The effectiveness of preventative mass vaccination regimes against the incidence of highly pathogenic avian influenza on Java Island, Indonesia.

We conducted an operational research study involving backyard and semicommercial farms on Java Island, Indonesia, between April 2008 and September 2009 to evaluate the effectiveness of two preventive mass vaccination strategies against highly pathogenic avian influenza (HPAI). One regimen used Legok 2003 H5N1 vaccine, while the other used both Legok 2003 H5N1 and HB1 Newcastle disease (ND) vaccine. A total of 16 districts were involved in the study. The sample size was estimated using a formal power calculation technique that assumed a detectable effect of treatment as a 50% reduction in the baseline number of HPAI-compatible outbreaks. Within each district, candidate treatment blocks with village poultry populations ranging from 80 000 to 120 000 were created along subdistrict boundary lines. Subsequently, four of these blocks were randomly selected and assigned one treatment from a list that comprised control, vaccination against HPAI, vaccination against HPAI + ND. Four rounds of vaccination were administered at quarterly intervals beginning in July 2008. A vaccination campaign involved vaccinating 100 000 birds in a treatment block, followed by another 100 000 vaccinations 3 weeks later as a booster dose. Data on disease incidence and vaccination coverage were also collected at quarterly intervals using participatory epidemiological techniques. Compared with the unvaccinated (control) group, the incidence of HPAI-compatible events declined by 32% (P = 0.24) in the HPAI-vaccinated group and by 73% (P = 0.00) in the HPAI- and ND-vaccinated group. The effect of treatment did not vary with time or district. Similarly, an analysis of secondary data from the participatory disease and response (PDSR) database revealed that the incidence of HPAI declined by 12% in the HPAI-vaccinated group and by 24% in the HPAI + ND-vaccinated group. The results suggest that the HPAI + ND vaccination significantly reduced the incidence of HPAI-compatible events in mixed populations of semicommercial and backyard poultry.

Predictors and subsequent decisions of physical therapy and nursing students to work with geriatric clients: an application of the theory of reasoned action.

BACKGROUND AND PURPOSE: In this study, the theory-based model of Ajzen and Fishbein was used to identify factors that influence physical therapist and registered nurse (RN) students' intentions toward working with elderly individuals. A follow-up identified actual job selection. SUBJECTS: Accredited physical therapist and RN education programs in the Northwest and California were surveyed. Two hundred one students responded; 176 survey questionnaires were usable. METHODS: A survey instrument was developed based on Ajzen and Fishbein's theory-based model to assess student intention to work with elderly individuals and factors influencing this intention. Graduates were later contacted to determine whether job selection matched intention. RESULTS: For all students, factors influencing intention were student attitudes and student perceptions regarding their families' expectations about the student working with elderly persons. Intention had a positive correlation with job selection. CONCLUSION AND DISCUSSION: Important underlying beliefs influencing student attitudes, which could be emphasized in academia, include the advantages of getting to know elderly patients and their families and having pleasant patients to work with. Faculty are encouraged to positively reinforce these beliefs throughout the curricula. Results of this study support using a theory-based model to identify predictors of job selection among physical therapist and RN graduates.

Temperature- and acceptor-specificity of cell-free vesicular transfer from transitional endoplasmic reticulum to the cis Golgi apparatus.

The temperature dependence and specificity of transfer of membrane constituents from donor transitional endoplasmic reticulum to the cis Golgi apparatus were investigated using a cell-free system from rat liver. The radiolabelled transitional endoplasmic reticulum donors were prepared from slices of rat liver prelabelled with [14C]leucine. The acceptor Golgi apparatus elements were unlabelled and immobilized on nitrocellulose. When Golgi apparatus stacks were separated by preparative free-flow electrophoresis into subfractions enriched in cisternae derived from the cis, medial and trans portions of the stack respectively, efficient specific transfer was observed only to cis elements. Trans elements were devoid of specific acceptor capacity. Similarly, when transfer was determined as a function of temperature, a transition was observed in transfer activity between 12 degrees C and 18 degrees C similar to that seen in vivo for formation of the so-called 16 degrees C cis Golgi-located membrane compartment. Transfer at temperatures below 16 degrees C and transfer to trans Golgi apparatus compartments at temperatures either above or below 16 degrees C was similar and unspecific. The unspecific transfer at low temperature was pH independent, whereas specific transfer was greatest at the physiological pH of 7, and was reduced to 10% and 18% of that occurring at pH 8 and pH 5.5 respectively. These findings show that the cell-free system derived from rat liver exhibits a high degree of fidelity to transfer in vivo, an efficiency approaching that observed in vivo, and a nearly absolute acceptor specificity for cis Golgi apparatus. The acceptor-, temperature- and pH-specificity of the cell-free transfer, as well as the saturation kinetics exhibited with respect to acceptor Golgi apparatus, support the concept of transition-vesicle-specific docking sites of finite number associated with cis Golgi apparatus cisternae.

Relationship of diuretic therapy and serum magnesium levels among participants in the Multiple Risk Factor Intervention Trial.

Thiazide-like diuretics cause an increased excretion of magnesium in the urine. Low serum and selected tissue magnesium levels have been reported among diuretic users. Low magnesium levels have been associated with cardiac arrhythmias, neuromuscular changes, and increases in lipoprotein levels. The dietary intake of magnesium is borderline compared with the recommended dietary allowances. Water sources may therefore play an important role. Hard water contains more magnesium than soft water. The authors studied serum magnesium levels among special intervention Multiple Risk Factor Intervention Trial participants in two centers: Pittsburgh, Pennsylvania and Davis, California. These participants were men aged 35-57 years at entry to the trial in 1972-1974; the blood samples were obtained primarily in 1980-1981. Diuretic users primarily of chlorthalidone had an average 1 ppm lower serum magnesium level than nondiuretic users. About 15% of diuretic users had persistently lower magnesium levels on two samples approximately four months apart. The serum magnesium level was not correlated with the serum potassium level. This study is the first long-term follow-up of a well-defined group of hypertensives taking thiazide-like diuretics versus suitable controls. The results suggest that within similar populations, low serum magnesium levels are relatively rare even in the absence of supplementation with magnesium. Specific high-risk populations may exist in which a combination of diuretic therapy and low intake may contribute to magnesium deficiency. Further epidemiologic studies should include monitoring both serum and intracellular levels of magnesium among these potential high-risk groups on diuretic therapy. This approach may offer the best method of testing the relationship between water hardness, minerals, and cardiovascular disease.