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A study of the perceptions of selected small Massachusetts manufacturers toward exporting.
Interventions to reduce physical restraints in general hospital settings: a scoping review of components and characteristics.
Abraham J, Hirt J, Kamm F, Möhler R. Interventions to reduce physical restraints in general hospital settings: a scoping review of components and characteristics. Journal of clinical nursing. 2020.AIMS AND OBJECTIVES: To describe the characteristics of interventions for reducing physical restraints in general hospital settings.; BACKGROUND: Physical restraints, such as bedrails and belts in beds and chairs, are commonly used in general hospital settings. However, there is no clear evidence on their effectiveness but some evidence on potential risks for harm.; DESIGN: Scoping review.; METHODS: We conducted a systematic database search (MEDLINE via PubMed, CINAHL, Cochrane Library; April 2019) and snowballing techniques. We included both interventional studies and quality improvement projects conducted in general hospital settings and published in English or German language. Two reviewers independently performed the study selection and data extraction. The Scoping Reviews (PRISMA-ScR) Checklist was used.; RESULTS: We included 31 articles (published between 1989 and 2018), 15 quality improvement projects and 16 intervention studies. Only five studies used a controlled design. Most studies and quality improvement projects investigated multi-component interventions including education (predominantly for nursing staff) and additional components (e.g. case conferences). Three studies examined simple educational programmes without additional components.; CONCLUSIONS: A large number of multi-component interventions for preventing and reducing physical restraints in general hospital settings have been developed. The interventions differed widely regarding the components, contents and settings. Well-designed evaluation studies investigating the effects of such interventions are lacking. Relevance to Clinical Practice Multi-component educational interventions might be one approach to change clinical practice, but only insufficient information is available about potential effects of these approaches. This article is protected by copyright. All rights reserved
Interventions to reduce physical restraints in general hospital settings: A scoping review of components and characteristics
EXPORT PERFORMANCE AND FOREIGN MARKET INFORMATION: RELATIONSHIPS FOR SMALL HIGH-TECHNOLOGY FIRMS
A novel CXCL10-based GPI-anchored fusion protein as adjuvant in NK-based tumor therapy
BACKGROUND: Cellular therapy is a promising therapeutic strategy for malignant diseases. The efficacy of this therapy can be limited by poor infiltration of the tumor by immune effector cells. In particular, NK cell infiltration is often reduced relative to T cells. A novel class of fusion proteins was designed to enhance the recruitment of specific leukocyte subsets based on their expression of a given chemokine receptor. The proteins are composed of an N-terminal chemokine head, the mucin domain taken from the membrane-anchored chemokine CX3CL1, and a C-terminal glycosylphosphatidylinositol (GPI) membrane anchor replacing the normal transmembrane domain allowing integration of the proteins into cell membranes when injected into a solid tumor. The mucin domain in conjunction with the chemokine head acts to specifically recruit leukocytes expressing the corresponding chemokine receptor. METHODOLOGY/PRINCIPAL FINDINGS: A fusion protein comprising a CXCL10 chemokine head (CXCL10-mucin-GPI) was used for proof of concept for this approach and expressed constitutively in Chinese Hamster Ovary cells. FPLC was used to purify proteins. The recombinant proteins efficiently integrated into cell membranes in a process dependent upon the GPI anchor and were able to activate the CXCR3 receptor on lymphocytes. Endothelial cells incubated with CXCL10-mucin-GPI efficiently recruited NK cells in vitro under conditions of physiologic flow, which was shown to be dependent on the presence of the mucin domain. Experiments conducted in vivo using established tumors in mice suggested a positive effect of CXCL10-mucin-GPI on the recruitment of NK cells. CONCLUSIONS: The results suggest enhanced recruitment of NK cells by CXCL10-mucin-GPI. This class of fusion proteins represents a novel adjuvant in cellular immunotherapy. The underlying concept of a chemokine head fused to the mucin domain and a GPI anchor signal sequence may be expanded into a broader family of reagents that will allow targeted recruitment of cells in various settings