A matter of policy: health groups face the AIDS crisis

Article Abstract:

One consequence of the AIDS epidemic has been the formulation of policies that govern interactions between people with AIDS, those with human immunodeficiency virus (HIV, associated with AIDS), and the rest of society. A review is presented of some guidelines that have been developed. In 1987, the Centers for Disease Control (CDC) published a set of recommendations for health care workers to help prevent infection by using universal precautions. Decisions concerning whether workers should be tested for infection were to be made on a case-by-case basis. Guidelines were expanded beyond avoiding infection, however, after public outcry accused health care workers of discriminating and of refusing to treat AIDS patients. In 1988, the American Dental Association adopted a policy that advocated treating HIV-infected people with dignity and compassion and serving them in private offices, while observing proper infection control procedures. Other medical professional groups adopted similar policies. When further concerns were raised about the possibility of patient risk from exposure to infected health care personnel, guidelines took on a moral/ethical tone. The reports that five patients of a Florida dentist had been infected by him, although no route of transmission was proven, caused many health organizations to review their policies. The ADA and the American Medical Association stated that HIV-infected health care workers should inform their patients of their status or stop practicing invasive procedures. This view is not shared by all professional associations, many of which maintain that the physician is under obligation to do no harm. Questions have been raised concerning the definition of invasive as it applies to dental procedures and HIV testing. Whether or not AIDS testing should be mandatory, and, if so, for whom, is also being questioned. Patients are demanding to know the HIV status of their doctors or dentists, and it is possible that mandatory testing, along with prohibitions on practicing medicine or dentistry, will be instituted. The effects of such changes on the delivery of health care remain to be determined. (Consumer Summary produced by Reliance Medical Information, Inc.)

Laws, regulations and rules, Communicable diseases, AIDS patients

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A national survey of women dentists

Article Abstract:

This article presents results from a study of a cross-section of all women dentists in the United States, Puerto Rico, and the US Virgin Islands. It has been estimated that women will make up 16 percent of all US dentists by the year 2000. Data concerning demographic aspects and practice patterns were collected via a 21-item questionnaire mailed to all women dentists listed by the American Dental Association (ADA; 8,857 questionnaires). The response rate was 74 percent. Almost 90 percent of the respondents graduated from dental school between 1970 and 1986; 77 percent were white. The proportion of Hispanic and Asian female dentists increased during the last three decades. Slightly more than half the respondents practiced in California, New York, Illinois, Texas, Pennsylvania, Michigan, or New Jersey. Most (82.8 percent) practiced general dentistry, with the remaining dentists involved in specialties. One third of the respondents had dental experience (as hygienists, for instance) before they began dental school. Three quarters of the women older than 45 had been pregnant at least once; the average number of pregnancies was 2.2. Respondents aged 23 to 64 worked, on average, 34.9 hours per week for 47.6 weeks each year. Women who had never been pregnant were more likely to work full time (at least 32 hours per week). Dentists between the ages of 23 and 44 with histories of pregnancy worked fewer weeks per year than those who had never been pregnant. Three hundred ten birth defects were reported for the 5,027 live births to the dentists. Miscarriages had occurred in 771 cases. The method of data collection made it impossible to link miscarriage rates or birth defects to occupational exposure. On average, the women dentists placed 24.1 mercury amalgam fillings per week. A review of the literature concerning women dentists and occupational exposure to hazardous substances is presented. Enough women dentists are now practicing that collection of such data should be possible. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surveys, American Dental Association, Women dentists

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Inappropriate infant bottle feeding: status of the Healthy People 2000 objective

Article Abstract:

Most US children have used baby bottles filled with fluids other than water and nearly one-fifth are put to sleep with these bottles. These feeding practices contribute to childhood tooth decay. Researchers generalized survey data on the feeding practices of 5,662 children to the corresponding US population. Ninety-five percent of children between the ages of six months and five years have been fed with a baby bottle that contained fluids other than plain water. Approximately 16.7% of US children in this age range are put to sleep with these bottles. More than 8% of children between the ages of two and five still use a bottle. Of the children who currently use a bottle, more than 40% are put to sleep with the bottle every night. Factors associated with an increased likelihood of bedtime bottle use are infant age greater than two years, Hispanic ethnicity, and less than 12 years of parental education.

Risk factors, Children, Food and nutrition, Dental caries, Bottle feeding

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