Participatory theatre and tuberculosis: a feasibility study with South African health care workers.

SETTING: Health care workers (HCWs) in South Africa have a risk of acquiring tuberculosis (TB) that is twice that of the general population. Nonetheless, adherence to infection control and TB disclosure requirements remain problematic. OBJECTIVE: To gain insight into the feasibility of an educational participatory theatre intervention to reduce the risk of occupational TB. DESIGN: An intervention using participatory theatre was developed progressively over six consecutive sessions with different groups of HCWs, totalling 83 participants. Videos of the sessions, field notes, observations, interviews and a post-experience survey were analysed to ascertain feasibility. RESULTS: The intervention was acceptable to participants, met a defined demand, proved adaptable to the target group and was practical if done during working hours or if integrated into already existing training sessions. The theatre work shed light on where to focus educational interventions. Preliminary efficacy outcomes included strengthened social cohesion via group work and reports of subsequent greater vigilance regarding occupational TB. CONCLUSION: Participatory theatre techniques may offer a useful, culturally appropriate supplement to existing educational approaches to the prevention and management of occupational TB. Given the limitations in resources and our assessment of feasibility, training existing health care educators in such techniques would be a promising next step.

Bone Disease in the Common Marmoset: Radiographic and Histological Findings.

The common marmoset (Callithrix jacchus) is a New World primate that is used in biomedical research due to its small size and relative ease of handling compared with larger primates. Although bone disease in common marmosets is well recognized, there are very few detailed descriptions in the literature that cover the range of lesions seen in these animals. For all animals used to model human disease, it is important to be aware of background lesions that may affect the interpretation of study findings. This retrospective study details bone diseases encountered in marmoset breeding colonies at 2 different institutions. Affected marmosets at Johns Hopkins University had lesions compatible with diagnoses of rickets, fibrous osteodystrophy and osteopenia. Affected marmosets at the Wisconsin National Primate Research Center exhibited severe lesions of osteoclastic bone resorption and remodeling that had an unusual distribution and were not easily categorized into a known disease entity. The purpose of this report is to document these naturally occurring skeletal lesions of common marmosets and suggest an approach to evaluating skeletal disease in prospective studies of these animals that will allow the most accurate diagnoses.

Psychiatric treatment in prison: a missed opportunity?

National Health Service Executive guidelines require psychiatric services to maintain links with prisoners previously subject to the Care Programme Approach (CPA) and to participate in discharge planning. We are unaware of previous studies assessing the involvement of general psychiatric services with patients in prison or prisoners' perceptions of their needs. Consecutive referrals to a prison psychiatric liaison service over a three-month period were screened for previous psychiatric contact. Half of those interviewed reported previous psychiatric contact. Two-thirds were in contact with services at the time of detention. One-third believed services knew of their imprisonment. Ninety-three per cent believed they would require psychiatric support after release. Few patients received input from general psychiatric services during imprisonment despite a high level of perceived need. Improved liaison would help facilitate both care in prison and discharge planning in the spirit of CPA and the government directive.

Analysis of protective immune responses to the glycoprotein H-glycoprotein L complex of herpes simplex virus type 1.

A recombinant vaccinia virus expressing both glycoprotein H (gH) and glycoprotein L (gL) of herpes simplex virus type 1 (HSV-1) was used to examine the protective response to gH-gL in immunized mice and to compare these responses with those induced by the highly protective immunogen, glycoprotein D (gD). Weak levels of HSV-1-specific neutralizing antibody were obtained in response to the gH-gL complex, virus clearance from the site of challenge was marginally enhanced compared to that observed following immunization with gH alone, and gH-gL was found to protect mice against acute infection in the ganglia, although not as efficiently as gD.

Precipitants of violence in a psychiatric inpatient setting.

Data gathered from the medical record and in interviews with staff and patients in an inpatient psychiatric setting at a Veterans Affairs medical center were used to examine events preceding 73 episodes in which patients were placed in four-point restraints. The behaviors leading to restraint included physical aggression, verbal threats, and threats with an object as a weapon. These behaviors were more likely to relate to external situations than to the patient's internal psychiatric symptoms. Staff were most frequently the target of patients' aggression, and patients were more likely to view the events leading to restraint as conflict with staff. No differences in the subsequent number of restraint episodes or hours in restraints were found between patients with positive and negative responses to the index restraint episode.