Characteristics of employment and job satisfaction in nontraditional dental hygiene practice settings

Little is known concerning the employment characteristics of hygienists practicing in nontraditional settings. Respondents were identified through screening (n = 38,380) a listing of the entire population of hygienists licensed in the United States. The screening identified 1,301 hygienists practicing in nontraditional settings. These hygienists were mailed comprehensive questionnaires; completed questionnaires were returned by 84.3 percent of the hygienists. Data were collected describing hygienists' reasons for seeking employment in nontraditional settings, their sources of information concerning job opportunities in nontraditional settings, benefits, and job satisfaction. The main source of information concerning employment opportunities in nontraditional settings was "word of mouth." Hygienists were motivated to seek employment in nontraditional settings primarily by a desire for a more challenging position and personal satisfaction. The hygienists were overwhelmingly satisfied with all aspects of nontraditional employment except opportunities for advancement. Respondents were found to receive standard benefits similar to those of employees in other industries.     

Erythrocyte homeostasis: antibody-mediated recognition of the senescent state by macrophages.

We tested the hypothesis that the accumulation of bound autologous antibody on a "senescent epitope" identifies aged erythrocytes for phagocytic removal by macrophages. Erythrocytes were collected from mice maintained on a hypertransfusion protocol designed to yield cells of defined age. The mouse erythrocytes were assayed for the presence of bound antibody by measuring their susceptibility to ingestion by macrophages from mouse peritoneal exudates and by flow cytofluorometry. Both assays disclosed that only the oldest mouse erythrocytes bore detectable levels of antibody. Flow cytofluorometric analysis revealed that the frequency distribution of IgG isotypes bound to the cells reflected their levels in normal serum. Finally, treatment with trypsin abolished the ability of the macrophages to ingest erythrocytes aged in vivo. These findings support the hypothesis that antibody mediates the clearance of senescent mouse erythrocytes from the circulation and demonstrate that the presence of a trypsin-sensitive recognition structure on macrophages is an essential requirement in this homeostatic process.     

A new musculoskeletal assessment in a student population

A common finding in repetition activities (typing, running, swimming . . .), are overuse syndromes arising from a mechanical imbalance affecting overstressed soft tissues and joints. A more subtle corollary, occasioned by a sedentary life-style, is an imbalance between postural and phasic muscle groups leading to joint dysfunction. Postural and phasic muscles as defined by V Janda (New Zealand Manip Ther Assoc Tech Newsletter 2: 1-3, 1977) interplay in complex patterns which determine strength and coordination for normal function. Joint pathology, and central or peripheral nervous system impairment, all lead to compensatory changes in the muscle function, namely the tendency for postural muscles to become tight and for phasic muscles to weaken. Faulty posture through muscle imbalance compromises joint mechanics predisposing to dysfunction. Appropriate management of musculoskeletal disorders should recognize the role of imbalance between postural and phasic muscles in both the etiology and sequelae of the disorder. A musculoskeletal examination of 35 students was undertaken to develop assessment skills, devise a recording form, and refine a test sequence to assist data collection. The principal finding of tightness in postural muscles is consistent with the theory that these muscles undergo adaptive shortening. This survey provided the opportunity to examine the incidence of muscle imbalance in a young adult population and to prepare guidelines for future study. J Orthop Sports Phys Ther 1986;8(1):34-41.     

Oligozoospermia, asthenozoospermia, and sperm abnormalities in ex-addict to heroin, morphine, and hashish

A 40-year-old male had been addicted to heroin, morphine, hashish, and other narcotics for 12 years. At examination, 2 years after abstinence from drugs, his semen analysis revealed oligozoospermia, asthenozoospermia, and morphologically abnormal spermatozoa such as "round-headed" and "kinked"--sperm with neck abnormalities and immature forms. There was no evidence of other morphological abnormalities or of the presence of morphologically normal sperm. A possible correlation is discussed between the long-lasting drug addiction and morphological sperm abnormality, endocrinological function, karyotype, and immunological status.     

Sexual Contact as Risk Factor for Campylobacter Infection,Denmark

Campylobacteriosis is a disease of worldwide importance, but aspects of its transmission dynamics, particularly risk factors, are still poorly understood. We used data from a matched case-control study of 4,269 men who have sex with men (MSM) and 26,215 controls, combined with national surveillance data on Campylobacter spp., Salmonella spp., and Shigella spp., to calculate matched odds ratios (mORs) for infection among MSM and controls. MSM had higher odds of Campylobacter (mOR 14, 95% CI 10–21) and Shigella (mOR 74, 95% CI 27–203) infections, but not Salmonella (mOR 0.2, 95% CI 0–13), and were less likely than controls to have acquired Campylobacter infection abroad (χ² = 21; p<0.001). Our results confirm that sexual contact is a risk factor for campylobacteriosis and also suggest explanations for unique features of Campylobacter epidemiology. These findings provide a baseline for updating infection risk guidelines to the general population.     

Bioethics for clinicians: 25. Teaching bioethics in the clinical setting

BIOETHICS IS NOW TAUGHT IN EVERY CANADIAN MEDICAL SCHOOL. Canada needs a cadre of teachers who can help clinicians learn bioethics. Our purpose is to encourage clinician teachers to accept this important responsibility and to provide practical advice about teaching bioethics to clinicians as an integral part of good clinical medicine. We use 5 questions to focus the discussion: Why should I teach? What should I teach? How should I teach? How should I evaluate? How should I learn?     

Einfach und praktisch: Anlage venöser Portsysteme in Rettungsdienst und Notaufnahme

Notfall + Rettungsmedizin -     

Letermovir in lung transplant recipients with cytomegalovirus infection: A retrospective observational study

Letermovir is a new antiviral drug approved for the prophylaxis of CMV infection in allogeneic stem cell transplants. The aim of the study was to assess the therapeutic efficacy of letermovir in difficult to treat CMV infections in lung transplant recipients. All lung transplant recipients between March 2018 and August 2020, who have been treated with letermovir for ganciclovir-resistant or refractory CMV infection were included in the study and analysed retrospectively. In total, 28 patients were identified. CMV disease was present in 15 patients (53.6%). In 23 patients (82.1%), rapid response was noticed, and CMV-viral load could be significantly decreased (>1 log₁₀) after a median of 17 [14–27] days and cleared subsequently in all of these patients. Five patients (17.9%) were classified as non-responder. Thereof, development of a mutation of the CMV UL56 terminase (UL-56-Gen: C325Y) conferring letermovir resistance could be observed in three patients (60%). Common side effects were mild and mostly of gastrointestinal nature. Mild adjustments of the immunosuppressive drugs were mandatory upon treatment initiation with letermovir. In addition to other interventions, letermovir was effective in difficult to treat CMV infections in lung transplant recipients. However, in patients with treatment failure mutation conferring letermovir, resistance should be taken into account.     

Differences in patient perceptions of integrated care among black,hispanic, and white Medicare beneficiaries

ObjectiveThis study sought to identify potential disparities among racial/ethnic groups in patient perceptions of integrated care (PPIC) and to explore how methodological differences may influence measured disparities.Data SourceData from Medicare beneficiaries who completed the 2015 Medicare Current Beneficiary Survey (MCBS) and were enrolled in Part A benefits for an entire year.Study DesignWe used 4‐point measures of eight dimensions of PPIC and assessed differences in dimensions among racial/ethnic groups. To estimate differences, we applied a “rank and replace” method using multiple regression models in three steps, balancing differences in health status among racial groups and adjusting for differences in socioeconomic status. We reran all analyses with additional SES controls and using standard multiple variable regression.Data Collection/Extraction MethodsNot applicable.Principal FindingsWe found several significant differences in perceived integrated care between Black versus White (three of eight measures) and Hispanic versus White (one of eight) Medicare beneficiaries. On average, Black beneficiaries perceived more integrated support for self‐care than did White beneficiaries (mean difference = 0.14, SE = 0.06, P =.02). Black beneficiaries perceived more integrated specialists’ knowledge of past medical history than did White beneficiaries (mean difference = 0.12, SE = 0.06, P =.01). Black and Hispanic beneficiaries also each reported, on average, 0.18 more integrated medication and home health management than did White beneficiaries (P <.01 and P <.01). These findings were robust to sensitivity analyses and model specifications.ConclusionsThere exist some aspects of care for which Black and Hispanic beneficiaries may perceive greater integrated care than non‐Hispanic White beneficiaries. Further studies should test theories explaining why racial/ethnic groups perceive differences in integrated care.