Care, disability and HIV in Africa: diverging or interconnected concepts and practices?

Recent research and policy have recognised the central role of unpaid care-givers (often women and girls) in the global South. Disability rights perspectives, however, challenge the language of ‘care’ and ‘dependence’. Drawing on qualitative research with women living with HIV and children caring for them in Tanzania, and on learning from the National Community of Women Living with HIV and AIDS in Uganda (NACWOLA), this paper explores the divergences and interconnections between the concepts and practices of care, disability and HIV in the context of East Africa. Despite the development of interdependent caring relations, both care-givers and people living with HIV in Tanzania experience ‘diminished autonomy’. The participation of people living with HIV, including disabled people, in home-based care and in peer support groups, however, can enhance ‘relational autonomy’ for both care-givers and care-recipients. We reflect on opportunities and challenges for mutual learning and cross-movement advocacy by disabled people, people living with HIV and care-givers.

Marketing the Damaged Self: The Construction of Identity in Advertisements Directed Towards People with HIV/AIDS

This paper explores the identities projected in advertisements directed towards HIV positive individuals and people with AIDS. Fifty such advertisements were collected from three popular American magazines for gay men over a period of seven months. Analysis of the ads reveals a paradoxical presentation of people with HIV/AIDS, which offers simultaneous conflicting images of hope and fear, power and weakness, innocence and guilt. An interactive sociolinguistic model through which this contradictory discourse might be understood is presented, drawing on Goffman’s insights on stigma management and the presentation of the self in social interaction. Advertisements directed towards people with HIV/AIDS, it is suggested, present a contradictory discourse in which the advertisers are positioned as ‘the wise’, offering to mediate the conflicting identities of the stigmatized. The identity values enacted in this contradictory discourse are further measured against American conceptions of communication and the self as observed by Carbaugh and others. The possible consequences of these positionings on the roles made available to people with HIV/AIDS in the wider social context are discussed.

Two Faces of AIDS in Hong Kong: Culture and the Construction of the `AIDS Celebrity'

Since the first reported case of HIV infection in Hong Kong in 1985, only two HIV-positive individuals in the territory have voluntarily made public their seropositivity: a British dentist named Mike Sinclair, who disclosed his condition to the media in 1992 and died in 1995, and J.J. Chan, a local Chinese disc-jockey, who came forward in 1995 and died just a few months later. When they made their revelations, both became instant media personalities and were invited by the Hong Kong Government to act as spokespeople for AIDS awareness and prevention. Mike Sinclair worked as an education officer for the Hong Kong AIDS Foundation, and J.J. Chan appeared in Government television commercials about AIDS. This article explores how the public identities of these two figures were constructed in the cultural context of Hong Kong where both Eastern and Western values exist side by side and interact. It argues that the construction of `AIDS celebrities' is a kind of `identity project' negotiated among the players involved: the media, the Government, the public, and the person with AIDS (PWA) himself, each bringing to the construction their own `theories' regarding the self and communication. When the players in the construction hold shared assumptions about the nature of the self and the role of communication in enacting it, harmonious discourses arise, but when cultural models among the players differ, contradictory or ambiguous constructions result. The effect of culture on the way `AIDS celebrities' are constructed has implications for the way societies view the issue of AIDS and treat those who have it. It also helps reveal possible sites of difficulty when individuals of different cultures communicate about the issue.

Imagining migration: Placing children's understanding of 'moving house' in Malawi and Lesotho

Research pertaining to children's geographies has mainly focused on children's physical experiences of space, with their 'imagined geographies' receiving far less attention. The few studies of children's imagined geographies that exist tend to focus on children's national identities and their understanding of distant places. However, children's lives are not necessarily static and they often move between places. Research has not so far considered children's images of these transitional spaces or how such images are constructed. Through an examination of over 800 thematic drawings and stories, regarding 'moving house, produced by children aged 10-17 years in urban and rural communities of Lesotho and Malawi, this paper explores southern African children's representations of migration. The research considers how ideas of migration are culturally-constructed based on notions of family, home and kinship, particularly in relation to the fluid family structure characteristic of most southern African societies. The results suggest that most children imagine migration as a household rather than an individual process.. rarely including micro -migrations between extended family households in their drawings. Further, children's images of migration are place-rooted in everyday life experiences. Their representations concentrate on the reasons for migration, both negative and positive, which are specifically related to their local social and environmental situations and whether house moves take place locally or over longer distances. The paper concludes by exploring the implications of these conceptualisations of moving house for children's contemporary migration experiences, particularly in light of changing family structures due to the effects of the HIV/AIDS pandernic. (c) 2005 Elsevier Ltd. All rights reserved

Young caregivers in the context of the HIV/AIDS pandemic in sub-Saharan Africa

Against a background of rising adult mortality and morbidity in the context of the HIV/AIDS pandemic in sub-Saharan Africa, this paper provides both quantitative and qualitative evidence for the existence of a largely neglected group of young people with increased responsibility for caregiving. Using questionnaire surveys, focus groups, storyboards and in-depth interviews in three studies across Southern and Eastern Africa some young people in Lesotho, Tanzania and Zimbabwe are found to devote considerable time and energy to caring for sick members of their households. Examination of the tasks carried out by these youngsters finds them to be burdened beyond usual familial and societal expectations of children's 'normal' contributions to the reproduction of households via domestic chores and suchlike. It is concluded that these young people can be described as 'young carers'. The three studies are presented to illuminate different sociospatial aspects of caregiving by young people. First, using qualitative data from Lesotho the range of caring tasks young caregivers; perform for care recipients - usually a grandmother, parent, or sibling - is identified. Second, the impact caregiving responsibilities have on children's primary school attendance is examined using survey data from Tanzania. Third, the wider negative and positive impacts of caregiving including loss of friends and gaining of emotional maturity for young carers and their households is explored with in-depth individual interviews from Zimbabwe. Finally, suggestions are made for further research to deepen understanding of the geographies of caring within the context of the population geographies of the HIV/AIDS pandemic in sub-Saharan Africa and beyond. Copyright (c) 2006 John Wiley & Sons, Ltd.

Imagining migration: Placing children's understanding of 'moving house' in Malawi and Lesotho

Research pertaining to children's geographies has mainly focused on children's physical experiences of space, with their 'imagined geographies' receiving far less attention. The few studies of children's imagined geographies that exist tend to focus on children's national identities and their understanding of distant places. However, children's lives are not necessarily static and they often move between places. Research has not so far considered children's images of these transitional spaces or how such images are constructed. Through an examination of over 800 thematic drawings and stories, regarding 'moving house, produced by children aged 10-17 years in urban and rural communities of Lesotho and Malawi, this paper explores southern African children's representations of migration. The research considers how ideas of migration are culturally-constructed based on notions of family, home and kinship, particularly in relation to the fluid family structure characteristic of most southern African societies. The results suggest that most children imagine migration as a household rather than an individual process.. rarely including micro -migrations between extended family households in their drawings. Further, children's images of migration are place-rooted in everyday life experiences. Their representations concentrate on the reasons for migration, both negative and positive, which are specifically related to their local social and environmental situations and whether house moves take place locally or over longer distances. The paper concludes by exploring the implications of these conceptualisations of moving house for children's contemporary migration experiences, particularly in light of changing family structures due to the effects of the HIV/AIDS pandernic. (c) 2005 Elsevier Ltd. All rights reserved

Poverty, HIV, and barriers to education: street children's experiences in Tanzania

This article discusses the links between poverty, HIV/AIDS, and barriers to education, based on the first-hand experiences of ‘street children’ in northern Tanzania. Within the context of national levels of poverty, ‘cost-sharing’ in health and education sectors, and the AIDS epidemic, poor families in Tanzania are under considerable pressure, and increasing numbers of girls and boys are consequently seeking a living independently on the streets of towns and cities. My research with street children shows that some children orphaned by AIDS are subject to rejection and exploitation by the extended family after the death of their parent(s). They are exposed to considerable risks of abuse, sexual violence and HIV within the street environment. Here, I discuss the links between poverty, HIV and barriers to education, which compound young people’s vulnerability, and offer some policy recommendations in response to the young people’s experiences.

HIV-related stigma, asset inheritance and chronic poverty: vulnerability and resilience of widows and caregiving children and youth in Tanzania and Uganda

This paper develops a framework of risk and protective factors to conceptualise the relationship between HIV-related stigma, asset inheritance and chronic poverty among widows and caregiving children and youth in eastern Africa. Analysis of two qualitative studies with 85 participants in rural and urban areas of Tanzania and Uganda reveals that gendered and generational inequalities and stigmatisation sometimes led to property grabbing and chronic poverty. Human and social capital and preventative measures however may help widows and caregiving young people in HIV-affected households to safeguard land and other assets, within a wider supportive environment that seeks to tackle structural inequalities.

Changing Standards? Children's awareness and knowledge of features of written standard English at ages 10-11

This paper reports the findings of a small-scale research project, which investigated the levels of awareness and knowledge of written standard English of 10- and 11-year-old children in two English primary schools over a six-year period, coinciding with the implementation in the schools of the National Literacy Strategy (NLS). A questionnaire was used to provide quantitative and qualitative data relating to: features of writing which were recognised as standard or non-standard; children's understanding of technical terminology; variations between boys' and girls' performance; and the impact of the NLS over time. The findings reveal variations in levels of recognition of different non-standard features, differences between girls' and boys' recognition, possible examples of language change, but no evidence of a positive impact of the NLS. The implications of these findings are discussed both in terms of changes in educational standards and changes to standard English.

Potential roles and clinical utility of prebiotics in newborns, infants, and children: proceedings from a global prebiotic summit meeting, New York City, June 27-28, 2008

Initial bacterial colonization, including colonization with health-positive bacteria, such as bifidobacteria and lactobacilli, is necessary for the normal development of intestinal innate and adaptive immune defenses. The predominance of beneficial bacteria in the gut microflora of breast-fed infants is thought to be, at least in part, supported by the metabolism of the complex mixture of oligosaccharides present in human breast milk, and a more adult-type intestinal microbiota is found in formula-fed infants. Inadequate gut colonization, dysbiosis, may lead to an increased risk of infectious, allergic, and autoimmune disorders later in life. The addition of appropriate amounts of selected prebiotics to infant formulas can enhance the growth of bifidobacteria or lactobacilli in the colonic microbiota and, thereby, might produce beneficial effects. Among the substrates considered as prebiotics are the oligosaccharides inulin, fructo-oligosaccharides, galacto-oligosaccharides, and lactulose. There are some reports that such prebiotics have beneficial effects on various markers of health. For example, primary prevention trials in infants have provided promising data on prevention of infections and atopic dermatitis. Additional well-designed prospective clinical trials and mechanistic studies are needed to advance knowledge further in this promising field. (J Pediatr 2009;155:S61-70).

Children's representation of family mealtime in the context of maternal eating disorders

Background Recent research provides evidence for specific disturbance in feeding and growth in children of mothers with eating disorders. Aim To investigate the impact of maternal eating disorders during the post-natal year on the internal world of children, as expressed in children's representations of self and their mother in pretend mealtime play at 5 years of age. Methods Children of mothers with eating disorders (n = 33) and a comparison group (n = 24) were videotaped enacting a family mealtime in pretend play. Specific classes of children's play representations were coded blind to group membership. Univariate analyses compared the groups on representations of mother and self. Logistic regression explored factors predicting pretend play representations. Results Positive representations of the mother expressed as feeding, eating or body shape themes were more frequent in the index group. There were no other significant group differences in representations. In a logistic regression analysis, current maternal eating psychopathology was the principal predictor of these positive maternal representations. Marital criticism was associated with negative representations of the mother. Conclusions These findings suggest that maternal eating disorders may influence the development of a child's internal world, such that they are more preoccupied with maternal eating concerns. However, more extensive research on larger samples is required to replicate these preliminary findings.

Picture book exposure elicits positive visual preferences in toddlers

Although the relationship between "mere exposure" and attitude enhancement is well established in the adult domain, there has been little similar work with children. This article examines whether toddlers' visual attention toward pictures of foods can be enhanced by repeated visual exposure to pictures of foods in a parent-administered picture book. We describe three studies that explored the number and nature of exposures required to elicit positive visual preferences for stimuli and the extent to which induced preferences generalize to other similar items. Results show that positive preferences for stimuli are easily and reliably induced in children and, importantly, that this effect of exposure is not restricted to the exposed stimulus per se but also applies to new representations of the exposed item. (C) 2009 Elsevier Inc. All rights reserved.

Worry and problem-solving skills and beliefs in primary school children

Objective. To examine the association between worry and problem-solving skills and beliefs (confidence and perceived control) in primary school children. Method. Children (8–11 years) were screened using the Penn State Worry Questionnaire for Children. High (N ¼ 27) and low (N ¼ 30) scorers completed measures of anxiety, problem-solving skills (generating alternative solutions to problems, planfulness, and effectiveness of solutions) and problem-solving beliefs(confidence and perceived control). Results. High and low worry groups differed significantly on measures of anxiety and problem-solving beliefs (confidence and control) but not on problem-solving skills. Conclusions. Consistent with findings with adults, worry in children was associated with cognitive distortions, not skills deficits. Interventions for worried children may benefit froma focus on increasing positive problem-solving beliefs.