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Aids: Prophecy And Present Reality, Victor De Gruttola, William Ira Bennett

New England Journal of Public Policy

Mathematical modeling of the AIDS epidemic can be useful for policymakers even though precise projections are not possible at this time. Models are useful in establishing ranges for current and future prevalence of HIV infection and incidence of AIDS, as well as in predicting the effect of a given intervention strategy. Most decision makers are using models implicitly when they use epidemiological information as a basis for policy; formulating a model explicitly permits examination of the underlying assumptions. By creating and testing a variety of models, an investigator can determine whether the models reflect more the underlying assumptions or the …

The Quest For An Aids Vaccine, Robert T. Schooley

New England Journal of Public Policy

More than fifty thousand cases of AIDS have been reported in the United States since the disease wasfirst described in 1981. Many times this number of people are infected with human immunodeficiency virus (HIV), which has been identified as the agent responsible for the illness. The seriousness of the disease, coupled with the relatively rapid spread of HIV, has fueled the effort for development of an effective vaccine.

Much is now known about the life cycle of the virus, and about its structural components. This information, and information about methods of transmission of the virus, form the basis for a …

Medical Care Of Aids In New England: Costs And Implications, Stewart J. Landers, George R. Seage Iii

New England Journal of Public Policy

This article presents an overview of cost issues related to AIDS. Data from the Massachusetts Cost of AIDS Study are combined with epidemiological projections to estimate the cost of treating people diagnosed with AIDS in New England. Aggregate inpatient, ambulatory, and home care costs are estimated to be $96.9 million and $524.8 million through 1987 and 1991, respectively. These estimates represent a relatively small percentage of total health care costs for all illnesses over the same time period.

The authors find that the cost of treating AIDS does not affect all health care providers uniformly and therefore argue that appropriate …

Introducing Aids Education In Connecticut Schools, William Sabella

New England Journal of Public Policy

Most of the nation 's schoolchildren are not infected with the AIDS virus (HIV). Since AIDS is a preventable disease, no one need become infected. In order to protect themselves, everyone, including children, must understand exactly how HIV is and is not contracted. The message of prevention, however, is controversial, since it must include advice on safer sex and drug use.

In 1984, Connecticut was forced to face the issue of a child with HIV infection entering school. The state responded by creating guidelines for prevention of disease transmission in schools and by subsequently developing an AIDS curriculum. Obstacles to …

Hiv Antibody Screening: An Ethical Framework For Evaluating Proposed Programs, Ronald Bayer, Carol Levine, Susan M. Wolf

New England Journal of Public Policy

The acquired immunodeficiency syndrome (AIDS) poses a compelling ethical challenge to medicine, science, public health, the legal system, and our political democracy. This report focuses on one aspect of that challenge: the use of blood tests to identify individuals who have been infected with the retrovirus human immunodeficiency virus (HIV). In this article, we follow the terminology recently proposed by the International Committee on the Taxonomy of Viruses; that is, we use the term human immunodeficiency virus. This replaces the more cumbersome dual terminology of human T-cell lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV).

The issue is urgent: the tests are …

Behavioral Change In Homosexual Men At Risk Of Aids: Intervention And Policy Implications, Suzanne B. Montgomery, Jill G. Joseph

New England Journal of Public Policy

With more than fifty thousand cases of acquired immunodeficiency syndrome (AIDS) diagnosed since its initial recognition in 1981 and no cure or vaccine in sight, experts agree that prevention is of the utmost importance. Yet very little research has investigated how existing social-psychological and health behavioral knowledge can be applied to the special circumstances of programmatic responses to AIDS. One of the central aims of our own research group has been to describe the psychosocial determinants of successful behavioral risk reduction among homosexual men, the largest affected group. This work is reviewed and its implications for the development of intervention …

Aids Initiatives In Massachusetts: Building A Continuum Of Care, Nancy Weiland Carpenter

New England Journal of Public Policy

The Health Resource Office was officially established within the Massachusetts Department of Public Health in August 1985 to coordinate policy, education, research, and service response to the AIDS epidemic, and to focus attention on the social and economic impact of the disease. The actual work of the office was begun earlier, in October 1983. This article reviews the activities of the Health Resource Office from October 1983 through June 1987 in allocating resources for AIDS and ARC programs and services. It then describes the conceptual model that evolved during this period for the continuum of services needed to reduce HIV …

The Role Of Education In Aids Prevention, George A. Lamb, Linette G. Liebling

New England Journal of Public Policy

The severity of the current AIDS epidemic, combined with the lack of successful biological interventions, necessitates an active educational program as the primary intervention strategy. Health education theories abound, but relatively little definitive application of these theories has been made to the issues involved with HIV transmission: sexual behavior and the sharing of intravenous drug apparatus. Significant behavior changes have occurred in some people, but the consistency of the behavior change may be difficult to sustain. Thus, the authors suggest that health education should be delivered repeatedly in culturally acceptable language and format, by community leaders, and through many different …

U.S. Women And Hiv Infection, P. Clay Stephens

New England Journal of Public Policy

Women are inadequately provided with HIV services and education and are differentially denied access to these. Divisions of race, ethnicity, economic class, and religion, among others, are compounded by sexual discrimination within each of these categories.

Review of current data on women with AIDS reveals that the reporting methods used convey a false impression that women are not at significant risk. Moreover, the persons indirectly affected by AIDS are predominantly women — mothers, sisters, partners, family members, teachers, and human service workers. Thus, AIDS is more of a women's issue than the statistics imply.

Women, as a gender-defined class, face …

Motivational Strategies For Employee Participation In Corporate Health Promotion, Laura Eileen Cook

Dissertations and Theses @ UNI

This study was designed to describe the motivational strategies being used by corporations to encourage and/or maintain employee participation in health promotion programs. A questionnaire was designed and mailed to 170 members of the Association for Fitness in Business working in corporate health promotion facilities. Subjects were asked their subjective opinion concerning motivational strategy use and effectiveness, important considerations in motivational strategy development and which strategies had been objectively evaluated, and what were the outcomes of those evaluations. Data collection occurred over a four week period. The overall return rate was 48.2%. Seven strategies were identified to be currently in …

Women And Aids: The Future Is Grim, Mary E. Guinan, Ann Hardy

School of Public Health Faculty Research

Recently, we analyzed the reported cases of acquired immunodeficiency syndrome (AIDS) in women in the United States.1 We found two areas of great concern: first, women are more likely than men to acquire AIDS through heterosexual intercourse, and second, women are the source of disease for about 80% of children with AIDS. In this column we will discuss the source and distribution of AIDS in women, and in a future piece we will discuss women as the source of infection for pediatric AIDS cases.

The Aids Project Newsletter (September 1987), David Ketchum, The Aids Project

AIDS Project Newsletter (1987-1991)

No abstract provided.

Health Care Policy Issues Related To Aids: Lessons Learned From The Henry Ford Hospital Experience, David W. Benfer

Henry Ford Hospital Medical Journal

No abstract provided.

Multiple Small Bowel Perforations Secondary To Cytomegalovirus In A Patient With Acquired Immunodeficiency Syndrome, Herman P. Houin, James C. Gruenberg, Evelyn J. Fisher, Eugene Mezger

Henry Ford Hospital Medical Journal

Cytomegalovirus gastroenteritis can be a life-threatening infection in patients with the acquired immunodeficiency syndrome. Although gastrointestinal ulcerations from cytomegalovirus have been widely reported, our patient is only the second case reported with actual perforations in the small bowel.

T-Lymphocyte Subset Studies To Monitor Patients With Aids And Aids-Related Complex, Hajime Hayashi, Eugene Mezger, Michael J. Deegan, Evelyn J. Fisher, Norman Markowitz

Henry Ford Hospital Medical Journal

Multiple specimens from 124 patients from our clinic were evaluated for T4/T8 cell ratio over three to 28 months. Twenty-nine of 30 patients with the acquired immunodeficiency syndrome (AIDS), 58 of 71 patients with AIDS-related complex (ARC), and four of 23 patients at risk showed initial T4/T8 cell ratios of less than 0.8. which either remained unchanged or decreased. Seventeen of 23 AIDS patients and two of 20 ARC patients with a consistently low ratio (0.3 or less) died during the follow-up period. This indicated that the severity of disease could be predicted by periodical T4/T8 cell ratio studies. These …

Gastrointestinal Complications Of Aids: Radiologic Findings, Marc A. Bernstein, Jeremy J. Hollerman, Peter J. Feczko

Henry Ford Hospital Medical Journal

The acquired immunodeficiency syndrome (AIDS) is a significant health problem. Patients with this disease develop unusual infections and neoplasms, many within the gastrointestinal tract. Of the 66 AIDS patients seen over a three-year period at Henry Ford Hospital, 25 patients had AIDS-related gastrointestinal disease, with one death attributed to this cause. The radiologic findings and pathologic correlation of this experience are presented.

The Clinicians' Guide To Creutzfeldt-Jakob Disease, Thomas H. Swanson

Henry Ford Hospital Medical Journal

Creutzfeldt-Jakob disease, a transmissible, rapidly progressive dementia of unknown etiology, mimics Alzheimer's disease, presents in middle life, and affects many central nervous system structures. The disease progresses in three distinct stages, culminating in death. Its occurrence is sporadic and its distribution worldwide. Pathological changes are varied, but spongy degeneration of the neuropil is classic. Research on scrapie, the animal model of Creutzfeldt-Jakob disease, has demonstrated that this unconventional, slow disease is transmitted via a small (less than 50,000 mW) particle, which is composed principally of protein. How this infectious particle, variably named prion, virino, or slow virus, invokes disease or …

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.

Aids Update, Evelyn J. Fisher

Henry Ford Hospital Medical Journal

No abstract provided.

Pulmonary Complications Of Aids: Henry Ford Hospital Experience Between January 1984 And July 1986, Barry Lesser, Joan Price, Phillip Bruno, Evelyn J. Fisher, John Popovich Jr., Michael S. Eichenhorn

Henry Ford Hospital Medical Journal

We have retrospectively reviewed our bronchoscopic experience in patients with suspected pulmonary complications of the acquired immunodeficiency syndrome (AIDS) or AIDS-related complex at Henry Ford Hospital between 1984 and 1986. The charts of 52 patients, representing a total of 87 bronchoscopic examinations, were available for review. The bronchoscopic findings as well as correlative chest roentgenograms and arterial blood gases are reviewed, and implications for therapy are discussed.

The Aids Challenge: A Psychosocial Perspective, Madelyn S. Plotkin, Margaret Dietz Domanski

Henry Ford Hospital Medical Journal

No abstract provided.

Biotechnology In The Conquest Of Infectious Diseases, Ashley T. Haase

Journal of the Minnesota Academy of Science

No abstract provided.

The Future Of Public Health Law, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Developments in medicine and constitutional law dictate modification of public health legislation in the United States. Traditionally overlooked by legislators, present public health laws provide inadequate decision-making criteria and inappropriate procedures for dealing with issues. Revised legislation should provide health care officials and agencies with the tools to balance individual rights against public health necessities. This article makes four recommendations for legislative reform: (1) remove artificial legislative distinction between venereal and other communicable diseases; (2) provide criteria defining "public health necessity" to limit discretionary exercise of police power by health officials; (3) provide strong confidentiality protections in the collection and …

Helminth Remains From Prehistoric Indian Coprolites On The Colorado Plateau, Karl J. Reinhard, Richard H. Hevly, Glenn A. Anderson

Karl Reinhard Publications

Examination of coprolites excavated from archaeological sites in the Americas demonstrates excellent preservation of helminth eggs and, in some cases, larvae. To gain an understanding of helminth parasitism in prehistory on the Colorado Plateau of Arizona, New Mexico, and Utah, 319 coprolites from 5 archaeological sites were analyzed. Helminth eggs and larvae were recovered after the coprolites were rehydrated, screened, and sedimented. At a sixth site, soils excavated from 5 rooms used as latrine areas were processed with palynological techniques. The results indicate that all but 1 of the prehistoric populations examined were infected with intestinal worms. The helminths implicated …

A Descriptive Survey Of Health Maintenance Practices In A University Hospital Ambulatory Care Center, John Ginnetti Jr.

Public Health Theses

No abstract provided.

Foreword: Public Health & The Law—A Symposium Dedicated To Professor William J. Curran, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

This essay serves as the foreword to Public Health & the Law, a symposium dedicated to Professor William J. Curran held in 1987.

During his career, Professor Curran chaired the Harvard School of Public Health Committee on Human Research; he directed the Program in Law and Public Health; and he was co-director of the Harvard Interfaculty Program in Medical Ethics from 1973 to 1980. He was also an advisor to the World Health Organization and spent two sabbatical periods in Europe with WHO organizations. He advised and lectured in countries throughout the world.

At Harvard Law School and at …

The Mortality Experience Of Major League Baseball Players., John William Waterbor

All ETDs from UAB

No abstract provided.

Money And Manpower In Graduate Medical Education, David C. Leach

Henry Ford Hospital Medical Journal

No abstract provided.

The Aids Project News (October 1986), The Aids Project

AIDS Project News (1986)

No abstract provided.

Bilateral Dislocation Of The Crystalline Lens In A Patient With Presumed Syphilitic Uveitis, Jeffrey S. Rapkin, David D. Bogorad

Henry Ford Hospital Medical Journal

Dislocation of the crystalline lens has been described in association with numerous systemic disorders and as a complication of ocular trauma. We present a case of bilateral lens dislocation in a patient with presumed syphilitic uveitis. The mechanism of lens dislocation is related to humoral and cellular effects of inflammation, although the role of trauma cannot be ignored. Persistent uveitis should be considered as a sign of active infection.