Attitudes, beliefs, and practices of nursing students concerning HIV/AIDS: implications for prevention in women

Nursing students are a group of predominantly young women who may be sexually active but who are well educated and presumably health conscious. It might be expected, therefore, that they are not a population at risk for sexually acquired HIV infection. Recent studies indicate that heterosexual women constitute the fastest growing population of persons with AIDS in the United States and Canada (Health and Welfare Canada, 1993b; Wofsky, 1992) and that women and adolescents will constitute the next surge of the AIDS epidemic (Novello, 1993). First-year nursing students in a major Canadian city were surveyed regarding HIV-related knowledge, attitudes, beliefs, and behaviors. The women were highly knowledgeable about HIV transmission but 15% to 25% reported high risk sexual behavior. The results reinforce that knowledge is not enough to prevent HIV infection among young women and that interventions must be based on an understanding of the social context of women's lives.     

Attitudes of oncologists, family doctors, medical students and lawyers to euthanasia

OBJECTIVE: To evaluate clearance of the vaccine strain, immunologic responses, and potential shedding of Brucella abortus strain RB51 organisms after vaccination of bison calves. ANIMALS: Fourteen 7-month-old female bison calves. PROCEDURE: 10 bison calves were vaccinated SC with 1.22 x 10(10) colony-forming units of B abortus strain RB51. Four bison calves were vaccinated SC with 0.15M NaCl solution. Rectal, vaginal, nasal, and ocular swab specimens were obtained to evaluate potential shedding by vaccinated bison. The superficial cervical lymph node was biopsied to evaluate clearance of the vaccine strain. Lymphocyte proliferative responses to strain RB51 bacteria were evaluated in lymph node cells obtained from biopsy specimens and also in peripheral blood mononuclear cells. RESULTS: Strain RB51 was recovered from superficial cervical lymph nodes of vaccinates examined 6, 12, and 18 weeks after vaccination (4/4, 3/4, and 1/4, respectively) but not in vaccinates examined at 24 weeks (0/3) after vaccination or nonvaccinates examined at all sample collection times (n = 1 bison/sample period). Serologic, immunologic, and bacterial culture techniques failed to reveal shedding of strain RB51 by vaccinates or infection of nonvaccinated bison. Lymphocyte proliferative responses were evident in lymph node cells and blood mononuclear cells from strain RB51-vaccinated bison beginning 12 weeks after vaccination. CONCLUSION: Strain RB51 was cleared from bison by 18 to 24 weeks after vaccination. Bison vaccinated with strain RB51 did not shed the vaccine strain to nonvaccinated bison housed in close proximity. Strain RB51 did not induce antibody responses in bison that would interfere with brucellosis surveillance tests, but did stimulate cell-mediated immunity.     

Attitudes toward abortion in Thailand: a survey of senior medical students

A majority of senior Thai medical students favored induced abortion in many circumstances not now considered legal. While 20 percent would not perform abortions for any reason, many of these would refer cases to colleagues. Independent variables consistently and significantly influencing attitudes conservatively were: female sex, certain medical schools attended, larger ideal family size, intention not to teach in a medical school as a career, having a father in unskilled or semiskilled or work, never having witnessed an illegal abortion, and never having been asked to find an abortion practitioner for a friend. A random reordering of the questions did not affect reports of attitudes toward or willingness to perform induced abortion.     

HIV infection and AIDS

The entry of one HIV virion into a human being has the potential to cause death by the inexorable replication of the virus within the principal T lymphocyte, the CD4+ T cell. Although combination antiretroviral therapy, particularly therapy with protease inhibitors, decreases the viral burden to very low, even undetectable, levels, sequestration of the virus in privileged sites, including a long-lived CD4+ T cell, has frustrated efforts at eradication of HIV. Activation of the immune system, therefore, appears essential before this infection can be conquered. Powerful vaccines capable of preventing infection remain the hope of the world.     

HIV/AIDS risk factors among adolescent students in Puerto Rico, 1994

PURPOSE: Identify several HIV risk behaviors among adolescent students. METHODS: The sample (n = 3,648) was selected using a two-staged stratified cluster sampling design, and weighted to represent all junior high and high school students. RESULTS: About 28.8% of the students reported ever having sexual activity. Less than half of the sexually active (44.5%) used condoms during their last sexual activity; 27.6% used them always. Only 54.7% knew correctly > 75% of the HIV knowledge questions. A HIV risk scale was constructed using five risk factors. About 15.9% of the students did not have any risk factor, 36.2% had one, 47.9% had two or more. Males and high school students had significantly more risk factors. Half of the students will abstain from having sex next year because they don't want to get HIV/AIDS. CONCLUSIONS: It is important to implement effective HIV prevention programs for adolescents in order to change their attitudes and behaviors.     

Multimedia to teach urology to medical students

OBJECTIVES: To test the hypothesis that an interactive multimedia-based computer application may be used to teach urology to undergraduate medical students. METHODS: Third-year medical students rotating on their urology clerkship were studied. Student knowledge was measured with a multiple choice test administered in a pretest-post-test experimental design. The educational intervention was a multimedia-based application that presented a clinical module on hematuria, using natural language-like entries. Student attitudes toward the multimedia application were assessed by a survey. RESULTS: Twenty-three consecutive third-year medical students participated. Mean pretest and post-test scores +/- standard deviation were 35%+/-11% versus 74%+/-17%, respectively, P<0.0001. Student questionnaire responses indicated highly positive opinions that the multimedia-based module was easy to use, was fun, provided natural patient responses, had clear exercises, provided immediate feedback, was educational, and had a nonthreatening format, and that the multiple choice questions were clear and fair. CONCLUSIONS: Multimedia-based education may be used to teach urology to undergraduate medical students.     

Family responses to HIV/AIDS in Mexico

This paper presents findings from a qualitative study of household and community responses to HIV/AIDS in Mexico. Fieldwork took place in two contrasting settings: (a) Ciudad Netzahualcóyotl, a socially marginalized urban community and (b) the homosexual community of Mexico City, a sexually marginalized social network. 113 in-depth interviews were conducted with people with HIV/AIDS, their relatives and members of their social networks. This paper describes findings from interviews conducted with family members of persons with AIDS. Four stages of response are identified and characterized within each community: (i) life before AIDS, (ii) life during the discovery of AIDS, (iii) living with a person with AIDS and (iv) surviving those who have died from AIDS. The social marginalization of both communities is central in explaining how families respond to the disease. In Ciudad Netzahualcoyotl, social support derives from a local culture of kinship. In the gay community, on the other hand, solidarity arises out of friendship. Between social support and discrimination, many more "ambivalent" behaviours (neither fully supportive nor discriminating) are displayed by family members and friends. Fear, pre-existing family conflicts and prejudice nurture these negative responses. Family responses and the processes to which they give rise, also differ depending on whether or not a male or female household member is affected. Policy recommendations are made concerning how best to promote positive family and household responses to persons with HIV/AIDS and how to inhibit negative ones.     

Conjuring medical science: the 1986 referendum on AIDS/HIV policy in California

Medical science occupies a peculiar status in American life. On the one hand, people often view medical science as a privileged and authoritative body of knowledge that transcends other kinds of knowledge. On the other hand, medical-scientific authority can be easily conjured from the popular symbols of science, e.g., credentials, technical terms, and white lab coats. This problem can be converted into an anthropological question of meanings and symbols, based on Geertz's interpretive anthropology and Baudrillard's sociology of hyperreality. This article uses these frameworks to explore the cultural construction of medical-scientific authority in the case of a 1986 referendum on AIDS/HIV policy in California. The interpretation of that construction raises some difficult problems concerning anthropology's treatment of medical science.     

AIDS is ... reflections on the Australian research response to the HIV and AIDS epidemics

Drawing on institutional history, biography, and interviews with key informants from the range of academic disciplines that have contributed to the Australian response to the HIV and AIDS epidemics, this article provides critical insights into the factors that have shaped the Australian research response. The author demonstrates conflicts between disciplines that are rooted in epistemological differences. While the conflicts and tensions are often expressed in terms of access to resources, the disputes are grounded in the relative power of academic disciplines, most particularly the preeminence of biomedicine, and are related to the weight attributed to the various knowledge claims of those disciplines.     

Research ethics and HIV/AIDS

The effect of 2-chloroadenosine (2CA), an adenosine receptor agonist, on the activation status of mouse natural killer (NK) cells was determined. Splenic lymphocytes incubated with 2CA exocytosed an NK cell-associated granzyme with N alpha-CBZ-L-lysine thiobenzyl ester (BLT) esterase activity in a dose- and time-dependent manner. Selective depletion of NK cells by anti-asialoGM1 antibody plus complement pretreatment confirmed that NK cells were the source of the BLT esterase activity. 2CA-induced granule exocytosis was not reduced in the presence of the nucleoside uptake blockers NBTI, dilazep, or dipyridamole, indicating the involvement of an extracellular receptor. However, adenosine or other A1, A2, or A3 cell-surface adenosine receptor agonists failed to trigger the exocytotic process. Furthermore, the nonselective adenosine receptor antagonist theophylline, as well as the selective A1 receptor antagonist DPCPX and the selective A2 receptor antagonist DMPX, did not interfere with 2CA-induced BLT esterase secretion. These data suggest that 2CA acts on NK cells via a novel (non-A1/A2/A3) cell-surface receptor. Genistein, a protein tyrosine kinase inhibitor, and calphostin C, a protein kinase C inhibitor, both interfered with 2CA-induced granule exocytosis. Pertussis toxin, an ADP-ribosylating toxin to which certain GTP-binding proteins are sensitive, also inhibited 2CA-stimulated BLT esterase release. In addition, 2CA-induced granule exocytosis was reduced in the presence of cyclosporin A, an inhibitor of Ca(2+)-dependent signaling pathways, and the Ca(2+)-chelating agent EGTA. We conclude that 2CA, acting through a novel extracellular receptor on mouse NK cells, triggers granule exocytosis via a Ca(2+)-dependent signal transduction pathway that is coupled to GTP-binding proteins and involves protein tyrosine kinase and protein kinase C activation.     

How to teach literature to medical students?

A pair of monozygotic twins suffering from noisy respirations and recurrent wheezes since early infancy were referred for evaluation. Using direct coronal CT and 3-dimensional reconstruction of the airway, congenital tracheobronchial stenosis was found in both twin babies, later confirmed by fibre optic bronchoscopy. The cause of congenital tracheobronchial stenosis remains obscure, but even in monozygotic twins an unidentified environmental factor cannot be excluded and may be responsible for discordant bronchopulmonary abnormalities. CONCLUSION: This case report shows that tracheobronchial stenosis may present in monozygotic twins. The pattern of malformation in twins differs from cases described previously.     

A national survey to medical and dental schools to assess the level of undergraduate teaching and research about HIV/AIDS in the UK

Rats given an antagonist against N-methyl-D-aspartate, (+)-10, 11-dihydro-5-methyl-5H-debenzo (a, d) cycloheptene-5, 10-imine (MK-801), were compared with control rats for their activity and exploratory behavior (habituation, exploration time to the spatial change of one of 4 objects and to the new object) in a circular open field. Rats given 0.07 mg/kg dose of MK-801 displayed no significant differences with the controls. Rats given 0.1 mg/kg dose of MK-801 failed to respond to the spatial change, whereas they displayed habituation and exploration to the new object at the same degree as the control rats. Rats given 0.3 mg/kg dose of MK-801 displayed hyperactivity and did not display habituation and exploration. The result suggests that the 0.1 mg/kg dose of MK-801, which dose not affect on activity, habituation and exploration to the new object in rats, selectively affects on acquisition of spatial information and reduces their spatial exploration.     

Progress in HIV and AIDS care

These recent meetings emphasized the considerable progress that has been made in HIV/AIDS. The prospect for non-progression of the disease, improved management of complications arising from the condition, and the potential for additional progress were the hallmarks of these meetings. The considerable developments that have occurred make it necessary for the dental profession to continue to play a role in the recognition, diagnosis, and management of oral conditions, and to keep abreast of the considerable developments in this field-and the implications that these developments have for patients presenting with complications related to other conditions, which may include bacterial, fungal or viral infections and malignant disease.     

HIV/AIDS risk in heterosexual college students. A review of a decade of literature

Empirical studies dealing with the psychosocial correlates of HIV risk among heterosexual college students are reviewed, including findings related to such theoretical variables as HIV/AIDS-related knowledge, personal and partner's attitudes toward condom use, perceived susceptibility, communication with sex partners, and sexual self-efficacy. Although college students are highly knowledgeable about basic HIV/AIDS facts, they retain some misperceptions about disease transmission. They hold neutral-to-negative hedonistic and practical attitudes about using condoms: those who have engaged in risky behavior accurately perceive their greater susceptibility to infection and experience anxiety regarding transmission of HIV infection. Heterosexual college students communicate infrequently with their partners about safer sex, but they often agree to a partner's suggestion that they use condoms. Higher levels of sexual self-efficacy among college students have been associated with a lower risk for HIV transmission. Limitations and clinical implications of the findings and recommendations for future interventions are discussed.     

Neurologic manifestations of HIV infections and AIDS

The paper presents the review of neurological manifestations of HIV infection. The pathogenesis of changes caused by HIV within central nervous system is discussed. The most common neurological syndromes occurring in AIDS patients as well as the division of these changes concerning peripheral and central nervous system are described.     

Attitudes towards suicide among medical students: comparison between Madras (India) and Vienna (Austria)

Twenty-two nitroso compounds with cyano, acyloxy, or carbonyl groups in geminal position were prepared, eight of them for the first time. In the solid state these compounds dimerize to colorless azodioxides. Exceptions are the 4-nitrobenzoyloxynitroso compounds 7b, f, and g which form bright blue crystals. In vitro (Born test, collagen) considerable antiplatelet activity was observed in each class of compounds. Azodioxides with cyano groups in geminal position (3a, b) were most active (IC50 approximately 10 microM) suggesting the importance of strong electron withdrawing groups in geminal position to the azodioxide partial structure. When administered orally to rats (60 mg/kg) all compounds inhibited the thrombus formation in mesenteric arterioles and venules. The acetyloxy derivatives 5d and 5e were most active (18-21% inhibition in arterioles and 11-15% inhibition in venules). In aqueous media at 37 degrees C the cyanonitroso compound 3b and the benzoyloxynitroso compound 7a decomposed to nitric oxide and its reduced form nitrosohydrogen. This suggests that the above pharmacological effects are mediated by a NO dependent mechanism.     

AIDS/HIV and university students in Delhi, India: knowledge, beliefs, attitudes and behaviors

Eight hundred eighty-seven students in social work, nursing, and humanities from two major universities in Delhi were compared regarding their knowledge about AIDS/HIV and attitudes toward PWAs and homosexuals. Their scores on the 20-item knowledge test indicate fair degree of knowledge; however, they lacked information in crucial areas of AIDS prevention and human sexual anatomy. Unmarried, female and older students and those in social work and nursing disciplines scored significantly higher on correct answers. Social work students were likely to be more positive in their attitudes toward AIDS victims than those in nursing or humanities. Knowledge was positively related to attitudes and perception of risk. Despite their awareness of personal risks only four in ten used condoms sometimes during intercourse. Educational strategies to increase cognitive and affective understanding of AIDS and its victims are discussed.