Effectiveness of Psycho-Educational Intervention in HIV Patients' Treatment

Adherence to Highly Active Antiretroviral Therapy (HAART) is the main prognostic factor associated with HIV disease progression and death. The aim was to evaluate the effectiveness of a psycho-educational program to promote adherence to HAART in HIV patients. A longitudinal study (n = 102) over 9 months in an Infectious Diseases Hospital was carried out. Adherence to HAART was measured with standardized scales and values of viral load. Two groups were defined: adherents and non-adherents. In the latter, a psycho-educational program was implemented and 6 months later measured adherence to HAART. Knowledge about the infection, CD4 T lymphocytes and HIV-ribonucleic acid values were measured before and after this program. The sample was predominantly male (70%), heterosexual (78%), with a mean age of 49 (SD = 12.7) years, and 48% of participants were not adhering to HAART. After the program, non-adherence decreased to 21.6%. Knowledge about the infection increased from 79 to 97%. A significant increase in CD4 T lymphocytes (mean 540-580) and a decrease in viral load (mean 5411-3052) were observed, the latter of statistical significance. This program seems to be feasible and efficient, improving adherence to HAART.

Associations prospectives entre l'environnement des repas en famille et le développement bio-psycho-social d'enfants d'âge scolaire

Contexte. Depuis quelques années, plusieurs études se sont intéressées aux effets protecteurs des repas en famille sur divers aspects du développement des enfants et des adolescents. Objectif. Identifier les associations prospectives entre l'environnement des repas en famille à 6 ans et le développement bio-psycho-social à 10 ans. Méthode. Les participants sont 1 085 filles et 1 138 garçons faisant partie de l'Étude Longitudinale du Développement des Enfants du Québec (ÉLDEQ), qui a sélectionné un échantillon aléatoire et stratifié en utilisant le registre des naissances du Québec. Dans ce devis prospectif-longitudinal, les parents ont fourni une mesure sur l'environnement de leurs repas en famille à l'âge de 6 ans. Quatre années plus tard, les parents ont également fourni des mesures sur le niveau de condition physique de leur enfant ainsi que sa fréquence de consommation de boissons gazeuses; les enseignants ont mesuré la réussite en lecture et en mathématiques; les enfants ont auto-rapporté leurs niveaux d’agressivité physique globale, d’opposition, du trouble du comportement non agressif et d’agressivité réactive. Des analyses de régressions multiples ont été réalisées. Résultats. Un environnement plus sain lors des repas en famille à 6 ans a prédit les bénéfices suivants à 10 ans : une augmentation de la condition physique (β = 0,24; 95 % intervalle de confiance [IC], 0,12 à 0,36) ainsi qu'une diminution de la consommation de boissons gazeuses (β = -0,43; 95 % IC, -0,62 à -0,23), de l'agressivité physique globale (β = -0,38; 95 % IC, -0,58 à -0,18), de l'opposition (β = -0,72; 95 % IC, -1 à -0,4), du trouble du comportement non agressif (β = -0,33; 95 % IC, -0,50 à -0,17) et de l'agressivité réactive (β = -0,70; 95 % IC, -0,98 à -0,42). Contrairement à nos attentes, l'environnement des repas en famille n'était pas significativement relié au rendement scolaire. Conclusion. Les repas familiaux ont une forte influence à long terme sur le développement de l'enfant, par rapport à sa santé physique et à son ajustement social. Par conséquent, ils pourraient nourrir une campagne informative intéressante qui porterait sur la promotion de la santé mentale et physique des jeunes à travers ce rituel social.

Associations prospectives entre l'environnement des repas en famille et le développement bio-psycho-social d'enfants d'âge scolaire

Contexte. Depuis quelques années, plusieurs études se sont intéressées aux effets protecteurs des repas en famille sur divers aspects du développement des enfants et des adolescents. Objectif. Identifier les associations prospectives entre l'environnement des repas en famille à 6 ans et le développement bio-psycho-social à 10 ans. Méthode. Les participants sont 1 085 filles et 1 138 garçons faisant partie de l'Étude Longitudinale du Développement des Enfants du Québec (ÉLDEQ), qui a sélectionné un échantillon aléatoire et stratifié en utilisant le registre des naissances du Québec. Dans ce devis prospectif-longitudinal, les parents ont fourni une mesure sur l'environnement de leurs repas en famille à l'âge de 6 ans. Quatre années plus tard, les parents ont également fourni des mesures sur le niveau de condition physique de leur enfant ainsi que sa fréquence de consommation de boissons gazeuses; les enseignants ont mesuré la réussite en lecture et en mathématiques; les enfants ont auto-rapporté leurs niveaux d’agressivité physique globale, d’opposition, du trouble du comportement non agressif et d’agressivité réactive. Des analyses de régressions multiples ont été réalisées. Résultats. Un environnement plus sain lors des repas en famille à 6 ans a prédit les bénéfices suivants à 10 ans : une augmentation de la condition physique (β = 0,24; 95 % intervalle de confiance [IC], 0,12 à 0,36) ainsi qu'une diminution de la consommation de boissons gazeuses (β = -0,43; 95 % IC, -0,62 à -0,23), de l'agressivité physique globale (β = -0,38; 95 % IC, -0,58 à -0,18), de l'opposition (β = -0,72; 95 % IC, -1 à -0,4), du trouble du comportement non agressif (β = -0,33; 95 % IC, -0,50 à -0,17) et de l'agressivité réactive (β = -0,70; 95 % IC, -0,98 à -0,42). Contrairement à nos attentes, l'environnement des repas en famille n'était pas significativement relié au rendement scolaire. Conclusion. Les repas familiaux ont une forte influence à long terme sur le développement de l'enfant, par rapport à sa santé physique et à son ajustement social. Par conséquent, ils pourraient nourrir une campagne informative intéressante qui porterait sur la promotion de la santé mentale et physique des jeunes à travers ce rituel social.

Von der Minderheit zur Mehrheit? Psycho-soziale Einflüsse bei der Verbreitung klima-schonender Innovationen

Vor dem Hintergrund des Klimawandels und weiterer Zukunftsherausforderungen stellt sich in drängenderem Maße die Frage, wie der Wandel zu einer nachhaltigen Gesellschaft gelingen kann. Im Zuge dessen rücken zunehmend solche Lösungsansätze in den Fokus, die an der Schnittstelle von technischen und sozialen Systemen nachhaltige und klimaschonende Innovationen entwickeln. Die vorliegende Dissertation beschäftigte sich in diesem Kontext mit der Frage, welche psychologischen und sozialen Faktoren und Mechanismen bei der individuellen Übernahme (Adoption) klimaschonender Innovationen von Bedeutung und für deren weitere Verbreitung (Diffusion) förderlich sind. Auf theoretischer und konzeptioneller Ebene wurden einerseits persönliche Eigenschaften von Adoptern wie der eigene Lebens- und Informationsverarbeitungsstil und andererseits die Charakteristika klimaschonender Innovationen und deren individuelle Wahrnehmung und Bewertung betrachtet und in einem umfassenden Modell integriert. Die Arbeit untersuchte zunächst mit Hilfe einer breit angelegten Fragebogenstudie (N = 778), wie weit die Innovationen Bezug von Ökostrom und Beteiligung an Bürger-Solaranlagen in verschiedenen sozialen Milieus bereits verbreitet waren und wie diese in milieuspezifischer Perspektive beurteilt und kommunikativ rezipiert wurden. Mittels Strukturgleichungsmodellierung wurde untersucht, inwiefern sich die Bewertungs- und Entscheidungsstrukturen von frühen und späteren Adoptern unterschieden. Es zeigten sich klare milieuspezifische Schwerpunkte: Personen aus dem postmateriellen und den hedonistischen Milieus bewerteten diese Innovationen positiver und waren häufiger unter den Adoptern zu finden als traditionelle und Mainstream-Milieus. Zudem deuteten die Ergebnisse auf eine stärker deliberativ ausgeprägte Entscheidungsstruktur bei frühen Adoptern hin – zumindest hinsichtlich des Bezugs von Ökostrom, der zum Zeitpunkt der Untersuchung bereits weiter verbreitet war als die Beteiligung an Bürger-Solaranlagen. In einer ergänzenden experimentellen Erhebung (N = 356) wurden die Teilnehmende zufällig einer von drei Untersuchungsbedingungen zugeordnet: In einem Informationstext über Smart Meter war eine (fingierte) entweder starke soziale Norm (Mehrheitsbedingung), eine schwache soziale Norm (Minderheitsbedingung) oder keine derartige soziale Information (Kontrollbedingung) enthalten. In einem nachfolgenden Test auf Wissenstransfer – als Indikator der Informationsverarbeitungstiefe – schnitten Personen mit geringerem Interesse an Smart Metern (also solche, die keine weiteren Informationen nachfragten) in der Mehrheitsbedingung am besten ab, wohingegen Personen mit größerem Interesse (fragten weitere Informationen nach) in der Minderheitsbedingung die beste Leistung erzielten. Auch diese Ergebnisse deuten auf unterschiedliche Informationsverarbeitungs- und Entscheidungsstrukturen je nach Wahrnehmung des bisherigen Verbreitungsgrads in Interaktion mit persönlichen Dispositionen hin. Aus den Ergebnissen lassen sich vielfältige Implikationen für ein verbessertes Marketing klimaschonender Innovationen, die umweltpolitische Praxis und für die weitere Forschung ableiten. Es wird empfohlen, bei der Kommunikation (z.B. im Rahmen zielgruppenspezifischer Kampagnen) soziale Normen und deren differentielle Wirkung auf die Verarbeitung innovationsbezogener Informationen gezielter zu nutzen. Da unter den aktuellen Rahmenbedingungen mit keiner hundertprozentigen Diffusion der betrachteten Innovationen in alle gesellschaftlichen Gruppen hinein zu rechnen ist, werden auf politischer Ebene neben „weichen“ politischen Instrumenten auch fiskalische oder ordnungsrechtliche Maßnahmen erforderlich sein. Schließlich erscheint es sinnvoll, sich in der weiteren Forschung stärker mit kommunikativen Prozessen wie beispielsweise Meinungsführerschaft oder dem Einfluss von Medienkampagnen und medialer Berichterstattung auseinander zu setzen.

In step

In Step was a wearable artwork consisting of a pair of embroidered foot bandages and an actuator ‘cushion’ embedded with 15 electromechanical actuator pistons. The bandage was embedded with woven, soft and flexible fabric sensors - interconnected with metallic connecting threads, fasteners and a wireless interface (in a final form). When wrapped around a foot and lower leg the sensors sat on the ball of the toes and heel. This ‘wearable interface’ was then connected wirelessly to a soft sculptural form, which employed actuators to tap gently in response to the qualities of the walk detected by the soft sensors. In this way the ‘tread qualities’ of the walker could then be felt by someone else holding this device against their stomach – thereby allowing pairs of participants to ‘feel’ the tactile qualities of the other's walk. The work was presented both as a working object and via a short videorecorded performance.----- In Step generated innovative new approaches to interface and sensor embedded clothing/footware whilst also creating an evocative vehicle to comment upon contemporary Post Colonial theories of weight and groundedness – particularly the psycho-geographical ‘separation’ from the landscape that inspired Paul Carter’s “environmentally grounded poetics”. The work’s final form also suggested critical new directions for responsive clothing and footwear for the emerging genre of smart textiles.

General practitioners’ experiences of the psychological aspects in the care of a dying patient

Objective: General practitioners (GPs) play an integral role in addressing the psychological needs of palliative care patients and their families. This qualitative study investigated psychosocial issues faced by GPs in the management of patients receiving palliative care and investigated the themes relevant to the psychosocial care of dying patients. Method: Fifteen general practitioners whose patient had been recently referred to the Mt. Olivet Palliative Home Care Services in Brisbane participated in an individual case review discussions guided by key questions within a semistructured format. These interviews focused on the psychosocial aspects of care and management of the referred patient, including aspects of the doctor/patient relationship, experience of delivering diagnosis and prognosis, addressing the psychological concerns of the patients' family, and the doctors' personal experiences, reactions, and responses. Qualitative analysis was conducted on the transcripts of these interviews. Results: The significant themes that emerged related to perceived barriers to exploration of emotional concerns, including spiritual issues, and the discussion of prognosis and dying, the perception of patients' responses/coping styles, and the GP's personal experience of the care (usually expressed in terms of identification with patient). Significance of results: The findings indicate the significant challenges facing clinicians in discussions with patients and families about death, to exploring the patient's emotional responses to terminal illness and spiritual concerns for the patient and family. These qualitative date indicate important tasks in the training and clinical support for doctors providing palliative care.

Existential experience : the unfolding

This paper reports on a project concerned with the relationship between person and space in the context of achieving a contemplative state. The need for such a study originated with the desire to contribute to the design of multicultural spaces which could be used for a range of activities including prayer and meditation. Given that the words ‘prayer’ and ‘meditation’ are highly value-laden and potentially alienating for some people, it was decided to use the more accessible term ‘contemplative’. While the project is still underway,several findings have emerged that can be reported on and are of relevance to the conference both methodologically and substantively. Informed by phenomenological methodology, data were collected from a diverse group of people using photo-elicitation and interviewing. The technique of photo-elicitation proved to be highly effective in helping people to reveal their everyday lived experience of contemplative spaces. This methodological aspect of the project is described more fully in the paper. The initial stage of analysis produced two categories of data: varying conceptions of contemplation and contemplative space; and, common understandings of contemplation and contemplative space. From this it was found that achieving a state of contemplation involves both the person and the environment in a dialectic process of unfolding. The unfolding has various physical, psycho-social, and existential dimensions or qualities which operate sequentially and simultaneously. In the paper, these are labelled:the unfolding of the core; distinction; manifestation; cleansing; creation; and sharing, and have parallels with Mircea Eliade’s 1959 definition of sacred as 'something that manifests itself, shows itself, as something wholly different from the profane’. It also connects with the views of Nishida Kitaro from the Kyoto School of Philosophy on the theme of ‘absolute nothingness’: ‘the body-mind is dropped off and we are united with the consciousness of absolute nothingness’ (Kitaro in Heisig, 2001, p. 169). According to Marion (2005), ‘nothingness’ is defined by givenness. In the paper, this fold of givenness is interpreted in the context of the qualities of the environment that accomplish the act of coming forward into visibility through the dialectic relationship with a person. (Eliade, 1959, Heisig, 2001, Marion, 2002)

The impact of perceived stage of cancer on carers’ anxiety and depression during the patients’ final year of life

Objective: This paper explores the effects of perceived stage of cancer (PSOC) on carers' anxiety and depression during the patients' final year. Methods: A consecutive sample of patients and carers (N=98) were surveyed at regular intervals regarding PSOC, and anxiety and depression using the Hospital Anxiety and Depression Scale. Means were compared by gender using the Mann-Whitney U-test. The chi-square was used to analyse categorical data. Agreement between carers' and patients' PSOC was estimated using kappa statistics. Correlations between carers' PSOC and their anxiety and depression were calculated using the Spearman's rank correlation. Results: Over time, an increasing proportion of carers reported that the cancer was advanced, culminating at 43% near death. Agreement regarding PSOC was fair (kappa=0.29-0.34) until near death (kappa=0.21). Carers' anxiety increased over the year; depression increased in the final 6 months. Females were more anxious (p=0.049, 6 months; p=0.009, 3 months) than males, and more depressed until 1 month to death. The proportion of carers reporting moderate-severe anxiety almost doubled over the year to 27%, with more females in this category at 6 months (p=0.05). Carers with moderate-severe depression increased from 6 to 15% over the year. Increased PSOC was weakly correlated with increased anxiety and depression. Conclusions: Carers' anxiety exceeded depression in severity during advanced cancer. Females generally experienced greater anxiety and depression. Carers were more realistic than patients regarding the ultimate outcome, which was reflected in their declining mental health, particularly near the end.

Doctors and their patients : A context for understanding the wish to hasten death

There is a paucity of research that has directly examined the role of the health professional in dealing with a terminally ill patient's wish to hasten death (WTHD) and the implications of this for the support and services needed in the care for a dying patient. Themes to emerge from a qualitative analysis of interviews conducted on doctors (n=24) involved in the treatment and care of terminally ill patients were (i) the doctors' experiences in caring for their patients (including themes of emotional demands/expectations, the duration of illness, and the availability of palliative care services); (ii) the doctors' perception of the care provided to their respective patients (comprising themes concerning satisfaction with the care for physical symptoms, for emotional symptoms, or overall care); (iii) the doctors' attitudes to euthanasia and (iv) the doctors' perception of their patients' views/beliefs regarding euthanasia and hastened death. When responses were categorised according to the patients' level of a WTHD, the theme concerning the prolonged nature of the patients' illnesses was prominent in the doctor group who had patients with the highest WTHD, whereas there was only a minority of responses concerning support from palliative care services and satisfaction with the level of emotional care in this group. This exploratory study presents a set of descriptive findings identifying themes among a small group of doctors who have been involved in the care of terminally ill cancer patients, to investigate factors that may be associated with the WTHD among these patients. The pattern of findings suggest that research investigating the doctor-patient interaction in this setting may add to our understanding of the problems (for patients and their doctors) that underpins the wish to hasten death in the terminally ill.

Attention and memory bias for body image and health related information using an Emotional Stroop task in a non-clinical sample

It has been proposed that body image disturbance is a form of cognitive bias wherein schemas for self-relevant information guide the selective processing of appearancerelated information in the environment. This threatening information receives disproportionately more attention and memory, as measured by an Emotional Stroop and incidental recall task. The aim of this thesis was to expand the literature on cognitive processing biases in non-clinical males and females by incorporating a number of significant methodological refinements. To achieve this aim, three phases of research were conducted. The initial two phases of research provided preliminary data to inform the development of the main study. Phase One was a qualitative exploration of body image concerns amongst males and females recruited through the general community and from a university. Seventeen participants (eight male; nine female) provided information on their body image and what factors they saw as positively and negatively impacting on their self evaluations. The importance of self esteem, mood, health and fitness, and recognition of the social ideal were identified as key themes. These themes were incorporated as psycho-social measures and Stroop word stimuli in subsequent phases of the research. Phase Two involved the selection and testing of stimuli to be used in the Emotional Stroop task. Six experimental categories of words were developed that reflected a broad range of health and body image concerns for males and females. These categories were high and low calorie food words, positive and negative appearance words, negative emotion words, and physical activity words. Phase Three addressed the central aim of the project by examining cognitive biases for body image information in empirically defined sub-groups. A National sample of males (N = 55) and females (N = 144), recruited from the general community and universities, completed an Emotional Stroop task, incidental memory test, and a collection of psycho-social questionnaires. Sub-groups of body image disturbance were sought using a cluster analysis, which identified three sub-groups in males (Normal, Dissatisfied, and Athletic) and four sub-groups in females (Normal, Health Conscious, Dissatisfied, and Symptomatic). No differences were noted between the groups in selective attention, although time taken to colour name the words was associated with some of the psycho-social variables. Memory biases found across the whole sample for negative emotion, low calorie food, and negative appearance words were interpreted as reflecting the current focus on health and stigma against being unattractive. Collectively these results have expanded our understanding of processing biases in the general community by demonstrating that the processing biases are found within non-clinical samples and that not all processing biases are associated with negative functionality

The new world of work and employment: fitness workers and what they want from the employment relationship

This paper reports on an empirically based study of the Queensland (Australia) health and fitness industry over 15 years (1993 -2008). This study traces the development of the new occupation of fitness instructor in a service industry which has evolved si nce the 1980s and is embedded in values of consumption and individualism. It is the new world of work. The data from the 1993 study was historically significant, capturing the conditions o f employment in an unregulated setting prior to the introduction of the first industrial a ward in that industry in 1994. Fitness workers bargained directly with employers over all a spects of the employment relationship without the constraints of industrial regulation or the presence of trade unions. The substantive outcomes of the employment relationship were a direct reflection of m anagerial prerogative and worker orientation and preference, and did not reflect the rewards and outcomes traditionally found in Australian workplaces. While the focus of the 1993 research was on exploring the employment relationship in a deregulated environment, an unusual phenomenon was identified: fitness workers happily trading-off what would be considere d standard working conditions for the opportunity to work (‘take the stage’). Since then, several streams of literature have evolved providing a new context for understanding this phenomenon in the fitness industry, including: the sociology of the body (Shilling 1993; Turner 1996); emotional (Hochschild 1984) and aesthetic labour (Warhurst et al 2000); the so cial relations of production and space (Lefebvre 1991; Moss 1995); body history (Helps 2007); the sociology of consumption (Saunders 1988; Baudrillard 1998; Ritzer 2004); and work identity (Du Gay 1996; Strangleman 2004). The 2008 survey instrument replicated the 1993 study but was additionally informed b y the new literature. Surveys were sent to 310 commercial fitness centres and 4,800 fitness workers across Queensland. Worker orientation appears unchanged, and industry working conditions still seem atypical despite regulation si nce 1994. We argue that for many fitness workers the goal is to gain access to the fitness centre economy. For this they are willing to trade-off standard conditions of employment, and exchange traditional employm ent rewards for m ore intrinsic psycho-social rewards gained the through e xp o sure of their physical capital (Bourdieu 1984) o r bo dily prowess to the adoration o f their gazing clients. Building on the tradition of emotional labour and aesthetic labour, this study introduces the concept of ocularcentric labour: a state in which labour’s quest for the psychosocial rewards gained from their own body image shapes the employment relationship. With ocularcentric labour the p sycho-social rewards have greater value for the worker than ‘hard’, core conditions of employment, and are a significant factor in bargaining and outcomes, often substituting fo r direct earnings. The wo rkforce profile (young, female, casual) and their expectations (psycho-social rewards of ado ration and celebrity) challenge traditional trade unions in terms of what they can deliver, given the fitness workers’ willingness to trade-off minimum conditions, hard-won by unions.

Getting creative in health care

Health care accounts for a substantial and growing share of national expenditures, and Australia’s health-care system faces some unprecedented pressures. This paper examines the contribution of creative expertise and services to Australian health care. They are found to be making a range of contributions to the development and delivery of health-care goods and services, the initial training and ongoing professionalism of doctors and nurses, and the effective functioning of health-care buildings. Creative activities within health-care services are also undertaken by medical professionals and patients. Key functions that creative activities address are innovation and service delivery in information management and analysis, and making complex information comprehensible or more useful, assisting communication and reducing psycho-social and distance-mediated barriers, and improving the efficiency and effectiveness of services.

Optimisation of performance in top level athletes : an action-based coping approach : a commentary

INTRODUCTION In their target article, Yuri Hanin and Muza Hanina outlined a novel multidisciplinary approach to performance optimisation for sport psychologists called the Identification-Control-Correction (ICC) programme. According to the authors, this empirically-verified, psycho-pedagogical strategy is designed to improve the quality of coaching and consistency of performance in highly skilled athletes and involves a number of steps including: (i) identifying and increasing self-awareness of ‘optimal’ and ‘non-optimal’ movement patterns for individual athletes; (ii) learning to deliberately control the process of task execution; and iii), correcting habitual and random errors and managing radical changes of movement patterns. Although no specific examples were provided, the ICC programme has apparently been successful in enhancing the performance of Olympic-level athletes. In this commentary, we address what we consider to be some important issues arising from the target article. We specifically focus attention on the contentious topic of optimization in neurobiological movement systems, the role of constraints in shaping emergent movement patterns and the functional role of movement variability in producing stable performance outcomes. In our view, the target article and, indeed, the proposed ICC programme, would benefit from a dynamical systems theoretical backdrop rather than the cognitive scientific approach that appears to be advocated. Although Hanin and Hanina made reference to, and attempted to integrate, constructs typically associated with dynamical systems theoretical accounts of motor control and learning (e.g., Bernstein’s problem, movement variability, etc.), these ideas required more detailed elaboration, which we provide in this commentary.

Substance Treatment Options in Psychosis (STOP) : a new intervention for dual diagnosis

Despite the high co-occurrence of psychosis and substance abuse, there is very little research on the development of effective treatments for this problem. This paper describes a new intervention that facilitates reaching functional goals through collaboration between therapists, participants and families. Substance Treatment Options in Psychosis (STOP) integrates pharmacological and psycho-logical treatments for psychotic symptoms, with cognitive-behavioural approaches to substance abuse. STOP is tailored to participants' problems and abilities, and recognises that control of consumption and even engagement may take several attempts. Training in relevant skills is augmented by bibliotherapy, social support and environmental change. A case description illustrates the issues and challenges in implementation.

Globalization, frontier masculinities and violence : booze, blokes and brawls

Over the last two decades, two new trajectories have taken hold in criminology - the study of masculinity and crime, after a century of neglect, and the geography of crime. This article brings both those fields together to analyse the impact of globalisation in the resources sector on frontier cultures of violence. This paper approaches this issue through a case study of frontier masculinities and violence in communities at the forefront of generating resource extraction for global economies. This paper argues that the high rates of violence among men living in work camps in these socio-spatial contexts cannot simply be understood as individualised expressions of psycho-pathological deficit or social disorganisation. Explanations for these patterns of violence must also consider a number of key subterranean convergences between globalising processes and the social dynamics of male-on-male violence in such settings.