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.     

The discursive construction of community identity

The aim of this article is to illustrate how a discourse‐oriented approach would open new theoretical and methodological perspectives to the study of community identity. Here outlined is the idea that community identity is discursively constructed by members in order to lend meaning to experience. An analysis of how community identity is constructed in subjects' discourse with reference to the local context is presented. Copyright © 2004 John Wiley & Sons, Ltd.     

Parent-School and Community Partnerships in Children's Mental Health: Networking Challenges, Dilemmas, and Solutions

Inter-agency collaboration, service coordination, and the creation of successful partnerships among parents, teachers, and human services professionals continues to be a challenge for the development of responsive community-based systems of care for at-risk youth and their families. We explore how one inner-city neighborhood struggles to create successful community partnerships through traditional networking strategies. Our findings identify networking strategies that appear to work and those that do not. Recommendations for improving communication are provided.     

社区医师应成为脑卒中治疗的重要环节

我国现代医疗技术对脑卒中的诊断和治疗手段越来越完善,但对于脑卒中的急救和预防水平却不尽人意,应当重视社区医院、社区医生在脑卒中急救、预防、治疗、康复中的重要作用,建立符合我国国情的“卒中单元”,使社区医生成为脑卒中治疗体系的起始点和终结点。     

Community and school choice: Geographies of care and responsibility

This paper draws on elements of critical discursive psychology in order to explore some of the issues and concerns raised by parents' responses to the policy and practice of school choice. Drawing on data from a group of mothers of diverse social class and racial backgrounds, this paper examines the dilemmas some mothers engage with in their role as chooser—reconciling competing rationalities for choosing or trying to manage contradictions. A central argument of this paper is that the policy and political context shaping the emergence of school choice in Britain has provisionally secured the development of certain trends in education—consumerism, individualism and competition. Alongside and coupled with this has been the veneration of a narrow utilitarian conception of parents as consumers of education services, defined as people who share the capacity and willingness to maximize the utility of their decisions in a rationally self‐interested way. This paper questions the value of this approach as a framing for understanding the aspirations, motivations and fantasies informing parents' school choice and highlights instead the ways in which some mothers articulate the importance of community in their decision‐making practices. Copyright © 2010 John Wiley & Sons, Ltd.     

Delivering Parent-Child Interaction Therapy in an Urban Community Clinic

Extensive evidence supports the efficacy of Parent-Child Interaction Therapy (PCIT) for reducing behavior problems in young children; however, little is known about the use of PCIT in a community mental health center (CMHC). This paper provides four clinical case examples of families who were referred to and successfully completed PCIT in an urban CMHC. The families were ethnically and socioeconomically diverse and presented with a wide range of treatment concerns and needs (e.g., autism, severe maternal psychopathology, involvement in child protective services, and complex family configurations) in addition to disruptive behavior. Our data and clinical observations suggest that PCIT decreased behavior problems, improved parent-child interactions, and, in some cases, reduced parental stress, with differing levels of change across families. Overall, the cases demonstrate that PCIT can be transported into a CMHC, and they illustrate supplemental services or minor accommodations to the established treatment protocol used to address individual family needs. Issues regarding the balance between fidelity and flexibility in transporting PCIT to a community setting are discussed, and future research topics are recommended.     

Job level, demands, and resources as antecedents of work–family conflict

Although substantial research has examined the conflict that employees experience between their work and family roles, the literature has not investigated the prevalence and antecedents of work–family conflict for individuals who work at different levels of an organization. This study examines differences in work–family conflict (work interference with family and family interference with work) for lower-level and higher-level employees, the factors that might explain these differences, and the differential effect of resources on conflict across job levels. Results indicate that higher-level workers experience greater conflict in both directions than lower-level workers, and that work- and home-based resources are differentially related to the conflict experienced by employees who hold lower-level and higher-level jobs.     

Religion and suicide acceptability: a cross-national analysis

Four perspectives (moral community thesis, religious integration, religious commitment, and social networks) guide the selection of variables in this study. Data are from the combined World Values/European Values Surveys for 2000 (50,547 individuals nested in 56 nations). The results of a multivariate hierarchical linear model support all four perspectives. Persons residing in nations with relatively high levels of religiosity, who are affiliated with one of four major faiths, are religiously committed, and are engaged with a religious network are found to be lower in suicide acceptability. The religious integration perspective, in particular, is empirically supported; affiliation with Islam is associated with low suicide acceptability. The findings provide strong support for an integrated model and demonstrate the usefulness of the moral community thesis in understanding suicide acceptability.     

The effects of prompting and reinforcement on safe behavior of bicycle and motorcycle riders

A reversal design was used to evaluate the effects of vocal and written prompts as well as reinforcement on safe behavior (dismounting and walking bicycles or motorcycles on a sidewalk) on a university campus. Results indicated that an intervention that consisted of vocal and written prompts and reinforcement delivered by security guards was effective at increasing safe behavior exhibited by bicycle and motorcycle riders. No differences were observed between vehicle type or gender with regard to engagement in safe behavior.     

Behavioral intervention to treat selective mutism across multiple social situations and community settings

We evaluated a behavioral intervention for a 9-year-old girl with selective mutism. The intervention consisted of role play and video self-modeling. The frequency of spoken initiations, responses to questions, and communication breakdowns was measured during three social situations (i.e., ordering in a restaurant, meeting new adults, and playing with new children) and in three community settings. Results demonstrated increases in spoken initiations and responses and decreases in communication breakdowns across all situations and settings.