The synthesis of peptide and lipid analogues incorporating very hydrophobic α-aminoalkanoic acids

The application of a series of α-aminoalkanoic acids to the synthesis of a novel phospholipase A2 analogue and a new class of very hydrophobic LHRH peptides is described. The racemic α-aminodecanoic α-aminotetradecanoic and α-aminoeicosanoic acids were synthesised and resolved with the chiral ketol (-)-(1S,2S,5S)-2-hydroxypinan-3-one as the methyl ester hydrochlorides. In addition, the two lower homologues were enzymatically resolved with renal acylase I and leucine aminopeptidase respectively. These enzymes could not resolve the higher homologue. Designation of the absolute configuration of the resolved amino acid derivatives was made with CD spectroscopy by comparison with enzymatically resolved amino acid. Both N and C protected DL-α-aminoalkanoic acids were used to synthesise phospholipids in an attempt to obtain non-hydrolysable substrate analogues of phospholipase A2 for active site protection. The design of the synthesis permitted the resolution of phosphorylated intermediates with the chiral ketol. Several very hydrophobic LHRH analogues were also synthesised incorporating the very hydrophobic α-aminoalkanoic acids. These peptides were synthesised as part of our studies in peptide drug delivery of analogues with enhanced membrane adhesion and permeability. These properties could ultimately determine the design of analogues for oral administration

The problem of death: a challenge for nursing students

Η διεργασία του θανάτου και η απώλεια της ανθρώπινης ζωής αποτελεί για τους λειτουργούς της υγείας ίσως την μεγαλύτερη πρόκληση που έχουν να αντιμετωπίσουν κατά την άσκηση των καθηκόντων τους. Στην χώρα μας το θέμα αυτό παίρνει ιδιαίτερες διαστάσεις, αφού εξακολουθεί να αντιμετωπίζεται σε μεγάλο βαθμό σαν θέμα ταμπού. Η διαχρονικότητα του προβλήματος και η δυσκολία που παρουσιάζεται στην αντιμετώπισή του με ώθησε στην επιλογή του θέματος αυτού. Σκοπός της παρουσίασης αυτής είναι η διερεύνηση των παραμέτρων που διέπουν την φροντίδα ασθενών που βρίσκονται στο τελικό στάδιο της ζωής τους, δίνοντας έμφαση στις περιπτώσεις που την φροντίδα αναλαμβάνουν φοιτητές της Νοσηλευτικής. Η εστίαση της μελέτης αυτής δεν εντοπίζεται τόσο στον ασθενή που βιώνει την διεργασία του θανάτου, όσο στα προβλήματα εκείνα που παρεμβάλλονται στην ολιστική προσέγγιση του ατόμου από τους φοιτητές της Νοσηλευτικής. Οι παράμετροι αυτοί αναλύονται σε σχέση με το νοσηλευτικό πρόγραμμα εκπαίδευσης, τους νοσηλευτικούς εκπαιδευτές και το μόνιμο προσωπικό στις διάφορες μονάδες. Προσωπικές εμπειρίες καθώς και εμπειρίες άλλων συναδέλφων μαζί με την σχετική βιβλιογραφία χρησιμοποιούνται για να υποστηριχθούν οι θέσεις που τίθενται από την εργασία αυτή. Στο τέλος της παρουσίασης γίνεται μια ανακεφαλαίωση των απόψεων που έχουν συζητηθεί και συγχρόνως γίνεται εξαγωγή των ανάλογων συμπερασμάτων. Βιβλιογραφική υποστήριξη των συμπερασμάτων επιχειρείται κι εδώ με σκοπό την εξεύρεση των αποδοτικότερων μεθόδων και προσεγγίσεων προς αντιμετώπιση και εξεύρεση διεξόδου στους φοιτητές οι οποίοι βρίσκουν συχνά τους εαυτούς τους παγιδευμένους σε διάφορα στρεσσογόνα περιστατικά που προκαλεί η διεργασία του θανάτου και η απώλεια της ανθρώπινης ζωής

Listening to the voices of patients with cancer and their nurses : a hermeneutic phenomenological approach to quality nursing care

The purpose of the thesis is to illuminate the meaning of quality nursing care in the three major inpatient cancer care centres in Cyprus as seen from the standpoint of patients with cancer, patients' advocates and nurses. The data are based on: a) interviews (narratives) with 25 patients with cancer and two focus groups b) a focus group with patients' advocates and c) interviews with 20 nurses working in the cancer care departments. . . The rational for this study echoed a conceptualisation problem among patients, nurses and patients' advocates in relation to quality nursing care. The different interpretations held by the informants around this issue often creates problems of communication and understanding between nurse-patients and between nurses-patients' advocates. It also prevents a commonly shared concept to be adopted in the clinical setting. In order to investigate this issue, a philosophical approach was adopted based on the philosophy of Paul Ricoeur and using the "lived experiences" of the informants as the basis of the investigation. The data were analysed using a hermeneutic phenomenological approach based on Ricoeur's interpretation theory but modified to suit the nursing paradigm. What stands out from the study is the overlapping of the patients', patients' advocates and the nurses' experiences of quality nursing care. Based on the attributes that the informants have used to interpret the concept of quality nursing care, a shared understanding of the concept materialised. This shared understanding formed the basis for developing a theory of quality nursing care. Simultaneously, the study reinforced the importance of "getting the basics right" for providing quality nursing care to patients with cancer. Based on the informants' lived experiences a set of guidelines of best practice were developed, as a means for influencing nursing practice.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Cancer Related Fatigue and Quality of Life in Patients with Advanced Prostate Cancer Undergoing Chemotherapy

Cancer related fatigue (CRF) is a common and debilitating symptom that can influence quality of life (QoL) in cancer patients. The increase in survival times stresses for a better understanding of how CRF affects patients’ QoL. This was a cross-sectional descriptive study with 148 randomly recruited prostate cancer patients aiming to explore CRF and its impact on QoL. Assessments included the Cancer Fatigue Scale, EORTC QLQ-C30, and EORTC QLQ-PR25. Additionally, 15 in-depth structured interviews were performed. Quantitative data were analyzed with simple and multiple regression analysis and independent samples -test. Qualitative data were analyzed with the use of thematic content analysis. The 66.9% of the patients experienced CRF with higher levels being recorded for the affective subscale. Statistically significant differences were found between the patients reporting CRF and lower levels of QoL (mean = 49.1) and those that did not report fatigue and had higher levels of QoL (mean = 72.1). The interviews emphasized CRF’s profound impact on the patients’ lives that was reflected on the following themes: “dependency on others,” “loss of power over decision making,” and “daily living disruption.” Cancer related fatigue is a significant problem for patients with advanced prostate cancer and one that affects their QoL in various ways.</p

Guided Imagery And Progressive Muscle Relaxation as a Cluster of Symptoms Management Intervention in Patients Receiving Chemotherapy: A Randomized Control Trial.

Patients receiving chemotherapy often experience many different symptoms that can be difficult to alleviate and ultimately negatively influence their quality of life. Such symptoms include pain, fatigue, nausea, vomiting and retching, anxiety and depression. There is a gap in the relevant literature on the effectiveness of cognitive-behavioural and relaxation techniques in symptom clusters. The study reflects this gap in the literature and aimed to test the effectiveness of Guided Imagery (GI) and Progressive Muscle Relaxation (PMR) on a cluster of symptoms experienced by patients undergoing chemotherapy. This was a randomized control trial with 208 patients equally assigned either in the intervention or the control group. Measurements in both groups were collected at baseline and at completion of intervention (4 weeks). Patients were assessed for pain, fatigue, nausea, vomiting and retching, anxiety and depression. The overall management of the cluster was also assessed based on the patients' self-reported health related quality of life-HRQoL. Chi-square tests (X2), independent T-tests and Linear Mixed Models were calculated. Patients in the intervention group experienced lower levels of Fatigue (p<0.0.0225), and Pain (p = 0.0003) compared to those in the control group and experienced better HRQoL (p<0.0001) [PRE-POST: Pain 4.2(2.5) - 2.5(1.6), Fatigue 27.6(4.1) - 19.3(4.1), HRQoL 54.9(22.7) - 64.5(23), CONTROL: Pain 3.5(1.7) - 4.8(1.5), Fatigue 28.7(4.1) - 32.5(3.8), HRQoL 51.9(22.3)- 41.2(24.1)]. Nausea, vomiting and retching occurred significantly less often in the intervention group [pre-post: 25.4(5.9)- 20.6(5.6) compared to the control group (17.8(6.5)- 22.7(5.3) (F = 58.50 p<0.0001). More patients in the control group (pre:n = 33-post:n = 47) were found to be moderately depressed compared to those in the intervention group (pre:n = 35-post:n = 15) (X2 = 5.93; p = 0.02). This study provided evidence that the combination of GI and PMR can be effective in the management of a cluster of symptoms in cancer patients receiving chemotherapy. These techniques can complement existing management measures to achieve a comprehensive management of this symptom cluster and increase patients HRQoL. ClinicalTrials.gov NCT01275872. OBJECTIVE METHODS RESULTS INTERVENTION CONCLUSION TRIAL REGISTRATIO

Supporting the spirituality of older people living with dementia in nursing care: A hermeneutic phenomenological inquiry into older people's and their family members' experiences

Background: Supporting spirituality is an essential aspect of the holistic nursing care of older people living with dementia. Spirituality is defined as a search for answers to questions about the meaning and purpose of life and the individual's relationship with the sacred or transcendent. This relationship may or may not involve an affiliation with a specific religion.Objective: To understand how older people living with dementia and their family members experience spirituality and its support in nursing care.Design: A qualitative study informed by the principles of Ricoeurian hermeneutic phenomenology.Settings: We conducted the study in home care and long-term care settings in Southern Finland.Participants: We collected data between 2017-2020 from a purposive sample of 10 older people living with dementia and their 9 family members (n = 19).Methods: We used interviews to collect data and adapted and used Ricoeur's theory of interpretation as a method for analysis.Results: The findings of this study show that older people living with dementia need spiritual support in nursing care based on their personal understanding of spirituality. The four elements of this spirituality that emerged were: religion, meaningful relationships, nature, and art. The participants addressed some challenges to spiritual support in the nursing care of older people living with dementia including: the competence and abilities of nursing, time available, presence and experience.Conclusions: Older people living with dementia and their family members consider spiritual support an important aspect of nursing care. To support the spirituality of these older people, the elements of spirituality need to be understood as these are central to each person's spiritual position. Additionally, spiritual support requires understanding knowledge, experience, time and presence, to manage all four elements with individuals

Associations of individualized nursing care and quality oncology nursing care in patients diagnosed with cancer

PurposeTo assess patients’ diagnosed with cancer perceptions on individualized nursing care and quality of oncology nursing care in Cyprus.MethodsThis was a descriptive correlational research with 150 patients diagnosed with cancer and receiving treatment as in-patients at three different urban hospitals of Cyprus, based on predetermined inclusion and exclusion criteria. Data were collected with the Individualized Care Scale-ICS and the Quality Oncology Nursing Care Scale-QONCS. Statistical significance was set at the 0.05 level.ResultsData showed that a medium level of support of patients’ individuality was provided by nurses (ICS-A mean = 3.41, SD = 0.98) and a high level of realization of perceived individuality in the provided care. Quality of oncology nursing care was found high on three dimensions of care, i.e. being supported and confirmed, being respected and having a sense of belonging. A statistically significant positive correla-tion was observed between the two scales of ICS, i.e. ICS-A and ΙCS-B (r = 0.80), and four of the dimensions of QONCS, i.e. “Being supported and confirmed”, “Being cared for religiously and spiritually”, “Sense of Belonging” and “Being respected” and all the subscales, i.e. Clinical Situation (r = 0.45, 0.27, 0.41, 0.42), Personal life sit-uation (r = 0.30, 0.51, 0.44, 0.35) and Decision control (r = 0.35, 0.46, 0.35, 0.40). Conclusion The correlations found between individualized care and quality of oncology nursing care, highlight the need to provide a more personalized nursing care as a means to achieve a high level of quality nursing care </div