Self-epistemic authority and nurses' reactions to medical information that is retrieved from Internet sites of different credibility.

This cross-sectional study investigated nurses' reactions to Internet medical information that was retrieved from sources of different scientific credibility and the association between self-epistemic authority and these reactions. The participants filled in questionnaires on their reactions to Internet medical information and self-epistemic authority. The nurses' reactions to Internet medical information from a highly credible source (Medline) correlated positively with self-epistemic authority. However, no such correlation was found with Internet medical information from a less credible Internet source (Ynet). Compared with the nurses without an academic degree, the nurses with an academic degree had more positive reactions to the information that was retrieved from Medline. The reactions to the medical information that was retrieved from Ynet did not differ by the education of the nurses. This study shows that nurses' reactions to different sources of Internet information vary according to their level of self-epistemic authority and education. As patients' use of Internet medical information is increasing, nurses need to expand their expertise in the various professional and popular medical information sites. Such skills will help to reduce any negative feeling that might arise when they encounter patients who present medical information from the Internet.

Nurses attitudes towards the informed patient.

UNLABELLED: The widespread use of the Internet for health information has resulted in knowledgeable clients referred to as "informed patients". Many patients bring the information they downloaded from the Internet to the appointments with the health care workers. OBJECTIVES: The present study examined the prevalence of nurses' encounters and attitudes to these patients and factors that might influence attitudes. METHOD: A cross-sectional study of a convenience sample of 110 nurses in Israel was conducted. The main variables measured were: attitudes, professional self-esteem, and two indices of Internet use. RESULTS: The results show that most nurses held positive attitudes towards patients presenting Internet Medical Information. Nurses with prior experience had more positive attitudes than nurses with no such experience. Professional self-esteem and Internet use were also positively correlated to positive attitudes to these patients. CONCLUSIONS: Since patients search the Internet for medical information, there is a need to prepare and train nurses to be Internet literate in order to be prepared for encounters with such patients.

Factors affecting nurses' attitudes in Israel toward patients who present them with Internet medical information.

Nurses regularly encounter patients bringing with them medical data from the Internet. The purpose of the present study was to examine the prevalence of these encounters, nurses' attitudes to these patients, and the factors that might influence their attitudes. A cross-sectional study of a convenience sample of 110 nurses (32 practical nurses, 35 registered nurses and 43 academically trained nurses). The main variables measured were: attitudes toward patients presenting Internet information, professional self-esteem, and three indices of Internet use. The results show that most nurses had encountered patients presenting Internet medical information and held positive attitudes to them. Nurses with such experience had more positive attitudes than nurses with no such experience. Professional self-esteem and indices of Internet use were also positively correlated to favorable attitudes to these patients. Regression analysis showed that professional self-esteem and Internet self-efficacy predicted attitudes to these patients. Since the number of patients presenting Internet information can only multiply, there is a need to prepare and train nurses for encounters with such patients.

[Prophylactic oophorectomy among carriers of BRCA1/2 mutations--demographic and pathologic data].

BACKGROUND: During the past few years, the genes BRCAI and BRCA2 were cloned. Mutations in each gene are responsible for the syndrome of familial breast and ovarian carcinoma. Among women who carry such a mutation, there is a 56%-80% life-time risk of developing breast cancer and a 16%-60% risk of developing ovarian cancer. Recently, it has been proven that prophylactic mastectomy and/or oophorectomy might reduce such risks of developing cancer. Neither of these treatments offers full protection and furthermore, compliance of carriers is partial, considering the physical and mental consequences of such treatment. GOALS AND METHODS: This study describes the sociodemographic profile of 30 healthy carriers of BRCA1/2 mutations that underwent prophylactic salpingo-oophorectomy. We also examined the pathological specimens and point out the ratio of significant pathological findings, especially the presence of cancer. The women are being followed-up at Hadassah Medical Center, Jerusalem. RESULTS: Pathological examination of the ovaries and fallopian tubes of 30 healthy carriers of BRCA1/2 mutations who underwent prophylactic salpingo-oophorectomy revealed tumor in three cases (10%). Two tumors were in the ovaries and one in the fallopian tube. One of these tumors was in an advanced stage and two were small and confined to the organ. CONCLUSIONS: Based on the above results, we noted that salpingo-oophorectomy, despite being quite a radical preventive method, might offer protection for the carriers against life-threatening silently-developing cancer. We found cancer in 10% (3) of the women, and in two of these cases, prophylactic salpingo-oophorectomy became the definitive treatment for a small occult tumor.

Differential expression of protease activated receptor 1 (Par1) and pY397FAK in benign and malignant human ovarian tissue samples.

Protease activated receptors (PAR) form a family of G-protein coupled receptors (GPCR) encoding their own ligands and uniquely activated via proteolytic cleavage. Although proteases in general have been implicated in the remodeling of the extracellular tumor microenvironment, the role of cell surface receptors activated by proteolysis is now emerging. In our present study we investigated the expression pattern of protease activated receptor 1 hPar1 in ovarian carcinoma tissue samples. Abundant hPar1 mRNA and protein were detected in "low malignant potential" and in invasive carcinomas, regardless of the histological subtype. In contrast, no hPar1 expression was detected on the cell surface of normal ovarian epithelium. The differential expression pattern of hPar1 was shown by in situ hybridization, immunohistochemistry and semi-quantitative RT-PCR analyses. In early stages of ovarian carcinoma (Ia), the contra lateral normal ovary showed strong PAR1 expression as opposed to the lack of expression in the ovarian epithelium obtained from normal individuals. In parallel, we analyzed the expression pattern of alphavbeta5 integrin and of activated focal adhesion kinase (FAK), a major focal contact protein, in these tissues. Although abundant expression of alphavbeta5 integrin was observed in all tissues specimens examined, regardless of either normal or malignant, the level of activated FAK was differentially expressed. Phosphorylated FAK was seen in invasive ovarian carcinoma, but not in the normal ovarian epithelium. The abundant hPar1 levels in pathological malignant ovarian carcinoma is likely to transmit signals leading to the phosphorylation of FAK and thereby alterations in the integrin functional state. Altogether our data suggest that hPar1 and FAK cooperate to promote ovarian cancer malignancy.

The pattern of expression of protease-activated receptors (PARs) during early trophoblast development.

Human fetal development depends on the ability of the embryo to gain access to the maternal circulation. Thus, specialized stem cells of the newly formed placenta, trophoblast, invade the uterus and its arterial network to establish an efficient feto-maternal molecular exchange. To accomplish this task, trophoblast differentiation during the first trimester of pregnancy involves cell proliferation, invasion, and extracellular matrix (ECM) remodelling. Trophoblast invasion shares many features with tumour cell invasion, with the distinction that it is strictly spatially and temporally controlled. We have previously demonstrated that PAR1, the first member of the protease-activated receptor (PAR) family, plays a central role in tumour cell invasion. In the present study we have examined the pattern of expression of PAR1 and other PAR family candidates during early human placental development. We show that PAR1 and PAR3 are highly and spatially expressed between the 7th and 10th weeks of gestation but not at the 12th week and thereafter. Likewise, high expression levels of PAR1 and PAR3 were observed in the cytotrophoblast cells of complete hydatidiform mole as compared to minimal levels in normal age-matched placenta. Together, our data suggest the involvement of PAR1 and PAR3 in restricted and unrestricted pathological trophoblast invasion.