Stigma, HIV/AIDS and prevention of mother-to-child transmission in Zambia

This report evaluates the extent of perceived and enacted HIV/AIDS-related stigma in a rural setting in Zambia. Stigmatisation is abundant, ranging from subtle actions to the most extreme degradation, rejection and abandonment. Women with HIV and pregnant women assumed to be HIV positive are repeatedly subjected to extensive forms of stigma, particularly once they become sick or if their child dies. Despite increasing access to prevention of mother to child transmission initiatives, including anti-retroviral drugs, the perceived disincentives of HIV testing, particularly for women, largely outweigh the potential gains from available treatments. HIV/AIDS related stigma drives the epidemic underground and is one of the main reasons that people do not wish to know their HIV status. Unless efforts to reduce stigma are, as one peer educator put it, “written in large letters in any HIV/AIDS campaign rather than small”, stigma will remain a major barrier to curbing the HIV/AIDS pandemic.     

A semi-parametric approach to robust parameter design

Parameter design or robust parameter design (RPD) is an engineering methodology intended as a cost-effective approach for improving the quality of products and processes. The goal of parameter design is to choose the levels of the control variables that optimize a defined quality characteristic. An essential component of RPD involves the assumption of well estimated models for the process mean and variance. Traditionally, the modeling of the mean and variance has been done parametrically. It is often the case, particularly when modeling the variance, that nonparametric techniques are more appropriate due to the nature of the curvature in the underlying function. Most response surface experiments involve sparse data. In sparse data situations with unusual curvature in the underlying function, nonparametric techniques often result in estimates with problematic variation whereas their parametric counterparts may result in estimates with problematic bias. We propose the use of semi-parametric modeling within the robust design setting, combining parametric and nonparametric functions to improve the quality of both mean and variance model estimation. The proposed method will be illustrated with an example and simulations.     

Parent‐Adolescent Communication About Sex: Retrospective Reports by Latino College Students

Latina female (n= 97) and Latino male (n= 69) college students (M age = 21.4 years) completed self‐report surveys regarding family of origin experiences, including sexual communication with parents while growing up. Latino parents of this comparatively highly educated sample tended to use direct rather than indirect strategies for communicating about sexuality with their children. Young women reported higher levels of sexual communication with mothers while growing up than did young men, and respondents reported less communication with fathers than mothers. Among young women, sexual communication with mother was positively associated with non‐Mexican origin and negatively associated with having older brothers living at home. In contrast, maternal education was positively associated with mother‐son communication about sex. Paternal education and the absence of older brothers positively predicted communication with both sons and daughters. The analyses provide novel information regarding sexual communication in Latino families and suggest directions for future research.     

WOMEN ATHLETES AS FALSELY ACCUSED DEVIANTS: Managing the Lesbian Stigma

As the behavior of women athletes is often interpreted to violate gender norms, women athletes are frequently devalued and stigmatized. The present study examines the manner in which such devaluation and stigmatization impact on women athletes and how these athletes manage the lesbian label attached to their sport participation. In-depth telephone interviews were conducted with 24 intercollegiate athletes from three Division I universities. Processes underlying athletes' responses parallel Becker's construction of the "falsely accused deviant" and Goffman's conceptualization of "stigma management." Factors leading to false accusation of lesbianism are discussed, as well as the various mechanisms utilized by athletes to manage the lesbian label.     

A sea change on the island continent: frameworks for risk assessment,prevention and intervention in child health in Australia

This article overviews prevention and early intervention approaches focusing specifically on their relevance to the health of children and young people in Australia. Australian public health has a sound track record although concealed within the aggregate profile are a number of sub-populations with poorer health indicators. Recognition of this has increased efforts to improve the health of children and young people especially in exploring the impact of social environments within the communities where children are raised. This paper examines emerging research in this area drawing out key lessons and learning from Australian experience in the field of early intervention and prevention in community settings.     

Minimal treatments and problem gamblers: A preliminary investigation

In view of the increasing popularity of minimal intervention treatments for problem drinking, a self-help manual for people who wish to reduce or stop gambling was prepared. Twenty-nine (ACT residents) who responded to advertisements for help with problem gambling were allocated to either of two minimal treatments, Manual (only) and Manual & Interview. On average, clients from both groups reduced the frequency of their gambling sessions, frequency of overspending, and amount spent per week in the first three months and next three months after first contact, but expenditure per session increased from three to six months, after an initial improvement. There was no evidence that a single in-depth interview added to the effectiveness of the manual.This project was funded by a grant from the Australian National University Faculties Research Fund.     

Three Object Relations Models of Couple Treatment

This article describes three different approaches to the treatment of couples, all based on different versions of object relations theories. Object relations as a term has various meanings embodying different theoretical assumptions. It is used differentially to highlight certain aspects of clinical phenomena, to connote certain developmental paradigms, and to signal the importance of real, interactional aspects of human behavior. The three therapeutic approaches to work with couples illustrate some of the ways that the greater conceptual complexity of object relations theories affects how love is explained, couple conflicts defined, and what makes for change in couples treatment. Understanding the basic assumptions of a given theory will enable us to increase our informed consent to the use of theory in our practices.     

The VFW — A case study in the “iron law of oligarchy” and goal displacement

The iron law of oligarchy is applied to the VFW. Using participant observation and qualitative interviews, membership of the VFW is dichotomized into a leadership oligarchy and a drinking membership. Opinions of members of the two groups about the purposes of the organization and about each other are documented. An historical analysis traces the change in organizational goals over time from promoting nationalism, fraternalism, and special benefits for members to political advocacy of veterans' rights.     

Compliance Versus Risk in Assessing Occupational Exposures

Assessments of occupational exposures to chemicals are generally based upon the practice of compliance testing in which the probability of compliance is related to the exceedance [γ, the likelihood that any measurement would exceed an occupational exposure limit (OEL)] and the number of measurements obtained. On the other hand, workers’ chronic health risks generally depend upon cumulative lifetime exposures which are not directly related to the probability of compliance. In this paper we define the probability of “overexposure” (θ) as the likelihood that individual risk (a function of cumulative exposure) exceeds the risk inherent in the OEL (a function of the OEL and duration of exposure). We regard θ as a relevant measure of individual risk for chemicals, such as carcinogens, which produce chronic effects after long-term exposures but not necessarily for acutely-toxic substances which can produce effects relatively quickly. We apply a random-effects model to data from 179 groups of workers, exposed to a variety of chemical agents, and obtain parameter estimates for the group mean exposure and the within- and between-worker components of variance. These estimates are then combined with OELs to generate estimates of γ and θ. We show that compliance testing can significantly underestimate the health risk when sample sizes are small. That is, there can be large probabilities of compliance with typical sample sizes, despite the fact that large proportions of the working population have individual risks greater than the risk inherent in the OEL. We demonstrate further that, because the relationship between θ and γ depends upon the within- and between-worker components of variance, it cannot be assumed a priori that exceedance is a conservative surrogate for overexposure. Thus, we conclude that assessment practices which focus upon either compliance or exceedance are problematic and recommend that employers evaluate exposures relative to the probabilities of overexposure.