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PubMed1990

Detection of ZC rosette-forming lymphocytes in the healthy aged with Taichiquan (88 style) exercise.

Taking the percentage of zymosan-complement complex rosette forming cells (ZC-RFC%) and the number of zymosan-complement Complex rosette forming cells (ZC-RFC) in the peripheral blood as indices of humoral immunity, bone marrow derived lymphocytes were detected by modified Sondra B cell assay in 24 healthy aged taking part in Taichiquan (88 style) exercise and 24 age-matched normal subjects without any physical training. At rest, the ZC-RFC% of the exercise group was lower than that of the controls; immediately following a set of Taichiquan exercise, the increments of ZC-RFC% and ZC-RFC were highly significant. These findings give evidence of humoral immunity which supports the viewpoint that Taichiquan exercise can induce enhancement of cellular immunity in the aged.

Aged↗
PubMedDate not supplied

Parents' assistance to children having immunizations.

The purpose of this descriptive study was to determine parents' naturally occurring assistive actions when their child received immunizations. Additional purposes included describing the preparation the parent provided to the child prior to the immunization and parents' plans for assistance following the immunization. The convenience sample included 41 parents (or grandparents) of 40 children between the ages of 18 months and 6 years who were receiving routine immunizations at two urban and five rural clinics in the Midwest. Parents were interviewed regarding plans to assist their child before and after immunization; actual parent-child interactions during immunizations were audiotaped. Data were analyzed descriptively; researchers worked in pairs to achieve 100% inter-rater agreement when coding observations into themes. The parents reported using nine psychological preparation strategies (i.e., procedural information, sensory information, relaxation training, telling the child why the procedure was necessary, and role play) to assist their children in the preparatory phase. Three strategies were used both during (procedural information, distraction, and physical contact) and after (physical contact, praise, and rewards) the immunization. Ten children received no preparation for the immunization; nine of these were younger than 3 years of age. The single most reported source of information to parents about helping their child with immunizations was their physician.

Adaptation, Psychological↗
PubMed1997

Control of infection: a survey of general medical practices.

BACKGROUND: The aims of the study were (1) to assess current infection control practice within general medical practices and establish a base line; (2) to identify potential infection control problems; (3) to assess the need for local infection control guidelines or standards related to general medical practice; (4) to assess the need for educational provision. METHODS: A survey was carried out, using questionnaire and structured interviews, of all general practices (92) within a Health Board area with a patient population of 561,300. RESULTS: Forty two (46 per cent) practices participated, serving 67 per cent of the patient population. Only three (7 per cent) practices had written infection control policies and only six (14 per cent) provided training on the subject. Thirty (71 per cent) practices had autoclaves; however, performance monitoring was poor. The majority of high-risk instruments were adequately decontaminated; of the medium-risk instruments, the auriscope speculum was the item most frequently inadequately treated [36 practices (88 per cent)]. Deficiencies were identified in treatment of blood spillage, and protective clothing provision was variable. The majority, 40 (95 per cent) practices, had systems to deal with clinical waste; however, only two (5 per cent) reported use of BS7320 sharps containers on domiciliary visits. Despite the recognized dangers, 23 (55 per cent) practices resheathed needles and only six (14 per cent) had first aid guidance for needlestick injuries. Only eight (19 per cent) practices knew and recorded staff immunity to hepatitis B following vaccination. CONCLUSIONS: Some deficiencies in infection control practice were identified and the need for policy guidance and staff training was highlighted.

Family Practice↗
PubMed1999

Use of a low-literacy patient education tool to enhance pneumococcal vaccination rates. A randomized controlled trial.

CONTEXT: Pneumococcal immunization rates for elderly and high-risk patients are only one third to one half the target rate of 60% established by the US Public Health Service. Limited or marginal literacy, which affects nearly 100 million Americans, especially the elderly, may contribute to these low rates of immunization. OBJECTIVE: To determine whether the use of a simple, low-literacy educational tool enhances patient-physician dialogue about pneumococcal vaccination and increases rates of immunization. DESIGN: A randomized controlled trial conducted between May and June of 1998. SETTING: Ambulatory care clinic of a 900-bed public teaching hospital serving a predominantly indigent, low-literate, African American, inner-city population. PARTICIPANTS: Of 433 patients who presented for routine primary care, had vaccine indications (age > or =65 years or chronic disease), and had not been previously vaccinated, 221 were randomly assigned to the intervention group and 212 to the control group. Of the total patient population (mean age, 63 years), 280 (64.7%) had less than a high school education, 401 (92.6%) were African American, and 300 (69.3%) were female. INTERVENTION: One-page, low-literacy (below fifth-grade level) educational handout encouraging patients to "ask your doctor about the pneumonia shot" vs a control group (1 -page, low-literacy educational handout conveying information about nutrition). MAIN OUTCOME MEASURES: Vaccination rates (documented by chart audit) of patients who received pneumococcal vaccination and rates of patients who self-reported having discussed vaccination with their physicians. RESULTS: Patients in the intervention group were 4 times more likely to have discussed the pneumococcal vaccine with their physicians than patients in the control group (87/221 [39.4%] vs 21/212 [9.9%]; relative risk [RR], 3.97 [95% confidence interval [CI], 2.71-5.83]), and were more than 5 times as likely to have received the pneumococcal vaccine than the control group (44/221 [19.9%] vs 8/212 [3.8%]; RR, 5.28 [95% CI, 2.80-9.93]). In a multivariate analysis controlling for race, sex, education, insurance status, age, level of physician training, health status, and vaccine indication, only assignment to the intervention group was statistically significantly related to the probability of being immunized or discussing the issue with their physicians (P<.001 for both trends). CONCLUSIONS: A simple, low-literacy educational tool increased pneumococcal vaccination rates and patient-physician discussions about the vaccine in an elderly, low-literate, indigent, minority population.

Aged↗
PubMed1998

Zinc, iron, and magnesium status in athletes--influence on the regulation of exercise-induced stress and immune function.

Intense physical exercise has been shown to be associated with immunosuppression and increased rate of infection. The immunosuppressive effect of exhaustive exercise has been attributed to a reduced helper/suppressor T-cell ratio, low salivary levels of immunoglobulin-A, decreased lymphocyte proliferative response and natural killer cell activity, and elevation of stress hormones. Yet some athletes can withstand intense training periods without health problems while others are prone to infections. Thus it has been postulated that other factors may interfere with immunoregulation. The notion that macro- and micronutrients are involved in the regulation of immunological processes and the ability to cope with muscular and systemic exercise stress has been gaining attention. Particularly trace elements have been shown to be related to cell mediated and humoral immunity such as NK-cell activity, T- and B-cell functions, and cytokine release. Many investigations have reported decreased concentrations of trace elements in blood and tissues after training and competition. However, the magnitude of losses is highly dependent on the type and intensity of exercise, the individual regulatory state, and most important, nutrition. This paper reviews the data on zinc, iron, and magnesium status in athletes and summarizes the consequences of deficiencies in these trace elements regarding exercise tolerance and immune function. These elements were chosen since there is evidence they are related to exercise-induced stress and immune function.

Animals↗
PubMed2006

Effects of unaccustomed and accustomed exercise on the immune response in runners.

PURPOSE: To test the hypothesis that long-term immunological response may be different after accustomed concentric and unaccustomed eccentric exercise in endurance-trained men. METHODS: Fourteen highly endurance-trained male runners performed two bouts of high-intensity exercise with at least 2-wk intervals between bouts. Concentric exercise consisted of a 60-min level run with a targeted heart rate of 80% VO2 peak. Eccentric exercise was conducted lying on a specially designed exercise rack, eliciting eccentric action of the musculus quadriceps femoris. Blood samples were taken before and 1, 6, 24, 72, and 144 h after exercise to determine creatine kinase (CK), C-reactive protein (CRP), and interleukin-6 (IL-6). Lymphocyte subset distribution was assessed using flow cytometry. RESULTS: We found a significant (P < 0.05) increase of CD4 (eccentric: 17%; concentric: 20%), CD3+/CD4+ (16 vs 19%), CD25+ (45 vs 29%), CD25+/CD4+ (27 vs 50%), HLA-DR+ (20 vs 15%), HLA-DR+/CD4+ (16 vs 67%), and CD19+/CD45+ (52 vs 103%) positive lymphocytes 1 h after both exercise bouts. However, eccentric exercise resulted in a significantly higher and longer (6 h) increase of CD25+/CD4+ and HLA-DR+/CD8+ lymphocytes and a peak increase of CK at 72 h. IL-6 and CRP increased only after concentric exercise within the first 24 h. Both exercises resulted in a decrease of monocyte activation (LFA-1: CD18+/CD11a+) after 6 h, with an increase for the eccentric exercise part after 24 h (P < 0.05). CONCLUSION: Accustomed concentric exercise mainly induced an acute-phase response, with increased CRP, IL-6, and activation of CD4 lymphocyte subsets. Unaccustomed eccentric exercise provided a delayed increase in CK and activation of monocytes and CD4+ and CD8+ subsets. Therefore, the immunological reaction depends not only on the type of contraction but also on the adaptation to the exercise.

Adult↗
PubMed2026

EscaPRRS-ORF5: a structure-aware evolutionary framework for prioritizing immune escape-prone variants in porcine reproductive and respiratory syndrome virus.

MOTIVATION: Porcine Reproductive and Respiratory Syndrome Virus (PRRSV) is a rapidly evolving RNA virus causing significant economic losses, posing a formidable challenge to vaccine efficacy due to its high mutational variability and immune escape. As the viral mutants evolve, their ability to sustain in population is driven by a range of host biology factors such as receptor binding, fusion, and uncoating. Existing tools that predict viral fitness and escape propensities rely heavily on extensive, up-to-date sequence data and lack integration of biochemical host interactions, limiting mechanistic understanding of the mutational landscape. We introduce Esca, a sequence-only toolchain framework that identifies immune escape-prone residues by exhaustively scanning each residue position for all amino acid substitutions using a Bayesian Variational Autoencoder (VAE) trained on protein language model embeddings. We demonstrate Esca on the GP5(ORF5) glycoprotein of PRRSV (EscaPRRS-ORF5) by training on ESM-2 embeddings of 32&#x2006;146 GP5 sequences (2015-2022) spanning 140 sub-lineages. RESULTS: Despite being trained only on GP5 sequence data, EscaPRRS-ORF5 recovered 85.7% of the surface-exposed receptor binding interfaces as escape-prone regions. We use a mutation-sensitive fitness scoring scheme that goes beyond Hamming distances, to predict antibody escape tendencies, supporting surveillance of (re) emerging PRRSV variants. We do not claim that ORF5 alone captures PRRSV evolution or serves as a surveillance endpoint; rather, Esca offers a scalable path toward whole-genome, structure-aware surveillance. AVAILABILITY AND IMPLEMENTATION: EscaPRRS-ORF5 is freely available at https://doi.org/10.6084/m9.figshare.32661033 with an interactive Colab notebook at https://colab.research.google.com/drive/1TEgzAhPwvNAZ01VXeJbIFibfri2jnDA5? usp=sharing.

Porcine respiratory and reproductive syndrome viru↗
PubMed1988

Vaccination strategies in developing countries.

By 1990 it is hoped that all of the world's infants will have access to immunization services and that these services will then continue indefinitely. The link between people and health services, including immunization, can only be forged and maintained by an effective system of delivery and support to all health workers. A careful choice of strategies for this delivery system and an understanding of local cultural attitudes and behaviour is vital if this link is to be effective. Health workers will have to be trained and then supported in the field by regular contact with their supervisors. They will also need continuous, reliable, predictable and adequate supplies of equipment, drugs, vaccines, fuel and money, including salaries. Immunization is cost effective as a health intervention, but an effective programme of immunization can contribute much more than just vaccines, if it is developed in the context of primary health care (PHC) as originally proposed in 1978 at the conference in Alma Ata.

Child, Preschool↗
PubMed1996

Student health policies of U.S. medical schools.

BACKGROUND: Medical students are at risk of exposure to bloodborne pathogens, yet few data are available about U.S. medical schools' policies to protect students. METHOD: A cross-sectional survey of the student affairs deans at the 126 U.S. medical schools was conducted in May 1994. A confidential questionnaire inquired about policies regarding vaccination for hepatitis B virus (HBV), blood and body-fluid exposures, universal precautions training, and health and disability insurance for students. RESULTS: A total of 108 (86%) of the schools participated in the survey. Most (99, 92%) required either HBV vaccination, evidence of immunity, or a signed waiver refusing vaccination. Nearly all (94, 87%) required health insurance, and almost all (101, 94%) offered a plan (at a mean cost of $690 annually), but fewer schools (69, 64%) offered disability insurance. The schools frequently held students responsible for the costs of HBV vaccination (73, 68%), postexposure serologic testing (22, 20%), and treatment of training-related medical problems (43, 40%). CONCLUSION: Most medical schools comply with current recommendations for preventing training-related exposures to bloodborne pathogens, illness, and injury, but students face a substantial financial responsibility for these services at a time when many have large debts. Many schools do not have disability insurance readily available for students. Medical schools should review their student health policies to protect students adequately.

Blood-Borne Pathogens↗
PubMed2003

Upper respiratory tract infections: who plays, who sits?

In athletes with upper respiratory infections (URIs), the question of who plays and who sits can be difficult to answer. Acute exercise suppresses several aspects of the immune system. None of these immunologic changes, however, consistently correlate with the incidence of URIs in athletes. The risk of infection with exercise seems to follow a J-curve relationship, with regular, moderate exercisers having a lower risk than sedentary people, and regular, strenuous exercisers having the highest risk of all. The decision to allow an athlete to play or not can be guided by the "neck check" rules, and can also take into account nonmedical factors. The athlete with infectious mononucleosis warrants more careful attention, as there are strict guidelines for return-to-play in these individuals, to avoid the possibility of splenic rupture.

Adolescent↗
PubMed2007

Cardiovascular therapy and pharmacogenetics in 2007.

John Carlquist received a PhD from the Department of Cellular Viral and Molecular Biology at the University of Utah School of Medicine (UT, USA) with research emphasis in molecular immunology. After completion of his training, he received a faculty appointment in the Department of Internal Medicine, University of Utah, where he became interested in immune mechanisms in cardiovascular disease. He developed an interest in genetics through studies of human leukocyte antigen (HLA) associations with idiopathic dilated cardiomyopathy and rheumatic heart disease. He began the Molecular Diagnostics Laboratory for Intermountain Healthcare and continues to serve as Technical Director; he also directs the Intermountain Heart Study Molecular and Genetic Research Laboratory. Current research interests include the genetics of lipid metabolism as related to coronary heart disease and the genetic factors influencing drug treatment outcomes.

Cardiovascular Agents↗
PubMed1992

Doctors' death experience and attitudes towards death, euthanasia and informing terminal patients.

In daily practice physicians are professionally obliged to interpret ethical precepts and laws in emergency situations under extreme pressure when resuscitation measures leave little or no time to consider deontological issues. The extent to which extraprofessional experiences influence physicians' attitudes towards death and terminal patients is a difficult issue to approach with precision. The purpose of this study was to analyse the influence of some personal biographical circumstances on physicians' attitudes towards death and terminal patients. A total of 153 doctors ranging in age from 22 to 77 years (mean 38.24; SD 13.08) were randomly chosen. Physicians, as an integral part of society, cannot be expected to be immune to the influences which mould our attitudes. We suggest that young physicians and medical students should receive information and training aimed at equipping them to face death and dying patients.

Adaptation, Psychological↗
PubMed1985

Comparing ambulatory care practices of primary care and traditional medicine residents.

Although special residency programs preparing internists for primary care have been in existence for a decade, little is known about whether these tracks have achieved their goals. As part of a multicenter evaluation of ambulatory care at four university hospitals, 1,040 patient care encounters were reviewed for 16 primary-care and 41 traditional medicine residents. Using a chart-based audit, the authors examined 16 discrete items of patient care to assess resident management in the following areas: screening for colorectal carcinoma, management of hypertension, benzodiazepine drug prescribing, and management of chronic lung disease. Their hypothesis that primary care residents would score higher than traditional medicine residents in the areas of screening, prevention, and prescribing of drugs was not supported. There was no association between type of training and performance of a task with the following exception: second-year primary care residents screened for colorectal carcinoma in 86% (126) of patients whose charts were audited, while second-year traditional medicine residents did so in 77% (160) (P less than 0.025). This difference was not maintained when the residents were reaudited 1 year later. Both groups of residents scored high in all areas with the following exceptions: documentation of the amount of sedative dispensed and immunization of susceptible patients against pneumococcus and influenza. The ambulatory practices of both groups of residents exceeded expectations, probably because of the wider influence of primary care training.

Ambulatory Care↗
PubMed1978

The expanded program in immunization. Ghana's experience.

The expanded programme on immunization feasibility studies is currently running into its second year of operations. The objectives of the study are to test the possibility of increased coverage using both fixed centre and mobile field teams for the vaccination of children under the age of 2 years against measles, poliomyelitis, diphtheria, pertussis, tuberculosis and smallpox and also to test the immunological response to two doses of pertussis and two doses of oral polio. Reports so far indicate some success in the areas of training and manpower development as well as the development of the cold chain system which is considered to be the most important requirement for an efficient, expanded immunization programme. It goes without saying that the progress of the study has been marked by some technical, social and administrative constraints.

Child↗
PubMed1979

The effect of outreach workers' educational efforts on disadvantaged preschool children's use of preventive services.

A special program of outreach services was implemented to assist a poverty population to appropriately use health services in the Kaiser-Permanente Medical Care Program. A study was conducted to determine the effect of outreach workers' intervention on the use of preventive services by this population. Intially, families were divided into two groups, one with and one without outreach workers. Outreach workers (neighborhood health coordinators) were trained in prevention and health education. They were then assigned to specific subgroups of the poverty population to teach the importance of preventive services and to motivate persons to use these services. This paper focuses on the effect of outreach workers' services on the use of selected preventive care services (immunizations and tine test) by preschool children from poverty families. Preschool children in families with coordinator services had higher use rates for preventive care. The sub-group for which outreach workers were specially trained to focus on preventive procedures for the pre-school group had markedly higher use rates for preventive care. The findings suggest that special intervention programs, using indigenous and nonprofessional outreach workers, can increase preventive service utilization by poverty groups.

Child, Preschool↗
PubMed1998

Overtraining and immune system: a prospective longitudinal study in endurance athletes.

A prospective longitudinal study investigated for 19 +/- 3) months whether immunophenotypes of peripheral leukocytes were altered in periods of severe training. Leukocyte membrane antigens (CD3, CD4, CD8, CD14, CD16, CD19, CD45, CD45RO, and CD56) of endurance athletes were immunophenotyped (dual-color flow cytometry) and list mode data analyzed by a self-learning classification system in a state of an overtraining syndrome (OT; N = 15) and several occasions without symptoms of staleness (NS; N = 70). Neither at physical rest nor after a short-term highly intensive cycle ergometer exercise session at 110% of the individual anaerobic threshold did cell counts of neutrophils, T, B, and natural killer cells differ between OT and NS. Eosinophils were lower during OT, activated T cells (CD3+HLA/DR+) showed slight increases (NS: 5.5 +/- 2.7; OT 7.3 +/- 2.4% CD3+ of cells; means +/- SD; P < 0.01) during OT without reaching pathological ranges. The cell-surface expression of CD45RO (P < 0.001) on T cells, but not cell concentrations of CD45RO+ T cells, were higher during OT. OT could be classified with high specificities (92%) and sensitivities (93%). It is concluded that OT does not lead to clinically relevant alterations of immunophenotypes in peripheral blood and especially that an immunosuppressive effect cannot be detected. Immunophenotyping may provide help with the diagnosis of OT in future, but the diagnostic approach presented here requires improvements before use in sports medicine practice is enabled.

Adult↗
PubMed2002

Rating maternal and neonatal health services in developing countries.

OBJECTIVE: To assess maternal and neonatal health services in 49 developing countries. METHODS: The services were rated on a scale of 0 to 100 by 10 - 25 experts in each country. The ratings covered emergency and routine services, including family planning, at health centres and district hospitals, access to these services for both rural and urban women, the likelihood that women would receive particular forms of antenatal and delivery care, and supporting elements of programmes such as policy, resources, monitoring, health promotion and training. FINDINGS: The average rating was only 56, but countries varied widely, especially in access to services in rural areas. Comparatively good ratings were reported for immunization services, aspects of antenatal care and counselling on breast feeding. Ratings were particularly weak for emergency obstetric care in rural areas, safe abortion and HIV counselling. CONCLUSION: Maternal health programme effort in developing countries is seriously deficient, particularly in rural areas. Rural women are disadvantaged in many respects, but especially regarding the treatment of emergency obstetric conditions. Both rural and urban women receive inadequate HIV counselling and testing and have quite limited access to safe abortion. Improving services requires moving beyond policy reform to strengthening implementation of services and to better staff training and health promotion. Increased financing is only part of the solution.

Benchmarking↗