Lack of discussion about the decision to screen for prostate cancer and general lack of culturally appropriate communication with healthcare providers has engendered distrust, created fear, fostered disconnect, and increased the likelihood of nonparticipation in prostate cancer screening among black men.

This case study reflects on the variety of approaches to health care in a pluralistic immigrant urban enclave in Southern California. In-depth interviews were conducted with a Mexican immigrant woman to explore and understand her health worldview and the strategies she uses in deciding among the diverse health care options available to protect and maintain her family's health. Kleinman's typology of health sectors (professional, folk, and popular) is applied to the popular healing practices of the key informant and her own health-seeking behaviors. These expose the conflict between a professional community that relies on categories and binary comparisons and the existence of multiple, simultaneous health care sectors. This case study highlights the paradoxical world of health and illness in a pluralistic medical setting and how those who reside in an environment where medical syncretism exists apparently see their options very differently from their professional health care providers.

The Adventist Development and Relief Agency (ADRA) is a nongovernmental organization that provides community development and disaster relief services in 120 countries around the world. ADRA is an agency of the Seventh-day Adventist Church, a Christian North American-based religious denomination that operates an international system of hospitals, clinics, schools, universities and human service programs (). Consistent with its non-pro®t status, ADRA employs and offers services to people without regard to age, ethnicity or political or religious af®liation. ADRA's services, which are provided to approximately 19 million people per year, include food security, economic development, primary health, disaster response and basic education programs (ADRA International, 2000: 3). The agency has a humanitarian and developmental philosophy of service rooted in the belief system of the Seventh-day Adventist Church. However, the mission statement of the agency and its annual report seem to support the claim that its purpose is not to engage in proselytism. The agency's high degree of administrative and ®nancial independence from the church also seems to support this claim. In 1999, only 7 percent of

This qualitative study explores the role of spirituality and meaning among 15 participants suffering from severe depression. During the time of this study, all the participants were in treatment at Loma Linda University Behavioral Medicine Center. The emerging themes are: (1) depression creates a sense of spiritual disconnection. Participants indicated feeling disconnected from God, the community, and oneself; (2) spirituality plays an important role in coping with the pain of depression; (3) there exists a deep yearning for a sense of meaning and a struggle to make sense of one's pain; and (4) coming to terms with one's circumstances and one's depression at some level assists in the healing process.

Ideology and attitudes of Latino church leaders in the United States toward HIV/AIDS are explored. A qualitative approach utilized with emergent categories including: a desire within the Latino church for greater acceptance of HIV/AIDS sufferers, the supposed contaminating influence of HIV/AIDS individuals over other church members, and the feelings of helplessness many church members experience in relation to the HIV/AIDS crisis. Understanding ideological resistance that prevents engagement is here identified and a strategy of empowerment of church leaders is recommended to overcome it including: adopting a strengths-oriented service model that focuses on resources religious denominations already have, as opposed to a financially driven, medically oriented service model that highlights what churches often do not have; church leaders educating health care agencies on how to use religious beliefs to motivate church members to work on behalf of HIV/AIDS patients; the power of doctrinal ideology in affecting church and civil society's response to HIV/AIDS.