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This article explores medical students' experiences and coping strategies when confronting patient loss in their 3rd and 4th years of their programs. Much of the literature on the impact of patient losses focuses on physicians. This article joins a handful of works aimed at how medical students experience and cope with patient loss. In-depth interviews with 20 medical students provided rich descriptions of their varying experiences coping with death. Consistent with previous work, students experience substantial emotional stress coping with patient deaths, though some were more difficult to bear than others, such as when the dying patient was a child or when treatment errors could have contributed to deaths. Common coping mechanisms included talking through their emotions, thrusting themselves into continuing their rounds, crying, participating in infant death rituals, and turning to religion. When deaths occurred, senior personnel who exhibited empathy toward the deceased and tolerance toward the students' emotional responses were lauded and made the process easier. Also emotionally daunting, in many instances, was dealing with the families of dying patients. Most of the students did not view death as a failure, contrary to much earlier literature, except in instances in which human error or decision making may have played a part in causing the death of a patient.

Summary Reasons for performing study: A silent cycle of equine herpesvirus 1 infection has been described following epidemiological studies in unvaccinated mares and foals. In 1997, an inactivated whole virus EHV‐1 and EHV‐4 vaccine was released commercially in Australia and used on many stud farms. However, it was not known what effect vaccination might have on the cycle of infection of EHV‐1. Objective: To investigate whether EHV‐1 and EHV‐4 could be detected in young foals from vaccinated mares. Methods: Nasal and blood samples were tested by PCR and ELISA after collection from 237 unvaccinated, unweaned foals and vaccinated and nonvaccinated mares during the breeding season of 2000. Results: EHV‐1 and EHV‐4 DNA was detected in nasal swab samples from foals as young as age 11 days. Conclusions: These results confirm that EHV‐1 and EHV‐4 circulate in vaccinated populations of mares and their unweaned, unvaccinated foals. Potential relevance: The evidence that the cycle of EHV‐1 and EHV‐4 infection is continuing and that very young foals are becoming infected should assist stud farms in their management of the threat posed by these viruses.

Analyses of an SSP program and in-depth qualitative interview data showed rapid reduction of injection-related HIV risk behaviors among PWID post-SSP implementation. Sterile syringe access as part of comprehensive HIV prevention is an important tool to control and prevent HIV outbreaks.

The prevalence of these health issues and the adverse effects of some of these on QOL underscore the importance of effective rehabilitation over the life course, especially including better mental health care and pain management.

AIDS stigma is a challenge to controlling the HIV/AIDS epidemic especially in more conservative cultures. This study explored the impact of knowledge about HIV and AIDS, and the impact of shame, on the stigmatization of people living with HIV/AIDS in the Arab world. Survey data were collected from 277 female college students in 3 Arab countries: Kuwait, Bahrain and Jordan. Only in Bahrain was knowledge about HIV and AIDS inversely related to negative attitudes toward people with HIV/AIDS. AIDS-related shame, however, was a strong predictor of AIDS stigma in all 3 countries. HIV education is needed for young people in Arab countries, especially women, both for their own health and to reduce the problem of AIDS stigma. Rôle de la honte dans la stigmatisation des personnes atteintes du virus de l'immunodéficience humaine : étude réalisée sur des lycéennes dans trois pays arabes RÉSUMÉ La stigmatisation du sida constitue un obstacle en matière de lutte contre l'épidémie de VIH/sida, en particulier au sein des cultures conservatrices. Cette étude portait sur les conséquences du niveau de connaissance sur le VIH et le sida et de la honte suscitée par la maladie, sur la stigmatisation des personnes vivant avec le VIH/ sida dans le monde arabe. Les données de cette étude ont été recueillies auprès de 277 étudiantes dans trois pays arabes : Bahreïn, la Jordanie et le Koweït. Bahreïn s'est révélé le seul pays où le niveau de connaissance sur le VIH/sida est inversement proportionnel aux attitudes négatives à l'égard des personnes vivant avec le virus. La honte associée au sida constitue toutefois un facteur prédictif important de la stigmatisation de la maladie dans les trois pays. L'éducation en matière de VIH est nécessaire auprès des jeunes des pays arabes, notamment des femmes, tant pour préserver leur propre santé que pour réduire le problème de la stigmatisation du sida.‫املتوسط‬ ‫لرشق‬ ‫الصحية‬ ‫املجلة‬ ‫عرش‬ ‫السادس‬ ‫املجلد‬ ‫التاسع‬ ‫العدد‬ 983

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