Communicating a terminal prognosis is challenging for patients, families and healthcare professionals. However, positive effects have been reported when children are told about their diagnosis and ...prognosis, including fewer symptoms of anxiety and depression and enhanced adherence to treatment (1). When research about prognostic communication was first published in the 1950s and 1960s, it recommended protecting children from bad news. By the late 1960s, a more open approach was recommended and by the late 1980s the advice was to always tell children. There has been a growing awareness of the complexity of prognostic disclosure and the need to balance often competing factors, such as hope and patient and family considerations, on a case-to-case basis (2).
Gluconeogenic enzymes are induced when Saccharomyces cerevisiae are starved of glucose. However, when glucose is added to prolonged starved cells, these enzymes are degraded in the vacuole via the ...vacuole import and degradation (Vid) pathway. The Vid pathway is linked to the nonclassical secretory and internalizing pathways. In prolonged starved cells, substantial amounts of the key gluconeogenic enzyme fructose-1,6-bisphosphatase (FBPase) are in the extracellular fraction (periplasm). However, when glucose is added to glucose-starved cells, levels of extracellular FBPase decrease rapidly. Ultrastructural studies indicate that FBPase is in Vid/endosomes following glucose addition, suggesting that FBPase is internalized in response to glucose refeeding. Under the same conditions, the majority of Vid vesicle proteins are in the intracellular fraction. In yeast, actin polymerization is involved in endocytosis. Vid vesicles associate with actin patches initially, and they dissociate later. Here, we show that VID28 plays a critical role in the association of Vid vesicles with actin patches and the retention of Vid vesicle proteins in the intracellular fraction. Vid28p was distributed to Vid vesicles and interacted with other Vid vesicle proteins. Vid28p contains an Armadillo (ARM) domain required for FBPase degradation. When VID28 was deleted or when the ARM domain was mutated, Vid vesicles failed to co-localize with actin patches, and Vid vesicle proteins appeared in the extracellular fraction. We suggest that the ARM domain is required for the association of Vid vesicles with actin patches and the retention of Vid vesicle proteins in the intracellular fraction.
Background: The Vid pathway is linked to the nonclassical secretory and internalizing pathways.
Results: Vid vesicle proteins are in the extracellular fraction when VID28 is deleted or mutated.
Conclusion:VID28 is required for the retention of Vid vesicle proteins in the intracellular fraction.
Significance: Learning how signal-less proteins are secreted is critical for understanding the nonclassical secretory pathway.
Nursing students are important future health care providers to the growing number of older persons in society. However, two barriers are their common ageist attitudes and lack of interest in ...geriatrics. This is a concern in light of the global demand for nurses and a challenge that need to be addressed in nurse education. Age suit simulation has been shown to affect the attitudes of students toward older persons, but the important context of home is often missing from studies. Accordingly, the present study employed a quantitative approach with the goal of investigating the effects of aging simulation with an age suit in a home context as a part of experiential learning among second-year nursing students. The age simulation allowed the students to experience both specific and common health problems from the patient's point of view in a controlled environment and a relevant context: the home. Data were collected using a questionnaire in a quasi-experimental pretest - posttest design with a control group. Results showed that the intervention had a positive effect on various aspects of the nursing students' perspectives on caring for older persons. Work experience was associated with more positive attitudes. The control group was more negative toward geriatrics as a career choice than the intervention group. In conclusion, age suit simulation can be an innovative part of nurse education because it raises awareness and understanding of the health challenges of older persons, which are important in combating ageism among future nurses.
Introducción: La provincia de Mendoza se caracteriza por un creciente desarrollo del cultivo de vid. Su expansión, ha llevado a la ocupación de áreas con presencia de una capa de carbonato de calcio, ...el “caliche”, planteando problemas agrícolas. Nuestro objetivo fue determinar la profundidad a la que se encuentra el “caliche” a través de la identificación de comunidades vegetales y zonificarlas para su uso con destino al cultivo de vid. M&M: Se trabajó en un terreno de 60 ha, Dpto. Tupungato. Se realizaron 27 censos fitosociológicos y 27 transectas de Point-quadrat para determinar cobertura vegetal. En cada punto de muestreo se midió la profundidad del caliche mediante la técnica de barrenado y se evaluó la altura de la vegetación dominante.Resultados: Se registraron 68 especies vegetales. La matriz dominante estuvo representada por Larrea divaricata. Se identificaron 5 UV florísticas y 5 UV fisonómicas, encontrándose una relación positiva entre ambas. La profundidad de caliche osciló entre 0-150 cm. Las UV florísticas mostraron un solapamiento en la profundidad del caliche, no así las fisonómicas. Geoffroea decorticans y Senna aphylla fueron indicadoras de la presencia de caliche. Conclusiones: El presente trabajo ofrece una alternativa de bajo costo, alto potencial y efectividad de uso, para el muestreo de profundidad de caliche.
Health, participation, and security are the basic pillars of active ageing suggested by the WHO. The concept is used by professionals but requires exploration from the perspectives of older people ...themselves. This study aims to explore how older adults experience and describe health, participation, and security.
A qualitative research approach was used based on open-ended interviews with 20 older Thai adults aged 60-92 years. The interviews were analysed using qualitative content analysis.
The results showed perspectives related to experiences of daily life and local culture. Health while ageing, was described as the absence of barriers to continued daily living, combined with a peaceful and adaptive mindset. Participation was described as maintaining social networks and being a formal volunteer, with an emphasis on the "making of merits", of meaningful activities and being respected. Security was described as manageable living conditions and managing to finalize life well by balancing dependency and independency in relation to children to sustain the traditional value of gratitude between generations.
These understandings will support healthy policy planning by providing resources and activities that relate to older Thai adults' perspectives of health, participation and security and ultimately contribute to a better quality of life.
Oral health care is essential, and digital training may influence healthcare professionals' attitudes to and knowledge of oral health. The aim, therefore, was to evaluate the impact on attitudes to ...and knowledge of oral health after using a digital training module among Swedish healthcare professionals working within a municipality-run healthcare service for older adults. A secondary aim was to explore the healthcare professionals' experiences of using the digital module. The study comprised a survey of healthcare professionals (registered nurses (RNs), assistant nurses, and care assistants) caring for older adults in a municipality in Sweden. Pre-post-tests were conducted to evaluate the outcomes for attitudes to and knowledge of oral health and of their experiences of completing the digital training module in oral health. These were statistically explored by comparing differences between the pre-post-tests, while the open-ended questions were analysed with qualitative content analysis. The findings of this study indicate that healthcare professionals had similar perceptions of their attitudes to and knowledge of oral health both before and after the digital training module in oral health. The study also indicates that healthcare professionals experienced that it is easier to perform practical oral health care after completing the digital training. The results also show that healthcare professionals value oral health knowledge and that the digital training module was easy to use and to disseminate knowledge throughout the municipality. The findings have implications for developing, implementing, and promoting healthcare professionals' attitudes to and knowledge of oral health and in using a digital training module in combination with practical exercises in oral health in municipality health care.
While midlife adiposity is a risk factor for dementia, adiposity in late-life appears to be associated with lower risk. What drives the associations is poorly understood, especially the inverse ...association in late-life. Using results from genome-wide association studies, we identified inflammation and lipid metabolism as biological pathways involved in both adiposity and dementia. To test if these factors mediate the effect of midlife and/or late-life adiposity on dementia, we then used cohort data from the Swedish Twin Registry, with measures of adiposity and potential mediators taken in midlife (age 40–64, n = 5999) or late-life (age 65–90, n = 7257). Associations between body-mass index (BMI), waist-hip ratio (WHR), C-reactive protein (CRP), lipid levels, and dementia were tested in survival and mediation analyses. Age was used as the underlying time scale, and sex and education included as covariates in all models. Fasting status was included as a covariate in models of lipids. One standard deviation (SD) higher WHR in midlife was associated with 25% (95% CI 2–52%) higher dementia risk, with slight attenuation when adjusting for BMI. No evidence of mediation through CRP or lipid levels was present. After age 65, one SD higher BMI, but not WHR, was associated with 8% (95% CI 1–14%) lower dementia risk. The association was partly mediated by higher CRP, and suppressed when high-density lipoprotein levels were low. In conclusion, the negative effects of midlife adiposity on dementia risk were driven directly by factors associated with body fat distribution, with no evidence of mediation through inflammation or lipid levels. There was an inverse association between late-life adiposity and dementia risk, especially where the body’s inflammatory response and lipid homeostasis is intact.
Aims and objectives
To explore the experiences of the fundamentals of care for people with a cancer diagnosis, from diagnosis to after adjuvant treatment.
Background
More focus is needed on the ...experience of people living with cancer, as current cancer care more emphasises on independence and resilience without fully acknowledging that there will be moments in the cancer journey where patients will need “basic nursing care” to manage their symptoms and care pathways.
Design
Secondary analysis of qualitative data.
Method
Secondary thematic analysis of interview data from 30 people with a diagnosis of breast (n = 10), colorectal (n = 10) or prostate (n = 10) cancer was undertaken.
Results
The findings revealed vivid descriptions of the fundamentals of care (i.e., basic needs) and participants described physical, psychosocial and relational aspects of the delivery of care. Both positive (e.g., supportive and kind) and negative (e.g., humiliating) experiences related to the relationship with the healthcare professionals were re‐counted and affected the participants’ experiences of the fundamentals of care. Participants’ accounts of their fundamental care needs were provided without them identifying who, within the healthcare system, was responsible for providing these needs. Specific nursing interventions were seldom described.
Conclusion
Some people with a cancer diagnosis have to strive for help and support from the nursing staff to manage to regain control over their recovery. Nurses in cancer care need to focus on the patients’ fundamental care needs to optimise their patients’ recovery.
Relevance to clinical practice
Cancer patients require support with their fundamental care needs and nurses need to be more aware of this and integrate it into the caring relationship. It is imperative that the complexity of the nurse–patient relationship is acknowledged and that models of care which honour this complexity are used.
Background
In coming decades, the number of people affected by illnesses who need palliative care will rise worldwide. Registered Nurses are in a central position in providing this care, and ...education is one of the necessary components for meeting coming requirements. However, there is a lack of knowledge about palliative care in undergraduate nursing education curricula, including the extent of the education provided and the related pedagogical methods.
Aim
The aim was to investigate the extent, content and pedagogical methods used and to explore lecturers’ experiences of being responsible for teaching and learning about palliative care for undergraduate nursing students on nursing programmes at Swedish universities.
Setting
All 24 universities responsible for providing undergraduate nursing education in Sweden participated.
Participants
One lecturer with in‐depth knowledge about palliative care or end‐of‐life care education participated in the quantitative (n = 24) and qualitative (n = 22) parts of the study.
Method
A mixed‐method research study with an explorative design was used. Descriptive statistics were used to analyse quantitative data, and content analysis for qualitative, with both also analysed integratively.
Results
Few undergraduate nursing programmes included a specific course about palliative care in their curricula, however, all universities incorporated education about palliative care in some way. Most of the palliative care education was theoretical, and lecturers used a variety of pedagogical strategies and their own professional and personal experience to support students to understand the palliative care approach. Topics such as life and death were difficult to both learn and teach about.
Conclusions
There is a need for substantial education about palliative care. Lecturers strive on their own to develop students’ understanding and increase the extent of palliative care education with innovative teaching strategies, but must compete with other topics. Palliative care teaching must be prioritised, not only by the universities, but also by the national authority.
Epidemiological research on dementia is hampered by differences across studies in how dementia is classified, especially where clinical diagnoses of dementia may not be available.
We apply structural ...equation modeling to estimate dementia likelihood across heterogeneous samples within a multi-study consortium and use the twin design of the sample to validate the results.
Using 10 twin studies, we implement a latent variable approach that aligns different tests available in each study to assess cognitive, memory, and functional ability. The model separates general cognitive ability from components indicative of dementia. We examine the validity of this continuous latent dementia index (LDI). We then identify cut-off points along the LDI distributions in each study and align them across studies to distinguish individuals with and without probable dementia. Finally, we validate the LDI by determining its heritability and estimating genetic and environmental correlations between the LDI and clinically diagnosed dementia where available.
Results indicate that coordinated estimation of LDI across 10 studies has validity against clinically diagnosed dementia. The LDI can be fit to heterogeneous sets of memory, other cognitive, and functional ability variables to extract a score reflective of likelihood of dementia that can be interpreted similarly across studies despite diverse study designs and sampling characteristics. Finally, the same genetic sources of variance strongly contribute to both the LDI and clinical diagnosis.
This latent dementia indicator approach may serve as a model for other research consortia confronted with similar data integration challenges.
PDF
