Young-onset dementia: a review of the literature and what it means for clinicians

It is estimated that more than a half million people in the United States are living with young-onset dementia and another half million with mild cognitive impairment, a precursor of dementia. Relatively little has been written about the psychosocial needs of these people, but information can be extrapolated from the literature on dementia in older adults and the developmental tasks and roles of middle age. This article synthesizes this literature and provides information to help psychiatric nurses and other health care professionals better understand individuals living with young-onset dementia.     

Heterosexism,racism, and mental illness discrimination: Experiences of people with mental health conditions and their families

Experiencing discrimination related to race/ethnicity, sexual orientation, or having a mental health condition is associated with negative outcomes. Research comparing types of discrimination or considering intersectionalities is lacking. This study reports findings from interviews with people with mental illnesses (PWMI) or family members of PWMI; all study participants also are of color and/or lesbian, gay, or bisexual. Findings include the following: participants experienced multiple forms of discrimination, mental illness discrimination shares characteristics with racism and heterosexism, and heterosexuals and people of color reported more mental illness discrimination than their counterparts. Implications for change advocates, mental health providers, and researchers are offered.     

‘IF I FEEL LIKE THIS,HOW DOES THE CHILD FEEL?’ CHILD PROTECTION WORKERS,SUPERVISION, MANAGEMENT AND ORGANISATIONAL RESPONSES TO PARENTAL VIOLENCE

This study analysed workers’ experiences of supervision following interactions with hostile and intimidating parents. This analysis examined management and organisational responses to worker stress, and assessed the adequacy of support that workers received. An online survey was designed to collect data on workers’ experiences and free text responses were qualitatively analysed for references to the supervision they received in response to working with parents. 590 participants responded to the survey. 402 were qualified social workers, and 423 worked in child protection. Participants had experienced a range of violent behaviour from parents. The overwhelming theme in responses was the lack of support and supervision workers received, often in stressful and frightening circumstances. Approximately one quarter of participants only used organisational procedures, guidelines or protocols on dealing with hostile parents. Workers reported that mismanaged parental hostility affected their practice and the quality of protection that children received. The violence experienced had a significant negative impact on their personal and professional lives. Organisational responses in the form of supervision and education were often inadequate and resulted in children receiving reduced quality of protection. Recommendations for policy and practice change are discussed, with the aim of caring for workers and the children they protect.     

Psychiatric Services: Organizing Impossibility

This paper explores the proposition thatelements of the work of psychiatric services areimpossible. The notion of impossibility is consideredfrom three perspectives: societal, interpersonal, andorganizational.Organizational elements of impossibility areevidenced in attempts to work with madness, a phenomenonthat defies clear definition. Resultant confusion inrole and task boundaries is exacerbated by madinterpersonal interactions. The situation iscompounded by societal conflicts between the mad and thesane. Attempts to house and treat the mad over the past200 years are reviewed, and recent illustrativecase material is presented from two communitytreatment teams. It is argued that primarilysolution-focused approaches to madness have limitedsuccess. To acknowledge impossible elements of the workmay enable psychiatric institutions to be designedin ways that help make individual and collective madnessmore bearable rather than something to be controlled andor denied.     

The effects of management practices on union election returns

This paper examines the importance of management suppression tactics on union activity in the United States. NLRB data on individual certification elections which have recently become available for the period 1972–1976 are merged with structural, demographic, and industry characteristics of the 96 largest SMSAs to ascertain the role of strategy versus structure in explaining union outcomes. The measures of election-generated membership outcomes are voter participation, the margin of pro-union votes, and union wins. Union suppression practices under study include consent elections, election delays, formal objections after unions win a certification election, elections overruled because of management unfair labor practices, elections held by management petition, and the number of unfair labor practice charges per representation election. Five of the six measures of suppression are significant determinants of some facet of union expansion after adjusting for structural characteristics of the area work force.     

The Relation of Patterns of Coping of Inner–City Youth to Psychopathology Symptoms

This study provides empirical verification that variations in patterns of coping can explain current and future functioning of youth. The study evaluated the methods and styles of coping of inner–city youth and their relation to age, gender, ethnicity, stress levels, and internalizing and externalizing symptom levels. Three hundred seventy–two 12– to 16–year–old adolescents from inner–city schools (67.0% African American, 24.4% Hispanic; 53.41% males) participated. One hundred forty–nine were also included in a follow–up evaluation of the prospective relation of coping to functioning. A seven–factor model of coping methods was identified and found to be applicable across age groups, genders, and ethnic groups. The model was robust over time. Coping methods were categorized through cluster analysis into five styles. Styles were found to relate somewhat to demographic characteristics and stress levels. Controlling for demographic characteristics and stress levels, coping style related concurrently and prospectively to internalizing and externalizing symptom levels. Except in one instance, age, ethnicity, and gender did not interact with coping in predicting symptoms. Implications for further coping research and risk and intervention design are discussed.     

Education in the Context of Conflict and Instability: The Palestinian Case

This paper draws on the results of a study carried out in the West Bank, in 1999, to explore the role of education as a coping strategy among the children of Palestinian refugees, and to examine how the state of being refugees affects perceptions of the value and importance of education. The paper first reviews the background to the development of a formal education system in Palestine and considers the different approaches to education in different political contexts, with ensuing particular reference to the West Bank. The findings of the regional study are then reported, with special reference to the various functions of education as a coping strategy—remedial, incentive‐mobilizing and identity‐building. Education, for those who have lost their property and whose identity is under threat, emerges as a key channel for maintaining consciousness of collective rights.