Adam Easterbrook

Community and Drug Use among Gay Men: The Role of Neighborhoods and Networks

Gay neighborhoods serve as vital places for gay men’s socializing, yet few studies have examined their contributions to gay men’s health—either directly or indirectly via residents’ social networks. Drawing from theoretical perspectives on community and networks, we test hypotheses concerning whether gay neighborhoods and social network factors are associated with patterns of recent illicit drug use among a sample of 740 urban gay men from New York City. Higher odds of drug use were observed among individuals who resided in gay neighborhoods, had networks composed predominantly of other gay men, and had increased socialization with gay men. Network factors did not mediate associations between gay neighborhoods and drug use. These findings highlight the need to better contextualize the health risks faced by gay men by accounting for both neighborhood and network structures.

Exploring the Gay Community Question: Neighborhood and Network Influences on the Experience of Community among Urban Gay Men

The reported declining significance of gay neighborhoods has raised questions about the role of gay enclaves as a locus for community building. Using Wellman and Leightons community “lost,” “saved,” and “liberated” frameworks, we examine the degree to which gay enclave residence and network socializing are associated with experiences of gay community among men in the New York City area. Multilevel models indicate that enclave residence is neither directly nor indirectly associated with perceived community cohesion or community attachment. Increased socializing with gay men and heterosexuals were, respectively, positively and negatively associated with our community outcomes. Increased socializing with lesbians was associated with greater community attachment, while socializing with bisexuals was associated with greater perceived community cohesion. Our findings lend support for a “gay community liberated” perspective; experiences of gay community are shaped principally by network relations rather than residential proximity to gay institutions.

The legitimization process of students with disabilities in Health and Human Service educational programs in Canada

Policy-makers have articulated the right to education for individuals with disabilities. Nevertheless, students with disabilities remain underrepresented in universities. Students in Health and Human Service (HHS) programs experience many unique challenges that disadvantage them, such as having to complete practicums. In-depth interviews were conducted with 12 students in HHS programs who identified as having a disability to explore the challenges that they experienced. We found that students had to legitimate their ability to perform the roles of student and future practitioner. This legitimization process involved three components: negotiation of the disability label, selective disclosure, and advocacy. Our findings demonstrate how subtle and insidious forms of marginalization and stigmatization work to create barriers for students with disabilities.

Participation in daily life of people with schizophrenia in comparison to the general population Comparaison de la participation à la vie quotidienne des personnes atteintes de schizophrénie à celle de la population générale

Background. Participation in occupations is a basic human right. Although people with schizophrenia commonly experience restrictions in participation, there is a paucity of research in this area. Purpose. This study aimed to compare the participation patterns of people with schizophrenia to people without mental illness (control group). Method. A total of 140 people of similar age and sex completed the Adults Subjective Assessment of Participation and provided demographic and health-related data. Findings. People with schizophrenia tend to participate in fewer activities and to participate alone. However, they participate with similar intensity as those in the control group. Implications. The participation patterns of people with schizophrenia are both unique and similar to those of the general population. The differences in participation raise concerns due to signs of restriction and social exclusion. However, it appears that people with schizophrenia benefit from occupation and community-based services that promote and support participation with others in diverse activities.

‘We are not anything alike’: marginalization of health professionals with disabilities

Abstract Despite inclusive rhetoric, disabled peoples’ participation in the Health and Human Service (HHS) professions remains limited. This study explores the perspectives of individuals in the HHS sector regarding inclusion-related barriers and facilitators. We found three mechanisms that marginalize disabled people in HHS education and professions: dominant disabling discourses; discriminatory design within programmes and universities; and oppressive interactions. The inclusion of disabled individuals is vital for ensuring HHS professionals represent the populations they serve. By challenging the views of educators, professionals, and scholars, these findings may become part of the foundation upon which change can be created.

From hospital admission to independent living: is prediction possible?

An integral component of recovery from mental illness is being able to engage in everyday activities. This ability is often restricted among people with schizophrenia. Although functional deficits are addressed during hospitalization, the ability to predict daily functioning based on information gathered during hospitalization has not been well established. This study examines whether measurements completed during hospitalization can be useful for predicting independent living within the community. Inpatients with schizophrenia (N=104) were enrolled in the study and assessed for cognitive functioning, functional capacity and symptoms. They were approached again 6 months after discharge to evaluate their functioning with respect to everyday life Instrumental Activities of Daily Living (IADL) and Activities of Daily Living (ADL). Functional capacity during hospitalization predicted 26.8% of ADL functioning and 38.8% of IADL functioning. ADL was best predicted by the severity of negative symptoms, cognitive functioning, and the number of hospitalizations (51.2%), while IADL was best predicted by functional capacity, cognition, and number of hospitalizations (60.1%). This study provides evidence that evaluations during hospitalization can be effective, and demonstrates the advantage of a holistic approach in predicting daily functioning. When a holistic approach is not practical, a functional capacity measurement may serve as an effective predictor.

Motor skills, cognition, and work performance of people with severe mental illness

Abstract Purpose: Employment offers many benefits to people with mental illness, yet their employment rate is much lower than that of the general population. We investigated the effect of work-related motor skills, neurocognition, and job attitudes on the work performance of people with mental illness, comparing those working in sheltered workshops, with controls working in similar jobs. Methods: Twenty-nine adults with severe mental illness and 27 controls matched by gender and age were enrolled into the study using convenience sampling. They were assessed for gross and fine motor hand functioning, job attitudes, work performance, and cognition. Results: People with mental illness scored lower on work performance, cognitive functioning, and hand dexterity while sitting and working with tools. They were assigned lower job loads than were controls, and perceived the physical environment at work as more constraining than did controls. Assembling motor skills significantly explained the work performance of people with mental illness. Conclusions: The results expand our understanding of the complexities involved in the employment of people with severe mental illness, and point to new paths for improving vocational outcomes of people with severe mental illness, taking into account their motor skills and job attitudes. Implications for rehabilitation Therapists should be aware that employed people with severe mental illness may have various unmet needs, affecting their work performance and experience of stress. This study results demonstrate importance of motor skills and perception of the work environment for the promotion of vocational outcomes among individuals with severe mental illness. Employment of people with severe mental illness should be viewed from holistic perspective as with general population, rather than focused on traditionally illness-related factors.