The Lactation Consultant as Public Health Practitioner

The lactation consultant (LC) profession is a relatively new one. The field has grown over the 2 past 25 years and, as a group, lactation consultants are trying to define their role in the healthcare team and the health system in general. As breastfeeding continues to emerge as an important public health benchmark and disease prevention strategy, the role of the lactation consultant stands to become more respected and diverse. The majority of those certified as lactation consultants come from clinical backgrounds and have most of their experience working one-on-one or in group settings with breastfeeding mothers and babies. While this will always be a large focus of the work of a lactation consultant, it is becoming increasingly evident that understanding and reducing the barriers to optimal breastfeeding is the most effective way of improving breastfeeding initiation and duration rates. Hospital, health insurance and employment policies as well as social norms and community health beliefs all impact a woman's decision to breastfeed and her chances of successfully meeting her goals once she starts. When a lactation consultant begins to look at the social, behavioral and environmental factors that impact breastfeeding practices within the community, she begins to act as a public health practitioner as well as a clinician. What is the potential role of the lactation consultant in helping to create and interpret policies and what skills will LCs need to have to be leaders in changing breastfeeding policy and the breastfeeding environment in the community?Master of Public Healt

High-Density Real-Time PCR-Based in Vivo Toxicogenomic Screen to Predict Organ-Specific Toxicity

Toxicogenomics, based on the temporal effects of drugs on gene expression, is able to predict toxic effects earlier than traditional technologies by analyzing changes in genomic biomarkers that could precede subsequent protein translation and initiation of histological organ damage. In the present study our objective was to extend in vivo toxicogenomic screening from analyzing one or a few tissues to multiple organs, including heart, kidney, brain, liver and spleen. Nanocapillary quantitative real-time PCR (QRT-PCR) was used in the study, due to its higher throughput, sensitivity and reproducibility, and larger dynamic range compared to DNA microarray technologies. Based on previous data, 56 gene markers were selected coding for proteins with different functions, such as proteins for acute phase response, inflammation, oxidative stress, metabolic processes, heat-shock response, cell cycle/apoptosis regulation and enzymes which are involved in detoxification. Some of the marker genes are specific to certain organs, and some of them are general indicators of toxicity in multiple organs. Utility of the nanocapillary QRT-PCR platform was demonstrated by screening different references, as well as discovery of drug-like compounds for their gene expression profiles in different organs of treated mice in an acute experiment. For each compound, 896 QRT-PCR were done: four organs were used from each of the treated four animals to monitor the relative expression of 56 genes. Based on expression data of the discovery gene set of toxicology biomarkers the cardio- and nephrotoxicity of doxorubicin and sulfasalazin, the hepato- and nephrotoxicity of rotenone, dihydrocoumarin and aniline, and the liver toxicity of 2,4-diaminotoluene could be confirmed. The acute heart and kidney toxicity of the active metabolite SN-38 from its less toxic prodrug, irinotecan could be differentiated, and two novel gene markers for hormone replacement therapy were identified, namely fabp4 and pparg, which were down-regulated by estradiol treatment