Stimulation of human cytotoxic T cells with HIV-1-derived peptides presented by recombinant HLA-A2 peptide complexes

HLA-A2 heavy chain and beta 2-microglobulin were expressed in Escherichia coli, and refolded in the presence of peptides derived from HIV-1 RT and gag proteins. When recombinant HLA-A2 molecules were attached to cells lacking HLA-A2, the cells became susceptible to lysis by HLA-A2-restricted cytotoxic T lymphocyte (CTL) clones specific for peptides derived from RT and gag proteins. Limiting dilution analyses of peripheral blood mononuclear cells from HIV-1-infected individuals showed that the recombinant HLA-A2 peptide complexes covalently immobilized on microspheres stimulated the development of HLA-A2 peptide-specific CTL. Preformed HLA-peptide complexes may provide an alternative to immunization procedures that depend upon intracellular processing of antigen to elicit T cell responses.      

A research-based method of selecting curriculum content

This paper reports on a study concerning the opinions of sisters and nurse teachers regarding the relevance of learning objectives for a specific teaching and learning course for hospital and community sisters. The respondents were 29 sisters who had attended the course, 32 sisters who had not attended the course but who were potential future 'consumers' and 25 nurse teachers. The results showed that a majority of the respondents rated 29 of the objectives as essential and these were suggested as the nucleus of the core curriculum for future courses. Responses to nine of the objectives showed statistically significant differences between the groups.     

The nursing process: implications for curriculum planning

The focus of this paper is an exploration of the implications for curriculum planning of adopting the nursing process; which, it is suggested, represents the most far-reaching innovation in British nursing of recent years. An examination of the abilities required by nurses in order for them to deliver care in this way shows that to encompass the philosophy of the nursing process, fundamental changes need to be made in the way nurses are prepared in schools of nursing. In particular, to those elements of the curriculum dealing with content and teaching methods.     

Quality of life and the right to die: an ethical dilemma

In an increasingly 'patient-centred' health service individuals are demanding to make independent judgements about their own fate. In keeping with this trend there is now a growing drive to review the current laws on euthanasia and assisted suicide. The issues in the euthanasia debate usually revolve around patients who are terminally ill and/or suffering intractable pain. However, pain is not the only determinant of an intolerable existence and the problems become more complex when existential quality of life issues are the focus. This can lead to difficult decision making for the health workers involved in care. The paper uses a case study approach to examine the ethical and legal issues surrounding euthanasia. The dilemma under discussion involves a quadriplegic patient who wished to commit suicide by refusing nutrition. The discussion offered centres around the principles of beneficence, non-maleficence and autonomy in relation to whether it was morally or legally appropriate to intervene with this patient's wishes by artificial feeding. Conclusions and recommendations are offered.     

Applying aspects of educational psychology to the practice of nurse teaching

One of the many facets of educational psychology to which the nurse teacher should give consideration is the nature of human knowledge. An individual interacting with his environment forms ideas or concepts which coalesce to create a mental organisation, or ‘conceptual framework’, that is unique to that individual. The nurse teacher takes account of this uniqueness of such a framework by assessing the conceptual position occupied by each of his learners, and by adapting his teaching strategies accordingly. Failure to do this can result in the inadequate learning of new ideas or concepts, in particular complex concepts such as are found in nursing. With reference to certain of the literature it is shown that the direct teaching of concepts does not occur, while the effectiveness of active learner participation is demonstrated as aiding the ‘personalisation’ of newly offered concepts, which then become truly part of the learner's conceptual framework.     

A model for estimating incremental benefits and costs of testing donated blood for human immunodeficiency virus antigen (HIV-Ag)

We propose a model for estimating the benefit of adding a test for the human immunodeficiency virus antigen (HIV-Ag) to current procedures for testing donated blood. Using this model, data on HIV infection from published studies, and certain assumptions about blood donor behavior, we estimate that the probability of detecting an additional HIV-infective blood component is approximately 1 in 4,860,000. If this estimate is correct, adding HIV-Ag testing would prevent approximately 4 cases of primary transfusion-transmitted HIV infection annually in the United States. After adjustments for the median incubation period for AIDS, and for mortality due to primary illnesses, this estimate represents prevention of approximately 1 case of AIDS per year, within the 4 years after transfusion. A primary advantage of this model is its adaptability for recalculating cost-benefit analyses if more sensitive tests for HIV infection become available. In addition, we propose that comparing the anticipated costs and benefits of HIV-Ag testing to other possible uses of these funds should be an important factor in assessing the desirability of HIV-Ag testing.