Hospital violence reduction among high-risk patients

We describe the success of one general hospital in reducing violent behavior among a group of repetitively disruptive patients. Following a pilot phase during which violent incidents at the medical center were characterized by location, type, and person responsible, a group of patients at high risk for repeated violence was identified (N = 48). Data were gathered for 1 year before and after the institution of a program designed to reduce violence, primarily in ambulatory care areas, among this group. Outcome assessment included comparison of the number of violent incidents and the number of visits to the medical center during the 12 months before and after the program was started. The number of incidents declined by 91.6%, and visits to the medical center for any reason decreased by 42.2%. The ratio of violent incidents to visits after the program was begun was less than one sixth the rate before the program. Components of the program are described, including staff resistance and management strategies.     

医院信息安全的危机处置意识

医院信息化的快速发展,为简便医疗流程、方便患者就医提供了很好的就医环境,但是,如果没有强烈的信息安全意识,就会出现宕机导致整个医疗活动的瘫痪。     

Awareness and Practice of Cervical Cancer Screening among Female Health Professionals in Murtala Mohammed Specialist Hospital, Kano

Background: Cervical cancer, although largely preventable, remains the most common cause of cancer mortality among women in the developing world. Other members of the community see health care workers as models, therefore their attitudes and actions are predictors of societal health behaviour. Objectives: We assessed the knowledge, attitude and practice regarding prevention of cervical cancer among female health professionals in a secondary health facility in Kano, Nigeria. Methods: A structured questionnaire was administered on 230 female respondents in the various health professions including doctors, pharmacists, nurses and laboratory technologists in Murtala Mohammed Specialist hospital, Kano. Results: Over 60% of the respondents were able to correctly identify all the important aetiological factors associated with cervical cancer, while a similar figure knew the important signs and symptoms of the disease. Up to 94.7% of the respondents had a positive attitude towards Pap smear while 8.2% disapproved of it. Only 20.8% of the respondents have had a Pap smear done previously. Married respondents were more than four times likely to have had a previous Pap smear compared to their single counterparts. (X(2) = 13.3 df=1 P = 0.0003)[O.R=4.8, 95% confidence interval= 1.9 -14.4]. In contrast, religion appeared to have no significant influence on the practice (X(2)= 0.87 df=1 P=0.35). Conclusions: Despite a moderately high level of knowledge of cervical cancer screening and positive attitude towards it, the uptake of Pap smear was low. There is a need for continuing education to improve uptake of these services by health professionals so as to serve as a motivating factor for the public. Key words: cervical cancer screening, pap smear, female health workers, knowledge, practices.     

Awareness of AIDS among transsexual prostitutes in Singapore

A study was conducted on 100 Singapore transsexual prostitutes in an attempt to discover AIDS awareness and any precautions which might have been taken by the prostitutes to limit their exposure to the AIDS virus. The results are as follows: the age, race and educational levels of the transsexuals were recorded. 55% of the transsexuals were Chinese, 36% were Malay, and 9% were Indian. The age range of the transsexuals was 20-55; the mean age of the Chinese transsexuals was 30.9; Malay was 33.1; and Indian was 27.0. 46% of the Chinese transsexuals, 64% of the Malay and 77% of the Indian had received only Primary education or were uneducated. 50% of the Chinese, 30% of the Malay and 23% of the Indians had received Secondary education. 4% of the Chinese and 6% of the Malay had received Post Secondary education. When asked, "Have you heard of AIDS?" 67% of the Chinese, 48% of the Malay and 44% of the Indians replied in the affirmative. When asked, "Has knowledge of AIDS altered your sexual practice?" 67% of the Chinese, 48% of the Malays and 44% of the Indians answered in the affirmative. Safe sex methods reported were: use of condoms, avoidance of Caucasians, checking of genitalia, non-penetration, and cleaning after the act.     

Red cell autoantibodies among thalassaemia patients in Hospital Universiti Sains Malaysia

INTRODUCTION: Thalassaemia is one of the major public health problems in Malaysia. Regular monthly blood transfusion remains the main treatment for severe thalassaemia patients. One of the complications of blood transfusion is the formation by the recipients of alloantibodies and autoantibodies against red blood cell (RBC) antigen. The purpose of this study was to determine the prevalence of RBC autoantibodies among multiple-transfused thalassaemic patients in our institution and factors that contribute to its development. METHODS: A prospective study was conducted in Haematology Laboratory, Hospital Universiti Sains Malaysia between January 2004 and December 2004. A total of 63 thalassaemia patients, who received regular blood transfusion were included in this study. Clinical and serological data were collected and analysed prospectively. Blood samples were subjected to standard blood bank procedures for screening of antibodies and their subsequent identification using reagent of Diamed-ID Gel microtyping system. RESULTS: There were 49 (77.8 percent) patients with Hb E/beta-thalassaemia, ten (15.9 percent) beta-thalassaemia major, three (4.7 percent) Hb H Constant Spring and one (1.6 percent) Hb H disease. Only one (1.6 percent) patient had autoantibodies. There were no statistical associations found between the formation of autoantibodies with age at the start of transfusion, number of packed cell transfused and splenectomy. CONCLUSION: Our data showed a low autoimmunisation rate in multiple-transfused thalassaemia patients in our hospital.     

Seroprevalence of toxoplasmosis among AIDS patients in Hospital Kuala Lumpur, 2001

Four hundred and six AIDS patients were recruited in this retrospective study. The seroprevalence of toxoplasmosis among 406 AIDS patients was 208 (51.2%). Their age ranged from 17 to 74 years with a median of 35 years. The majority of patients were males 172 (82.6%), Malays 99 (47.5%), single 109 (52.4%), unemployed 99 (47.6%) and heterosexual with commercial sex workers (CSW) 97 (46.6%) as the risk marker to HIV infection. Thirty-one (14.9%) of 208 AIDS-related toxoplasmosis were diagnosed as active toxoplasmic encephalitis. The most common clinical manifestation was headache (67.7%). The CT scan findings showed most lesions to be multiple (87.5%), hypodense (66.7%), and in frontal region (41.7%). Twenty-two (71%) patients had chronic (latent) Toxoplasma infection as evidenced by seropositivity for anti-Toxoplasma (IgG) antibody. They were statistically significant in the association between CD4 count and toxoplasmic encephalitis (P = 0.019; OR = 2.6; 95% CI = 1.14-6.02). After the initial six weeks of anti-TE therapy, relapsing toxoplasmic encephalitis was detected in 9.7% in this study.     

Awareness of tobacco-related health hazards among adults in China

Objective To determine the level of awareness of the hazards of tobacco smoking and secondhand smoke inhalation among adults in China. Methods Household surveys were conducted with a total of 13 354 respondents aged 15 years or over from 100 counties of 28 Chinese provinces using a stratified multi-stage geographically clustered sample design. Results The findings revealed that 81.8% of the population was aware that smoking causes serious diseases, and 27.2% and 38.7% were aware that smoking causes stroke and heart attack, respectively. Only 64.3% of respondents were aware that secondhand smoke can cause serious diseases, and 27.5%, 51.0%, and 52.6% were aware that secondhand smoke causes heart disease in adults, lung disease in children and lung cancer in adults, respectively. Awareness regarding smoking-related hazards across all participants was significantly associated with several factors, including gender, smoking status, urban/rural residency, education level and exposure to tobacco control publicity in the last 30 days. Awareness regarding tobacco-related hazards in smokers was significantly associated with urban/rural residency, education level, exposure to tobacco control publicity in the last 30 days, and physician＇s advice. Awareness relating to the hazards of inhaling secondhand smoke was associated with smoking status, urban/rural residency, age, education level, and exposure to tobacco control publicity in the last 30 days. Medical professionals were found to know more about the health hazards of tobacco compared with people in other types of employment. Conclusions Overall awareness of the health hazards of tobacco has improved in the last 15 years in China, but is still relatively poor. Improved means of communicating information and more effective warning labels on cigarette packaging are necessary for increasing public awareness of tobacco hazards, particularly among rural residents and people with less education.     

南京市3所高校学生角膜捐献意识调查

目的角膜移植供者缺乏制约角膜病治疗。调查研究南京市3所高校学生角膜捐献意识现状,分析其角膜捐献意愿的相关因素,探讨促进角膜捐献的可行方法,以增加角膜移植供者。方法以调查问卷的形式,分层整群抽样930名在校学生,对其人口统计学信息及12个角膜捐献意识问题回答情况进行描述性分析,并以是否愿意身后捐献角膜为结果变量,采用单因素、多因素Logistic族回归模型分析高校学生角膜捐献意愿的相关因素。结果回收合格问卷884份,合格率95.1%。①角膜捐献意识现状:高校学生对角膜捐献相关知识认知不够。医学生与非医学生角膜捐献知识认知组间差异存在统计学意义(P<0.05),但知识正向总得分组间差异无统计学意义(P=0.793)。高校学生角膜捐献态度并不积极,仅36.9%表示愿意身后捐献角膜。49.9%学生赞成立法,89.7%学生反对有偿捐献。②角膜捐献意愿相关因素分析:Logistic回归模型分析显示高校学生的专业[优势比(odd ratio,OR)=1.41;95%可信区间(confidence interval,CI):1.03～1.92]、性别(OR=1.51;95%CI:1.14～2.01;P=0.004)与身后角膜捐献意愿相关,有统计学意义,其中医学生,女学生更愿意捐献角膜;而政治面貌、宗教信仰对其影响无统计学意义(P>0.05)。结论愿意身后捐献角膜的高校学生并不多,大部分高校学生赞成立法、反对有偿捐献;高校学生中医学生、女学生更愿意身后捐献角膜。对高校学生进行医学知识尤其角膜捐献知识宣传,完善角膜捐献法律、法规,提倡无私的角膜捐献精神,将有利于促进角膜捐献。     

广西百色男性矿工包皮环切接受意愿的流行病学调查

目的 调查男性矿工对包皮环切术的接受意愿,分析影响其接受意愿的关键因素.方法 采用随机整群抽样的方法,抽取广西百色市煤矿中男性矿工作为研究对象,对其包皮环切术接受意愿及影响因素进行问卷调查.结果 569名男性矿工中有包皮环切意愿的占25.13%(143/569).单因素分析结果显示,愿意接受包皮环切手术组和不愿意接受手术组矿工中的婚姻、文化程度、对包茎或包皮过长的危害及实施包皮环切手术的原因的认知差异有统计学意义(P均＜0.05);两组矿工中患包茎或包皮过长的比例差异也有统计学意义(P=0.0001).多因素Logistic回归分析结果显示,未婚(OR=0.498,95%CI=0.272～0.913)、有包皮疾患(OR=8.181,95%CI=4.252～15.741)和知道包皮过长可形成包皮垢(OR=1.713,95%CI=1.090～2.693)更愿意手术.结论 男性矿工包皮环切接受意愿较低,提高艾滋病和包皮环切术基本知识可能有助于在该人群中推广包皮环切术.     

Awareness about organ donation among school girls

Prevalence of organ failure is high through out the world. Organ transplantation, the definitive treatment option of organ failure keeps very low due to scarcity of organ. Most of the people are not aware about organ donation. Adolescent girls will be the mother of future nation and they can motivate family members for organ donation. This study was carried out to see attitudes towards organ donation and determine the negative factors of organ donation prevailing among school girls. One hundred sixty eight girls from class VIII to class X of a higher secondary school were participated. A structured questionnaire was filled up by the girls. The data were processed from questionnaire and analyzed. Among study population, most of them (64%) had no idea about on going organ donation and transplantation. The positive attitude of the girls towards organ donation was low when they are live (16%) and their attitudes also kept low even after their death (14%). The girls who did not agree to donate organ were further asked to mention the reasons. The reasons of negative attitude were religious belief, fear of illness and social and familial reservation. The result of this study suggests that among girls, awareness and attitudes about organ donation is poor. There were several reasons identified for low consent rates. Multidisciplinary actions should be taken to improve the awareness of the people about organ donation and motivate them for donation.     

Awareness of hypertension among a north Indian population

Developing countries are going through a demographic transition. Non-communicable diseases like hypertension are emerging in epidemic proportions. Education and awareness among people is the key to reduce the burden of the disease. To see the levels of awareness and characteristic of aware and unaware hypertensives, 7630 employees in Shimla town were screened for hypertension. Hypertension was detected in 2535 cases of which 559 (22.05%) were aware. The aware hypertensives were predominantly symptomatic and had higher age and blood pressure than the unaware hypertensives. The aware hypertensives were predominantly overweight. This low level of awareness highlights the need for a comprehensive hypertension education programme to be taken up at the national level.