Branhamella catarrhalis pneumonia with bacteremia in a pediatric patient with smoke inhalation.

Branhamella catarrhalis, a common inhabitant of the upper respiratory tract, has been identified recently as a cause of lower airway infection. In this report we present a case of B. catarrhalis pneumonia and bacteremia in a child with smoke inhalation as the first description of invasive disease involving this organism in a traumatized airway. In addition, other pediatric cases of B. catarrhalis bacteremia are reviewed, suggesting immunocompromise as a risk factor.

Rapid detection of respiratory syncytial virus by a biotin-enhanced immunoassay: test performance by laboratory technologists and housestaff.

A biotin-enhanced enzyme immunoassay (EIA) for respiratory syncytial virus (RSV) antigen detection (TESTPACK RSV) was prospectively compared with virus isolation in cell culture and immunofluorescence. Of 156 nasopharyngeal swab specimens from infants with respiratory symptoms, 81 (52%) yielded RSV in culture. Compared with culture the sensitivity of the EIA was 95% and specificity was 92%; the specificity increased to 97% with a blocking assay. Compared with immunofluorescence the sensitivity of EIA was 92% and specificity was 93%. In order to assess the performance of TESTPACK RSV as a bedside test, nasopharyngeal swabs from 49 children were tested by EIA at the bedside by housestaff and by immunofluorescence in the laboratory; the sensitivity of the EIA was lower (78%) while specificity remained high (95%). Inclusion of older children may have resulted in diminished sensitivity. The TESTPACK RSV is a simple, rapid test that performs well and is easily adaptable to an office setting. Further evaluation of the test in older children may be required.

Effect of recombinant human fibroblast interferon and mezerein on growth, differentiation, immune interferon binding and tumor associated antigen expression in human melanoma cells.

The combination of recombinant human fibroblast interferon (INF-delta) and the antileukemic compound mezerein (MEZ) results in a synergistic suppression in the growth of human melanoma cells and a concomitant increase in melanin synthesis. In the present study we have further analyzed this synergistic interaction and have also evaluated the effect of IFN-delta and MEZ, alone and in combination, on recombinant human gamma interferon (IFN-gamma) binding and Class I HLA and melanoma associated antigen (MAA) expression in the HO-1 human melanoma cell line. Single cell clones isolated from the HO-1 cell line varied in their sensitivity to the antiproliferative effects of IFN-delta and MEZ. With all twelve clones, however, the combination of IFN-delta plus MEZ was more growth inhibitory than either agent used alone, even in HO-1 subclones displaying relative resistance to IFN-delta. By continuous growth in gradually increasing concentrations of IFN-delta, a variant population of HO-1 cells, HO-1 delta R-D, was generated which was more resistant to the antigrowth effects of IFN-delta than the original HO-1 parental cell line. In the IFN delta R-D cell line the combination of IFN-delta plus MEZ synergistically suppressed growth. Exposure of HO-1 cells to 2500 units/ml IFN-delta or 50 ng/ml MEZ for 96 hr resulted in no change or an increase in the binding of labelled IFN-gamma to surface receptors, whereas the combination of IFN-delta plus MEZ increased IFN-gamma binding 2-to-4-fold in HO-1 cells. This increase was the result of an increase in the number of receptors on treated cells coupled with a protection against a decrease in receptors observed for confluent untreated cells. Changes in IFN-gamma binding resulting from treatment with IFN-delta plus MEZ were not associated with alterations in the binding affinity of INF-gamma to its receptor. Changes were also observed in the expression of HLA Class I antigens and MAAs following treatment of HO-1 cells with IFN-delta, MEZ or IFN-delta plus MEZ. IFN-delta and MEZ increased the expression of HLA Class I antigens a 96 kd MAA defined by MoAb CL203, a 100 kd MAA defined by MoAb 376.96 and a 115 kd MAA defined by MoAb 345.134 but decreased the expression of a high molecular weight-melanoma associated antigen (HMW-MAA) defined by MoAb 325.28S.(ABSTRACT TRUNCATED AT 400 WORDS)

A national study of student selection practices in the allied health professions.

Allied health education program directors must often deal with a selective admissions policy that results in large numbers of rejected applicants. This study reports the national outcomes of a 1978 survey of candidate selection practices in four baccalaureate level and seven associate degree level allied health disciplines. A total response rate of 53% (451 of 848 programs) was achieved. The survey evaluated the content of the selection process (types of selection variables and weighting of data sources) and the process or mechanics of applicant selection (selection committees, interviewing, data quantification, and evaluation of the process). The applicants' academic records and interview outcomes were primary data sources. Few programs conducted evaluation of their admissions activities. Physical therapy and dental hygiene programs, the most competitive curricula in terms of applicant numbers at each educational level, evidenced the greatest degree of structure in student selection. The authors propose guidelines designed to address some of the admissions weaknesses revealed by the survey.

Student selection in dietetic internship programs.

Recent events mandate that internship faculties review their selection criteria and processes carefully. These events include legal decisions and the implementation of federal regulations, as well as the dietetic traineeship "phase-out" and ADA's decision to rescind application restrictions. This study profiles the 1978 selection criteria and processes used by 47 of the 68 accredited dietetic internship programs. The most common criteria included (in decreasing order of importance): academic records, letters of recommendation, applicant essays, and demographic/biographic data. Standardized tests and applicant interviews were used infrequently. The reliability and validity of certain selection criteria, e.g., letters of recommendation, are questioned. Recommendation for increasing the predictive quality of the letters and other selection tools are included. Criteria of questionable legality should be reviewed and clarified or eliminated from selection processes. Finally, internship directors are encouraged to evaluate their selection processes to assure objectivity and sensitivity. The authors found that the selection criteria used by internship programs corresponded to those used by most academic and allied health professions to predict success in the programs. Although intended for internship faculties, the recommendations may be useful to coordinated undergraduate dietetics programs as they define their selection criteria.

Putting objectivity in the allied health student selection process.

The allied health student selection process in often not as well organized as those found in the other health professions. This may be an outcome of the newness of some of the allied health disciplines. Allied health educators must assure the potential applicant, the consumer, and governmental agencies that their admissions process is rational, fair, and humane. This paper describes four major types of decisions which can help ensure that these qualities are present. The steps include: (a) refining the criteria by which applicants are to be evaluated, (b) identifying information sources whose data can be quantified, (c) transforming these data into measurable form, and, (d) conducting evaluation of admissions criteria. Practical suggestions are offered at each step to help the allied health educator put quality control into the student selection process.

The school of allied health--a political model of university governance.

Curtailment of direct federal funding coupled with greater governmental demands for fiscal accountability in the 1970s has led to events such as allied health program moratoria and a closer scrutiny of the fundamental goals of allied health schools. Resulting organizational stress has also stimulated an emergence of interest groups in these schools. This paper attempts to place these events in a historical and sociological context by: (1) summarizing three governance models; (2) relating these models to the organizational maturation of allied health schools in light of predictions from contemporary management theory; (3) discussing the interrelationships between organizational structure, age of allied health schools, and characteristics of allied health administrators; (4) describing variables of organizational transition that affect organizational effectiveness; and (5) making recommendations to assist schools in organizational planning so they can adjust to the potential negative impact of organizational maturation, shrinking resources, and increasing accountability. A series of recommendations from the Baldridge political model of contemporary organizational research is presented. These recommendations may help facilitate conflict resolution in schools of allied health.

The affective domain in medical technology education.

Evaluation of medical technology students often deemphasizes the affective behavioral domain. The intangible dimensions of the domain and its subsequent difficulties in measurement have been offered as rationales for this lack of curricular emphasis. The work of Klopfer and others in science education constitute a resource from which to construct an affective table of specifications for medical technology students. The Krathwohl taxonomy permits quantifications of these goals. Some techniques for such measurement (open-ended approaches, checklists, Likert scales, and semantic differentials) are reviewed. Finally, the nature of the interface between the affective and cognitive domains is analyzed. The clinical laboratory sciences educator functions as a nonverbal as well as a verbal affective role model for his/her students. This paper emphasizes the responsibility of the educator in creating flexible student assessment approaches in the domain.

The relationship between biographic profile and job role preceptions of the allied health chair: a national study.

The purpose of the study was to construct a professional profile of medical technology and physical therapy baccalaureate chairs to compare male and female respondents in the areas of (1) biographic background, (2) career aspiration, (3) influence in decision making, (4) job-related stress, (5) goals important to role as chair, (6) skills important to role as chair, and (7) perception of ideal power. The response rate to a 1978 national survey was 72%. Statistical analysis on the 25 physical therapy females, 23 physical therapy males, and 20 medical technology female respondents revealed they were comparable in terms of the above variables. The three groups shared a common biographic profile except in the areas of marital status and clinical experience. These chairs exhibited low scholarly productivity and little interest in careers in academic administration or the clinical setting. Rather, they indicated sustained interest in departmental chair status or a return to fulltime faculty status. There was also perceived high participation in decision making, low to moderate job-related stress, and high concern for personal and faculty development. They agreed that selected administrative skills were necessary to their role as chairs. Finally, they reported that a considerable amount of power was necessary to their role as chairs in their institutions. Implications for chair development and recommendations for future research are discussed.

A proposed curriculum on death and dying for the allied health student.

Encounters with a dying patient create a triple dilemma for the allied health professional. These include the anxiety aroused in the dying patient, the avoidance of the patient by other members of the health team and the allied health professional's own anxieties about death. This article summarizes the existing curricular models on death education for health professions students. A proposed course design for allied health professions students modified from Bloch's medical education objectives for a thanatology course is presented. Special emphasis is given to development of active listening skills which allied health personnel need in their role as supportive significant others for dying patients.

A comparative study of student MLT traits and articulation interests.

Allied health community college students have not been characterized according to their intentions to pursue a health careers ladder. This paper describes an analysis of the demographic-biographic, cognitive, psychomotor, and affective profiles of 326 female second-year MLT students contrasted with their articulation interests. The articulation categories included AAS termination, delayed MT transfer, immediate MT transfer, and non-MT continuation. Chi-square analysis and analysis of variance revealed few statistical differences between such articulation interests and test outcomes. Results are interpreted and directions for future study are presented.

MLT and MT student performance on a preliminary psychomotor test battery.

Psychomotor ability is a neglected component of student clinical evaluation in the laboratory setting. This paper describes development of an experimental psychomotor test battery containing mechanical comprehension, spatial perception, and manual dexterity subscales. A small sample of MLT and MT students constituted the study population used to determine interrelationships among the subscales. Pearson product moment correlations and factor analysis suggest isolation of hand-eye motor and perception-intelligence psychomotor components in the battery. Clinical laboratory implications of the findings are discussed.