Prevalence of nosocomial infections in high-risk units in the university clinical center of Kosova.

A point-prevalence study was performed to determine the prevalence of nosocomial infections in University Clinical Center of Kosova. Of 167 surveyed patients, 27 had a total of 29 nosocomial infections, with an overall prevalence rate of 17.4%. Nosocomial bloodstream infections were most prevalent (62%). The prevalence was highest among neonates in intensive-care units (77.8%).     

Health intervention in an Albanian-Kosovar refugees camp

This paper focuses on the health intervention developed in a camp of Albanian-Kosovar refugees, displaced as a consequence of the Balcans war in Kosova. Between May and June 1999, the camp of Kavaj? in Albania, received 1,700 refugees, with an average age of 24 years old. During this period, 1904 cases were registered at the primary health care centre settled in the camp. The most frequent causes of consultation were respiratory infections (22%), external causes (21%), skin infections and intestinal diseases (12%). A part of the psychological damage, the population attended didn't present with relevant health problems. Most of the visits to the doctor, related to the difficulties suffered on their way to the camp and to the conditions they were living on.     

Lowbury Lecture 2008: infection control and limited resources – searching for the best solutions

Healthcare-associated infections constitute an important public health problem in both developing and transitional countries. Despite considerable progress in the development of infection control programmes in some countries with limited resources, programmes in most developing world settings are non-existent, or are not implemented. Kosova, the poorest country in Europe, illustrates the challenges posed by infection control in the developing world. In many hospitals activities are limited by the lack of financial resources, poor infrastructure, overcrowding, inadequate hygiene, poorly functioning laboratory services, poor management, insufficient technology and a shortage of trained staff. Infection control guidelines from developed countries are often perceived as a standard for the developing world, but have to be modified to take into account differences in local needs. The best solutions entail greater governmental commitment and application of infection control procedures consistent with available resources. The International Nosocomial Infection Control Consortium (INICC) plays an important role in these activities in developing countries.     

Outcome of medical screening of Kosovan refugees in Ireland: 1999

In March 1999 armed conflict broke out in Kosova and about 900,000 ethnic Albanians were displaced. We reviewed the health care offered to the 945 Kosovan refugees who arrived in Ireland in 1999, which included screening for tuberculosis (TB) and hepatitis B. On arrival in Ireland 540 refugees had already received oral polio vaccine (57%), 512 diphtheria, tetanus, and acellular pertussis or diphtheria and tetanus vaccine (54%), 310 BCG (33%), 207 measles, mumps, and rubella vaccine (22%) and 60 Haemophilus influenzae type b (6%). Twelve refugees were diagnosed with TB. Twenty-six refugees were HBsAg positive (3%) and 168 were anti-HBcAg positive (18%). Organised screening of Kosovan refugees on a voluntary basis (uptake > 95%) revealed low percentages who had been immunised and relatively high rates of TB and hepatitis B. The provision of optimum immunisation, screening, and treatment services to address these issues requires substantial staffing and financial resources.     

A novel bio-psycho-social approach for rehabilitation of traumatized victims of torture and war in the post-conflict context: a pilot randomized controlled trial in Kosovo

Background

Some evidence showed that multidisciplinary rehabilitation in Western countries is effective for treating war-related trauma, but it remains unclear whether this approach is applicable to civilians living in resource-poor countries affected by war. In 2012–14, Danish Institute against Torture (DIGNITY) conducted a randomized controlled trial (RCT), in partnership with Kosova Rehabilitation Centre for Torture Victims (KRCT), to examine the effects of multidisciplinary intervention among victims of torture and war in Kosovo.

Methods

A single-center, randomized, parallel-arm, single-masked, waiting-list controlled trial was implemented in northern Kosovo. Thirty-four participants meeting the recruiting criteria were randomized to either intervention group, which received integrated treatments plus a once-daily multivitamin, or the waiting list group, which received multivitamin alone. The integrated treatments consisted of 10 weekly individual 60-min sessions of cognitive behavioral therapy (CBT), based on an adapted prolonged exposure therapy manual, an individual 20-min breathing exercise with an emWave biofeedback device, and 90-min group physiotherapy. The waiting list group also received the same treatment after the intervention group had completed their sessions. Outcome assessments were conducted at 3, 6 and 9 months after baseline assessment. Outcomes measures consisted of 4 subtypes: mental, emotional, physical health, functioning and social outcomes, i.e. PTSD, depression, anxiety, chronic pain, anger and hatred expression, body mass index, handgrip strength, standing balance, income, employment rate and disability score.

Results

Over 1/3 of PTSD cases were successfully treated. Inconsistent patterns with mental health and chronic pain outcomes were observed while there was a definite impact of intervention on functioning and social outcomes, i.e. the employment rate, which increased nearly 15 %, and the monthly wage, which rose 45–137 %. There was also a noticeable improvement in handgrip strength and disability score; the feelings of anger and hatred diminished. However, most of these changes did not reach statistical significance.

Conclusions

The impact of bio-psycho-social intervention is likely sensitive to the context of post-war economy in Kosovo and the treatment goals. The potential for improving the emotional well-being and employment outcome in victims was demonstrated. A larger scale RCT in a similar setting is needed, with close monitoring of treatment integrity and data reliability.

Trial registration

Clinicaltrials.gov (NCT01696578).

     

国有资产在科研机构中管理措施探讨

国有资产是科研机构不断获得生存与发展的物质基础保障,对国有资产的有效管理及运作是提升科研机构综合服务水平及基础工作质量的必要前提和重要保障,是维持单位正常运作的关键。国有资产的管理工作必须以服务于科研机构为最大前提。本文简要阐释当前我国科研机构在国有资产管理工作中存在的主要问题,以及关于加强科研机构国有资产市场化运作的相关分析和具体措施研究,以供参考。     

Provider Portrayals and Patient–Provider Communication in Drama and Reality Medical Entertainment Television Shows

Portrayals of physicians on medical dramas have been the subject of research attention. However, such research has not examined portrayals of interactions between physicians and patients, has not compared physician portrayals on medical dramas versus on medical reality programs, and has not fully examined portrayals of physicians who are members of minority groups or who received their education internationally. This study content-analyzes 101 episodes (85 hours) of such programs broadcast during the 2006–2007 viewing season. Findings indicate that women are underrepresented as physicians on reality shows, though they are no longer underrepresented as physicians on dramas. However, they are not as actively portrayed in patient-care interactions as are male physicians on medical dramas. Asians and international medical graduates are underrepresented relative to their proportion in the U.S. physician population, the latter by almost a factor of 5. Many (but certainly not all) aspects of patient-centered communication are modeled, more so on reality programs than on medical dramas. Differences in patient–provider communication portrayals by minority status and gender are reported. Implications for public perception of physicians and expectations regarding provider-patient interaction are discussed.     

A feminist critique of research on women's work and health

Research on women's work and health largely has failed to incorporate gender into the models of the processes through which work influences well-being. In this article, the research on women's work and health is critiqued from a feminist perspective; male-oriented and ethnocentric views on women's work are negated, and gender and socioeconomic issues are highlighted and included in the picture of women's work. Male-centered and ethnocentric views and assumptions on women's work are prevalent in the whole research process, and methodological limitations due to the distorted views are indicated. Based on the critique, some implications for future research on women's work and health are proposed.     

基于内容的医学图像检索

首先介绍了文本检索的医学使用中存在的弊端，引出了基于内容的医学图像检索概念，分析了医学图像的特征，讨论了特征提取方法。接着，提出了基于内容的医学图像检索在实际应用中所面临的问题，分析了基于内容的医学图像检索国内外的研究现状。最后，对未来的发展方向做了展望。     

Roaming through methodology. XXVI. The ecological fallacy and its less well-known counterpart, the atomistic fallacy

Usually, individuals form the unit of observation and analysis in epidemiological studies, but such is not the case in the ecological study design in which determinants and diseases are related at the group level (school classes, companies, suburbs, countries). Ecological studies are subject to the ecological fallacy when they are used to make inferences on relationships between determinants and diseases at the individual level: the relationship on the group level may not reflect the relationship on the individual level. On the other hand, individual-level studies are subject to the atomistic fallacy, when they are used to make inferences on relationships between determinants and diseases at the group level: a relationship between a determinant and disease on group level may not be exclusively based on the relationship on the individual level.     

The genetics of drug resistance in malaria parasites

The available experimental data on the genetics of drug resistance in malaria parasites are reviewed. Seven possible mechanisms for the origin of drug resistance are considered, and it is pointed out that spontaneous gene mutation is probably the most important. Experiments on the production of pyrimethamine-resistant and chloroquine-resistant strains of rodent Plasmodium species, and on the inheritance of such drug resistance, are reviewed. Relevant biochemical data are also considered in relation to the genetics of drug resistance. Studies on competition between drug-sensitive and drug-resistant parasites in mixed populations of rodent plasmodia are described. The implications of these findings for drug resistance in P. falciparum are discussed.     

Game biofeedback: networking

Analyzed in the paper are stages of networking of game biofeedback. Three main stages are defined on the basis of practical experience, they are: unification of local databases, use of game biofeedback in local network and training in game biofeedback via Internet. Possible solutions are suggested; technical and organizational issues are discussed on working out and using a set of therapeutic and health-improving training equipment based on the principles of LAN game biofeedback.     

The mechanism of the development of contact sensitivity and the methods of assessing allergenicity of contact sensitizers

Recent reports on the mechanism of the development of contact sensitivity and on the method of assessing allergenicity both in vivo and in vitro are reviewed. Various cell types and two processes, afferent and efferent limbs, involved in the contact sensitivity are discussed. Conditions for applying contact sensitizers which induce specific unresponsiveness, desensitization and antigenic competition are also discussed. Diagnostic methods for identifying contact sensitizers in vivo, patch testing, and in vitro, migration inhibition test and blastoid transformation are reported. Moreover, methods of assessing the allergenicity of contact sensitizers are reported centering on the guinea pig maximization testing.     

Theories on immigrant women's health

Our purpose in this article is to review theories critically that have been used to explain immigrant women's health based on 4 case studies of Korean immigrant women's experiences in the United States and suggest directions for future development of theories on immigrant women's health. First, 3 existing theories on immigration and health (selective migration, negative effect of immigration, and acculturation) are concisely described. Then, the daily experiences of 4 low-income Korean immigrant women are described in a narrative mode, and the 3 existing theories are critiqued in terms of how they can explain the women's narratives. Finally, implications for future theory development on immigrant women's health experience are proposed based on the discussion.     

A FEMINIST CRITIQUE OF RESEARCH ON WOMEN'S WORK AND HEALTH

Research on women's work and health largely has failed to incorporate gender into the models of the processes through which work influences well-being. In this article, the research on women's work and health is critiqued from a feminist perspective; male-oriented and ethnocentric views on women's work are negated, and gender and socioeconomic issues are highlighted and included in the picture of women's work. Male-centered and ethnocentric views and assumptions on women's work are prevalent in the whole research process, and methodological limitations due to the distorted views are indicated. Based on the critique, some implications for future research on women's work and health are proposed.     

Dutch practice guidelines for managing adjustment disorders in occupational and primary health care

Stress-related disorders, especially adjustment disorders, are widespread among working populations and are responsible for high costs in terms of suffering, sick leave, disability, and economic losses. Despite their high prevalence, there has been relatively little research on the effectiveness of treatments in an occupational health care setting. Guidelines for occupational physicians and general practitioners in relation to mental health problems were recently developed in The Netherlands and are discussed in this article. The guidelines provide a classification based on terms that are already used in the profession and are consistent with the diagnosis "adjustment disorder". They give recommendations for guidance and treatment on the basis of existing evidence, experience in adjacent fields, and consensus procedures. They are based on cognitive behavioral principles, mainly stress inoculation training and graded activity, and aim to enhance the problem-solving capacity of patients in relation to the work environment. The aim of this paper is to contribute to the exchange of and a discussion on methods and good practices in primary and occupational health care.     

Comparative study of the PARK and ASTRAL post-accidental decision support software

The French radioecological assessment model ASTRAL and the German model PARK have been developed to evaluate the radiological situation in the case of an accidental release of radionuclides and a widespread contamination of the environment. For decision makers it is of importance that the results on foodstuff contamination and on dose to humans are in fairly good agreement, when areas of the common border are affected. Therefore a comparative study has been done for two scenarios, assuming accidental releases on 1 June and 1 October. The study indicates that the models' structures and the transfer parameters are in good agreement. Only model principles for root vegetables are different in both models. Significant differences in results on the contamination of foodstuff and on dose to humans by ingestion are caused by different assumptions on dates of harvest and feeding methods of animals. A corresponding harmonization is essential with respect to decision making.     

Does the Timing of Food Stamp Distribution Matter? A Panel‐Data Analysis of Monthly Purchasing Patterns of US Households

In this paper, we examine the relationship between the timing of food stamp receipt and purchasing patterns. We combine data on state distribution dates of food stamps with scanner data on a panel of households purchases tracked between 2004 and 2011. We find that purchases of a variety of goods are meaningfully higher on receipt days, consistent with previous work that suggests that recipients are very impatient. Additionally, and importantly, estimates indicate that when food stamp receipt days fall on weekends, total monthly purchases within the same households are affected. In particular, monthly purchases of beer are higher when food stamps are distributed on a weekend rather than in months where benefits are distributed on weekdays. For these households, total beer purchases are between 4 and 5% higher in those months. Among households ineligible for food stamps, no effect is identified. These results demonstrate that the ‘day‐of‐the‐week’ of SNAP treatment may have important impacts on household purchase habits. Copyright © 2016 John Wiley & Sons, Ltd.     

Environmental Interventions to Enhance Student Adjustment: Implications for Prevention

School settings, often the sites for the prevention of adverse outcomes or the promotion of adjustment, are usually not the actual targets of such interventions. However, some interventions focus on modifying the school or classroom environments themselves. This review examines such approaches, and considers how school regularities that might undermine student adjustment are addressed. The environmental interventions are clustered in terms of focus: on student–student interactions, on teacher and peer influences, and on organizational function and structure. Reasons for the paucity of environmental change efforts and the inherent difficulties are discussed, and recommendations for creating ways to undertake future environmental interventions in schools are offered.     

Sexueller Missbrauch an Kindern und Jugendlichen

The present paper gives an overview on the development of professional discourse on sexual abuse over the last 20 years in the field of child protection. After the introduction, definitions from different professional perspectives (civil law, criminal law, psychotherapy, counseling, etc.) are given. Based on these definitions an epidemiological range of prevalence figures is described. In the literature, rates ranging from 6 to 25 % in girls and 2 to 8 % in boy as victims of sexual abuse can be observed. Psychiatric consequences of sexual abuse are described based on an overview of the literature. Diagnostic approaches to posttraumatic problems are discussed and distinguished from obsolete measures. Some neurobiological findings are presented. Finally the foundations of counseling, psychotherapy and pharmacotherapy of behavioral of symptoms and PTSD are discussed on the bases of a literature review of controlled clinical trials. In conclusion, further developments in psychotherapy and research are discussed for the German practical child protection field.