Oral health and personnel needs in the Pacific

A regional review of oral health in the Pacific showed the major problems to be dental caries, periodontal diseases, poor dental health service management and lack of appropriate dental personnel. A strategy for training appropriate dentists to manage oral health services in the Pacific was suggested. Such a strategy must include training of ancillary and auxiliary dental health workers guided by dentists with clinical and managerial competencies. The training programme for dentists must be career-ladder, problem-based, and community-oriented with competency-based learning of a spiral of tasks with increasing sophistication. The curriculum content must contain about 50 per cent on public health and clinical aspects, respectively.     

Current Cervical Cancer Screening Knowledge,Awareness, and Practices Among U.S. Affiliated Pacific Island Providers: Opportunities and Challenges

Background.

Cervical cancer is a leading cause of cancer mortality in nearly all U.S. Affiliated Pacific Island Jurisdictions (USAPIJ); however, most jurisdictions are financially and geographically limited in their capacity to deliver routine screening.

Methods.

We conducted a cross-sectional survey of 72 health care providers from five of the six USAPIJ in 2011 to assess knowledge, beliefs, practices, and perceived barriers regarding routine cervical cancer screening. We compared the responses of providers from jurisdictions that were funded by the Centers for Disease Control and Prevention’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP) with those that were not funded.

Results.

Most providers reported cervical cancer prevention as a priority in their clinical practices (90.3%) and use the Papanicolaou test for screening (86.1%). Many providers reported knowledge of screening guidelines (76.4%); however, more than half reported that annual screening is most effective (56.9%). Providers in non-NBCCEDP-funded jurisdictions reported greater acceptance of visual inspection with acetic acid (93.9%) and self-sampling for human papillomavirus testing (48.5%) compared with NBCCEDP-funded jurisdictions (15.4% and 30.8% respectively). Providers from non-NBCCEDP-funded jurisdictions reported inadequate technological resources for screening women (42.4%), and approximately 25% of providers in both groups believed that screening was cost-prohibitive.

Conclusion.

Although cervical cancer screening is a priority in clinical practice, beliefs about annual screening, costs associated with screening, and varying levels of support for alternative screening tests pose barriers to providers throughout the USAPIJ. Further exploration of using evidence-based, lower cost, and sustainable screening technologies is warranted in addition to emphasizing timely follow-up of all positive cases.     

Divergent KSHV/HHV-8 subtype D strains in New Caledonia and Solomon Islands, Melanesia

Background

KSHV/HHV-8 is the etiological agent of Kaposi's sarcoma, primary effusion lymphoma and most multicentric Castleman's disease cases. KSHV exhibits a high genetic variability comprising five genotypes (A-E). Few data are yet available concerning the situation of KSHV, its genetic variability and the associated diseases in Melanesia.

Objectives

We performed a study on 626 natives Melanesians from New Caledonia and Vanikoro Island to evaluate KSHV seroprevalence and characterize molecularly the viral strains.

Study design

Plasma from 343 males and 283 females (age range: 15-86 years, mean age: 60) were tested for KSHV latent antibodies by an immunofluorescence assay (IFA) using BC-3 cells. DNAs extracted from peripheral blood buffy-coat of KSHV seropositive individuals were amplified to obtain a 737-bp fragment of the ORF-K1 gene. Phylogenetic analyses were then performed.

Results

Among 626 samples, 148 were IFA positive (dilution ≥ 1:80). The overall seroprevalence was 23.6% (25.2% in New Caledonia, 17.5% in Vanikoro). Fifteen (8 men and 7 women, mean age 69 years) out of 148 DNA samples were found PCR positive. All ORF-K1 sequences belonged to KSHV genotype D. A geographic clustering according to the island of origin of KSHV infected persons was clearly observed with sequences from New Caledonia clustering with most Vanuatu strains.

Conclusions

New Caledonia and Vanikoro are endemic for KSHV with a high diversity of genotype D variants. These strains were probably introduced into New Caledonia during multiple waves of migrations of Melanesian and Polynesian individuals that have colonized this archipelago.     

奥美拉唑联合莫沙必利治疗反流性食管炎60例疗效观察

目的观察奥美拉唑联合西沙比利治疗反流性食管炎的临床疗效。方法将符合病例入选标准的120例反流性食管炎患者随机分为观察组、对照组,每组60例。2组患者入院后均给予饮食调理、心理精神治疗,同时给予莫沙必利,5mg/次,3次/d,饭前服。观察组在此基础上给予奥美拉唑,20mg/次,2次/d,饭前服。2组均以治疗4周为1个疗程,治疗2个疗程后观察疗效。结果临床疗效观察组治愈率为70.00%,总有效率为93.37%;对照组治愈率为50.00%,总有效率为73.33%。2组治愈率、总有效率相比有明显差异(P<0.05)。胃镜下疗效观察组治愈率为73.33%,总有效率为96.67%;对照组治愈率为36.67%,总有效率为76.67%。2组治愈率、总有效率相比有明显差异(P<0.05)。2组治疗前后均未见不良反应,心电图、肝肾功等等理化检查亦未发现明显变化。结论奥美拉唑联合西沙比利治疗反流性食管炎临床疗效显著。     

Mental health services in the Solomon Islands

The Solomon Islands comprise an archipelago of nearly 1,000 islands and coral atolls and have an estimated population of 549,574 people. Formal mental health services date back to 1950 when an asylum was established. Since then the process of mental health service development has been largely one of incremental change, with a major boost to community services in the last two decades. During the 1990s a mental health outpatient clinic was established in Honiara, together with attempts to recruit nursing staff as psychiatric coordinators in the provinces. In 1996, the Ministry commenced sending registered nurses for psychiatric training in Papua New Guinea. By 2010, there were 13 psychiatric nurses and one psychiatrist, with a second psychiatrist in training. A National Mental Health Policy was drafted in 2009 but is yet to be endorsed by Cabinet. A significant portion of the population still turns to traditional healers or church leaders for purposes of healing, seeking help from Western medicine only after all other alternatives in the community have been exhausted. There is still a long way to go before mental health services are available, affordable and accessible to the whole population, including people living in geographically remote areas. Realization of this vision requires increased resourcing for mental health services; improved communication and collaboration between the centrally‐based, national mental health services and the provincial health services; and closer, ongoing relationships between all stakeholders and partners, both locally and internationally.     

Background levels of polychlorinated biphenyls in the population of the Canary Islands (Spain)

Polychlorinated biphenyls (PCBs) are persistent and toxic compounds that have been detected in human serum or tissues worldwide. The objective of our study was to determine serum PCB levels in a representative sample of the general population of the Spanish Archipelago of the Canary Islands (607 serum samples from subjects aged between 6 and 75 years) in order to establish the main causes of this contamination and to evaluate the potential risks posed by these chemicals on the population through the use of toxicity equivalence to dioxins (TEQs). PCB congeners (28, 52, 77, 81, 101, 105, 114, 118, 123, 126, 138, 153, 156, 157, 167, 169, 180, and 189) were measured by gas chromatography–mass spectrometry (GC/MS). Our results showed that PCB residues were found in 76% of serum samples analyzed, with the congeners 153 and 180 being the most frequently detected and having the highest median values (21.8 and 6.7 ng/g lipid, respectively). Serum levels of non-dioxin-like PCBs increased with age, body mass index (BMI), urban habitat, and smoking. The median concentration of the sum of PCBs considered as markers of environmental contamination by these chemicals (M-PCBs) was 46.4 ng/g lipid. Levels of the sum of dioxin-like PCBs (DL-PCBs) were 48.5 ng/g lipid in the 95th percentile, and were also positively associated with age. As a consequence, age seemed to be positively associated with TEQs levels, reaching values as high as 58.6 pg/g lipid in the serum samples from oldest people. Our results indicate that the inhabitants of the Canary Archipelago show levels of PCB contamination lower than other populations present on the Spanish mainland, as well as many populations from developed countries. Nevertheless, as these compounds may induce adverse health effects even at very low doses, our findings should be considered by local Public Health authorities in order to establish measures for diminishing the exposure of the population of these islands to PCBs.     

微囊化大鼠胰岛异种移植治疗小鼠实验性糖尿病的研究

目的 研究海藻酸钠－聚赖氨酸－海藻酸钠包裹胰岛进行移植的效果。方法 将Ｗｉｓｔａｒ大鼠的胰腺先行胶原酶胰管内注射消化,然后分离,纯化,所得胰岛经培养后制成微囊包膜的胰岛,微囊直径为０．４￣０．５ｍｍ,每个微囊内包１个胰岛。     

胸腺内胰岛移植的实验研究

目的观察胸腺内和肾包膜下胰岛移植对移植物存活时间的影响。方法以Ｃ５７ＢＬ／６小鼠为受体,ＢＡＬＢ／ｃ小鼠为供体,肾包膜下胰岛移植分为单纯移植和移植的同时加腹腔内一次性注射兔抗小鼠胸腺细胞血清（ＡＴＳ）两组,胸腺内移植组亦分为单纯移植和移植加用ＡＴＳ两组。结果单纯胸腺内移植组其移植物的存活期为（１９．５±１０．１）天,长于单纯肾包膜下移植组（１４．０±２．１）天;移植的同时加用ＡＴＳ,则肾包膜下移植组移植物的存活期为（４３．０±１１．７）天,胸腺内移植组可达（９３．８±２５．５）天以上,其中６只（６／８）胸腺内移植物获长期存活,并且诱导了受体对供体的特异无反应性。结论胸腺可能为胰岛移植的理想部位,而且在诱导免疫耐受中具有重要作用。     

西沙群岛植物资源物种组成及药用植物多样性研究

目的：全面掌握西沙群岛主要岛礁的植物资源物种组成及药用植物多样性。方法：根据第四次全国中药资源普查的调查方法,选择样方和普遍调查相结合开展了西沙群岛18个岛礁的普查工作,收集野生和栽培药用植物资源的标本、分子样品并引种种植特色海岛植株。结果：合计调查到植物物种159种,重要的药用植物资源有68种。普遍调查发现,西沙群岛18个岛礁的植物资源分布存在差异,晋卿岛（71种）、东岛（62种）和赵述岛（66种）的植物资源物种数较多,而盘石屿和全富岛未发现有植物分布;依据样方套的方法得出药用植物资源物种累计较多的主要分布在晋卿岛（45种）、甘泉岛（35种）和东岛（51种）;74个样方套的均匀度（Pielou）指数为0～1.00、香农-威纳（Shannon-Wiener）指数为0～1.50、辛普森（Simpson）指数为0～0.75、逆辛普森（Inverse Simpson）指数为1.00～4.00。结论：西沙群岛18个岛礁的生态系统脆弱,原生物种种类单一且容易灭绝,本次调查有助于了解西沙群岛主要岛屿的植物资源分布状况和药用植物多样性,为三沙市药用植物资源的合理利用和保护提供基础性科学资料。