Change in subjective social status following HIV diagnosis and associated effects on mental and physical health among HIV-positive gay men in Australia

Objective: This study investigates the impact of HIV diagnosis on subjective social status and if changes are linked to health outcomes.

Design: Two measures of subjective social status, socio-economic and standing in the community were examined in 342 Australian HIV-positive gay men in 2014. Participants recalled ratings at diagnosis were compared with current ratings.

Main outcome measures: Self-reported mental (psychological distress, self-esteem, positive mental health and satisfaction with life) and physical health (self-rated health, CD4 count, viral load).

Results: Half of the participants reported improvements in subjective socio-economic status (59%) or standing in the community (52%) since diagnosis, yet one quarter reported socio-economic status (25%) or standing in the community had decreased (23%). Increases in either measure of subjective social status were linked to higher self-esteem, positive mental health, satisfaction with life and better self-rated health. Decreases in subjective social status, however, were strongly linked to poorer outcomes on all mental health measures. Decreases in standing in the community were also associated with poorer physical self-rated health.

Conclusion: Most participants reported their subjective social status were the same or better since diagnosis. Changes in subjective social status following diagnosis were strongly linked to mental health outcomes. Those who reported a decrease in subjective social status were particularly vulnerable to mental health problems.     

Is it possible to experimentally determine the extension of cognition?

Various analytical tools originally developed for theories of mechanistic explanation have recently been imported into the ongoing debate on the hypothesis of (extracerebrally) extended cognition (HEC). One such tool that appears particularly relevant to that debate is Craver’s mutual manipulability account of constitution (MM), most of all because it promises to settle the debate on experimental grounds. This paper investigates whether it is possible to deliver on that promise. We first find that, far from grounding an experimental evaluation of HEC, MM is conceptually incompatible with both internalist and externalist accounts of cognition. Next, we propose a suitable modification of MM, MM*, but it turns out that MM* presupposes rather than produces clarity on the extension of cognition. Moreover, subject to MM* the inference to constitution is radically empirically underdetermined. Finally, we argue that our results can be generalized and conclude that, for principled reasons, it is impossible to experimentally determine whether cognitive processes have extracerebral constituents. Determining the extension of cognition is an inherently pragmatic matter.     

Self-Reported Questionnaire Detects Family History of Cancer in a Pancreatic Cancer Screening Program

Pancreatic ductal adenocarcinoma (PDAC) is a leading cause of cancer death; approximately 5–10% of PDAC is hereditary. Self-administered health history questionnaires (HHQs) may provide a low-cost method to detail family history (FH) of malignancy. Pancreas Center patients were asked to enroll in a registry; 149 with PDAC completed a HHQ which included FH data. Patients with FH of PDAC, or concern for inherited PDAC syndrome, were separately evaluated in a Prevention Program and additionally met with a genetic counselor (GC) to assess PDAC risk (n?=?61). FH obtained through GC and HHQ were compared using Wilcoxon signed-rank sum and generalized linear mixed models with Poisson distribution. Agreement between GC and HHQ risk-assessment was assessed using kappa (κ) statistic. In the Prevention Program, HHQ was as precise in detecting FH of cancer as the GC (all p?>?0.05). GC and HHQ demonstrated substantial agreement in risk-stratification of the Prevention Program cohort (κ?=?0.73, 95% CI 0.59–0.87.) The sensitivity of the HHQ to detect a patient at elevated risk (i.e., moderate- or high-risk) of PDAC, compared to GC, was 82.9% (95% CI 67.3–92.3%) with a specificity of 95% (95% CI 73.1–99.7%). However, seven patients who were classified as average-risk by the HHQ were found to be at an elevated-risk of PDAC by the GC. In the PDAC cohort, 30/149 (20.1%) reported at least one first-degree relative (FDR) with PDAC. The limited sensitivity of the HHQ to detect patients at elevated risk of PDAC in the Prevention Program cohort suggests that a GC adds value in risk-assessment in this population. The HHQ may offer an opportunity to identify high-risk patients in a PDAC population.     

Death anxiety and sexual risk-taking: different manifestations of the process of defense

College students(n = 162) completed measures of death anxiety and sexual risk-taking, with a thought listing procedure in-between. Those who completed the death anxiety measure first (Death Salient condition) reportedgreater willingness to engage in high-risk sexual behavior than the Non-Death Salient group. This result was consistent with the hypothesis that evoking death anxiety would produce denial-based defensive activity. Also, Death Salient participants reporting more death thoughts were lower on risk-taking, as predicted. Interestingly, Death Salient participants reporting stressful thoughts about issues unrelated to personal mortality (displacement) were also less willing to engage in high-risk sexual behavior. The results are discussed in relation to a new, avowal-based model of the process of psychological defense.     

Repetition priming within and between languages in semantic classification of concrete and abstract words

Although concrete nouns are generally agreed to have shared core conceptual representations across languages in bilinguals, it has been proposed that abstract nouns have separate representations or share fewer semantic components. Conceptual repetition priming methodology was used to evaluate whether translation equivalents of abstract nouns have shared conceptual representations and compare the degree of conceptual overlap for concrete and abstract nouns. Here 72 Spanish-English bilinguals made concrete-abstract decisions on English and Spanish nouns. Both concrete and abstract nouns elicited substantial between-language priming and these effects were of equivalent size, indicating that translation equivalents of both concrete and abstract nouns have shared conceptual representations and that abstract words do not share fewer components. The between-language priming effects and their attenuation relative to within-language priming indicate that the within-language effect is based on facilitation of both word comprehension and semantic decision processes.     

Clinical Use of the Surgeon General’s “My Family Health Portrait” (MFHP) Tool: Opinions of Future Health Care Providers

This study examined medical students’ and house officers’ opinions about the Surgeon General’s “My Family Health Portrait” (MFHP) tool. Participants used the tool and were surveyed about tool mechanics, potential clinical uses, and barriers. None of the 97 participants had previously used this tool. The average time to enter a family history was 15 min (range 3 to 45 min). Participants agreed or strongly agreed that the MFHP tool is understandable (98%), easy to use (93%), and suitable for general public use (84%). Sixty-seven percent would encourage their patients to use the tool; 39% would ensure staff assistance. Participants would use the tool to identify patients at increased risk for disease (86%), record family history in the medical chart (84%), recommend preventive health behaviors (80%), and refer to genetics services (72%). Concerns about use of the tool included patient access, information accuracy, technical challenges, and the need for physician education on interpreting family history information.     

Teachers’ use of fear appeals in the Mathematics classroom: Worrying or motivating students?

Aim. This study examined whether teachers’ use of fear appeals in the classroom, attempts to motivate students to perform well in high‐stakes examinations by highlighting the educational, and/or occupational consequences of failure did indeed motivate students or whether it contributed to an increase in worry, anxiety, and fear of failure. Sample. A total of 132 secondary school students. Method. Self‐report data were collected for teachers’ use of fear appeals, test anxiety, and achievement goals in the context of Mathematics at the end of Years 10 and 11, the final 2 years of compulsory schooling. Results. The frequency with which teachers were reported to make fear appeals was unrelated to future test anxiety and achievement goals. When fear appeals were perceived to be threatening, however, they were related to an increase in the worry and tension components of test anxiety and increases in performance‐avoidance and mastery‐approach goals. Conclusion. Fear appeals appear to have competing positive and negative outcomes, resulting in both anxiety and a fear of failure, and a mastery‐approach goal.