Masterworks of art and chronic illness experiences in the elderly

AIM: This article presents findings of a qualitative study, conducted between 1997 and 2000, to investigate the plausibility of integrating masterworks of art with care of the chronically ill elderly, and to analyse perceptions about chronic illness among three groups: registered nurses, nursing students, and the elderly. BACKGROUND AND SIGNIFICANCE: Statistically the incidence of chronic illness increases in the elderly. Although pathophysiology of chronic illness is increasingly understood, few studies explore the experience of living with chronicity from the perspective of the elderly. Understanding and intervening appropriately for the elderly with chronic illness may contribute significantly to improving quality of life for this growing population. ETHICAL ISSUES AND APPROVAL: The study was approved through an Institutional Review Board. Facility permission and participant informed consent were obtained. Anonymity and confidentiality were protected. DESIGN: Using hermeneutic phenomenology and masterworks of art as a centre point for dialogue, the investigators explored the perceptions of nurses, students, and the elderly about living with a chronic illness. A purposive sample of 65 participants made up seven focus groups with which group interviews were conducted. Themes were explicated and analysed from audiotaped interviews until data saturation was reached. FINDINGS: Content analysis of focus group interviews revealed themes of social isolation, inevitable role change, and inertia-movement. Only the elderly acknowledged hope and a steadfast refusal to give up, while nurses and students viewed chronicity more negatively. Themes of social isolation and role change are consistent with other studies of the elderly. A paradox of inertia-movement in the chronically ill elderly has not been reported in the nursing literature. CONCLUSIONS: Paradoxical tension of inertia-movement in the chronically ill elderly appears to be linked to the broader concept of energy in nursing science, and to Parse's theory of human becoming. Masterworks of art can generate energy exchange between the elderly and caregivers, providing a plausible catalyst for meaningful interventions that transcend age and practice settings.     

Current status of reproductive behaviour in Africa

The current annual population growth rate of 3.2% in Africawill double the population by the year 2025. The majority ofthis population is below 15 years of age, and Africa concurrentlyalso has the highest incidence of infertility in the world.Sexual behaviour, which has been poorly studied in Africa, hasa direct impact on reproductive health [including fertility,infertility and sexually transmitted diseases (STDs)]. The multiplecultures and religions which characterize the African continentalso affect reproductive health. Factors that have a significanteffect on reproductive health in Africa include greater prevalenceof extramarital/commercial sexual activity, polygamy, lowerprevalence of contraceptives, reliance on traditional practices,high incidence of STDs and teenage pregnancies. High risk reproductivebehaviours are predominantly displayed by adolescents, and theprevalence of STDs, including HIV (human immunodeficiency virus),is very high in this group. Pregnancy-related complicationsare the major cause of health-related problems in 15-19 yearold girls. Maternal mortality rates in most countries remainhigh. Literacy rates affect these behaviours. It is apparentthat changing the sexual behaviour of adolescents is one wayof reversing the adverse trends, such as STD transmission, unwantedpregnancy and poor general reproductive health.     

Predictors of mental health in women of a politically unstable country,the Philippines

In a study conducted in Manila, the Philippines, the relationships among the (a) negative appraisal of and coping with political instability, (b) socio‐demographic characteristics, (c) morale, and (d) mood of Filipino women (N = 200) were investigated. Findings were as follows: The political instability in the Philippines had a mild negative impact on the women's lives. The women reported mild depression and moderate morale. Their primary coping style was problem‐focused coping. A positive relationship was found among annual individual income, educational achievement, and morale. A negative relationship was found among annual individual income, educational achievement, and depression. Negative relationships were also found between negative appraisals of news of brutal murders and morale and between frequent changes in the President's cabinet and morale. A positive relationship was found between affect‐focused coping and depression, whereas problem‐focused coping and depression were negatively related. No relationship was found between coping style and morale. The findings are discussed from the perspectives of Lazarus and Folkman's (1984) coping theory and Filipino culture. Guidelines for health care delivery are specified.     

Emerging techniques in molecular detection of circulating tumor cells

Circulating tumor cells (CTCs) are increasingly recognized for their potential utility in cancer diagnosis and prognosis. Emerging technologies in the past decade have allowed possible isolation and characterization of CTCs in the peripheral blood of cancer patients, including immunomagnetic technique coupled with immunofluorescence methodology, microfluidic platform, x-ray imaging technique and flow cytometry, filter-adapted FISH and miRNA microarray. Although there are still a number of challenges associated with the identification and molecular characterization of CTCs, the analysis of CTCs carries important prognostic and therapeutic implications for personalized cancer management.     

Obesity and thyroid cancer: epidemiologic associations and underlying mechanisms

The incidence of thyroid cancer has been rising over the past few decades along with a parallel increase in obesity. Observational studies have provided evidence for a potential association between the two. By contrast, clinical data for a link between type 2 diabetes mellitus, a condition strongly associated with obesity, and thyroid cancer are limited and largely not supportive of such an association. Obesity leads to hypoadiponectinemia, a pro‐inflammatory state, and insulin resistance, which, in turn, leads to high circulating insulin and insulin‐like growth factor‐1 levels, thereby possibly increasing the risk for thyroid cancer. Thus, insulin resistance possibly plays a pivotal role in underlying the observed association between obesity and thyroid cancer, potentially leading to the development and/or progression of thyroid cancer, through its interconnections with other factors including insulin‐like growth factor‐1, adipocytokines/cytokines and thyroid‐stimulating hormone. In this review, epidemiological and clinical evidence and potential mechanisms underlying the proposed association between obesity and thyroid cancer risk are reviewed. If the association between obesity and thyroid cancer demonstrated in observational studies proves to be causal, targeting obesity (and/or downstream mediators of risk) could be of importance in the prevention and management of thyroid cancer.     

Pharmacological concentrations of irisin increase cell proliferation without influencing markers of neurite outgrowth and synaptogenesis in mouse H19-7 hippocampal cell lines

Aims/Hypothesis

Irisin is a novel, myocyte secreted, hormone that has been proposed to mediate the beneficial effects of exercise on metabolism. Irisin is expressed, at lower levels, in human brains and knock-down of the precursor of irisin, FNDC5, decreases neural differentiation of mouse embryonic stem cells. No previous studies have evaluated whether irisin may directly regulate hippocampal neurogenesis in mouse hippocampal neuronal (HN) cells.

Methods

Hippocampal neurogenesis and irisin signaling were studied in vitro using mouse H19-7 HN cell lines.

Results

We observed that cell proliferation is regulated by irisin in a dose-dependent manner in mouse H19-7 HN cells. Specifically, physiological concentrations of irisin, 5 to 10 nmol/L, had no effect on cell proliferation when compared to control. By contrast, pharmacological concentrations of irisin, 50 to 100 nmol/L, increased cell proliferation when compared to control. Similar to these results regarding irisin's effects on cell proliferation, we also observed that only pharmacological concentrations of irisin increased STAT3, but not AMPK and/or ERK, activation. Finally, we observed that irisin did not activate either microtubule-associated protein 2, a specific neurite outgrowth marker, or Synapsin, a specific synaptogenesis marker in mouse H19-7 HN cells.

Conclusions/Interpretations

Our data suggest that irisin, in pharmacological concentrations, increases cell proliferation in mouse H19-7 HN cells via STAT3, but not AMPK and/or ERK, signaling pathways. By contrast, neither physiological nor pharmacological concentrations of irisin alter markers of hippocampal neurogenesis in mouse H19-7 HN cell lines.