RESUMO
Quantitative and qualitative analyses of a caring family are needed to improve home care. We propose a three-dimensional quantitative evaluation of family functioning. The first dimension is food, clothing, and shelter; the second dimension is patient, medical, and caring conditions; and the third dimension is the caring family condition. We used the home care score and Family Adaptability and Cohesion Evaluation Scale at Kwansei Gakuin(FACESKG)IV for the quantitative evaluation of family functioning. Narrative medicine and ethnography are valuable for the qualitative evaluation of a caring family.
Assuntos
Cuidadores , Serviços de Assistência Domiciliar , Vestuário , Família , Alimentos , ZeladoriaRESUMO
Since 2008, we held a palliative care workshop primarily aimed for physicians, who engaged in clinical practice for cancer treatment. In order to improve the end-of-life stage patient care at home, we made all sorts of efforts not only for physicians, but we also made a workshop available for healthcare professionals to participate. There were more than 60 people participated the workshop: our 20% of physicians and 24% of nurses, 13% of nearby hospital and clinic physicians, 12% of pharmacists and 17% of nurses. According to our questionnaire survey, more than 90% of the participants were satisfied with the workshop. Only 8% of the participants expressed that the workshop was rather difficult. From our analysis of the results, it was clear that we attained a high level of participants' satisfaction.
Assuntos
Educação Médica Continuada , Educação Continuada em Enfermagem , Serviços de Assistência Domiciliar , Cuidados Paliativos , Assistência Terminal , Humanos , Neoplasias/terapia , Inquéritos e QuestionáriosRESUMO
Cyclic ADP-ribose (cADPR) induces the release of Ca2+ from microsomes of pancreatic islets for insulin secretion. It has been demonstrated that cADPR binds to FK506-binding protein 12.6 (FKBP 12.6) on rat islet ryanodine receptor and that the binding of cADPR to FKBP12.6 frees the ryanodine receptor from FKBP12.6, causing it to release Ca2+ [Noguchi, N., Takasawa, S., Nata, K., Tohgo, A., Kato, I., Ikehata, F., Yonekura, H., Okamoto, H., 1997. Cyclic ADP-ribose binds to FK506-binding protein to release Ca2+ from islet microsomes. J. Biol. Chem. 272, 3133-3136.]. In this study, we cloned, characterized the structural organization of the human FKBP12.6, which is highly homologous to human FKBP12, and analyzed the promoters for FKBP12.6 and FKBP12. Human FKBP12.6 gene spanned about 16 kb in length and consisted of four exons and three introns. The positions of exon-intron junction of the FKBP12.6 gene were perfectly matched with those of FKBP12 gene except that FKBP12 has an additional exon, exon V, to code exclusively for 3'-UTR. Fluorescence in situ hybridization revealed that the FKBP12.6 gene was located on chromosome 2 p21-23, which is different from the locus (chromosome 20 p13) of the FKBP12 gene. Reporter gene analyses revealed that the regions of -58 approximately -24 of FKBP12.6 and -106 approximately -79 of FKBP12 are important for promoter activities. The promoters contain a consensus transcription factor binding sequence for Sp family in FKBP12.6 and Ets-1 in FKBP12. Electrophoretic mobility shift assays showed that nuclear proteins bind to the promoters. The DNA/protein complex on FKBP12.6 promoter was competed out by Sp1 consensus probe and the complex was supershifted by anti-Sp3 antibodies. On the other hand, the DNA/protein complex on FKBP12 promoter was competed out by Ets-1 consensus probe but not by its mutant probe, indicating that Sp3 and Ets-1 play an essential role in transcription of FKBP12.6 and FKBP12, respectively.
Assuntos
Cromossomos Humanos Par 2/genética , Éxons/genética , Íntrons/genética , Regiões Promotoras Genéticas/genética , Proteína 1A de Ligação a Tacrolimo/genética , Proteínas de Ligação a Tacrolimo/genética , Regiões 3' não Traduzidas , Sequência de Bases , Células Cultivadas , Ensaio de Desvio de Mobilidade Eletroforética , Humanos , Hibridização in Situ Fluorescente , Rim/metabolismo , Luciferases/metabolismo , Dados de Sequência Molecular , Proteína Proto-Oncogênica c-ets-1/metabolismo , Fator de Transcrição Sp1/metabolismo , Fator de Transcrição Sp3/metabolismoRESUMO
In the present study, we applied a fluorescent differential display method to mRNAs from aortae of spontaneously hypertensive rats (SHRs), stroke-prone spontaneously hypertensive rats (SPSHRs), and their parental strain, Wistar Kyoto rats (WKYRs), to identify the genes involved in the development of hypertension. Through this screen we came across a gene that is consistently up-regulated in hypertensive rats. Nucleotide sequence determination of the corresponding cDNA revealed that the gene is the rat orthologue of cyr61. Northern blot analysis showed that cyr61 expression increases in SHR and SPSHR before the onset of hypertension and is sustained thereafter at higher levels than in age-matched WKYRs. In situ hybridization analysis demonstrated that cyr61 is expressed strongly in smooth muscle cells (SMCs) in media of SHR and SPSHR but not WKYR aorta. Fluorescent in situ hybridization mapped the cyr61 gene to rat chromosome 1p12-13, which is located in close proximity to a recently defined quantitative trait locus including NHE3 Na(+)/H(+) exchanger. Overexpression of the cyr61 gene in stably transfected rat SMC line A7r5 caused rather inhibitory effects on the proliferation and DNA and protein synthesis. Our results thus demonstrate for the first time that cyr61 can also act as a growth inhibitor in SMC of genetically hypertensive rats. This may reveal a new route for investigation of the pathogenesis of hypertension.