Skin related injuries are some of the most dangerous forms of wounds. In addition to treating the wound itself, health care providers must be cautious of microbial infections. In this study, we evaluate a novel all-natural antimicrobial gel compound (AMG) designed to kill planktonic bacteria, penetrate bacterial biofilms, and accelerate wound healing. In -vitro experiments demonstrate that AMG is effective in inhibiting planktonic growth and biofilm development of eight common pathogens. LIVE/DEAD staining and confocal microscopy reveal that planktonic growth and three-dimensional structure of biofilms were significantly reduced. Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) was used to investigate a small panel of genes (PrsA, Sprx) and showed potential targets for future study. A physiologically relevant wound model was created for treating S. aureus infections by using AMG alone or in combination with a common topical antibiotic, Mupirocin. AMG is a safe and effective treatment option for skin related infection.

In the United States alone, there were 25.8 million people suffering from diabetes in 2010. The prevalence of diabetes is expected to markedly increase worldwide over the next 30 years, an estimated 2.8% in 2000 and 4.4% in 2030. For individuals diagnosed with type 2 diabetes mellitus (T2DM), treatment is essential to control adverse effects such as hypertension and diabetic neuropathy. The focus of this study is to examine various approaches to maintain and improve the lifestyle of individuals suffering from T2DM. A comparative approach has been used to evaluate the differences in the treatment of T2DM with the use of traditional Chinese medicine (TCM) and Western medicine. In Western society, pharmaceuticals are commonly used as a treatment method to manage hyperglycemia, along with life-style modifications. Furthermore, TCM views the human body and its functioning in a holistic way, stating that no single body part or symptom can be understood apart from its relation to a whole. Herbal medications and other treatments in TCM are targeted to treat underlying medical complaints that resulted in symptoms, instead of treating one specific manifestation. Data collection has been gathered through Qualitative over the phone interviews with patients suffering from T2DM, as well as TCM physicians. Interviews were conducted on patients that were diagnosed with T2DM (fasting plasma glucose levels of 126 or greater and HbAlc levels [greater than] 8%), and had continued treatment longer than three months prior to interviews. Collection of chart notes containing glucose levels, levels of pain, lifestyle changes, and vital signs were also used. A total of 21 patients from a family practice were interviewed, answering 23 constructed questions based on treatment of choice (TCM or western) and their personal input on treatment satisfaction. Patients varied in age, ethnicities, and gender, ranging from 39-70 years of age. Two traditional Chinese medicine physicians were also interviewed. Interviews with TCM physicians elaborated on course of treatment and steps taken to diagnose T2DM. Furthermore, prescription medications were also charted and documented to further analyze with secondary data. Upon completing the interviews, the data stated 21 patients (total population questioned) had not experienced alternative medicine and were exposed only to western medicine as treatment. A major concern for most patients were the pharmaceutical side effects, and 85.1% of patients stated they would be interested in an alternative treatment. Due to insufficient sources and knowledge on TCM treatment, 14.2% of patients stated they were satisfied with their western medicine treatment of choice and would not change treatment. The research's objective was to evaluate the differences in treatment of T2DM. Data collected supported the objective and showed the lack of sources to alternative treatments aside from western medicine. The researcher informed and educated interviewees about literature review on traditional Chinese medicine about alternative treatments available to treat T2DM.

The purpose of this study was to determine the profile of parents with children in Early Childhood Development (ECD) centres using Over the Counter (OTC) homeopathic remedies, specific to the Pretoria East region. Secondary objectives included determining the extent of use of OTC homeopathic remedies, the perceptions of parents regarding homeopathy and natural remedies as well as the positioning of homeopathy. The research was designed around descriptive and exploratory methods using quantitative research techniques. Aspects such as demographic information and the general health of families, attitudes, perceptions and opinions specific to homeopathy, natural remedies and conventional medicine, as well as details on remedy usage and brands, were addressed. From the findings of the study a clear profile could be identified. Further to the profile, the perceptions of respondents regarding OTC homeopathic remedies as well as reasons for using these remedies are discussed. The positioning of OTC homeopathic remedies was done based on spider graphs, exploratory factor analysis, cluster analysis and multidimensional scaling. Several recommendations were made to the homeopathic industry, the Ministry of Health, medical professionals, Medical Aid Schemes, pharmacists and the pharmaceutical industry, as well as the Department of Social Development. The study concludes with details specific to the limitations of the study and further research suggestions. / Economics / M.A. Commerce (Business Management)

Esta pesquisa discute a Comunicação em Saúde no contexto das Práticas Integrativas e Complementares (PIC) no Sistema Único de Saúde (SUS), no que concerne ao tratamento do câncer realizado num hospital público de Campinas. O arcabouço teórico se debruça sobre as diretrizes do ideário da Promoção da Saúde e sobre as discussões da Educação em Saúde, por serem premissas fundamentais para que a Comunicação em Saúde seja participativa e democrática, e que a Comunicação das PIC conquiste maior espaço na Saúde Pública. O objetivo geral foi investigar o processo de comunicação entre profissionais de saúde e usuários do SUS participantes do Projeto de Construção do Cuidado Integrativo (PCCI). A metodologia utilizada foi a qualitativa tendo como instrumentos pesquisa documental e entrevistas semi-estruturadas para a coleta dos dados. Os participantes do estudo foram usuários que fizeram parte do grupo de Acupuntura e de Fitoterapia e usaram práticas complementares ao tratamento convencional do câncer, e também os profissionais de saúde envolvidos no PCCI realizado no Hospital de Clínicas da Universidade Estadual de Campinas (UNICAMP)/SP. Os dados foram analisados por meio da análise temática de conteúdo de Bardin, que permitiu identificar as seguintes categorias: Medo da intervenção, Analgesia como resultado, Continuidade do tratamento, Falta de informação e Divulgação das práticas. Os resultados mostraram que houve dificuldades de comunicação, indicando lacunas importantes em relação à infraestrutura, à falta de divulgação e continuidade do tratamento complementar com as PIC, a falta de valorização da participação popular e estímulo à autonomia como preconiza o ideário da Promoção da Saúde. Concluiu-se que o modelo de saúde vigente, de base biomédica, não tem permitido a participação dos usuários, e, mais ainda, tem dificultado o desenvolvimento da comunicação democrática, humanizada e solidária. O Projeto (PCCI) foi importante em sua execução, uma vez que trouxe resultados positivos com o uso das PIC por melhorar as condições da qualidade de vida dos usuários e ter promovido analgesia, conferido maior disposição e recuperação dos movimentos. Entretanto, o Projeto (PCCI) não teve potencial o suficiente para provocar uma mudança na lógica do tratamento convencional que está hegemonicamente imerso no modelo biomédico, com isso limitando a inserção e a comunicação das PIC na Saúde Pública e dificultando a abertura para o diálogo entre os diferentes saberes. Entende-se que este é um dos principais desafios da Medicina Tradicional e Complementar (MTC). / In this research is discussed Health Communication in the light of Integrative and Complementary Practices (PIC) of the Brazilian Unified Health System (SUS), regarding cancer treatment performed in a public hospital in Campinas. The rationale is Health Promotion as an idealistic guideline, as well as the discussions of Health Education. These are fundamental premises to guarantee Health Communication in a participatory and democratic manner, and that the communication of PIC conquers more space in Public Health. The overall objective was to investigate the process of communication between health professionals and users of the Unified Health System (SUS) that participate in the Construction of Integrative Care Project (Projeto de Construção do Cuidado Integrativo - PCCI). The methodology was qualitative having as documentary research tools and semi-structured interviews for data collection. Study participants were users part of the Acupuncture and Herbal Medicine Group, which used the practices complementing the conventional cancer treatment, and also the health professionals involved in the PCCI conducted at the Clinical Hospital of the State University of Campinas (Unicamp) / SP. The data were analyzed using thematic analysis of content (Bardin), which identified the following categories: \"Intervention Fear\", \"Analgesia as a Result\", \"Follow-up Care\", \"Lack of Information\" and \"Propagation of Practices\". The results showed that there were communication difficulties, indicating significant gaps in relation to infrastructure, lack of propagation and continuity of complementary treatment with PIC, and yet no proper appreciation of popular participation neither the encouragement of autonomy advocated by the ideas of Health Promotion. Concluding, the current Public Health policy, which is biomedical based, has not yet allowed the participation of users and, even more, has hindered the development of democratic, humane and supportive communication. The Project (PCCI) was important in its execution as it brought positive results regarding the use of PIC to improve the quality of life of users, promote analgesia, confer greater willingness and recovery of movement. However, the project (PCCI) did not have enough potential, yet, to promote a change in the logic of conventional treatment, which is hegemonic immersed in the biomedical model, thereby limiting the inclusion and communication of PIC in Public Health, and hindering an opening for dialogue between different knowledge. This is one of the main challenges of Traditional and Complementary Medicine (TCM).

Esta pesquisa discute a Comunicação em Saúde no contexto das Práticas Integrativas e Complementares (PIC) no Sistema Único de Saúde (SUS), no que concerne ao tratamento do câncer realizado num hospital público de Campinas. O arcabouço teórico se debruça sobre as diretrizes do ideário da Promoção da Saúde e sobre as discussões da Educação em Saúde, por serem premissas fundamentais para que a Comunicação em Saúde seja participativa e democrática, e que a Comunicação das PIC conquiste maior espaço na Saúde Pública. O objetivo geral foi investigar o processo de comunicação entre profissionais de saúde e usuários do SUS participantes do Projeto de Construção do Cuidado Integrativo (PCCI). A metodologia utilizada foi a qualitativa tendo como instrumentos pesquisa documental e entrevistas semi-estruturadas para a coleta dos dados. Os participantes do estudo foram usuários que fizeram parte do grupo de Acupuntura e de Fitoterapia e usaram práticas complementares ao tratamento convencional do câncer, e também os profissionais de saúde envolvidos no PCCI realizado no Hospital de Clínicas da Universidade Estadual de Campinas (UNICAMP)/SP. Os dados foram analisados por meio da análise temática de conteúdo de Bardin, que permitiu identificar as seguintes categorias: Medo da intervenção, Analgesia como resultado, Continuidade do tratamento, Falta de informação e Divulgação das práticas. Os resultados mostraram que houve dificuldades de comunicação, indicando lacunas importantes em relação à infraestrutura, à falta de divulgação e continuidade do tratamento complementar com as PIC, a falta de valorização da participação popular e estímulo à autonomia como preconiza o ideário da Promoção da Saúde. Concluiu-se que o modelo de saúde vigente, de base biomédica, não tem permitido a participação dos usuários, e, mais ainda, tem dificultado o desenvolvimento da comunicação democrática, humanizada e solidária. O Projeto (PCCI) foi importante em sua execução, uma vez que trouxe resultados positivos com o uso das PIC por melhorar as condições da qualidade de vida dos usuários e ter promovido analgesia, conferido maior disposição e recuperação dos movimentos. Entretanto, o Projeto (PCCI) não teve potencial o suficiente para provocar uma mudança na lógica do tratamento convencional que está hegemonicamente imerso no modelo biomédico, com isso limitando a inserção e a comunicação das PIC na Saúde Pública e dificultando a abertura para o diálogo entre os diferentes saberes. Entende-se que este é um dos principais desafios da Medicina Tradicional e Complementar (MTC). / In this research is discussed Health Communication in the light of Integrative and Complementary Practices (PIC) of the Brazilian Unified Health System (SUS), regarding cancer treatment performed in a public hospital in Campinas. The rationale is Health Promotion as an idealistic guideline, as well as the discussions of Health Education. These are fundamental premises to guarantee Health Communication in a participatory and democratic manner, and that the communication of PIC conquers more space in Public Health. The overall objective was to investigate the process of communication between health professionals and users of the Unified Health System (SUS) that participate in the Construction of Integrative Care Project (Projeto de Construção do Cuidado Integrativo - PCCI). The methodology was qualitative having as documentary research tools and semi-structured interviews for data collection. Study participants were users part of the Acupuncture and Herbal Medicine Group, which used the practices complementing the conventional cancer treatment, and also the health professionals involved in the PCCI conducted at the Clinical Hospital of the State University of Campinas (Unicamp) / SP. The data were analyzed using thematic analysis of content (Bardin), which identified the following categories: \"Intervention Fear\", \"Analgesia as a Result\", \"Follow-up Care\", \"Lack of Information\" and \"Propagation of Practices\". The results showed that there were communication difficulties, indicating significant gaps in relation to infrastructure, lack of propagation and continuity of complementary treatment with PIC, and yet no proper appreciation of popular participation neither the encouragement of autonomy advocated by the ideas of Health Promotion. Concluding, the current Public Health policy, which is biomedical based, has not yet allowed the participation of users and, even more, has hindered the development of democratic, humane and supportive communication. The Project (PCCI) was important in its execution as it brought positive results regarding the use of PIC to improve the quality of life of users, promote analgesia, confer greater willingness and recovery of movement. However, the project (PCCI) did not have enough potential, yet, to promote a change in the logic of conventional treatment, which is hegemonic immersed in the biomedical model, thereby limiting the inclusion and communication of PIC in Public Health, and hindering an opening for dialogue between different knowledge. This is one of the main challenges of Traditional and Complementary Medicine (TCM).

Breast cancer mortality is mainly due to distant recurrence of the disease arising from dormant tumor cells established by cancer therapies. Patients who initially respond to cancer therapies often succumb to distant recurrence of the disease. It is not clear why people with the same type of breast cancer respond to treatments differently; some escape from dormancy and relapse earlier than others. In addition, some tumor clones respond to immunotherapy while others do not. We investigated how autophagy plays a role in accelerating or delaying recurrence of neu overexpressing mouse mammary carcinoma (MMC) following adriamycin (ADR) treatment, and in affecting response to immunotherapy. We explored two strategies: 1) transient blockade of autophagy with chloroquine (CQ), which blocks fusion of autophagosomes and lysosomes during ADR treatment, and 2) permanent inhibition of autophagy by a stable knockdown of ATG5 (ATG5KD), which inhibits the formation of autophagosomes in MMC during and after ADR treatment. We found that while CQ prolonged tumor dormancy, but that stable knockdown of autophagy resulted in early escape from dormancy and recurrence. Interestingly, ATG5KD MMC contained an increased frequency of ADR-induced polyploid-like cells and rendered MMC resistant to immunotherapy. On the other hand, a transient blockade of autophagy did not affect the sensitivity of MMC to immunotherapy. Our observations suggest that while chemotherapy-induced autophagy may facilitate tumor relapse, cell-intrinsic autophagy delays tumor relapse, in part, by inhibiting the formation of polyploid-like tumor dormancy. Although immunotherapy of breast cancer by means of anti-HER2 antibodies prolongs survival of breast cancer patients, disease recurrence remains a major challenge. On the other hand administration of human vaccines against infectious disease in a preventive setting or during latency/dormancy has been successful in offering a cure. Here, we sought to use adoptive immunotherapy (AIT) at the time of tumor dormancy in order to prevent progression of breast cancer. We used a low dose immunogenic chemotherapy by means of 5-FU, Adriamycin, and Cyclophosphamide (FAC) in order to stabilize tumor progression prior to AIT using autologous tumor-reactive lymphocytes. Low dose FAC established local tumor dormancy, inhibited distant tumor dormancy occurring long before distant metastasis, and induced predominate a Ki67- quiescent type of tumor dormancy, which is less susceptible to tumor immunoediting. Dormant tumor cells expressed the cell survival pathways, including the endothelin receptor/ligand (ETRA, ETRB and ET-1) and PD-L1, thereby protecting them from elimination by AIT. In addition, tumor-reactive CD8+ T cells also produced ET-1 as a survival ligand for ETRA positive tumor cells. A combination of AIT with the blockade of tumor cell survival pathways resulted in a significant improvement of AIT against tumor dormancy. We also showed that the inhibition Bcl-xL downstream of the tumor cell survival pathways is specifically effective against dormant tumor cells, suggesting a combination of AIT with small molecules inhibitors of Bcl-xL. Altogether, we showed that distant tumor dormancy is established long before distant recurrence of breast cancer, and that the expression of several tumor cell survival pathways in dormant cells protects them from immunotherapy. Our results suggest that immunotherapeutic targeting of tumor dormancy combined with the blockade of a common downstream cell survival pathway could prevent tumor progression and recurrence of the disease.

<p>Den här studien fokuserar på komplementärmedicin ur fyra informanters perspektiv och med kopplingar till aktuella vetenskapliga diskussioner och strömningar. Bakgrunden till studien är en ökande användning av komplementärmedicin i samhället och livliga debatter kring dess vetenskapliga status. Syftet är att genom kvalitativa metoder belysa viktiga aspekter av informanternas användning av komplementärmedicin. Mycket uppmärksamhet ägnas åt informanternas syn på de olika metodernas effektivitet, hur denna definieras och vilka konkreta resultat informanterna strävar efter eller upplever.</p> / <p>This study focuses on complementary medicine from the perspectives of four informants, and with reference to topical scientific discussions and currents. The background of this study is to be found in the growing use of complementary medicine in the society. The main goal is to shed light on important aspects of the informants’ use of complementary medicine. Much attention is focused on their views regarding the efficacy of the various methods, how it is defined and what concrete results they are striving for, or experiencing.</p>

Den här studien fokuserar på komplementärmedicin ur fyra informanters perspektiv och med kopplingar till aktuella vetenskapliga diskussioner och strömningar. Bakgrunden till studien är en ökande användning av komplementärmedicin i samhället och livliga debatter kring dess vetenskapliga status. Syftet är att genom kvalitativa metoder belysa viktiga aspekter av informanternas användning av komplementärmedicin. Mycket uppmärksamhet ägnas åt informanternas syn på de olika metodernas effektivitet, hur denna definieras och vilka konkreta resultat informanterna strävar efter eller upplever. / This study focuses on complementary medicine from the perspectives of four informants, and with reference to topical scientific discussions and currents. The background of this study is to be found in the growing use of complementary medicine in the society. The main goal is to shed light on important aspects of the informants’ use of complementary medicine. Much attention is focused on their views regarding the efficacy of the various methods, how it is defined and what concrete results they are striving for, or experiencing.

The purpose of this study was to determine the profile of parents with children in Early Childhood Development (ECD) centres using Over the Counter (OTC) homeopathic remedies, specific to the Pretoria East region. Secondary objectives included determining the extent of use of OTC homeopathic remedies, the perceptions of parents regarding homeopathy and natural remedies as well as the positioning of homeopathy. The research was designed around descriptive and exploratory methods using quantitative research techniques. Aspects such as demographic information and the general health of families, attitudes, perceptions and opinions specific to homeopathy, natural remedies and conventional medicine, as well as details on remedy usage and brands, were addressed. From the findings of the study a clear profile could be identified. Further to the profile, the perceptions of respondents regarding OTC homeopathic remedies as well as reasons for using these remedies are discussed. The positioning of OTC homeopathic remedies was done based on spider graphs, exploratory factor analysis, cluster analysis and multidimensional scaling. Several recommendations were made to the homeopathic industry, the Ministry of Health, medical professionals, Medical Aid Schemes, pharmacists and the pharmaceutical industry, as well as the Department of Social Development. The study concludes with details specific to the limitations of the study and further research suggestions. / Economics / M.A. Commerce (Business Management)

That people should take responsibility for their health is a prominent contemporary idea. But what does such responsibility actually entail, and what demands are being put on people? The objective of the dissertation is to describe and critically examine various ideas on personal responsibility for health. In the first step, I identify and describe a wide variation of uses of responsibility and in the second step, I problematize them. The analyzed material consists of Swedish government reports and various types of health advice literature, including medical books and alternative medicine literature. I employ a framework of philosophical, social scientific, and developmental psychology theories on responsibility to critically examine the material. The study shows that taking responsibility involves both body and mind. Common ideas are that it requires maintaining a healthy lifestyle and managing one's self-care. But it is also considered important to take responsibility for beliefs and emotions and to adopt an accepting attitude. Another idea is that spiritual insights expand the scope of responsibility. Some important abilities required to take responsibility are conscious healthy choices, self-knowledge, and critical thinking. The view of responsibility is also influenced by individual factors, cultural beliefs about health and disease, and social structures. In the literature, health responsibility is regarded both as a social duty and as a never-ending task performed by an active individual. Finally, I use Robert Kegan's theory of adult development to show that taking responsibility imposes psychological demands on people's awareness. The demands are often higher than many people can manage. Some of the stress and poor health that people experience may be the product of an inability to manage all of life's demands. The developmental perspective also asserts that people can develop the requisite capacity. One conceivable conclusion of the study is that if we want people to take more responsibility, we should not only invest resources in health information, but also in measures that generate self-knowledge, reflection, and personal development.