The proportion of those over the age of 65 years in black and minority ethnic (BME) groups in England and Wales is increasing. The prevalence of dementia and depression…
The proportion of those over the age of 65 years in black and minority ethnic (BME) groups in England and Wales is increasing. The prevalence of dementia and depression among BME elders from different groups in the United Kingdom is generally similar to or higher than in indigenous white British elders. Two methods were used to provide a conservative estimate of the absolute number of cases of dementia and depression among BME elders. Data on prevalence from published studies of different BME elderly groups and the number of those over the age of 65 years from different BME groups in the general population in the 2001 population census were used for analysis. The most conservative estimates of the absolute number of cases of dementia among BME elders were 7270 and 10,786 for the two methods of analysis; the corresponding figures for depression were 33,559 and 52,980. There is a significant amount of psychiatric morbidity among the elderly from BME groups. A multi‐faceted approach is needed to ensure that commissioning, design, development and delivery of culturally capable, appropriate and sensitive old age psychiatry actually occurs and improves the equity of service access by BME elders.
The Mental Capacity Act 2005 (MCA) was fully implemented in October 2007 in England and Wales. This article reports on two similar, but separate, pilot questionnaire…
The Mental Capacity Act 2005 (MCA) was fully implemented in October 2007 in England and Wales. This article reports on two similar, but separate, pilot questionnaire studies that examined the experience of consultants in old age psychiatry and consultants in other psychiatric specialities in the early implementation of the MCA pertaining to issues relevant to black and minority ethnic (BME) groups. Fifty‐two (27%) of the 196 consultants in old age psychiatry and 113 (12%) of the 955 consultants in other psychiatric specialities returned useable questionnaires. Eighty per cent or more of the consultants in old age psychiatry and consultants in other psychiatric specialities gave consideration to religion and culture and ethnicity in the assessment of decision‐making capacity (DMC). Almost 50% of the consultants in old age psychiatry reported that half or more of the patients lacking fluency in English or where English was not their first language received an assessment of DMC with the aid of an interpreter and 40% of the consultants in other psychiatric specialities reported that no such patients received an assessment of DMC with the aid of an interpreter.The low rate of using interpreters is of concern. The nature of the consideration and implementation of factors relevant to culture, ethnicity and religion in the application of the MCA and the precise reasons for the low rate of using interpreters in patients lacking fluency in English or English not being their first language require clarification in further studies.
The black and ethnic minority (BME) elderly population in England and Wales is increasing. As dementia is an age‐related disorder and the prevalence of depression in old…
The black and ethnic minority (BME) elderly population in England and Wales is increasing. As dementia is an age‐related disorder and the prevalence of depression in old age is high, the absolute number of cases of dementia and depression will increase among BME elders. This has implications for the development and delivery of old age psychiatry services (OAPSs) for BME elders. Demographic data pertaining to the elderly from BME groups in the 2001 population census were analysed in detail to evaluate the implications for development and delivery of OAPSs for BME elders. The demographic changes identified have important future implications for the development and delivery of OAPSs for BME elders. Unless they are addressed systematically, BME elders will continue to harbour untreated, hidden psychiatric morbidity. Strategies to ensure that this vulnerable group of elderly are identified and provided with accessible, acceptable and culturally sensitive OAPSs should be developed.
This article considers the effectiveness of two one‐day events designed to raise awareness of The Mental Capacity Act 2005 (MCA) in BME communities. The events were held…
This article considers the effectiveness of two one‐day events designed to raise awareness of The Mental Capacity Act 2005 (MCA) in BME communities. The events were held using specially developed materials and were evaluated with the help of a 12‐item questionnaire. The results of the evaluation showed that there was an increase in the proportion of correct responses for 10 of the 12 questions after attending awareness‐raising events. The total score for all correct responses on the 12‐item questionnaire significantly increased after attending the awareness‐raising events. Collectively, the findings suggest that the awareness‐raising events were able to improve awareness of the MCA among representatives of BME communities. Such awareness‐raising events should be encouraged by health and social care providers
The Mental Capacity Act 2005 (MCA) was fully implemented in October 2007 within England and Wales as a framework for making decisions about incapacitated persons' care and…
The Mental Capacity Act 2005 (MCA) was fully implemented in October 2007 within England and Wales as a framework for making decisions about incapacitated persons' care and treatment generally not amounting to a deprivation of their liberty (although such could be authorised under its powers by the new Court of Protection). From a planned date of April 2009, the MCA is to be enlarged by the provisions of the Mental Health Act 2007 (MHA 2007) to encompass deprivation of liberty, with the addition of a new framework of Deprivation of Liberty Safeguards (DOLS). The MHA 2007 also revised significant aspects of the Mental Health Act 1983 (MHA), which were implemented in November 2008. The interface between the MCA, as amended to include DOLS, and the revised MHA is complex and potentially ambiguous. This paper describes in detail some issues that may arise at the interface of the two acts, and seeks to inform professionals involved in the use of these legal frameworks of the resulting complexity.
In this article, we return to a piece of work we did with two NHS trusts in the mid 1990s that focused squarely on tackling institutional racism. We do this for two…
In this article, we return to a piece of work we did with two NHS trusts in the mid 1990s that focused squarely on tackling institutional racism. We do this for two reasons. First, because we feel that the current context for equalities may be obscuring the need to continue to find ways to tackle institutional racism. Second, we brought together very achievable survey and group work techniques in a co‐produced process, which makes tackling institutional racism less laden with rhetoric and much more of a practical proposition. This article articulates a three‐staged approach to identifying racism operating inside the trusts, an appraisal of the experience of black patients and the development of learning groups. In these learning groups, black and white practitioners and managers engaged with each other on their impacts and relationships with black patients, thereby changing their practices with all patients. What achieves equality of health service response from this experience is the creation of an environment in which practitioners can become self‐motivated in re‐working ‘with and for themselves’ the way they work with patients based on a recognition of racial identities in service relationships.
The purpose of the chapter is to integrate the understanding of diversity from different perspectives in Indian context and see how the holistic view emerges.
The methodology used is primarily the literature review of the concepts and their evolution in Indian context and the use of secondary sources to extract praxis information.
It emerged from the exploration on diversity practices at the societal as well as organizational level in India that the country demonstrates intent to mainstream the people from different wakes, but with the changing context the format of the practices has changed.
The basic premise of the chapter needs to be explored further through primary data from practice.
This chapter is novel in a way that it integrates the diversity scholarship of four different streams viz. caste, gender, disability, and generation. Most of the existing research focuses only on a thin slice/one key dimension of diversity.
The purpose of this study is the development of an objective approach to prioritize and rank airfield pavement sections based on their condition and justify their funding…
The purpose of this study is the development of an objective approach to prioritize and rank airfield pavement sections based on their condition and justify their funding requirements using a soft-computing technique.
The airfield pavement condition is evaluated by collecting data through field tests and visual surveys. The performance indicators are selected as deflection, structural index, subgrade modulus and pavement condition index, by taking the help of field experts. The condition of pavement sections is analyzed by obtaining scores for each sections using Buckley’s fuzzy analytic hierarchy process. The sections are finally ranked for performing their maintenance and repair activities.
The condition of pavements is represented using a single score that takes an account of cumulative impact of various parameters as well as any subjectivity associated with human perceptions.
The developed methodology is very useful for its practical implications, and it is explained using a case study of an international airport.
Decision-making for maintenance and repair practices is often based on subjective decisions and lacks a robust and judicious approach. Thus, obtaining sufficient budget for repair and maintenance becomes one of the primary challenges. This study adds a value to prevailing practices by developing an objective decision-making methodology. Additionally, the use of non-destructive testing techniques, which pose little or no necessity to destructive coring and boring, eases this task.
The purpose of this paper is to develop a numerical model for estimating the unknown boundary heat flux in a parallel plate channel for the case of a hydrodynamically and…
The purpose of this paper is to develop a numerical model for estimating the unknown boundary heat flux in a parallel plate channel for the case of a hydrodynamically and thermally developing laminar flow.
The conjugate gradient method (CGM) is used to solve the inverse problem. The momentum equations are solved using an in-house computational fluid dynamics (CFD) source code. The energy equations along with the adjoint and sensitivity equations are solved using the finite volume method.
The effects of number of measurements, distribution of measurements and functional form of unknown flux on the accuracy of estimations are investigated in this work. The prediction of boundary flux by the present algorithm is found to be quite reasonable.
It is noticed from the literature review that study of inverse problem with hydrodynamically developing flow has not received sufficient attention despite its practical importance. In the present work, a hydrodynamically and thermally developing flow between two parallel plates is considered and unknown transient boundary heat flux at the upper plate of a parallel plate channel is estimated using CGM.