Tolerance induction following orthotopic rat liver transplantation: cytokine production by CD4+ T cells determines the immunological response.
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Animals↗
Biomedical subjects
N Martens
Publications and source records attributed to N Martens.
Effects of prolactin on signal transduction and gene expression: possible relevance for systemic lupus erythematosus.
Receptors for prolactin (PRL-R) are expressed in normal leukocytes from rat and man. PRL signals through PRL-R associated Janus tyrosine kinase (Jak)-2 and signal transducers and activators of transcription (Stat). In addition, in human leukocytes PRL also activates the p38 MAP kinase pathway. PRL, at physiological concentrations, stimulates the expression of the interferon regulatory factor (IRF)-1 gene in rat spleen and bone marrow cells. In man, genes induced by PRL include several members of the 'suppressors of cytokine signaling' (SOCS) family and inducible nitric oxide synthase (iNOS; in mononuclear cells and in granulocytes) and IRF-1 (in granulocytes). Thus, in normal leukocytes, PRL induces the expression of several genes relevant to innate and acquired immune responses. Sex hormones, such as estrogen and PRL, have been implicated in the pathogenesis of murine and human SLE. Also defective signaling in leukocytes is a feature of the disease. What the origin is of aberrant signaling processes in SLE lymphocytes and how they relate to tolerance breakdown and immunopathology is still unknown. It is not unlikely that PRL is a player at some level. The exact contribution of PRL to immune responses in normal subjects and in SLE patients is not known. Further work should also indicate whether PRL might contribute to the onset or progression of the disease and assess the possible benefits of manipulating PRL concentrations in patients.
Animals↗
Family functioning and its implications for palliative care.
Palliative care programs are based on the principle that care should be directed to the family as a unit. However, existing guidelines for care of the family tend to be described in general terms. Analysis of data from a series of three research studies describing the experience of twenty-three families caring for a terminally ill member revealed that family functioning influenced their experience. The dimensions of family functioning are described and guidelines for working with families are proposed.
Adaptation, Psychological↗
Palliative care. The nurse's role in helping families through the transition of "fading away".
Oncology nurses are finding themselves increasingly involved in providing palliative care. A foundational tenet of palliative care is that the entire family, not just the patient, is the unit of care. Although nursing literature on care of the family is growing, nursing approaches tend to be described in general terms. A recent study of families caring for a member with advanced cancer generated a theoretic scheme which indicated that the families' experience could be conceptualized as a transition: the transition of fading away. This theoretic scheme served as the foundation for identifying nursing approaches which could be helpful to families engaged in the transition. This paper expands on the nursing approaches so that nurses may be better prepared to help families through the transition of fading away.
Adaptation, Psychological↗
The work of patients and spouses in managing advanced cancer at home.
The purpose of this paper is to report the findings of a descriptive study which identified the resources used by patients with advanced cancer and their spouses to manage at home. Data were collected through semi-structured interviews with a sample of seven couples identified through two ambulatory clinics at a regional cancer institute. Participants were patients with advanced cancer, between the ages of 45 and 66, and their spouses. Interviews, conducted with each individual and with each couple, were audiotaped, transcribed, and subjected to qualitative analysis. Content analysis showed that patients and spouses utilized internal and external resources, and that external resources were either physical or interpersonal in nature. Conceptual analysis indicated that both patients and spouses dealt with facing either inevitable or uncertain death by engaging in various types of "work." Understanding the dimensions of such work has implications for health care professionals caring for patients and families in palliative care.
Activities of Daily Living↗
Families in supportive care--Part I: The transition of fading away: the nature of the transition.
The entire family unit is affected when one of its members is in need of supportive care; however, relatively few studies pertaining to palliative care have focused on the family as a unit. The purpose of this study was to examine the experience of families having a member with advanced cancer who was receiving palliative care either at home or in the hospital. Eight families (24 family members) participated in semistructured interviews which were audiotaped, transcribed, and subjected to qualitative methods of analysis. Results indicated that the families' experience can be conceptualized as a transition of fading away. The transition began with an ending, characterized by the processes of redefining and dealing with burden. A period of chaos, confusion, fear, and uncertainty characterized the neutral zone. The end point of the transition was a new beginning where families focused on living day-to-day and preparing for death.
Adaptation, Psychological↗
Families in supportive care--Part II: Palliative care at home: a viable care setting.
The growth of various palliative care programs is continuing. The family unit is affected by the need for palliative care in one family member. It is critical, therefore, to know what models of palliative care are preferred by families who are experiencing the need for such services. Content analysis of in-depth interviews with eight families (24 members) indicated that families preferred palliative care at home over care in any institution. Five interrelated concepts explained this preference. The ability of families to realize their preference was dependent upon four factors. These concepts and factors are discussed, focusing on resultant implications for practice.
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