Missed opportunities for immunisation at hospitals in the western Cape--a reappraisal

Immunisation practices were examined at 6 hospitals in the western Cape during the latter half of 1992 to determine whether these practices had improved subsequent to the February 1991 resolution of the Health Matters Committee (HMC) on immunisation in hospitals, and since a similar study was undertaken in 1990. Exit interviews were conducted with the escorts of all children aged 3-59 months who attended the study hospitals on the days designated for the study. In the second study, 88 of the 311 children studied (28.3%) were in need of immunisation on arrival, but only 12 of the 88 (13.6%) were immunised during the hospital visit. There was no evidence of an increase in requests to see children's Road-to-Health cards (37.1% compared with 35.2% previously). The incidence of missed opportunities for measles immunisation in children aged 6-59 months remained unacceptably high (51.4% compared with 63.7% previously, when a strict definition was used; and 15.7% compared with 18.1% previously, when a lenient definition was used). Health authorities at all levels need to take urgent action to address the problem of missed opportunities for immunisation at hospitals.     

Knowledge, data, and models

The object-oriented approach to integrating knowledge data, and models is examined. Under the object-oriented paradigm, everything is an object, which is itself an encapsulation of data and methods to manipulate and access the data within the object. Thus knowledge, data, and models can be defined as special kinds of objects. Active knowledge/data language (KDL), a functional object-oriented database system is considered, covering the active-KDL-type system and functions, and query-driven simulation     

A probabilistic method for the design of power grounding systems

An improved multivariable, probabilistic method for the safety analysis of power grounding systems is presented. The application of this method is demonstrated in four examples. The first three examples illustrate the practical evaluation of one new and two existing substation grounding grids when the substation is connected to an overhead distribution system. The fourth example ascertains the relative impact of a difference between the S curve of IEC Publication 479 and Dalziel's equation for the allowable body current used in ANSI/IEEE Std 80-1986 on the validity of an exposure model based on the requirements of Std 80. In this example, the statistical data on ground faults have been taken from actual system records. Further possible refinements of the exposure model are discussed     

Comparing the motivations of Spanish and Finnish computer personnel with those of the United States

A survey of perceptions of IS personnel – managers, technical specialists and programmer/analysts – was conducted by the Association for Technical Information in Spain, using the JDS/DP, a modification of the job diagnostic survey instrument. Data were collected on fifteen job variables, related to four motivation aspects: job components, satisfaction levels, need for growth/achievement and goal participation/feedback. The results were compared with those of a similar survey for the same job types in Finland. Results were also compared with the norms developed for computer personnel in the USA. The survey revealed that personnel attracted to the computer field have a high need for growth and a low need for social interaction. It also revealed that the work itself was ranked highest among eleven motivating factors. For both Spain and Finland, the technical specialist job had a mis-match between the job's motivating potential and the employee's need for growth, compared with similar personnel in the USA. By examining the core job dimensions, managers can redesign the job to produce a match between these two major components of motivation.     

Keynote paper: Architectures for integrating manufacturing activities and enterprises

This paper is a summary of the major technical report (Williams et al., 1993) of the IFAC/IFIP Task Force on Architectures for Integrating Manufacturing Activities and Enterprises. It presents a synopsis of the investigations of pertinent architectures undertaken, and the findings generated relating to the suitability of various architectures for the integration task. It also presents the Task Force's recommendations for achieving a “complete” architecture in terms of the necessary capabilities by “completing” a currently available architecture. The Task Force also outlined how a “best” architecture could be achieved by selecting and combining the best features of the available architectures.     

Cooperation of Ito cells and hepatocytes in the deposition of an extracellular matrix in vitro

Cellular and molecular mechanisms involved in the deposition of extracellular matrix components in both normal and fibrotic liver are still poorly understood. We have investigated the influence of cooperation between Ito cells and hepatocytes in matrix deposition in vitro. Immunoprecipitation of radiolabeled proteins from media of 5-day-old Ito cell primary cultures showed that these cells secreted high levels of the major basement membrane components, ie, collagen IV, laminin, and entactin/nidogen. By immunocytochemistry, precursors of basement membrane components were found intracellularly, but only scarce deposits were seen around the cells. When hepatocytes were added to 2-day-old Ito cell primary cultures, they established close contacts with Ito cells in less than 24 hours and expressed ZO-1, a tight junction-associated protein not detectable in standard hepatocyte culture. Cytochemistry analysis revealed an abundant extracellular matrix deposited over hepatocyte cords and between hepatocytes and Ito cells. Immunocytochemistry studies showed that this matrix contained laminin, fibronectin, and collagens proIII and IV. These data indicate that a high level of matrix protein synthesis by liver cells in vitro is not sufficient to induce extracellular matrix deposition, and that cell-cell interactions are strongly involved in this process. Hepatocyte/Ito cell co-culture, which may reflect the actual situation in vivo, represents a useful tool for studying liver fibrogenesis.     

Nonlinear electrical transport in K-TCNQ at low temperatures

A remarkable nonlinearity has been observed for electric transport in K-TCNQ (potassium tetracyanoquinodimethane) quasi-one-dimensional conductor. The negative differential resistance region appears afterV _m (turn over voltage), beyond which voltage goes down with increase of current. A possible mechanism is discussed in terms of dynamics of charged solitons and domain walls in one-dimensional molecular stacks of these types of crystals.     

Isoforms p69 and p100 of 2'',5''-oligoadenylate synthetase induced differentially by interferons in vivo and in vitro

There is no better place to test life-saving resuscitation interventions than in the prehospital setting. Patients rarely survive cardiac arrest if resuscitation techniques have failed before leaving the scene. Also, paramedics are usually very experienced in key initial resuscitative techniques, and they routinely operate under strict paramilitary protocol, resulting in better study compliance. In addition, the large study populations that are derived from emergency medical services (EMS) systems lead to faster study completion and statistically stronger data. Most important, by reinforcing standardized care, rigidly scrutinized trials improve patient care, regardless of the effect of the study intervention. The success of productive EMS research centers requires routine communication between hospital and EMS administrators and their medical directors, designation of mutually acceptable data collectors who guarantee confidentiality, reciprocal exchange of study data provided as educational seminars to the hospitals, commitments to support the budget requests of an EMS program and appropriate system modifications, inclusion of EMS personnel in study design from the very beginning, prospective education of the medical community and media before protocol implementation, an authoritative grassroots medical director, and a paramedic supervisor system.