Beliefs Contributing to HIV‐related Stigma in African and Afro‐Caribbean Communities in the Netherlands

Thirty years after the first diagnosis, people living with HIV (PLWH) around the world continue to report stigmatizing experiences. In this study, beliefs contributing to HIV‐related stigma in African and Afro‐Caribbean diaspora communities and their cultural context were explored through semi‐structured interviews with HIV‐positive (N = 42) and HIV‐negative (N = 52) African, Antillean and Surinamese diaspora community members in the Netherlands. Beliefs that HIV is highly contagious, that HIV is a very severe disease, and that PLWH are personally responsible for acquiring their HIV infection were found to contribute to HIV‐related stigma, as did the belief that PLWH are HIV‐positive because they engaged in norm‐violating behaviour such as promiscuity, commercial sex work, and, for Afro‐Caribbean diaspora, also homosexuality. These beliefs were found to be exacerbated and perpetuated by cultural taboos on talking about HIV and sexuality. HIV‐related stigma reduction interventions should focus on changing these beliefs and breaking cultural taboos on HIV and sexuality in a manner that is participatory and consistent with the current theory and empirical findings. Copyright © 2011 John Wiley & Sons, Ltd.     

Understanding the Role of Everyday Practices of Privilege in the Perpetuation of Inequalities

To explain the interrelated effects of material and psychosocial inequalities, we suggest a move beyond research focused on deprived communities to include their broader social situation. Bourdieu's theory of practice explains how social and material disadvantages are interconnected, and struggles for power are enacted in everyday practice. In this paper, we draw on data from a qualitative study of two neighbourhoods to provide examples of everyday practice as people work to perpetuate or overcome inequalities in one field: education of their children. These examples show that those with more resources are actively working to retain and improve their children's social advantage, which rests on the disadvantage of others. In conclusion, we suggest that many current interventions to improve material and social conditions within disadvantaged communities ignore the damaging effects of social inequalities between social groups. Work towards understanding the nature of power struggles in daily life and the everyday actions of the privileged will help us understand and address the damaging effects of inequalities. Copyright © 2011 John Wiley & Sons, Ltd.     

实施社区首诊制的意义及建议

目前,实施社区首诊制有重要的意义在于,可以缓解看病难、看病贵问题,适应人口老龄化的需求,改善流动人口的健康状况,以及减少私人诊所和药店不规范医疗带来的危害。但是,首诊制的实施也必然面临一定的困难。因此,应积极倡导医保制定向社区倾斜的政策,鼓励社区提高医务人员的技术水平、服务质量,并且完善双向转诊制度。     

Community perceptions of mental disorders: a Greek perspective

The present cross‐sectional study examines the perceptions of residents of a rural community in Greece pertaining to the interpretation, explanation, treatment and prognosis of various psychological problems. In all, 100 community residents took part. A series of vignettes in combination with both qualitative and quantitative data collection procedures was employed. The findings indicate a variation in the endorsement of interpretations and causal attributions as a function of the type of symptomatology presented. The overt psychotic cases of schizophrenia were more likely to be understood within a genetic explanatory framework while the less overt symptoms of mental disorders were perceived as being indicative of emotional problems triggered by personality and social environmental factors. A preference for psychological methods of treatment was expressed. Copyright © 2006 John Wiley & Sons, Ltd.     

What is the Strength of the Link Between Objective and Subjective Indicators of Urban Quality of Life?

Urban quality of life is usually measured by either subjective indicators using surveys of residents' perceptions, evaluations and satisfaction with urban living or by objective indicators using secondary data and relative weights for objective indicators of the urban environment. However, rarely are subjective and objective indicators of urban quality of life related to each other. In this paper, these two types of indicators were linked using Geographical Information Systems (GIS) to both locate respondents to the “2003 Survey of Quality of Life in South East Queensland” and also to gather objective indicators about their urban environment within the region with regard to services, facilities and overcrowding. Using Structural Equation Modelling (SEM), the strength of the relationships between these objective indicators and subjective indicators was examined. The results show that relationships between objective and subjective indicators of urban QOL can be weak, and suggests care should be taken when making inferences about improvements in subjective urban QOL based on improvements in objective urban QOL. However, further research is needed into the links between objective and subjective indicators of urban QOL including examining other aspects of the urban environment, non-linear relationships, and moderating effects for individual differences.     

TEACHING FUNCTIONAL COMMUNITY SKILLS TO AUTISTIC CHILDREN USING NONHANDICAPPED PEER TUTORS

In this study, two autistic children were paired with normal peers who, after pretraining sessions, taught community skills to the autistic children. Data were collected during three conditions: baseline, modeling, and peer tutoring. Results demonstrated that no identified skills were acquired during the baseline and modeling conditions. However, direct instruction of each child by a peer tutor resulted in the learning and maintenance of functional community skills.     

TRAINING APARTMENT UPKEEP SKILLS TO REHABILITATION CLIENTS: A COMPARISON OF TASK ANALYTIC STRATEGIES

The research was designed to validate procedures to teach apartment upkeep skills to severely handicapped clients with various categorical disabilities. Methodological features of this research included performance comparisons between general and specific task analyses, effect of an impasse correction baseline procedure, social validation of training goals, natural environment assessments and contingencies, as well as long-term follow-up. Subjects were taught to perform upkeep responses on their air conditioner-heating unit, electric range, refrigerator, and electrical appliances within the context of a multiple-probe across subjects experimental design. The results showed acquisition, long-term maintenance, and generalization of the upkeep skills to a nontraining apartment. General task analyses were recommended for assessment and specific task analyses for training. The impasse correction procedure generally did not produce acquisition.     

A PERSONALIZED SYSTEM OF INSTRUCTION FOR TEACHING CHECKING ACCOUNT SKILLS TO ADULTS WITH MILD DISABILITIES

This study evaluated the efficacy of a personalized system of instruction to teach checking account skills to persons with mild disabilities. Using a self-paced manual, 8 participants in two groups were taught to write checks, complete deposit slips, and reconcile monthly bank statements. Four participants were assessed for generalization from the classroom to community sites and demonstrated nearly perfect performance. A multiple probe design showed that acquisition occurred sequentially for each skill only after training using the self-paced manual. Follow-up sessions demonstrated that participants maintained the checking account skills. The results provide evidence of the effectiveness and adaptability of a personalized system of instruction for teaching complex monetary skills to persons with mild disabilities.     

AN ANALYSIS OF AND INTERVENTION IN THE SEXUAL TRANSMISSION OF DISEASE

Sexually transmitted diseases are a serious threat to the public health. Indeed, when an individual seeks medical treatment for a sexually transmitted disease, health authorities frequently attempt to identify, procure, and treat that individual's sexual contact(s). We conducted a comparative analysis of three alternative approaches to tracing the sexual partners of individuals diagnosed as having a sexually transmitted disease. The first approach involved counseling individuals (n = 27) infected with either gonorrhea or nongonococcal urethritis and exhorting them to procure their sexual partners for treatment. In addition to counseling, the second and third approaches involved distributing “occasion cards” for patients to use when informing sexual contacts of the need for treatment. Moreover, in the second approach, the counselor (a nurse or physician) informed infected patients (n = 19) that they and their partners could waive the $3 clinic fee contingent upon the partners seeking treatment within 1 week. In the third approach, the counselor asked infected persons (n = 19) to accept a follow-up telephone contact if their sexual partners failed to seek treatment within 1 week. The third approach was most effective. Ninety percent of the partners identified through this approach sought treatment, versus only about 60% of the partners in the other two conditions. The third approach was also the least expensive, costing about $2.95 to procure each partner for treatment.     

Training self-advocacy skills to adults with mild handicaps.

We developed and empirically evaluated an instructional program to teach self-advocacy skills to eight young adults with mild handicaps. Participants were taught to discriminate whether or not possible violations of legal rights occurred in socially validated scenarios and, if so, to role-play how to redress rights violations. Experimental control was demonstrated with a multiple probe design across four general legal rights categories for the discrimination component of training, and a multiple probe across groups of subjects for the redressing legal rights component of training. Participants'' behavior was probed in simulations and deceptions of legal rights violations in natural settings. There were marked increases in dependent measures after instruction. Difficulties in assessing generalization and maintenance of low-rate behaviors and suggestions for future research are presented.