Educators' occupational well-being in health and social care education.

BACKGROUND: The occupational well-being (OW) of educators can be defined as a balance between resources and workload factors as seen from four aspects of working life: (i) individual, (ii) working conditions, (iii) professional competence and (iv) work community. The research in this study examined the individual aspect as particular importance to the physical and mental workability of educators. AIMS: To study the individual aspect of the OW of educators as well as the associating factors. METHODS: A cross-sectional survey design was conducted among educators working in health and social care education in Finland. The data were collected with an electronic survey using the 'Occupational well-being of social and health care teachers-index questionnaire'. The data were analysed with an SPSS version 27 using descriptive statistics, explorative factor analysis and linear regression analysis. RESULTS: The educators (n = 552, response rate 31%) assessed their resources for managing their mental workload as quite poor (2.41, standard deviation [SD] 0.98). In addition, workplace support promoting OW was assessed as being quite poor (2.37, SD 0.88), and as especially requiring more measures during working hours. Associations with the individual aspect of OW were found between the personal and work-related background variables as well as overall OW. CONCLUSIONS: The perceptions of the educators indicated that resources to cope with workload factors should be promoted. Investing in educators' resources at work, enabling well-being actions during working hours and avoiding backlog situations would all help promote the educators' OW.

In vitro biocompatibility of degradable biopolymers in cell line cultures from various ocular tissues: direct contact studies.

Synthetic biodegradable polymers have many potential therapeutic applications. In ophthalmology, biodegradable polymers have been used as viscoelastic agents and surgical implants. Other potential applications include controlled release of drugs and growth factors, gene therapy, and tissue engineering. In the present study, in vitro biocompatibility of three biodegradable polymers, 50:50 PDLGA, 85:15 PDLGA, and Inion GTR membrane was evaluated in comparison to tissue culture polystyrene by investigating cell proliferation and potential acute toxicity by the WST-1 cytotoxicity/cell proliferation test, the ATP test, and the lactate dehydrogenase (LDH) test. Evaluations were conducted with cell line cultures from various ocular tissues, human corneal epithelial cells (HCE), rabbit stromal fibroblasts (SIRC), bovine corneal endothelial cells (BCE), human conjunctival epithelial cells (IOBA-NHC), and human retinal pigment epithelial cells (ARPE-19) by direct contact studies by plating the cells on the polymer film specimens in 96-wells. The proliferation results show that cell lines from various ocular tissues attached and grew on PDLGA 50:50, PDLGA 85:15, and Inion GTR membrane. Cytotoxicity experiments with the LDH and ATP tests showed no or extremely slight toxic adverse effects. These polymers have potential to be used as scaffolds in cell transplantation devices or as surgical implants.

Systemic absorption of topically applied ocular atropine.

We quantitated atropine plasma levels and monitored blood pressure, heart rate, and salivary secretion after ocular application. Eight patients received 40 microliters 1% atropine in the lower cul-de-sac of one eye in connection with ocular surgery. Atropine plasma levels were determined for 90 minutes by radioreceptor assay. The peak plasma atropine concentration of 860 +/- 402 pg/ml was reached within 8 minutes in all patients. The ocular absorption of atropine was at least as rapid as that reported for intramuscular administration. Ocular atropine did not affect patients' blood pressure or heart rate when compared with those of the placebo group. Thirty minutes after administration of atropine eyedrops, the salivary secretion in the experimental group was reduced, but was statistically insignificant from the placebo group.

Beta-blocking effects of timolol at low plasma concentrations.

The concentration-effect relationship of 0.25 mg intravenous timolol with and without pretreatment with 100 mg quinidine was studied in six healthy young volunteers with a randomized, double-blind, crossover study design. Blockade of cardiac beta-adrenoceptors was assessed by determining the dose ratios (DR) of isoproterenol infusions required to increase heart rate by 25 beats/min before and after timolol infusion. The logarithm of timolol concentration in plasma was linearly related to the logarithm (DR-1) of isoproterenol infusion, with a mean Pearson correlation coefficient of 0.89 +/- 0.11 (+/- SD; n = 24) at timolol concentrations well below 1 ng/ml. The increases in cyclic adenosine monophosphate (cAMP) and norepinephrine plasma levels caused by isoproterenol infusions were attenuated after timolol. Quinidine administration increased timolol plasma levels and cardiac beta-blocking effects by 10% to 40%. It was concluded that timolol at concentrations below 1 ng/ml in plasma competitively antagonizes cardiac and noncardiac effects of isoproterenol infusions. Timolol effects are augmented after quinidine administration. The beta-blockade occurring at low plasma levels can explain side effects and actions of ocularly applied timolol.

Minimizing systemic absorption of topically administered ophthalmic drugs.

Due to absorption several ocularly applied medications give rise to systemic side-effects. The problem of systemic drug absorption should be taken into account in designing ocular drug and dosage forms so that oculospecificity of the medications is optimized. In this review we summarize the current knowledge about the systemic absorption of ocularly applied topical drugs. Special emphasis is directed to the methods that can be used to minimize systemic absorption and increase the oculospecificity of drugs, e.g., reducing volume and increasing viscosity of eyedrops, controlling drug release from depot preparations, prodrug-derivatization, and addition of vasoconstrictive agents.

Orbital laceration caused by a blast of water: report of 2 cases.

Two cases of orbital injuries caused by the jet of water from an irrigation sprinkler are described; they were of a type not previously reported. The jet of water, possessing high kinetic energy, stretched the orbital tissues and resulted in a rupture which followed the anatomical seams. Thus there was no bleeding, but oedema was present. The eyeball was also injured.

Chlamydial immunofluorescence serology in anterior uveitis.

Chlamydial immunofluorescence (IF) serology was determined in 118 patients with acute anterior uveitis (AAU), half of whom had anti-chlamydia antibodies. Men and women were equally affected. The chlamydial IF antibody titre was generally 1/16-64, but a few higher values were also measured. The age distribution, ocular pathology, and duration of AAU were identical in the chlamydial seropositive and seronegative patient groups. In the seropositive group there were 3 men with Reiter's syndrome. The prevalence of anti-chlamydia antibodies (50%) was higher than in other patients studied in the same laboratory. Further population studies are in progress to see whether our AAU patients represent an accumulation of chlamydial-positive persons.

Evaluation of the cytotoxicity of selected systemic and intravitreally dosed drugs in the cultures of human retinal pigment epithelial cell line and of pig primary retinal pigment epithelial cells.

The cytotoxicity of the selected systemic and intravitreally dosed drugs tamoxifen, toremifene, chloroquine, 5-fluorouracil, gentamicin and ganciclovir was studied in retinal pigment epithelium (RPE) in vitro. The cytotoxicity was assayed in the human RPE cell line D407 and the pig RPE cell culture using the WST-1 test, which is an assay of cell proliferation and viability. The effects of experimental conditions on the WST-1 test (cell density, serum content in the culture medium, the exposure time) were evaluated. The EC50 values in tamoxifen-treated D407 cells ranged between 6.7 and 8.9 micromol/l, and in pig RPE cells between 10.1 and 12.2 micromol/l, depending on the cell density used. The corresponding values for toremifene were 7.4 to 11.1 micromol/l in D407 cells and 10.0 to 11.6 micromol/l in pig RPE cells. In chloroquine-treated cells, the EC50 values were 110.0 micromol/l for D407 cells and 58.4 micromol/l for pig RPE cells. Gentamicin and ganciclovir did not show any toxicity in micromolar concentrations. The exposure time was a significant factor, especially when the drug did not induce cell death, but was antiproliferative (5-fluorouracil). Serum protected the cells from the toxic effects of the drugs. Both cell cultures were most sensitive to tamoxifen and toremifene, and next to chloroquine. The drug toxicities obtained in the present study were quite similar in both cell types; that is, the pig RPE cells and the human D 407 cell line, despite the differences in, for example, the growth rate and melanin contents of the cell types. Owing to the homeostatic functions important for the whole neuroretina, RPE is an interesting in vitro model for the evaluation of retinal toxicity, but, in addition to the WST-1 test, more specific tests and markers based on the homeostatic functions of the RPE are needed.

The treatment of endophthalmitis after cataract surgery: review of 26 cases.

A retrospective study of 26 cases of postoperative endophthalmitis occurring after extracapsular cataract extraction and lens implantation was conducted between January 1989 and December 1992. Twenty-one of the 26 cases (81%) were diagnosed within two weeks after surgery. The most common organism isolated was Staphylococcus saprophyticus (23%). After the bacterial samples had been taken, cefotaxime or gentamicin was injected into anterior chamber and vitreous space. The therapy regimen consisted of topical tobramycin, Polysporin (polymyxinsulfate, neomycinsulfate and gramicidin), dexamethasone and atropine and parabulbar cefotaxime, netilmicin and betamethasone. Cefotaxime or, alternatively, clindamycin, ciprofloxacin and prednisolone were given systemically. The final visual acuity of 20/40 or more was obtained in 15 cases (58%). Twenty-one patients (81%) achieved a visual acuity of 20/400 or better. Three patients had no light perception after the treatment of endophthalmitis. Silk as suture material in wound closure and rupture of the posterior capsule were found to be risk factors in the development of endophthalmitis. The results of the present study show that effective drug treatment also results in good visual outcome.

Corneal vascularization and opacification during long-term use of dipivefrin.

Dipivefrin hydrochloride is a lipophilic prodrug for epinephrine hydrochloride, allowing lower concentration of the drug to achieve the same intraocular pressure lowering effect and having also less harmful effects than epinephrine hydrochloride. However, harmful effects have been associated also with the use of dipivefrin and here we report of a case of corneal vascularization during long-term use of dipivefrin.

Retinal pigment epithelial cell cultures as a tool for evaluating retinal toxicity in vitro.

This article reviews in vitro testing of retinal toxicity in retinal pigment epithelium (RPE) cell cultures. It is based on the literature on RPE cell cultures and on our recent studies on the retinal toxicity of selected amphiphilic drugs. The RPE plays a major role in maintaining the homeostasis and health of the retina. Various pharmacological agents are known to cause adverse effects in RPE cells. For example, long-term treatment with chloroquine in patients with rheumatoid arthritis has induced retinopathy, and tamoxifen, a drug that is commonly used in the treatment of advanced breast cancer and in the prevention of breast cancer among high-risk women, has been reported to cause retinal changes and impaired vision. During our research, we have developed novel in vitro methods for evaluating the retinal toxicity of xenobiotics. We have used a pig RPE primary culture and a human RPE cell line (D407), which retain epithelial cell characteristics. They form a layer of hexagonal cells with intercellular junctions, and possess a keratin-containing cytoskeleton. They are both good models for determining the retinal cell toxicity of test compounds. Further studies on phagocytic activity, lysosomal enzyme activity and glutamate uptake might generate new methods for the toxicological evaluation of the retinal side-effects of drugs in vitro.

Teleconsultations between general practitioners and ophthalmologists in Finland.

We carried out a study of the value of videoconferencing in consultations between general practitioners (GPs) and ophthalmologists in Finland. We used ISDN lines (128 kbit/s) between the Primary Health Care Centre in Ikaalinen and the ophthalmology clinic at the Tampere University Hospital (TAUH). Questionnaires covering both clinical and technical matters were given to patients and doctors after the consultation. During the 10-month study, consultations were carried out successfully for 23 of 24 patients (96%). Most consultations (84%) took less than 15 min. If we had not had this system, the GP would have made 21 referrals to an ophthalmologist. After teleconsultation, six patients were sent to the TAUH, so the system saved 15 referrals. Twenty-two patients (92%) thought that videoconferencing was a reliable tool for GPs. Our system proved to be a valuable and reliable tool for the GPs in ophthalmology consultations and continuing education.