ABSTRACT
AIM: To propose nursing clinical practice changes to improve the development of patient self-management. BACKGROUND: Chronic obstructive pulmonary disease is one of the main causes of chronic morbidity, loss of quality of life and high mortality rates. INTRODUCTION: Control of the disease's progression, the preservation of autonomy in self-care and maintenance of quality of life are extremely challenging for patients to execute in their daily living. However, there is still little evidence to support nursing clinical practice changes to improve the development of self-management. METHODS: A participatory action research study was performed in a medicine inpatient department and the outpatient unit of a Portuguese hospital. The sample comprised 52 nurses and 99 patients. For data collection, we used interviews, participant observation and content analysis. RESULTS: The main elements of nursing clinical practice that were identified as a focus for improvement measures were the healthcare model, the organization of healthcare and the documentation of a support decision-making process. The specific guidelines, the provision of material to support decision-making and the optimization of information sharing between professionals positively influenced the change process. This change improved the development of self-management skills related to the awareness of the need for 'change', hope, involvement, knowledge and abilities. DISCUSSION: The implemented changes have improved health-related behaviours and clinical outcomes. CONCLUSION: To support self-management development skills, an effective nursing clinical practice change is needed. This study has demonstrated the relevance of a portfolio of techniques and tools to help patients adopt healthy behaviours. IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY: The involvement and participation of nurses and patients in the conceptualization, implementation and evaluation of policy change are fundamental issues to improve the quality of nursing care and clinical outcomes.
Subject(s)
Nursing Care/standards , Patient Education as Topic/standards , Practice Guidelines as Topic/standards , Pulmonary Disease, Chronic Obstructive/nursing , Self Care/standards , Self-Management/methods , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle AgedABSTRACT
From 2006 to 2011, Roslin Cells Ltd derived 17 human embryonic stem cells (hESC) while developing (RCM1, RC-2 to -8, -10) and implementing (RC-9, -11 to -17) quality assured standards of operation in a facility operating in compliance with European Union (EU) directives and United Kingdom (UK) licensure for procurement, processing and storage of human cells as source material for clinical application, and targeted to comply with an EU Good Manufacturing Practice specification. Here we describe the evolution and specification of the facility, its operation and outputs, complementing hESC resource details communicated in Stem Cell Research Lab Resources.
Subject(s)
Cell Culture Techniques/standards , Human Embryonic Stem Cells/cytology , Cell Differentiation , Cells, Cultured , Government Regulation , Humans , Quality ControlABSTRACT
The human embryonic stem cell line RCe021-A (RC-17) was derived under quality assured compliance with UK regulation, European Union Directives and International guidance for tissue procurement, processing and storage according to Good Manufacturing Practice (GMP) standards. The cell line was derived from a day 3 embryo voluntarily donated as unsuitable or surplus to fertility requirements following informed consent. RCe021-A (RC-17) shows normal pluripotency marker expression and differentiation to the three germ layers in vitro. It has a normal 46XX female karyotype and microsatellite PCR identity, HLA and blood group typing data are available.
ABSTRACT
The human embryonic stem cell line RCe013-A (RC-9) was derived under quality assured compliance with UK regulation, European Union Directives and International guidance for tissue procurement, processing and storage according to Good Manufacturing Practice (GMP) standards. The cell line was derived from a failed to fertilise oocyte voluntarily donated as unsuitable and surplus to fertility requirements following informed consent. RCe013-A (RC-9) shows normal pluripotency marker expression and differentiation to the three germ layers in vitro and in vivo. It has a normal 46XY male karyotype and microsatellite PCR identity, HLA and blood group typing data are available.
ABSTRACT
The human embryonic stem cell line RCe015-A (RC-11) was derived under quality assured compliance with UK regulation, European Union Directives and International guidance for tissue procurement, processing and storage according to Good Manufacturing Practice (GMP) standards. The cell line was derived from a fragmented cleavage stage embryo voluntarily donated as unsuitable or surplus to fertility requirements following informed consent. RCe015-A (RC-11) shows normal pluripotency marker expression and differentiation to the three germ layers in vitro and in vivo. It has a normal 46XX female karyotype and microsatellite PCR identity, HLA and blood group typing data are available.
ABSTRACT
The human embryonic stem cell line RCe009-A (RC-5) was derived from a frozen and thawed Day 2 embryo voluntarily donated as unsuitable and surplus to requirement for fertility treatment following informed consent under licence from the UK Human Fertilisation and Embryology Authority. RCe009-A carries the common DF508 mutation on the cystic fibrosis trans-membrane regulator gene associated with the disease cystic fibrosis. The cell line shows normal pluripotency marker expression and differentiation to the three germ layers in vitro. It has a normal 46XX female karyotype and microsatellite PCR identity, HLA and blood group typing data are available.
Subject(s)
Blastocyst/cytology , Human Embryonic Stem Cells/cytology , Cell Differentiation , Cells, Cultured , Cellular Reprogramming , Comparative Genomic Hybridization , Embryoid Bodies/cytology , Female , Flow Cytometry , Histocompatibility Testing , Human Embryonic Stem Cells/metabolism , Humans , Karyotype , Microsatellite Repeats/genetics , Microscopy, Fluorescence , Transcription Factors/genetics , Transcription Factors/metabolismABSTRACT
The human embryonic stem cell line RCe006-A (RC-2) was derived from a frozen and thawed blastocyst voluntarily donated as surplus to fertility requirements following ethics committee approved informed consent under licence from the UK Human Fertilisation and Embryology Authority. The cell line exhibits expression of expected pluripotency markers and in vitro differentiation potential to three germinal lineage representative cell populations. It has a male trisomy 12 karyotype (47XY, +12). Microsatellite DNA marker identity and HLA and blood group typing data are available.
Subject(s)
Blastocyst/cytology , Human Embryonic Stem Cells/cytology , Cell Differentiation , Cells, Cultured , Cellular Reprogramming , Chromosomes, Human, Pair 12 , Comparative Genomic Hybridization , Down Syndrome/metabolism , Down Syndrome/pathology , Embryoid Bodies/cytology , Genotype , Histocompatibility Testing , Human Embryonic Stem Cells/metabolism , Humans , Karyotype , Male , Microscopy, Fluorescence , Polymerase Chain Reaction , Transcription Factors/genetics , Transcription Factors/metabolism , TrisomyABSTRACT
The human embryonic stem cell line RCM-1 was derived from a failed to fertilise egg undergoing parthenogenetic stimulation. The cell line shows normal pluripotency marker expression and differentiation to three germ layers in vitro and in vivo. It has a normal 46XX female karyotype and microsatellite PCR identity, HLA and blood group typing data is available.
Subject(s)
Human Embryonic Stem Cells/cytology , Ovum/cytology , Animals , Cell Differentiation , Cells, Cultured , Cellular Reprogramming , Comparative Genomic Hybridization , Embryoid Bodies/cytology , Female , Flow Cytometry , Histocompatibility Testing , Human Embryonic Stem Cells/metabolism , Human Embryonic Stem Cells/transplantation , Humans , Karyotype , Mice , Mice, SCID , Microsatellite Repeats/genetics , Microscopy, Fluorescence , Teratoma/metabolism , Teratoma/pathology , Transcription Factors/genetics , Transcription Factors/metabolism , Transplantation, HeterologousABSTRACT
The human embryonic stem cell line RCe010-A (RC-6) was derived from a frozen and thawed blastocyst voluntarily donated as unsuitable and surplus to fertility requirements following ethics committee approved informed consent under licence from the UK Human Fertilisation and Embryology Authority. The cell line shows normal pluripotency marker expression and differentiation to the three germ layers in vitro. It has a normal 46XY male karyotype and microsatellite PCR identity, HLA and blood group typing data are available.
Subject(s)
Blastocyst/cytology , Human Embryonic Stem Cells/cytology , Alleles , Cell Differentiation , Cells, Cultured , Cellular Reprogramming , Embryoid Bodies/cytology , Genotype , Histocompatibility Testing , Human Embryonic Stem Cells/metabolism , Humans , Karyotype , Lewis X Antigen/metabolism , Male , Microsatellite Repeats/genetics , Microscopy, Fluorescence , Transcription Factors/genetics , Transcription Factors/metabolismABSTRACT
The human embryonic stem cell line RCe011-A (RC-7) was derived from a failed to fertilise oocyte voluntarily donated as unsuitable and surplus to fertility requirements following ethics committee approved informed consent under licence from the UK Human Fertilisation and Embryology Authority. The cell line shows normal pluripotency marker expression and differentiation to the three germ layers in vitro. It has a normal 46XY male karyotype and microsatellite PCR identity, HLA and blood group typing data are available.
Subject(s)
Embryo, Mammalian/cytology , Human Embryonic Stem Cells/cytology , Alleles , Cell Differentiation , Cells, Cultured , Embryoid Bodies/cytology , Genotype , Histocompatibility Testing , Human Embryonic Stem Cells/metabolism , Humans , Karyotype , Lewis X Antigen/metabolism , Male , Microsatellite Repeats/genetics , Microscopy, Fluorescence , Octamer Transcription Factor-3/metabolism , Polymerase Chain ReactionABSTRACT
The human embryonic stem cell line RCe012-A (RC-8) was derived from a frozen and thawed day 5 embryo cultivated to the blastocyst stage. The embryo was voluntarily donated as unsuitable and surplus to fertility requirements following ethics committee approved informed consent under licence from the UK Human Fertilisation and Embryology Authority. The cell line shows normal pluripotency marker expression and differentiation to the three germ layers in vitro. It has a normal 46XX female karyotype and microsatellite PCR identity, HLA and blood group typing data is available.
Subject(s)
Blastocyst/cytology , Human Embryonic Stem Cells/cytology , Alleles , Cell Differentiation , Cells, Cultured , Embryoid Bodies/cytology , Female , Genotype , Histocompatibility Testing , Human Embryonic Stem Cells/metabolism , Humans , Karyotype , Lewis X Antigen/metabolism , Microsatellite Repeats/genetics , Microscopy, Fluorescence , Octamer Transcription Factor-3/metabolism , Polymerase Chain ReactionABSTRACT
The human embryonic stem cell line RCe014-A (RC-10) was derived from a fresh oocyte voluntarily donated as unsuitable and surplus to fertility requirements following ethics committee approved informed consent under licence from the UK Human Fertilisation and Embryology Authority. The cell line shows normal pluripotency marker expression and differentiation to the three germ layers in vitro. It has a mixed 46XY and 47XY +12 male karyotype and microsatellite PCR identity, HLA and blood group typing data is available.
Subject(s)
Human Embryonic Stem Cells/cytology , Cell Differentiation , Cells, Cultured , Chromosomes, Human, Pair 12 , Embryo, Mammalian/cytology , Embryoid Bodies/cytology , Genotype , Histocompatibility Testing , Human Embryonic Stem Cells/metabolism , Humans , Immunohistochemistry , Karyotype , Male , Microsatellite Repeats/genetics , Microscopy, Fluorescence , Oocytes/cytology , Transcription Factors/metabolism , TrisomyABSTRACT
The human embryonic stem cell line RCe007-A (RC-3) was derived from a blastocyst voluntarily donated as unsuitable and surplus to fertility requirements following ethics committee approved informed consent under licence from the UK Human Fertilisation and Embryology Authority. The cell line shows normal pluripotency marker expression and differentiation to the three germ layers in vitro. It has a normal 46XX female karyotype and HLA and blood group typing data is available.
Subject(s)
Human Embryonic Stem Cells/cytology , Blastocyst/cytology , Blood Group Antigens/genetics , Blood Group Antigens/metabolism , Cell Differentiation , Cells, Cultured , Female , Genotype , Histocompatibility Testing , Human Embryonic Stem Cells/metabolism , Humans , Karyotype , Microsatellite Repeats/genetics , Transcription Factors/metabolismABSTRACT
The human embryonic stem cell line RCe008-A (RC-4) was derived from a blastocyst voluntarily donated as unsuitable and surplus to fertility requirements following ethics committee approved informed consent under licence from the UK Human Fertilisation and Embryology Authority. The cell line shows normal pluripotency marker expression and differentiation to ectoderm and mesoderm in vitro. It has a mixed 46XX/45X female karyotype and microsatellite PCR identity and blood group typing data is available.
Subject(s)
Human Embryonic Stem Cells/cytology , Blastocyst/cytology , Blood Group Antigens/genetics , Blood Group Antigens/metabolism , Cell Differentiation , Cells, Cultured , Female , Genotype , Histocompatibility Testing , Humans , Karyotype , Microsatellite Repeats/genetics , Transcription Factors/metabolismABSTRACT
The human embryonic stem cell line RCe019-A (RC-15) was derived under quality assured compliance with UK regulation, European Union Directives and International guidance for tissue procurement, processing and storage according to Good Manufacturing Practice (GMP) standards. The cell line was derived from a cleavage stage embryo voluntarily donated as unsuitable or surplus to fertility requirements following informed consent. RCe019-A (RC-15) shows normal pluripotency marker expression and differentiation to the three germ layers in vitro. It has a mixed 46XX/47XX, +8 female karyotype and microsatellite PCR identity, HLA and blood group typing data is available.
Subject(s)
Blastocyst/cytology , Human Embryonic Stem Cells/cytology , Blood Group Antigens/metabolism , Cell Differentiation , Cells, Cultured , Cellular Reprogramming , Female , Genotype , Histocompatibility Testing , Human Embryonic Stem Cells/metabolism , Humans , Karyotype , Microsatellite Repeats/genetics , Transcription Factors/genetics , Transcription Factors/metabolismABSTRACT
The human embryonic stem cell line RCe017-A (RC-13) was derived under quality assured compliance with UK regulation, European Union Directives and International guidance for tissue procurement, processing and storage according to Good Manufacturing Practice (GMP) standards. The cell line was derived from a frozen and thawed blastocyst stage embryo voluntarily donated as unsuitable or surplus to fertility requirements following informed consent. RCe017-A (RC-13) shows normal pluripotency marker expression and differentiation to the three germ layers in vitro. It has a mixed 47XY, +12/48XY, +1, +12 male karyotype and microsatellite PCR identity, HLA and blood group typing data are available.
Subject(s)
Blastocyst/cytology , Human Embryonic Stem Cells/cytology , Cell Differentiation , Cells, Cultured , Cellular Reprogramming , Chromosomes, Human, Pair 12 , Genotype , Histocompatibility Testing , Human Embryonic Stem Cells/metabolism , Humans , Karyotype , Male , Microsatellite Repeats/genetics , Transcription Factors/genetics , Transcription Factors/metabolism , TrisomyABSTRACT
The human embryonic stem cell line RCe018-A (RC-14) was derived under quality assured compliance with UK regulation, European Union Directives and International guidance for tissue procurement, processing and storage according to Good Manufacturing Practice (GMP) standards. The cell line was derived from a blastocyst stage embryo voluntarily donated as unsuitable or surplus to fertility requirements following informed consent. RCe018-A (RC-14) shows normal pluripotency marker expression and differentiation to the three germ layers in vitro. It has a male karyotype with an extra copy of chromosome 8 (47XY, +8). Microsatellite PCR identity, HLA and blood group typing data are available.
Subject(s)
Blastocyst/cytology , Human Embryonic Stem Cells/cytology , Blood Group Antigens/metabolism , Cell Differentiation , Cells, Cultured , Cellular Reprogramming , Chromosomes, Human, Pair 8 , Genotype , Histocompatibility Testing , Human Embryonic Stem Cells/metabolism , Humans , Karyotype , Male , Microsatellite Repeats/genetics , Transcription Factors/genetics , Transcription Factors/metabolism , TrisomyABSTRACT
The human embryonic stem cell line RCe016-A (RC-12) was derived under quality assured compliance with UK regulations, EU Directives and International guidance for tissue procurement, processing and storage according to good manufacturing practice (GMP) standards. The cell line was derived from a cryopreserved blastocyst stage embryo voluntarily donated as surplus to fertility requirements following informed consent. RCe016-A (RC-12) shows normal pluripotency marker expression and differentiation to three germ layers in vitro. Karyology revealed a mixed male karyotype at early passage (P15), which resolved as normal 46XY by passage 33. Microsatellite PCR identity, HLA and blood group typing data is available.
Subject(s)
Blastocyst/cytology , Human Embryonic Stem Cells/cytology , Blood Group Antigens/metabolism , Cell Differentiation , Cells, Cultured , Cellular Reprogramming , Genotype , Histocompatibility Testing , Human Embryonic Stem Cells/metabolism , Humans , Karyotype , Male , Microsatellite Repeats/genetics , Transcription Factors/genetics , Transcription Factors/metabolismABSTRACT
The human embryonic stem cell line RCe020-A (RC-16) was derived under quality assured compliance with UK regulation, European Union Directives and International guidance for tissue procurement, processing and storage according to Good Manufacturing Practice (GMP) standards. The cell line was derived from a failed to fertilise oocyte voluntarily donated as unsuitable or surplus to fertility requirements following informed consent. RCe020-A (RC-16) shows normal pluripotency marker expression and differentiates to mesoderm and potentially ectoderm in vitro. It has an abnormal 47XX, +14, i(20)(q10) female karyotype and microsatellite PCR identity, HLA and blood group typing data is available.
Subject(s)
Blastocyst/cytology , Human Embryonic Stem Cells/cytology , Blood Group Antigens/metabolism , Cell Differentiation , Cells, Cultured , Cellular Reprogramming , Female , Genotype , Histocompatibility Testing , Human Embryonic Stem Cells/metabolism , Humans , Karyotype , Microsatellite Repeats/genetics , Transcription Factors/genetics , Transcription Factors/metabolismABSTRACT
The broad capacity of pluripotent human embryonic stem cells (hESC) to grow and differentiate demands the development of rapid, scalable, and label-free methods to separate living cell populations for clinical and industrial applications. Here, we identify differences in cell stiffness, expressed as cell elastic modulus (CEM), for hESC versus mesenchymal progenitors, osteoblast-like derivatives, and fibroblasts using atomic force microscopy and data processing algorithms to characterize the stiffness of cell populations. Undifferentiated hESC exhibited a range of CEMs whose median was nearly three-fold lower than those of differentiated cells, information we exploited to develop a label-free separation device based on the principles of tangential flow filtration. To test the device's utility, we segregated hESC mixed with fibroblasts and hESC-mesenchymal progenitors induced to undergo osteogenic differentiation. The device permitted a throughput of 10(6)-10(7) cells per min and up to 50% removal of specific cell types per single pass. The level of enrichment and depletion of soft, pluripotent hESC in the respective channels was found to rise with increasing stiffness of the differentiating cells, suggesting CEM can serve as a major discriminator. Our results demonstrate the principle of a scalable, label-free, solution for separation of heterogeneous cell populations deriving from human pluripotent stem cells.
