COVID-19 convalescent plasma: current status,lessons from the past and future perspectives

When the COVID-19 pandemic hit, blood transfusion services worldwide started collection of convalescent plasma as early as possible, as exemplified by the response in Norway. There were challenges related to donor selection, donor safety, testing for relevant antibodies and indications for and dosing of the convalescent plasma. As more knowledge became available, the product quality was more standardised. Multiple case reports, observational studies and some randomized studies were published during the pandemic, as well as laboratory studies reporting different approaches to antibody testing. The results were conflicting and the importance of convalescent plasma was disputed.Even though there has been strong international collaboration with involvement of many key organisations, we may better prepare for the next pandemic. An even stronger, more formalised collaboration between these organisations could provide more clear evidence of the importance of convalescent plasma, based on the principles of passive immunisation.     

Stakeholder collaboration in long-term care of older people in Lithuania

Demographic situation, changes in the role of women in society and growing demand for long-term care (LTC) of older people have challenged the ability to meet the growing LTC needs in most developed countries. In countries where responsibility for LTC is still largely laid on families, it is, however, even more critical and calls for improvements in formal LTC systems. More intensive stakeholder collaboration in LTC policy development, organising and delivery are of primary importance in improving LTC systems. Such collaboration, however, is not always successful; thus, it is critical to understand what makes it effective and efficient. In this paper, we specifically look into multistakeholder collaboration in LTC in Lithuania, one of the fastest ageing countries in the EU, with the demand for LTC services growing fast and exceeding the supply despite rising business and NGO engagement. To determine facilitators of such collaboration, we build on the data obtained through eight focus group discussions with all key stakeholder representatives (LTC policymakers, organisers and service providers [public, private and NGOs], 54 participants in total). Our findings indicate that in addition to national and organisational level facilitators studied in prior research, there are important individual level factors, such as meaningfulness at work, concern and care for others, possibility for personal growth and development, satisfaction with supervision, a sense of belonging and role clarity. On the other hand, our results show that collaboration is constrained by a shortage of human resources, increased workload caused by growing LTC demand, bureaucratic requirements, legal restrictions, lack of awareness of LTC service availability among elder persons, and prevailing social norms and attitudes to institutionalised care. Interestingly, a lack of financial resources is not perceived as a major constraint.     

Interventions to respond to COVID 19 pandemic in Mumbai and way forward

With the emergence of COVID 19 pandemic, the approach used by Municipal Corporation of Greater Mumbai (MCGM) was based on all guidelines of COVID 19 prepared by Ministry of Health and Family Welfare (MoHFW). However, Mumbai undertook a special innovate model used in the mission Mumbai – Dharavi for COVID 19. Additionally, MCGM undertook a proactive approach of “chasing the virus” with its 4Ts: 1. Tracing 2. Tracking 3. Testing 4. Treating in high-risk slum clusters and it reflects the result of declining the incidence and case fatality due to COVID 19. Establishing public health surge capacities which include active surveillance, contact-tracing and follow-up besides early detection, isolation and management of cases are important steps for fighting the COVID 19 pandemic. Collaborating with all partners and setting up a Task force for establishing clinical management protocols was unmissable.     

师承教育在医教协同创新中医人才培养中的作用

中医师承教育是当今社会中医传承的主要方式,其培养了大量的中医优秀人才,促进中医药文化和中医学术思想传播,是现代中医药发展不可缺少的组成部分。但近代以来,人们脑海中逐渐形成了以西方医学为体系的思维模式时,中医学教育该如何的发展与传承。针对这一现象,我们分析了现代院校教育与师承教育的特点,阐述师承教育在现代中医人才培养中的作用,以期探讨高等中医药院校教育改革的模式。     

Experiences and perceived roles of occupational therapists working with children with special learning needs during transition to school: A pilot study

Occupational therapists provide support to children with special learning needs and their families during the child's transition from early childhood to mainstream school. Little has been documented regarding the role and experiences of occupational therapists working with children, families and teachers during transition in an Australian context. Six paediatric occupational therapists from one geographical area in New South Wales were interviewed and asked to relay their role and experiences when providing a service to children with special learning needs during their transition to school. Participants described their role to include: preparing the child for school; working with school personnel; and providing parental support. Although participants described both positive and negative experiences, among the negative experiences were: limited time to provide a service; recommendations to school personnel not being followed; school personnel not being supportive; feeling uncomfortable in the classroom; and limited involvement in planning. Participants described a role which is consistent with current school-based occupational therapy practice; however, in the participants' experience, there was a gap between the ideal service and what participants were able to provide. This included limited collaboration with teachers.     

Health promotion and environmental management: a partnership for the future

Health Promotion as a professional practice is facing its thirdmajor challenge this century. To the infectious diseases ofthe past and the lifestyle risks of the present have been addedthe global environmental hazards of the future. Each wave of health risk has three things in common. The firstis that ill-health results from a change in the relationshipbetween the environment and society. The second is that theill-health so caused falls predominantly on already disadvantagedgroups in the community. Third in each case there is a tunelag of two or more decades between recognition of the freshrisks to health and effective professional response. The challengetoday is to shorten the lead time for responding to the thirdphase, the degradation of the global environment. This willgive a radical reorientation to the field of health promotion,which has traditionally safe guarded the health of people fromenvironmental change, not vice versa. The reorientation of health promotion is discussed in termsof the contributions which health promotion can make to environmentalmanagement. The options for managing environmental change areidentified as protection, prevention, resilience and adaptation.These strategies are already in use in the different branchesof health promotion.     

Coming of age: critical challenges to the future development of pediatric psychology

Described five professional challenges that will affect the future development of pediatric psychology: specialization and professional identity, relationships with other professions, securing resources necessary for effective functioning, the conflict between clinical service delivery and prevention, and development of training models. To meet these challenges, pediatric psychologists need to maintain strong connections with other psychologists, develop new models of collaborative training, practice, and research, emphasize prevention activities, and enhance the scientific basis of pediatric psychology through innovative training programs and support for faculty development.     

Promoting inter-agency collaborátion in child services

Summary Effective collaboration between agencies is often difficult to achieve. Children and their families/carers, who have complex therapeutic needs, present particular difficulties in that agencies need to work together, if they are to produce a co-ordinated and integrated package of care. A Multi-Agency-Consultation-Team (MACT) was set up in an attempt to overcome some of these problems of interagency co-operation. This paper describes the protocol, types of children referred and the recommendations made by the team. Follow-up of these children at 4 months suggests that a MACT does have a role to play in developing high quality services.     

Germinal center formation in mice lacking αβ T cells

T cells are essential for inducing clonal B cell expansion in germinal centers during T cell-dependent antibody responses. However, class-switched antibodies are readily detectable in TCRα-deficient mice that congenitally lack αβ T cells, including those such as IgG1 that are considered to be dependent on collaboration between B cells and αβ T cells. This observation suggests that a novel form of B:T collaboration may be evident in TCRα^?/? mice. We report that germinal centers develop spontaneously in mice lacking T cell receptor α genes (TCRα^?/?), despite the absence of αβ T cells. They are not seen in TCRβ^?/? mice kept in similar conditions. Both strains of mice have γδ T cells, but it is a subset of T cells expressing TCRβ and CD4 that is dominant in the germinal centers of TCRα^?/? mice. Exceptionally, germinal centers were associated with CD4⁺ γδ T cells. The expression of CD4 seems to be important, for few extrafollicular T cells have CD4 and CD4 is largely absent from TCRβ^?/? T cells. The CD4⁺ TCRβ cells may help B cells produce autoantibodies that have been identified in TCRα^?/? mice.