"Paper, face-to-face and on my mobile please": A survey of women's preferred methods of receiving antenatal education.

BACKGROUND: Antenatal education prepares women for childbirth and can be delivered face-to-face, in hard-copy and electronically. Smartphones allow access to online learning and internet searching is common among pregnant women. It is unclear which mode of health information delivery women prefer. AIM: This study aimed to investigate how women at one Local Health District (LHD) preferred to receive health information during pregnancy and the early postnatal period. METHODS: We developed a survey to gather data on women's preferences for educational information. Women who were discharged from one LHD, in NSW Australia, were invited, in 2019, to participate in a simple 14 question survey, either online or in hard copy format. FINDINGS: In total, 685 women completed the survey which represented a 40% response rate over a period of two months. The survey revealed women commonly used smart phones, or other devices, to source information. Despite this, most women preferred to receive antenatal education via non-electronic methods. Of note many participants felt underprepared for the post-birth period. The method of survey completion, whether hardcopy or online, aligned with individuals' preferences for information delivery. CONCLUSION: Non-electronic methods of education delivery were the preferred method for most women, and this was consistent across all educational, cultural and socioeconomic levels. Women sought information online, or through apps, but these options did not always meet their knowledge needs, especially regarding the postnatal period. We recommend that hospitals continue to provide information in a variety of modes, as exclusively electronic methods may marginalise groups of women.

Finding the balance: adolescents with type 1 diabetes and their parents.

INTRODUCTION: The purpose of this study was to describe the ways that parents and 11- to 15-year-old teens communicate and the recurrent themes and patterns of behavior that were revealed during brief interactions about issues related to diabetes management. METHOD: A secondary qualitative analysis of data, based on a template for analysis developed from the literature, was completed on audiotaped interactions of 28 adolescents and their parents. RESULTS: Themes identified were frustration, fear, normalizing, trusting, and discounting. Trusting the adolescent to manage diabetes was difficult for the parents and was associated with frustration, fear, and discounting communication. DISCUSSION: Results support the need for clinicians to work with families to facilitate trust and positive parent-adolescent communication about diabetes management.

CHR-2797: an antiproliferative aminopeptidase inhibitor that leads to amino acid deprivation in human leukemic cells.

CHR-2797 is a novel metalloenzyme inhibitor that is converted into a pharmacologically active acid product (CHR-79888) inside cells. CHR-79888 is a potent inhibitor of a number of intracellular aminopeptidases, including leucine aminopeptidase. CHR-2797 exerts antiproliferative effects against a range of tumor cell lines in vitro and in vivo and shows selectivity for transformed over nontransformed cells. Its antiproliferative effects are at least 300 times more potent than the prototypical aminopeptidase inhibitor, bestatin. However, the mechanism by which inhibition of these enzymes leads to proliferative changes is not understood. Gene expression microarrays were used to profile changes in mRNA expression levels in the human promyelocytic leukemia cell line HL-60 treated with CHR-2797. This analysis showed that CHR-2797 treatment induced a transcriptional response indicative of amino acid depletion, the amino acid deprivation response, which involves up-regulation of amino acid synthetic genes, transporters, and tRNA synthetases. These changes were confirmed in other leukemic cell lines sensitive to the antiproliferative effects of CHR-2797. Furthermore, CHR-2797 treatment inhibited phosphorylation of mTOR substrates and reduced protein synthesis in HL-60 cells, both also indicative of amino acid depletion. Treatment with CHR-2797 led to an increase in the concentration of intracellular small peptides, the substrates of aminopeptidases. It is suggested that aminopeptidase inhibitors, such as CHR-2797 and bestatin, deplete sensitive tumor cells of amino acids by blocking protein recycling, and this generates an antiproliferative effect. CHR-2797 is orally bioavailable and currently undergoing phase II clinical investigation in the treatment of myeloid leukemia.

Use of retroillumination to visualize optical aberrations caused by tear film break-up.

PURPOSE: The aim of the current study was to develop quantitative methods to assess optical aberrations caused by tear film disruption. METHODS: We used standard fluorescein imaging (FL) and a novel retroillumination (RI) method to image tear film disruption in 12 eyes. Using a clinical slit lamp biomicroscope, we alternated between widefield blue and narrow-beam white light to obtain an interleaved series of FL and RI images of the time course and pattern of tear film break-up. We developed an optical analysis that indicates that the RI image should be proportional to the spatial derivative of the FL image. Intensity fluctuations in the RI images are due to thickness changes in the tear film, whereas intensity fluctuations in FL images are directly determined by tear film thickness. RESULTS: As predicted by optical analysis of RI, the spatial distribution of gaps in the tear film seen with fluorescein appeared as pairs of light and dark contours in the RI images, and a precise correspondence between the spatial derivative of the FL image (slope) and the RI image was found. Both methods showed a gradual spreading of the tear disruption during blink suppression that varied tremendously among eyes in both time and spatial pattern. Resumption of normal blinking did not produce an immediate reconstitution of the normal tear film, and areas of tear break-up created during blink suppression remained abnormal for up to several minutes of normal blinking. CONCLUSIONS: Our analysis indicates that both FL and RI have the potential to quantify optical changes occurring during tear break-up. These results support an interpretation of RI as an intensity-based method for mapping the highly irregular optical aberrations of the eye produced by tear film disruption.