Active tuberculosis detection by pouched rats in 2014: More than 2,000 new patients found in two countries

Tuberculosis (TB) is a major problem in poor countries because sensitive diagnostic tools are unavailable. In 2014, our pouched rats evaluated sputum from 21,600 Tanzanians and 9,048 Mozambicans whose sputum had previously been evaluated by microscopy, the standard diagnostic for TB. Evaluation by the rats revealed 1,412 new patients with active TB in Tanzania and 645 new patients in Mozambique, increases of 39% and 53%, respectively, when compared to detections by microscopy alone. These results provide further support for the applied use of scent‐detecting rats.     

Giant African Pouched Rats as Detectors of Tuberculosis in Human Sputum: Comparison of Two Techniques for Sputum Presentation

Previous studies have shown that pouched rats can detect the presence of Mycobacterium tuberculosis, which causes tuberculosis, in human sputum samples obtained from clinical facilities. Although pouched rats evaluate sputum samples quickly, preparing the samples is relatively slow. The present study evaluated whether the rats can detect tuberculosis in microscope slides, which are routinely prepared at these facilities. Results indicate that they can do so, but their accuracy is considerably lower than that of rats exposed to pots containing sputum, as in prior studies.

     

Using trained pouched rats to detect land mines: another victory for operant conditioning

We used giant African pouched rats (Cricetomys gambianus) as land mine-detection animals in Mozambique because they have an excellent sense of smell, weigh too little to activate mines, and are native to sub-Saharan Africa, and therefore are resistant to local parasites and diseases. In 2009 the rats searched 93,400 m(2) of land, finding 41 mines and 54 other explosive devices. Humans with metal detectors found no additional mines. On average, the rats emitted 0.33 false alarm for every 100 m(2) searched, which is below the threshold given by International Mine Action Standards for accrediting mine-detection animals. These findings indicate that Cricetomys are accurate mine-detection animals and merit continued use in this capacity.     

乡村医生发现可疑结核病症状者研究综述

结核病仍然是严重危害我国人群健康的传染病,如何有效发现结核病病例是制约目前结核病控制项目是否成功的瓶颈。乡村医生在结核病病例发现方面具有至关重要的作用,如何提高其作用已成为研究的热点。本文对现阶段乡村医生发现可疑结核病症状者的方式及现状进行综述,并提出提高乡村医生在结核病病例发现中作用的措施。     

Assessing the stigma of tuberculosis

Tuberculosis (TB) stigma is considered a vague concept, because it is not easily assessed. The purpose of this article is to review methodological approaches for assessing TB stigma. We reviewed the published studies and the gray literature. We also present the main features of a qualitative and quantitative assessment of TB stigma, which has been done in one specific project in Nicaragua. As a whole, we illustrate the variety of TB stigma in terms of domains, consequences, determinants and methods used; some features emerge more frequently than others from the studies. However, results of the review show a relative scarcity of the TB stigma assessment experiences, mainly in looking at the consequences for the TB patient and in the use of quantitative methods and scales. Additional assessment studies in diverse contexts are needed so that stigma will be considered a priority in the organization of care for people affected by tuberculosis.     

Detecting Potential Underreporting of Suicide Ideation Among U.S. Military Personnel

Using a military sample comprised largely of National Guard personnel, zero‐inflation negative binomial regression was applied to estimate the effects of indirect, nonface valid indicators of suicide ideation [Thwarted Belongingness (TB), Perceived Burdensomeness (PB), and Hopelessness], in predicting suicide ideation. Data from a sample of 497 military personnel (82.1% male; m_age = 27.24; range = 18–59) were analyzed. TB and the interaction of TB with Hopelessness were significant predictors in the logistic regression, and in the negative binomial regression, the main effects of TB and hopelessness, and the interactions of TB with hopelessness and PB with hopelessness were significant. The findings further indicated that approximately 10% of those not reporting ideation would be predicted to be ideators. Clinically, these results indicate that, in samples reluctant to report ideation, the assessment of suicide risk may improve through the use of relevant measures that do not explicitly reference suicide thoughts.     

The moderating role of pessimism in the association between retrospective relational peer victimization,interpersonal risk factors,and suicide ideation

Peer victimization (PV) is a serious concern for youth and is associated with subsequent suicide ideation in young adulthood. The interpersonal theory of suicide may provide a framework for understanding suicide ideation in this population. Specifically, thwarted belongingness (TB) and perceived burdensomeness (PB) have been significantly associated with suicide ideation among young adults with a history of peer victimization. Additionally, the personality trait of pessimism is associated with elevated suicide ideation. Thus, this study tested the association between self-reported frequency of retrospective relational (i.e., verbal and indirect) PV in primary and secondary school, thwarted interpersonal needs (TB and PB), and current suicide ideation, as well as how these relations may vary based on current pessimism. Participants were 330 undergraduate students. Nonparametric bootstrap moderated mediation procedures were used to test hypotheses. Results indicated significant indirect effects of frequency of retrospective relational PV and suicide ideation through PB and TB. Contrary to predictions, results did not indicate significant moderated mediation; however, the association between PB and suicide ideation was stronger at lower pessimism levels. We also provide supplemental analysis with optimism as the moderator. These findings suggest that clinicians may consider targeting TB, PB, as well as pessimism and optimism among those with a history of relational PV when assessing and intervening on current suicide ideation. Implications, limitations, and future directions are further discussed.     

Sources of acute stress in american and australian basketball referees

Abstract

Team building (TB) research in sport psychology can be those forms of investigation that systematically examine the effectiveness of interventions developed to (a) influence, expectations and attitudes, and (d) reduce or eliminate group properties that detract or hinder the group's development toward effective teamwork. The objective of TB research is to identify controlled targetted approaches to interventions to produce valid, reliable, and cost-effective results. While these goals are desirable, caution must be taken to avoid the multiple problems and Criticisms levelled at TB research and practice in nonsport settings (DeMeusc &; Liebowitz 1981). Before problems occur in sport research, investigators need to recognize and learn from past errors. The objective of this paper is to summarize characteristic research problems, give examples of research on TB in sport that have made a new beginning, and suggest types of research conducted by both the scientist and the practitioner. Practitioners need to evaluate TB program effectiveness in order to distinguish between team building of different types, indifferent situations, and of differing levels of quality. While the TB research definition for sport psychology emphasizes the scientific process, this requirement does not restrict the scientist-practitioner. The entire spectrum of intra to interteam behavior can be addressed from the controlled experiment or single group design to program development or evaluation research. Examples of other factors such as various TB models, design issues, and the coach as the agent of change are discussed to reflect the potential opportunities for improving TB research and TB program evaluation in sport.     

妊娠合并结核临床诊治的决策

妊娠合并结核是一种对母婴健康危害极大的妊娠期疾病。在妊娠期结核病中,多数患者无明显症状,早期症状与妊娠期某些生理反应相似,加之妊娠与结核病的相互影响,x线、CT等重要的影像学检查受限,致使本病易被误诊或误治。某些抗结核药物对母婴的不良影响,使其治疗难以实施,由于结核病本身及治疗后可能对胎儿的影响,在临床上是否终止妊娠往往难以决策。本文就妊娠合并结核诊治过程中的相关问题进行综述,以期为临床诊治决策提供帮助。     

Multi-disclinational description of pentagonal particles with subsurface layer free of twin boundaries

We present the results on the modelling of structural changes in pentagonal small particles (PSPs) during their growth. We prove that after a certain critical size it becomes energetically favourable for a PSP to form a subsurface layer free of twin boundaries (TBs), which are only typical structural elements for smaller size PSPs. In this layer, the low-angle dislocation boundaries (DBs) are formed. Our calculations of the energy stored in the transformed PSP are based on the disclination model of a PSP, in which the TB junctions, as well as TB–DB junctions are treated as wedge disclinations.     

流动人口结核病知识水平的定性调查

为了解农村流动人口结核病及相关知识的需要,在重庆市的渝中区和九龙坡区,进行了12组共73位农村流动人口参加的专题小组讨论。发现他们对结核病及相关知识的了解不够,结核病防治的意识较差。因此,加强健康教育是促进流动人口结核病控制必要的和可行的措施。     

流动人口对结核病相关知识和政策的认知及态度研究

对229例流动人口结核病疑似患者采用问卷调查,开展多次专题小组讨论和个人深入访谈。结果发现,流动人口对结核病相关知识和免费治疗政策了解有限,看法不一。对结核病治疗转归情况有不同程度的担心,且对结核病人持谨慎态度。建议加大流动人口健康教育的力度,以减少对结核病人的社会歧视,并探索建立传染病专项保险制度以提高全国性减免方案的效果。     

The effect of asymmetrical sample training on retention functions for hedonic samples in rats

Rats were trained in a symbolic delayed matching-to-sample task to discriminate sample stimuli that consisted of the presence of food or the absence of food. Asymmetrical sample training was provided in which one group was initially trained with only the food sample and the other group was initially trained with only the no-food sample. In addition, within each group half of the rats were trained with an illuminated intertrial interval (ITI) and the remaining rats with a dark ITI. While the retention functions did not differ as a function of which sample was trained first, they did differ as a function of the similarity in the illumination conditions during the ITI and the delay interval. Symmetrical retention functions were obtained when the lighting conditions were similar and slightly asymmetrical retention functions were obtained when the lighting conditions were dissimilar. Probe tests confirmed that features of the no-food sample were attended to and used to generate a memory representation for the no-food sample. The results are not consistent with the hypothesis that asymmetrical sample training encourages coding of the sample introduced initially and default responding to the subsequently introduced sample. Rats generate memory representations for both samples when asymmetrical sample training is given with hedonic samples.     

A Prospective Examination of the Interpersonal‐Psychological Theory of Suicidal Behavior Among Psychiatric Adolescent Inpatients

The challenge of identifying suicide risk in adolescents, and particularly among high‐risk subgroups such as adolescent inpatients, calls for further study of models of suicidal behavior that could meaningfully aid in the prediction of risk. This study examined how well the Interpersonal‐Psychological Theory of Suicidal Behavior (IPTS)—with its constructs of thwarted belongingness (TB), perceived burdensomeness (PB), and an acquired capability (AC) for lethal self‐injury—predicts suicide attempts among adolescents (N = 376) 3 and 12 months after hospitalization. The three‐way interaction between PB, TB, and AC, defined as a history of multiple suicide attempts, was not significant. However, there were significant 2‐way interaction effects, which varied by sex: girls with low AC and increasing TB, and boys with high AC and increasing PB, were more likely to attempt suicide at 3 months. Only high AC predicted 12‐month attempts. Results suggest gender‐specific associations between theory components and attempts. The time‐limited effects of these associations point to TB and PB being dynamic and modifiable in high‐risk populations, whereas the effects of AC are more lasting. The study also fills an important gap in existing research by examining IPTS prospectively.     

结核病防治中的人文关怀

结核病的防治不仅仅是公共卫生问题,更是一个社会问题。尽管在现阶段结核病防治中已体现了人文关怀的精神,在今后结核病防治中还需要进一步做到重视社会宣传教育,加强家庭督导作用,强化对流动人口中DOTS策略的实施,力争医疗保险参与防治减轻患者经济负担,研制新疫苗等,从而降低我国疫情,促进构建和谐社会。     

Latent variable assessment of outcomes in a nurse-managed intervention to increase latent tuberculosis treatment completion in homeless adults.

OBJECTIVE: To assess predictors of latent tuberculosis infection (LTBI) completion by using structural equation modeling (SEM) among homeless adults, a group at great risk for LTBI and active tuberculosis (TB). LTBI therapy is effective in stemming the progression to active TB, yet treatment adherence among homeless persons is difficult to attain. DESIGN: By using SEM, the authors assessed predictors of LTBI completion among a sample of 494 homeless adults in Los Angeles, CA, who received either a nurse case-managed program (NCM) or a usual care program. MAIN OUTCOME MEASURES: Latent variables were created with the baseline variables of site type, age, intervention status, dissatisfaction with health care, depression, TB risk assessment, alcohol use, heroin or cocaine use, and TB knowledge. Outcome variables included many of the same baseline variables as well as treatment completion. RESULTS: LTBI treatment completion (100% adherence) was significantly and positively associated with participation in NCM, older age, and less heroin or cocaine use. NCM also predicted greater TB knowledge, greater ease of treatment, and more satisfaction with treatment (NCM completion rate = 64%, control rate = 42%). CONCLUSION: The culturally competent NCM program, combined with active tracking and incentives, was successful in a difficult-to-treat and highly transient population.     

肺结核患者的血糖控制

肺结核与糖尿病是两种严重危害人类健康的疾病。越来越多的研究证明,发生结核病的一个重要的危险因素为糖尿病,而且可能会影响肺结核患者的表现和治疗反应。另外,结核病可能会导致糖耐量异常,并使糖尿病患者的血糖控制不良。糖尿病引起肺结核发病增加,可能是因为持续的高血糖损害了针对结核杆菌的机体免疫。对结核病患者合并糖尿病者,药物治疗需考虑到药物动力学,监测血糖,谨慎用药。     

特殊人群结核病的流行病学调查

为了了解某监狱犯人中结核病的患病及结核菌耐药情况,为防治提供依据,采用痰检和结核菌素试验的方式对研究对象进行普查,结核分枝杆菌采用罗氏培养,药敏试验采用比例法。结果显示,PPD试验总阳性率为60．54％。痰检发现24例患者,涂阳患病率为898．54／10万。培养菌株总耐药率为95．83％,其中初治耐药率、复治耐药率和多重耐药率分别为87．5％,100％和73．91％。提示该特殊人群结核病患病率高于一般人群。     

Acetylcholine release in the hippocampus and striatum during place and response training

These experiments examined the release of acetylcholine in the hippocampus and striatum when rats were trained, within single sessions, on place or response versions of food-rewarded mazes. Microdialysis samples of extra-cellular fluid were collected from the hippocampus and striatum at 5-min increments before, during, and after training. These samples were later analyzed for ACh content using HPLC methods. In Experiment 1, ACh release in both the hippocampus and striatum increased during training on both the place and response tasks. The magnitude of increase of training-related ACh release in the striatum was greater in rats trained on the response task than in rats trained on the place task, while the magnitude of ACh release in the hippocampus was comparable in the two tasks. Experiment 2 tested the possibility that the hippocampus was engaged and participated in learning the response task, as well as the place task, because of the availability of extra-maze cues. Rats were trained on a response version of a maze under either cue-rich or cue-poor conditions. The findings indicate that ACh release in the hippocampus increased similarly under both cue conditions, but declined during training on the cue-poor condition, when spatial processing by the hippocampus would not be suitable for solving the maze. In addition, high baseline levels of ACh release in the hippocampus predicted rapid learning in the cue-rich condition and slow learning in the cue-poor condition. These findings suggest that ACh release in the hippocampus augments response learning when extra-maze cues can be used to solve the maze but impairs response learning when extra-maze cues are not available for use in solving the maze.     

Testing the Four Main Predictions of the Interpersonal–Psychological Theory of Suicidal Behavior in an Inpatient Sample Admitted Due to Severe Suicidality

This study aimed to evaluate four main predictions of the Interpersonal Psychological Theory of Suicide (IPTS): the importance of perceived burdensomeness (PB), thwarted belongingness (TB), hopelessness (H), and capability for suicide (CS) for (passive/active) suicide ideation, suicide intent and suicide attempts. N = 308 psychiatric inpatients admitted due to severe suicidality (53.6% female: n = 165; age: M = 36.82, SD = 14.30, range: 18–81) completed self-report measures of TB, PB, H, CS and suicide ideation as well as interviews on suicide intent and suicide attempts. TB and PB were associated with (passive/active) suicidal ideation, whereas the three-way interaction PB, TB, and H was not associated with active suicide ideation. Fearlessness about death in conjunction with active suicidal ideation was not associated with suicide intent and the interaction of PB, TB, and CS was neither predictive of recent suicide attempt status nor lifetime number of suicide attempts. Given the cross-sectional nature of the data, conclusions on causality should be handled carefully. The results challenge the theoretical validity of the IPTS and its clinical utility—at least within the methodological limitations of the current study. Yet, findings underscore the importance of PB in understanding suicidality.