Articles: School of Nursing

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Presenting Oneself as a Nurse: A Social and Professional Reality Construction
(Unisa Press, 2002-11) Ojo, A.A.; Mutea, Naomi K.; Wambui, T.; Chelagat, D.
The paper examined the historical development of nursing education and practice in two selected African countries as a background for analysing the image of nurses and nursing. Mead's (1934) Symbolic InteractionistTheof\' was employed to describe the basis of nurse;' low social and professional image which has been perpetuated by feminization of nursing, its classification as a low status occupation, its consignment as an appendage of medicine and widespread discrimination against womcn in Africa. Since reality construction is a continual creation as individuals interact in any social situation and as the social status and professional roles of nurses improve the image and self presentation will be enhanced. The submissive, accepting and passive doer-oriented critical mass of practising nurses in these countries cxplains the need for expanding degree programmcs that will facilitate collegiality in clinical relationships. It is argued that liberal university education is an important prerequisite for nurses to effectively use the concepts of assertiveness, power and influence to bring about positive change in their image and provision of quality nursing care. Recommendations made include need for nurses to convey messages of maturity, responsibility and expertise to patients, relatives and other stakeholders in health care services through their appearance, language, behaviour and performance of their professional responsibilities.
Kenyan Nurses’ involvement in managing hospitalized diabetic patients
(2008) Mutea, Naomi K.; Baker, C.M.
Diabetes is a global public health concern because the incidence, prevalence and financial burden are rapidly increasing. Clinical nursing research in developing countries is rare. This study examines nurses' involvement in the management of diabetic patients in a western Kenya Hospital. A descriptive exploratory design is used, data were collected in structured interviews with 15 registered nurses using an investigator-designed instrument. Content analysis produced eight categories of nurses' involvement in managing hospitalized diabetic patients. Facilitators and barriers to managing diabetic care are presented from the perspective of the nurse, hospital, patient, family and community. Workforce redesign is needed to cope with nursing shortages.
Using Podcasts to Help Students Apply Informatics Concepts: Benefits and Unintended Consequences. CIN: Computers, Informatics Nursing
(2012-03) Meek, A.J.; Mutea, Naomi K.; Mikyoung, L.; Jones, J.F.
Despite requirements for robust health informatics education, a multitude of educators and policy analysts report that programs are not adequately preparing nurses to handle the bevy of technologies that will be a part of their practice. A series of 14 "Podcasted" exemplars were developed to help graduate online students visualize the application of health informatics concepts in real-world settings and to determine the impact of podcasting on student cognition, engagement, and satisfaction. Although no significant differences in student cognition scores or student engagement were found between course conditions, course satisfaction was significantly higher in Podcasted weeks of the course. Also, student engagement was positively correlated with aspects of course satisfaction and overall cognition scores under both course conditions. This result suggests that student engagement plays an important mediating role in improving cognition. Students' use of podcasting did produce a temporary drop in scores for one group; therefore, more research is needed to understand these unintended consequences. With distance/online education becoming mainstream, it is imperative that faculty deploy and confirm ways to improve student cognition, engagement, and satisfaction.
Kenya and distance education: a model to advance graduate nursing
(Blackwell Publishing Ltd, 2012-08) Mutea, Naomi K.; Cullen, D.L.
Africa is faced with a myriad of challenges, such as HIV/AIDS, malaria, tuberculosis, and a variety of political and historical complications that have affected the educational system for advanced nursing practice. In Kenya, the current situation in the higher education sector does not give nurses an opportunity to pursue graduate education after they have acquired the basic diploma in nursing due to limited government support and the type of education system existing in the country today. Although distance education has been available in Kenya for professionals such as teachers, in public universities, this kind of opportunity is unreachable for nurses who are working and need to further their education. Nurses desire to have access to advanced practice education to equip them with the relevant knowledge to cope and address the complex health issues arising in the management and care of patients. A collaborative model is presented as a potential solution for this need. Four major constituents are identified including hospitals and agencies, communities of interest, Kenyan universities and international education partners. Each has a part to play including contributions to information, communication of opinion and expertise, money and support, infrastructure and in-kind resources. Distance education is cost-effective and will help in building capacity at various levels of nursing including leadership in clinical practice, teaching, administration and research.
Women Empowerment and Skilled Attendance/Facility Delivery in a Rural Community of Western Kenya
(2014-04) Asweto, Collins O.; Ouma, J. O.; Aluoch, J. R.; Obonyo, C. O.
It is estimated that over 500,000 women die annually due to maternity complications, majority occur in the developing countries. In Kenya, maternal mortality ratio still remains high despite increased maternal health intervention efforts. Many developing countries have expanded their primary health facilities to improve access to maternal health services. However, disparity in use of health services is not very well understood. To determine relationship between women’s empowerment and utilization of delivery care services, a survey of 403 mothers was conducted in Madiany division of Rarieda district, Kenya. About half the women had skilled delivery and health facility delivery. Predictors of skilled delivery and health facility delivery were education, autonomy, knowledge on pregnancy and delivery risks, occupation, parity, cost and travelling time. In order to move towards achieving MDG 5 we recommend empowering women by better education and income, and raising women’s awareness on pregnancy danger signs by comprehensive health education.
Maternal Autonomy, Distance to Health Care Facility and ANC Attendance Findings from Madiany Division of Siaya County, Kenya
(Science and Education Publishing, 2014-08) Asweto, Collins O.; Aluoch, J. R.; Obonyo, C. O.; Ouma, J. O.
Half a million women die annually from pregnancy related causes. In Kenya, maternal mortality ratio (MMR) remains high in spite of great efforts to improve maternal health care. We studied some factors linked to maternity in a rural community setting. A survey was conducted in the community living in Madiany division of Siaya County, Kenya. We randomly sampled 403 mothers of children under three years old. Variables of interest were antenatal care attendance (ANC), parity, distance from the health facility and women empowerment (autonomy). Nearly 94% of the mothers had at least one ANC visit and 48.6% had completed the recommended four or more ANC visits; about 65.7% initiated ANC at first trimester. Parity, distance to the health facility and autonomy were associated with ANC visits. Mothers with one child had a twice higher chance of at least four ANC visits than those with more than one child. Those living at most 60 minutes travel-time from the health facility were seven times more likely have early ANC initiation and five times more likely to have at least four ANC attendance than those living more than 60 minutes travel-time from the health facility. Autonomy was linked to early initiation of ANC visit. This may indicate that improving maternal care and achieving Millennium Development Goal (MDG) 5 target, it is important to improve coverage of health facilities and implement development programs that empower rural women.
Determinants of immediate post partum intrauterine contraceptive device uptake among mothers delivering in meru hospital
(2014-09) Kirigia, Consolata; Muraya, M; Gitonga, L.
Utilization of ANC and PNC Services in Nepal: A Multivariate Analysis Based on Nepal Demographic Health Survey 2001 and 2006.
(Science Publishing Group, 2015-10-12) Mahara, G.; Asweto, Collins O.; Cao, K.; Alzain, M. A.; Sebastian, A.; Barr, J.; Guo, X.; Wei, W.
Background: Maternal Mortality is a public health problem in Nepal, which was highest in 1990 among the South Asian countries. Associated factors of maternal mortality are various; among them maternal health services such as antenatal (ANC) and postnatal care (PNC) services are the main. Methods: A multivariate secondary data analysis out based on Nepal Demographic Health Surveys 2001 and 2006. Logistic regression models was performed to compare the utilization of the ANC and PNC services, with background characteristics of women aged between 15 to 49 years old. Results: A total of 8913 reproductive aged groups (15-49) women were taken for analysis and the mean age was 28.59±7.040 years. Logistic regression analysis revealed that health facility delivery (AOR=1.297, 95% CI=1.135-1.481), PNC check-up at health facility (AOD=4.442, 95% CI=2.815-7.011) and PNC service with a skilled health worker (AOD=4.533, 95% CI=2.753-7.465) utilized more in 2006 compared to 2001. This study also found that highly educated women had (AOD, 95% CI=10.823- 22.968) more utilized the heath facility during pregnancy and (AOD, 95% CI=2.194-16.950) more likely during a PNC checkup, whereas, educated women were less (AOR=0.043, 95% CI=0.007-0.254) likely consult with a skilled professional. Similarly, antenatal care (ANC) visits (4 or more than four) and ANC visit in the first trimester were increased (95% CI=1.137- 1.518) and (AOD=1.041, 95% CI=0.924-1.173) respectively. This study found that educated women, those who were living in urban areas, were more likely to use maternal health services compared to other regions. Conclusion: Increased in utilization of the ANC and PNC services through skilled health workers in a health facility among cohorts of educated women. However, the improvements were not equally distributed across the all regions in the country. This utilization of maternal health services is not sufficient to achieve the MDG goal. Because, health facility delivery is poor and counterpart home delivery is still high in Nepal.
Implementation of Nursing Process among Nurses Working In In-Patients Wards in Rift Valley Provincial General Hospital, Nakuru County, Kenya
(2016) Kamau, M.; Maingi, Nancy; Ndungu, E. W.; Karonjo, J. M.
BACKGROUND The nursing process has been described as a theory of how nurses organize the care of individuals, families and communities and implement this using a nursing care plan (NCP). The extent of implementation of the nursing process in the clinical setting has not been extensively studied nor documented in many countries in Africa, Kenya included. This study therefore sought to determine knowledge, attitude and factors hindering implementation of nursing process in Rift Valley Provincial General Hospital. MATERIALS AND METHODS A descriptive cross sectional study design was carried out in Rift Valley Provincial General Hospital. Simple random sampling was used to select 148 nurses working in the in- patients wards in the hospital. Semi-structured questionnaire was used to collect data. Descriptive data was analyzed presented in charts, graphs and tables. RESULTS More than half (86, 58%) were diploma holders and (95, 62.7%) had worked for >10yrs at the hospital. Half (74, 50%) were able to list the components of NCP. Even though (42, 25.4%) said that they knew how to evaluate patient care using a NCP, only (7, 4.9 %) were able to come up with assessment data. Fifty four (33.8%) agreed that NCP should be used as an evidence of implementation of the nursing process. Only (12, 8%) used the NCP to manage patient care in the ward. 132 (89%) opined that in-service training on use of NCP was beneficial to implementation of the nursing process. However, majority (111, 74.9%) said this training was not being offered at the facility. Most (73, 47.2%) had learnt on nursing process last in college. CONCLUSION The nursing process is not well implemented at the in-patient wards of Rift Valley Provincial General Hospital. Lack of continuous in-service training on nursing process and use of NCP can be attributed to this. The study recommends in-service training on use of NCP by the nurse manager through continuous progress department.
Factors Contributing To Abortions among Youths Aged 18 -25 in Rift Valley Provincial General Hospital Nakuru
(2016) Maingi, Nancy; Ndungu, J.; Ndungu, E.; Okova, R.
Background Worldwide, unsafe abortion persists as a serious and continuing public health challenge (WHO, 2011). Unsafe abortion mainly endangers women in developing countries where it is highly restricted by law and countries where, although legally permitted, safe abortion is not easily accessible (WHO 2012). Of estimated 464,690 induced abortions in Kenya, majority is unsafe; involving girls and young women aged 10-24 years (APHRC, MOH, 2013). In Kenya, severe complications of unsafe abortions were most common among women aged 10- 19 (45%), divorced women (56%) (MOH, 2013) . The Cost of unsafe abortion to healthcare system is approximated at Ksh 250–300 million annually (CRR, 2010). In Nakuru provincial general hospital there were total of 604 abortions in 2014 out of which 63% involved the youth in the range of 18 to 25 years. Abortions are currently claiming 30-40% of maternal deaths in Kenya, far more than the worldwide average of 13% (WHO, 2011). Methods The study was a descriptive cross sectional study .Systematic random sampling technique was used to pick 192 participants. The sample was determined using the formula by W. G. Cochran (2011). Data collection was through questionnaires, key informant interview and focused group discussions. Ethical clearance was sought from Mount Kenya University ethics review committee. Results Majority 57.3% of the respondents have had an abortion while 42.7% have never had an abortion. 67% of the respondents had unprotected sex, 21% undertook abortion following rape, while 12% did it because of medical reasons. 33.3% respondents’ parents don’t know their daughters have had an abortion 37% of the respondents agreed they would never attempt an abortion again. 55.7% of the respondents think youths require guidance and counseling. 85.9% of the respondents are comfortable talking to a friend matters concerning sexuality, 9.4% are comfortable talking to parents, 3.6% would be comfortable talking to the teacher, while 1% would be comfortable talking to a health worker. On whether the respondents attributed their getting pregnant to the influence of the drugs, 61% attributed it to influence of the drugs, while 39% did not attribute it to drug influence. A key informant indicated, “reasons for inducing an abortion included: wanting to continue with studies, relationship problems and socio-cultural factors.” “Misoprostol was revealed to be the most frequently used method to end pregnancy while mechanical means, such as insertion of a foreign object or substance through the cervix and use of herbs were however commonly reported.” Key informant interview revealed that lack of information on sexual reproductive health (SRH) was a major issue among youths. Conclusion Use of drugs has a role to play in the high rate of abortions among youth 18-25 as 66.1% of youth were under influence of alcohol during their first sex and these affected the decision making and negotiating for safer sex. There is a dire need for sexual health education.
Values of Caring and Knowing: A case of Malaria
(2016) Gitonga, Pius; Mwamisi, Joseph; Gatere, Ruth
Health care is a universal right for all human beings; individuals or families or communities. Care is a universal need for all humans. The relationship between caring and knowing is complex and involves a constant reflective process of professional training. Caring involves displaying kindness and concern for others while knowing is the state of being aware or informed. In fact, people do not care how much we know until they know how much we care about them. Knowledge of self-worth creates value for others, their pain, the standards of care and processes to alleviate pain, suffering and patient’s perspectives and dimensions of pain, care and healing. Caring takes a very strong, intelligent, and compassionate person to take on the tasks of caring with passion and purpose to maintain the health and well-being of the human person. Anecdotes suggest that even those without diseases require some degree of care and love. In many occasions, whenever pain comes our way, we desire to be healed from the obnoxious feeling. During the healing process, care is given by family members or health care professionals; knowing how to take care for the suffering is a professional preparation and the proximity to those in needs by their significant others and family members plays a pivotal role in the healing process. The sick should also be willing to be optimistic in the healing process. The family members and significant others need to know that taking care of the sick and weak is more demanding than taking care for the well and healthy. Caring to know the other person’s pain and caring to know what causes it and how to relieve or remove it, is important knowledge as we purpose to heal the human person through diagnosis, planning and implementing treatment regimens and discuss about integrated care protocols. Medical and nursing knowledge helps make our caring acts more productive and fruitful. Knowing and caring is our drive and our avenue to show empathy to sick, healthy, recovering or deteriorating from illnesses and diseases
Does Breast Cancer Risk Awareness Motivate Personal Prevention Practices: Findings from a Community-based Assessment?
(2016-01) Ouma, J.; Olang’, S.; Asweto, Collins O.; Obago, I. T.; Kaseje, D.
Breast cancer, is the leading cause of cancer specific mortality. But nearly 80% of the mortality is preventable by early diagnosis. We assessed knowledge and practice of breast cancer prevention by women in a rural community setting. Data was collected on demographics, family history, knowledge and practice of breast cancer by interviewer administered questionnaire. Knowledge (including knowledge of risk) and practice were measured using a response-based score to a set of 9 and 10 questions respectively. Prevalence odds ratio was calculated to estimate association between independent and outcome variables. Knowledge of breast cancer risk was low (14.2%). Family history and socioeconomic status were significantly associated with knowledge; respondents with more than eight years of school were more likely to have higher knowledge (OR=2.859; CI=1.578-5.178). Practice of prevention was equally low (17.2%). Practice was significantly associated with knowledge; respondents with higher knowledge of prevention were more likely to practice prevention (OR=6.8; CI=3.308-14.104). We propose that community-based risk communication and awareness creating programs may motivate breast cancer prevention practices. Women of lower socio-economic status should especially be targeted with such interventions. There is need to develop these into a sustainable community-based health education program.
The Malaysian health care system: Ecology, plans, and reforms.
(2016-01) Sebastian, A.; Alzain, M. A.; Asweto, Collins O.; Mahara, G.; Guo, X.; Song, M.; Wang, Y.; Wang, W.
Malaysia is on its way to achieving developed nation status in the next 4 years. Currently, Malaysia is on track for three Millennium Development Goals (MDG1, MDG4, and MDG7). The maternal mortality rate, infant mortality rate, and mortality rate of children younger than 5 years improved from 25.6% (2012) to 6.6% (2013), and 7.7% (2012) per 100,000 live births, respectively whereas immunization coverage for infants increased to an average of 90%. As of 2013 the ratio of physicians to patients improved to 1:633 while the ratio of health facilities to the population was 1:10,272. The current government administration has proposed a reform in the form of the 10th Malaysian Plan coining the term "One Care for One Malaysia" as the newly improved and reorganized health care plan, where efficiency, effectiveness, and equity are the main focus. This review illustrates Malaysia's transition from pre-independence to the current state, and its health and socioeconomic achievement as a country. It aims to contribute knowledge through identifying the plans and reforms by the Malaysian government while highlighting the challenges faced as a nation.
Integration of community health workers into health systems in developing countries: Opportunities and challenges
(Systematic Review, 2016-01) Asweto, Collins O.; Mohamed, Ali Alzain; Sebastian, Andrea; Rachel, Alexander; Wei, Wang
Background: Developing countries have the potential to reach vulnerable and underserved populations marginalized by the country’s health care systems by way of community health workers (CHWs). It is imperative that health care systems focus on improving access to quality continuous primary care through the use of CHWs while paying attention to the factors that impact on CHWs and their effectiveness. Objective: To explore the possible opportunities and challenges of integrating CHWs into the health care systems of developing countries. Methods: Six databases were examined for quantitative, qualitative, and mixed-methods studies that included the integration of CHWs, their motivation and supervision, and CHW policy making and implementation in developing countries. Thirty-three studies met the inclusion criteria and were double read to extract data relevant to the context of CHW programs. Thematic coding was conducted and evidence on the main categories of contextual factors influencing integration of CHWs into the health system was synthesized. Results: CHWs are an effective and appropriate element of a health care team and can assist in addressing health disparities and social determinants of health. Important facilitators of integration of CHWs into health care teams are support from other health workers and inclusion of CHWs in case management meetings. Sustainable integration of CHWs into the health care system requires the formulation and implementation of polices that support their work, as well as financial and nonfinancial incentives, motivation, collaborative and supportive supervision, and a manageable workload. Conclusions: For sustainable integration of CHWs into health care systems, high-performing health systems with sound governance, adequate financing, well-organized service delivery, and adequate supplies and equipment are essential. Similarly, competent communities could contribute to better CHW performance through sound governance of community resources, promotion of inclusiveness and cohesion, engagement in participatory decision making, and mobilization of local resources for community welfare.
Early Mobilization and Physical Activity Improve Stroke Recovery: A Cohort Study of Stroke Inpatients in Kisumu County Referral Hospitals, Kenya
(2016-01) Ogolla, M. M.; Opemo, D. O.; Asweto, Collins O.
Early mobilization in acute stroke care is highly recommended in a range of developed countries policy; however, in developing countries like Kenya, lack of evidence seems to hinder formulation and implementation of policy guideline on early mobilization in acute stroke care. Therefore, to estimate the safe optimal time for early mobilization of stroke patients in Kenya, we conducted a prospective cohort study in two purposively selected health facilities in Kisumu County, Kenya. About 100 stroke patients admitted in medical wards (mean age 59.1±2.3 years, females 61%) were recruited. Barthel Index’ tool was used to assess recovery and physical activity levels. It comprised of scoring scale ranging from 0-100. The participants were categorized as follows: Patients who score between 0 – 30 were considered as mildly recovered, 31 - 60 as moderately recovered and patients who score from 61 – 100 were regarded as fully recovered. Multiple logistic regression model was used to compute adjusted ORs (AOR) of early mobilization and Barthel Index variable, adjusting for age, gender and type of stroke. Early mobilization improves patient recovery. Participants in early mobilization group were more like to independently feed, groom, dress, use toilet, use wheel chair and climb stairs with help compared to late mobilization (p <0.05). Most (76%) participants who were exposed to high physical activity had full recovery than the (5%) bones in low physical activity (p< 0.001). This study provides evidence that early mobilization and high physical activity improves stroke patient recovery.
Fine particulate matter induces vascular endothelial activation 4 via IL-6 dependent JAK1/STAT3 signaling pathway. Toxicol.
(2016-04) Hu, H.; Wu, J.; Li, Q.; Asweto, Collins O.; Lin, F.; Xiaozhe, Y.; Duan, F.; Duan, J.; Sun, Z.
Exposure to PM2.5 has been strongly linked to endothelial dysfunction. However, the underlying mechanism of PM2.5 on the vascular endothelial function is poorly understood. This study examined the toxic effect and underlying mechanism of PM2.5 on human umbilical vein endothelial cells (HUVECs). Decreased cell viability and increased LDH activity were observed in the PM2.5-treated HUVECs in a dose-dependent manner. The production of ROS, MDA, and the inhibition of SOD activity were also triggered by PM2.5 in HUVECs. In addition, PM2.5 increased the intracellular levels of proinflammatory cytokines (IL-6, TNF-a, IL-1β, IL-8 and CRP), cell adhesion molecules (ICAM-1, VCAM-1) and tissue factor (TF), resulted in endothelial activation. For an in-depth study, the protein levels of IL-6, JAK1 and STAT3 were up-regulated significantly, while the expression of JAK2 and SOCS1 were down-regulated gradually in PM2.5-treated HUVECs in a dose-dependent manner. These results show that PM2.5 triggered endothelial activation via upregulation of the IL-6 dependent JAK1/STAT3 signaling pathway. This will provide new insights into the toxic effects and mechanisms of cardiovascular diseases triggered by ambient air pollution.
Glycan Biomarkers for Rheumatoid Arthritis and Its Remission Status in Han Chinese Patients.
(2016-06) Sebastian, A.; Alzain, M. A.; Asweto, Collins O.; Song, H.; Cui, L.; Yu, X.; Ge, S.; Dong, H.; Rao, P.; Wang, H.; Fang, H.; Gao, Q.; Zhang, J.; He, D.; Guo, X.; Song, M.; Wang, Y.; Wang, W.
Rheumatoid arthritis (RA), a systemic, chronic, and progressive inflammatory autoimmune disease, affects up to 1.0% of the world population doubling mortality rate of patients and is a major global health burden. Worrisomely, we lack robust diagnostics of RA and its remission status. Research with the next-generation biomarker technology platforms such as glycomics offers new promises in this context. We report here a clinical case–control study comprising 128 patients suffering from chronic RA (80.22% in remission, 19.78% active clinically) and 195 gender- and age-matched controls, with a view to the putative glycan biomarkers of RA as well as its activity or remission status in Han Chinese RA patients. Hydrophilic interaction liquid chromatography–ultra-performance liquid chromatography (HILIC-UPLC) was used for the analysis of IgG glycans. The regression model identified the glycans that predict RA status, while a receiver operating characteristic (ROC) curve analysis validated the sensitivity and prediction power. Among the total 24 glycan peaks (GP1–GP24), ROC analysis showed only GP1 prediction to be highly sensitive with an area under the curve (AUC) = 0.881. Even though GP21 and GP22 could predict active status among the RA cases (p < 0.05), they had lower sensitivity of prediction with an AUC = 0.658. Taken together, these observations suggest that GP1 might have potential as a putative biomarker for RA in the Han Chinese population, while the change in IgG glycosylation shows association with the RA active and remission states. To the best of our knowledge, this is the first glycomics study with respect to disease activity and remission states in RA.
Early growth in preterm infants after hospital discharge in rural Kenya: longitudinal study
(Pan African Medical Journal, 2016-06-22) Mawia, Diana S.; Chege, Margaret N.; Oyieke, Jennifer
Prematurity is the single most important cause of mortality during the neonatal period. The early growth of these infants has been shown to be a predictor of their later growth and neurodevelopmental outcomes. The objective of this study was to establish the determinants of early growth in preterm infants after hospital discharge at the Kitui District Hospital, Kenya. Methods: A short longitudinal study design was adopted to execute the study. During the period of April and June 2014, all the preterm infants who were discharged from the Kitui District Hospital Newborn Unit were enrolled in the study by obtaining written informed consent from their guardians. The anthropometric measurements of these infants were taken at discharge and repeated two weeks later at the Pediatric Outpatient Clinic and the Maternal Child health Clinic. A questionnaire guided interview was held with the guardians to establish infant and maternal characteristics which influenced the infants' early growth. Results: A total of 112 participants were enrolled for the study with 106 (94.4%) of them being available for reassessment after two weeks. Majority (72.6%) had deficit in growth by failing to attain the recommended WHO average weight gain of 15g/kg/day. Most of the mothers (63.4%) were between the ages of 20-29 years with half of them being first time mothers. Many of them (66.1%) had only attained primary education and were married (66.1%) to self-employed husbands (56%). Conclusion: Most of the preterm infants at discharge were females who were born between 33 and 36 weeks gestation. Growth deficit was present in the majority and gestational age at birth was a major determinant of the early growth in these preterm infants.
Co-exposure to amorphous silica nanoparticles and benzo[a]pyrene at low level in human bronchial epithelial BEAS-2B cells
(SpringerLink, 2016-11) Wu, J.; Shi, Y.; Asweto, Collins O.; Lin, F.; Xiaozhe, Y.; Zhang, Y.; Duan, J.; Sun, Z.
Both ultrafine particles (UFP) and polycyclic aromatic hydrocarbons (PAHs) are widely present in the environment, thus increasing their chances of exposure to human in the daily life. However, the study on the combined toxicity of UFP and PAHs on respiratory system is still limited. In this study, we examined the potential interactive effects of silica nanoparticles (SiNPs) and benzo[a]pyrene (B[a]P) in bronchial epithelial cells (BEAS-2B). Cells were exposed to SiNPs and B[a]P alone or in combination for 24 h. Co-exposure to SiNPs and B[a]P enhanced the malondialdehyde (MDA) contents and reduced superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities significantly, while the reactive oxygen species (ROS) generation had a slight increase in the exposed groups compared to the control but not statistically significant. Cell cycle arrest induced by the co-exposure showed a significant percentage increase in G2/M phase cells and a decrease in G0/G1 phase cells. In addition, there was a significant increase in BEAS-2B cells multinucleation as well as DNA damage. Cellular apoptosis was markedly increased even at the low-level co-exposure. Our results suggest that co-exposure to SiNPs and B[a]P exerts synergistic and additive cytotoxic and genotoxic effects.
Genome-wide transcriptional analysis of cardiovascular-related genes and pathways induced by PM2. 5 in human myocardial cells.
(2017-04) Feng, L.; Yang, X.; Asweto, Collins O.; Wu, J.; Zhang, Y.; Hu, H.; Shi, Y.; Duan, J.; Sun, Z.
Air pollution has been a major environment-related health threat. Most of the studies on PM2.5 toxicity have verified on the cardiovascular system and endothelial cells. However, researches on PM2.5-induced myocardial-related toxicity are limited. This study aims to fully understand the toxic effects of PM2.5 on human myocardial cell (AC16) and explore its molecular mechanism based on microarray analysis and bioinformatics analysis. Microarray data analysis manifested that PM2.5-induced toxicity affected expression of 472 genes compared with the control group, including 166 upregulated genes and 306 downregulated genes in human myocardial (AC16) cells. GO analysis showed that cellular processes such as immune response, cell maturation, embryonic heart tube morphogenesis, cellular response to electrical stimulus, skeletal muscle tissue regeneration, and negative regulation of signal transduction were upregulated, while regulation of transcription (DNA-dependent), rhythmic process, protein destabilization apoptotic process, and innate immune response were downregulated. The pathway analysis indicates that cell signaling pathways such as cytokine-cytokine receptor interaction, NF-κB signaling pathway, chemokine signaling pathway, endocrine and other factor-regulated calcium reabsorption, HTLV-I infection, and cell adhesion molecules (CAMs) were upregulated, while the TGF-β signaling pathway was downregulated. In addition, Signal-net showed that the TUBA4A, ADRBK2, BRIX1, SMC4, EIF5B, PRMT1, ATG4B, and NDC80 genes were significantly decreased, while the expression of the KRT6B gene was markedly increased compared with the control group. All the genes were verified by qRT-PCR. This study had provided new bioinformatics evidences in PM2.5-induced myocardial tissue toxicity which is necessary for further cardiovascular system toxicity studies.

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