Pediatrics: The emerging psychosocial challenges of the AIDS epidemic

HIV has a pervasive and profound effect on the psychological, social and neuropsychological functioning of infected infants, children and their families. This article discusses direct and indirect psychological manifestations of HIV in children. Direct effects are the outcome of the virus acting on the central nervous system and can result in compromised cognitive, language, motor, socio-emotional and motivational functioning. Indirect effects involve psychological responses to the stress of living with a life threatening illness, the social ostracism, disruption in life goals and undergoing frequent invasive and protracted medical procedures. A major focus of this article is to outline and describe a model comprehensive psychosocial support system developed within the Pediatric Branch of the National Cancer Institute. This includes early intervention issues and strategies for working with families during the introductory phase of the treatment program that also provides the framework for a care management approach, salient mental health problems that frequently occur in this group, and appropriate interventions for individuals and families. Attention is also given to dealing with anticipatory loss and bereavement, implementing traditional innovative intervention techniques, and for providing advocacy services concerning possible legal, financial, housing, and educational issues.     

Keeping the faith. Religion in the healing of phobic anxiety

1. Change invariably occurs following a crisis, which enables a new paradigm to be adopted. 2. Religious faith may be one possible paradigm that may be of benefit to patients. 3. Nurses have a responsibility to explore this untapped potential with their patients. 4. A patient with severe phobic anxiety who made a sustained positive response to becoming a Christian is described.     

Of designs and disappointments: Some limits to participatory research in a third world context

This paper introduces issues associated with the practice of participatory research (PR) in a Third World context by describing the experience of carrying out a study of urban housing cooperatives in Zimbabwe. A contrast is presented between the PR model, derived from the literature, and the implementation of this model. Five explanations for the discrepancy are proposed, including: differences between the rural and urban context, the questionable suitability of PR for multiple and concurrent case studies, and the need for early intervention. The paper concludes that a methodology is needed for assessing whether a given research context is appropriate for application of a PR model.     

AIDS instruction in US schools of social work: 20 years into the epidemic

A survey of 108 accredited master of social work (MSW) programs was conducted to examine curriculum attention to acquired immune deficiency syndrome (AIDS). More than half of the programs (57.4%) offer no HIV/AIDS courses; more than three quarters (87%), however, do provide HIV/AIDS internship experiences. Interestingly, urban schools of social work, areas with higher rates of reported AIDS cases, and larger schools of social work do not offer more formal opportunities for HIV/AIDS education compared to rural schools, areas with lower rates of reported cases, and smaller schools of social work. Students wanting more formal instruction in HIV/AIDS issues, therefore, may not find more opportunities in larger urban schools. Institutes of higher education can be proactive in the continued need for offering HIV/AIDS educational opportunities.     

Evaluation capacity building in the nonformal education context: Challenges and strategies

Policymakers’ demand for increased accountability has compelled organizations to pay more attention to internal evaluation capacity building (ECB). The existing literature about ECB has focused on capacity building experiences and organizational research, with limited attention on challenges that internal evaluation specialists face in building organizational evaluative capacity. To address this knowledge gap, we conducted a Delphi study with evaluation specialists in the United States’ Cooperative Extension Service and developed a consensus on the most pervasive ECB challenges as well as the most useful strategies for overcoming ECB challenges. Challenges identified in this study include limited time and resources, limited understanding of the value of evaluation, evaluation considered as an afterthought, and limited support and buy-in from administrators. Alternatively, strategies found in the study include a shift in an organizational culture where evaluation is appreciated, buy-in and support from administration, clarifying the importance of quality than quantity of evaluations, and a strategic approach to ECB. The challenges identified in this study have persisted for decades, meaning administrators must understand the persistence of these issues and make an earnest investment (financial and human resource) to make noticeable progress. The Delphi approach can be used more often to prioritize ECB efforts.     

The power of the context map: Designing realistic outcome evaluation strategies and other unanticipated benefits

Developing a feasible evaluation plan is challenging when multiple activities, often sponsored by multiple agencies, work together toward a common goal. Often, resources are limited and not every agency's interest can be represented in the final evaluation plan. The article illustrates how the Antecedent Target Measurement (ATM) approach to logic modeling was adapted to meet this challenge. The key adaptation is the context map generated in the first step of the ATM approach. The context map makes visually explicit many of the underlying conditions contributing to a problem as possible. The article also shares how a prioritization matrix can assist the evaluator in filtering through the context map to prioritize the outcomes to be included in the final evaluation plan as well as creating realistic outcomes. This transparent prioritization process can be especially helpful in managing evaluation expectations of multiple agencies with competing interests. Additional strategic planning benefits of the context map include pinpointing redundancies caused by overlapping collaborative efforts, identifying gaps in coverage, and assisting the coordination of multiple stakeholders.     

The integral paradigm: The truth of faith and the social sciences

This article proposes a paradigm for the social sciences derived from Pitirim A. Sorokin’s writings about Integralism. His conception of a three-component system of truth and knowledge which includes the senses, reason, and faith is the foundation of this integral perspective. The paradigm entails the incorporation of religious-ethical ideas within the established frame of reference of the social sciences. The consensus among several world religions that some version of the Golden Rule is the most fundamental ethical principle, and the idea of individual transformation involving the realization of this principle, are advanced as the foundation for integral social science. The virtues, the vices and the Ten Commandments are presented as more specific schemes which articulate the positive and negative precepts associated with the Golden Rule. The incorporation of these religious-ethical ideas in value premises, existing paradigms and theories, special fields, and empirical research is considered. Integralism is proposed as a solution to the current crisis of fragmentation and anomie in the social sciences.     

Independent child protection assessments: incorporating a therapeutic focus from an integrated service context

Assessment following serious child abuse is a significant activity for the social work, psychology and psychiatric professions. Notwithstanding the profound significance of the consequences for abused children and their families from recommendations made by such assessments, there is little research which examines the process and outcome of child protection assessments. This paper describes the professional practice principles of an independent assessment team and presents preliminary findings from a retrospective examination of 160 major independent assessments undertaken over a period of 11 years. The review suggests that nearly 60% of the families gained some therapeutic benefit from the assessment process and outlines the areas in which such benefits occurred. It is argued that structuring assessments in a way which maximizes the possibility of parents/carers effecting changes in problem areas is the essence of a constructive partnership relation with families. Copyright © 1999 John Wiley & Sons, Ltd.     

The trouble with 'inclusion': a case study of the faith zone at the Millennium Dome

Some sociologists of religion would argue that there has been a move away from ‘religion’, in terms of institutionalised dogmas and established corporate ways of believing, towards ‘spiritualities of life’ where the emphasis lies on the personal, the individual and the experiential ( Heelas, 2002 ; Wuthnow, 2001 ). Given the evidence for the apparent popularity of spirituality in contemporary Western society, it is surprising that between 1996 and 2000, the Zone concerned with religion at the Millennium Dome in Greenwich was re‐named from‘The Spirit Zone’to‘The Faith Zone’. A range of political, economic and religious interests lay behind the Zone’s re‐naming, and both the name (and the content) changed to reflect ‘religion’ rather than ‘spirituality’. The process of constructing the Zone thus moved in a diametrically opposite direction to some of the trends associated with religious belief in modern Britain. An investigation of the dynamics behind the construction of the Faith Zone at the Dome provides an opportunity to evaluate what ‘counted’ as religion ( Beckford, 2003 ) at a specific time and context in British society. The paper also shows that behind the Labour Government rhetoric of ‘inclusion’, various dimensions of spiritual belief and activity in Britain are excluded from the public sphere. When it comes to religion, taken‐for‐granted criteria operate – resulting in the prioritisation of the official, the ‘representative’, the ‘respectable’, and ‘the unified’ over the unofficial, the deviant, the private, and the contested. This paper looks at the struggles and the conditions associated with the idea and the policy of inclusion in relation to religion in modern Britain, using the Faith Zone at the Dome as a case study.     

The tomboyism of faith: spiritual tomboyism in the cult of Sainte Foy

This article offers a reading of premodern, spiritual tomboyism as evident in the cult of Sainte Foy in France during the ninth to eleventh centuries. It draws attention to the signs of differently gendered and aged masculinities in the female child saint. Martyred at the cusp of puberty, Sainte Foy remains forever suspended in her gender development. Bernard of Angers, in the Liber miraculorum, portrays Foy as a trickster tomboy whose miracles are known as her "jokes." But beyond the historical Foy and the textual Foy, there is a third Foy who is embodied in a reliquary statue with an adult male head. In times of social upheaval, Sainte Foy, whose earthly presence is manifest in her relics and reliquary statue, functions as a local patronus who protects her monastery, properties, and devotees. Her male-headed reliquary further affirms her identity as a holy warrior of Christ who fights to uphold the Peace of God. As trickster-tomboy and warrior-patronus, Sainte Foy hovers at and crosses over the boundaries of both gender- and age-based identities and practices.     

Labour geographies of the platform economy: Understanding collective organizing strategies in the context of digitally mediated work

The article examines the geographies of collective labour struggle in the platform economy. It distinguishes between the unique spatial features associated with place-based work and crowdwork to examine the divergent collective organizing strategies developed therein. Taking works councils, collective bargaining and multi-enterprise agreements as three examples of social dialogue, the article considers why different types of platform workers gravitate towards particular strategies, analyses the regulatory frameworks within which these workers' collective struggles are bound, and assesses the propensity for these expressions of solidarity to improve the terms and conditions of platform work.     

The third sector in welfare policies in Italy: the contradictions of a protected market

The paper describes how the involvement of non-profit organisations (NPOs) in welfare politics in Italy has historically developed in a mutual accommodation with the state, which has prevented the growth and the public recognition of an independent third sector. Using data from official statistics and recent research on non-profits, three analytical dimensions of the relationship between State and the third sector are considered: the resource exchange; the division of responsibility for delivering public services; and the dynamics of social policy making. The study indicates that distinctive features of the ‘welfare mix’ in Italy have been: the attribution of public status to many NPOs as a consequence of an arrangement between Church and state; the weakness of state guidance, in spite of the generous economic assistance provided to NPOs by the state; the substitutive role of NPOs in providing basic public services; and the emergence of informal arrangements between public authorities and NPOs mediated by political patronage. I thank Ralph Kramer, Ugo Ascoli, Perri 6, and three anonymous referees ofVoluntas for helpful comments they provided on an earlier draft of this paper. My research was supported by a grant from the National Council of Research of Italy, and through facilities provided by the School of Social Welfare at the University of California, Berkeley. An earlier version of this paper is published in P. 6 and I. Vidal (eds)Delivering Welfare: Re-positioning Non-profit and Co-operative Action in Western European Welfare States, CIES, Barcelona, 1994.     

The choice agenda in the Australian supported housing context: a timely reflection

The last 30 years has seen significant developments in the Australian housing sector for people with disabilities. Despite much change in the sector, and advancements in disability services, the range of current supported housing options for younger Australian adults with a neurological disability remains vastly under-developed. This is despite a widely accepted and endorsed recognition that, as is the general population, people with all forms of disability have a right to housing of their choice. This paper presents a timely critique of the key actions made by the Australian disability and housing sectors and subsequently proposes a more informed approach to supported housing design and development: one that is based on a comprehensive understanding of consumer housing priorities and preferences, and is conducive to a person’s biopsychosocial health.     

Imagining The Sociological Imagination: the biographical context of a sociological classic

Charles Wright Mills's arguments in The Sociological Imagination are very popular and this paper focuses on the biographical context in which his programmatic statements were occasioned. This breaks new ground by locating The Sociological Imagination and earlier programmatic statements in the professional and personal travails that motivated them. This approach is adopted in order to display the intersection between biography and sociology in Mills's life and career, a feature that he made a central part of sociology's promise. The paper utilizes this approach to reflect on the reasons why The Sociological Imagination became so popular and was able to transcend Mills's general unpopularity at the time of his death; and as part of the explanation of why the dismissal of the book on its publication contrasts with the contemporary view, enabling it to transpose successfully to a time significantly different than at its writing.     

A comparative study of crisis communication strategies between Mainland China and Taiwan: The melamine-tainted milk powder crisis in the Chinese context

The purpose of this paper is twofold: (1) to identify and compare the crisis communication strategies (CCSs) that organizations used to respond to a congenetic melamine-tainted milk crisis in two Chinese societies (i.e., Mainland China and Taiwan), and (2) to explore the underlying political and media system reasons that led to the differences. Content analysis and discourse analysis of media coverage were used. The most significant finding is that Sanlu (a Mainland China-based organization) and KingCar (a Taiwan-based organization) demonstrated inverse pattern of the CCS adoption. Specifically, according to Coombs’ (1998) defense-accommodation continuum, Sanlu's CCSs moved from defensive to accommodative pole as time went by whereas, in contrast, KingCar started with accommodative strategies and moved towards the defensive pole gradually. Besides, the results showed that both organizations adopted denial, corrective action and apology strategies. However, on the Sanlu part, the most frequently used strategy was denial, while KingCar used justification most often. Moreover, this paper suggests that besides cultural dynamics, political and media systems also play a part in corporate selection of CCSs, and they are among the most important factors that should be taken into account to explain the differences in societies even with an identical traditional culture.     

Defining the challenges of providing long-term care: the case of the nursing home industry's response to the AIDS epidemic

Acquired Immune Deficiency Syndrome (AIDS) is now viewed as a chronic disease requiring long-term management. As a result, more persons with AIDS (PWAs) are seeking long-term care in facilities that have primarily served the elderly. In some regions, however, the nursing home market into which PWAs may introduce new demand is a market already characterized by excess demand. In light of this, competition for limited long-term care resources may develop between the frail elderly and PWAs. The nursing home industry has raised many issues regarding the feasibility of admitting AIDS patients as residents, but little is known about how important these issues are in deciding admissions policy. How the industry perceives and resolves the concerns it has regarding delivery of care to PWAs can affect the overall long-term care system and thus affect the traditional users-the frail elderly. Knowing the concerns and preferences of the industry may help guide and anticipate future changes in the system. In this pilot study, a random sample of 250 nursing home administrators in the five highest AIDS-incidence areas in the United States was surveyed to determine (1) the industry's concerns and issues regarding AIDS care, (2) data regarding requests for admission by PWAs to nursing homes, and (3) data concerning the industry's preferred way of delivering AIDS care. Important admissions policy issues cited by the respondents included the ability to meet special care needs, costs of care, and inadequate reimbursement. The majority also believed the most appropriate methods of providing care were special care units for AIDS within nursing homes or dedicated HIV/AIDS nursing facilities.