Patient Blood Management and Its Role in Supporting Blood Supply

Blood donors and voluntary blood donations are essential for ensuring the blood supply that can be maintained by good patient blood management (PBM) practices. This review article explores the role of blood donation in PBM and highlights the importance of donor screening and selection processes in different regions worldwide. The donor health questionnaires and the focused physical examination guidelines have changed in the last decade to increase donor and recipient safety. This article also discusses the status of transfusion practices, including the challenges of ensuring a safe blood supply. Significant among these are the effects of the COVID-19 pandemic on the blood supply chain and the impact of an aging donor population, especially. Promoting autologous donations and other blood conservation strategies are suggested to mitigate these issues. The role of replacement donors and the upper age limit for voluntary blood donation may be decided based on the demography and donor pool. The involvement of C-suite executives is also critical in implementing and running a successful PBM program. The review highlights how these different aspects of blood donation are integral to a successful PBM program and the safety of patients who receive blood transfusions.

Implementing Mental Health Promotion Initiatives - Process Evaluation of the ABCs of Mental Health in Denmark

Treatment and prevention alone are unlikely to make a significant difference in reducing the burden of poor mental health and mental illness. Therefore, mental health promotion (MHP) initiatives are advocated. In 2014, the ABCs of mental health (ABCs) partnership was established in Denmark; in the partnership, partner organisations, e.g., municipalities and NGOs, use a research-based framework for MHP, the ABC-framework, to develop and implement MHP initiatives. This presentation has two aims: (1) to outline the overall characteristics of these MHP initiatives; and (2) to explore local coordinator and stakeholder perceptions of the implementation processes and the impact of the MHP initiatives. Questionnaire surveys, individual interviews and group interviews were conducted during 2017-2020. The MHP initiatives were grouped according to three strategies: building MHP capacity, campaign activities to promote mental health awareness and knowledge and establishing and promoting opportunities to engage in mentally healthy activities. The ABC-framework was positively received and viewed as providing relevant knowledge for working with MHP as well as fostering intersectoral and interprofessional collaborations. However, using a bottom-up approach to develop and implement MHP initiatives can be time-consuming and resource demanding, and it requires a deliberate balancing of local adaptability and concrete guidance when engaging stakeholders and implementers. Overall, using the ABC-framework to develop and implement MHP initiatives holds great promise for advancing and promoting MHP practice.

The membrane capacity of mammalian skeletal muscle fibres

Membrane capacity was measured as a function of fibre diameter in mammalian skeletal muscle fibres under normal conditions and under conditions designed to reduce the membrane chloride conductance, i.e. in solutions in which chloride ions were replaced by sulphate or methylsulphate ions, or in normal Krebs solutions containing 2,4-dichlorophenoxyacetic acid (2.5 mM). The experiments were done on rat sternomastoid, extensor digitorum longus and soleus muscle fibres. The average membrane capacity of fibres in each muscle was greater than normal when chloride conductance was reduced and the slope of the relationship between membrane capacity and fibre diameter increased. The results were consistent with the hypothesis that the space constant of the transverse tubule system in mammalian fibres is normally short because the transverse tubule membrane has a high chloride conductance. The experimental results imply that the space constant of the transverse tubule system was less than 40 microns for fibres in normal Krebs solution and greater than 100 microns for fibres with low membrane chloride conductance. The space constant was calculated using measured geometrical parameters of the transverse tubule, and measured membrane conductance, and the values were close to 20 microns for fibres in normal Krebs solution and between 50 and 120 microns for fibres with low chloride conductance.

The contractile properties, histochemistry, ultrastructure and electrophysiology of the cricothyroid and posterior cricoarytenoid muscles in the rat

The contractile, histochemical, morphological and electrophysiological properties of two rat laryngeal muscles, the cricothyroid and posterior cricoarytenoid, have been measured. Both muscles act during respiration to maintain upper airway patency and an even distribution of air in the lungs. The cricothyroid and posterior cricoarytenoid are fast-twitch muscles, having contraction times of 3.4 and 7.2 ms respectively, high myosin ATPase activity, abundant sarcoplasmic reticulum (with average volumes of 9% and 15%, respectively, of the fibre volume) and T-system membrane (with average areas of 0.4 and 0.5 micron 2 micron -3 of fibre). The large areas of T-tubule membrane are reflected in the average specific membrane capacities of 6.5 muF cm-2 to 10.5 muF cm-2, which are high considering the small diameter of the fibres (20-30 micron). Of the two muscles, the posterior cricoarytenoid has the faster contraction time and the more abundant sarcoplasmic reticulum content. In addition, the posterior cricoarytenoid is less resistant to fatigue and demonstrates lower succinic dehydrogenase activity. The fatigability of this muscle, coupled with its general lack of functional reserve, suggest that its failure may contribute to upper airway obstruction during respiratory distress.