Contextual Grounding Research Articles

‘Your baby’s life depends on those first 1000 days’: community health workers’ perspectives of the first 1000 days of life

ABSTRACT Community health workers possess valuable insight into the experiences of South Africa’s children and caregivers. However, their knowledge is often overlooked in efforts to understand local realities, inform interventions, and develop relevant policies. This study aimed to explore community health workers’ perspectives of the first 1000 days of life, the critical period of development between conception and two years of age. Semi-structured interviews were conducted with 15 community health workers working with mothers and infants in Khayelitsha, Cape Town. A thematic analysis suggests that the community health workers view the first 1000 days as fundamental and foundational for children’s development. Furthermore, the community health workers identified key needs for mothers/caregivers and infants within the first 1000 days. The findings provide contextual grounding for the importance of the first 1000 days within South African communities.

Stranded College Students amid Corona Virus Disease 2019 Pandemic: An Existential Phenomenology

This paper explores the lived experiences of college students who are stranded in the middle of the Corona Virus Disease 2019 (COVID-19) crisis. It follows the approach of Heideggerian existential phenomenology in studying ontology or what it means to be. Five college students were purposively selected to participate in the study. The researcher gained insight into each world of the students using interview procedures and thematic analysis. The results are presented through emerging themes and contextual ground. A conceptual structure that depicts the essence of the lived experiences of the stranded college students is offered in the end of the paper.

The intellectual contours of corporate social responsibility literature

PurposeCorporate Social Responsibility (CSR) deliberated regarding business firms' actions for doing well to society and natural environment. Specifically, CSR has been about firms contributions towards stakeholder management. As world economy has prospered over the last couple of centuries, business firms have had also increased its footprints in social landscape. In such a scenario, the roles and responsibilities of business firms have expanded in society. Over the years, CSR as a domain of research and literature has developed into a very potent and rich field. Presently, CSR literature as a body of knowledge has become substantial. The authors in this literature review study attempts to conceptually map this complex field of CSR literature.Design/methodology/approachThe objective of this literature review study was to present a visual mapping of intellectual structure of CSR in five-dimensions and to identify the subfields of CSR research concluded by co-citation analysis. All the citation research documents which were listed in the Web of Knowledge (WoK) database between 1998 and 2019 were analysed. Multivariate analysis was undertaken for the literature review. The study conducted a sequence of statistical analyses comprising of factor analysis, multidimensional scaling and cluster analysis.FindingsThis literature review research study summarised the contours and status of CSR research by categorizing the CSR literature into five classification factors, namely CSR Drivers CSR, Contextual Grounding of CSR, Historical Legacy of CSR, Strategic CSR and CSR Implementation. Further, based upon the analysis of literature review of extant research in CSR, both the contemporary and imminent CSR-related research themes were also deliberated upon.Research limitations/implicationsThe results were helpful for academic scholars of CSR to comprehend both the gamut and focus of CSR literature over the years (between the years 1998 and 2019). The sequence of analyses involved factor, multidimensional scaling and cluster analysis. CSR literature was categorized into five factors namely- CSR Drivers, Contextual Grounding of CSR, Historical Legacy of CSR, Strategic CSR and CSR Implementation.Originality/valueThis study was one of the first set of studies to review the literature on CSR research articles by using citation, co-citation and social network analysis.

Renewable energy sources and technologies in commercial buildings

PurposeThe purpose of this paper is to explore the perceptions and experiences of building practitioners in the adoption of renewable energy (RE) in commercial buildings in Nigeria.Design/methodology/approachA qualitative methodology was used guided by the principles of the Grounded Theory Method (GTM). Data were collected using in-depth semi-structured interviews with a purposive sample of five industry practitioners.FindingsFive distinct factors emerged, namely, being compliant, change in mindset, normalising, being autonomous and identity. The research revealed the significance of contextual (cultural) peculiarities and the role identity plays in informing RE adoption. The findings substantiate the significance of RE adoption in the future practice of building practitioners and in ensuring environmental stability within the Sub-Saharan Africa (SSA) context.Research limitations/implicationsThe study focuses on commercial office buildings and attempts to provide contextual grounding to inform theory generation as part of a wider study.Originality/valueThis research contributes methodologically and empirically by providing grounded insight into the adoption of RE in commercial buildings. Thereby, enabling a much greater understanding of the issues associated with enhanced promotion and adoption by professionals and stakeholders, which can inform policy interventions. Furthermore, it will benefit further research within the SSA context and provide valuable lessons associated with adopting GTM in construction research.

Boring philology: The meaning of zdh in the Siloam inscription

ABSTRACTThe hapax legomenon זדה has been called the crux of the Shiloaḥ (Siloam) inscription. It is usually interpreted as ‘fissure, crack, void, cavity, etc’, but sixteen other interpretations have been proposed in the 140 years since the inscription’s discovery. This article argues on contextual and etymological grounds that the lexeme means ‘misalignment’.

Anticorruption as Transnational Law: The Foreign Corrupt Practices Act, PRC Law, and Party Rules in China

Abstract Corruption has been linked to urgent transnational problems, including, inter alia, market uncertainties, the undermining of democracy, economic disparity, religious extremism, and authoritarianism. As corruption is a global problem, it requires coordination across states’ anticorruption laws. Anticorruption thus provides grounds to reassess the promise and limits of transnational law. This Article examines the operation of anticorruption as transnational law across the corporate governance regimes of the United States and China, the world’s two largest economies. As opposed to perceptions that Washington and Beijing are engaged in a zero-sum game, anticorruption is a policy concern against which both states may rally. Inter-regulatory coordination is far from a frictionless process, however. Cross-border lawyers working on both sides of the Pacific engaged in anticorruption law are a type of transnational community and highlight these tensions. Lawyers apply standards in the 1977 U.S. Foreign Corrupt Practices Act, the People’s Republic of China antibribery laws, and internal Chinese Communist Party rules to ensure their clients comply with multiple regimes. Ethnographic data shows that lawyers assess different regulatory environments, in this case, one of extraterritorial jurisdiction and the other characterized by a political campaign, in the course of advising multinational companies. The Article argues that lawyers’ roles are a lynchpin of these overlapping systems of compliance as their work operates to discipline corporations in China; nonetheless, lawyers’ position in the global legal market impacts what they deem to be “corrupt” and which rules apply. A focus on cross-border lawyers as transnational communities thus marries legal analysis with a contextual grounding in lawyers’ work, an approach that has merit for the study of comparative law more generally. The Article finds that given market pressures, in the area of anticorruption, trends show a preference for “bicultural lawyers,” those who are both embedded within transnational communities and respond to demands in the global market.

Theorizing distributive justice and the practice of post-disaster housing recovery

ABSTRACTThis paper examines the implications of contemporary conceptions of distributive justice for post-disaster recovery programmes. The question asked in this paper is essentially theoretical: what does a concern with distributive justice entail when developing and evaluating post-disaster recovery programmes? Housing recovery programmes are employed to provide a contextual grounding for the discussion. We present a review of the disaster recovery literature and recent programmes of post-disaster housing recovery to map the ways in which distributive justice have been theorized, interpreted, debated and put into practice. We reflect on what different principles of distributive justice imply for post-disaster recovery programmes in terms of their impact on opportunities for individuals and communities to recover from disasters, and also on their realizing possibilities of advancing justice in the post-disaster society. The paper concludes by outlining a number of dimensions of a pluralist account of distributive justice. Using these dimensions and taking into account tensions within and between them, we attempt to offer a framework for reflecting on and assessing distributive arrangements of disaster recovery programmes.

‘I’m more aware of my HIV risk than anything else’: syndemics of syphilis and HIV among gay men in Winnipeg

Despite decreased rates of HIV infection in Winnipeg, syphilis incidence continues to rise. Communities of men who have sex with men shoulder much of this burden of illness. This qualitative study aimed to better understand the co-evolution of HIV and syphilis in Winnipeg through a series of interviews with gay men. Eighteen individuals were recruited through advertising in sexual health centres and through subsequent snowball sampling. Thematic interpretive analysis and inductive reasoning were used to find individual and shared group meanings. We found that HIV formed the contextual ground on which sexual decision-making was made, with three main themes emerging during interviews: 1) bacterial STI transience being contrasted against HIV permanence; 2) syphilis being ‘dirty’ versus HIV carrying significant stigma, though being spared the label of uncleanliness; and 3) the role of pleasure and intimacy in sexual health decision-making. Based on these findings, we recommend further exploration to develop more effective strategies around syphilis prevention, in particular with regards to the longer-term illness ramifications and its relationship to HIV transmission.

Anatomy of forest-related corruption in Tanzania: theoretical perspectives, empirical explanations, and policy implications

ABSTRACTThe majority of studies on natural resources management in both developed and developing countries are silent on the issue of analysis of corruption – or they treat it tangentially, as an annoying anomaly, or simply deviance from the rules. As a result, the issue has hardly been subjected to in-depth characterisation or reforms. This study employed and integrated mainstream principal-agent theory and more recently developed collective action theory to enhance our understanding – in different but complementary ways − of the socio-political underpinnings of corruption. A supposed ‘best case’ participatory forest management scheme in Tanzania reveals significant forest-related corrupt undertakings, which led to forest encroachment in the form of charcoal and timber exploitation. The findings point to contextual grounds for corruption, namely: undermined assumptions of the mainstream principal-agent institutions; the presence of alternative informal principal-agent institutions; the presence of immediate and substantial benefits that flow to such alternative institutions; and the huge market demands for their forest products and services. Through such a nuanced approach that blends the two above-mentioned theories in meaningful ways, more appropriate options for policy formulation and implementation are proposed.

Geoffrey Chaucer: A New Introduction by David Wallace

Reviewed by: Geoffrey Chaucer: A New Introduction by David Wallace Megan E. Murton David Wallace. Geoffrey Chaucer: A New Introduction. Oxford: Oxford University Press, 2017. Pp. xiv, 172. $19.95. David Wallace's Geoffrey Chaucer: A New Introduction lives up to its name in inviting its readers to look anew at Chaucer, seeing in him not the founding father of English letters but "the poet of an unfinished Englishness" (142). Wallace shows how Chaucer's Middle English absorbs influences ranging from scientific treatises to "urban noise" (44) to become a capacious and flexible poetic medium. The experimental quality of Chaucer's language is, Wallace proposes, a reason why his works are enjoying a far-reaching appeal now, in a world where English has become dominant. Wallace's dual focus on language and global reception makes his book a thought-provoking read that not only introduces its audience to Chaucer's writings but also demonstrates their present-day significance and vitality. The introductory chapter, "Beginnings," covers both theoretical and contextual ground. It opens with a discussion of audience and persona, concepts Wallace presents as integral to Chaucer's art and to current criticism of it. The chapter then shifts, via Terry Eagleton's description of Chaucer as a "class traitor" (10), to an overview of the poet's life and times. The thesis here is that Chaucer was "first and foremost a European" (12), a claim that Wallace, of all Chaucerians, is ideally suited to expound and defend. He first makes a compelling and admirably condensed case for Chaucer's continental focus, and then vindicates the cosmopolitanism of the Middle Ages more broadly. The chapter ends with a section on war as the dark underside of the interconnected medieval world. Insightful references to Chaucer's writings are sprinkled throughout the introductory chapter, but more developed readings begin in the second, "Schoolrooms, Science, Female Intuition." This is one of two thematic chapters that bracket a more or less chronological tour of Chaucer's writings in the book's middle three chapters. This structure is complex but effective, as it allows Wallace to trace both Chaucer's recurrent engagement with certain topics and his trajectory of development as a poet. The second chapter examines Chaucer's interest in ways of knowing. After a brief overview of Scholasticism and exegesis, Wallace describes Chaucer's scientific expertise and his readiness to make fun of it; The [End Page 387] House of Fame, for instance, is "perched somewhere between science and farce" (33). The chapter then pivots to the relationship between women and Latinate intellectual culture, introducing the Wife of Bath as "a tissue of … anti-feminist texts" (36) and then, in the space of a few pages, examining gendered presentations of knowledge in The Nun's Priest's Tale, The Second Nun's Tale, The Merchant's Tale, Troilus and Criseyde, and The House of Fame, with references to As You Like It and Sir Gawain and the Green Knight along the way. This section is typical of the book as a whole in the expert way in which it charts a path through Chaucer's writings while referencing other medieval poems and later works of English literature. The chapter concludes with the claim that, for Chaucer, "women are different" (42) in a specifically epistemological sense. Readers who are familiar with Chaucer criticism will appreciate this chapter's illuminating perspective on his treatment of gender. The third chapter, "A Life in Poetry," begins the chronological section of the book. Living in a world where "'English poetry' was a contradiction in terms," Chaucer "aspires to" this label in his early works (43). The chapter examines how this aspiration leads Chaucer to learn from French models and then Italian ones, though Wallace cautions that French and Italian do not represent fully distinct creative phases. The core of the chapter discusses Machaut alongside The Book of the Duchess and Dante alongside The House of Fame. The conclusion focuses on The Parliament of Fowls as a case study in Chaucer's response to Italian metrics, which Wallace describes as a "liberatory" influence that may have led Chaucer to invent rhyme royal (57). Rhyme royal provides a transition...

A semiotics of comedy

This article develops an analytic approach to comedic performance by examining the performance of the Chapayeka ritual clowns as a series of semiotic shifts and reversals: the Chapayekas play with images and contexts, introducing unpredictable figures to effectively shift the grounding conditions of their own performance. The Chapayeka performance combines both conventional and set forms as well as improvised and newly invented ones. As they shift from convention to invention (in the sense of Roy Wagner), the Chapayekas emerge as “symbols that stand for themselves.” This capacity allows the Chapayekas to function as both symbolic figures in the ritual and self-contained contextual grounds, which enables them to produce further signs and manipulate figure-ground relations within and beyond the ritual. The analytic view developed here is informed by the complex and multilayered semiotics of comedic performance; this exploration offers a novel perspective on how comedic performances create and wield semiotic force through establishing grounds and evoking figure-ground relations.

Collective Sensemaking: The Cave within the Cage

Situated cognition and neo-institutional theory have revived two fruitful allegories of collective sensemaking within organizations: Plato's Simile of the Cave and Max Weber's Iron Cage. Scholarly efforts to combine these two approaches have converged towards a shared vision of collective sensemaking as an interaction between institutionalized cognitive schemas and contextual grounding. Nevertheless, the mechanisms framing and shaping the outcome of this contextual cognitive interaction, i.e. the collective meanings actually produced and institutionalized, have remained largely unexplored. We aim to address this common gap by examining how the interplay of institutional and contextual factors determined the collective sensemaking of an emergent occupational group, namely, management controllers in French hospitals. Comparing the results from a two-year focus group study held in a community of practice and survey data from 163 respondents, we draw consistent findings indicating that a similar position within supervision micro-structures, which we label isothetism, contributed to shaping the group's transactive memory and to framing the institutionalization of its cognitive schemas. We conclude by discussing the implications of isothetism for future research on the meaningfulness of organizations.

Little White Lies: Racialization and the White/Black Divide

This article emphasizes the importance of considering the history, context and epistemological bases of the use of race and racial categories in North America. Using this contextual grounding, I propose that racial categories are born of racism and not the reverse. I include some salient personal examples of the effects of the construct Whiteness in my own life experience. They are, at the same time, personal, political and cultural. Finally, some suggestions are offered for dealing with the issue of Whiteness, in particular, in feminist therapy, which seeks to uncover power differentials and the personal and political, each embedded in the other.

Teaching Evidence Assimilation for Collaborative Health Care (TEACH) 2009-2014: Building Evidence-Based Capacity within Health Care Provider Organizations.

Background:Clinical guidelines, prediction tools, and computerized decision support (CDS) are underutilized outside of research contexts, and conventional teaching of evidence-based practice (EBP) skills fails to change practitioner behavior. Overcoming these challenges requires traversing practice, policy, and implementation domains. In this article, we describe a program’s conceptual design, the results of institutional participation, and the program’s evolution. Next steps include integration of instruction in principles of CDS.Conceptual Model:Teaching Evidence Assimilation for Collaborative Health Care (TEACH) is a multidisciplinary annual conference series involving on- and off-site trainings and facilitation within health care provider organizations (HPOs). Separate conference tracks address clinical policy and guideline development, implementation science, and foundational EBP skills. The implementation track uses a model encompassing problem delineation, identifying knowing-doing gaps, synthesizing evidence to address those gaps, adapting guidelines for local use, assessing implementation barriers, measuring outcomes, and sustaining evidence use. Training in CDS principles is an anticipated component within this track. Within participating organizations, the program engages senior administration, middle management, and frontline care providers. On-site care improvement projects serve as vehicles for developing ongoing, sustainable capabilities. TEACH facilitators conduct on-site workshops to enhance project development, integration of stakeholder engagement and decision support. Both on- and off-site components emphasize narrative skills and shared decision-making.Experience:Since 2009, 430 participants attended TEACH conferences. Delegations from five centers attended an initial series of three conferences. Improvement projects centered on stroke care, hospital readmissions, and infection control. Successful implementation efforts were characterized by strong support of senior administration, involvement of a broad multidisciplinary constituency within the organization, and on-site facilitation on the part of TEACH faculty. Involvement of nursing management at the senior faculty level led to increased presence of nursing and other disciplines at subsequent conferences.Conclusions:A multidisciplinary and multifaceted approach to on- and off-site training and facilitation may lead to enhanced use of research to improve the quality of care within HPOs. Such training may provide valuable contextual grounding for effective use of CDS within such organizations.

The Curious Case of 'Smith Dakota v. North Carolina': The Pathology of a Bad Cite in East Africa

This article was roused by errors. Its catalyst is the widespread misciting and misquoting of a US Supreme Court case by courts in Uganda and Kenya. The maltreated case is South Dakota v. North Carolina, 192 U.S. 286 (1904). Although this case is not prominent in recent American jurisprudence, it has managed to rise to prominence in East Africa. Unfortunately, the case’s eminence is marred by the courts’ failure to properly cite to and quote from the case. This article explores reasons why Ugandan and Kenyan appellate courts consistently miscite and misquote the case. By examining the causes that sustain the misreferencing we increase our understanding of the conditions and challenges facing common law judicial craft in post-colonial settings. Certain analytical perspectives are useful in this analysis. This article presents historic, socio-legal and comparative content to provide useful contextual grounding. Because this article is written for an American legal audience, the article uses American legal history and development as a comparative foil. The broader aim of this article is to improve the way that post-colonial judiciaries engage in and take ownership of the common law process. The article concludes with lessons that can be used going forward.

Eschatology in Genesis 15:6

The word חשׁב in Gen 15:6 has traditionally been read in terms of God “considering” or “reckoning” Abram’s belief as righteousness. This understanding, however, is not consistent with current Pauline studies. The present article reads Gen 15:6 eschatologically. It will be shown that the biblical text opens itself up to such interpretation on semantic and contextual grounds: חשׁב can be read as God “planning” righteousness for Abram. The context of the chapter and Genesis as a whole supports the eschatological reading. That is also the case with the reception history of the verse including Paul’s usage of it in Romans and Galatians. The reading of Gen 15:6 offered in the present article has theological implications for our understanding of justification and our reading of Pauline texts.

Opportunities and Challenges Associated with Engaging Immigrant Women in Participatory Action Research

With increasing recognition of the importance of knowledge exchange between researchers and research stakeholders, community member involvement remains poorly accessed. A promising community-based research methodology for knowledge exchange is participatory action research (PAR). This review examines opportunities and challenges associated with using PAR to examine issues related to community health, specifically that of immigrant women. The literature search included published and grey literature relevant to immigrant women and PAR. PAR actively engages community members of the study population throughout the research process. The involvement of immigrant women in research that explores issues pertinent to their health is essential to conducting relevant research to subsequently inform policies and programs. There are numerous advantages to using a PAR approach, including enhanced research relevance and utilization; notwithstanding, there are challenges to overcome in order to engage community based immigrant women in research. Ultimately, policies that have contextual grounding through PAR have better likelihood of effectively addressing priority issues for immigrant women.

The Journal of the History of Philosophy : What It All Means

The Journal of the History of Philosophy: What It All Means Richard A. Watson (bio) The Study of the History of Philosophy as an independent discipline to exhibit and explicate philosophical systems as their originators meant them to be understood is less than one hundred years old. On the other hand, philosophers from Plato and Aristotle through the Middle Ages to Bertrand Russell and Richard Rorty have represented the systems of their predecessors in the light of, and as leading to, their own philosophical positions. It is not surprising then that the study of the long history of the history of philosophy itself discloses a series of often greatly divergent expositions of philosophical systems throughout the ages. The purist conception of the study of the philosophical position of a given philosopher or school of philosophers as meant and understood in the context of the times of that philosopher or school is fairly recent. On this contextual ground, to study any part of the history of philosophy, one must examine and give expositions of philosophers and of the philosophies that influenced them as they were understood in their own times. Such a study of the history of philosophy—call it historicist history of philosophy—further requires knowledge of the history of ideas, of society, and of politics. This historicist stance makes pursuit of the history of philosophy more intricate and more relevant to philosophy per se than is often recognized by philosophers who construct, analyze, and defend contemporary philosophical positions. When contemporary analytic philosophers direct constructive and analytical work on historical philosophers and historical philosophical positions, this work is called analytic history of philosophy, and it is often undertaken with the goal of advancing contemporary philosophy. A recent analytic philosopher who has specialized in this area is Jonathan Bennett.1 An example of a philosopher who provides a history of philosophy in the classic sense to support his own philosophical position is Richard Rorty.2 [End Page 1] In 1983, the History of Philosophy Quarterly was established in some part to publish articles in which historical positions and arguments are analyzed using the techniques of contemporary analytic philosophy. Critics of such analytic history of philosophy point out that the philosophical positions that result are by definition and intent not true to the actual positions of the philosophers under consideration. This is true, but to present it as criticism is to miss the point of analytic history of philosophy, which just is to construct, on the foundations of historical systems, reconstructed systems that are more consistent and more relevant to contemporary philosophical issues and problems than are the unrevised historical systems in themselves. To provide explications of philosophical systems as their creators meant them to be is the work of historicist historians of philosophy. Reconstructions of philosophical systems to rectify and improve them to make them comprehensible to philosophers today and relevant to contemporary philosophical issues is the work of analytic historians of philosophy. Analytic history of philosophy is older than historicist history of philosophy. In fact, it is as old as Western philosophy, and, as I remark above, it has been practiced by philosophers from Plato to Russell and Rorty. The Journal of the History of Philosophy was established fifty years ago to publish articles in which philosophical texts are examined to explicate what their authors meant in historical—as well as in biographical, scientific, religious, and political—context. This requires that a historicist historian of philosophy know the language in which the text was written, the meanings of philosophical words at the time of its composition, and the general historical, social, and political context in which a given text was written. It goes without saying that the historian is presumed also to have enough general philosophical training to be able to understand, analyze, and assess philosophical arguments. If my exposition here seems a bit overdone, it might be because a fine historian of philosophy, Gregor Sebba, took me to task, because while he approved of the historicist history of philosophy in my book The Downfall of Cartesianism,3 he disapproved mightily of my critical analyses of the key notions of Cartesians. He correctly saw the book as a bastard mix...

The CNN defect

Zimbabwe has been in a political and economic crisis for nearly a decade. Although the causes of the crisis are complex and multifaceted, the global media have tended to foreground human rights and good governance issues at the expense of other possible news frames. This article focuses on CNN's representations of the crisis within the context of an election. It argues that while CNN played an important role in human rights within that context, the appropriation of this discourse was largely selective and race and class were very influential in its news narratives. Apart from this, the article also observes that CNN's news frames on the election were episodic, simplistic and lacked contextual grounding. The network's sensationalistic reporting and its selective application of human rights are seen as largely caused by certain ideological and economic imperatives that continue to affect Western journalism's reportage of Africa even in the global age. While CNN's logistical problems of its ban in Zimbabwe are acknowledged, they are not seen as hugely influential in the organisation's news reports. The article concludes that in the global age, global news media such as CNN need a paradigm shift from Eurocentricism to polycentricism where their news must embody and articulate the multiple narratives and worldviews that reflect the hybridity of Africa's post colonies. The subtle demonization of the decolonisation agenda in CNN's news and its isolation from the democratisation project is seen as inimical to the creation of a post-colonial Zimbabwe that can transcend the greater questions of historical justice and economic democracy.

Social Context of Rural Women with HIV/AIDS

The South has more AIDS cases than any other region of the US, with most new diagnoses among African American women (56%). In a previous study, a peer counseling intervention for rural women with HIV/AIDS was developed and tested. The purpose of this analysis was to describe, from the peer counselors’ perspective, the predominant concerns of the women, contextualized by living in isolated, impoverished circumstances in the rural Deep South. Following home visits, peer counselors recorded a description of the encounter. A multidisciplinary qualitative research group extracted, coded, and thematized the chief concerns and context of the women's lives. Findings provide a vivid portrait of HIV-infected women experiencing deeply troubling psychological and physiological symptoms of HIV/AIDS against the contextual ground of poverty and isolation. Themes include: (1) struggle/effort; (2) stigma/hiding; (3) loss/depression; and (4) independence/ dependence. These women lived in extremely difficult life circumstances that reflected not only a devastating chronic illness, but a life of poverty and abuse. Appropriate care for HIV-infected women living in the rural Deep South will need to address the whole context of their lives.