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A survey about blood bank policies and procedures.

A questionnaire about blood bank policies and procedures was prepared and sent out to 170 hospitals across the nation, 50 per cent responded. There is wide variation in both technical and nontechnical policies and procedures. Serum is separated from the original tube within 8 hours by 68 per cent of the hospitals and in 32 per cent serum is never separated from the original tube. Auto-control is included by 66 per cent of hospitals in at least one phase of the antibody testing, 34 per cent do not include auto-control in any phase. Du testing of the recipient is done in 85 per cent of the hospitals and in 15 per cent Rho type is determined by the immediate spin reactions alone. Slide type is the only method used to determine ABO group of cells of the recipients in 10 per cent of the hospitals, 18 per cent use serum-cell suspension, 10 per cent use the applicator stick method and only 62 per cent use washed saline-cell suspension routinely. Compatiblity testing between a recipient and a donor vary from a one-tube major crossmatch to a three-tube major crossmatch and minor crossmatch.

ABO Blood-Group System

Bluetongue certification -- Australian policy.

Australian quarantine policies with respect to BT are based on regarding this disease as one of high risk and major potential economic importance to our ruminant population. There are deficiencies in our knowledge of world distribution, epidemiology and pathogenesis. There may be unknown vectors and unsuspected animal reservoir hosts. The international distribution of BT could be extending through the movements of insects or cattle. If introduced into Australia, the cattle and sheep populations would probably be at continuous risk as eradication would be difficult or impossible. Costs to the sheep industry at least could be high and productivity gravely affected. To reduce the probability of introduction, imports of ruminants and semen have, for the last 16 years, been restricted to a very small number of countries presumed free from BT. Future policies will almost certainly be based on these same considerations taking into account scientific advances in diagnosis and virus detection. The establishment of an off-shore high security quarantine station will facilitate imports of ruminants even from known BT-infected countries.

Animals

Sabbatical policies and their implementation at United States dental schools.

An ad hoc Committee on Sabbaticals created by the Council of Faculties of the AADS surveyed sabbatical policies and their implementation at dental schools in the United States. Data from a questionnaire completed by 56 of 60 members of the Council of Faculties reveal that a majority of U.S. dental schools have sabbatical policies but that dental educators are less likely to apply for or to be awarded sabbaticals than educators from other parts of the university, except perhaps the medical school. Information was also obtained on the regulations governing sabbaticals--interval between leaves, rates of remuneration, and rules defining how the leave may be spent. Finally, suggestions are made as to how this important benefit of academic life might be made more available to dental educators.

Education, Dental

The annual Pap test: a dubious policy success.

The annual Pap test became a recommended standard for American women without ever having been subjected to controlled trials to estimate its efficacy and effectiveness. After more than 30 years of routine use, the Pap test fails to meet most of the generally accepted criteria for a mass screening program. The policy persists, however, because the nation's ideology supports the maximum utilization of new technologies; and special interest groups have promoted the test as the major weapon in the "War on Cancer." With some exceptions, this is a questionable allocation of public and private health resources.

American Cancer Society

Comparison of two successive policies of cervical cerclage for the prevention of pre-term birth.

The percentage of women receiving cervical cerclage increased from 5% to 18% between two periods at Haguenau maternity hospital, according to a new policy for the prevention of pre-term birth. A parallel reduction of premature deliveries by about a half was observed in the relevant group of women. This suggests that cerclage might be employed on another basis than is currently the case, and that a randomized trial is urgently needed to define its indications more precisely.

Cervix Uteri

Maternal rubella at St. Thomas' Hospital: is there a need to change British vaccination policy?

During the 28 weeks starting April 3, 1978, 269 pregnant women were assessed serologically because of exposure to or development of rubella-like illnesses, this number being four times greater than that during either of the previous 2 years. Only 33 (12%) of these patients had previously been given rubella vaccine. Rubella was confirmed serologically in 17 patients; among patients attending antenatal clinics the overall risk of acquiring infection was about 1 in 155. The mean age of patients acquiring maternal rubella was 27.9 years, and all but 1 had left school before the rubella vaccination programme started. 55 (92%) of 60 household contacts were children, of whom 24 (40%) were of preschool age and 13 (21.7%) aged less than 2 years. The interval between contact and presentation for serological studies was often long and, because of this, 79 sera had to be tested for virus-specific IgM. No drastic change in rubella vaccination policy is required but there should be more emphasis on vaccination of women of childbearing age.

Adolescent

Effect of different operation policies on mortality from bleeding peptic ulcer.

The outcome in bleeding gastric and duodenal ulcer has been compared in two hospitals in Nottingham which take their patients randomly from a common source according to a fixed daily admission rota. Bleeding seemed equally severe in the two groups but 66 (32%) of 206 patients were operated upon at hospital A compared with 44 (46%) of 96 at hospital B (P=0.03), where operations also tended to be done earlier. Postoperative mortality-rates were virtually identical at the two hospitals, but at hospital B the overall death-rate from bleeding ulcer was higher, partly because of its higher operation-rate. The value of an aggressive surgical policy in bleeding peptic ulcer is questionable.

Adult

A manpower policy for primary health care.

A National Academy of Sciences study of policy options for the supply of primary health-care manpower has produced a comprehensive set of recommendations. The study finds an adequate overall supply of physicians, but a shortage of primary health-care practitioners. It recommends maintaining current enrollment levels in medical schools and training programs for nurse practitioners and physician assistants and increasing the proportion of primary-care residents. To enhance the availability of primary care, the report advocates reimbursement for all physicians within a state at the same payment level for the same primary-care service, a reduction in payment differentials between primary-care services and nonprimary-care services, and reimbursement for educational and preventive services and for new health-practitioner services. The report supports a team approach in primary-care training and recommends that all medical students obtain clinical experience in a primary-care setting and some instruction in epidemiology and behavioral and social sciences.

Education, Medical

Chlorfenapyr-pyrethroid nets for pyrethroid-resistant malaria vectors: efficacy, resistance risks, and policy implications.

The Global Technical Strategy for Malaria 2016-2030 aims to reduce malaria incidence and mortality by 90%, yet widespread pyrethroid resistance among major malaria vectors in sub-Saharan Africa threatens this goal. Thus, the World Health Organization recommends chlorfenapyr-pyrethroid combination nets as a priority intervention where pyrethroid resistance undermines vector control. This systematic review synthesizes evidence on the performance, emerging resistance risks, and policy implications of these next-generation insecticide-treated nets. A structured search of literature from 2010 to 2024 across PubMed, Embase, WHO IRIS, and Google Scholar identified 31 eligible studies from 113 records. Evidence shows that chlorfenapyr-pyrethroid nets consistently outperform pyrethroid-only nets against resistant Anopheles populations, demonstrating a 1.8-fold increase in mosquito mortality (95% CI: 1.5-2.1). Community trials report 40-60% reductions in malaria infection incidence and entomological inoculation rates following deployment. However, early signs of chlorfenapyr resistance have emerged in Anopheles gambiae populations in Central Africa (RR: 2.4, p&#x2009;=&#x2009;0.01), linked to CYP6P4 metabolic overexpression. A significant correlation was also observed between agricultural pesticide use and vector resistance patterns (r&#x2009;=&#x2009;0.62, p&#x2009;<&#x2009;0.05). Although chlorfenapyr-pyrethroid nets provide an important short-term tool for managing pyrethroid resistance, their long-term effectiveness depends on integrated resistance management. Rotational deployment with other insecticide classes, strengthened genetic and phenotypic surveillance, and a coordinated 'One Health' approach involving both public health and agriculture are essential to sustain gains and advance progress toward the 2030 malaria targets.

Pyrethrins

National policy and situated meaning: the case of Head Start and the handicapped.

Recent amendments to the Economic Opportunity Act required Head Start programs to increase the number of "handicapped" children to ten percent of those served. Using an interactionist perspective and participant observation data from 30 programs, this paper discusses the effect of the legislation on local programs, the process by which official rates of deviance are produced, and the manner in which mandates from the national level alter situated meaning. Implications for theory and policy are suggested.

Attitude of Health Personnel

Policy paper of the Committee on Ethics and Task Force on Migration and Mental Health: Migration and mental health of migrants, refugees, asylum seekers - Ethical dilemmas and concerns.

BACKGROUND: International migration is a complex phenomenon of global and historical relevance. It includes voluntary, forced, and workforce migration, shaped by diverse determinants. Push factors comprise war, persecution, and political instability, while pull factors include stability, economic opportunities, education, and favorable living conditions. Forced migration is frequently associated with displacement and a disproportionate burden of mental health disorders, which are urgent yet difficult to address due to structural, cultural, and legal barriers. METHODS: Evidence demonstrates that restricted health care access exacerbates psychiatric disorders, while treatment delays contribute to poorer outcomes. Barriers include administrative limitations, linguistic and cultural differences, stigma, and resource shortages. This policy paper was developed by the Committee on Ethics and the Task Force on Migration and Mental Health of the European Psychiatric Association (EPA). Relevant literature was reviewed and combined with the professional expertise of committee members. The draft was subsequently evaluated by the Publication Committee and the EPA Board, and revised accordingly. RESULTS: Ethical principles in refugee care are insufficiently implemented in many European countries. Core principles of medical ethics - beneficence, respect for autonomy, non-maleficence, and justice - as well as the obligation to advance psychiatric standards and apply psychiatric expertise for societal benefit, are inconsistently upheld. CONCLUSIONS: The primary duty of physicians is to promote health and well-being through competent, timely, and compassionate care. The EPA therefore advocates coordinated strategies to mitigate the mental health consequences of war, displacement, and trauma, and to secure equitable access to psychiatric services for migrants and refugees.

Humans