Social relationships of men at risk for AIDS

Survey data collected in 1984-85 from a community sample of 637 gay and bisexual men were used to determine the features of social relationships that were most conductive to changes in both psychological health and AIDS-related sexual risk behavior. Multiple regression analyses showed that both the perceived availability of social support and the absence of conflicts in the social network were related to improved psychological health. At the same time, the subjective experience of integration into social networks was associated with increased psychological distress, and validation (the experience of being accepted by others) was related to a higher level of risk activity. These findings are discussed in terms of the social relationships among community members that share a common stressor--in this case the shared problem of being at risk for AIDS.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30825/1/0000487.pd

Effects of HIV infection, perceived health and clinical status on a cohort at risk for aids

Data from a general population sample of 621 healthy homosexual men are used to evaluate the social and emotional effects of HIV antibody status, clinical signs detected by medical examination, and subjectively perceived symptoms. Participants are unaware of their serologic status at the time of data collection, thus allowing the effects of the virus to be separated from reactions to the knowledge of serologic status.The data show that seropositivity for HIV is not associated with elevated levels of social or emotional impairment. Clinical signs lead to impairment in baseline data, but these effects do not persist at a second wave. This weakening suggests that the effects are mediated by psychological pathways rather than biologic ones. This suspicion is confirmed in further analyses, which show that the effects of clinical signs are mediated by subjectively perceived symptoms.These results show that neither social nor emotional impairment is likely to be a prodromal sign of HIV infection in otherwise healthy homosexual men. The substantial levels of distress found among these men is more directly influenced by psychological determinants than biologic ones. This suggests that physicians should be aware of the psychological toll imposed on gay men who develop health problems in the current atmosphere of uncertainty regarding risk of AIDS.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/27577/1/0000621.pd

Primary Relationships and Mental Health in a Cohort At Risk for Aids (Immune Deficiency).

This research examined the effects of AIDS-related stress and primary relationships on the mental health of homosexually active men at risk for AIDS. Participants were 447 gay and bisexual men living in the Chicago area who completed self-administered questionnaires at three timepoints six months apart beginning in June 1984. The research asked: (1) Does the stress a man at risk experiences because of the AIDS crisis--in the form of knowing someone who has been diagnosed or who has died from AIDS--affect his mental health? Does it matter to psychological health whether the person who is diagnosed or who died is an acquaintance, a friend, or a sexual partner? (2) Does this effect of stress on mental health depend upon whether or not the individual is in a primary relationship? (3) What aspects of primary relationships particularly benefit mental health? Does the effect of AIDS-related stress on psychological health depend on overall relationship quality? In performing these analyses, the respondent's previous level of psychological health was included as a statistical control. Men who knew someone with AIDS showed increased distress, regardless of whether the person was an acquaintance, friend, or sexual partner. Effects of past stress in the personal network were not significant, but current stress was related to an increase in psychological problems. Relationship status was not associated with changes in psychological health. The stress of knowing someone with AIDS did not affect the mental health of men who were consistently out of relationships more than those who were consistently in them. However, stress did affect the mental health of men whose relationship status changed during the previous year. Relationship quality proved more influential than simply having a relationship. Four types of relationship quality were examined: relationship satisfaction, lack of relationship tension, concordance, and affirmation. Each type contributed to improved psychological health. In particular, men who felt affirmed in their primary relationships--for example, who felt their partners appreciated them just as they were--became psychologically more healthy during the course of the study.Ph.D.Social psychologyUniversity of Michiganhttp://deepblue.lib.umich.edu/bitstream/2027.42/161610/1/8729290.pd

Social relationships of men at risk for AIDS

Survey data collected in 1984-85 from a community sample of 637 gay and bisexual men were used to determine the features of social relationships that were most conductive to changes in both psychological health and AIDS-related sexual risk behavior. Multiple regression analyses showed that both the perceived availability of social support and the absence of conflicts in the social network were related to improved psychological health. At the same time, the subjective experience of integration into social networks was associated with increased psychological distress, and validation (the experience of being accepted by others) was related to a higher level of risk activity. These findings are discussed in terms of the social relationships among community members that share a common stressor--in this case the shared problem of being at risk for AIDS.social relationships AIDS HIV

Out-of-Hospital Pediatric Patient Safety Events: Results of the CSI Chart Review

<p><b>Objective</b>: Studies of adult hospital patients have identified medical errors as a significant cause of morbidity and mortality. Little is known about the frequency and nature of pediatric patient safety events in the out-of-hospital setting. We sought to quantify pediatric patient safety events in EMS and identify patient, call, and care characteristics associated with potentially severe events. <b>Methods</b>: As part of the Children's Safety Initiative -EMS, expert panels independently reviewed charts of pediatric critical ambulance transports in a metropolitan area over a three-year period. Regression models were used to identify factors associated with increased risk of potentially severe safety events. Patient safety events were categorized as: Unintended injury; Near miss; Suboptimal action; Error; or Management complication (“UNSEMs”) and their severity and potential preventability were assessed. <b>Results</b>: Overall, 265 of 378 (70.1%) unique charts contained at least one UNSEM, including 146 (32.8%) errors and 199 (44.7%) suboptimal actions. Sixty-one UNSEMs were categorized as potentially severe (23.3% of UNSEMs) and nearly half (45.3%) were rated entirely preventable. Two factors were associated with heightened risk for a severe UNSEM: (1) age 29 days to 11 months (OR 3.3, 95% CI 1.25-8.68); (2) cases requiring resuscitation (OR 3.1, 95% CI 1.16-8.28). Severe UNSEMs were disproportionately higher among cardiopulmonary arrests (8.5% of cases, 34.4% of severe UNSEMs). <b>Conclusions</b>: During high-risk out-of-hospital care of pediatric patients, safety events are common, potentially severe, and largely preventable. Infants and those requiring resuscitation are important areas of focus to reduce out-of-hospital pediatric patient safety events.</p