The Use of Lysostaphin in in Vitro Assays of Phagocyte Function: Adherence to and Penetration into Granulocytes

The usefulness of lysostaphin for the removal of cell-adherent and extracellular bacteria in assays performed to measure the intracellular killing of Straphylococcus aureus by granulocytes was investigated. The results showed that the adherence of lysosiaphin to the granulocyte surface is effectuated by a temperature-independent process and that bound lysostaphin is still microbicidal. Lysosiaphin also penetrates into the granulocytes by a temperature dependent process and kills ingested S. aureus intracellularly. Therefore, despite reports to the contrary in the literature, lysosiaphin is not a reliable agent for the removal of only extracellular S. aureus and should no longer be used in assays to determine the rate of intracellular killing by granulocytes.     

Evaluation of linear registration algorithms for brain SPECT and the errors due to hypoperfusion lesions

The semiquantitative analysis of perfusion single-photon emission computed tomography (SPECT) images requires a reproducible, objective method. Automated spatial standardization (registration) of images is a prerequisite to this goal. A source of registration error is the presence of hypoperfusion defects, which was evaluated in this study with simulated lesions. The brain perfusion images measured by 99mTc-HMPAO SPECT from 21 patients with probable Alzheimer's disease and 35 control subjects were retrospectively analyzed. An automatic segmentation method was developed to remove external activity. Three registration methods, robust least squares, normalized mutual information (NMI), and count difference were implemented and the effects of simulated defects were compared. The tested registration methods required segmentation of the cerebrum from external activity, and the automatic and manual methods differed by a three-dimensional displacement of 1.4+/-1.1 mm. NMI registration proved to be least adversely effected by simulated defects with 3 mm average displacement caused by severe defects. The error in quantifying the patient-template parietal ratio due to misregistration was 2.0% for large defects (70% hypoperfusion) and 0.5% for smaller defects (85% hypoperfusion).     

New method of evaluating patient preference for different inhalation delivery systems.

In order to assess patients' preferences for different inhalation devices a questionnaire has been developed. The questionnaire consisted of items covering various aspects considered important for patients who regularly use inhalation devices. The questions were designed to be of a general character so any inhalation device could be evaluated. We evaluated the questionnaire in a multicenter, open crossover study comparing patients' opinions of MDI with and without spacer and of a dry powder inhaler, Turbuhaler. One hundred twenty-three patients with stable asthma confirmed by daily peak expiratory flow rate (PEF) measurements used for 2 weeks MDI only and MDI with spacer and for 2 weeks Turbuhaler. The order was randomized. The drugs were terbutaline inhaled via MDI and Turbuhaler and budesonide inhaled via MDI with spacer and turbuhaler. At the end of each evaluation period the patients answered a number of questions about their opinion by marking on a visual analogue scale. A factor analysis revealed that the different questions represent a few common factors important for evaluating opinion about inhalation devices. These factors are handling of the device, use, time to learn how to use the device properly, how confident the patients feel about the use of it, and taste/irritation. A standardized questionnaire of reduced size seems to be a suitable method for evaluating patient preference for different inhalation devices.     

Sympathomimetic Bronchodilators: Increased Selectivity with Lung-Specific Prodrugs

The development of selective bronchodilator -adrenoceptor agonists is reviewed with emphasis on a pharmacodynamic approach, which is directed to drugs with high specificity for the ₂-adrenoceptor, and on a pharmacokinetic approach in which known ₂-adrenoceptor agonists are converted to prodrugs with selectivity for the lung. The pharmacodynamic approach has produced drugs that display high specificity for the ₂-adrenoceptor but still suffer from side-effects including tremor and palpitations. This is due to the fact that the ₂-adrenoceptors present in skeletal muscle and blood vessel are indistinguishable from those in the airways. On the other hand, the prodrug pharmacokinetic approach offers a promising way to obtain selectively acting bronchodilators with significantly fewer side-effects.     

Public opinion on the ambulance service in a rural and an urban region

Two groups of parents to schoolchildren (7 y and 15 y) were formed. The aim was to study if there were any differences in attitudes and knowledge concerning ambulance services in rural and urban areas. The results showed that knowledge about the ambulance service is good. Further, that day to day activities were considered more important than security measures to be used in emergencies. Parents living in rural parts considered the ambulance "near" but not as "near" as the parents in urban districts.     

Assessing the future direction of sustainable development in public hospitals: Time-horizon,path and action

PurposeTo assess the future direction of sustainable development in public hospitals, focusing on their short- versus long-term time horizons, top-down versus bottom-up paths, and intra-organizational versus inter-organizational actions.Design/Methodology/approachThe selection of significant health care organizations was based on judgmental sampling. This study applied an inductive approach. The interviewees were identified according to their knowledge of the future direction of their organizations’ sustainable development.FindingsThe sustainable development of the studied public hospitals is aimed at the synchronization of actions with other hospitals in the public healthcare system. The public hospitals studied differ in their interconnected elements of time (short- versus long-time horizons), paths (top-down versus bottom-up) and specific actions (intra-organizational versus inter-organizational).Research limitations/implications Offers insights into how to assess the direction of sustainable development in public hospitals. We stress the importance of time, path and action in conjunction. Furthermore, this study provides a three-dimensional framework to assess the future direction of sustainable development in organizations as well as in industries. Both the former and latter characteristics are shaped by the elements of time, path and action.Managerial ImplicationsProvides a three-dimensional framework of criteria to assess the direction of sustainable development in organizations. The assessment criteria may be used by organizations to assess the direction of other organizations in their industry. Industry associations or authorities may look into the status and future direction of sustainable development in industries or sectors as a whole. The assessment criteria provide an opportunity and foundation to benchmark against others in the same industry and insights to face pandemic as Covid-19.Originality/ValueFirst study to consider a three-dimensional framework based on time, path and action to assess the future direction of sustainable development in an organization.