[Assessing disability--a piece of cake or a profound challenge?]. / Begutachtung bei Berufsunfähigkeit-- kein Problem oder eine besondere Herausforderung?

When evaluating disability for BUZ (German income protection benefit) a medical expert's task is to assess the consequences any physical or mental impairment may have on the insured's ability to perform his/her occupation. In the absence of specific details regarding the core and secondary duties which the insured has last performed, the expert is unable to accomplish his task. In fact, in a legal dispute the expert's opinion would be rendered worthless if it was not based on precisely established non-medical aspects of the insured's individual occupation. Details about the insured's occupation and duties must be provided to the expert by the insurer who in turn has to ensure that full details have been obtained from the insured. Only then will the expert be in a position to establish the insured's remaining abilities and assess any occupational impairment and its likely duration. The medical expert must relate specific legal aspects and income protection insurance terms to the medical facts and occupational merits of the case. Only then can his opinion be considered decision-relevant and court-proof. To accomplish this complex task the medical expert must be familiar with these specific conditions. A high standard of quality for BUZ expert opinions is best assured with continuing training and education in this field.

Development of a medical nutrition therapy protocol for female collegiate athletes.

Nutrition intervention can improve athletic performance and reduce the risk of nutrition related problems in women athletes. The current healthcare environment demands that dietitians document the outcomes of the medical nutrition therapy (MNT) they provide. This requires the development and validation of MNT protocols so that outcomes can be documented and compared in similar populations across multiple settings. The purpose of this project was to develop a sports nutrition management MNT protocol for collegiate women athletes. A registered dietitian currently working with collegiate women athletes collaborated with four dietitians from the community to develop an MNT protocol. Further testing and validation using this MNT protocol will help dietitians document the outcomes of their interventions in this population.

Specific detection of membrane-toxic substances with a conductivity assay.

A conductivity assay that represents a new biotest able to detect the effects of membrane-toxic compounds, e.g., detergents, organic solvents, and radical formers, on various organisms was previously described and developed. The conductivity assay measures ion leakage from cells, tissues, or whole plant and animal organisms whose membrane systems have been damaged by membrane-toxic compounds. In this study the specificity of the conductivity assay for membrane-toxic compounds was tested by comparing the electrolyte efflux from Elodea canadensis leaves during incubation with a well-known detergent (benzalkonium chloride) using different plant physiological and biochemical techniques (photochemical efficiency, plasmolysis capacity, NBT reduction, and electron microscopy of membranes of E. canadensis leaves). The comparison of the different methods proved that the electrolyte loss during benzalkonium chloride incubation determined in the conductivity assay is due to membrane impairment. The observed electrolyte loss correlated with a reduction of photochemical efficiency and a decrease in both plasmolysis and NBT reduction capacity. Furthermore, a disintegration of the plasmalemma could be seen in the electron micrographs. These results indicate that the measured electrolyte loss in the conductivity assay is a specific effect of membrane-toxic compounds.

Validation of use of the Nageotte hemocytometer to count low levels of white cells in white cell-reduced platelet components.

BACKGROUND: Determination of the white cell (WBC) count in WBC-reduced platelet components requires methods that have a detection limit in the range of approximately 5.0 x 10(2) to 5.0 x 10(4) per mL. STUDY DESIGN AND METHODS: With a 50-microL Nageotte hemocytometer and bright-field microscopy (200x magnification), studies were conducted to develop and validate a method that could be used routinely with filtered and apheresis-harvested platelets. A 1-in-5 dilution of sample with a commercially available blood-diluting fluid was used because, with a lower (1-in-2) dilution, the observed number of WBCs was substantially less than the number expected at relatively high platelet counts (> 1.9 x 10(9)/mL). RESULTS: The observed and expected WBC counts in WBC-reduced platelet samples correlated well at levels between approximately 5 and 1100 WBCs per counting area (5.0 x 10(2)-1.1 x 10(5)/mL). At levels of more than 300 to 400 WBCs per counting area, accurate counts were obtained when 10 of the 40 rectangles were counted. CONCLUSION: These studies provide data to confirm that the 50-microL Nageotte hemocytometer can be used to accurately count low levels of WBCs in platelet components.

Encoding-imagery specificity in alcohol state-dependent learning.

A free-recall procedure demonstrated state-dependent learning using alcohol. Tests of long-term memory showed that both high- and low-imagery words were less likely to be recalled if stored while intoxicated rather than under sober conditions. However, information encoded and stored while intoxicated was more effectively retrieved when later tests of recall were performed while intoxicated, as compared to recall accomplished in the sober state. This dissociative recall effect was far more robust with low-imagery than with high-imagery words.