"Please help us with important research": A retrospective analysis examining the impact of research invitation and participation on subsequent blood donor behavior.

BACKGROUND: As over-communication can negatively impact consumer behavior, it is important to understand the impact of research communication on donors' future donation behavior. The aim of this study was to determine the effect of (i) being invited to participate in research, and (ii) participating in that research, on future donation behavior. STUDY DESIGN AND METHODS: A retrospective cohort analysis was conducted with 36,418 donors who were invited to participate in one of 17 research projects, and a matched control group of 36,252 non-invited donors. Poisson regression models were used to examine the associations between invitation or participation in the studies and the likelihood of creating an appointment to donate and attending an appointment at 1, 3, and 6 months. RESULTS: Donors were significantly more likely to create an appointment within 14 days of receiving an invitation compared to controls (RR: 1.91, 95% CI 1.81-2.02), and to return to donate at 1 (RR:1.18, 95% CI 1.13-1.24), 3 (RR:1.10, 95% CI 1.07-1.13) and 6 (RR:1.11, 95% CI 1.09-1.13) months compared to non-invited controls. Donors who participated in the research were more likely to return than control donors at all time points, while donors who were invited but did not participate were also likely to return more at 1 month (RR:1.06, 95% CI 1.00-1.11) and 6 months (RR:1.03, 95% CI 1.00-1.5) than non-invited controls. DISCUSSION: Our findings suggest that research participation is positively associated with future donor behavior and provides reassurance that contacting donors for research does not negatively impact blood collections.

Intravenous Thrombolysis for a Stroke Mimic Patient.

The authors present the case of a young woman on phentermine and herbal supplements who presented as an acute stroke alert with right-sided facial droop and numbness. She was treated acutely with intravenous tissue plasminogen activator (tPA). However, the workup did not reveal any evidence of cerebrovascular disease or cerebral infarct. The authors discuss plausible stroke mimics and the safety of administering tPA to such patients.

Anaphylaxis Presenting as Uvulitis.

The authors present a case of a young man who woke up with uvular swelling resulting in a severely narrowed airway. He had ingested peanut butter the prior night but was unaware of any allergies. He was treated with epinephrine, diphenhydramine, and methylprednisolone which resulted in resolution of the airway compromise. The authors discuss the mechanism of anaphylaxis and the emergency management of this life-threatening condition.

The vasovagal reaction experience among blood donors: A qualitative study of factors that affect donor return.

RATIONALE: Blood collection agencies face ongoing challenges in retaining voluntary donors to meet the demand for blood and blood-related products by healthcare services. A known deterrent to continued blood donation is the experience of a vasovagal reaction (VVR). However, there has been little research into donors' experiences of these reactions and the factors that influence their decision to return, which is essential information to inform strategies to improve donor return. OBJECTIVE: The aim of this paper was to explore blood donor views and experiences of a VVR, with a particular interest in how the reaction influenced their return behaviour, using the Transactional Model of Stress and Coping. METHODS: We conducted 34 semi-structured in-depth interviews between February and April 2018 with a sample of Australian donors who had experienced a VVR in the last seven days. Transcripts were analysed using the Framework Method. RESULTS: The VVR elicited various emotional responses, which appeared to be influenced by social support, being aware of the possibility of experiencing a VVR, or the donation outcome. In turn, the VVR experience affected intentions to return, with those who reported more positive experiences expressing stronger intentions. Further, donors felt more likely to return if they perceived their risk of a recurrent event as low and if they were able to identify appropriate problem and emotion-focused coping strategies. CONCLUSION: This article provides novel insights into possible ways to encourage blood donor return following a VVR.

Gone, but haven't forgotten: insights on plasmapheresis donation from lapsed donors.

BACKGROUND AND OBJECTIVES: Blood Collection Agencies in several countries have implemented strategies to increase the number of plasmapheresis collections. Despite this, a sizable minority of plasma donors lapse from donation each year, with little research conducted on this topic. An understanding of the plasma donation experience from the perspective of lapsed donors, insights into why they stopped donating and their views on returning to donate may provide opportunities to intervene to increase the retention and reactivation of plasma donors. MATERIALS AND METHODS: A qualitative approach was used in this study, with 17 lapsed plasma donors (no plasma donation for at least 13 months) interviewed. A purposive recruitment strategy was used to obtain a sample with diversity in gender (47% men), age (M = 36·2 years, SD = 13·6) and donation experience (M = 9·2 years, SD = 9·6). Semi-structured, narrative interviews were conducted, with participants describing their plasma donation careers chronologically from first donation to most recent. RESULTS: The majority of participants described at least some aspect of the plasma donation procedure as unpleasant. However, adverse experiences were only attributed to lapsing in a minority of cases, with other participants reporting significant life events, perceived ineligibility and concerns about the safety of the procedure as the reason why they lapsed. CONCLUSION: It is common for lapsed plasma donors to intend to donate again in the future. Recommendations are given for strategies to address barriers to returning, noting the potential role of tailored education and support.

Do we cause harm? Understanding the impact of research with young children about their body image.

Although research into the early development of body image and eating behaviors is essential, concerns have been raised about whether their assessment might precipitate body or eating concerns in children. We aimed to identify how parents perceived their young children (under 9 years) had been impacted from involvement in the longitudinal Children's Body Image Development Study (CBIDS) that assessed body image and eating behaviors. Participants were 218 parents (99 % mothers) who completed an online questionnaire assessing whether and why their child discontinued participation in CBIDS, and the perceived impact of participation on children's body image, weight attitudes, language about bodies, internalisation of appearance ideals, peer appearance conversations, dietary restraint, muscle building activities, and physical activity. Impact and reasons for cessation of participation were assessed retrospectively. Almost all parents were positive or neutral about their child's involvement, 0.5%-3.2% of parents perceived a negative impact in an area, and 0.9 % of parents moderately agreed that they regretted participating in CBIDS. Themes for positive and negative aspects of CBIDS involvement were explored using thematic analysis. Although research is essential to guide development of prevention strategies, this study highlights the need to implement safeguards to ensure a positive experience for all children.

Bringing new plasma donors back: testing the efficacy of telephone and e-mail communications with first-time donors.

BACKGROUND: As demand for plasma-derived products grows, retention of voluntary nonremunerated plasmapheresis donors is crucial for many blood collection agencies. Currently, there is limited evidence of how to encourage first-time plasmapheresis donors to return and establish a high-frequency donation routine. This study tested the effectiveness of an intervention designed to increase retention of first-time plasmapheresis donors, increase donation frequency, and reduce time to return. STUDY DESIGN AND METHODS: A total of 6788 first-time plasmapheresis donors were randomly assigned to one of four conditions. Donors received an alternative e-mail or the business-as-usual control e-mail paired or not with a phone call. Outcomes were compared to the control e-mail in intention-to-treat analyses. RESULTS: Compared with control, donors in all intervention conditions were more likely to donate plasma as their first return donation in 6 months; however, there were no significant differences between intervention conditions. Rates of plasma donation in the alternative e-mail, control e-mail plus call, and alternative e-mail plus call conditions were 17.0, 15.0, and 18.0% higher than control. While the extra donations obtained in the alternative e-mail condition were cost neutral, the cost of one additional donation in the call conditions ranged from 20.14-20.89 AUD (13.08-13.56 USD). CONCLUSION: Communications specifically designed to encourage first-time plasmapheresis donors to view regular plasmapheresis donations as "easy"; to forward-book more than one appointment; and to provide education about plasma are effective in encouraging donors to return to plasma, to donate more frequently, and to return faster.

Understanding donation frequency: insights from current plasma donors.

BACKGROUND AND OBJECTIVES: Encouraging existing plasma donors to donate more frequently is a key objective for blood donation services committed to expanding yield through voluntary non-remunerated plasmapheresis donation. This requires an understanding of donors' perspectives on their current donation practice and how this relates to their knowledge and beliefs about the need for plasma. To explore this, Australian plasma donors were interviewed about how they arrived at the frequency at which they donate. MATERIALS AND METHODS: Semi-structured telephone interviews were conducted with 105 Australian plasmapheresis donors. RESULTS: Key themes identified were as follows: fitting donation into busy lives and how ideas about being an ongoing donor and the institutional context shaped their perspective on frequency; perceptions of the impact of donation on health; and wanting to make a greater contribution. CONCLUSION: Experienced plasma donors work to maintain a donation practice in the context of busy lives often by adopting a flexible approach to donation frequency. Their knowledge of the contribution their donations make is key to their continued donation, yet most identified constraints to donating more frequently. Health concerns were a particular concern for some, and more research is needed to understand donors' perspectives on the impact of donating on their health.

Regulation of GAP-43 at serine 41 acts as a switch to modulate both intrinsic and extrinsic behaviors of growing neurons, via altered membrane distribution.

GAP-43 is the major neuronal substrate of protein kinase C (PKC). Its phosphorylation status dictates the severity of pathfinding errors by GAP-43 (+/-) growth cones in vivo, as well as its modulation of actin dynamics in vitro. These experiments show that stably overexpressing cDNAs mutant at its single PKC phosphorylation site at serine41 in retinoic acid treated SH-Sy5Y neuroblastoma cells regulates intrinsic and extrinsic behaviors of growing neurons. Intrinsically, only Wt and pseudophosphorylated GAP-43Ser41Asp precipitated with F-actin and potentiated F-actin - regulated filopodia formation. GAP-43Ser41Asp inhibited neurite outgrowth whereas only unphosphorylatable GAP-43Ser41Ala precipitated neurotubulin, potentiated neurotubulin accumulation in neurites and increased outgrowth. When PI3-kinase was inhibited GAP-43Ser41Asp-mediated filopodia formation was inhibited whereas GAP-43Ser41Ala-mediated neurite extension was potentiated. Extrinsically, only Wt and GAP-43Ser41Asp potentiated both homotypic adhesion and neurite outgrowth on NCAM-expressing monolayers and promoted NCAM stability. With respect to the underlying mechanism, more F-actin and NCAM colocalized with Wt and GAP-43Ser41Asp in detergent resistant membranes (DRMs) isolated from live cells and GAP-43Ser41Asp-mediated functions were insensitive to cholesterol depletion. In contrast, GAP-43Ser41Ala-mediated functions were sensitive to cholesterol depletion. Neither GAP-43Ser41Asp nor GAP-43Ser41Ala was able to protect against growth cone collapse mediated by PIP2 inhibitors. The results show that modification of GAP-43 at its PKC phosphorylation site directs its distribution to different membrane microdomains that have distinct roles in the regulation of intrinsic and extrinsic behaviors in growing neurons.

Immortalization of neural precursors when telomerase is overexpressed in embryonal carcinomas and stem cells.

The DNA repair enzyme telomerase maintains chromosome stability by ensuring that telomeres regenerate each time the cell divides, protecting chromosome ends. During onset of neuroectodermal differentiation in P19 embryonal carcinoma (EC) cells three independent techniques (Southern blotting, Q-FISH, and Q-PCR) revealed a catastrophic reduction in telomere length in nestin-expressing neuronal precursors even though telomerase activity remained high. Overexpressing telomerase protein (mTERT) prevented telomere collapse and the neuroepithelial precursors produced continued to divide, but deaggregated and died. Addition of FGF-2 prevented deaggregation, protected the precursors from the apoptotic event that normally accompanies onset of terminal neuronal differentiation, allowed them to evade senescence, and enabled completion of morphological differentiation. Similarly, primary embryonic stem (ES) cells overexpressing mTERT also initiated neuroectodermal differentiation efficiently, acquiring markers of neuronal precursors and mature neurons. ES precursors are normally cultured with FGF-2, and overexpression of mTERT alone was sufficient to allow them to evade senescence. However, when FGF-2 was removed in order for differentiation to be completed most neural precursors underwent apoptosis indicating that in ES cells mTERT is not sufficient allow terminal differentiation of ES neural precursors in vitro. The results demonstrate that telomerase can potentiate the transition between pluripotent stem cell and committed neuron in both EC and ES cells.