AIDS Exceptionalism: On the Social Psychology of HIV Prevention Research

The current analysis considers the  human immunodeficiency virus (HIV)  prevention research record in the social sciences. We do so with special reference to what has been termed "AIDS Exceptionalism"—departures from standard public health practice and prevention research priorities in favor of alternative approaches to prevention that, it has been argued, emphasize individual rights at the expense of public health protection. In considering this issue, we review the historical context of the HIV epidemic; empirically demonstrate a pattern of prevention research characterized by systematic neglect of prevention interventions for HIV-infected persons; and articulate a rationale for "Prevention for Positives," supportive prevention efforts tailored to the needs of HIV+ individuals. We then propose a social psychological conceptualization of processes that appear to have influenced developments in HIV prevention research and directed its focus to particular target populations. Our concluding section considers whether there are social and research policy lessons to be learned from the record of HIV prevention research that might improve our ability to address effectively, equitably, and in timely fashion future epidemics that play out, as HIV does, at the junction of biology and behavior.     

Animal Abuse as a Sentinel for Human Violence: A Critique

It has been suggested that acts of violence against human and nonhuman animals share commonalities, and that animal abuse is a sentinel for current or future violence toward people. The popular and professional acceptance of strong connections between types of violence is beginning to be used to justify social work interventions and to influence legal decision making, and so requires greater scrutiny. Examination of the limited pool of empirical data suggests that animal abuse is relatively common among men, with violent offenders having an increased probability of reporting prior animal abuse—with the majority of violent offenders not reporting any animal abuse. Causal explanations for "the link," such as empathy impairment or conduct disorder, suffer from a lack of validating research and, based on research into interhuman violence, the assumption that violence has a predominant, single underlying cause must be questioned. An (over)emphasis on the danger that animal abusers pose to humans serves to assist in achieving a consensus that animal abuse is a serious issue, but potentially at the cost of failing to focus on the most common types of abuse, and the most effective strategies for reducing its occurrence. Nothing in this review and discussion should be taken as minimizing the importance of animals as frequent victims of violence, or the co-occurrence of abuse types in "at-risk" households. However, given the weakness of the underlying data, emphasizing the indiscriminate dangerousness of all animal abusers may have unforeseen and unwanted consequences.     

Preventing Substance Abuse Among American Indian and Alaska Native Youth

Research on the prevention of substance abuse among American Indian and Alaska Native youth offers challenges and demands careful methods. This paper describes such challenges in terms of philosophical, political, and cultural issues surmundiig substance abuse prevention research with American Indian and Alaska Native people. The authors suggest how social work researchers can address these issues through strategies of community 'collaboration, goal sening, and cultural sensitivity. The paper discusses the limits, implications, and future applications of the described strategies for research on the prevention of alcohol and drug abuse among American Indian and Alaska Native youth.     

Ageism and Abuse in the Workplace: A New Frontier

The economic crisis in the United States has led to increased media coverage of older workers being laid off, forced to retire, or working longer than planned. Embedded in these reports are the intimations of workplace abuse. Social workers need to start taking into account ageism and abuse in the workplace as possible cooccurring issues to effectively implement policy, and organizational change that will address both issues. This brief article discusses ageism and abuse in the workplace using a human rights framework, the current state of the literature, and directions for future research.     

The role of funding on research and science: The impact of glyphosate herbicides on health and the environment

The objective of this research is to determine the factors that influence the outcomes of previous scientific research on the potential adverse effects of glyphosate-based herbicides (GBH) on human and animal health and the environment. The emphasis is placed on answering the questions about the causal linkages between who funds and performs the research and the research outcomes. A lack of change in use of the GBHs in agriculture stems directly from public (Government) support of the position how the GBHs are safe for humans and the environment. The results of our meta-analysis clearly demonstrate how large and growing majority of influential research on the subject suggests otherwise. Early research on the subject, prior to 2010, done by private and public sector researchers was strongly indicating how GBHs are safe for humans, animals and the environment. It is possible that there is inertia in food safety policy leading to this large gap and disconnect between the results of hundreds of more recent studies and the (current) course of public policy. This study helps us better understand why science on this subject has not been conclusive and thus not the main driver of “science-based” policies about the GBH based production of genetically modified foods. The importance and the implications of this research are obvious: Evidence-based decisions and policies informed by rigorous research and unimpeded by other interested parties are necessary when it comes to developing public policy that affects food safety and in turn human and animal health, and the environment.     

All Creatures Great and Small: New Perspectives on Psychology and Human–Animal Interactions

Relations between humans and nonhuman animals are morally significant, intense, enduring, and pervasive. Presented here are current perspectives on social and psychological aspects of human–animal interactions. The articles in this issue focus on three broad themes—attitudes toward the use of other species, the effects of relationships with companion animals on human health and well-being, and the ethical and policy implications of our interactions with other species. The article represent a mix of theory, qualitative and quantitative empirical approaches, review, and policy recommendations on a topic that has historically been neglected by social scientists.     

A Framework for Exploring the Policy Implications of UK Medical Tourism and International Patient Flows

It is estimated that over 50,000 individuals from the UK each year elect to fund their own treatment abroad. Such treatments commonly include cosmetic and dental surgery; cardio, orthopaedic and bariatric surgery; IVF treatment; and organ and tissue transplantation. The UK has also experienced inward flows of patients who travel to receive treatment and pay out of pocket, being treated in both private and NHS facilities. The rise of ‘medical tourism’ presents new opportunities and challenges in terms of treatment options for consumers/patients and health policymakers. Such developments denote a commercialization, commodification and internationalization of health care in a way that UK policy has not experienced to date. This article addresses four key issues. We explain the rise of medical‐related travel (applied to the UK), identify key policy considerations for the future, highlight important research gaps and explore conceptual frameworks which might help us understand better the observed patterns of medical tourism. Whilst the context for policy and practice is undoubtedly dynamic, we argue the need for greater clarity in understanding the emergent implications for health policy and health care delivery.     

Compulsory income management: Combatting or compounding the underlying causes of homelessness?

Compulsory Income Management (CIM) is a form of conditional welfare that involves the mandatory quarantining of a portion of welfare recipients’ social security payments. Quarantined funds are accessible via a government-issued debit card, with restrictions surrounding where and on what funds can be spent. Official justifications of CIM have framed these policies as attempts to combat substance abuse and gambling problems, and to thus secure better outcomes for welfare recipients and their families. Central to this narrative has been the argument that welfare quarantining will ensure more money is spent on ‘essentials’, including accommodation. No existing studies, however, have specifically interrogated the impacts of CIM on housing security. This article responds to this gap in the literature by reviewing existing research concerning CIM's impacts and locating this research within broader debates regarding the causes of homelessness and the efficacy of individualised policy interventions. In doing so, it highlights CIM's potential to exacerbate housing insecurity not only through technical issues such as rental transfer failures, but also by contributing to underlying stressors such as economic disadvantage; relationship difficulties, poor health and addiction; and social stigma. The article concludes that – far from addressing the structural causes of homelessness – CIM has enflamed them.     

Factors that contribute to high turnover among residential child care staff

In this paper we draw on our own empirical research and that of others to consider the factors that contribute to high staff turnover in residential child care. First, we focus on the problem of retaining staff in children’s services. Second, we turn our attention to the factors that contribute to staff turnover in residential care: namely, perceptions of the service; of children and young people; and of human resource issues. Third, we attempt to draw out the implications of high turnover for policy and practice. The negative image of residential care has persisted in the wake of a plethora of abuse scandals. The increasing emotional and behavioural problems presented by the children cared for, and the violence and verbal abuse directed at staff are key retention issues. Moreover, poor conditions of employment contribute to staff perceptions of the work as a short‐term career choice only. The potential means of resolving these problems are explored, and the future research agenda highlighted.     

A triple test for behavioral economics models and public health policy

We propose a triple test to evaluate the usefulness of behavioral economics models for public health policy. Test 1 is whether the model provides reasonably new insights. Test 2 is on whether these have been properly applied to policy settings. Test 3 is whether they are corroborated by evidence. We exemplify by considering the cases of social interactions models, self-control models and, in relation to health message framing, prospect theory. Out of these sets of models, only a correctly applied prospect theory fully passes the tests at present. Specifically, in broad agreement with the evidence, a gain frame has positive implications for welfare encourages disease prevention activity, though this does not apply if the perceived probability of the bad health outcome is large enough. We see our tests as being useful to identify how much health policy weight policy makers should assign to specific behavioral economic models; they are also useful to verify what next steps would be most useful in further research.     

Social inclusion: an interplay of the determinants of health - new insights into elder abuse

Social and economic exclusion and inclusion are receiving growing attention and study in North America for their usefulness as a conceptual framework that addresses the many dimensions of poverty and inequality in our society. A discussion of social and economic exclusion/ inclusion flows naturally out of the population health field in which the social determinants of health have become well-established over the last twenty years or more. The determinants of health provide a broad and inclusive outline within which to situate prevention, early detection and effective intervention of the abuse of older persons. A Social Inclusion Lens offers exciting possibilities for addressing the issue of elder abuse and neglect.     

Intergenerational Relations: Themes, Prospects, and Possibilities

This commentary provides an examination of the articles within this issue with a focus on common themes throughout. Each article is briefly reviewed in the context of how it contributes to four overarching themes of current intergenerational research. The articles within this issue also have implications for developing policy that fosters intergenerational relationships. This commentary concludes with a discussion of the complex issues that arise in creating such policy and utilizes Allport's (1954) "contact hypothesis" as a framework to guide future policy work addressing the myriad of issues within the realm of intergenerational relationships.     

Help or hindrance? Social policy and the ‘social determinants of health’

In recent years, public health research has become increasingly focused on issues of social inequality and social disadvantage. This is because social issues, such as poor housing and unemployment, have been found to impact health significantly, and are now referred to as ‘the social determinants of health‘. As a result of this shift, public health is now principally concerned with what are historically considered to be social policy issues. This paper discusses the confluence of public health and social policy; it examines the opportunities and risks posed by this convergence for those working in social policy seeking to reduce poverty and inequality. We argue that, while much can be gained in the two fields by working more closely together, there remain fundamental differences in perspectives and approaches. In order to maximise benefits, these points of difference need to be thought through sooner rather than later.     

'Policies Don't Protect People, It's How They Are Implemented': Policy and Practice in Protecting People with Learning Disabilities from Abuse

Recent years have seen the development of policy guidance documents in both Wales and England relating to the protection of vulnerable adults from abuse. This policy guidance does, however, require translation into policies at the local level and that these policies are then implemented in day‐to‐day practice. This article reports some of the findings of a two‐year study that examined the development and implementation of such policies in services for people with learning disabilities within Wales. Data were gathered by means of a survey of service providers from across Wales and also via focus groups held with direct care staff and those with a responsibility for investigating alleged abuse. Positive developments include a commitment to multi‐disciplinary working, increased clarity and consistency, and greater awareness. Less positive aspects include the potential for policy ‘overload’ and a feeling that, while there is awareness of the existence of vulnerable adults policies, knowledge of their content may be more limited. Recommendations are made for the development of policy, practice and research.     

Research on environmental health interventions: ethical problems and solutions

This article reviews a variety of ethical issues one must consider when conducting research on environmental health interventions on human subjects. The paper uses the Kennedy Krieger Institute lead abatement study as well as a hypothetical asthma study to discuss questions concerning benefits and risks, risk minimization, safety monitoring, the duty to warn, the duty to report, the use of control groups, informed consent, equitable subject selection, privacy, conflicts of interest, and community consultation. Research on environmental health interventions can make an important contribution to our understanding of human health and disease prevention, provided it is conducted in a manner that meets prevailing scientific, ethical, and legal standards for research on human subjects.     

Research on Environmental Health Interventions: Ethical Problems and Solutions

This article reviews a variety of ethical issues one must consider when conducting research on environmental health interventions on human subjects. The paper uses the Kennedy Krieger Institute lead abatement study as well as a hypothetical asthma study to discuss questions concerning benefits and risks, risk minimization, safety monitoring, the duty to warn, the duty to report, the use of control groups, informed consent, equitable subject selection, privacy, conflicts of interest, and community consultation. Research on environmental health interventions can make an important contribution to our understanding of human health and disease prevention, provided it is conducted in a manner that meets prevailing scientific, ethical, and legal standards for research on human subjects.     

Reducing Alcohol Abuse in Gay Men: Clinical Recommendations From Conflicting Research

ABSTRACT

Gay men entering the health care system present with unique needs essential for health care providers to comprehend and address. While data indicate mental health and substance abuse disorders are more prevalent among gay men compared with their heterosexual counterparts, the literature assessing abuse of alcohol by gay men is conflicting. This article explores the conflicting research examining the use and abuse of alcohol by gay men, common findings and themes among studies addressing the issue, the theoretical concepts of internalized homophobia and heterosexism as they relate to alcohol abuse, and clinical strategies providers can implement when encountering this issue among their gay male patients. This comprehensive assessment of the literature will also provide direction for future critical inquiries and outline ways to improve the current methods of inquiry.     

Ethics and research assessing the relative roles of genes and the environment

Research on the interaction of genes and the environment is revealing that many human diseases have both genetic and environmental components. Even traditional "environmental" diseases, such as infections, appear to interact with genetic components in the human host. Environmental genetics research will inevitably increase understanding of individual susceptibilities to toxic exposures in the environment and harmful side effects of medications; therefore, it has great promise for improving the prevention and treatment of human diseases. However, realizing the benefits of this research requires careful attention to ethical issues that are particularly relevant in this context. This article reviews some of the most pressing issues related to research design and methods, as well as from the application of research results (e.g., workplace genetic screening and legal toxic torts, personal medical responsibility, and the relationship between genetics and public health measures).     

Ethics and Research Assessing the Relative Roles of Genes and the Environment*

Research on the interaction of genes and the environment is revealing that many human diseases have both genetic and environmental components. Even traditional “environmental” diseases, such as infections, appear to interact with genetic components in the human host. Environmental genetics research will inevitably increase understanding of individual susceptibilities to toxic exposures in the environment and harmful side effects of medications; therefore, it has great promise for improving the prevention and treatment of human diseases. However, realizing the benefits of this research requires careful attention to ethical issues that are particularly relevant in this context. This article reviews some of the most pressing issues related to research design and methods, as well as from the application of research results (e.g., workplace genetic screening and legal toxic torts, personal medical responsibility, and the relationship between genetics and public health measures).     

'School was just a nightmare': childhood abuse and neglect and school experiences

Children who have experienced abuse display significant difficulties in dealing with all aspects of the school environment. This paper examines the experiences at school of a group of respondents who had been subject to abuse and neglect during their childhood and adolescence. A qualitative research approach, utilizing in-depth interviews, was used to explore their perspectives and insights in relation to their experiences. The findings of this study show how the various forms of abuse and neglect experienced in their families had consequences for them in the school setting. A further important finding was a lack of professional student welfare support for the interviewees at school. Implications for prevention and intervention approaches in relation to both policy and service delivery are outlined.