Paternalism and Competent Patient Choice in the Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People

In 2016 physicians in Ontario will be granted the authority to refer patients with gender dysphoria for sex reassignment surgery. In order to be granted this authority physicians must be trained in the World Professional Association for Transgender Health’s Standards of Care, which outlines healthcare procedures for the treatment of gender dysphoria and provides background information concerning transgender health. The Standards of Care require that patients undergo a process of 12 months of continuous living in a gender role that is congruent with their gender identity prior to being given access to sex reassignment surgery. While this requirement can sometimes be helpful it can also cause more harm than benefit. This paper argues that the requirement is strongly paternalistic in its current form and should no longer be mandatory in most cases.

Marginalised Mothers: Exploring Working Class Experiences

Successive moral panics have cast poor or socially excluded mothers - associated with social problems as diverse as crime, underachievement, unemployment and mental illness - as bad mothers. Their mothering practices are held up as the antithesis of good parenting and are associated with poor outcomes for children. Marginalised Mothers provides a detailed and much-needed insight into the lived experience of mothers who are frequently the focus of public concern and intervention, yet all too often have their voices and experiences overlooked. The book explores how they make sense of their lives with their children and families, position themselves within a context of inequality and vulnerability, and resist, subvert and survive material and social marginalisation. This controversial text uses qualitative data from a selection of working class mothers to highlight the opportunities and choices they face and to expose the middle class assumptions that ground much contemporary family policy. It will be of interest to students and researchers in sociology, social work and social policy, as well as social workers and policymakers.

The discrepancy between social isolation and loneliness as a clinically meaningful metric: findings from the Irish and English longitudinal studies of ageing (TILDA and ELSA)

Objective
Scant evidence is available on the discordance between loneliness and social isolation among older adults. We aimed to investigate this discordance and any health implications that it may have.

Method
Using nationally representative datasets from ageing cohorts in Ireland (TILDA) and England (ELSA), we created a metric of discordance between loneliness and social isolation, to which we refer as Social Asymmetry. This metric was the categorised difference between standardised scores on a scale of loneliness and a scale of social isolation, giving categories of: Concordantly Lonely and Isolated, Discordant: Robust to Loneliness, or Discordant: Susceptible to Loneliness. We used regression and multilevel modelling to identify potential relationships between Social Asymmetry and cognitive outcomes.

Results
Social Asymmetry predicted cognitive outcomes cross-sectionally and at a two-year follow-up, such that Discordant: Robust to Loneliness individuals were superior performers, but we failed to find evidence for Social Asymmetry as a predictor of cognitive trajectory over time.

Conclusions
We present a new metric and preliminary evidence of a relationship with clinical outcomes. Further research validating this metric in different populations, and evaluating its relationship with other outcomes, is warranted.

The impact of childhood residential mobility on mental health outcomes in adolescence and early adulthood: a record linkage study.

Background Understanding the causes of poor mental health in early childhood and adolescence is important as this can be a significant determinant of mental well-being in later years. One potential and relatively unexplored factor is residential mobility in formative years. Previous studies have been relatively small and potentially limited due to methodological issues. The main aim of this study was to investigate the relationship between early residential instability and poor mental health among adolescents and young adults in Northern Ireland.

Methods A Census-based record linkage study of 28% of children aged 0–8 years in 2001 in Northern Ireland (n=49 762) was conducted, with six monthly address change assessments from health registration data and self-reported mental health status from the 2011 Census. Logistic regression models were built adjusting for socioeconomic status (SES), household composition and marital dissolution.

Results There was a graded relationship between the number of address changes and mental ill-health (adjusted OR 3.67, 95% CIs 2.11 to 6.39 for 5 or more moves). This relationship was not modified by SES or household composition. Marital dissolution was associated with poor mental health but did not modify the relationship between address change and mental health (p=0.206). There was some indication that movement after the age of five was associated with an increased likelihood of poor mental health.

Conclusions This large study clearly confirms the close relationship between address change in early years and later poor mental health. Residential mobility may be a useful marker for children at risk of poorer mental health in adolescence and early adulthood

Positive narratives: the stories young people with Social, Emotional and Behavioural Difficulties (SEBD) tell about their futures

This research drew on positive psychology in order to offer an optimistic way of conceptualising the lives of young people who are often described as having ‘SEBD’ (Social, emotional, behaviour difficulties), now SEMH (Social, emotional, mental health) in the new SEND Code of Practice (2014). Positive psychology places emphasis on: the future, strengths, resources and potential, and suggests that negative experiences can build positive qualities. A life path tool was used in order to hear the stories that eight young people tell about themselves in the future. Narrative Oriented Inquiry (NOI) was used to analyse the themes of potential and growth in their stories. The young people in this research identified a range of strengths and resources in their lives that they had built as a result of earlier negative experiences. Their stories reveal their hopes and aspirations for the future. By giving these young people the opportunity to tell their stories this research permitted them to focus on where they were going, rather than where they had been.

Medicated bodies: Mental distress, social media and affect

Social media are increasingly being recruited into care practices in mental health. This paper analyses how a major new mental health social media site (www.elefriends.org.uk) is used when trying to manage the impact of psychiatric medication on the body. Drawing on Henri Bergson's concept of affection, analysis shows that Elefriends is used at particular moments of reconfiguration (e.g. change in dosage and/or medication), periods of self-experimentation (when people tailor their regimen by altering prescriptions or ceasing medication) and when dealing with a present bodily concern (showing how members have a direct, immediate relationship with the site). In addition, analysis illustrates how users face having to structure their communication to try to avoid 'triggering' distress in others. The paper concludes by pointing to the need to focus on the multiple emerging relationships between bodies and social media in mental health due to the ways the latter are becoming increasingly prominent technologies through which to experience the body when distressed.

Searching for knowledge in the belly of the beast: diversity, social equity and the African graduate student mother's experience in US higher education

Diversity has become a buzz word in public discourse and in educational circles. Higher education institutions in the US have increasingly used this word as a cornerstone of their mission statements and have made increasing efforts to attract students from different backgrounds. As part of the increase in diversity efforts among US colleges, is a significant rise in the number of international students. Attracting international students has become a priority for U.S. universities regardless of size or location. This study examines the intersection between the structure of American educational environment and the blended identities of African Graduate Student Mothers. Within the context of contemporary diversity efforts in US educational institutions, this study examines both the structural environments and the socio-cultural constructs that affect the experiences of African graduate student mothers. Based on a qualitative research interview design, a total of nineteen African graduate student mothers at a Mid-Western University in the US were interviewed individually and in groups over a six weeks period. Results from this study show that apart from the difficult and often dehumanizing treatment African student mothers endure from immigration and consular officials in their various countries and ports of entry, they often find themselves at the margins of their various programs and departments with very little support if any. This is because most of them enroll into graduate programs after arriving as dependants of their spouses; a process that does not allow them to negotiate for departmental commitments and support prior to their arrival. Not only do these women face racial discrimination from white professors, staff and fellow students, but they also experience discrimination and hostilities from African Americans and other minority groups who see them as threats to the limited resources that are often set aside for minority groups in such institutions.

Content analysis model to analyze facets of social mission of public library on the Facebook and in the websites

In this paper we present the development and the implementation of a content analysis model for observing aspects relating to the social mission of the public library on Facebook pages and websites. The model is unique and it was developed from the literature. There were designed the four categories for analysis Generate social capital and social cohesion, Consolidate democracy and citizenship, Social and digital inclusion and Fighting illiteracies. The model enabled the collection and the analysis of data applied to a case study consisting of 99 Portuguese public libraries with Facebook page. With this model of content analysis we observed the facets of social mission and we read the actions with social facets on the Facebook page and in the websites of public libraries. At the end we discuss in parallel the results of observation of the Facebook of libraries and the websites. By reading the description of the actions of the social mission, the general conclusion and the most immediate is that 99 public libraries on Facebook and websites rarely publish social character actions, and the results are little satisfying. The Portuguese public libraries highlight substantially the actions in the category Generate social capital and social cohesion.

‘Old and ill’ : death anxiety and coping strategies influencing health professionals' well-being and dementia care

Social engagement and adaptive functioning during early childhood: Identifying and distinguishing among subgroups differing with regard to social engagement

This study tested the hypothesis that social engagement (SE) with peers is a fundamental aspect of social competence during early childhood. Relations between SE and a set of previously validated social competence indicators, as well as additional variables derived from observation and sociometric interviews were assessed using both variable-centered and person-centered approaches (N = 1453, 696 girls) in 4 samples (3 U.S.A., 1 Portuguese). Directly observed SE was positively associated with broad-band measures of socially competent behavior, peer acceptance, being a target of peers' attention, and also with broad-band personality dimensions. Using individual Q-items significantly associated with SE in 3 of our 4 samples, a hierarchical cluster analysis yielded a 5-cluster solution that grouped cases efficiently. Tests on relations between cluster membership and the set of social competence and other variables revealed significant main effects of cluster membership in the full sample and within each individual sample, separately. With the exception of tests for peer negative preference, children in the lowest SE cluster also had significantly lower overall social competence, personality functioning scores than did children in higher SE clusters.

The dynamics of professions and development of new roles in public services organizations: the case of modern matrons in the English NHS

This study contributes to research examining how professional autonomy and hierarchy impacts upon the implementation of policy designed to improve the quality of public services delivery through the introduction of new managerial roles. It is based on an empirical examination of a new role for nurses – modern matrons – who are expected by policy-makers to drive organizational change aimed at tackling health care acquired infections (HCAI) in the National Health Service (NHS) within England. First, we show that the changing role of nurses associated with their ongoing professionalization limits the influence of modern matrons over their own ranks in tackling HCAI. Second, the influence of modern matrons over doctors is limited. Third, government policy itself appears inconsistent in its support for the role of modern matrons. The attempts of modern matrons to tackle HCAI appear more effective where infection control activity is situated in professional practice and where modern matrons integrate aspirations for improved infection control within mainstream audit mechanisms in a health care organization.

Structural Health Monitoring Inside Concrete and Grout Using the Wireless Identification and Sensing Platform (WISP)

This research investigates the implementation of battery-less RFID sensing platforms inside lossy media, such as, concrete and grout. Both concrete and novel grouts can be used for nuclear plant decommissioning as part of the U.S. Department of Energy’s (DOE’s) cleanup projects. Our research examines the following: (1) material characterization, (2) analytical modeling of transmission and propagation losses inside lossy media, (3) maximum operational range of RFID wireless sensors embedded inside concrete and grout, and (4) best positioning of antennas for achieving longer communication range between RFID antennas and wireless sensors. Our research uses the battery-less Wireless Identification and Sensing Platform (WISP) which can be used to monitor temperature, and humidity inside complex materials. By using a commercial Agilent open-ended coaxial probe (HP8570B), the measurements of the dielectric permittivity of concrete and grout are performed. Subsequently, the measured complex permittivity is used to formulate analytical Debye models. Also, the transmission and propagation losses of a uniform plane wave inside grout are calculated. Our results show that wireless sensors will perform better in concrete than grout. In addition, the maximum axial and radial ranges for WISP are experimentally determined. Our work illustrates the feasibility of battery-less wireless sensors that are embedded inside concrete and grout. Also, our work provides information that can be used to optimize the power management, sampling rate, and antenna design of such sensors.

Self-affirmation before exposure to health communications promotes intentions and health behavior change by increasing anticipated regret

Health-risk information can elicit negative emotions like anticipated regret that may positively affect health persuasion. The beneficial impact of such emotions is undermined when target audiences respond defensively to the threatening information. We tested whether self-affirming (reflecting on cherished attributes) before message exposure can be used as strategy to enhance the experience of anticipated regret. Women were self-affirmed or not before exposure to a message promoting fruit and vegetable consumption. Self-affirmation increased anticipated regret and intentions reported following message exposure and consumption in the week after the intervention; regret mediated the affirmation effect on intentions. Moreover, results suggest that anticipated regret and intentions are serial mediators linking self-affirmation and behavior. By demonstrating the mediating role of anticipated regret, we provide insights into how self-affirmation may promote healthy intentions and behavior following health message exposure. Self-affirmation techniques could thus potentially be used to increase the effectiveness of health communication efforts.

Social participation and interventions supporting teenagers and young adults living with developmental coordination disorder (DCD): results from a Scoping Review

Background: The impact of Developmental Coordination Disorder (DCD) on teenagers’ and young adults’ participation is not well documented. This article aims to synthesize the current knowledge on social participation, which is the performance of an individual in realizing his daily activities and social roles within its life environment. Strategies and interventions to support youths (15-25 years old) with DCD were also synthesized. Methods: A scoping review interrogating three databases and using ‘snowballing techniques’ was performed to identify both scientific and grey literature published between 2004 and 2014. Over 1000 documents were screened and 57 were read in full; 28 met inclusion criteria. A charting form based on 12 life habits described in the Disability Creation Process (DCP) and developed by two reviewers was used to extract data and report the results. Results: All life habits were reported to be affected for teenagers and young adults with DCD, with education and interpersonal relationships being the most frequently discussed. During adolescence and adulthood, new tasks and subsequent difficulties emerge, such as driving. Mental health difficulties emerged as a key theme. Few strategies and interventions were described to support social participation of youths with DCD. Conclusion: Many life habits are challenging for youths with DCD, but few evidence-based strategies and interventions have been designed to help them to increase their social participation.