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Biomedical subjects

M M Ross

Publications and source records attributed to M M Ross.

At least 19 recordsLinked to original sources
PubMed1998

The peptide recognized by HLA-A68.2-restricted, squamous cell carcinoma of the lung-specific cytotoxic T lymphocytes is derived from a mutated elongation factor 2 gene.

The identification of naturally processed tumor peptides that can stimulate a tumor-specific, CTL response is crucial to the development of a vaccine-based, immunotherapeutic approach to cancer treatment. One type of cancer in which a tumor-specific, CTL response has been observed is squamous cell carcinoma of the lung. In the system investigated here, the tumor-specific CTLs are HLA-A68.2 restricted. Immunoaffinity chromatography was used to isolate the HLA-A68.2 molecules from the tumor cell line, and peptide was eluted with acid from the HLA-A68.2 molecules and subjected to three rounds of separation by reversed phase-high performance liquid chromatography (RP-HPLC). To determine which fractions contained the peptide recognized by the tumor-specific CTLs, an aliquot of each RP-HPLC fraction was added to the autologous, B-lymphoblastoid cell line, and the cells were then tested as targets for tumor-specific CTLs. After the third round of RP-HPLC, mass spectrometry was used to sequence individual peptide candidates, and a peptide with a m/z of 497 was identified as the active peptide. Collision-activated dissociation of m/z 497 allowed identification of the peptide sequence as ETVSEQSNV. With the exception of a single amino acid difference (glutamic acid versus glutamine as the sixth position in the peptide), this peptide is identical to residues 581 to 589 of elongation factor 2. The PCR was used to amplify the elongation factor 2 gene in both the tumor cells and the autologous B cell line, and DNA sequencing of the products revealed the presence of a heterozygous mutation in the tumor cells that accounts for the difference between the two peptide sequences. Although a similar analysis did not reveal the presence of the mutation in three additional lung cell carcinomas, this does not rule out the possibility that a survey of a larger population of tumor cells would reveal the presence of the mutation at a low frequency. These results demonstrate the utility of this approach for identifying tumor-specific antigens that are the targets of a CTL response.

Antigens, Neoplasm↗
PubMed1998

Elderly recipients of home nursing services: pain, disability and functional competence.

Despite increasing evidence that pain is a problem with which many in their later years must contend, little is known about the experience of community-dwelling seniors who require the assistance of home nursing services to remain independent and functional in their homes. This study investigated the prevalence and experience of pain among seniors who were recipients of home nursing services. The study was guided by the World Health Organization Classification of Impairment, Disability and Handicap. Face to face interviews were conducted with 66 individuals who reported whether they were often troubled by pain and/or had experienced pain of a noteworthy nature within the 2 weeks prior to the interview. In addition, they responded to standardized questions about their pain experience and their levels of disability and functional competence. Findings revealed that although three-quarters of respondents reported pain, there was no association between pain and measures of disability. Findings, however, revealed an association between pain and measures of functional competence, more specifically, global function, level of depressive symptomatology, sleep impairment and satisfaction with life. Implications for nursing include the need for a heightened awareness of the prevalence of pain in community-dwelling older adults and the development of assessment and intervention strategies that support their quality of life.

Activities of Daily Living↗
PubMed1998

Nursing curricula and violence issues.

This article presents the findings of a survey of Canadian schools of nursing (N = 155) that determined the extent to which violence-related content is addressed in nursing curricula. The study yielded a response rate of 88%. Theoretical content regarding violence against children and women of all ages, and suicide as a response to abuse formed part of the curriculum of all schools of nursing, if only in readings. Child abuse and suicide received the greatest number of hours of instruction, followed by woman abuse, sexual assault, and elder abuse. University schools of nursing provided the greatest number of hours of instruction when compared with other types of schools. Schools in Western and Atlantic Canada provided the greatest number of hours of instruction on woman abuse when compared with other regions of the country. The majority of university schools provided experiential instruction in the area of violence, with the other types of schools providing very little such instruction. Findings revealed a sensitivity to the importance of including content on violence in nursing curricula; however, the approach to this content is largely incidental and heavily dependent on individual faculty interests. Implications of this study point to the need for the systematic inclusion of violence-related content and the sharing of resources among schools of nursing.

Canada↗
PubMed1997

Patterns of caregiving following the institutionalization of elderly husbands.

The purpose of this study was to examine the caregiving career of older women following the institutionalization of their husbands. Informed by the interpretive perspective in sociology and Hughes's (1971) concept of career, the study employed a longitudinal, prospective, and descriptive design and combined the quantitative and qualitative approaches. The data used in the analysis were drawn from a larger study designed to explore the transition to quasi-widowhood and wives' responses to their husbands' institutionalization. The caregiving career of wives was seen as a pattern of frequent visiting and increasing involvement in the provision of care. Over the nine-month period of the study, two caregiving patterns emerged that were distinguished by a variety of circumstances and interactions. Wives who relinquished aspects of caregiving were more likely to be caring for husbands who were, in large measure, cognitively impaired. These wives reported good morale, few symptoms of depression, change in marital closeness, and satisfaction with aspects of institutional care. Wives who continued to be heavily involved in caregiving were more likely to have husbands who were physically impaired. They had depression scores indicative of moderate to severe depression, reported no change in marital closeness, and were dissatisfied with aspects of institutional care.

Aged↗
PubMed1997

Spousal caregiving in the institutional setting: visiting.

The purpose of this study was to investigate the visiting experience of wives whose husbands had been admitted to a long-term care institution. The study employed a longitudinal and prospective design and combined qualitative and quantitative approaches. The data were drawn from a larger study designed to explore the transition to quasi-widowhood. This article reports on one aspect of spousal caregiving following the admission of a husband to a long-term care setting, i.e. visiting. In this study, wives visited frequently. Their reasons for visiting included love and devotion, duty and obligation, the monitoring of husbands' well-being and the provision of assistance to both husbands and staff. They engaged in task performance and social interaction during visiting. Their feelings of satisfaction and enjoyment with visiting were associated with their husbands' well-being and feeling useful. Over the 9-month period of the study, two patterns of visiting and involvement emerged that were associated with different outcomes related to depression, morale and satisfaction with institutional dimensions of care.

Adult↗
PubMed1996

Local recurrence in malignant melanoma: long-term results of the multiinstitutional randomized surgical trial.

BACKGROUND: In the past, radical margins of excision were prescribed for cutaneous melanoma based on preconceived notions rather than on hard clinical evidence. METHODS: In a prospective study of 742 patients with intermediate-thickness melanoma (1-4 mm), 470 patients with trunk or proximal extremity lesions were randomized into a 2- or 4-cm margin. Patients with distal extremity or head and neck lesions (n = 272) received uniformly a 2-cm margin. RESULTS: The overall rate of local recurrence was 3.8%. This rate in the randomized portion (n = 470) was 2.1% for the 2-cm margin and 2.6% for the 4-cm margin (p = 0.72). A progressive increase in local recurrence rates was observed with thickness: 2.3% for lesions 1.0-2.0 mm, 4.2% for those 2.01-3.0 mm, and 11.7% for those 3.01-4.0 mm thick (p = 0.001). Local recurrence occurred in 1.5% of those without ulceration and in 10.6% of those with ulceration of the primary lesion (p = 0.001). The local recurrence rate was not significantly affected by the margin of resection even among the thicker or ulcerated lesions. It also was not affected significantly by the method of closure of the primary site or management of the regional nodes, or the age or gender of the patients. CONCLUSIONS: A 2-cm margin is as effective as a 4-cm margin in local control and survival of intermediate-thickness melanomas. The local recurrence rate is significantly affected by the thickness of the primary lesion and the presence or not of ulceration.

Adolescent↗
PubMed1996

The palliative care quiz for nursing (PCQN): the development of an instrument to measure nurses' knowledge of palliative care.

This paper describes the process and outcomes of a study to develop a tool to measure nurses' knowledge of palliative care. The development of the palliative care quiz for nursing (PCQN) entailed the convening of an advisory committee, a wide process of consultation, the development of a conceptual framework, determination of format, generating of items and pre-testing, piloting and further testing of the quiz. The PCQN is a 20-item true, false and 'I don't know' test of knowledge that is easily administered and has utility for assessing knowledge, stimulating discussion and identifying misconceptions about palliative care nursing.

Education, Nursing↗
PubMed1995

Novel 3,4-di- and 3,4,5-trihydroxyphenylalanine-containing polypeptides from the blood cells of the ascidians Ascidia ceratodes and Molgula manhattensis.

Acetic acid urea extraction of the blood cells of two ascidian species yielded four novel families of polypeptides (3500-5300 Da) containing 3,4-dihydroxyphenylalanine (DOPA) and 3,4,5-trihydroxyphenylalanine (TOPA) from the Phlebobranch Ascidia ceratodes and two DOPA proteins (9-10 kDa) from the Stolidobranch Molgula manhattensis. 3,4,5-Trihydroxyphenylalanine residues have not been found previously in polypeptides in any biological system. The DOPA content of the M. manhattensis proteins is the highest yet reported for a naturally occurring DOPA protein. The successful isolation of proteinaceous components from A. ceratodes blood cells requires the incorporation of high concentrations of complexing agent in the extraction buffers to inactivate vanadium(III) which forms intractable organometallic polymers. The A. ceratodes blood cell polypeptides are all rich in alanine and TOPA residues, have neutral to basic pI values, and, while all give single bands on acid urea-polyacrylamide electrophoresis, they exhibit extensive microheterogeneity. This is reflected by their large molecular weight distribution as determined by matrix-assisted laser desorption ionization-mass spectrometry, the variation in the ratio of their 280-nm absorption to chromophores of unknown structure in the polypeptide's electronic absorption spectra, and the N-terminal sequence analysis. The two M. manhattensis proteins consist largely of four amino acids (alanine, valine, phenylalanine, and DOPA) with DOPA accounting for upward of 40 mol%. Both give an N-terminus of Ala-Phe-Tyr before resisting further progress by Edman degradation. Proteins and polypeptides from both ascidians are extremely resistant to proteases, a property which, while hampering characterization by sequence analysis, appears ideally suited to their proposed function of forming an impervious hemostat at the site of vascular injury. The yield of proteins and polypeptides relative to tunichromes appears to be seasonally dependent. The presence of DOPA and TOPA moieties in the proteins and polypeptides implicates them, as well as the tunichromes, as potential metal-sequestering agents.

Amino Acid Sequence↗
PubMed1994

The use of the diary as a data collection technique.

The initiation of a research project requires many decisions, not the least of which is the selection of a method for data collection. This decision is, in large measure, guided by the nature of the research question which generally prescribes the selection of a strategy for data collection from among an array of possible alternatives. This article addresses the use of a diary for data collection. Although diaries have traditionally been used in social science and health research, their use in nursing research is more recent. The article begins with a brief discussion of the rationale for using the diary to gather data in a study of personal and professional caregiving. A brief review of the use of diaries in previous studies follows, along with a description of the use of a diary in the caregiving study and a discussion of the possible threats to high quality data as well as measures used to ensure the collection of high quality data. The article concludes with a discussion of the strengths and weaknesses of the diary and makes recommendations regarding its use in nursing research.

Autobiographies as Topic↗
PubMed1994

Providing palliative care to older adults: context and challenges.

This paper presents the findings of a study aimed at understanding more fully the work of nurses who provide care to older adults who are dying at home. The method employed was qualitative in nature and involved the use of focus groups for data collection. Data were gathered from a total of 40 community-based nurses during four sessions lasting approximately two hours each. Analysis revealed that the provision of care occurred within a context of aging and dying characterized by clients' awareness of impending death, the presence of multiple pathologies, diminishing social support, and a lack of control. Challenges to providing care stemmed from an ethic of high expectation and a health care system experienced as fragmented, bureaucratic, and driven by cost efficiency. Challenges included working in isolation, achieving closure, securing personal support, working collaboratively with others, and keeping up to date. Findings from this study have implications for both education and practice.

Aged↗
PubMed1994

Nurses' work: balancing personal and professional caregiving careers.

Forty full-time nurses who were also responsible for providing care to individuals in their private lives volunteered for a qualitative study of combined caregiving careers. Each respondent kept a diary of caregiving activities during two representative 24-hour periods, and was interviewed prior to, and after diary-recording. Most nurses experienced high levels of stress associated with caregiving in both their professional and private lives. In general, they were relatively satisfied with their lives in both spheres, and felt a slightly greater sense of control in their work lives than in their home lives. Regarding the tensions/conflicts they alluded to, the following themes emerged: an ethic of high expectation, feeling torn between two worlds, a sense of working in isolation, and working in overdrive. The rewards/benefits included remuneration, recognition and self-esteem, opportunities for personal growth, and opportunities for family growth.

Adaptation, Psychological↗
PubMed1993

Spousal caregiving following institutionalization: the experience of elderly wives.

A large body of research reveals the contribution of families to the care of elderly and health-impaired community-dwelling individuals. Less is known about the contribution of families to the provision of care following the admission of elderly relatives to a long-term care institution. Still less is known of the experience of elderly wives following the institutionalization of their husbands. The purpose of this paper is to increase nurses' awareness, through a review of the literature on family caregiving in later life, of the contribution to care made by elderly wives following the institutionalization of their husbands. We also hope to provide direction for clinicians with respect to the needs and concerns of wives, particularly at the time of, and following, the admission of their husbands to long-term care institutions.

Aged↗
PubMed1990

Time-use in later life.

This paper seeks to demonstrate the significance of the time budget methodology for nursing as a means of exploring the use of time in later life and its relation to health and well-being. With increasing concern for quality of life issues, the use of time and the proportion of time that is allocated to specific domains of life become important life-style decisions that merit both personal concern and professional inquiry. The paper begins with a review of the time budget methodology and the research employing the time budget methodology dating back to the 1960s. It continues with a description of how people allocate and use their time in later life as revealed by these studies, and concludes with the significance of this method of inquiry for nursing.

Activities of Daily Living↗