Delivering a psychosocial program for older people living in retirement homes during the Covid-19 pandemic: A process evaluation and recommendations for community interventions

The Covid-19 pandemic lockdown regulations caused retirement homes to temporarily ban in-person visitation potentially increasing the mental health risks of older people. An opportunity arose for a multistakeholder community collaboration to design a mental health program for older people. To evaluate the process of delivering a 12-week psychosocial program aimed at preventing loneliness, countering boredom, and providing older people in restricted settings with education about Covid-19 during the lockdown, in Durban, South Africa. A qualitative retrospective design was used. Data from two focus groups and six semistructured individual interviews conducted with stakeholders (volunteers, social workers, and residents) postproject were analyzed using reflexive thematic analysis. Stakeholders had varied experiences of the project, in terms of content, processes of engagement, and implementation, resulting in five themes. The study concluded with recommendations. A strong need exists for multistakeholder community collaborations when implementing a program where the context restricts physical access.     

社区老年高血压病人健康教育近期效果评价

为了解在社区老年高血压患者中进行的联合型健康教育活动的近期效果,作者重复调查了健教组社区老年人有关高血压“知-信-行”的状况,与基线和对照组的情况进行了比较分析。结果表明：本次联合型的健康教育活动使健教组在高血压的相关知识、信念、行为方面均有一定的改善。作者还对这项联合型健康教育活动的可行性及存在的问题进行了讨论。总结了本次研究的体会,并指出了进一步提高这项活动效率、效果的工作重点和建议。     

Natural helping functions of lay health advisors in breast cancer education

Summary The Save Our Sisters Project builds on the roles of 95 natural helpers to increase mammography screening among older African American women in a NC county. Natural helpers are lay people to whom others naturally turn for advice, emotional support, and tangible aid. Findings from 14 focus group interviews showed that older women seek out these individuals when they have a female-specific concern, rather than or before seeking help from professionals. The characteristics of natural helpers, revealed in the findings, were used to identify and recruit them to become trained lay health advisors in breast cancer education. Through the SOS Project, natural helpers provide a community-based system of care and social support that complements the more specialized role of health professionals; linking them to women through places and ways that no health professional could begin to acquire. The three roles of lay health advisors are: (1) to assist individuals in their social networks with needs that are difficult for professionals to address; (2) to negotiate with professionals for support from the health system; and (3) to mobilize the resources of associations in their community to sustain support from the health system.     

Public participation and marginalized groups: the community development model

Objectives  To develop ways of reaching house-bound people and enabling them to give their views in planning and monitoring health and social care.
Strategy  HealthLINK – a project based in a community health council – explored ways of involving older house-bound people in the London Borough of Camden, in planning and monitoring health and social care using community development techniques.
Results  HealthLINK set up an infrastructure to enable house-bound people to have access to information and to enable them to give their views. This resulted in access for health and local authorities to the views of house-bound older people and increased the self esteem and quality of life of those who became involved.
Conclusions  Community development approaches that enable an infrastructure to be established may be an effective way of reaching marginalized communities. However, there are tensions in this approach between the different requirements for public involvement of statutory bodies and of users, and between representation of groups and listening to individual voices.     

萎缩性阴道炎阴道菌群的研究

目的：研究萎缩性阴道炎患者的阴道菌群分布情况。方法：收集萎缩性阴道炎病人５０ 例、绝经前健康妇女３０ 例和绝经后阴道萎缩妇女２０ 例,进行阴道需氧菌和厌氧菌培养。结果：５０ 例萎缩性阴道炎组共分离出需氧菌６５ 株,分离率由高到低前４ 位依次是大肠埃希氏菌（１３／５０ ,２６ ％ ） 、表皮葡萄球菌（９／５０ ,１８ ％ ） 、粪链球菌（７／５０ ,１４ ％ ） 和绿色链球菌（６／５０ ,１２ ％ ） ,分离出厌氧菌５６ 株,分离率由高到低前４ 位依次是拟杆菌（２１／５０ ,４２ ％ ） 、消化链球菌（１９／５０ ,３８ ％ ） 和真杆菌（６／５０ ,１２ ％ ） 。除大肠埃希氏菌的分离率明显高于绝经前对照组外,其余各菌群与另外两组比较无明显差异, Ｐ ≤００５ 。结论：萎缩性阴道炎的菌群分布除大肠埃希氏菌外,其它菌群与绝经前妇女基本相似。     

广州地区女性生殖道支原体感染及其药敏状况

目的： 了解广州地区女性生殖道支原体感染及药敏状况及其临床意义。方法：收集我院妇科门诊５４３ 例宫颈分泌物标本进行支原体培养及药敏分析。结果：本院妇科门诊生殖道支原体感染率６０．８％ ;其中,解脲脲原体感染占６８．９％ ;新一代大环内酯类药及喹诺酮类药对解脲脲原体的敏感性较高;支原体混合感染可使其耐药性提高６～１２ 倍。结论：宫颈分泌物支原体阳性标本的药敏试验有助于本地区妇科门诊合理用药,减少盲目性。     

Developing community mental health services: an evaluation of Glasgow's mental health resource centres

Greater Glasgow Health Board's strategy for the development of community mental health services includes the establishment, over a 7-year period, of multi-disciplinary community mental health resource centres throughout Glasgow. An evaluation of the first phase of the development was carried out in three resource centres. This focused on three key themes: the establishment of multi-disciplinary teams, targeting of those with the most severe illnesses and the participation of users in the care process. The evaluation exercise comprised five substantive elements: analysis of the clinical database; interviews with staff within each of those centres, interviews with representatives of key external agencies associated with each centre; a survey of general practitioners; and a survey of the views of clients, their carers, their key workers, and their general practitioners (GPs). Clients were generally very satisfied with the services and felt that the resource centres met all their mental health needs. Although the majority of current centre cases had severe mental illnesses and those with the more severe conditions had the highest contact rates there was evidence that in the absence of a clear framework for referral the centres were also providing services for those with less severe illnesses. Despite a wish by centre staff to move towards modes of working less dominated by health professionals and more inclusive of other resources and especially of clients themselves, these goals remained to be achieved: there was a lack of clarity in the definition of the appropriate target groups for the centres; access to crisis support was regarded as problematic; the concept of multi-disciplinary team working had yet to be fully realized with evidence suggesting that some psychiatrists working in the resource centres had not embraced many aspects of the new approach to service delivery including a focus on the severely ill; and progress towards the ideal of active client involvement had been slow.     

The willingness to continue caring in family supporters of older people

Research has revealed the importance of characteristics of the supporter, the care-recipient, and circumstances of caregiving in the success or failure of community-based care of older people. The Dundee Study of Carers and Dementia examined factors associated with the maintenance and care of older people in the community, and with the impact of dementia on family supporters. Two hundred and twenty-eight family supporters of community-resident older people (≥65) (50% with dementia, 50% without, matched for age and sex) were interviewed. Supporters' responses to their relative's condition and circumstances, their ways of coping with stressful caregiving problems, and their willingness to continue their caregiving role, were assessed. Findings indicated that willingness to care and stress were associated in different ways with the supporter's response to his/her relative. Coping was found to be significantly associated with stress, response to relative, and willingness to care in only three out of a total of 45 tests. Willingness to care was positively associated with the coping behaviour internalization. The findings are discussed in the context of developing interventions for improving the well-being of supporters of an older relative in the community.