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HIV prevention education for lesbians and bisexual women: a cultural analysis of a community intervention.

AIDS is increasing almost four times as fast among women, yet lesbians and bisexual women are among the least studied, least understood and most elusive populations affected by the AIDS epidemic. This paper reports the results of community-level HIV prevention research designed: (a) to examine the knowledge, perceptions, social contingencies and political constraints affecting the HIV risk taking of lesbians and bisexual women; and (b) to offer them context specific HIV prevention education. The study was a peer educator-based intervention project situated in San Francisco's women's bars, dance clubs, and sex clubs to reach socially and sexually active lesbians and bisexual women in natural settings. Between June 1992 and May 1993, ethnographic interviews were conducted with 626 women attending the bars and clubs; group presentations at these locales reached 1,315 women. The structure of the intervention was effective in prompting interest in HIV prevention information and intent to change behavior. The resultant cultural analysis details risk behaviors lesbians and bisexual women participate in, myriad constraints they face in trying to enact safer behaviors, gaps in knowledge, difficulties comprehending the relevance of HIV prevention, and risk reduction strategies commonly employed.

Adult↗

Living a responsible life: the impact of AIDS on the social identity of intravenous drug users.

The dominant image of an intravenous (i.v.) drug user in U.S. society is that of the unbridled 'dope fiend'. It is common in treatment literature to refer to users as diseased and pathologically unable to control their lives. Female i.v. drug users, as the bearers of children, even more than males, are faced with the paradox posed by conflicting social messages labeling them as irresponsible, dirty 'dope fiends' while approaching them as responsible citizens who need to 'clean up their act' for their children. The paradox of these messages creates a profound moral dilemma involving agency--the ability to develop a flow of conduct by reflexively monitoring intention, purpose, and accountability of actions in the pursuit of a goal--and the social identity of 'junkie'. This article examines this social condition and how it affects the life and options of a woman diagnosed HIV positive. Using narrative discourse and analyzing it through the study of voice I show how an i.v. drug using woman uses her diagnosis to redefine her life and her social identity, as she changes a negative 'deviant' image into a positive one.

Acquired Immunodeficiency Syndrome↗

The effects of phencyclidine on spontaneous aggressive behavior in the rat.

Phencyclidine induced dose-related alterations in the pattern of spontaneous aggressive behavior in pairs of rats, in which only one animal of each pair was drug-treated. At the lowest dose tested (0.25 mg/kg, sc), phencyclidine produced attacks by the drug-treated animal and a corresponding increase in submissive behavior by the untreated partner, as well as an increase in boxing behavior by both animals. In contrast, the highest dose of phencyclidine tested (1.0 mg/kg, sc) elicited attacks and allogrooming by the untreated animal. The low dose effect is interpreted as the result of phencyclidine-induced distortion in perception of social cues, while the high dose effect may be due to a general disruption in social communication by ataxia in the phencyclidine-treated animal.

Aggression↗

The relationship of social context of drinking, perceived social norms, and parental influence to various drinking patterns of adolescents.

An anonymous questionnaire was administered to a sample of over 890 adolescent drinkers. The questionnaire contained measures of their social context of drinking, perceived social norms, and perceived parental behaviors regarding drinking. These measures were related to a variety of alcohol problem behaviors including binge drinking, driving while alcohol-impaired, riding with an alcohol-impaired driver, and experiencing one or more negative consequences because of drinking. Results indicated that drinking frequently in a social context of social facilitation, stress control or school defiance, as well as having close friends engage in these behaviors, tended to separate alcohol abusers from nonabusers. The implications for program development are discussed.

Adolescent↗

Drug abuse in a farm community; a brief appraisal of a research work.

This project was initiated in the rural areas of the Punjab to assess the prevailing trends in the abuse of intoxicating drugs by rural folk, with a view to contributing to future primary mental health care planning as an integral part of comprehensive health care planning. Twenty-four villages were selected from six community development blocks in the three bordering districts of the Punjab. In the rural population, the abuse of intoxicating drugs is mainly confined to alcohol, tobacco, opium and cannabis. Among psychosocial correlates, religion was of obvious predominance. Since Sikh are non-smokers, tobacco abuse was much less among them; but they had maximum alcohol ;and opium abuse. The structure of the family and number of family members tend to move together in their association with drug abuse. In relation to income in general, drug abuse was more common at the two ends of economic scale-the richest and the poorest. Social perception of drug abuse has highlighted the fact that in villages it has still not become an illicit or underground activity. The findings suggest a number of measures for promoting future primary mental health care among rural fold of the country.

Adolescent↗

Elementary schoolchildren's use of alcohol, cigarettes and marijuana and classmates' attribution of socialization.

In each of 2 years beginning in fourth and fifth grades, urban elementary public schoolchildren completed surveys about abusable substance use and health promoting behaviors and completed an instrument that permitted each child to have a socialization score attributed by classmates. A factor weighted 12-item scale was developed from 15 items in three domains (personal, interpersonal and school). The scale was positively correlated over the 2 years and positively correlated with a healthful activities scale in both years. Conditional multiple logistic regression, matching on school classroom, indicated that socialization was negatively associated with use of alcohol without parental permission and cigarettes in both years (grades 4-5, grades 5-6) and with use of marijuana in year 1. Socialization measured in year 1 was negatively associated with cigarette use in year 2 and with onset of use from year 1 to year 2. Shyness, a non-socialization scale item, was negatively associated with use of cigarettes in both years and with use of alcohol without permission and use of marijuana in year 2. Being 'good at sports' was an attribute positively associated with alcohol use without permission and cigarette use in year 2. Results suggest that elementary schoolchildren can ascribe social characteristics to their classmates that are associated with and predict health related behaviors.

Alcohol Drinking↗

Social networks and recovery: one year after inpatient treatment.

In an effort to understand the effect of social networks on outcome for treatment of alcoholism, a 1-year follow-up prospective study of 156 inpatients was undertaken. Treatment outcome was associated with diverse aspects of the social network: whether individuals were family, friends, or co-workers; the type of relationship--whether or not drinking together was part of social interaction; and the presence of social support, both perceived support and support through participation in treatment. Hierarchical path analysis using Lisrel 6 was used to analyze the data. The active support of co-workers not regularly drinking with the patient and the perceived support of co-workers without respect to their drinking were influential in recovery, exerting positive and negative effects, respectively. The indirect effect of other variables indicates that nondrinking and drinking family and friend relationships also exert positive and negative effects, respectively. The authors suggest that a major factor in recovery is the ability to elicit and receive support. Improving this ability may be a fruitful objective in treatment.

Adolescent↗

Cultural awareness of Inuit patients' experiences with emergency nursing care.

Around 1500 Inuit patients fly annually from Nunavik to hospital centres in Montreal. This is a tense experience for many Inuit, due to cultural differences, and task-driven nursing practices often inadequately meeting their holistic health beliefs. In this qualitative study, we explored the experiences of Inuit patients with emergency nursing (EN) in the McGill University Health Centre, to inform on the best holistic nursing practices to meet culturally specific needs. Data analysis from semi-structured interviews with four participants generated a single theme: "rationalizing the care". While staying in the emergency department (ED), Inuit patients progressed through three steps in this rationalization process: first impressions of EN, perceiving the realities of EN, and appreciating EN care. "Being away from home" emerged as a stressor, and "other Inuit support", acted as a mediator. The participants in this study felt they had been shown culturally sensitive treatment through being kept informed, and skills of the nurses. As instruments of healing, therefore, the nurses in this study were able to apply a holistic approach to provide culturally sensitive care. Participants also highlighted speaking the same language and having direct access to an interpreter as key to improving ED experiences.

Adult↗

Attributions of responsibility for motor vehicle crashes.

A sample of 321 motor vehicle crash survivors completed a survey in which they provided attribution ratings of the extent to which they were responsible for their crashes, other people (drivers) were responsible, or road/weather conditions were responsible. The attribution ratings were consistent with the predictions of defensive attribution theory (DAT; [Walster, E., 1966. Assignment of responsibility for an accident. J. Pers. Soc. Psychol. 3, 73-79]) in that people who experienced crashes of greater severity (necessitating medical treatment for injuries) attributed greater responsibility to other drivers than to self or to weather/road conditions. People who were in crashes of lesser severity attributed approximately the same amount of responsibility to themselves as they did to others. An actor-observer effect also appeared in survivors' attribution ratings in that self-acceptance of responsibility for the crash was positively correlated with attributions to the situation (road/weather conditions) whereas such attributions to the situation were negatively correlated with attributions of responsibility to other drivers. Consistent with results of prior research, survivors who assigned crash responsibility to other drivers reported increased levels of driving and riding avoidance compared to people who accepted responsibility for their crashes.

Accidents, Traffic↗

The relationship of proximal normative beliefs and global subjective norms to college students' alcohol consumption.

OBJECTIVE: Heavy drinking among college students is a major concern across the country. Several studies have shown that students tend to overestimate the alcohol consumption of students, in general (global social norms), and of their close friends (proximal normative beliefs). Research has also shown that beliefs about others' alcohol consumption is strongly related to alcohol use. We hypothesized that normative beliefs about important referent individuals would mediate the relationship between campus social norms and alcohol consumption. METHOD: A survey of alcohol use and related variables was completed by 433 university students. Multiple regression was used to examine the mediational role of normative beliefs on social norms and alcohol consumption. RESULTS: These analyses indicate that normative beliefs are a significant mediator of the relationship between social norms and alcohol consumption. Normative beliefs accounted for 52-62% of the proportion of variance mediated. CONCLUSIONS: Normative beliefs are an important construct in understanding the relationship between social norms and alcohol use among college students and may be an important area for future interventions.

Adolescent↗

Ethnic identity, self-esteem, and perceived efficacy as mediators of the relation of supportive parenting to psychosocial outcomes among urban adolescents.

The present study examined the direct and indirect relationships among supportive parenting, ethnic identity, self-esteem, perceived efficacy, and psychological adjustment in an urban sample of 133 African American (M age=16.37) and 110 European American (M age=16.43) adolescents. Although the mediational model was partially supported for both African American and European American youth, the data better fit the model for the African American group. Specifically, perceived efficacy fully mediated the relation between ethnic identity and depressive symptoms, and partially mediated the relation between self-esteem and depressive symptoms for African American youth. For European Americans, self-esteem fully mediated the relation between supportive parenting and perceived efficacy. This study illustrates the importance of examining developmental models separately for adolescents from different ethnic/racial backgrounds.

Adolescent↗

When the heat is on: romantic partner responses influence distress in socially anxious women.

This study provided a preliminary test of whether socially anxious women and their partners would show more negative social support behavior, especially among those with low relationship satisfaction, and whether this would increase the distress of the socially anxious women. Women with (n=22) and without (n=23) heightened social anxiety were observed interacting with their partners under a social-evaluative threat and support behaviors were coded. Unexpectedly, no differences were found between socially and non-socially anxious women and their partners. Although relationship satisfaction influenced this process, it was the more satisfied women who showed more negative behavior. Additionally, the more positive behaviors the partner exhibited, the greater was the distress reported by socially anxious women, particularly among women whose partners reported high relationship satisfaction. Implications for how these findings might expand theories on interpersonal processes in social anxiety are discussed.

Adult↗

Identification, situational constraint, and social cognition: studies in the attribution of moral responsibility.

In three experiments we studied lay observers' attributions of responsibility for an antisocial act (homicide). We systematically varied both the degree to which the action was coerced by external circumstances and the degree to which the actor endorsed and accepted ownership of the act, a psychological state that philosophers have termed "identification." Our findings with respect to identification were highly consistent. The more an actor was identified with an action, the more likely observers were to assign responsibility to the actor, even when the action was performed under constraints so powerful that no other behavioral option was available. Our findings indicate that social cognition involving assignment of responsibility for an action is a more complex process than previous research has indicated. It would appear that laypersons' judgments of moral responsibility may, in some circumstances, accord with philosophical views in which freedom and determinism are regarded to be compatible.

Adult↗

Residential instability in socioeconomically deprived neighbourhoods, good or bad?

Previously, both positive and negative effects of residential instability on various health outcomes have been described. The present study tests these effects in a European context, using two different data-sources (1) neighbourhood level data on socioeconomic deprivation and residential instability, and (2) individual-level community survey data to assess quality of life. Multilevel regression analyses showed that socioeconomic deprivation was negatively associated with several dimensions of quality of life, in stable neighbourhoods, while no such effect was observed in average or unstable neighbourhoods. Thus, when accounting for interaction effects, residential instability appeared to protect against negative effects of neighbourhood poverty and, therefore, may be beneficial for residents' quality of life.

Adult↗

Introducing a means of quantifying community reputation: the print media as a data source.

A community's reputation may have implications for self-esteem, morale, or other health outcomes of residents. In this study, we introduce a means of quantifying the reputation of communities in Calgary, Canada based on their portrayal in the daily citywide newspaper. Publication dates were selected from an 8.5-year period using constructed week sampling. For communities designated as high or low in well-being, sampled references were rated as positive, negative, or neutral in topic, by two independent raters who were blind to community identity. Findings suggest that the print media represent a convenient and discriminating data source for characterising some aspects of community reputation.

British Columbia↗

Place, health and home: gender and migration in the constitution of healthy space.

This paper contributes to recent literature that considers the role of everyday activity in constructing 'healthy space', specifically exploring the tension between agency and structural processes in explanation. The focus is a comparison of two groups of migrant women in British Columbia, Canada: South Asian Sikhs from Punjab, India, and Afghan-Muslim refugees. It explores the routine practices whereby they work to create 'healthy space' as they orchestrate their families' health. Through food preparation and consumption practices, traditional healing and religious observance, the women delineate the physical, social and symbolic dimensions of healthy space. The women's narratives demonstrate the productive capacity of everyday routines in forging healthy space within the particularities of migrant settlement.

Afghanistan↗

The professional self-image of nurses in Belgian hospitals: a cross-sectional questionnaire survey.

This paper reports data on the professional self-image of 9638 nurses employed in 22 Belgian general hospitals with the goal of identifying problems affecting recruitment and retention. Nurses reported having a positive self-image. Most were proud to be a nurse and considered themselves competent health professionals having great responsibility. Although they reported that an ideal practice requires effective teamwork, supportive management, societal recognition, and sufficient time to perform their duties, they also felt that these essential conditions were absent in daily practice.

Adult↗