Rachael Charles

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Scholarly Contributions

Journals/Publications

• Agrawal, N. R., Charles, R. A., Dharel, D., Dudani, R., Rani, A., & Sultania, P. (2019). Breastfeeding Knowledge and Behavior Among Women Visiting a Tertiary Care Center in India: A Cross-Sectional Survey.. Annals of global health, 85(1). doi:10.5334/aogh.2093
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  Breastfeeding is commonly practiced by a majority of mothers in developing countries, though there are widespread misconceptions about optimal breastfeeding traditions. In addition to culturally prominent rituals and social norms, incorrect and inadequate breastfeeding knowledge is major factors for this high-risk behavior..To assess knowledge, attitude and practices of breastfeeding among girls and women visiting a tertiary care center in India and to find out the factors, which influence the breastfeeding behaviors..It is a cross-sectional, questionnaire-based study done among women attending outpatient and inpatient Department of Obstetrics & Gynecology of S.S. Hospital, Banaras Hindu University, India. A face-to-face interview using a pre-designed, self-administered, standardized questionnaire regarding knowledge, attitude, and practices of breastfeeding was conducted. The information was collected and analyzed using SPSS statistical software..Among 1000 women enrolled in the study, 89% were married, 25% were primiparous, and 52% were multiparous. More than 50% were illiterate, 91% unemployed, and 90% had hospital delivery. Of the total 770 mothers, only 55% received proper antenatal care during pregnancy, of which only 40% were counseled about breastfeeding. Regarding knowledge and attitude about breastfeeding, majority females (71.4%) considered breast milk as best food for a newborn, which was better in younger women
• Brooks, T. A., Charles, R. A., Davis, T. P., & Nametz, N. (2008). Diclofenac Attenuates the Regional Effect of λ-Carrageenan on Blood-Brain Barrier Function and Cytoarchitecture. Journal of Pharmacology and Experimental Therapeutics. doi:10.1124/jpet.107.135632
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  The microenvironment of the brain requires tight regulation for proper neuronal function. Protecting the central nervous system (CNS) from the varying concentrations of ions, proteins, and toxins in the periphery is the dynamically regulated blood-brain barrier (BBB). Recent studies have demonstrated significant modulation of the BBB in a number of diseases and physiological states, including pain. This study expands on previous explorations of acute and chronic pain-induced effects on the function and molecular cytoarchitecture of the barrier. It describes the role of cyclooxygenase (COX) up-regulation by blocking with diclofenac (30 mg/kg, i.p.), and it examines the variation in BBB regulation through various brain regions. Edema and hyperalgesia were induced by lambda-carrageenan and attenuated by the additional administration of diclofenac. Examination of unidirectional [14C]sucrose permeability with multitime in situ perfusion studies demonstrated that lambda-carrageenan significantly increased cerebral permeability and decreased brainstem permeability. There were no significant changes in any of the other brain regions examined. These permeability changes correlated with up- and down-regulation of the tight junction (TJ) protein claudin-5 in the cerebrum and brainstem, respectively. Diclofenac administration attenuated the cerebral permeability uptake as well as the claudin-5 up-regulation. In addition, diclofenac reversed the lowered permeability in the brainstem, but it did not attenuate TJ protein expression. These studies demonstrate the complex regulation of the BBB occurring during inflammatory pain and the role of COX in this process. An understanding of BBB regulation during pain states is critically important for pharmacotherapy, and it holds great promise for new therapies to treat central nervous system pathologies.
• Brooks, T. A., Charles, R. A., Davis, T. P., Egleton, R. D., Nametz, N., Ocheltree, S. M., & Seelbach, M. J. (2006). Biphasic cytoarchitecture and functional changes in the BBB induced by chronic inflammatory pain. Brain Research. doi:10.1016/j.brainres.2006.08.085
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  The blood-brain barrier (BBB) is a dynamic system which maintains brain homeostasis and limits CNS penetration via interactions of transmembrane and intracellular proteins. Inflammatory pain (IP) is a condition underlying several diseases with known BBB perturbations, including stroke, Parkinson's, multiple sclerosis and Alzheimer's. Exploring the underlying pathology of chronic IP, we demonstrated alterations in BBB paracellular permeability with correlating changes in tight junction (TJ) proteins: occludin and claudin-5. The present study examines the IP-induced molecular changes leading to a loss in functional BBB integrity. IP was induced by injection of Complete Freund's Adjuvant (CFA) into the plantar surface of the right hindpaw of female Sprague-Dawley rats. Inflammation and hyperalgesia were confirmed, and BBB paracellular permeability was assessed by in situ brain perfusion of [14C]sucrose (paracellular diffusion marker). The permeability of the BBB was significantly increased at 24 and 72 h post-CFA. Analysis of the TJ proteins, which control the paracellular pathway, demonstrated decreased claudin-5 expression at 24 h, and an increase at 48 and 72 h post-injection. Occludin expression was significantly decreased 72 h post-CFA. Expression of junction adhesion molecule-1 (JAM-1) increased 48 h and decreased by 72 h post-CFA. Confocal microscopy demonstrated continuous expression of both occludin and JAM-1, each co-localizing with ZO-1. The increased claudin-5 expression was not limited to the junction. These results provide evidence that chronic IP causes dramatic alterations in specific cytoarchitectural proteins and demonstrate alterations in molecular properties during CFA, resulting in significant changes in BBB paracellular permeability.

Poster Presentations

• Kraught, J. (2023, July). Lactation Education for Medical Residents: Creating an Interdisciplinary Breastfeeding Elective. AZ AAP Pediatrics in the Red RocksAZ AAP.