Objectives:Prehospital personnel, including law enforcement officers, paramedics, and fire-fighters, may be exposed to the human immunodeficiency virus (HIV) while working. This study of prehospital personnel sought to determine: 1) their knowledge of the acquired immune syndrome (AIDS) and HIV transmission; 2) the extent of AIDS training received; 3) self-assessment of risk for HIV infection; and 4) precautions adopted to reduce occupational risk of exposure to HIV.Methods:A survey was administered to prehospital personnel in a large Southern California jurisdiction. The response rate was 41% (n = 1,756) in 10 city and county departments where respondents were employed. Law enforcement officers (44%), firefighters (44%), and paramedics (12%) comprised the sample.Results:Respondents had accurate knowledge about AIDS, but incorrect perceptions about HIV transmission. A minority believed that HIV could be contracted from casual contact. Training relating to AIDS was not frequent. Preventive practices were infrequent in the work setting, with precautions used less than 50% of the time on eight of 10 measures. One-third of these prehospital personnel assessed their risk for HIV infection as medium to high, largely attributable to fear of occupational exposure.Conclusions:Improved educational programs regarding HIV/AIDS are needed for prehospital personnel to increase the use of preventive occupational practices in the field.
A survey on AIDS was administered within a large, southern California jurisdiction to law enforcement officers and first responders (paramedics, firefighters). Respondents had accurate knowledge about AIDS but several incorrect perceptions about HIV transmission; a substantial proportion believed that HIV could be contracted from casual contact. AIDS training was not frequent. Self-assessment of HIV risk was medium to high risk in one-third of respondents, and was largely attributable to fear of occupational exposure. Appropriate precautionary professional practices were adopted at low frequencies, with respondents adopting preventive measures less than 50% of the time on 7 of 10 measures. Seventeen percent reportedly received requests for HIV/AIDS education from members of the public, which is incongruous with law enforcement officers' and first responders' demonstrated level of knowledge about HIV transmission. It was concluded that improved educational programs on HIV/AIDS are needed for law enforcement officers and first responders to increase the use of occupational precautions in the field, and to improve the accuracy of public AIDS education activities conducted by these professionals.
This study assessed the situational and sociodemographic characteristics of children infected with human immunodeficiency virus (HIV) from pediatric sexual abuse. A letter of inquiry was sent to 2147 professionals across health and social service disciplines involved with child abuse assessment, treatment, and prevention. Respondents working in programs where HIV antibody testing of abuse victims occurs and who had identified HIV infection in one or more abused children were sent a survey to assess the demographics of victims, the family/living situation where abuse occurred, alternative risks for HIV infection, bases for diagnosis of sexual abuse and for HIV antibody testing, and profiles of the perpetrator and type of abuse. Of 5622 estimated HIV antibody tests conducted during 113 198 sex abuse assessments, 28 children were infected with HIV and lacked any alternative transmission route to that of sexual abuse. A total of 41 HIV-infected children with a history of sexual abuse were identified. Thirteen cases had alternative risk factors and were excluded from analysis. Sixty-four percent of the 28 victims with sexual abuse as the sole risk factor were female and 71% were African-American. The mean age was 9 years. Coinfection with another sexually transmitted disease (STD) occurred in 9 (33%) cases. Sexual abuse was diagnosed on the basis of a victim disclosure in 21 (75%) cases. The basis for HIV antibody testing was physical findings suggestive of HIV infection in 9 (32%) cases, HIV-seropositive or high-risk perpetrator in 6 (21%) and 2 (7%) cases, respectively, and the presence of another STD in the victim in 4 (14%) cases. Perpetrators were a child's parent in 10 (42%) cases and another relative in 6 (25%) cases. Perpetrators had behavioral risk factors for or signs/symptoms of HIV infection in 14 (58%) cases. The serostatus of perpetrators was known at time of abuse assessment in 16 (67%) cases and all were seropositive. Duration and form of abusive acts were variable, with 3 victims reporting a single episode and 13 (68%) reporting 6 or more episodes. Penile vaginal and/or rectal penetration was reported in only 50% of cases. It is concluded that sexual abuse must be considered as a potential, although infrequent, mode of transmission of HIV infection in children. Children who have been abused should be evaluated selectively for HIV infection particularly if the perpetrator is known to be HIV seropositive or engages in HIV high-risk behavior, if abuse occurred in a geographic area of high disease prevalence, and if the child has symptoms of HIV infection or another STD. Children who are found to be HIV infected and lack risk factors such as prior transfusion or maternal (perinatal) infection should be assessed for pediatric sexual abuse.
Spindly leg syndrome (SLS) is a relatively common musculoskeletal abnormality associated with captive-rearing of amphibians with aquatic larvae. We conducted an experiment to investigate the role of environmental calcium and phosphate in causing SLS in tadpoles. Our 600-tadpole experiment used a fully-factorial design, rearing Atelopus varius tadpoles in water with either high (80mg/l CaCO 3), medium (50mg/l CaCO 3), or low calcium hardness (20mg/l CaCO 3), each was combined with high (1.74 mg/l PO 4) or low (0.36 mg/l PO 4) phosphate levels. We found that calcium supplementation significantly improved tadpole survival from 19% to 49% and that low calcium treatments had 60% SLS that was reduced to about 15% at the medium and high calcium treatments. Phosphate supplementation significantly reduced SLS prevalence in low calcium treatments. This experimental research clearly links SLS to the calcium: phosphate homeostatic system, but we were unable to completely eliminate the issue, suggesting an interactive role of other unidentified factors.
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