The practice of geriatric psychiatry in three countries: observations of an American in the British Isles

The author compares the practice of geriatric psychiatry among three countries: Ireland, the United Kingdom and the United States. The two main areas reviewed are how the practice of geriatric psychiatry is done, and the mental health services available in each country, including organizational characteristics. The US is the most entrepreneurial of the three, Britain's greatest strength is the uniformity and comprehensiveness of its services, and Ireland provides an excellent model for nations of comparable size. Considerable change is occurring in all three countries.     

ABH secretion in populations of the British Isles

Saliva specimens were collected from 163 Manx and 994 Cumbrian individuals and tested for secretor group. The findings confirm the pattern of variability in non-secretor frequencies reported in populations of the British Isles. A possible explanation for this distribution of secretor groups is suggested. The Cumbrian sample is also examined for intra-regional heterogeneity.     

Neonatal vitamin K administration and childhood cancer in the north of England: retrospective case-control study

OBJECTIVE: To explore the possible association between intramuscular vitamin K given to neonates and the subsequent development of childhood cancer. DESIGN: Retrospective case-control study on the basis of hospital records. SETTING: The former Northern Health region of England. SUBJECTS: 685 children who were born and lived in the region and who developed cancer before their 15th birthday, and 3442 controls also born between 1960 and 1991 and matched only for date and hospital of birth. The notes of a further 701 index cases were untraceable. MAIN EXPOSURE MEASURE: Administration of intramuscular vitamin K versus no exposure to vitamin K. RESULTS: There was no association between the administration of vitamin K and the development of all childhood cancers (unadjusted odds ratio 0.89; 95% confidence interval 0.69 to 1.15) or for all acute lymphoblastic leukaemia (1.20; 0.75 to 1.92), but there was a raised odds ratio for acute lymphoblastic leukaemia developing 1-6 years after birth (1.79; 1.02 to 3.15). No such association was seen in a separate cohort-based study not dependent on case note retrieval in which the rates of acute lymphoblastic leukaemia in children born in hospital units where all babies received vitamin K were compared with those born in units where less than a third received prophylaxis. CONCLUSIONS: It is not possible, on the basis of currently published evidence, to refute the suggestion that neonatal intramuscular vitamin K administration increases the risk of early childhood leukaemia. Any association may have been masked in earlier studies that did not use controls matched for time and locality by other unidentified factors affecting the spatiotemporal variations in incidence of leukaemia.     

Restriction endonuclease profiles of orf virus isolates from the British Isles

A comparison of DNA profiles of representative isolates of orf virus, obtained using four different restriction endonucleases (RE), showed that the enzyme EcoRI could be used to discriminate between wild-type virus isolates and vaccine strains. The enzyme was used to compare the RE profiles of orf virus isolates from 43 outbreaks of orf that occurred in vaccinated flocks between 1988 and 1993; 21 outbreaks yielded wild-type virus, 10 yielded vaccine viruses, three produced both vaccine and wild-type viruses and no clear result was obtained from nine of the outbreaks. From the 21 outbreaks yielding wild-type viruses, 28 orf virus isolates had clear RE profiles and 15 distinct RE profiles were recorded. Usually only one virus type was associated with each outbreak but from two farms, two different wild-type viruses were recovered. No predominant genotype was identified, with four RE profile types being recovered for more than one outbreak. From the more severe form of orf involving the buccal cavities of lambs only wild-type viruses were recovered, with at least four different genotypes being represented.     

Current hygienic practice: the problems and the developmental trends]

Analysis of hygiene practice of to-day and how its forms and methods conform with the needs of military healthcare. The author makes a conclusion that due to certain objective conditions there was no substantial progress in the hygiene practice for the last decade. At the same time he points out that it is necessary to preserve and develop new traits in the hygiene methods that steer the growth of practical hygiene as a part of medical prophylactics.     

Vitamin K requirement and the concentration of vitamin K in rat liver

The concentration of vitamin K was determined in the liver of different strains of rats, and in male and female warfarin-resistant rats by feeding 3H-vitamin K in a purified diet. In each case, the level of vitamin K in the liver correlated approximately with the amount of vitamin K fed. The results indicate that differences in the requirement for vitamin K between the sexes and between strains of rats are due principally to different required concentrations of vitamin K in liver and not to differences in absorption or turnover of the vitamin. The results of the determination of vitamin K epoxide levels in male and female warfarin-resistant rats, and other data, suggest that the amount of vitamin K required in liver may be in part due to differences in the activity of the enzyme, vitamin K epoxide reductase.     

Lasers in plastic surgery: current practice

A wide variety of lasers provides the plastic surgeon with treatment options that were not available previously. Appropriate, safe use of lasers complements the many therapeutic treatment options available to plastic surgeons. Lasers have introduced a new therapeutic modality. Because of the ways the skin and its defects may be altered with lasers, they will be an increasingly important part of plastic surgery.     

Commentaries: British debate on obstetric practice

Inoculation of mice with antiserum to peritoneal exudate cell on the eve of intraperitoneal immunization with influenza A2 virus delays an immunologic response as manifested by an increase in the inductive phase of antibody formatin and a slower rise of antibody titre. The immunodepressive effect of the anti-macrophage serum corresponds to inhibition of the activity of macrophages and the lack of plasma cell reaction in the thymus. The anti-macrophage serum does not influence the development of secondary immune response which indicates that it affects the antigen-reacting cells.     

End-of-life decision-making in the hospital: current practice and future prospects

The contributions of the various ulnar-innervated muscles of the hand to the hypothenar compound muscle action potential (CMAP) were estimated by directly stimulating individual muscles and by analyzing CMAP shape changes resulting from manipulations that changed individual muscle lengths. The results show that the first peak of the negative phase of the hypothenar CMAP comes from the hypothenar muscles, but that the second peak is due to a large volume-conducted potential from the interosseous muscles. The interosseous contribution affects both the amplitude and the area of the CMAP, and makes these parameters sensitive to changes in the configuration of the fingers and the temperature gradient in the hand. To reduce the interosseous contribution, a "balanced reference" consisting of two reference electrodes, one over each tendon, is proposed.     

Rehabilitation: scope for improvement in current practice

This article concludes this part of the rehabilitation series by looking at the nursing contribution to rehabilitation. It brings together the common elements which have emerged in the previous seven articles, identifying areas in which there is considerable scope for improvement to current practice. Indicative areas of knowledge and skill required for nurses to play a more active role are considered and a number of potential models are briefly described.     

Intravenous therapy: current practice and nursing concerns

The field of intravenous (i.v.) therapy has been subject to major change, with increasing numbers of nurses taking on the high profile, technical aspects of care. The transfer of previously medicalized tasks such as cannulation has been welcomed by nurses who are keen to develop practical skills in order to embrace the concept of holistic patient care. This literature review aims to clarify the role of the nurse in i.v. therapy, exploring cannulation as a specific issue. Legal and professional aspects are discussed in terms of extended/expanded practice and practical aspects in terms of i.v. access and maintenance. Discussion focuses on a team approach to the management of i.v. therapy. Finally, the nursing process is applied to an i.v. therapy scenario. Exploration of the nursing issues enables practitioners to justify the expansion of individual practice in order to deliver holistic care and improve standards of service. The review concludes that nurses cannot afford to lose sight of the caring component of their role as a result of immersion in the culture of technical skill acquisition.     

Nursing practice in Canada: the influence of current and proposed legislation

Nursing practice in Canada is regulated by separate acts in each of the 10 provinces and two territories. These acts grant self-governance to the nursing profession, define a scope of practice, and establish mechanisms for registration and quality assurance. The Canada Health Act 1984, the Agreement on Internal Trade (1994) between provinces, and the North American Free Trade Agreement have potentially great effects on Canadian nursing by altering the regulation of professionals within the various jurisdictions.     

Emerging trends in mental health policy and practice

The continuing deinstitutionalization of patients in public mental hospitals and the growth of managed care are fundamentally altering mental health practice. Managed care provides opportunities for achieving parity of insurance coverage between mental and physical illness, but serious problems persist in integrating mental health, substance abuse, and general medical care and assuring an appropriate range of services and programs for persons with serious mental illness residing in community settings. Hospital and community care are poorly coordinated, and hospital care needs to be integrated into a more balanced system of services. Important new roles are emerging for purchasers, patient advocates, and mental health authorities.     

School psychology: The current state of practice and future practice of the specialty.

Defines 6 conceptual issues that form a partial basis for the practice of school psychology and delineates 16 domains of competence that may be necessary for the effective practice of school psychology. These issues and domains of competence present a frame of reference for future practice and training that differs from current approaches. An example illustrates the implications of these factors for future practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)