Intersecting stigma and HIV testing practices among urban refugee adolescents and youth in Kampala,Uganda: qualitative findings

IntroductionHIV‐related risks may be exacerbated in humanitarian contexts. Uganda hosts 1.3 million refugees, of which 60% are aged under 18. There are knowledge gaps regarding HIV testing facilitators and barriers, including HIV and intersecting stigmas, among urban refugee youth. In response, we explored experiences and perspectives towards HIV testing strategies, including HIV self‐testing, with urban refugee youth in Kampala, Uganda.MethodsWe implemented a qualitative study with refugee cisgender youth aged 16 to 24 living in Kampala''s informal settlements from February‐April 2019. We conducted five focus groups with refugee youth, including two with adolescent boys and young men, two with adolescent girls and young women and one with female sex workers. We also conducted five key informant (KI) interviews with government, non‐government and community refugee agencies and HIV service providers. We conducted thematic analyses to understand HIV testing experiences, perspectives and recommendations.ResultsParticipants (n = 49) included young men (n = 17) and young women (n = 27) originally from the Democratic Republic of Congo [DRC] (n = 29), Rwanda (n = 11), Burundi (n = 3) and Sudan (n = 1), in addition to five KI (gender: n = 3 women, n = 2 men; country of origin: n = 2 Rwanda, n = 2 Uganda, n = 1 DRC). Participant narratives revealed stigma drivers included fear of HIV infection; misinformation that HIV is a “Ugandan disease”; and blame and shame for sexual activity. Stigma facilitators included legal precarity regarding sex work, same‐sex practices and immigration status, alongside healthcare mistreatment and confidentiality concerns. Stigma experiences were attributed to the social devaluation of intersecting identities (sex work, youth, refugees, sexual minorities, people living with HIV, women). Participants expressed high interest in HIV self‐testing. They recommended HIV self‐testing implementation strategies to be peer supported and expressed concerns regarding sexual‐ and gender‐based violence with partner testing.ConclusionsIntersecting stigma rooted in fear, misinformation, blame and shame, legal precarity and healthcare mistreatment constrain current HIV testing strategies with urban refugee youth. Findings align with the Health Stigma and Discrimination Framework that conceptualizes stigma drivers and facilitators that devalue intersecting health conditions and social identities. Findings can inform multi‐level strategies to foster enabling HIV testing environments with urban refugee youth, including tackling intersecting stigma and leveraging refugee youth peer support.     

2019年内蒙古包头市细菌耐药监测

目的 监测2019年包头市11所三级医院所有临床分离菌株的构成及对常用抗菌药物的耐药情况,为临床科室选择抗菌药物提供可靠依据。方法 对上述医院的临床分离菌采用纸片扩散法（KB法）或全自动药敏仪法进行药敏试验,按CLSI 2018年版 M - 100标准判读药敏结果,采用WHONET 2019软件进行数据分析。结果 2019年共收集上述医院非重复临床分离菌8 430株,其中革兰阳性菌2 278株,占比27.0%,革兰阴性菌6 152株,占比73.0%。葡萄球菌属中耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）和耐甲氧西林金黄色葡萄球菌 (MRSA）检出率分别为65.5%和12.8%,未检出利奈唑胺、万古霉素和替考拉宁耐药菌株。粪肠球菌（EFA）对多数抗菌药物的耐药率均低于屎肠球菌（EFM）,EFA中检出2株利奈唑胺耐药菌株,EFM中检出1株替考拉宁耐药菌株、2株万古霉素耐药菌株。产超广谱β- 内酰胺酶（ESBLs）大肠埃希菌（ECO）和ESBLs（+）克雷伯菌属菌株的检出率分别为46.0%和16.8%。耐碳青霉烯大肠埃希菌（CREC）和耐碳青霉烯肺炎克雷伯菌（CRKP） 的检出率分别为0.5%和1.1%,CREC对左旋氧氟沙星的耐药率为100%,远高于CRKP的29.4%。结论 本地区ECO对喹诺酮类抗菌药物耐药率较高,应继续做好耐药监测工作,加强抗菌药物的合理使用,预防耐药菌的产生与传播。     

似昼夜节律与学习效应对脑事件相关电位P300的影响

目的 探讨昼夜节律和学习效应对脑事件相关电位P300成分的影响。方法 8名被试者在非连续的5d的实验中每天在5个时间点（7：00,12：00,16：00,20：00和0：00）重复相同的听觉Oddball模式测试以诱发脑事件相关电位（ERP）。然后测量各次的ERPP300成分,得到其潜伏期及波幅。结果 P300波幅明显高于下午的波辐。重复测量也使P300波幅从第1个实验日的平均13.0uV降至第5个实验日的9.2uV。P300潜伏期随着重复测试的增加出现了习服,它从第2个实验日的平均350.6ms缩短为第5个实验日的平均343.5ms.结论 似昼夜节律和学习效应对脑事件相关电位P300成分的波幅和潜伏期均有影响。     

Preventive effect of magnesium supplement on noise-induced hearing loss in the guinea pig

The effect of magnesium (Mg) on noise-induced hearing loss was investigated in two groups of adult pigmented guinea pigs maintained either on optimal or suboptimal (physiologically high or low) Mg produced by different diets. The total Mg concentrations of the perilymph (PL), cerebrospinal fluid, blood plasma and red blood cells were measured by atomic absorption spectrometry and were found to differ significantly between the two groups (P < 0.01). One ear of each animal was exposed to either a single shooting impulse at a peak pressure level of 187 dB or two impulse noise series at a rate of 1/s and peak pressure levels of 150 dB (1,000 impulses) and 167 dB (2,280 impulses), respectively. Temporary (TTS) and permanent (PTS) hearing threshold shifts in anesthetized animals were measured 2 h and 1 week after the noise exposure, using auditory brain stem response (ABR) audiometry at a frequency range from 3.75 to 30 kHz. Exposure to the single noise impulse resulted in a mean TTS that was significantly lower in the high Mg group than that in the low Mg group (P < 0.05), although no substantial PTS was observed in either group. In the animals exposed to 150 dB noise, the TTS showed a tendency towards an Mg-related reduction at the higher frequencies. A small difference in PTS was found between the low Mg and high Mg groups, but was not significant. Exposure to the 167-dB noise series caused a considerable TTS, which was significantly lower in the high Mg group at 7.5 and 15 kHz than in the low Mg group (P < 0.05). The mean PTS showed a significant difference between the two Mg groups over the whole frequency range (P < 0.05) and was found to correlate negatively with the total Mg concentrations of both PL and plasma (P < 0.05). Moreover, the high Mg group showed a faster recovery from the hearing threshold shift than the low Mg group. The present findings show that preventive oral Mg supplements can significantly reduce the rate of acoustic trauma caused by high-level impulse noise exposure in the guinea pig. Received: 23 March 1999 / Accepted: 15 April 1999     

教考分离的实践与探索

通过对学校三个年级学生使用“基础医学课程国家试题库”后的情况分析,认为教考分离是今后考试工作的一个趋势。但目衣使用的试题库在知识点的构成,个别试题质量以及适应性方面有待改进。因此有必要建立适合我校的,反映最新学科进展的试题库,以利于提高教学质量。     

ATP生物发光法检测卵巢癌细胞对化疗药物的敏感性

目的 探讨ＡＴＰ生物发光法药物敏感试验在卵巢癌中的应用的可行性。方法 以ＡＴＰ生物发光法检测卵巢癌ＨＯ－８９１０细胞对１１种常用化疗药物的敏感性,并与ＭＴＴ法相比较。结果 ＡＴＰ浓度、细胞浓度的对数与发光强度（ＲＬＵ）的对数值之间有较好的线性关系,并存在直线回归关系。两种方法测定的抑制率基本符合,但ＡＴＰ法测定的抑制率数值大,变异系数小,结果稳定。结论 ＡＴＰ生物发光法是一种高度敏感的化疗药物敏感