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PURPOSE: The purpose of this study was to assess the knowledge and attitudes of adolescent Jamaicans in a church youth group, regarding HIV/AIDS. METHODS: A convenience sample of 45 adolescents from a Jamaican youth group completed a modified version of the AIDS Attitude Scale (AAS). The subjects were assessed for having empathy or avoidance towards people with HIV/AIDS. A focus group discussion after completion of the AAS provided information about the participants' knowledge regarding HIV transmission and self-protection. FINDINGS: The adolescents' responses on the AAS indicated strong empathy (4.66) and an overall supportive attitude (+1.77) for people with HIV/AIDS. While the adolescents incorrectly felt that HIV/AIDS was being spread mainly by homosexual encounters in their country, other responses regarding mode of transmission were quite accurate. Since these adolescents were practicing abstinence and the avoidance of drugs and alcohol, they weren't worried about protecting themselves from the transmission of HIV; however, when asked what they would tell their friends outside of the church about HIV protection, most subjects were able to provide accurate information. CONCLUSIONS: These findings indicate that Jamaican adolescents actively committed to the teachings of the church are generally knowledgeable about HIV/AIDS and supportive of people with HIV/AIDS. Nurses and other health care professionals working with members of the church youth groups to develop peer educator programs, would have effective role models to help influence the sexual behaviors of their adolescents.

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CONTEXT: Despite evidence that methadone maintenance treatment (MMT) is effective for opioid dependence, it remains a controversial therapy because of its indefinite provision of a dependence-producing medication. OBJECTIVE: To compare outcomes of patients with opioid dependence treated with MMT vs an alternative treatment, psychosocially enriched 180-day methadone-assisted detoxification. DESIGN: Randomized controlled trial conducted from May 1995 to April 1999. SETTING: Research clinic in an established drug treatment service. PATIENTS: Of 858 volunteers screened, 179 adults with diagnosed opioid dependence were randomized into the study; 154 completed 12 weeks of follow-up. INTERVENTIONS: Patients were randomized to MMT (n = 91), which required 2 hours of psychosocial therapy per week during the first 6 months; or detoxification (n = 88), which required 3 hours of psychosocial therapy per week, 14 education sessions, and 1 hour of cocaine group therapy, if appropriate, for 6 months, and 6 months of (nonmethadone) aftercare services. MAIN OUTCOME MEASURES: Treatment retention, heroin and cocaine abstinence (by self-report and monthly urinalysis), human immunodeficiency virus (HIV) risk behaviors (Risk of AIDS Behavior scale score), and function in 5 problem areas: employment, family, psychiatric, legal, and alcohol use (Addiction Severity Index), compared by intervention group. RESULTS: Methadone maintenance therapy resulted in greater treatment retention (median, 438.5 vs 174.0 days) and lower heroin use rates than did detoxification. Cocaine use was more closely related to study dropout in detoxification than in MMT. Methadone maintenance therapy resulted in a lower rate of drug-related (mean [SD] at 12 months, 2.17 [3.88] vs 3.73 [6.86]) but not sex-related HIV risk behaviors and in a lower severity score for legal status (mean [SD] at 12 months, 0.05 [0.13] vs 0.13 [0.19]). There were no differences between groups in employment or family functioning or alcohol use. In both groups, monthly heroin use rates were 50% or greater, but days of use per month dropped markedly from baseline. CONCLUSIONS: Our results confirm the usefulness of MMT in reducing heroin use and HIV risk behaviors. Illicit opioid use continued in both groups, but frequency was reduced. Results do not provide support for diverting resources from MMT into long-term detoxification.

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This report describes the fabrication of a flexible multichannel electrode array suitable for use in humans. The conductors, pads, and stimulating tips are made of platinum on a polyimide substrate. Photolithographic techniques are employed in the fabrication of the electrode on a planar surface in the form of a film. The film is rolled subsequently into a cylinder of diameter 0.50 mm and the cylinder is filled with medical grade silicone rubber. The stimulation pads then form rings around the cylinder. In vitro and in vivo tests are ongoing with good results so far.

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While most health care is provided at the primary care level, little research has been done to document the ethical issues of such care. A stratified random sample of 702 physicians, nurses, physical therapist, and physician assistants within one southeastern state was surveyed to determine the frequency of ethical issues in primary care. The most frequently occurring issue concerned moral decisions about the amount of time to spend with each patient. A comparison of physician and nonphysician professional groups revealed significant differences in frequencies of the issues. Age had a slight impact on the responses, while gender, religion, and region of practice had none. The study showed that the most frequently occurring issues are pragmatic, not dramatic, and center on patient self-determination, adequacy of care and professional responsibility, and distribution of resources.

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