Midwestern Rural Adolescents’ Anal Intercourse Experience

Purpose: The purpose of this study was to examine the prevalence of anal intercourse and its associated risk behaviors in a sample of Midwestern, predominantly white rural adolescents. Most of the research on this activity has been local or regional studies, with urban East and West Coast racial and ethnic minority adolescents. Methods: A surveillance questionnaire based on the Youth Risk Behavior Survey was distributed in 2009 to 820 rural middle and high school students in grades 6‐12, across 2 rural counties in a Midwestern state. The school districts were stratified by grade level and a stratified random sample of schools (n = 17) was used. Data were analyzed using Fisher's exact test and multiple logistic regression. Findings: A total of 778 (95%) students completed the survey. The rural adolescents were in grades 6‐12, were primarily white (95%), and were evenly distributed by gender. Similar amounts of students had engaged in sexual intercourse (24%) and oral sex (23%). Seven percent reported engaging in anal sex (1.6% middle school, 10.9% high school). Multivariate logistic regression controlling for other risk behaviors found that 2 variables were associated with increased anal sexual activity: ever had sexual intercourse (adjusted odds ratios [AOR]= 14.5) and ever had oral sex (AOR = 6.0). Conclusions: Anal sexual activity is a component of some rural adolescents’ sexual experiences. These findings have important implications for sex education programs targeted to rural schools, where the typical high school classroom may have some students engaging in anal sex.     

谈交流原则在医患沟通中的运用

临床医生应当遵循交流的具体原则,掌握沟通技巧,才能增进相互理解,改善医患关系。文章介绍了"敬、诚、当、效、听"5字原则在医患沟通中的应用。     

Relational Aggression in Adolescents’ Sibling Relationships: Links to Sibling and Parent‐Adolescent Relationship Quality*

Abstract: This study examined the links between sibling relational aggression and other sibling relationship qualities (i.e., intimacy, negativity, and temporal involvement) and broader parenting dynamics. Participants included 185 adolescent sibling pairs and their mothers and fathers. Data were gathered during home interviews and a series of nightly phone calls with adolescents and parents. Findings revealed that sibling relational aggression was related to sibling intimacy and negativity. In addition, connections emerged between relational aggression and qualities of the parent‐child relationship, parents’ differential treatment, and parents’ strategies for handling sibling conflict.     

Stigma in an era of medicalisation and anxious parenting: how proximity and culpability shape middle‐class parents’ experiences of disgrace

This study examines the stigma experiences of middle‐class parents whose children have physical, psychological and behavioural problems. Qualitative interviews with 34 mothers and 21 fathers demonstrate that parents experience two types of stigma: courtesy stigma and the stigma of being a bad parent. While the former stems from close social proximity to stigmatised children, the latter stems from ostensible culpability for children’s problems. Both characteristics are social constructs embedded in the larger contexts of an anxious, intensive parenting culture and the problematisation and medicalisation of childhood. As a consequence, mothers, parents whose children have invisible disabilities, and the parents of young children are particularly susceptible to negative labelling. These findings highlight the constructed and political nature of parents’ stigmatisation.     

Latino Adolescents’ Adjustment,Maternal Depressive Symptoms,and the Mother‐Adolescent Relationship*

Abstract: This study examined associations between adolescent behaviors, maternal depressive symptoms, and mother‐adolescent relationships. Latina mothers and adolescents (111 dyads) completed questionnaires and participated in videotaped discussions. Mothers’ depressive symptoms related to adolescents’ internalizing and externalizing behaviors and family satisfaction. Observed maternal behavior during a conflict conversation also related to adolescent substance use. Family satisfaction partially mediated the relation between maternal depressive symptoms and adolescents’ substance use. Clinical implications for working with Latino adolescents are discussed.     

The Influence of Academic Support on Latino Adolescents’ Academic Motivation

Abstract: The current study examined the extent to which mothers, fathers, teachers, and teenage friends influenced Latino adolescents’ academic motivation. Using path analysis, separate models were tested for 154 Latino boys and 156 Latina girls. Findings indicated that mothers’ and teachers’ academic support were positively related to adolescent girls’ academic motivation, and fathers’ and teachers’ academic support were positively related to adolescent boys’ academic motivation. The salience of teachers’ support, possible reasons for gender differences, and implications for future research are discussed.     

Providers’ HIV‐related avoidance attitude and patient satisfaction

Objectives This article explores the associations between medical care providers’ attitudes towards patients living with HIV (PLH) and the service satisfaction reported from general patients. Methods Data were collected from 40 county‐level hospitals in China, including 1760 service providers and 1000 patients receiving medical services from the hospitals. Provider and patient assessments were conducted by self‐administered questionnaires and face‐to‐face interviews, respectively. Random‐effect regression models were used to examine relationships between the providers’ avoidance attitudes and patient satisfaction at the hospital level while taking into account variations in demographics and professional experience within each hospital. Results and Conclusions Service providers’ avoidance attitudes towards PLH were negatively associated with general patients’ satisfaction with service providers at the hospital level. The relationship was strong and significant whether or not adjustments were made for background characteristics. Medical care providers’ stigmatizing attitudes towards PLH could be a reflection of the providers’ general outlook with all patients. This study underscores a broader focus for HIV‐related stigma reduction interventions in medical settings at both individual and institutional levels, targeting attitudes towards both patients with HIV/AIDS and the general patient population.     

Being ‘fat’ in today’s world: a qualitative study of the lived experiences of people with obesity in Australia

Objective To develop an in‐depth picture of both lived experience of obesity and the impact of socio‐cultural factors on people living with obesity. Design Qualitative methodology, utilizing in‐depth semi‐structured interviews with a community sample of obese adults (body mass index ≥30). Community sampling methods were supplemented with purposive sampling techniques to ensure a diverse range of individuals were included. Results Seventy‐six individuals (aged 16–72) were interviewed. Most had struggled with their weight for most of their lives (n = 45). Almost all had experienced stigma and discrimination in childhood (n = 36), as adolescents (n = 41) or as adults (n = 72). About half stated that they had been humiliated by health professionals because of their weight. Participants felt an individual responsibility to lose weight, and many tried extreme forms of dieting to do so. Participants described an increasing culture of ‘blame’ against people living with obesity perpetuated by media and public health messages. Eighty percent said that they hated or disliked the word obesity and would rather be called fat or overweight. Discussion and Conclusion There are four key conclusions: (i) the experiences of obesity are diverse, but there are common themes, (ii) people living with obesity have heard the messages but find it difficult to act upon them, (iii) interventions should be tailored to address both individual and community needs and (iv) we need to rethink how to approach obesity interventions to ensure that avoid recapitulating damaging social stereotypes and exacerbating social inequalities.     

Opportunistic Intestinal Parasite Infection and Mode of Sexual Intercourse of HIV-Infected Patients in the Era of HAART

One of the major health problems among HIV-infected patients is the intestinal parasite infestations. At present, opportunistic intestinal parasite infection is very common in patients with HIV/AIDS and remains a treat to public health. Association of HIV infection with gut parasites is likely to be related to sexual modes of contact that favour both HIV and the parasite. A cross-sectional study to determine the correlation between opportunistic intestinal parasite infection and mode of sexual intercourse among HIV/AIDS patients was conducted. In the study of 40 HIV/AIDS adult patients with diarrhea, a total of 38 cases with heterosexual mode of intercourse and 2 with homosexual mode of intercourse were reported during the study period. Of interest, there is no association between opportunistic intestinal parasite infection and mode of sexual intercourse of HIV-infected patients (P value > 0.05).     

高职学生买性、卖性可能性调查分析

目的了解高职学生买性、卖性可能性状况,为开展有针对性的性教育提供依据。方法自编问卷,对有一定代表性的高职学生进行大样本抽样测试,然后进行统计分析。结果高职学生性交行为发生率为19.6%,有买性、卖性想法的分别为13.4%、10.8%,实际做过的为2.2%、1.7%,在买性、卖性、性行为上男生均高于女性(p<0.01),性观念上,男生较女生开放(p<0.01)。结论高职学生卖性、买性现象已存在,且有扩大趋势,应加强对学生的性教育,尤其是男生。     

“对娱乐场所从业女性实施预防性病/艾滋病的综合干预”项目实施报告

目的运用宣传教育、安全套推广、性病防治等综合手段进行干预,控制性病/艾滋病向娱乐场所从业女性的传播,并探索人口和计划生育部门针对娱乐场所从业女性进行性病/艾滋病预防干预的模式。方法根据“对项目点娱乐场所从业女性实施预防性病/艾滋病综合干预”的两个季度项目评估表,进行对比分析。结果经过综合干预,参与项目的4省12个地区娱乐场所从业女性在性病/艾滋病认知方面有了改善,最后一次商业性行为使用安全套有所提高,加强了各部门协同工作的力度。结论人口和计划生育部门在多部门协作框架下,对娱乐场所从业女性实施预防性病/艾滋病的综合干预,取得了成效。     

高职学生买性、卖性可能性调查分析

目的了解高职学生买性、卖性可能性状况,为开展有针对性的性教育提供依据。方法自编问卷,对有一定代表性的高职学生进行大样本抽样测试,然后进行统计分析。结果高职学生性交行为发生率为19．6％,有买性、卖性想法的分别为13．4％、10．8％,实际做过的为2．2％、1．7％,在买性、卖性、性行为上男生均高于女性（p〈0．01）,性观念上,男生较女生开放（p〈0．01）。结论高职学生卖性、买性现象已存在,且有扩大趋势,应加强对学生的性教育,尤其是男生。     

The Role of Stigma in Access to Health Care for the Poor

Context

The Affordable Care Act provides new Medicaid coverage to an estimated 12 million low-income adults. Barriers to access or quality could hamper the program''s success. One of these barriers might be the stigma associated with Medicaid or poverty.

Methods

Our mixed-methods study involved 574 low-income adults and included data from an in-person survey and follow-up interviews. Our analysis of the interviews showed that many participants who were on Medicaid or uninsured described a perception or fear of being treated poorly in the health care setting. We defined this experience as stigma and merged our qualitative interviews coded for stigma with our quantitative survey data to see whether stigma was related to other sociodemographic characteristics. We also examined whether stigma was associated with access to care, quality of care, and self-reported health.

Findings

We were unable to identify other sociodemographic characteristics associated with stigma in this low-income sample. The qualitative interviews suggested that stigma was most often the result of a provider-patient interaction that felt demeaning, rather than an internalized sense of shame related to receiving public insurance or charity care. An experience of stigma was associated with unmet health needs, poorer perceptions of quality of care, and worse health across several self-reported measures.

Conclusions

Because a stigmatizing experience in the health system might interfere with the delivery of high-quality care to new Medicaid enrollees, further research and policy interventions that target stigma are warranted.     

Shame in a post-socialist society: a qualitative study of healthcare seeking and utilisation in common mental disorders

After the regime collapse, the former socialist societies in Central and Eastern Europe experienced rapid social and economic transformations. Consequently, mental health deterioration coupled with ambitions to break with the past triggered reforms of mental health systems. Yet, 30 years later, mental health in the region remains poor. Stigma of mental illness may be one of the factors that delays help seeking and, therefore, maintains status quo. Thus, the aim of the article is to better understand the roots of stigma and the process of stigmatisation in one of these countries – Lithuania. Drawing on Norbert Elias’s model of established-outsider relations, the article presents the analysis of 23 in-depth interviews with healthcare providers and users of services diagnosed with depression or anxiety disorders. Said analysis reveals how stigma of mental illness might result in damaged self-image and shame of feeling different. Mental illness and healthcare seeking are perceived as a threat to culturally and historically determined self-values, at the core of which seems to be intolerance of difference. The article contributes not only to research concerning mental health in a relatively understudied region of Central and Eastern Europe, but also to existing literature on stigma as embedded in a local context.     

Fear and Shame: using theatre to destigmatise mental illness in an Australian Macedonian community

In the article entitled ‘Fear and Shame: using theatre to destigmatise mental illness in an Australian Macedonian community’ by Blignault et al., an incorrect year was used. Page 124, col. 2, para 3, line 3 should read: When asked who they would contact for help if someone they knew was showing signs of mental illness, 84% of the overall sample nominated health workers or services in 2009 compared to 60% in 2003 (see Table 5).