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Canadian HIV/AIDS researchers, service providers and policy-makers are faced with new challenges of providing effective and inclusive care that meets the needs of the changing populations infected with and affected by HIV. Since 2005 immigrants and refugees from ethno-racial minority communities have comprised close to 20 percent of all new HIV infections in Canada. Anecdotes shared by PLWHAs and service providers indicated that mental health challenges faced by newcomer PLWHAs was a priority concern for HIV prevention, treatment and care. This paper reports on the results of an exploratory study, which examined the complex factors that influence the mental health of immigrants and refugees living with HIV/AIDS (IR-PLWHAs).

This exploratory study is informed by a critical social science paradigm, which acknowledges that the everyday reality is shaped by interlocking systems of social processes and unequal power relations. The paper used a qualitative interpretative design and focus groups to explore the intersecting effects of living with HIV/AIDS, migration and settlement, and HIV stigma and discrimination on the mental health of IR-PLWHAs.

The paper found that in addition to social and economic marginalization, IR-PLWHAs experienced multiple stressors associated with their HIV status: neurocognitive and physical impairments, HIV stigma and discrimination, and fear of deportation. The paper also found that the experiences of stigma and discrimination among IR-PLWHAs were complex and contextual, closely linked to their social positions defined by the intersecting dimensions of race, class, gender, citizenship, sexualities, body norms, and HIV status. The paper concludes that effective HIV prevention, treatment and care, and mental health promotion in newcomer and ethno-racial minority communities must consider the bio-psycho-social connections of different stressors and the interlocking systems of oppression faced by IR-PLWHAs.

This study was exploratory in nature with a small number of participants who were recruited through AIDS organizations in Toronto. Consequently, the recruitment strategy may reach only those who were connected to the AIDS organizations. The paper believes that IR-PLWHAs who were not connected to the AIDS organizations might experience even more social exclusion and marginalization. These factors may limit the transferability of this study.

This is the first study that explores the bio-psycho-social connections and intersecting determinants of mental health among immigrants and refugees living with HIV and AIDS in Canada. The results of this study contribute to cross-sector dialogue among practitioners and researchers in the HIV/AIDS, mental health, and immigration and settlement services sectors.

This integrated care study seeks to highlight how voluntary sector “wellbeing co-ordinators” co-located in a horizontally and vertically integrated, multidisciplinary community hub within one locality of an Integrated Care Organisation contribute to complex, person-centred, co-ordinated care.

This is a naturalistic, mixed method and mixed data study. It is complementing a before-and-after study with a sub-group analysis of people receiving input from the wider hub (including Wellbeing Co-ordination and Enhanced Intermediate Care), qualitative case studies, interviews, and observations co-produced with embedded researchers-in-residence.

The cross-case analysis uses trajectories and outcome patterns across six client groups to illustrate the bio-psycho-social complexity of each group across the life course, corresponding with the range of inputs offered by the hub.

To consider the effectiveness and mechanisms of complex system-wide interventions operating at horizontal and vertical interfaces and researching this applying co-produced, embedded, naturalistic and mixed methods approaches.

How a bio-psycho-social approach by a wellbeing co-ordinator can contribute to improved person reported outcomes from a range of preventive, rehabilitation, palliative care and bereavement services in the community.

To combine knowledge about individuals held in the community to align the respective inputs, and expectations about outcomes while considering networked pathways based on functional status, above diagnostic pathways, and along a life-continuum.

The hub as a whole seems to (1) Enhance engagement through relationship, trust and activation, (2) Exchanging knowledge to co-create a shared bio-psycho-social understanding of each individual’s situation and goals, (3) Personalising care planning by utilising the range of available resources to ensure needs are met, and (4) Enhancing co-ordination and ongoing care through multi-disciplinary working between practitioners, across teams and sectors.

This chapter seeks to shed light on the many factors that contribute to people becoming school shooters. These factors are divided into four domains: biological, psychological, social, and cultural. At the biological level, this chapter explores the potential influence of genetics, pre- and post-natal development, and body-related issues that may affect the perpetrators' sense of self. A psychological typology is presented, consisting of psychopathic, psychotic, and traumatized school shooters. Socially, school shooters often have multiple setbacks, failures, and rejections that contribute to their distress. Finally, the cultural domain includes such factors as media violence, role models for killing, and ideologies of hatred and supremacy. Rather than attributing school shootings to a simplistic cause such as bullying, this chapter discusses a wide range of potential influences that combine to cause mass attacks at schools.

It matters to be aware of the important role played by the brain in the progressive constitution and unification of the three major facets of the human being: a biological individual; a social actor; a self‐conscious, reflective, and deliberating subject. The aim is to discuss this role.

The dialogues carried on by each one of these facets with an environment of its own (the material environment; the social milieu; the subject's inner world) are related to the functioning of three distinct levels of integration, organization, and adaptation within the human brain.

The neural substrate of basic affective processes pervades the entire brain and the latter processes play a predominant role in the mediation and integration of the individual's interactions with his/her environments. The degree of “plasticity”, i.e. the sensitivity to the shaping influence of environmental conditions, increases markedly from the lower to the higher level of brain functioning. Any individual characteristic of brain functioning is the outcome of a series of complex and evolving interactions between genetic and environmental factors.

Since brain development highly depends on the early environment (the first years of life), it is of the utmost importance to ensure that every developing brain benefits from optimal environmental conditions.

The paper brings together a series of scientific facts in an integrated and dynamic bio‐psycho‐social perspective which aims at working out a “model of man” thought to be an appropriate basis for any study of human development.

Early bio-psycho-social experiences can dramatically impact all aspects of development. Both autism and traumagenic histories can lead to trans-diagnostic behavioural features that can be confused with one another during diagnostic assessment, unless an in-depth differential diagnostic evaluation is conducted that considers the developmental aetiology and underpinning experiences and triggers to trans-diagnostic behaviours.

This paper will explore the ways in which biological, cognitive, emotional and social sequelae of early trauma and attachment challenges, can look very similar to a range of neurodevelopmental disorders, including autism. Relevant literature and theory will be considered and synthesised with clinical knowledge of trauma and autism.

Recommendations are made for how the overlap between features of autism and trauma can be considered during assessments alongside consideration for interventions to enable people to access the most appropriate support for their needs.

Many features of the behaviours of individuals who have experienced early childhood trauma and disrupted or maladaptive attachments, may look similar to the behaviours associated with autism and hence diagnostic assessments of autism need to carefully differentiate traumagenic causes, to either dual diagnose (if both are present) or exclude autism, if it is not present. This has for long been recognised in child and adolescent autism specialist services but is less well developed in adult autism specialist services.

To examine the ways in which sports-related brain injury (concussion and subconcussion) is both similar to and different from other injuries and to set out a sociological understanding of the injury, its manifestation and management.

There is a broad contextualization of the ‘issue’ of concussion and the processes that have brought this to the fore, an examination of the ways in which concussion has been figuratively clouded from plain view, and an outline of the main contributions of the social sciences to understanding this injury – the culture of risk and the mediating effect of social relationships. The chapter concludes by questioning whether the emergence of concerns over chronic traumatic encephalopathy has stimulated a fundamental change in attitudes towards sport injuries, and if this has had a significant impact on the social visibility of concussion.

The two available sociological studies of the lived experiences of concussion are situated within a broader analysis of the politicization of sports medicine and the emergence of a particular social discourse around sports-related brain injury.

The difficulties emanating from the dominance of a biomedical approach to concussion are discussed along with the need for further research, incorporating a more holistic view of concussion, as a bio-psycho-social phenomenon.

Inclusive Education promotes access to quality education, as well as participation and achievement opportunities for all learners in heterogeneous settings, particularly for those who are vulnerable, have been marginalized, discriminated against, labeled, and segregated in separate schools for “special needs.” Key issues include equal opportunity, and systemic change to accommodate diversity. This discussion essay addresses the question of how comparative and international education research advances understanding of these issues. As a key strategy for school reform adopted by UNESCO for its millennium development goal of universal education, implications for research and professional development of inclusive education policy and practices are discussed.

Annoying and bothersome behaviours among persons with developmental disabilities (DD) is a relatively frequent phenomenon. However, not all behaviour that is difficult to accept in its surroundings should be seen as abnormal or problem behaviour (PB). Some of these behaviours may be an expression of a person’s psychosocial needs and may be considered as adaptive and normal. The paper aims to discuss these issues.

Authors attempt to discuss relevant issues in persons with DD which have an impact on their behaviour, intending in this way to define criteria for a reliable differentiation between normal and abnormal behaviour and psychiatric disorders.

Differentiating between normal and abnormal may be a difficult task for a professional treating persons with DD because of the lack of adequate criteria for such differentiation. The problem becomes even more complex when one attempts to differentiate between PB and psychiatric disorder. By approaching the subject from a developmental perspective and by determining the level of the person’s emotional development, insight in subjective person’s experiences was achieved. On the ground of a “good practice” the authors made schemata outlining criteria for differentiation between these constructs.

The application of these schemata in the practice made it easier to establish appropriate diagnoses and was favourable for the planning of adequate treatment and support of persons with DD and mental health problems.

Although there is substantial evidence about the association between frailty and mental illnesses in older people, there is currently little evidence about how this is integrated into psychiatric clinical practice. The purpose of this paper is to explore the attitudes of a sample of psychiatrists in the UK about the concept and assessment of frailty in their clinical practice.

This research used a qualitative approach with semi-structured interviews. Interview schedules and transcripts were analysed using thematic analysis. NVivo software and an audit trail were used for the data analysis.

There were ten respondents (all psychiatrists) in this study. From the interviews, it appeared that some respondents were not be fully familiar with existing concepts of frailty. However, from their perspectives, frailty appeared to be multidimensional, reversible and for some could be enhanced by older people’s ability. Negative stereotypes of being frail could undermine the accessibility to appropriate assessment and care. Existing multidisciplinary assessments, with some adjustments to the particular needs of psychiatric patients, can be used to establish a frailty index.

The concept of frailty, especially those concerning its multidimensional and homeostatic nature, should be further examined to make it more applicable to psychiatric practice. Without much more effort, frailty could be assessed within current psychiatric practices. This could constitute a care plan tailored for frail people with a psychiatric illness, so as to improve the outcomes of their treatment and quality of life.