A life of fear: Sex workers and the threat of HIV in Uganda

Schoemaker J, Twikirize J. A life of fear: sex workers and the threat of HIV in Uganda The way individuals perceive their risk to certain threats influences their adoption of preventive behaviour. This study explored sex workers' perception of risk of HIV infection within the context of other serious threats. The study was carried out in Kampala, Uganda, using peer ethnography. Sex workers were well aware of their risk of HIV infection but this risk was eclipsed by other more immediate and frightening threats. Sex workers' willingness to gamble with HIV is explained by the fact that their existence is already very dangerous, and taking risks is an inherent part of their trade. Decriminalising sex work could make their lives somewhat safer, motivating them to better protect themselves, but this is unlikely to happen in Uganda. Attempting to enforce some coercive control mechanisms would not work, given the pervasive corruption in law enforcement and the judiciary, the institutions that would be responsible for implementing such control.     

Responding to child deaths: the work of Australia's Victorian Child Death Review Committee

The Victorian Child Death Review Committee (VCDRC) in Australia is a multidisciplinary Ministerial Advisory Committee established to review the deaths of children either currently child protection clients or known to the statutory child protection system. The Committee provides advice about each child death as well as insights into what are the surrounding patterns and issues. Key to this role is examining the contribution of the service sectors to the protection of children and the routine practices that are in place to respond to children and vulnerability. This paper provides a snapshot of the cases referred to the VCDRC and the key messages for practice drawn from them. What emerges is that often the threshold for when statutory child protection services must be involved in child and family matters can be ambiguous and that agreement about intervention, the level and nature of need or risk, and when cumulative harm and neglect require statutory responses are not always shared between agencies. It is clear that the lack of common frameworks about what constitutes child protection intervention challenges services. It is recommended that there be and used agreed definitions and frameworks to ensure shared understandings and collaborative responses across the service and legal systems.     

Women's participation in self‐help groups as a pathway to women's empowerment: A case of Nepal

Non‐governmental organizations (NGOs) and the government of Nepal have made some effort to reduce poverty in Nepal by creating women's affiliation groups, some of which are micro‐credit organizations. Using capabilities as defined by Amartya Sen (Development as freedom, Oxford University Press, New Delhi, 2000), which includes employment opportunities, women's ownership in productive resources such as land and/or homes, educational opportunities, and women's participation in decision‐making in the family, this study evaluated the extent to which women's ethnic group or caste affiliation affected a woman's likelihood of being empowered by participation in these groups. We analyzed a sample of 8,973 women which was taken from the 2011 Nepal Demographic and Health Survey. Previous research has demonstrated that participation in gender‐based groups is correlated with higher economic status. This study adds to the literature on women's affiliation groups by investigating the impact of structural factors, such as caste and ethnicity, on women's self‐help group participation (women's groups and credit groups).     

Using a “child's‐eye view” of social success to understand the importance of school readiness at the transition to formal schooling

Recent research into school readiness has highlighted the importance of not only children's cognitive and socio‐emotional skills, but also the degree to which they have family support in the home. The current study examines the association between social success upon school entry and teacher‐ratings of school readiness as assessed by the Brief Early Skills and Support Index (BESSI), controlling for language ability. Importantly, social success was assessed using a “child's‐eye view” with peer‐reported assessments of both social preference and reciprocated friendships. A total of 244 children (131 boys, M_age = 61 months, SD = 4.78 months) in their first year of formal schooling participated. Child school readiness was found to be important for social preference, with the association being more marked for boys versus girls. Family support was the only independent predictor of children's reciprocated friendships. The use of the BESSI, with its broad scope compared to other measures of school readiness, highlights the importance of focusing both on a child's cognitive and socio‐emotional skills at school entry and their family support when exploring the association of school readiness to children's social success at the transition to formal schooling.     

Comiendo Bien: The Production of Latinidad through the Performance of Healthy Eating among Latino Immigrant Families in San Francisco

Utilizing a bricolage of interactionist cultural studies, ethnic foodways, and situational analysis this paper examines how Latino immigrants, representing six countries and multiple preimmigration class positions, come to perform Latinidad through the lay health practice of comiendo bien (eating well). Comiendo bien was examined through participant observation of 15 families living in San Francisco and 27 key informant interviews. Comiendo bien is a performance that exists through the convergence of multiple identity positions. Latina/o immigrants not only enact the Latinidad in the United States through artistic expression or political strategizing, but also by sharing an idealized practice of healthy eating.     

Early stopping in seamless phase I/II clinical trials

In recent years, seamless phase I/II clinical trials have drawn much attention, as they consider both toxicity and efficacy endpoints in finding an optimal dose (OD). Engaging an appropriate number of patients in a trial is a challenging task. This paper attempts a dynamic stopping rule to save resources in phase I/II trials. That is, the stopping rule aims to save patients from unnecessary toxic or subtherapeutic doses. We allow a trial to stop early when widths of the confidence intervals for the dose-response parameters become narrower or when the sample size is equal to a predefined size, whichever comes first. The simulation study of dose-response scenarios in various settings demonstrates that the proposed stopping rule can engage an appropriate number of patients. Therefore, we suggest its use in clinical trials.     

Complex home care: challenges arising from the blurring of boundaries between family and professional care

Over the last 50 years, increasingly complex care (such as tracheostomy management, dialysis or enteral feeding) has shifted from hospital to home, with a concomitant rise in patient self-management and care given by family members. Recognition of the importance of the contribution of family care to the health system is also growing. This article reports the findings of a New Zealand study which explored the experiences of family carers who manage technical health procedures at home. It then draws attention to some broader issues raised by shifting complex care from professional management in hospital settings to family care at home, namely the ways in which complex home care blurs the boundaries between professional and family care (creating the ambiguous position of the expert carer) and questions of safety and responsibility in family care. We also discuss the implications for policy around family caregiving in New Zealand. Given the potential physical and mental health impacts of caring, it is time for renewed consideration of what family carers should be expected or allowed to manage and how the health system can support them in their important role.     

Less than human: a qualitative study into the experience of parents involved in the child protection system

This paper reports on the findings from a qualitative study into the experiences of parents who were involved in the English child protection system in 2013. Seventeen in‐depth interviews were conducted involving 19 parents and/or partners, and a framework approach was used to analyse the data. There were positive experiences of individual social workers and some positive experiences of the child protection system. However, the overwhelming theme of the parents' experiences was that the system was uncaring, inflexible and for some harmful to both themselves and their children. Despite being included in the child protection process, parents felt they were not afforded the same rights as a participant, as a decision‐maker or as a partner in seeking to improve the situation. The threat of consequences silenced parents who felt unable to speak out or challenge the things they disagreed with or coerced others into signing agreements they did not agree to. Such experiences related to a sense that they were being treated as ‘less than human’. These findings are considered within the context of recent reforms within the English child protection system.     

Cultural Sexism is Ordinary: Writing and Re‐Writing Women in Academia

When we ‘write women’ in academia, the focus in much of the literature to date has been to write about women. The focus of this article is the writing of women themselves; to give voice to women's experiences as constructors of knowledge. Through so doing this article uses writing as praxis; as a mechanism to disrupt, challenge and open a space for renegotiation of cultural norms within academic institutions. Based on qualitative data collection over a six‐year period, this article writes women's experiences and unpacks the way in which cultural sexism has become an ordinary feature of women's academic lives. It also considers ways in which the underlying cultural interpretations of hegemonic masculinized structures may be re‐written.