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PubMed2002

No evidence of an epidemic of locally acquired heterosexual HIV infection in Norway.

BACKGROUND: An early sign of a major heterosexual human immunodeficiency virus (HIV) epidemic will be heterosexual infection acquired from persons who were themselves infected through heterosexual intercourse. GOAL: To test the hypothesis that there is a growing heterosexual epidemic of HIV in Norway. STUDY DESIGN: Data from the mandatory, comprehensive, anonymous HIV case reporting system were analyzed concerning Norwegian residents who had acquired HIV heterosexually and for whom such infections were diagnosed before the year 2001. RESULTS: One hundred fifty-five (71%) of 221 men were infected abroad, whereas 107 (76%) of 140 women were infected in Norway (mainly by drug injectors and immigrants); 23 men and 55 women had been infected in Norway by partners who themselves acquired HIV through heterosexual intercourse (secondary heterosexual transmission). There was a slightly increasing incidence of all heterosexual cases and secondary cases. CONCLUSIONS: Secondary heterosexual HIV transmission remains rare in Norway, and a sustainable epidemic of locally acquired infection seems unlikely in the foreseeable future. The magnitude of the heterosexual epidemic will be strongly influenced by infections acquired abroad.

Adult↗
PubMed1998

Dermatologists' attitudes toward independent nonphysician electrolysis practice.

BACKGROUND: Dermatologists' attitudes toward independent electrolysis practice by nonphysicians has historically ranged from the critical to the praiseworthy. It is hypothesized that dermatologists' attitudes toward independent electrolysis practice by nonphysicians is related to physicians' perception of licensing requirements for independent nonphysician electrologists (INE). METHODS: Nine hundred and thirty-seven fellows of the American Academy of Dermatology (AAD) residing in the Southern United States were anonymously surveyed about independent electrolysis practice by nonphysicians. The results of the survey were analyzed using the Pearson chi-square test. RESULTS: Dermatologists who perceived that licensing was required for INE were significantly more likely to refer patients to INE for hair removal (P = 0.001) and prescribe EMLA cream (lidocaine 2.5% and prilocaine 2.5%) to patients requesting it for electrolysis performed by INE (P = 0.001). However, those dermatologists who had electrolysis services available in their practice settings (15.1%) were significantly less likely to refer patients to INE (P = 0.001) and to prescribe EMLA cream to patients seeking electrolysis from INE (P = 0.034). Only 5.7% of responding dermatologists supported the use of hair removal lasers by INE. CONCLUSION: Dermatologists' attitudes toward INE generally appear to be positively related to perceived licensure requirements for INE, but these positive attitudes do not extend to independent laser use by nonphysician electrologists for hair removal.

Allied Health Personnel↗
PubMed2004

The donor notification process from the donor's perspective.

BACKGROUND: Despite large numbers of blood donors being notified of abnormal infectious disease screening results, there has been little scientific study of the effects of this process. STUDY DESIGN AND METHODS: With a 28-item questionnaire, an anonymous mail survey was conducted of 4141 blood donors notified of 15 distinct categories of abnormal infectious disease screening and confirmatory test results. RESULTS: The survey had a 42 percent response rate, and 10 percent of the respondents did not recall being notified of their results. Of the 1556 respondents who recalled being notified, 27 percent contacted the blood center for further information, 60 percent discussed their results with a health care provider, and 73 percent of permanently or indefinitely deferred donors correctly understood their deferral status. Confusion and emotional upset were reported in 81 and 75 percent of notified donors, respectively. CONCLUSIONS: The notification process appears to achieve most of its aims in the majority of donors. Nevertheless, some donors did not understand that they were ineligible for future donation, and many donors were confused and upset. These data indicate that the adverse impact of notifying donors about abnormal test results needs to be considered when new blood donor screening tests and confirmatory algorithms are being licensed and implemented. Further studies of the effectiveness of newer revised donor notification materials are needed.

Adult↗
PubMed2004

The Internet and HIV study: design and methods.

BACKGROUND: The Internet provides a new meeting ground, especially for gay men, that did not exist in the early 1990s. Several studies have found increased levels of high risk sexual behaviour and sexually transmissible infections (STI) among gay men who seek sex on the Internet, although the underlying processes are not fully understood. Research funded by the UK Medical Research Council (2002-2004) provided the opportunity to consider whether the Internet represents a new sexual risk environment for gay and bisexual men living in London. METHODS: The objectives of the Internet and HIV study are to: (i) measure the extent to which gay men living in London seek sexual partners on the Internet; (ii) compare the characteristics of London gay men who do and do not seek sex on the Internet; (iii) examine whether sex with Internet-partners is less safe than with other sexual partners; (iv) compare use of the Internet with other venues where men meet sexual partners; (v) establish whether gay men use the Internet to actively seek partners for unprotected anal intercourse; (vi) determine the potential for using the Internet for HIV prevention. These objectives have been explored using quantitative and qualitative research methods in four samples of London gay men recruited and interviewed both online and offline. The four samples were: (i) gay men recruited through Internet chat rooms and profiles; (ii) HIV positive gay men attending an NHS hospital outpatients clinic; (iii) gay men seeking an HIV test in an NHS HIV testing or sexual health clinic; (iv) gay men recruited in the community. RESULTS: Quantitative data were collected by means of confidential, anonymous self-administered questionnaires (n>4000) completed on-line by the Internet sample. Qualitative data were collected by means of one-to-one interviews (n = 128) conducted either face-to-face or on-line. CONCLUSION: The strength of the Internet and HIV study is its methodological plurality, drawing on both qualitative and quantitative research among online and offline samples, as well as taking advantage of recent advances in web survey design. The study's findings will help us better understand the role of the Internet in relation to gay men's sexual practice.

Adult↗
PubMedDate not supplied

[Personality factors and psychiatry specialty attraction].

INTRODUCTION: In this article, we analyse the possible rapport between the determined trends of personality and the Psychiatry Specialty and we try determinate the existence of certain Profiles of Personality in the students who feel attracted by this specialty. MATERIAL AND METHOD: We analyse 1484 students of second year of Medicine Faculty's of the Valencia University (Spain). An anonymity interview about the sociodemographics characteristic and vocational interests of the students has done. We determinate their personality profile with the Test of personality 16 PF of Cattell. We analyse the dates with an t-Student Test. RESULTS AND CONCLUSIONS: The population analyses was of predominantly feminine (62.7%) and with an age medium of 20 years. The Psychiatry specialty was chose by the 8.06% of the students. These students tend be in reference with the another students sensitive, immature emotionally, insure. (I+) and unstable, impulsive, untidy (Q3-). The bibliographic revision tend to confirm this tendency.

Adult↗
PubMed2004

[Health risk behavior among students of vocational schools].

UNLABELLED: Behaviour of an individual person has a significant influence on the health. The stimulant abuse and lack of various safety regulations have an inefficient influence. The aim of the study was to identify the frequency of health risk behaviour among adolescents as well as the assessment of their level of health awareness. The investigated population consisted of third grade pupils from vocational schools in Poznań and Wagrowiec. Stereotypically, vocational schools' pupils are evaluated to have a low level of health awareness and to behave in unhealthy way. It was intended to find out if city versus small town young population differs on account of their health awareness and behaviour. A questionnaire was the basic tool to collect data. It was chosen because of its anonymity in order to guarantee honest answers. The results were analysed statistically using SPSS and Statistica programmes. Chi square and significance tests between two differences were used. The differences were statistically significant when p < 0.05. The results were subsequently analysed according to following independent variables: place of living, sex, parental education, the family economic self-evaluation. CONCLUSIONS: 1. The level of health awareness among the investigated population can be generally described as medium. 2. There were no differences in the level of health awareness between the city youth and the small town youth. 3. A large proportion of the youth had unhealthy behaviour. 4. City dwellers tended to behave recklessly more often. 5. The high level of health awareness was connected to less frequency of health risk behaviours.

Adolescent↗
PubMed2006

[Assessment of HBV, HCV and HIV injection in a population of Polish orthopedic surgeons].

UNLABELLED: Orthopedic surgeons are at risk for occupationally acquired infections with blood borne pathogens. OBJECTIVE: To estimate the prevalence of infection with HBV, HCV, CMV and HIV among orthopedic surgeons. DESIGN: Voluntary, anonymous serosurvey at an annual meeting of Polish Association of Orthopedic Surgeons held in Szczecin, Poland in 2004. Serum samples were tested for anti-HIV, anti-CMV IgG, anti-HCV and markers of HBV infection: anti-HBc total and HBs. RESULTS: Of 1000 eligible orthopedic surgeons at the meeting, 101 (10.4%) participated; 75% participants reported a percutaneous blood contact in the previous month. None of the doctors was positive for HIV (0%, 95% CI:0-3.7%). One participant (1%, 95% CI: 0.2-5.4%), 26 years in profession, had anti-HCV. There was evi-dence of infection with HBV in 10 of 96 participants (10.4%) who had reported having no nonoccupational risk factors and in 5 participants with such factors. None of them developed a chronic infection. Only 5 out of 15 doctors infected with HBV knew their serological status, 13 out of those 15 had been immunized with hepatitis B vaccine, 4 revaccinated. The immunization rate was 91%. The seroprevalence for CMV was 63/101 (62%); it increased with age (p < 0.0003). CONCLUSIONS: Despite infection control precautions and availability of hepatitis B vaccine, orthopedic surgeons remain at risk for acquiring bloodborne viral infection. CMV poses the highest risk, followed by HBV and HCV. As the majority of HBV infected doctors did not know their serological status and underwent immunization with hepatitis B vaccine, testing for anti-HBc before vaccination remains crucial.

Female↗
PubMed1986

The LAV/HTLV-III screening in Copenhagen. Epidemiological results from four clinics over the period 1 July 1984 to 1 April 1985.

Over the nine month period from 1st July 1984 to 1st April 1985, 737 persons attended the four AIDS-screening clinics in Copenhagen. The attendance was unconditional, and the examination free of charge. All were examined clinically and serologically for LAV/HTLV-III infection. Ninety-seven percent were males; 490 (68%) and 198 (28%) described themselves as homosexual or bisexual respectively. This study presents epidemiological data on that group. As in other studies, we found a relationship between anti-LAV/HTLV-III and male homosexual promiscuity, i.e. trends towards higher antibody prevalences, the higher the number of different sexual partners annually and the number of previous sexually transmissible diseases. The occurrence of 18 percent seropositivity in a group with no previous sexually transmissible disease indicate a dissemination of the infection to a subpopulation of Danish homosexuals with a nonpromiscuous lifestyle. Night sweats and lymph node enlargement as subjective complaints along with lymphadenopathy and anal pathology on objective examination were significantly (p less than 0.025) related to positive LAV/HTLV-III serology. Fifty-one percent (337 persons) had neither subjective symptoms nor objective signs, and 50 of these (28% of this asymptomatic group) were seropositive. At this stage of the AIDS epidemic, it is important for surveillance purposes that anti-LAV/HTLV-III testing is made available to all members of risk groups. The establishment of the screening clinics with unconditional attendance and ensured anonymity seems to be an important step in this effort.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Prevalence of chlamydial infection and frequency of risk behaviours for STDs and HIV infection among adolescents in public juvenile facilities in the province of Quebec.

This study aimed to determine the prevalence of chlamydial infection in adolescents entering public juvenile facilities in the province of Quebec and the frequency of their risk behaviours for STDs and HIV infection. Adolescents were asked to complete an anonymous self-administered questionnaire and to be screened for Chlamydia trachomatis. Of 731 sexually active adolescents, 62% agreed to be tested. The overall prevalence rate was 7.7% (95% confidence interval: 5.1%-10.3%). The prevalence was significantly higher in female than in male teenagers: 12% vs 3% (p < 0.001, Fisher's exact test). These results suggest that screening for chlamydial infection should be offered to all sexually active female teenagers admitted into juvenile facilities. For males, selective screening taking into account sexual history would be a more realistic approach. The frequency of high risk activities for STDs and HIV infection points to the importance of specific prevention programs for this population.

Adolescent↗
PubMedDate not supplied

[Viewing of horror and violence videos by adolescence. A study of speech samples of video consumers with the Gottschalk-Gleser Speech Content analysis].

In 1990 pupils of different schools in Württemberg were interviewed about their television and video consumption. It turned out that a high percentage of mainly male pupils of Hauptschulen (upper division of elementary schools) and special schools excessively and regularly consumed films which were on the index (X-rated) or seized depicting horror and violence. Subsequent to the inquiry through questionnaires and different personality tests, speech samples of 51 test persons were recorded on tape. 5 speech samples had to be excluded from further investigation since they contained less than 70 words. The transcribed and anonymized records were examined according to the Gottschalk-Gleser content analysis of verbal behavior, and two groups of so-called seldom lookers (n = 22) and frequent lookers (n = 24) were compared to each other. The frequent lookers significantly often reported about film contents which presumably means that their imagination is more restricted and less productive than that of the other group. In addition, this group of frequent lookers had significantly higher scores concerning death anxiety and guilt anxiety. With regard to hostility affects, their scores were also significantly raised concerning outward-overt hostility, outward-covert hostility, and ambivalent hostility. Probably the group of frequent lookers comprised more test persons with relationship disorders, with borderline risks, dissocial personality features, and problems to cope with their aggressiveness. So they show on the one hand a raised affinity to watch such films, but simultaneously unconscious and conscious learning processes take place which stimulate further aggressive fantasies (and possibly also actions).

Adolescent↗
PubMed2004

[Four years of quality assurance of dermatologic procedures: report from the ABD clearing institution].

BACKGROUND: Expert dermatologic evaluation is the most relevant tool for secondary prevention in occupational dermatology in Germany. If there is a possibility of a work-related skin disorder in an employee, dermatologists may conduct the relevant diagnostic procedures (e.g. patch-and prick-tests, serology) at the expenses of the public employers' liability insurance fund (UVT). Most dermatologists make careful use of this unparalleled privilege, which is also an obligation. However, recently, with an increasing number of dermatologist's reports submitted, there have been occasional complaints by the UVT concerning overly extensive testing. In 1999 the Task Force on Occupational and Environmental Dermatology (ABD) of the German Dermatological Society established a clearing procedure. Two experienced occupational dermatologists will--separately--give their expert opinion on dermatologist's reports which have been forwarded anonymously by the UVT for expert review. RESULTS: Thus far, from May 1999 to May 2003 155 dermatologist's reports have been submitted to the clearing procedure. The complaints were in > 95% of cases considered justified by the experts. Their criticism was primarily directed towards excessive testing procedures and failure to provide sufficient clinical information. CONCLUSIONS: The UVT does not undertake such extensive preventive efforts for any other occupational disease. Therefore, quality management of the dermatologist's procedure--conducted by dermatologists and providing transparency--is essential to maintain and develop this effective tool of secondary prevention for the benefit of workers and employers.

Germany↗
PubMed2002

[Detection of HIV antibodies in clients of the AIDS Center of the District Health Service in Karvina 1993-2000].

The authors present the trends of some characteristics recorded in a group of subjects examined for HIV antibodies in the AIDS centre of the District Hygiene Station in Karviná in 1993 to 2000. These characteristics reflect the development of activities of the centre. During the period a total of 3733 HIV tests were made, incl. three positive ones. In two instances men with homosexual relations in the case-history were involved, in one case a male heterosexual. The declining trend of the ratio of anonymous examinations is apparent from 58.8% in 1993 to 7.7% in 2000. Parenteral drug users, prostitutes (in particular women) and homosexuals account on a long-term basis for ca 30% of all examinations. Recently this ratio is even higher. Repeated examinations (check-ups) of the same client account for 16.1% of all implemented HIV tests. At least once 384 parenteral drug users were examined, in prostitutes similarly as in men with homosexual relationships the number of subjects examined at least once is ca 200. Repeated tests were made in ca one quarter of all parenteral drug users, ca one third of the prostitutes and ca one fifth of homosexuals. In none of the repeated tests seroconversion to HIV positivity was recorded. To achieve close contact and monitoring of the HIV statute of groups with a risk behaviour despite their existence at the brink of law and despite their natural tendency to hide is real. Without collaborating organizations, without gaining their confidence and in particular without the confidence of the clients this would not be possible.

Adolescent↗
PubMed2002

Reliability of the 1999 youth risk behavior survey questionnaire.

PURPOSE: To assess the test-retest reliability of the 1999 Youth Risk Behavior Survey (YRBS) questionnaire. METHODS: A sample of 4,619 male and female high school students from white, black, Hispanic, and other racial/ethnic groups completed the YRBS questionnaire on two occasions approximately two weeks apart. The questionnaire assesses a broad range of health risk behaviors. This study used a protocol that maintained anonymity yet allowed matching of Time-1 and Time-2 responses. The authors computed a kappa statistic for the 72 items measuring health risk behaviors, and compared group prevalence estimates at the two testing occasions. RESULTS: Kappas ranged from 23.6% to 90.5%, with a mean of 60.7% and a median of 60.0%. Kappas did not differ by gender, grade, or race/ethnicity of the respondent. About one in five items (22.2%) had significantly different prevalence estimates at Time 1 vs. Time 2. Ten items, or 13.9%, had both kappas below 61% and significantly different Time-1 and Time-2 prevalence estimates. CONCLUSIONS: Overall, students appeared to report health risk behaviors reliably over time, but several items need to be examined further to determine whether they should be revised or deleted in future versions of the YRBS.

Adolescent↗
PubMed1999

Interethnic differences in the humoral response to non-repetitive regions of the Plasmodium falciparum circumsporozoite protein.

We analyzed the humoral immune response to the amino- (amino acids 22-125) and carboxy-terminal (amino acids 289-390) non-repetitive domains of the Plasmodium falciparum circumsporozoite protein (PfCSP) in individuals belonging to three west African ethnic groups (the Fulani, Mossi, and Rimaibé) living in the same conditions of hyperendemic transmission in a Sudan savanna area of Burkina Faso. Previous surveys conducted in the same area showed obvious interethnic differences in the susceptibility and immune reactivity to malaria, with the Fulani showing lower infection and disease rates and higher humoral responses to various P. falciparum antigens than sympatric ethnic groups. A total of 764 subjects (311 Mossi, 273 Rimaibé, and 180 Fulani) of all age classes were tested. The total mean +/- SE anti-(CSPf-N-term) and anti-(CSPf-C-term) seroprevalences were 65.6 +/- 1.7% and 57.0 +/- 1.8%, respectively. These seroprevalences were lower than that recorded in the same sample for the central (NANP)40 repetitive domain (88.3 +/- 1.2%). As previously reported for other P. falciparum antigens (PfCSP-(NANP)40, thrombospondin-related anonymous protein, merozoite surface protein-1, Pf155-ring-infected erythrocyte surface antigen, and Pf332), in spite of similar exposure to malaria, the Fulani showed higher immune reactivity than sympatric populations for both antigens tested. Our results confirm the presence of B cell epitopes in the non-repetitive regions of the PfCSP; moreover a further evidence of interethnic differences in the capacity to mount humoral responses against P. falciparum malaria was obtained. The assessment of the biological basis of interethnic heterogeneities in the susceptibility and in the humoral immune responses to malaria appears relevant in the development of anti-malaria vaccines.

Adolescent↗
PubMed1986

Recognition memory and psychophysiological responses to stimuli with neutral or emotional content: a study of Korsakoff patients and recently detoxified and longterm abstinent alcoholics.

Possible relations between chronic alcohol abuse and impairments in cognitive functioning were tested in six groups of subjects, groups A1, A2, CGy, AA, KO, and CGo: The first three groups were about 35 years old, the last three about 50 years. Groups A1 and A2 each consisted of ten men hospitalized for the treatment of alcohol dependency, group A1 having been detoxified for less than one week, and group A2 for more than five months. Group CGy constituted the matched control group. Group AA consisted of six Alcoholics Anonymous, sober for more than five years, nine Korsakoff patients made up group KO, and group CGo was the control group matched for groups AA and KO. As the main tests, all subjects were given a number of slides showing scenes, humans, or animals, half of which had been rated as neutral while the other half was emotionally arousing (in either a negative or a positive way). In two tests, one after ten minutes, and one after two days, the subjects were required to reidentify those slides which they had seen before, and their galvanic skin response was measured simultaneously. Several psychological tests including one for paired associate learning were given as well. The main results were that alcoholics, whether they had been abstinent for a longer time or not, were inferior to nonalcoholics, but that a prolonged period of soberness nevertheless most likely leads to the recovery of cognitive functions. Though the underlying causes of the cognitive deficits found in the four experimental groups (A1, A2, AA, KO) may be due at least in part to different or even contradictory underlying causes, they provide support for "simple versions" of the so-called continuity and premature aging hypotheses.

Adult↗
PubMed2003

Correlation of standardized testing results with success on the 2001 American Board of Physical Medicine and Rehabilitation Part 1 Board Certificate Examination.

OBJECTIVE: To determine if standardized testing results and other factors correlate with success on the 2001 American Board of Physical Medicine and Rehabilitation part 1 board certification examination (POE). DESIGN: An anonymous two-part survey was distributed to 302 senior resident physicians in the American College of Graduate Medicine Education-accredited physical medicine and rehabilitation training programs in the United States deemed eligible for the 2001 POE. RESULTS: A total of 94 of 302 distributed surveys (31.1%) were returned; 86 met the inclusion criteria (81 passes and five failures). A significant correlation was found between both quartile ranking on the Self Assessment Examination and United States Medical Licensing Examination (USMLE) passage on the first attempt with POE quartile rank (P < 0.01). Other factors, such as number of hours of faculty-led didactics per week, textbook use, and participation in formal board review courses did not correlate with POE quartile ranking. CONCLUSION: Residents who were successful on previous standardized tests scored well on the POE. Quartile ranking on Self Assessment Examination and USMLE or National Board of Osteopathic Medical Examiners success was found to correlate significantly with POE quartile rank. This information may be helpful for future POE preparation and prospective candidate selection for physical medicine and rehabilitation.

Educational Measurement↗
PubMed2003

Peace test: is war sometimes a better solution? Survey of students of Zagreb and Mostar Schools of Medicine.

AIM: To investigate the differences among medical students from two medical schools, one in Zagreb, Croatia, and the other in Mostar, Bosnia and Herzegovina, in their affinity towards peaceful vs violent way of solving conflicts. METHODS: A total of 733 students from the Zagreb and 102 medical students from the Mostar University School of Medicine filled out an anonymous questionnaire during their enrollment into the next academic year. The questionnaire consisted of 10 Likert-type questions with 1-5 answer scale, which were designed to give an illustration of students' attitude towards war. The test score was calculated as the sum of all answers x 2+20. The total score ranged from minimum 40 to maximum 120 points, with a higher score indicating stronger inclination toward peaceful way of solving conflicts. RESULTS: There was no difference between the mean total scores of Zagreb and Mostar students (66-/+17 and 67-/+18, respectively; p=0.744). The mean score of female students was higher than that of male students (71-/+19 vs 63-/+16; p<0.001) for the whole sample as well as for Zagreb and Mostar samples separately (p<0.001 for both). The average score of 2.3-/+0.9 per question indicated that the students' choice was mostly undecided on war-prone activities. Younger students were more war-prone than older ones (p=0.008 for age, and p=0.024 and 0.013 for comparisons between students in earlier and later academic years). Students from cities that were affected by war but not severely damaged seemed less war-prone than students from cities that were either seriously damaged or not directly affected by war (p=0.032). CONCLUSION: Women, older students, and students from cities that were under war threat but not seriously damaged showed to be more morally engaged towards peace.

Adult↗
PubMed1998

Ethical and legal issues in the procurement, storage and use of DNA.

At the risk of ignoring the benefits, the problems of genetic testing have been widely discussed. Many clinical laboratories are archival stores for human tissues and very few have formal policies and procedures for the use of this material. There is little evidence of planning or preparation of appropriate protocols for the safekeeping of the collected clinical material. The process of informed consent needs to be re-examined. The standard of what would be expected by a reasonable and prudent person poses challenging questions relating to confidentiality and privacy, control and ownership of the stored tissue and cells, withdrawing from a research study, length of storage of samples, the use of biological materials by other parties, and the use of biological materials for purposes other than those for which they were first obtained. There also needs to be a clear understanding of identifiable, non-identifiable and anonymous samples. Clinical laboratory staff and their professional organisations need to engage in the discussion and development around the ethical, legal and social issues raised by testing human DNA. Clinical research laboratories will be increasingly involved in DNA testing and will be asked for access to stored blood or tissue. It is essential that professional responsibility is understood and is then exercised in the presence of appropriate policies and procedures. There is also a paramount need to involve the public who are already demonstrating evidence of alienation from the world occupied by genetics research.

Confidentiality↗