Predicting turnover rates among the staff of English and Welsh old people's homes

Staff turnover and wastage are particularly damaging in the personal social services where the establishment of staff-client relationships and a fund of experience are so important for 'successful' service or care. The vulnerability and dependence of the frail elderly in old people's homes make staff turnover and wastage especially problematic. The implications of staff turnover are briefly reviewed in this paper, and used as a basis for a study of the extent of staff turnover in the residential care sector. Using data on the personal characteristics of 8588 staff employed in old people's homes in England and Wales during 1976-1977, we estimated the individual propensities to change jobs and to leave social work-related employment altogether. These propensities were found to be significantly associated with age, sex, length of service, basic education and professional qualifications.

Inter-sectoral cost comparisons: day care for the elderly

It is often argued that there are significant differences in the costs of providing public and non-public services. However, these arguments have almost invariably been based on crude comparisons of bald expenditure figures of rather dubious validity. In this paper we describe and apply a conceptual framework which attempts to place such inter-sectoral comparisons on a more reliable basis. Our application is to day care services for elderly people provided by local authority social services departments, area health authorities and voluntary organizations, although the framework has much wider relevance. Our results provide clear evidence to refute the oft-made assumption that voluntary services are universally cheaper than their statutory counterparts. Standardizing costs for the dependency characteristics of users and the activities of day units, we find that voluntary-statutory cost differences are dependent upon the scale of operation. Small voluntary units certainly enjoy a cost advantage, but larger voluntary units are unlikely to be cheaper, and are probably more expensive, than local authority units of a similar scale.

Characterization of the spontaneous murine B cell leukemia (BCL1). III. Evidence for monoclonality by using an anti-idiotype antibody

We have raised an anti-idiotypic antibody against the cell surface IgM of the murine BCL1 tumor cells. This antiserum reacts exclusively with the IgM expressed on the tumor cells and detects a unique population of cells in the spleen and blood of the tumor-bearing mice. When these cells are stimulated in vitro with LPS, they secrete an IgM bearing the same idiotype as the cell surface Ig. These results are discussed in terms of a model for the immunotherapy of a chronic lymphocytic leukemia-like syndrome in mice.

Characterization of the Spontaneous Murine B Cell Leukemia (BCL1)

We have raised an anti-idiotypic antibody against the cell surface IgM of the murine BCL1 tumor cells. This antiserum reacts exclusively with the IgM expressed on the tumor cells and detects a unique population of cells in the spleen and blood of the tumor-bearing mice. When these cells are stimulated in vitro with LPS, they secrete an IgM bearing the same idiotype as the cell surface Ig. These results are discussed in terms of a model for the immunotherapy of a chronic lymphocytic leukemia-like syndrome in mice.

Isolation of mutant adrenocortical tumor cells resistant to cyclic nucleotides

A somatic cell genetic approach was used to study the role of cyclic nucleotides in adrenal steroidogenesis. 8-Bromoadenosine 3',5'-monophosphate (8BrcAMP) stimulated steroidogenesis (K'd=0.1 mM) in cultured mouse adrenocortical tumor cells (Clone Y1). In addition, 8BrcAMP inhibited Y1 cell growth and caused Y1 cell monolayers to assume a rounded morphology. As a consequence, 8BrcAMP (at concentrations greater than or equal to 0.4 mM) reduced the relative plating efficiency of Y1 cells to less than 10(-5). Y1 cells were mutagenized with ethyl methanesulfonate (300 microgram/ml) and grown in the presence of 0.4 mM 8BrcAMP. A surviving colony (8BrcAMPr-1) was shown to be resistant to growth inhibition (relative plating efficiency at 1.0 mM 8BrcAMP=50 percent)) and to morphological changes induced by 8BrcAMP. 8BrcAMPr-1 cells had diminished steroidogenic responses to cyclic nucleotides and to ACTH (less than or equal to 33 percent of maximum). In 8BrcAMP(R)-1 cells, adenylate cyclase activity remained responsive to ACTH, and cyclic AMP phosphodiesterase activity was not increased. These data suggest that 8BrcAMPr-1 cells are defective at a point common to cyclic AMP action on growth, morphology and steroidogenesis. The associated decrease in responsiveness of the steroidogenic pathway to ACTH suggests that ACTH-regulated steroidogenesis is via a cyclic nucleotide-mediated mechanism.

Naturally occurring low molecular weight IgM in patients with rheumatoid arthritis, systemic lupus erythematosus and macroglobulinemia. I. Purification and immunologic studies

A method for purification of low molecular weight IgM (LMW IgM) which utilized salt precipitation, gel filtration, and insoluble immunoadsorbents is described. The yield from pathologic sera containing LMW IgM in the range of 15 to 36 mg% was approximately 20%. Antisera prepared against LMW IgM, IgM, and reduced-alkylated IgM recognized common determinants. Purified LMW IgM from seropositive rheumatoid subjects did not have rheumatoid factor activity in agglutination tests but demonstrated binding to 125I-labeled aggregated IgG. LMW IgM from a patient with SLE and vasculitis had anti-nuclear factor activity and anti-native DNA activity. When complexed with reduced-alkylated aggregated IgG, LMW IgM and IgM with anti-IgG activity were essentially equivalent on a weight basis in complement fixation. The source and function of LMW in biologic processes remain unknown.