Matrix design for human service organizations

The matrix design structures the organization according to specific work projects rather than along department lines. Its value to the human service organization has yet to be demonstrated though it has been successful in industry.     

Primary risk factors in patients with myocardial infarction.

A predicted probability of suffering myocardial infarction based on a multiple risk function involving serum cholesterol, systolic blood pressure, and tobacco consumption, was allocated retrospectively to 270 men who survived a primary myocardial infarction. The infarction patients were representative of all surviving, diagnosed cases of primary infarction in men in certain age groups in G?teborg, Sweden, during the years 1968-70. The patients were divided into three groups-low, moderate, and high risk. A large number of patients had suffered infarction despite relatively low risk, but the patients showed a tendency toward higher risk in comparison with the risk distribution in a representative population sample. In order to study whether other variables, not included in the risk function, could "explain" the infarction in patients with relatiely low risk, the different risk groups were compared. A high degree of mental stress, diabetes mellitus, and dyspnea on exertion, and possibly also raised triglycerides, contributed to "explain" the infarctions in the low-risk group. Low physical activity during leisure time was probably also of importance.     

The fair sex? Foul play among female rugby players

Rugby, a full contact sport, exposes participants to a high risk of injury. While several studies have explored injuries among male rugby players, few have investigated injuries among females. We conducted a cross-sectional study of United States of America (USA) female rugby players to assess the players' perception of foul play and the referee response to foul play and to evaluate the association between players' perception of foul play and injury. An anonymous, self-administered questionnaire reporting injury status, history of player perceived foul play and referee response was administered to 258 players recruited at a women's rugby tournament. The overall rate of injury was 4.4 injuries/100 matches, 0.2 injuries/100 practices and 1.4 injuries/100 total rugby exposures (matches and practices), with 107 (41.5%) players classified as injured. While 16.5% of players admitted to perpetrating foul play without an assessed penalty and 13.8% to being penalised for foul play, a smaller proportion reported being sent to the 'sin bin' (temporarily removed from play) or being ejected from a match (3.3% and 1.3% respectively). Of the 107 injured, 24.3% believed they had been injured as a result of foul play. Among all 258 players, self-perception of having been hurt due to unpenalised foul play was associated with study-defined injury (OR = 2.4, 95% CI = 1.0-5.9, p = 0.046). To make the sport safer, efforts should be made to minimise foul play. Suggested preventive methods include educating referees, coaches and players about the prevalence of foul play in women's rugby and the association between foul play and injury.     

Chemical pleurodesis in the management of iatrogenic chylothorax

Abstrct A case of chylothorax following ligation of persistent ductus arteriosus, successfully treated by drainage and chemical pleurodesis is reported.     

Excess release of ferriheme in G6PD-deficient erythrocytes: possible cause of hemolysis and resistance to malaria

Hemoglobin in glucose-6-phosphate dehydrogenase (G6PD)-deficient erythrocytes is abnormally vulnerable to oxidative denaturation, which may release ferriheme, a known cytolytic agent. We found 13.3 nmol of ferriheme in G6PD-deficient erythrocyte membranes (per gram of total erythrocyte hemoglobin) using a spectrophotometric assay, as compared to 9.8 in normal membranes (P less than .05). After incubation of erythrocytes with 250 mumol/L menadione, an oxidant drug, the values increased by 37.4 nmol in G6PD-deficient membranes and by 26 in normal membranes (P less than .005), indicating increased hemoglobin denaturation. To verify that hemoglobin denaturation in G6PD-deficient erythrocytes releases ferriheme in a form available to interact with other ligands, [14C]-chloroquine binding to intact erythrocytes was measured. With an initial concentration of 5 mumol/L chloroquine in a medium containing no menadione, an excess of 14.8 nmol of chloroquine was bound in G6PD-deficient erythrocytes (per gram of hemoglobin) as compared to normal erythrocytes (P less than .005). In the presence of 250 mumol/L menadione, chloroquine binding increased by 17.9 nmol in G6PD-deficient and by 7.2 in normal erythrocytes (P less than .005). These results indicate that ferriheme becomes available to interact with endogenous ligands and, thus, to mediate menadione-induced hemolysis in patients with G6PD deficiency. Furthermore, the increase in ferriheme may mediate the selective toxicity of menadione for Plasmodium falciparum parasites growing in G6PD-deficient erythrocytes. Ferriheme release in response to the intraerythrocytic oxidant stress introduced by malaria parasites also may account for the resistance to malaria afforded by G6PD deficiency. This is a US government work. There are no restrictions on its use.