HIV workshop

Download HIV Group discussion topics PDF or read here:

Why and how to make the best from multi-multidisciplinary

research on HIV/AIDS?

To contribute to the global goal of reverse the epidemic by 2015

Group Discussion

Discuss the topic provided among the group and attempt to answer the posed questions. The focus should be on a multidisciplinary approach so try to incorporate the experience of all fields represented round the table.

It should be kept in mind that innovative, cost effective and long term approaches are required to achieve the challenging goal of a reversal of the HIV epidemic. Please choose one of the following topics:

A. Building on previous successes.

The effect of programs which address the HIV epidemic have had differing success. It is important therefore to make a good assessment of the effect of such a program.

The characteristics of mothers at high risk of obstetric intervention in the Millennium Cohort Study

Holly Nicole Essex

hne100@york.ac.uk, Department of Health Sciences, University of York

Background: The UK has one of the highest rates of caesarean section (CS) in the world, and this has continued to increase over the past decades, with no associated decrease in numbers of instrumental births, and no improvement in perinatal outcomes. CS and other interventions in childbirth represent a psychological risk to mothers, a physiological risk to both mothers and babies and a substantial cost to the NHS. There is a need to understand this trend of increased intervention and reverse it.

Objective: To identify the demographic, psychosocial and clinical characteristics of women who have high rates of intervention at birth.

Methods: The sample consisted of 18,238 natural mothers of infants from the Millennium Cohort Study. Multivariable regression models, stratified by parity, were used to examine socio-demographic, cultural, socio-economic, psychosocial and pregnancy characteristics in relation to mode of birth.

Results: Among primiparous mothers, all types of intervention (instrumental delivery, planned CS and emergency CS) were more likely with increasing maternal age and for mothers who had clinical problems during pregnancy. Instrumental births were more likely for mothers with lower occupational status, and less likely for mothers who were Black, Hindu, closely involved with the father of the baby. Planned CSs were more likely for Pakistani or Bangladeshi origin and for mothers who never saw their own mother, and less likely for Muslim and low income mothers. Emergency CSs were less likely for Pakistani or Bangladeshi mothers, Black mothers and mothers who were closely involved with the father of the baby. Among multiparous mothers, increasing maternal age and clinical problems during pregnancy were more likely for all types of intervention. Instrumental births were also more likely for Indian, mixed race and low income mothers. Planned CSs were more likely for other non-Christian mothers, and less likely for mothers whose parents ever separated. Emergency CSs were more likely for mothers of “other” ethnic background.

Conclusion: Maternal age, ethnic identity, socio-economic status and family relationships were all significantly related to mode of birth. An understanding of the characteristics of women at high risk of intervention is crucial to developing and providing appropriate and high quality maternity services.

My research is interdisciplinary as it is social epidemiology; an investigation into how health, social and psychosocial factors relate to obstetric interventions. Discovering who the women are who are most at risk of intervention in birth will also have the potential to influence policy.

Addressing the social significance of HIV

George Shirreff

george.shirreff07@ic.ac.uk. Department of Infectious Disease Epidemiology, Imperial College, London

Addressing the social significance of HIV is essential in understanding and preventing its spread and alleviating its impact on the population.

HIV infections are often most prevalent among hard-to-reach populations such as intravenous drug users and commercial sex workers. This creates challenges for identifying and treating individual infections, and it is also difficult to estimate the prevalence of the infection and the effectiveness of interventions. Many with HIV infection experience considerable stigma and this is a barrier both to human well-being and to control of the epidemic. Social reactions to HIV are also important in assessing the impact of changes to behaviour such as condom use or other sexual risk factors. For example, how does condom use change following a test, either with a positive or negative result.

In most cases, the spread of HIV is highly dependent on sex and therefore sexual networks. Network science is an emerging field and is essential to epidemiology of HIV infection. The spread of HIV through sexual networks is dependent on many aspects of the network such as number of partners, heterogeneity of sexual behaviour and concurrency of multiple partnerships. The spread of other sexually transmitted infections is also important as a risk factor for HIV.

In countries where HIV prevalence is extremely high, as in sub-Saharan Africa, the infection devastates the working age population. Large quantities of orphans and a shortage of teachers are among the more direct effects of the premature deaths caused by AIDS.

How Acupuncturists Envision Treating IBS

Tracy Stuardi

tls504@york.ac.uk, Department of Health Sciences, University of York

Purpose: The study’s purpose is to relate how acupuncturists envision treating IBS in routine practice to the treatments they actually deliver as part of a pragmatic trial of acupuncture for IBS.

Methods: In-depth interviews based on a flexible topic guide were used to access acupuncturist views on potential treatments. A purposive sample of acupuncturists, with membership in the British Acupuncture Council and a background in traditional Chinese medicine, was invited to participate. Data were analyzed using a thematic framework approach. The second part of the research question – exploring what acupuncturists actually delivered – was addressed using extracted material from acupuncturists’ log books, which was then (or will be) compared to material from the interviews.

Results: Twelve acupuncturists completed an in-depth interview. Acupuncturists acknowledged that patients rarely mention IBS as their primary complaint, but as many as half of their patients have irregular bowel symptoms. Additionally acupuncturists agreed on several commonly encountered diagnoses based on TCM principles and the importance of diagnosis in influencing treatment principle, point selection, use of additional therapies (i.e. moxa), and dissemination of lifestyle advice. The trial of acupuncture for IBS, which will provide results for the second part of the research question, began in October 2008. Since this is a pragmatic trial, we expect treatments to be highly individualized as indicated by the interviews. The treatments themselves may vary from the ones described due to the fact that trial participants will have a known diagnosis of IBS, which is not commonly encountered in routine practice.

Conclusions: Although there was some repetition of diagnoses and points selected, acupuncturists maintained that understanding each individual case was essential to determining the treatment to be delivered. Thus researchers may make generalizations about the treatment of IBS with regard to acupuncture, however each patient will receive a treatment based on his/her needs. Whether this notion correlates with the treatments delivered in the trial is under evaluation.

Why this study has relevance interdisciplinary: This study is directly relevant to the health sciences because it explores the delivery of a treatment modality for IBS. Additionally this study is relevant to the social sciences because it explores what influences the acupuncturists’ decisions and actions regarding treatment.

Policy Decisions and Community Participation in Health: Understanding the public’s view of the National Health Insurance Scheme (NHIS)

Gina Teddy

gt501@york.ac.uk, Department of Social Policy and Social Work, University of York

Background and Aims: Government response to public concerns has been to develop policies to deal with them. Policy makers are increasingly designing strategies to address public needs and problems. With regard to health policies, governments play significant roles in developing them and executing them. Meanwhile, policy recipients tend to have little or no role in the development and measurement of these policies. The public’s understanding of a policy affect how they respond to it and the outcome. Yet little has been done to involve them. This study explored the views and perceptions of community residents on their understanding and experience of the National Health Insurance Policy (NHIP) in Ghana. It tests how much the public knew about the policy, how that affect the response to healthcare use under the scheme, what additional information they require on NHIP and the significance of that knowledge to them, their decisions and reactions to it.

Data and Methods: A qualitative research was employed to explore participants’ views, using nine focus group discussions based on a purposive sampling of three districts with previous experience of community health financing. These discussions were set to include residents of: Dangme West; Kwahu West; and Nkoranza districts. Participants included both scheme and non-scheme members who are 18 years and above from various socio-demographic backgrounds. Each FGD consisted between 8-16 participants.

Results and Conclusion: Findings from the study showed that the public want to be adequately informed of health policies and decisions made at both the national and local levels. They noted that even though the NHIP require their participation at the community level and affect their decision on healthcare, they have very vague information on it. Policies tend to be imposed on them with little or no reference to their individual circumstances. As a result, membership to the scheme is challenged, despite the policy’s aim to improve healthcare access. And this is because the level of information and education about the scheme is very limited. The general public lack information on the NHIP and their place as members, so they tend to rely on uninformed sources. They, therefore, expressed interest in being informed of health policies undertaken locally and nationally. The study concluded that policy recipients must be included more in policy processes, especially, when it has direct impact on them. Policy makers and implementers must employ various means to communicate policy decisions to the best of their ability and beyond the general provision of advertisements.

The Training Needs Analysis of Syrian EFL Secondary School Teachers

Taha Rajab

tr535@york.ac.uk. Department of Educational Studies, The University of York

Background: The last two decades have witnessed a worldwide proliferation of inter-communication pedagogical practices in the field of education. Several studies have showed that the introduction of Communicative Language Teaching (CLT) curriculum in several developing countries is often not preceded by a systematic research-based needs analysis of both teachers and learners. Although such curricula ideally urges teachers to employ inter-communicative approaches, EFL teachers in Syria continue to teach in the grammar-translation approach dominated by: rote learning, recitation, translation, and the transmission of facts through teacher explanation with overwhelming predominance of teacher-fronted explanations and question-answer exchanges. The co-construction of knowledge is a shared responsibility between teachers and learners (Hardman, 2008).

Aim: The research is meant to begin to develop baseline about EFL Syrian secondary teachers: their background and training, their priorities, the problems they face in the classroom and the influence that the new CLT course guidelines have actually had on teaching practice. Also, it will fill a gap in research to date in the Syrian context to investigate how teachers interact with students in English classrooms over time.

It contributes to the world literature on the professional development of language teachers because achieving quality in English teaching necessitates training teachers to use interactive style of teaching.

Methods: A mixed method approach will be taken up. This would involve an array of methods like systematic computerized observation, digitally audio-visual observation, and post-observation interviews with teachers. The participants will be teachers at two Syrian urban schools, one average and one dedicated for the elite students. I will be working with 2 teachers in each school observing 4 lessons of each teacher over 2 or 3 months with the hope of generating a total of 16 observed lessons.

References:

Hardman, F. (2008) The Guided Co-construction of Knowledge. In M. Martin-Jones, A. M. de Mejia and N. H. Hornberger (eds.), Encyclopaedia of Language and Education (3) Discourse and Education, 253-263.

Development of a new set of criteria to assess the quality of diverse studies as part of a systematic review

Reema Sirriyeh

R.H.Sirriyeh07@leeds.ac.uk. Institute of Psychological Sciences, University of Leeds

Whilst attempting to conduct a systematic review of research relating to the impact of medical error on the health professional, the lack of a suitable tool to assess study quality where study designs are diverse became apparent. A number of existing scales were examined which led to the identification of a set of 17 criteria (Jackson, Cheater & Reid, 2008) that had been developed for diverse studies based on prior attempts (Edwards, Hood, Matthews et al, 2000; Thomas & Harden, 2008; Thomas, Sutcliffe, Harden et al, 2003). However, difficulties arose in their application due to the dichotomous nature of assessments, reliance on reviewer’s judgements and omissions within the criteria. Therefore, the aim of this project was to combine existing strategies with expert opinion to devise a tool to be used in systematic reviews for the assessment of study quality where study designs are diverse.

The original 17 criteria were adapted to form a new set of 16 new criteria. Each item was scored using a scaled response from 0 ‘no mention at all’ – 3 ’complete’, to indicate the extent to which the issue had been covered in each paper. Guidelines for scoring each item were developed to minimise the level of judgement or expertise required from reviewers. The tool was trialled with 3 reviewers and a random sample of the papers from the review (4). Following 2 stages of revisions and refinements to the tool, substantial agreement (Landis & Koch, 1977) was established between 3 reviewers (κ = 62.9%) and the scale was applied to all the 25 papers in the review. Review findings indicated that the quality of evidence was poor in this set of papers, achieving only 47.8% of the total possible maximum score. Despite descriptive components of the papers scoring highly, key weaknesses were identified in aspects of study design such as sample size, and the quality of the measurement tools that were employed.

This project has established a quality assessment tool to establish the quality of evidence where studies are diverse. Such a tool is valuable for much health and social research where variation in study design often raises challenges in determining the strength of evidence in a body of research. Further work to determine the validity and usability of this tool continues.

Facilitators and Barriers in Lower-Secondary Schools: Representative Cases in Oaxaca, Mexico

Elia Lorena Lopez

ell500@york.ac.uk. Educational Studies Department, University of York

Background: Lower-Secondary School is the final stage of compulsory education in Mexico, yet statistics indicate that not all eligible children are enrolled in school. Why, in reality, is it not compulsory? What are the factors affecting students’ academic performance at this level of education?

Aim: This study explores (a) what the factors that influence secondary school girls and boys’ failure in this level of education are and, simultaneously, (b) the factors that enhance their academic success and finally, (c) to what extent these factors vary if coming from a socioeconomically advantaged or disadvantaged background.

Methods: Data was collected using a total of 80 semi-structured interviews with high-achievers, under-achievers, dropouts, parents and staff at schools in advantaged and disadvantaged locations.

Based on models similar to those of authors who have looked into this problem (Rumberger 1983, 2001, Ekstrom et al., 1986, Orfield, 2004), interviews took into consideration factors that included family, school, educational policies and geographical location.

Findings: Findings revealed that various factors intertwine in students’ educational outcomes: contrary to what is generally expected, parental socio-economic status (SES) did not seem to be directly proportional to students’ academic performance. It may, however, add additional value in so far as educational resources become more available at home. In addition, parents with a higher SES are more likely to monitor their children’s educational performance.

Due to the fact that homework is a very important part of the Mexican system for basic education, having assistance for homework seems to be a major key element that impacts on students’ attainment in school.

Stability at home and having good communication within the family seems to motivate students to do well in school. Consequently, instability at home triggers students’ disinterest in school. The “It’s in my head all day” effect appears to be one of the main reasons that lead children to disengage from the family nucleus, by getting jobs, joining gangs or by getting married.

School factors also exert a strong influence, particularly the quality of teaching.

Participants thought that not all teachers are able to deliver appropriate teaching, which limits students’ learning processes and educational outcomes. Old classroom methods (corporal punishment, removing a child for being disruptive, etc.) and punitive school policies (not allowing a child in school because of incorrect uniform, ‘unacceptable’ appearance, or if a girl is found to be pregnant) are practices that, if in conjunction with unfavourable conditions at home, reinforce students’ disengagement from their education.

Discussion and conclusions:

Making compulsory education a reality forms part of the internationally agreed goals that emerged from the World Declaration on Education for All, and Lower-Secondary Education for all is not yet a reality in Mexico.

As Rumberger (2003) stated, it is a complex problem for which there is no simple solution. It is imperative that the social and health sciences work together towards the design of strategies that help students to have better educational opportunities.

Teachers and social workers need to develop their skills to offer adequate welfare assistance by either providing better counseling at school or by establishing formal agreements with health institutions that could assist students in the emotional and physical arenas.

Educational policies also need changing to prevent early marriage, teenage pregnancy and drug abuse, yet making sure students are able to remain in school.

Equally imperative is that parents and teachers become more sensitive to their crucial and indistinguishable roles as guardians and educators.

References:

Ekstrom, R.B., Goertz, M.E., Pollack, J.M., and Rock, D.A. (1986). Who drops out of high school and why? Findings from a national study. Teachers College Record, 87, 356-373.

Orfield, G. (2004) Dropouts in America: Confronting the Graduation Rate Crisis. Cambridge (MA): Harvard Education Press.

Rumberger, R. (1983) Dropping out of High School: The Influence of Race, Sex and Family Background. American Educational Research Journal, 20 (2), 199-220.

Rumberger, R. (2001) Why Students Drop Out of School and What Can be Done. Paper prepared for the Conference “Dropouts in America: How Severe is the Problem? What Do We Know about Intervention and Prevention?, Harvard University, January 13, 2001.

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Personal Narratives of Environmental Behaviour

Sarah Hards

skh500@york.ac.uk. Department of Social Policy and Social Work, University of York

Background: While individual environmental behaviour is currently high on the agenda, both in academia and in policy circles, our understanding of the topic remains patchy. Key issues, such as the factors that drive behavioural change, remain only partially understood. To understand these issues, an interdisciplinary approach is needed. This study draws on literature from psychology and behavioural studies, sociology, social policy and political studies. While studies in the past have provided descriptions of behaviour across the population, in-depth, individual-scale approaches are also needed, to explain the underlying psychological and emotional processes.

Aim: This study aims to address this need, taking account of the dynamic nature of environmental behaviour throughout the life-course, and recognising that environmental behaviour may be entwined with other aspects of an individual’s life, and needs to be studied within this social and personal context. The central question to be answered by this study is: How and why does participation in action on climate change develop over time?

Methods: The study adopts a Narrative Life-Course approach. This combines elements of Narrative Inquiry (Riessman, 2008) with elements of Life Course or Biographical methods. In-depth interviews are being conducted with environmentally-active individuals in York. By inviting participants to “tell the story” of their environmental behaviour over time, this study takes a holistic approach to an individual’s life, focusing on processes of change, and the factors driving and obstructing them.

Results/Findings, Discussion, Conclusion: This paper presents some preliminary results from the first phase of data-collection, including life graphs drawn by participants. It also offers reflections on the challenges and benefits of this unconventional methodology, with particular reference to its potential applications within other disciplines.

References:

Riessman, C. K. (2008) “Narrative Methods for the Human Sciences”, Sage: London.

Cyberpsychics: Subjective experiences of psychic readings on the internet

Tamlyn Ryan

tr519@york.ac.uk. Department of Sociology, University of York

Background: In recent years, psychic practitioners have been able to take full advantage of the opportunities afforded by the development of the internet. Indeed, the internet appears to have been particularly instrumental in facilitating the growth in the number of websites offering psychic services such as Tarot card readings and clairvoyance. However, there appears to be very little sociological analysis of the nature and consumption of these psychic services, particularly those available on the web, or indeed the spiritual orientations of these kinds of services.

Aim: This research, currently in its early stages, examines the ways in which the internet is used for the purpose of psychic readings. How people employ internet technologies to locate and consume psychic readings is explored alongside the ways in which psychic practitioners themselves utilise the web to promote and offer their services. How the internet facilitates the spiritual orientation of psychic readings within the context of psychic-spiritual virtual communities will also be investigated, specifically in regards to online ‘psychic development circles’. In analyzing the various ways people utilise internet technologies for psychic readings this research contributes to the appreciation of the diverse ways people seek spiritual resources from the internet. This study will also contribute to research concerning the psychological study of the production of discourse around contestable knowledge claims.

Methods: To gain a deeper understanding of psychic readings via the internet, I will be using a combination of qualitative methods. These will include participant observation in online ‘psychic development circles’, web-based interviews and solicited diaries. Data will be analyzed using ethnomethodologically informed methods such as computer-mediated discourse analysis and discursive psychology. By employing computer-mediated discourse analysis, this research will also provide a useful contribution to the wider interdisciplinary study of computer-mediated communication.

Emotional and Behavioural Problems of Pakistani Adolescents

Nazar Soomro and Jane Clarbour

nhs501@york.ac.uk. Department of Psychology, University of York

Background: Adolescents represent the largest portion of the Pakistani population and many display significant emotional and behavioural problems, which can have serious consequences for them and the wider society such as academic drop-out and failure, delinquency, drug abuse and unemployment.

Aim: The major aim of this study is to present the Emotional Behavioural Scale for Pakistani Adolescents (EBS-PA), a new measure of emotional and behavioural problems in Pakistani adolescents. A further aim of the study was to investigate the association of the new EBS-PA with the Urdu version of Strength and Difficulties Questionnaire (SDQ).

Methods: A cross-sectional research design was used. Data were collected from two private schools in Hyderabad, Sindh, Pakistan. The EBS-PA and SDQ were administered to 109 Year 8 students between 13-16 years. Teachers also rated 56 of these students on the SDQ-Teacher version.

Results/Findings: The EBS-PA subscales were found to be significantly correlated with the SDQ in the expected directions. For example, the EBS-PA Social Anxiety subscale was positively associated with the SDQ emotional symptoms, whereas EBS-PA Malevolent Aggression subscale was significantly correlated with conduct problems and hyperactivity. The EBS-PA Social self-esteem subscale was strongly negatively correlated with SDQ conduct problems.

The correlations between self and teacher ratings SDQ were found to be substantial particularly for the conduct problem and prosocial behaviour subscales. The highest level of difficulties identified with the SDQ were found for the conduct problems, peer problem and emotional problems subscales in the Pakistani adolescents. 21% and 30.4% were rated as abnormal by themselves and teachers respectively.

Discussion: There is a paucity of reliable and valid indigenous questionnaires to assess emotional and behavioural problems in Pakistani adolescents (Ahmer, Faruqui & Aijaz, 2007). Thus, the new EBS-PA scales will be useful to identify children who are in the early stages of developing emotional and behavioural problems for early intervention and support.

Conclusion: A significant number of Pakistani adolescents show emotional and behavioural problems. Thus, EBS-PA will be used for screening purposes in schools as well as in clinical settings. In addition, it will also facilitate to estimate the prevalence of emotional and behavioural problems in Pakistan.

Comparing economic and non-economic outcome measurements in the evaluation of drug misuse intervention

Stacey Ching-Wen Chang

cc544@york.ac.uk. Department of Health Sciences, University of York

Background

In current cost-effectiveness analysis of drug misuse intervention there are a number of different outcome measurements that are carried out independently of one another. It is not clear the extent to which these are related to and compliment each other or are measuring independent domains.

Aim

The aim of this research is to explore the relationship between economic outcomes and non-economic outcomes and examine the implications for drug misuse policy.

Method

The research consists of a systematic review and secondary data analysis of existing studies. Both economic outcomes and non-economic outcomes are examined.

The WHO’s International Classification of Functioning, Disability and Health (ICF) is used as the classification system to identify the different constructs of outcome measurements. This involves considering how at a theoretical level the different constructs that are used are related and then analysing whether the measurements that are used reflect and illustrate these relationships.

Results

The results show that some ICF concepts are measured both in economic and non-economic outcomes, particularly in the body function category and activities and participation category.

Most questionnaire items that are categorised in the same ICF concepts are correlated. Items from the Social Satisfaction Questionnaire are not correlated with items from other outcome measurements, due to the different approaches for determining the outcome.

Conclusion

That existing research on drug intervention may not necessarily be measuring adequate outcomes because it fails to take into account certain relationships between outcome domains. The relationships between the different individual outcome domains that are measured should be considered in a research. This research has interdisciplinary relevance across economic and psychological theories, and the results carry important implications for health policy.

A systematic review of randomised controlled trials of interventions to change maladaptive illness beliefs in patients with coronary heart disease

Lucy Goulding

lg529@york.ac.uk. Department of Health Sciences, University of York

Background: Many people with coronary heart disease (CHD) report poor functional and psychological status. An increasing body of evidence suggests that some of these difficulties may arise as a result of maladaptive illness beliefs such as ‘exercise is bad for CHD, I must rest and take it easy’. The effectiveness of interventions which are designed to change maladaptive beliefs in people with CHD is unknown.

Aims: The purpose of the systematic review was to investigate whether interventions to change maladaptive illness beliefs are effective in changing beliefs and other behavioural, functional and psychological outcomes in people with CHD, and thus to establish which types of intervention are most effective.

Methods: A systematic review was conducted in order to assimilate the results of RCTs of interventions to change maladaptive illness beliefs in people with CHD using a transparent method which minimises bias.

Results: Thirteen randomised controlled trials met the inclusion criteria. These studies varied in terms of participants, interventions, outcome measures, outcomes and study quality. Due to this heterogeneity, quantitative synthesis was not practicable, thus descriptive synthesis was undertaken.

Conclusions: Descriptive synthesis of the results suggested that it is possible to devise interventions to change maladaptive illness beliefs in people with CHD. Cognitive behavioural interventions may be particularly effective and counselling and / or educational interventions can be effective in some circumstances. The review was not able to reveal whether interventions to change maladaptive cognitions result in positive behaviour change or improved functional or psychological outcomes in people with CHD. The quality of studies that have been conducted in this area is mixed. The poor quality of some of the included trials in addition to unreliable outcome measures mean that the results included in the present review may be subject to methodological bias. There may also be publication bias due to lack of a search for studies not written in English. It is therefore important to interpret the results of the review with caution. Perhaps the most important finding of the present review is that there is a lack of good quality randomised controlled trials investigating the efficacy of maladaptive belief change interventions for people with CHD.

Mental Health Policy and Service Delivery in Taiwan and England

Jin-Yong Wang

jw536@york.ac.uk. Department of Social Policy and Social Work, University of York

Background: Over the last one hundred years, the way people with mental illness are treated and cared has hugely changed due to various reasons. It is argued that contextual factors such as culture apparently play a pivotal role in shaping societal perceptions and reactions to mental health problems.

Aim: In my study, I try to discover the historic development of mental health policy in Taiwan and England, and accordingly propose the possible future development of mental health policy in Taiwan. Also, I am interested to know the various stakeholders’ perspectives on mental health policy and how they have shaped the formation of mental health policy.

Methods: I conducted 41 qualitative semi-structured interviews with service users, family carers, professionals, staff of voluntary organisations and governmental policy officers. In addition to interview transcripts, I also used official statistics and policy documents to answer my research questions.

Findings: In Taiwan, psychiatric stigma and fear of mental illness have made the government to segregate people with mental illness from the community in long-term care hospitals. Psychiatric treatment has been sufficiently offered but rehabilitation and social care are relatively under-developed. Psychiatrists and policy makers have significantly influenced the direction of mental health policy.

Conclusion: There are possibilities that in the future community-based mental health care may be furthered in Taiwan, and the English experience may offer some lessons in this regard. Also, there are issues in developing culturally appropriate practice and helping service users reintegrate into the community.

Based on my social work and social policy training background, I stand on the ground of social science and am more concerned about the social issues and social care needs of people with mental illness and their families.

Can rich areas be bad for the health of the poor? The protective effect of living amongst one’s own.

Christo Albor [1], Dimitris Ballas [2], Richard Wilkinson [3], and Kate Pickett [1].

ca533@york.ac.uk 1Department of Health Sciences, University of York; 2Department of Geography, University of Sheffield, UK;  3Division of Epidemiology and Community Health, University of Nottingham Medical School

Aim: To find whether poor mothers and their infants have better or worse health in richer areas.

Health Outcomes: Self-rated health, limiting long-term illness (LLI), low birthweight (LBW), and preterm delivery.

Design: Analysis of 14,465 white mothers in the UK. Neighbourhood ‘poor’ density was measured by area-level measures of income: for the UK, neighbourhood income ranks from the index of multiple deprivation; for subset of 7,288 mothers in England, raw neighbourhood income scores. Analyses were stratified by poor (<£10,400) and non-poor households. Age, marital status, parity, urban status, and duration at address were controlled for. Further models additionally adjusted for occupation and education.

Results: For poor mothers, odds for LBW and LLI increased for every decile of area income, by 9% and 8%. For non-poor mothers – odds decreased 6% and 5% (LLI non-sig.). In the subset analysis, for poor mothers, the area income relationship with LLI and LBW remained positive but LBW lost significance. Self-rated health did not vary significantly for poor mothers. For non-poor mothers, better self-rated health was associated in richer areas. Odds of preterm delivery decreased for poor mothers by 7% per decile, but this was not significant in further models. No preterm delivery models were significant for non-poor mothers.

Conclusion: Except preterm delivery, the health of non-poor mothers improve when living in richer areas. This is not the case for poor mothers, who do not have better self-rated health and have worse odds for LBW and LLI in richer areas.

These findings support a psycho-social explanation mediated by neighbourhood socio-economic density. Understanding the underlying mechanisms require input across biological, psychological and sociological fields. Through collaboration, intermediate pathways such as social engagement and socio-relational stress could be more effectively tested.

Knowledge of HIV among multidisciplinary community-clinic workers in Chile: Disparities by occupational risk and educational level

Baltica Cabieses [1], Lilian Ferrer [2], Kathleen Norr [3], Helena Tunstall [4], Kate E. Pickett [1] & Christo Albor [1]

bbcv500@york.ac.uk. 1Department of Health Sciences, University of York, UK; 2School of Nursing, Pontificia Universidad Católica, Chile; 3College of Nursing, University of Illinois, Chicago, US.

Background: HIV is a growing health problem in Chile and no particular prevention strategy has been targeted to multidisciplinary primary-care setting.

Aim: To analyse the level of knowledge of HIV by occupational risk and educational level of community-clinic workers in Chile.

Methods: Cross-sectional survey of 720 community-clinic workers in Santiago.

Outcome: Knowledge of HIV; Educational level.

Exposures: Occupational risk of HIV

Controls: age, marital status and religion.

Descriptive analysis was conducted through proportions/averages estimation and association analysis through Chi-square tests and logistic regression.

Results: Community-clinic workers showed significant differences in knowledge of HIV by educational level (p<0.001), with a higher level of knowledge among those with higher levels of education (OR=2.5, 95% CI=1.7-3.4).

When stratifying knowledge by occupational risk of HIV, 63.8% of those at risk showed an adequate level of knowledge, in contrast to 36.1% of those not at risk (OR=3.3, 95%CI=2.2-5.0, p<0.0001). However, within the group occupationally at risk, most dental/health care assistants and cleaners reported an inadequate level of knowledge, while most in professional occupations had adequate level (p<0.0001).

Discussion: Level of knowledge of HIV among community-clinic workers in Chile varied significantly. Community-clinic workers educated up to high-school level and with occupational risk of HIV should be urgently trained to increase their knowledge and reduce their potential risk.

Conclusions: The interpretation and application of our findings would benefit from inter-disciplinary collaboration. They provide further understanding of the reasons for the disparity in HIV knowledge across occupations. However, determining practical and effective educational strategies still require a deeper assessment of other socio-political and economic dimensions.

Lebanese Adolescents Post-War: the relation between war experience, resiliency, emotional intelligence and personality factors

Rana Tayara

rt526@york.ac.uk. Department of Psychology, University of York

Background: Lebanon has been experiencing conflicts (internal and external) since 1960, and Lebanese from all regions have been affected by them through either exposure to shelling or combat, displacement, bereavement, emigration, separation from parents, or by being witness or even victims of violent acts (Macksoud & Aber, 1996).

Aim of the Study: The literature studying Lebanese adolescents’ psychological, social and emotional well-being is minimal or limited to one region. Therefore, the purpose of this study is to examine the relation between exposure to war violence and emotional intelligence, personality and resiliency among Lebanese adolescents from the South of Lebanon an area that has been mostly affected by the July 2006 war due to its borders with Israel.

Methods: The participants comprised an opportunity sample of 137 middle school students from South Lebanon that have been directly affected by the Lebanese-Israeli war in 2006. The pupils were aged between 13 to 18-years old from grades 8 to 12 (mean age= 15.37 years; SD=1.24). Students were asked to complete 5 scales, the BarOn Emotional Quotient Inventory: YV (Bar-On & Parker, 2000), the Resiliency Scales for Children and Adolescents (Prince-Embury, 2008), the Big Five Inventory (John & Srivastava, 1999), the Trauma Screening Questionnaire (Brewin, Rose, Andrews, Green, Tata, McEvedy, Turner & Foa, 2002) and a Demographic Survey. All scales were translated into Arabic and back translated.

Results: On a sample of 137 Lebanese adolescents, 93.6% of the adolescents were exposed to shelling during the July war 2006, 12.5% were exposed to combat, 61.8 % experienced displacement, 5.9% experienced bereavement, 12.5% were separated from their parents, 3.7% were injured and 4.4% carried weapons. Resiliency negatively correlated with place of living during the war and the neuroticism scale on the BFI (r = -.195 and r = -.331, p<.01 respectively). Resiliency positively correlated with the Conscientiousness Scale on the BFI, r = .255, p<.01. Trauma Screening Questionnaire positively correlated strongest with shelling and separation from parents r = .279 and .178 with p<.01 respectively. Scores on the TSQ negatively correlated with religious affiliation, r = -.256, p<.01. In contrast with our hypothesis, emotional intelligence did not correlate with resiliency, trauma or war experiences.

Discussion: The current study evaluated hypotheses about the relationship between resiliency, personality and emotional intelligence to war experiences. Results were consistent with the study hypotheses in that the above mentioned moderators demonstrated a meaningful relationship with war experience and also between themselves as resiliency correlated highly with scales on the BFI and the TSQ as also reported by Sibai, Tohme, Beydoun, Kanaan, Sibai (2008) and Kashdan, Julian, Merritt & Uswatte (2005). Student who were living in a highly affected war zone scored higher on the resiliency scale showing that experience of stress due to war in some cases increase resistance to more minor stresses such as the stress that comes with being socially accepted at school (Rutter, 1985).

In contrast with our hypotheses, emotional intelligence did not correlate with resiliency, trauma or war experiences. Different areas in Lebanon have been affected differently by the war and therefore in our future study we are looking at comparing between those areas.

Conclusion: The aim of the current study was to examine the relation between war experience and moderators such as emotional intelligence, personality factors and resiliency in a sample of 137 Lebanese adolescents from the South of Lebanon that have been affected by the July 2006 war. Although a strong relation has been found between resiliency, trauma and place of residence during the war including experiencing shelling and combat and being separated from care takers further research is needed on a wider geographical scale.

References:

BarOn, R., & Parker, J. (2000). BarOn Emotional Inventory: Youth version. Multi-Health Inc. Canada.

Brewin, C., Rose, S., Andrews, B., Green, J., Tata, P., McEvedy, C., Turner, S. & Foa, E. (2002) Brief Screening Instrument for Post-traumatic Stress Disorder. British Journal of Psychiatry 181, 158-162.

John, O. P., & Srivastava, S. (1999). The Big Five trait taxonomy: History, measurement, and theoretical perspectives. In L. A. Pervin & O. P. John (Eds.), Handbook of personality: Theory and research (2nd ed., pp. 102-138). New York: Guilford.

Kashdan, T. B., Julian, T., Merritt, K., & Uswatte, G. (2005). Social anxiety and posttraumatic stress in combat veterans: relations to well-being and human strengths. Behavior Research and Therapy. Behaviour Research and Therapy, 44(4), 561-583.

Macksoud, M. S. & Aber, J. L. (1996). The war experience and psychosocial development of children in Lebanon. Child Development, 67, 70-88.

Prince-Embury, S. (2008). The Resiliency Scales for Children and Adolescents, Psychological Symptoms and Clinical Status in Adolescents. The Canadian Journal of School Psychology. 23(1), 41-56.

Rutter M. (1985). Resilience in the face of adversity. Protective factors and resistance to psychiatric disorder. British Journal of Psychiatry, 147, 598–611.

Sibai T., Tohme R. A., Beydoun H. A., Kanaan N., & Sibai A. M. (2008). Violent behavior among adolescents in post-war Lebanon: the role of personal factors and correlation with other problem behaviors. Journal of Public Health, 1, 39-46.

An exploration of the barriers to friendship formation for adults with learning disabilities who have low support needs.

Gillian Allan

gja500@york.ac.uk. Social Policy and Social Work

Background: Although often neglected in policy and practice, the question of the friendships and social networks of people with learning disabilities has received increasing interest amongst researchers over the past two decades (See e.g. Myers et.al 1998; McConkey 2007). Reasons for this include the fact that social networks, composed of a rich variety of relationships, have been found to be lacking in the lives of people with learning disabilities and therefore may be seen as a vital component of social inclusion strategies (Carnaby 1998; Leyin 2008).

Aim: The present study seeks (a) to explore the meaning of friendship to people with learning disabilities and the functions provided by their social networks (b) to discover the friendship aspirations of participants alongside a discussion of potential barriers and (c) to consider the role of social policy in helping people to overcome these barriers.

Method: An approach rooted in the principles of participatory research will be adopted.

Aim of Presentation: As the PhD is in the early stages (coming to the end of the first year), it is proposed to present the research topic and literature review. It is hoped that this presentation will not only be of interest to those working in social policy or social work but also to those interested in other areas as the question of friendship raises both sociological issues and has implications for health and wellbeing.

References:

Carnaby, S. (1998) Reflections on social integration for people with intellectual disability: Does interdependence have a role? Journal of Intellectual and developmental disability Vol 23; 3 pp219-228

Leyin (2008) Social Inclusion: Ten Years On Learning Disability Review Vol 13; 1 pp10- 17

Myers, F., Ager, K., Kerr, P. & Myles, S. (1998) Outside looking in? Studies of the community integration of people with learning disabilities. Disability and Society Vol 13 pp389-413

McConkey, R (2007) Variations in the social inclusion of people with intellectual disabilities in supported living schemes and residential settings Journal of Intellectual Disability Research, vol 51; 3, pp207-217

Critical Moments in and Case Histories of Marginalised Young People’s Lives

Aniela Wenham* and Hannah King§

*amw128@york.ac.uk, §hkk501@york.ac.uk. Social Policy and Social Work, University of York

Qualitative longitudinal research (QLR) has been described as an emerging and innovative methodology particularly adept to explore the complex multifaceted nature of young people’s lives. This approach has been found to be useful within the area of youth studies, with research focusing upon identity construction, youth transitions and critical moments. Exploring the potential of a holistic biographical approach, this paper draws upon the doctoral research of two students within the area of youth studies, which utilise its principles. Drawing on and further developing the Inventing Adulthoods study (Henderson et al 2006), the theses explore the role of ‘critical moments’ through time in defining and impacting upon young people and their life chances. Firstly, an example of research into the experiences of educationally excluded young people will highlight the use and value of this methodology. Secondly, a case history of a young mother from research into experiences of teenage pregnancy and motherhood will be drawn upon to demonstrate the complexity of this issue, especially with regard developments through time and how an individual narrative can unfold. The QLR approach allows diachronic and synchronic analysis, providing time and texture to the research. The value of focusing upon processes rather than simply outcomes can also help inform more receptive policy approaches. Being able to grasp the significance of events, and ascertain the causes and processes through time which lead to change and/or particular outcomes are integral if policy is to correspond to the needs of service users. Such depth and detail is often overlooked within the mainstream which potentially can result in a limited understanding of complex social issues. As the on-going doctoral research will highlight, QLR should be viewed as a distinctive methodological approach that can provide unique and valuable insights into the processes attached to complex social phenomena.

References:

Henderson, S., Holland, J., McGrellis, S., Sharpe, S. and Thomson, R., (2006) Inventing Adulthoods: A Biographical Approach to Youth Transitions, Sage: London

Paying for poster printing

Poster printing will be covered by ARRC, provided that the size is A1. If posters are larger, the difference should be paid by presenters or their research funding. Poster presenters: please email your posters to arrc-conference@events.york.ac.uk. Deadlines for poster submission for printing will be poster here shortly.

We are currently negotiating with ARRC and a couple of printing services to find the best deal for printing posters for conference participants, and to see how much ARRC can subsidise. If you are presenting a poster in the conference, and have not yet printed your poster, please hold back until we have confirmed any subsidy.

Wordles of the abstracts

Above is a wordle of all the abstracts that were submitted for the conference. A wordle is a visual representation of the frequency of words in any document. The larger the words on the wordle, the more they have been used. To create these, I took all text from abstracts, removed names and contact details, copied all, then pasted into www.wordle.net. Click on the title of this post to see more wordles.

Posters

1) Last call for posters: Deadline 17th June

email: arrc-conference@events.york.ac.uk

2) ARRC Skills training: Designing a Conference Poster

19th June 1.30-16.30 followed by lunch, ARRC Auditorium

Booking: email Karen Bloor (keb3@york.ac.uk) by noon on 15^th June to book

Please include any dietary or other special requirements and whether you are a student (if so on which programme) or member of research staff.

Synopsis: This course will include information on why to submit a conference poster, how to design it, what kind of information to include and how best to present it.  This is not software based training, although there will be hints and tips on programs you can use, but more aimed at content and design of posters, and how to make the best of your research using this particular form. ARRC conference poster presenters will have priority over the 30 places.

Keynote speaker

Dr Roberto De Vogli

Lecturer in Global Heath and Social Epidemiology, UCL

Roberto De Vogli is a member of the Globalization and Health Knowledge Network of the WHO Commission on Social Determinants of Health. He has worked for the World Bank, the WHO, and the Mexican Institute of Public Health.

He will talk about globalization and health, review the evidence and the views, and offer his opinion on how to make our world healthier.

Registration

Free Registration: Deadline 14th July

Click here to go to the online registration page

Why attend?

• Registration, lunch and refreshments are free.

• Meet researchers early in their careers, across a wide spread of disciplines.

• Help build a more fluid research community within the ARRC collaboration of social sciences, health sciences, politics, economics, etc.

Clarification

It has come to our attention that several people have been confused regarding the nature of research that would be relevant to the conference. You do not have to be working in health-related sciences. We would like talks on research from any of the following disciplines: health science, social science, economics, political science, psychology, educational science, social policy, or any discipline allied to the wide-ranging Alcuin Research Resource Centre (ARRC).

However, we would like presenters to bear in mind the central theme: Cross-disciplinary research. We do not expect for each of the presenters to work across disciplines, but we do want to hear how you think your research could inform academics in other fields, and what possibilities there could be for collaborative work.

The deadline is on Friday 5th June. Even if you could send a very short abstract that you plan to update at a later date, that would be fine. Email abstracts to arrc-conference@events.york.ac.uk. We would like to know exactly who would be presenting by next week on Thursday, 11th June. The conference itself will take place on Tuesday, 21st July.

Call for Abstracts

Cross-disciplinary Conference for Postgraduate and Early Career Researchers in Health or Social Sciences

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Abstracts should reach us by 5^th of June and we will let you know if you have been chosen to present by 11^th of June.

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This one day conference will bring together postgraduate and early career researchers from across the health and social sciences and provide them with the opportunity to:

• present their own research and get constructive feedback
• meet researchers from other social science disciplines
• learn more about developing an academic career

The conference is organised by ARRC, a group which encourages interdisciplinary research and collaboration within the health and social sciences. We are inviting papers and posters from researchers whose work will have relevance across the health and social science disciplines. This could be in terms of methodology, topic or theoretical approach. Researchers and postgraduates at all stages of their research are welcome. We do not expect all abstracts to be about completed research, they can also reflect on work in progress.  There will be a prize for the best paper.

If you would like to present a paper or display a poster at this event please email a short abstract (300 words) to arrc-conference@events.york.ac.uk . The research can be on any topic but you must explain why it has interdisciplinary relevance across the health or social sciences. Papers should reach us by 5^th of June and we will let you know if you have been chosen to present by 11^th of June. Please include your name and university department with your abstract. If you are a student please include your year of study.

The conference is free to attend and lunch and refreshments are provided. There are some limited funds available towards travel costs for those who are presenting papers. It will be held in the ARRC building in the University of York.