Nonadherence with medical treatment is a critical threat to the health of those living with HIV disease. Unfortunately the search for explanatory factors for nonadherence is still not fully developed, particularly in the area of religion and spirituality. Extant literature suggests that church attendance, religious practices and spiritual beliefs may improve health and generally benefit patients. However, religious beliefs may also play a negative role in treatment adherence due to the stigma attached to HIV disease, particularly in geographical areas and in population subgroups where religious practices are strong. In this exploratory study, HIV-positive individuals (n = 306) in a southern state were surveyed as to their attitudes and beliefs surrounding HIV disease and adherence with medical treatment for the disease. The results indicate that multiple factors influence adherence with treatment and that certain religious practices are positively associated with adherence, but certain religious beliefs are negatively related to adherence. The findings of this study reinforce the importance of remembering and addressing a patient's religious beliefs as a part of medical care.
IntroductionPerhaps no movement or school of thought had more effect upon the field of American public administration in the mid-twentieth century than did logical positivism. In the late 1930s the field was beginning to flower both as a profession and as an academic discipline-due in large part to the pioneering work of classical period writers such as Frank Goodnow, Leonard White, W.F. Willoughby, Luther Gulick and Lyndall Urwick. At that time, the seeds of the logical positivist perspective were planted, mainly in the form of works published by Chester I. Barnard. He questioned the basic tenets propounded by Gulick and Urwick and, by implication, the writings of the field's first serious scholar, Woodrow Wilson. Soon the attacks were further refined and were led most notably and articulately by a young University of Chicago doctoral student named Herbert A. Simon. During the late 1940s and early 1950s, these attacks would be responsible for such a fundamental shift in the focus and composition of the discipline that, for a time, even the name "Public Administration" seemed to disappear from the academic and professional landscape. Although over 50 years and millions of critiquing words have passed since the start of the logical positivist revolution, its after effects-like lingering radiation from an atomic bomb-resonate in the discipline today as the twenty-first century dawns. This article will explore the rise of the logical positivist perspective in American public administration, its heyday, and finally its diminution. The logical positivist perspective limited, inappropriately, the scope of inquiry within the field since its adoption as the de facto epistemological perspective in the early 1950s [1]. In recent years this limitation was challenged by a call for the return to value-based traditions present in the field prior to the 1950s. Aiding in this call for a return to a values-centered approach to research in public administration has been the acceptance of alternative non-positivist methodological perspectives. Several of these perspectives, and their corresponding epistemological bases, will be discussed here.
In this article, the authors argue that there is a positive relationship between productivity and morality in public-sector organizations. If there are ethical problems such as corruption in such organizations, the administrative answer typically is added rules, more complex procedures, and greater sanctions. In other words, we increase organizational red tape to confront our ethical problems rather than address the real problem directly. Using a systems modeling approach informed by Kohlberg's moral development theory and Friedrich's view of "inner controls," we suggest (a) a more direct method to assess the level of ethical development in organizations and (b) a technique by which to improve public-sector organization productivity that places greater emphasis on individual morality rather than on more administrative controls.In this article, we argue that there is a relationship between productivity and morality in an organization. If there are ethical problems such as corruption in an organization, the administrative answer typically is adding more rules and making more complex procedures. In other words, we increase organizational red tape to confront our ethical problems rather than address the real problem directly. In the article, we suggest how we can address that problem directly by building on the literature of individual moral development so that we upgrade our organizations directly rather than lower efficiency by adding red tape.As advances in technologies accelerate the increase of organizational and institutional relationships, the need for a strong foundation in moral 347
This study surveyed employees of the Comprehensive AIDS Program of Palm Beach County, Florida, a community-based AIDS service organization, to understand employees' motives for working for the organization and their attitudes toward their jobs, the organization, its clients (persons with AIDS), and governments. The study revealed that the primary reasons employees work for the organization are a desire for personal involvement in the AIDS fight and the personal lifestyle and/or feeling of each employee. These employees were highly motivated, showing some very positive attitudes toward their jobs, organization, and clients. On the other side, these employees reported concern for future funding of their organization and unhappiness with both federal and state governments' role in the fight against AIDS. Based on these findings, the authors discuss implications for the management of AIDS service organizations, the quality of the AIDS service delivery system, and the future development of AIDS service organizations.
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