Othering, blame and shame when working with people living with HIV

Significant advances in HIV treatment has meant that for the majority of patients with HIV they are able to live a normal lifespan. However, HIV remains a highly stigmatizing disease with the potential to significantly impact on ones social identity and sense of self. This paper draws on data from a qualitative study of interviews with five gay men, to explore the experiences of shame in relation to living with HIV. The paper adopts a psychoanalytic lens to highlight the mechanisms of splitting that may be involved at both a social and individual level, and the experience of shame among the participants. The paper aims to use this research data to supplement our understanding of what may be occurring ‘on the couch’ with patients who are living with HIV

Learning together: Lessons from a collaborative curriculum design project

Based on an action research project implemented at two South African universities, we argue that content and language integration (ICL) collaborative partnerships benefit not only from collaboration between language and content specialists, but in addition, from collaboration between language specialists, general education specialists and content specialists from a variety of disciplines. However, as we illustrate below, these benefits may be accompanied by substantial challenges. We make a further claim, for the value of a transformative approach towards collaboration for content and language integration, in which the teacher/researchers engage in their practice in a critical and reflexive manner, and by so doing, foster their own deep learning, as well as the deep learning of the students

Taking into account the quality of the relationship in HIV disclosure

Despite growing interest in HIV disclosure, most theoretical frameworks and empirical studies focus on individual and social factors affecting the process, leaving the contribution of interpersonal factors relatively unexplored. HIV transmission and disclosure often occur within a couple however, and this is where disclosure has the most scope as a HIV transmission intervention. With this in mind, this study explores whether perceived relationship quality influences HIV disclosure outcomes. Ninety-five UK individuals with HIV participated in a cross-sectional survey. Retrospective data were collected on their perceived relationship quality prior to disclosing their HIV positive status, and on disclosure outcomes. Perceived relationship quality was found to significantly affect disclosure outcomes. Positive qualities in the relationship were associated with positive outcomes, whereas negative qualities were associated with negative outcomes. Results further confirmed that this association was not merely correlational, but demonstrated predictive power. Relationship quality might act as either a risk or a resilience factor in the disclosure process, and thus warrants greater attention in future research

‘Experience of sexual self-esteem among men living with HIV’

Much of the focus on sexual health for people living with HIV has been on promoting safe sex behaviours. However, also important for sexual health is a positive sexual self-esteem. This article reports on an Interpretative Phenomenological Analysis of interviews with seven men about the impact that having HIV has had on their sense of sexual self. Five overarching themes were identified: the ‘destruction’ of a sexual self; feeling sexually hazardous; sexual inhibition; reclaiming a sexual self; finding a place through sero-sorting. With HIV now being a chronic illness, interventions are required to support people to lead sexually satisfying lives

Berom cultural beliefs and attitudes towards mental health problems in Nigeria: a mixed-methods study

Beliefs and attitudes are essential in mental health discourse. However, cultural beliefs and attitudes towards mental health problems (ATMHPs) among the Berom people of Nigeria are under-researched. The present studies made original contributions using the Cultural Identity Model (CIM) as predictors to investigate ATMHPs, and semi-structured interviews to further explain the potential impact of cultural beliefs on MHPs. In study-1, N = 140 participants responded to questionnaires on ATMHPs and were analysed using multivariate multiple regression in RStudio. Study-2 interviewed N = 13 participants (n = 7 laypeople; n = 6 practitioners). Interviews were recorded, transcribed and analysed thematically. Study-1 findings showed CIM as a non-significant predictor of ATMHPs. However, in study-2, four themes emerged: Cultural beliefs that MHPs are caused by spiritual forces; Berom indigenous preference for traditional healing; Christian religious healing in Berom communities; and Western-trained mental health practitioners' perception of lay service-users. The authors concluded that the Berom traditional and Christian religious healings are beneficial

Reducing appointment lead-time in an outpatient department of gynecology and obstetrics through discrete-event simulation: A case study

Appointment lead-time is a critical variable in outpatient clinic services. In Gynecology and Obstetrics departments, longer appointment lead times are associated with lower patient satisfaction, the use of more complex healthcare services, development of long-term and severe complications and the increase of fetal, infant and maternal mortality rates. This paper aims to define and evaluate improvement alternatives through the use of Discrete-event simulation (DES). First, input data analysis is performed. Second, the simulation model is created; then, performance metrics are calculated and analyzed. Finally, improvement scenarios are designed and assessed. A case study of a mixed-patient type environment (Perinatology and Gynecobstetrics) in an outpatient department has been explored to verify the effectiveness of the proposed approach. Statistical analysis evidence that appointment lead times could be significantly reduced in both Perinatology and Gynecobstetrics appointments based on the proposed approaches in this paper

Fast evaluation of appointment schedules for outpatients in health care

We consider the problem of evaluating an appointment schedule for outpatients in a hospital. Given a fixed-length session during which a physician sees K patients, each patient has to be given an appointment time during this session in advance. When a patient arrives on its appointment, the consultations of the previous patients are either already finished or are still going on, which respectively means that the physician has been standing idle or that the patient has to wait, both of which are undesirable. Optimising a schedule according to performance criteria such as patient waiting times, physician idle times, session overtime, etc. usually requires a heuristic search method involving a huge number of repeated schedule evaluations. Hence, the aim of our evaluation approach is to obtain accurate predictions as fast as possible, i.e. at a very low computational cost. This is achieved by (1) using Lindley's recursion to allow for explicit expressions and (2) choosing a discrete-time (slotted) setting to make those expression easy to compute. We assume general, possibly distinct, distributions for the patient's consultation times, which allows us to account for multiple treatment types, as well as patient no-shows. The moments of waiting and idle times are obtained. For each slot, we also calculate the moments of waiting and idle time of an additional patient, should it be appointed to that slot. As we demonstrate, a graphical representation of these quantities can be used to assist a sequential scheduling strategy, as often used in practice

A family of diameter-based eigenvalue bounds for quantum graphs

We establish a sharp lower bound on the first non-trivial eigenvalue of the Laplacian on a metric graph equipped with natural (i.e., continuity and Kirchhoff) vertex conditions in terms of the diameter and the total length of the graph. This extends a result of, and resolves an open problem from, [J. B. Kennedy, P. Kurasov, G. Malenov\'a and D. Mugnolo, Ann. Henri Poincar\'e 17 (2016), 2439--2473, Section 7.2], and also complements an analogous lower bound for the corresponding eigenvalue of the combinatorial Laplacian on a discrete graph. We also give a family of corresponding lower bounds for the higher eigenvalues under the assumption that the total length of the graph is sufficiently large compared with its diameter. These inequalities are sharp in the case of trees.Comment: Substantial revision of v1. The main result, originally for the first eigenvalue, has been generalised to the higher ones. The title has been changed and the proofs substantially reorganised to reflect the new result, and a section containing concluding remarks has been adde

Dating persons with physical disabilities: The perceptions of South Africans without disabilities

There is good reason to believe that the attitudes of persons without disability towards dating a person with a physical disability might be unfavourable. However, in general, and in the Global South in particular, there is a dearth of research in this area. This study sought to take the first step in addressing this lack of enquiry, by surveying the attitudes of a general population sample in South Africa towards dating people with physical disabilities, using a vignette. Data from 1,723 survey respondents were analysed thematically. Findings reveal largely negative attitudes towards people with physical disabilities. Respondents without disability perceived numerous barriers to dating a person with a physical disability, including social stigma, anxiety, and concerns about the burden of care they believed such a relationship would place upon them. However, there was some evidence to suggest that some positive attitudes do exist, and a few respondents were open to dating a person with physical disabilities. Findings contribute to a nuancing and expanding of the ‘myth of asexuality’ among physically disabled people by showing that people with physical disabilities are actively desexualised by persons without disability. Future research is needed to explore how the inclusive attitudes, of which we did find evidence here, can be further cultivated

Symbolic violence and the invisibility of disability

Disability as a social justice issue is not part of mainstream talk. Approximately 15% of the world’s population has a disability, and yet persons with disabilities are systematically subjected to this sort of exclusion. If considered in terms of social power, then persons with disabilities are the largest single minority group. Amongst minorities, exclusion from the social and representational order is a forceful form of symbolic violence. Persons with disabilities are systematically subjected to this sort of exclusion. In the public domain, persons with disabilities are either not represented at all, or misrepresented. The misrepresentation of persons with disabilities takes a host of cultural forms. This paper explores a few examples of these forms, as they can be considered examples of symbolic violence. We explore how negative social value may be internalised, and how this constitutes a form of symbolic violence experienced by persons with disabilities. We argue that persons with disabilities must constantly act against subtle and blatant acts of symbolic violence – including exclusion – and that the necessity of constant resistance characterises the lives of disabled persons. We argue that it is necessary not only to recognise the detrimental effects of having to confront the symbolic violence of a society which is structured for the benefit of those with typical embodiment, but also to frame this social injustice as something which leads to very real and very dangerous exclusions