A Survey of Community Nurses' Knowledge and Strategies Used to Relieve Breathlessness in People with Chronic Obstructive Pulmonary Disease.

BACKGROUND: Little is known about community nurses' knowledge of breathlessness and its management in chronic obstructive pulmonary disease (COPD). AIM: To explore the community registered nurses' knowledge of COPD and the strategies that they use to manage breathlessness in people with COPD. METHODS: A cross-sectional survey study of community registered nurses was conducted using the 65-item Bristol COPD Knowledge Questionnaire and an open-ended item to outline breathlessness strategies. FINDINGS: A total of 59 nurses participated. The total mean Bristol COPD Knowledge Questionnaire Score was 43. The breathlessness category was the lowest scoring category. There were three themes that synthesised: the community nurse's role in monitoring self-management of medications to relieve breathlessness; the use of non-pharmacological strategies to relieve breathlessness; the nursing skills used to monitor breathlessness in people with COPD.

Adolescent chronic pain problems in the school setting: exploring the experiences and beliefs of selected school personnel through focus group methodology.

PURPOSE: To systematically analyze school personnel's understanding of adolescent chronic pain problems and to learn how healthcare and school systems can collaborate more effectively to address these problems. METHODS: Focus group methodology was employed in middle- and high-school settings. Five groups, comprised of 38 schoolteachers, administrators, school nurses, and guidance/mental health staff participated. RESULTS: Transcript analyses indicate that focus group members cited many challenges related to working with adolescents with pain in school (including high absence rates, wide individual variation in presentation of symptoms and impairment, the need to balance accommodations with school policies, attending to the needs of other students, and dealing with parents) and identified needs for more information about chronic pain problems and more guidance from healthcare professionals regarding how to manage pain symptoms and pain-related behaviors in the school setting. CONCLUSIONS: Results indicate that school personnel struggle when they encounter chronic pain problems in the school setting and feel inadequately educated about how to work effectively with students with chronic pain. Improved collaboration between healthcare and school systems is needed and could increase school success (i.e., the ability to attend school and to perform to the best of one's abilities) for adolescents with chronic pain disorders.

Annexin 2 binding to phosphatidylinositol 4,5-bisphosphate on endocytic vesicles is regulated by the stress response pathway.

Annexin 2 is a Ca(2+)-binding protein that has an essential role in actin-dependent macropinosome motility. We show here that macropinosome rocketing can be induced by hyperosmotic shock, either alone or synergistically when combined with phorbol ester or pervanadate. Rocketing was blocked by inhibitors of phosphatidylinositol-3-kinase(s), p38 mitogen-activated protein (MAP) kinase, and calcium, suggesting the involvement of phosphoinositide signaling. Since various phosphoinositides are enriched on inwardly mobile vesicles, we examined whether or not annexin 2 binds to any of this class of phospholipid. In liposome sedimentation assays, we show that recombinant annexin 2 binds to phosphatidylinositol 4,5-bisphosphate (PtdIns-4,5P(2)) but not to other poly- and mono-phosphoinositides. The affinity of annexin 2 for PtdIns-4,5P(2) (K(D) approximately 5 microm) is comparable with those reported for a variety of PtdIns-4,5P(2)-binding proteins and is enhanced in the presence of Ca(2+). Although annexin 1 also bound to PtdIns-4,5P(2), annexin 5 did not, indicating that this is not a generic annexin property. To test whether annexin 2 binds to PtdIns-4,5P(2) in vivo, we microinjected rat basophilic leukemia cells stably expressing annexin 2-green fluorescent protein (GFP) with fluorescently tagged antibodies to PtdIns-4,5P(2). Annexin 2-GFP and anti-PtdIns-4,5P(2) IgG co-localize at sites of pinosome formation, and annexin 2-GFP relocalizes to intracellular membranes in Ptk cells microinjected with Arf6Q67L, which has been shown to stimulate PtdIns-4,5P(2) synthesis on pinosomes through activation of phosphatidylinositol 5 kinase. These results establish a novel phospholipid-binding specificity for annexin 2 consistent with a role in mediating the interaction between the macropinosome surface and the polymerized actin tail.