BK virus has tropism for human salivary gland cells in vitro: Implications for transmission

BACKGROUND: In this study, it was determined that BKV is shed in saliva and an in vitro model system was developed whereby BKV can productively infect both submandibular (HSG) and parotid (HSY) salivary gland cell lines. RESULTS: BKV was detected in oral fluids using quantitative real-time PCR (QRTPCR). BKV infection was determined using quantitative RT-PCR, immunofluorescence and immunoblotting assays. The infectivity of BKV was inhibited by pre-incubation of the virus with gangliosides that saturated the major capsid protein, VP1, halting receptor mediated BKV entry into salivary gland cells. Examination of infected cultures by transmission electron microscopy revealed 45-50 nm BK virions clearly visible within the cells. Subsequent to infection, encapsidated BK virus was detected in the supernatant. CONCLUSION: We thus demonstrated that BKV was detected in oral fluids and that BK infection and replication occur in vitro in salivary gland cells. These data collectively suggest the potential for BKV oral route of transmission and oral pathogenesis

Service Provision for Children and Young People with Acquired Brain Injury; Practice Recommendations: – International Paediatric Brain Injury Society (IPBIS).

Background: Providing appropriate rehabilitation services for Acquired Brain Injury (ABI) in childhood presents a number of challenges for caregivers, health and education professionals and the young person as they develop. Primary objective: To record the challenges and possible creative solutions generated by an international group of professionals to address the needs of children with ABI. Review of information: Recommendations were generated from children’s special interest group meetings of the International Brain Injury Association (Turin, Italy, 2001; Stockholm, Sweden, 2003; Melbourne, Australia, 2005; Lisbon, Portugal, 2008) and through meetings of the International Paediatric Brain Injury Society (IPBIS), formed in 2009. Delegates participating in the workshops were representative of nations from around the world and included The Netherlands, New Zealand, Australia, the UK, Finland, Germany, South Africa, the US, Canada, Sweden, Brazil and Italy. Outcomes: The information presented is based on a retrospective review of those meetings and the summaries of the topics considere

Using patients' experiences to identify priorities for quality improvement in breast cancer care: patient narratives, surveys or both?

Background: Patients’ experiences have become central to assessing the performance of healthcare systemsworldwide and are increasingly being used to inform quality improvement processes. This paper explores therelative value of surveys and detailed patient narratives in identifying priorities for improving breast cancer services as part of a quality improvement process.Methods: One dataset was collected using a narrative interview approach, (n = 13) and the other using a postalsurvey (n = 82). Datasets were analyzed separately and then compared to determine whether similar priorities forimproving patient experiences were identified.Results: There were both similarities and differences in the improvement priorities arising from each approach. Daysurgery was specifically identified as a priority in the narrative dataset but included in the survey recommendationsonly as part of a broader priority around improving inpatient experience. Both datasets identified appointmentsystems, patients spending enough time with staff, information about treatment and side effects and more information at the end of treatment as priorities. The specific priorities identified by the narrative interviews commonly related to ‘relational’ aspects of patient experience. Those identified by the survey typically related to more ‘functional’aspects and were not always sufficiently detailed to identify specific improvement actions.Conclusions: Our analysis suggests that whilst local survey data may act as a screening tool to identify potentialproblems within the breast cancer service, they do not always provide sufficient detail of what to do to improvethat service. These findings may have wider applicability in other services. We recommend using an initialpreliminary survey, with better use of survey open comments, followed by an in-depth qualitative analysis to help deliver improvements to relational and functional aspects of patient experience