HIV Status Disclosure in the Workplace: Positive and Stigmatizing Experiences of Health Care Workers Living with HIV.

We explored workplace experiences of 10 health care providers with HIV in the Netherlands. We used semi-structured interviews to discuss motivations for disclosure and concealment, reactions to disclosures, the impact of reactions, and coping with negative reactions. Reasons for disclosure were wanting to share the secret, expecting positive responses, observing positive reactions to others, wanting to prevent negative reactions, and being advised to disclose. Reasons for concealment included fearing negative reactions, observing negative reactions, previous negative experiences, having been advised to conceal, and considering disclosure unnecessary. Positive reactions included seeing HIV as a nonissue; showing interest, support, and empathy; and maintaining confidentiality. Negative reactions included management wanting to inform employees, work restrictions, hiring difficulties, gossip, and hurtful comments, resulting in participants being upset, taken aback, angry, depressed, or feeling resignation. Participants coped by providing information, standing above the experience, attributing reactions to ignorance, seeking social support, or leaving their jobs.

Disclosure of HIV Status to Health Care Providers in the Netherlands: A Qualitative Study.

We qualitatively investigated perspectives on HIV disclosure to health care providers (HCP) by people living with HIV (PLWH). Perspectives varied across PLWH and between PLWH and HCP. Some PLWH felt they should always disclose so that HCP could take necessary precautions or because disclosure optimized care. Others felt that disclosure was not an obligation but a courtesy. Still others felt that disclosure was unnecessary as all HCP should apply universal precautions or because HIV status was not relevant to care. Most HCP claimed they should be informed about patients' HIV status as this would reduce occupational risk of infection and improve care. HCP also felt that disclosure concerns by PLWH were unnecessary given the HCP' duty of professional confidentiality. Some acknowledged that disclosure was not always necessary but still indicated wanting to be informed. Perspectives on HIV disclosure in health care settings differed substantially between PLWH and HCP.

Patient and provider perspectives on HIV and HIV-related stigma in Dutch health care settings.

Ensuring that people living with HIV (PLWH) feel accepted in health care settings is imperative. This mixed methods study explored the perspectives of PLWH and health professionals on their interactions. A total of 262 predominantly gay men of Dutch origin participated in a survey study of possible negative interactions with health professionals, and semi-structured interviews were subsequently conducted with 22 PLWH and 14 health professionals. Again, most PLWH were gay men of Dutch origin. All health professionals were Dutch. PLWH reported negative experiences with health professionals including awkward interactions, irrelevant questions, rude treatment, blame, pity, excessive or differential precautions, care refusal, unnecessary referrals, delayed treatment, poor support, and confidentiality breaches. They also reported positive experiences including equal treatment, being valued as a partner in one's health, social support provision, and confidentiality assurances. Health professionals reported having little experience with PLWH and only basic knowledge of HIV. They contended that PLWH are treated equally and that HIV is no longer stigmatized, but also reported fear of occupational infection, resulting in differential precautions. Additionally, they conveyed labeling PLWH's files to warn others, and curiosity regarding how patients acquired HIV. The findings suggest that there is a gap in perception between PLWH and health professionals regarding the extent to which negative interactions occur, and that these interactions should be improved. Implications for stigma reduction and care optimization are discussed.

Independent component approach to the analysis of EEG recordings at early stages of depressive disorders.

OBJECTIVE: A modern approach for blind source separation of electrical activity represented by Independent Components Analysis (ICA) was used for QEEG analysis in depression. METHODS: The spectral characteristics of the resting EEG in 111 adults in the early stages of depression and 526 non-depressed subjects were compared between groups of patients and healthy controls using a combination of ICA and sLORETA methods. RESULTS: Comparison of the power of independent components in depressed patients and healthy controls have revealed significant differences between groups for three frequency bands: theta (4-7.5Hz), alpha (7.5-14Hz), and beta (14-20Hz) both in Eyes closed and Eyes open conditions. An increase in slow (theta and alpha) activity in depressed patients at parietal and occipital sites may reflect a decreased cortical activation in these brain regions, and a diffuse enhancement of beta power may correlate with anxiety symptoms playing an important role on the onset of depressive disorder. CONCLUSIONS: ICA approach used in the present study allowed us to localize the EEG spectra differences between the two groups. SIGNIFICANCE: A relatively rare approach which uses the ICA spectra for comparison of the quantitative parameters of EEG in different groups of patients/subjects allows to improve an accuracy of measurement.

EEG power spectra at early stages of depressive disorders.

In previous quantitative EEG studies of depression, mostly patients with a lifetime history of depressive disorders were reported. This study examined quantitative EEG parameters obtained in the early stages of depression in comparison with age-matched healthy controls. EEG was recorded using two different montages in eyes closed and eyes open resting states. A significant increase in spectrum power in theta (4-7.5 Hz), alpha (7.5-14 Hz), and beta (14-20 Hz) frequency bands was found in depressed patients at parietal and occipital sites, both in eyes closed and eyes open conditions. These results suggest that an increase in slow (theta and alpha) activity in the EEG pattern may reflect a decreased cortical activation in these brain regions. Enhancement of beta power may correlate with anxiety symptoms that most likely play an important role on the onset of depressive disorder.