Using Critical Creativity to Reveal Nursing Student Learning in Long-Term Care.

Background: The use of teaching-learning strategies that emphasize critical reflection aids students in making sense of complex clinical placement settings, such as those in long-term care (LTC) settings.

Method: A qualitative descriptive research design was used to explore the assumptions, anticipations, and realizations of six undergraduate nursing students regarding aging, gerontological nursing, and LTC as they engaged in facilitated critical reflection activities during a 12-week LTC placement.

Results: The content analysis process revealed four main categories describing the student learning experience: Exploring the Therapeutic Nurse-Resident Relationship, Navigating Preceptor Relationships, Expanding Awareness of Context, and Embracing Many Feelings.

Exploring Health Care Professionals' Perceptions of Incidents and Incident Reporting in Rehabilitation Settings.

Objectives: Research exploring patient safety in rehabilitation settings is limited. This study's aim was to describe team members' perceptions of incidents and incident reporting in rehabilitation settings.

Methods: Semistructured interviews were conducted with 18 health care professionals from multiple rehabilitation units (medical, neurological, and orthopedic) at 2 inner-city rehabilitation centers.

Facilitating best practice in aged care: exploring influential factors through critical incident technique.

Aim.  The focus of this study is on the perspective of facilitators of evidence-based aged care in long-term care (LTC) homes about the factors that influence the outcome of their efforts to encourage nursing staff use of best practice knowledge. Design.

Figuring it out in the moment: a theory of unregulated care providers' knowledge utilization in dementia care settings.

Background: Within the context of knowledge translation, the disconnect between the results of research and the practice patterns of nursing care providers has not been reported in the context of institutional dementia care practice. Therefore, little is known about how knowledge about best dementia care practice, defined broadly as the person-centered approach, gets used by institutional nursing care providers.

Aim: Unregulated care providers provide the majority of nursing care for older people with Alzheimer's disease and related disorders living in long-term care facilities.

Effects of D-myo-inositol 1-phosphate on the transfer function of phosphatidylinositol transfer protein alpha.

The lipid metabolite D-myo-inositol-1-phosphate is shown to increase the phospholipid transfer activity of phosphatidylinositol transfer protein alpha from liposomal and liver microsomal membranes. Dose-response curves indicated substantial enhancements of transfer in the low mM range that upon normalization were independent of membrane composition or the identity of the transferred phospholipid. The unnormalized effect is potentiated by anionic membrane surface charge and substantial membrane phosphatidylethanolamine content consistent with alterations of the protein's membrane binding affinity and alterations of surface electrostatic interactions as contributing factors.

L-alpha-glycerylphosphorylcholine inhibits the transfer function of phosphatidylinositol transfer protein alpha.

Phosphatidylinositol transfer protein alpha (PITP-alpha) is a bifunctional phospholipid transfer protein that is highly selective for phosphatidylinositol (PtdIns) and phosphatidylcholine (PtdCho). Polar lipid metabolites, including L-alpha-glycerylphosphorylcholine (GroPCho), increasingly have been linked to changes in cellular function and to disease. In this study, polar lipid metabolites of PtdIns and PtdCho were tested for their ability to influence PITP-alpha activity.

Activity of phosphatidylinositol transfer protein is sensitive to ethanol and membrane curvature.

Phosphatidylinositol transfer protein (PITP) is critical for many cellular signalling and trafficking events that are influenced by ethanol. The influence of ethanol and membrane curvature on the activity of recombinant mouse PITP-alpha in vitro is evaluated by monitoring the transfer of phosphatidylinositol (PtdIns) from rat hepatic microsomes to unilamellar vesicles. Acute exposure to pharmacological levels of ethanol enhanced the function of PITP.

Saturable ethanol binding in rat liver mitochondria.

The binding of ethanol to rat liver mitochondria is shown to be saturable at physiologically relevant ethanol concentrations. This effect is reversible and is not observed in extracted mitochondrial phospholipids. Brief exposure of the mitochondria to heat abolishes saturable ethanol binding.

Direct determination of hydration in the interdigitated and ripple phases of dihexadecylphosphatidylcholine: hydration of a hydrophobic cavity at the membrane/water interface.

Hydrophobic cavities at the membrane/water interface are stably expressed in interdigitated membranes. The nonsolvent water associated with 1,2-di-O-hexadecyl-sn-glycero-3-phosphocholine (Hxdc(2)GroPCho) in the interdigitated (L(beta)I) and ripple (P(beta')) states and with its ester analogue 1, 2-dipalmitoyl-sn-glycero-3-phosphocholine (Pam(2)PtdCho) in the gel (L(beta')) and P(beta') states are determined directly. In the L(beta)I state at lower temperatures (4-20 degrees C), 16-18 water molecules per phospholipid are bound, consistent with water-filled cavities and hydrated headgroups.

Human sexuality in long-term care.

Sexual expression is a basic human need, a normal part of life that is integral to who we are as human beings. As we age, we continue to be challenged to grow in every area of our lives, including our sexuality. In institutionalized settings, however, human sexuality can be an area in which growth is not fostered, but restrained.

Tracking phospholipid populations in polymorphism by sideband analyses of 31P magic angle spinning NMR.

A method was developed to track the distributional preferences of phospholipids in polymorphism based on sideband analyses of the 31P magic angle spinning nuclear magnetic resonance spectra. The method was applied to lipid mixtures containing phosphatidylcholine (PtdCho), phosphatidylethanolamine (PtdEtn) and either cholesterol (Chol) or tetradecane, as well as mixtures containing the anionic phosphatidylmethanol, phosphatidylethanolamine, and diolein. The phospholipid composition of coexisting lamellar (Lalpha) and inverted hexagonal (HII) phases remained constant throughout the Lalpha --> HII transition in all mixtures, except those that contained saturated PtdCho and unsaturated PtdEtn in the presence of cholesterol-mixtures that are known to be microimmiscible because of favored associations between Chol and saturated acyl chains.

Effect of antithyroid drugs on hydroxyl radical formation and alpha-1-proteinase inhibitor inactivation by neutrophils: therapeutic implications.

The release of proteolytic enzymes and generation of strong oxidants such as the hydroxyl radical by activated neutrophils has been proposed to play an important role in mediating toxin-induced liver injury. The antithyroid drug propylthiouracil protects against liver injury induced by many hepatotoxic agents and markedly reduces mortality in patients with alcoholic liver disease. However, the mechanism(s) by which propylthiouracil protects against liver injury is not well understood.

Elderly patients' experiences with nurses guided by Parse's theory of human becoming.

The purpose of this study was to describe the experience of being cared for by nurses who are guided by Parse's theory of human becoming from the perspective of hospitalized elderly patients. Open-ended interviews were used to collect data from a sample of 10 patients. The descriptions obtained from the interviews were analyzed using Colaizzi's phenomenological method.

Packing constraints and electrostatic surface potentials determine transmembrane asymmetry of phosphatidylethanol.

The energetic determinants of the distribution of anionic phospholipids across a phosphatidylcholine (PtdCho) bilayer with different packing constraints in the two leaflets were studied, using (13)CH2-ethyl-labeled phosphatidylethanol (PtdEth) as a (13)C NMR membrane probe. PtdEth is unique in exhibiting a split (13)CH2-ethyl resonance in sonicated vesicles, the two components originating from the inner and outer leaflets, thus permitting the determination of the PtdEth concentration in each leaflet. Small and large unilamellar PtdEth-PtdCho vesicles were prepared in solutions of different ionic strengths.

Ethanol binding to a model carbohydrate, glycogen.

The binding affinity of ethanol for carbohydrates is unknown. Glycoconjugates are postulated to be sensitive targets of ethanol action. The glycogen content of muscle, liver, and brain is sensitive to ethanol.

Saturable ethanol binding in rat liver microsomes.

The binding of ethanol to rat liver microsomes is shown to be saturable at clinically relevant ethanol concentrations, whereas this effect is not observed in extracted microsomal phospholipids. Brief exposure of the microsomes to heat abolishes saturable ethanol binding. Equilibrium binding data analysis, although only approximate in this context, suggests the presence of at least two groups of specific sites: high capacity sites with affinities near the pharmacological range and low capacity sites at lesser levels.

Alcohol binding to liposomes by 2H NMR and radiolabel binding assays: does partitioning describe binding?

Implicit within the concept of membrane-buffer partition coefficients of solutes is a nonspecific solvation mechanism of solute binding. However, (2)H NMR studies of the binding of (2)H(6)-ethanol and [1-(2)H(2)] n-hexanol to phosphatidylcholine vesicles have been interpreted as evidence for two distinct alcohol binding modes. One binding mode was reported to be at the membrane surface.

Hydrophobic alkyl headgroups strongly promote membrane curvature and violate the headgroup volume correlation due to "headgroup" insertion.

The ability of lipid aggregates to form planar bilayers, rather than highly curved micellar or inverted structures, is dependent on the relative geometries of the headgroup and hydrocarbon regions. The headgroup volume approach to lipid structure provided a quantitative link between a lipid's headgroup size and its ability to promote curved, inverted hexagonal (H(II)) structures in a phosphatidylethanolamine (PtdEtn) matrix [Lee et al. (1993) Biophys.

Support for the shape concept of lipid structure based on a headgroup volume approach.

Headgroup volumes of seven dioleoyl lipid species, calculated from covalent radii, are shown to correlate linearly (r = 0.95) with the ability of those lipids to alter the midpoint temperature of the lamellar to inverted hexagonal phase transition (L alpha-->HII) of a 95 mole fraction percent phosphatidylethanolamine matrix. The results illustrate the utility of the shape concept and basic considerations of headgroup volume as a predictive tool for the determination of lipid structure.

Configurational entropy is the driving force of ethanol action on membrane architecture.

A colligative thermodynamic framework is developed to describe the action of ethanol on membranes. The partitioning of ethanol into a membrane structure imparts a randomness, configurational entropy, that stabilizes that structure from an energetic standpoint. When partitioning between membrane structures differs, the equilibrium between them is altered to favor the structure with the largest partition coefficient for ethanol.

Nature of alcohol and anesthetic action on cooperative membrane equilibria.

A generalized, colligative thermodynamic framework is used to treat the action of solutes on cooperative membrane equilibria. Configurational entropy, the randomness imparted by solutes through the partitioning or mixing process, is implicated as the energetic driving force for the action of anesthetics on cooperative membrane equilibria. The equilibria predicted to be most sensitive to solute action--in which the dilute solute causes a perturbation equivalent to a large change in temperature--are (1) low-enthalpy processes that coincide with (2) large partitioning differences between states.

Magnetic resonance chemical shift imaging and spectroscopy of atherosclerotic plaque.

An in vivo magnetic resonance imaging (MRI) technique for identification and characterization of atherosclerotic plaque was assessed in animal and human models. Atherosclerosis was induced in the abdominal aorta of four rabbits by a combination of balloon denudation and a high cholesterol diet. In vivo conventional spin-echo and fat/water suppressed images of the rabbit aortae were obtained at 1.

The effect of chronic ethanol consumption on the fatty acid composition of phosphatidylinositol in rat liver microsomes as determined by gas chromatography and 1H-NMR.

Cell membranes and vesicles composed of extracted phospholipids isolated from rats chronically-fed ethanol develop a resistance to disordering by ethanol in vitro (membrane tolerance) and a decreased partitioning of ethanol into the membranes. The anionic lipid phosphatidylinositol (PtdIns) is the only microsomal phospholipid from the ethanol-fed rats that confers tolerance to vesicles of microsomal phospholipids from control rats in a paradigm where phospholipid classes are sequentially swapped. To investigate the molecular basis of this adaptation, the fatty acid content of microsomal PtdIns extracted from the livers of rats chronically fed ethanol for 5 weeks and their calorically-matched controls was analyzed by gas-liquid chromatography (GLC) and 1H-NMR spectroscopy.