Hemophagocytosis causes a consumptive anemia of inflammation

Cytopenias of uncertain etiology are commonly observed in patients during severe inflammation. Hemophagocytosis, the histological appearance of blood-eating macrophages, is seen in the disorder hemophagocytic lymphohistiocytosis and other inflammatory contexts. Although it is hypothesized that these phenomena are linked, the mechanisms facilitating acute inflammation-associated cytopenias are unknown. We report that interferon γ (IFN-γ) is a critical driver of the acute anemia observed during diverse microbial infections in mice. Furthermore, systemic exposure to physiologically relevant levels of IFN-γ is sufficient to cause acute cytopenias and hemophagocytosis. Demonstrating the significance of hemophagocytosis, we found that IFN-γ acts directly on macrophages in vivo to alter endocytosis and provoke blood cell uptake, leading to severe anemia. These findings define a unique pathological process of broad clinical and immunological significance, which we term the consumptive anemia of inflammation.     

Prevalence of asymptomatic malaria parasitaemia

ObjectiveTo evaluate factors associated with prevalence of malaria parasitaemia at first antenatal care visit.MethodsThe study was conducted at the University of Calabar Teaching Hospital from 1st June, 2007 to 31st July, 2007. A structured questionnaire was administered to a total of 545 pregnant women that were recruited in this study after obtaining informed consent and two slides of thin and thick films were prepared for each participant.ResultsFive hundred and twenty (95.4%) out of the 545 participants suffered from malaria parasitaemia, the rest 4.6% of those who had no parasitaemia had experienced symptomatic malaria before and were treated in private hospitals prior to their recruitment into the study. All participants (100%) who did not have antimalarials had parasitaemia compared with 91.1% among those that had antimalarials. The proportion of moderate to severe parasitaemia was also significantly higher among the former. Besides, the difference in parasitaemia between primigravidae and multigravidae was statistically significant (P=0.000) too. Among the methods used for vector control, only insecticide treated nets (ITNS) was associated with significant reduction in the level of parasitaemia (RR =0.83).ConclusionMalaria parasitaemia at first booking is significantly higher in primigravidae and women who have no anti-malaria treatment. The use of safe and effective antimalarial treatment along with ITNs will significantly reduce the level of parasitaemia in pregnant women.     

Factors for Accessing a Medical Home Vary Among CSHCN from Different Levels of Socioeconomic Status

Purpose The purpose of this research study was to identify factors that are associated with receiving care in a medical home for children with special health care needs (CSHCN) and to identify how these factors vary among different socioeconomic levels. Methods Data were obtained from the National Survey of Children with Special Health Care Needs, 2000–2002. Access to a medical home was derived using an algorithm. This survey analysis also included demographic characteristics, geographical location of household, severity of condition, and social factors. Multiple logistic regression models were constructed for socioeconomic status (SES) levels defined by federal poverty level (FPL): <133%; 133–199%; 200–299%; ≥300%. Results Age group was significant in all but the 200–299% of FPL stratum. Severity of condition was significant in all strata. Race was significant in all but the ≥300% stratum. Maternal education was borderline significant in the lowest and highest strata. Insurance type/status was significant in all but the 133–199% of FPL stratum. Geographical location was significant in the lowest and highest strata. The language of the interview was only significant in the lowest stratum. The relationship of the respondent to the child was significant in the middle two strata. The total number of adults in the household was significant in the highest stratum, and the total number of children in the household was significant in the 200–299% of FPL stratum. Conclusions Factors affecting access to a medical home differed among socioeconomic groups. Future research should explore the CSHCN population by income groups to better serve this population.     

长期口服小剂量阿司匹林不能预防健康女性患2型糖尿病

慢性无临床症状的炎症与2型糖尿病的发生有关,流行病学资料认为这种关联在妇女表现得更为强烈。虽然小型临床研究显示短期口服大剂量阿司匹林具有明显的降糖效果,但是并没有随机试验直接评估临床可接受的剂量的阿司匹林预防糖尿病的效果。在美国一项随机、双盲、安慰剂-对照的女性健康研究（Women＇s Health Study）中,38716名45岁以上的且无临床糖尿病的健康女性随机口服小剂量的阿司匹林（n=19326）或安慰剂（n=19390）,     

The impact of psychosocial training on staff attitudes towards people living with dementia: A systematic review

Background

As the prevalence of dementia increases, the need for appropriately trained and skilled care teams also increases. Staff attitudes towards people living with dementia have a significant impact on caregiving behaviours and staff and resident outcomes. Training within care settings is a potential way of improving staff attitudes towards residents in their care.

Objectives

This review aimed to (i) assess the effectiveness of psychosocial training in improving care staff attitudes towards dementia; and (ii) examine the content and focus of training.

Method

The review was conducted following PRISMA guidance and the protocol was registered on PROSPERO prior to conducting the review. A comprehensive search of peer-reviewed literature was undertaken using CINAHL, Medline and PsycINFO from inception to March 2021. All papers were evaluated using a quality appraisal tool.

Results

Ten studies met inclusion criteria and were of variable quality. However, six studies found significant improvements in staff attitudes towards dementia following staff training. The studies varied in terms of training focus and included behavioural, communication and cognitive-based approaches.

Conclusions

Staff training could be an effective method of improving staff attitudes towards dementia in care settings. Further research adopting high-quality randomised controlled designs to further explore staff attitudes following psychosocial training would make a valuable contribution to the literature base.