A perfect storm: Challenges encountered by family caregivers of persons with Alzheimer’s disease during natural disasters

ABSTRACT

Since Hurricane Katrina there has been a movement across the U.S. to examine best practice for disaster response within the aging population. However, little is known about the experience of natural disasters from the perspective of family caregivers of persons with Alzheimer’s disease and related dementia (ADRD). In this exploratory, qualitative study, family caregivers (n=27) were interviewed about their experience with the historic 2015 South Carolina flood. By using thematic analysis, themes were identified to better understand what unique challenges caregivers of person with ADRD experienced. While many caregivers stated they had experienced a natural disaster previously, none had ever done so in their current caregiving role. The caregiving role affected their ability to prepare for the storm and influenced their decision-making regarding evacuation and utilization of recovery resources. Thus, caregivers were confronted by a “perfect storm” of circumstances and uncertainty. Family caregivers need to have actionable emergency plans for disasters that are specific to their role as caregivers of persons with ADRD. Study implications also suggest the role social work professionals can have in educating, advocating, evaluating, and coordinating support to assist caregivers of persons with ADRD as a potentially vulnerable and at-risk population during all phases of disaster.     

Radical Social Work in These Contemporary Times

This article explores the educational journey of one man from leaving school in the mid-1970s, at the age of 14, through a period of chaotic drug use, and on to developing his career helping other chaotic drug users back into a “normal” life. Although focused on someone with drug dependency as part of his history, the article exposes issues that potentially underlie the experiences of many learners within working-class communities. In particular, it examines the role of formal and informal education, considers education's ability to liberate or domesticate (Freire, 1972), and examines approaches to learning that support recovery and transformation.     

The influence of dual‐identity development on the psychosocial functioning of African‐American gay and bisexual men

To examine the influence of racial‐ethnic and sexual identity development on the psychosocial functioning of African‐American gay and bisexual men (AAGBM), 174 AAGBM completed questionnaire packets designed to assess their levels of racial‐ethnic and sexual identity development, self‐esteem, social support, male gender role stress, HIV prevention self‐efficacy, psychological distress, and life satisfaction. The results indicate that AAGBM who possess more positive (i.e., integrated) seif‐identification as being African American and gay reported higher levels of self‐esteem, HIV prevention self‐efficacy, stronger social support networks, greater levels of life satisfaction, and lower levels of male gender role and psychological distress than their counterparts who reported less positive (i.e., less well integrated) African‐American and gay identity development. Although higher levels of racial‐ethnic identity development were associated with greater levels of life satisfaction, sexual identity development was not.     

Exploring and Adapting a Conceptual Model of Sexual Positioning Practices and Sexual Risk Among HIV-Negative Black Men Who Have Sex With Men

Estimates show a 50% lifetime human immunodeficiency virus (HIV) risk among Black men who have sex with men (BMSM) in the United States(U.S.). Studying the dynamics of sexual positioning practices among BMSM could provide insights into the disparities observed among U.S. groups of men who have sex with men (MSM). This study explored sexual positioning dynamics among HIV-negative BMSM and how they aligned with a theoretical model of sexual positioning and HIV/sexually transmitted infection (STI) risk among MSM. In-depth qualitative interviews were conducted with 29 HIV-negative BMSM between ages 25 and 35 in Los Angeles. Comments related to sexual behaviors were reviewed for relevance regarding oral or anal sexual positioning practices. Data presented represent the range of themes related to decision making regarding sexual positioning. Personal preference, partner attraction, HIV avoidance, and feeling obligated to practice partner preferences influenced sexual positioning. Drug use also affected decision making and was sometimes preferred in order to practice receptive anal intercourse. These variables build on the conceptual model of sexual positioning practices and sexual risk, and add understanding to the relationship between preferences, practices, and risk management. Future research on risk among HIV-negative BMSM should quantify the relative impact of personal preferences, partner attraction, partner type, compromise, and substance use on sexual positioning practices and risk.     

Supporting the Sexual Rights of Women Living With HIV: A Critical Analysis of Sexual Satisfaction and Pleasure Across Five Relationship Types

In the context of human immunodeficiency virus (HIV), a focus on protecting others has overridden concern about women’s own sexual well-being. Drawing on feminist theories, we measured sexual satisfaction and pleasure across five relationship types among women living with HIV in Canada. Of the 1,230 women surveyed, 38.1% were completely or very satisfied with their sexual lives, while 31.0% and 30.9% were reasonably or not very/not at all satisfied, respectively. Among those reporting recent sexual experiences (n = 675), 41.3% always felt pleasure, with the rest reporting usually/sometimes (38.7%) or seldom/not at all (20.0%). Sex did not equate with satisfaction or pleasure, as some women were completely satisfied without sex, while others were having sex without reporting pleasure. After adjusting for confounding factors, such as education, violence, depression, sex work, antiretroviral therapy, and provider discussions about transmission risk, women in long-term/happy relationships (characterized by higher levels of love, greater physical and emotional intimacy, more equitable relationship power, and mainly HIV-negative partners) had increased odds of sexual satisfaction and pleasure relative to women in all other relational contexts. Those in relationships without sex also reported higher satisfaction ratings than women in some sexual relationships. Findings put focus on women’s rights, which are critical to overall well-being.     

Trends in gender segregation in the choice of science and engineering majors

Numerous theories have been put forward for the high and continuing levels of gender segregation in science, technology, engineering, and mathematics (STEM) fields, but research has not systematically examined the extent to which these theories for the gender gap are consistent with actual trends. Using both administrative data and four separate longitudinal studies sponsored by the U.S. Department of Education’s National Center for Education Statistics (NCES), we evaluate several prominent explanations for the persisting gender gap in STEM fields related to mathematics performance and background and general life goals, and find that none of them are empirically satisfactory. Instead, we suggest that the structure of majors and their linkages to professional training and careers may combine with gender differences in educational goals to influence the persisting gender gap in STEM fields. An analysis of gendered career aspirations, course-taking patterns, and pathways to medical and law school supports this explanation.