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571.
目的评价在小型娱乐场所暗娼人群中开展预防艾滋病综合干预措施的效果。方法在上海市虹口区选择G和X街道小型娱乐场所,对G街道娱乐场所的暗娼实施面对面宣传、安全套推广使用、医疗转介等综合性干预措施,对X街道的暗娼采用常规宣传干预措施。通过问卷调查和血清学检测,对干预前后两条街道暗娼的艾滋病防治知识、态度及行为进行评估。结果干预前共有244人接受基线调查,其中G街道131人,X街道113人。干预后共有360人接受评估,其中G街道197人,X街道163人。干预后G街道艾滋病防治知晓率78.17%(154/197),最近一次性行为安全套使用率42.13%(83/197),综合性医院或妇女保健所就医选择率91.37%(180/197),均明显高于X街道(P<0.05);近一月与客人性行为时安全套从不使用率(43.15%)显著低于X街道66.87%(P<0.05);两街道HIV及梅毒感染率无显著差异。结论综合干预效果在艾滋病防治的知信行方面明显优于常规宣传,但对降低艾滋病性病发病效果方面的作用需要做进一步的研究。 相似文献
572.
573.
Christopher Hildebrand Elizabeth Trowbridge Mary A. Roach Anne Gravel Sullivan Aimee Teo Broman Bennett Vogelman 《Journal of general internal medicine》2009,24(3):361-365
BACKGROUND Chart review represents a critical cornerstone for practice-based learning and improvement in our internal medicine residency
program.
OBJECTIVE To document residents’ performance monitoring and improvement skills in their continuity clinics, their satisfaction with
practice-based learning and improvement, and their ability to self-reflect on their performance.
DESIGN Retrospective longitudinal design with repeated measures.
PARTICIPANTS Eighty Internal Medicine residents abstracted data for 3 consecutive years from the medical records of their 4,390 patients
in the University of Wisconsin-Madison (UW) Hospital and Clinics and William S. Middleton Veterans Administration (VA) outpatient
clinics.
MEASUREMENT Logistic modeling was used to determine the effect of postgraduate year, resident sex, graduation cohort, and clinic setting
on residents’ “compliance rate” on 17 nationally recognized health screening and chronic disease management parameters from
2003 to 2007.
RESULTS Residents’ adherence to national preventive and chronic disease standards increased significantly from intern to subsequent
years for administering immunizations, screening for diabetes, cholesterol, cancer, and behavioral risks, and for management
of diabetes. Of the residents, 92% found the chart review exercise beneficial, with 63% reporting gains in understanding about
their medical practices, 26% reflecting on specific gaps in their practices, and 8% taking critical action to improve their
patient outcomes.
CONCLUSIONS This paper provides support for the feasibility and practicality of this limited-cost method of chart review. It also directs
our residency program’s attention in the continuity clinic to a key area important to internal medicine training programs
by highlighting the potential benefit of enhancing residents’ self-reflection skills. 相似文献
574.
《African Journal of AIDS Research》2013,12(4):337-344
Disclosure by people living with HIV or AIDS is critical for HIV prevention and care. However, many women choose not to disclose their HIV status for fear of negative outcomes, such as blame and rejection. The World Health Organization suggests that HIV/AIDS support groups help to encourage women to disclose their status, but little is known about the role of such groups in Kenya. This study used qualitative research methods to gain insight into rural women's experience of disclosing a positive HIV status and it explores opinions about the role of support groups in relation to disclosure. Focus group discussions and semi-structured interviews were conducted with HIV/AIDS support group members and leaders. Thematic analysis showed that the women felt a sense of duty to inform others of their HIV status, particularly in order to prevent HIV transmission and to encourage sexual partners to be tested. There were multiple problems associated with disclosure, and negative outcomes such as blame and rejection were common. Support groups gave the women confidence and provided emotional support, which may have assisted them with coping with the negative outcomes of disclosure. The findings demonstrate that such support may improve women's experience of HIV-status disclosure and possibly even promote disclosure. However, initiatives such as these must protect those who disclose and therefore should take into account the local cultural and economic context. 相似文献
575.
Background and purposeThe aim of this study was to investigate the demographic variables and clinical characteristics of behaviorally induced insufficient sleep syndrome (BIISS) and to compare it with the other major hypersomnia disorders.Patients and methodsOne-thousand two-hundred forty-three consecutive patients referred to the outpatient clinic for complaint of excessive daytime sleepiness (EDS) were retrospectively investigated.ResultsThe rate of BIISS in patients with EDS was 7.1%, predominant in males. The mean age of initial visit was younger than that for obstructive sleep apnea syndrome (OSAS), while the mean age of onset of symptoms was older than that for idiopathic hypersomnia, narcolepsy, and circadian rhythm sleep disorders. The mean Epworth sleepiness scale (ESS) score before treatment was lower than that for narcolepsy but higher than that for both OSAS and circadian rhythm sleep disorders. Twenty-two percent of BIISS cases reported having accidents or near-miss accidents during the five-year period preceding the investigation, and this group showed higher ESS scores than the group without accidents.ConclusionsOur findings showed that an unignorably large number of people suffer from BIISS, and that people with severe cases of the disorder are at high risk for getting into an accident. Characteristics and demographic information could be helpful for making a differential diagnosis of BIISS. 相似文献
576.
《Journal of mental health research in intellectual disabilities》2013,6(3):205-222
With the desegregation processes of services for people with intellectual disability (ID) that is taking place in most Western countries there is a need for more knowledge related to the prevalence of behavior problems among people living in community settings. This study investigates the prevalence of behavior problems among 140 adolescents and adults with ID living in 5 municipalities in Norway using the Aberrant Behavior Checklist (Aman & Singh, 1986, 1994). Twenty percent of the sample were reported to show severe behavior disorder or “challenging behavior,” and this gives a prevalence for challenging behavior of 63.6 people per 100,000 base population. On the average, people showing challenging behavior had 7 behaviors rated as severe problems. A total of 60 participants were reported to have moderate or severe behavior problems, giving a prevalence for moderate and severe behavior problems of 136.3 per 100,000 base population. There were more people with profound ID and more people with autism in the group with challenging behavior and more people with Down syndrome in the group with mild or no problems. Those with severe behavior problems were perceived to be significantly less satisfied with their life situation than people without severe behavior problems. Challenging behavior seems to have a significant negative impact on the quality of life of people with ID. The results of this and other studies of challenging behavior among individuals with ID who live in areas with different service structures, using base population information, are important for analyzing the impact of reforms and different service systems on the life quality and well-being of people with ID. 相似文献
577.
Kate Shearer Alana T Brennan Mhairi Maskew Lawrence Long Rebecca Berhanu Ian Sanne Matthew P Fox 《Journal of the International AIDS Society》2014,17(1)