Tasks and responsibilities in physical activity promotion of older patients during hospitalization: A nurse perspective.

Aim: To investigate how nurses perceive tasks and responsibilities in physical activity promotion of hospitalized older patients and which factors are of influence. Design: Mixed methods sequential explanatory design. Methods: One hundred and eight nurses participated in a questionnaire survey and 51 nurses in a subsequent in-depth interview. Data were collected on tasks and responsibilities in physical activity promotion and their influencing factors as perceived by nurses. Quantitative data were analysed using descriptive statistics and a deductive approach with directed content analysis was used for the data from the interviews. Results: Nurses perceived to have a dominant role in physical activity promotion of older patients during hospitalization. Ninety per cent of the nurses stated to be responsible for physical activity promotion and 32% stated to be satisfied with the actual level of physical activity of their patients. Nurses have specified to be responsible for signalling and performing physical activity promotion tasks and had final responsibility for transfers from bed to chair and promotion of daily activities. Influencing factors were low patient motivation, high workload causing priority shifts of tasks and the role of physicians.

Identification of mycobacterial alpha-glucan as a novel ligand for DC-SIGN: involvement of mycobacterial capsular polysaccharides in host immune modulation.

Mycobacterium tuberculosis possesses a variety of immunomodulatory factors that influence the host immune response. When the bacillus encounters its target cell, the outermost components of its cell envelope are the first to interact. Mycobacteria, including M. tuberculosis, are surrounded by a loosely attached capsule that is mainly composed of proteins and polysaccharides. Although the chemical composition of the capsule is relatively well studied, its biological function is only poorly understood. The aim of this study was to further assess the functional role of the mycobacterial capsule by identifying host receptors that recognize its constituents. We focused on alpha-glucan, which is the dominant capsular polysaccharide. Here we demonstrate that M. tuberculosis alpha-glucan is a novel ligand for the C-type lectin DC-SIGN (dendritic cell-specific ICAM-3-grabbing nonintegrin). By using related glycogen structures, we show that recognition of alpha-glucans by DC-SIGN is a general feature and that the interaction is mediated by internal glucosyl residues. As for mannose-capped lipoarabinomannan, an abundant mycobacterial cell wall-associated glycolipid, binding of alpha-glucan to DC-SIGN stimulated the production of immunosuppressive IL-10 by LPS-activated monocyte-derived dendritic cells. By using specific inhibitors, we show that this IL-10 induction was DC-SIGN-dependent and also required acetylation of NF-kappaB. Finally, we demonstrate that purified M. tuberculosis alpha-glucan, in contrast to what has been reported for fungal alpha-glucan, was unable to activate TLR2.