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Individuals are becoming more dependent on medication for conditions such as chronic-pain, anxiety, and depression. It is reported that patients are often overprescribed medication while health outcomes do not improve. The medicalization of society is distracting attention from the possibility of other therapies such as complementary or alternative medicine (CAMs) that can improve health outcomes if they were as supported as pharmacological research and better received by the medical community. Yoga and meditation, the components of Mindfulness Based Stress Reduction (MBSR) and yoga therapy, have been shown as effective CAMs for cases of anxiety and depression related to chronic illness or chronic pain. There is little agreement in research, among yoga practitioners, and in the medical community on how to prescribe the delivery of yoga therapy interventions to reduce pain, depression, or anxiety. The purpose of this quantitative study and, to address this gap in the literature, is to provide the medical community protocols for the delivery of yoga therapy and to discover a “dose response” for yoga therapy among 6 individuals suffering pain and related affective disorders such as anxiety and depression. The findings of this study showed no significant difference among individuals who practice yoga therapy at the rate of one or three times per week on reported levels of depression, anxiety, pain, perceived stress or quality of life depending on the rate of practice. This study could impact the over-prescription of medication and reduce the dependence on psychopharmacology for management of affective disorders

Individuals with epilepsy manage the clinical manifestations of the condition, primarily seizure-related activity, with daily use of pharmacologic agents, making it one of the most common neurological conditions treated with drug therapy for symptom management. Pharmacologic agents for epilepsy, also known as anti-epileptic drugs (AEDs), are commonly prescribed to treat seizures and neurologic conditions associated with epilepsy but can lead to a reduced quality of life and many unwanted side effects. Complementary and alternative treatments can also provide relief from seizures associated with epilepsy. The purpose of this literature review was to evaluate the effectiveness of complementary and alternative treatments compared to pharmacological treatment for individuals with epilepsy. A literature review examining different alternative treatments, such as physical activity, medical cannabis, neurostimulation, and various diets, and their benefits on seizure reduction, seizure frequency, and the quality of life was conducted from various online databases. Research articles published from 2003 to 2020 that focused on the benefits of complementary and alternative therapies in controlling the clinical manifestations of epilepsy were included for synthesis. Results from 10 studies that used a complementary or alternative therapy as a treatment for epilepsy, alone or in combination with pharmacological therapy, were compared for effectiveness on clinical manifestations. Seventy percent of the studies analyzed show at least a fifty percent reduction in seizure frequency. The studies suggest that complementary and alternative therapies can be effective as monotherapy or as adjuvant agents for reducing seizure frequency, reducing seizure duration, and improving quality of life. Although benefits were found in each study, many studies were performed on animals or had small sample sizes, indicating the need for further research.

In people with Multiple Sclerosis (MS) balance impairments may lead to increased falls and mobility loss. In quiet stance, people with MS display greater postural sway than healthy controls. Tai Chi is a Chinese martial art that has decreased the risk of falling in frail elderly individuals (Wolf et al., 1996). The purpose of this study was to determine if a three week Tai Chi intervention would improve postural stability in people with MS. Seven participants (6F/1M, age 48.5 ± 10.8 years, height 1.66 ± 0.08m, mass 68.6 ± 19.8kg) attended nine one hour training sessions to practice two types of Tai Chi: standing meditation and slow walking. Postural stability was assessed before and after training using average center of pressure (CoP) velocity, total excursion and time to contact (TtC) for the static trials, and dual and single limb support times for the walking trials. To measure postural stability trials of quiet stance (QS), Tai Chi standing meditation with (SMA) and without arms (SM), tandem stance (TS), preferred speed walking (PW) and slow speed walking (SW) were assessed. Kinematic data recorded by a 12 camera motion capture system (Qualysis AB), and kinetic data collected from a single forceplate (AMTI) were used to compute net CoP. Because functional parameters can influence stability, strength obtained from a chair rise test and neural drive obtained from a foot tapping test were obtained. All results were assessed with paired t-tests (p.05). For SMA, average CoP velocity (p=.006) and excursions (p=.023) increased, and average TtC (p=.020) was reduced. For TS average CoP velocity (p=.06) and excursions (p=.09) trended towards decreased values, and average TtC (p=.045) increased. With the exception of increased left single limb support time (p=.009) PW and SW were not affected by the intervention. In conclusion, the increased neural drive, muscular strength, and postural stability in TS supports the idea that a three week Tai Chi intervention is effective at improving static balance in people with MS.

Obesity is an urgent global public health concern as prevalence rates continue to increase, especially among children. At the cellular level obesity is defined by an increase in adipocyte number (hyperplasia) and size (hypertrophy). Both lead to the dysfunction of adipose tissue, which has been identified as the link between obesity and chronic disease. Bioactive compounds, naturally occurring in fruits and vegetables, hold enormous potential in regulating adipocyte biology. Quercetin, the most commonly consumed dietary flavonoid, is a strong potential anti-obesity agent that has been implicated as an AMP-activated protein kinase (AMPK) activator and shown to ameliorate symptoms of metabolic syndrome in vivo. Here we investigated quercetin’s effect on (1) adipogenesis, the process of increasing adipocyte number, and (2) metabolism of mature adipocytes. In 3T3-L1 preadipocytes, quercetin dose-dependently inhibited adipogenesis, as evidenced by decreased lipid accumulation and expression of adipogenic markers such as peroxisome proliferator-activated receptor (PPAR) γ, CCAAT/ enhancer binding protein (C/EBP) α, adipocyte fatty acid binding protein 2 (aP2), and acetyl-CoA carboxylase (ACC) on mRNA and protein levels. This inhibitory effect was limited to the early stages of adipogenesis (0-36 hours), and quercetin treatment altered the normal expression pattern of cell cycle related genes Cyclin A and p27, indicating quercetin may inhibit adipogenesis through cell cycle events. We next investigated quercetin’s ability to activate AMPK and the metabolic pathways related to AMPK activation: lipolysis and b-oxidation. Quercetin increased phosphorylation of AMPK and its downstream target ACC. Further, quercetin treatment (100μM) increased free fatty acid content in the media through an AMPK-dependent mechanism. Quercetin up-regulated mRNA expression of uncoupling proteins 3 (UCP3) and peroxisome proliferator-activated receptor-gamma co-activator 1 alpha (PGC-1a), indicating that quercetin may induce mitochondrial oxidative pathways, also through an AMPK-dependent pathway. These findings suggest (1) quercetin inhibits adipogenesis through the regulation of early cell cycle events required for adipogenic differentiation, and (2) quercetin’s activation of AMPK induces lipolytic and oxidative pathways. Taken together, quercetin could be further developed as an anti-obesity agent because of its potential to inhibit both hyperplasia and hypertrophy in vitro.

For the past 40 years, antiangiogenic approaches have been of major interest in the development of methods to cure and prevent cancer. Angiogenesis, the development of blood vessels from pre-existing vascularization, is essential for cancer growth and spread of metastasis through the delivery of nutrients and oxygen essential to sustain the metabolic activity of these malignant cells. Blocking access to blood will cause cancerous cells to assume a dormant state creating inactive micro-tumors innocuous to the host. Angiostatin, the internal fragment of the fibrinolytic zymogen plasminogen, has shown great potential in reducing cancer size and number of metastatic colonies in animal models. Owing to the success of these preliminary results angiostatin is currently on clinical trials. Plasminogen is known to be transferred from blood to milk during lactation. The objectives of this research were to: 1) investigate the ability of various proteases in cleaving plasminogen, both from human and bovine sources, and consequently release the angiostatin like fragment; 2) determine the anticancer activity of bovine angiostatin; 3) examine ability of the antiangiogenic fragment to survive digestion; 4) purify the fragment of interest through column chromatography. Production of angiostatin was tested through hydrolysis of plasminogen via Bacillus Polymyxa protease (or dispase I), elastase, lactic acid bacteria and Bacilli originated enzymes. Once proteases capable of angiostatin like peptide production were identified, and sequence analysis of the fragments obtained conducted to confirm that bovine angiostatin was indeed produced, ability of angiostatin, both human and bovine, in inhibiting malignant melanoma as well as colon cancer cells was evaluated in vitro. From the results obtained we can confirm that bovine angiostatin inhibitory activity on cancerous cells is similar to that observed for human angiostatin. Analysis of bovine angiostatin survival through in vitro human digestion model was also examined. Results show good possibility of angiostatin surviving digestion, even if confirmation of these results is required through further in vivo studies. Additionally, digestive enzymes such as trypsin and α-chymotrypsin showed ability in cleaving plasminogen directly to release a 25kDa fragment. Knowing that each kringle has some degree of anticancer activity it would be of interest to further study the possibility of angiostatin related fragments to be produced during milk digestion. Finally, affinity chromatography through L-lysine used to purify human angiostatin resulted to be an adequate method for bovine angiostatin purification. Preliminary results obtained from this study open a new area worth investigating to uncover the potential of using bovine angiostatin in the development of novel food products capable of cancer prevention.

The objectives of this research were to evaluate the antibacterial activity and to determine the chemical composition of a list of medicinal plants used by Native Americans in California. Artemisia californica, Mimulus aurantiacus, Equisetum telmateia, Equisetum hyemale, and Marah fabacea were selected from a list of plants reported as having been used for ailments related to infections by tribes located in California. The extracts obtained through steam distillation from E. telmateia, E. hyemale and M. fabacea were assayed for in vitro antibacterial activity against 16 Gram-negative and 6 Gram-positive bacteria using disk diffusion assays and measuring the diameters of inhibition zones. E. telmateia showed the most promising antibacterial activity. The extracts from A. californica, M. aurantiacus and E. telmateia were analyzed for chemical composition, finding eucalyptol, thujone, eugenol, caryophyllene, germacrene D, and propanal as some of the secondary metabolites identified using GC-MS. Our results suggest that E. telmateia can be a potential source for novel antimicrobials against pathogenic bacteria.

Objective . To examine the feasibility of family participation in a nurse-supported, multicomponent intervention program for delirium prevention in the older hospitalized adult. Background . Delirium is the leading complication of hospitalization for older adults and is associated with important consequences including increased morbidity and mortality, increased use of health care resources, and increased caregiver burden. The potential role that family caregivers could play in delirium prevention and how nurses could facilitate family participation has been largely unexplored. The Calgary Family Intervention Model (CFIM), operating on the assumptions of a family-centered care philosophy, provided a framework for understanding the feasibility of family participation in delirium prevention efforts. Methods . A descriptive exploratory design using a convenience sample of 15 family caregivers of older hospitalized adults at a large teaching hospital was used to address the research questions. For the Family Participation Delirium Prevention Program (FPDPP), family caregivers implemented five intervention protocols targeted toward four baseline risk factors for delirium and self-tracked daily intervention completion. Feasibility was based on rates of intervention completion, and consideration of the barriers and facilitators for participation based on older adults' and family caregivers' responses on discharge questionnaires and staff nurses' responses on a questionnaire. Results . Intervention completion was highest for the orientation protocol (83.5%), followed by the vision protocol (81.5%), therapeutic activities protocol (76.9%), hearing protocol (73.6%), and early mobilization protocol (55.3%). Three themes emerged on the barriers and facilitators for family participation: therapeutic relationships, partnership, and environment. The barriers and facilitators were generally consistent with the concept of family-centered care as described in the CFIM. Conclusion . Based on the rates of intervention completion, it appears that the FPDPP is feasible for implementation in clinical practice. A remarkable level of agreement was found on the concept of the feasibility of family participation among older adult patients, family caregivers, and staff nurses with the common themes that emerged. Key to its successful implementation will be recognition and attention to the barriers and facilitators for participation. In addition, operating from a framework of family-centered care, nurses can advocate for environments that support family caregivers' participation in a delirium prevention program.

Alzheimer’s disease (AD) affects over 5 million individuals in the United States annually. By the year 2050, the number of individuals living with AD is projected to triple (Latest Alzheimer’s Facts and Figures, 2016). Although there is no cure for AD, there are many prescriptive pharmacologic agents used to help manage the clinical manifestations of the disease. Complementary and alternative medicines (CAM) and herbal supplements are also used in the treatment of AD, however indications for their use and effectiveness during the progression of AD have not been examined. The purpose of this study was to examine the use of herbal supplements in managing the clinical manifestations of AD. The secondary purpose was to compare a variety of herbal supplements used to treat the clinical manifestations of AD and to evaluate the most widely used and most beneficial for clinical practice. A literature review examining herbal supplements and their risks, benefits, and uses in AD was conducted from multiple online databases. Peer reviewed articles published in the English language from 1998-2016 that focused on herbal supplements used to control the clinical manifestations of mild to severe AD were included for synthesis. Results from 14 studies that used herbal supplements as a treatment for the clinical manifestations of AD were compared for effectiveness in the management of symptoms. The findings suggest Ginkgo Biloba is the most effective and widely used herbal supplement in the treatment for cognitive decline in AD. Other supplements including Saffron, Curcumin, Cistanches Herba, and Sage were found to improve memory function and activities of daily living in individuals with AD. Herbal supplements can be cost effective and easier to retrieve for many individuals in comparison with prescriptive drug therapy. Although the research demonstrated beneficial results with the use of herbal supplements, the limitations of these studies make the application of the results problematic. Therefore, further research in this area is required.

Ginger (Zingiber Officinale) has been used in Asia for centuries to treat various ailments. Ginger has been reported to alleviate migraine pain via four bioactive compounds that can reduce nitric oxide synthase (NOS) resulting in the inhibition of nitric oxide (NO). The inhibition of nitric oxide results in the vasoconstriction of the intracranial blood vessels alleviating migraine pain. It is hypothesized that ginger has structural similarities to vasoconstrictor drugs causing similar receptor interactions. A review of the bioactive compounds in ginger and popular vasoconstrictor drugs was done to determine structural similarities. The results of this study show that the compounds in ginger share no structural similarities with vasoconstrictor drugs used in the treatment of migraine headaches.