Using a Reflective Diary Method to Investigate the Experiences of Paid Home Care Workers Caring for People With Dementia

This article reports on the use of an innovative reflective diary method with paid home care workers caring for people with dementia. It examines the key features of the diary design, recruitment and training of participants, diarists’ approaches and responses to diary-keeping, and evaluates the use of diaries in this context. Following training, 11 volunteers (all female) employed by a U.K.-based home care organization kept diaries of their experiences of caring for those with dementia. Using specially designed diaries, they wrote about their visits to clients for a period of approximately 4 months and were remunerated for up to 16 extra hours at their usual hourly rate of pay. Overall, home care workers engaged well with the process, keeping regular, lengthy, timely, and reflective diary entries. Diary-keeping provided a means for these workers to express their emotions about their work, while enhancing their self-insight and care practices. We demonstrate the feasibility of diaries for research with this occupational group and conclude that the written reflexivity employed in diaries can document, enrich, and improve the work of these caregivers

Householders’ Mental Models of Domestic Energy Consumption: Using a Sort-And-Cluster Method to Identify Shared Concepts of Appliance Similarity

If in-home displays and other interventions are to successfully influence people's energy consumption, they need to communicate about energy in terms that make sense to users. Here we explore householders' perceptions of energy consumption, using a novel combination of card-sorting and clustering to reveal shared patterns in the way people think about domestic energy consumption. The data suggest that, when participants were asked to group appliances which they felt naturally 'went together', there are relatively few shared ideas about which appliances are conceptually related. To the extent participants agreed on which appliances belonged together, these groupings were based on activities (e.g., entertainment) and location within the home (e.g., kitchen); energy consumption was not an important factor in people's categorisations. This suggests messages about behaviour change aimed at reducing energy consumption might better be tied to social practices than to consumption itself

Developing a conceptual framework for an evaluation system for the NIAID HIV/AIDS clinical trials networks

Globally, health research organizations are called upon to re-examine their policies and practices to more efficiently and effectively address current scientific and social needs, as well as increasing public demands for accountability

The testing of saliva samples for HIV-1 antibodies: reliability in a non-clinic setting

Aims: To assess the reliability of saliva samples as a means of testing for HIV-antibodies outside clinic settings. Methods: Men taking part in a non-clinic longitudinal study of homosexually active men provided samples of saliva and blood. Sera was screened using a competitive ELISA (Wellcozyme) and positive sera were confirmed by an indirect ELISA (Abbott). Saliva samples were screened either using an IgG captive radioimmunoassay or an amplified ELISA. Results: A total of 534 paired saliva and blood sample were tested. Overall sensitivity was 96.2% and specificity was 100%. None of the saliva tests were falsely positive for HIV-1 antibodies. Conclusions: HIV-1 saliva tests can reliably be used in a non-clinic or field setting. However, if results are to be given to respondents, it is necessary to offer adequate counselling and consider the mechanisms for referral and follow-up for those that are found to be HIV-1 antibody positive

Sex role separation in sexual diaries of homosexual men

Objective: To measure types of sex role prevalence in common and risk-related behaviours among gay men for modelling HIV transmission. Design: Cohort study of 385 homosexually active men recording sexual diaries over 1-month periods. Methods: Measures of incidence of behavioural sex roles for masturbation, fellatio, anal intercourse and anilingus by relationship type, derived from 1-month sexual diary data. Results: Low behavioural role rigidity for masturbation and fellatio, but higher rigidity for anal intercourse and anilingus. Participants with no regular partner showed a relatively low frequency of anal intercourse, whereas those in closed relationships showed a high frequency. Conclusion: Although anal intercourse shows a certain degree of behavioural role rigidity, this rigidity is not large enough to conclude that gay men exclusively engage in either an active or a passive role. Typical rates for exclusive active and passive roles for anal intercourse during the month the diaries were recorded were in the range of 12-15%; the dual role was significantly higher. Keywords: Homosexual behaviour, HIV transmission, modelling, behavioural role separation, sexual diaries

Changes in sexual behaviour in a large cohort of homosexual men in England and Wales, 1988-1989

The uptake of safer sexual practices by homosexually active men in the light of AIDS has led to downward revisions of the predicted spread of HIV and a decline in the prevalence of rectal gonorrhoea and other sexually transmitted diseases. We report a reversal of this trend in 1988-89 in terms of the proportion of men engaging in anal intercourse and the numbers of partners with whom it occurred

Sexual partners, penetrative sexual partners and HIV risk

This paper argues that the notion of sexual partners per se is insufficient for estimating levels of HIV risk behaviour or changes in HIV risk over time, even though it is a crucial element of most epidemiological models of HIV. The concept of penetrative sexual partner (PSP) is introduced as a considerably more accurate measure of HIV risk. Using data from a longitudinal study of 930 homosexually active men in England and Wales, this paper demonstrates that variation in numbers of PSPs (and thus HIV risk) is not related to variation in gross numbers of sexual partners. Key words: epidemiology; modelling; anal intercourse; gay men; sexual partners; penetrative sexual partners

Condom use in a large cohort of homosexually active men in England and Wales

As part of a prospective study of the seroprevalence of HIV, a cohort of 930 men were interviewed regarding their condom use. Of the 270 respondents that engaged in insertive anal intercourse in the month preceding interview 38.9% always used a condom, 49.6% never used one, and 11.5% sometimes used one. Of the 254 respondents that engaged in receptive anal intercourse in the same time period 42.5% always used a condom, 45.7% never used one, and 11.8% sometimes used one. Compared to other research the proportion of respondents who always use a condom for anal intercourse is relatively high, though use is by no means universal. Condom use is more widespread and consistent with casual rather than regular sexual partners, and it is significantly more common within open rather than monogamous relationships. Out of a wide range of other factors only geographical location (London against outside), marital status, perceived HIV status, number of sexual partners, and how seriously respondents take safer sex are correlated with condom use