Opsonic effect of equine plasma from different donors

The ability of equine plasma from different donors to enhance phagocytic capacity was assessed in neutrophils obtained from seven foals, aged 7-8 days (Study A), and from seven adult horses (Study B). Neutrophils were allowed to phagocytize fluorescent yeast cells opsonized with plasma from one of three donors or with pooled serum, all previously frozen (-18 degrees C) and thawed. The results were analysed by flow cytometry. In study A, fresh autologous foal serum was also used for opsonization, and in study B, heat-inactivated plasma and pooled serum were used in addition to untreated samples. The plasma from donor GN induced a higher number of truly phagocytic neutrophils (mean 78%) than did plasma from donors GD (68%), OD (66%) and pooled serum (59%) when neutrophils from foals were used (p < 0.05). Similar results were obtained when adult neutrophils were used. Phagocytosis was markedly reduced with beat-inactivated plasma as a result of there being fewer phagocytic neutrophils and less phagocytized material per cell. The opsonic capacities of the autologous foal sera were lower than that of adult donor plasma in six out of seven foals. It is concluded that there is significant individual variation in the opsonic activity amongst plasma donors with similar serum IgG concentrations. The results were consistent irrespective of whether neutrophils from adults or foals were used.     

Prenatal risk factors for cryptorchidism: a record linkage study

Using data from the Oxford Record Linkage Study (ORLS), we conducted a case-control study to examine prenatal risk factors for cryptorchidism. We identified 1449 boys born during 1970-86 for whom there was a record of an orchidopexy during 1970-87. Up to eight controls were matched to each case on year of birth and hospital or place of delivery. For each boy and his mother we extracted abstracts of maternity and general hospital records from the ORLS. Low birthweight (trend P < 0.001), low social class (trend P < 0.001), breech presentation (relative risk 1.67; 95% confidence interval [CI] 1.16, 2.41), pre-eclampsia (1.17 [1.00, 1.37]), artificial feeding (1.22 [1.04, 1.45]) and episiotomy (1.13 [1.00, 1.27]) were identified as independent risk factors for cryptorchidism. Gestational age was not independently associated with cryptorchidism after adjusting for birthweight (P = 0.33), and this observation suggested that some cryptorchid boys may have suffered from intrauterine growth retardation. Low birthweight, breech presentation and pre-eclampsia may have in common poor placental function and impaired fetal growth, which may be causes of cryptorchidism.     

Prevalence of hepatitis C antibodies in plasma donors for the treatment of Argentine hemorrhagic fever

For Argentine Hemorrhagic Fever, a disease caused by Junin virus (JV), there is an effective treatment, consisting of the transfusion of immune plasma (IP). This plasma is obtained from individuals who have had the disease. Since Hepatitis C virus (HCV) is transmitted parenterally, this study was aimed to estimate the prevalence of anti-HCV in a population of IP donors. In this study, 376 donors (47 females and 329 males) were studied: 95 individuals (24 females and 71 males) who had had FHA but had not received treatment and 88 laboratory workers (57 females and 31 males) who were included as controls. Serum samples were tested by EIA (Abbott, Germany) for HCV, and later confirmed by LIATEK (Organon, Ireland). Antibodies to HCV were detected in 29/376 donors (7.7%), in only 1/95 (1.0%) untreated convalescents of AHF and in 1/ 88 (1.1%) of laboratory workers. Retrospective analysis of the seroconversion for HCV in these individuals demonstrated that in 16/24 donors (66.6%) the infection by HCV was probably associated with the IP transfusion. The data presented herein show how the infection with HCV was disseminated among donors of IP, stressing the risk associated to transfusional practices, and emphasizing the need of vaccination to prevent AHF and also the risk inherent to its treatment.     

The medical record: a comprehensive computer system for the family physician

BACKGROUND: Despite the early excitement regarding the possible uses of computers in medical care in the 1980s, the computer has not had much effect on routine outpatient medicine except for billing and accounting. METHODS: An emerging comprehensive ambulatory care computer system, The Medical Record (TMR), is used extensively in a large family practice, the Duke Family Medicine Center. TMR is the central system for accounting, appointments, billing, and reporting of laboratory results, radiographic findings, and medications. TMR also records problem lists and generates prompts to the clinicians for needed health maintenance, laboratory tests, and reminder letters. The most innovative function of TMR is the computerized obstetric patient record, which can be accessed from multiple sites. Cost savings compared with a manual system were found to be in excess of $7 per patient visit or approximately $500,000 per year for the Duke Family Medicine Center. RESULTS AND CONCLUSIONS: A comprehensive computer system in a large family practice is cost effective and facilitates better patient care through improved access to patient data.     

Workers' compensation: Opening up a major market for psychological practice.

A review of licensure history and a summary of state freedom-of-choice legislation for health insurance underscore the limited attention paid to workers' compensation by the psychological profession. The scope, types, trends, and recent growth of workers' compensation insurance and the extant law are summarized. Recent California law and premium volume (i.e., gross total premiums) illustrate the major practice potential. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

破伤风疫苗免疫供血浆者抗-TT血浆效价观察与分析

目的 分析破伤风疫苗免疫对不同性别和年龄段供血浆者抗-TT效价变化,为提高抗-TT高效价血浆采集量提供参考依据.方法 对符合规定的志愿供血浆者按不同年龄段分组,以相同的疫苗剂量和免疫程序进行免疫.采用ELISA定量检测供血浆者抗-TT效价水平,将抗-TT、效价≥8IU/ml的供血浆者列为采集特免血浆对象.结果 不同年龄段供血浆者组别间相同剂量疫苗和免疫程序产生高效价抗-TT的比率比较差异明显;21～35岁组产生高效价的比率明显高于36～45岁组,46～55岁组产生高效价比例最低,而且年龄小的抗-TT高效价持续时间较年龄大的长.结论 采用40IU吸附破伤风疫苗,0、4、4周程序免疫,38%的供血浆者可获得高效价抗-TT原料血浆,各年龄段供血浆者的破伤风抗体水平均能够达到保护的浓度.     

Retesting of bone donors 2 months after donation guarantees sufficient safety of bone allografts

Both allogeneic bone grafting and blood transfusion may transmit infections from the donor to the recipient. The most effective means to reduce the risk of infection is careful donor selection and screening of donors for markers of infection. The risk of blood transfusion-transmitted HIV infection in Finland, calculated with the incidence/window period model, is approximately 1:3,300,000. The calculated risk for hepatitis B (HBV) and C (HCV) is 1:217,000 and 1:147,000 donations, respectively. In bone banking we can further reduce the risks by retesting the living donors. Retesting 2 months after donation seems to be sufficient, at least in countries with a low incidence of transplantation-transmitted infections.     

Gradient moment smoothing: a new flow compensation technique for multi-shot echo-planar imaging

This work identifies an additional source of phase error across ky in multi-shot echo-planar imaging resulting from flow or motion along the phase-encoding direction. A velocity-independent flow compensation technique, gradient moment smoothing, is presented that corrects this error by forcing the phase to have smooth quadratic behavior. The correction is implemented, without compromising scan time, by changing the first moment of a bipolar prephaser pulse on a shot-by-shot basis. In phantom and in vivo experiments, gradient moment smoothing effectively eliminates ghosting and signal loss due to phase-encoding flow. When used in conjunction with a "flyback" echo-planar readout, which compensates for flow in the frequency-encoding direction, gradient moment smoothing renders multi-shot echo-planar imaging relatively insensitive to in-plane flow. This can make multi-shot echo-planar imaging a viable technique for accurately imaging in-plane flow and may desensitize it to the otherwise serious problem of in-plane motion.     

Workers' compensation past, present, and future: a model for reform

The author describes the volatile and highly complex nature of workers' compensation programs and details the successful evolution of Kentucky's system.     

Improving vision: neural compensation for optical defocus

Anecdotal reports abound of vision improving in myopia after a period of time without refractive correction. We explored whether this effect is due to an increased tolerance of blur or whether it reflects a genuine improvement in vision. Our results clearly demonstrated a marked improvement in the ability to detect and recognize letters following prolonged exposure to optical defocus. We ensured that ophthalmic change did not occur, and thus the phenomenon must be due to a neural compensation for the defocus condition. A second set of experiments measured contrast sensitivity and found a decrease in sensitivity to mid-range (5-25 cycles deg-1) spatial frequencies following exposure to optical defocus. The results of the two experiments may be explained by the unmasking of low contrast, high spatial frequency information via a two-stage process: (1) the pattern of relative channel outputs is maintained during optical defocus by the depression of mid-range spatial frequency channels; (2) channel outputs are pooled prior to the production of the final percept. The second set of experiments also provided some evidence of inter-ocular transfer, indicating that the adaptation process is occurring at binocular sites in the cortex.     

Understanding donors' motivations: a study of unrelated bone marrow donors

Medical advances in bone marrow transplantation techniques and immunosuppressive medications have dramatically increased the number of such transplants performed each year, and consequently, the demand for bone marrow from unrelated donors. Although physiological aspects of bone marrow donation have been thoroughly investigated, very few studies have examined psychosocial factors that may impact individuals' donation decisions and outcomes. To examine one particular set of donor psychosocial issues, this study investigated motives for bone marrow donation among 343 unrelated bone marrow donors who donated through the National Marrow Donor Program. Six distinct types of donor motives were identified from open-ended questionnaire responses. Donors most frequently reported motives reflecting some awareness of both the costs (to themselves) and potential benefits (to themselves and the recipient) of donation. A desire to act in accordance with social or religious precepts, expected positive feelings about donating, empathy for the recipient, and the simple desire to help another person were also commonly cited reasons for donating. Among a series of donor background characteristics, donors' gender was the variable most strongly associated with motive type; women were most likely to cite expected positive feelings, empathy, and the desire to help someone. Central study findings indicated that donor motives predicted donors reactions to donation even after the effects of donor background characteristics (including gender) were controlled. Donors who reported exchange motives (weighing costs and benefits) and donors who reported simple (or idealized) helping motives experienced the donation as less positive in terms of higher predonation ambivalence and negative postdonation psychological reactions than did remaining donors. Donors who reported positive feeling and empathy motives had the most positive donation reactions in terms of lower ambivalence, and feeling like better persons postdonation. These finding add substantially to the body of work concerning medical volunteerism generally, and also have important practical implications for the recruitment and education of potential bone marrow donors.     

Evaluation of the home-based maternal record: a WHO collaborative study

Thirteen centres in eight countries (Egypt, India, Pakistan, Philippines, Senegal, Sri Lanka, Democratic Yemen and Zambia) participated in the WHO collaborative study to evaluate the home-based maternal record (HBMR). The evaluation showed that use of the HBMR had a favourable impact on utilization of health care services and continuity of the health care of women during their reproductive period. When adapted to local risk conditions, their cut-off points and the available resources, the HBMR succeeded in promoting self-care by mothers and their families and in enhancing the timely identification of at-risk cases that needed referral and special care. The introduction of the HBMR increased the diagnosis and referral of at-risk pregnant women and newborn infants, improved family planning and health education, led to an increase in tetanus toxoid immunization, and provided a means of collecting health information in the community. The HBMR was liked by mothers, community health workers and other health care personnel because, by using it, the mothers became more involved in looking after their own health and that of their babies. Apart from local adaptation of the HBMR, the training and involvement of health personnel (including those at the second and tertiary levels) from the start of the HBMR scheme influenced its success in promoting maternal and child health care. It also improved the collection of community-based data and the linking of referral networks.     

Perceived organizational support for safety and employee safety voice: The mediating role of coworker support for safety.

In the present study, we modeled 2 sources of safety support (perceived organizational support for safety and perceived coworker support for safety) as predictors of employee safety voice, that is, speaking out in an attempt to change unsafe working conditions. Drawing on social exchange and social impact theories, we hypothesized and tested a mediated model predicting employee safety voice using a cross-sectional survey of urban bus drivers (n = 213) in the United Kingdom. Hierarchical regression analysis showed that perceived coworker support for safety fully mediated the relationship between perceived organizational support for safety and employee safety voice. This study adds to the employee voice literature by evaluating the important role that coworkers can play in encouraging others to speak out about safety issues. Implications for research and practice related to change-oriented safety communication are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Considerations for sociotechnical design: experiences with an electronic patient record in a clinical context

This paper argues that we should understand the process of IT design as the development of sociotechnical configurations. Drawing upon our experiences with an electronic patient record (EPR) on an Intensive Care Unit (ICU), we depict medical work practices as natural systems. Several considerations for design are developed. First, the EPR should not be overly structured with rationalistic and prefixed notions of the organization and content of medical work. Implementing structure is crucial, however, this should be derived from detailed, empirical knowledge of the practice involved. Second, it is crucial to ensure that the usage of the system will yield immediate benefits for primary users: the systems should support work, not generate it. Third, designing IT should include being aware of the socio political nature of seemingly 'neutral' tools as EPRs.     

Quantitative bacteriological evaluation of a method for skin disinfection in blood donors

Skin disinfection at the site of venipuncture is a critical point in every blood transfusion collection procedure, as it contributes to ensure the bacterial safety of transfusion. Quantitative and qualitative analysis of bacteria present in the antecubital fossae before and after skin disinfection may be one method of assessing the anti-bacterial efficiency of disinfection. Swab culture systems and contact plates are the two techniques usually employed for this purpose. A washing and swabbing technique was used to quantify bacteria before and skin disinfection of the antecubital fossae in blood donors. This contra-placebo study was carried out on 32 donors, each of whom served as his own control, with a random choice of test arm and opposing control arm. Bacterial counts were determined in the antecubital fossae without skin disinfection (control, n = 32) and after a 3 step skin preparation procedure (cleaning, wiping, disinfection) using placebo (distilled water, n = 16) or an antiseptic product (mixture of chlorexidine, benzalkonium chloride and benzylic alcohol, n = 16). The absence of a statistical difference in bacterial counts between the right and left antecubital fossae without disinfection was controlled in a preliminary study of 20 subjects. Mean bacterial counts were 25,000/cm2 and 27,400/cm2 respectively for aerobic and anaerobic bacteria before disinfection, with a wide variation in results between individuals. When using placebo, preparation of the venipuncture site by the 3 step method (cleaning, wiping, disinfection) resulted in a non significant mean reduction of 0.56 log in aerobic and anaerobic bacteria. Using the antiseptic product, the same method resulted in a significant mean reduction of 1.8 and 1.7 log respectively in aerobic (p = 0.015) and anaerobic flora (p = 0.005). On an average, 2,750 aerobic bacteria/cm2 and 2,910 anaerobic bacteria/cm2 remained after disinfection, while qualitative analysis showed that disinfection suppressed the transitory flora in all cases but left part of the resident flora in 12/16 cases. These findings are comparable to those of other studies carried out to evaluate this kind of technique for the disinfection of operation sites. In comparison with other techniques classically employed for this type of evaluation (swab systems or contact plates), the method used in this study was the advantage of allowing the quantification of the reduction in bacteria. Hence this method could be employed for comparative assessment of skin disinfection techniques with the aim of improving their anti-bacterial efficiency and could also make possible the definition of a minimum bacterial count (resident flora) to be obtained in all cases after disinfection.