Human immunodeficiency virus risk: is it possible to dissuade people from having unsafe sex?

Summary. The cumulative number of human immunodeficiency virus (HIV) infections worldwide has reached 60 million in little over 30 years. HIV continues to spread despite a detailed understanding of the manner in which it spreads and measures which can prevent spread. Some governments have been highly successful in containing the spread of HIV through blood products and from mother to child and among injecting drug users. Lack of political will, lack of resources or challenges to widely accepted scientific evidence have held back similar interventions in other countries. It has proved much more difficult to reduce the sexual transmission of HIV in both high and low income countries. A wide range of strategies has been identified but it remains unclear which strategies deserve priority and what methods of promoting them have the greatest effect. There is ample evidence that awareness of HIV and changes in sexual behaviour have occurred widely but the penetration of information remains poor in some vulnerable groups especially adolescents and women in poorer countries. Further obstacles face those who have information about the risk. The subordinate position of women and a desire for large families are important obstacles to condom negotiation and use. Urbanization, poverty, conflict and declining public services all exacerbate unsafe sexual behaviour. We argue that so-called 'structural' interventions directed at these wider contexts of unsafe behaviour merit greater attention. Such approaches have the added benefit of being less susceptible to 'risk compensation' which has the potential to undermine strategies directed at reducing the transmission efficiency of HIV.     

A Quantitative Assessment of the Risks from Illegally Imported Meat Contaminated with Foot and Mouth Disease Virus to Great Britain

Foot and mouth disease (FMD) is considered by many as the most important animal disease in the world. FMD is highly contagious and outbreaks incur significant costs as affected countries are severely limited in their ability to trade. A number of trade commodities may be contaminated with FMD virus (FMDV) including animal products, for example, meat. As a member of the European Union, Great Britain (GB) has put in place a number of regulations to prevent the importation of pathogens in imported meat products. However, the illegal importation of meat provides a route by which safety controls may be circumvented and meat from FMD affected areas may be imported. This study assesses the FMD infection risk posed to the livestock population of GB from the illegal importation of meat, and estimates the major contributors to this overall risk, through the development of a quantitative risk assessment model. From model results, the total amount of illegal meat entering GB each year is estimated on average to be 11,875 tonnes. with 90% certainty that this is between 4,398 and 28,626 tonnes per year; of which between 64.5 and 565 kg are contaminated with FMDV. This flow of illegal meat results in an estimate of a frequency of FMD infection in GB livestock of 0.015 cases of infected animals per year, with 90% certainty it is between 0.0017 and 0.053. Imports from the region Near and Middle East account for 47% of this risk, and 68% of the risk is attributed to bone-in and dried de-boned products.     

‘It's their word against mine’: young people's attitudes to the police complaints procedure in Northern Ireland

One of the central aims of the police reform process in Northern Ireland has been to increase the legitimacy of the policing structures and police officers amongst those who are served and policed by the Police Service of Northern Ireland (PSNI). To meet this aim, structures have been created to ensure that the PSNI is accountable to all sections of the community for its strategy and performance, and in monitoring the attitudes and behaviour of its officers. To that end, the Office of the Police Ombudsman for Northern Ireland (PONI), the Northern Ireland Policing Board and 26 District Policing Partnerships have been created. This paper aims to break ground by looking in some detail at young people's attitudes to and experiences of the workings of one of those new bodies, the Police Ombudsman, and to explore issues related to young people's willingness to engage with the PONI.     

Art therapy as a modality for crisis intervention: Children express reactions to violence in their community

Ten days after the Symbionese Liberation Army's shoot out in Los Angeles in 1974, the Cedars-Sinai Medical Center, Department of Family Child Psychiatry, Thalians Community Mental Health Center, sent a crisis team of three psychotherapists to a school in the black community. The psychotherapists used an art therapy approach with a third grade classroom of 21 black children. The team's procedure helped the children ventilate their reactions to a frightening event which occurred in their neighborhood. This paper describes the art therapy techniques which were utilized, the children's vivid pictorial and verbal expressions accompanied by the psychological aspects of their responses.     

Factors That Impact a Social Worker's Capacity to Supervise a Student

With sector constraints and higher education economic imperatives increasingly impacting the provision of social work field education, university programs lack an understanding of the factors that enable or prohibit field educators’ capacity to provide placements. Despite the significance of field education in the curriculum, it remains unclear what the experiences and motivations of field educators are to provide universities with student placements. This research addresses this gap through surveying 101 field educators that attended statewide Victorian field education training. Results indicated that although field educators recognised the benefits of supervising students, workload relief, additional training, and further student placement preparation by the university were emphasised as the primary factors that would enable them to respond positively to placement requests. Payments for placements did not necessarily ameliorate these issues nor guarantee the provision of more placements. The implications of these findings for universities and the field are discussed.     

Supporting foster and kinship carers to promote the mental health of children

The majority of children and young people removed from the care of their parents by the state of Victoria, Australia, reside in foster or kinship care. These children have experienced a broad range of adverse conditions and are up to 4 times more likely to experience problems with mental health than their mainstream peers. This paper draws on the perspectives of foster and kinship carers, describing the disconnection between their role as mental health advocates and their interest in early intervention in a field which is dominated by crisis and the historic marginalisation of foster and kinship carers. Thirty‐one foster and kinship carers across greater metropolitan Melbourne, Australia, contributed to this study through interviews and focus groups. Participants demonstrated a practical understanding of mental health and an ability to identify a range of conditions that have an adverse impact on the mental health of children and young people in their care. The paper concludes that there is a lack of systemic support and even a range of barriers that affect the capacity of foster and kinship carers to promote the mental health and well‐being of the children and young people in their care.     

English proficiency in Australia, 1981 to 2016

Using Australian census data, the paper examines the incidence of poor English competency in Australia from 1981 onwards. The paper examines English competency in relation to various characteristics such as sex, age, language spoken, visa type, citizenship, duration of residence and location. It finds that there was a sharp rise in the numbers of people not speaking English well between the 2011 and 2016 Censuses and special attention is given to this rise in the paper. Recently, the Australian Government unsuccessfully legislated for the introduction of a requirement of English competency at the level of IELTS 6 (the commonly used university entrance level) as a condition for the award of Australian citizenship. The paper argues that this test would have led to a very large number of disenfranchised Australian permanent residents and this would be a highly undesirable result. Nevertheless, employment and social participation are strongly influenced by English competency and residents with poor English are disadvantaged. The policy suggestion is made that participation in a course of English language training for those without functional English skills could be made a precondition of the award of permanent residence—without the application of a passing grade.     

Socially disadvantaged women's views of barriers to feeling safe to engage in decision-making in maternity care

BackgroundAlthough midwifery literature suggests that woman-centred care can improve the birthing experiences of women and birth outcomes for women and babies, recent research has identified challenges in supporting socially disadvantaged women to engage in decision-making regarding care options in order to attain a sense of control within their maternity care encounters.ObjectiveThe objective of this paper is to provide an understanding of the issues that affect the socially disadvantaged woman's ability to actively engage in decision-making processes relevant to her care.Research designThe qualitative approach known as Interpretative Phenomenological Analysis was used to gain an understanding of maternity care encounters as experienced by each of the following cohorts: socially disadvantaged women, registered midwives and student midwives. This paper focuses specifically on data from participating socially disadvantaged women that relate to the elements of woman-centred care-choice and control and their understandings of capacity to engage in their maternity care encounters.FindingsSocially disadvantaged women participants did not feel safe to engage in discussions regarding choice or to seek control within their maternity care encounters. Situations such as inadequate contextualised information, perceived risks in not conforming to routine procedures, and the actions and reactions of midwives when these women did seek choice or control resulted in a silent compliance. This response was interpreted as a consequence of women's decisions to accept responsibility for their baby's wellbeing by delegating health care decision-making to the health care professional.ConclusionThis research found that socially disadvantaged women want to engage in their care. However without adequate information and facilitation of choice by midwives, they believe they are outsiders to the maternity care culture and decision-making processes. Consequently, they delegate responsibility for maternity care choices to those who do belong; midwives. These findings suggest that midwives need to better communicate a valuing of the woman's participation in decision-making processes and to work with women so they do have a sense of belonging within the maternity care environment. Midwives need to ensure that socially disadvantaged women do feel safe about having a voice regarding their choices and find ways to give them a sense of control within their maternity care encounters.