深圳市肾综合征出血热自然疫源地调查

目的了解深圳市肾综合征出血热(HFRS)疫源地的现状,为制定防治策略提供依据。方法在我市所辖4个区设25个点采用笼日法布笼捕鼠,调查鼠类种群构成;间接免疫荧光法检验鼠血清汉坦病毒(HV)抗体;直接免疫荧光法检验鼠肺抗原。结果共捕获鼠形动物472只,捕获率为8.25%,隶属于2目2科3属4种,4种鼠形动物中,除板齿鼠外,其余3种均发现携带HV或感染,带毒鼠全部为成鼠。褐家鼠占捕获鼠形动物的87.50%,为本市优势鼠种,其HV感染率和带毒率分别为18.20%和10.97%,臭鼩鼱占4.45%,HV感染率和带毒率均为11.76%,黄胸鼠占8.05%,HV感染率和带毒率均为2.94%。鼠血清平均HV感染率为16.78%,鼠肺平均带毒率为10.38%,平均带病毒指数为0.09。福田区鼠HV感染率、带毒率最高,分别为32.41%和20.69%,带毒指数达0.14。不同生境中旧居民区、菜市场及餐饮类场所鼠带毒指数较高,分别为0.13、0.11、0.11。结论深圳市广泛存在家鼠型HFRS疫源地,呈增强趋势,主要宿主动物为褐家鼠、臭鼩鼱和黄胸鼠。     

Knowledge of the patient as decision‐making power: staff members' perceptions of interprofessional collaboration in challenging situations in psychiatric inpatient care

Challenging situations in psychiatric inpatient settings call for interprofessional collaboration, but the roles and responsibilities held by members of different professions is unclear. The aim of this study was to describe staff members' perceptions of interprofessional collaboration in the context of challenging situations in psychiatric inpatient care. Prior to the study taking place, ethical approval was granted. Focus group interviews were conducted with 26 physicians, ward managers, psychiatric nurses, and nursing assistants. These interviews were then transcribed and analysed using qualitative content analysis. Results described participants' perceptions of shared responsibilities, profession‐specific responsibilities and professional approaches. In this, recognising knowledge of the patient as decision‐making power was understood to be a recurring theme. This is a delimited qualitative study that reflects the specific working conditions of the participants at the time the study was conducted. The findings suggest that nursing assistants are the most influential professionals due to their closeness to and first‐hand knowledge of patients. The results also point to the possibility of other professionals gaining influence by getting closer to patients and utilising their professional knowledge, thus contributing to a more person‐centred care.     

Health and Safety Issues Relating to Maine's Fishing Industry

SUMMARY

The Maine Agricultural Safety and Health Program performed a needs assessment to determine the health and safety concerns of Maine's fishing community. Information for the assessment was obtained from clinicians, focus groups of wives of fishers, and government agencies. Reports from the United States Coast Guard showed that during 1993-1994, sixty-five people were injured on commercial fishing vessels and eight people died. Decompression illness was the most frequently reported non-fatal injury (n = 15). Chronic injuries reported by clinicians included back pain, tendinitis, carpal tunnel syndrome, dysbaric osteonecrosis. Clinicians and family members were also concerned about hand and arm infections from the bait and sun exposure. Family health issues and access to care are addressed in the report. Recommendations include, in part, increasing surveillance, reducing barriers to access, increasing clini-cians' knowledge about the fishing industry, and fostering collabora-tion between agencies providing health and safety information to fishers.     

Nonfinancial Barriers to Prenatal Care

No abstract available for this article.     

‘If your husband doesn't humiliate you,other people won't’: Gendered attitudes towards sexual violence in eastern Democratic Republic of Congo

More than a decade of fighting in the Democratic Republic of the Congo (DRC) has resulted in extensive human rights abuses, of which sexual and gender-based violence (SGBV) is one of the most salient and disturbing features. This paper uses qualitative data, based on 10 focus groups with 86 women and men to better understand gendered community perspectives on SGBV and its consequences in South Kivu. We conclude that for many survivors, rape has consequences far beyond the physiological and psychological trauma associated with the attack. Respondents say sexual violence has become a societal phenomenon, in which the community isolation and shame experienced as a result of the attack become as important as concerns about the attack itself. Male focus group participants explain their own feelings of shame and anger associated with knowing their female relatives were raped. These findings highlight the complexity of community reintegration for survivors and identify a number of programmatic and policy implications, such as the need for counselling for survivors of sexual violence with their families as well as individually; the importance of income-generating training; and the need for improved justice mechanisms to bring perpetrators to justice.