Bakgrund Tidigare studier visar att preoperativ oro och rädsla är vanligt förekommande bland barn. Maktlöshet och känslan av att förlora kontrollen är vanliga känslor hos barn som står inför en operation. Oron och rädslan påverkas också av att barn ofta har svårt att förstå operationsprocessen som de ska genomgå. Därför är det av vikt att öka kunskapen om vad som kan minska dessa känslor och lugna barnen i denna fas. Syfte Syftet med denna litteraturöversikt var att beskriva vad som kan minska barns oro och rädsla i den preoperativa fasen. Metod En strukturerad litteraturöversikt med inslag av den metodologi som används vid systematiska översikter. Resultatet baserades på 16 kvantitativa artiklar som kvalitetsgranskats och analyserats. Resultat I resultatet identifierades två huvudkategorier; information och distraktion, med underkategorierna skärmabaserad information, information i pappersform, informativ lek, musik som distraktion och lek som distraktion. Slutsats Resultatet visar exempel på omvårdnadsåtgärder och interventioner som har visat sig ha god effekt på barns preoperativa oro och rädsla. Information är en väsentlig del av förberedelsen av barn inför operation, och ges i fördel i olika format på ett anpassat sätt. Att distrahera barn genom musik och olika typ av lek är också en effektiv metod för att lugna barn inför operation. / Background Previous studies show that preoperative anxiety and fear is common among children. The feeling of powerlessness and losing control are common feelings in children facing surgery. The anxiety and fear is also affected by the fact that children often have difficulty understanding the surgical process that they are about to undergo. Therefore, it is important to have knowledge of what can reduce these feelings and calm the children in this phase. Aim The aim of this literature review was to describe what can reduce children’s anxiety and fear in the preoperative period. Method A structured literature review with elements of the methodology used in systematic reviews. The result was based on 16 quantitative articles that were quality reviewed and analyzed. Results In the result, two main categories were identified; information and distraction, with the subcategories screen-based information, paper-based information, informative play, music as distraction, and play as distraction. Conclusions The results show examples of nursing measures and interventions that have been shown to have a good effect on children´s preoperative anxiety and fear. Information is an essential part of preparing children for surgery and is preferably provided in various formats in an age-appropriate manner. Distracting children through music and different types of play is also an effective method to calm children before surgery.

Bakgrund: Palliativ vård innefattar vård i livets slutskede utifrån ett holistiskt synsätt på patienten och vård ges utifrån symptomlindring, samarbete, kommunikation och närståendestöd för att lindra det totala lidandet. Inom grundutbildningen för sjuksköterskor ingår verksamhetsförlagd utbildning, dock i olika omfattningar beroende på lärosäte. Färdiga sjuksköterskor förväntas kunna mildra det totala lidandet. Sjuksköterskestudenter känner sig oförberedda, både teoretiskt och praktiskt, för att möta patienten i livets slutskede och ge en värdig vård. Syfte: Syftet var att beskriva sjuksköterskestudenters erfarenheter av att vårda patienter i livets slutskede. Metod: En allmän litteraturöversikt har genomförts där nio kvalitativa artiklar samt två kvantitativa artiklar har analyserats. Resultat: Analysen av de elva artiklarna resulterade i fem områden Betydelsen av förberedelse, kommunikation, stöd från kollegor, att våga möta sina känslor samt betydelsen av god vårdrelation. Slutsats: Sjuksköterskestudenter erfar kunskapsbrister inom palliativ vård, som är komplext och kräver erfarenhet för att tillhandahålla god vård. Studenter har känslomässigt svårt att hantera utmaningar som uppstår vid palliativ vård, samt adekvat förberedelse från sjuksköterskeutbildningen kan skapa förutsättningar för god palliativ vård. / Background: Palliative care involves end-of-life care based on a holistic approach to the patient, focusing on symptom relief, collaboration, communication, and support for family members to alleviate overall suffering. In nursing education, practical training is included, varying in extent depending on the institution. Registered nurses are expected to alleviate overall suffering. Nursing students often feel unprepared, both theoretically and practically, to encounter patients at the end of life and provide dignified care. Objective: To describe nursing students' experiences of caring for palliative patients at the end of life. Method: A general literature review was conducted, analyzing nine qualitative articles and two quantitative articles. Results: The analysis of the 11 articles resulted in five areas: the importance of preparation, communication, support from colleagues, the courage to face one's emotions, and the importance of a good care relationship. Conclusion: Nursing students experience knowledge gaps in palliative care, which is complex and requires experience to provide quality care. Students emotionally struggle to handle challenges in palliative care, and adequate preparation in nursing education can create conditions for good palliative care."

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Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

No / Chemotherapeutic agents induce p53-dependent apoptosis in the hair follicle (HF) resulting in hair loss, a common side effect of cancer therapy. Here, we show that Fas as a p53 target plays important role in the HF response to cyclophosphamide. Specifically, we demonstrate that Fas is up-regulated in HF keratinocytes after cyclophosphamide treatment, Fas ligand-neutralizing antibody partially inhibits HF response to cyclophosphamide in wild-type mice, and Fas knockout mice show significant retardation of cyclophosphamide-induced HF involution associated with reduced Fas-associated death domain and caspase-8 expression. These data raise a possibility to explore blockade of Fas signaling as a part of complex local therapy for inhibiting keratinocyte apoptosis and hair loss induced by chemotherapy.

Die Identifizierung von Apoptose-modifizierten Proteinen erfolgte durch Proteomanalyse per 2D-Gelelektrophorese und Massenspektrometrie. Zunächst wurde eine 2DE-Datenbank errichtet, die im Internet zugänglich ist. Die Identifikation von Proteinen durch Peptidmassenfingerabdruck konnte durch Verwendung einer zweiten Matrix verbessert werden. Die Analyse ausgelassener tryptischer Spaltstellen, N-terminaler Pyroglutamatbildung und Oxidation von Tryptophan konnte die Identifikation von Proteinen mittels Peptidmassenfingerabdruck verbessern. Die Apoptose wurde über den Fas-Rezeptor-Signalweg oder durch DNA-Schädigung mittels Cis-Platin eingeleitet und das Totallysat oder die Kompartimente von Jurkat T-Zellen der Proteomanalyse unterworfen. Große Übereinstimmungen der beiden Prozesse wurden festgestellt. 95 Apoptose-modifizierte Proteine wurden identifiziert, wovon 78 Proteine bisher unbekannt für den Apoptoseprozess waren. Auffällig war, dass 40 % der Proteine RNA-Bindungsmotive enthielten und das 21 Onkoprotein oder Onkoprotein-interagierende Proteine identifiziert wurden. Für 39 Proteine konnten bisher proteolytische Spaltungen vorausgesagt werden. Eine Fülle von Informationen wurde über putative Translokationen der Proteine erhalten. Für das Protein p54nrb wurden drei Caspase-3 Spaltstellen durch die Einführung von Mutationen und die Abhängigkeit der Caspase-3 Spaltung von RNA bewiesen. Mitochondriale ribosomale Proteine von Mensch, Maus und Ratte wurden durch Abgleichung von EST-Datenbanken mit partiellen Aminosäuresequenzen aus dem Rind bestimmt. Die Konservierung der Sequenzen der Säugetierproteine der mitochondrialen ribosomalen Proteinen war geringer als von den bekannten cytosolischen ribosomalen Proteinen. Weiterhin wurden unterschiedliche Ergebnisse bzgl. der mitochondrialen Signalsequenzen der Proteine gefunden. RNA-Protein-Wechselwirkungen im Ribosom wurden nach Quervernetzung auf einzelne Aminosäuen bzw. Nukleotide bestimmt. Die Daten wurden zur Verbesserung von ribosomalen Modellen verwendet. Die mittlerweile erhaltenen Kristallstrukturen des Ribosoms zeigten, dass die Ergebnisse der Quervernetzungsexperimente mit den tatsächlichen RNA-Protein-Wechselwirkungen weitgehend übereinstimmen. Die Affinität von verschiedenen Komponenten zu einem Zielmolekül zur Bildung von nicht-kovalenten RNA-Peptid-Wechselwirkungen wurde mit Hilfe von MALDI-MS ermittelt. Die Interaktionen sind stark abhängig von der Anzahl der Arginine. / Apoptosis-modified proteins were identified by proteome analysis via 2D gel electrophoresis and mass spectrometry. First, a internet-accessible 2DE database was rendered. The identification of the proteins by peptide mass fingerprinting was improved using a second matrix. The analysis of missed tryptic cleavage sites, the formation of N-terminal pyroglutamine and oxidation of tryptophan could improve the identification of proteins by peptide mass fingerprinting. Apoptosis was induced via the Fas-receptor signaling pathway or by means of DNA damage by cis-platin. The total lysate and the compartments of Jurkat T cells were analyzed by proteome analysis. High similarities between both processes were observed. 95 apoptosis-modified proteins were identified, 78 of these were until now unknown to be involved in apoptosis. Noticeable, 40% of the proteins include a RNA-binding motif and 21 oncogene or oncogene-interacting proteins were identified. A proteolytic cleavage could be predicted for 39 proteins. Some information was received about the putative translocation of the proteins. Three caspase-3 cleavage sites were shown for the protein p54nrb with the incorporation of mutations. Furthermore, the caspase-3 cleavage was dependent on the occurrence of RNA. Mitochondrial ribosomal proteins of human, mouse and rat were determined by screening of EST-databases with partial amino acid sequences from bovine. The conservation of sequences of mammalian proteins of the mitochondrial ribosomal proteins was less than for known cytosolic ribosomal proteins. Furthermore, different results were obtained considering mitochondrial signal sequences. RNA-protein interaction within the ribosome were determined on single amino acids and nucleotides, respectively, after cross-linking. These data were used to improve models of the ribosome. The in the meantime obtained 3D-structures of the ribosome showed high consistency with the revealed RNA-protein interaction sites after cross-linking. The affinity of different components to a target molecule to form RNA-peptide interactions was determined by MALDI-MS. The interactions were strongly dependent on the number of arginines.

A exocitose de grânulos secretórios é o principal mecanismo efetor de células TCD8+. No entanto, pouco se sabe sobre a composição dos grânulos líticos dessas células. Resultados prévios do nosso grupo identificaram algumas dezenas de novas proteínas desses grânulos. Dentre elas foi identificada Gal-1. A literatura relata que Gal-1 age por via exógena através de sua secreção por via não convencional. Dados iniciais do nosso grupo apontam um novo cenário para esta proteína no qual ela está presente em grânulos citotóxicos. Através das técnicas de microscopia eletrônica e confocal e de ensaios de citotoxicidade, nossos resultados sugerem que Gal-1 participa do papel citotóxico das CTLs modulando a via dos receptores de morte FAS-FASL. Nós também mostramos que Gal-1 interfere com o tempo de contato entre APCs e linfócitos TCD8+, com a ativação dessas células e com o controle da proliferação dos linfócitos. Nossos resultados apontam um novo cenário para Gal-1, no qual ela está presente em grânulos líticos das CTLs e está relacionada a resposta efetora dessas células. / Exocytosis of secretory granules is the main effector mechanism of CD8+ T cells. In particular, little is known about CTLs lytic granules composition. Previous results from our group identified a few dozens of new proteins associated with these granules. Among them, we identified galectin-1. Literature reports the extracellular action of Gal-1. Initial data from our group suggested a new scenario for this protein, since Gal-1 was found inside cytotoxic granules. Here, we show by transmission electron and confocal laser scanning microscopy and cytotoxicity assays that Gal-1 has a role on CTL killing probably mediating the FAS-FASL pathway. We also show that Gal-1 is regulates the time of contact between APCs and TCD8+ lymphocytes, the activation of APCs and the proliferation of CD8 T cells. Taken together, our findings suggest a new scenario, in which Gal-1 is present in CTL granules and participates in cytotoxic effector response.