Evaluation of a targeted HIV testing program for at-risk youth

With the advent of new therapies for HIV, case identification through HIV counseling and testing (CTS) has become critically important. Young women, youth of color, and disenfranchised youth are at significant risk of acquiring HIV. This study describes clients who access CTS at a program of comprehensive care for high-risk youth (aged 12 to 24 years), and assessed, using logistic regression analyses, whether youth at highest risk utilized CTS. Most of the 531 youth were female (72 percent) and nonwhite (60 percent). Sixty-eight percent received CTS. Logistic regression modeling revealed that white race and receiving care at the teaching hospital were the only independent predictors of testing. Data indicate that, despite targeted, youth-specific, developmentally appropriate and culturally sensitive outreach and intervention efforts, youth of color and high-risk youth are poorly accessing CTS. A greater understanding of the barriers to and cultural norms regarding CTS is needed.     

Religion and Spirituality in the Face of Illness: How Cancer, Cardiac, and HIV Patients Describe their Spirituality/Religiosity

This study reports the results of semi-structured interviews conducted with 60 medically ill (cancer, myocardial infarction, HIV/AIDS) people in an attempt to define what people facing a life-threatening illness mean when they say they are 'spiritual' or 'religious'. Questions were asked about beliefs and affective, behavioral, and somatic realms. Subjects initially self-identified as considering themselves to be spiritual, religious, or both. While some similarities existed between the groups (e.g. amount of time spent in prayer, beliefs set the tone for their life, give them a sense of well-being, guidance, a sense of right and wrong, a connection to God, and a sense they will live on in some form), significant differences were discovered in overall belief systems, as well as in interpretation of the mechanisms whereby subjects' beliefs impacted their health and their recovery. Those identifying as spiritual described recovery and healing as happening through them whereas those identifying as religious were more likely to say it happens to them. In addition, significant differences existed between the groups in their overall view of God, self, world, and others. Implications for future studies are discussed.     

Commercial applications of Tuned Aperture Computed Tomography

Tuned Aperture Computed Tomography will allow the creation of three-dimensional images of dental structures from layers of digital information that can be gathered in the dental office. These three-dimensional images will give a fuller view of the structures, thereby providing more information from which to make a better diagnosis. Unlike similar medical tomosynthetic imaging techniques, TACT should be easily accommodated into dental practice needs.     

Cardiorenal destiny: the role of genes and environmental factors

For many years, it has been known that genes and environmental factors interact to determine an individual's blood pressure. The purpose of this article is twofold. First, the authors review current molecular genetic approaches to delineating genes that lead to the development of hypertension, focussing on the renin-angiotensin system. We then consider perinatal environmental factors that impact adult blood pressure. Epidemiologic data suggest that good maternal nutritional status is essential to avoid programming individuals for future health problems as adults. One factor that appears to play an important role in programming for hypertension in adulthood is maternal dietary protein restriction during pregnancy, possibly by suppression of the fetal renin-angiotensin system and consequent impairment of renal development. The association between lower birthweight and increased adult blood pressure, established in epidemiologic studies, may be caused by suboptimal maternal diet or placental insufficiency, resulting in transient changes in fetal hormone systems or gene expression that permanently alter the structure and function of the kidney and vasculature.     

Potential toxicity of retrograde uterine passage of particulate matter

Dusting powders are commonly used on surgical gloves, examination gloves, and condoms. In addition, they are used in diaphragms, sanitary napkins, and toiletries. These dusting powders can gain access to the abdominal cavity through the vagina or through surgical intervention. The toxicity of these dusting powders in the abdominal cavity can be divided into acute and chronic complications that may be life-threatening. The use of medical and surgical products without dusting powders is strongly recommended.     

An obligation to provide abortion services: what happens when physicians refuse?

Access to abortion services in the United States continues to decline. It does so not because of significant changes in legislation or court rulings but because fewer and fewer physicians wish to perform abortions and because most states now have "conscientious objection" legislation that makes it easy for physicians to refuse to do so. We argue in this paper that physicians have an obligation to perform all socially sanctioned medical services, including abortions, and thus that the burden of justification lies upon those who wish to be excused from that obligation. That is, such persons should have to show how requiring them to perform abortions would represent a serious threat to their fundamental moral or religious beliefs. We use current California law as an example of legislation that does not take physicians' obligations into account and thus allows them too easily to declare conscientious objection.