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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

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

Reporting alcohol-impaired drivers: results from a national survey of emergency physicians.

STUDY OBJECTIVE: The purpose of this exploratory study was to learn of physicians' opinions on mandatory reporting of alcohol-impaired drivers they encounter in the course of their clinical work to the police or authorities from the Division of Motor Vehicles. DESIGN AND PARTICIPANTS: Two thousand four hundred sixty-four physicians randomly selected from the American College of Emergency Physicians were sent an anonymous, one-time only, self-administered questionnaire seeking demographic information and assessing attitudes toward mandatory reporting and alcohol treatment. MEASUREMENTS AND MAIN RESULTS: One thousand fifty-five physicians returned the survey. Seventy-eight percent of respondents agreed with mandatory reporting. More than half expressed strong agreement. Through canonical discriminant analysis we are able to identify the complex factors influencing attitude toward mandatory reporting. CONCLUSION: Although our preliminary results must be interpreted with caution, it appears that with the appropriate legal safeguards, physicians are supportive of mandatory reporting of the alcohol-impaired driver encountered in the course of clinical work.

Adult

Screening for human immunodeficiency virus.

Screening for human immunodeficiency virus (HIV) antibodies as a means of preventing both the progress and spread of acquired immunodeficiency syndrome (AIDS) is problematic in terms of efficacy, effectiveness, and ethics. The few desired effects are mostly offset by greater and more certain undesirable effects on individuals and society.

AIDS Serodiagnosis

What hope for AIDS?

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Acquired Immunodeficiency Syndrome