Multiple Risks,Multiple Worries,and Adolescent Coping

Summary

To describe the process that clinicians use to engage vulnerable urban adolescents in mental health counseling, the authors propose a tri-partite model of clinical engagement that takes into account: (1) consumer preference; (2) risk and worry; and (3) youth development (YD) perspectives. These conceptual lenses embody what adolescents want to talk about, their exposure to behavioral and environmental risks, and their coping and strengths. Based on responses given by urban adolescents seeking mental health services to a clinical self-assessment questionnaire (Adquest), this paper uses this tripartite model to summarize patterns of risk that service applicants experience, what they worry about, and how they cope. It explores the substructure of adolescent risk and vulnerability, through factor analysis of relevant items across a broad range of Adquest life areas, to develop a typology of adolescents by risk and worry. Patterns of coping and desire to talk across a range of life areas within this typology are described, as are the practice implications. The authors conclude that even those adolescents who most concern clinicians—because they have high environmental and behavioral risk and low worry-present many different opportunities for engagement.     

Concern, Caution, and Care: HIV Risk Perception among Hospital Nurses

Nurses routinely confront uncertainties surrounding the risk of occupationally transmitted HIV, particularly in the context of hospital AIDS care. Nurses respond to their perception of this HIV risk with a mixture of concern, caution, and care. This study empirically examines HIV risk perception based on a survey of hospital nurses in U.S. cities with high HIV seroprevalence rates. There is variation in the degree to which hospital nurses worry about HIV at work, despite widespread use of universal precautions. Occupational HIV risk perception is associated with knowledge of workplace transmission vectors, comfort with AIDS patients, AIDS care experience, and working conditions. Results show that nurses on AIDS care units are more habituated to HIV risk, whereas those with less AIDS care knowledge, tolerance, and experience are more concerned about HIV Consequently, nurses who worry less about being infected with HIV are more willing to perform AIDS care, predict plans to continue AIDS care in the future, and report more equal treatment of people with AIDS. Supportive workplaces which reduce stress and emotional exhaustion, together with enhanced and improved training for hospital nurses, may temper provider concerns and improve the continuity and quality of care.     

Bureaucrats and expertise: Elucidating a problematic relationship in three tableaux and six jurisdictions

It is frequently assumed that the expertise of bureaucrats gives them policy-making power. This paper examines critically this proposition on the basis of a study of 52 regulations passed in six jurisdictions. The paper presents the material from this study in the form of three tableaux: the bureaucrat as expert, the bureaucrat as mobiliser of expertise and the bureaucrat as servant of experts. Expertise is primarily understood as either scientific expertise or policy expertise -knowledge or experience of a specific policy area. In each tableau the significance of expertise as a source of influence can be questioned. Where “experts” have influence, it is because of their status rather than the content of their expertise. Max Weber himself was ambivalent about the importance of expertise and its role in strengthening bureaucratic power in policy-making is likely to have been exaggerated.     

Knowledge,attitudes, and behavior related to condom use and STDs in a high risk population

Since the mid‐1980s, the incidence of sexually transmitted diseases (STDs) among Blacks has increased dramatically nationwide, particularly in Philadelphia and other major urban areas. One approach to this public health problem is to prevent the further transmission of disease through the use of condoms during sexual activity. To provide a basis for condom‐promotion programs within a high risk Black urban community, we explored condom use behavior and the relationship between condom use and variables related to demographic characteristics, knowledge, attitudes, perceived risk and concern about STDs, and STD history. A household survey was conducted of a stratified, quota sample of 925 male and female adolescent and adult residents in North and West Philadelphia. These areas have the highest rate of STDs in the city and among the highest rates in the country. The survey revealed a trichotomy among respondents with respect to condom use: approximately one‐third of the sample used condoms consistently; one‐third used them intermittently, and one‐third never used condoms. Consistent condom users tended to use condoms with both steady and casual partners; less frequent condom users tended to use condoms with partners who could be considered higher risk: new partners and casual partners. Although condom use rates did not vary as a function of age among males, women under age 20 were far more likely to use condoms than were other female age groups. Knowledge about STDs and prevention was not found to predict condom use. Negative attitudes toward condoms were related to non‐use, with the exception of women who used condoms in perceived high risk situations despite negative attitudes.     

Ethnographic Film as Exchange

This paper discusses how film impacts on the relationship between researchers/filmmakers and their collaborators in the field. Film can function as a gift that strengthens reciprocal relationships and it is a medium that facilitates dialogue and intercultural exchange. The author argues that film has great potential for eliciting cultural differences and enhancing intercultural communication as people relate to the same visual material from their different perspectives more easily than in the case of written text. Through ‘feedback’ and the ‘parallax effect’ film contributes to a reflective space both for the researchers and their local collaborators. Local collaborators often have different stakes in the film and the filmmakers may find themselves in the role of circumstantial activists with only limited control over the film's use and impact once it is produced.     

Vulnerable Multiracial Families and Early Years Services: Concerns,Challenges and Opportunities

In Britain, very young mixed-parentage children are more likely to receive state care than any other children. However, despite a dramatic increase in the number of multiracial families, their experiences have received little research attention. This article reviews the research on the experiences of vulnerable and poor multiracial families. Three areas of concern emerge—the relationship between family structure, locality and racism, disadvantage and oppression; the impact on family life of structurally reinforced and culturally defined gender roles; and the strengths and limitations of current early years research and practice. Suggestions are made about ways in which early years professionals might develop their practice with young vulnerable multiracial families.     

What We Should Want with History: A Meditation on Cultural Studies,Methodology, and Politics

This essay evaluates two of the central problems for Cultural Studies as a field: how to generate methodologically rigorous scholarship that is also politically useful; and how to productively use models and theory in the practice of history. Beginning with conversations about the place of (disciplinary) history in Cultural Studies, this essay explores one of the legendary debates in the field: between E. P. Thompson, Perry Anderson, and (at least in theory) Louis Althusser. Though the debate centered on the degree to which the English Civil War could be termed a “bourgeois revolution,” Thompson's fundamental critique concerned Anderson's use of abstract models in history. However, the distinctions Thompson makes are not nearly as clear‐cut in practice – particularly when we look at Ellen Meiksins Wood's attempt to intervene on Thompson's side in her 1991 book The Pristine Culture of Capitlism. Wood's understanding of capitalism relies on an abstract conceptualization of that mode of produciton that is ironically similar to that of Althusser and Anderson. Arguing this as an illustratration of the importance of explicit models and methods, the essay develops Richard Johnson's account of Marx's use of abstraction and theory in his own historical scholarship. Marx's framework is then deployed to reconsider the English Civil War in realation to a key contemporary concern: the origins of copyright and intellectual property. It ends by advocating for what I term anarchic abstraction: a conscious, rigorous, politically‐committed, and dialectical attention to the order and determinations of history with no strict hierarchy given in advance.     

Boater training, drinking and boating, and other unsafe boating practices

OBJECTIVES: Identify associations between lack of formal boater training, drinking and boating, and other unsafe boating practices. METHODS: A telephone survey queried respondents (age 16 or older in continental United States) about boating experience, type of boat used, and training. RESULTS: Of the 3,042 boaters surveyed (70% response), most had no formal training (73%). Boaters with formal training failed to use PFDs about as often as those without formal training and were equally or more likely to use alcohol while boating. CONCLUSIONS: The unexpected association between formal training and unsafe boating practices is probably due to reduced risk perception and inadequacies of boater training programs. Such programs seldom mention the risks of alcohol use while boating. Decisions to mandate formal training should be informed by these results; if mandated, training should address the risks of alcohol use while boating, and should be renewed frequently enough to offset reductions in risk perception.     

Listening to Words,Hearing Feelings: Links Between Eating Disorders and Alexithymia

Research suggests that eating disorders often involve difficulty with affect regulation and processing of emotions. Studies also show that many individuals with these difficulties suffer from alexithymia, or an impaired ability to use language to tolerate or process emotions. Many clients with eating disorders are highly verbal, able to talk about feelings and even have good insight into the causes of their behaviors. Yet their verbal and cognitive strengths may disguise their inability to use thoughts to manage their emotions. Such clients often have a lifelong experience of appearing more capable and competent than they feel. Self-criticism and negative self-image concretized in a negative body image are part of their eating disorder. Therapeutic exploration can increase anxiety and self-criticism, aggravating feelings of inadequacy and the concomitant need for self-soothing. Techniques that focus on affect regulation have been shown to be effective, yet a psychodynamic approach can be an important tool in such an integrative practice. In this article, clinical material and theory will illustrate some of the ways that incorporating an understanding of alexithymia into the work can enhance the use of both psychodynamic exploration of meaning and also tools to manage affect and change behavior.     

Trauma symptoms, sexual behaviors, and substance abuse: correlates of childhood sexual abuse and HIV risks among men who have sex with men

Childhood sexual abuse is associated with high-risk sexual behavior in men who have sex with men. This study examined psychological and behavioral correlates of HIV risk behavior associated with childhood sexual abuse in a sample of men who have sex with men. Men attending a large gay pride event (N = 647) completed anonymous surveys that assessed demographic characteristics, childhood sexual abuse history, symptoms of dissociation and trauma-related anxiety, borderline personality characteristics, substance use, and sexual risk behavior. Results indicated that men who have a history of childhood sexual abuse were more likely to: engage in high-risk sexual behavior (i.e., unprotected receptive anal intercourse), trade sex for money or drugs, report being HIV positive, and experience non-sexual relationship violence. Results of this study extend previous research to show that men who have sex with men and who have a history of child sexual abuse are more likely to be at high risk for HIV infection.     

EARLY CINEMA'S HEYDAY OF COPYING

Between 1895 and 1909, new American film entrepreneurs complained that ‘copying’ was out of control. Although ‘copying’ may have been widespread, and sometimes referred to as ‘theft’, it was more a worldwide industry practice than an extralegal operation. Before the 1909 US court case that decided the question of copyright in the motion picture, movie producers copied in an attempt to meet the demand for product. My discussion of the notion of ‘copying’, however, is somewhat ambiguous in that I need to make the term cover motion picture print duplication (‘duping’) as well as remaking. Framed by Lawrence Lessig's statement about the contemporary period, ‘copyright is out of control’, I wonder here if today's excessive use of copyright could be foretold in the way in which early cinema pioneers talked about the order that regulation would bring to the new industry. I ask, more specifically, if this early period of unfettered reproduction can tell us anything about contemporary conditions in which the technological capacity to duplicate has outstripped the state's capacity to regulate duplication.     

The Use of Humor,Jesting, and Playfulness With Traumatized Elderly

Current statistics indicate that there are a fair proportion of American elderly who have been traumatized in a variety of ways during their lifetime. Social workers and health care workers are likely to encounter this population in a myriad of contexts. This article presents the benefits of humorous interventions in trauma work, guidelines for its use, and case examples when working with the elderly.     

The Conclusions and Recommendations of the Commission on the Investigation of the Social Studies in the Schools

ABSTRACT

How can teachers effectively use documentary film to teach history, and toward what goals? This article addresses these important questions by: (1) exploring what we know about secondary teachers' practices with documentary film and secondary students' beliefs about documentary film as a source of knowledge about the past, (2) proposing a rationale for the use of documentary film that supports the goals of history education, and (3) discussing examples of documentaries that can be shown to further the rationale presented. Although there are numerous suitable purposes and methods for using documentary film, we argue that two of the most powerful and appropriate are as a way to explore multiple perspectives and as a way to teach about controversial issues.     

Embodiment, experience and theory: in defence of the sociological tradition

This paper examines whether the theoretical analyses and ambitions of sociologists of the body are increasingly making obstructive and irrelevant the subject boundaries and methodological conventions associated with their parent discipline. Concerns about the utility of the discipline have been expressed by a number of body studies emanating from within and outside of sociology. These imply that it is necessary to reject the dominant problematic of sociology and utilise non disciplinary resources if we are to understand issues surrounding the ‘lived experience’ of embodiment. In opposing this rejection of sociology, if not the use of other intellectual resources, I argue that the discipline contains much valuable theorising about experience which has yet to be developed by body theorists. Many of sociology's central concepts, indeed, evoke dimensions of human experience that remain highly pertinent to an understanding of the individual and societal significance of the body in the contemporary era. In order to illustrate this argument, I focus on the writings of Durkheim and Simmel. Their work is rarely central to writings on the body, but provides good examples of the diversity of theoretical approaches within sociology that remain relevant to body theorists. Specifically, I want to use it to develop the outlines of a theory of embodiment as a medium for the constitution of society which has at its centre a concern with human experience. I conclude by reassessing the strategic options sociologists of the body confront in developing their analyses.     

Gender,Race, and Risk: Intersectional Risk Management in the Sale of Sex Online

Sex worker experience of risk (e.g., physical violence or rape) is shaped by race, gender, and context. For web-based sex workers, experience of risk is comparatively minimal; what is unclear is how web-based sex workers manage risk and if online advertising plays a role in risk management. Building on intersectionality theory and research exploring risk management in sex work, we content-analyzed 600 escort advertisements from Backpage.com (http://www.backpage.com) to explore risk management in web-based sex work. To guide our research we asked: Do advertisements contain risk management messages? Does the use of risk management messaging differ by sex worker race or gender? Which groups have the highest overall use of risk management messages? Through a multivariate analysis of covariance (MANCOVA) we found that advertisements contained risk management messages and that uses of these phrases varied by race and gender. Blacks, women, and transgender women drove the use of risk management messages. Black and White transgender women had the highest overall use of these phrases. We conclude that risk management is an intersectional practice and that the use of risk management messages is a venue-specific manifestation of broader risk management priorities found in all venues where sex is sold.     

Associations Between Psychological,Physical, and Sexual Intimate Partner Violence and Health Outcomes Among Women Veteran VA Patients

Women veterans experience high rates of lifetime intimate partner violence (IPV) and suffer a variety of trauma-related health conditions. The purpose of this study was to identify health status and health risk behaviors associated with experiences of psychological, physical, or sexual IPV among women veterans receiving care at a Veterans Affairs (VA) medical center. We conducted surveys with 249 women veteran patients and examined health factors associated with each form of violence. Sexual IPV victimization had the most pronounced associations with adverse health. In multivariate analysis, controlling for age, race, and income, women veterans who experienced sexual violence victimization were close to or more than three times as likely as those who experienced no IPV to report poor or fair overall health, a diagnosis of post-traumatic stress disorder or depression, bipolar disorder, or anxiety, difficulty sleeping, cigarette smoking, and problem drinking. Those who reported psychological violence only (without physical or sexual violence) also reported greater odds of self-rated poor or fair health. These findings are consistent with findings from studies with non-veteran populations and serve to further identify the unique contributions of sexual IPV to health outcomes. The integrated VA health care system offers opportunities for IPV identification and response including a coordinated team-based care model with social work integrated within primary care.     

Visual sociology: A practical pedagogy

As a part of an organisational sociological study of Danish film projects, I followed the development of a feature film over a one-year period in 2006–2007. Coincidentally, this film came to be about a drama in the academic world. Thus, while I researched the filmmakers, they investigated life in Academia, using me as an informant. In that way, the positions of researcher and informants were turned upside-down. Or rather, a two-way relation of mutual investigations was introduced between the filmmakers and me. In the empirical analysis of the filmmaker's work, I employ the concept of symmetrical ethnography, which has been introduced by the Brazilian anthropologist Eduardo Vivieros de Castro in an attempt to equalise the knowledge practices of informants to those of ethnographers. Vivieros de Castro suggests that such symmetry entails a turn from epistemology to ontology. Hence I discuss whether the filmmakers’ work can be seen as an invention of ontologies. Whereas studies in organisational aesthetics and sociological appraisals of documentaries within visual sociology have a tendency to compare art to academic work, I suggest looking into the filmmakers’ ‘point of view on point of view’, suggesting that the filmmakers and I may not be representing the same world differently but representing different worlds.     

One love: explicit monogamy agreements among heterosexual young adult couples at increased risk of sexually transmitted infections

HIV prevention strategies among couples include condom use, mutual monogamy, and HIV testing. Research suggests that condom use is more likely with new or casual partners, and tends to decline as relationships become steady over time. Little is known, however, about explicit mutual monogamy agreements and HIV testing within heterosexual couples. This study used data from 434 young heterosexual couples at increased risk of HIV and sexually transmitted infections (STIs) to assess (a) couple concordance on perceptions of a monogamy agreement, sustained monogamy, and HIV testing; and (b) the associations of relationship and demographic factors with monogamy agreement, sustained monogamy, and HIV testing. Results indicated only slight to fair agreement within couples on measures of monogamy agreement and sustained monogamy. Overall, 227 couples (52%) concurred that they had an explicit agreement to be monogamous; of those, 162 (71%) had sustained the agreement. Couples with greater health protective communication and commitment were more likely to have a monogamy agreement. Couples of Latino and Hispanic ethnicity and those with children were less likely to have a monogamy agreement. Only commitment was related to sustained monogamy. Having children, greater health protective communication, and perceived vulnerability to HIV and STIs were associated with HIV testing within the couple.     

Reflective Journaling as a Flipped Classroom Technique to Increase Reading and Participation with Social Work Students

Students in undergraduate social work practice courses come to class with varying levels of educational, life, and practice experience. Students require an introduction to the material through textbook reading before they are able to engage in critical discussions, yet reading adherence varies widely among students. This research explores the use of reflective journals as a flipped classroom technique to promote completion of reading assignments. This study surveys 27 students in 2 practice courses about the use of weekly reflective journaling as a flipped classroom assignment. Findings support that reflective reading journals increase student preparation and engagement but require more work for students and instructors. Implications are discussed.     

Conflicts in Family Relations,Children's Emotions and Agency

What kind of conflicts and tensions do children experience with other children and adults in the family? Content analysis of 32 thematic interviews with 10‐ to 13‐year‐old children revealed that while conflicts often concern daily actions, tasks and routines, they also relate to decision‐making and fair treatment or to matters threatening the child's sense of emotional security. Parental conflicts and conflicts in child–parent relationships often arouse negative emotions that lead children to suppress their agency. However, conflicts, particularly those between siblings, may also open up possibilities for negotiation and agency.