Digital Commons Network^™

The Aids Project Newsletter (January 1988), David Ketchum, The Aids Project

AIDS Project Newsletter (1987-1991)

No abstract provided.

Have You Had Your Mammogram, Doctor?, Mary Guinan

School of Public Health Faculty Research

Breast cancer incidence continues to increase in the United States, with more than 130,000 new cases and 42,000 deaths expected this year. Today, one in every ten women in the United States will develop breast cancer at sometime during their lives. Breast cancer can be prevented by early prophylactic bilateral mastectomy, ie, removal of the breasts before any signs or symptoms develop. This practice was advocated by a male gynecologist colleague of mine. When I expressed horror at his suggestion that I have such a procedure at age 32, he challenged me to defend myself against advocating a practice that …

Pms Or Perifollicular Phase Euphoria?, Mary Guinan

School of Public Health Faculty Research

Why is it that so little is known about PMS? First of all, there is no agreement on what PMS is. If investigators are referring to different sets of symptoms, how can studies be comparable? In fact, they are not. Not only are the symptoms different, but the timing of symptoms is different, Some studies describe symptoms that occur 7 to 10 days before the onset of menses, while others include symptoms that begin 14 days before the onset of menses and continue for 7 days after onset. This definition suggests that women may have PMS-related symptoms during 21 days …

Cloning And Sequencing Of The Genes For Shiga Toxin From Shigella Dysenteriae Type 1, Nancy A. Strockbine, Matthew Jackson, Lawrence Sung, Randall Holmes, Alison D. O'Brien

United States Public Health Resources

The structural genes for Shiga toxin, designated stx A and stx B, were cloned from Shigella dysenteriae type 1 3818T, and a nucleotide sequence analysis was performed. Both stx A and stx B were present on a single transcriptional unit, with stx A preceding stx B. The molecular weight calculated for the processed A subunit was 32,225, while the molecular weight of the processed B subunit was 7,691. Comparison of the nucleotide sequences for Shiga toxin and Shiga-like toxin I (SLT-I) from Escherichia coli revealed that the genes for Shiga toxin and SLT-I were greater than 99% homologous; three nucleotide …

Conduct Disorder And Cognitive Functioning: Testing Three Causal Hypotheses, Irvin Sam Schonfeld, David Shaffer, Patricia O'Connor, Stephanie Portnoy

Publications and Research

Studied the relation between cognitive functioning, as evidenced by IQ and achievement test performance, and Diagnostic and Statistical Manual of Mental Disorders (DSM-III) categories of conduct disturbance, using data from Black adolescents who were members of collaborative perinatal project from birth to age 7 yrs. At age 17 yrs, Ss and their parents were administered a battery of instruments that included standardized psychiatric diagnostic interviews as part of a call-back study. Analyses were compatible with the hypothesis that deficiencies in cognitive functioning are causally related to adolescent conduct disorder as defined by DSM—III. Results suggest that the relation of cognitive …

The Aids Epidemic: A Prism Distorting Social And Legal Principles, Alec Gray

New England Journal of Public Policy

The AIDS epidemic is affecting American society in far-reaching and unexpected ways. It touches our institutions, our value systems, and our private lives. Social issues seem to change and become distorted by the epidemic 's prismlike effect. This article examines some of the major public health issues raised by the epidemic, ranging from testing to contact tracing and quarantine. It argues that while the civil rights of individuals may have to be sacrificed to stem the spread of the disease, those rights should not be abandoned unless a clear benefit to the public health would result.

Issues of discrimination in …

Aids And New England Hospitals, Jesse Green, Neil Wintfeld, Madeleine Singer, Kevin Schulman

New England Journal of Public Policy

The Centers for Disease Control projects that nine thousand persons with AIDS will be alive in New England in 1991, representing a sevenfold increase from 1986. Our analysis indicates that more than 2 percent of medical/surgical beds in New England will be used for AIDS care by 1991, representing 766 fully occupied hospital beds. The direct cost of providing hospital care to New England's AIDS patients is projected to be $195.2 million in 1991, reflecting 3 percent of all hospital inpatient costs in the region.

AIDS treatment is very unevenly distributed among hospitals in New England. Just twenty hospitals (8 …

Epidemiology And Health Policy Imperatives For Aids, Katherine Hill Chavigny, Sarah L. Turner, Anne K. Kibrick

New England Journal of Public Policy

The purpose of this article is to describe the statistics and epidemiological facts about the most virulent epidemic of our age, acquired immunodeficiency syndrome (AIDS). The discussion argues for broadened public policy to promote the surveillance of communities in order to enhance the effectiveness of data gathering for epidemiological reasoning, analysis, and control measures. To accomplish these goals, the essential characteristics of epidemiology are defined. The use of deductive and inductive reasoning is applied to describe and analyze known facts concerning the AIDS epidemic. Hypotheses are suggested from current amorphous and continually changing information to assist in further explanations of …

Neuropsychiatric Complications Of Hiv Infection: Public Policy Implications, Alexandra Beckett, Theo Manschreck

New England Journal of Public Policy

The human immunodeficiency virus (HIV) infects the central nervous system (CNS), causing symptoms in most persons with AIDS-related complex (ARC) and AIDS, and in a significant proportion of those classified as asymptomatic seropositive. The most common clinical syndrome secondary to CNS infection is known as HIV encephalopathy. When sufficiently disabling, HIV encephalopathy is known as AIDS dementia, and must be reported to the Centers for Disease Control as a case of AIDS.

AIDS dementia is a complex of cognitive, affective, behavioral, and motor symptoms which varies widely in its presentation. In some persons, cognitive impairment predominates, manifesting in a loss …

Understanding The Psychological Impact Of Aids: The Other Epidemic, Marshall Forstein

New England Journal of Public Policy

HIV has created two epidemics, one of disease, the other the consequence of the psychological response to that disease. Thus far, behavioral change is the only effective means of interrupting the transmission of HIV. The underlying psychological dimensions of the societal and individual responses to AIDS are discussed, with suggestions for how both rational thinking and irrational fears and anxiety contribute to the development of public policy. Examples are given of how short-term solutions to reduce anxiety may actually create long-term problems, potentially increasing the risk of transmission of HIV. Specific psychological mechanisms that contribute to the epidemic of fear …

Ethical Issues In Aids Research, Michael A. Grodin, Paula V. Kaminow, Raphael Sassower

New England Journal of Public Policy

There is a need for carefully controlled and scientifically rigorous research studies of the acquired immunodeficiency syndrome (AIDS). The morbidity and mortality associated with AIDS patients and the public health concerns for control of this epidemic have distorted the usual process of research. The Institutional Review Board at Boston City Hospital is suggested as an appropriate mechanism for clarifying the distinctions between research and innovative therapies and for assuring the protection of this vulnerable population of research subjects. This article addresses ethical concerns relating to the time frame of research, drug and antibody testing, vaccine trials, and questions of justice …

Minorities And Hiv Infection, Veneita Porter

New England Journal of Public Policy

This article discusses a preliminary comparison of responses to AIDS in ethnic communities and their basis in previously established support systems. The importance of public policy and its connection to racism and cultural insensitivities are discussed as they relate to communities of color at risk. Particular attention is paid to problems of communication and to the ethics involving confidentiality.

Call To Action: A Community Responds, Larry Kessler, Ann M. Silvia, David Aronstein, Cynthia Patton

New England Journal of Public Policy

This article will examine the early formation of the AIDS Action Committee of Massachusetts, and what it has become. It will examine particular philosophical and organizational conflicts, some unique to AIDS organizing, that have influenced the direction the group has taken. It will try to tease out some of the factors that have made the organization successful in delivering services, providing education, and affecting city and state policy. It will also examine some of the unresolved conflicts that threaten the organization.

Aids Public Policy: Implications For Families, Elaine A. Anderson

New England Journal of Public Policy

Much has been written about the AIDS crisis in the past few years. However, relatively little of this discussion has focused on AIDS as it may affect families. This report emerged from the 1987 Groves Conference on Marriage and the Family. It is a version of the chapter on public policy in AIDS and Families (ed. Eleanor Macklin, Hayworth Press, forthcoming, summer 1988), prepared by the conference's Task Force on AIDS and Families. The book details the probable impact of AIDS on individuals, families, and communities and delineates the implications for relevant professionals, organizations, and public policy. Those individuals who …

New England And National Resources: For People With Aids, Arc, Or Hiv Infection, Their Families, And Friends, Diane Fentress, Betsy Anne Youngholm

New England Journal of Public Policy

A listing of resources and services, compiled in 1988 for this issue, for people with AIDS, ARC, or HIV, as well as their families and friends.

List Of Terms

New England Journal of Public Policy

Lists and defines terms relevant to the study of HIV/AIDS that are used throughout this issue of the New England Journal of Public Policy.

The Acquired Immunodeficiency Syndrome In New England: An Epidemiological Review Of The First Six Years, Laureen M. Kunches, Jeanne M. Day

New England Journal of Public Policy

Between 1981 and 1987 — the six-year period following initial recognition of the acquired immunodeficiency syndrome (AIDS) — 1,475 cases were reported among residents of the six New England states. Of nearly 40,000 cases nationwide, 3.8 percent occurred among New England residents, though the region 's population represents 5.5 percent ofthe total United States population. The groups most affected include homosexual or bisexual men (65 percent) and intravenous drug users (20 percent). However, in the two southernmost states — Rhode Island and Connecticut — 32 to 40 percent of all cases have used intravenous drugs. In these states, the male:female …

The Hiv Seropositive State And Progression To Aids: An Overview Of Factors Promoting Progression, Paul H. Black, Elinor M. Levy

New England Journal of Public Policy

We have considered factors that predispose to infection by the human immunodeficiency virus as well as the clinical consequences of infection. We have also reviewed what is known about the virological status of the asymptomatic carrier, particularly the female, and the fact that pregnancy may be a cofactor for progression of HIV disease in seropositive women. Additionally, we have discussed several other cofactors that may promote the progression of HIV infection. These include intercurrent infection, excessive use of recreational drugs and alcohol, malnutrition, and stress. With respect to stress, we have reviewed evidence indicating that certain personality factors, by buffering …

The Port Sudan Small Scale Enterprise Program, Eve Hall

Poverty, Gender, and Youth

Euro-Action ACORD (EAA) is a consortium of 20 European and Canadian aid agencies working in refugee farming settlements in Central and Southern Sudan, and with various rural development projects in other parts of Africa, which responded to a request from the Sudanese Commissioner of Refugees to work in Port Sudan. This was the first time the agency considered working with poor urban people, and staff were determined to understand the economic and social forces which governed life in the slums. The program noted a number of findings that will help determine its future: reaching out to women where they live …

A Crisis In Insurance, Benjamin Lipson

New England Journal of Public Policy

As the life and health insurance industry evaluates its long-term financial goals, the cloud of Black Monday — October 19, 1987, the day the stock market collapsed — blurs its cherished investment income projections. With investment portfolios under siege, mutual life insurance companies and stock companies alike are wary of making policy-pricing miscalculations that could prove to be disastrous. As if that weren't enough, one single disease — acquired immunodeficiency syndrome — looms as the most serious threat to life and health insurers for the remainder of this century. The spread of the new disease has caused insurers to adjust …

Editor's Note, Padraig O'Malley

New England Journal of Public Policy

On occasion, the New England Journal of Public Policy will devote an entire issue to consideration of a public policy matter of major importance. The AIDS epidemic is such a matter, with a likely impact of overwhelming consequence well into the twenty-first century. The epidemic raises fundamental questions regarding the nature of individual freedom, our responsibilities to others, the always delicate balance between private rights and the public interest, and society's obligation to its "out" groups — whose members it has stigmatized, discriminated against, ridiculed, and treated as less than full and equal citizens. Indeed, it requires us to ask …

Human Retroviruses: Illustration

New England Journal of Public Policy

An illustration of human retroviruses and the life cycle of retroviruses.

Aids In Children: An Overview Of The Medical, Epidemiological, And Public Health Problems, Ellen R. Cooper

New England Journal of Public Policy

Cases of AIDS in children under thirteen years of age have been described since 1982. Diagnosis is more difficult in children than in adults, owing to the more varied clinical presentation and the difficulty in interpretation of laboratory tests. Current diagnostic criteria of HIV infection are reviewed, as well as symptomatology, natural history, and controversies surrounding management and therapy. Without a full appreciation of the transmissibility of HIV, issues including school and day-care attendance and foster family placement remain emotionally charged. Conflicting public policies contribute to fears on the part of the general public. Because ofthe unique implications for the …

Hiv Antibody Testing: Performance And Counseling Issues, Michael Gross

New England Journal of Public Policy

This article assesses the performance of currently used tests for exposure to human immunodeficiency virus (HIV), the infectious agent associated with acquired immunodeficiency syndrome (AIDS); suggests, in view of that information, guidelines for counseling people seeking HIV antibody testing; and evaluates the claim that because antibody test results will effect behavior change in those who are infected, all members of high-risk groups should be tested.

HIV testing is likely to yield a high proportion of false-positive results in low-risk populations and infants born to infected mothers. A negative result may not establish freedom from infection in high-risk groups or the …

Aids And A-Bomb Disease: Facing A Special Death, Chris Glaser

New England Journal of Public Policy

In 1979 it was called "gay cancer," and it took the life of an acquaintance. Then "gay-related immune deficiency," or GRID, claimed neighbors, friends of friends, fellow activists. I began grief and death counseling with a segment of the population ordinarily concerned with life's ambitions and enjoyments: men in their twenties and thirties. Hospital visits and memorial services became more frequent.

By 1983, when it had come to be called AIDS, my own friends began to be affected. One was a man I dated in seminary, and I was devastated to learn of his illness only upon receiving a notice …

Human Immunodeficiency Virus In Intravenous Drug Users: Epidemiology, Issues, And Controversies, Donald E. Craven

New England Journal of Public Policy

Intravenous drug users are the second most common risk group for acquired immunodeficiency syndrome (AIDS) in the United States, and they account for approximately 25 percent of the cases. Drug users may spread human immunodeficiency virus (HIV) by sharing contaminated drug injection paraphernalia and through sexual contact; women who use drugs can transmit the virus to their children. The rapid spread of HIV in this risk group and the fact that intravenous drug users are a source for heterosexual and perinatal transmission underscore the need for immediate intervention. In addition, many drug addicts are poor, have limited career possibilities, and …

New Hampshire: The Premarital Testing Debacle, Susan D. Epstein

New England Journal of Public Policy

In 1987, the New Hampshire Division of Public Health Services had a bill introduced in the legislature to improve contact tracing and establish statewide public education on HIV infection, transmission, and disease control. This article traces the bill, and issues surrounding the bill, through the legislative process and focuses on an unexpected intervention by the governor through a proposed amendment to add mandatory premarital testing. Its conclusions offer advice to other states on how best to avoid political exploitation of AIDS/HIV issues.

By the summer of 1987, the AIDS issue in New Hampshire had become devoted to everything but AIDS. …

Qualité De L'Air Et Ventilation Dans Trois Édifices À Bureaux, Van Hiep Nguyen, Nicole Goyer

Rapports de recherche scientifique

Depuis quelques années, la qualité de l'air dans les édifices à bureaux est un sujet de préoccupation pour les occupants. Dans ce contexte, l'IRSST et l'Association paritaire du secteur Administration provinciale ont entrepris une étude visant à développer une démarche d'analyse des problèmes et à dégager des recommandations. Trois édifices ont été évalués dans le cadre de ce projet.

Les problèmes de santé et d'inconfort observés sont le résultat de l'interaction de différents facteurs. Parmi ceux-ci, les contaminants chimiques, les agents microbiologiques, les paramètres de confort thermique et les caractéristiques des systèmes de ventilation ont été retenus. De plus, un …

Méthodologie Pour Évaluer L'Exposition Des Individus Aux Vibrations Main-Bras En Milieu De Travail : Annexe Au Rapport De Recherche, Paul-Émile Boileau, Henri Scory, Denis Turcot

Rapports de recherche scientifique

Certains outils ou machines percutantes, roto-percutantes, rotatives ou alternatives peuvent transmettre des vibrations intenses aux mains et aux bras de leurs utilisateurs. Sur le plan professionnel, l'utilisation habituelle et prolongée de machines vibrantes tenues à la main est à l'origine de troubles et lésions qui sont de plusieurs ordres ^[1] : vasculaire, nerveux, musculaire ou osseux. L'atteinte la plus connue est le phénomène de Raynaud, caractérisé par le blanchissement du bout des doigts. Dans les cas graves, les vaisseaux sanguins ne sont plus capables de se contracter et de se dilater, causant un ralentissement de la circulation sanguine, d'où le …

Évaluation Comparative En Milieu De Travail Du Capteur Cip-10, Yves Cloutier

Rapports de recherche scientifique

Le capteur CIP-10, qui fait l'objet de la présente étude, est en quelque sorte une version miniaturisée du capteur français de poussières respirables le CPM-3. Il s'impose par ses qualités physiques comme une sérieuse alternative aux techniques de prélèvements des poussières à l'aide des cassettes.

Les solutions qu'il offre à certains problèmes rencontrés lors de l'échantillonnage de poussières, notamment celui de la mauvaise adhésion des particules sur les membranes filtrantes et celui des phénomènes de dépôts sur les parois des cassettes ont rapidement suscité le besoin de le confronter à nos techniques habituelles de prélèvements.

L'évaluation que nous avons faite …