Staff attitudes and services provided by community-based organizations for alcohol and other drug users in Cape Town,South Africa: Implications for training and education

Aims: The aims of this study were: (i) to describe the nature of and the extent to which community-based organizations (CBOs) in Cape Town provide services to people who have alcohol and other drug (AOD) problems; (ii) to examine the relationship between CBOs’ attitudes towards individuals with AOD problems and the types of services provided; and (iii) to compare CBOs’ attitudes towards alcohol- and drug-using clients. Method: A cross-sectional survey of 51 health and social welfare CBOs in Cape Town, South Africa. Results: A high proportion of clients served at CBOs have alcohol- and drug-related problems. Findings suggest that CBOs may be more accessible to poor black South Africans and women than traditional AOD treatment centres. CBOs that hold more positive attitudes towards AOD-using clients tend to provide more AOD-related services and serve more clients with AOD-related problems. Findings also indicate that CBOs’ attitudes are more positive towards alcohol users than towards drug users. Conclusions: This study highlights the important role that CBOs play in the delivery of services for people with AOD-related problems in South Africa. It also reveals the need to increase capacity among the agencies via training and education.     

Increased hand washing reduces influenza virus surface contamination in Bangkok households, 2009–2010

Within a hand‐washing clinical trial, we evaluated factors associated with fomite contamination in households with an influenza‐infected child. Influenza virus RNA contamination was higher in households with low absolute humidity and in control households, suggesting that hand washing reduces surface contamination.     

Alterations of the thrombin generation profile in rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disorder resulting in the erosion of the cartilage and bone. Systemic involvement including the cardiovascular system with the risk of atherosclerosis may also occur. Calibrated automated thrombogram (CAT), a commercially available thrombin generation assay is suitable for the general assessment of the functionality of coagulation system. In this study we performed CAT assay in RA patients and in non-affected control subjects (matched for age, sex and comorbidities). Among the CAT parameters Velocity Index increased (from 60 to 83 nM/min), Lag Time and Time to Peak decreased (from 3.47 to 2.83 min and from 6.98 to 5.58 min respectively) in RA. On the other hand, Endogenous Thrombin Potential values decreased (from 1242 to 1108 nM min). The observed alterations were not associated with the applied therapy. These results indicate that the velocity of thrombin formation is increased, while the thrombin generating capability is reduced in RA.     

Weight-of-evidence evaluation of long-term ozone exposure and cardiovascular effects

We conducted a weight-of-evidence (WoE) analysis to assess whether the current body of research supports a causal relationship between long-term ozone exposure (defined by EPA as at least 30 days in duration) at ambient levels and cardiovascular (CV) effects. We used a novel WoE framework based on the United States Environmental Protection Agency's National Ambient Air Quality Standards causal framework for this analysis. Specifically, we critically evaluated and integrated the relevant epidemiology and experimental animal data and classified a causal determination based on categories proposed by the Institute of Medicine's 2008 report, Improving the Presumptive Disability Decision-making Process for Veterans. We found that the risks of CV effects are largely null across human and experimental animal studies. The few positive associations reported in studies of CV morbidity and mortality are very small in magnitude, mainly reported in single-pollutant models, and likely attributable to bias, chance, or confounding. The few positive effects in experimental animal studies were observed mainly in ex vivo studies at high exposures, and even the in vivo findings are not likely relevant to humans. The available data also do not support a biologically plausible mechanism for the effects of ozone on the CV system. Overall, the current WoE provides no convincing case for a causal relationship between long-term exposure to ambient ozone and adverse effects on the CV system in humans, but the limitations of the available studies preclude definitive conclusions regarding a lack of causation; thus, we categorize the strength of evidence for a causal relationship between long-term exposure to ozone and CV effects as “below equipoise.”     

Methodenintegration in Beratung und Psychotherapie

The article in the journal “Zeitschrift für Psychodrama und Soziometrie” discusses the question as to how methods can be satisfactorily integrated in psychotherapy and counselling. The author shows how the process of integration takes place in a field of tension between continuous differentiation and integration. The view of integration presented contrasts with unreflected eclecticism. The attempt is also made to describe valid integrators that practitioners can employ to make fruitful use of new experiences and knowledge for their therapeutic interventions. A further perspective throws light on phenomena of the implicit knowledge acquired and utilized by practitioners in the course of their careers.     

Sociocultural Determinants of Anticipated Vaccine Acceptance for Acute Watery Diarrhea in Early Childhood in Katanga Province,Democratic Republic of Congo

Rotavirus and oral cholera vaccines have the potential to reduce diarrhea-related child mortality in low-income settings and are recommended by the World Health Organization. Uptake of vaccination depends on community support, and is based on local priorities. This study investigates local perceptions of acute watery diarrhea in childhood and anticipated vaccine acceptance in two sites in the Democratic Republic of Congo. In 2010, 360 randomly selected non-affected adults were interviewed by using a semi-structured questionnaire. Witchcraft and breastfeeding were perceived as potential cause of acute watery diarrhea by 51% and 48% of respondents. Despite misperceptions, anticipated vaccine acceptance at no cost was 99%. The strongest predictor of anticipated vaccine acceptance if costs were assumed was the educational level of the respondents. Results suggest that the introduction of vaccines is a local priority and local (mis)perceptions of illness do not compromise vaccine acceptability if the vaccine is affordable.