Rebuilding Life: Investigating the Long-Term Homecare Needs of Clients With Spinal Cord Injuries.

BACKGROUND: Clients with a spinal cord injury (SCI) must learn to manage their disabilities and may never be able to resume their previous lifestyle. Therefore, receiving relevant information and support from care practitioners and institutions is essential for clients with long-term SCI. PURPOSE: This study investigated the long-term homecare needs of clients with SCIs. METHODS: A qualitative approach was used in this study. Data were collected from March to May 2013. Four SCI associations were selected using purposive sampling, and four focus group interviews were conducted in Northern, Central, Southern, and Eastern Taiwan. Each focus group was composed of 7-12 participants. In-depth interviews (1.5-2.5 hours) were conducted. A content analysis method was adopted for data analysis. RESULTS: Thirty-eight participants took part in the study. The long-term care needs of clients with SCI require the following dynamic processes for rebuilding their lives: physical care and complication prevention, life planning, social support, discovery of the value of existence, and sexual satisfaction. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The results reveal the long-term care needs of clients with SCI. Nurses are expected to provide client-centered care, emphasize prevention rather than treatment of complications, initiate life planning at the early stages of a client's rehabilitation, enhance a client's social support, encourage a client's search for companionship and search for the value of existence and a life purpose, and be attentive to the sexual concerns of people with physical disabilities.

In planta expression screens of Phytophthora infestans RXLR effectors reveal diverse phenotypes, including activation of the Solanum bulbocastanum disease resistance protein Rpi-blb2.

The Irish potato famine pathogen Phytophthora infestans is predicted to secrete hundreds of effector proteins. To address the challenge of assigning biological functions to computationally predicted effector genes, we combined allele mining with high-throughput in planta expression. We developed a library of 62 infection-ready P. infestans RXLR effector clones, obtained using primer pairs corresponding to 32 genes and assigned activities to several of these genes. This approach revealed that 16 of the 62 examined effectors cause phenotypes when expressed inside plant cells. Besides the well-studied AVR3a effector, two additional effectors, PexRD8 and PexRD36(45-1), suppressed the hypersensitive cell death triggered by the elicitin INF1, another secreted protein of P. infestans. One effector, PexRD2, promoted cell death in Nicotiana benthamiana and other solanaceous plants. Finally, two families of effectors induced hypersensitive cell death specifically in the presence of the Solanum bulbocastanum late blight resistance genes Rpi-blb1 and Rpi-blb2, thereby exhibiting the activities expected for Avrblb1 and Avrblb2. The AVRblb2 family was then studied in more detail and found to be highly variable and under diversifying selection in P. infestans. Structure-function experiments indicated that a 34-amino acid region in the C-terminal half of AVRblb2 is sufficient for triggering Rpi-blb2 hypersensitivity and that a single positively selected AVRblb2 residue is critical for recognition by Rpi-blb2.