'I went back to being myself': acceptability of a culturally adapted task-shifted cognitive-behavioural therapy (CBT) treatment for depression (Ziphamandla) for South African HIV care settings.

There is a need for a culturally adapted, evidence-based, psychotherapy treatment that is effective, acceptable, and feasible for integration into primary care in South Africa. This qualitative study used exit interviews to examine participants' experiences of an adapted cognitive-behavioural therapy treatment for adherence and depression, task-shifted and delivered by nurses in two peri-urban HIV clinics near Cape Town. Nine semi-structured exit interviews were conducted with isiXhosa-speaking females and analysed using thematic analysis. Overall, participants responded positively to the treatment, viewing it as acceptable and beneficial and as a catalyst to returning to normalcy. Results indicated that participants viewed the treatment as being effective in ameliorating their depressive symptoms and improving their adherence to ART . Additional benefits described included improvements in subjective wellbeing and social and occupational functioning. Several began or resumed employment, an important behavioural indicator of the treatment's capacity to facilitate positive change and cost saving. Recommendations to improve the treatment included using video material and educating others about depression. These findings have positive implications regarding the acceptability and cultural applicability of the treatment for use in South Africa.

Risk factors of elder abuse in a community dwelling Spanish sample.

We analyzed the discriminative capacity of several risk factors for elder abuse and neglect, in order to identify what characteristics distinguish between caregivers with a high or low risk of abuse and neglect. Forty-five caregivers of relatives with dementia participated. The combination of caregiving impact, frequency of aggressive behaviors by care-recipients, stress related to provocative and aggressive behaviors, the frequency of provocative behaviors, interpersonal burden, autoefficiency expectations, quantity of help received and depression classify correctly as risk factors in 90.9% of the cases. This study permits us to identify what characteristics distinguish between caregivers with a high or low risk of abuse and neglect and caregivers.

Bruises on the soul: older women, domestic violence and elder abuse.

PIP: This article presents an overview on the status of current knowledge concerning elder abuse and neglect, and to move to a consideration of factors from the field of domestic violence. For many years, attempts to understand the phenomenon of elder abuse remained a problem because of its complexity. This paper, however, discusses abuse and neglect at three levels--macro, mezzo, and micro: macro abuse refers to issues at a societal level; mezzo abuse refers to behaviors, attitudes, and policies inflicted on older people at the community level; micro abuse refers to issues in the domestic setting. All definitions of elderly abuse generally include physical, psychological and financial abuses and neglect. Added to these categories of abuse are sexual and social abuses. Attempts were also made to understand the dynamics of elderly abuse. Majority of the cases of abuse among elderly people happens among the females and is mostly inflicted by their spouses. Deteriorating health, thwarted hopes, expectations and plans; a diminution in capacities to function and manage; an increase in vulnerability and dependence all contribute to the development or continuation of abusive situations within intimate relationships in old age. Although gender played a major role in elderly abuse, attempts to consider it in relation to this issue remained limited. Based on the discussions presented, it was made clear that elderly abuse is comparable to domestic violence, although it is different from other forms of family violence.^ieng

Issues in the sphere of elder abuse and neglect: the role of education.

In recent years, there has been an increased emphasis on violence and abuse within society. It therefore seems appropriate to consider the role of education in promoting a greater understanding of the linked phenomena of elder abuse and neglect, and of the quality of life of older people. The rationale behind the educational process covering the area of elder abuse and neglect has not, until now, been discussed in any structured or open way. Education concerning these social problems has tended to develop in an ad hoc manner, with numerous organizations, professionals and academics developing their own ideas about what might be considered to be an appropriate curriculum. This paper aims to address some of the fundamental questions which need to be explored, including: who is to be educated; what knowledge is to be taught; and how is it to be taught?

Recognising and dealing with the abuse of older people.

The phenomenon of elder abuse and neglect is not new; indeed, there is evidence that suggests the issues have been present within society for a considerable period of time. Despite the efforts of health- and social-care professionals to draw attention to the topic since the issue was first raised in the late 1970s, it is only since 1988 that the issues related to elder abuse and neglect have begun to be addressed. Health and social-care professionals have not viewed work with older people very positively.

Elder abuse and neglect: issues in the accident and emergency department.

Recognition and identification of elder abuse and neglect within the Accident and Emergency (A & E) department currently appears less evident than recognition of child abuse and domestic violence. As the population of older people increases, it is likely that there will be an increased usage of the A & E department by older people, some of whome may have been subject to abuse or neglect. Elder abuse and neglect constitute potentially serious health and social problems. The need for the A & E nurse to identify and respond to elder abuse and neglect is therefore a professional responsibility. The nursing profession is clearly in a position to contribute to the recognition of elder abuse and neglect, and A & E nurses are in a unique position to assist this process. This paper seeks to assist nurses with this task by arguing for a 'higher index of suspicion', allied to a sound knowledge base of the circumstances surrounding elder abuse, signs and symptoms and known risk factors. Finally, practical suggestions are offered to assist in the assessment and intervention with suspected or known cases of elder abuse and neglect.

A major problem needing recognition. Assessment and management of elder abuse and neglect.

While the abuse of children and adults receives widespread coverage, that of older people has only recently been acknowledged. It is vital that nurses improve their understanding of this problem, so they can participate effectively in multidisciplinary assessment and care.

The case for samples of anonymized records from the 1991 census.

"The census of population represents a rich source of social data. Other countries have released samples of anonymized records from their censuses to the research community for secondary analysis. So far this has not been done in Britain. The areas of research which might be expected to benefit from such microdata are outlined, and support is drawn from considering experience overseas. However, it is essential to protect the confidentiality of the data. The paper therefore considers the risks, both real and perceived, of identification of individuals from census microdata. The conclusion of the paper is that the potential benefits from census microdata are large and that the risks in terms of disclosure are very small. The authors therefore argue that the Office of Population Censuses and Surveys and the General Register Office of Scotland should release samples of anonymized records from the 1991 census for secondary analysis."