Highly sensitive interleukin 6 detection by employing commercially ready liposomes in an LFA format.

Recent years have confirmed the ubiquitous applicability of lateral flow assays (LFA) in point-of-care testing (POCT). To make this technology available for low abundance analytes, strategies towards lower limits of detections (LOD), while maintaining the LFA's ease of use, are still being sought. Here, we demonstrate how liposomes can significantly improve the LOD of traditional gold nanoparticle (AuNP)-based assays while fully supporting a ready-to-use system for commercial application. We fine-tuned liposomes towards photometric and fluorescence performance on the synthesis level and applied them in an established interleukin 6 (IL-6) immunoassay normally using commercial AuNP labels. IL-6's low abundance (< 10 pg mL-1) and increasing relevance as prognostic marker for infections make it an ideal model analyte. It was found that liposomes with a high encapsulant load (150 mmol L-1 sulforhodamine B (SRB)) easily outperform AuNPs in photometric LFAs. Specifically, liposomes with 350 nm in diameter yield a lower LOD even in complex matrices such as human serum below the clinically relevant range (7 pg mL-1) beating AuNP by over an order of magnitude (81 pg mL-1). When dehydrated on the strip, liposomes maintained their signal performance for over a year even when stored at ambient temperature and indicate extraordinary stability of up to 8 years when stored as liquid. Whereas no LOD improvement was obtained by exploiting the liposomes' fluorescence, an extraordinary gain in signal intensity was achieved upon lysis which is a promising feature for high-resolution and low-cost detection devices. Minimizing the procedural steps by inherently fluorescent liposomes, however, is not feasible. Finally, liposomes are ready for commercial applications as they are easy to mass-produce and can simply be substituted for the ubiquitously used AuNPs in the POCT market.

Socio-demographic and motivational correlates of smoking status at term and postpartum.

BACKGROUND: Tobacco consumption during pregnancy has consequences for pregnant women and their fetus, as well as during the postnatal period. Many women stop their tobacco consumption during pregnancy, but statistics vary about the exact proportion, and a non-negligible number of them are still smoking at term. Moreover, tobacco relapse after birth is frequent. This study aims to provide epidemiological indicators about tobacco consumption at term and post-partum relapse in Switzerland, and test risks factors associated with tobacco consumption at term, including Theory of Planned Behaviour variables for the motivational correlates. Losses to follow-up precluded testing risk factors associated with post-partum relapse. PARTICIPANTS AND PROCEDURE: Respondents were recruited at the pre-birth consultations at the hospital and answered the initial survey. They were contacted by email in the post-partum period two and six months after childbirth. RESULTS: 10.6% of our sample were still smoking at the end of their pregnancy. The low-end estimate of relapse is 21.2% at two months (the high-end estimate being 74% after six months, using the worst-case scenario). Higher education level, income, and multiparity were descriptively associated with less tobacco consumption at term. Perceived behavioural control was the motivational variable differing the most between smokers and non-smokers, and with the broadest variance. Scores of attitudes and subjective norms had higher levels and were more consensual. CONCLUSIONS: Incidence of tobacco consumption during pregnancy and during the post-partum period is problematic in Switzerland. One promising avenue is increasing pregnant women's perceived behavioural control toward smoking cessation during pregnancy and long-term abstinence.

Psychological predictors of the use of complementary and alternative medicines during pregnancy within a sample of Swiss women.

Past works have witnessed increased prevalence of complementary and alternative medicines (CAM) among women during pregnancy. This study aimed to identify psychological antecedents underlying CAM use through the exploration of various predictors. Drawing upon the literature on the use of CAM in contexts unrelated to pregnancy, this research explored the role of various predictors: perceived stress, beliefs about medicine, health locus of control (HLOC), health literacy, bullshit receptivity, and belief in conspiracy theories (CT). 376 Swiss women were recruited to complete a web-based questionnaire in which the use of different kinds of CAM was investigated. We performed hierarchical regression analyses with backward method to assess the overall variance explained by the predictors, as well as their unique contributions. We measured the number of CAM used during last pregnancy and frequency of use. Analyses showed that CAM use was positively associated with perceived stress, beliefs about medicine, internal HLOC, and belief in CT. In contrast, negative relationships were found with external HLOC, bullshit receptivity, and health literacy. By illuminating such factors, this research contributed to explaining why women may be tempted to choose CAM in place of conventional medicine, which may be of particular interest for health professionals in the planning of communication strategies aimed at limiting risks associated to their use during pregnancy.

Cationic liposomes for generic signal amplification strategies in bioassays.

Liposomes have been widely applied in bioanalytical assays. Most liposomes used bare negative charges to prevent non-specific binding and increase colloidal stability. Here, in contrast, highly stable, positively charged liposomes entrapping the fluorescent dye sulforhodamine B (SRB) were developed to serve as a secondary, non-specific label' and signal amplification tool in bioanalytical systems by exploiting their electrostatic interaction with negatively charged vesicles, surfaces, and microorganisms. The cationic liposomes were optimized for long-term stability (> 5 months) and high dye entrapment yield. Their capability as secondary, non-specific labels was first successfully proven through electrostatic interactions of cationic and anionic liposomes using dynamic light scattering, and then in a bioassay with fluorescence detection leading to an enhancement factor of 8.5 without any additional surface blocking steps. Moreover, the cationic liposomes bound efficiently to anionic magnetic beads were stable throughout magnetic separation procedures and could hence serve directly as labels in magnetic separation and purification strategies. Finally, the electrostatic interaction was exploited for the direct, simple, non-specific labeling of gram-negative bacteria. Isolated Escherichia coli cells were chosen as models and direct detection was demonstrated via fluorescent and chemiluminescent liposomes. Thus, these cationic liposomes can be used as generic labels for the development of ultrasensitive bioassays based on electrostatic interaction without the need for additional expensive recognition units like antibodies, where desired specificity is already afforded through other strategies. Graphical abstract.

Positive Effects of Practical Nutrition Lessons in a Primary School Setting with a High Proportion of Migrant School Children.

BACKGROUND: Children with migration background are at increased risk for overweight, partly due to less favorable dietary habits compared to their German counterparts. We examined the effects of practical nutrition lessons among children with a high proportion of migration background in a primary school setting. METHODS: Ten 3rd and 4th grade classes (n=166 children, 73% with migration background) received the intervention and nine school classes (n=139 children, 76% with migration background) served as control. Before, shortly after (only among the intervention group) and three months after the three-day practical nutrition lessons, the nutrition-related skills, behavior, attitudes, and knowledge of the children were assessed using a questionnaire. Changes between baseline and 1st follow-up among children of the intervention group were calculated using linear mixed models. Differences between the two groups for changes between baseline and 2nd follow-up were tested using linear regression analyses. Models were adjusted for potential confounders. RESULTS: Shortly after the practical nutrition lessons, the children of the intervention group had improved their knowledge (ß=1.7; 95% CI: 1.0; 2.4, P<0.001) and skills (ß=1.8; 95% CI: 1.4; 2.2, P<0.001). These changes were sustainable and larger in the intervention compared to the control group (knowledge: ß=1.6; 95% CI: 0.7; 2.5, P<0.001; skills: ß=1.3; 95% CI: 0.7; 1.9, P<0.001). Changes in nutrition-related behavior and attitudes did not differ between the groups. CONCLUSIONS: Providing practical nutrition lessons in a primary school setting with a high proportion of children with immigrational background improved the children's nutrition-related knowledge and skills.

Human Papillomavirus Infection and Vaccination: Knowledge, Attitude and Perception among Undergraduate Men and Women Healthcare University Students in Switzerland.

Abstract: Background: Human Papillomavirus is a common sexually transmitted infection, representing the main cause of genital warts and cervical cancer. The objective of this study was to evaluate basic knowledge and beliefs regarding HPV infection and HPV vaccine among undergraduate healthcare men and women students, as well as their attitudes towards HPV vaccine. METHODS: Undergraduate women and men (nursing and midwifery curses) attending three Schools of Health Sciences located in Switzerland. A total of 427 women and 223 men have completed the web questionnaire, which included questions on their socio-demographic background and about basic knowledge and attitudes toward the HPV infection and vaccination. RESULTS: Women undergraduate students have a better knowledge of HPV infection than their men counterparts, although there was a significant gap in knowledge of the disease's mode of transmission and prevention. Among women, 72.6% of respondents reported having received at least one dose of HPV vaccines versus 31.4% for men respondents. CONCLUSION: The results of this study revealed a poor understanding among undergraduate healthcare men and women students about the HPV infection, its mode of transmission and its prevention. Our findings highlight the need to improve education on HPV for undergraduate healthcare students in order to increase the awareness of the disease.

Relationship between perceived perinatal stress and depressive symptoms, anxiety, and parental self-efficacy in primiparous mothers and the role of social support.

The aim of the authors in this study was to evaluate the relationships between perceived perinatal stress and social support to psychological health outcomes in mothers. A longitudinal, quantitative study was conducted in Geneva, Switzerland on 235 primiparous mothers from September 2010 to January 2012. Data were collected between gestational weeks 37 and 41 (T1), 2 days post-delivery (T2), and at 6 weeks postpartum (T3). Perinatal stress was associated with depressive symptoms (R2 = 0.223), anxiety (R2 = 0.242), and a low sense of parental self-efficacy (R2 = 0.21). However, satisfaction with social support moderated the relationship of stress to the health of mothers. In particular, the authors noted that the more women were provided with support from their partners, the less depressive symptoms and elevated levels of anxiety they reported, even under stressful conditions, while the satisfaction of support from their mothers boosted their sense of competency. Furthermore, satisfaction with emotional support from professionals tempered the stress during the post-partum period (∆R2 = 0.032; p < .05). The results revealed that perinatal stress was related to the psychological health of mothers, but social support may modulate these effects. A number of approaches could be implemented to manage this stress.

Determinants of Health Behaviors After Gestational Diabetes Mellitus: A Prospective Cohort Study in Geneva.

INTRODUCTION: Gestational diabetes mellitus (GDM) is one of the most common complications in pregnancy. The objective of this study was to specify the determinants of postpartum physical activity and dietary habits after a pregnancy complicated by GDM in a population of Swiss women. This information will be used to improve health promotion and diabetes prevention interventions for women with a history of GDM. METHODS: A prospective cohort study of 173 pregnant women with a diagnosis of GDM was carried out. Quantitative data were collected at the end of pregnancy (T1) and at 6 months postpartum (T3). Bivariate and multivariate logistic regression analysis was conducted to assess associations between the level of healthy lifestyle at 6 months postpartum, clinical and sociodemographic characteristics, motivation to adopt a healthy lifestyle after birth at the end of pregnancy, and postulated psychosocial correlates of health behaviors. RESULTS: Multivariate regression analysis showed that only 2 variables were determinants in a low adherence to healthy lifestyle in the postpartum period after GDM: a lower level of social support (odds ratio [OR], 1.5; P < .001) and more perceived barriers to a healthy lifestyle (OR, 1.2; P = .002). DISCUSSION: This study shows that, for women who had GDM, the problem of low adherence to a healthy lifestyle to prevent the onset of type 2 diabetes may be secondary to the lack of resources available for the promotion and development of healthy eating habits and regular physical activity. The findings of this study suggest that some women with a history of GDM do not have the means and resources in the postpartum period to apply the advice given during antenatal monitoring.

The role of satisfaction with social support on the psychological health of primiparous mothers in the perinatal period.

The aim of this study was to develop a satisfaction scale for social support and to investigate the relation of satisfaction with social support to the psychological health of primiparous mothers in terms of depressive symptoms, anxiety, and parental self-efficacy. We carried out a quantitative study during the last month of pregnancy (T1) and 6 weeks after birth (T2) including 235 mothers who were expecting their first child in Geneva (Switzerland) from September 2010 to April 2012. The satisfaction scale for social support revealed five sources of support (from the spouse, young woman's mother, family, friends, professionals), each associated with different types of support (i.e., emotional, esteem, material, and informative). This scale showed good internal consistency for each factor. Moreover, the results revealed a relationship between satisfaction with social support and the mental health of mothers, in particular in the postnatal period for depressive symptoms, anxiety, and self-efficacy. This study highlights the important role of social support and the scale specifically developed during this period is a useful tool to investigate this aspect.

Validation of the post-delivery perceived stress inventory.

This article presents the post-delivery perceived stress inventory (PDPSI) and its psychometric properties. This inventory is unique in that it links the measurement of perceived stress to events experienced during and after delivery. A total of 235 French-speaking, primiparous mothers completed the PDPSI two days after their delivery. To evaluate the predictive validity of the PDPSI on anxiety and depression, participants also completed the EPDS and the STAI two days and six weeks postpartum. The exploratory analysis revealed a 16-item structure divided into five factors: F1: relationship with the child; F2: delivery; F3: fatigue after delivery; F4: breastfeeding; and F5: relationship with the caregivers. The PDPSI demonstrated good internal consistency. Moreover, confirmatory factor analysis produced excellent indices, indicating that the complexity of the PDPSI was taken into account and its fit to the sample. The discriminant analysis showed that the PDPSI was not sensitive to specific changes in the sample making the inventory generalizable to other populations. Predictive validity showed that the scale significantly predicted depression and anxiety in the early postpartum period as well as anxiety six weeks postpartum. Overall, the PDPSI showed excellent psychometric qualities, making it a useful tool for future research-evaluating interventions related to perceived stress during the postpartum period.

Validation of the Antenatal Perceived Stress Inventory.

This article presents the Antenatal Perceived Stress Inventory. The originality of this scale is to assess the impact of events experienced during pregnancy on the stress perceived by mothers. Scale validation was performed using data from 150 French-speaking nulliparous mothers and collected between 36 and 39 weeks of gestation (T1), and between 2 days (T2) and 6 weeks postpartum (T3). Factor analysis revealed a hierarchical three-factor structure that closely fit the data, including medical and obstetric risks/fetal health (F1), psychosocial changes (F2), and the prospect of childbirth (F3). The Antenatal Perceived Stress Inventory is a valid French prenatal stress scale with good psychometric properties.

Validation of the postnatal perceived stress inventory in a French speaking population of primiparous women.

OBJECTIVE: To develop a Postnatal Perceived Stress Inventory (PNPSI) and assess its psychometric properties. DESIGN: Cross-sectional quantitative study. SETTING: One nurse-managed labor and delivery unit in a university hospital in a major metropolitan area. PARTICIPANTS: One hundred seventy-nine (179) primiparous French speaking women who gave birth at term. METHODS: The PNPSI was validated at 6 weeks postpartum. Its predictive validity for depression and anxiety was assessed at the same time. RESULTS: The exploratory analysis revealed a 19-item structure divided into six factors. This inventory has good internal consistency (Cronbach's alpha = .815). The predictive validity shows that the PNPSI significantly predicts depression and anxiety at 6 weeks postpartum, and that certain factors are particularly prominent. CONCLUSION: The PNPSI's psychometric properties make it a useful tool for future research to evaluate interventions for perceived stress during the postnatal period. Its predictive power for depression indicates that it is also a promising tool for clinical settings.

Impact of health beliefs, social support and self-efficacy on physical activity and dietary habits during the post-partum period after gestational diabetes mellitus: study protocol.

BACKGROUND: Gestational diabetes mellitus (GDM) is defined as a glucose intolerance of variable severity occurring or diagnosed for the first time during pregnancy. Numerous epidemiological studies show that this disorder affects between 1 and 18% of pregnancies, depending on the ethnicity of the populations studied, the diagnostic criteria, or the body mass index (BMI). Its incidence is constantly rising worldwide. Patients with GDM have a high risk of developing type 2 diabetes in the months after delivery. For this reason, GDM patients are encouraged to practice specific health behaviors (dietary habits, physical activity) during the postpartum period. It is important to identify the factors that may impact adherence to these behaviors. METHODS/DESIGN: A targeted sample size of 200 eligible pregnant women with a diagnosis of GDM will be enrolled in this prospective, cohort study. They will be recruited from 30-36 weeks of gestation as part of their diabetes consultation in Geneva University Hospital (GUH) maternity unit. Psychosocial variables that could impact adherence to health behaviors in the postpartum period (behavioral intentions, risk perceptions, general knowledge about diabetes, health beliefs, social support, self-efficacy) will be evaluated using specific tools at the end of pregnancy, at 6 weeks postpartum and at 6 months postpartum. Multiple regression analyses will be performed on SPSS. DISCUSSION: For the first time in Europe, the objective of this research is to study in women with very recent GDM the link between dietary habits, physical activity levels, and psychosocial and cognitive factors possibly involved in the adoption of health behaviors in the postpartum period. These factors have been identified in the literature, but to date have never been combined in a single study. The study will allow a predictive theoretical model of health behavior to be established and used as a basis for reflection to optimize interventions carried out on women who have had GDM.

A qualitative review of migrant women's perceptions of their needs and experiences related to pregnancy and childbirth.

AIM: A synthesis of the evidence of migrant women's perceptions of their needs and experiences in relation to pregnancy and childbirth. BACKGROUND: Despite the fact that all European Union member states have ratified human rights-based resolutions aimed at non-discrimination, there is a relationship between social inequality and access to pre-, intra-, and postpartum care. DESIGN: A qualitative systematic review of studies from European countries. DATA SOURCES: A search was made for relevant articles published between January 1996-June 2010. REVIEW METHODS: Data were analysed by means of thematic synthesis. RESULTS: Sixteen articles were selected, analysed, and synthesized. One overall theme; 'Preserving one's integrity in the new country' revealed two key aspects; 'Struggling to find meaning' and 'Caring relationships'. 'Struggling to find meaning' comprised four sub-themes; 'Communication and connection', 'Striving to cope and manage', 'Struggling to achieve a safe pregnancy and childbirth', and 'Maintaining bodily integrity'. 'Caring relationships' was based on the following three sub-themes: 'Sources of strength', 'Organizational barriers to maternity care', and 'The nature and quality of caring relationships'. CONCLUSION: The results of this review demonstrate that migrant women are in a vulnerable situation when pregnant and giving birth and that their access to health services must be improved to better meet their needs. Research is required to develop continuity of care and improve integrated maternal care.

Relation between perceived stress, social support, and coping strategies and maternal well-being: a review of the literature.

The objective of this work was to review published articles on the impact of perinatal stress on mothers' medium- or long-term psychological health and the efficacy of coping strategies, to determine if social support plays a role in the interaction between birth events and mothers' psychological experiences, and to identify the tools used for these measurements. MEDLINE, PsycINFO, and CINAHL databases were searched for English and French language articles from 2000 through 2010 inclusive. Thirty-seven articles fulfilled the selection criteria. The results of this review highlight an association between perceived stress and postpartum depressive symptoms. However, because perceived stress has been evaluated in a general manner, it was not possible to identify events having more or less relation to postpartum depressive symptoms in mothers. Social support also appeared to be related to mothers' psychological health. Coping strategies were difficult to analyze because of the lack of homogeneity in their definition across studies. The comparison among studies of social support and coping strategies was also difficult due to the diversity of tools used and their lack of specificity. New tools should be specifically developed for the perinatal period, and further research should be performed to understand better the events and adequacy of social support.

Determinants of postpartum physical activity, dietary habits and weight loss after gestational diabetes mellitus.

AIM: To describe the most significant findings of the studies that examined the prevalence and determinants of postpartum health behaviours (physical activity, dietary habits and/or weight loss) in patients with gestational diabetes mellitus (GDM). BACKGROUND: Patients with gestational diabetes have a high risk of developing type 2 diabetes in the months after delivery. For this reason, GDM patients are encouraged to practice specific health behaviours during the postpartum period. It is important to identify the factors that may impact the adherence to these behaviours. EVALUATION: Eighteen published research articles that examined postpartum health behaviours and/or their potential determinants in women diagnosed with GDM were selected from electronic databases. KEY ISSUES: Physical activity and diet rarely meet the recommendations. Risk perception, health beliefs, social support and self-efficacy are the main factors identified as having an impact on the adoption of health behaviours. However, the cross-sectional nature of the studies and the lack of social, geographical and/or ethnic variety in the populations studied do not allow us to generalize the conclusions. IMPLICATIONS FOR NURSING MANAGEMENT: This literature review reports all the information currently available that can enable nurses and midwives to engage in the evaluation and optimization of their interventions in GDM patients. Motivational interventions based on Social Cognitive Theory are proposed.

Tau protein degradation is catalyzed by the ATP/ubiquitin-independent 20S proteasome under normal cell conditions.

Tau is the major protein exhibiting intracellular accumulation in Alzheimer disease. The mechanisms leading to its accumulation are not fully understood. It has been proposed that the proteasome is responsible for degrading tau but, since proteasomal inhibitors block both the ubiquitin-dependent 26S proteasome and the ubiqutin-independent 20S proteasome pathways, it is not clear which of these pathways is involved in tau degradation. Some involvement of the ubiquitin ligase, CHIP in tau degradation has also been postulated during stress. In the current studies, we utilized HT22 cells and tau-transfected E36 cells in order to test the relative importance or possible requirement of the ubiquitin-dependent 26S proteasomal system versus the ubiquitin-independent 20S proteasome, in tau degradation. By means of ATP-depletion, ubiquitinylation-deficient E36ts20 cells, a 19S proteasomal regulator subunit MSS1-siRNA approaches, and in vitro ubiquitinylation studies, we were able to demonstrate that ubiquitinylation is not required for normal tau degradation.

Hyperammonemia causes protein oxidation and enhanced proteasomal activity in response to mitochondria-mediated oxidative stress in rat primary astrocytes.

Hyperammonemia, as a consequence of severe liver failure, is strongly associated with the neurological syndrome hepatic encephalopathy (HE) whereby excessive ammonia is metabolized by astrocytes, followed by cell and brain swelling in vivo. In the present study we were able to show that ammonia treatment of primary astrocytes in vitro is followed by cell swelling and a loss of cell viability at higher ammonia concentrations. Lower ammonia concentrations are accompanied by mitochondria-derived oxidative stress, as demonstrated by using inhibitors of mitochondrial glutaminase I, 143B-rho (0) cells and isolated mitochondria. The oxidative stress generated by mitochondria is accompanied by protein oxidation. In further studies we could show, that an activation of the proteasomal system takes place during ammonia exposure and protects cells. The proteasome acitvation can be blocked by antioxidants or by inhibitors of enzymes of glutamine metabolism. We conclude that oxidative stress-mediated proteasomal activation is important for survival of astroglial cells.

Intracellular distribution of oxidized proteins and proteasome in HT22 cells during oxidative stress.

The production of free radicals and the resulting oxidative damage of cellular structures are always connected with the formation of oxidized proteins. The 20S proteasome is responsible for recognition and degradation of oxidatively damaged proteins. No detailed studies on the intracellular distribution of oxidized proteins during oxidative stress and on the distribution of the proteasome have been performed until now. Therefore, we used immunocytochemical methods to measure protein carbonyls, a form of protein oxidation products, and proteasome distribution within cells. Both immunocytochemical methods of measurement are semiquantitative and the load of oxidized proteins is increased after various oxidative stresses explored, with the highest increase in the perinuclear region of the cell. Distribution of the proteasome and the total protein content revealed the highest concentration of both in the nucleus. No redistribution of the proteasome during oxidative stress occurs. The normalized ratio of protein carbonyls to protein content was formed, indicating the highest concentration of oxidized proteins in the cytosolic region near the cell membrane. By forming the protein oxidation-to-proteasome ratio it was concluded that the highest load of oxidized proteins to the proteasome takes place in the cytosol, independent of the oxidant explored.

Distribution of oxidized and HNE-modified proteins in U87 cells.

Protein modification is one of the important processes during oxidative stress. This modification of proteins is either due to direct oxidation of proteins by various oxidants or due to secondary modification by lipid peroxidation products, e.g. 4-hydroxynonenal. In the here presented work we compare the intracellular distribution of protein modification products after treatment of human U87 astrocytoma cells with hydrogen peroxide or HNE. The treatment with hydrogen peroxide leads mainly to a cytosolic formation of oxidized proteins whereas HNE treatment is forming HNE-adducts throughout the cell. Therefore, we concluded that HNE diffusion distance in cells enables this lipid peroxidation product to act as a second messenger within the cell and on the other hand is the reason for the genotoxic properties of this compound.