Journal of community health
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The purpose of this study was to assess knowledge regarding STD spread and prevention, and to assess motivational and behavioral factors that influence the use of condoms to prevent STD acquisition among inner-city women at high risk for STD infection. In addition, the effect of past and/or current STD infection on a woman's knowledge of the mechanism of STD acquisition and subsequent use of a condom to prevent STD infection was explored. We utilized three inner-city clinics offering family planning or gynecologic care located in Brooklyn, New York. ⋯ Condom use to prevent STD acquisition was more than twice as frequently reported when a favorable attitude was perceived by a male sexual partner (OR = 2.30, 95% CI 1.54-3.43). Our findings suggest that prevention of unplanned pregnancy was a stronger motivator for condom use than disease prevention among the women comprising our study group. The findings also indicate the need for more extensive information regarding STD prevention among women at high risk for STD acquisition.(ABSTRACT TRUNCATED AT 400 WORDS)
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A confederate civilian physician shot and killed a white Union officer who was drilling Negro troops in Norfolk, Virginia. With no question as to guilt, President Abraham Lincoln decided to have a medical expert conduct a professional sanity/insanity examination. Documentation indicates that legal and political factors may have influenced Lincoln's decision. ⋯ Politically, Lincoln faced serious issues such as the draft riots, the military necessity to recruit slaves into the army, the impact of Union Negro soldiers upon the border states, the morale and discipline of the army and the upcoming presidential election. Upon Seward's recommendation, Lincoln chose a physician who had a reputation for finding the accused sane and who did so in this case. As the southern physician was hanged, Lincoln's means achieved the desired legal and political ends.
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A patient's right to decide about life-sustaining treatment may conflict with the policies of health care facilities that refuse on the basis or religious or moral convictions to honor certain decisions to forgo treatment. The New York State Task Force on Life and the Law examined the prevalence and nature of facility conscience objections to the refusal of life-sustaining treatment by conducting a survey of New York hospitals. Written questionnaires were distributed to hospitals in New York State. ⋯ The patient's medical condition and the type of life-sustaining treatment to be withdrawn or withheld are important factors in determining whether a hospital will object on grounds of conscience. The imminence of death appeared more decisive than the degree of debilitation or disability as a factor in the willingness to accept decisions to forgo life-sustaining treatment. Hospitals should establish clear, written policies about their objections to forgoing treatment so that patients and their families can evaluate whether the facility meets their needs.
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The purpose of this study was to identify predictors of survival over five years in a sample of 377 elderly (age 55+) chronically ill men. Subjects were selected at baseline from consecutive appointments at a geriatric clinic and given extensive medical and psychosocial assessment. Five years later, subjects who could be located were interviewed by telephone. ⋯ Other variables included functional health status [Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL)], mental health status [Mini-Mental Status Exam (MMSE), morale], health habits (smoking, alcohol use and exercise), use of health services (physician visits, emergency room (ER) visits, hospital stays), and demographic factors (age, income, marital status and living arrangements). Proportional hazard models showed that the variables with statistically significant direct effects on survival time were younger age, higher functional health status on IADL, non-smoking, moderate alcohol use, and perception of adequate income. Nutritional status was indirectly associated with survival.
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Historical Article
Historical precedent and the obligation to treat AIDS patients.