Romerostallings3284

BACKGROUND Patient participation in treatment and care is often encouraged and is desirable because of its proven positive impact on treatment, quality of care and patient safety. AIMS To develop an instrument to measure patient participation in health care and to investigate the measurement properties of the Patient Participation Questionnaire (PPQ). METHODS A literature review was conducted to develop a model of patient participation. The PPQ was constructed consisting of 17 items organized into four subscales. Psychometric evaluation of factor structure, convergent construct validity by hypothesis testing and analyses of internal consistency using Cronbach's alpha were performed on data from a hospitalised mixed group of patients with cardiac disease, pulmonary disease and cancer (N=378 patients). RESULTS Confirmatory factor analysis did not show a clear model fit, which is why an exploratory factor analysis was performed, suggesting a different four subscale structure consisting of a total of 16 items. The four subscales were labelled Shared decision power, Adapted and individualized knowledge, Collaboration and Human approach. There were strong ceiling effects on all items. Analysis of convergent construct validity showed a moderate correlation (0.59) between the PPQ and another instrument measuring patient participation. Internal consistency for the total PPQ score was high 0.89. CONCLUSION In a mixed group of patients with cardiac disease, pulmonary disease and cancer, the PPQ showed promising psychometric properties in terms of factor structure, convergent construct validity and internal consistency. The PPQ may be used to shed light on the experience of patient participation and guide quality improvements.Chronic stress is a crucial public issue that occurs when a person is repetitively stimulated by various stressors. Previous researches have reported that chronic stress induces spermatogenesis dysfunction in the reproductive system, but its molecular mechanisms remain unclear. The nectin protein family, including nectin-1 to nectin-4, is Ca(2+)-independent immunoglobulin-like cell adhesion molecules, that are widely expressed in the hippocampus, testicular tissue, epithelial cells and other sites. Nectin-3 contributes to the sperm development at the late stage, and the abnormal expression of nectin-3 impairs spermatogenesis. read more Some recent studies have demonstrated that stress induces a decrease in nectin-3 expression in the hippocampus via corticotropin-releasing hormone (CRH) to corticotropin-releasing hormone receptor 1 (CRHR1) pathway. Here, we tested whether chronic stress also caused a reduction in nectin-3 expression in the testis. We established a chronic social defeat stress paradigm, which provides naturalistic and complex chronic stress inmale C57BL/6 mice. After 25 days of chronic social defeat stress, the mice showed weight loss, thymic atrophy and some other typical symptoms of chronic stress (e.g.anxiety-like behavior and social avoidance behavior). We found gonad atrophy, testicular histological structure changes and semen quality reductions in the stressed mice. The stressed male mice significantly spent more time to impregnate the female mice than the control male mice. Moreover, nectin-3 protein levels in stressed mice were significantly decreased in the testes compared with those in control mice. In addition, we found that the CRHR1 expression level was increased in the testes of stressed mice. Therefore, we demonstrated a decreased level of nectin-3 expression and an increase in CRHR1 expression in the testis after exposure to chronic stress, which may provide a potential therapeutic target for the spermatogenesis dysfunction induced by chronic stress.Despite known use of antibody screening (AS), it has not been adopted uniformly across blood centers in India. Many centers in India are currently using a type and hold policy with subsequent antihuman globulin (AHG) crossmatch when blood units are requested. The main aim of this study was to assess the benefits of a type and screen (TS) policy in which blood grouping and AS are performed simultaneously during the first hospital visit. If the AS is negative, subsequent requests for blood units would require an immediate spin test (IST) crossmatch with release of blood units, followed by an AHG crossmatch. This prospective, observational study was conducted at a tertiary health care center between July 2014 and December 2018 and included only Indian patients. Blood grouping and AS were performed during the first hospital visit on a total of 22,888 patients; the majority of patients were from hemato-oncology and blood marrow transplant, hepatology and liver transplant, cardiothoracic vascular surgery, and medical intensive care units. Demographic parameters were evaluated for risk of alloimmunization, and a record of the same was maintained. Depending on the AS results, a further course of action was chosen. Clinically significant alloantibodies were detected in 145 patients, and autoantibodies were detected in 53 patients. Alloantibodies were mainly against Rh and Kell blood group antigens. A significantly higher proportion of patients in the AS+ group required blood transfusion when compared with the AS- group. In cases wherein the IST crossmatch was compatible but AHG crossmatch was not, follow-up did not demonstrate any clinical or laboratory evidence of hemolysis. AS is a safe, efficient, and beneficial tool for pretransfusion compatibility testing in both AS+ and AS- patients. With a TS policy, AHG crossmatch can be omitted in AS- patients without compromising safety.This article is an update of the review of the FORS system published in Immunohematology in 2017 (Hult AK, Olsson ML. The FORS awakens review of a blood group system reborn. Immunohematology 2017;3364-72). This update incorporates the most recently presented knowledge on this still enigmatic system and its genetic, enzymatic, and immunological aspects. Further insight into the genetic variation and allele frequencies of the GBGT1 locus has been reported, and screening studies regarding the prevalence of naturally occurring anti-FORS1 in human plasma have been performed and presented. More basic knowledge on the specificity of the gene product, the Forssman synthase, has been obtained in several detailed studies, and its relation to the homologous ABO gene has been investigated. Taken together, we summarize recently added information about the carbohydrate-based FORS blood group system (International Society of Blood Transfusion number 031).Specialist in Blood Banking (SBB) programs play an important role in preparing technologists to become leaders and contributors to the field of transfusion medicine through dedicated education and training. The SBB program at the National Institutes of Health (NIH) Clinical Center has graduated 55 students since 1994 with an overall pass rate of 96 percent for the American Society for Clinical Pathology (ASCP) SBB examination. Graduates hold positions in a variety of transfusion medicine-related fields, with hospitals, blood centers, and Immunohematology Reference Laboratories being the most common categories of employer. Projects completed as part of the program added to transfusion medicine knowledge as evidenced by publications and awards. Almost half of all projects completed led to publications (49%), and greater than 50 percent of submissions have been selected for the AABB Future Leaders Scholarship (previously known as AABB Fenwal Scholarship Award). The students have completed over 40 program value-added opportunities. This information was available for retrieval and review. In this review, we analyzed data for the last 25 years from the SBB program at the NIH Clinical Center on program statistics, student accomplishments (such as publications in peer-reviewed journals), program value-added opportunities (such as other publications and audits performed with our Quality Assurance office), and job procurement. The collected, reviewed, and organized data provided a useful internal self-assessment to review the history of our program and head into the future.This update of the Xg blood group system (Johnson NC. XG The forgotten blood group system. Immunohematology 2011;2768-71) notes the identification of a cis-regulatory element of both XG and CD99 expression, remarkably by two independent groups during 2018, and confirmed by another in 2019. A single nucleotide change at the XG locus (rs311103) abolishes GATA1 binding and suppresses both XG and CD99. The last blood group system to resist elucidation of its genetic basis was thereby resolved. Soon afterwards, it was discovered that the rare anti-Xga response, mainly seen in men, is produced by individuals primarily carrying a large deletion in the X chromosome that truncates XG and leads to the Xgnull phenotype.The presence of HLA antibodies in patient serum or plasma may make antibody identification difficult. These HLA antibodies may mask the presence of clinically significant red blood cell (RBC) alloantibodies. Because platelets strongly express HLA antigens, it is possible to remove HLA antibodies by adsorbing the patient's serum or plasma using a platelet pool. Large numbers of random platelets are pooled to ensure a wide variety of HLA types are present. Elimination of the reactivity after adsorption suggests the presence of HLA antibodies in the patient's serum or plasma. The adsorbed patient sample may then be used to evaluate RBC alloantibodies without HLA antibody interference.Humans have a uniquely sophisticated ability to see past superficial features and to understand the relational structure of the world around us. This ability often requires that we compare structures, finding commonalities and differences across visual depictions that are arranged in space, such as maps, graphs, or diagrams. Although such visual comparison of relational structures is ubiquitous in classrooms, textbooks, and news media, surprisingly little is known about how to facilitate this process. Here we suggest a new principle of spatial alignment, whereby visual comparison is substantially more efficient when visuals are placed perpendicular to their structural axes, such that the matching components of the visuals are in direct alignment. In four experiments, this direct alignment led to faster and more accurate comparison than other placements of the same patterns. We discuss the spatial alignment principle in connection to broader work on relational comparison and describe its implications for design and instruction. (PsycInfo Database Record (c) 2020 APA, all rights reserved).How bilinguals control their languages and switch between them may change across the life span. Furthermore, bilingual language control may depend on the demands imposed by the context. Across 2 experiments, we examined how Spanish-Basque children, teenagers, younger, and older adults switch between languages in voluntary and cued picture-naming tasks. In the voluntary task, bilinguals could freely choose a language while the cued task required them to use a prespecified language. In the cued task, youths and older adults showed larger language mixing costs than young adults, suggesting that using 2 languages in response to cues was more effortful. Cued switching costs, especially when the switching sequence was predictable, were also greater for youths and older adults. The voluntary switching task showed limited age effects. Older adults, but not youths, showed larger switching costs than younger adults. A voluntary mixing benefit was found in all ages, implying that voluntarily using 2 languages was less effortful than using one language across the life span.