Convicted Cook, Lisa M
The American journal of nursing,
03/2010, Letnik:
110, Številka:
3
Journal Article
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Cook reflects on her duties to his pedophile patient who was just released from prison after 20 years. Appalled by the patient's past crime, she was at first hesitant to administer care, reasoning ...that what led him to his current predicament was the decisions he made. But she eventually realized that she also made a decision to become a nurse, and that she should at least be responsible for that decision.
In Schizosaccharomyces pombe, three genes, sir2(+), hst2(+), and hst4(+), encode members of the Sir2 family of conserved NAD(+)-dependent protein deacetylases. The S. pombe sir2(+) gene encodes a ...nuclear protein that is not essential for viability or for resistance to treatment with UV or a microtubule-destabilizing agent. However, sir2(+) is essential for full transcriptional silencing of centromeres, telomeres, and the cryptic mating-type loci. Chromatin immunoprecipitation results suggest that the Sir2 protein acts directly at these chromosomal regions. Enrichment of Sir2p at silenced regions does not require the HP1 homolog Swi6p; instead, Swi6-GFP localization to telomeres depends in part on Sir2p. The phenotype of sir2 swi6 double mutants supports a model whereby Sir2p functions prior to Swi6p at telomeres and the silent mating-type loci. However, Sir2p does not appear to be essential for the localization of Swi6p to centromeric foci. Cross-complementation experiments showed that the Saccharomyces cerevisiae SIR2 gene can function in place of S. pombe sir2(+), suggesting overlapping deacetylation substrates in both species. These results also suggest that, despite differences in most of the other molecules required, the two distantly related yeast species share a mechanism for targeting Sir2p homologs to silent chromatin.
IntroductionUse of administrative health data and primary care electronic medical record data are both ubiquitous in Alberta, but linkage between them at patient level and implementation of the ...linked data into primary care practice are rare. This demonstration project sought to achieve this for a sample of patients with diabetes.
Objectives and ApproachAcademic family physicians in the Department of Family Medicine at the University of Calgary who participate in the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) identified diabetes–related variables, either in their EMRs or in administrative data, that they wished to obtain in a linked dataset. Secure data linkage was obtained through Alberta Health Services (the provincial health authority) following transmission of patient mapping files direct from the clinics. The de-identified, linked, patient data was then transferred to CPCSSN-Alberta data managers for processing and displayed to users through an interactive Diabetes Dashboard.
Results2598 patients with diabetes were identified using a validated CPCSSN case definition from 47 family physicians in three clinics. CPCSSN EMR data included primary care encounters, date of diagnosis, deprivation index, BMI, blood pressure, comorbidity, diabetes medications prescribed, risk factors, etc. Administrative data included laboratory results (HbA1c, fasting blood glucose, cholesterol, triglycerides, creatinine), medication dispensed, emergency room visits, inpatient admissions and costs. Integrated, interactive provider reports were created and sent to participating physicians. The reports presented the information about diabetes patients at individual provider level, bench-marked at clinic, primary care network and provincial levels. Follow-up with providers led to further dashboard development . We propose to scale up implementation of the integrated diabetes database and dashboard to include all 23,000 CPCSSN-identified diabetes patients in Alberta.
Conclusion/ImplicationsIntegration of EMR and administrative data and its application to clinical care, panel management, and quality improvement in primary care, as well as to surveillance and research, was feasible and acceptable to the family physicians participating in this project.
We used proteins with randomized transmembrane (TM) domains to explore the role of hydrophobic amino acids in mediating specific interactions between transmembrane helices. The 44-aa bovine ...papillomavirus E5 protein, which binds to the TM domain of the PDGFβ receptor (PDGFβR) was used as a scaffold to construct a library encoding small dimeric proteins with randomized, strictly hydrophobic TM domains, and proteins were selected that induced focus formation in mouse C127 cells by activating the PDGFβR. Analysis of these proteins identified a motif of two hydrophobic residues that, when inserted into a 17-residue polyleucine TM domain, generated a protein that activated the PDGFβR and transformed cells. In addition, we identified transforming proteins that activated the wild-type PDGFβR but did not activate a series of PDGFβR TM point mutants that were efficiently activated by the E5 protein, indicating that these proteins were more specific than the E5 protein. Our results implied that multiple van der Waals interactions distributed along the entire length of the TM domains were required for productive interaction between the PDGFβR and some small proteins lacking hydrophilic TM residues. Our results also suggested that excluding hydrophilic residues from small TM proteins and peptides is a strategy to increase the specificity of heteromeric TM helix-helix interactions.
The practice of intentional unplugging from Information and Communication Technologies (ICT), often called a technology Sabbath, appears to be a growing trend discussed in the popular press. The ...relationship between technology Sabbath and feelings of connection to people and the Earth is explored through two modes of inquiry: (1) a one-month phenomenological study of ten individuals’ weekly, 24-hour technology Sabbath experiences recorded in journals and interviews and (2) a review of biological, social science, and theological perspectives on a rhythm of rest. Study results suggest participants generally experience intentional unplugging as a pause for reflection on technology’s role and value in their lives. Results are mixed as to how people experience feelings of connection to other people and the Earth during technology Sabbath time. Review of biological and social science literature reveals that 24-7 connectivity can disrupt the rest humans need. Theologians Richard H. Lowery, Arthur Waskow, and Norman Wirzba make the case that Sabbath spirituality—through the experience of delight and gratitude for an abundant creation, liberation from human productivity and control of the Earth, and reflective time—offers wisdom for restoring a rhythm of rest necessary for both personal and planetary well-being
Viruses have been subjected to intense study because of their medical importance and because they can provide fundamental insights into normal and pathological cellular processes. Indeed, much of our ...knowledge about basic cellular biology and biochemistry was acquired through the study of viruses, and some of medicine's greatest triumphs and challenges involve viruses. Since viruses have evolved to exploit important cell processes, they can provide tools and approaches to manipulate cell function. The small transmembrane E5 protein of bovine papillomavirus type 1 transforms cells by a unique mechanism involving ligand-independent activation of the platelet-derived growth factor beta receptor. Experiments summarized in this review suggest that it may be possible to use the E5 protein as a model to design an entirely new class of small, modular transmembrane proteins with novel biological activities.
We used proteins with randomized transmembrane (TM) domains to explore the role of hydrophobic amino acids in mediating specific interactions between transmembrane helices. The 44-aa bovine ...papillomavirus E5 protein, which binds to the TM domain of the PDGFb receptor (PDGFbR) was used as a scaffold to construct a library encoding small dimeric proteins with randomized, strictly hydrophobic TM domains, and proteins were selected that induced focus formation in mouse C127 cells by activating the PDGFbR. Analysis of these proteins identified a motif of two hydrophobic residues that, when inserted into a 17-residue polyleucine TM domain, generated a protein that activated the PDGFbR and transformed cells. In addition, we identified transforming proteins that activated the wild-type PDGFbR but did not activate a series of PDGFbR TM point mutants that were efficiently activated by the E5 protein, indicating that these proteins were more specific than the E5 protein. Our results implied that multiple van der Waals interactions distributed along the entire length of the TM domains were required for productive interaction between the PDGFbR and some small proteins lacking hydrophilic TM residues. Our results also suggested that excluding hydrophilic residues from small TM proteins and peptides is a strategy to increase the specificity of heteromeric TM helix-helix interactions.
This paper argues that Russian financial markets are more developed than typically supposed. I show that non-financial firms, suppliers of credit to other firms, support the role of financial ...intermediaries in helping to surmount problems of information asymmetries. Trade credit works as a signal; firms receiving it obtain access to bank loans. I test this hypothesis using data from my survey of 352 firms in Russia in 1995. Firms using trade credit are shown to have a higher probability of acquiring bank credit.
Attachment to a primary care physician (PCP) is a foundational component of the Patient's Medical Home. Yet how can attachment exist in a system that does not limit where patients seek care? This ...article describes a top-down approach with the ideologies of a bottom-up collaborative to address attachment within an Alberta primary care network. The steps taken to reduce the number of patients listed on multiple PCP panels from 27% to 4% will be described. Learnings from this initiative suggest that direct involvement with providers, coupled with engaged physician leadership, can create a local system of information delivery that supports the attachment of patients to their most responsible PCP.
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