Do Tanzanian hospitals need healthcare ethics committees? report on the 2014 dartmouth/penn research ethics training and program development for tanzania (DPRET) workshop

Ethical issues are common in the global community. The shortage of human and medical resources when working with vulnerable populations requires institutional support to address the challenges that often arise in the patient-provider relationship. The 2014 Dartmouth/Penn Research Ethics Training and Program Development for Tanzania (DPRET) workshop centred on discussions about research and clinical ethics issues unique to Tanzanian healthcare providers. This article discusses some of the ethical challenges that workshop participants reported in their day-to-day work life with patients and families, such as truth-telling, disagreements over treatment plans and patient distrust of local physicians and hospital staff, among others. The Tanzanian participants recognised the need for supportive mechanisms within their local hospital environments. Further dialogue and research on the development ofinstitutional ethics committees within hospital systems is critically needed so that healthcare providers can meet their ethical and professional obligations to patients and families and address ethical conflicts that arise in a timely and productive fashion

Oomycete plant pathogens use electric fields to target roots.

Plant roots generate electrical currents and associated electrical fields as a consequence of electrogenic ion transport at the root surface. Here we demonstrate that the attraction of swimming zoospores of oomycete plant pathogens to plant roots is mediated in part by electrotaxis in natural root-generated electric fields. The zones of accumulation of anode- or cathode-seeking zoospores adjacent to intact and wounded root surfaces correlated with their in vitro electrotactic behavior. Manipulation of the root electrical field was reflected in changes in the pattern of zoospore accumulation and imposed focal electrical fields were capable of overriding endogenous signals at the root surface. The overall pattern of zoospore accumulation around roots was not affected by the presence of amino acids at concentrations expected within the rhizosphere, although higher concentrations induced encystment and reduced root targeting. The data suggest that electrical signals can augment or override chemical ones in mediating short-range tactic responses of oomycete zoospores at root surfaces.

Tactic response of zoospores of the fungus Phytophthora palmivora to solutions of different pH in relation to plant infection.

SUMMARYZoospores of the plant pathogen Phytophthora palmivora use a number of tactic responses to target specific infectible regions of host roots. Although the dominant one is believed to be chemotaxis, it has been shown that zoospores of oomycetes may also use the exogenous proton/electrical currents generated by plant roots for guidance. Since these proton currents also generate significant pH gradients in the rhizosphere, the tactic response of zoospores to changes in pH was examined. Using 'swim-in' capillary tests, zoospores of P. palmivora were found to be repelled by solutions of high pH and attracted to solutions of low pH, relative to a control at neutrality. This in vitro tactic response was generally consistent with the measured pH at sites of zoospore accumulation around intact and wounded roots. However, the endogenous pH gradient around host roots could be abolished with buffers and this treatment did not affect the extent or pattern of zoospore accumulation. Therefore, detection of root-generated pH gradients is unlikely to have a major role in the homing response of zoospores towards plant roots.

Patients with red cell autoantibodies: selection of blood for transfusion.

The provision of blood for transfusing patients whose sera contain red cell autoantibodies requires considerable expertise. Over 8 years, 3888 samples from 2149 patients were examined; the varying clinical presentation necessitated a flexible investigative approach. The autoantibodies showed evidence of blood group specificity in 706 patients (32.9%), usually within the Rh system for warm reacting antibodies, whereas cold antibodies were mostly anti-I. Concomitant alloantibodies were detected by noting varying reaction strengths during antibody investigation and compatibility testing, and by absorption techniques using autologous or selected allogenous red cells. Alloantibodies were found in 294 patients (13.7%); the most frequent were anti-E and anti-K. Compatibility tests were performed on SAG-M donor blood of suitable ABO group, similar Rh genotype, Kell negative and lacking antigens to any alloantibodies detected. All units of blood were incompatible by at least one technique and were issued as 'not compatible but considered suitable'. A total of 7052 units was issued for 1685 patients; no haemolytic reactions were reported. It was concluded that blood can be safely given to patients with autoantibodies, even in serologically complex cases, providing adequate investigations are carried out.