Barriers to care among persons living with HIV/AIDS in urban and rural areas

Phenols constitute an important toxic component of the main stream (MS) of cigarette smoke. The content of volatile fraction of that group of compounds in MS depends on the tobacco type and conditions in which cigarettes are smoked, as well as on the filters applied. The purpose of the research was to determine the content of volatile in steam phenols in the MS of selected brands of cigarettes produces in Poland, as well as imported ones, and the assessment of the toxicity of doses of the phenols that smokers were exposed to. Cigarettes conditioned in constant humidity were smoked in standard conditions in the simulator of smoking, designed by the authors, while MS was absorbed in Zaitcev washers, filled with methanol. The absorbed phenols were distilled in steam and extracted with ethyl acetate. Then the phenols were separated by the method of overpressure thin-layer chromatography on DC Alufolien Polyamid 11F254 Merck chromatoplates, in the developing system chloroform-methanol 99:1 v/v, were induced with sodium diazofluoroborate, and after eultuion the separated phenol, and o-cresol were determined, as well as the non-separated mixture of p- and m-cresols, by the spectrophotometric method. The determined contents of phenols in MS were assessed regarding their toxicity applying the criteria of environmental exposure. When calculating the results, the efficiencies of the applied in the analytical procedures processes of absorption, distillation and extraction of the investigated phenols previously determined experimentally, were taken into consideration. The content of determined compounds in the brands of the cigarettes examined was in the case of phenols, changing within the range from 41.25 +/- 1.15 to 7.60 +/- 0.93 (the average of 20.31 +/- 9.61 micrograms per cigarette); in the case oo-cresol it was within the range from 28.16 +/- 0.95 to 5.72 +/- 0.53 (the average of 11.56 +/- 6.7), while for the non-separated p- and m-cresols the range was from 21.12 +/- 0.5 to 7.31 +/- 0.45 (the average amounted to 11.48 +/- 4.98 micrograms per cigarette The conclusions of the study were the brands of cigarettes significantly influences the content of the phenols examined in the cigarette smoke the phenols determined coexist in the MS of examined cigarettes in similar proportions the doses of phenols inhaled by a smoker during a day with the MS of examined brands of cigarettes participate essentially in the toxicity of the cigarette smoke and smoking 20 cigarettes a day causes the smoker's organism to be exposed to incomparably larger doses of phenols than those from unpolluted atmospheric air.     

Psychosocial predictors of employment status among men living with spinal cord injury.

Objective: To explore the relationship between employment status and community access, perceived community discrimination, social support from significant others, depressive symptoms, and gender-related variables for 83 men living with spinal cord injury. Study Design: Correlational research. Setting: Internet-based investigation employing spinal cord injury listservs. Main Outcome Measure: Participant employment status. Results: A forced-entry hierarchical logistic regression indicated that means of injury, community access and perceived community discrimination, social support from significant others, depressive symptoms, and men’s adherence to masculine norms for primacy of work, self-reliance, and emotional control significantly predicted employment status. Conclusions: Psychosocial variables such as community access, perceived discrimination, social support from significant others, depressive symptoms, and gender identity represent important and understudied predictors of employment status among men living with spinal cord injury. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of employment and disability among people living with HIV/AIDS.

Objective: To explore the relationship between employment/disability and selected demographic, biological, and functionality variables for people living with HIV/AIDS. Study Design: Cross-sectional, correlational analysis. Setting: Outpatient HIV/AIDS immunosupression clinic. Main Outcome Measure: Participant employment and disability status. Results: Results of a forced-entry hierarchical logistic regression analysis indicated that race, age, CD-4, and measures of mental and physical functionality significantly predicted employment/disability among study participants. Conclusions: Demographic, biological, and functionality variables represent important predictors of employment and disability among people living with HIV/AIDS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prospective memory deficits are associated with unemployment in persons living with HIV infection.

Objective: To determine whether deficits in prospective memory (i.e., “remembering to remember”) confer an increased risk of unemployment in individuals living with chronic HIV infection. Methods: Fifty-nine Unemployed and 49 Employed individuals with HIV infection underwent comprehensive neuropsychological and medical evaluations, including measures of prospective memory. Results: The Unemployed participants demonstrated significantly lower performance on time- and event-based prospective memory, which was primarily characterized by errors of omission. Importantly, prospective memory impairment was an independent predictor of unemployment when considered alongside other neurocognitive abilities, mood disturbance, and HIV disease severity. Conclusions: Prospective memory impairment is a salient predictor of unemployment in persons living with HIV infection and might be considered in screening for unemployment risk and developing vocational rehabilitation plans. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Fatalism, current life satisfaction, and risk for HIV infection among gay and bisexual men.

This study surveyed 430 men at an urban gay pride celebration to assess fatalism, current life satisfaction, and perceived expected years of life among men who have sex with men. Analyses showed that men who engaged in unprotected anal intercourse outside of exclusive relationships reported a greater fatalistic outlook, were more dissatisfied with life, and perceived a shorter life for themselves than men who practiced only safer sex and men who were in exclusive relationships. Gay men in exclusive relationships scored higher than nonexclusively partnered gay men on the measure of current life satisfaction. These results suggest that efforts to prevent HIV infection among gay men should include building personal self-worth, support of long-term relationships, and future goal orientations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cryptosporidiosis in persons with HIV infection

Cryptosporidium parvum is an ubiquitous protozoan parasite that is a major cause of diarrhoea in individuals infected with human immunodeficiency virus. The hallmarks of infection include profuse watery diarrhoea which may become chronic in the severely immunosuppressed individual. No uniformly effective therapy exists. Current treatment relies upon a trial of anti-retroviral and specific anti-cryptosporidial medications, adequate fluid and nutritional support, and anti-motility agents.     

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.     

Relationships over time between mental health symptoms and transmission risk among persons living with HIV.

Relationships between mental health symptoms (anxiety and depression) or a positive state of mind and behavior associated with HIV transmission (substance use and risky sexual behavior) were explored in a longitudinal study of persons living with HIV (PLH; N = 936) who were participants in a transmission-prevention trial. Bivariate longitudinal regressions were used to estimate the correlations between mental health symptoms and HIV-related transmission acts for 3 time frames: at the baseline interview, over 25 months, and from assessment to assessment. At baseline, mental health symptoms were associated with transmission acts. Elevated levels of mental health symptoms at baseline were associated with decreasing alcohol or marijuana use over 25 months. Over 25 months, an increasingly positive state of mind was associated with decreasing alcohol or marijuana use; an increasingly positive state of mind in the immediate intervention condition and increasing depressive symptoms in the lagged condition were related to increasing risky sexual behavior. Our findings suggest that mental health symptoms precede a decrease in substance use and challenge self-medication theories. Changes in mental health symptoms and sexual behavior occur more in tandem. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The life satisfaction of nonnormal persons.

Tested the proposition that membership in a fixed-status class would be unrelated to life satisfaction. In 2 experiments, questionnaire responses of handicapped persons (144 and 46) were compared with those of normals (151 and 44). No differences were found along the dimensions of life satisfaction, frustration with life, and mood, while some evidence indicated that the handicapped were less suicidal, more religious, more oriented toward the generalized other, and felt their lives were more difficult. Handicapped Ss who acquired their defect did not differ from those born with it. In Exp III, the observed moods of 40 mentally retarded children (mean age = 13) were compared with those of 40 normals (mean age = 13) via a time-sampling procedure while they were in class and at recess at school. Parents and teachers responded to a rating scale indexing intelligence, social adjustment, and happiness for each S. Differences uncovered favored the intelligence and social adjustment of the normals and the happiness of the male retardates. Results are construed as demonstrating essential equivalence in life satisfaction for handicapped, retarded, and normal persons. (16 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Primary care and case management of persons with HIV/AIDS

The nurse practitioner can meet the multiple needs of people living with HIV disease. Given the broad scope and integration of services required to care for clients with HIV/AIDS, the skill of a nursing case manager is also an integral part of the health care team. Together, these nursing clinicians can enhance the quality of care provided to HIV-infected individuals as each plays numerous roles with specific competencies and skills. This article discusses primary care services and the role of health care providers in working with persons with HIV/AIDS.     

The chronic illness quality of life (CIQOL) model: Explaining life satisfaction in people living with HIV disease.

The chronic illness quality of life (CIQOL) model theorizes that life satisfaction in persons living with a chronic illness such as HIV disease is a function of illness-related discrimination, barriers to health care and social services, physical well-being, social support, and coping. The CIQOL model was evaluated using data from 275 persons living with HIV disease. Women reported less life satisfaction and confronted more barriers to health care and social services than men, and White participants reported higher perceptions of AIDS-related discrimination than non-White participants. The CIQOL model provided an excellent fit to study data (root-mean-square error of approximation = .03) and accounted for almost a third of the variance in life satisfaction scores. Barriers to health care and social services played a particularly prominent role in the model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patient attitudes toward rooming with persons with HIV infection

BACKGROUND: Early in the HIV epidemic, hospitals developed strict isolation policies for patients with HIV infection, some of which have not been revised. The objectives of this study were to examine patient attitudes about rooming with persons with various medical conditions, including HIV, and to assess their knowledge about the transmission of HIV. METHODS: One hundred four inpatients at a university hospital were surveyed by means of a structured interviewer-administered questionnaire. Patients were asked about preference for a single or double room, and about their objections to rooming with patients with HIV infection and other medical conditions. The questionnaire also examined subject's knowledge about the transmission of HIV. RESULTS: Of 104 inpatients surveyed, 55% objected to rooming with an HIV-seropositive patient. Patients who objected to rooming with an HIV-seropositive patient were also more likely to object to rooming with a disfigured patient (relative risk = 1.5; 95% CI, 1.1 to 2.2), or with a demented patient (relative risk = 1.7; 95% CI, 1.0 to 2.9). Also, patients who objected to rooming with an HIV-seropositive patient had greater misconceptions about the transmissibility of HIV infection. CONCLUSIONS: A significant proportion of patients reported an unwillingness to room with patients with HIV infection, but also had misconceptions about the transmissibility of HIV. Current rooming policies may perpetuate misconceptions about the possibility of causal transmission of HIV.     

Risk for human immunodeficiency virus (HIV) infection among persons with severe mental illnesses

Individuals diagnosed with a severe mental illness are at significantly enhanced risk for infection with the human immunodeficiency virus (HIV). To better understand elevated seroprevalence in this population, we review the research literature that has investigated HIV-related risk behavior among adults who have a severe and persistent mental illness. This review indicates that 54%-74% of adults report that they have been sexually active in the last year with approximately one third reporting two or more partners. Among those who were sexually active, condom use was inconsistent. A significant minority (4%-35%) of adults also reported a history of injection drug use. Overall, the data indicate that the severely mentally ill engage regularly in practices known to involve increased risk for HIV transmission. We introduce and modify Fisher and Fisher's (1992) theoretical model to organize the possible determinants of HIV-related risk taking among severely mentally ill adults, and encourage use of this model in the design of behavioral epidemiological and risk reduction studies. We also identify several methodological challenges to HIV-related research, including problems associated with the use of self-report measures; diagnostic imprecision; and participant recruitment and retention.     

Palliative care: pain and symptom management in persons with HIV/AIDS

As patients with HIV/AIDS are living longer with the illness, pain and symptom management are increasingly important health issues. This article will discuss the assessment and management of such common problems as pain, fatigue and weakness, dyspnea and cough, anorexia and weight-loss, nausea and vomiting, sleep disorders, dry mouth, diarrhea, itching, and fever and night sweats.     

Psychosocial predictors of binge eating and purging behaviors among adolescents with and without diabetes mellitus

The way of announcing a late-onset, heritable, disabling disease, and the impact of this realisation on the patient's life, were studied by means of unstructured interviews conducted with 10 neurologists and 22 patients. All physicians announced the name of the disease to the patient, and considered it important to do so. At the same time they also provided explanations concerning the unpredictable prognosis, the absence of curative therapy, and genetic transmission. It was extremely shocking for the patients to learn that their illness is a myopathy and furthermore that it is genetically transmissible. This shock was linked to the naming of the disease, which represented an abrupt transition in the patient's life. Patients feel that this moment marks the beginning of social exclusion. A strong disavowal of the disease is developed, regarding its disabling and heritable characteristics. This disavowal hampers reconstruction of the personality. A post-diagnostic follow-up by a genetic counsellor is highly recommended for patients and relatives alike. This should allow the patient to mourn his/her previous life, a prerequisite for positive rebuilding.     

Perceptions of AIDS susceptibility among minority and nonminority women at risk for HIV infection.

272 women sampled from mass transit waiting areas in an urban center completed anonymous surveys of AIDS-related risk behavior, perceptions of susceptibility, and knowledge. Variable patterns of HIV risk behaviors were identified, with 22% of women reporting high-risk behavior. Perceptions of susceptibility were associated with an interaction between ethnicity and level of risk; nonminority women at high risk reported greater concern about AIDS than did minority women at high risk, who did not differ from women at low risk. With an array of life problems and inaccurate information about HIV transmission, minority women were found to be at continued risk for AIDS-related behavior. Implications for culturally sensitive and relevant AIDS prevention efforts are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A social-cognitive-behavioral model of academic predictors of adolescents' life satisfaction.

The current study provided a comprehensive examination of factors related to school that are implicated in students' life satisfaction. A theoretical model is put forth that hypothesizes that behavior experiences (classroom conduct, school grades) and social experiences (perceived school climate) at school influence students' cognitions relative to their global academic beliefs and attitudes toward their current school. These cognitive contexts of schooling are hypothesized to constitute students' judgments of their satisfaction with school, an important predictor of global life satisfaction. Self-report measures assessing adolescents' perceptions of these constructs were administered to a pilot sample of 321 high school students in a southeastern city. Simultaneous regression and correlational analyses clarified which aspects of school climate and other school-related factors were significantly associated with students' life satisfaction. Results of a revised path model provided preliminary support for the model. Findings support the relevance of considering students' quality of life in addition to the current focus on monitoring academic achievement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting life satisfaction among adults with spinal cord injuries.

Examined life satisfaction among 91 adults with spinal cord injury (SCI) through structured personal interviews that used the Center for Epidemiological Studies Depression Scale, Rosenberg's Self-Esteem Scale, the Life 3 Measure, and a number of items related to satisfaction with various life domains. Results suggest leisure satisfaction was the most significant predictor of life satisfaction, explaining 43% of the variance in the life satisfaction scores; an additional 16% of the variance was explained by self-esteem and health satisfaction. Findings highlight the role of leisure satisfaction in enhancing life satisfaction among individuals with SCI, given the high unemployment rate in this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)