Nurses' experiences of the family's role in end-of-life care.

Background: Family units can be deeply affected and require nurses' attention and care when their loved ones reach the end-of-life stage. However, the role of the family in end-of-life nursing is under-researched in a tertiary hospital setting. Aim: This study aims to explore and describe nurses' lived experiences of the family's role in end-of-life care at a tertiary hospital in the Western Cape. Setting: The study took place in a tertiary hospital in the Western Cape. Methods: A qualitative hermeneutic design with a phenomenological approach was used. Ten professional nurses were interviewed in person, and two focus groups comprised enrolled and auxiliary nurses (11) with a minimum of 6 months of experience in end-of-life care. Data analysis was conducted by categorising qualitative information into codes and themes, following Creswell's outlined methodology. Results: Three themes emerged: emotional challenges associated with families of end-of-life patients, strategies that assist families and impediments to providing care. Participants experienced challenges managing strong emotions expressed by families and their own, but provided care regardless. Strategies that have been found to be helpful to families include communication, access, and involving them in patient care. Participants experienced the need for emotional support and specialised end-of-life training. Conclusion: Participants strive to provide understanding and support to families despite challenges, but emotional and end-of-life training resources are required to equip nurses to address patients' and families' needs competently. Contribution: This study adds the nurses' experience and understanding of the family's role in providing end-of-life care in a tertiary hospital.

CDK1/cyclin B regulation during oocyte maturation in two closely related lugworm species, Arenicola marina and Arenicola defodiens.

The molecular mechanisms underlying oocyte maturation in the annelid polychaetes Arenicola marina and Arenicola defodiens were investigated. In both species, a hitherto unidentified hormone triggers synchronous and rapid transition from prophase to metaphase, a maturation process which can be easily reproduced in vitro. Activation of a roscovitine- and olomoucine-sensitive M-phase-specific histone, H1 kinase, occurs during oocyte maturation. Using affinity chromatography on immobilized p9CKShs1, we purified CDK1 and cyclin B from oocyte extracts prepared from both phases and both species. In prophase, CDK1 is present both as an inactive, but Thr161-phosphorylated monomer, and as an inactive (Tyr15-phosphorylated) heterodimer with cyclin B. Prophase to metaphase transition is associated with complete tyrosine dephosphorylation of the cyclin B-associated CDK1, with phosphorylation of cyclin B, and with dramatic activation of the kinase activity of the CDK1/cyclin B complex. We propose that Arenicola oocytes may provide an ideal model system to investigate the acquisition of the ability of oocytes to be fertilized that occurs as oocyte shift from prophase to metaphase, an important physiological event, probably regulated by active CDK1/cyclin B.

Application of reproductive biotechnology in animals: implications and potentials. Applications of reproductive cloning.

The development of new methods of nuclear transfer in mammals is creating many new opportunities in research, medicine and agriculture. The method of cloning is repeatable and has been established in many laboratories worldwide. However, the present procedure is inefficient with fewer than 4% of embryos becoming viable offspring. A considerable improvement in efficiency is required before wide scale use for livestock improvement. The opportunity to introduce precise genetic changes to livestock is available for the first time through the use of gene targeting procedures in cultured cells that are used as nuclear donors. This has potential application in the production of organs for transplantation to humans, studies of human genetic disease and basic research in to the control of gene expression and function.

Somatic cell nuclear transfer.

Embryos produced by nuclear transfer from a patient's somatic cell offer one potential source of embryonic stem cells for treatment of human degenerative diseases. As with all of the approaches to such therapy, this has both strengths and weaknesses. The cells would be histocompatible with the patient's cells, be expected to have a normal life span, and in principle be a source of any other cell type. However, the time taken and the costs involved in the isolation of the appropriate cell population would probably prohibit large-scale application. Clones have been produced from the cells of adults of five species, but similar studies in at least five other species have produced early embryos, but not offspring. A variety of somatic cells have been used as successful nuclear donors. The present procedures have proved to be repeatable, but are very inefficient when typically between 1% and 4% of reconstructed embryos develop to adulthood. The inefficiency is the accumulated effect of failure at all stages of development. There may be differences between species and donor cell type in the precise pattern of loss. This outcome is assumed to reflect the inappropriate expression of a large number of genes whose lethal effect is exerted at different stages. Improvements in the efficiency may depend upon understanding those mechanisms in the early embryo that establish the precise chromatin structure that governs development.