HIV/AIDS and other household shocks as catalysts of local commercialization of non‐timber forest products in Southern Africa

Local trade in non‐timber forest products (NTFPs) is increasing globally, yet the causes have been little studied. We examine household shock as a driver of NTFP trade in five southern African countries, with an emphasis on HIV/AIDS‐related illness and death. Over the past two years, 95% of trader households experienced at least one shock, with family illness and death recorded for 68% and 42% of households, respectively. Almost 40% had entered the trade because of HIV/AIDS‐related shocks. Additional shocks included natural disasters, crop pests or failure and livestock loss. The sale of NTFPs was the third most common coping strategy, after kinship and agricultural adjustments. Coping strategies differed between sites and type of shock.     

What are the Risk Factors for Antisocial Behavior Among Low‐income Youth in CapeTown?

Research in high‐income countries has identified an array of risk factors for youth antisocial behavior. However, in low‐ and middle‐income countries, despite higher prevalence of offending and antisocial behavior, there is a paucity of prospective, longitudinal evidence examining predictors. South Africa is a middle‐income country with high rates of violence and crime, and a unique social context, characterized by striking income and gender inequality, and increasing number of children orphaned by AIDS. We tested predictors of antisocial behavior at community, family, and individual levels over four years. One thousand and twenty five adolescents from poor, urban South African settlements were assessed in 2005 (50 percent female; M = 13.4 years) and followed up in 2009. The sample analyzed consisted of the 723 youth (71 percent) assessed at both time points. We employed sociodemographic questionnaires and standardized scales. Validity of our antisocial behavior measure was supported by cross‐sectional associations with well‐evidenced concomitants of youth antisocial behavior, including drug taking and truancy. Regression analysis indicated that male gender and experience of community violence, but not poverty or abuse, predicted antisocial behavior. Despite many South African youth experiencing abuse and poverty at the family level, our findings suggest that high levels of violence in communities may be a more important factor contributing to the development of antisocial behavior, particularly among males.     

医患关系现状及基于EAP视角的改进对策研究

医生的天职是治病救人，医生同患者之间彼此信任、和谐友好的关系是取得良好治疗效果的前提。但是近些年来医患之间矛盾不断，医患纠纷事件频发。这个问题已经不仅仅是牵涉到医疗方面的问题，而是已经上升至整个社会层面的问题。引起医患矛盾产生的因素有很多，对这些因素进行总结分析，并对建立和谐的医患关系的方法进行探讨和分析，能够基于EAP视角对构建和谐的医患关系提供一些参考和思路。     

Effect of tuberculosis on immune restoration among HIV-infected patients receiving antiretroviral therapy

In this article, time to immune recovery during antiretroviral therapy was estimated and compared between HIV-infected children with and without tuberculosis (TB). CD4?T-cell restoration was used as a criterion for determining immune recovery. The median residual lifetime function, which is more intuitive and robust compared to the frequently used measures of lifetime data, was used to estimate time to CD4?T-cell restoration. The median residual lifetime is not influenced by extreme observations and heavy-tailed distributions which are commonly encountered in clinical studies. Permutation-based methods were used to compare the CD4?T-cell restoration times between the two groups of patients. Our results indicate that children with TB had uniformly higher median residual lifetimes to immune recovery compared to those without TB. Although TB was associated with slower CD4?T-cell restoration, the differences between the restoration times of the two groups were not statistically significant.     

医疗信息共享对患者转移数量和服务质量水平影响研究

当前我国医院间存在严重的"信息孤岛"，医院参与医疗信息共享意愿不高，患者的诊疗信息被静态碎片化储存而无法充分有效地利用。考虑到医院进行医疗信息共享将降低患者转移成本，本文构建一个多阶段双寡头动态博弈模型研究医疗信息共享对医院竞争过程中患者转移数量和服务质量水平决策的影响。首先，根据是否存在转移成本，将患者分为新患者和经验性患者，借助Hotelling模型刻画患者的效用函数，分析患者就诊决策。然后，在政府价格规制和不考虑医院利他性情景下，构建了医院累积期望收益目标函数，使用动态规划方法，求解实现医院累积期望收益最大化的服务质量水平，获得了实现患者相互转移且医院在市场中共存的马尔可夫完美均衡。最后，根据医院参与医疗信息共享后患者转移成本降为零，分析与比较信息共享前后患者转移数量和服务质量水平变化。研究发现：在不同医院间本身存在患者转移背景下，医院参与信息共享后，患者转移数量增加但存在一个上限，增加的转移量与患者在医院间的转移成本呈正相关，与初始感知效用的差值范围呈负相关；医院参与信息共享后，均衡状态下的医院服务质量水平高于信息共享前的服务质量水平。因此，在不改变当前医保支付方式下，要加快推进医疗信息共享，政府部门可以根据医院的患者数量和服务质量水平变化对其进行定期补贴，以激励医院积极参与医疗信息共享，本文给出了这个补贴的量化表达。     

从"权利"到"仪式":南非的艾滋病行动主义

在本文中,我考察了南非HIV/AIDS行动主义的道德政治如何有助于公民身份(citizen-ship)新形式的出现,这种新形式既与基于权利(rights-based)的斗争相关,又与个体HIV/AIDS患者对病痛和污名化(stigmatization)极端体验的共享意义相关。我指出,可以确定的是,正是晚期艾滋病患者"接近死亡"的绝境体验、以及与这种疾病晚期阶段相连的巨大污名和"社会死亡",为HIV/AIDS的幸存者对"新生命"和社会行动主义的委身提供了平台。行动主义者的干预和对这些创伤经验的重述也推动了HIV/AIDS对行动主义的委身和社会底层的动员。此外,污名和社会死亡的巨大否定性也驱使行动主义者重建对HIV检测呈阳性人群新的、正面的身份认同,并促使他们思考,作为一名公民-行动主义者和一项社会运动的成员意味着什么。     

Blood Money: Bayer’s Inventory of HIV-Contaminated Blood Products and Third World Hemophiliacs

This article presents an overlooked case of research misconduct and violations of basic principles of medical and business ethics. When Bayer’s Cutter Laboratories realized that their blood products, Factor VIII and IX or antihemophiliac factor (AHF), were contaminated with human immunodeficiency virus (HIV), the financial investment in the product was considered too high to destroy the inventory. Cutter misrepresented the results of its own research and sold the contaminated AHF to overseas markets in Asia and Latin America without the precaution of heat treating the product recommended for eliminating the risk. As a consequence, hemophiliacs who infused the HIV-contaminated Factor VIII and IX tested positive for HIV and developed AIDS.     

Differences in health-related quality of life among persons living with HIV/AIDS

We sought to identify differences in health-related quality of life (HRQoL) among a sample of HIV positive individuals receiving case management services in northern Florida. Our study consisted of 97 individuals receiving HIV case management that included 56 males (57.7%) and 81 African Americans (83.5%) who were 47.05 years old (SD = 9.33). HRQoL was measured using the HIV/AIDS Targeted-Quality of Life scale (HAT-QOL). Results show significant group differences in HRQoL by race, income, tobacco use, alcohol use, drug use, and CD4 cell count, despite only 43% of this sample being able to recall their most recent CD4 count. Translating these findings to inform practice, HIV care providers need to provide continuing education to patients about their disease status, knowledge, and treatment as it relates to self-care. Also, HIV care providers should be especially cognizant of the impact that tobacco, alcohol, and illicit drug use has on HRQoL for persons living with HIV/AIDS (PLHA) by working to assess social support, identify readiness for change, and make appropriate referrals for treatment.     

Fetishizing the health sciences: Queer theory as an intervention

Queer theory often falls impotent in its palatability across disciplinary lines. I offer a conceptual article that interrogates the dis-ease and divide when considering queer theory in and for the health sciences. In so doing, I look to foster a process of making queer theory more tenable to applied practice—and to make practice in social work, at least, more queer. The exemplar of HIV is deconstructed as a preeminent discourse and health disparity. In the end, it is argued that queer theory may be an essential intervention in the arsenal of the helping professions.     

In Circle: A Healthy Relationship,Domestic Violence,and HIV Intervention for African American Couples

While marriage and healthy relationship education has grown, limited interventions have been developed specifically to support the development and flourishing of African American couples. African Americans are also disproportionately impacted by HIV/AIDS and are more likely to experience lethality and serious injury due to domestic violence compared to Whites. Despite this, African American couples have been resilient and managed to thrive in relationships. Little has been done to capture these strategies, build on cultural strengths, and design an intervention specifically crafted for this population. This article describes an intervention “In Circle” developed, implemented, and evaluated for African American couples to support healthy relationship and healthy marriage education. The intervention is based on an Ancient Egyptian value system and undergirded by three integrated theoretical perspectives. The article also includes implications for practice and research.