The efficacy of a psychosocial intervention for HIV/AIDS caregiving dyads and individual caregivers: a controlled treatment outcome study

The present study examined the comparative efficacy of intervening at the caregiver/care-recipient dyadic level, versus the individual caregiver level, for caregivers and their care-recipients with HIV/AIDS. Participants were randomly assigned to a Dyad Intervention (DI), a Caregiver Intervention (CI) or Wait List Control group (WLC), and assessed by interview and self-administered scales immediately before treatment and eight weeks later. Participants in the intervention groups also completed a four-month follow-up assessment. Dependent variables included global distress, social adjustment, dyadic adjustment, subjective health status, HIV/AIDS knowledge and target problem ratings. Results showed that caregivers in the DI group showed greater improvement from pre- to post-treatment on global distress, dyadic adjustment and target problems than the CI and WLC caregivers. The CI and DI caregivers showed greater improvement than the WLC group on all dependent variables except social adjustment. Care-recipients in the DI group improved significantly from pre- to post-treatment on dyadic adjustment, social adjustment, knowledge, subjective health status and Target Problem 1, whereas the CI and WLC care-recipients failed to improve on any of these measures. The treatment gains made by the DI caregivers and care-recipients on most dependent variables were maintained at a four-month follow-up. Findings support a reciprocal determinism approach to the process of dyadic adjustment and suggest that intervening at the caregiver/care-recipient level may produce better outcomes for both the caregiver and care-recipient than intervening at the individual caregiver level.

Educating Practitioners for Integrative Rural Practice

Arguably, living and working in rural communities can pose significant challenges for human service practitioners - challenges that are different from those encountered by their urban counterparts. Human services employers, like many other employers in rural areas, have difficulty in recruiting and retaining staff. There is now considerable evidence to support the notion that rural and remote practice constitutes a different and distinct form of practice and has undergone significant changes over the past decade. Living and working in rural communities means that practitioners are not only influenced by the rural and remote context of practice, they are also part of that context. Given the difficulty encountered in attracting and retaining rural practitioners and the changes in this area, an important question which emerges is: How can practitioners best be prepared for this work through largely urban based social work and human service education? The multifaceted and multilayered complexities in rural practice requires creativity, improvisation and a capacity for 'integrative thinking' (Martinez-Brawley 2002). This paper discusses six elements of newer forms of rural and remote practice and how they might be most effectively addressed through social work and human service curricula. An education model which integrates these elements and other principles for rural practice is proposed.

Reconceptualising social sustainability in urban development

Although the social dimension is often cited as the third leg of triple bottom line sustainability, there is at present general agreement on the difficulty of saying just what social sustainability is and how it can be related to enivironmental sustainability. This paper proposes that a sociotechnical understanding of the relationship beween human behaviour and technical developments provides a way of making the social dimension accessible to engineers, designers and developers. We draw on early work in master planned urban developments to show how a sociotechnical model, married to a life cycle assessment approach can help us understand and design for effective and efficient implementation of sustainability systems

Food habits of young and middle-aged women living outside the capital cities of Australia

Young (18-22 years) and middle-aged (45-49 years) women living in urban and rural areas of New South Wales completed a brief food frequency questionnaire as part of a wider health survey. Urban women in both age groups consumed meat less frequently than women in rural areas; and women in the less populated rural areas were more likely to eat green and yellow vegetables and least likely to eat dried beans. There were few other geographic differences in food habits. Middle-aged women consumed reduced-fat milk, fruit, vegetables, fish, biscuits and cakes significantly more frequently, and rice, pasta, full-cream milk, fried food and take-away food less frequently than younger women. Smokers in both age groups consumed fresh fruit, vegetables and breakfast cereals significantly less frequently than non-smokers, and women with low levels of habitual physical activity consumed fresh fruit and cereals less frequently than more active women. The findings suggest that strategies aimed at changing eating behaviours should be age-group-specific and targeted specifically to smokers and less active women.

Social and psychiatric influences on urban-rural differentials in Australian suicide

The purpose of this study was to investigate urban-rural differentials in Australian suicide rates, and to examine influences that previously have remained largely speculative. Suicide rates for males (all ages and young adults) were significantly higher in rural areas compared to urban areas. Urban-rural suicide rate differences in males were rendered nonsignificant after adjustment for migrant and area socioeconomic status. Adjusting for mental disorder prevalence, in addition to migrant status, reduced the excess suicide risk in rural areas; the excess was reduced further with addition of mental health service utilization. The implications of this study are that socioeconomic circumstances in rural populations contribute to higher male suicide rates compared to urban areas, but these conditions may be partly mediated by mental disorder prevalence and mental health service utilization.

Belgrade vs. Serbia: Spatial re-configurations of belonging

This article explores the relationship between the nation, the city, narratives, and belonging in Serbia through an analysis of narratives of a set of 30 interviews with young Belgrade intellectuals aged 23-35. I argue that what appears to be emerging in post-Milosevic Serbia is a new articulation and a new scale of belonging. Most of my informants are mobilising their city identities, moving from a national to an urban perspective. They imaginatively defend their city identity through a discourse that, others' its newcomers, i.e. the rural residents. However, the article is critical of their articulated dichotomous rhetoric of 'Us, the City Cosmopolitans' vs. I Them, the Rural Nationalists' My overall aim is to offer an analysis of the Serbian case, where one sees that the city of Belgrade has become a microcosm and a symbolic expression for modernity, resistance, openness and democracy. However, instead of seeing urbanity as the only locus of modernity, one needs to understand that urbanity does not one-dimensionally lead to the urbanisation of the mind, implying that once you have cities, or live in a city, there is a specific urban, cosmopolitan experience.

Urban vulnerability in Sydney: Policy and institutional ambiguities in bushfire protection

Despite the inevitability of the bushfires hazard across the Sydney region, a mismatch exists between reactive technological fixes and proactive social programs which have far-reaching vulnerability and governance consequences. This paper questions the adequacy of current policy and action, revealing contradictions and tensions that expose Sydney's vulnerability and have implications for other Australian cities.

Post-Fordism, the welfare state and the personal social services: A comparison of Australia and Britain

The Post-Fordist welfare state thesis locates contemporary social welfare change within a wider analysis of the transformation of capitalist accumulation regimes. Whilst this analysis is useful in directing attention to macro socio-economic change, it has for the most part contained three shortcomings. First, the Post-Fordist thesis has overemphasized the role of historical 'breaks' in the development of social welfare as it purportedly passes from Fordism to Post-Fordism. Second, the thesis has assumed a degree of convergence between welfare states as a result of global economic forces. In doing so, it has underemphasized the mediating impact of existing institutional arrangements within nations. Third, the thesis has assumed, rather than demonstrated, the specific changes which are alleged to be taking place in various fields of social welfare. As a consequence, aspects of continuity in social welfare have been neglected. These three lacunae are addressed through a comparative analysis of developments in the personal social services in Australia and Britain. Services to older people are employed as the specific context of comparison in relation to three dimensions of measuring transformation along a Post-Fordist trajectory: a shift from a unitary economy to a mixed economy of service provision; changes in the model of service delivery and consumption; and strengthening the governance function of the central state. This comparative analysis suggests the need for refinement of the Post-Fordist welfare state thesis concerning the restructuring of social welfare and its impact on the personal social services.