Developing a strategy for red cell antigen typing and matching of blood for chronic transfusion

Red cell allo and autoantibodies have the potential to cause haemolytic transfusion reactions and can also create challenges with subsequent compatibility testing, sourcing compatible blood, delays in the provision of blood and cost implications. A retrospective review of chronically transfused patients revealed considerably higher costs associated with provision of blood for patients with red cell allo/autoantibodies than for non-immunised patients. The risk of development of red cell allo/autoantibodies could be reduced by implementing red cell phenotyping prior to transfusion and matching donor blood for, at least, Rh (CcEe) and K as well as the standard ABO and RhD match. A novel method was validated for performing high throughput extended red cell antigen serological phenotyping on an automated platform which would support a type and match strategy. Red cell genotyping prior to transfusion or following the development of a red cell antibody could also support a strategy for type and match in chronically transfused patients. A platform for this technique was evaluated and the results compared well to the serological assay. A large scale randomised controlled trial to investigate the benefit and cost effectiveness of a type and match strategy has not been attempted in the United Kingdom, therefore a pilot study was performed in which patients were randomly assigned to a standard care or intervention (type and match) group. The pilot study demonstrated the feasibility of a larger scale trial and also informed on the potential to implement a type and match strategy using hospital transfusion service routine blood stocks

Using transcranial magnetic stimulation to map the cortical representation of lower-limb muscles

Objective To evaluate the extent to which transcranial magnetic stimulation (TMS) can identify discrete cortical representation of lower-limb muscles in healthy individuals.MethodsMotor evoked potentials were recorded from resting vastus medialis, rectus femoris, vastus lateralis, medial and lateral hamstring, and medial and lateral gastrocnemius muscles on the right leg of 16 young healthy adults using bipolar surface electrodes. TMS was delivered through a 110-mm double-cone coil at 63 sites over the left hemisphere. Location and size of cortical representation and number of discrete peaks were quantified.ResultsWithin the quadriceps group there was a main effect of muscle on anterior-posterior centre of gravity (p = 0.010), but the magnitude of the difference was small. There was also a main effect of muscle on medial-lateral hotspot (p = 0.027) and map volume (p = 0.047), but no post-hoc tests were significant. The topography of each lower-limb muscle was complex and variable across individuals.ConclusionsTMS delivered with a 110-mm double-cone coil could not reliably identify discrete cortical representations of resting lower-limb muscles when responses were measured using bipolar surface electromyography

New tricks for old dogs? Is there a role for librarians in knowledge management?

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Exploring single trial appetitive conditioning and the modulation of attention

Pavlovian conditioning processes may be central to hedonic overeating. The following experiments were conducted to explore how learning shapes motivational and attentional processes that might enhance reactivity to food-related cues. A primary aim was to explore the efficacy of a novel, naturalistic appetitive conditioning procedure, first described by Blechert et al. (2016), for producing rapid conditioned responses in as little as a single conditioning trial. This novel paradigm was designed to mimic a real-life experience with a new food, from the initial sight, smell and touch, to consumption. Subjective measures of craving, expectancies and liking tapped in to explicit motivational processes, and an Emotional Blink of Attention (EBA) task, originally reported by Piech, Pastorino & Zald (2010), was used to explore implicit attentional processes. The degree of incentive salience acquired by newly learned cues was measured as the extent to which they captured attention in a rapid serial visual presentation task (RSVP), preventing accurate target detection in a phenomenon known as an attentional blink. Experiments 1 and 2 (Chapter 3) failed to show evidence for appetitive conditioning on explicit measures, which I suggest can be attributed to the relatively low reward value of the food item chosen for conditioning (marzipan). Findings presented in Chapters 4 – 7 found more convincing evidence that appetitive conditioning shapes motivational processing of newly learned food cues; after a single pairing, an edible object made from a highly rewarding foodstuff (chocolate) elicited cravings, expectancies for chocolate and was perceived as more highly pleasant than a visually similar plastic object. Experiment 4 (Chapter 5) demonstrated that additional trials did not enhance conditioning, supporting the view that single trial learning with hedonic food rewards is a powerful phenomenon. Furthermore, Chapter 6 demonstrated how this learning spreads to cues varying in their similarity to the original conditioned stimulus via generalisation. A consistent finding throughout Chapters 3-6 was that attentional processing was modulated by this naturalistic conditioning procedure, although not as originally predicted. After just one conditioning trial, both reinforced and non-reinforced cues captured attention more readily than neutral cues, suggesting salience acquisition independent of reward. Whilst Chapter 4 confirmed that reward-paired cues acquire greater salience than novel or familiar cues after a single exposure, it seems that the novelty has a synergistic influence over this process. I suggest that contextual novelty, in the form of the unusual conditioning procedure, promotes further learning and exploration of newly encountered stimuli, thus maximizing the possibility of acquiring reward. Chapter 7 presents a final experiment, which explored the neural correlates of appetitive conditioning in a single trial. Again, conditioning was evident based on subjective evaluations. Tentative evidence suggested a potential role for the right superior frontal gyrus in enhancing inhibitory control in response to passive viewing of cues signalling no reward. Brain activity in areas related to salience attribution was greater for a reward-paired cue presented briefly in an EBA paradigm. Although, evidence for reward-driven attentional capture was absent at a behavioural level. Overall, this thesis supports the utility of a novel naturalistic conditioning paradigm for studying appetitive conditioning processes in a single trial. Just one experience with a novel edible object transformed it into a highly desirable, craved cue. Potential applications of these findings for informing treatment and interventions for obesity and eating disorders, as well as methodological considerations and limitations are discussed in chapter 8

Has climate change taken prominence over biodiversity conservation?

The growing prominence of climate change has led to concerns that other important environmental issues, such as biodiversity loss, are being overshadowed. We investigate this assertion by examining trends in biodiversity and climate change coverage within the scientific and newspaper press, as well as the relative distribution of funding through the World Bank and the National Science Foundation, since the late 1980s. Our indicators substantiate some of these fears. To prevent biodiversity from becoming a declining priority, conservationists need to analyze the discourse surrounding climate change and determine how it has become the predominant environmental topic. In addition, given the common drivers of biodiversity loss and climate change, we argue that win–win solutions must be sought wherever possible. Conservationists need to be proactive and take this opportunity to use the mounting interest in climate change as a flagship to leverage more support and action to prevent further biodiversity loss

Visiting and Office Home Care Workers’ Occupational Health: An Analysis of Workplace Flexibility and Worker Insecurity Measures Associated with Emotional and Physical Health

The home health care sector in Canada experienced major restructuring in the mid-1990s creating a variety of flexibilities for organizations and insecurities for workers. This paper examines the emotional and physical health consequences of employer flexibilities and worker insecurities on home health care workers. For emotional health the focus is on stress and for physical health the focus is on selfreported musculoskeletal disorders. Data come from our survey of home health care workers in a mid-sized city in Ontario, Canada. Data are analyzed separately for 990 visiting and 300 office workers. For visiting workers, results showed that none of the ‘objective’ flexibility/insecurity measures are associated with stress or musculoskeletal disorders controlling for other factors. However, ‘subjective’ flexibility/insecurity factors, i.e. feelings of job insecurity and labour market insecurity, are significantly and positively associated with stress. When stress is included in the analysis, for visiting workers stress mediates the effects of ‘subjective’ flexibility/insecurity with musculoskeletal disorders. For office workers, none of the objective flexibility/insecurity factors are associated with stress but subjective flexibility/insecurity factor of feelings of job insecurity is positively and significantly associated with stress. For office home care workers, work on call is negatively and significantly associated with musculoskeletal disorders. Feeling job insecurity is mediated through stress in affecting musculoskeletal disorders. Feeling labour market insecurity is significantly and positively associated with musculoskeletal disorders for office home care workers. Decision-makers in home care field are recommended to pay attention to insecurities felt by workers to reduce occupational health problems of stress and musculoskeletal disorders.home health care workers, stress, worker insecurity

Coordination of Foliar and Wood Anatomical Traits Contributes to Tropical Tree Distributions and Productivity along the Malay-Thai Peninsula

Drought is a critical factor in plant species distributions. Much research points to its relevance even in moist tropical regions. Recent studies have begun to elucidate mechanisms underlying the distributions of tropical tree species with respect to drought; however, how such desiccation tolerance mechanisms correspond with the coordination of hydraulic and photosynthetic traits in determining species distributions with respect to rainfall seasonality deserves attention. In the present study, we used a common garden approach to quantify inherent differences in wood anatomical and foliar physiological traits in 21 tropical tree species with either widespread (occupying both seasonal and aseasonal climates) or southern (restricted to aseasonal forests) distributions with respect to rainfall seasonality. Use of congeneric species pairs and phylogenetically independent contrast analyses allowed examination of this question in a phylogenetic framework. Widespread species opted for wood traits that provide biomechanical support and prevent xylem cavitation and showed associated reductions in canopy productivity and consequently growth rates compared with southern species. These data support the hypothesis that species having broader distributions with respect to climatic variability will be characterized by traits conducive to abiotic stress tolerance. This study highlights the importance of the well-established performance vs. stress tolerance trade-off as a contributor to species distributions at larger scales

Derivation of Economic and Social Indicators for a Spatial Decision Support System to Evaluate the Impacts of Urban Development on Water Bodies in New Zealand

There is mounting evidence that urban development in New Zealand has contributed to poor water quality and ecological degradation of coastal and fresh water receiving waters. As a consequence, local governments have identified the need for improved methods to guide decision making to achieve improved outcomes for those receiving waters. This paper reports progress on a research programme to develop a catchmentscale spatial decision-support system (SDSS) that will aid evaluation of the impacts of urban development on attributes such as water and sediment quality; ecosystem health; and economic, social and cultural values. The SDSS aims to express indicators of impacts on these values within a sustainability indexing system in order to allow local governments to consider them holistically over planning timeframes of several decades. The SDSS will use a combination of deterministic and probabilistic methods to, firstly, estimate changes to environmental stressors such as contaminant loads from different land use and stormwater management scenarios and, secondly, use these results and information from a range of other sources to generate indicator values. This paper describes the project’s approach to the derivation of indicators of economic and social well being associated with the effects of urban storm water run-off on freshwater and estuarine receiving waters.Environmental Economics and Policy,

Survey Results of the New Health Care Worker Study: Implications of Changing Employment Patterns

This report examines the effects of contemporary employment arrangements on the quality of nursing work life, and the implications of these employment arrangements for individual nurses, the hospitals, and also for the organization. First we look at nurse work status (full-time, part-time or casual job), contract status (permanent or temporary), and employment preference as factors affecting commitment to the hospital and profession, job satisfaction, retention in the organization, and absenteeism from work. Second, we examine stress, burnout, and physical occupational health problems (in particular, musculoskeletal disorders), as affecting nurse and hospital outcomes. This project investigated how the quality of nursing worklife and career choices differ for nurses in full-time, part-time and casual employment, and whether nurses who have the employment arrangements they prefer enjoy a standard of worklife that encourages retention. We collected data for the study from 1,396 nurses employed at three large teaching hospitals in Southern Ontario (Hamilton Health Sciences, Kingston General Hospital, and St. Michael's Hospital in Toronto) using the New Health Care Worker Questionnaire. Results indicate that although a substantial majority of the nurses were employed in the type of job that they preferred, problems of stress, burnout and physical health problems were reported. Further, these problems affected the nurses' job satisfaction, commitment, and propensity to leave the hospitals.health care workers, employment status, nurses, job satisfaction, commitment, stress, burnout, physical health problems, MSD, propensity to leave

Association between genotypic diversity and biofilm production in group B Streptococcus

Background: Group B Streptococcus (GBS) is a leading cause of sepsis and meningitis and an important factor in premature and stillbirths. Biofilm production has been suggested to be important for GBS pathogenesis alongside many other elements, including phylogenetic lineage and virulence factors, such as pili and capsule type. A complete understanding of the confluence of these components, however, is lacking. To identify associations between biofilm phenotype, pilus profile and lineage, 293 strains from asymptomatic carriers, invasive disease cases, and bovine mastitis cases, were assessed for biofilm production using an in vitro assay. Results: Multilocus sequence type (ST) profile, pilus island profile, and isolate source were associated with biofilm production. Strains from invasive disease cases and/or belonging to the ST-17 and ST-19 lineages were significantly more likely to form weak biofilms, whereas strains producing strong biofilms were recovered more frequently from individuals with asymptomatic colonization. Conclusions: These data suggest that biofilm production is a lineage-specific trait in GBS and may promote colonization of strains representing lineages other than STs 17 and 19. The findings herein also demonstrate that biofilms must be considered in the treatment of pregnant women, particularly for women with heavy GBS colonization