Morality, responsibility and risk: Gay men and proximity to HIV. London

Network analysis and network theory have emerged in various strands of research on HIV. Epidemiological research has used network analysis to map and predict the course of the HIV and STI epidemics among Gay men (Doherty et al. 2005; Piqueira et al. 2004). It constitutes an advance on cruder epidemiological models of random mixing (see Keeling & Eames 2005). Social network analysis and social attachment have been important concepts in informing more recent HIV prevention interventions (see Fernandez et al. 2003; Latkin and Knowlton 2005) and have had specific applications in the case of disadvantaged communities such as injecting drug users and sex workers (Latkin et al. 2003; Rhodes et al. 2005). Moreover, network analysis has been useful in understanding social support of disadvantaged groups living with HIV such as African migrants and ethnic minority women (Hough et al. 2005; Asander et al. 2004; Sivaram et al. 2005). Considering a Gay man as part of a social network involves engaging with the social and cultural factors that shape his experience. Rather than thinking of his relationships as essentially random, we characterise them as being profoundly influenced by his social environment; an environment made up by other individuals who share common understandings and social norms. This social network is generally self-perpetuating and limited. Individuals come into contact and hence derive friends and partners from this finite network. Network analysis is especially valuable when examining a population that is highly heterogeneous and made up of individuals who enter that population as autonomous adults. Gay men are such a population being made up of socially mobile individuals deriving from a range of social, ethnic and geographical backgrounds. Social networks are central to our understanding of the dynamics of HIV risk among Gay men. The nature and density of social networks have been found to be connected to sexual risk practices and susceptibility to HIV infection in Gay men (Smith et al. 2004). Moreover, networks influence Gay men’s perceptions and understandings of the HIV epidemic (Grierson 2005). In addition, social networks may have a role in influencing an individuals’ knowledge and understandings of, and access to new technologies such as PEP (see Dodds & Hammond 2006; Korner et al. 2005). Social norms have been found to be important in influencing Gay men’s attitudes towards safer sex and risk-taking especially among groups that have been traditionally disempowered or marginalised such as young Gay men (see Amirkhanian et al. 2005a) and Black/ethnic minority Gay men (see Wilson et al. 2002; Peterson et al. 2003; Zea et al. 2005). Finally social network analysis has been useful in describing social support for Gay men living with HIV and their carers (Shippy et al. 2003; White and Cant 2003; Cant 2004; Zea et al. 2005). A range of HIV prevention interventions have been based around social networks and innovation diffusion theory (see Amirkhanian et al. 2005a). Such interventions would seem to have most salience with disadvantaged groups of Gay and Bisexual men and have achieved some success (see Amirkhanian et al. 2005b). Other authors point out the limitations of network interventions in reaching men at relatively low risk or stress limitations in their efficacy over time (see Martin et al. 2003). Findings from the 2003 Gay Men’s Sex Survey (GMSS) highlight the importance of proximity to HIV. That is, men in certain social and cultural networks had limited experience of HIV in their social network and these men tended to have greater HIV prevention need (see Reid et al. 2004). GMSS 2003 established a range of indicators to measure personal and social proximity to the epidemic. These included: • Having tested for HIV. • Not having tested positive, but believing you are or could be infected. • Being in or having had a sero-discordant relationship. • Personally knowing someone with HIV. At the population level proximity to HIV was mediated by a range of demographic factors. • Area of residence: Men resident in London had greater proximity than men resident elsewhere, although men with low proximity to HIV were present in every city and town and in every area of the UK. • Age: Men in their 30's and 40's had greater proximity than either older or younger men. • Ethnicity: Black men and White men of ethnicities other than British had greater proximity than men in other ethnic groups. • Education: Better educated men had greater proximity (even though less well educated men were more likely to have HIV). • Income: Men in higher income brackets had greater proximity than men in lower income brackets. • Gender of sexual partners: Exclusively homosexually active men had greater proximity to HIV than men who were behaviourally bisexual. • Numbers of male partners: Men with greater numbers of partners had greater proximity than men with fewer partners. While these differences are important it is essential to note that they denote difference at the population level. In fact, there are men with low proximity to HIV in every city and town in the UK (including London); in every age group and ethnic group; with every level of formal education and at every income level; and with a range of sexual identities and sexual practices. These population differences in proximity to HIV present an interesting health promotion dilemma. Those men with greatest proximity have less unmet needs but are more likely to be involved in HIV exposure. Those with less proximity have the greatest unmet need and will therefore be vulnerable if they do come into contact with HIV (either knowingly or unknowingly) but they are probably less likely to do so. In response, the original research recommends “a diverse portfolio of interventions that are encountered by men with a wide variety of relationships to HIV” (Reid et al. 2004). The study presented in this report is in response to these findings. That is, a qualitative examination of social proximity to the epidemic among Gay men. However, we must start with a caveat. Neither GMSS nor this study measures actual proximity to HIV, that is the numbers of social and sexual contacts an individual has who are actually HIV positive, or the percentages of a social network who are actually positive. Rather, GMSS sets up a range of proxy markers to indicate proximity (such as testing history, beliefs about one’s own status and beliefs about the HIV status of social and sexual partners). Likewise, this study measures perceptions of proximity to the epidemic rather than actual proximity (to study actual proximity would require an ambitious network analysis where we recruited all the social and sexual contacts of respondents and asked them about their actual or known HIV status). Studying men’s perceptions of their proximity to the epidemic allows us to examine the ways in which men’s perceptions of their social surroundings influence how they experience and negotiate sexual risk. Moreover, an individual’s perception of the world around him influences the types of information and messages he is likely to notice. The purpose of this study is to inform the nature of interventions targeting men based on their perceived proximity to the epidemic. We will do so by exploring how their perceptions of proximity influence management of HIV-related sexual risk among men who assume or know themselves to be HIV negative

From Reflection to Employment: Using Digital Portfolios in School Counselor Education

Many counselor education programs utilize digital portfolios for students to archive assignments. Such portfolios can also be used when students exit the program interviewing for employment. This presentation highlights how one counselor education program implemented digital portfolios as a means for fostering student reflection, and subsequently evolved the portfolios towards satisfying both comprehensive exam and student employment goals

Career Ready or Rushed? Developing Career Exploration in CSCPs

While national focus on college/career-readiness has placed welcome attention on school counseling, overzealous emphases to pick a specific college and/or career can leave students feeling rushed. Broad school-wide or grade-level programs aimed at college/career preparation may trump individual career development. This session presents how to infuse career exploration into the current educational landscape (i.e., RTI, Common Core, etc.) via the multiple components of a Comprehensive Guidance and Counseling Program (CGCP): Foundation, Management, Delivery, and Accountability

Designing an Adaptive Web Navigation Interface for Users with Variable Pointing Performance

Many online services and products require users to point and interact with user interface elements. For individuals who experience variable pointing ability due to physical impairments, environmental issues or age, using an input device (e.g., a computer mouse) to select elements on a website can be difficult. Adaptive user interfaces dynamically change their functionality in response to user behavior. They can support individuals with variable pointing abilities by 1) adapting dynamically to make element selection easier when a user is experiencing pointing difficulties, and 2) informing users about these pointing errors. While adaptive interfaces are increasingly prevalent on the Web, little is known about the preferences and expectations of users with variable pointing abilities and how to design systems that dynamically support them given these preferences. We conducted an investigation with 27 individuals who intermittently experience pointing problems to inform the design of an adaptive interface for web navigation. We used a functional high-fidelity prototype as a probe to gather information about user preferences and expectations. Our participants expected the system to recognize and integrate their preferences for how pointing tasks were carried out, preferred to receive information about system functionality and wanted to be in control of the interaction. We used findings from the study to inform the design of an adaptive Web navigation interface, PINATA that tracks user pointing performance over time and provides dynamic notifications and assistance tailored to their specifications. Our work contributes to a better understanding of users' preferences and expectations of the design of an adaptive pointing system

HIV diagnosis and disclosure

For those we interviewed the knowledge that either they or their partner had diagnosed HIV needed to be managed on both an individual and collective level. It impacted on how each partner saw themselves and also how they perceived the future of their relationship. This report begins by exploring how participants with diagnosed HIV became aware of their HIV status, and how they have tried to come to terms with it, before describing their decision making about sharing this status with their partner and their means of doing so. The thoughts and experiences of participants who had not disclosed their status are described. Finally it explores the reactions of the HIV negative or untested partners to disclosure, its impact on a personal level and how they sought to come to terms with this news

Relationships between psychological factors and immune dysregulation in context: a life-course approach

The thesis provides evidence about relationships between adverse exposures, psychological responses to them and immune dysregulation. The approach taken is informed by theories about the life-course, the stress process, the stress response and the inflammatory theory of depression. The first two empirical chapters provide evidence about the contribution of psychosocial factors to immune dysregulation. Immune dysregulation is measured by onsets of asthma and rheumatoid arthritis during adulthood. Comprehensive life-course data are used to provide valuable evidence about the epidemiology of each disease. More specifically, new evidence is provided about the psychosocial pathways that lead to disease onset. After adjustment for material adversities, social adversities predict onsets of each disease. Chronic as opposed to acute adversities are salient for rheumatoid arthritis onset, which is consistent with existing theory that chronic stress contributes to immune dysregulation. Depressive symptoms mediate an association between childhood adversity and asthma onset decades later. A small but consistent association between depressive symptoms and asthma onset soon afterwards may reflect psychological consequences of chronic inflammation preceding asthma diagnosis. The third empirical chapter tests prospective associations between chronic inflammation and depressive symptoms. It finds that chronic inflammation predicts depressive symptoms and provides new evidence that these associations are mediated by factors associated with sickness behaviours. Findings indicate the relevance of psychosocial pathways to the development of immune-mediated diseases and the potential involvement of immune behaviours in psychological symptoms. Practitioners and policy makers working with people who have conditions characterised by immune dysregulation should consider the psychological predictors and consequences of immune dysregulation. More research in this area is needed and this would be facilitated by the development and inclusion in surveys of well-validated measures of psychological and biological stress and of the psychological and behavioural correlates of sickness behaviours thought to be induced by inflammation

A Role for Actin, Cdc1p, and Myo2p in the Inheritance of Late Golgi Elements in \u3cem\u3eSaccharomyces cerevisiae\u3c/em\u3e

In Saccharomyces cerevisiae, Golgi elements are present in the bud very early in the cell cycle. We have analyzed this Golgi inheritance process using fluorescence microscopy and genetics. In rapidly growing cells, late Golgi elements show an actin-dependent concentration at sites of polarized growth. Late Golgi elements are apparently transported into the bud along actin cables and are also retained in the bud by a mechanism that may involve actin. A visual screen for mutants defective in the inheritance of late Golgi elements yielded multiple alleles of CDC1. Mutations in CDC1 severely depolarize the actin cytoskeleton, and these mutations prevent late Golgi elements from being retained in the bud. The efficient localization of late Golgi elements to the bud requires the type V myosin Myo2p, further suggesting that actin plays a role in Golgi inheritance. Surprisingly, early and late Golgi elements are inherited by different pathways, with early Golgi elements localizing to the bud in a Cdc1p- and Myo2p-independent manner. We propose that early Golgi elements arise from ER membranes that are present in the bud. These two pathways of Golgi inheritance in S. cerevisiae resemble Golgi inheritance pathways in vertebrate cells

Midbrain dopaminergic neurons generate calcium and sodium currents and release dopamine in the striatum of pups

Midbrain dopaminergic neurons (mDA neurons) are essential for the control of diverse motor and cognitive behaviors. However, our understanding of the activity of immature mDA neurons is rudimentary. Rodent mDA neurons migrate and differentiate early in embryonic life and dopaminergic axons enter the striatum and contact striatal neurons a few days before birth, but when these are functional is not known. Here, we recorded Ca2+ transients and Na+ spikes from embryonic (E16–E18) and early postnatal (P0–P7) mDA neurons with dynamic two-photon imaging and patch clamp techniques in slices from tyrosine hydroxylase-GFP mice, and measured evoked dopamine release in the striatum with amperometry. We show that half of identified E16–P0 mDA neurons spontaneously generate non-synaptic, intrinsically driven Ca2+ spikes and Ca2+ plateaus mediated by N- and L-type voltage-gated Ca2+ channels. Starting from E18–P0, half of the mDA neurons also reliably generate overshooting Na+ spikes with an abrupt maturation at birth (P0 = E19). At that stage (E18–P0), dopaminergic terminals release dopamine in a calcium-dependent manner in the striatum in response to local stimulation. This suggests that mouse striatal dopaminergic synapses are functional at birth