Cultural change,hybridity and male homosexuality in Mexico

This paper analyses how contemporary perceptions of male homosexuality are being shaped in the Mexican cultural landscape. I argue that in order to fully understand the future of homosexuality in Mexico, we need to take into consideration the role of hybridity in the construction of sexual identities; accelerated internal cultural change that results from rapid and uneven modernization; and the unparalleled effects of exposure to external ideas and media, particularly from the USA. Instead of predicting that Mexico will follow a path similar to that of the USA and Europe in terms of the understanding or confrontation of homosexuality, activists interested in homosexual rights need to incorporate in their perspectives the rapid changes in worldview among Mexicans and the multiple contradictions that accompany them.     

Cultural change,hybridity and male homosexuality in Mexico

This paper analyzes how contemporary perceptions of male homosexuality are being shaped in Mexico. Ethnographic analysis included four short case studies from 64 mostly middle class individuals for two years in Guadalajara City. Mexican sexual culture is often portrayed traditionally as grounded in values inherent in machismo and influenced by Catholicism. There is a contrast between these traditional interpretations of roles and sexual identities in Mexico and the identities that are being adopted by many contemporary Mexican homosexual men. The homosexual men were categorizable in terms of 1) those who dominated in the sexual relationship and who were capable of maintaining a nonstigmatized identity as regular men, 2) those who assumed a feminine role and were penetrated and who were stigmatized for their effeminate demeanor, and 3) a minority of men who assumed both roles and who were termed "anally active and passive". The study revealed that middle-class homosexuals established networks in which individuals, supported by their friends, acquired the strength to effect personal changes along with other larger cultural changes. Thus, individual actions are beginning to have a collective effect on the society at large.     

Attitude change in a human sexuality course that de-emphasizes small group activities

The attitudes of second-year medical students were measured to determine if positive attitude changes could be obtained in a human sexuality course that de-emphasized small group activities. Students were given a semantic differential instrument and were asked to rate four concepts related to human sexuality: (a) my sexuality, (b) masturbation, (c) homosexuality, and (d) my role in understanding sexual problems.
Significant changes in student attitudes were reported at the 0.05 level for the concept, my sexuality; at the 0.01 level for the concept, my role in understanding sexual problems; and at the 0.001 level for the concepts, homosexuality and masturbation. Females had more positive attitudes ( P 0.001), pre and post, towards homosexuality than did males. No significant differences were found between married and single students.     

Physician response to a change in Medicaid fees.

This study examines the effects of a change in Medicaid fees on the volume of physician services provided to beneficiaries. The data set includes price and volume at the procedure-level for Medicaid physician services in Texas in 1991, 1993, and 1995. The empirical analysis compares the volume of services provided to Medicaid participants before and after a 1992 change in reimbursement method. The results indicate that, over the period 1991 to 1993, the change in Texas Medicaid physician fees did not have a statistically significant effect on the volume of services provided. When measured over a longer period of time (1991-1995), however, volume increased significantly when price decreased, but, when price increased, there was no significant effect on volume. The results thus provide empirical support for the behavioural offset assumption underlying the switch to Medicare's Resource-Based Relative Value Scale (RBRVS) method of physician payment. A key policy implication is that reduced fees did not lead to a lower volume of physician services provided to Medicaid patients at least over the period of analysis. However, the new Medicaid fee schedule did not have the desired effect of controlling Medicaid expenditures on physician services.     

Becoming an information master: using POEMs to change practice with confidence. Patient-Oriented Evidence that Matters

Today's physicians are faced with identifying, evaluating, and applying a huge quantity of medical information. In addition, many stakeholders in health care, from patients to payers, are taking an active role in the previously inviolable process of physician decision making. This is the third paper in a series discussing the concept of information mastery. In the first paper we discussed using the criteria for Patient-Oriented Evidence that Matters (POEMs) to distill clinically relevant information. The second paper in the series focused on techniques for efficiently obtaining this information from the myriad resources available. In this paper we discuss the final step in the process, changing practice habits after finding new information that necessitates it. We discuss managing change, consider barriers, and present ideas to help with the process.     

Measuring response to a cancer information telephone facility: Can-Dial.

In an attempt to meet the need for increasing public knowledge about cancer, a system providing free information by telephone has been developed. The system is comprised of 36 pre-recorded taped lectures containing information about various aspects of cancer. Interested individuals call a toll-free number, indicate a topic of interest, and listen to the pre-recorded lecture over the phone. An operator handles incoming calls and obtains information from callers used in evaluating the program. During the first year of operation, over 30,000 calls were processed. Topics most frequently requested included those concerning smoking, breast and cervical cancer, and general information. Female response exceeded male response in all age categories. Older people responded less frequently than younger. Urban utilization greatly exceeded suburban and rural utilization. Considerable fluctuation in response related to promotional activities was found. Printed advertisements elicited far greater response than radio and television. Promotional efforts in an experimental group of low-utilizing townships greatly increased utilization while no change was observed in a control group.     

Reflections on ethical problems encountered in field research on Mexican male homosexuality: 1968 to present

The author candidly presents the major ethical problems he encountered over time in conducting field research on male homosexuality in Mexico from 1968 to now and describes how they were resolved. Some of the research methods used in pioneering studies by Laud Humphreys thirty years ago and by Ralph Bolton more recently are then discussed to exemplify some of the ethical problems researchers may have to resolve while gathering data on male homosexual behaviours in the field. Looking even further back in time, recently revealed hidden qualitative research methods used by Kinsey and his colleagues back in the 1940s are also noted. The final part of the discussion focuses on the role the private sex life of an ethnographer may play in the research design and data collection strategies of a study in the field. Serendipity is revealed to be an important but often hidden factor in the design of ethnographic field studies of human sexual behaviours. When knowledge from an ethnographer's private sex life is used to inform field research on human sexual behaviours, a careful and continuous review must be made with respect to the ethicality of its effect on the research design.     

Reflections on ethical problems encountered in field research on Mexican male homosexuality: 1968 to present

This paper presents field research on the major ethical problems in the study of male homosexuality in Mexico from 1968 up to the present and describes a solution to these problems. Ethical concerns about the psychological and social well-being of respondents are heightened in when the focus of a study is on a highly private, sensitive and sanctioned human behavior such as sexual relations. The ethics of a gay man conducting participant observation studies of male homosexuality tend particularly to be open to special scrutiny and suspicion. Most of the major ethical concerns about the study of male homosexuality are related to 1) the methods used by the researcher to collect participant-observation and interview data and 2) the possibility that the dissemination of study findings by the researcher to the outside world may lead to unwanted adverse effects on project respondents and on the population they represent. The use of the participant-observer in gathering of data in the field presents a serious ethical problem that must be addressed by sex researchers. Thus, future researchers contemplating ethnographic participant observation studies in the field must take into account the reality that it is extremely unlikely that they will be able to separate their private sex lives completely from their research.     

Controlled comparison of attitudes of psychiatrists, general practitioners, homosexual doctors and homosexual men to male homosexuality.

A controlled analysis of the attitudes of doctors and homosexual men to male homosexuality is reported. Not surprisingly the homosexual men held the most liberal attitudes which served as a yard-stick against which the doctors' attitudes could be assessed. The implications of these data, collected before the AIDS era, are discussed in terms of the current needs of homosexual patients.     

Maryland Health Care System, Inc.: a creative response to change

Maryland Health Care System, Inc. represents the first multihospital activity in a large eastern city to incorporate a subsidiary management system. The creative coordination of health care capabilities encouraged by the MHCS interpretation may be applied elsewhere as new hospital systems develop.     

Intergovernmental preparedness and response to potential catastrophic biological terrorism.

The 20th century is replete with examples of the use of biological weapons in times of war. Today, it is only a matter of time before terrorists find a way to develop and deploy biological weapons as well. Because of the narrow window of opportunity in which treatment and prophylaxis can positively affect the outcome of those exposed to and infected by biological weapons, aggressive public health surveillance is the best early defense. A casualty management and mass prophylaxis campaign will require coordination at all levels of government involving many agencies.     

Stage of change as a predictor of response to psychotherapy for bulimia nervosa.

OBJECTIVE: This study was designed to test the hypotheses that stage of change is a useful predictor of dropout and that it is related to treatment outcome in patients receiving brief psychotherapy for bulimia nervosa. METHOD: One hundred ten patients with bulimia nervosa were randomly assigned treatment with cognitive-behavioral therapy (CBT) or interpersonal therapy (IPT). On initial screening, patients were classified as being in the stage of precontemplation, contemplation, or preparation. RESULTS: Initial stage of change was not related to dropout either before or following randomization. Among all treatment completers, stage of change was related to outcome. Of the patients assigned to CBT, stage of change was not related to outcome. However, stage of change was related to outcome in patients randomized to IPT. DISCUSSION: This study suggests that initial stage of change may, under certain circumstances, be a useful predictor of outcome and that its utility as an outcome predictor may vary according to treatment.     

沈阳市男同性恋者性病艾滋病相关KABP分析

目的 掌握沈阳市男同性恋人群性病艾滋病相关知识、态度及行为等现状，为制定有针对性的干预措施提供依据。方法 采用横断面调查和追踪调查相结合的方式，对342名出入酒吧的男同性恋者进行问卷调查及自愿检测。结果 调查对象年龄较轻，文化程度普遍较高，但艾滋病相关知识较缺乏，知识来源主要为电视、报纸及互联网，59.1％的人进行了HIV及梅毒检测，其中抗HIV阳性率为1％，梅毒(TPPA)阳性率为20.8％，11.7％认为自己很可能被感染HIV，47.1％觉得有50％的可能性。首次性行为年龄中位数为18岁，性伴数较多，平均为4.4个。且近半年36.3％的人有过女性性伴。91.5％近半年内有过肛交史，每次均使用安全套者只占11.1％。不用的原因是不喜欢或没必要。结论 本次调查的男同性恋者感染及传播艾滋病的危险行为普遍存在，相关知识知晓率低。安全套使用率低，该人群中已经具备了艾滋病流行的条件，应立即采取有效的措施加以控制，扭转其流行态势。