Rapid Ethnographic Assessment of HIV/AIDS among Garífuna Communities in Honduras: Informing HIV Surveillance among Garífuna Women

ABSTRACT

Garífuna, an Afro-Caribbean ethnic group in Honduras, have among the highest HIV prevalence rates in Central America; 15- to 49-year-old Garífuna have HIV rates comparable to heterosexual transmission rates in regions of sub-Saharan Africa. The heightened rates in this age range pose a significant risk of vertical transmission from woman to child at birth. In 2006, a Behavioral Surveillance Survey plus Biomarkers (BSS+) reexamined seroprevalence of HIV, sexually transmitted infections, and HIV-related risk behaviors among Garífuna to inform HIV prevention activities and monitor trends in HIV transmission over time. To inform the BSS+ survey protocol, we conducted a rapid ethnographic assessment (REA) in Garífuna communities to specifically examine acceptability among Garífuna to be surveyed, suggest ways to minimize HIV-testing related stigma, and determine female gender-specific concerns among BSS+ respondents. Data were collected in 2 weeks in November, 2004, using a semi-structured interview guide for key informant interviews and focus groups. Seventeen key informant interviews and three focus groups were conducted; participant observation and 11 site visits were also conducted. Major findings included high Garífuna acceptability to participate in the BSS+ with key member involvement and incentives. Maintaining confidentiality at HIV testing sites is required to minimize Garífuna women's risk of intimate partner violence. Recommendations to BSS+ partners from this REA informed the BSS+ study protocol and was expected to increase participation and validity and decrease potential risks associated with women's survey participation.     

Infant-Mother Attachment at One Year Predicts Children's Understanding of Mixed Emotions at Six Years

Data from the six-year follow up of a longitudinal study investigating intergenerational patterns of attachment and the effects of early relationships upon subsequent social, emotional and cognitive development are presented. Around the time of their sixth birthday, 63 children participated in an affect understanding task, involving cartoon diagrams depicting social and emotional dilemmas. As predicted, performance on this task, assessed in terms of mixed-emotion understanding, was predicted by security of the infant-mother attachment relationship (as assessed in the Strange Situation at one-year) and security or autonomy in the mother's representations of, and reflections upon, her attachment history (as assessed with the Adult Attachment Interview of AAI–during pregnancy) prior to the child's birth. Regression analyses suggested that the infant-mother attachment data significantly enhanced the prediction of an advanced understanding of mixed emotions at six-years, even after controlling for variations in the children's age at time of testing, as well as child and parent verbal skills. The inclusion of earlier assessments of the child-father Strange Situation assessment (at 18-months) did not enhance the model; nor did the attachment status of the mothers or fathers as observed in their prenatal AAIs. Discussion concerns the contributions of early attachment processes, including family conflict, to the ability to verbally express an understanding of mixed emotions in a task depicting hypothetical social and emotional dilemmas.     

Older people's experiences of community life: patterns of neighbouring in three urban areas

This paper examines changes to the community life of older people living in three urban areas of England: Bethnal Green, Wolverhampton and Woodford. All three were the subject of classic community studies in the 1940s and 1950s, these providing rich material about the lives of groups such as elderly people. Using this earlier research as a baseline, the paper presents data on how the experience of living in urban neighbourhoods has changed for older people in the intervening years. The article reviews the relationship between elderly people and their neighbours, drawing on quantitative as well as qualitative data. In conclusion, the paper identifies a number of general arguments pointing to the value of a community and locality perspective for understanding the impact of social changes on later life.     

German family policy at the crossroads: analysing the impact of parental leave reform through simulation

Comparative studies of welfare reforms encounter two problems. First, the counterfactual problem is that in the real world schemes and their reforms do not coexist simultaneously and are hard to compare. Second, the contextual problem derives from the absence of comparable measures for change. Microsimulation helps to overcome these problems. It compares policy options – actual reforms or reform plans – simultaneously and provides a comparable measure: the disposable income of model families. This article uses a type–case approach to investigate recent reforms of the German parental leave benefit. Simulation makes those reforms comparable over time and across countries. Results show that the profile of the German scheme is changing from 'general family' towards 'dual-earner' support. Furthermore, the recent reforms make the German scheme converge towards the Swedish leave scheme. The recent reforms introduce a new concept of fairness and a focus on gender equality to German family policies.     

On a Correction of the Scale MLE for a Two-Parameter Exponential Distribution Under Progressive Type-I Censoring

In this article, we present a corrected version of the maximum likelihood estimator (MLE) of the scale parameter with progressively Type-I censored data from a two-parameter exponential distribution. Furthermore, we propose a bias correction of both the location and scale MLE. The properties of the estimates are analyzed by a simulation study which also illustrates the effect of the correction. Moreover, the presented estimators are applied to two data sets. Finally, it is shown that the correction of the scale estimator is also necessary for other distributions with a finite left endpoint of support (e.g., three-parameter Weibull distributions).     

Rural child welfare practice from an organization-in-environment perspective

An "organization-in-environment" perspective can help researchers understand how rurality influences child welfare practice. Drawing from theoretical perspectives on environment and organizations, researchers find rural/urban differences in practice at the level of the organization, which is the immediate environment of child welfare practice, and also in the relationship between organization and environment. Results challenge previous findings of few differences between rural and urban practice and offer particular implications for rural child welfare practice.     

Mental illness,partial hospitalization,and the family

Summary When illness is socially defined, the task of therapy is to enable the patient to move from a sick role to one of maximal social functioning. In a day hospital setting, methods are explored to involve a patient with his family both directly and indirectly. Thus the patient is supported both in the treatment milieu and when he is at home. Not only the patient, but the family, is vulnerable at this time and each must be helped to make parallel and complementary shifts in interpersonal behavior. To view the family solely as a resource for the support of the ill member and his treatment is to fail to accept the need of the family as a whole for reorganization and strengthening.