RESUMEN
Age categories are related to perceptions and norms concerning appropriate behaviour, appearances, expectations, and so forth. In Sweden, municipal home care and residential care are commonly referred to as "elder care", primarily catering to individuals in their 80s or 90s. However, there is no set age limit reserving these services for an older age group. In intra-professional case conferences, care managers convene with colleagues to discuss care needs and eligibility for elder care services. Despite their significance, these conferences have received limited scholarly attention. The aim of this study was to analyse how care managers categorise persons based on age in intra-professional case conferences when discussing care needs and appropriate support to meet these needs. The study utilised data from 39 audio-recorded case conferences involving the discussion of 137 different cases, which were analysed using discourse analysis. Our findings showed that chronological age was frequently made relevant and applied in discussions about the appropriateness of usual elder care services. Four themes emerged, representing how the care managers implicitly and explicitly categorised clients of different chronological ages as typical/normal or atypical/deviant in these discussions: the "too young", the "not-so-old", the "old", and the "extraordinarily old". The findings contribute to research on ageing by demonstrating that, in an elder care context, being categorised as atypical/deviant (in terms of being younger) may be more beneficial than being seen as a normal or older elder care recipient. This underscores the importance of further research on the impact of informal age categorisations of clients on actual decisions about welfare services.
Asunto(s)
Servicios de Salud para Ancianos , Humanos , Suecia , Anciano de 80 o más Años , Femenino , Masculino , Anciano , Gestores de Casos , Persona de Mediana Edad , Factores de EdadRESUMEN
European local authorities increasingly use social media to present services and activities organized for citizens living in the particular area. Previous studies found that authority-managed social media visually depicted older adults as being active, sociable, happy, and physically capable, reflecting the normative "third age" representation. Yet few studies to date have examined how local authorities produce the photos of older adults for social media posting. Drawing on semi-structured interviews with communication officers in a Swedish municipality, the purpose of this study is to investigate the production process for social media photos of older adults within local authorities from an institutional logics perspective. The analysis illustrates that communication officers strive to create a good image of the municipality and its services, follow municipal policy and EU law on data protection, seek photos through particular sources, adjust to and develop photographic standards of good photos, and endeavor to promote social media engagement in the photos. These motives and work practices of communication officers contribute to the visual representations of older adults as engaging in municipal services, being socially active, and staying physically capable. The analysis also indicates that both social media and bureaucratic logics encourage officers to produce photos of older adults that highlight the bright side of later life. The findings contribute to previous studies on online representations of older adults generated by local authorities, by showing how the third age representation may come about in practice, and which logics may influence officers to generate such representation. Furthermore, the knowledge provided could be used as a basis for assessment and improvement on authorities' production for social media photos of older adults, which in turn contributes to more diverse and thoughtful representations of older adults and later life in authority-managed social media.
Asunto(s)
Gobierno , Medios de Comunicación Sociales , Anciano , Comunicación , Procesos de Grupo , Humanos , Motivación , Fotograbar , Políticas , SueciaRESUMEN
Flow velocity measurement by duplex ultrasonography (DUS) is widely accepted as a preoperative method for grading carotid stenoses. Diameter-based grading is used for angiographic methods, but so far the experience is limited regarding diameter-based grading using DUS. In 101 cases with different degrees of carotid stenoses, we compared diameter- and velocity-based grading using DUS and evaluated variability and reproducibility for diameter measurements in 38 of the stenoses. In 18% of the cases, suboptimal image quality with calcifications and acoustic shadowing precluded diameter measurements. In the remaining 83 cases, the agreement between velocity-based and diameter-based grading for distinction between significant and non-significant stenosis was 69% with a kappa value of 0.40. Repeated measurements of diameters showed a coefficient of variation of 10% and intraclass coefficients of correlation of 0.9. We conclude that diameter measurement with DUS can be performed with high reproducibility in most patients with carotid stenosis. These measurements can then be used for calculations of the degree of stenosis, to supplement velocity-based grading. The moderate agreement between diameter-based and flow velocity-based grading cannot easily be explained. Discrepancies probably constitute a mixture of methodological errors and hemodynamic factors and need further evaluation.
Asunto(s)
Estenosis Carotídea , Velocidad del Flujo Sanguíneo , Arteria Carótida Interna/diagnóstico por imagen , Estenosis Carotídea/diagnóstico por imagen , Humanos , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Ultrasonografía , Ultrasonografía Doppler DúplexRESUMEN
PURPOSE: International and national bodies have identified tackling ageism in health care as an urgent goal. However, health professionals, researchers, and policy makers recognize that it is not easy to identity and fight ageism in practice, as the identification of multiple manifestations of ageism is dependent on the way it is defined and operationalized. This article reports on a systematic review of the operational definitions and inductive conceptualizations of ageism in the context of health care. DESIGN AND METHODS: We reviewed scientific articles published from January 1995 to June 2015 and indexed in the electronic databases Web of Science, PubMed, and Cochrane. Electronic searches were complemented with visual scanning of reference lists and hand searching of leading journals in the field of ageing and social gerontology. RESULTS: The review reveals that the predominant forms of operationalization and inductive conceptualization of ageism in the context of health care have neglected some components of ageism, namely the self-directed and implicit components. Furthermore, the instruments used to measure ageism in health care have as targets older people in general, not older patients in particular. IMPLICATIONS: The results have important implications for the advancement of research on this topic, as well as for the development of interventions to fight ageism in practice. There is a need to take into account underexplored forms of operationalization and inductive conceptualizations of ageism, such as self-directed ageism and implicit ageism. In addition, ageism in health care should be measured by using context-specific instruments.
Asunto(s)
Ageísmo , Atención a la Salud , Estereotipo , Afecto , Conducta , Cognición , Formación de Concepto , Política de Salud , Humanos , Cultura OrganizacionalRESUMEN
Bicyclist fatalities are a great concern in the European Union. Most of them are due to crashes between motorized vehicles and bicyclists at unsignalised intersections. Different countermeasures are currently being developed and implemented in order to save lives. One type of countermeasure, active safety systems, requires a deep understanding of driver behaviour to be effective without being annoying. The current study provides new knowledge about driver behaviour which can inform assessment programmes for active safety systems such as Euro NCAP. This study investigated how drivers responded to bicyclists crossing their path at an intersection. The influences of car speed and cyclist speed on the driver response process were assessed for three different crossing configurations. The same experimental protocol was tested in a fixed-base driving simulator and on a test track. A virtual model of the test track was used in the driving simulator to keep the protocol as consistent as possible across testing environments. Results show that neither car speed nor bicycle speed directly influenced the response process. The crossing configuration did not directly influence the braking response process either, but it did influence the strategy chosen by the drivers to approach the intersection. The point in time when the bicycle became visible (which depended on the car speed, the bicycle speed, and the crossing configuration) and the crossing configuration alone had the largest effects on the driver response process. Dissimilarities between test-track and driving-simulator studies were found; however, there were also interesting similarities, especially in relation to the driver braking behaviour. Drivers followed the same strategy to initiate braking, independent of the test environment. On the other hand, the test environment affected participants' strategies for releasing the gas pedal and regulating deceleration. Finally, a mathematical model, based on both experiments, is proposed to characterize driver braking behaviour in response to bicyclists crossing at intersections. This model has direct implications on what variables an in-vehicle safety system should consider and how tests in evaluation programs should be designed.
Asunto(s)
Accidentes de Tránsito/prevención & control , Conducción de Automóvil/psicología , Ciclismo , Simulación por Computador , Entrenamiento Simulado , Adulto , Desaceleración , Femenino , Humanos , Masculino , Modelos Teóricos , Evaluación de Programas y Proyectos de Salud , Adulto JovenRESUMEN
Since living with dementia implies increasing difficulties in taking charge of rights due to cognitive as well as communicative impairments, many people with dementia are vulnerable and in need of support in order to realize full citizenship. In Sweden, all adults right to self-determination is strongly emphasized in law, regulations, and policies. Further, and in contrast to the situation in many other countries, people living with dementia cannot be declared as incompetent of making decisions concerning social care and their right to self-determination cannot legally be taken away. The article shows that in the Swedish welfare system, the focus is more on protecting the self-determination of citizens than on supporting people in making decisions and exercising citizenship. Subsequently, this causes legally constructed zones of inclusion and exclusion. This article examines and problematizes how different institutional contexts, legal constructions, norms, and practices in Sweden affect the management of issues concerning guardianship, supported decision-making and self-determination, and outline the implications for people living with dementia.
Asunto(s)
Toma de Decisiones , Demencia/psicología , Competencia Mental/legislación & jurisprudencia , Enfermos Mentales/legislación & jurisprudencia , Autonomía Personal , Humanos , Tutores Legales/legislación & jurisprudencia , Apoyo Social , SueciaRESUMEN
In assessment meetings concerning care services for people with dementia, Swedish case managers face a dilemma. On the one hand, according to the law, the right to self-determination of every adult citizen must be respected, but on the other hand cognitive disabilities make it difficult to fulfill obligations of being a full-fledged citizen. In this article, we examine 15 assessment meetings to identify discursive strategies used by case managers to handle this dilemma. We also examine how these affect the participation of persons with dementia, and indicate implications of our study for social work practice and research.
Asunto(s)
Gestores de Casos , Demencia , Evaluación Geriátrica/métodos , Competencia Mental , Autonomía Personal , Servicio Social/métodos , Anciano , Toma de Decisiones , Demencia/diagnóstico , Demencia/psicología , Humanos , Rol Profesional , Técnicas Psicológicas , SueciaRESUMEN
BACKGROUND: During recent decades, there has been a growing recognition that people cannot be assumed incapable of making decisions about their own care solely on the basis of a dementia diagnosis and international agreements and legislative changes have strengthened the formal right for people with dementia to participate in decisions on care services. This raises important questions about how these decisions are currently made and experienced in practice. In this review, we address this question and highlight directions for further research. METHODS: We searched CINAHL, PsycINFO, ASSIA, Social Services Abstracts, Science Direct, Academic Search Premier, and PubMed. Twenty-four pertinent articles were identified, all representing qualitative studies. Relevant findings were extracted and synthesized along dimensions of involvement of the person with dementia in decisions on care services, using an integrative approach to qualitative synthesis. RESULTS: We identified three overarching ways in which people with dementia are involved, primarily, in the informal part of a process of decisions: excluded, prior preferences taken into account, and current preferences respected. Several (10) articles seemed to be based on the assumption that decisions on care services are invariably and solely made within the family and without participation of the person with dementia. CONCLUSIONS: The review emphasizes the need for more updated research about international debates and agreements concerning capabilities and rights of people with dementia and about the (potential) formal contexts of care decisions in the country concerned. This, we argue, is vital for future knowledge production in the area.
Asunto(s)
Toma de Decisiones , Demencia/terapia , Anciano , Demencia/psicología , Familia/psicología , Humanos , Prioridad del Paciente/psicologíaRESUMEN
What does it mean to live a long life and grow old with disabilities? Or to be an aging parent and still be a caregiver to a disabled adult child? These are questions discussed in this article, the aim of which is to show how a life course perspective adds insight to the lived experience of disability and ageing of adults with disabilities. It is argued that the time concept is fundamental to the understanding of the lives of disabled people. Results are presented which challenge established knowledge regarding disability policies, autonomy, body, biographical disruption and prerequisites of active aging.
Asunto(s)
Envejecimiento , Personas con Discapacidad , Adaptación Psicológica , Anciano/psicología , Envejecimiento/psicología , Personas con Discapacidad/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Jubilación , SueciaRESUMEN
This article focuses on individuals who are growing old with chronic illnesses and early onset impairments. Their experience of illness complications, bodily and functional losses is similar to what Bury has referred to as a biographical disruption. However, whereas Bury argues that a chronic illness amounts to a critical situation for the individual, partly due to its unexpected nature, this does not apply to the participants in our two studies. A second difference concerns Bury's implicit suggestion that the disruption is a single event that is characteristic of the early stage of a chronic illness. Repeated disruptions seemed to shape the lives of several of those interviewed. At the same time, this article challenges studies which suggest that the notion of disruption is less relevant to people in later life and to those who have experienced difficult lives, and also questions the argument that continuity rather than change characterises the lives of people who have had chronic conditions since their early years. In its approach, the article responds to Williams' request for studies in the sociology of chronic illness that extend the predominant biographical focus on the middle years of life to both ends of the life course.
Asunto(s)
Enfermedad Crónica/psicología , Composición Corporal , Brasil , Femenino , Infecciones por VIH/psicología , Humanos , Acontecimientos que Cambian la Vida , Masculino , Insuficiencia Renal/psicologíaRESUMEN
Plants respond to changes in the environment by altering their growth pattern. Light is one of the most important environmental cues and affects plants throughout the life cycle. It is perceived by photoreceptors such as phytochromes that absorb light of red and far-red wavelengths and control, for example, seedling de-etiolation, chlorophyll biosynthesis and shade avoidance response. We report that the terminal flower2 (tfl2) mutant, carrying a mutation in the Arabidopsis thaliana HETEROCHROMATIN PROTEIN1 homolog, functions in negative regulation of phytochrome dependent light signalling. tfl2 shows defects in both hypocotyl elongation and shade avoidance response. Double mutant analysis indicates that mutants of the red/far-red light absorbing phytochrome family of plant photoreceptors, phyA and phyB, are epistatic to tfl2 in far-red and red light, respectively. An overlap between genes regulated by light and by auxin has earlier been reported and, in tfl2 plants light-dependent auxin-regulated genes are misexpressed. Further, we show that TFL2 binds to IAA5 and IAA19 suggesting that TFL2 might be involved in regulation of phytochrome-mediated light responses through auxin action.
Asunto(s)
Proteínas de Arabidopsis/metabolismo , Arabidopsis/genética , Proteínas Cromosómicas no Histona/metabolismo , Luz , Plantones/crecimiento & desarrollo , Arabidopsis/crecimiento & desarrollo , Arabidopsis/metabolismo , Proteínas de Arabidopsis/genética , Clorofila/análisis , Proteínas Cromosómicas no Histona/genética , Regulación de la Expresión Génica de las Plantas , Hipocótilo/crecimiento & desarrollo , Ácidos Indolacéticos/metabolismo , Mutación , Fenotipo , Fitocromo A/metabolismo , Fitocromo B/metabolismo , Plantones/genética , Plantones/metabolismo , Transducción de SeñalRESUMEN
Automation, in terms of systems such as adaptive/active cruise control (ACC) or collision warning systems, is increasingly becoming a part of everyday driving. These systems are not perfect though, and the driver has to be prepared to reclaim control in situations very similar to those the system easily handles by itself. This paper uses a questionnaire answered by 130 ACC users to discuss future research needs in the area of driver assistance systems. Results show that the longer drivers use their systems, the more aware of its limitations they become. Moreover, the drivers report that ACC forces them to take control intermittently. According to theory, this might actually be better than a more perfect system, as it provides preparation for unexpected situations requiring the driver to reclaim control.
Asunto(s)
Conducción de Automóvil , Automóviles , Adulto , Anciano , Automatización , Conducción de Automóvil/psicología , Conducción de Automóvil/estadística & datos numéricos , Automóviles/normas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Análisis y Desempeño de TareasRESUMEN
The highly diverse deposition pattern displayed by systemic amyloidoses, sometimes within the same amyloid disease, remains unexplained. The localized medin (AMed) amyloidosis develops from the precursor protein lactadherin and deposits in the media of the thoracic aorta in almost all individuals above 50 years of age. Given its high prevalence in the population, and the fact that systemic amyloidoses also deposit in the aorta, led us to investigate whether AMed amyloid could influence the tissue distribution of serum amyloid A derived (AA) amyloidosis. Seven aortas from patients with diagnosed systemic AA amyloidosis were investigated. Four displayed partial co-localization between medin and AA aggregates when examined with double-labeling immunofluorescence. Furthermore, in vitro studies showed that AMed amyloid-like fibrils promote the aggregation of protein AA into fibrils. The findings indicate that the highly frequent "senile" amyloidoses may have the potential to initiate fibril formation of the more uncommon amyloidoses by a cross-seeding mechanism.
Asunto(s)
Amiloidosis/etiología , Antígenos de Superficie/metabolismo , Aorta Torácica/metabolismo , Artritis Psoriásica/complicaciones , Artritis Reumatoide/complicaciones , Proteínas de la Leche/metabolismo , Proteína Amiloide A Sérica/metabolismo , Anciano , Anciano de 80 o más Años , Amiloide/química , Amiloide/metabolismo , Amiloidosis/patología , Aorta Torácica/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Multimerización de ProteínaRESUMEN
Somatic embryogenesis is used for vegetative propagation of conifers. Embryogenic cultures can be established from zygotic embryos; however, the embryogenic potential decreases during germination. In Arabidopsis, LEAFY COTYLEDON (LEC) genes are expressed during the embryonic stage, and must be repressed to allow germination. Treatment with the histone deacetylase inhibitor trichostatin A (TSA) causes de-repression of LEC genes. ABSCISIC ACID3 (ABI3) and its Zea mays ortholog VIVIPAROUS1 (VP1) act together with the LEC genes to promote embryo maturation. In this study, we have asked the question whether TSA treatment in a conifer affects the embryogenic potential and the expression of embryogenesis-related genes. We isolated two conifer LEC1-type HAP3 genes, HAP3A and HAP3B, from Picea abies and Pinus sylvestris. A comparative phylogenetic analysis of plant HAP3 genes suggests that HAP3A and HAP3B are paralogous genes originating from a duplication event in the conifer lineage. The expression of HAP3A is high, in both somatic and zygotic embryos, during early embryo development, but decreases during late embryogeny. In contrast, the expression of VP1 is initially low but increases during late embryogeny. After exposure to TSA, germinating somatic embryos of P. abies maintain the competence to differentiate embryogenic tissue, and simultaneously the germination progression is partially inhibited. Furthermore, when embryogenic cultures of P. abies are exposed to TSA during embryo maturation, the maturation process is arrested and the expression levels of PaHAP3A and PaVP1 are maintained, suggesting a possible link between chromatin structure and expression of embryogenesis-related genes in conifers.
Asunto(s)
Regulación de la Expresión Génica de las Plantas/efectos de los fármacos , Inhibidores de Histona Desacetilasas/farmacología , Histona Desacetilasas/metabolismo , Picea/efectos de los fármacos , Picea/genética , Pinus sylvestris/efectos de los fármacos , Pinus sylvestris/genética , Cotiledón/genética , Cotiledón/metabolismo , Regulación del Desarrollo de la Expresión Génica/efectos de los fármacos , Regulación Enzimológica de la Expresión Génica/efectos de los fármacos , Genes de Plantas/efectos de los fármacos , Filogenia , Picea/crecimiento & desarrollo , Picea/metabolismo , Pinus sylvestris/crecimiento & desarrollo , Pinus sylvestris/metabolismo , Técnicas de Embriogénesis Somática de Plantas , Semillas/genética , Semillas/crecimiento & desarrolloRESUMEN
TERMINAL FLOWER2 (TFL2) is the plant homologue of metazoan HETEROCHROMATIN PROTEIN1 (HP1) protein family. It is known that, unlike most HP1 proteins, TFL2 does not primarily localize to heterochromatin; instead it functions in regulation of specific genes in euchromatic regions. We show that the tfl2 mutant has a lower rate of auxin biosynthesis, resulting in low levels of auxin. In line with this, tfl2 mutants have lower levels of expression of auxin response genes and retain an auxin response. The reduced rate of auxin biosynthesis in tfl2 is correlated to the down-regulation of specific genes in the tryptophan-dependent auxin biosynthesis pathway, a sub-set of the YUCCA genes. In vivo, TFL2 is targeted to a number of the YUCCA genes in an auxin-dependent fashion revealing a role of TFL2 in auxin regulation, probably as a component of protein complexes affecting transcriptional control.
Asunto(s)
Proteínas de Arabidopsis/genética , Proteínas de Arabidopsis/metabolismo , Arabidopsis/genética , Arabidopsis/metabolismo , Proteínas Cromosómicas no Histona/genética , Proteínas Cromosómicas no Histona/metabolismo , Genes de Plantas , Ácidos Indolacéticos/metabolismo , Oxigenasas/genética , Oxigenasas/metabolismo , Reguladores del Crecimiento de las Plantas/biosíntesis , Secuencia de Bases , Cartilla de ADN/genética , Regulación hacia Abajo , Regulación de la Expresión Génica de las Plantas , Familia de Multigenes , Mutación , Plantas Modificadas GenéticamenteRESUMEN
Amyloid fibrils are found in approximately 25 different diseases, including Alzheimer's disease. Lung surfactant protein C (SP-C) forms fibrils in association with pulmonary disease. It was recently found that the C-terminal domain of proSP-C (CTC), which is localized to the endoplasmic reticulum (ER) lumen, protects the transmembrane (TM) part of (pro)SP-C from aggregation into amyloid until it has a folded into an alpha-helix. CTC appears to have a more general anti-amyloid effect by also acting on TM regions of other proteins. Here we investigate interactions of CTC with the amyloid beta-peptide (Abeta) associated with Alzheimer's disease and medin, a peptide that forms fibrils in the most common form of human amyloid. CTC prevents fibril formation in Abeta and medin and forms a complex with Abeta oligomers, as judged by size-exclusion chromatography and electrospray ionization mass spectrometry. These data suggest that CTC functions as a chaperone that acts preferentially against unfolded TM segments and structural motifs found during amyloid fibril formation, a mechanism that may be exploited in forming a basis for future anti-amyloid therapy.
Asunto(s)
Péptidos beta-Amiloides/antagonistas & inhibidores , Proteínas de la Leche/antagonistas & inhibidores , Fragmentos de Péptidos/antagonistas & inhibidores , Precursores de Proteínas/fisiología , Proteína C Asociada a Surfactante Pulmonar/fisiología , Secuencia de Aminoácidos , Péptidos beta-Amiloides/ultraestructura , Antígenos de Superficie/ultraestructura , Humanos , Proteínas de la Leche/ultraestructura , Chaperonas Moleculares/química , Chaperonas Moleculares/fisiología , Chaperonas Moleculares/ultraestructura , Datos de Secuencia Molecular , Fragmentos de Péptidos/ultraestructura , Pliegue de Proteína , Precursores de Proteínas/ultraestructura , Estructura Terciaria de Proteína/fisiología , Proteína C Asociada a Surfactante Pulmonar/química , Proteína C Asociada a Surfactante Pulmonar/ultraestructuraRESUMEN
The pathogenesis of sporadic thoracic aortic aneurysm and dissection, which may lead to rupture of the aorta, remains largely unknown. Amyloid deposits, formed from the medin peptide, are very prevalent in the media of the thoracic aorta. We have studied the occurrence of medin-derived amyloid in specimens from patients with thoracic aortic aneurysm, aortic dissection type A and normal dimensioned aorta. Surprisingly, the amount of amyloid was significantly lower in the aneurysm and dissection groups (0.63+/-0.13 and 0.36+/-0.24 amyloid particles per mm2, respectively) compared to the control material (2.37+/-0.58). However, focal medin immunoreactivity not associated with amyloid was found more conspicuously in the media of the two diseased groups. Recent amyloid research indicates that prefibrillar oligomeric aggregates, rather than mature amyloid fibrils, are toxic to the surrounding cells. The non-amyloid medin immunoreactivity observed may represent such toxic oligomers. This is supported by the fact that aggregated medin induced death of aortic smooth muscle cells in vitro. In addition, cells incubated together with medin increased the production of matrix metalloproteinase-2, a protease that degrades elastin and collagen and subsequently weakens the vessel wall. We therefore propose that medin oligomers are involved in the degeneration process of sporadic thoracic aortic aneurysm and dissection.
Asunto(s)
Amiloide/metabolismo , Antígenos de Superficie/fisiología , Aorta Torácica/patología , Aneurisma de la Aorta Torácica/patología , Disección Aórtica/patología , Anciano , Disección Aórtica/metabolismo , Antígenos de Superficie/metabolismo , Aorta Torácica/metabolismo , Aneurisma de la Aorta Torácica/metabolismo , Muerte Celular , Células Cultivadas , Humanos , Metaloproteinasa 2 de la Matriz/biosíntesis , Persona de Mediana Edad , Proteínas de la Leche/metabolismo , Miocitos del Músculo Liso/patologíaRESUMEN
Medin amyloid affects the medial layer of the thoracic aorta of most people above 50 years of age. The consequences of this amyloid are not completely known but the deposits may contribute to diseases such as thoracic aortic aneurysm and dissection or to the general diminished elasticity of blood vessels seen in elderly people. We show that the 50-amino acid residue peptide medin forms amyloid-like fibrils in vitro. With the use of Congo red staining, Thioflavin T fluorescence, electron microscopy, and a solid-phase binding assay on different synthetic peptides, we identified the last 18-19 amino acid residues to constitute the amyloid-promoting region of medin. We also demonstrate that the two C-terminal phenylalanines, previously suggested to be of importance for amyloid formation, are not required for medin amyloid formation.
Asunto(s)
Amiloide/química , Antígenos de Superficie/química , Proteínas de la Leche/química , Algoritmos , Secuencia de Aminoácidos , Amiloide/ultraestructura , Humanos , Datos de Secuencia Molecular , Péptidos/químicaRESUMEN
Cancer pain is a difficult symptom for patients to handle, causing patients extreme discomfort and a decreased quality of life. To support independent pain control for patients with refractory pain while staying in their home, an intrathecal approach for continuous pain management with patient-controlled extra doses from an external pump was implemented. Pain management was supported by a structured guideline for the nursing interventions: To enhance the understanding of how the patients experienced their pain and the continuous pain management at the end of life, a pilot study was conducted. The study followed a qualitative design with unstructured tape-recorded interviews. Three themes emerged from the analysis: (1) The pain was dreadful, reminding the patient of the cancer and the uncertainty of the future; (2) the need to reveal and conceal pain coexisted; and (3) the pain management and structured guideline contributed positively to gain a new perspective on health in which pain did not play the central role. The conclusion is that patients need to communicate their experiences of the pain to manage the pain adequately, while at the same time they need to conceal it to manage their everyday environment. Forthcoming research will focus on the relation between the pain and the way patients experience cancer and on the experience and specific needs of their family.