The Sacred Space: Using Stages of Change Model With Motivational Interviewing to Promote Patient-Centered Healing.

OBJECTIVE: Help patients make necessary life changes to reach desired health outcomes. METHODS: By combining the transtheoretical stages of the change model with motivational interviewing, nurse practitioners can hone powerful skills to enable patients to make their desired life changes. RESULTS: Nurses and nurse practitioners can make a difference in patients' lives by connecting and partnering with them to create positive change for improved health outcomes. CONCLUSIONS: Nurse educators should provide opportunities for nurses at all levels to learn and incorporate these skills into their practice.

Implementation science: Changing practice in oral health.

Caries remain the most common preventable chronic childhood disease. One state oral health program including fluoride varnish showed a decrease in presence of decay and improvement in overall oral health; however, early childhood caries did not improve. Implementation of an oral health preventive program during well-child medical visits may address this gap.

PLGA-PEG nanoparticles containing gallium phthalocyanine: Preparation, optimization and analysis of its photodynamic efficiency on red blood cell and Hepa-1C1C7.

Poly(lactide-co-glycolide) (PLGA) has been used for the encapsulation of phthalocyanine motived by its biocompatibility and biodegradability. Many studies have already been done to evaluate the influence of parameters used in the PLGA nanoparticle synthesis but without the evaluation of the combinatory interaction between these parameters on the nanoparticulate properties. Ga(III)-phthalocyanine (GaPc) was encapsulated into the PEGlated PLGA-nanoparticles and the individual and combinatory effects of the emulsification time, the method used for the nanoparticle synthesis and the temperature of the aqueous phase was evaluated on the size, entrapment efficiency, efficacy of nanoparticle recovery, residual PVA and zeta potential value using a 23 factorial design (FD). Mathematical models were adjustable to the data and evolutionary operations were performed to optimize the nanoparticle size. The ability of the optimized nanoparticle to decrease the viability of the Hepa-1C1C7 cell and the blood red cell was also evaluated. The FD disclosed the emulsification-diffusion method decreased the residual PVA and the size of PLGA-PEG nanoparticle, but also decreased the entrapment efficiency of GaPc, the zeta potential absolute value and the recovery efficacy of nanoparticles. The combinatory effect between the method used in the nanoparticle preparation and the temperature of aqueous phase influenced four of the five evaluated properties. The viability of Hepa-1C1C7 cells was reduced until 13× when the cells were irradiated in the presence of encapsulated GaPc while it was decreased until 4.7× when the experiment was carried out with the free GaPc. The encapsulated GaPc was also more efficient to cause the haemolysis of the RBC than it was the free GaPc. The optimization of the nanoparticles synthesis increased the efficiency of the GaPc to oxidize the evaluated cells.

An oral health program for children.

Caries, the most infectious chronic disease of childhood in America, leads to health, learning, and quality-of-life issues. Using the Missouri Preventive Service Program model, a pilot oral health program for children from ages birth to 5 years in a rural health clinic was the first to implement the application of fluoride varnish.

Endosialin protein expression and therapeutic target potential in human solid tumors: sarcoma versus carcinoma.

PURPOSE: Endosialin/CD248/tumor endothelial marker 1 is expressed in stromal cells, endothelial cells, and pericytes in various tumors; however, few studies have focused on expression in malignant cells. EXPERIMENTAL DESIGN: We studied expression of endosialin in clinical specimens, cell culture, and animal models and designed an anti-endosialin therapeutic prototype. RESULTS: Fifty human tumor cell lines and 6 normal cell types in culture were assayed by reverse transcription-PCR and/or flow cytometry for endosialin. Cell surface protein was found on 7 sarcoma lines, 1 neuroblastoma, and 4 normal cell types in culture. A fully human anti-endosialin antibody bound to human A-673 Ewing's sarcoma cells and SK-N-AS neuroblastoma cells but not HT-1080 cells. Exposure of cells to an anti-human IgG conjugated to saporin resulted in growth inhibition only of endosialin-expressing cells. Endosialin expression was assessed by immunohistochemistry in 250 clinical specimens of human cancer including 20 cancer subtypes. Endosialin is frequently found in human cancers. Endosialin expression is mainly a perivascular feature in carcinomas, with some expression in stromal cells. In sarcomas, endosialin is expressed by malignant cells, perivascular cells, and stromal cells. Development and characterization of experimental models for studying endosialin biology in sarcomas and evaluating anti-endosialin therapies is presented. CONCLUSIONS: Findings suggest that an anti-endosialin immunotoxin might be a promising therapeutic approach for endosialin-positive neoplasia, especially synovial sarcoma, fibrosarcoma, malignant fibrous histiocytoma, liposarcoma, and osteosarcoma. Thus, a diagnostic/therapeutic targeted therapeutic approach to treatment of endosialin-expressing tumors may be possible.

CD5- mantle cell lymphoma.

Mantle cell lymphoma (MCL) typically expresses B-cell antigens and CD5 and overexpresses bcl-1 protein. However, unusual cases of bcl-1+ and CD5-MCL have been observed, posing a practical challenge for correct diagnosis and management. We identified 25 cases (48 samples) of bcl-1+ and CD5- lymphoma. CD5 expression was assessed by flow cytometric analysis alone (1 case), immunohistochemical analysis alone (17 cases), or dual flow cytometric/immunohistochemical methods (7 cases). The morphologic features were consistent with MCL with centrocytic cytomorphology in 20 cases and blastic variant in 5 cases. The t(11;14) was confirmed in 8 of 11 cases by fluorescence in situ hybridization of paraffin-embedded tissue. Cytogenetic analysis revealed the t(11;14) within a complex karyotype in 2 additional cases. These data show that MCL may lack CD5 expression. Evaluation of bcl-1 expression by immunohistochemical analysis or molecular genetics may be indicated if MCL is suspected clinically or morphologically despite a lack of CD5 expression.