Employer‐sponsored programmes for the prevention and treatment of HIV/AIDS: Recent experience from sub‐Saharan Africa

This article examines a sample of employer programmes in sub‐Saharan Africa that supplement government efforts to prevent and treat human immunodeficiency virus (HIV). Some of these programmes provide workers with in‐house education, voluntary HIV testing and antiretroviral treatment. Others rely on new forms of employment‐based group health insurance that include an HIV treatment package. In addition, some enterprises use the workplace as a platform for launching efforts into neighbouring communities to reach spouses, children, sex workers, secondary school students and others. Early evidence suggests that employer programmes maintain the health of large fractions of workers living with HIV who are served by them. They further enable enterprises to avoid productivity losses and turnover costs associated with HIV. At the same time, they take pressure off government agencies that face demands for treatment far exceeding their capacity. The article identifies features of successful employer programmes including “elite appeal”, which mobilizes community leaders and role models to deconstruct stigma, change perceptions and call for behavioural change; and “collateral linkage”, which extends the reach of HIV workplace programmes by linking them to related community concerns: e.g. alcohol abuse, malaria and domestic violence. Looking forward, the potential for expanding employer programmes as well as the restrictions associated with the limited scale of formal‐sector employment within sub‐Saharan African economies is assessed. Actions by which governments, employer associations, trade unions and international organizations can encourage further development of such programmes and extend their reach are suggested.     

Understanding the Self Through Siblings: Self‐awareness Mediates the Sibling Effect on Social Understanding

This study addresses the role of sibling influence on social understanding in the second year of life, in a sample of families living in New Zealand who identify as Pacific Island (N = 43). We tested toddlers at 20 and 26 months on social understanding tasks, as well as their levels of self‐awareness on the Stipek self‐concept questionnaire. We hypothesized that the presence of siblings provides a rich resource from which to learn about the mind. There were significant differences in children's social understanding and self‐awareness as a function of having older siblings. Further analyses revealed that the relation between older siblings and social understanding was mediated by toddlers' level of self‐awareness.     

A meta-ethnographic study of health care staff perceptions of the WHO/UNICEF Baby Friendly Health Initiative

BackgroundImplementation of the Baby Friendly Health Initiative (BFHI) is associated with increases in breastfeeding initiation and duration of exclusive breastfeeding and ‘any’ breastfeeding. However, implementation of the BFHI is challenging.AimTo identify and synthesise health care staff perceptions of the WHO/UNICEF BFHI and identify facilitators and barriers for implementation.MethodSeven qualitative studies, published between 2003 and 2013 were analysed using meta-ethnographic synthesis.FindingsThree overarching themes were identified. First the BFHI was viewed variously as a ‘desirable innovation or an unfriendly imposition’. Participants were passionate about supporting breastfeeding and improving consistency in the information provided. This view was juxtaposed against the belief that BFHI represents an imposition on women's choices, and is a costly exercise for little gain in breastfeeding rates. The second theme highlighted cultural and organisational constraints and obstacles to BFHI implementation including resource issues, entrenched staff practices and staff rationalisation of non-compliance. Theme three captured a level of optimism and enthusiasm amongst participants who could identify a dedicated and credible leader to lead the BFHI change process. Collaborative engagement with all key stakeholders was crucial.ConclusionsHealth care staff hold variant beliefs and attitudes towards BFHI, which can help or hinder the implementation process. The introduction of the BFHI at a local level requires detailed planning, extensive collaboration, and an enthusiastic and committed leader to drive the change process. This synthesis has highlighted the importance of thinking more creatively about the translation of this global policy into effective change at the local level.     

Becoming institutional bodies: Socialization into a long-term care home

This paper reports the findings from a phenomenological study examining the lived experience of moving to a long-term care facility and the process of socialization for new residents into the nursing home culture and environment. Three residents were followed over the first six months after moving to a long-term care facility using a series of in depth interviews and participant observation with residents themselves, staff members and family members. This paper focuses on the five institutional level processes related to socialization into the long-term care environment as they were experienced by the new residents. These included: placing the body, defining the body, focusing on the body, managing the body, and relating to the body. The findings point to the importance of place in the construction of institutional bodies in the long-term care context.     

跟自己的人生平起平坐

商场女装部,一个正血拼的贵妇喊出我名字,我们有多久没见？五年？还是六年？我赶紧奉上不失礼的笑,打心底认定完全陌生的她十有八九认错人。她接着报出自己姓名和一些关键词,我才恍然记起彼此曾是同事。辞职嫁作商人妇的她妆容精致得像油画,原本黑油油的直发又染又烫。     

The participation of social services in youth justice systems in Europe

This article considers the participation of social services in youth justice systems in 11 European countries. In international children's rights instruments, the importance of the assessment of the background situation of juvenile defendants is acknowledged. In this article, three models for social work participation are proposed, on the basis of the distinction between adversarial and inquisitorial legal traditions and welfare and justice approaches towards youth justice. In the welfare model, social workers play the most active role in the youth justice process, whereas in the justice model, social workers have the least active role. In between, a mixed model can be found in which social workers play an active role in the youth justice system only to some extent.