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PubMed1983

The U.S. Uranium Registry tissue program.

The U.S. Uranium Registry tissue program was established in December 1980. It is patterned after the U.S. Transuranium Registry program. Both are funded by DOE. The objectives of the program are to: (1) detect the presence and distribution of uranium, if any, in human tissue in occupationally exposed workers, (2) compare bioassay and in vivo measurements for exposed individuals with the results of analysis of tissue obtained at autopsy, (3) seek evidence of histopathological changes related to any uranium deposition found, (4) conduct analyses of whole bodies, when available, to obtain more precise data on the uranium burdens, if any, in the body and organs, and especially the distribution in parts of the body, such as most of the skeleton, that are not usually accessible for sampling. The program will include (1) participants who have been permissibly exposed, (2) participants who were exposed at a time when current limits did not exist and (3) reference individuals without exposure. The program will develop data that will assist in evaluating (1) the accuracy of current in vivo measurement techniques, (2) the propriety of existing regulations and (3) the adequacy of current protection programs. Enrollment in the program is voluntary.

Autopsy↗
PubMed2001

Unsuccessful voluntary prenatal testing for human immunodeficiency virus infection.

Within the Kaiser Permanente system of Northern California, testing for HIV during prenatal vis its was encouraged. During a 5-year period the percentage of women agreeing to HIV testing increased from 50% to 76%. Eighty-three HIV-positive pregnancies occurred in 63 women. Only 17 (20%) of the 83 pregnancies were identified by the voluntary testing program.

AIDS Serodiagnosis↗
PubMedDate not supplied

Voluntary human immunodeficiency virus testing, recidivism, partner notification, and sero-prevalence in a sexually transmitted disease clinic: a need for mandatory testing.

Universal, voluntary testing for antibodies to the human immunodeficiency virus (HIV) was offered to 17,092 eligible clients attending a public sexually transmitted disease clinic between March, 1988 and June, 1989. In an environment of legally mandated reporting and partner notification, 15,649 (91.6%) clients were tested, 160 of whom were HIV sero-positive. Client acceptance of testing is discussed, and the serologic data compared with results of a federally funded sero-prevalence survey conducted in-clinic. A recidivism rate of 20% was observed among sero-positive individuals. Of 159 contacts for whom HIV sero-status was determined, 66 (42%) were seropositive. It is proposed that, in the setting of sexually transmitted disease clinics, HIV testing be changed from a voluntary service to a mandatory test. Some benefits of this change are defined.

AIDS Serodiagnosis↗
PubMed1991

Voluntary human immunodeficiency virus testing: acceptance levels and identification of seropositive individuals.

Of 4340 clients of a clinic for those with sexually transmitted diseases who were eligible for voluntary, confidential, serologic testing for the human immunodeficiency virus, 4246 (97.8%) consented to testing; 23 (0.5%) were seropositive. Of 94 persons who declined voluntary testing but who were tested in a blinded study, nine (9.6%) were seropositive. Seropositive persons who declined voluntary testing did not conceal their association with a risk group, while only 61% of seropositive individuals who accepted voluntary testing admitted to inclusion in a risk group before the test. Voluntary testing appears to be insufficient, because 28% of the seropositive individuals were not identified as being seropositive; also, there was a significant deficiency associated with identification of risk at pretest counseling among persons agreeing to voluntary testing.

AIDS Serodiagnosis↗
PubMed1994

Comparison of individuals receiving anonymous and confidential testing for HIV.

We assessed the magnitude, demographics, seroprevalence, and reasons for site selection among South Carolina residents who chose to be tested in bordering states offering anonymous testing for human immunodeficiency virus (HIV). Residents tested from July 1990 through July 1991 at selected HIV testing sites in bordering states were surveyed and HIV test results were recorded. Of the 75 residents tested at these sites, 66 (88%) were white, 44 (59%) were male, and 9 (12.3%) of the 73 whose test results were recorded were HIV infected. During the same period, 57,137 individuals were HIV tested in-state by the state health department, of which 1,752 (3.1%) were positive. Residents tested outside the state were more likely to be HIV infected, male, and white than individuals tested within the state. Our findings suggest that although large numbers of South Carolinians are not HIV tested anonymously in other states, those tested anonymously out of state have a different demographic and risk profile than those tested confidentially in state.

Adolescent↗
PubMed2003

Voluntary HIV testing among inmates: sociodemographic, behavioral risk, and attitudinal correlates.

We sought to determine the prevalence and correlates of self-reported HIV testing among inmates in correctional centers in Ontario, Canada. A cross-sectional survey was conducted with a stratified random sample of 597 male and female adult inmates. The participation rate was 89%. Descriptive statistics and multiple logistic regression were used to analyze HIV testing. Fifty-eight percent had ever been tested, and 21% had voluntarily tested while incarcerated in the past year. Having ever been tested was more common among those at risk for HIV through injection drug use (IDU) or sexual behavior. Testing while incarcerated in the past year was independently associated with being single (OR = 2.6), frequent IDU (OR = 4.0), not having casual sex partners prior to incarceration (OR = 0.53), a history of hepatitis (OR = 2.4), previous HIV testing (OR = 3.7), a close relationship with an HIV-positive person in the outside community (OR = 1.7), knowing an HIV-positive person inside (OR = 2.7), a perceived chance of being infected during incarceration (OR = 2.2), and support of mandatory testing (OR = 2.0). The predominant motivations for testing while incarcerated were IDU or fears of infection inside, possibly through contact with blood, during fights, or even by casual contact. Voluntary HIV testing in prison should be encouraged, and inmates should receive appropriate counseling and information to allow realistic assessment of risk.

AIDS Serodiagnosis↗
PubMed2006

'We couldn't function without volunteers': volunteering with a disability, the perspective of not-for-profit agencies.

Volunteers play an important role in many organisations that deliver services for the public good. Many people within the community choose to volunteer and there is a rich literature on the reasons why people do so, as well as the benefits that accrue to individuals, organisations and the community. However, there are few reports of people with long-standing disability becoming volunteers. The aim of this study was to explore the views of volunteer coordinators in not-for-profit organisations concerning people with long-standing disability as volunteers. Seven coordinators participated in two focus groups. The participants identified opportunities for people with a disability to contribute as volunteers, but were also quick to point out significant barriers. The findings from this exploratory study suggest that if people with long-standing disability are to volunteer, consideration must be given to their individual requirements and overcoming negative community attitudes.

Communication Barriers↗
PubMed2006

Botswana's Tebelopele voluntary HIV counseling and testing network: use and client risk factors for HIV infection, 2000-2004.

BACKGROUND: : HIV services, including voluntary counseling and testing (VCT) and antiretroviral (ARV) therapy, expanded rapidly in Botswana from 2000 through 2004. METHODS: : Client data from Botswana's Tebelopele VCT network were analyzed to describe clients, factors associated with HIV infection, and trends in VCT use. RESULTS: : Tebelopele provided free, anonymous, same-day HIV tests for 117,234 clients from 2000 through 2004. Before ARV therapy was available, 8.3% of clients sought a test because of illness, and 26.3% were HIV-positive. After ARV therapy became available, 20.1% of clients sought a test because of illness, and 38.8% were HIV-positive. Most VCT clients (82.7%) were unmarried; 89.8% reported no or 1 sexual partner in the last 3 months; and 50.2% of unmarried clients reported always using condoms in the last 3 months. In multivariate analysis, higher educational level, marriage, and always using condoms were associated with a lower risk of HIV. Having only 1 recent sexual partner was associated with less condom use and a higher risk of being HIV-positive for men. CONCLUSIONS: : VCT has been well accepted in Botswana. Analysis of this data set supports efforts to promote 100% condom use and to emphasize that partner reduction must be combined with condom use and HIV testing to protect against HIV.

Adult↗
PubMed1994

The notion of gift-giving and organ donation.

The analogy between gift-giving and organ donation was first suggested at the beginning of the transplantation era, when policy makers and legislators were promoting voluntary organ donation as the preferred procurement procedure. It was believed that the practice of gift-giving had some features which were also thought to be necessary to ensure that an organ procurement procedure would be morally acceptable, namely voluntarism and altruism. Twenty-five years later, the analogy between gift-giving and organ donation is still being made in the literature and used in organ donation awareness campaigns. In this paper I want to challenge this analogy. By examining a range of circumstances in which gift-giving occurs, I argue that the significant differences between the various types of gift-giving and organ donation makes any analogy between the two very general and superficial, and I suggest that a more appropriate analogy can be found elsewhere.

Altruism↗
PubMed2006

Randomised controlled trial of a parenting intervention in the voluntary sector for reducing child conduct problems: outcomes and mechanisms of change.

BACKGROUND: To test effectiveness of a parenting intervention, delivered in a community-based voluntary-sector organisation, for reducing conduct problems in clinically-referred children. METHODS: Randomised controlled trial, follow-up at 6, 18 months, assessors blind to treatment status. Participants--76 children referred for conduct problems, aged 2-9, primarily low-income families, randomised to treatment vs. 6-month wait-list group. Retention was 93% at 6 months, 90% at 18 months. Interventions--Webster-Stratton Incredible Years video-based 14-week group programme, teaches cognitive-behavioural principles for managing behaviour, using a collaborative, practical, problem-solving approach. Primary outcomes--child problem behaviour by parent-report (Eyberg) and home-based direct observation; secondary outcomes--observed positive and negative parenting; parent-reported parenting skill, confidence and depression. RESULTS: Post-treatment improvements were found in child problem behaviour, by parent-report (effect size (ES) .48, p = .05) and direct observation (ES .78, p = .02); child independent play (ES .77, p = .003); observed negative (ES .74, p = .003) and positive (ES .38, p = .04) parenting; parent-reported confidence (ES .40, p = .03) and skill (ES .65, p =.01), using ANCOVA to control for baseline scores. Maternal depression did not change. Consumer satisfaction was high. At 18-month follow-up, although no randomised comparison was possible, changes appeared to maintain, with no significant change toward baseline level on any measure. Change in observed positive parenting appeared to mediate change in child problem behaviour (p < .025). CONCLUSIONS: Findings suggest that a group-based cognitive-behavioural parenting programme, delivered by well-trained and supervised staff, can be effective in a community voluntary-sector setting, for reducing conduct problems and enhancing parenting skills. Change in parenting skill appears to be a key mechanism for change in child behaviour. Findings have implications for feasibility of translating evidence-based programmes, even for clinically-referred conduct problems, into less specialised community settings, likely to have lower costs and be more accessible for families.

Child↗