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.

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.