Health Care and Social Service Providers' Descriptions of Pacific Islander Mothers' Breastfeeding Patterns

Introduction: Despite recommendations and numerous health benefits attributed to breastfeeding, rates in the United States are below desired levels, particularly within vulnerable populations. In Hawaí, breastfeeding rates are higher than national averages except in Native Hawaiian and other Pacific Islander populations. Health care and social service providers are integral to successful breastfeeding promotion efforts. They are in an ideal position to reflect on the context in which their clients live and on its relationship to breastfeeding activities. The aim of this study was to describe health care and social service providers' perceptions of the influences on the breastfeeding patterns of Pacific Islander women. Methods: Focus ethnographic methods were used to collect interview data from health care and social service providers (N = 20) serving Native Hawaiian and Pacific Islander women in one rural community. An iterative analysis process of coding and categorizing, followed by conceptual abstraction into patterns, was completed. Results: Four patterns emerged: shaped by connections, lived unfamiliarity, stressed by circumstance, and missed opportunities. Participants' insights concerning the needs of this population yielded population‐specific issues and health care system issues affecting breastfeeding promotion. A number of gaps in breastfeeding services were identified. Discussion: Sociocultural, maternal knowledge, and workload barriers to successful breastfeeding predominated providers' perspectives. Broader system and community level issues were implied, but not directly addressed. The nature of successful breastfeeding support and promotion requires inclusion of this broader level perspective. J Midwifery Womens Health 2010;55:162–170 c̊ 2010 by the American College of Nurse‐Midwives.     

Opposite effect of stable transfection of bioactive transforming growth factor-β1 (TGFβ1) versus exogenous TGFβ1 treatment on expression of 92-kDa type iv collagenase in mouse skin squamous cell carcinoma CH72 cells

We have previously shown that transforming growth factor-β1 (TGFβ1) mRNA is consistently overexpressed in squamous cell carcinomas relative to normal mouse skin. Here we show that 92-kDa type IV collagenase (matrix metalloproteinase) (MMP-9) mRNA was likewise progressively overexpressed during mouse skin carcinogenesis. To determine if overexpression of MMP-9 and TGFβ1 are linked, we stably transfected a bioactive TGFβ1 into a mouse skin squamous cell carcinoma cell line (CH72), which resulted in about twofold to threefold higher levels of secreted active TGFβ1. Active TGFβ1–transfected cells grew only slightly, but not significantly, more slowly in vitro and in vivo than vector-only transfectants. Two clones overexpressing active TGFβ1 secreted much reduced levels of MMP-9 activity, as determined by zymogram analyses. However, treatment of these clones with 40 pM exogenous TGFβ1 for 48 h enhanced secretion of MMP-9 activity. Constitutive mRNA expression of MMP-9 was reduced twofold to 70-fold in five untreated active TGFβ1–transfected clones relative to the other transfectants. In contrast, treatment with 40 pM exogenous TGFβ1 induced MMP-9 mRNA expression in a time-dependent fashion, from twofold to fourfold after 4 h to a maximum of 12- to 19-fold after 24–48 h. Induction of MMP-9 mRNA was dose dependent at TGFβ1 concentrations of 4–400 pM. Thus, stable transfection of bioactive TGFβ1 downregulated whereas exogenous TGFβ1 treatment upregulated MMP-9 activity and expression. Treatment of transfectants with a neutralizing TGFβ1 antibody slightly downregulated constitutive MMP-9 mRNA (20–30%) but completely blocked induction by exogenous TGFβ1. Thus, the effect of TGFβ1 transfection was not due to secreted TGFβ1 but may have been a secondary effect. Mol. Carcinog. 19:122–136, 1997. © 1997 Wiley-Liss, Inc.     

Uncoordinated regulation of mRNA expression of the three isoforms of transforming growth factor-β in the mouse skin carcinogenesis model

The mRNA expression and autoregulation of expression of the three isoforms of transforming growth factor-β (TGFβ) were examined in the mouse skin carcinogenesis model by northern analyses. We found that TGFβ3 mRNA levels followed a pattern similar to those of TGFβ1 during carcinogenesis: the levels were somewhat low in normal skin but became highly overexpressed in late-stage papillomas and squamous cell carcinomas (15- to 20-fold higher than in normal skin). On the other hand, the TGFβ2 mRNA levels remained relatively low in all benign and malignant tumors, even though the levels were higher than the nearly undetectable levels in normal skin. In a squamous cell carcinoma cell line (CH72), stable transfection and expression of a mutated simian TGFβ1 cDNA producing bioactive TGFβ1 significantly downregulated (mean greater than tenfold) TGFβ2 mRNA levels and modestly downregulated (about twofold) murine TGFβ1 expression but had no effect on TGFβ3 mRNA. In contrast, treatment of all CH72 clones with exogenous TGFβ1, TGFβ2, or TGFβ3 either had no effect or slightly downregulated TGFβ1 mRNA, upregulated TGFβ2 mRNA expression an average of twofold to threefold, and strongly upregulated (mean 13- to 27-fold) TGFβ3 mRNA levels. TGFβ treatment of primary cultures of mouse skin keratinocytes upregulated all three TGFβ mRNA levels slightly to moderately (1.3- to 5-fold). Thus, although TGFβ1 and TGFβ3 mRNA expressions were apparently coordinately upregulated during mouse skin carcinogenesis, the three TGFβ mRNAs were differentially regulated by stable transfection of active TGFβ1 versus exogenous TGFβ treatment in CH72 cells and by TGFβ treatments of normal keratinocytes versus carcinoma CH72 cells. Mol. Carcinog. 18:115–126, 1997. © 1977 Wiley-Liss, Inc.     

Effects of two different methods of non-surgical periodontal therapy on patient perception of pain and quality of life: a randomized controlled clinical trial

BACKGROUND: The purpose of this study was to investigate the effect of two modes of delivery of non-surgical periodontal therapy on patient experience of pain and oral health-related quality of life (OHQoL). METHODS: Fifty-nine patients with mild to moderate periodontitis received non-surgical therapy using a piezo-ceramic device (n = 30) or curets (n = 29). Periodontal examinations were carried out at baseline and 8 weeks following therapy. Subjects completed the short-form McGill pain questionnaire, visual analog scales regarding sensitivity and satisfaction, and the United Kingdom OHQoL questionnaire (OHQoL-UK) at baseline, treatment, and 1, 4, and 8 weeks. RESULTS: Both groups showed improvements in clinical parameters with no significant differences between the groups. Pain scores and OHQoL-UK showed no significant differences between the groups. After treatment, OHQoL-UK scores improved from an initially negative effect on quality of life to a level of no effect. Differences in sensitivity scores between the groups were statistically significant at 1 week (P = 0.011), 4 weeks (P = 0.005), and 8 weeks (P = 0.025), favoring the use of the piezo-ceramic device. CONCLUSIONS: In mild to moderate periodontitis, therapy had a small positive impact on pain and OHQoL-UK scores. These data support the concept that periodontitis may negatively affect a patient's quality of life and that treatment may improve it.     

The pathogenesis of pterygium: current concepts and their therapeutic implications

Pterygium is a disease of the ocular surface that is associated with chronic UV exposure and is characterized by proliferation, inflammatory infiltrates, fibrosis, angiogenesis and extracellular matrix breakdown. Although pterygium is not fully understood, significant progress has been made toward understanding the mechanisms involved in its pathogenesis. In this review, we provide an update on the signaling pathways activated by UV light that result in induction of mediators responsible for the growth of pterygium. We also review the recent genetic studies on hereditary factors and provide a brief overview of the role of epithelial mesenchymal transition, bone marrow progenitor cells, and neuronal signals that may also contribute to the pathogenesis of pterygium. Therapeutic options for pterygium are discussed based on the mechanisms that perpetuate its growth.     

Nutritional risk and low weight in community-living older adults: a review of the literature (1995-2005)

Although many studies have examined weight loss and low weight in institutionalized persons, there has been little research exploring the community-living older adult's nutritional risk. The purpose of this literature review (1995-2005) is to describe our current understanding of nutritional risk and low weight in community-living older adults 65 years old and older. Computerized database searches and footnote reviews were used to find published studies on nutritional risk and low weight. Twenty-two research articles are reviewed and summarized. Each study was reviewed according to preset criteria.