The cultural representation of older people: ageism and the National Health Service

The care of older people in the hospital setting has been the subject of increasing scrutiny from policymakers, researchers, philosophers and age campaigners over the last twenty years. However, in spite of continued attention in organisational training, dignity campaigns and government policy, reports of undignified care continue to surface through notable incidents such as the Mid Staffordshire Public Inquiry. This study examined the role that the cultural representation of older people may have on the attitudes of NHS staff towards them, hypothesising that this influence can be as meaningful as that gathered in the work or social settings. The research adopted a mixed methods approach incorporating a national survey of NHS staff cultural consumption habits, multi-modal discourse analysis of cultural texts typically consumed by that population, and semi-structured interviews with NHS staff. The findings show that older people are generally underrepresented from large swathes of culture, and when represented there is a tendency towards either negative or positive stereotypes. Market trends and operational processes within the cultural industries help to explain the variation of representation on offer, with audience segmentation being a key factor in cases where older people were absent or negatively stereotyped. These representations were found to inform the interviewees’ perceptions of the older population, although this was also mediated by experiences gathered on the job, in training or through social engagement. While efforts are ongoing to foster intergenerational understanding in NHS organisational culture and local communities, the unique position of the cultural industries makes similar interventions in this field more challenging

Preventative Social Care and Community Development in Wales: "New" Legislation, "Old" Tensions?

Prevention is becoming ever more central in UK care policy for older people, though precisely what this entails, and how it works most effectively in social care and support, remains ambiguous. Set against the "newness" of recent social care legislation in Wales, this article explores the perspectives of professionals on prevention and community development, particularly for older people. This draws on qualitative data collected from 11 Welsh local authorities, four NHS Wales health boards, and eight regional third-sector organisations, incorporating 64 interviews with directors, executives, and senior managers. Recent research has highlighted concerns over the slipperiness of prevention as a concept, resulting in multiple interpretations and activities operating under its banner. Consistent with this, our data suggested a kaleidoscopic picture of variously named community-based initiatives working to support the intricate web of connections that sustain older people, as well as provide practical or material help. Similarly, professionals highlighted varied agendas of community resilience, individual independence, and reducing the need for state-funded health and social care, as well as a range of viewpoints on the roles of the state, private sector, and the third sector. Analysis revealed fragments of familiar themes in community development; positive hopes for community initiatives, tensions between the mixed agendas of state-instigated activities, and the practical challenges arising from systems imbued with neo-liberal ideas. Realising the promise of prevention will require deft steering through these challenges

Problematising ‘Fused Principles’ in Discourses of Preventative Social Care: Interpreting the Implementation of National Social Services Legislation in Wales, UK

Prevention is a core principle in social care legislation across the UK. However, history shows great variability in how a preventative social care agenda is conceptualised and implemented. We report findings from an independent evaluation of the implementation of the ‘2014 Social Services and Well-being (Wales) Act’ incorporating a document analysis of reports and plans from Wales’ twenty-two local authorities (LAs) and eighty-eight qualitative interviews from social services strategic leaders and operational managers within four Welsh LAs. Analysis highlighted multiple interpretations of national policy, with notable overlapping agendas. In Gramscian terms, there is a constant process of negotiating prevention values and agendas, with consequences for whose interests are served. This was apparent through drives towards cost-saving, financial sustainability and reduced service demand operating alongside values-based principles rooted in well-being and mutualism. Following Kenny’s work in community development, we argue a ‘fusing’ of principles whilst espousing benefits for service users, potentially blurs the aims of the legislation, with implications for practice

Reflections on Community Development, Preventative Care, and Ageing

Recently there has been a chorus of demands to "re‐imagine" social care. Community and faith‐based organisations, policy, and academic communities are engaged in discussions on issues such as human rights for older populations, the future of residential care, how to better support family/community care, and strengthen local place‐based community development. Moreover, the Covid‐19 pandemic has added new urgency to this mission, galvanizing developments for change and collective action and exposing public troubles of endemic system failings, prevailing discourses of ageism, tensions with health systems, and limitations of market models of care and support. Prevention is a central social welfare principle in many countries. It is associated with policy and practices that aim to meet social care needs early and is explored in this thematic issue

Translation: From bench to brain – Using the visual arts and metaphors to engage and educate

This article examines multidisciplinary public engagement projects that bring together developments in psychiatric research and practice with visual art and its use of metaphor. The article focuses on the art exhibition Translation: From bench to brain, which was the basis for further collaborations, illustrating how the learning from the original event influenced subsequent projects. Combining art exhibitions with online documentation and resources, the projects explored not only medical and scientific themes, but also the wider social, cultural and ethical ramifications, specifically aspects of identity, risk and stigma. The activities demonstrate the value of a developmental approach to public engagement as a process, whereby projects build on previous activities and evolving multidisciplinary perspectives, networks and expertise

A versatile reducible polycation-based system for efficient delivery of a broad range of nucleic acids

Synthetic vectors based on reducible polycations consisting of histidine and polylysine residues (HIS RPCs) were evaluated for their ability to deliver nucleic acids. Initial experiments showed that RPC-based vectors with at least 70% histidine content mediated efficient levels of gene transfer without requirement for the endosomolytic agent chloroquine. Significant gene transfer was observed in a range of cell types achieving up to a 5-fold increase in the percentage of transfected cells compared to 25 kDa PEI, a gold standard synthetic vector. In contrast to 25 kDa PEI, HIS RPCs also mediated efficient transfer of other nucleic acids, including mRNA encoding green fluorescent protein in PC-3 cells and siRNA directed against the neurotrophin receptor p75(NTR) in post-mitotic cultures of rat dorsal root ganglion cell neurons. Experiments to elevate intracellular glutathione and linear profiling of cell images captured by multiphoton fluorescent microscopy highlighted that parameters such as the molecular weight and rate of cleavage of HIS RPCs were important factors in determining transfection activity. Altogether, these results demonstrate that HIS RPCs represent a novel and versatile type of vector that can be used for efficient cytoplasmic delivery of a broad range of nucleic acids. This should enable different or a combination of therapeutic strategies to be evaluated using a single type of polycation-based vector

PEACH: Promoting Excellence in All Care Homes

The Promoting Excellence in All Care Homes study focuses on the position of staff in care homes, and the influences upon them. The care home workforce has a pivotal role in the quality of care provided to residents of care homes, which in turn is a major influence on quality of life. This large work-force, of probably over a half a million people, carry out work that is often seen as unattractive, at rates of pay that are seen as under-valuing the contribution made, without a clear career structure, in a sector that is marked by constant change. Individual staff members are influenced by their personal attributes and resources, their own families, relationships and social networks, but also by the social climate in their work-place and by the organisational environment. Burn-out and low job satisfaction have been related to negative attitudes to residents and lower quality of life. The sector often attracts unfavourable publicity in relation to reported instances of abuse and neglect, although estimating the extent of such problems is challenging. Training is often viewed as a vehicle for reducing the risk of abuse and neglect, and to increase the value afforded to those undertaking this work

Weakening dark-matter cusps by clumpy baryonic infall

We consider the infall of a massive clump into a dark-matter halo as a simple and extreme model for the effect of baryonic physics (neglected in gravity-only simulations of large-scale structure formation) on the dark-matter. We find that such an infalling clump is extremely efficient in altering the structure of the halo and reducing its central density: a clump of 1% the mass of the halo can remove about twice its own mass from the inner halo and transform a cusp into a core or weaker cusp. If the clump is subsequently removed, mimicking a galactic wind, the central halo density is further reduced and the mass removed from the inner halo doubled. Lighter clumps are even more efficient: the ratio of removed mass to clump mass increases slightly towards smaller clump masses. This process is the more efficient the more radially anisotropic the initial dark-matter velocities. While such a clumpy infall may be somewhat unrealistic, it demonstrates that the baryons need to transfer only a small fraction of their initial energy to the dark matter via dynamical friction to explain the discrepancy between predicted dark-matter density profiles and those inferred from observations of dark-matter dominated galaxies.Comment: 17 pages, 13 figures, accepted for publication in MNRA