Victor Minichiello

Perceptions and consequences of ageism: views of older people

This qualitative study examines meanings and experiences of ageism for older Australians. While the concept is widely applied in academic social analysis, the term is not understood or used by many of the informants. They talk freely, however, about negative experiences in ‘being seen as old’ and ‘being treated as old’. Active ageing is viewed as a positive way of presenting and interpreting oneself as separate from the ‘old’ group. Informants recognise that older people as a group experience negative treatment in terms of poor access to transport and housing, low incomes, forced retirement and inadequate nursing home care. While few have experienced overt or brutal ageism, interaction in everyday life involves some negative treatment, occasional positive ‘sageism’, and others ‘keeping watch’ for ones vulnerabilities. Health professionals are a major source of ageist treatment. Some older people limit their lives by accommodating ageism, while others actively negotiate new images of ageing for themselves and those who will be old in the future.

The meaning of music in the lives of older people: a qualitative study

This qualitative study describes the experience of music and focuses on the emotional, social, intellectual and spiritual well-being roles that music plays in the lives of older people. In-depth interviews were used to explore the meaning, importance and function of music for 52 older Australians living in the community aged 60 years and older. The findings revealed that music provides people with ways of understanding and developing their self-identity; connecting with others; maintaining well-being; and experiencing and expressing spirituality. The results show how music contributes to positive ageing by providing ways for people to maintain positive self-esteem, feel competent, independent, and avoid feelings of isolation or loneliness. The study highlights the need to be better informed about how music can facilitate and sustain older people’s well-being.

SEXUALITY AND OLDER PEOPLE: REVISITING THE ASSUMPTIONS

Anyone who aspires to a fulfilling life would probably accept that this should include a right to sexual fulfillment. Yet modern Western culture continues to deny older people the same opportunities enjoyed by the young to express their sexuality. We review the psychosocial and physiological factors that influence the sexual expression of older people, provide a critical review of research paradigms used in the study of aging and sexuality, and discuss educational issues that health professionals and older people themselves must consider in order to dispel myths about asexual older people. We argue that it should not be assumed that the physical and pathological changes associated with advancing age reduce the opportunity to enjoy sex. Alternative interpretations and expressions of sexuality may be one of the great opportunities of growing older, especially in the absence of societal and culturally adverse expectations and attitudes.

Self‐reported and clinically determined oral health status predictors for quality of life in dentate older migrant adults

OBJECTIVE This paper reports the impact of oral health on the quality of life (QOL) of Southern European, dentate older adults, living independently in Melbourne, Australia. Participants were recruited through ethnic social clubs and interviewed about oral health, general health, socio-demographics, and QOL using the Medical Outcomes Study Short-Form 12 (SF-12). The SF-12s physical and mental health component summary scores (PCS and MCS, respectively) were computed. The Oral Health Impact Profile (OHIP-14) assessed the specific impact of oral health on QOL. Participants were also given a clinical oral examination. RESULTS A total of 603 eligible older adults volunteered; 308 were from Greek background and 295 were from Italian background. Mean age was 67.7 years (SD 6.2), with 63.7% being female. The PCS score had a mean value of 45.8 (SD 11.8), and MCS had a mean of 47.8 (SD 5.7). PCS was associated with, periodontal status, chronic health condition, self-perceived oral health needs, self-assessed oral health status, oral health impact score and the interaction between gender and level of education [F(11 552) = 10.57; P < 0.0001]. These independent variables accounted for 16% of the variance in PCS. The multivariate model predicting MCS had only one significant variable (self-reported gingival bleeding), explaining 1.5% of the variance. The OHIP-14 ranged from 0 to 48 with a mean score of 5.6 (SD 9.3). The model predicting OHIP-14 contained four significant variables: perceived oral health treatment needs, number of missing natural teeth, reports of having to sip liquid to help swallow food, and gender [F(4576) = 33.39; P < 0.0001], and explained 18% of the variance. The results demonstrated a negative association between oral health indicators and both the oral health-related QOL and the physical component of the SF-12. CONCLUSION The present findings support a growing recognition of the importance of oral health as a mediator of QOL. However, the self-selected sample and modest predictive power of the multivariate models suggest that further research is needed to expand this explanatory model.

The contribution of music to quality of life in older people: an Australian qualitative study

This study examines the personal meaning and importance of music in the lives of older people, paying particular attention to the ways in which music contributes to self-identity and the quality of life. The data derive from qualitative interviews with a sample of older Australians aged 65 years and over who live in rural and urban settings. The findings reveal that music provides people with ways of understanding and developing their self-identity, of connecting with other people, of maintaining wellbeing and of experiencing and expressing spirituality, and that it provides strong associations with and memories of a persons life. Specifically, the results show how music is used as a source of entertainment as well as a forum to share and interact with others. Music was described as a personal experience to which people assigned meaning and emotions. The informants also described how music allowed them to engage in imaginative play and to escape from some of the hardships experienced in later life. The results reveal that music promotes quality of life by contributing to positive self-esteem, by helping people feel competent and independent, and by lessening feelings of isolation and loneliness. The paper argues that music can be used to maintain and promote a better quality of life for older people.

Understanding the New Context of the Male Sex Work Industry

The article reviews past and recent research on male sex work to offer a context to understand violence in the industry. It provides a critical review of research to show, first, the assumptions made about male sex workers and violence and, second, how such discourses have shaped thinking on the topic. The article presents a case study and original findings from two studies conducted by the authors in Australia and Argentina on violence in the male sex industry. Finally, the article reviews examples of legislative reforms to show how the sex industry is being regulated.

New Pleasures and Old Dangers: Reinventing Male Sex Work

Understandings of male sex workers (MSWs) shift with technological, conceptual, and social changes. Research has historically constructed MSWs as psychologically unstable, desperate, or destitute victims and their clients as socially deviant perverts. These perceptions, however, are no longer supported by contemporary research and changing societal perceptions of the sex industry, challenging how we understand and describe “escorts.” The changing understandings of sexuality and the increasing power of the Internet are both important forces behind recent changes in the structure and organization of MSWs. The growth in the visibility and reach of escorts has created opportunities to form an occupational account of MSWs that better accounts for the dynamic and diverse nature of the MSW experience in the early 21st century. Recent changes in the structure and organization of male sex work have provided visibility to the increasingly diverse geographical distribution of MSW, the commodification of race and racialized desire, new populations of heterosexual men and women as clients, and the successful dissemination of safer sexual messages to MSWs through online channels. This article provides a broad overview of the literature on MSWs, concentrating its focus on studies that have emerged over the past 20 years and identifying areas for future research.

Male sex workers in three Australian cities: socio-demographic and sex work characteristics.

Abstract This article describes the socio-demographic and sex work characteristics of sex workers in Sydney, Melbourne, and Brisbane. A total of 185 male sex workers completed the questionnaire component of the study. The results of this study serve to debunk many of the myths surrounding the popular view of the male sex worker (MS W). The respondents in this study were on average 27 years old, and the majority had completed secondary education, with 30% having gained some form of tertiary qualification. Interestingly, those MSWs who had not completed secondary education were mostly street workers and were generally aged under 25 years. The majority of sex workers lived in rented accommodation, with only 6% reporting to be homeless. Half of all respondents identified as being “gay,” 31% as “bisexual” and 5.5% as “straight.” More than half of the respondents were in a permanent relationship. Only 7.3% of this group reported using heroin daily, although the majority consumed alcohol, tobacco, marijuana, and ecstasy. The majority of sex workers had been in the profession for less than six months, although some had been working in the industry for more than ten years. Most of the sex workers reported having taken an HIV test and a preference to offer safer sex. The article highlights ways in which the work context of MSW can be better understood and supported by education and public policy programs.

The social and work context of commercial sex between men: a research note:

A qualitative approach was used to explore the social and work contexts of the commercial sexual encounter between male sex workers and their clients. Male sex workers aged between 19 and 34 were interviewed in Melbourne. This preliminary, exploratory study suggests that dominant traditional models of male sexuality and masculinity may be reflected in how male sex workers give meaning to commercial sex. The study also reveals that, by using a career orientation towards their work, male sex workers may be able to separate work sex from personal sex, understand their work within the broader social context of work, reject the stigma of commercial sex, use their bodies as a resource that allows them to capitalise on male sexual privilege, and practise safe sex with their clients. Suggestions for further research into safe sex negotiations and practices in male commercial sex encounters are outlined.

Does physician bias affect the quality of care they deliver? Evidence in the care of sexually transmitted infections

Background: Primary care providers are well placed to control the spread of sexually transmitted infections (STI); however, care is likely to be influenced by their attitudes and beliefs. The present study investigates the relationship between general practitioner’s (GP) self-reported level of comfort in dealing with patients with STI and the care they deliver. Methods: A postal survey was conducted using a stratified random sample of 15% of GPs practising in New South Wales, Australia, to assess practitioners’ management of STI. A total of 409 GPs participated in the study yielding a response rate of 45.4%. Results: Although over two-thirds (69–72%) of GPs were comfortable in managing STI in heterosexual or young patients, fewer than half (40–46%) felt comfortable caring for patients who were sex workers, indigenous, people who inject drugs, gay or lesbian. Practitioners who were comfortable were more likely to offer sexual risk assessment, safe-sex counselling, and were less likely to report limited ability to influence patients’ risk behaviours. Practitioner discomfort was positively associated with reporting constraints in sexual history-taking and the need for training in sexual health. Conclusions: Practitioners’ care and support for patients with STI are influenced by their inexperience, lack of skills and/or attitudes. The reasons for GP discomfort in managing STI patients need further exploration as does its impact on patient care.