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1.
Cell Mol Bioeng ; 17(1): 7-24, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38435793

RESUMO

Introduction: Breast tumors often display an astonishing degree of spatial and temporal heterogeneity, which are associated with cancer progression, drug resistance, and relapse. Triple-negative breast cancer (TNBC) is a particularly aggressive and heterogeneous subtype for which targeted therapies are scarce. Consequently, patients with TNBC have a poorer overall prognosis compared to other breast cancer patients. Within heterogeneous tumors, individual clonal subpopulations may exhibit differences in their rates of growth and degrees of invasiveness. We hypothesized that such phenotypic heterogeneity at the single-cell level may accelerate tumor progression by enhancing the overall growth and invasion of the entire tumor. Methods: To test this hypothesis, we isolated and characterized clonal subpopulations with distinct morphologies and biomarker expression from the inherently heterogeneous 4T1 mouse mammary carcinoma cell line. We then leveraged a 3D microfluidic tumor model to reverse-engineer intratumoral heterogeneity and thus investigate how interactions between phenotypically distinct subpopulations affect tumor growth and invasion. Results: We found that the growth and invasion of multiclonal tumors were largely dictated by the presence of cells with epithelial and mesenchymal traits, respectively. The latter accelerated overall tumor invasion, even when these cells comprised less than 1% of the initial population. Consistently, tumor progression was delayed by selectively targeting the mesenchymal subpopulation. Discussion: This work reveals that highly invasive cells can dominate tumor phenotype and that specifically targeting these cells can slow the progression of heterogeneous tumors, which may help inform therapeutic approaches. Supplementary Information: The online version contains supplementary material available at 10.1007/s12195-023-00792-w.

2.
Annu Rev Biomed Eng ; 26(1): 93-118, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38316064

RESUMO

Cell traction force plays a critical role in directing cellular functions, such as proliferation, migration, and differentiation. Current understanding of cell traction force is largely derived from 2D measurements where cells are plated on 2D substrates. However, 2D measurements do not recapitulate a vital aspect of living systems; that is, cells actively remodel their surrounding extracellular matrix (ECM), and the remodeled ECM, in return, can have a profound impact on cell phenotype and traction force generation. This reciprocal adaptivity of living systems is encoded in the material properties of biological gels. In this review, we summarize recent progress in measuring cell traction force for cells embedded within 3D biological gels, with an emphasis on cell-ECM cross talk. We also provide perspectives on tools and techniques that could be adapted to measure cell traction force in complex biochemical and biophysical environments.


Assuntos
Matriz Extracelular , Esferoides Celulares , Humanos , Matriz Extracelular/metabolismo , Esferoides Celulares/citologia , Animais , Movimento Celular , Géis/química , Adesão Celular , Microscopia de Força Atômica/métodos , Análise de Célula Única/métodos , Hidrogéis/química
3.
Cell Commun Signal ; 19(1): 32, 2021 03 10.
Artigo em Inglês | MEDLINE | ID: mdl-33691719

RESUMO

The epithelial-mesenchymal transition (EMT) is intrinsically linked to alterations of the intracellular cytoskeleton and the extracellular matrix. After EMT, cells acquire an elongated morphology with front/back polarity, which can be attributed to actin-driven protrusion formation as well as the gain of vimentin expression. Consequently, cells can deform and remodel the surrounding matrix in order to facilitate local invasion. In this review, we highlight recent bioengineering approaches to elucidate EMT and functional changes in the cytoskeleton. First, we review transitions between multicellular clusters and dispersed individuals on planar surfaces, which often exhibit coordinated behaviors driven by leader cells and EMT. Second, we consider the functional role of vimentin, which can be probed at subcellular length scales and within confined spaces. Third, we discuss the role of topographical patterning and EMT via a contact guidance like mechanism. Finally, we address how multicellular clusters disorganize and disseminate in 3D matrix. These new technologies enable controlled physical microenvironments and higher-resolution spatiotemporal measurements of EMT at the single cell level. In closing, we consider future directions for the field and outstanding questions regarding EMT and the cytoskeleton for human cancer progression. Video Abstract.


Assuntos
Bioengenharia , Citoesqueleto/patologia , Transição Epitelial-Mesenquimal , Animais , Bioensaio , Matriz Extracelular/metabolismo , Humanos , Filamentos Intermediários/metabolismo
4.
Proc Natl Acad Sci U S A ; 117(11): 5655-5663, 2020 03 17.
Artigo em Inglês | MEDLINE | ID: mdl-32123100

RESUMO

Epithelial tissues mechanically deform the surrounding extracellular matrix during embryonic development, wound repair, and tumor invasion. Ex vivo measurements of such multicellular tractions within three-dimensional (3D) biomaterials could elucidate collective dissemination during disease progression and enable preclinical testing of targeted antimigration therapies. However, past 3D traction measurements have been low throughput due to the challenges of imaging and analyzing information-rich 3D material deformations. Here, we demonstrate a method to profile multicellular clusters in a 96-well-plate format based on spatially heterogeneous contractile, protrusive, and circumferential tractions. As a case study, we profile multicellular clusters across varying states of the epithelial-mesenchymal transition, revealing a successive loss of protrusive and circumferential tractions, as well as the formation of localized contractile tractions with elongated cluster morphologies. These cluster phenotypes were biochemically perturbed by using drugs, biasing toward traction signatures of different epithelial or mesenchymal states. This higher-throughput analysis is promising to systematically interrogate and perturb aberrant mechanobiology, which could be utilized with human-patient samples to guide personalized therapies.


Assuntos
Movimento Celular , Ensaios de Seleção de Medicamentos Antitumorais/métodos , Células Epiteliais/fisiologia , Transição Epitelial-Mesenquimal , Alicerces Teciduais/química , Fenômenos Biomecânicos , Linhagem Celular , Colágeno/química , Fibroínas/química , Humanos , Hidrogéis/química , Fenótipo , Medicina de Precisão/métodos , Cultura Primária de Células/métodos , Esferoides Celulares/fisiologia
5.
J Cell Physiol ; 235(2): 1425-1437, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31287165

RESUMO

SH2-containing inositol-5'-phosphatase-1 (SHIP-1) controls the phosphatidylinositol-3'-kinase (PI3K) initiated signaling pathway by limiting cell membrane recruitment and activation of Akt. Despite the fact that many of the growth factors important to cartilage development and functions are able to activate the PI3K signal transduction pathway, little is known about the role of PI3K signaling in chondrocyte biology and its contribution to mammalian skeletogenesis. Here, we report that the lipid phosphatase SHIP-1 regulates chondrocyte hypertrophy and skeletal development through its expression in osteochondroprogenitor cells. Global SHIP-1 knockout led to accelerated chondrocyte hypertrophy and premature formation of the secondary ossification center in the bones of postnatal mice. Drastically higher vascularization and greater number of c-kit + progenitors associated with sinusoids in the bone marrow also indicated more advanced chondrocyte hypertrophic differentiation in SHIP-1 knockout mice than in wild-type mice. In corroboration with the in vivo phenotype, SHIP-1 deficient PDGFRα + Sca-1 + osteochondroprogenitor cells exhibited rapid differentiation into hypertrophic chondrocytes under chondrogenic culture conditions in vitro. Furthermore, SHIP-1 deficiency inhibited hypoxia-induced cellular activation of Akt and extracellular-signal-regulated kinase (Erk) and suppressed hypoxia-induced cell proliferation. These results suggest that SHIP-1 is required for hypoxia-induced growth signaling under physiological hypoxia in the bone marrow. In conclusion, the lipid phosphatase SHIP-1 regulates skeletal development by modulating chondrogenesis and the hypoxia response of the osteochondroprogenitors during endochondral bone formation.


Assuntos
Diferenciação Celular/fisiologia , Condrócitos/citologia , Hipertrofia/metabolismo , Metabolismo dos Lipídeos/fisiologia , Osteogênese , Fosfatidilinositol-3,4,5-Trifosfato 5-Fosfatases/metabolismo , Esqueleto/crescimento & desenvolvimento , Animais , Osso e Ossos/metabolismo , Ciclo Celular/fisiologia , Proliferação de Células/fisiologia , Condrogênese/genética , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Lipídeos , Camundongos , Osteogênese/genética , Fosfatidilinositol 3-Quinases/metabolismo , Fosfatidilinositol-3,4,5-Trifosfato 5-Fosfatases/deficiência
6.
ACS Biomater Sci Eng ; 5(9): 4341-4354, 2019 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-31517039

RESUMO

Invading cancer cells adapt their migration phenotype in response to mechanical and biochemical cues from the extracellular matrix. For instance, mesenchymal migration is associated with strong cell-matrix adhesions and an elongated morphology, while amoeboid migration is associated with minimal cell-matrix adhesions and a rounded morphology. However, it remains challenging to elucidate the role of matrix mechan-ics and biochemistry, since these are both dependent on ECM protein concentration. Here, we demonstrate a composite silk fibroin and collagen I hydrogel where stiffness and microstructure can be systematically tuned over a wide range. Using an overlay assay geometry, we show that the invasion of metastatic breast cancer cells exhibits a biphasic dependence on silk fibroin concentration at fixed collagen I concentration, first increasing as the hydrogel stiffness increases, then decreasing as the pore size of silk fibroin decreases. Indeed, mesenchymal morphology exhibits a similar biphasic depen-dence on silk fibroin concentration, while amoeboid morphologies were favored when cell-matrix adhesions were less effective. We used exogenous biochemical treatment to perturb cells towards increased contractility and a mesenchymal morphology, as well as to disrupt cytoskeletal function and promote an amoeboid morphology. Overall, we envision that this tunable biomaterial platform in a 96-well plate format will be widely applicable to screen cancer cell migration against combinations of designer biomaterials and targeted inhibitors.

7.
Proc Natl Acad Sci U S A ; 116(35): 17298-17306, 2019 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-31413194

RESUMO

Migratory cells transition between dispersed individuals and multicellular collectives during development, wound healing, and cancer. These transitions are associated with coordinated behaviors as well as arrested motility at high cell densities, but remain poorly understood at lower cell densities. Here, we show that dispersed mammary epithelial cells organize into arrested, fractal-like clusters at low density in reduced epidermal growth factor (EGF). These clusters exhibit a branched architecture with a fractal dimension of [Formula: see text], reminiscent of diffusion-limited aggregation of nonliving colloidal particles. First, cells display diminished motility in reduced EGF, which permits irreversible adhesion upon cell-cell contact. Subsequently, leader cells emerge that guide collectively migrating strands and connect clusters into space-filling networks. Thus, this living system exhibits gelation-like arrest at low cell densities, analogous to the glass-like arrest of epithelial monolayers at high cell densities. We quantitatively capture these behaviors with a jamming-like phase diagram based on local cell density and EGF. These individual to collective transitions represent an intriguing link between living and nonliving systems, with potential relevance for epithelial morphogenesis into branched architectures.


Assuntos
Comunicação Celular , Movimento Celular , Fator de Crescimento Epidérmico/metabolismo , Células Epiteliais/metabolismo , Glândulas Mamárias Humanas/metabolismo , Contagem de Células , Linhagem Celular , Células Epiteliais/citologia , Feminino , Humanos , Glândulas Mamárias Humanas/citologia
8.
Sci Rep ; 8(1): 5581, 2018 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-29615650

RESUMO

Spatiotemporal tracking of tracer particles or objects of interest can reveal localized behaviors in biological and physical systems. However, existing tracking algorithms are most effective for relatively low numbers of particles that undergo displacements smaller than their typical interparticle separation distance. Here, we demonstrate a single particle tracking algorithm to reconstruct large complex motion fields with large particle numbers, orders of magnitude larger than previously tractably resolvable, thus opening the door for attaining very high Nyquist spatial frequency motion recovery in the images. Our key innovations are feature vectors that encode nearest neighbor positions, a rigorous outlier removal scheme, and an iterative deformation warping scheme. We test this technique for its accuracy and computational efficacy using synthetically and experimentally generated 3D particle images, including non-affine deformation fields in soft materials, complex fluid flows, and cell-generated deformations. We augment this algorithm with additional particle information (e.g., color, size, or shape) to further enhance tracking accuracy for high gradient and large displacement fields. These applications demonstrate that this versatile technique can rapidly track unprecedented numbers of particles to resolve large and complex motion fields in 2D and 3D images, particularly when spatial correlations exist.


Assuntos
Algoritmos , Imageamento Tridimensional/métodos , Hidrodinâmica , Movimento (Física) , Razão Sinal-Ruído
9.
Lab Chip ; 17(20): 3474-3488, 2017 10 11.
Artigo em Inglês | MEDLINE | ID: mdl-28906525

RESUMO

3D printed biomaterials with spatial and temporal functionality could enable interfacial manipulation of fluid flows and motile cells. However, such dynamic biomaterials are challenging to implement since they must be responsive to multiple, biocompatible stimuli. Here, we show stereolithographic printing of hydrogels using noncovalent (ionic) crosslinking, which enables reversible patterning with controlled degradation. We demonstrate this approach using sodium alginate, photoacid generators and various combinations of divalent cation salts, which can be used to tune the hydrogel degradation kinetics, pattern fidelity, and mechanical properties. This approach is first utilized to template perfusable microfluidic channels within a second encapsulating hydrogel for T-junction and gradient devices. The presence and degradation of printed alginate microstructures were further verified to have minimal toxicity on epithelial cells. Degradable alginate barriers were used to direct collective cell migration from different initial geometries, revealing differences in front speed and leader cell formation. Overall, this demonstration of light-based 3D printing using non-covalent crosslinking may enable adaptive and stimuli-responsive biomaterials, which could be utilized for bio-inspired sensing, actuation, drug delivery, and tissue engineering.


Assuntos
Alginatos/química , Materiais Biocompatíveis/química , Hidrogéis/química , Técnicas Analíticas Microfluídicas , Impressão Tridimensional , Materiais Biocompatíveis/toxicidade , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Ácido Glucurônico/química , Ácidos Hexurônicos/química , Humanos , Teste de Materiais
10.
Biomater Sci ; 5(8): 1460-1479, 2017 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-28530743

RESUMO

Cancer cell invasion through the extracellular matrix is associated with metastatic spread and therapeutic resistance. In carcinomas, the detachment and dissemination of individual cells has been associated with an epithelial-mesenchymal transition, but tumors can also invade using collective, multicellular phenotypes. This malignant tumor progression is also associated with alignment and stiffening of the surrounding extracellular matrix. Historically, tumor invasion has been investigated using 2D monolayer culture, small animal models or patient histology. These assays have been complemented by the use of natural biomaterials such as reconstituted basement membrane and collagen I. More recently, engineered materials with well-defined physical, chemical and biomolecular properties have enabled more controlled microenvironments. In this review, we highlight recent developments in multicellular tumor invasion based on microfabricated structures or hydrogels. We emphasize the role of interfacial geometries, biomaterial stiffness, matrix remodeling, and co-culture models. Finally, we discuss future directions for the field, particularly integration with precision measurements of biomaterial properties and single cell heterogeneity, standardization and scale-up of these platforms, as well as integration with patient-derived samples.


Assuntos
Biomimética/métodos , Neoplasias/patologia , Animais , Matriz Extracelular/efeitos dos fármacos , Matriz Extracelular/metabolismo , Humanos , Hidrogéis/farmacologia , Invasividade Neoplásica , Esferoides Celulares/efeitos dos fármacos , Esferoides Celulares/patologia
12.
Integr Biol (Camb) ; 8(11): 1133-1144, 2016 11 07.
Artigo em Inglês | MEDLINE | ID: mdl-27722556

RESUMO

Single cells respond heterogeneously to biochemical treatments, which can complicate the analysis of in vitro and in vivo experiments. In particular, stressful perturbations may induce the epithelial-mesenchymal transition (EMT), a transformation through which compact, sensitive cells adopt an elongated, resistant phenotype. However, classical biochemical measurements based on population averages over large numbers cannot resolve single cell heterogeneity and plasticity. Here, we use high content imaging of single cell morphology to classify distinct phenotypic subpopulations after EMT. We first characterize a well-defined EMT induction through the master regulator Snail in mammary epithelial cells over 72 h. We find that EMT is associated with increased vimentin area as well as elongation of the nucleus and cytoplasm. These morphological features were integrated into a Gaussian mixture model that classified epithelial and mesenchymal phenotypes with >92% accuracy. We then applied this analysis to heterogeneous populations generated from less controlled EMT-inducing stimuli, including growth factors (TGF-ß1), cell density, and chemotherapeutics (Taxol). Our quantitative, single cell approach has the potential to screen large heterogeneous cell populations for many types of phenotypic variability, and may thus provide a predictive assay for the preclinical assessment of targeted therapeutics.


Assuntos
Células Epiteliais/citologia , Células Epiteliais/metabolismo , Transição Epitelial-Mesenquimal/fisiologia , Ensaios de Triagem em Larga Escala/métodos , Mesoderma/citologia , Mesoderma/metabolismo , Modelos Estatísticos , Linhagem Celular , Tamanho Celular , Simulação por Computador , Humanos , Modelos Biológicos , Distribuição Normal
13.
Soft Matter ; 12(40): 8327-8337, 2016 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-27722738

RESUMO

Collective behaviors emerge from coordinated cell-cell interactions during the morphogenesis of tissues and tumors. For instance, cells may display density-dependent phase transitions from a fluid-like "unjammed" phase to a solid-like "jammed" phase, while different cell types can "self-sort". Here, we comprehensively track single cell dynamics in mixtures of sheet-forming epithelial cells and dispersed mesenchymal cells. We find that proliferating epithelial cells nucleate multicellular clusters that coarsen at a critical density, arresting migration and strengthening spatial velocity correlations. The addition of mesenchymal cells can slow cluster formation and coarsening, resulting in more dispersed individual cells with weak spatial velocity correlations. These behaviors have analogies with a jamming-unjamming transition, where the control parameters are cell density and mesenchymal fraction. This complex interplay of proliferation, clustering and correlated migration may have physical implications for understanding epithelial-mesenchymal interactions in development and disease.


Assuntos
Movimento Celular , Técnicas de Cocultura , Células Epiteliais/citologia , Células-Tronco Mesenquimais/citologia , Animais , Comunicação Celular , Células Cultivadas , Ratos
14.
Carbon N Y ; 97: 14-24, 2016 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-25848137

RESUMO

Textured surfaces with periodic topographical features and long-range order are highly attractive for directing cell-material interactions. They mimic physiological environments more accurately than planar surfaces and can fundamentally alter cell alignment, shape, gene expression, and cellular assembly into superstructures or microtissues. Here we demonstrate for the first time that wrinkled graphene-based surfaces are suitable as textured cell attachment substrates, and that engineered wrinkling can dramatically alter cell alignment and morphology. The wrinkled surfaces are fabricated by graphene oxide wet deposition onto pre-stretched elastomers followed by relaxation and mild thermal treatment to stabilize the films in cell culture medium. Multilayer graphene oxide films form periodic, delaminated buckle textures whose wavelengths and amplitudes can be systematically tuned by variation in the wet deposition process. Human and murine fibroblasts attach to these textured films and remain viable, while developing pronounced alignment and elongation relative to those on planar graphene controls. Compared to lithographic patterning of nanogratings, this method has advantages in the simplicity and scalability of fabrication, as well as the opportunity to couple the use of topographic cues with the unique conductive, adsorptive, or barrier properties of graphene materials for functional biomedical devices.

15.
BMC Med Inform Decis Mak ; 12: 21, 2012 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-22429384

RESUMO

BACKGROUND: Decision aids are often used to assist individuals confronted with a diagnosis of a serious illness to make decisions about treatment options. However, they are rarely utilised to help those with chronic or age related conditions to make decisions about care services. Decision aids should also be useful for carers of people with decreased decisional capacity. These carers' choices must balance health outcomes for themselves and for salient others with relational and value-based concerns, while relying on information from health professionals. This paper reports on a study that both developed and pilot tested a decision aid aimed at assisting carers to make evaluative judgements of community services, particularly respite care. METHODS: A mixed method sequential study, involving qualitative development and a pilot randomised controlled trial, was conducted in Tasmania, Australia. We undertook 13 semi-structured interviews and three focus groups to inform the development of the decision aid. For the randomised control trial we randomly assigned 31 carers of people with dementia to either receive the service decision aid at the start or end of the study. The primary outcome was measured by comparing the difference in carer burden between the two groups three months after the intervention group received the decision aid. Pilot data was collected from carers using interviewer-administered questionnaires at the commencement of the project, two weeks and 12 weeks later. RESULTS: The qualitative data strongly suggest that the intervention provides carers with needed decision support. Most carers felt that the decision aid was useful. The trial data demonstrated that, using the mean change between baseline and three month follow-up, the intervention group had less increase in burden, a decrease in decisional conflict and increased knowledge compared to control group participants. CONCLUSIONS: While these results must be interpreted with caution due to the small sample size, all intervention results trend in a direction that is beneficial for carers and their decisional ability. Mixed method data suggest the decision aid provides decisional support that carers do not otherwise receive. Decision aids may prove useful in a community health services context. TRIAL REGISTRATION NUMBER: ISRCTN: ISRCTN32163031.


Assuntos
Cuidadores/psicologia , Serviços de Saúde Comunitária/métodos , Demência/terapia , Cuidados Intermitentes/psicologia , Técnicas de Apoio para a Decisão , Estudos de Avaliação como Assunto , Feminino , Grupos Focais , Humanos , Masculino , Projetos Piloto , Desenvolvimento de Programas , Cuidados Intermitentes/provisão & distribuição , Inquéritos e Questionários
16.
Am J Respir Cell Mol Biol ; 47(3): 306-14, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22461429

RESUMO

Recent studies suggest the importance of the transition of airway epithelial cells (EMT) in pulmonary fibrosis, and also indicate a role for Wingless protein (Wnt)/ß-catenin signaling in idiopathic pulmonary fibrosis. We investigated the possible role of the Wnt signaling pathway in inducing EMT in lung epithelial cells, and sought to unravel the role of c-Jun-N-terminal-kinase-1 (JNK1). The exposure of C10 lung epithelial cells or primary mouse tracheal epithelial cells (MTECs) to Wnt3a resulted in increases in JNK phosphorylation and nuclear ß-catenin content. Because the role of ß-catenin as a transcriptional coactivator is well established, we investigated T-cell factor/lymphocyte-enhancement factor (TCF/LEF) transcriptional activity in C10 lung epithelial cells after the activation of Wnt. TCF/LEF transcriptional activity was enhanced after the activation of Wnt, and this increase in TCF/LEF transcriptional activity was diminished after the small interfering (si)RNA-mediated ablation of JNK. The activation of the Wnt pathway by Wnt3a, or the expression of either wild-type or constitutively active ß-catenin (S37A), led to the activation of an EMT transcriptome, manifested by the increased mRNA expression of CArG box-binding factor-A, fibroblast-specific protein (FSP)-1, α-smooth muscle actin (α-SMA), and vimentin, increases in the content of α-SMA and FSP1, and the concomitant loss of zona occludens-1. The siRNA-mediated ablation of ß-catenin substantially decreased Wnt3a-induced EMT. The siRNA ablation of JNK1 largely abolished Wnt3a, ß-catenin, and ß-catenin S37a-induced EMT. In MTECs lacking Jnk1, Wnt3a-induced increases in nuclear ß-catenin, EMT transcriptome, and the content of α-SMA or FSP1 were substantially diminished. These data show that the activation of the Wnt signaling pathway is capable of inducing an EMT program in lung epithelial cells through ß-catenin, and that this process is controlled by JNK1.


Assuntos
Pulmão/metabolismo , Mesoderma/metabolismo , Proteína Quinase 8 Ativada por Mitógeno/metabolismo , Proteínas Wnt/fisiologia , beta Catenina/fisiologia , Animais , Sequência de Bases , Western Blotting , Células Cultivadas , Primers do DNA , Células Epiteliais/metabolismo , Imunofluorescência , Pulmão/citologia , Camundongos , Fosforilação , RNA Interferente Pequeno , Transcrição Gênica
17.
Work ; 39(4): 477-83, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21811036

RESUMO

Carers of bariatric (morbidly obese) clients are exposed to manual handling injury risk throughout the journey that such clients take within the healthcare system. To identify the factors that affect risks associated with bariatric clients and the subsequent adoption of risk control measures focus groups were conducted in two Australian state capitals: a suburban region of Melbourne and a large regional Victorian town. Participants, were recruited from within the primary health care sector, ambulance services, fire services and funeral businesses. It was found that the risks to which nurses, ambulance officers, fire fighters, and funeral industry employees are exposed are significant. The injury risk is influenced by the nature and design of the range of environments within which client movement is undertaken; the limited range of handling equipment available for use with bariatric clients; and the efficacy of organisational procedures and training. Adoption of risk controls is hampered by the absence of a standard definition of the term ``bariatric'' and the gaps in information flow during the bariatric client journey through the health care system. Various definitions of bariatric are applied in different sectors and there are limitations to the use of both weight and body mass index in those definitions.


Assuntos
Bariatria , Movimentação e Reposicionamento de Pacientes , Obesidade Mórbida/terapia , Transporte de Pacientes , Austrália , Índice de Massa Corporal , Auxiliares de Emergência , Feminino , Bombeiros , Grupos Focais , Pessoal de Saúde , Humanos , Masculino , Medição de Risco , Fatores de Risco
18.
Int J Nurs Pract ; 16(3): 262-7, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20618536

RESUMO

To gain an understanding of the factors that affect the risks and the adoption of risk control measures during the care of bariatric patients, focus groups were conducted in rural and metropolitan locations in Australia. It was found that the manual handling injury risk to carers is influenced by the design of the environments within which patient movement is undertaken; the limited range of handling equipment available for use with bariatric patients; and the efficacy of organizational procedures and training. Adoption of risk controls is hampered by the absence of a standard definition of the term 'bariatric' and limitations in the use of weight and body mass index in definitions. There are gaps in information flow during the bariatric patient journey through the health-care system and a lack of knowledge about how to safely manage the unique needs of bariatric patients.


Assuntos
Bariatria , Medição de Risco , Transporte de Pacientes , Austrália , Índice de Massa Corporal , Feminino , Humanos , Masculino
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