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PURPOSE/OBJECTIVES: To investigate whether differences in age and death rates exist between hospitalized Asian/Pacific Islander American (APIA) women and women of other racial groups. DESIGN: Secondary data analysis of a national data set. SETTING: The Healthcare Cost and Utilization Project Nationwide Inpatient Sample, Release 6, was used to obtain hospitalization data on women with breast cancer based on racial status. A total of 20,507 hospitalization records met the study criteria. SAMPLE: All women who were hospitalized with a primary diagnosis of breast cancer, were older than 18, and did not die during hospitalization, plus all women who met the criteria stated above but died during hospitalization. METHODS: Secondary data analysis. Post hoc analysis was used to identify significant differences among racial groups. FINDINGS: Significant differences were found between APIA and Caucasian and Latino women. Significant differences based on race were found between subjects who had died during hospitalization. On average, APIA women were the youngest to die. CONCLUSIONS: APIA women with breast cancer were among the youngest women being hospitalized and the youngest to die during hospitalization. IMPLICATIONS FOR NURSING: Cultural awareness by nurses is critical when discussing methods for prevention and early detection of breast cancer with minority women. Targeting new immigrants is a priority for those who screen and educate women about detection and treatment of breast cancer. [Abstract for this article also available on page 689 of printed version. Full article available at www.ons.org/xp6/ONS/Library.xml/ONS_Publications.xml/ONF.xml [ABSTRACT FROM AUTHOR]

Objective: Guided by theoretical and empirical work attesting to the health benefits of social connections, we tested whether Internet connectivity, and training in its use for social purposes, can support the well-being of older adults receiving care., Method: Participants ( N = 76) were randomly assigned to receive 3 months training versus care-as-usual. Cognitive and mental health were assessed before and after the intervention., Results: Results show significant cognitive improvements across time in the training, but not control, group. This effect was mediated through a combination of increased social activity, improved self-competence, and maintained personal identity strength. Indirect effects on mental health outcomes via these processes were also observed., Discussion: These findings suggest that Internet access and training can support the self and social connectedness of vulnerable older adults and contribute positively to well-being.

The purpose of this study was to examine the impact of race on length of hospital stay (LOS) and number of procedures on elderly persons hospitalized with chronic heart failure (CHF). Secondary data analysis was used to obtain data on 99,543 hospitalized Medicare patients with CHF age 65 years or older. MANOVA was utilized to examine the effects of race, age, and total hospital charges on LOS, number of procedures, and diagnosis. Asian American Pacific Islanders had significantly higher number of procedures and LOS compared to Whites. The combined dependent variables were significantly affected by race, F(9, 99,543) = 121.95, p =.000; the covariates of age, F(3, 99,543) = 720.65, p =.000; and total charges F(3, 99,543) = 38,962.95, p =.000. LOS accounted for 50% of the variance. Studies that examine cultural variables and their effect on LOS and number of procedures are needed.

Concentrations of GDP, which are expected to bind to the catalytic site and inhibit the autophosphorylation of succinyl-CoA synthetase (SCS) when NTP is used as a substrate, were found to increase the level of phosphoenzyme formed. The ability of GDP to do so is dependent upon the presence of a protein distinct from SCS. The effector protein could be separated from SCS by ammonium sulfate fractionation. Reconstitution experiments show that the protein inhibits SCS, that the inhibition is relieved by GDP, and that the inhibitor recognizes both Escherichia coli and eukaryotic forms of SCS. The inhibitor is itself regulated by the conditions used to grow the bacteria and in a manner that appears distinct from that of SCS., (Copyright 1997 Academic Press.)

The relationship among stress, age, and social support was explored in 30 women scheduled for a breast biopsy. Stress was determined using the State Trait Anxiety Inventory. Social support strength and network size were measured using the Norbeck Social Support Questionnaire in this correlational study. Findings demonstrated that women do experience stress before their biopsies. Stress was also found to have a negative correlation with social support strength. Moreover, although statistically insignificant, these women tended to have increased stress with aging until age 40, then stress decreased with increasing age. Additional research should replicate the natural age division of < or = 40 years and > 40 years in a larger sample of women. Advanced practitioners are ideally suited to affect patient outcomes by providing social support. This social support could consist of facilitated support groups or access to the information needed by women during this stressful diagnostic experience.

We have isolated and characterized a genomic fragment and a cDNA clone for the alpha subunit of succinyl-CoA synthetase (SCS) from Dictyostelium discoideum. The coding region predicts a protein of 310 amino acids. Direct amino acid sequence data indicate that the first 16 amino acids encoded by the cDNA comprise a mitochondrial targeting sequence. The predicted molecular mass of the mature protein is 31 kDa on sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The deduced amino acid sequence of the alpha subunit from D. discoideum shows 75% identity to that from rat liver, which represents a GTP-utilizing form of SCS, and 62% identity to the Escherichia coli protein, which is an ATP-utilizing form. We have previously shown that the enzyme purified from growing D. discoideum is a GTP-utilizing enzyme. In D. discoideum, the alpha subunit is a single copy gene that is developmentally regulated. Highest levels of its mRNA are seen in growing cells, which is followed by a relatively dramatic decline at the time cells complete their aggregation program. In contrast, the level of the protein, as determined by Western blots, remains unchanged throughout development. This indicates that any developmental changes in SCS activity reflect changes in the availability of its substrates or effectors and not changes in the level of enzyme.

The heart functions as an endocrine organ, releasing atrial natriuretic peptide (ANP), a hormone, in response to sodium and fluid overload. Specifically, ANP is released by cardiac myocytes in response to atrial distension. As a hormone, ANP has far-reaching multiorgan effects. The body systems affected include the cardiovascular, renal, neural, gastrointestinal, and endocrine systems. However, the main effects of this hormone are on the renin-angiotensin-aldosterone system. ANP acts to oppose this system by causing vasorelaxation, blocking the secretion and sodium-retaining effects of aldosterone, and inhibiting renal renin secretion. ANP has many potential implications for clinical practice in both short-term and long-term care of patients with fluid and electrolyte balance. Clinicians may use methods to enhance or block endogenous ANP secretion based on assessment of clinical disorder, cause, status of homeostatic mechanisms, and implications for treatment. In addition, ANP may soon be administered pharmacologically, as well as monitored hematologically, in patients with fluid volume overload. In this article we describe the physiologic effects of ANP and address specific implications for clinical practice.