'Wet' care homes for older people with refractory alcohol problems: a qualitative study

Background This study describes a registered care home in England and a registered nursing home in Norway which provide permanent care for alcohol-dependent older people who are unable or unwilling to stop drinking and cannot maintain an adequate standard of self-care and/or live independently. Prior to admission, most residents have been living unsafely in their own home or were homeless. They have high levels of contact with health, social and criminal justice services and complex needs as a result of mental illness, poor physical health and physical disabilities. Most have lost contact with their families. The aim is to stabilise drinking, physical and mental health and improve quality of life. The homes are based on a harm reduction philosophy, that is, they focus on strategies to reduce harm from high-risk alcohol use, rather than insisting on abstinence. Residents can drink as much alcohol as they want on the premises but staff encourage them to drink less and in a less harmful way (e.g. spreading drinking throughout the day and having ‘dry’ days). Method We carried out interviews and focus groups with staff and residents, observed verbal exchanges, experiences and routines in communal areas, took field notes during staff rounds and analysed documents such as care plans for individual residents. Key findings • Most residents’ drinking, physical and mental health stabilises and their use of health, social and criminal justice services reduces following admission. • This is achieved by encouraging less harmful drinking, providing on-site health care, assistance with medication and self-care and provision of nutritious meals and social activities. • Wet care homes are viewed by some residents as a safe refuge which has improved their quality of life. • Other residents are frustrated by a lack of personal autonomy. • Suitable outcomes include improved hygiene and nutrition, increased self-esteem, better compliance with healthcare, healthier living which is not entirely alcohol focused and more hope for the future. • Homes should have processes in place to collect quantitative measures which provide clear evidence of impact.        

National evaluation of Diplomas: cohort 1 - the second year

The introduction of Diplomas for 14-19 year olds represented a major innovation in educational opportunity for young people in England. The Diplomas are being offered at three levels and across 14 subjects and have been implemented in three phases (from September 2008, 2009 and 2010). Following the establishment of the Coalition government in May 2010, a number of changes to the implementation and delivery of the Diploma qualification were introduced. The Minister of State for Schools announced that development of new Diplomas in science, humanities and languages, which were due to be introduced from September 2011, would be discontinued. Additionally the Diploma entitlement, whereby all young people within an area would be able to access any of the Diploma subjects, would be removed and that the decision about which Diploma subjects would be available to students would in future be made by schools and colleges. Moreover, it was decided that the Gateway application process whereby consortia (of schools, colleges, training providers, employers and Higher Education Institutes (HEIs)) had previously submitted an application to the Department for Education (DfE) for each Diploma subject they wanted to offer would no longer be required for provision commencing from 2012. Other changes included the freedom for institutions to decide whether or not they wanted to work collaboratively to provide Diploma provision

When Gay Was Not Okay with the APA: A Historical Overview of Homosexuality and its Status as Mental Disorder

While homosexuals have historically experienced many different forms and types of intolerance, perhaps some of the most harmful discrimination in recent decades can be said to have come from mental health and medical professionals. These professionals have labeled homosexuals as abnormal, pathological, and deviant. In the 1950s, the American Psychiatric Association (APA) made this discrimination against homosexuals official when it classified homosexuality as a mental disorder. This label had a huge impact on the homosexual community, which was just then beginning its fight for acceptance in mainstream society. thus the fight for the reversal of the APA diagnosis became a focus of the gay rights movement. Although it would take over two decades, the APA eventually made the decision to remove homosexuality from its list of mental disorders and began to move toward the acceptance of homosexuality as normal behavior. this paper will examine the history of how homosexuality has been viewed throughout the history of psychology, focusing on early research as well as the events that led up to the APA\u27s eventual decision to remove homosexuality from its list of mental disorders

Understanding recovery: the perspective of substance misusing offenders

Purpose – The purpose of this paper is to critically regard the concept of recovery from the perspective of substance misusing offenders. It intended to understand how these individuals came to define recovery by asking “what does recovery mean to you?” Design/methodology/approach – In total, 35 semi-structured interviews were undertaken with individuals with a history of heroin and crack cocaine use as well as convictions for a range of offences. Interviews took place in both prison and community settings, reflecting a spectrum of experience. Findings – Whilst the constellation of recovery varied, it was at times made up of the same “stars” – and some re-occurring themes emerged; recovery was transient, fragile and unpredictable, it was ongoing, lacking a definitive end, it was more than abstinence and often involved a total psychological overhaul, recovery was about reintegrating with society and feeling “normal”. Practical implications – Practitioners and services need to value the individual interpretations of recovery rather than being prescriptive around what it “should” look like. The components of recovery that were raised by participants permit specific recommendations for practice to be made. Originality/value – This study sought the perspectives of those actually affected by and experiencing drug treatment in the Criminal Justice System. It allowed participants to tell their story without preconceived ideas or hypotheses, putting their voice at the centre of the stage. The study uses feedback from the ground to make informed recommendations for practice. </jats:sec

The Kalahari Copperbelt in central-eastern Namibia

The continuity of the Kalahari Copperbelt (KCB) beneath the Cenozoic cover of the Kalahari Group in central eastern Namibia has long been assumed, but was only confirmed by exploration drilling in 2010 when Eiseb Prospecting and Mining (EPM) uncovered Ag-bearing Cu sulfide mineralisation comparable to that found elsewhere in the belt. The geology of this region has not been described in any detail in the literature to date. Zircon geochronology suggests that sedimentation of the Eiseb started at ~1170 Ma. An uplifted basement horst of deformed acid volcanics marks the western edge of the Eiseb. There is no eastern border to the Eiseb, which extends into the Ghanzi-Chobe Belt of Botswana. Deformation and folding of the belt occurred during the Pan African Damara Orogen which peaked at ~530 Ma. Cu-Ag mineralisation is disseminated across a range of rock types, from the volcanic basement horst, to sandstones and argillites. Mineralisation also occurs in veins, often discordant to stratigraphic boundaries, and within the coarse laminae of interbedded siltstones. The preservation of delicate sulfide replacement textures of evaporite minerals in micro-folded rocks suggests that the mineralisation is largely epigenetic, favouring pressure shadows and foliation on a local scale, and fold-closures, faults and thrusts on a regional scale. Magnetite is commonly associated with with Cu-Ag mineralisation both textually and spatially, across a range of rock types. Paleomagnetic methods were unable to constrain the timing of magnetite growth. The trace element contents of magnetite, as deduced by laser ablation inductive coupled plasma mass spectrometry (ICP-MS), is able to distinguish between barren and Cu-Ag mineralised host-rocks using element ratios. The V vs. Ni binary plot is effective for the acid volcanic rocks, and the V vs. Co plot distinguishes between mineralised and un-mineralised sedimentary rocks. Magnetite trace element concentrations show that it formed from hot (150-250˚C) metalliferous fluids with an IOCG (iron-oxide-copper-gold) affinity. The most likely mechanism for magnetite formation is by replacement of pyrite, with textures suggesting this occurred during deformation, i.e. during the Damara Orogeny. The syn-deformation, epigenetic Cu-Ag mineralisation recognised in the Eiseb has been reported from numerous other deposits traditionally classified as ‘sediment-hosted stratiform copper’ (SSC). In these deposits mineralisation has been shown to be coeval with regional plate movements and orogenesis, which is fundamentally different to the SSC model where mineralisation is related to diagenetic processes. An alternative mineralisation model is thus proposed, orogenic-sediment-hosted-copper (O-SSC)