Antitumor activity of the tea polyphenol epigallocatechin-3-gallate encapsulated in targeted vesicles after intravenous administration

The therapeutic potential of epigallocatechin gallate, a green tea polyphenol with anti-cancer properties, is limited by its inability to specifically reach tumors following intravenous administration. The purpose of this study is to determine whether a tumor-targeted vesicular formulation of epigallocatechin gallate would suppress the growth of A431 epidermoid carcinoma and B16-F10 melanoma in vitro and in vivo. Transferrin-bearing vesicles encapsulating epigallocatechin gallate were intravenously administered to mice bearing subcutaneous A431 and B16-F10 tumors. The intravenous administration of epigallocatechin gallate encapsulated in transferrin-bearing vesicles resulted in tumor suppression for 40% of A431 and B16-F10 tumors. Animal survival was improved by more than 20 days compared to controls. Encapsulation of epigallocatechin gallate in transferrin-bearing vesicles is a promising therapeutic strategy

Exploring wind-driving dust species in cool luminous giants I. Basic criteria and dynamical models of M-type AGB stars

This work is part of an ongoing effort aiming at identifying the actual wind-drivers among the dust species observed in circumstellar envelopes. In particular, we focus on the interplay between a strong stellar radiation field and the dust formation process. To identify critical properties of potential wind-driving dust species we use detailed radiation-hydrodynamical models which include a parameterized dust description, complemented by simple analytical estimates to help with the physical interpretation of the numerical results. The adopted dust description is constructed to mimic different chemical and optical dust properties in order to systematically study the effects of a realistic radiation field on the second stage of the mass loss mechanism. We see distinct trends in which combinations of optical and chemical dust properties are needed to trigger an outflow. Dust species with a low condensation temperature and a NIR absorption coefficient that decreases strongly with wavelength will not condense close enough to the stellar surface to be considered as potential wind-drivers. Our models confirm that metallic iron and Fe-bearing silicates are not viable as wind-drivers due to their near-infrared optical properties and resulting large condensation distances. TiO2 is also excluded as a wind-driver due to the low abundance of Ti. Other species, such a SiO2 and Al2O3, are less clear-cut cases due to uncertainties in the optical and chemical data and further work is needed. A strong candidate is Mg2SiO4 with grain sizes of 0.1-1 micron, where scattering contributes significantly to the radiative acceleration, as suggested by earlier theoretical work and supported by recent observations.Comment: 15 pages, 12 figure

An exploratory Interpretative Phenomenological Analysis (IPA) of childbearing women's perceptions of risk associated with having a high Body Mass Index (BMI)

Background: In 2016, the World Health Organization (WHO) labelled 13% of the world's adult population as obese. This increase in obesity is accompanied by mortality and morbidity problems, with maternal obesity and its accompanying risk for mother and infant requiring to be carefully managed.Aim: To explore childbearing women with a high BMI (>35kg/m2) perceptions of risk and its potential impacts upon pregnancy and outcome.Method: Qualitative Interpretative Phenomenological Analysis (IPA) was used to gain deeper understanding of the lived experiences of childbearing women with a BMI>35kg/m2 and perceptions of their risk and potential pregnancy outcome.Findings: One of the superordinate themes that emerged was (1) Risk or no risk, and its associated three subthemes of (1a) Emotional consequences of her risky position, (1b) Recognition of high-risk complications finally sinking in, and (1c) Accepting the risk body.Recommendations for practice: In general, health care professionals are uncomfortable about discussing obesity-associated risks with pregnant women. The participants in this study did not classify themselves as obese, with this absence of acknowledgement and 'risky talk' leaving participants' unaware of their obesity-associated risk. This downplaying of obesity related talk requires to be corrected, simply because women in denial will perceive no need to engage with health promotion messages. In response, directives are required to be embedded into policy and practice.Conclusion: Specific training is required to teach maternity care professionals how to have difficult, sensitive conversations about obesity related risks with childbearing women with high BMI's. In addition, this risk information needs to be accompanied by relevant advice and support

Reflective evaluations of perinatal bereavement care provision in the US and UK: an exploratory qualitative comparative study

There is increased recognition of the need to improve standards of perinatal bereavement care, due to its frequency and potential sequelae. As part of a Fulbright Scholar award, United States (US) and United Kingdom (UK) researchers collaborated to explore similarities and differences in perinatal bereavement care between two nations. Using an explorative qualitative comparative method, key categories within perinatal bereavement provision were identified and analysed. Themed findings include: (1) Differences in definitions of miscarriage and stillbirth impact care pathways; (2) For the experiencer grief is the same regardless of legal lines drawn; (3) The meaning of loss is personal and ‘fetal personhood’ needs to be acknowledged during care; (4) Appropriate psychological care is required whether miscarriage or stillbirth is experienced. We conclude that perinatal bereavement care should include screening for Postnatal Depression (PND) and Post-Traumatic-Stress-Disorder (PTSD), and support should be equally available to all women who experience perinatal bereavement, irrespective of type of loss. Acknowledging that cultures react to loss in different ways, we recommend that strategies are developed to build human resilience. For example, Compassionate-Mind-Training (CMT), which helps people cope with trauma through cultivating compassion and teaching self-care strategies to build resilience, reduce self-criticism, and decrease threat-based emotions

Midwives' role in screening for antenatal depression and postnatal depression

This is an educational paper which aims to inform midwives of tools available to help them make appropriate provisional diagnosis of perinatal depression. A second aim of the paper is to increase midwives' awareness of the relatively newer diagnosis of antenatal depression (AND). Of additional clinical importance, midwives need to recognise that postnatal depression (PND) may be a continuation of AND. To date, screening for AND has received relatively little attention compared with PND, with the evidence-base supporting that the impact can be as severe. It is important for midwives to know that screening for AND can be undertaken using valid and reliable psychometric self-report depression screening questionnaires which have known validity characteristics and threshold cut-off scores. There are several of these tools available to help midwives make the decision about whether or not to refer the women to the mental health team. Current practice in the UK involves the midwife asking an initial short two-item ‘Whooley Question’ screen which, if indicates depression, can be followed up by the women completing a self-report depression screening questionnaire. To highlight their availability, a selection of valid and reliable psychometric self-report depression screening questionnaires are discussed herein, with it being important for midwives to develop a toolkit that can be given to women at clinics, in pamphlets, online or embedded into mobile applications

Teaching Compassionate Mind Training to help midwives cope with traumatic clinical incidents

Compassionate Mind Training (CMT) is taught to cultivate compassion and teach midwives how to care for themselves. The need to build midwives' resilience is recognised by the Nursing and Midwifery Council (NMC), who advocate that mental health coping strategies be embedded into the midwifery curriculum. In this respect, CMT can be used as a resilience-building method to help midwives respond to self-criticism and threat-based emotions with compassion. The underpinnings of CMT involve understanding that people can develop cognitive biases or unhelpful thinking patterns, co-driven by an interplay between genetics and the environment. Within this paper, the underpinning theory of CMT and how it can be used to balance psychological threat, drive, and soothing systems are outlined. To contextualise the application to midwifery practice, a traumatic incident has been discussed. Teaching CMT has the potential to improve professional quality of life, and reduce midwife absence rates and potential attrition from the profession

Optimising the continuity experiences of student midwives: an integrative review

Background: In several countries, midwifery students undertake continuity of care experiences as part of their pre-registration education. This is thought to enable the development of a woman-centred approach, as well as providing students with the skills to work in continuity models. A comprehensive overview of factors that may promote optimal learning within continuity experiences is lacking.Aim: To identify barriers and facilitators to optimal learning within continuity experiences, in order to provide a holistic overview of factors that may impact on, modify and determine learning within this educational model.Methods: An integrative literature review was undertaken using a five-step framework which established the search strategy, screening and eligibility assessment, and data evaluation processes. Quality of included literature was critically appraised and extracted data were analysed thematically.Findings: Three key themes were identified. A central theme was relationships, which are instrumental in learning within continuity experiences. Conflict or coherence represents the different models of care in which the continuity experience is situated, which may conflict with or cohere to the intentions of this educational model. The final theme is setting the standards, which emerged from the lack of evidence and guidance to inform the implementation of student placements within continuity experiences.Conclusion: The learning from continuity experiences must be optimised to prepare students to be confident, competent and enthusiastic to work in continuity models, ultimately at the point of graduation. This will require an evidence-based approach to inform clear guidance around the intent, implementation, documentation and assessment of continuity experiences