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PubMed1990

International behavioral responses to a health hazard: AIDS.

This paper expands on Jonathan Mann's third wave of the AIDS pandemic: the epidemic of economic, social, political, and cultural reaction and response to the HIV infection and to AIDS. This worldwide epidemic is a major economic challenge, especially in Third World countries, which can ill afford additional health care costs. AIDS is also a harbinger of political and cultural conflicts between and among nations, states, institutions, and people everywhere. It may ultimately transform law as radically as it has health care practices. In terms of management, it is possible to approach AIDS much as we do natural and technological hazards. The biology and epidemiology of AIDS require a coordinated attack, involving research on vaccines and drugs, modification of human behavior and education of populations to arrest the disease. All of these require money, of which the United States was the major contributor before the Reagan years. Funding to the United Nations and WHO has since languished, jeopardizing the AIDS efforts of those two organizations.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Facing AIDS: reactions among police officers, nurses and the general public in Sweden.

This study compares police officers and registered nurses and the general public concerning their perceptions of the risk of HIV infection, attitudes toward HIV-infected individuals, and attitudes toward measures used to fight the AIDS epidemic. Information was obtained through mail questionnaires sent to random samples of individuals, aged 25-44 years, from the 3 groups. The samples included 525, 501 and 1600 individuals respectively. Response rates were 85, 93 and 74%. The study showed good knowledge concerning verified carriers of HIV infection (blood, sperm, vaginal secretion, etc.). A widespread fear of unverified carriers of infection (public toilets, kissing on the mouth) existed particularly among the public and police officers. Negative attitudes toward HIV-infected individuals and demands for compulsory measures were common among all groups, although least common among nurses and most common among the police. Positive relationships were established between the fear of unverified carriers of infection, repulsive attitudes toward individuals infected by HIV, and demands for compulsory measures.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Ethical and legal implications of the new genetics: issues for discussion.

The so-called 'new genetics,' a phrase sometimes associated with The Human Genome Initiative, poses no really new ethical problems, but exacerbates old ones. The issues of most concern to geneticists and their patients are summarized under the eleven headings below. These issues emerged from a 19-nation study of ethics and genetics in 1985-86 and from preliminary work on a forthcoming 36-nation study by the same authors.

Abortion, Legal↗
PubMed1991

Drug addiction in pregnancy: the interface of science, emotion, and social policy.

The problem of drug addiction in pregnancy has been posed as a conflict between the rights of women and those of their fetuses. This paper presents a framework that incorporates emotion, identification, scientific research, and ethical issues as components to be used in establishing policy with respect to drug addicted pregnant women. Three approaches--voluntary treatment, involuntary treatment or incarceration, and maintaining of the status quo--are discussed with attention to class and economic aspects of women's lives and society's concern for fetal well-being. A model is proposed that addresses the needs of pregnant drug-addicted women and their fetuses, and that serves as an alternative to forced treatment or criminal prosecution.

Attitude↗
PubMed1994

Ethics, epidemiology, and women's health.

Ethical issues arise throughout the conduct of epidemiologic studies, in the processes of determining the study question, designing the protocol, and implementing the study. There also is an ethical dimension when studies are not done, for example, in studies of the effect of drugs and chemicals on male reproductive capacity. Harm as well as risk must be considered in the conduct of epidemiologic studies. The ethical principles that govern research, while independently justifiable, may come into conflict. Principles that govern research also may conflict with those that predominate in clinical practice. An example is the current controversy over unblinding anonymous, newborn human immunodeficiency virus seroprevalence studies to identify potentially infected infants. As women's health becomes more prominent on the research agenda, the resolution of these conflicts will become a complex challenge to epidemiologists, ethicists, clinicians, and the communities they serve.

AIDS Serodiagnosis↗
PubMed1990

Health workers and the human immunodeficiency virus: knowledge, ignorance and behaviour.

The attitude of health personnel towards the human immunodeficiency virus (HIV) has a great influence on public opinion. Thus appropriate knowledge about HIV and its routes of transmission, plus safe and professional behaviour are crucial. A survey of 359 Norwegian health workers (75% response) revealed that factual knowledge was good. Fear of occupational transmission was substantial, but was not reflected in behaviour: 25-50% of the personnel reported not using gloves when exposed to blood. No relationship was found between knowledge and behaviour. A majority (79%) of the sample held the view that every hospital patient should be routinely tested on admission. Seventy-four per cent advocated preoperative screening, with special precautions if the results are positive. Knowledge did not seem to influence these attitudes. It is concluded that the behaviour of health personnel in relation to occupational risks is unrelated to factual knowledge, and further studies are needed to uncover behavioral determinants.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Outcome of short-term hospitalization for children with severe asthma.

This study presents results of a family-centered, short-term residential program in which medical, behavioral, and treatment assessments were provided to the child with severe asthma and the family. After a median stay of 15 days, forty-four consecutively admitted children with severe asthma achieved a 93% reduction in hospital days (median, 7 hospital days for the year before treatment versus median 0 hospital days per patient per year at 20 1/2-month follow-up; p less than 0.001) and an 81% reduction in emergency care (median, 4 visits for the year previously versus median, 0.4 visits per patient per year at follow-up; p less than 0.01). There was also a significant reduction in corticosteroid bursts and improvement in FEV1. Unique to this program was mandatory family participation focusing on the child's and family's adaptation to severe asthma and development of family-specific interventions to promote compliance with the treatment regimen. Child and family functioning was assessed at admission and follow-up. Hospital use at follow-up was greater for children from dysfunctional families. Families demonstrating difficulties in disciplining the child with asthma required more hospital days both before admission and at follow-up. Short-term hospitalization for children with severe asthma is associated with significant improvement in pulmonary morbidity when the family of the child is included in assessment and treatment.

Acute Disease↗