Mother Knows Best? Mother and Child Report of Behavioral Difficulties of Children of HIV-Infected Mothers

Children of HIV-infected mothers have more psychosocial adjustment difficulties than do those of noninfected mothers. In this study, child psychosocial adjustment in children of HIV-infected women is examined across the three stages of HIV-infected: asymptomatic, symptomatic and AIDS. Participants were 99 HIV-infected women and 148 noninfected women. Children were not identified as being HIV infected. Mother and child reports of behavioral difficulties are compared, and competing hypotheses about mother report of child behavior difficulties are tested. Results indicate an ascending linear trend for child report of internalizing and externalizing difficulties from the noninfected stage through increasingly severe stages of HIV-infection. According to mother report, child externalizing and internalizing difficulties are nonlinear, as mothers report an increase through the infected symptomatic stage, then a decrease in the AIDS stage. Implications for assessment, prevention and intervention in families with maternal HIV infection are discussed.     

Knowing God directly

International Journal for Philosophy of Religion -     

Personal Strategies for HIV Prevention: The Development and Validation of a Strategy-Coding Instrument1

This paper describes the development of a coding instrument to classify college students' strategies for preventing HIV infection, and examines the association of distinct strategies with social cognitive and behavioral measures related to safer sexual behavior. This instrument classifies each strategy into both a content domain (e.g., using condoms, remaining abstinent, limiting sexual partners), and 3 distinct dimensions: commitment, specificity, and effectiveness. We examine the reliability and validity of this instrument by showing the discriminative associations of each dimension with social cognitive and behavioral measures, and demonstrate the differential importance of distinct dimensions in predicting behavior in different content domains. Discussion focuses on the importance of tailoring HIV prevention messages to change strategy dimensions in order to maximize behavior change.     

Psychosocial factors and the development of breast cancer: a meta-analysis.

A meta-analysis examined the relationship between psychosocial factors and the development of breast cancer. Average effect sizes (Hedges's g) were calculated from 46 studies for 8 major construct categories: anxiety/depression, childhood family environment, conflict-avoidant personality, denial/repression coping, anger expression, extraversion-introversion, stressful life events, and separation/loss. Significant effect sizes were found for denial/repression coping (g = .38), separation/loss experiences (g = .29), and stressful life events (g = .25). Although conflict-avoidant personality style was also significant (g = .19), the effect size was less robust, and a moderate number of future studies with null results would reduce the significance. Results overall support only a modest association between specific psychosocial factors and breast cancer and are contrary to the conventional wisdom that personality and stress influence the development of breast cancer.     

Examination of the PC-PTSD in previously deployed Air Force Medical Service personnel

This study assessed the performance of the PC-PTSD in diagnosing postdeployment posttraumatic stress disorder (PTSD) in a cohort of Air Force Medical Services personnel (N = 18,530). The prevalence of PTSD in the cohort was 5.18% based on medical record data. The area under the receiver operating characteristic curve was 0.69, indicating poor classification accuracy. Sensitivity was 47.55%, specificity was 90.68%, positive predictive value was 21.79%, and negative predictive value was 96.94%. The positive and negative likelihood ratios were 5.10 and 0.58, respectively. Several risk factors were found to be associated with a diagnosis of postdeployment PTSD: being a nurse, being enlisted in the medical service career field, being enlisted in the mental health service career field, those over age 30, being a member of the Active Duty service component, and having one’s first deployment be to Iraq. Being an officer was found to be a protective characteristic. These factors could potentially improve screening for PTSD among Air Force healthcare personnel.     

The Clash of Medical Civilizations: Experiencing “Primary Care” in a Neoliberal Culture

An anthropologist describes how he found himself at the vortex of a “clash of medical civilizations:” neoliberalism and the international primary health care movement. His involvement in a $6 million social change initiative in medical education became a basis to unlock the hidden tensions, contradictions and movements within the “primary care” phenomenon. The essay is structured on five ethnographic stories, situated on a continuum from “natural” species-level primary care to “unnatural” neoliberal primary care. Food is an element of all tales. Taking the long view of history/prehistory permits us to better recognize ideological distortions in order to more capably transform medicine.     

An Investigation of Student-Selected and Parent-Delivered Reading Interventions

In this study, we examined whether individualized, student-selected, parent-delivered reading interventions would produce generalized oral reading fluency improvements. Three 3rd-grade students received reading fluency interventions (repeated readings, modeling, error correction, and flashcard instruction) 1 at a time and were shown the results that each intervention produced. The students then selected the intervention strategies they wanted their parents to use. We trained parents in the student-selected reading intervention package who delivered the interventions for 4–5?weeks, and students were given the opportunity to earn rewards for generalized performance improvements at the end of each week in school. Using an alternating treatments design, results of parent tutoring were compared to a control condition that included a reinforcement contingency for generalized performance improvements to control for reinforcement effects across conditions. Generalized improvements in oral reading fluency (to high-word-overlap passages) were found for all participants. Results are discussed in terms of how educators can improve parent-tutoring outcomes by influencing students’ motivation to engage in tutoring procedures.