Children with AIDS.Teachers spend a lot of time discussing and dealing with "at-risk" children. In the Summer 1992 issue of Childhood Education, Selma Wassermann reminded us of the varied troubles that some children bring to school. We should ask ourselves what more can we do, as teachers, to help these child victims of poverty, physical and emotional abuse, drug abuse, disease and, most pertinent to this article, pediatric AIDS pediatric AIDS AIDS acquired HIV perinatally or by 'vertical'–maternal-infant transmission; children with PAIDS may become symptomatic–lymphoid interstitial pneumonia, encephalopathy, recurrent bacterial infection, Candida . The current and future realities of AIDS-infected children in the classroom are forcing teachers to evaluate and, perhaps, redefine their definition of "at-risk" in a very personal sense. Etiological etiological pertaining to etiology. etiological diagnosis the name of a disease which includes the identification of the causative agent, e.g. Streptococcus agalactiae mastitis. Background What is the true scope of the problem? During the 1980s, acquired immunodeficiency syndrome acquired immunodeficiency syndrome, see AIDS. (AIDS) became one of the most important public health problems in the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. . In the 1990s, health officials will record the 200,000th case of AIDS (Fennell, 1991). Even this figure is considered only the "tip of the iceberg tip of the iceberg n. pl. tips of the iceberg A small evident part or aspect of something largely hidden: afraid that these few reported cases of the disease might only be the tip of the iceberg. ," as an estimated 1 to 1.5 million people in the United States are infected with the human immunodeficiency virus human immunodeficiency virus n. HIV. Human immunodeficiency virus (HIV) A transmissible retrovirus that causes AIDS in humans. (HIV HIV (Human Immunodeficiency Virus), either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States. ), the retrovirus retrovirus, type of RNA virus that, unlike other RNA viruses, reproduces by transcribing itself into DNA. An enzyme called reverse transcriptase allows a retrovirus's RNA to act as the template for this RNA-to-DNA transcription. that causes AIDS (Fauci, 1988; Watkins, 1988). The rate of AIDS infection in children under 13 is also increasing. The number of pediatric AIDS cases diagnosed in the last six years has leaped from a cumulative total of 232 in December 1984 to 4,249 in December 1992 (Moll, 1991; U.S. News & World Report U.S. News & World Report Weekly newsmagazine published in Washington, D.C. U.S. News was founded in 1933 by David Lawrence (1888–1973) to cover important domestic events; he founded World Report in 1945 to treat world news. The two magazines were merged in 1948. , 1993). As in adult AIDS, the number of pediatric AIDS cases reported is a severe underestimate of the true scope of the problem. For every child with AIDS, another 2 to 10 children are likely to be HIV-infected. AIDS has become one of the top ten causes of death for children under 5. According to according to prep. 1. As stated or indicated by; on the authority of: according to historians. 2. In keeping with: according to instructions. 3. estimates, AIDS will rank in the top five by the year 2000 (U.S. News & World Report, 1993). The most important factor in the increased incidence of pediatric AIDS is the rate of heterosexual transmission. Nationwide, heterosexual contact accounts for about 6 percent of diagnosed AIDS cases. In many states, such as New York New York, state, United States New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of , Florida and Alabama, that figure is more than doubled (Alabama Department of Public Health |ADPH ADPH Alabama Department of Public Health ~, 1992). These statistics have definite implications for the health of children. As AIDS affects the female population, more and more children are being born HIV-positive. Today, 1,800 HIV-infected infants are born each year in the United States. By the year 2000, there will be from 5 to 10 million infants born with HIV worldwide (U.S. News & World Report, 1993). What do these projections really mean to teachers and administrators? It means that: 1) probably all teachers, at some point in their careers, will have an AIDS-infected child in their classroom; 2) minority children will bear more of the burden of this disease than others; 3) teachers will be among those leaders asked to deal with the fears and phobias Phobias Definition A phobia is an intense but unrealistic fear that can interfere with the ability to socialize, work, or go about everyday life, brought on by an object, event or situation. of the public; and 4) knowledge of and attitudes toward the disease will need to be addressed in teacher training. Quality of Life The statistics clearly demonstrate that more and more children are becoming infected with the AIDS virus AIDS virus n. See HIV. . Since the Federal Drug Administration (FDA FDA abbr. Food and Drug Administration FDA, n.pr See Food and Drug Administration. FDA, n.pr the abbreviation for the Food and Drug Administration. ) approved zidovudine zidovudine /zi·do·vu·dine/ (zi-do´vu-den) a synthetic nucleoside (thymidine) analogue that inhibits replication of some retroviruses, including the human immunodeficiency virus; used in the treatment of HIV infection and AIDS. and dideoxyinosine dideoxyinosine /di·de·oxy·in·o·sine/ (-in´o-sen) didanosine. di·de·ox·y·in·o·sine n. ddI. for use with pediatric patients, AIDS-infected children are remaining symptom-free and are functioning at more normal developmental levels for longer periods of time (Burroughs-Wellcome Co., 1991; Santelli, Birn & Linde, 1992). AIDS-infected children experiencing this increased quality of life must have opportunities to attend education programs appropriate for their age and developmental level. Since the largest number of AIDS-infected children are from low-income minority groups, their educational needs will have to be met by federally funded child care, Head Start and other government programs. Minority Children Although census figures identify Black and Hispanic children as minority populations, they are in the majority when it comes to AIDS infection. These subpopulations contract the disease at rates that are very disproportionate to their distribution in the general population. Seventy-five percent of pediatric AIDS cases are diagnosed among Black and Hispanic children, while only 26 percent of the pediatric pediatric /pe·di·at·ric/ (pe?de-at´rik) pertaining to the health of children. pe·di·at·ric adj. Of or relating to pediatrics. population is Black or Hispanic (Moll, 1991). Several factors account for the overrepresentation of minority children among HIV-infected patients. High-risk groups for pediatric AIDS include infants of infected mothers, children needing blood transfusions, sexually abused children, and infants of intravenous drug abusers and/or sexual partners of abusers. Many of these at-risk groups are often found in minority families living at or below the poverty level in inner-city environments (Cruz, 1988). Most of these families are faced with a day-to-day struggle for survival. The children's lives are tremendously complicated by poverty, poor education, unemployment, single-parent households, inadequate housing or homelessness, and drug use by family members (Nicholas, Sondheimer, Willoughby, Jaffe & Katz, 1989). School and health care systems serving in low-income areas are already severely overburdened trying to provide education, social and intervention services to this population. Additional responsibilities brought on by the AIDS crises may stretch already slim resources to the breaking point. Concerns Surrounding AIDS The increased awareness of AIDS has raised the public's concern about AIDS-infected children attending public schools and child care centers. Fear and misinformation mis·in·form tr.v. mis·in·formed, mis·in·form·ing, mis·in·forms To provide with incorrect information. mis about all aspects of AIDS are widespread among the general population. School boards have adopted restrictive policies, teachers have threatened work stoppages and parents have boycotted schools to block admission of AIDS-infected children (Black, 1986). Research literature documents fears concerning transmission of the virus and possible infection of healthy children and education professionals (Brucker, Martin & Shreeve, 1989; Jessee, Poteet-Johnson & Nagy, 1993; Morrow, Benton, Reves & Pickering, 1991; Rubinstein, 1986; Wetterau & Stegelin, 1991). For example, Brucker and his colleagues found that well over half of the teachers surveyed in their study (N=500) were fearful about having either children or fellow teachers diagnosed with AIDS participate in day-to-day school activities. In a study of child care centers (N=151), more than half of the teachers (59.2 percent) felt that infected people should be banned from working in health care settings and hospitals, over one-third (37.2 percent) felt they should not be allowed to work in education and child care settings, and a few (16.5 percent) felt that infected individuals should be quarantined (Jessee et al., 1993). Sixty-eight percent reported they would feel uneasy if an AIDS-infected child were in their center. Only 43 percent of the parents (N=219) in the study conducted by Morrow et al. (1991) were willing to allow their child to stay in the same room with an HIV-infected child. Forty-eight percent of child care providers were unwilling to care for a child with HIV. They believed that such a child was likely to infect others, was dangerous to others and that common child care center contacts could transmit HIV. Some of these fears are based on realistic concerns, whereas others are not. A majority of respondents, however, were interested in knowing more about modes of transmission and specific ways of dealing with infected people and/ or children. When young children are in group environments, concerns arise about the frequency of biting and opportunity for casual contact with blood and other body fluids. An incidence of approximately three biting episodes per 100 child-days among toddlers in group care was reported by Garrard, Leland & Smith (1988). Although low, this incidence still presents a risk for disease transmission. There have been reported cases in which bites from an HIV-infected child were suspected of having infected otherwise healthy persons (Anonymous, 1987; Shirley & Ross, 1989; Wahn, Kramer, Voit, Bruster, Scrampical & Scheid, 1986). Until the mechanisms of disease transmission vis-a-vis casual contact and typical child behaviors are resolved, parents and child care providers will continue to worry about the risk of contracting HIV from an infected young child, whether or not this fear is warranted. As the HIV-infected child reaches school age, classmates Classmates can refer to either:
Cells, cell products, organs, and structures of the body involved in the detection and destruction of foreign invaders, such as bacteria, viruses, and cancer cells. Immunity is based on the system's ability to launch a defense against such invaders. , HIV-children need to be protected from infection (Black, 1986; Santelli, Birn & Linde, 1992). Normal childhood diseases, as well as inoculations for certain diseases, can be fatal for a child with HIV or AIDS. Current Knowledge Are teachers being prepared to deal with the issues of pediatric AIDS on an intellectual and emotional level? Studies dealing with teachers' knowledge and attitudes suggest that they are not. Brucker and Hall (1991) have noted, however, a slight increase in knowledge among new teachers as compared to teachers who graduated five years ago. Results of a pediatric AIDS workshop held at the National Institutes of Health (NIH "Not invented here." See digispeak. NIH - The United States National Institutes of Health. ) in Bethesda, Maryland Bethesda is an urbanized, but unincorporated, area in southern Montgomery County, Maryland, just Northwest of Washington, D.C. It takes its name from a church located there, the Bethesda Presbyterian Church, built in 1820 and rebuilt in 1850, which in turn took its name from , determined that child-to-child transmission of HIV infection is one of the areas most urgently needing further research (Nicholas et al., 1989). Such research efforts are particularly germane ger·mane adj. Being both pertinent and fitting. See Synonyms at relevant. [Middle English germain, having the same parents, closely connected; see german2. to issues of group care for young HIV-infected children. Within our current knowledge base, AIDS is not spread through the kinds of contact children in group situations have with each other, including touching, hugging or sharing meals and bathroom facilities. Studies show that family members who have cared for both adults and children with AIDS have not been infected (Black, 1986; Friedland et al., 1986; Kaplan et al., 1985). Furthermore, the transmission of HIV from an infected child to other children or caregivers has not been documented in a child care setting (Lifson, 1988; Rogers et al., 1990). Education personnel also can take some reassurance from research on health care workers whose occupational exposure has led to relatively few documented cases of disease transmission (Hirsch et al., 1985). Institutional Responses In response to some of the many medical, psychosocial and education needs of these children, national pediatric health institutions developed goals to increase public and professional awareness of the education needs of AIDS-infected children and their families by fostering collaborative, community-wide efforts to enhance their quality of life. Coordinated approaches to caregiving that are family-centered and community-based have been suggested by the American Academy The American Academy in Berlin is a non-partisan academic institution in Berlin. It was founded in September 1994 by a group of prominent Americans and Germans, among them Richard Holbrooke, Henry Kissinger, Richard von Weizsäcker, Fritz Stern and Otto Graf Lambsdorff and opened in of Pediatrics' Task Force on Pediatric AIDS. The task force also recommended that existing school and child care services be open to AIDS-infected or HIV-seropositive children who are well enough to participate in group activities when special programs are not available (American Academy of Pediatrics' Task Force on Pediatric AIDS |AAP AAP - Association of American Publishers ~, 1989). The Centers for Disease Control issued guidelines that address the need for teaching caregivers about modes of possible virus transmission and procedures for handling blood, urine and other body fluids (Centers for Disease Control, 1988). Because of the complex medical and social needs, a multidisciplinary team approach is necessary to provide care to HIV-infected children and their families. Effective programs provide special services for families, including affordable medical care, culturally appropriate advocacy, outreach translators, child care help and school involvement (Stein & Jessop, 1985). Programs that are the most effective are tailored to meet specific cultural and language needs of individual communities (AAP, 1989). Successful efforts, such as the Baltimore City experience, can be models for protecting families' confidentiality, providing access to education and promoting special care for HIV-infected students (Santelli, Birn & Linde, 1992). As the number of AIDS cases continues to increase and our knowledge base continues to expand, additional ethical and legal issues emerge. Many of these issues will have a major effect upon the education system. In a review of HIV-related court cases through February 1990, 469 cases were decided, settled, pending or filed at the federal, state and local levels (Gostin, 1990). Sharp differences in perception of public health, ethics and civil liberties have resulted in the largest body of legal challenges based on a single disease in the history of jurisprudence jurisprudence (j  r'ĭspr d`əns), study of the nature and the origin and development of law. .
This new body of case law will fundamentally affect public health policy
and expose conflicts in values that will possibly require resolution by
legislatures and the courts.
What practical procedures should group caregivers or teachers follow when dealing with an AIDS-infected child? First, everyone should practice universal precautions universal precautions, n.pl 1. approaches to infection control designed to prevent transmission of bloodborne diseases, such as AIDS and hepatitis B in health care settings. . Universal precautions include washing hands after contact with any bodily fluids from a child, wearing gloves when contact with fluids is necessary and assuming every child in the class could be HIV-infected. Observing universal precautions also means understanding that, to date, no concrete evidence exists of horizontal transmission horizontal transmission n. Transmission of infection by contact. horizontal transmission Epidemiology The transmission of an infection from one to another person of the same generation in the same population. of HIV to or from people by contacts such as holding, touching, hugging or sharing meals and bathroom facilities. Because a child with AIDS is very susceptible to normal childhood diseases that can be deadly in an immunosuppressed Immunosuppressed A state in which the immune system is suppressed by medications during the treatment of other disorders, like cancer, or following an organ transplantation. Mentioned in: Fifth Disease system, parents and teachers must make every attempt to prevent such infections. When outbreaks do occur or when children in the class are to receive immunizations, parents of the AIDS-infected child need to be informed immediately. Second, if teachers and providers are fearful about having HIV-positive children or fellow teachers participate in school activities, then school administrators should accept the responsibility for developing education and support programs. Programs that are appropriate for teachers and parents should provide current information on AIDS and HIV transmission and clarify school policy on the placement of HIV-infected children in the classroom (AAP, 1989) (see appendix). Open and honest interactions should be encouraged among participants. Knowledgeable and supportive staff will then be able to facilitate positive interchanges. Conclusion Teachers have confronted the ethical issues of how and when to teach children about sex and drug abuse for a long time. Today, the issue is expanded to include the urgent question of how, when and who should teach children about HIV infection and its relationship to sex and drugs  This article or section is in need of attention from an expert on the subject.Please help recruit one or [ improve this article] yourself. See the talk page for details. . Eighty-seven percent of Americans polled said they approved of teaching children about AIDS and other sexually transmitted diseases Sexually transmitted diseases Infections that are acquired and transmitted by sexual contact. Although virtually any infection may be transmitted during intimate contact, the term sexually transmitted disease is restricted to conditions that are largely in the early grades (U.S. News & World Report, 1993). A study assessing opinions about who should have primary responsibility for conducting HIV education ranked teachers first (36 percent), parents second (27 percent) and school nurses third (26 percent) (Kerr, Allensworth & Gayle, 1989). The researchers pointed out that improvement of knowledge alone is insufficient for changing attitudes and motivating people toward healthful health·ful adj. 1. Conducive to good health; salutary. 2. Healthy. health  ful·ness n. behaviors. Other studies also yield data to suggest that
attitudes and appropriate beliefs about the disease do not necessarily
correlate with the level of knowledge (Basch, 1989; Fennell, 1990; Kerr,
Allensworth & Gayle, 1989; Walker, 1992).
Schools are the optimal setting for reaching the vast majority of young people. Teachers, however, need to be prepared to deal with the multiple issues and concerns that surround AIDS. One way to address these additional responsibilities is to include in the teacher training curriculum the kind of information that will lead to a broader understanding of the problems surrounding AIDS. Potential educators must have hands-on opportunities to develop skills in areas outside the traditional subject-focused curriculum, such as: * having sensitivity to a variety of attitudes and cultural values * being able to advise and counsel students regarding human sexuality This article is about human sexual perceptions. For information about sexual activities and practices, see Human sexual behavior. Generally speaking, human sexuality is how people experience and express themselves as sexual beings. * being able to communicate effectively with students * feeling comfortable dealing with a variety of human emotions, including hostility and fear * being able to assume roles as group moderators and facilitators of learning. Some education organizations are attempting to communicate AIDS information and needs assessment through their professional journals. Many, if not most, of the articles, however, are being published in journals concerned only with school health; i.e., Journal of School Health, Journal of Health Education. Unfortunately, these journals do not always reach the classroom teacher. Professional journals from all education disciplines should consider AIDS education a top priority for their readers. For teachers in the field, inservice education that addresses the issue of AIDS and caring for children affected by AIDS should be available. The resources and policies needed to provide medical care and social services social services Noun, pl welfare services provided by local authorities or a state agency for people with particular social needs social services npl → servicios mpl sociales for children with AIDS will come with teachers' education, knowledge and attitudinal changes. It has been stated that education is our "best weapon against HIV" (Cruz, 1988, p. 909). This is especially true for educators. References Alabama Department of Public Health. (1992). Special edition. Alabama HIV/AIDS HIV/AIDS Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Update, 3(2). American Academy of Pediatrics' Task Force on Pediatric AIDS. (1989). Infants and children with acquired immunodeficiency syndrome: Placement in adoption and foster care. Pediatrics, 83, 609-612. Anonymous. (1987). Transmission of HIV by human bite. Lancet, 2, 522. Basch, C. E. (1989). Preventing AIDS through education: Concepts, strategies, and research priorities. Journal of School Health, 59(7), 296-300. Black, J. L. (1986). AIDS: Preschool and school issues. Journal of School Health, 56(3), 93-95. Brucker, B. W., & Hall, W. H. (1991). AIDS in the classroom: Are teacher attitudes changing? Early Child Development and Care, 77, 137-147. Brucker, B. W., Martin, J. J., & Shreeve, W. C. (1989). AIDS in the classroom: A survey of teacher attitudes. Early Child Development and Care, 43, 61-64. Burroughs-Wellcome Company. (1991, April). Management of HIV infection treatment team workshop handbook. Raleigh, NC: Author. Centers for Disease Control. (1988). Education and foster care of children infected with human T-lymphotrophic virus III/lymphadenopathy-associated virus. The Morbidity and Mortality Weekly Report Morbidity and Mortality Weekly Report (MMWR) is a weekly epidemiological digest for the United States published by the Centers for Disease Control and Prevention. The 5 June 1981 issue of the MMWR published the cases of five men in what turned out to be the first report of AIDS. , 34(34). Cruz, L. D. (1988). Children with AIDS: Diagnosis, symptoms, care. AORN AORN Association of periOperative Registered Nurses AORN Association of Operating Room Nurses (name changed) AORN As of Right Now Journal, 48(5), 893-910. Fauci, A. S. (1988). The human immunodeficiency virus: Infectivity and mechanisms of pathogenesis. Science, 239, 617-622. Fennell, R. (1990). Knowledge, attitudes and beliefs of students regarding AIDS: A review. Health Education, 21(4), 20-25. Fennell, R. (1991). AIDS/HIV articles published in selected professional health journals: 1981-1990. Journal of School Health, 61(9), 385-387. Friedland, G. H., Saltzman, B. R., Rogers, M. F., Kahl, P. A., Lesser, M. L., Mayers, M. M., & Klein, R. S. (1986). Lack of transmission of HTLV-III/LAV infection to household contacts of patients with AIDS or AIDS-related complex AIDS-related complex n. Abbr. ARC A combination of symptoms, including fever, lymphadenopathy, blood abnormalities, and susceptibility to opportunistic infections that is a precursor to AIDS in some individuals infected with HIV. with oral candidiasis oral candidiasis Infectious disease A yeast infection of the adult oral mucosa, caused by Candida albicans, an opportunistic pathogen linked to immune compromise–eg, with AIDS, immunosuppression in transplants, chemotherapy, corticosteroids, DM, ↑ . New England Journal of Medicine The New England Journal of Medicine (New Engl J Med or NEJM) is an English-language peer-reviewed medical journal published by the Massachusetts Medical Society. It is one of the most popular and widely-read peer-reviewed general medical journals in the world. , 314, 344-349. Garrard, J., Leland, N., & Smith, D. K. (1988). Epidemiology of human bites to children in a day care center. American Journal of Diseases of Children, 142, 643-650. Gostin, L. O. (1990). The AIDS litigation An action brought in court to enforce a particular right. The act or process of bringing a lawsuit in and of itself; a judicial contest; any dispute. When a person begins a civil lawsuit, the person enters into a process called litigation. project: A national review of court and human rights commission decisions. Part 1: The social impact of AIDS. Journal of the American Medical Association JAMA: The Journal of the American Medical Association is an international peer-reviewed general medical journal, published 48 times per year by the American Medical Association. JAMA is the most widely circulated medical journal in the world. , 263(4), 1961-1970. Hirsch, M. S., Wormser, G. P., Schooley, R. T., Ho, D. D., Filenstein, D., Hopkins, C. C., Joline, C., Duncanson, F., Sarngadharan, M. G., Saxinger, C., & Gallo, R. C. (1985). Risk of nosocomial infection Nosocomial infection An infection that can be acquired in a hospital. ABPA is a nosocomial infection. Mentioned in: Allergic Bronchopulmonary Aspergillosis, Hospital-Acquired Infections, Pseudomonas Infections with human T-cell lymphotrophic virus III (HTLV-III). New England Journal of Medicine, 382, 1-4. Jessee, P. O., Poteet-Johnson, D., & Nagy, M. C. (1993). Fear of AIDS among day care administrators and teachers. Early Child Development and Care, 89, 19-30. Kaplan, J. E., Oleske, J. M., Getchell, J. P., Kalyanaraman, V. S., Minnefor, A. B., Zabala-Ablan, J., Joshi, V., Denny, T., Cabradilla, C. D., Roger, M. F., Sarngadharan, M. G., Sliski, A., Gallo, R. C., & Grancis, D. P. (1985). Evidence against transmission of HIV-III/LAV in families of children with AIDS. Pediatric Infectious Diseases infectious diseases: see communicable diseases. , 4, 468-471. Kerr, D. L., Allensworth, D. D., & Gayle, J. A. (1989). The ASHA national HIV education needs assessment of health and education professionals. Journal of School Health, 59(7), 301-307. Lifson, A. R. (1988). Do alternate modes of transmission of human immunodeficiency virus exist? A review. Journal of the American Medical Association, 259, 1353-1356. Moll, L. (1991). Pediatric AIDS: Hitting closer to home. Pediatric Management, 38-41. Morrow, A. L., Benton, M., Reves, R. R., & Pickering, L. K. (1991). Knowledge and attitudes of day care center parents and care providers regarding children infected with human immunodeficiency virus. Pediatrics, 87(6), 876-883. Nicholas, S. W., Sondheimer, D. L., Willoughby, A. D., Jaffe, S., & Katz, S. L. (1989). Human immunodeficiency virus infection in childhood, adolescence and pregnancy: A status report and national research agenda. Pediatrics, 83(2), 293-308. Rogers, M. F., White, C. R., Sanders, R., Schable, C., Sell, T. E., Wasserman, R. L., Bellanti, J. A., Peter, S. M., & Wray, B. B. (1990). Lack of transmission of human immunodeficiency virus from infected children to their household contacts. Pediatrics, 85, 210-214. Rubinstein, A. (1986). Schooling for children with acquired immune deficiency syndrome Acquired immune deficiency syndrome (AIDS) A viral disease of humans caused by the human immunodeficiency virus (HIV), which attacks and compromises the body's immune system. . Journal of Pediatrics, 109, 242-244. Santelli, J. S., Birn, A., & Linde, J. (1992). School placement for human immunodeficiency virus-infected children: The Baltimore City experience. Pediatrics, 89(5), 843-848. Shirley, L. R., & Ross, S. A. (1989). Risk of transmission of human immunodeficiency virus by bite of an infected toddler. The Journal of Pediatrics, 114(3), 425-427. Stein, R. E., & Jessop, D. J. (1985). Delivery of care to inner-city children with chronic conditions. In N. Hobbs & J. M. Perrin (Eds.), Issues in the Care of Children with Chronic Illness (pp. 382-401). San Francisco San Francisco (săn frănsĭs`kō), city (1990 pop. 723,959), coextensive with San Francisco co., W Calif., on the tip of a peninsula between the Pacific Ocean and San Francisco Bay, which are connected by the strait known as the Golden : Jossey, Bass. U.S. News & World Report. (1993, February 22). Outlook, p. 8. Wahn, V., Kramer, H. H., Voit, T., Bruster, H. T., Scrampical, B., & Scheid, A. (1986). Horizontal transmission of HIV infection between two siblings. Lancet, 2, 694. Walker, S. H. (1992). Teenagers' knowledge of the acquired immunodeficiency syndrome and associated risk. Journal of Pediatric Nursing, 7(4), 246-250. Wassermann, S. (1992). Professional teachers deal with children "in trouble." Childhood Education, 68, 232-236. Watkins, J. (1988). Report of the Presidential Commission of the Human Immunodeficiency Virus Epidemic. Washington, DC: U.S. Government Printing Office. Publication No. 0-214-701. Wetterau, P. K., & Stegelin, D. A. (1991). Day care providers' knowledge and attitudes about AIDS: A needs assessment. Children's Health Children's Health Definition Children's health encompasses the physical, mental, emotional, and social well-being of children from infancy through adolescence. Care, 20(2), 108-113. APPENDIX Resources for Teachers Association for the Care of Children's Health (ACCH ACCH Association for the Care of Children's Health ACCH Associated Control Channel ACCH American Car Club Hungary ACCH Albuquerque Christian Children's Home (Albuquerque, NM) ACCH Air Cooled Chiller (HVAC) ), National Center for Family-Centered Care, Family-Centered HIV Project, 7910 Woodmont Ave., Suite 300, Bethesda MD 20814 American Red Cross American Red Cross: see Red Cross. , AIDS Education Office, 1730 D Street, NW, Washington, DC Centers for Disease Control, U.S. Department of Health and Human Services Noun 1. Department of Health and Human Services - the United States federal department that administers all federal programs dealing with health and welfare; created in 1979 Health and Human Services, HHS , National AIDS Information and Exchange Program, Atlanta, GA 30333 Children's Hospital A children's hospital is a hospital which offers its services exclusively to children. The number of children's hospitals proliferated in the 20th century, as pediatric medical and surgical specialties separated from internal medicine and adult surgical specialties. National Medical Center, 111 Michigan Ave., NW, Washington, DC. 20010 Division of Services to Children with Special Health Needs, Bureau of Maternal and Child Health and Resources Development, Department of Health and Human Services, Washington, DC 20202 New Parents Network Computer Bulletin Board System, P. O. Box 44226, Tucson, AZ 85733 Office of Public Affairs Those public information, command information, and community relations activities directed toward both the external and internal publics with interest in the Department of Defense. Also called PA. See also command information; community relations; public information. , U.S. Department of Education, AIDS and the Education of Our Children, 400 Maryland Ave., SW, Washington, DC 20202 State Departments of Education, AIDS Awareness and Education, capital cities of individual states Peggy O. Jessee is Assistant Professor, Department of Human Development and Family Studies; M. Christine Nagy Christine Nagy is most notable for her career as a radio broadcaster. She is a morning radio personality at WLTW-FM (106.7 Lite FM), which is New York City's highest rated radio station. She is also an actress. is Director of Health Research, Department of Behavioral and Community Medicine; Deborah Poteet-Johnson is Assistant Professor, Department of Pediatrics, The University of Alabama The University of Alabama (also known as Alabama, UA or colloquially as 'Bama) is a public coeducational university located in Tuscaloosa, Alabama, USA. Founded in 1831, UA is the flagship campus of the University of Alabama System. , Tuscaloosa. |
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