HIV/Aids: an encounter with death or a journey into life?

This is an account of a panel discussion. It focuses on an encounter with the HIV/Aids virus. Such an encounter may result in a descent into despair, hopelessness and ultimately death, or it may offer the opportunity of possible transformation of consciousness to embrace a life lived productively and meaningfully with a chronic but manageable disease. A picture is provided of the dire situation that exists regarding the HIV/Aids pandemic in South Africa. The HI-virus is compared to a malevolent trickster type energy that uses ingenious means to gain access to the host. It is an impersonal agent seeking only its own survival but if left untreated will ultimately result in the death of the host. Reference is made to characters in the musical, The Lion King, to illustrate that it is the willingness to suffer the painful emotions evoked following a diagnosis of being HIV-positive more consciously that allows for a transformation from despair and hopelessness to a life lived productively and meaningfully. Two of the panelists who are HIV-positive share their experiences of this process. One recounts how, living with Aids, his connections with others and human relatedness helped to restore his dignity and self-worth. The other relates how his willingness to state his status publicly allowed him to overcome the stigma and shame that are evoked when diagnosed as HIV-positive. This has allowed him to seek appropriate treatment with ARV's. He now lives with a chronic but manageable infection and leads a creative and significant life. The difficulties encountered regarding the prevention of HIV/Aids when attempting to change potentially destructive sexual behaviours in teenagers are discussed. An inspiring account of work in treating those that live with HIV/Aids under difficult circumstances is also discussed.     

糖尿病足诊疗与预防进展

糖尿病足是糖尿病的严重并发症,血管狭窄闭塞、神经病变和感染是主要的临床表现,本文主要从糖尿病足的定义、病因、病理生理、临床表现、检测方法、分级及治疗和预防进展方面进行总结。糖尿病足的诊治是个系统工程,单一的方法难以治愈,且治疗效果欠佳,故我们在临床上以预防为主,早期诊断,早期治疗。     

TAKING THEOLOGY AND SCIENCE SERIOUSLY WITHOUT CATEGORY MISTAKES: A RESPONSE TO IAN BARBOUR

In my response to Ian Barbour's criticisms, I first argue for the anthropological dimensions and contextuality of any theology. Next I examine and criticize Barbour's thesis that I am an in‐compatibilist about divine action. Finally I illustrate the fact that I see genuine opportunities for a dialogue between theologians and scientists without apologetics, category mistakes, or relegating theology to the fringes of science, by pointing to evolutionary explanations of religion.     

Repeat HIV Testing and HIV Transmission Risk Behaviors Among Sexually Transmitted Infection Clinic Patients

HIV testing and counseling expends considerable HIV prevention resources and offers great opportunities for HIV risk reduction. Individuals who are at risk for HIV and have not been HIV tested are the focus of current targeted testing campaigns and yet persons who are repeatedly tested for HIV often continue engaging in high-risk practices. This study examined HIV testing, risk behaviors, and other medical diagnostic testing practices of men (N = 231) and women (N = 86) attending an inner-city sexually transmitted infections (STI) clinic. Results showed that 75 (23%) participants had not yet been tested for HIV, 45 (14%) had been tested once, and 197 (63%) had been tested two or more times. Patients that had not been tested and those who were repeatedly tested were similar in their risk behaviors; both demonstrated significantly greater risks for HIV than persons tested just once, although repeat testers were more likely to have had a past STI. HIV testing history was minimally associated with other medical testing and health protective practices, such as testicular self-examination, mammography, and having had PAP tests. Results support targeting high-risk untested persons for HIV testing and suggest an urgent need for interventions to reduce risk behaviors among STI clinic patients who repeatedly test for HIV.     

不同文化程度者对艾滋病预防干预措施的认知研究

国务院于2006年2月12日公布了《艾滋病防治条例》,从法律上对预防艾滋病传播的干预措施予以确定。但社会公众对艾滋病预防干预措施的认知,特别是文化程度较低者的知晓率和认知态度还需通过宣传进一步加强,以利艾滋病预防干预措施更好实施,进一步防治艾滋病的传播。     

多模式镇痛在幻肢痛预防中的临床研究

为探讨多模式镇痛预防截肢后幻肢痛的临床效果。选择50例下肢截肢患者,随机分为2组,试验组（Ⅰ组）和对照组（Ⅱ组）,观察患者疼痛评分,患者自控镇痛按压次数,使用其他镇痛药物的情况,记录所有的不良反应及幻肢痛发生率。结果显示,镇痛评分,Ⅱ组高于Ⅰ组（P〈0．01）;PCA按压次数,Ⅱ组多于Ⅰ组（P〈0．01）;不良反应发生率Ⅱ组高于Ⅰ组（P〈0．01）;Ⅱ组幻肢痛发生率明显高于Ⅰ组（P〈0．01）。采取多模式镇痛预防幻肢痛是安全有效的。     

对构建我国艾滋病防治督导与评估预期框架的探讨

根据艾滋病防治督导与评估框架具有的功能及构建框架的原则,提出了构建我国艾滋病防治督导与评估预期框架的思路。该预期框架包括总框架和组织管理与协调、指标体系和数据管理三个分框架。通过对构建预期框架的探讨,为制定我国艾滋病防治督导与评估方案提供参考。     

新型农村合作医疗中的道德风险及防范

以“新乡模式”为例对商业保险公司参与承办新型农村合作医疗进行了有益的探索。对商业保险公司利益激励不足致使其参与新农舍的积极性不高,而激励不足主要是源于制度不足导致对新农合中的道德风险约束无力。探讨了对道德风险的防范措施。     

The role of computer‐aided psychotherapy within an NHS CBT specialist service

To date, the feasibility of computer‐aided psychotherapy as an intervention has only been recognised in primary care practice. The present study sought to evaluate the impact of ‘Beating the Blues’ (BtB), an established computerised cognitive behaviour therapy (CCBT) self‐help programme for the management of anxiety and depression, within an NHS CBT specialist healthcare centre. Of the 555 service users who used BtB as part of routine care, with follow‐up assessment at six to eight weeks, 71% completed all eight sessions. Statistically significant differences on the Beck Depression Inventory‐II (BDI‐II) and Beck Anxiety Inventory (BAI) were found in completer and intention‐to‐treat analyses; 50% of completers achieved reliable change on the BDI‐II and approximately 25% of completers achieved reliable and clinically significant change on both measures. Outcomes were benchmarked against outcomes in studies of routine face‐to‐face CBT. These findings provide evidence that BtB may be of value to service users in secondary mental healthcare centres, alleviating current burdens on public health and therapeutic resources. Future research directions should include examining which factors influence individuals’ decisions to try computer‐aided psychotherapy, which individuals are best suited to using these interventions, and why some users drop out prior to programme completion.