The Dutch Objective Burden Inventory:Validity and reliability in a Canadian population of caregivers for people with heart failure

Evidence suggests that caregivers of people with heart failure (HF) often experience caregiver burden and emotional distress. However, these studies measured the caregiving experience using generic tools since a disease-specific tool was not available. Recently, the Dutch Objective Burden Inventory (DOBI) was developed as a disease-specific tool measuring objective caregiver burden in a Dutch HF population of caregivers. Using a cross-sectional design, caregivers of HF patients attending an outpatient HF clinic completed the DOBI, the Hosptial Anxiety and Depression Scale (HADS) and the Caregiver Reaction Assessment (CRA). Caregivers (n=47) were mainly female (72%) and spouses (72%) of the HF patients with a mean age of 63.1 (+/-10.4) years. Patients were older (mean age 72.7; +/-10.6), 64% male and had advanced HF. Feasibility for the objective portion of the DOBI was excellent with .80 for all DOBI subscales. The DOBI is the only disease-specific tool that measures burden for caregivers of HF patients. The objective portion of the DOBI showed evidence of adequate internal consistency and construct validity in a Canadian population of caregivers of HF patients attending a HF Clinic. Further testing is needed to determine floor and ceiling effects for DOBI items and responsiveness of this tool. (C) 2010 European Society of Cardiology. Published by Elsevier B.V. All rights reserved

New Family of Tungstate-Responsive Transcriptional Regulators in Sulfate-Reducing Bacteria

The trace elements molybdenum and tungsten are essential components of cofactors of many metalloenzymes. However, in sulfate-reducing bacteria, high concentrations of molybdate and tungstate oxyanions inhibit growth, thus requiring the tight regulation of their homeostasis. By a combination of bioinformatic and experimental techniques, we identified a novel regulator family, tungstate-responsive regulator (TunR), controlling the homeostasis of tungstate and molybdate in sulfate-reducing deltaproteobacteria. The effector-sensing domains of these regulators are similar to those of the known molybdate-responsive regulator ModE, while their DNA-binding domains are homologous to XerC/XerD site-specific recombinases. Using a comparative genomics approach, we identified DNA motifs and reconstructed regulons for 40 TunR family members. Positional analysis of TunR sites and putative promoters allowed us to classify most TunR proteins into two groups: (i) activators of modABC genes encoding a high-affinity molybdenum and tungsten transporting system and (ii) repressors of genes for toluene sulfonate uptake (TSUP) family transporters. The activation of modA and modBC genes by TunR in Desulfovibrio vulgaris Hildenborough was confirmed in vivo, and we discovered that the activation was diminished in the presence of tungstate. A predicted 30-bp TunR-binding motif was confirmed by in vitro binding assays. A novel TunR family of bacterial transcriptional factors controls tungstate and molybdate homeostasis in sulfate-reducing deltaproteobacteria. We proposed that TunR proteins participate in protection of the cells from the inhibition by these oxyanions. To our knowledge, this is a unique case of a family of bacterial transcriptional factors evolved from site-specific recombinases