Fear,mistrust, and vaccine hesitancy: Narratives of the dengue vaccine controversy in the Philippines

This article applies a qualitative approach to the 2017 dengue vaccine controversy involving Sanofi Pasteur’s Dengvaxia to understand vaccine hesitancy and related anxieties in contemporary Philippines. Through a multisited project that investigated the health aspirations and lived experiences of low- and middle-income Filipinos across urban and rural Philippines, this article distills the perspectives of both ordinary community members and health workers in local and national capacities regarding the controversy—and how it altered their perceptions toward vaccines, health care, and government. Our study reveals widespread mistrust and fear in the communities toward both the state and health institutions following the controversy, with frontline health workers bearing the brunt of the communities’ apprehensions, and the media partly responsible in fomenting these fears. Given the repetitive nature of health and vaccine controversies, this article suggests the importance of responsible journalism, well-calibrated crisis communications, and a people-centered health paradigm that involves exploring local contexts of vaccine hesitancy and mining people’s lived experiences in tackling present and future health crises—especially now in the advent of COVID-19 vaccinations.     

Retinal arteriovenous communication in retinitis pigmentosa with Refsum's disease-like findings

In this report we describe, herewith, a patient with primary pigmentary dystrophy of the retina (retinitis pigmentosa) associated with unilateral retinal arteriovenous communication and exudative retinal detachment. The patient had complete resolution of the retinal detachment following laser photocoagulation treatment. Such association has not been previously reported.     

Building a relationship: communications and relationships between staff and stroke patients on a rehabilitation ward

Communications among staff and patients on a stroke rehabilitation ward form the focus of this article, which reports on some aspects of a larger study using a grounded theory approach. Tape-recorded interviews were transcribed and analysed concurrently according to recommendations for the approach. A main theme entitled building a relationship was identified, and this process was found to occur in a context varying from participative at one end of a continuum to hierarchical at the other. Building a relationship was found to be influenced by role, personal qualities and organizational context. Appropriate relationships between role-holders were subject to negotiation, leading to a resulting congruence or incongruence between participants' expectations of each other and their roles. Personal qualities were brought into play in the process, with patients' views of staff and staff views of patients both being influential. Some of these views seemed to parallel what has been described in earlier literature as ‘the sick role’ and the labelling of patients as ‘good’ or ‘bad’. Responses to personal qualities led to nurses ascribing meaning to patients' behaviour in terms of adjustment to their stroke, giving time to them to help them to adjust, and withdrawal and handing over to other staff if this strategy failed. Organizational context also had an influence on building a relationship, with time constraints being identified particularly by nurses, and the need to fit in the most essential aspects of care. Place was also important, in that nurses were confined to the ward as a work location, whereas other therapists and doctors worked in other places and sometimes had the facility to take patients off the ward to concentrate on therapy. The findings are discussed against the background of related literature and the conclusion is drawn that the crucial role of nurses in rehabilitation is not recognized and valued, and that shortages of resources - especially suitably qualified and trained nursing staff- are a negative influence on building the relationships which are vital to successful rehabilitation.     

CTI和3G技术在120急救指挥中心的应用

介绍了120急救指挥中心的结构、计算机电话一体化和卫星定位系统、地理信息系统以及无线通讯系统的功能，分析了CTI和3G技术在120急救指挥中心的实际应用和取得的成效。     

Corporate influence on threshold limit values

Investigations into the historical development of specific Threshold Limit Values (TLVs) for many substances have revealed serious shortcomings in the process followed by the American Conference of Governmental Industrial Hygienists. Unpublished corporate communications were important in developing TLVs for 104 substances; for 15 of these, the TLV documentation was based solely on such information. Efforts to obtain written copies of this unpublished material were mostly unsuccessful. Case studies on the TLV Committee's handling of lead and seven carcinogens illustrate various aspects of corporate influence and interaction with the committee. Corporate representatives listed officially as "consultants" since 1970 were given primary responsibility for developing TLVs on proprietary chemicals of the companies that employed them (Dow, DuPont). It is concluded that an ongoing international effort is needed to develop scientifically based guidelines to replace the TLVs in a climate of openness and without manipulation by vested interests.     

Spontaneous age-associated amyloidosis in senescence-accelerated mouse (SAM)

Morphological studies on spontaneous systemic amyloidosis were conducted on 222 senescence-accelerated mice (SAM) (P) and on 150 mice in the senescence-resistant series (R).Among the pathologic findings, amyloidosis showed the highest incidence in both SAM (79.7%) and R (32.7%) Although an extensive deposition of amyloid was evident in some aged mice in the R series, a more severe amyloidosis occurred with a higher incidence in the P series. There was a statistical significance between the incidence of amyloidosis and age, in both the P and R series. There were no differences in organ distribution and mode of amyloid deposition between the P and R series or between the sexes. In about 60% of the amyloid-positive cases in the 28 killed SAM and 7 mice in the R series, there were no signs of inflammation or neoplasm.The morphological features in SAM more closely resembled those seen in cases of murine spontaneous senile amyloidosis than the features seen in cases of experimentally induced amyloidosis. This model is expected to be a valuable tool with which to assess the relationship between amyloid deposition and the aging process or senescence, perhaps even cases of human senile amyloidosis.     

Grading score system: A method for evaluation of the degree of senescence in Senescence Accelerated Mouse (SAM)

For evaluation of the degree of senescence in SAM-P, accelerated senescence prone mouse, formerly called SAM or prone series or P-series, consisting of SAM-P/1, SAM-P/2, SAM-P/3 and SAM-P/4 corresponding to P-1, P-2, P-3 and P-4 series, respectively, in the previous reports, and in SAM-R, accelerated senescence resistant mouse, formerly called resistant series or R-series, consisting of SAM-R/1, SAM-R/2 and SAM-R/3 corresponding to R-1, R-2 and R-3 series, respectively, in the previous reports, the grading score system was adopted. The items to be examined in this system include 11 categories selected from the clinical signs and gross lesions considered to be associated with the aging process. The degree of the senescence in each category was graded from 0 to 4 according to the detailed criteria devised in our laboratory. After 8 months of age each mouse was examined every 4 months, and some of the mice were examined after 2 months of age.In almost all categories, the grading score and incidence began to increase from 4 or 6 months of age and continued to increase with advancing age in both SAM-P and SAM-R. The increase, however, was more marked in SAM-P than in SAM-R. The slow but steady increase in the SAM-R levelled out at 24 months of age and was comparable to that of 12 months of age in SAM-P. In both SAM-P/1 at 8 months of age and SAM-R/2 at 12 months of age, there was a significant reverse correlation between total score of this grading score system and length of residual life after examination.Systematic and extensive studies using the grading score system showed that if the validity of the system is, based on “irreversibility” and “universality” of the changes in     

FROM THE EDITORS

Abstract

Consumer empowerment through authoritative health information is a positive force in today's health care environment. As the nation's lead agency for protecting the health and safety of people, the Centers for Disease Control and Prevention (CDC) has as part of its mission the responsibility of providing credible information to enhance health decisions. CDC health communications are provided through many venues, and particularly its Web site. This article identifies CDC consumer health sites, giving particular attention to two new initiatives, the CDC Kids Page and CDC en Espãol, which have been developed for specialized consumer health audiences.     

The use of absorbable polyglactin/polydioxanon implant (Ethisorb) in non-surgical closure of oro-antral communication

Oro-antral communications (OAC) greater than 4-5mm in diameter can seldom be counted on to heal spontaneously without the necessity for surgical closure. The initial experience in applying an absorbable polyglactin/polydioxanon implant (Ethisorb^®), in non-surgical closure of OAC ranging from 5 to 7 mm in diameter, is presented. Twelve patients of varying ages with OAC up to72 h in duration, have been treated with Ethisorb^®. Failures were not demonstrated in the form of the creation of an oro-antral fistula (OAF), and in all patients, OAC-s were closed with the epithelization of post-extraction wounds up to 21 days after implantation of Ethisorb^®. Based on these initial encouraging results, we propose that an Ethisorb^® biopolymeric absorbable implant can be used in selected clinical cases for non-surgical closure of OAC.