Lived experience of gay men caring for others with HIV/AIDS : living, loving and dying in the era of HIV/AIDS

This thesis explored gay male carers’ experience of caring for their partner, brother or friend who had HIV/AIDS. Through using phenomenological methodology (van Manen, 1990), the day-to-day caring experiences were uncovered. The data gathered were then analysed through a nursing ‘lens’, with the concept of stigma as an anchoring point. The dual stigmas of homophobia and AIDS phobia impacted on the daily lives of these men as they cared for their loved one. The research identified six themes. These were: 1) the relationship; 2) coping with HIV and AIDS; 3) the corporal impact of HIV/AIDS; 4) experiences of carers including the absence of others; 5) living daily with the virus: Demands of people living with HIV/AIDS (PLWHA); and 6) saying goodbye, but wanting to keep the memory alive. The caring these men undertook, for which they were frequently unprepared, was intensive and complex, but because of their commitment and love they battled on. Because of a sense of shame associated with AIDS phobia on the part of the PLWHA, the carer often had to undertake this care in isolation, without support from family, friends or home health care agencies. The carers struggled with not only the demands of day-to-day care, but also with non-acceptance from family, both of the nature of the relationship with their partner and of their homosexuality. Family members were forced, often with great difficulty, to acknowledge the close commitment the men had to each other. Recognition that one had a terminal disease, HIV/AIDS was also required. The fear of potential transmission was high among carers, friends and family members. Notably, there was an absence of blame on the part of the carer towards his partner for contracting HIV/AIDS. The physical decline and marking of the body further stigmatised the PLWHA, which added to carers’ burdens. They endeavoured to minimise the physical decline in their partner, so he could continue to pass as healthy, and attempted to make the day-to-day living as normal as possible. The methods of combating weight loss and opportunistic infections meant frequent medical appointments, complex intensive medical procedures and help with personal care, which was undertaken at home largely without support from health care staff. Carers frequently struggled also with their partner’s denial of being ill. One strategy all carers used was to escape with their partners from their everyday life in Melbourne and attempt metaphorically to leave the HIV/AIDS behind; this was a time when they could rekindle their life together as it was before HIV/AIDS came into their lives. Some carers chose to holiday without their partner, to give themselves a break from the day-to-day caring, while others planned and took holidays with their partner. The decline of the health in the PLWHA meant that family members had to recognise and accept both the nature of the relationship and the presence of the disease. This recognition and acceptance often came only when the partner was very ill, even at the point of dying. Carers and their partners discussed the potential use of euthanasia, as a means of ending the final phase of life with some dignity. One carer and his partner used euthanasia, despite its illegal status. The main concern for all carers was providing comfort and a reduction in the pain associated with HIV/AIDS for the partner. The widespread grief associated with HIV/AIDS was evident amongst these carers. All had known other gay men who had died, some carers own partner had died, or was about to die. There was an overwhelming sense of grief, which at times was repressed as a means of coping day-to-day. All carers felt it was important and necessary to remember those lost to HIV/AIDS through the various public memorials, as they did not want their partner to be just another faceless person lost to this disease. This phenomenological study of carers’ experience highlights the need for health care workers to be aware of the differing strategies that gay men use to cope with HIV/AIDS. While it may seem that the carers are coping with care of their partner, the outer façade is not always an accurate portrayal of the true situation. Health care workers should enquire as to the assistance these carers need from health care services in order to continue to care for their loved one. Such assistance can be the simple recognition of the partner and acceptance of them as part of the PLWHA’s network; this inclusion and acceptance is half the battle.

English and its others : towards an ethics of transculturation

The article focuses on the significant role of English subject in the quality education. It states that a dialogical ethics might play in English education today as an alternative to the latest forms of political moralism in schooling the other. It highlights the need for a shift from the contradictory moralism of empowerment to a dialogical ethics of teaching and learning English language and literarcy for students and teachers to obtain a critical distance from their cultural bearings.

Understanding why cancer survivors help others

The research for the thesis examined cancer survivors' reasons for providing peer support to cancer patients, and the impact of this type of helping behaviour has on cancer survivors' quality of life. Results revealed six prominent reasons for providing peer support, and that helping others did not increase survivors' already high quality of life. The portfolio presents the content, facilitator perceptions, participant evaluations and outcomes of four group programs which targeted specific groups of participants.

Why do some socioeconomically disadvantaged women eat better than others? An investigation of the personal, social and environmental correlates of fruit and vegetable consumption

The purpose of this paper was to examine the contribution of individual, social and environmental factors to predicting fruit and vegetable consumption among women of low socioeconomic position (SEP). An Australian community sample of 355 women of low SEP provided survey data on sociodemographic information, diet (fruit and vegetable consumption), and various cognitive, behavioural, social and perceived environmental influences on healthy eating. Information on the availability and accessibility of major chain supermarkets and fruit and vegetable stores from participant's residence was collected through objective audits. Women who were older, dieting to lose weight, had a greater taste preference for fruit and perceived the cost of fruit to be lower were more likely to be high fruit consumers. Women who had a high BMI were more likely to be high vegetable consumers. Women who perceived a greater availability of healthy foods in their neighbourhoods were more likely to be high fruit and vegetable consumers. Strategies aimed at increasing fruit and vegetable consumption among low SEP women should focus on modifying perceptions about the cost, availability and taste of fruits and vegetables. Tailoring nutrition interventions to accommodate differences in age, weight-control practices and weight status may also prove beneficial.

Current empirical assessment methods for adolescents and children who sexually abuse others

The assessment of adolescents and children who commit sexually abusive behavior is a complex and challenging task. Incorporating empirically based assessment methods into psychosexual evaluations promises appropriate coverage of relevant domains, sound interpretation of the meaning of data, reduced clinician biases and error, and greater certainty in decision-making. In this paper we review empirically-based assessment methods currently available for use in psychosexual assessment of adolescents and children who sexually abuse others. Our review describes the robustness of these measures and provides guidance for their appropriate use in assessment. The review highlighted that several empirically-based measures are suitable for clinical use with adolescents, but very little is available to guide assessment of children's abusive behavior per se.

The role of science education in reducing violence towards others

This thesis explored how science education could contribute to the amelioration of violent behaviours in schools. Findings show that a shift in the way we relate with nature and animals could contribute to change the attitudes of children who, at the age of nine years, are already presenting aggressive behaviours.

Consumer motivation in a tourism context : continuing the work of Maslow, Rokeach, Vroom, Deci, Haley and others

This paper examines the literature on understanding and measuring consumer motivation and the application of these theories and procedures to understanding and researching tourist motivation. The application of consumer motivation theory to tourism is considered especially relevant, because motivation is considered a critical variable in the tourist decision-making process.

When understanding and predicting consumer and tourist behaviour, some measures are considered superior to others and this will be examined in this paper. Also many measures of motivation are often used as one of the segmentation bases for tourist and other consumer markets, thereby indicating a strong relationship between motivation and market segmentation, also to be discussed in this paper.

The purpose of this study is threefold: (1) to investigate what standards or consensus for determining consumer motivation have emerged in the academic marketing literature, (2) to review the theoretical knowledge about approaches and procedures for determining and measuring consumer motivation in general and their application to understanding tourist motivation (3) to suggest implications for future research of consumer motivation in a tourism context.

Why are some people with neurological illness more resilient than others?

The current qualitative study was designed to evaluate the coping strategies of people living with a chronic progressive neurological illness and their carers. The neurological illnesses were Huntington’s disease, motor neurone disease, multiple sclerosis and Parkinson’s disease. Participants included 15 people who showed high levels of adjustment and 15 who showed low levels of adjustment. Participants were selected from an earlier study, to ensure that they satisfied the inclusion criteria for the current study. Interviews were completed to determine the strategies used to cope with the demands of the illness. Participants who demonstrated good adjustment were more likely to draw on social support to provide them with the resources to deal with the illness. In contrast, those who evidenced poor adjustment were more likely to draw on external supports to complete tasks for them. The implications of these findings for people with chronic neurological illnesses and their families are discussed.

Negotiating agents that learn about others’ preferences

In multiagent systems, an agent does not usually have complete information about the preferences and decision making processes of other agents. This might prevent the agents from making coordinated choices, purely due to their ignorance of what others want. This paper describes the integration of a learning module into a communication-intensive negotiating agent architecture. The learning module gives the agents the ability to learn about other agents’ preferences via past interactions. Over time, the agents can incrementally update their models of other agents’ preferences and use them to make better coordinated decisions. Combining both communication and learning, as two complement knowledge acquisition methods, helps to reduce the amount of communication needed on average, and is justified in situation where communication is computationally costly or simply not desirable (e.g. to preserve the individual privacy).

Helping others or a rewarding career? Investigating student motivations to train as social workers in England

• Summary: Understanding why people want to be social workers is important both for developing social work education and for the profession as a whole. This article presents evidence about the motivations of students enrolled on social work degree programmes in England and draws on data from 3000 responses of three successive intakes of students responding to six online surveys and 26 focus group interviews involving 168 students from nine different social work programmes in six case study sites. The article locates these data in the context of earlier studies of social workers’ motivations, the changing policy context and the changes introduced by the new degree.

• Findings: Similar to previous studies, the current analysis shows that altruistic motivations dominated, but students were also influenced by career issues and the day-to-day aspects of social work. The data highlight continuities with the former qualification in social work in the UK (the DipSW) and provide evidence that the introduction of the social work degree has not dramatically changed the underlying motivations of social work students.

• Applications: Understanding student motivations is important in terms of recruitment to social work qualifying programmes and subsequent retention within the profession. Social work educators and employers need to pay attention to the consequences of mismatches between motivations and expectations about what professional practice involves.