Donor type microchimerism is an infrequent event following liver transplantation and is not associated with graft acceptance

Donor-type microchimerism, the presence of a minority population of donor-derived haematopoietic cells following solid organ transplantation, has been postulated as a mechanism for induction of donor-specific graft tolerance. The stability, frequency, and relevance of microchimerism with respect to long-term outcome, however, remains uncertain. Using a polymerase chain reaction (PCR)-based method of microsatellite analysis of highly polymorphic short tandem repeat sequences (STRs) to detect donor-type cells, DNA from 11 patients was analyzed prospectively at specific time points for 12 months following liver transplantation, and from a further six patients retrospectively 2 years after liver transplantation. Using a panel of STRs, transient peripheral blood donor microchimerism was detected in 2 of 11 patients at a single time-point following transplantation, but persistent evidence of donor-derived cells was not observed during the study period. Analysis of DNA extracted from skin and duodenum in two patients likewise failed to show donor-type cells at these sites. None of the six patients in the retrospective arm showed donor microchimerism, resulting in an overall detection rate of 1.58%. These results suggest that donor microchimerism following liver transplantation is an infrequent event, and that the generation of graft tolerance is independent of microchimerism.

Inside the tent: Community and government in refugee camps

Refugee camps are increasingly managed through a liberal rationality of government similar to that of many industrialized societies, with security mechanisms being used to optimize the life of particular refugee populations. This governmentality has encompassed programmes introduced by the United Nations High Commissioner for Refugees (UNHCR) and various non-governmental organizations (NGOs) to build and empower communities through the spatial technology of the camp. The present article argues that such attempts to ‘govern through community’ have been too easily dismissed or ignored. It therefore examines how such programmes work to produce, manage and conduct refugees through the use of a highly instrumentalized understanding of community in the spatial and statistical management of displaced people in camps. However, community is always both more and less than what is claimed of it, and therefore undermines attempts to use it as a governing tactic. By shifting to a more ontological understanding of community as unavoidable coexistence, inspired by Jean-Luc Nancy, we can see how the scripting of and government through community in camps is continually exceeded, redirected and resisted. Ethnographies of specific camps in Africa and the Middle East enable us both to see how the necessary sociality of being resists its own instrumentalization and to view the camp as a spatial security technology. Such resistance does not necessarily lead to greater security, but it redirects our attention to how community is used to conduct the behaviour of refugees, while also producing counter-conducts that offer greater agency, meaning and mobility to those displaced in camps.

HPV vaccine acceptance in males

Background Despite Human Papillomavirus (HPV)’s impact on the health of both sexes, there is debate around the inclusion of males in HPV vaccination programmes. The aim of this scoping review was to synthesize the evidence on vaccine acceptability to males. Given that the vaccine is most effective in adolescent males, vaccine acceptance in parents and health care professionals (HCPs) was also examined. Method A rapid synthesis using specified key words of published systematic reviews into vaccine acceptability in adolescent males, parents and HCPs was conducted. The most common electronic databases were searched including: Medline, EMBASE, PsychINFO, and CINAHL. Results There was variability amongst studies with respect to design and methodological approaches. Despite this there appears to be a positive attitude towards male HPV vaccination from both parents and older males. There is currently insufficient evidence on vaccine acceptance to adolescent males. Understanding the risks involved in HPV acquisition, and receiving a recommendation from a HCP, appear to be the major factors involved in males deciding to be vaccinated. Parents consistently report the importance of a HCP recommendation, yet HCPs (in the US) appear to have a preference for vaccinating older than younger adolescents, and for vaccinating females. Conclusions The absence of an agreed definition of vaccine acceptance leads to a lack of a universally accepted tool for its measurement. This makes comparison of studies difficult. With no established theoretical framework the identification and exploration of factors that influence vaccine uptake can be variable. In addition, acceptance is not indicative of uptake. The majority of studies are cross-sectional which makes the identification of factors that lead to actual vaccine uptake difficult. Prospective, longitudinal studies identifying individuals that acted on vaccine intention should be conducted to identify the factors that mediate the uptake.

A randomized, controlled trial of an intervention promoting cataract surgery acceptance in Rural China:The Guangzhou uptake of surgery trial (GUSTO)

PURPOSE. To evaluate an educational intervention promoting acceptance of cataract surgery in rural China using a randomized controlled design. METHODS. Patients aged 50 years or older with presenting visual acuity (PVA) less than 6/18 in one or both eyes due to cataract were recruited from 26 screening sessions (13 intervention, 13 control) conducted by five rural hospitals in Guangdong, China. At intervention sessions, subjects were shown a 5- minute informational video, and counseled about cataract, surgery, and surgical cost. During screening, all subjects answered questionnaires on knowledge and attitudes about cataract, their finances, and transportation, and were referred for definitive examination if eligible. Study outcomes were acceptance of surgery (principal outcome) and hospital followup. RESULTS. Subjects in the intervention group were younger than controls (P = 0.01), but the groups did not otherwise differ. Among 212 intervention patients and 222 controls, no differences in knowledge and attitude regarding cataract were found. Surgery was accepted by 31.1% of intervention patients and 34.2% of controls (P > 0.50). Predictors of acceptance included younger age, worse logMAR PVA, knowing that cataract can be treated surgically only, greater anticipated loss in income from hospitalization, and greater house floor space per person. Membership in the intervention group was not associated with accepting surgery (odds ratio [OR]=1.11, 95% confidence interval [CI] 0.67-1.84) or hospital follow-up (OR= 1.03, 95% CI = 0.63-1.67). CONCLUSIONS. Educational interventions that successfully impart the knowledge that cataract can be only treated surgically may be more effective in increasing uptake in this setting. © 2012 The Association for Research in Vision and Ophthalmology, Inc.

Spectacle acceptance among secondary school students in rural China: the Xichang Pediatric Refractive Error Study (X-PRES)--report 5.

PURPOSE: To assess determinants of spectacle acceptance and use among rural Chinese children. METHODS: Children with uncorrected acuity < or = 6/12 in either eye and whose presenting vision could be improved > or = 2 lines with refraction were identified from a school-based sample of 1892 students. Information on obtaining glasses and the benefits of spectacles was provided to children, families, and teachers. Purchase of new spectacles and reasons for nonpurchase were assessed by direct inspection and interview 3 months later. RESULTS: Among 674 (35.6%) children requiring spectacles (mean age, 14.7 +/- 0.8 years), 597 (88.6%) were followed up. Among 339 children with no glasses at baseline, 30.7% purchased spectacles, whereas 43.2% of 258 children with inaccurate glasses replaced them. Most (70%) subjects paid US$13 to $26. Among children with bilateral vision < or = 6/18, 45.6% bought glasses. In multivariate models, presenting vision < 6/12 (P < 0.009), refractive error < -2.0 D (P < 0.001), and amount willing to pay for glasses (P = 0.01) were predictors of purchase. Reasons for nonpurchase included satisfaction with current vision (78% of those with glasses at baseline, 49% of those without), concerns over price or parental refusal (18%), and fear glasses would weaken the eyes (13%). Only 26% of children stated that they usually wore their new glasses. CONCLUSIONS: Many families in rural China will pay for glasses, though spectacle acceptance was < 50%, even among children with poor vision. Acceptance could be improved by price reduction, education showing that glasses will not harm the eyes, and parent-focused interventions.

Psychological determinants of consumer acceptance of personalised nutrition in 9 European countries

OBJECTIVE: To develop a model of the psychological factors which predict people's intention to adopt personalised nutrition. Potential determinants of adoption included perceived risk and benefit, perceived self-efficacy, internal locus of control and health commitment.

METHODS: A questionnaire, developed from exploratory study data and the existing theoretical literature, and including validated psychological scales was administered to N=9381 participants from 9 European countries (Germany, Greece, Ireland, Poland, Portugal, Spain, the Netherlands, the UK, and Norway).

RESULTS: Structural equation modelling indicated that the greater participants' perceived benefits to be associated with personalised nutrition, the more positive their attitudes were towards personalised nutrition, and the greater their intention to adopt it. Higher levels of nutrition self-efficacy were related to more positive attitudes towards, and a greater expressed intention to adopt, personalised nutrition. Other constructs positively impacting attitudes towards personalised nutrition included more positive perceptions of the efficacy of regulatory control to protect consumers (e.g. in relation to personal data protection), higher self-reported internal health locus of control, and health commitment. Although higher perceived risk had a negative relationship with attitude and an inverse relationship with perceived benefit, its effects on attitude and intention to adopt personalised nutrition was less influential than perceived benefit. The model was stable across the different European countries, suggesting that psychological factors determining adoption of personalised nutrition have generic applicability across different European countries.

CONCLUSION: The results suggest that transparent provision of information about potential benefits, and protection of consumers' personal data is important for adoption, delivery of public health benefits, and commercialisation of personalised nutrition.

Refugee crisis and re-emergence of forgotten infections in Europe

Makeshift shelters are becoming increasingly evident in European cities as a consequence of the momentous influx of refugees seeking asylum in European countries. These individuals have endured long gruelling journeys to reach their target countries, often having to have survived appalling living conditions (figure 1a). One of the routes chosen by migrants is that from East Africa, through Sudan and Libya before reaching North Africa and eventually Europe (see figure 1b). Not unsurprisingly, this has led to the introduction of infectious diseases rarely encountered in developed nations, most notably louse-borne relapsing fever (LBRF).

Statue of Hon. John C. Calhoun erected in Statuary Hall of the Capitol at Washington ; proceedings in Statuary Hall and in the Senate and the House of Representatives on the occasion of the unveiling, reception, and acceptance of the statue from the State of South Carolina / compiled under the direction of the Joint Committee on printing

This publication is the proceedings of the unveiling ceremony for the statue of John C. Calhoun in the Statuary Hall in Washington D.C.

A psychosocial approach to understanding pilot and controller acceptance of change in ATM, based on three CDA case studies

Next generation ATM systems cannot be implemented in a technological vacuum. The further ahead we look, the greater the likely impact of societal factors on such changes, and how they are prioritised and promoted. The equitable sustainability of travel behaviour is rising on the political agenda in Europe in an unprecedented manner. This paper examines pilot and controller attitudes towards Continuous Descent Approaches (CDAs). It aims to promote a better understanding of acceptance of change in ATM. The focus is on the psychosocial context and the relationships between perceived societal and system benefits. Behavioural change appeared more correlated with such benefit perceptions in the case of the pilots. For the first time in the study of ATM implementation, and acceptance of change, this paper incorporates the Seven Stages of Change model, based on the constructs of the Theory of Planned Behaviour. It employs a principal components (factor) analysis, and further explores the intercorrelations of benefit perceptions, known in psychology as the ‘halo effect’. Disbenefit perceptions may break down this effect, it appears. For implementers of change, this evidence suggests an approach in terms of reinforcing the dominant benefit(s) perceived, for sub-groups within which a halo effect is evident. In the absence of such an effect, perceived disbenefits, such as with respect to workload and capacity, should be off-set against specific, perceived benefits of the change, as far as possible. This methodology could be equally applied to other stakeholders, from strategic planners to the public. The set of three case studies will be extended beyond CDA trials. A set of concise guidelines will be published with a strong focus on practical advice, in addition to continued work enabling a better understanding of the expected, increasing psychosocial contributions to successful and unsuccessful efforts at ATM innovation and change.

Os Azorean refugee acts de 1958 e 1960

Polissema: Revista de Letras do ISCAP 2002/N.º 2 Linguagens