Shock tactics to counter AIDS: The australian experience

Abstract

The use of shock tactics to motivate people to learn more about AIDS and to take appropriate protective action characterised the approach adopted by the national health authorities in Australia during 1987. The rationale underlying this approach is critically examined, particularly in the light of results obtained from surveys of community concern and knowledge about AIDS in the state of South Australia before the campaign and after it had been in progress for some five months. Contrary to expectations no significant increases in either personal or social concern were found; in fact, among older respondents personal concern had decreased significantly. Levels of knowledge about AIDS, in general, remained unchanged, apart from an increase in acceptance of the safety of blood transfusions from a very low to a somewhat higher level. Among a minority of respondents (29%) who approved of the campaign and also believed they had been influenced by it, personal and social concern about AIDS, but not knowledge, was significantly greater than among others. The view that fear-inducing techniques can be used to bring about increases in knowledge about AIDS was not supported, although some positive effects on the social attitudes of respondents most affected by the campaign are suggested.     

Predictors of willingness to register as an organ donor among dutch adolescents

Abstract

In order to identify relevant determinants of organ donor registration among Dutch adolescents, a school-based cross-sectional survey was conducted among 145 high school students. Fifty-one percent of respondents indicated they were willing to register as organ donors and 80% reported a positive general attitude towards registration. Various misconceptions about the registration and donation procedure were identified. On average only moderate knowledge levels related to organ donation were found. In order of strongest association, negative outcome expectancies, past behaviour and experience, positive outcome expectancies, and social outcome expectancies proved to be significant predictors of willingness to register as organ donors. Self-efficacy was indirectly associated with willingness via outcome expectancies. Knowledge about organ donation was not significantly associated with willingness. The results suggest that in order to persuade adolescents to register as organ donors, refutational messages will have to be developed to counterargue the prevailing negative outcome expectancies related to organ donation and registration as an organ donor.     

Affective and health-related outcome expectancies for physical activity in older adults

This study tests the effects of affective and health-related outcome expectancies on physical exercise, assuming stronger direct and indirect (via intention) effects from affective outcome expectancy to physical exercise than from health-related outcome expectancy to exercise. Physical exercise and social cognitive variables were assessed at baseline, and 6- and 12-month follow-up in 335 older adults (60–95 years of age). Applying structural equation modelling, there was a direct effect from affective, but not from health-related outcome expectancy on intentions and behaviour. Also, the indirect effect from self-efficacy on physical exercise via affective outcome expectancy was significant, whereas the mediation via health-related outcome expectancy was not. These findings emphasise the relative importance of affective versus health-related outcome expectancies in predicting intentions and physical exercise in older adults and highlight the importance to separate these facets at a conceptual level to enhance both theory development and health promotion.     

Neuropsychological Functioning in Children with Medium Chain Acyl Coenzyme A Dehydrogenase Deficiency (MCADD): The Impact of Early Diagnosis and Screening on Outcome

Children with medium chain acyl coenzyme A dehydrogenase deficiency (MCADD) have been reported to be at high risk for neurocognitive deficits. However this has not been systematically studied and little is known about the exact nature of neuropsychological sequelae or of the impact of early diagnosis and screening on outcome. We examined cognitive and adaptive outcome in children with MCADD (N?=?38, age range: 2 years, 2 months – 10 years, 3 months) diagnosed either through a newborn screening program (tandem mass spectrometry/MSMS) or upon clinical presentation. There was no evidence of overall intellectual impairment in either groups but there was some suggestion of poorer verbal and specific executive functioning (i.e., planning) abilities in the unscreened cohorts. Adaptive functioning was relatively intact with the exception of reduced Daily Living Skills in both our screened and unscreened groups. Early diagnosis and greater number of hospitalizations were related to higher verbal, communication, and socialization skills. Overall, our results highlight the importance of early diagnosis and management for children with MCADD.     

Implementation of Cognitive Therapy for PTSD in routine clinical care: Effectiveness and moderators of outcome in a consecutive sample

ObjectiveTrauma-focused psychological treatments are recommended as first-line treatments for Posttraumatic Stress Disorder (PTSD), but clinicians may be concerned that the good outcomes observed in randomized controlled trials (RCTs) may not generalize to the wide range of traumas and presentations seen in clinical practice. This study investigated whether Cognitive Therapy for PTSD (CT-PTSD) can be effectively implemented into a UK National Health Service Outpatient Clinic serving a defined ethnically mixed urban catchment area.MethodA consecutive sample of 330 patients with PTSD (age 17–83) following a wide range of traumas were treated by 34 therapists, who received training and supervision in CT-PTSD. Pre and post treatment data (PTSD symptoms, anxiety, depression) were collected for all patients, including dropouts. Hierarchical linear modeling investigated candidate moderators of outcome and therapist effects.ResultsCT-PTSD was well tolerated and led to very large improvement in PTSD symptoms, depression and anxiety. The majority of patients showed reliable improvement/clinically significant change: intent-to-treat: 78.8%/57.3%; completer: 84.5%/65.1%. Dropouts and unreliable attenders had worse outcome. Statistically reliable symptom exacerbation with treatment was observed in only 1.2% of patients. Treatment gains were maintained during follow-up (M = 280 days, n = 220). Few of the selection criteria used in some RCTs, demographic, diagnostic and trauma characteristics moderated treatment outcome, and only social problems and needing treatment for multiple traumas showed unique moderation effects. There were no random effects of therapist on symptom improvement, but therapists who were inexperienced in CT-PTSD had more dropouts than those with greater experience.ConclusionsThe results support the effectiveness of CT-PTSD and suggest that trauma-focused cognitive behavior therapy can be successfully implemented in routine clinical services treating patients with a wide range of traumas.     

Politicised religion and the religionisation of politics

The dilemmas of dealing with difference are currently at the heart of our society. Among the anomalies of our age is the survival and even flourishing of complex systems of values based on religion. However, we see that mosques flourish, ethnic associations with religious undertones multiply and religion is present in the public sphere through conflicts about religion or persons believed to be religious. Islam is a much discussed topic. The line between private and public religion is as thin as ever, and I would argue so is the line between religion and politics. This can be observed at two levels. First, the invocation of religion in the political discourse, leading to the politicisation of religion and second, as the influence religion has on political life, the religionisation of politics.     

Health Literacy,Health Inequality and a Just Healthcare System

Limited health literacy is a pervasive and independent risk factor for poor health outcomes. Despite decades of reports exhibiting that the healthcare system is overly complex, unneeded complexity remains commonplace and endangers the lives of patients, especially those with limited health literacy. In this article, we define health literacy and describe the empirical evidence associating health literacy and poor health outcomes. We recast the issue of poor health literacy from within the ethical perspective of the least well-off and argue that poor health outcomes deriving from limited health literacy ought to be understood as a fundamental injustice of the healthcare system. We offer three proposals that attempt to rectify this injustice, including: universal precautions that presume limited health literacy for all healthcare users; expanded use of technology supported communication; and clinical incentives that account for limited health literacy.     

An Evaluation of the Effects of Diagnostic Composition on Individual Treatment Outcome Within Transdiagnostic Cognitive–Behavioral Group Therapy for Anxiety

Recently, studies have supported the efficacy of treating anxiety disorders utilizing a transdiagnostic, or non-diagnosis-specific, framework (Erickson, D. H. (2003). Group cognitive behavioural therapy for heterogeneous anxiety disorders. Cognitive Behaviour Therapy, 32, 179–186; Garcia, M. S. (2004). Effectiveness of cognitive-behavioural group therapy in patients with anxiety disorders. Psychology in Spain, 8, 89–97; Norton, P. J., & Hope, D. A. (2005). Preliminary evaluation of a broad-spectrum cognitive-behavioral group therapy for anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 36, 79–97). Transdiagnostic group treatment packages focus on the common aspects inherent across the anxiety disorders such as behavioral and cognitive avoidance, and faulty cognitive appraisals of threat potential or meaning (Barlow, D. H., Allen, L. B., & Choate, M. L. (2004). Toward a unified treatment for emotional disorders. Behavior Therapy, 35, 205–230). Although research supports the overall efficacy of transdiagnostic cognitive behavior therapy (CBT) for anxiety disorders (Norton, P. J., & Philipp, L. M. (2008). Transdiagnostic approaches to the treatment of anxiety disorders: A quantitative review. Psychotherapy: Theory, Research, Practice and Training, 45, 214–226), the effect of diagnostically mixed group composition on individual outcomes is less clear. This study investigated the relationship between group composition and treatment outcome within diagnostically heterogeneous groups with the purpose of determining if diagnostic heterogeneity differentially impacted treatment outcome for 84 individuals during a 12-week transdiagnostic cognitive–behavioral group anxiety treatment program (Norton, P. J. (2012a). Group cognitive-behavioral therapy of anxiety: A transdiagnostic treatment manual. New York: Guilford). The diagnostic makeup of the treatment group was examined at the beginning of treatment and at the end of treatment, and the results indicated that the diagnostic makeup of the treatment group had no significant impact on individual treatment outcome. These findings have direct implications for the delivery of transdiagnostic treatments, and are discussed in terms of their global implications for the transdiagnostic approach to the treatment of anxiety disorders.     

Why Do Police Arrest Victims of Domestic Violence? The Need for Comprehensive Training and Investigative Protocols

After all the positive changes in the criminal justice system over the last ten to fifteen years concerning the response to incidents of domestic violence, there remains the problem of battered women who are arrested as perpetrators of domestic violence. The reasons for these arrests are complex and varied. They range from the patriarchal structure of criminal justice agencies, to the staffing of these agencies, and finally to the inappropriate and inadequate training of police officers. This article includes real life examples of cases where victims were arrested, and why these arrests occurred. It also includes suggestions on how to minimize these illegal arrests.     

Violence against Women in Contemporary Ghanaian Society

Abstract

Overcoming violence against women requires critical reflective questioning both by individuals and human societies. At stake are not just questions of whether we respond to situations of violence but more importantly, where, when and how we respond. This paper examines the problem with respect to new dimensions arising from existing interventions on violence against women in the Ghanaian context. It calls for well-planned and sustained strategies to help break the cycle of violence being created.

The paper also calls upon the Church to look within its own resources for strategies that are life transforming to help break the vicious cycle. It notes that the Church is not only well placed to respond appropriately but it has been commissioned and given the requisite tools to do so. The call is therefore for the Church to enlist these foundational resources available to it and to put them to good use as it is demanded by its calling.