Managing HIV-positive sero-status in Ghana’s most HIV concentrated district: self-perceived explanations and theoretical discourse

As of December 2015 there were 37 million persons living with HIV/AIDS (PLWHAs), 70% of whom are in sub-Saharan Africa. Ghana, which contributes a relatively small number to Africa’s HIV burden, has a generalised HIV epidemic. The current national prevalence is 1.47%. Agormanya, one of the HIV sentinel sites in the county and where this study was conducted, has current prevalence of 11.6%. This makes it critical to explore how persons infected with HIV manage their lives, especially in the midst of entrenched stigma and discrimination. However, available information on how PLWHAs in sub-Saharan Africa handle their day-to-day lives mostly dwell on food and nutrition. Thus, there is dearth of information on how PLWHAs in Ghana particularly handle the circumstances of their daily lives which are mostly coloured by their HIV-positive statuses, given their stigmatised identity. We explore how PLWHAs respond to the experiences and challenges of living with HIV/AIDS in Lower Manya Krobo, consistently most HIV-infected district in Ghana. Data were collected from 38 combined purposive and randomly selected HIV-positive persons in two leading hospitals (St Martins Depores Agormanya and Atua Government hospitals which provide specialised HIV care in the district. Using in-depth interviews, we studied how PLWHAs managed their routine livelihoods in the midst of extreme stigma. We combined the social capital and resilience theoretical frameworks to show that our respondents were mostly resilient and strategically mostly drew upon extended family social support to cope with their livelihood challenges. We recommend that community opinion leaders and other stakeholders sensitise community members in Lower Manya Krobo to better understand the mode of HIV infection and encourage/strengthen family and community cohesion and social support.     

Does Quality of Life Vary with Different Types of Housing Among Older Persons? A Pilot Study

With the increasing number of persons who are elderly, identification of the characteristics of optimal housing that contribute to meeting the various needs of older persons is essential. A pilot study to identify the effects of three different housing environments (personal dwellings, specialized housing and nursing homes) on reported quality of life was conducted, using the Flanagan Quality of Life Scale plus two general health items, among persons over the age of 65 (n = 87). Significant differences were found in several quality of life issues related to relationships and satisfaction with life. Persons in specialized housing consistently reported good quality of life related to socialization. While individuals in each group reported no difference in the importance of each quality of life factor, individuals in the nursing home consistently reported the lowest quality of life. The implication of this study for housing placement, transition, planning, and creating housing contexts that promote quality of life are discussed.     

PTSD factor structure and relationship with self-construal among internally displaced persons

The present study examined the factor structure of six competing posttraumatic stress disorder (PTSD) models based on the recent changes in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in a sample that, while highly vulnerable to PTSD, very few studies have focused on—Asians, particularly Filipino internally displaced persons (IDPs). In recognition of the role of culture in PTSD factor structure, we also investigated the associations of the factors of the best-fitting model with self-construal. A sample of 460 IDPs in government resettlement communities participated in the study. Results of confirmatory factor analyses revealed the seven-factor hybrid model composed of intrusion, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal as the best-fitting model. Furthermore, it was found that associations between independent self-construal and PTSD factors were higher than that of interdependent self-construal and PTSD factors.     

Cardiovascular Disease and Homelessness

Cardiovascular disease (CVD) is a major cause of death among homeless adults, at rates that exceed those in nonhomeless individuals. A complex set of factors contributes to this disparity. In addition to a high prevalence of cigarette smoking and suboptimal control of traditional CVD risk factors such as hypertension and diabetes, a heavy burden of nontraditional psychosocial risk factors like chronic stress, depression, heavy alcohol use, and cocaine use may confer additional risk for adverse CVD outcomes beyond that predicted by conventional risk estimation methods. Poor health care access and logistical challenges to cardiac testing may lead to delays in presentation and diagnosis. The management of established CVD may be further challenged by barriers to medication adherence, communication, and timely follow-up. The authors present practical, patient-centered strategies for addressing these challenges, emphasizing the importance of multidisciplinary collaboration and partnership with homeless-tailored clinical programs to improve CVD outcomes in this population.     

自我管理对院外抗病毒治疗HIV感染者生活质量的影响

目的探讨自我管理对院外抗病毒治疗的艾滋病(HIV)感染者生活质量的影响。方法将在我院艾滋病咨询处定点抗病毒治疗的40例艾滋病患者随机分为对照组和试验组,每组20例。对照组采用常规健康教育,试验组开始使用抗病毒药物同时,实施自我管理教育。分别在实施自我管理教育前和实施自我管理教育12个月后对两组患者进行自我管理能力、生活质量评价。结果实施自我管理教育前,两组患者自我管理能力、生活质量指数,差异无统计学意义(P>0.05);实施自我管理教育后,试验组自我管理能力、生活质量指数均显著提高(均P<0.05)。结论自我管理教育能提高院外抗病毒治疗HIV感染者的自我管理能力,改善患者生活质量。     

老年消化性溃疡的临床特点

老年人消化性溃疡的发病率在中国呈现出上升的趋势。且其在发病部位、临床症状、并发症及病理特征等方面均具有明显的特点。因此,正确认识老年人消化性溃疡的临床特点,及早地诊断和治疗老年消化性溃疡具有重要意义。结合自己多年的临床经验,对老年消化性溃疡的临床特点进行了深入的分析。     

基于强化实践的应用型生物医药人才培养模式探讨-以成都大学生物产业学院为例

为加强应用型生物医药人才的培养,该研究以成都大学生物产业学院为例探讨了基于强化实践环节的人才培养模式构建,结合地方产业发展,以行业需求为导向,力争通过完善的专业实践以及社会实践体系来强化人才培养。