International Journal of Nursing Education and Research

M. Marie Rosy ¹

Affiliations
1 KVM Trust, KVM College of Nursing, Pb.No 13, Cherthala, Alappuzha-688539, Kerala, IN

Abstract

To establish self-reported skill levels, behaviors and barriers in relation to evidence-based practice (EBP) among a nurses and midwives in senior roles. Capacity building interventions are needed among senior nurses and midwives, as the most prominent knowledge sources reported are non-evidentiary in nature and barriers to finding and reviewing evidence, along with barriers to making practice change, remain significant. Women with less access to resources, particularly those in rural areas, can face considerable obstacles in obtaining maternal health care Pregnant women in rural areas are more likely to receive delayed or no prenatal care and to receive less adequate care when it is available, factors that contribute to higher infant mortality. The vast majority of midwives in the United States (U.S.) are certified nurse-midwives (CNMs) and certified midwives (CMs). CNMs are licensed and have prescriptive authority in every state. CMs are licensed in five states. This growth of midwifery has been supported by published research that demonstrates midwifery care is associated with high-quality and is comparable or in some studies, better outcomes than care provided by obstetrician/gynecologists. Recipients of care by midwives report high levels of patient satisfaction, and midwifery care results in lower costs due to fewer unnecessary, invasive, and expensive interventions.

Keywords

EBP-Evidence Based Practice, PICO-Problem Intervention, Comparison, Outcome, MIDIRS-Midwife Information Resource Service, CINAHL-Cumulative Index of Nursing and Allied Health Literature, MeSH-Medical Subject Heading, RR-Risk Ratio, RRR-Relative Risk Ratio, CI-Cumulative Index, ARR-Absolute Risk Reduction, CER–Control Group Exposed to Risk, EER-Experimental Group Exposed to Risk.

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M. Marie Rosy ¹

Affiliations
1 Aditya College of Nursing, Kogilu Cross, Behind Annapornaserwari Temple, Yelahanaka, Bangalore-64, IN

Abstract

Stem cell science and therapies related to stem cell are making remarkable progress. Menstrual blood has always been a subject of study in different researches due to its easy availability. The possibility of isolation of stem cells from the menstrual blood and the umbilical cord blood cells has opened a new channel in stem cell research that can offer future therapeutic benefits to mankind. Several successful researches have shown the use of the stem cells derived from the endometrial blood for the treatments of different fatal diseases. The current breakthrough discovery that the menstrual blood contains stem cells that are proliferative and are capable of differentiating into different types of cells including cardiac cells, neural cells and into almost 9 types of tissues including heart, liver and lung, has opened a new field for therapeutic treatment.

Since the stem cells can be easily obtained from the sources of umbilical cord blood and menstrual blood, hence much research on the subject has been made possible. Moreover, the stem cells from these sources have the potential to differentiate into many types of cells and being immunologically immature offers them the potential to promote cell survival rather than playing a role in cell replacement, which takes place after cell transplantation. The stem cells derived from the menstrual blood i.e. menstrual blood-derived stem cells (MenSCs) have the additional advantage of being available every month in a woman in her reproductive age; hence, could be collected easily than the human umbilical cord blood cells (huCBs), which could be collected only at the time of birth. According to research based on neuroscience, it has been found that the transplantation of the stem cells isolated from the umbilical cord blood cells and the menstrual blood cells can help the therapeutics of the various neurological disorders like Alzheimer's disease (AD), amyotrophic Lateral sclerosis, stroke, etc. It has been found that the transplantation of huCBs in the animal models of those neurological diseases helped in the reduction of inflammation that is the main component of the neuro degenerative diseases. Although, the transplanted huCBs failed to enter the brain in most of the cases, they often helped in the behavioural improvement. These cells were found to have anti-inflammatory properties as also being proangiogenic in nature, that is, capable of encouraging tissue repair and cell growth.

The transplantation of MeSCs in the animal models of stroke resulted in the differentiation of the MeSCs into different neural cell types. It had the potential to protect against the deprivation of oxygen-glucose in the animal models as well as the laboratory cultures of stroke (in vitro and in vivo). The transplanted cells secreted factors that had neuro-protective effect. This may be related to the secretion of vascular endothelial growth factors (VEGF), brain-derived growth factors (BDNF), and neurotrophin-3 (NT-3) by the cells, which play important role in the treatment of stroke.Both blood vessels as well as neurons are essential for brain repair after stroke. The stem cells have the potential to spur the growth of both the vital components. It has been found that a specific type of stem cell derived from the menstrual blood was more potent than the adult stem cells as it could differentiate into more tissue types i.e. from fat to muscle to nerve.

Research studies have proved the use of MeSCs in preventing amputation of limbs due to peripheral artery disease. Critical limb ischemia is an advanced stage of Peripheral artery disease that caused very low blood flow in the limbs thereby causing withering of limbs leading to its amputation. There is neither medicinal nor surgical treatment for the advanced stage of the disease. Studies in mice models of the advanced stage of the disease were carried out and it was seen that the treatment with the injection of endometrial regenerative cells (ERCs) or the MeSCs were found to help in the revitalisation of the limbs and restored its functionality. The ERCs have regenerative properties and could help in the stimulation of blood vessel growth. Moreover, the ERCS are easily injectable without the use of any complex instruments. The ERCs did not invoke any immunological response, hence could be used in "off the shelf" manner i.e. the injection of ERCs do not require any sort of matching before introduction into the point of care. The translation of the mice studies into human clinical trials are awaited in near future.

Hence, the menstrual blood offers a better alternative for adult stem cells that can circumvent the various logistical and ethical limitations faced by the embryonic stem cells, due to constant debates over the use of embryonic stem cells in medical research, thereby helping in new discoveries related to use of stem cells in medical practice.

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