When biological scientists become health-care workers: emotional labour in embryology.

STUDY QUESTION: Can biological scientists working in medically assisted reproduction (MAR) have a role as health-care workers and, if so, how do they engage in the emotional labour commonly associated with health-care work? SUMMARY ANSWER: The scientists at Fertility Associates (FA) in New Zealand perform the technical and emotional cares associated with health-care work in an occupationally specific manner, which we refer to as a hybrid care style. Their emotional labour consists of managing difficult patients, 'talking up' bad news, finding strategies to sustain hope and meaning, and 'clicking' or 'not clicking' with individual patients. WHAT IS KNOWN ALREADY: Effective emotional labour is a key component of patient-centred care and is as important to the experience of high-quality MAR as excellent clinical and scientific technique. STUDY DESIGN, SIZE, DURATION: This is a qualitative study based on open-ended interviews and ethnographic observations with 14 staff in 2 laboratories conducted over 2 separate periods of 3 weeks duration in 2007. Analysis of fieldnotes and interviews was conducted using thematic analysis and an NVivo qualitative database and compared for consistency across each interviewer. PARTICIPANTS/MATERIALS, SETTING, METHODS: The participants were consenting biological scientists working in one of the two laboratories. Semi-structured interviews were conducted in 'quiet' work times, and supervised access was allowed to all parts of the laboratories and meeting places. Opportunities for participant review of results and cross comparison of independent analysis by authors increases the faithfulness of fit of this account to laboratory life. MAIN RESULTS AND THE ROLE OF CHANCE: The study suggests that emotional labour is a part of routinized scientific labour in MAR laboratories for FA. LIMITATIONS, REASONS FOR CAUTION: This is a qualitative study and thus the findings are not generalizable to populations beyond the study participants. WIDER IMPLICATIONS OF THE FINDINGS: While little has been published of the emotional component of scientist's working lives, there may be a New Zealand style of doing scientific work in MAR laboratories which is patient centred and which incorporates much higher patient contact and involvement than is experienced in other laboratories. STUDY FUNDING/COMPETING INTEREST(S): This study was funded by a research grant from the University of Otago and was also partly funded by a Marsden Grant administered by the Royal Society of New Zealand. TRIAL REGISTRATION NUMBER: N/A.

Corticosteroid-binding globulin, cortisol, free cortisol, and sex hormone-binding globulin responses following oral glucose challenge in spinal cord-injured and able-bodied men.

Circulating cortisol, corticosteroid-binding globulin, and sex hormone-binding globulin were measured retrospectively in plasma samples following the oral glucose tolerance test in 20 spinal cord-injured men and 20 able-bodied controls. Plasma-free cortisol responses attenuated more rapidly in the able-bodied men, compared to spinal cord-injured subjects, due to significant rise in circulating corticosteroid-binding globulin whereas changes in total plasma cortisol were similar in both groups. The changes in plasma-free cortisol in both groups paralleled changes in insulin and glucose and show that spinal cord-injured men had heightened exposure to free cortisol during this dynamic test. This raises the possibility that the mechanism of abdominal obesity and the propensity towards insulin resistance in spinal cord-injured men could be subtly mediated by perturbations in free cortisol. There were no significant changes in plasma sex hormone-binding globulin in either group.

Widely tunable laterally coupled distributed feedback laser diodes for multispecies gas analysis based on InAs/InGaAs quantum-dash material.

Applying the concept of binary superimposed gratings, widely tunable single-mode laser diodes suitable for multispecies gas detection in the 1.8 microm wavelength range could be manufactured on InAs/InGaAs quantum dash-in-a-well material. A discrete wavelength tuning range of 21 nm as well as continuous tuning over 0.8 nm are demonstrated. Water and hydrogen chloride could be detected at absorption lines 13 nm apart.

Stem cell spinal cord regeneration: first do no harm.

The prospect of "curing" spinal cord injury using stem cell therapy is one of the significant goals of many stem cell researchers. In this communication we consider some of the physiological implications of successful in vivo spinal cord repair and the ethical issues this potential revolutionary therapy will raise.

Transfer of dry surface biofilm in the healthcare environment: the role of healthcare workers' hands as vehicles.

BACKGROUND: Dry surface biofilms (DSBs) persist for extended periods in hospital, and may play a significant role in transmission of healthcare-associated infections. AIM: To determine whether DSBs may be transferred from hospital surfaces to healthcare workers' hands. METHOD: Twelve-day Staphylococcus aureus DSB was grown on polycarbonate and glass coupons in a CDC Biofilm Reactor®. A total of 1.8 × 106 and 8.8 × 105 bacteria grew on the polycarbonate and glass coupons respectively. Transmission was tested by lifting the coupon with forefinger and thumb of ungloved hands to a height of 30 cm, then touching horse blood agar (HBA) plates 19 sequential times. Transferred bacterial number was determined by colony-forming units. The effect of DSB wetting on biofilm transfer was tested with 5% neutral detergent treatment for 5 s. FINDINGS: Between 5.5 and 6.6% of the DSB bacteria were transferred to hands with one touch and ∼20% were then transferred to HBA with one touch, giving an overall transfer rate of 1.26% and 1.04% for polycarbonate and glass coupons, respectively. Detergent treatment had little effect on bacterial removal from coupons, but, for biofilm grown on polycarbonate, significantly increased transferral to HBA (P < 0.001) to 5.2%. Large numbers of bacteria were transferred by bare hands to multiple fomites. One-third of polycarbonate coupons transferred >1000 colonies during the first five sequential touches. Sufficient bacteria to cause infection were transmitted up to 19 times following one touch of the DSB. CONCLUSION: DSB bacteria are transferred by hands from one fomite to multiple fomites, suggesting that DSB may serve as a persistent environmental source of pathogens.

All troponins are not created equal.

Troponin measurement is central to the management and risk stratification of acute coronary syndromes. Decisions are made by categorizing troponin as positive or negative. We sought to evaluate categorical agreement between four troponin assays. Sixty blood samples were analysed by three troponin I assays (Centaur, Architect and point-of-care i-STAT) and one troponin T (TnT) assay (Roche Elecys). The upper reference limit was taken as the lowest value with a coefficient of variation of 10% or less. Continuous agreement between assays was good (Pearson's correlation coefficient 0.871-0.995). Categorical agreement assessed by Cohen's kappa varied from poor (between Architect and Centaur kappa = 0.37, and between TnT and Centaur kappa = 0.48) to good (between Architect and i-STAT kappa = 0.68, and between TnT and i-STAT kappa = 0.68). Percentage of positive results varied almost twofold, from 37% for the Centaur to 72% for the Architect. Comparison of four troponin assays showed up to twofold variations in the proportion of positive results. This implies that either a large proportion of troponin-positive diagnoses are missed by some assays or the assays with higher positivity are generating large numbers of false positives. Clinicians should evaluate troponin results in the clinical context and not base decisions solely on the 'normal range' of their local troponin assay.

Oocyte and zygote ketoaldehyde utilisation.

Mouse oocytes and zygotes, when solubilised demonstrated that a range of ketoaldehydes could be utilised as substrates. Of the five ketoaldehydes investigated the overall substrate utilisation was hydroxypyruvate > glyoxylate > 2-ketobutyrate > pyruvate > glycolate. The utilisation of these ketoaldehydes during early development by LD-1 may provide a source of new metabolic substrates in addition to the potential control of aldehyde toxicity. It is proposed therefore that the LD-1 isoenzyme is responsible for ketoaldehyde utilisation prior to implantation thereby providing a source of alternative metabolic substrates for the developing embryo.

No evidence for a genetic blueprint: The case of the "complex" mammalian photoreceptor.

Despite the intensity of the search for genes causing inherited retinal degenerations over the past 3 decades, of the approximately 200 disease genes identified to date, all appear to be ordinary housekeeping genes specifying proteins playing basic structural and functional roles in the mature photoreceptor cells. No genes or genetic elements have been identified which can be construed as having a specific morphogenic role, directing the development of the cytoarchitecture of any particular retinal cell. The evidence suggests that the cytoarchitecture of the retinal photoreceptors, although enormously complex, arises from the self-organization of the cells constituents without any regulation or direction from an external genetic blueprint.

Regular exercise dissociates fat mass and bone density in premenopausal women.

Body weight is one of the principal determinants of bone density and fracture frequency, but there is significant disagreement in the literature regarding the relative contributions of the lean and fat components of body weight to this relationship. As previous studies have not considered the possible role of exercise in soft tissue-bone density interrelationships, we measured areal bone mineral density (BMD), fat mass, and lean mass in eumenorrheic premenopausal women and determined whether the interrelationships of these variables are influenced by the subject's exercise status. Subjects with mean activity levels of more than 140 kilojoules/kg.day (equivalent to undertaking vigorous physical activity for > 1.5 h/week) were classified as exercisers. In the nonexercising subjects (n = 36; age, 36 +/- 8 yr), BMD was markedly weight dependent (0.45 < r < 0.62), and this was contributed to by both fat and lean tissue. Because this finding may have arisen from the mutual dependence of soft tissue mass and areal BMD on body size, fat and lean masses were reexpressed as a percentage of body weight. The percent fat tended to be positively related to areal BMD (0.23 < r < 0.35), whereas the percent lean was inversely related to this index. A second way of obviating the mutual dependence of soft tissue mass and areal BMD on body size is to derive BMD/height as an index of volumetric bone density. This parameter was only related to lean mass in the femur, whereas the correlations with fat mass were little changed. The percent fat was positively (0.29 < r < 0.43) and the percent lean was negatively (-0.43 < r < -0.29) related to BMD/height throughout the skeleton, including the femur. In the exercising subjects (n = 63; age, 33 +/- 8 yr), fat mass and lean mass were unrelated to BMD/height (r < 0.23). However, the percent lean was positively correlated with BMD and BMD/height in the femoral neck (r = 0.28 and r = 0.31, respectively). It is concluded that bone density is only associated with fat mass in sedentary women. In exercisers, femoral neck density is related to lean mass, possibly through the effects of weight-bearing exercise on both of these variables.

Plasma diamine oxidase levels in pregnancy complicated by threatened abortion.

Plasma diamine oxidase levels were assayed in 66 patients who presented with pregnancy complicated by threatened abortion. Levels within the normal range were associated with continuing pregnancies, whereas levels below the normal range were associated with subsequent abortion. Among those patients in whom gestation was greater than eight weeks, 66.6% of diamine oxidase levels correctly predicted the pregnancy outcome. Assay of the diamine oxidase levels at eight weeks of gestation or less gave little useful information.

Amniotic fluid fluorescence polarisation values for assessing fetal lung maturation.

The fluorescence probe 1,6, diphenyl-1,3,5-hexatriene was used to determine the micro-viscosity of third trimester amniotic fluid samples utilising an Aminco Bowman spectrofluorometer fitted with a polariser prism. The results were related to the lecithin sphingomyelin (L:S) ratio. A fluorescence polarisation value of 0.360 corresponded to an L:S ratio of 2.0 in uncomplicated and diabetic pregnancies. Pregnancies complicated by Rhesus disease gave significantly different fluorescence polarisation values when compared with the uncomplicated pregnancies.

Maternal serum alpha 1-antitrypsin concentrations in normotensive and hypertensive pregnancies.

Maternal serum alpha 1-antitrypsin concentrations were measured serially in pregnant women who were normotensive and those with mild, moderate, and severe hypertension of pregnancy from 27 weeks' gestation to term. alpha 1-antitrypsin concentrations increased with advancing gestation in all four groups. In addition, the hypertensive pregnancies showed higher than normal concentrations at each stage of pregnancy, with values in the severe hypertension group being higher than values in the other two hypertensive groups. At 35-36 weeks' gestation to term the increase in alpha 1-antitrypsin in the severe hypertension group was significant (p less than 0.05) when compared with the normotensive group. Although plasma oestriol and progesterone concentrations increased with advancing gestation in all groups, there was no direct relation between their concentrations and the increase in alpha 1-antitrypsin concentration in the hypertensive groups.

Amniotic fluid endocrine changes during maternal hyperalimentation.

Ten women with low estriol excretion received hyperalimentation prior to induction of labor. Six received an amino acid mixture (5% Aminofusin) and 25% dextrose, two received the amino acid mixture, and two received 25% dextrose. Amniotic fluid obtained before and after hyperalimentation was assayed for fetal surfactant production, thyroid, pituitary, and carbohydrate regulating hormones. In the combined amino acid/dextrose infusion group the amniotic fluid palmitic acid levels increased significantly post infusion; rT3 also increased significantly but T3 and T4 showed no significant change. The pituitary hormones growth hormone, prolactin, and ACTH showed no significant change, but beta-endorphin-like activity was significantly elevated. No thyroid-stimulating hormone was detected in any of the samples. All the carbohydrate regulating hormones, insulin, cortisol, and cAMP, showed significant increases but cGMP showed a significant decrease. The amino acid and dextrose only groups gave similar results. Seven of the infants showed some degree of intrauterine growth retardation but no neonatal complications attributable to the hyperalimentation.

Glycosaminoglycans of the uterine and vaginal cul-de-sac tissue in the brushtail possum (Trichosurus vulpecula).

Live-captured feral brushtail possums (Trichosurus vulpecula) received slow-release progestagen implants for 16 days after removal of pouch young. At the time of implant removal one group was injected intramuscularly with pregnant mare serum gonadotrophin (PMSG, 2 I.U. kg-1 in 0.2 mL saline) and another group received an equivalent volume of sterile saline. Animals from each group were killed on Days 0, 3, 4, 5 or 6 after implant removal (PMSG, n = 4 per day; saline controls, n = 3 per day). The uterus and vaginal cul-de-sac were excised and tissue was analysed for glycosaminoglycans (GAGs) and keratan sulfate content. GAG concentration increased progressively over the six-day period following implant removal. Mean uterine GAG concentrations were significantly higher than those in vaginal cul-de-sac from Day 3 to Day 6 in PMSG-treated and saline-treated animals following progestagen implant removal (P < 0.05). Keratan sulfate concentrations showed a similar response--concentrations were higher in uterine tissue than in vaginal cul-de-sac tissue and PMSG-treated animals showed a greater response than did saline controls in the uterine tissue, but the same response in cul-de-sac tissue (P < 0.05 for all groups). The progressive increase in GAG concentrations of reproductive tract tissue following removal of the progesterone implant is indicative of hormonal stimulation and suggests that GAGs may have a supportive role in gamete and embryo nutrition and growth in the brushtail possum.

Age related changes in drivers' crash risk and crash type.

Age and gender differences in the rates of crash involvement of Western Australian drivers were examined using the Road Injury Database of the Road Accident Prevention Research Unit at the University of Western Australia. The population examined was all drivers of cars, station wagons and related vehicles involved in property damage, injury and fatal crashes reported to the police in Western Australia from 1 January 1989 to 31 December 1992. It was found that drivers aged < 25 years were involved in ca 35% of crashes, compared with 3% for drivers 70 years and over. Drivers under 25 years had the highest rates on a population and licence basis, but when the distance travelled was taken into account, rates of crash involvement for the 75 or more age group were as high as those of the youngest age group. Females had higher rates of crash involvement than males in all age groups. Drivers over 70 years were involved in relatively more crashes involving fatalities and hospital admissions than younger drivers, although the number of such crashes was small. The youngest groups of drivers had proportionately more single vehicle crashes, drivers 30-59 years had more same direction crashes, and drivers over 60 years, particularly those over 75 years, had more direct and indirect right angle crashes. There were also age related patterns in the movements associated with these crashes. Drivers under 30 years were associated with swerving and swinging wide, drivers 30-59 years were stopped at the time of the crash disproportionately often, and drivers over 60 years were associated with turning movements. The percentage of crashes in daylight ranged from ca 64% for drivers under 20 years to a maximum of over 90% for those 80 years and over. These patterns are consistent with changes in exposure to risk of crash involvement with age, and also with changes in ability, experience and psychological function, which are also related to age.

L-cysteine improves growth of human peritoneal mesothelial cells in vitro.

OBJECTIVE: To improve the growth characteristics of human peritoneal mesothelial cells (HPMC). DESIGN: The effect of commonly used agents, L-cysteine and epidermal growth factor (EGF), added individually ("single") or mixed with hydrocortisone and apo-transferrin ("admixture") in the culture medium (M199) on cultured HPMC, was investigated. METHODS: Growth agents were added to M199 medium along with 2% fetal bovine serum and L-glutamine. Growth was determined by the analysis of thymidine ([methyl-3H] thymidine) incorporation into deoxyribonucleic acid, total cell protein, and by cell counts. Morphology was assessed by phase contrast light microscopy and scanning electron microscopy. RESULTS: HPMC exposed to L-cysteine 0.25 x 10(-3) mol/L (30 micrograms/mL) exhibited significantly improved attachment and growth. Attached cells appeared flat and well spread out shortly after seeding, and produced a tight polygonal monolayer in 14 days, in contrast to the growth of HPMC in control M199 medium, which failed to reach confluence. After an initial lag period in cell growth, EGF (0.01 microgram/mL) produced a greater increase in cell growth than L-cysteine did; however, this was associated with changes in HPMC morphology. During the growth period (14 days), EGF-stimulated HPMC appeared distorted and irregular compared to L-cysteine-treated cells, which had the characteristic tight "cobblestone" appearance. CONCLUSION: L-cysteine improved cell attachment with preservation of the characteristic morphology of HPMC. Epidermal growth factor improved cell growth but produced changes in morphology. The addition of L-cysteine to the culture medium has an important cell growth enhancement role due to the improved cell attachment and cell viability.

Urinary creatinine excretion during pregnancy.

Twenty-four urinary creatinine excretion was measured in pregnant women. Three groups were selected, the first were those who were normotensive throughout pregnancy and had normal fetal outcome, the second were those who developed hypertension during pregnancy with normal fetal outcome and the third group were those who had twins with normal fetal outcome. The normotensive and twin pregnancies had creatinine excretion rates which were not statistically different. The creatinine excretion rate in the hypertensive pregnancies was statistically significant when compared with the normotensive population.

Amniotic fluid gamma-glutamyl transpeptidase activity during the second trimester.

Gamma glutamyl transpeptidase (GGTP) activity was determined in second trimester amniotic fluid taken from normal fetuses and those with fetal abnormalities. GGTP activity decreased with advancing gestation. Increasing meconium contamination correlated with an increase in GGTP activity as did increasing fetal blood contamination. Maternal blood did not affect GGTP activity. Anencephaly did not significantly alter the GGTP activity, however, fetuses with spina bifida had significantly lower activity. Klinefelters and Turners syndromes both had GGTP activity close to the 50th percentile, and two trisomy 21 fetuses had GGTP activity below the 40th percentile. Two trisomy 18 fetuses and two translocation Downs syndromes (46 XY, t (14;21) had GGTP activities considerably lower than the 20th percentile as did a fetus with gastroschisis. Second trimester amniotic fluid GGTP activity may provide an easy preliminary test to screen amniotic fluids for the possibility of certain fetal chromosome abnormalities.

Second trimester amniotic fluid acetylcholinesterase quantitation in the prenatal diagnosis of neural tube defects.

Amniotic fluid acetylcholinesterase (AChe) activity was assayed in second trimester amniotic fluids by inhibition of non-specific cholinesterase using lysivane. Of the 196 samples analysed, 146 were from normal pregnancies; 11 (5.6%) from severe open neural tube defects; two from small open spina bifidas; seven from fetal chromosome abnormalities and two from severe skeletal dysplasias. In addition nine amniotic fluids were meconium stained and 19 (9.7%) had varying degrees of blood staining. Acetylcholinesterase values remained relatively constant from 13-21 weeks gestation in normal pregnancies and a cut-off limit of 3.2 U/l was set (mean + 2 SD). Heavily blood stained amniotic fluids were associated with AChe levels on or above the normal cut-off limit. Meconium staining caused a non-significant elevation of AChe. No significant elevation of AChe was demonstrated for fetal chromosome abnormalities, or severe skeletal dysplasias. Anencephaly and severe open spina bifida had significantly elevated AChe levels.

Prenatal diagnosis using amniocentesis: the Christchurch experience.

A service for biochemical analysis of amniotic fluid has been available since 1975. A total of 186 early pregnancy samples were received, the majority were from patients at risk for chromosome abnormalities or neural tube defects. The indications for analysis and the problems related to the results are presented and the need for an established genetic counselling system with a supra-regional assay service is discussed.