A qualitative exploratory analysis of channeled content.

Throughout history, within numerous multicultural contexts across the globe, channeling has been expressed, practiced, revered and shunned. Broadly defined, channeling is "communication of information to or through a physically embodied human being, from a source that is said to exist on some other level or dimension of reality than the physical as we know it, and that is not from the normal mind…of the channel" (Klimo, 1998, p. 2). Despite its persistence and presence across time, the enigmatic, speculative nature of channeling creates a unique research challenge. Historically, scientific channeling research tends to minimize attention on the actual channeled material, in part due to validation constraints. The focus of this qualitative exploration was to categorize and thematically analyze content channeled during the final segment of a trance channeling study. Recorded over two days, 13 healthy adult trance channels responded to the question, "Do you have any suggestions/messages regarding the current or future channeling experiments?" Transcribed content analysis revealed seven common themes under three categories - Scientific Methodology: (1) Constraints of the current quantitative study, (2) Advancing channeling research; Channeling Processes:(3) 'How-to' of channeling, (4) Experienced processes described from the "non-physical being's" point-of-view; Open-Ended Information: (5) Philosophical - personal to global to universal, (6) Gratitude and Collaborative spirit, and (7) Personal messages for healing/growth. Themes 2 and 6 were the most represented content of messages delivered. This analysis was designed to present the experiences of the channelers, how that might be interpreted and to provide global access to the potentially valuable content.

A physiological examination of perceived incorporation during trance.

Background: Numerous world cultures believe channeling provides genuine information, and channeling rituals in various forms are regularly conducted in both religious and non-religious contexts. Little is known about the physiological correlates of the subjective experience of channeling. Methods: We conducted a prospective within-subject design study with 13 healthy adult trance channels. Participants alternated between 5-minute blocks of channeling and no-channeling three times while electroencephalography (EEG), electrocardiography (ECG), galvanic skin response (GSR), and respiration were collected on two separate days. Voice recordings of the same story read in channeling and no-channeling states were also analyzed.   Results: The pre-laboratory survey data about demographics, perception of the source, purpose and utility of channeled information reflected previous reports. Most participants were aware of their experience (rather than in a full trance) and had varying levels of perceived incorporation (i.e. control of their body). Voice analysis showed an increase in voice arousal and power (dB/Hz) differences in the 125 Hz bins between 0 and 625 Hz, and 3625 and 3875 Hz when reading during the channeling state versus control. Despite subjective perceptions of distinctly different states, no substantive differences were seen in EEG frequency power, ECG measures, GSR and respiration. Conclusions: Voice parameters were different between channeling and no-channeling states using rigorous controlled methods, but other physiology measure collected were not. Considering the subjective and phenomenological differences observed, future studies should include other measures such as EEG connectivity analyses, fMRI and biomarkers.

HIV Stigma and Social Capital in Women Living With HIV.

Women living with HIV (WLWH) continue to experience HIV-related stigma. Social capital is one resource that could mitigate HIV stigma. Our cross-sectional study examined associations between social capital and HIV-related stigma in 135 WLWH in the San Francisco Bay Area. The mean age of study participants was 48 years; 60% were African American; 29% had less than a high school education; and 19% were employed. Age was significantly associated with perceived HIV stigma (p = .001), but total social capital was not. Women with lower Value of Life social capital scores had significantly higher total stigma scores (p = .010) and higher Negative Self-image stigma scores (p = .001). Women who felt less valued in their social worlds may have been more likely to perceive HIV stigma, which could have negative health consequences. This work begins to elucidate the possible relationships between social capital and perceived HIV stigma.

Appreciating Reasons for Nonadherence in Women.

Women aged 15-24 years have an HIV infection rate twice that of men the same age. In this study we examined reasons why HIV-infected women taking antiretroviral therapy (ART) report missing HIV medications. Women (N = 206) on ART were 2.2 times more likely to endorse reasons pertaining to forgetfulness versus reasons pertaining to problems taking pills (OR = 2.2, 95% CI = 1.63, 2.94, p <.001). There was a difference between the adherent and nonadherent groups in types of reasons overall (p <.001, 95% CI = -3.82, -2.03). Using a patient-centered approach to understand type of nonadherence (intentional vs. unintentional) may support development of novel interventions.

The impact of social context on self-management in women living with HIV.

HIV self-management is central to the health of people living with HIV and is comprised of the daily tasks individuals employ to manage their illness. Women living with HIV are confronted with social context vulnerabilities that impede their ability to conduct HIV self-management behaviors, including demanding social roles, poverty, homelessness, decreased social capital, and limited access to health care. We examined the relationship between these vulnerabilities and HIV self-management in a cross-sectional secondary analysis of 260 women living with HIV from two U.S. sites. All social context variables were assessed using validated self-report scales. HIV Self-Management was assessed using the HIV Self-Management Scale that measures daily health practices, HIV social support, and the chronic nature of HIV. Data were analyzed using appropriate descriptive statistics and multivariable regression. Mean age was 46 years and 65% of participants were African-American. Results indicated that social context variables, particularly social capital, significantly predicted all domains of HIV self-management including daily health practices (F = 5.40, adjusted R(2) = 0.27, p < 0.01), HIV social support (F = 4.50, adjusted R(2) = 0.22, p < 0.01), and accepting the chronic nature of HIV (F = 5.57, adjusted R(2) = 0.27, p < 0.01). We found evidence to support the influence of the traditional social roles of mother and employee on the daily health practices and the chronic nature of HIV domains of HIV self-management. Our data support the idea that women's social context influences their HIV self-management behavior. While social context has been previously identified as important, our data provide new evidence on which aspects of social context might be important targets of self-management interventions for women living with HIV. Working to improve social capital and to incorporate social roles into the daily health practices of women living with HIV may improve the health of this population.

Measuring HIV self-management in women living with HIV/AIDS: a psychometric evaluation study of the HIV Self-management Scale.

OBJECTIVE: To develop and validate the HIV Self-management Scale for women, a new measure of HIV self-management, defined as the day-to-day decisions that individuals make to manage their illness. METHODS: The development and validation of the scale was undertaken in 3 phases: focus groups, expert review, and psychometric evaluation. Focus groups identified items describing the process and context of self-management in women living with HIV/AIDS (WLHA). Items were refined using expert review and were then administered to WLHA in 2 sites in the United States (n = 260). Validity of the scale was assessed through factor analyses, model fit statistics, reliability testing, and convergent and discriminate validity. RESULTS: The final scale consists of 3 domains with 20 items describing the construct of HIV self-management. Daily self-management health practices, social support and HIV self-management, and chronicity of HIV self-management comprise the 3 domains. These domains explained 48.6% of the total variance in the scale. The item mean scores ranged from 1.7 to 2.8, and each domain demonstrated acceptable reliability (0.72-0.86) and stability (0.61-0.85). CONCLUSIONS: Self-management is critical for WLHA, who constitute over 50% of people living with HIV/AIDS (PLWHA) and have poorer health outcomes than their male counterparts. Methods to assess the self-management behavior of WLHA are needed to enhance their health and wellbeing. Presently, no scales exist to measure HIV self-management. Our new 20-item HIV Self-management Scale is a valid and reliable measure of HIV self-management in this population. Differences in aspects of self-management may be related to social roles and community resources, and interventions targeting these factors may decrease morbidity in WLHA.

Problems taking pills: understanding HIV medication adherence from a new perspective.

HIV medication adherence remains a challenge for people taking antiretroviral therapy. In the last decade research in this area has proliferated, yet there is a need for novel research approaches that provide information on the development of successful medication adherence interventions. This study examined several key potential correlates of reasons for missed medication in a diverse sample of people living with HIV/AIDS (PLWHA) from nine cities in the US using an ordinal regression model. Examining the reasons for missed medication in relationship with regimen type, symptom experience, AIDS diagnosis, other health conditions, and social support offers a new approach. Problems taking pills (a factor of five reasons) was significantly associated (p=0.003) with use of a protease inhibitor (PI) regimen. A person taking a PI regimen has a 70% increase of having more problems taking pills versus a non-PI regimen. Symptom experience (odds ratio [OR]: 3.8; 95% confidence interval [CI]: 2.7, 5.2) and other health conditions (OR: 0.7; 95% CI: 0.45, 0.98) were found to be independently associated with problems taking pills. This new perspective may provide a framework for further conceptualizing new analyses that are related to enhancing adherence intervention research and development.

Psychometric properties of a Symptom Management Self-Efficacy Scale for women living with HIV/AIDS.

CONTEXT: Many people with HIV/AIDS find it difficult to manage the symptoms of the disease, but by adopting effective symptom management behavior, they increase the potential of alleviating the burden of those symptoms. Self-efficacy is a recognized mediator of successful behavior change and is used by many researchers and clinicians when developing symptom management interventions. Despite this, an instrument measuring the self-efficacy of symptom management behavior specifically for people living with HIV/AIDS has not yet been made available. OBJECTIVES: To introduce and test the psychometric properties of the HIV Symptom Management Self-Efficacy for Women Scale (HSM-SEWS) for women with HIV/AIDS. This scale, a new nine-item measurement instrument, was modified from the Chronic Disease Self-Efficacy Scale. METHODS: In this study, psychometric testing focused on the reliability and validity of the HSM-SEWS instrument. Reliability was assessed using Cronbach's alpha. Exploratory factor analysis with oblique promax rotation was used to examine validity and test hypothetical associations. RESULTS: Eighty-nine HIV-positive women were recruited and asked to complete the scale every four weeks for a total of 16 weeks. Factor analysis supported a one-factor solution explaining 93% of the variance among items. Internal consistency of the nine items was found to range from 0.83 to 0.93, with an overall Cronbach's alpha of 0.92. CONCLUSION: Psychometric analyses suggest that the HSM-SEWS is a reliable and valid instrument that measures the self-efficacy of symptom management behavior in women with HIV/AIDS and can be used during interventions and in studies targeting this area of health care research.

The Tanzania HIV/AIDS nursing education (THANE) preservice curriculum.

The Schools of Nursing at Muhimbili University of Health and Allied Sciences and the University of California, San Francisco (UCSF) have been collaborating on a twinning partnership to develop an HIV nursing education preservice curriculum. The Tanzania HIV/AIDS Nursing Education (THANE) project was designed to increase the HIV education capacity of Tanzanian nursing schools by strengthening the knowledge and skills of the nurse educators. The THANE project includes three components: (a) development of 12 curriculum modules, (b) training of trainers, and (c) roll-out to all nurse educators in the eight zones of Tanzania and Zanzibar. The evaluation plan focuses on three main areas: (a) HIV knowledge, confidence in teaching, and thoughts about HIV, (b) participant satisfaction with the workshops, and (c) monitoring educators to assess implementation and dissemination of the THANE curriculum into existing curricula. To date, 300 nurse educators have been trained.

A systematic review of the effectiveness of peer-based interventions on health-related behaviors in adults.

We reviewed 25 randomized clinical trials that assessed the effect of peer-based interventions on health-related behaviors in adults. Effect sizes were calculated as odds ratios or standardized mean differences. We grouped most of the studies by 7 measured outcomes, with effect sizes ranging from -0.50 to 2.86. We found that peer-based interventions facilitated important changes in health-related behaviors, including physical activity, smoking, and condom use, with a small- to medium-sized effect. However, the evidence was mixed, possibly because of the heterogeneity we found in methods, dose, and other variables between the studies. Interventions aimed at increasing breastfeeding, medication adherence, women's health screening, and participation in general activities did not produce significant changes.

Considerations for preparing collaborative international research: a Ugandan experience.

This article describes issues to consider when planning and conducting international research projects. Key considerations include building collaboration, developing a comprehensive and feasible research plan, funding and budgets, addressing human subjects concerns, and analyzing and disseminating project findings. These considerations and related methodological issues are discussed in the context of a replication pilot project conducted outside Kampala, Uganda. Ongoing dialog, flexibility, and collaboration, in addition to good science, are critical to developing successful international research projects.

Knowledge and attitude of nurses caring for patients with HIV/AIDS in Uganda.

Nurses working in a regional hospital represent the largest group of health care workers in Uganda. Four hundred seventy-seven nurses and midwives completed the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) knowledge and attitude surveys (86% response rate). Approximately 95% (n = 452) had provided care to HIV/AIDS patients; yet 86% (n = 388) believed resources to obtain HIV/AIDS information were inadequate. Fear of contagion was great (47%, n = 232). HIV/AIDS knowledge gaps included "precaution and transmission" (64.7%) and "agent and immunology" (53.4%). Knowledgeable respondents had less fear of contagion. Positive attitudes toward patients with HIV/AIDS were displayed despite fear of contagion.