Nanocarrier of α-Tocopheryl Succinate Based on a Copolymer Derivative of (4,7-dichloroquinolin-2-yl)methanol and Its Cytotoxicity against a Breast Cancer Cell Line.

In order to improve the water solubility and, therefore, bioavailability and therapeutic activity of anticancer hydrophobic drug α-tocopherol succinate (α-TOS), in this work, copolymers were synthesized via free radicals from QMES (1-[4,7-dichloroquinolin-2-ylmethyl]-4-methacryloyloxyethyl succinate) and VP (N-vinyl-2-pirrolidone) using different molar ratios, and were used to nanoencapsulate and deliver α-TOS into cancer cells MCF-7. QMES monomer was chosen because the QMES pendant group in the polymer tends to hydrolyze to form free 4,7-dichloro-2-quinolinemethanol (QOH), which also, like α-TOS, exhibit anti-proliferative effects on cancerous cells. From the QMES-VP 30:70 (QMES-30) and 40:60 (QMES-40) copolymers obtained, it was possible to prepare aqueous suspensions of empty nanoparticles (NPs) loaded with α-TOS by nanoprecipitation. The diameter and encapsulation efficiency (%EE) of the QMES-30 NPs loaded with α-TOS were 128.6 nm and 52%; while for the QMES-40 NPs loaded with α-TOS, they were 148.8 nm and 65%. The results of the AlamarBlue assay at 72 h of treatment show that empty QMES-30 NPs (without α-TOS) produced a marked cytotoxic effect on MCF-7 breast cancer cells, corresponding to an IC50 value of 0.043 mg mL-1, and importantly, they did not exhibit cytotoxicity against healthy HUVEC cells. Furthermore, NP-QMES-40 loaded with α-TOS were cytotoxic with an IC50 value of 0.076 mg mL-1, demonstrating a progressive release of α-TOS; however, the latter nanoparticles were also cytotoxic to healthy cells in the range of the assayed concentrations. These results contribute to the search for a new polymeric nanocarrier of QOH, α-TOS or other hydrophobic drugs for the treatment of cancer or others diseases treatable with these drugs.

'He who helps the guilty, shares the crime'? INGOs, moral narcissism and complicity in wrongdoing.

Humanitarian organisations often work alongside those responsible for serious wrongdoing. In these circumstances, accusations of moral complicity are sometimes levelled at decision makers. These accusations can carry a strong if unfocused moral charge and are frequently the source of significant moral unease. In this paper, we explore the meaning and usefulness of complicity and its relation to moral accountability. We also examine the impact of concerns about complicity on the motivation of humanitarian staff and the risk that complicity may lead to a retreat into moral narcissism. Moral narcissism is the possibility that where humanitarian actors inadvertently become implicated in wrongdoing, they may focus more on their image as self-consciously good actors than on the interests of potential beneficiaries. Moral narcissism can be triggered where accusations of complicity are made and can slew decision making. We look at three interventions by Médecins Sans Frontières that gave rise to questions of complicity. We question its decision-guiding usefulness. Drawing on recent thought, we suggest that complicity can helpfully draw attention to the presence of moral conflict and to the way International Non-Governmental Organisations (INGOs) can be drawn into unintentional wrongdoing. We acknowledge the moral challenge that complicity presents to humanitarian staff but argue that complicity does not help INGOs make tough decisions in morally compromising situations as to whether they should continue with an intervention or pull out.

Humanitarian agencies and authoritarian states: a symbiotic relationship?

The relationship between humanitarian agencies and authoritarian states is of growing concern to Médecins Sans Frontières (MSF), given the recurring difficulties experienced in negotiating access and implementing operations in such contexts. The effort to negotiate and gain approval from states to operate on their territory prompts reflection on the sources of legitimacy for action. Drawing on direct field examples in two countries only very rarely examined--Turkmenistan and Uzbekistan--this paper explores MSF's attempts to offer live-saving medical care there. It shows that successful access negotiations hinged heavily on demonstrating added value (medical relevance) while simultaneously building relationships with authorities, identifying possible allies within health ministries, and hoping that such measures could promote a level of acceptance or trust needed to operate. It is clear that the operational space achieved is bound to remain limited and fragile, and that many compromises have to be considered and judged against ethical principles and the overall impact of the intervention.

Prevalencia de trastornos mentales comunes en barrios marginales urbanos con población desplazada en Colombia / The prevalence of common mental disorders in urban slums with displaced persons in Colombia

OBJETIVOS: Investigar la prevalencia de trastornos mentales comunes en grupos con un alto porcentaje de familias desplazadas que viven en barrios marginales urbanos en Sincelejo (Sucre), Colombia. MÉTODOS: Se realizó un estudio transversal con muestreo aleatorio bietápico por conglomerados en barrios considerados marginales de Sincelejo que contienen un alto porcentaje de población desplazada. Se realizó una encuesta domiciliaria para determinar la presencia de trastornos mentales comunes -trastornos psicosomáticos, ansiedad y depresión- en la población estudiada. Se fijó como valor discriminatorio para determinar la presencia de un trastorno mental común en personas de 18 años o más una puntuación de 7 en las 20 primeras preguntas del Cuestionario de declaración de síntomas (Self-Reporting Questionnaire, SRQ) de la Organización Mundial de la Salud. Se buscaron asociaciones entre las variables recogidas (grupo de edad, sexo, tipo de carné sanitario y tiempo de residencia en el barrio), y entre ellas y la puntuación obtenida en el SRQ. Se utilizó la prueba de ji al cuadrado, con un valor de significación estadística de 0,05, y se realizó una regresión logística con todas las variables relacionadas. RESULTADOS: Se encontró una prevalencia de 27,2 por ciento (intervalo de confianza de 95 por ciento [IC95 por ciento]: 24,0 por ciento a 30,0 por ciento) de trastornos mentales comunes en la población adulta de los barrios estudiados. En general, 13,6 por ciento (IC95 por ciento: 11,4 por ciento a 16,1 por ciento) de la población encuestada reconoció tener problemas de consumo excesivo de alcohol. Se encontró una asociación entre la prevalencia de trastornos mentales comunes y el tipo de carné usado para acceder a la atención de salud (razón de posibilidades [RP]: 1,66 para el carné de desplazado frente a cualquiera de los otros dos) y el sexo (RP: 1,78 para mujeres frente a hombres); dicha asociación persistió aun después del ajuste en función...

OBJECTIVES: To investigate the prevalence of common mental disorders in groups with a high percentage of families who have been displaced by armed conflict and political instability and are living in urban slum areas on the outskirts of Sincelejo, a city in the department of Sucre, Colombia. METHODS: A cross-sectional study was conducted, with two-stage random cluster sampling, in slum neighborhoods of Sincelejo that contain a high percentage of displaced persons. A household survey of persons 18 years old or older was used to determine the presence of common mental disorders-psychosomatic disorders, anxiety, and depression-in the population studied. A score of 7 or more on the first 20 questions of the Self-Reporting Questionnaire (SRQ) of the World Health Organization was used to determine the presence of a common mental disorder. We searched for associations among the studied variables (age group, gender, type of health care card, and length of residence in the neighborhood) and among those variables and the score on the SRQ. The chi-square test was used, with statistical significance set at 0.05. Logistic regression was carried out with all the related variables. RESULTS: The prevalence of common mental disorders in the adult population of the neighborhoods studied was 27.2 percent (95 percent confidence interval (95 percent CI) = 24.0 percent to 30.0 percent); 13.6 percent (95 percent CI = 11.4 percent to 16.1 percent) of the population surveyed had problems with excessive alcohol consumption. There was an association between the prevalence of common mental disorders and the type of health care card used (odds ratio = 1.66 for persons using the health care card for displaced persons versus persons using other types of health care cards). In addition, there was an association between the prevalence of common mental disorders and gender (OR = 1.78 for women); this association remained after adjusting for other...

[The prevalence of common mental disorders in urban slums with displaced persons in Colombia]. / Prevalencia de trastornos mentales comunes en barrios marginales urbanos con población desplazada en Colombia.

OBJECTIVES: To investigate the prevalence of common mental disorders in groups with a high percentage of families who have been displaced by armed conflict and political instability and are living in urban slum areas on the outskirts of Sincelejo, a city in the department of Sucre, Colombia. METHODS: A cross-sectional study was conducted, with two-stage random cluster sampling, in slum neighborhoods of Sincelejo that contain a high percentage of displaced persons. A household survey of persons 18 years old or older was used to determine the presence of common mental disorders-psychosomatic disorders, anxiety, and depression-in the population studied. A score of 7 or more on the first 20 questions of the Self-Reporting Questionnaire (SRQ) of the World Health Organization was used to determine the presence of a common mental disorder. We searched for associations among the studied variables (age group, gender, type of health care card, and length of residence in the neighborhood) and among those variables and the score on the SRQ. The chi-square test was used, with statistical significance set at 0.05. Logistic regression was carried out with all the related variables. RESULTS: The prevalence of common mental disorders in the adult population of the neighborhoods studied was 27.2% (95% confidence interval (95% CI)=24.0% to 30.0%); 13.6% (95% CI=11.4% to 16.1%) of the population surveyed had problems with excessive alcohol consumption. There was an association between the prevalence of common mental disorders and the type of health care card used (odds ratio=1.66 for persons using the health care card for displaced persons versus persons using other types of health care cards). In addition, there was an association between the prevalence of common mental disorders and gender (OR=1.78 for women); this association remained after adjusting for other explanatory variables. CONCLUSIONS: Using the study criteria (type of health care card and length of time living in the slum area), it was difficult to separate the displaced persons from other persons living in the same slum areas, and thus to measure the prevalence of common mental disorders among just the displaced persons. The prevalence of common mental disorders in the urban population studied showed a statistical association with the type of health care card, which in turn determined the level of access to public health services. This association between the type of health care card held and the prevalence of common mental disorders is strong enough to justify providing mental health care services to persons who have the health care card for displaced persons.