Sexual Self-Efficacy and Gender: A Review of Condom Use and Sexual Negotiation Among Young Men and Women in Sub-Saharan Africa

Sexual self-efficacy (SSE), one’s perceived control of or confidence in the ability to perform a given sexual outcome, predicts sexual behavior; however, important questions remain regarding whether gender modifies observed associations. In a comprehensive review of peer-reviewed HIV-prevention literature focusing on youth (ages 10 to 25) in sub-Saharan Africa, we measured and assessed the influence of SSE on condom use and sexual refusal, overall and by gender. Our results, after reviewing 63 publications, show that SSE is inconsistently measured. Most studies measured condom use self-efficacy (CUSE) (96.8%) and/or sexual refusal self-efficacy (SRSE) (63.5%). On average, young men had higher CUSE than young women, while young women had higher SRSE than young men. While cross-sectional studies reported an association between high SSE and sexual behaviors, this association was not observed in interventions, particularly among young women who face a disproportionate risk of HIV acquisition. In all, 25% of intervention studies demonstrated that fostering CUSE increased condom use among young men only, and one of two studies demonstrated that higher SRSE led to reduced frequency of sexual activity for both men and women. Future research and HIV-prevention interventions must be gender targeted, consider improving CUSE for young men, and move beyond limited individual-level sexual behavior change frameworks.     

GENDER ISSUES IN PSYCHOSOCIAL MORBIDITY IN GENERAL PRACTICE

The objective of this study was to compare differences in reasons for encounters, diagnosis and treatment between men and women patients presenting with psychosocial problems as recognised by their general practitioners. The research design was a survey based on structured questionnaires completed by the general practitioners on patients consulting with mental health problems in Bunbury in the rural South West region of Western Australia. The data collection took place for a period of 5 weeks. Twenty two general practitioners, from 5 surgeries, collected information on 428 patients, pertaining to socio-demographic characteristics, reasons for encounter, diagnoses, social problems, chronicity, counselling, medication and use of referral services. The gender differences in the illness profile was quite pronounced. Men patients were older, were more likely to be diagnosed with psychosis or character disorders, to have employment or unknown problems. On the other hand, female patients were younger and more likely not to be given a definite diagnosis, to report more social isolation, dependent/difficult relatives and problems resulting from assault. Men were more likely to be on medication and to be referred to psychiatrists, while women received more counselling from their GPs or were referred to counselling services. On the basis of the findings, it is pointed out that men and women differ in terms of the recognition that they are suffering from a problem, that outside help is needed and making the decision to consult. They also differ in terms of the social factors influencing gender differences in recognition of the illness by the GP and the decision to treat and/or refer.     

Changes in flourishing from adolescence to young adulthood: An 8-year follow-up

Most research on mental health among adolescents and young adults concentrates on understanding mental illness. However, mental health is more than the absence of mental illness. Among adolescents and young adults, positive mental health—a combination of emotional, social and psychological well-being—is related to higher prosocial behaviour, school integration and self-concept. However, much of the research on positive mental health among young adults has been with college students. Limited research has examined the presence and correlates of positive mental health, or flourishing, among a nationally representative sample of US young adults. This study extended from another researcher's original examination of positive mental health among US adolescents to describe the prevalence of flourishing among these same individuals in young adulthood. Our sample included 1090 individuals from the 2011 Panel Study of Income Dynamics Transition into Adulthood Supplement. Univariate and bivariate tests were used to describe the prevalence of flourishing during young adulthood and changes from adolescence to young adulthood. We used multivariable logistic regression to examine the relationships among indicators of healthy development and flourishing. Results suggest that flourishing improved during the transition into young adulthood and that targeting factors like life skills and civic engagement may enhance flourishing.     

Responding to children's disclosure of familial abuse: what survivors tell us.

This study is based on the reports of 384 adults who were abused physically, sexually, and/or emotionally in childhood by family members. It describes the survivors' attempts, as children, to get help by disclosing the abuse to someone who might intervene; those who did not disclose explain their reasons. The results indicate that disclosure usually did not bring an end to the abuse, and that little action was taken to control the perpetrator, even after disclosure took place. The responses received by the children to their disclosure are linked to their levels of self-esteem and family functioning as adults.     

An integrated model for measuring management performance

A model of organizational performance measurement that compels attention to the proper balance among quality, cost, and access; takes into account patient perceptions; produces clear targets for continual quality improvement (CQI); yields easily understood graphical displays; and captures health care organizations in simultaneous operation across the functions of cost, quality, and access was designed for the 22 medical treatment facilities of the Strategic Air Command. Such a tool provides practitioners, payers, and patients a range of information--from systemwide, facility, clinical service, and practitioner-specific insights on current performance to resource forecasts and easily understood targets for CQI. This case study shows that integrated performance modeling may be useful in examining many health management and reform issues.     

The British are not coming!: UK higher education and the nonprofit sector

The rationale for the growth of nonprofit management education in the United States has recently been charted by O'Neill (2005). Ten years previously, the United States and the United Kingdom were at similar levels of development. By 2006 the parallel lines had been broken. Why has nonprofit management education expanded in the United States while provision of graduate education for the voluntary sector in the United Kingdom has stood still? This article explores the factors that have prevented parallel growth in education provision. It argues that the university as an institution, both in terms of its nature and its power structures, is one of those factors. It presents the story of the closing of the world's first voluntary sector course at the London School of Economics and concludes with reflection on the likely future of voluntary sector management education provision in the United Kingdom.     

Integrating child welfare, juvenile justice, and other agencies in a continuum of services

This article presents a comprehensive strategy framework for integrating mental health, child welfare, education, substance abuse, and juvenile justice system services. It proposes an infrastructure of information exchange, cross-agency client referrals, a networking protocol, interagency councils, and service integration models. This infrastructure facilitates integrated service delivery.