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At least 757 records · Page 42Linked to original sources
PubMed2005

Integrating long-term care concepts into baccalaureate nursing education: the road to quality geriatric health care.

Increased numbers of aging Americans requires that today's health care professionals be grounded in education that focuses on patient-centered care of older adults. The growing demand for competent geriatric nurses in West Texas, led the School of Nursing (SON) at Texas Tech University Health Sciences Center (TTUHSC) to conduct an in-depth analysis of its baccalaureate curriculum to determine how, when, and where care of older adults was being addressed. A task force appointed by the SON subsequently chose, as a blueprint for curricular redesign, Older Adults: Recommended Baccalaureate Competencies and Curricular Guidelines for Geriatric Nursing Care (American Association of Colleges of Nursing & the John A. Hartford Foundation Institute for Geriatric Nursing, 2000). This article describes how the SON task force planned and implemented a new and strengthened geriatric core in its curricula.

Aged↗
PubMed2002

The proinflammatory CD14+CD16+DR++ monocytes are a major source of TNF.

In human blood two monocyte populations can be distinguished, i.e., the CD14(++)CD16(-)DR(+) classical monocytes and the CD14(+)CD16(+)DR(++) proinflammatory monocytes that account for only 10% of all monocytes. We have studied TNF production in these two types of cells using three-color immunofluorescence and flow cytometry on whole peripheral blood samples stimulated with either LPS or with the bacterial lipopeptide S-(2,3-bis(palmitoyloxy)-(2-RS)-propyl)-N-palmitoyl-(R)-Cys-(S)-Ser-(S)-Lys(4)-OH,trihydrochloride (Pam3Cys). After stimulation with LPS the median fluorescence intensity for TNF protein was 3-fold higher in the proinflammatory monocytes when compared with the classical monocytes. After stimulation with Pam3Cys they almost exclusively responded showing 10-fold-higher levels of median fluorescence intensity for TNF protein. The median fluorescence intensity for Toll-like receptor 2 cell surface protein was found 2-fold higher on CD14(+)CD16(+)DR(++) monocytes, which may explain, in part, the higher Pam3Cys-induced TNF production by these cells. When analyzing secretion of TNF protein into the supernatant in PBMCs after depletion of CD16(+) monocytes we found a reduction of LPS-induced TNF by 28% but Pam3Cys-induced TNF was reduced by 64%. This indicates that the minor population of CD14(+)CD16(+) monocytes are major producers of TNF in human blood.

Adjuvants, Immunologic↗
PubMed2005

Infection-induced marginal zone B cell production of Borrelia hermsii-specific antibody is impaired in the absence of CD1d.

Ab that arise in the absence of T cell help are a critical host defense against infection with the spirochetes Borrelia burgdorferi and Borrelia hermsii. We have previously shown that CD1d-deficient (CD1d(-/-)) mice have impaired resistance to infection with B. burgdorferi. In mice, CD1d expression is highest on marginal zone B (MZB) cells, which produce Ab to blood-borne Ag. In this study we examined MZB cell activation and Ab production in mice infected with B. hermsii, which achieve high levels of bacteremia. We show by flow cytometry that MZB cells associate with B. hermsii and up-regulate the activation markers syndecan I and B7.1 within 16 h of infection. By 24 h, MZB cells secrete B. hermsii-specific IgM, coinciding with the loss of activation marker expression and the reduction in spirochete burden. In contrast, MZB cells from CD1d(-/-) mice remain activated for at least 96 h of infection, but produce only minimal B. hermsii-specific IgM in vivo and ex vivo; pathogen burden in the blood also remains elevated. Wild-type mice depleted of MZB cells using mAb to LFA-1 and alpha(4)beta(1) integrin have reduced serum levels of B. hermsii-specific IgM and increased pathogen burden, similar to B. hermsii-infected CD1d(-/-) mice. Passive transfer of immune mouse serum, but not naive mouse serum, into infected CD1d(-/-) mice leads to down-regulation of activation markers and clearance of B. hermsii from the MZB cells. These results demonstrate that blood-borne spirochetes activate MZB cells to produce pathogen-specific IgM and reveal a role for CD1d in this process.

Animals↗
PubMed2006

Autophosphorylation of Ser66 on Xenopus Myt1 is a prerequisite for meiotic inactivation of Myt1.

Myt1 is a dual-specificity kinase that contributes to the regulation of the cell cycle by adding inhibitory phosphates to the cyclin-dependent kinases (Cdk/cyclins). Myt1 is found to be phosphorylated and less active in M-phase compared to interphase. Although Myt1 can be phosphorylated by several different kinases in vitro, it is not well understood how Myt1 is regulated in vivo. Additionally, the interplay between phosphorylation by other kinases and autophosphorylation has not been investigated. Since phosphorylation is an important mode of regulation for Myt1, we have investigated the properties and physiological significance of the autophosphorylation of Myt1 from Xenopus laevis (XMyt1). Using MALDI mass spectrometry we have identified Ser66 and Ser76 as autophosphorylation sites. Autophosphorylation is important for the activity of XMyt1 in intact cells, as found by comparing the timing of the cell cycle in Xenopus oocytes expressing either exogenous wild type XMyt1 or its autophosphorylation site mutants. Specifically, S66A is significantly more potent than wild type XMyt1 at delaying entry into meiosis and concomitantly is hypophosphorylated as evident by a loss of mobility shift. However, this cannot be accounted for by a simple increase in kinase activity towards Cdk/cyclins in vitro. We therefore propose that Myt1 catalyzed autophosphorylation of residue S66 is a prerequisite and/or trigger for the further phosphorylation and inactivation of Myt1. Thus autophosphorylation of Myt1 is a novel inhibitory mechanism that adds another layer of complexity to the phosphorylation-dependent mechanism of Myt1 regulation.

Animals↗
PubMed2006

High-cost users of hospital beds in Western Australia: a population-based record linkage study.

OBJECTIVE: To describe how high-cost users of inpatient care in Western Australia differ from other users in age, health problems and resource use. DESIGN AND DATA SOURCES: Secondary analysis of hospital data and linked mortality data from the WA Data Linkage System for 2002, with cost data from the National Hospital Cost Data Collection (2001-02 financial year). OUTCOME MEASURES: Comparison of high-cost users and other users of inpatient care in terms of age, health profile (major diagnostic category) and resource use (annualised costs, separations and bed days). RESULTS: Older high-cost users (> or = 65 years) were not more expensive to treat than younger high-cost users (at the patient level), but were costlier as a group overall because of their disproportionate representation (n = 8466; 55.9%). Chronic stable and unstable conditions were a key feature of high-cost users, and included end stage renal disease, angina, depression and secondary malignant neoplasms. High-cost users accounted for 38% of both inpatient costs and inpatient days, and 26% of inpatient separations. CONCLUSION: Ageing of the population is associated with an increase in the proportion of high-cost users of inpatient care. High costs appear to be needs-driven. Constraining high-cost inpatient use requires more focus on preventing the onset and progression of chronic disease, and reducing surgical complications and injuries in vulnerable groups.

Adolescent↗
PubMed2002

Secretion of a lysophospholipase D activity by adipocytes: involvement in lysophosphatidic acid synthesis.

The aim of the present work was to depict the metabolic pathways involved in extracellular production of lysophosphatidic acid (LPA) by adipocytes. LPA was followed by quantifying the accumulation of LPA in the incubation medium (conditioned medium, CM) of 3T3F442A adipocytes or human adipose tissue explants using a radioenzymatic assay. Surprisingly, after separation from the cells, the amount of LPA present in CM could be significantly increased by further incubation at 37 degrees C. This suggested the presence of a LPA-synthesizing activity (LPA-SA) in CM. LPA-SA appeared as a soluble activity which was inhibited by divalent ion chelators EDTA and phenanthrolin. The effect of EDTA was preferentially reverted by CoCl2, as described for a lysophospholipase D (lyso-PLD) activity previously identified in rat plasma. LPA concentration could also be increased by treatment with a bacterial PLD, demonstrating the presence of PLD-sensitive LPA precursors (mainly lysophosphatidylcholine) in adipocyte CM. LPA-SA could be increased by the addition of exogenous lysophosphatidylcholine, lysophosphatidylglycerol, or lyso-platelet activating factor, demonstrating that LPA-SA resulted from the action of a lyso-PLD. LPA-SA was not inhibited, but rather activated, by primary alcohol (ethanol and 1-butanol), suggesting that adipocyte lyso-PLD was not a classical PLD. Finally, LPA-SA was found to be weaker in CM of undifferentiated adipocyte (preadipocytes) compared with CM of differentiated adipocytes. In conclusion, our results reveal the existence of a secreted lyso-PLD activity regulated during adipocyte-differentiation and involved in extra cellular production of synthesis of LPA by adipocytes.

Adipocytes↗
PubMed2003

Quality of life in patients with stomas: the Montreux Study.

Ostomy surgery profoundly affects a person's life. To determine the extent of the effect, the Stoma Care Quality of Life Index instrument was developed from a quality-of-life index. After ascertaining its validity and reliability, the instrument was used to measure patient quality of life in a European-wide study (16 countries). Six hundred, eighteen (618) stoma care nurses recruited 4,739 patients following stoma surgery. The self-administered questionnaire was completed immediately following surgery and after 3,6, 9, and 12 months. The mean age of patients was 61.6 years (+/- 13.4 years), 53.7% were men, and the majority (66.5%) had a colostomy. Stoma Care Quality of Life Index scores were fairly consistent in all patients throughout Europe immediately following surgery. While scores improved steadily over time, only the difference between the postoperative and 3-month scores was significant (P < 0.001). Stoma Care Quality of Life Index scores were significantly higher in patients who were satisfied with the care received than in those who were not satisfied. Similarly, patients who had a good relationship with the stoma care nurse and felt confident about changing the appliance had significantly higher Stoma Care Quality of Life Index scores than those who did not have a good relationship or feel confident. The results of this study suggest that stoma patient quality of life can be assessed, that it changes over time, and that patient access to specialist ostomy care nurses is particularly important during the first 3 to 6 months following surgery.

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