Why we need a relevant theory of conditionals

This paper presents ConR (Conditional R), a logic of conditionals based on Anderson and Belnap's system R. A Routley-Meyer-style semantics for ConR is given for the system (the completeness of ConR over this semantics is proved in E. Mares and A. Fuhrmann, A Relevant Theory of Conditionals (unpublished MS)). Moreover, it is argued that adopting a relevant theory of conditionals will improve certain theories that utilize conditionals, i.e. Lewis' theory of causation, Lewis' dyadic deontic logic, and Chellas' dyadic deontic logic.I am of course deeply indebted to André Fuhrmann, who co-wrote the paper on which the present effort is based. Perhaps I should also thank the Social Sciences and Humanities Research Council of Canada because the original research for this project was funded by them in the form of a post-doctoral fellowship.     

Why we still need a mark of the cognitive

What makes a process a cognitive process? I’m not just asking for a list of cognitive processes, but for what makes an item on that list a cognitive process. Why should it be on the list? This is a question that has been ignored far too long in the domain of research calling itself cognitive science. It is time to give an answer and that is what I propose in this paper. I contrast my answer with others that have been given and defend the need against some claims in the literature that a mark of the cognitive is not needed.     

Sexual orientation and HIV risk among youth in South Africa: a brief report

This study investigated the prevalence of homosexual orientation and HIV risk in a population-based survey among youth in South Africa. A cross-sectional population-based household survey was conducted using a multi-stage stratified cluster sampling approach. The total sample included 1859 sexually experienced youth, aged 18–24, from four provinces (Eastern Cape, Gauteng, KwaZulu-Natal and Mpumalanga). Results indicate that 128 (4.9%) had had a homosexual experience. In a multivariate analysis, peer pressure and, for men, having been circumcised as an adult were associated with having had a homosexual experience. Having had a homosexual experience increased, but not significantly, HIV risk and HIV positive status.     

Relative versus absolute standards for everyday risk in adolescent HIV prevention trials: expanding the debate

The concept of minimal risk has been used to regulate and limit participation by adolescents in clinical trials. It can be understood as setting an absolute standard of what risks are considered minimal or it can be interpreted as relative to the actual risks faced by members of the host community for the trial. While commentators have almost universally opposed a relative interpretation of the environmental risks faced by potential adolescent trial participants, we argue that the ethical concerns against the relative standard may not be as convincing as these commentators believe. Our aim is to present the case for a relative standard of environmental risk in order to open a debate on this subject. We conclude by discussing how a relative standard of environmental risk could be defended in the specific case of an HIV vaccine trial among adolescents in South Africa.     

Exploring risk and protective mechanisms associated with HIV infection among adolescents in South Africa

This study explored South African adolescents’ perceived risk and protection for HIV infection. Adolescents (N=28) with a mean age of 14.6 years receiving mental health care participated in Focus Group Discussions (FGDs) to engage in an in-depth exploration of their perceived risk and protective mechanisms for HIV prevention. The data were analysed using thematic content analysis. Themes that emerged from the FGDs associated with risk for HIV infection were: Alcohol and illicit drug use; Non-condom use; Prostitution and risky sexual activity with multiple partners; and Non-disclosure of HIV status. Themes that emerged as protective mechanisms included: HIV knowledge and appropriate HIV risk reducing behaviour; and Proactive parental attitudes and behaviour. These findings highlight the importance of ascertaining the perceptions of adolescents about risk and protection from HIV infection in order to inform future programs for HIV prevention among adolescents.     

HIV risk perceptions and first sexual intercourse among youth in Cape Town South Africa

CONTEXT: HIV prevalence is high among South African youth. Health behavior models posit that the perceived level of risk of HIV infection is associated with the level of HIV risk behavior; however, there has been limited research in Sub-Saharan Africa on factors associated with perceived risk or on the relationship between perceived risk and risk behaviors. METHODS: Longitudinal data collected in 2002 and 2005 from 3,017 black, colored and white youth in Cape Town, South Africa, were analyzed using multivariate regression to examine whether a reciprocal relationship exists between sexual experience and perceived HIV risk. Independent variables taken from the 2002 survey were used to predict dependent variables taken from the 2005 survey. RESULTS: In 2005, most youth (82% of males and 83% of females) viewed themselves as being at no or small risk of HIV infection. A reciprocal relationship in which higher perceived HIV risk was associated with a delay in sexual debut (odds ratio, 0.8) and sexual experience was associated with higher perceived risk (1.4) was found for females, but not for males. Knowing someone who had died of AIDS was associated with sexual debut and with an elevated perceived HIV risk among females (1.7 and 1.3, respectively). The associations between race and perceived risk of HIV infection varied by gender. CONCLUSIONS: HIV/AIDS education and prevention programs should consider more carefully how gender and race may intersect to influence risk perceptions and risk behaviors. In addition, possible reciprocal relationships between risk behaviors and risk perceptions should be considered in education and intervention programs.     

Contrast and contradiction: Being a black adolescent in contemporary South Africa

This study aimed to gain in-depth understanding of the lived identity of black African adolescents in a contemporary South African setting. A purposive sample of 59 adolescents (females = 47%; Sesotho = 46%, Setswana = 36%, Other = 18%) from the Motheo district of the Free State, South Africa, participated in focus group discussions and in-depth individual interviews. Thematic analysis suggested that black South African adolescents experience transitional identities characterised by contrasts and contradictions. Altruism, autonomy, religiosity and cultural experiences were important to their lived identities. The interplay between African rituals, Christian principles, Western values and the globalisation of cultures provided fertile ground for developing a nuanced and multi-dimensional identity as an adolescent living in contemporary South Africa.     

Why we need more psychology programmers/ EL Knife, a data utility for transforming spreadsheets

The software needs of psychology researchers are sufficiently diverse that they cannot be met by the commercial sector. The field needs more psychologists who publish software, and individual researchers need to be able to write their own. To support this view, the author offers EL Knife, a data utility for reconfiguring multifactor spreadsheet files. Data may be divided by up to four factors, each of which may have an unlimited number of levels. The interface makes it easy to specify a wide variety of different configurations (different ways of packing multiple data dimensions into a two-dimensional spreadsheet). Many other possibilities for useful research software remain to be invented.     

Counsellor-delivered HIV risk reduction intervention addresses safer sex barriers of people living with HIV in KwaZulu-Natal,South Africa

This study developed an HIV risk reduction intervention for people living with HIV (PLWH) obtaining care at primary healthcare clinics in KwaZulu-Natal, South Africa by (1) conducting elicitation research to understand the dynamics of risk behaviour among PLWH, (2) modifying an existing HIV risk reduction intervention based on research findings and (3) conducting a pilot study to evaluate feasibility, acceptability and fidelity of the modified intervention implemented by trained lay counsellors at a rural clinic in KwaZulu-Natal. A total of 61 healthcare providers and 77 HIV+ patients from four primary healthcare clinics participated in 14 focus groups and 20 individual interviews to identify informational, motivational and behavioural skills (IMB) factors contributing to PLWH's sexual risk behaviour. Elicitation research findings were incorporated into a revised version of Options for Health, an evidence-based risk reduction intervention for PLWH in clinical care. In a 5-day training, lay counsellors learned strategies to address IMB barriers to safer sex identified in elicitation research. The revised intervention, which was implemented by six counsellors with 39 patients, was feasible to implement, acceptable to patients and counsellors, and implemented with good fidelity. This study makes an important contribution towards development of a theory-based HIV risk reduction intervention for PLWH linking prevention with treatment in South Africa.     

Counsellor-delivered HIV risk reduction intervention addresses safer sex barriers of people living with HIV in KwaZulu-Natal, South Africa

This study developed an HIV risk reduction intervention for people living with HIV (PLWH) obtaining care at primary healthcare clinics in KwaZulu-Natal, South Africa by (1) conducting elicitation research to understand the dynamics of risk behaviour among PLWH, (2) modifying an existing HIV risk reduction intervention based on research findings and (3) conducting a pilot study to evaluate feasibility, acceptability and fidelity of the modified intervention implemented by trained lay counsellors at a rural clinic in KwaZulu-Natal. A total of 61 healthcare providers and 77 HIV+ patients from four primary healthcare clinics participated in 14 focus groups and 20 individual interviews to identify informational, motivational and behavioural skills (IMB) factors contributing to PLWH's sexual risk behaviour. Elicitation research findings were incorporated into a revised version of Options for Health, an evidence-based risk reduction intervention for PLWH in clinical care. In a 5-day training, lay counsellors learned strategies to address IMB barriers to safer sex identified in elicitation research. The revised intervention, which was implemented by six counsellors with 39 patients, was feasible to implement, acceptable to patients and counsellors, and implemented with good fidelity. This study makes an important contribution towards development of a theory-based HIV risk reduction intervention for PLWH linking prevention with treatment in South Africa.     

Factors affecting behaviors that address HIV risk among senior secondary school pupils in South Africa.

The purpose of this study was to identify factors affecting HIV risk reduction among senior secondary school pupils in South Africa. The sample included 460 Grade 12, Secondary School pupils whose ages ranged from 16 to 30 years (M = 19.7 yr., SD = 2.5) and who were chosen at random from the total Grade 12 population throughout one region in the Northern Province of South Africa. Measures were of sexual behavior and condom use, knowledge about correct condom use, intention of condom use, behavioral norms, attitudes, normative beliefs, and subjective norms about condoms, HIV/AIDS vulnerability (likelihood to get it) and severity of the illness in the country, and condom use self-efficacy. Bivariate analysis gave positive significant relations among normative beliefs, subjective norms, and attitudes towards condom use as well as HIV/AIDS vulnerability and HIV risk behavior. Regression analysis indicated that for boys, younger age at first vaginal intercourse, less intention for condom use, and HIV/AIDS vulnerability were predictive for HIV/AIDS risk behavior and explained 39% of the variance. It is suggested that these predictors should be included in intervention programs for HIV prevention.     

The implications of maternal grandmother coresidence and involvement for adolescent adjustment in South Africa

Maternal grandmothers residing in 3‐generation households often provide care and support to their grandchildren. However, the implications of grandmother coresidence and involvement for adolescent adjustment have been neglected in the South African literature. This study examined whether the involvement of maternal grandmothers who coreside with grandchildren and their parents differed from that of non‐coresident grandmothers. In addition, we assessed the associations between maternal grandmother coresidence and involvement, and adolescents' internalising problems, externalising problems and prosocial behaviour. Self‐report survey data were obtained from a sample of 384 “coloured” (mixed‐race) and black African Grade 8 and Grade 9 students in Cape Town. The mean age of the participants was 13.96 years, 58% were females and 27% lived in 3‐generation households. Results indicated that there was no significant difference in the involvement of coresident and non‐coresident grandmothers, and that adolescents in 3‐generation and 2‐generation households displayed similar levels of adjustment. Hierarchical multiple regression analyses revealed that greater maternal grandmother involvement was associated with more adolescent prosocial behaviour (p < .001) regardless of household structure, and with fewer adolescent internalising problems in 3‐generation households (p = .03). Findings underscore the need to move beyond the immediate family to consider how grandparents may influence adolescent development.     

HIV risk after release from prison: a pilot case-control study in Canada,France, Ivory Coast and South Africa

This study aimed to assess HIV knowledge, risk perception and risk behaviour of ex-offenders at risk of new infection and to compare them with the general population. A case-control interview study was conducted with conveniently sampled ex-offenders and persons with no history of incarceration in four countries (Canada, France, Ivory Coast, South Africa). The total sample included 232 participants with a mean age of 33.9 years (SD=9.8 years). Results indicate various high HIV risk behaviours including multiple sexual partners, irregular sexual partner, and commercial sexual partner. Other risk factors were unprotected sex at last intercourse with a regular partner, with an irregular partner and with a commercial sexual partner. A history of incarceration did not differentiate risk for infection. Younger age, coming from the Ivory Coast, and higher HIV risk perception were found to be associated with HIV risk behaviour. Prevention efforts should focus on education, promotion of safe sex and substance abuse treatment.     

Why we need a theory of suffering, and lots of other theories as well: commentary

In the first section of his article, "The Role of Suffering and Community in Clinical Ethics," Erich Loewy sketches a theory of suffering. His conviction is that clinical medical ethics is not clearly rooted in theory and is inadequately grounded because of this. While acknowledging the merits of virtue ethics and casuistry, Loewy quickly dispenses with them, as contenders for this theoretical basis. Kantianism and utilitarianism are likewise rejected as "a universally acceptable grounding for ethics." In their place, Loewy proposes that "a deeper and more universal grounding can be found in the capacity of sentient beings to suffer." It is on this capacity to suffer that he builds his hierarchies of moral value, including primary, secondary, and symbolic worth. This theory of suffering should be welcomed. It promises to expand our awareness of clinical experience, and moral life generally, away from autonomy, utility, or virtue orientations toward attention to suffering and our response to it. Such a theory can give us a revitalized language to probe the issues of medical ethics. This should lead us to a careful reading of Loewy's larger work on which this article is based. Yet my enthusiasm is tempered by Loewy's noncritical acceptance of a peculiar, yet pervasive, understanding of the role and use of theory in ethics....     

HIV/AIDS in South Africa: a review of sexual behavior among adolescents

South Africa has a fast-growing HIV/AIDS rate, with the highest prevalence among young people (15 to 24 years), especially females. This paper is a comprehensive analytical review of available research concerning the sexual behavior of adolescents in South Africa. It offers insight into HIV infection among adolescents and provides an important base for educational interventions aimed at behavior change and reducing further transmission. The most important conclusion is that, despite the research (however limited) that has been done, there has been no significant change in the rate of infection among adolescents in South Africa. A new generation of behavioral interventions, involving both factual knowledge and life skills to promote behavioral risk reduction, is recommended.     

Intimate partner violence among HIV positive pregnant women in South Africa

The aim of the study was to determine the prevalence of intimate partner violence (IPV) and associated factors among pregnant HIV-infected women in primary health care facilities in Nkangala and Gert Sibande districts, Mpumalanga, South Africa. Participants were 673 women who were, on average, 28.39 ± 5.73 years old. Data were collected through Audio Computer Assisted Self Interview (ACASI), and analysed using the IBM Statistical Package for Social Sciences (SPSS). Overall, 56.3% reported having experienced either psychological or physical IPV, and 19.6% reported physical IPV. In logistic multivariable regression analyses, higher levels of depressive symptoms and greater perceived stigma were associated with combined physical and psychological IPV. Psychological IPV and physical IPV were also individually associated with greater perceived stigma and higher levels of depressive symptoms. The design and implementation of evidence-informed interventions that can empower and protect HIV-infected pregnant women from IPV is essential to managing their health-related quality of life.