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In order to elucidate the mechanism of angiotensin II (ANG II)-induced proliferation in vascular smooth muscle cells in culture, growth rates and 3H-thymidine incorporation into DNA in response to ANG II treatment were examined in cultured rat aortic smooth muscle cells. ANG II-treated and control cells were exposed to the ANG II receptor antagonists [Sar1, Val5, Ala8]-ANG II (Sar) and DUP753 and to antibody against platelet-derived growth factor (PDGF). In growing cells, ANG II acted as a moderate mitogen, inducing an increase in growth rate during the first two days of treatment. ANG II induced a marked increase in 3H-thymidine incorporation in cultured vascular smooth muscle cells. The effect was blocked by the ANG II inhibitors Sar and DUP753 and by the PDGF antibody. ANG II was able to stimulate vascular smooth muscle growth in cell culture. The effect seemed to be mediated, at least in part, by PDGF. These results are in agreement with a possible role of ANG II in promoting vascular growth in physiological and/or pathological situations.

Acknowledging unexpressed aspects of an organisation's culture and ethos when working with supervisees enriches the supervision process and supports both the counsellor and the client. [ABSTRACT FROM AUTHOR]

BackgroundThe general practitioner's (GP) role in advance care planning is commonly tied to their knowledge of the patient and the family, but with limited attention to the nature of this knowing or the expectations it may give rise to (2012). GPs are often involved in advance care planning with the aim of having the patient complete formal documentation (2012). This paper proposes a broader role for the GP based on findings from a PhD study exploring older people's understandings of decision making in incompetence.AimTo explore patient's understanding of the GP's role in decision making in incompetence.MethodsIn-depth interviews with 19 people, aged ≥65 years, recruited from five general practices analysed using Giligan's (Gilligan et al., 2006) listening guide.ResultsParticipants distinguished between their GP and other doctors. Participants described their relationship with their GP as grounds for providing the GP with a distinct role in the event of their future incompetence. Participants expected this relationship to inform the way their GP approached advance care planning.DiscussionParticipants expected the GP to have a richer role reflective than they are commonly provided. Relational ethics and the concept of ‘generalism’ provide a theoretical basis for expanding the GP's role.ConclusionCurrent characterisations of the GP's role overlook much of what they can bring to the process of advance care planning.