Introduction
Tuberculosis is a major health problem in Lusaka, Zambia, where 16% of the people of productive age was infected with HIV. DOTS coverage is 100% with 81% case detection and 73% cure rate.Following the spread of HIV infection, the number of tuberculosis patients has been increasing. Within this context, the HIV/AIDS and TB Control Project established a model external quality assessment (EQA) system for AFB microscopy service at peripheral laboratories.This study aims to show importance of EQA in quality NTP laboratory system.
Methods
All 22 diagnostic centers in Lusaka during the period from July 2003 to September 2005 were evaluated following internationally recognized guidelines. Sample slides were taken randomly from among slides read at peripheral diagnostic centers and were blindly rechecked by controllers at the quality assurance (QA) center. Quality of smear preparation was also assessed.
Results and Discussions
Between 2003 and 2005, major reading errors (discrepancy: two reading scales and over) found by controllers decreased from 5% of sample slides to 0.7%, and minor errors (one scale discrepancy) from 3.4% to 0.3%. The number of diagnostic centers without any errors was only 3 at the beginning of study and this number increased to 17 at the end. Quality of smear preparation such as thickness, size and evenness also improved based on international standards. These results highlighted the effectiveness of the quality assurance system (blinded rechecking of sample slides and effective feedback with frequent visits to peripheral diagnostic centers) in terms of maintaining the proficiency of AFB microscopy service. EQA system should be expanded in the areas where both HIV and TB prevalence is high. The effective implementation of EQA service in the NTP is the essential factor for the success of DOTS strategy and may contribute ultimately to prevent new tuberculosis infection among persons, including HIV-infected.

Introduction
One of the challenges related to global health is the imbalanced distribution of health professionals and the HIV/AIDS pandemic. Under this situation, the importance of HIV/AIDS care with health volunteers has been recognized, especially in developing countries, which suffer from the double burden. A task shifting approach is encouraged among health professionals, as well as, between health professionals and non health professionals.
Objective
To discuss supportive surroundings for sustainable HIV/AIDS care with heath volunteers from the perspective of motivation.
Methods
A literature review, where articles were searched and extracted through the PubMed database, was conducted in May, 2010. In total, 16 combinations with 11 keywords were used for searching. (First keyword: motivation, second keyword: HIV or AIDS, third keyword: community health aides, community health workers, community workers, lay counselors, adherence support workers, adherence counselors, care givers or volunteers)
Results
Among the 290 articles extracted, nine articles meeting the criteria of this literature review were selected. Eight articles were reported from developed countries and one article was from a developing country. About half of the study participants in six articles were People With HIV (PWH) or homosexuals. Through all articles, “altruism” and “self development” were recognized as motivation for health volunteers to join and maintain activities. Especially for continuity of activities, “support from other members and staff” and “recognition” were raised. Specific motivation from a developing country was the “ step to formal employment”.
Discussion and Conclusion
Regardless of developed- or developing- countries, fundamental motivation of health volunteers for HIV/AIDS care is similar. However, in developing countries, where health volunteers are adopted as part of the health system, adequate and continuous support and supervision are required more than in developed countries for sustainability of stable care provision. PWH can, also, play an active role as HIV/AIDS care providers by themselves, and they will be a key component for HIV/AIDS care. Further exploration is necessary to determine the motivation of health volunteers for HIV/AIDS care in developing countries where a task shifting approach is encouraged under a shortage of health professionals and HIV/AIDS epidemic.

Purpose: This study investigates the situation surrounding the use of massage to relieve cancer pain by nurses in hospices and palliative care wards all over Japan and factors affecting this usage. Methods: We conducted a survey of 989 nurses with two or more years of clinical experience employed at approved palliative care wards around Japan, using a questionnaire prepared by researchers. Results: The questionnaire was answered by 606 nurses, and 95.7% of the subjects used massage in their routine nursing care. They recognized the benefits, such as comfort, reducing anxiety and so on. From a multivariate logistic model, 'a great number of years of clinical experience in cancer nursing' (OR: 2.51, 95%CI: 1.20-4.80) and 'the superior assessment ability for the use of massage' (OR: 1.18, 95%CI: 1.09-1.27) had a significant impact on the active use of massage. Conclusion: In order to use massage more effectively it is necessary to develop knowledge acquired through clinical experience and improve nurse's assessment ability. Palliat Care Res 2010; 5(1): 101-113

　The purpose of this study was to clarify the survey of non－pharmacological interventions provided by nurses in palliative care units for dyspnea in terminally ill cancer patients. A survey of 450 palliative care unit nurses working in the Kanto and Koshinetsu regions was conducted using an anonymous, self－completed questionnaire between September and November 2011. Data on 414 respondents (response rate, 92.0%) were analyzed. The questionnaire was based on a literature review and interviews with nurses, and it asked about the frequency of non－pharmacological interventions (nursing support) in 31 items and the nurses’impressions of whether these interventions were effective. In the items which frequency of intervention was high, there are nursing support which provide with ease and nearly cost or time free. In the low, there are nursing supports which need for knowledge and skills when the supports are provided. In the items which impression that it was effective was high, there are similar supports with frequency of intervention. These results may be useful when discussing future support for dyspnea in patients with terminal cancer.

Fish sausage is a common food in Japan. It is mainly made from surimi, which contains a high amount of fish protein. Although it has been reported that the administration of fish protein reduces blood total cholesterol, LDL-cholesterol, and triglycerides in experimental animals, it has not been studied whether the intake of fish protein improves blood cholesterol profiles in humans. In the present study, male subjects (n = 20) with fasting blood LDL-cholesterol (140–179 mg/dL) were enrolled. Subjects consumed a total of 225 g of fish sausage daily for 8 weeks, and the total ingestion dose of fish protein was 13.5 g/day. Blood total cholesterol, LDL-cholesterol, and atherogenic index were significantly reduced (p < 0.01, p < 0.05, and p < 0.01, respectively), and HDL-cholesterol was significantly increased (p < 0.01) by fish sausage intake after 4 and/or 8 weeks of intervention without side effects. These results imply that the short-term intake of fish protein achieved by the eating of fish sausage improves cholesterol profiles in hypercholesterolemia subjects.