Current concepts of dementia often act to exclude the internal world of the dementia sufferer from consideration as a valid object of study. This paper presents a three stage model of the subjective world of dementia sufferers, drawing on ideas from both clinical and social psychology. The first stage involves the feelings engendered by the process of dementia and includes at least four discrete states: anxiety; depression; grief; and despair/terror. The second stage of the model concerns the behaviour provoked in response to the process of decline. Finally, we consider the social nature of emotional behaviour, with emotional actions falling along a continuum. The ability of an individual with dementia to engage in emotional behaviour depends upon the extent of their cognitive impairment and the social context in which they are located. This model has implications for the delivery of services, including psychotherapy, to people with dementia.

Sexual harassment is a problem faced by women in the workplace which can lead to adverse psychological consequences as well as impaired work performance. Sexual harassment is about the abuse of power and status rather then merely being about sex per se and has to be viewed in the context of institutionalized male power. Although there is a relative dearth of research, there is increasing evidence that sexual harassment of nurses is common and that it can have adverse effects on nurses physical and psychological health as well as a direct impact on patient care. Nursing, by its very nature of having to care for patients bodily needs, transgresses normal social rules regarding bodily contact. This is exploited by the perpetrator who relies on nurses' caring attitude to be able to harass. A descriptive model of the processes involved in harassment is presented which offers the possibility of being able to intervene at a number of points in the process. Interventions need to be aimed at both individual and organizational levels if there is to be a prospect of reducing a major occupational stressor for nurses.

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Until the last 10 years or so, dementia research had been dominated by the psychiatric or medical approach to dementia. However, increasing numbers of new psychological and social psychological approaches to dementia have begun to emerge. Consequently, there has been a significant change in the descriptions of the losses involved in the dementing process: from being represented in terms of brain functioning, they have become repositioned as occurring within both personal and social contexts. We elaborate these frameworks and apply them to three phenomena associated with dementia--depressions, delusions and denial. While these conceptualizations are limited by a number of difficulties, they nevertheless represent a significant change in approaches to dementia care and allow the potential for positive change through psychological as well as chemical means. The emergence of these new accounts of the losses involved in dementia needs to be matched by the equivalent development of effective psychosocial interventions to maintain individuals within their own homes.

Summary A pilot study of nurses and nursing auxiliaries was carried out to determine the prevalence and psychological sequelae of sexual harassment. Thirteen nurses and 22 nursing auxiliaries were interviewed. Sixty per cent reported having experienced sexual harassment on at least one occasion. The results showed that the predominant experience typically occurred: to female nursing staff; by male patients; on the wards; often while washing patients. There was minimal reporting of the incident. The overriding emotion felt was embarrassment which was perceived as resulting in impaired work performance.