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ABSTRACT: The aim of this study was to investigate person and environment factors of elders that facilitate adaptation to relocation to long-term care skilled nursing facilities. Results represent findings from Phase 1 of three phases of a 2-year study to develop and test a cultural heritage intervention to improve adaptation to nursing home relocation.
Qualitative interviews were conducted with 23 newly admitted Caucasians and African Americans residing in skilled nursing facilities. FINDINGS/RESULTS: Themes that emerged include (a) spirituality, death and dying, and philosophy of life; (b) life experiences with change; (c) cultural heritage; (d) health; (e) ethnicity; (f) social support, family and friends; (g) long-term care facility (LTCF) relationships; (h) LTCF system maintenance; and (i) LTCF support of personal growth. Comparison of African Americans and Caucasians showed more similarities than differences between the groups.
Implications for research, clinical practice, and cultural heritage interventions for LTCF adaptation are discussed.
Journal of Transcultural Nursing 08/2011; 22(4):397-404. · 0.93 Impact Factor
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ABSTRACT: As the scope of plastic surgical practice expands to include disorders of the carpus and wrist, it has become increasingly important for plastic surgeons to understand pathoanatomy that has not traditionally been considered an integral component of training. The Essex-Lopresti injury consists of a radial head fracture with associated injury to the forearm interosseus membrane and longitudinal instability of the distal radioulnar joint. Early recognition of this disorder usually results in a predictable and satisfactory outcome. However, when this disorder is unrecognized, late reconstruction is challenging and unpredictable, and treatment may be misdirected to the wrist alone if the forearm and elbow are not considered as a component of this injury. The present report describes the importance of examining the elbow in all cases of wrist pain. As well, the literature is reviewed regarding the differences in treatment of acute and chronic Essex-Lopresti injuries. As plastic surgeons become more involved in the treatment of wrist injuries, the conscientious practitioner should be aware of more complicated pathology that may present as a seemingly straightforward wrist problem.
The Canadian journal of plastic surgery, Journal canadien de chirurgie plastique 02/2006; 14(4):215-8. · 0.18 Impact Factor
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ABSTRACT: The kallikrein family is a group of 15 serine protease genes clustered on chromosome 19q13.4. Binding of kallikreins to protease inhibitors is an important mechanism for regulating their enzymatic activity and may have potential clinical applications. Human kallikrein gene 5 (KLK5) is a member of this family and encodes for a secreted serine protease (hK5). This kallikrein was shown to be differentially expressed at the mRNA and protein levels in diverse malignancies. Our objective was to study the enzymatic activity and the interaction of recombinant hK5 protein with protease inhibitors. Recombinant hK5 protein was produced in yeast and mammalian expression systems and purified by chromatography. HPLC fractionation, followed by ELISA-type assays, immunoblotting and radiolabeling experiments were performed to detect the possible interactions between hK5 and proteinase inhibitors in serum. Enzymatic deglycosylation was performed to examine the glycosylation pattern of the protein. The enzymatic activity of hK5 was tested using trypsin and chymotrypsin-specific synthetic fluorogenic substrates. In serum and ascites fluid, in addition to the free ( approximately 40 kDa) form, hK5 forms complexes with alpha(1)-antitrypsin and alpha(2)-macroglobulin. These complexes were detected by hybrid ELISA-type assays using hK5-specific coating antibodies and inhibitor detection antibodies. The ability of hK5 to bind to these inhibitors was further verified in vitro. Spiking of serum samples with 125I-labeled hK5 results in the distribution of the protein in two higher molecular mass (bound) forms, in addition to the unbound form. The hK5 mature enzyme is active and shows trypsin, but not chymotrypsin-like, activity. The pro-form of hK5 is not active. Recombinant hK5 shows a higher than predicted molecular mass due to glycosylation. hK5 is partially complexed with alpha(1)-antitrypsin and alpha(2)-macroglobulin in serum and ascites fluid of ovarian cancer patients. The recombinant protein is glycosylated and its mature form shows trypsin-like activity.
Biochimica et Biophysica Acta 08/2003; 1628(2):88-96. · 4.66 Impact Factor
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ABSTRACT: Human kallikrein 6 (hK6) is significantly increased in serum in many patients with ovarian cancer and may have a role in amyloid precursor processing and Alzheimer disease. The forms of hK6 in biological fluids are poorly characterized.
hK6 protein was immunoaffinity-purified and positively identified by Western blotting, N-terminal sequencing, and mass spectrometry. hK6 in cerebrospinal fluid (CSF), milk, ascites, and serum was size-fractionated by chromatography and then measured by a highly sensitive and specific immunoassay. Hybrid assays were performed to detect the possible interactions between hK6 and proteinase inhibitors in CSF, milk, ascites fluid, and serum.
N-Terminal sequencing identified hK6 in the proform in both CSF and milk. hK6 exists in two forms in milk and ascites fluid: a free form with a molecular mass of approximately 25 kDa and a higher molecular mass form. Hybrid sandwich assays (capture antibody for hK6 and detection antibody for inhibitors), utilizing a panel of known serine protease inhibitors, indicated that alpha(1)-antichymotrypsin forms a complex with hK6 in milk and ascites fluid. Only the free form of hK6 was detected in CSF and serum.
hK6 exists mainly as a proenzyme in milk and CSF. A fraction of this enzyme is partially complexed with alpha(1)-antichymotrypsin in milk and ascites fluid of ovarian cancer patients.
Clinical Chemistry 06/2003; 49(5):746-51. · 7.91 Impact Factor
