Caring for vulnerable populations: curricula in U.S. internal medicine residencies

The Accreditation Council for Graduate Medical Education (ACGME) encourages internal medicine training programs to include specific curricula devoted to health care issues of vulnerable populations. Our aim was to determine the prevalence of curricula involving selected vulnerable populations among U.S. Internal Medicine residencies. We conducted a survey of Program Directors of all US Internal Medicine Residencies assessing whether the program had a curriculum for six vulnerable populations (racial and ethnic minorities, non-English speaking patients, lesbians, gay men, victims of domestic violence and patients with substance abuse problems). Most residencies address substance abuse and victims of domestic violence, while there remains a lack of dedicated teaching on other vulnerable populations, including lesbians, gay men, racial and ethnic minorities and non-English speaking patients.     

‘A commitment to cultural pluralism’. Diversity practices in two Amsterdam venues: Paradiso and De Meervaart

Cultural policy has traditionally had close ties with the construction of the society as a nation state, which has been marked by its built-in tendency towards cultural homogenisation. Post-World War II, multicultural societies pose profound challenges to these traditional forms of cultural policy. Although, in the last decades, western democracies have been designing cultural diversity plans, this does not mean that governmental policies have successfully been translated in institutional practice. In the Netherlands, mainly established cultural institutions have failed to integrate diversity into their core business. Yet, there have been a few exceptions that continue to make attempts to adapt their programmes to address new populations. In this article, we use Parekh’s view of a multiculturalism that reconciles unity and diversity, as a heuristic device that allows us to explore and examine the bottom-up diversity policies and practices of two Amsterdam-based cultural institutions: Paradiso and De Meervaart.     

Implementation of a Collaborative Care Initiative for PTSD and Depression in the Army Primary Care System

Collaborative care models hold promise as a means to improve the Military Health System (MHS) to better meet the mental health needs of U.S. military personnel. This article describes an Army-wide collaborative care initiative, RESPECT-Mil (“Re-engineering Systems of Primary Care Treatment for Depression and PTSD in the Military”), aimed at improving care for soldiers with depression and post traumatic stress disorder. Essential to the implementation of RESPECT-Mil has been the use of a centralized coordinating team to facilitate collaborative care practice and policy activities across the multiple levels of the MHS. The article explores the relevance of collaborative care frameworks to the social work profession and concludes with a discussion of future directions for the social work field to promote greater involvement in the integrated care movement.     

Racial inequality and the recognition of racial discrimination in Jamaica

A growing body of literature posits that a population’s denial of the salience of racial discrimination acts as a mechanism of its perpetuation. Moreover, scholars locate a population’s propensity to deny racial discrimination in contemporary ideologies of racial mixing or ethnic fusion. Most quantitative studies of public opinion on these issues are limited to Latin America and the Spanish-speaking Caribbean. This study examines the case of Jamaica. We first (1) examine the extent of Jamaica’s contemporary racial inequality using national census data. We then (2) use nationally representative data from the AmericasBarometer social survey to determine the extent to which a recognition of racial discrimination characterizes Jamaican public opinion. Finally, we (3) explore the salience of an ideology of racial mixing in Jamaica and (4) test whether that ideology affects the likelihood that Jamaicans acknowledge contemporary racial discrimination. Our findings document dramatic social inequality by skin colour in Jamaica and suggest that a majority embrace an ideology that racial mixing is negatively associated with Jamaicans’ recognition of racial discrimination. We discuss our findings and their implications for understanding ideologies of racial mixing and racial inequality in the Americas.     

Lo andino,duality, and indigenous identities in Prehispanic highland Bolivia

This argument examines duality as part of a constellation of cultural traits used by Andean archaeologists in a prehistoric conception of lo andino, a regionally specific worldview and way of life that is presumed to have included ayllus, paired moieties, ecological complementarity or verticality, and dualism. Several lines of material evidence from Jachakala, a highland Bolivian site dating to ca. AD 170–1000, are presented. The timing of the appearance of duality at Jachakala suggests that the ideological division of the whole into two complementary halves may be most useful in times of crisis, as a mechanism for coping with socioenvironmental stress. The article compares this prehistoric version of lo andino to another version of cultural essentialism at work in Andean indigenous identity politics today, one that uses a different set of features (coca chewing, indigenous language and dress) to symbolize the regionally shared core of Andean indigenous cultures as a counterpoint to modernity.     

Sexual vs. Nonsexual Currently Most Upsetting Trauma: A Fresh Look at Attenuation of Sexual Response,Alcohol Intoxication,and Post-Traumatic Stress

This study examined the dependence of sexual response (vaginal pulse amplitude [VPA] and subjective sexual arousal) on alcohol intoxication (.10% breath alcohol concentration [BrAC] versus no alcohol) and the nature of a woman’s currently most upsetting traumatic event (C-MUTE), whether it was sexual (e.g., rape) or nonsexual (e.g., combat). Self-reported sexual outcomes were also compared by C-MUTE type. A total of 117 women completed background measures and either drank alcoholic or nonalcoholic beverages. They were shown erotic films and their VPA was assessed. A two (sexual versus nonsexual C-MUTE) by two (.10% BrAC versus no alcohol) analysis of variance (ANOVA) showed that, controlling for post-traumatic stress (PTS) symptoms, women with a sexual C-MUTE showed lower percent VPA change than women with a nonsexual C-MUTE. No significant effects were found for subjective sexual arousal. A multivariate analysis of variance (MANOVA) showed that women with a sexual C-MUTE reported more frequent anxiety and inhibition during partnered sex and more frequent lack of vaginal lubrication versus women with a nonsexual C-MUTE. There was no significant interaction between C-MUTE and alcohol intoxication. Whether a woman is currently upset by past sexual victimization may influence current sexual difficulties. Attenuated VPA may be attributable to the sexual nature of a C-MUTE as opposed to general trauma exposure.     

Back to the future: mapping a historic turn in youth studies

Traditionally, the study of youth culture has been dominated by contemporary, sociological accounts of young people's leisure pursuits and identity-laden social practices. However, in recent years, it has become evident that there is an emergent scholarly interest in examining youth culture history. While many historians and sociologists situate the birth of youth culture as a post-WWII phenomenon, this essay contends that scholars from varying disciplines are expanding upon this popularly accepted timeline. Moreover, it is argued that there is now a historic turn in youth studies both in content and methodology. By providing an overview of what current youth history scholarship exists, and what methodologies enable such texts, this article advocates for further socio-historical work that foregrounds the longstanding, indelible influence and importance of young people's experiences within the tapestry of everyday cultural life.     

Good jobs and bad jobs for Indonesia's informal workers

In contrast to the majority of studies that have treated informal workers as a single homogeneous group, this article accounts for the possibility of “winners” and “losers” among informal workers. Applying unconditional quantile regressions to data from the Indonesian Family Life Survey, the authors are able to estimate the formal–informal wage gaps for different segments of the earnings distribution. Although the evidence confirms the existence of a substantial earnings penalty for many informal workers, there is also a group who earn roughly similar incomes to formal workers. The findings are consistent with Fields's (1990 and 2005) model of heterogeneous informal employment.     

Parental Perspectives on the Emotional,Relational and Logistical Impacts on Siblings of Youth Who Sexually Offend

This qualitative study explored parents’ perspectives on the collateral consequences of youth sexual offending on siblings through the analysis of interview data among 16 caregivers from 10 Canadian families. Using thematic coding procedures, findings indicated that parents identified a range of safety, emotional and interpersonal impacts on siblings beginning with the criminal justice and child welfare investigations of the sexual offending and extending to siblings’ relationships with the offending youth, their caregivers and other relatives. Results demonstrate the need for greater acknowledgement of, and parent‐informed interventions that specifically address the impact of youth sexual offending on siblings by professionals and non‐professionals (e.g. relatives) alike.