Dysphagia in psychiatric patients

1. Psychiatric patients in acute and long-term care settings may be at high risk for dysphagia and its sequelae. 2. The prevalence of dysphagia in the psychiatric population is higher than commonly believed. 3. Routine screening is essential for the safety and management of psychiatric patients at risk for dysphagia.     

On Being Attracted to the Possibility of a Win: Reward Sensitivity (via Gambling Motives) Undermines Treatment Seeking Among Pathological Gamblers

Unfortunately, only a small percent of pathological gamblers seek the professional help they need. In the current study, we test the idea that individual differences in reward sensitivity should predict whether a pathological gambler has sought treatment—the odds of treatment seeking should decrease as reward sensitivity increases. This hypothesis rests on the proposition that reward sensitive pathological gamblers should find treatment seeking aversive because doing so would remove a route to reward. We also tested those motivations to gamble that are positively reinforcing (social affliction and self-enhancement) as a possible mechanism by which reward sensitivity undermines treatment seeking—we did not anticipate negatively reinforcing motivations (e.g., coping) to be a mechanistic variable. Ninety-two pathological gamblers completed a large-scale survey that contained the variables of interest. As predicted, pathological gamblers were less likely to have sought treatment as reward sensitivity increased. Moreover, this relationship was mediated by social affiliation motivations to gamble, but not self-enhancement or coping motives. Reward sensitive gamblers did not wish to seek treatment to the extent that they were motivated to gamble for the social interactions it provides—seeking treatment would cut this avenue of affiliation with others. In light of these results, we suggest health care professionals take reward sensitivity into account when trying to promote treatment seeking, to say nothing of the social affiliation motives that underlie the reward sensitivity-treatment seeking link.     

Research note: Strategies in eliciting sensitive sexual information: the case of gay men

Project SIGMA's research on gay men's sexual behaviour and Aids and HIV infection has posed complex ethnographic and methodological problems which have required unorthodox and innovative strategies for their solution. Three main problem areas included: value-conflict between interviewer/HIV tester roles; Issues concerning data confidentiality and legal interference, and the elicitation of detailed sexual behaviour. The procedures developed have clear applicability to other research concerned with covert, stigmatised and legally-sensitive behaviour or data.     

The adequacy of college health insurance coverage

This analysis of private health insurance plans offered in 100 four-year colleges and universities in 1988 indicates a tremendous diversity in plan options, benefits covered, cost-sharing requirements, and catastrophic protections. Consistent with relatively low premium prices, most student health insurance plans offer limited benefits and expose students to significant out-of-pocket medical cost liabilities. Only a minority of schools use financial incentives, such as preferred provider arrangements, to integrate their health insurance plans with their university health service system. We conclude that universities should carefully reexamine the adequacy of their health insurance plans and their relationship to student health centers. As more students rely on student health insurance as their only source of coverage, the quality of these plans assumes an even greater importance.     

Rural Community and Rural Resilience: What is important to farmers in keeping their country towns alive?

Many studies have highlighted the phenomenon of rural decline in parts of the developed world, summarised as a loss in agricultural employment leading to a decline in the number and size of rural settlements. This study of small towns in part of Australia’s inland rural “heartland” employs the concepts of interactional rural community of place and rural resilience to identify how farmers perceive their interactions with their local town. This study suggests that robust levels of ongoing engagement between farmers and town communities are important in maintaining rural populations and services along with both a strong local economy and environment. Face-to-face interviews with 115 farmers in two rural regions of New South Wales, Australia, highlight the importance of the local economy and jobs, the quality of the local environment and a strong sense of belonging, in contributing to a strong sense of local community and potential for resilience.     

Student debt and wellbeing: a research agenda

ABSTRACT

With levels of student debt unprecedented and rising in many democracies, growing attention has been given by academics and practitioners to its possible effects for student wellbeing. This article makes three contributions to this debate. First, it offers a critical review of literature that considers the relationship of student debt and wellbeing to open up discussion about the dimensions, limitations and possibilities of the field. Second, the paper points to potential avenues for future research about student debt and wellbeing by considering indicative comments made by New Zealand university students as part of a series of in-depth interviews. Third, the article makes a practical contribution to current debates about the tuition ‘fees free’ policy in New Zealand. We argue that developing a more robust understanding of how student debt affects wellbeing may help to broaden and reinvigorate academic and public debate about student debt.     

ECONOMIC ROULETTE

Complementing previous literature on welfare reform and the character of jobs in the low-wage labour market, we illustrate the lack of regularity and security that mark the jobs held by many low-income mothers. To do so, we present a typology of mothers’ work patterns and illustrate their experiences through case examples. Our qualitative analysis of longitudinal pathways-to-work in three cities involved an examination of the experiences of 99 diverse, low-income working mothers with a young child. The work patterns that emerged from this analysis include: continuous duration of a single job; multiple job spells; underemployment; and churning in and out of employment. Findings indicate that a complicated ‘coming together’ of well-paying stable jobs, consistent aid from public systems and stable family networks are necessary for mothers to take even the first steps into stable employment.     

Work-Life Balance: A Case of Technical Disempowerment?

Work–life balance (WLB) is an emblematic strategy to achievewell-being for Third Way governments around the world and anexercise in nurturing self-actualizing and entrepreneurial citizens.By reading a case study of New Zealand's Labour WLB projectthrough a poststructuralist perspective, I demonstrate thatThird Way WLB policy projects are technical exercises in ethicalization.These practices serve to de-contextualize and de-politicizethe terrain of well-being. This analysis highlights a contradictionin Third Way agendas to address the well-being of the needybecause they disempower those they seek to empower.     

Nurses' representations of the perceived causes of work-related stress: a network drawing approach

This paper reports a study, involving a network drawing approach, that examined how nurses perceive the interrelationship between causes of workplace stress. Network analysis originated in sociology as a method of examining the relationship between people, objects or events. It has recently been adapted to examine participants' perceptions of the relationships between causes of a phenomenon, either by asking participants to complete a grid rating the strength of all the possible links between causes or by getting them to draw a diagram of the links that they think are important. The network drawing technique, in which participants are asked to draw a diagram indicating perceived causal links between nominated causes of stress and also to indicate the strength of these links, was employed in this study. The causes of stress were taken from a previous study in which nurses kept a diary for one week detailing stressful events and their causes. There were 48 participants in the present study and the main results confirmed the importance of staffing levels and inadequate support as perceived direct causes of stress. The study also revealed the importance of indirect links between staffing levels and other causes of stress. The networks illustrate how direct and mediating causes of stress are connected and lie largely outside nurses' control. The results are discussed in relation to other recent work on the causes and experience of stress by nursing staff.