Surveillance of antibody to rubella virus in Grampian: closing the immunity gap.

OBJECTIVES--To identify causes for the continuing deficit of rubella immunity in women of childbearing age with a view to further reducing the risk of the congenital rubella syndrome. DESIGN--A questionnaire was sent to the general practitioner and a laboratory follow up study conducted in a one year cohort of women found on screening to have inadequate protection against rubella. SETTING--Virus laboratory of the department of medical microbiology, Aberdeen, serving the health board areas of Grampian, Orkney, and Shetland. PATIENTS--239 women whose concentration of antibodies to rubella virus was either absent or below standard (15,000 IU/l) and whose general practitioner could be contacted to supply a history of infection, immunisation, pregnancy, and antibody testing. MAIN OUTCOME MEASURES--Whether rubella vaccination was given and whether those vaccinated were tested for seroconversion. RESULTS--Only 122 (55%) of the women for whom information was available received the recommended vaccine; only 74 (61%) of these were tested for seroconversion. Oversight was the reason given for not vaccinating 64 (65%) of the women who remained at risk. Women who were pregnant when tested were significantly less likely to receive vaccine (odds ratio 3.36) than women who were not pregnant, and even if vaccinated were less likely to have a follow up antibody test (odds ratio 1.94). CONCLUSION--Once women are identified as being unprotected against rubella they are often overlooked and not vaccinated. Prompting mechanisms aimed at general practitioners, such as the one recently set up in Grampian, should reduce the immunity gap and help to eradicate rubella in pregnancy.     

Effect of environmental phosphate concentration on protein export by Bacillus licheniformis NCIB 6346

Bacillus licheniformis NCIB 6346 was grown under phosphate or magnesium limitation in continuous culture and forward and reverse transitions carried out to examine their effects upon extracellular enzyme production. Analysis of the observed kinetics allowed a distinction to be made between the effects of phenotypic variation and of genetic selection upon exoenzyme production. Furthermore, increases in the phosphate concentration (0.3–30 mM) were directly related to increased phenotypic expression of alpha-amylase. By contrast, penicillinase production was reduced under these conditions but analysis revealed that its phenotypic expression was only indirectly influenced by the concentrations of either magnesium or phosphate present during the transitions.     

Measurement of lipoxygenase activity in crude and partially purified potato extracts

Two assay systems, one a spectrophotometric assay at 234 nm, the other based on the oxygen electrode, were compared as methods for the routine analysis of lipoxygonase activity in crude and partially purified potato extracts. The spectrophotometric assay was unsuitable for the analysis of crude extracts and only gave meaningful results under very restricted reaction conditions. The oxygen electrode provided a reliable method for routine analysis of lipoxygenase activity.     

Community Perceptions of Hospitals and Shared Physical Space: A Qualitative Study

In addition to providing critical medical services to communities, hospitals are also forces of broader change when seen from the perspective of neighborhood development. Over the past few decades the obligation on the part of U.S. nonprofit hospitals to positively impact the communities in which they are located has become entrenched in both U.S. tax law and the practices of many hospitals. This article presents findings from a grounded theory qualitative study of the relationship between a non-profit children’s hospital in Columbus, Ohio, and the neighborhood in which it is located. Based on in-depth interviews with local residents and community leaders, findings suggest that community members often interpret distance, safety, and transportation in different, and often counter-intuitive ways. Drawing upon literature from medical geography and sociology, the authors argue that hospitals may benefit from working closely with community members to determine how space is understood and constructed when planning community health interventions.