Group therapists' countertransference reactions to multiple deaths from aids

Group therapists for those with HIV Related Diseases are becoming the “professional” survivors of this world-wide epidemic. From their experiences we may learn a great deal more about the effects of multiple deaths on mental health care professionals. As therapists they are constantly eliciting and listening to the fears, hopes, agonies and terrors of those with this disease. They become the bereaved. Witnesses to the deaths of many of their group members, they struggle with a wide range of emotional responses while at the same time assisting surviving group members in their struggle to live with these deaths. Mourning reactions and countertransference phenomena are in abundance as these therapists grapple with these group processes. This article identifies and examines these therapists' responses by focusing on clinical illustrations drawn from their bi-weekly supervision sessions.     

Developing Age-Friendly Cities: Case Studies From Brussels and Manchester and Implications for Policy and Practice

Developing environments responsive to the aspirations of older people has become a major concern for social and public policy. Policies and programs directed at achieving “age-friendly” communities are considered to require a wide range of interventions, including actions at the level of the social and physical environment. This article compares the age-friendly approaches of two European cities, Brussels and Manchester, with a particular focus on policies and initiatives that promote active aging in an urban context. The article examines, first, the demographic, social, and multicultural contexts of Brussels and Manchester; second, the way in which both cities became members of the World Health Organization Global Network of Age-Friendly Cities and Communities; third, similarities and differences in the age-friendly approaches and actions adopted by both cities; and fourth, opportunities and barriers to the implementation of age-friendly policies. The article concludes by discussing the key elements and resources needed to develop age-friendly cities.     

Ambulance allocation for maximal survival with heterogeneous outcome measures

This paper proposes new models for locating emergency medical services (EMS) by incorporating survival functions for capturing multiple-classes of heterogeneous patients. The Maximal Expected Survival Location Model for Heterogeneous Patients (MESLMHP) aims to maximize the overall expected survival probability of multiple-classes of patients, whereby different classes could be defined according to agreed patient categories based on response time targets, or by capturing differing medical conditions each with a corresponding survival function. Furthermore, we propose and demonstrate an approximation approach to solving the extended stochastic version of MESLMHP, which utilizes queuing theory to permit the modeling of congestion and utilization at each ambulance station, and does not require assumptions to be made on the utilization of ambulances. Both models are demonstrated using data from the ambulance service in Wales. We show that our multiple outcome measures and survival-maximizing approach, rather than one based on average response time targets alone or a single patient class provides more effective EMS ambulance allocations.     

Why is the History of Heterosexuality Essential? Beliefs About the History of Sexuality and Their Relationship to Sexual Prejudice

Heterosexual people with more positive attitudes to lesbians and gay men generally believe that homosexuality is immutable, is not a discrete social category, and that homosexuality exists in all cultures and time periods. Equivalent beliefs about heterosexuality and beliefs about components of sexuality have been less often researched. 136 people with diverse sexualities described heterosexuality as more universal across history and culture than homosexuality (Study 1). 69 heterosexual-identified participants similarly believed that love, identity, behavior, and desire were more historically invariant aspects of heterosexuality than of homosexuality (Study 2). Less prejudiced participants thought all components of homosexuality—except for identity—were more historically invariant. Teasing apart beliefs about the history of components of heterosexuality and homosexuality suggests that there is no “essential” relationship between sexual prejudice and the tension between essentialist and constructivist views about the history of sexual identity.     

Intimate Partner Violence,Minority Stress,and Sexual Risk-Taking Among U.S. Men Who Have Sex With Men

This article examines the prevalence of intimate partner violence (IPV) among a national sample of Internet-recruited U.S. men who have sex with men (MSM) (n = 1,575), and associations between reporting of IPV, minority stress, and sexual risk-taking. Five outcomes are examined: experiences of physical and sexual violence, perpetration of physical and sexual violence, and unprotected anal intercourse (UAI) at last sexual encounter. MSM who reported experiencing more homophobic discrimination and internalized homophobia were more likely to report experiences of IPV. The results point to the need for prevention messages to address the external and internal stressors that influence both violence and sexual risk among MSM.