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M J Hirschfeld

Publications and source records attributed to M J Hirschfeld.

14 recordsLinked to original sources
PubMed2001

Signal integration in lipopolysaccharide (LPS)-stimulated murine macrophages.

Using a panel of LPS-inducible genes, selected for the capacity of their products to contribute to endotoxicity, normal macrophages were compared to macrophages deficient in CD14, CD11b/CD18, or TLR4 to elicit gene expression in response to Escherichia coli LPS or the LPS mimetic, Taxol. All genes were TLR4-dependent. At low doses of LPS or Taxol, all genes were also CD14-dependent; however, IP-10 and ICSBP remained poorly inducible even at much higher concentrations. A distinct subset of genes (COX-2, IL-12 p40, and IL-12 p35) was CD11b/CD18-dependent. NF-B translocation and MAPK phosphorylation were dysregulated in receptor-deficient macrophages. In contrast to E. coli LPS, a Porphyromonas gingivalis LPS preparation was found to be TLR2-, rather than TLR4-dependent, and resulted in differential expression of genes within the panel. These data suggest that: (i) TLR4 is necessary, but not sufficient, to induce the full repertoire of genes examined; (ii) CD14 and CD11b/CD18 facilitate signaling for induction of select subsets of genes that are also TLR4-dependent; and (iii) signaling through TLR2 versus TLR4 differs quantitatively/qualitatively. These data support an LPS signaling complex on murine macrophages that minimally includes CD14, CD11b/CD18, and TLR4 to respond to E. coli LPS to elicit the full spectrum of gene expression.

Animals↗
PubMed1994

Management and leadership by nurses.

Good management and leadership by nurses is essential for the achievement of health for all. Well-prepared nurses are required locally and nationally who can identify problems and needs, work on interdisciplinary teams to formulate development plans for human resources, improve working conditions, and raise the quality of care at reasonable cost.

Education, Nursing, Continuing↗
PubMed1987

The World Health Organization's regions of the eastern Mediterranean and Europe: ageing of the population and nursing care.

This paper discusses the context and implications of nursing as a social force in regard to quality of care for the aged. The demographic transformations and its consequences in the WHO regions of the Eastern Mediterranean and Europe are discussed in their relation to socio-political, economic and educational developments and epidemiological changes. It is postulated that nursing has the choice of becoming a social force through raising its awareness of the new reality of a sizeable dependent population with chronic diseases. Nursing knowledge and research, the sharpening of political skills and the refinement of caring skills have the potential for influencing health care policy and long-term care services toward quality health care for the aged. Special attention is given to the use and misuse of concepts as self-care and appropriate technology. The final proof of nursing's willingness and ability to act as a social force will be in the allocation of efforts and resources in different countries. The value of nursing's contribution to the actual care of the aged will depend upon careful ethical considerations, as much as upon knowledge and influence.

Africa, Northern↗
PubMed1985

Ethics and care for the elderly.

This article uses the case of presenile and senile dementia to discuss ethical concepts that have potential to guide nursing action. The concepts of 'sanctity of life' versus 'quality of life' or 'dignity' are both unsatisfactory for directing nursing intervention whenever proxy judgment is necessary. Guidelines for action must evolve from research, the search for clinical knowledge. As an underlying attitude and additional guide the author describes a Jewish ethical perspective which defines dependence and interdependence as an essential part of human existence and accepts the inevitability of living with moral uncertainty.

Aged↗
PubMed1979

Research in nursing gerontology.

Nursing gerontology is the scientific study of the nursing care of the elderly as individuals, family members and population groups. The author identifies and discusses the ethical issues which must be considered in relation to research in nursing gerontology: respect for persons, adequate knowledge base for decision-making, quality of life, quality of death and distribution of limited resources. Research priorities are then discussed.

Aged↗
PubMedDate not supplied

WHO priorities for a common nursing research agenda.

In September 1997 a high-powered research team was brought to Geneva by ICN to set priorities and recommend strategies for ICN leadership roles (see INR, November-December 1997, page 161). An analysis of their findings is now being made. Meanwhile, extracts from country and regional reviews of nursing research presented at the expert group meeting are provided on the following pages, beginning with the WHO Nursing Unit analysis of research at nursing/midwifery collaborating centres and suggested future focus for nursing research.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

The continuation of home care to severely impaired children and aged in Israel: family attitudes.

There are a growing number of children and aged with severe chronic health problems in the community. Mothers become the prime caregivers to these children and aging spouses or middle-aged offspring the caregivers to these aged. The services offered to these families are determined by economic and social conditions, as well as changing fashions, rather than knowledge of the patients' and caregivers' needs. The purpose of this study was to assess the impact of homecare upon families caring for children versus those caring for aged and these families' attitudes toward continuation of home care versus institutionalization. The families included in the study were drawn randomly from the case load of community nurses in central Israel. In-depth interviews were conducted with 92 families of severely impaired children and 181 families of severely impaired adults and aged in their homes. While the majority of both populations carry a heavy burden of caregiving over years, they also receive gratification from their ability to care for their patient at home. There is little difference between those caring for children and those caring for adults in their attitudes toward continuation of home care. Mental rather than physical impairment, a deteriorating illness trajectory; depression, aggression and tension of the caregiver, the absence of sufficient social support and home care services correspond with negative feelings toward continued home care. The perceived impact of caregiving responsibilities upon the caregivers' lives, the ability to tolerate and manage symptoms and above all the quality of the patient-caregiver relationship influenced the caregivers' attitudes toward institutionalization in both populations. Family attitude toward continued homecare and institutionalization of children and adults are compared and the needs for services discussed.

Aged↗