Humoral Response to the Influenza A H1N1/09 Monovalent AS03-Adjuvanted Vaccine in Immunocompromised Patients

In this observational study, safety and immunogenicity after one dose of the AS03-adjuvanted influenza H1N1/09 vaccine was overall appropriate in HIV-infected patients and solid-organ transplant recipients. A second dose of the vaccine only moderately improved the antibody respons

Thymic Selection Generates a Large T Cell Pool Recognizing a Self-Peptide in Humans

The low frequency of self-peptide–specific T cells in the human preimmune repertoire has so far precluded their direct evaluation. Here, we report an unexpected high frequency of T cells specific for the self-antigen Melan-A/MART-1 in CD8 single–positive thymocytes from human histocompatibility leukocyte antigen-A2 healthy individuals, which is maintained in the peripheral blood of newborns and adults. Postthymic replicative history of Melan-A/MART-1–specific CD8 T cells was independently assessed by quantifying T cell receptor excision circles and telomere length ex vivo. We provide direct evidence that the large T cell pool specific for the self-antigen Melan-A/MART-1 is mostly generated by thymic output of a high number of precursors. This represents the only known naive self-peptide–specific T cell repertoire directly accessible in humans

CCL19 and CCR7 Expression, Signaling Pathways, and Adjuvant Functions in Viral Infection and Prevention.

Chemokine (C-C motif) ligand 19 (CCL19) is a critical regulator of the induction of T cell activation, immune tolerance, and inflammatory responses during continuous immune surveillance, homeostasis, and development. Migration of CC-chemokine receptor 7 (CCR7)-expressing cells to secondary lymphoid organs is a crucial step in the onset of adaptive immunity, which is initiated by a complex interaction between CCR7 and its cognate ligands. Recent advances in knowledge regarding the response of the CCL19-CCR7 axis to viral infections have elucidated the complex network of interplay among the invading virus, target cells and host immune responses. Viruses use various strategies to evade or delay the cytokine response, gaining additional time to replicate in the host. In this review, we summarize the impacts of CCL19 and CCR7 expression on the regulation of viral pathogenesis with an emphasis on the corresponding signaling pathways and adjuvant mechanisms. We present and discuss the expression, signaling adaptor proteins and effects of CCL19 and CCR7 as these molecules differentially impact different viral infections and viral life cycles in host homeostatic strategies. The underlying mechanisms discussed in this review may assist in the design of novel agents to modulate chemokine activity for viral prevention

Developing a business strategy to support the international expansion of a European business firm : facts, trends and considerations

The purpose of this research paper is to explore the business strategy development and implementation process behind a firm’s international expansion, and to identify the core components that need to be considered in order for the expansion process to be successful over time. The study particularly focuses on European businesses and their motivations for wishing to expand globally, driven by the recent declining growth and fading competitiveness of the European markets. Through analysis of established literature and recent case studies, the research paper will explore the following five factors, proposed to be of vital importance to the expansion process: business climate; developing a global marketing strategy; regionalization; social entrepreneurship and product diversification. At its end, the study discusses three main activities of importance for the expansion process: to analyze the competitive environment, to clearly define the firm’s position, and to develop their competitive and corporate advantages. It also concludes in a series of basic questions that a firm’s expansion team will have to ask itself, emphasizing the need for planning and research in order to ensure the greatest chance of success in international expansion processes.M-Ø

Nurses\u27 construction of clinical situations: A study conducted in an acute-care setting in Norway

The purpose of this study was to describe the nature of clinical constructions that nurses make in their practice. The study was based on a qualitative descriptive design in an acute-care setting in Norway with a convenience sample of 6 registered nurses providing direct patient care. These nurses were considered typical staff nurses working in acute-care settings. Data were collected through observation of and in-depth interviews with participants during 3 full shifts for each nurse and also from nursing documents regarding the patients. Qualitative data analyses were carried out using a method that coalesces analyses of the parts with analysis of the whole. The findings revealed that nurses encounter patients and provide direct care by formulating pictures of encountered clinical situations with a specific way of seeing, which the authors conceptualize as a comprehensive nursing gaze. This nursing gaze was the basis upon which the nurses arrived at clinical constructions. There is a need for further research to investigate how nurses differentiate the significance of information in arriving at clinical constructions, and to investigate aspects of the nursing gaze in various clinical settings

Nursing gaze as framework for nursing practice: a study from acute care settings in Korea, Norway and the USA

The aim of the study was to investigate the nature of nurses' clinical practice in terms of what frames their clinical engagement, and to examine how clinical constructions were made. The study is based on a descriptive design using a clinical field approach in acute care settings in Korea, the USA and Norway. A theoretical sample consisted of between four and six Registered Nurses in each country: up to three from medical wards and three from surgical wards. Data were collected through participant observation of and in-depth interviews with the nurses, as well as from nursing documentation about the patients. The result showed an overall model of a theory of nursing practice consisting of three processes: nursing gaze, clinical construction and clinical engagement. This first article outlines the overall descriptive theory of nursing practice and provides a detailed description of the first aspect: the nursing gaze. The model of the structuring of nursing gaze is set within the philosophy of nursing, consisting of the ontology of client and the ontology of practice. The dimensions of normality and needs constitute the ontology of client, and the dimension of clinical expectations constituted the ontology of practice

Clinical constructions by nurses in Korea, Norway, and the United States

Nursing practice involves engagement of nurses in clinical fields through deliberation and enactment. In the phase of deliberation, nurses observe, recognize, form ideas about and decide on clinical situations, and construct clinical pictures. Clinical pictures are critically connected to nursing enactments, thus it is important to discover how nurses arrive at clinical pictures. The purpose of this article is to describe how nurses construct meanings of clinical situations and arrive at specific clinical pictures. The results are from a clinical fieldwork study replicated in Korea, Norway, and the United States, with samples of nurses working in acute-care hospitals. Data were collected through participant observations and in-depth interviews. A general model of clinical construction was derived from the results, which specifies four dimensions (i.e., problem, progress, status, and particularism) as the bases for clinical picture evocations. Clinical pictures are constituted by nurses' elicitations of meanings of clinical situations on these dimensions