HIV seroprevalence among patients admitted to two psychiatric hospitals

OBJECTIVE

The authors determined the seroprevalence of HIV-1 among patients admitted to two psychiatric hospitals in New York City.

METHOD

Patients consecutively admitted to an acute psychiatric unit in Manhattan and a large state hospital in Queens were anonymously tested for HIV-1 antibodies from December 1989 through July 1990. Test results were linked to age, gender, ethnicity, and two risk behaviors: male homosexual activity and injection drug use.

RESULTS

Blood was obtained from 83.0% of the eligible patients. The prevalence of HIV was 5.5% (25 of 451). Black patients accounted for 38.0% of the patients tested and 76.0% of positive results (N = 19), a rate of 11.1% for this group. The rate of seropositivity was comparable in women and men. Clinicians had charted risk behavior for nine (36.0%) of the 25 HIV-positive patients. Infection control records suggested that clinicians were aware of seven (28.0%) of the positive cases.

CONCLUSIONS

One in every 18 patients admitted to two public psychiatric hospitals in New York City was HIV positive. Clinical staff largely failed to identify HIV-positive patients. Ethnicity and a history of homosexual activity among men or use of injected drugs were strongly associated with seropositivity. This pattern of infection may be linked to needle sharing and/or sexual activity with partners who have shared needles. Future research should clarify how psychiatric illness affects risk-taking behavior, focus on improving detection by clinicians, and identify effective prevention strategies in this population.

Using a "lifestyle" perspective to understand toothbrushing behaviour in Scottish schoolchildren

Using data from a wider survey of health related behaviour in 4,935 Lothian schoolchildren, 11, 13, and 15 yr old, this paper analysed toothbrushing frequency and its relation to "lifestyle" factors. Analysis of the results showed that girls brush more frequently than boys and that children with higher social class background brushed more frequently than children with low social class background. Further toothbrushing frequency was significantly related to the subjects' health perception, smoking and drinking habits, eating habits, bedtimes, and video-watching. Moreover, all these lifestyle factors were inter-related. The paper reinforced the concept of lifestyle as a meaningful descriptive term. The results demonstrated that the bivariate associations are pieces in a more complex mosaic. Toothbrushing thus seems to be an integrated part of a child's lifestyle and should be regarded as such in future health promotion efforts.

The incidence and correlates of health-related behavioural change in a small Scottish community

This paper reports on a survey of health related behavioural change in a small Scottish town. Four types of behaviour were surveyed; smoking, alcohol use, dietary habits and exercise. The results indicate that for both smoking exercise behavioural change is very unstable. Cutting down or giving up alcohol was significantly associated with cessation of smoking in women but not in men. All dietary changes were strongly inter-related. Giving up smoking, taking exercise and eating more fibre were significantly associated with very good reported health. Sex, age and social class patterns in health-related changes were evident.

Health-related behaviour in a small Scottish community

A survey of health-related behaviours was carried out in a small Scottish town. A random sample stratified by age and sex was drawn from the records of the sole local health centre. A previously validated questionnaire was sent by post with a covering letter from the general practitioners and a reply paid envelope. An overall response rate of 71.3% was achieved. The results indicated very high rates of smoking for women with manual jobs, but differences between men in manual & non manual groups were not significant. Younger women reported higher alcohol consumption than older women, but there were no significant differences between occupational groups or employed and unemployed men. Only a minority of respondents reported regular consumption of high fibre products, low fat milk and polyunsaturated margarine and few claimed to undertake vigorous exercise. In general health-related behaviours showed little association with self-rated health. Whilst the data confirm the importance of socio-demographic factors in certain behaviours they also indicate that these are inadequate to predict the pattern of such behaviours within a community.

Dental health-related behaviour in Scottish schoolchildren aged 11, 13 and 15 from Edinburgh city

The two most important individually-mediated factors for the control of dental decay and periodontal diseases are frequency of sugar consumption commonly in the form of sweets, and toothbrushing. Most dental health education efforts have therefore been concentrating on informing and motivating parents and children to restrict sugar intake and to brush their teeth twice a day. The present investigation was undertaken, as part of a wider survey of health related behaviour in Scottish schoolchildren, to determine the frequency of tooth brushing and sweet consumption in relation to age, gender and social background. Data was collected from 4,890 children aged 11, 13 and 15 years from independent and state schools in Lothian. Subjects completed a questionnaire, anonymously, in class.

Comparison of admission and discharge medications in two geriatric populations

Drug usage patterns were determined from a chart review of two groups of the elderly upon admission to and discharge from the hospital. A comparison was made between a United States group (N = 60) and a Scotland group (N = 60). The most common drugs noted in both groups were cardiovascular drugs (primarily diuretics) and vitamins and minerals. The mean number of drugs per patient in both groups was approximately four, with minimal change in number between admission and discharge. The number of drugs decreased with male sex and increasing age in the United States group and increased with male sex and increasing age in the Scotland group. The Scotland group was on more short-acting benzodiazepines, more bowel medications, more antidepressants, more antiparkinson agents, and fewer respiratory drugs than the United States group. Although both groups tended to have certain drugs deleted, Scotland patients were more likely to have narcotics discontinued and bowel medications added before discharge. These drug usage patterns demonstrate substantial polypharmacy in the elderly and the importance of selecting appropriate drugs in the elderly.

Prevalence of psychosexual problems in patients attending a genitourinary clinic

The prevalence of self reported psychosexual problems in 265 men and 160 women who attended the genitourinary clinic at this hospital was assessed. Twenty-six (10.6%) men and 13 (9.0%) women had sexual problems either as an individual or within their regular relationship. The highest prevalence of problems was in married or cohabiting women and men, both homosexual and heterosexual, over 30.

Teaching medical ethics: University of Edinburgh

The Edinburgh Medical Group Research Project is unique in Britain. Part of its function is to experiment with teaching medical ethics both inside and outside of the Medical School. The papers which follow have been written by two full-time reseach fellows working with the Project and two of the professional advisers, one nursing and one medical. Together they give a picture of the wide scope of exerimental teaching taking place in Edinburgh and present some preliminary results from these experiments.