Peptide-induced coalescence of bicellar lipid assemblies: sensitivity to anionic lipid and peptide properties

Bicellar lipid mixture dispersions progressively coalesce to larger structures on warming. This phase behaviour is particularly sensitive to interactions that perturb bilayer properties. In this study, ²H NMR was used to study the perturbation of bicellar lipid mixtures by two peptides (SP-B₆₃₋₇₈, a lung surfactant protein fragment and Magainin 2, an antimicrobial peptide) which are structurally similar. Particular attention was paid to the relation between peptide-induced perturbation and lipid composition. In bicellar dispersions containing only zwitterionic lipids (DMPC-d₅₄/DMPC/DHPC (3:1:1)) both peptides had little to no effect on the temperature at which coalescence to larger structures occurred. Conversely, in mixtures containing anionic lipids (DMPC-d₅₄/DMPG/DHPC (3:1:1)), both peptides modified bicellar phase behaviour. In mixtures containing SP-B₆₃₋₇₈, the presence of peptide decreased the temperature of the ribbon-like to extended lamellar phase transition. The addition of Magainin 2 to DMPCd₅₄/ DMPG/DHPC (3:1:1) mixtures, in contrast, increased the temperature of this transition and yielded a series of spectra resembling DMPC/DHPC (4:1) mixtures. Additional studies of lipid dispersions containing deuterated anionic lipids were done to determine whether the observed perturbation involved a peptide-induced separation of zwitterionic and anionic lipids. Comparison of DMPC/DMPG-d₅₄/DHPC (3:1:1) and DMPC-d₅₄/DMPG/DHPC (3:1:1) mixtures showed that DMPC and DMPG occupy similar environments in the presence of SP-B₆₃₋₇₈, but different lipid environments in the presence of Magainin 2. This might reflect the promotion of anionic lipid clustering by Magainin 2. These results demonstrate the variability of mechanisms of peptide-induced perturbation and suggest that lipid composition is an important factor in the peptide-induced perturbation of lipid structures.

The transition experience for registered nurses new to case management in the community

Case management is increasingly being used within today‟s healthcare system in an effort to reduce healthcare costs while meeting the complex needs of populations within the community. Registered nurses (RNs) are often recruited for the role of case managers in the community because of their specific skill set and ability to navigate the healthcare system. There is a vast amount of literature related to the client and system benefits of case management, the roles and responsibilities of RN case managers, and job satisfaction among RN case managers. However, there is a literature gap noted in relation to the transition experience for RNs new to case management in the community setting. This research study used grounded theory methodology, guided by Glaser and Strauss (1967) to explore the process of RNs transitioning to case management in the community setting. Eleven RNs new to case management in the community were interviewed using semi-structured interviews. Data analysis was carried out using the constant comparative method. Three stages of adjusting to case management in the community were identified: slugging it out, seeing the job as it is, and finding the way. By gaining an understanding of this transition experience, recommendations for nursing practice and administration, education, and research that are based on the evidence from this study can be implemented to improve the transition experience for RNs new to case management in the community setting