Is family medicine meeting the HIV/AIDS challenge? A national survey of family physicians' beliefs, clinical competence, and experience regarding HIV disease

A national sample of family physicians was surveyed to (1) assess family physicians' beliefs about the human immunodeficiency virus (HIV) and individuals at risk for infection, their clinical competence regarding HIV-related issues, and their experiences with HIV disease; (2) present conclusions to the American Academy of Family Physicians (AAFP) to effect the development of an early clinical care protocol and a continuing medical education curriculum; and (3) collect base-line data for use in the evaluation of an early clinical care protocol and a continuing medical education curriculum, in the case that such programs are developed and disseminated. After considering retired or deceased respondents, of the 2,660 physicians surveyed, 1,678 (63.7%) responded. The resulting sample was representative of the active members of the AAFP. About 77% of the respondents were unable to accurately identify the universal precautions for blood and body fluids to prevent occupational transmission of HIV or hepatitis B virus (HBV). Residency trained and board certified physicians expressed fewer "external constraints," such as fear of losing patients, obviating them from providing treatment to individuals with HIV disease (p =.004 and p $<$.001, respectively). These physicians also manifested fewer "internal constraints" to the provision of HIV treatment, such as fear of becoming infected (p $<$.001 and p =.012, respectively). Residency trained physicians also expressed a greater comfort with discussing sexually-related topics with their patients than did non-residency trained physicians (p $<$.001). There were 67.1% of the physicians surveyed who reported never providing treatment to an individual with HIV disease. Residency trained and board certified physicians expressed a greater likelihood to provide treatment to HIV-infected patients (p $<$.001) than non-residency trained and non-board certified physicians.^ Among the various primary care specialties, family medicine is especially vulnerable to the current challenges of HIV/AIDS. These challenges are augmented by the epidemiologic pattern that characterizes AIDS. For the past several years, we have seen AIDS in this country assume a similar pattern to that seen in most other countries; HIV is becoming increasingly prevalent in the heterosexual population as well as in locations removed from metropolitan centers. This current phase of the epidemic generates greater pressures upon primary care physicians, particularly family physicians, to become better acquainted with the means to provide early care to HIV/AIDS patients and to prevent HIV/AIDS among their patients. Family medicine is especially appropriate for providing care to HIV patients because family medicine involves treatment to all age groups and conditions; other primary care specialties focus on limited patient populations or specific conditions. Family physicians should be armed with the expertise to confront HIV/AIDS. However, family physicians' clinical competence and experience with HIV is not known. The data collected in this survey describes their competencies, attitudes, and experiences. ^

Art influences on Mark Z. Danielewski's House of Leaves and Los Angeles's influence on Johnny Truant

"...is a novel that combines literature and art to create a unique postmodern object. It was published just over a decade ago, and in that time numerous scholars and students have written papers and articles on it. Within these articles, the themes are usually about deconstruction, the house as a digital object, the house's lack of homeliness, or characters who claim authorial presence. Danielewski distance himself from that role. The house and its impossible labyrinth are the central feature of the book. A house should provide stability, but this house shifts its rooms and walls at random. A house should protect its occupants, but this one kills people. This house links itself into an infinite amount of information through its use of the internet as an influence and a stylistic device, but it has nothing but an absence in its very foundation, an empty labyrinth with an unseen monster."

The Saturday review of politics, literature, science, art, and finance.

Title from caption.

Italian sculpture of the middle ages and period of the revival of art. A descriptive catalogue of the works forming the above section of the museum, with additional illustrative notices.

Mode of access: Internet.

International Congress of Arts and Science.

Contents.--v. 1. Philosophy and metaphysics.--v. 2. Aesthetics and mathematics.--v. 3. History and law.--v. 4. Law and religion.--v. 5. History of language.--v. 6. Literature and art.--v. 7. Physics and chemistry.--v. 8. Astronomy and earth sciences.--v. 9. Biology.--v. 10. Anthropology and mental science.--v. 11. Medicine.--v. 12. Medicine and technology.--v. 13. Economics and social regulation.--v. 14. Jurisprudence and social science.--v. 15. Secular and religious education.

Illustrated supplement to the descriptive catalogue published by Edmond Johnson ... of fac-simile reproductions of Irish antique art metal work : specially manufactured for exhibition at the World's Fair, Chicago, 1893; the International Exposition, Paris, 1900; and the International Exhibition, Glasgow, 1901; and as supplied to the principal museums of America, Great Britain, and the Continent /

Acquisition made accessible thanks to the generous support of the Frederick J. and Margret L. Worden Endowment.

Art, literature, and the drama

Spine title: Margaret Fuller's works

Examples of the works of art in the Museum and of the decorations of the building : with brief descriptions.

Pub. with the sanction of the Science and art department.

Putnam's magazine. Original papers on literature, science, art, and national interests.

Indexed by Poole's index to periodical literature.

A list of books and pamphlets in the National Art Library, South Kensington Museum, on drawing, geometry, and perspective.

At head of title: Department of Science and Art of the Committee of Council on Education.

Science and education; essays

With his Man's place in nature ... New York, 1904.

The International magazine of literature, art, and science.

Vol. title pages, issued separately, have title: International monthly magazine of literature, science, and art.

Art of practice

Mode of access: Internet.

Effect of Depression and Substance Abuse on Antiretroviral Therapy (ART) Adherence in Men Who Have Sex With Men (MSM) of Mexican Descent on the US-Mexico Border

Thesis (Master's)--University of Washington, 2016-06