Læknaneminn - 01.04.2008, Page 93

2000. Implementation of VCT and
ARV treatment was observed, data
collected from Health Management
Information System (HMIS) andother
statistical resources, and interviews
conducted with health workers
involved. Additional information was
sought in local University libraries,
national and international reports
and guidelines. Statistical data and
analysis was conducted in Excel
for Windows v2003. The study was
approved by ICEIDA and the MBCH
project management.
Result:
Ihe HlV-prevalence in Malawi is
estimated 14% in the age-group 15-
49 years. The national policy is to
increase the access to VCT and ARV.
VCT clinic has been open at MBCH
since April 2005, the first of its kind in
the area outside the District hospital
in Mangochi. In total, 5043 people
(about 9% of the target population)
have attended the VCT in the whole
health area. Among them 1257
(24.9%) were HlV-positive. Among
the people tested, 2542 (50.4%) were
pregnant women ofwhom 392 (15.4%)
were positive. At MBCH the most
common reasons for attendance are
voluntary testing (39%), pregnancy
(56%), and opportunistic infections
(3%). Increasingly people attend
for PMTCT rather than VCT. Since
June 2006, 317 persons have initiated
ARV treatment. Of these 18 (5.7%)
have died, 6 (1.9%) have dropped out
and 3 (0.9%) where transferred out.
In the period, 111 children born to
HlV-positive mother have received
nevirapine as prophylaxis. Health
workers complained mostly of
limited space and heavy work load.
New facilities for the services are in
its final phase of construction.
Conclusions:
HIV/AIDS is a serious health
problem in Malawi. Global efforts
to offer VCT and ARV are reaching
the rural periphery of the Malawian
health system. The importance of
VCT should be stressed in health
information while PMTCT should
continue and strengthened. Access
to ARV treatment and continuous
supplies of drugs needs to be
secured. Improved facilities funded
by ICEIDA contribute to better
VCT and ARV services to the rural
population involved, and are in line
with the MDGs.
Memory of self-related
emotional stimuli in
high and low ruminators
Katrin Jonsdottirl, Emma Pegg2 and
Bill Deakin2
Objective:
Rumination is the tendency to focus
passively and repetitively on one’s
own thoughts, feelings, problems
and symptoms of depression. Studies
have showed that it predicts both
subclinical symptoms of depression
and depressive disorders. Women
are approximately twice as likely
as men to show depression and
the differences might be because
of rumination. Considering that
rumination involves sustained or
repetitive negative thoughts it is
expected to result in sustained brain
activity which could affect a range
of cognitive tasks by occupying the
necessary brain circuits. A number
of studies have shown link between
rumination and cognitive deficits,
supporting that theory. However,
it has been hypothesised that if
memory was tested for a topic that
was the content of rumination,
rumination should increase recall,
as the process of rumination should
have over-consolidated the memory.
Emotionally charged materials have
been found to elicit higher levels
of recall than neutral materials
which could be because of increased
tendency for people to ruminate
on emotionally charged stimuli.
In a recent study, low and high
ruminative volunteers were given
partly insoluble problem solving
tasks and it was thought that high
ruminators would ruminate more
than the low ruminators about their
failure. In a surprise recognition test
for stimuli used in the tasks high
ruminators did significantly better
than low ruminators. However, low
ruminators did significantly better
on an unrelated cognitive task. We
wanted to replicate the results of the
previously described experiment, but
this time using emotional stimuli and
we are expecting high ruminators
to recall more of the emotionally
valenced stimuli, especially the
negative stimuli.
Material and Methods:
33 healthy volunteers, 17 low
ruminators and 16 high ruminators
completed a battery of computerised
cognitive tasks and personality
questionnaires. First they had to rate
how much 20 positive and 20 negative
emotionally valenced words applied
to them on the scale from one to four.
Later, in a surprise word recognition
task, they were shown a series of
words and asked to identify whether
the words had been presented in the
first task or not.
Results:
Low and high ruminative groups
were well characterised. There were
significant differencesbetween the two
groups on symptoms of depression
(t(16.409)=-8.084, p<0.001) and
neuroticism personality trait (t(31)=-
7.624, p<0.001). This is consistent
with the literature. In addition, there
was significant difference between
how the groups rated themselves on
both negatively valenced words (F(l,
29)=45.833, p<0.001) and positively
valenced words (F(l,29)=19.893,
p<0.001) in the first task. Initially,
two factor anova showed significant
main effects of rumination group and
gender on positive word recognition,
and a significant main effect of
gender on overall word recognition.
However, there was no significant
difference on word recognition,
between neither low and high
ruminators nor genders, when two
outliers were taken into account.
Conclusions:
Low and high ruminative groups
have the characteristics expected
and interestingly rate themselves
differently on the first task. But the
word recognition taslc showed no
significant difference which could
be result of ceiling effects or that the
emotionally valenced words were
not subjects of rumination in the
participants.
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