HIV in young men who have sex with men: a review of epidemiology, risk and protective factors, and interventions

Epidemiological studies have found that young men who have sex with men (YMSM) represent the majority of young people infected with HIV annually in the United States. Further, they are one of the few risk groups to show an increase in the rate of infections in recent years. In addition to these disparities in prevalence and infection rates, there is an inequity in prevention and intervention research on this population. The purpose of this article is to review the existing YMSM literature on HIV epidemiology, correlates of risk, and intervention research. The article concludes that promising future directions for basic research include a focus on multiple clustering health issues, processes that promote resiliency, the role of family influences, and the development of parsimonious models of risk. In terms of intervention research, the article suggests that promising future directions include Internet-based intervention delivery, integration of biomedical and behavioral approaches, and interventions that go beyond the individual level to address partnership, structural, community, and network factors.     

Perceived Environmental Uncertainty, Entry Mode Choice and Satisfaction with EC-MNC Performance

Previous theoretical and empirical research provides substantial support for a contingency approach toward international entry-mode selection. Similarly, additional empirical research supports the notion that different international ownership-based entry modes tend to be associated with varying performance levels. In this study we provide an initial attempt to use Werner, Brouthers and Brouthers' (1996) multiple measures of Perceived Environmental Uncertainty (PEU) to determine the entry mode choices of firms and link these risk-adjusted mode choices to managerial satisfaction with firm performance. We hypothesize and find that firms which make PEU risk-adjusted entry mode choices are significantly more satisfied with their firm's performance than firms whose entry mode choices cannot be predicted using multiple PEU risk measures.     

Risk Management in a Polio-Free World

Inherent in the decision to launch the Global Polio Eradication Initiative in 1988 was the expectation for many people that immunization against poliomyelitis would eventually simply stop, as had been the case with smallpox following its eradication in 1977. However, the strategies for managing the risks associated with a "polio-free" world must be continuously refined to reflect new developments, particularly in our understanding of the live polioviruses in the oral poliovirus vaccine (OPV) and in the international approach to managing potential biohazards. The most important of these developments has been the confirmation in 2000 that vaccine-derived polioviruses (VDPVs) can circulate and cause polio outbreaks, making the use of OPV after interruption of wild poliovirus transmission incompatible with a polio-free world. A comprehensive strategy has been developed to minimize the risks associated with eventual OPV cessation, centered on appropriate long-term biocontainment of poliovirus stocks (whether for vaccine production, diagnosis, or research), the controlled reintroduction of any live poliovirus vaccine (i.e., from an OPV stockpile), and appropriate use of the inactivated poliovirus vaccine (IPV). Although some aspects of this risk management strategy are still debated, there is wide agreement that no strategy would entirely eliminate the potential risks to a polio-free world. The current strategy for risk management in a polio-free world will continue to evolve with better characterization of these risks and the development of more effective approaches both to reduce those risks and to limit their consequences should they occur.     

Social Guardianship and Social Isolation: An Application and Extension of Lifestyle/Routine Activities Theory to Rural Adolescents*

Abstract Although the overall crime rate dropped between 1993 and 2000, both adolescent violence and violent crime in rural areas has been on the rise. However, little research has been conducted on the determinants of rural violence using targeted regional samples of rural youth. This study examines the applicability of lifestyle/routine activities (RA) theory to a large sample of rural adolescents from Alabama. Multivariate logistic regression analyses indicate that: (1) social guardianship reduces the risk of assault and robbery victimization; (2) blacks are less likely to be assault and robbery victims; and (3) males are less likely to be robbery victims. Social isolation at the individual level is also a strong risk factor for both robbery and assault victimization. The theoretical implications of these findings and suggestions for future research are also discussed.     

OSHA''s Permissible Exposure Limits: Regulatory Compliance Versus Health Risk

Workplace exposures to airborne chemicals are regulated in the U.S. by the Occupational Safety and Health Administration (OSHA) via the promulgation of permissible exposure limits (PELs). These limits, usually defined as eight-hour time-weighted average values, are enforced as concentrations never to be exceeded. In the case of chronic or delayed toxicants, the PEL is determined from epidemiological evidence and/or quantitative risk assessments based on long-term mean exposures or, equivalently, cumulative lifetime exposures. A statistical model was used to investigate the relation between the compliance strategy, the PEL as a limit never to be exceeded, and the health risk as measured by the probability that an individual's long-term mean exposure concentration is above the PEL. The model incorporates within-worker and between-worker variability in exposure, and assumes the relevant distributions to be log-normal. When data are inadequate to estimate the parameters of the full model, as it is in compliance inspections, it is argued that the probability of a random measurement being above the PEL must be regarded as a lower bound on the probability that a randomly selected worker's long-term mean exposure concentration will exceed the PEL. It is concluded that OSHA's compliance strategy is a reasonable, as well as a practical, means of limiting health risk for chronic or delayed toxicants.     

DOING THERAPY: A POST-STRUCTURAL RE-VISION*

The purpose of this essay is to develop a way to look at doing therapy based on (a) Wittgenstein's concept of “language game”; (b) the relationship between Wittgenstein's “private language” argument, language games, and constructivism; and (c) post-structural thinking about language, how therapy works within language, and how language works within therapy. Case material is used to illustrate the usefulness of this approach.