Autostimulation of growth by human myelogenous leukemia cells (HL-60)

We have studied the effects of medium conditioned by the human progranulocytic leukemia cell line, HL-60, on the subsequent growth of new inocula of HL-60 cells. When HL-60 cells were cultured at high cell density, optimal growth rate occurred in liquid suspension and confluent colony growth was observed in viscous medium without the addition of conditioned medium. However, when cells were cultured at lower cell density, growth rate was reduced and colony growth was nil unless conditioned medium from HL-60 culture was added. All HL-60 populations studied, including the earliest available passage, 9, both elaborated and responded to HL-60 CM. HL-60 CM did not stimulate normal human or mouse granulocyte-monocyte colony-forming cell (CFU-GM) growth. Conditioned media from other human cell lines varied in the ability to stimulate HL-60 cell and CFU-GM proliferation. Some, such as GCT CM, stimulated both HL-60 cells and normal CFU-GM, whereas others, like HL-60 CM, stimulated only HL-60 growth. The majority of cell line CMs tested did not stimulate either HL-60 or CFU-GM. Chromatography of HL-60 CM on Ultrogel AcA54 showed a single peak of HL-60 stimulating activity of apparent molecular weight 13,000. The ability of HL-60 cells to elaborate this activity provides a possible explanation for their proliferation at higher cell densities. Autostimulation may prove to be important in the high growth potential of other cell populations that undergo unrepressed proliferation.     

Nurses' Perceptions of Pediatric Nursing Functions

The purpose of this study was to describe nurses' perceptions of the importance of pediatric nursing functions and to determine if there were differences in perceptions of nurses in managerial clinical and teaching positions Subjects were 125 pediatric nurses in managerial clinical and teaching positions Respondents were asked to rate the importance of 43 nursing functions on a 9-point scale ranging from highly important to not at all important Mean ratings of pediatric nursing functions were determined and one-way analyses of variance performed. The five nursing functions perceived to be most important were, in order of ranking (a) providing emotional support of children (b) recognizing significant physical deviations, (c) implementing nursing interventions (d) preparing children psychologically for procedures and surgery and (e) identifying nursing problems Significant differences were found between groups in perceptions of the importance of 23 nursing functions mainly in the areas of psychosocial care teaching and nursing process Most differences were between the teaching and managerial groups or between teaching and the managerial and clinical groups combined Differences in perceptions of the importance of a number of nursing functions though not great suggest a need for more dialogue between managers teachers and clinicians.     

An analytical approach to identifying potential use-related issues concerning a medical device under development

Identifying potential use-related issues at the onset of the design process of a medical device can reduce use errors, enhance safety and improve usability of the product. Regulatory bodies such as the US Food and Drug Administration (FDA) suggest manufacturers should investigate use-related problems that have occurred in the past with devices that are similar to the one under development. Publically available device incident databases, such as the FDA’s Manufacturer and User Facility Device Experience (MAUDE) database, are a good source of information. However, haphazard searches of these databases can be confounding and unproductive. This paper presents a systematic approach to conducting the database searches, analysing the data and reporting the findings in a meaningful way. The approach outlined in this paper is an extract of the methodology that has been effectively implemented in a number of medical products that are already on the market, in submission or under development.     

Health risk perception and shale development in the UK and US

In this paper, we examine discourse in public deliberations in pre-development locales in the UK and US about advantages and disadvantages of future shale development (‘fracking’). We aimed to understand how people anticipate potential health effects, broadly construed, of environmental toxicity and disturbance in the context of planned, but not yet implemented, energy development. In day-long deliberations with small, diverse groups in two cities in each country (London, Cardiff in the UK; Los Angeles, Santa Barbara in the US), participants discussed impacts on health and well-being using three main rubrics: ‘It’s money or health’, ‘Why take chances?’ and ‘Beyond the tipping point’. Throughout, participants framed health as an intrinsically moral issue, with collective responsibility as a dominant normative frame. We identify the concept of compound risk to underscore effects of multiple risks and hazards on people’s sensibilities about anticipated future health and environmental harm. The findings demonstrate how and why diverse publics in pre-impact sites in both countries saw shale extraction as high stakes development that poses significant, often unacceptable, risks to human and environmental health and well-being. Risks extended beyond toxicity to broad threats to health, including, for some, the end of life as we know it on the planet. Overall, participants’ discussions of health were more connected to social categories and their underlying moral principles than to technological details. This work contributes evidence of blurred boundaries between environment and health as well as the importance people place on social risks in the context of proposed energy system change.     

Simulation and its role in medical education

Medical education is increasingly laying emphasis on a curriculum based on cognitive, psychomotor, and affective domains of learning which were originally proposed nearly 50 years ago. These reforms are framed around best standards of care, error management and patient safety, patient autonomy, and resource allocation. There is a worldwide shift in the method of medical education towards experiential (‘hands-on’) medical learning; however, applying this concept to real patients is less acceptable to society and is subject to legal and ethical issues.