Assessment of prevalence and load of torquetenovirus viraemia in a large cohort of healthy blood donors.

OBJECTIVES: Torquetenovirus (TTV) is an emerging marker of functional immune competence with the potential to predict transplant-related adverse events. A large-scale epidemiological study was performed to understand how basal values vary in healthy individuals according to age and gender. METHODS: We tested plasma from 1017 healthy blood donors aged 18-69 years. The presence and load of TTV were determined by a real-time PCR assay. A sub-cohort of 384 donors was tested for anti-cytomegalovirus IgG antibodies, and 100 participants were also tested for TTV viraemia on a paired whole blood sample. RESULTS: The overall prevalence of TTV was 65% (657/1017) with a mean (±SD) growth of 5 ± 4% every 10 years of age increase, but stably higher in males (465/690, 67%) than in females (192/327, 59%). Mean (±SD) TTV load was 2.3 ± 0.7 Log copies/mL with no sex difference. TTV viraemia showed modest increases along 10-year age intervals (mean ± SD: 0.3 ± 0.1). TTV viraemia in donors sampled 2 years later remained stable (mean ± SD: 2.3 ± 0.8 versus 2.2 ± 0.7 Log copies between samples). Twenty-six per cent (9/34) of blood donors with TTV-negative plasma scored positive when whole blood was tested, and the donors with positive plasma showed a mean (±SD) 1.4 ± 0.5 Log increase in copy numbers when whole blood was tested. CONCLUSIONS: This study establishes the mean value of TTV viraemia in plasma in healthy blood donors and suggests that ageing causes only minimal increases in TTV viraemia.

Consumer contributions in developing clinical practice guidelines.

Clinical practice guidelines are designed for use with consumers. However, consumers are rarely consulted about their development. This paper describes a research project to develop clinical practice guidelines for a community meeting to prevent and intervene with assaultive behavior. The research included consumer input from psychiatric inpatients. The two-phase approach with the consumers included a focus group, followed by survey research. Results, problems, and recommendations are presented.

Money: personal issues affect professional practice.

Money is a taboo subject. Clinicians have much ambivalence about money, both personally and professionally, and are often more comfortable discussing clients' issues around money than examining their own. As a result, how clinicians handle money with clients is often determined by the clinicians' personal feelings about money; however, they do not explore the meaning and origin of these feelings or determine how these feelings affect their practices. This article explores the conscious and unconscious issues surrounding money, case examples of therapists' dilemmas in handling money, and implications for practice.

The relationship of behavioral cues to assaultive behavior.

The purpose of this 2-year, case control study was to determine whether differentiation between assaultive and nonassaultive patients can be made based on behavioral assessments and/or sociodemographic variables. For each assault incident, the chart of the patient who assaulted and a randomly chosen patient who did not assault on that day were reviewed (N = 72 subjects or 26 pairs). Various scales were used to evaluate the subjects retrospectively (the day prior to the assault), and patients who assaulted staff were interviewed when possible. An analysis found no differences between patients who assaulted and controls on sociodemographic variables. Those who assaulted had significantly more prior assaults (p = .04) and more difficulty verbalizing angry feelings appropriately on their units (p < .01). Prior to the assault, assaultive patients were more verbally hostile (p = .037) and showed more increased motor activity (p = .001) than controls.

Nurses as patient assault victims: an update, synthesis, and recommendations.

The literature documenting the incidence and reactions of nursing staff who have been assaulted by patients is increasing. Before 1980 very little work was done in the area. What did appear generally indicated that patient violence against staff was infrequent, and on the rare occasion when it did occur the staff member was usually in some way responsible. Current research shows that assault is a serious risk factor for nurses. The incidence of assault is high and vastly underreported. Staff members experience short- and long-term emotional, social, biophysiological, and cognitive reactions to being assaulted. Interventions to help the staff victim in the recovery process are increasingly used.