Perception and social consequences of tuberculosis: A focus group study of tuberculosis patients in Sialkot, Pakistan

Treatment defaulting is one of the major causes of the failure of TB control programs. In Bethania Hospital. Sialkot, defaulting rates are high: 72% for the standard 12 months course and 56% for the 8 months course. Attrition is especially important in the first weeks of treatment: < 70% of the patients start the 10th week of treatment. A focus group discussion study has been carried out to gain a better understanding of the impact of social stigmatization, treatment cost and pregnancy on defaulting. The study population consisted of 3 male and 3 female groups each with 8 hospitalized TB patients. The study shows that TB is perceived as a very dangerous, infectious and incurable disease. This perception has many social consequences: stigmatization and social isolation of TB patients and their families; diminished marriage prospects for young TB patients, and even for their family members; TB in one of the partners may lead to divorce. Due to fear patients often deny the diagnosis and reject the treatment. While both male and female TB patients face many social and economical problems, female patients are more affected. Divorce and broken engagements seem to occur more often in female patients. Females are usually economically dependent on their husbands and family in law, and need their cooperation to avail of treatment. The belief that pregnancy enhances the risk for relapse decreases their marriage prospects. Pregnancy is also a reason for stopping TB treatment as both are considered as incompatible. The findings of this study reveal the urgent need for a health education campaign to convince the general population that tuberculosis is curable. All health care providers should act as destigmatizers.     

高迁移率族蛋白B1对大鼠脾脏树突状细胞表面共刺激分子表达的影响

目的观察高迁移率族蛋白B1(HMGB1)对树突状细胞(dendritic cells,DC)表面共刺激分子表达的影响,并对其机制进行初步探讨。方法分离正常Wistar大鼠脾脏DC后置于96孔培养板(1×10~5/孔),采用HMGB1刺激,观察HMGB1刺激与DC表面共刺激分子CD80、CD86和主要组织相容性复合物(MHC)Ⅱ表达的时间-效应关系及剂量-效应关系。结果HMGB1刺激后,DC表面共刺激分子CD80、CD86和MHCⅡ表达分别于24～72 h明显上调(P＜0．05,0．01),其中以作用48 h后DC表面共刺激分子表达上调尤为显著(P＜0．01)；0．1μg/ml、1μg/ml、10μg/ml的HMGB1刺激均可诱导DC表面共刺激分子CD80、CD86和MHCⅡ表达增强(P＜0．05,0．01),其中HMGB1的浓度在1μg/ml时,大鼠DC表面共刺激分子CD80、CD86和MHCⅡ的表达增强最明显(P＜0．01)。结论HMGB1能诱导DC表面共刺激分子表达增强,HMGB1可能是诱导DC成熟的免疫刺激信号。     

Patterns of asbestosis in New Jersey.

Hospital discharge data from New Jersey were used to identify cases of asbestosis for the 8 years 1979-1986. Multiple admissions were deleted so that each individual was counted once at the time of his/her first hospitalization with an asbestosis diagnosis. White males had the highest age-adjusted average annual discharge rate of 19.3 cases/100,000 population, followed by black males (12.3 cases/100,000) and white females (1.2 cases/100,000). The discharge rate was positively associated with age in each race/sex category. The relationship between rates for black males and white males depended on age: under 65 years, the rates were almost equal, and at 65 years and older, the white rates were nearly twice the black rates. There were two areas of the state where the rates were highest: the north-central and southwest regions. These two areas represent manufacturing and shipbuilding applications of asbestos, respectively. During the years 1979-1986, the annual percentage increase in asbestosis rates was 20% for white males, 17% for black males, and 8% for white females. Continued surveillance will reveal when the rates for asbestosis stop increasing.     

Psychiatric morbidity in policemen and the effect of brief psychotherapeutic intervention — a pilot study

The level of psychiatric morbidity and perceived sources of stress among police officers were investigated using the General Health Questionnaire (GHQ) and a stress situation questionnaire, which were sent to 171 officers. Half of the responders were invited to attend group counselling sessions weekly for 12 weeks. Outcome measures studied were a second GHQ completed at the end of the treatment period and the amounts of sick leave taken in the 12-week period before, during and after the treatment period. The results were that 61 people returned the first GHQ of whom 59 were male and of whom 14 were classed as ‘cases’. Of the 31 assigned to the treatment group, 22 attended at least one session. Responses to the stress situation questionnaire and the content of counselling sessions tended to confirm the impression that internal aspects of the organization were viewed as prime sources of stress and dissatisfaction. There were no significant changes in GHQ score within or between groups, nor were there significant differences in the amount of sick leave taken. Nevertheless the sessions appeared to be valued and we conclude that this sort of intervention is at least feasible. We recommend that similar studies measure psychiatric morbidity during treatment and at follow-up, rather than immediately after finishing, when reactions to this termination are prominent.     

流行性腮腺炎流行病学调查分析与控制对策

目的分析新兴县流行性腮腺炎的流行病学特点，以提供防治参考。方法运用描述性流行病学的统计方法对新兴县2008年报告的腮腺炎病例进行分析。结果新兴县2008年1月至12月共报告流行性腮腺炎23例，年报告发病率为4.98／10万，病例主要集中在流动人口较多的新城镇、太平镇等地区，6月为高发月份，占总发病数26.08％，发病人群主要是10-15岁小学生，占60.86％，腮腺炎相关疫苗免疫史空白和免疫史不详占73.73％。结论加强儿童腮腺炎疫苗的接种工作，重点是流动儿童，发生疫情及时采取综合措施，是控制流行性腮腺炎疫情的重要手段。     

Experiences and learning during a graduate nurse program: an examination using a focus group approach

The graduate nurse year requires individuals to make a huge transition from university student to registered nurse as part of the health care workforce. New graduates experience steep learning curves throughout the first year of professional practice. This study sought to explore experiences and learning occurring throughout the graduate nurse program for a group of seven new nurse graduates. Focus group interviews were conducted at six months and 12 months into the program using the same set of guiding questions. The first interview highlighted that graduates early in the graduate year were internalised, concentrating on their own survival in managing workloads, facing practice realities and coming to terms with themselves as nurses. Learning was primarily about survival strategies and performing tasks. By the second interview, graduates were much less focussed on themselves. They understood their place in the health care team, had gained confidence in their relationships, and were showing concern for the next graduates arriving. Learning at this stage involved more higher order skills, including critical thinking.     

哮喘患者团体辅导实践与体会

结合临床实践,重点介绍作为心理干预形式之一的团体辅导在哮喘患者中的应用情况,包括实施方案、过程、所遇问题及处理等方面。笔者旨在验证、推广团体辅导这一有效改善哮喘患者情绪的心理干预方法,为提高哮喘患者生活质量的临床实践活动提供参考。     

Quality Control in Laboratory Hemostasis and Thrombosis

<正>laboratory equipment,akey to success is not only high quality,complete,technician knowledge,skills,and experiment a clear purpose,select the project has specificity     

社区高血压病患者的群体干预效果

目的根据"以病人为中心、以家庭为单位、以社区为范围"的全科理念对高血压病患者进行群体干预,以达到更为理想的治疗效果。方法将社区中303名高血压病患者作为一个群体统一管理。结果群体干预效果明显优于针对某一患者治疗的专科模式,有显著性差异(P0.01)。结论高血压病患者群体干预效果显著,在慢性病管理中,全科模式有明显优越性,值得提倡。