of dementia.

Even though state governments assume public responsibility for persons with dementia, formal analysis of state laws concerning individuals with Alzhemier's disease and other forms of dementia has been rare. We responded to this by collecting and evaluating state legislation targeted towards individuals with dementia. These laws were collected by searching online statutory archives and were defined by the type of action, year of passage, and legislative purpose. Our research revealed that the legislatures have targeted an average of slightly more than five action towards persons with dementia. We also discovered that the earliest legislative act targeting individuals with dementia was passed by South Dakota in 1939, and by the end of the 1997 sessions, 49 state legislatures had enacted at least one targeted law. We sorted the variety of legislative actions into eight categories and illuminated how the purposes of these laws differed from one state legislature to the next. This research expands knowledge concerning state policies targeting people with dementia, imtroduces a reliable method of collecting state laws, and contributes to the advocacy effort made on behalf of persons with dementia.     

The Use of Tracking Technologies for the Analysis of Outdoor Mobility in the Face of Dementia: First Steps into a Project and Some Illustrative Findings From Germany

As people age in place, cognitive impairment is a major threat to maintaining out-of-home mobility. The SenTra project measures outdoor mobility by taking advantage of tracking technology in an interdisciplinary project involving researchers from geography, social work, gerontology, psychology, and medicine disciplines. The project assesses mobility patterns of urban-dwelling demented and mildly cognitively impaired elders and cognitively intact persons over a period of 3 years in Israel and Germany. The main objectives are to learn more about out-of-home mobility by means of global positioning system/geographical information system technology, to analyze the relationships between cognitive functioning, mobility behavior, and well-being, to examine the ethical implications of the use of advanced tracking technologies in this population, and to assess the potential of tracking technologies in the diagnosis of various types of cognitive impairment. The article presents preliminary findings to illustrate the potential of interdisciplinary data analyses to be performed later in the project. Pilot data were drawn from a combined psychiatric, psycho-social, and tracking data assessment of a group of 19 men and women between 63 and 80 years of age (7 who were healthy, 6 who were mildly cognitive impaired, 6 who were demented) living in Germany. The findings revealed that healthy participants have better health and higher levels of well-being and smaller networks compared to elders who are cognitively impaired. Examples of daily outdoor trips indicate meaningful mobility patterns and the need to combine psycho-social and geographical data to understand the relationships between outdoor mobility, socio-structural dimensions, behavior patterns, and well-being. By achieving its aims, the project will be able to make a substantial contribution to basic, applied, and clinical knowledge gaps in the area of mobility and cognitive impairment research.