Relative efficacies of omega-3 polyunsaturated fatty acids in reducing expression of key proteins in a model system for studying osteoarthritis.

OBJECTIVE: To assess the relative efficacy of three different omega-3 (n-3) polyunsaturated fatty acids (PUFAs) in suppressing the mRNA levels for important proteins involved in the etiology of osteoarthritis (OA). METHODS: A model cell culture system (bovine chondrocytes) was used. Inflammatory factors and enzymes involved in OA were induced by exposure of the chondrocyte cultures to interleukin-1alpha (IL-1alpha). The effect of pre-incubating cultures with various amounts of exogenous fatty acids on subsequent levels of mRNAs was assessed by reverse transcription-polymerase chain reactions (RT-PCR). RESULTS: Exposure of cultures to IL-1alpha induced expression of the cartilage proteinases A Disintegrin And Metalloproteinase with ThromboSpondin motifs (ADAMTS)-4 and ADAMTS-5, cyclooxygenase (COX)-2, the matrix metalloproteinase (MMP)-3 and the inflammatory cytokines IL-1alpha, interleukin-1beta (IL-1beta) and tumour necrosis factor-alpha (TNF-alpha). n-3 PUFAs were able to reduce the levels of mRNA for ADAMTS-4, ADAMTS-5, MMP-3, MMP-13, COX-2 (but not COX-1), IL-1alpha, IL-1beta and TNF-alpha. Eicosapentaenoic acid (EPA) was the most effective, followed by docosahexaenoic (DHA) and then alpha-linolenic (ALA) acid. The n-6 PUFA, arachidonic acid (AA) had no effect. CONCLUSION: These results show that omega-3 (n-3) PUFAs cause a reduction in the mRNA levels for various proteins known to be important in the pathology of OA. They provide a molecular explanation, at least in part, for beneficial effects of dietary omega-3 PUFAs for the amelioration of symptoms of the disease. The relative efficacy of EPA suggests that this omega-3 PUFA may be especially useful for dietary supplementation in patients with OA.

Isolation and characterization of a cDNA encoding a Delta8 sphingolipid desaturase from Aquilegia vulgaris.

We have isolated a cDNA encoding the Delta(8) sphingolipid desaturase from the plant Aquilegia vulgaris L. via a PCR-based strategy using primers designed to target the conserved histidine box regions of microsomal desaturases. The function of the cDNA was confirmed by expression in the yeast, Saccharomyces cerevisiae. Analysis of the long-chain sphingoid bases as their dinitrophenyl derivatives by reverse-phase HPLC demonstrated the accumulation of cis - and trans -desaturated sphingoid bases which were not present in the wild-type yeast cells. The Delta(8) desaturated products co-eluted with known Delta(8)-desaturated phytosphingenine and the molecular mass of these products was confirmed by liquid chromatography-MS. The Delta(8) long-chain base desaturase was also able to desaturate dihydrosphingosine substrates. This is the first report of the functional characterization of an A. vulgaris gene product.

An unusual desaturase in Aquilegia vulgaris.

Aquilegia vulgaris seed oil contains high levels of the rare fatty acid columbinic acid (18:3 Delta(5,9,12)), which is unusual in having the double bond at the Delta(5) carbon in the trans configuration. Columbinic acid was found to be a seed-specific fatty acid not only present in the storage oil but also in membrane lipids. Several putative gene fragments have been isolated from plant RNA with sequences similar to previously characterized 'front-end' desaturases. Functional characterization of the Aquilegia cDNA is underway.

Side-effects burden, psychological adjustment, and life quality in women with breast cancer: pattern of association over time.

PURPOSE/OBJECTIVES: To describe the side-effects burden experienced over time by 53 women who were receiving treatment for breast cancer and to describe the association of side-effects burden with psychological adjustment and life quality. DESIGN: Data were drawn from the Self-Help Intervention Project (SHIP), an intervention study designed to test the effectiveness of nursing interventions for women receiving treatment for breast cancer. SETTING: Subjects were interviewed in their homes or treatment locations three times over a period of four to five months. SAMPLE: 53 women randomly assigned to the control group of the SHIP. METHODS: The researchers collected data after treatment was initiated, six to eight weeks later, and three months after that. MAIN RESEARCH VARIABLES: Side-effects burden, psychological adjustment, and life quality. FINDINGS: Fatigue was the most problematic side effect over time. Other problematic side effects included sore arm(s), difficulty sleeping, hair loss, and skin irritation. Significant associations were evident for psychological adjustment with symptom extension and number of side effects at Time 2 and Time 3. Depression burden and anxiety burden were associated significantly with psychological adjustment at all three times. Overall life quality and present life quality was associated negatively with symptom extension and number of side effects at all three times. Fatigue burden was associated negatively with life quality at Time 2 and Time 3 with depression burden and anxiety burden negatively associated with life quality at all three times. CONCLUSIONS: Over time, evidence showed that negative feelings, in particular depression burden and anxiety burden, persist. Depression burden and anxiety burden each were negatively associated with overall and present life quality at all three times. IMPLICATIONS FOR NURSING PRACTICE: A need exists for clinically individualized nursing interventions that will reduce the side effects burden of women receiving treatment for breast cancer. Interventions can do much to reduce the perception of illness severity so that psychological adjustment and life quality can be maintained.

Self-Help Intervention Project. Women receiving breast cancer treatment.

PURPOSE: The purpose of this study was to determine the efficacy of self-care/self-help promotion and uncertainty management interventions offered by the Self-Help Intervention Project (SHIP) for women receiving chemotherapy, radiation therapy, or hormone therapy for breast cancer. DESCRIPTION OF STUDY: One hundred ninety-three women were randomly assigned either to one of three intervention groups (self-help course, uncertainty management, or self-help course plus uncertainty management) or to a control group. Data were analyzed by a repeated measures multivariate analysis of variance procedure using a two-level blocking factor (high and low resourcefulness) and four outcome variables (self-care, self-help, psychological adjustment, and confidence in cancer knowledge). Data were collected at baseline (T1), which was after initiation of adjuvant therapy, allowing for the emergence of treatment-related side effects; 6 to 8 weeks after T1 (T2); and 3 months after T2 (T3). RESULTS: At baseline, women having high resourcefulness compared with women having low resourcefulness evidenced greater self-care, self-help, psychological adjustment, and confidence in cancer knowledge. Participation in SHIP interventions resulted in higher levels of self-care, self-help, psychological adjustment, and confidence in cancer knowledge by time effect in a significant number of women regardless of their baseline resourcefulness. Women participating in SHIP interventions who had low baseline resourcefulness demonstrated the greatest change over time in the outcome variables. Post hoc results indicated that the effect primarily was the result of changes in psychological adjustment, confidence in cancer knowledge, and self-care. CLINICAL IMPLICATIONS: The findings of this study address both the treatment effect for supportive care interventions and the needs that have emerged from review of the last 20 years of supportive care research. Some SHIP interventions evidenced more strength than others; data indicated that large percentages of women with low resourcefulness who received no SHIP interventions experienced a decrement in self-care, self-help, confidence in cancer knowledge, and psychological adjustment over the time that they received adjuvant therapy. Women's level of confidence in their knowledge about cancer being sufficient for self-management and self-help activities was not linked to baseline resourcefulness level. Thus, inherent resourcefulness was not a factor in need for supportive services that could maintain or increase confidence in cancer knowledge usefulness for self-management and self-help. Healthcare providers should note that although the women with low resourcefulness benefited the most from the interventions, women who evidenced high resourcefulness at baseline reported the same level of need for confidence in cancer knowledge and for self-help.

Pattern of association over time of side-effects burden, self-help, and self-care in women with breast cancer.

PURPOSE/OBJECTIVES: To describe the side-effects burden experienced over time by 53 women who were receiving treatment for breast cancer, and to describe the association of side-effects burden with self-help and self-care. DESIGN: Data were drawn from the Self-Help Intervention Project (SHIP), an intervention study designed to test the effectiveness of nursing interventions for women who were receiving treatment for breast cancer. SETTING: Subjects were interviewed in their homes or treatment locations three times over a period of four to five months. SAMPLE: 53 women randomly assigned to the SHIP control group. METHODS: The researchers collected data at a designated period of time after treatment was initiated (Time 1), six to eight weeks later (Time 2), and three months after that (Time 3). MAIN RESEARCH VARIABLES: Side-effects burden, as measured by items from the Symptom Transition Scale and the Side Effects Checklist; self-help, as measured by the Inventory of Adult Role Behavior; and self-care, as measured by the Inventory of Adult Self-Care Behaviors and the Self-Care Inventory-Wellness Promotion subscale. FINDINGS: Fatigue was the most frequent and problematic side effect over time. Other frequent and problematic side effects over time included sore arm(s), difficulty sleeping, and skin irritation. Significant correlations were evident for self-help with symptom extension, number of side effects, depression, difficulty concentrating, and pain. No significant relationships were evident between self-care and an increase in side effects. Small relationships existed for self-care between symptom extension at Time 2 and Time 3. CONCLUSIONS: Over time, side effects interfered with patients' ability to perform adult role activities. For the most part, problematic side-effects burden was not associated with self-care at any point in time. The scattered associations that did exist were in the negative direction. IMPLICATIONS FOR NURSING PRACTICE: A need exists for clinically individualized nursing interventions to reduce the side-effects burden of women receiving treatment for breast cancer. Interventions can do much to reduce the perception of illness severity so that self-help and self-care can be maintained.

Peer review, authorship, ethics, and conflict of interest.

PURPOSE: To explore problems in peer review, authorship, ethics, and conflict of interest related to writing and publishing. Publishing and adhering to principles is critical as nurse researchers, educators, administrators, and practitioners participate in the development and dissemination of knowledge. CONCLUSIONS: The quality and integrity of nursing publications are affected by peer review, author collaboration, and ethical conduct. Understanding the conflicts of interest inherent in each action and being committed to impartial review and meeting the requirements of authorship can ensure fewer difficulties for authors, publishers, and consumers.

Side effects burden in women with breast cancer.

PURPOSE: This article describes the side effects burden of 307 women who were receiving treatment for breast cancer. The study provides a description of the impact of side effects burden on adult role activities (self-help), self-care, psychological adjustment, and quality of life. DESCRIPTION OF STUDY: Data to describe the side effects burden characteristics of 307 women receiving treatment for breast cancer were drawn from the Self-Help Intervention Project. Data were collected after medical treatment was underway and treatment-related side effects were evidenced. The impact of side effects burden on adult role activities (self-help), self-care, psychological adjustment, and life quality is described. RESULTS: Fatigue was the most common side effect as well as the most problematic. Number of side effects and increase in side effects were moderately correlated (P < 0.0001) in a negative direction with fatigue and depression. Self-care behaviors also were associated negatively with the extension of side effects and with fatigue and depression (P < 0.001). Psychological adjustment was associated with difficulty sleeping, anxiety, and depression. Overall life quality was noted to be negatively related to depression as was present life quality. CLINICAL IMPLICATIONS: Data support the need for clinical interventions that are individualized to women's side effects experience. Additional research is underway to test the effectiveness of the interventions specified by the overall study.

Connecting and disconnecting: bereavement experiences of six mothers whose sons died of AIDS.

The bereavement experiences of 6 mothers whose sons died of AIDS-related complications were identified. Interviews with these women provided data for grounded-theory analysis. Two basic social processes were identified: Connecting and Disconnecting. Connecting included support, rituals, transitions, and gathering mementos, and Disconnecting included accepting the death, performing death-related tasks, and letting go. Special considerations for mothers of sons who have died of AIDS are discussed.

Breast cancer screening among older Hispanic women: knowledge, attitudes, and practices.

A survey was conducted with 409 Hispanic and 138 Anglo women in Tucson, Arizona, to assess their knowledge of breast cancer and cancer screening tests, their attitudes toward breast cancer and cancer screening, and their use of screening tests. There were few differences between these two groups in use of breast cancer screening tests, with both group falling well below the recommended levels of screening frequency. Clinical breast exam was most often used, followed by breast self-exam, with mammography a distant third. Levels of knowledge about the risks for breast cancer and the ways to detect it were also low. Comparison with national data show Arizona women to have lower rates of breast cancer screening than the national average; this may be due to the absence of the Medicaid program in Arizona. The rates for Tucson Hispanics, although lower than that for Anglos, are comparable with the findings of other studies. More needs to be done to alert all older women about breast cancer screening, but more specific attention needs to be paid to the population of older Hispanic women. We suggest some culturally relevant strategies to address this problem.

Connecting and disconnecting: bereavement experiences of six gay men.

This research investigation explored the bereavement experiences of gay partners of men who died of AIDS-related complications. Interviews with six men provided data for analysis using the qualitative method of grounded theory. Two basic social-psychological processes were identified that characterized the bereavement experience: connecting and disconnecting. Themes generated from the data that described the process of connecting were: sharing the death, caring for the PWA, legitimizing the relationship, memorializing, and AIDS-related work. Performing death-related tasks, letting go of the relationship, and passage characterized the process of disconnecting. Special considerations for bereavement in gay men and implications for nursing are discussed.

Use of breast cancer screening by older Hispanic women.

The purpose of this exploratory study was to provide information on older Hispanic women's access to and use of breast cancer screening services. Interviews were conducted with 150 Hispanic women, 47 to 93 years of age, in a southwestern city. The results indicated that differences in use and compliance with recommended screening guidelines were due primarily to differences in access to the health care system and attitudes about preventive care. Targeted strategies for these women have to be developed and implemented to ensure that they receive the necessary information to avail themselves of breast cancer screening procedures.

Care needs of home-based cancer patients and their caregivers. Quantitative findings.

The purpose of this study was to identify care needs of home-based patients receiving treatment for cancer and their caregivers. The sample consisted of 30 patients receiving radiation therapy and/or immunologically based treatments for a variety of cancers and 29 caregivers. Patient and caregiver needs scales were used to elicit the needs of patients and caregivers. Patients and caregivers were able to cite their unique needs. Patients had more needs for themselves in the areas of personal care, activity management, and interpersonal interaction than did the caregivers. The necessity for individualization of care was noted by both patients and caregivers, an area that nursing is in a unique position to address.

Educating nursing home staff in lower extremity assessment and care.

A neglected area of care for the elderly in long-term care facilities is that of appropriate assessment and care of the lower extremities, particularly the feet. Two assessment guides--one for the registered nurse and one for the nursing assistant--are presented.

Oncology Knowledge Inventory for undergraduate students.

A Knowledge Inventory was developed and used to measure undergraduate students' knowledge level of oncology nursing. Initial items were written by clinical experts, and content was validated by faculty. Pretesting of test items resulted in a final scale of 30 items. To further test items for difficulty and discrimination, students were asked to complete the Knowledge Inventory each semester of the program over a period of three semesters. Results indicated that the scale provides a short, general measure of oncology knowledge that differentiates student knowledge levels and experience.

Research utilizaton: an evaluation and critique of research related to oral temperature measurement.

The problem addressed was whether a research-based protocol on oral temperature measurement could be developed and used in the practice setting. The first phase of the study proposed to (a) identify research articles related to the subject; (b) evaluate the quality of the research; (c) assess the adequacy of the research base; and (d) select areas for future study. The results indicated that further clinically-based studies are needed before a protocol can be designed and tested in clinical practice.

Perceived home care needs of cancer patients and their caregivers.

The purpose of this study was to identify perceived home care needs of outpatients receiving treatment for cancer and their caregivers. The purposive subsample consisted of 16 subjects, 8 patients receiving treatment as outpatients and their 8 caregivers. Two interview guides, one for the patients and the other for their caregivers, were based on the Neuman Systems Model to assess patient and caregiver stressors The data were analyzed in relation to intrapersonal stressors (within the individual), interpersonal stressors (between the individual and others), and extrapersonal stressors (between the individual and the environment) Several stressors within each category were identified by both the patients and caregivers. Intrapersonal stressors included treatment uncertainty and role change, the interpersonal stressor of lack of social support, and the extrapersonal stressors of lack of transportation and limited finances. In addition, patients identified specific intrapersonal stressors in relation to their situation. These included assistance in coping with physical restrictions resulting in subsequent anger and depression. On the other hand, intrapersonal stressors identified by the caregivers included support in coping with the added responsibilities in relation to patient care, the fear of being alone, guilt, and the interpersonal stressor of limited knowledge regarding the patient situation. The stressors identified by both the patients and caregivers can serve as a beginning means to explore the needs encountered by this population group.

Preliminary evaluation of bereavement experiences in a hospice program.

The purpose of this study was to determine how the services of a bereavement program could be more helpful to survivors following the death of a spouse and/or significant other. Ninety-seven bereaved individuals were interviewed thirteen months after the death over a period of two years. The results of this pilot study revealed that most of the subjects were managing their lives and coping with their loss without undue stress. Overall, subjects were satisfied with the services of the hospice program and were experiencing recovery. Implications for further study and practice are discussed.