Sulforaphane as an anticancer molecule: mechanisms of action, synergistic effects, enhancement of drug safety, and delivery systems.

Sulforaphane is an isothiocyanate compound that has been derived from cruciferous vegetables. It was shown in numerous studies to be active against multiple cancer types including pancreatic, prostate, breast, lung, cervical, and colorectal cancers. Sulforaphane exerts its therapeutics action by a variety of mechanisms, such as by detoxifying carcinogens and oxidants through blockage of phase I metabolic enzymes, and by arresting cell cycle in the G2/M and G1 phase to inhibit cell proliferation. The most striking observation was the ability of sulforaphane to potentiate the activity of several classes of anticancer agents including paclitaxel, docetaxel, and gemcitabine through additive and synergistic effects. Although a good number of reviews have reported on the mechanisms by which sulforaphane exerts its anticancer activity, a comprehensive review on the synergistic effect of sulforaphane and its delivery strategies is lacking. Therefore, the aim of the current review was to provide a summary of the studies that have been reported on the activity enhancement effect of sulforaphane in combination with other anticancer therapies. Also provided is a summary of the strategies that have been developed for the delivery of sulforaphane.

Cultural Competence and Related Factors Among Taiwanese Nurses.

BACKGROUND: Taiwan is a multicultural and multiethnic society with a growing number of immigrants who have diverse ethnic, racial, and cultural needs. Although this diversity highlights the pressing need for culturally competent healthcare providers, cultural competence is a concept that is little understood and implemented only sporadically in Taiwan. PURPOSE: This study investigates the cultural competence of Taiwanese nurses and the related factors of influence. METHODS: An online self-report survey was used to collect data from 221 Taiwanese nurses from December 2012 through January 2013. Data from the demographic questionnaire, the Nurses' Cultural Competence Scale, and the Perceived Nurses' Cultural Competence Rating were analyzed using descriptive statistics, Pearson correlation, independent sample t tests, and multiple regressions. RESULTS: The cultural competence of the participants was in the "low to moderate" range, with relatively higher mean scores for the subscales of cultural awareness and cultural sensitivity and relatively lower scores for the subscales of cultural knowledge and cultural skills. Participants generally perceived themselves as being "not culturally competent." Variables found to predict cultural competence included years of work experience, hours of continuing education related to cultural nursing care, and frequency of caring for clients from culturally and ethnically diverse backgrounds. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Participating Taiwanese nurses rated their level of cultural competence as in the low-to-moderate range and self-perceived as being not culturally competent. These findings support the need to further expand and enhance cultural-competence-related continuing education and to address the topic of cultural care in the nursing curricula.