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.

BACKGROUND: All human societies have developed ways of maintaining health, dealing with illness and injury in ways that conform to their culture and environment. People worldwide draw upon a variety of healing systems, therapeutic methods, practices, and products, often referred to as Traditional and Complementary Medicine (T&CM). The World Health Organization (WHO) has encouraged member states to develop national policies that advance the integration of T&CM in national healthcare systems to harness their potential contribution to health, wellness, and people-centered health care. Yet, no global guidelines have been developed for assisting countries in structuring and developing such policies, and little is known about the characteristics of existing T&CM policies in Latin America and their level of implementation. METHODS: A qualitative research design was used to conduct a landscape analysis characterizing existing therapeutic pluralism policies in Latin American countries through a comprehensive literature review, a policy focused qualitative content analysis, key informant interviews and a case study analyzing the formulation process of Brazil's National Policy for Integrative and Complementary Health Practices (PNPICS). A technical cooperation tool to guide T&CM policy development and revision for Latin American countries was refined through face validation and an expert consensus method (Delphi process). Data categorization and analysis were performed in MS Excel and NVivo, using deductive and inductive coding. RESULTS: A total of 74 T&CM policy documents from the 16 Latin American countries were identified and characterized according to policy mechanisms. A typology of Latin American policy approaches identified policies as: health services-centered, model of care-based, participatory, and indigenous people-focused. Selection of T&CM practices for policy inclusion vary across countries; criteria change over time in Brazil might have compromised PNPICS’ political status. Lack of PNPICS financing jeopardized its implementation. A technical cooperation tool for T&CM policy development was structured on the policy cycle: national situation analysis, policy formulation, policy implementation, policy monitoring and evaluation, and policy re-formulation, re-prioritization for incremental policy developments. CONCLUSION: With a few exceptions, therapeutic pluralism policy implementation in Latin America seems to be a real challenge, often reducing policies to cultural and political symbols. Continued research is needed on assessing the various stages of the policy process in T&CM. / 2023-09-10T00:00:00Z

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.

Yes / Studies have shown that a significant proportion of people with epilepsy use complementary and alternative medicine (CAM). CAM use is known to vary between different ethnic groups and cultural contexts; however, little attention has been devoted to inter-ethnic differences within the UK population. We studied the use of biomedicine, complementary and alternative medicine, and ethnomedicine in a sample of people with epilepsy of South Asian origin living in the north of England. Interviews were conducted with 30 people of South Asian origin and 16 carers drawn from a sampling frame of patients over 18 years old with epilepsy, compiled from epilepsy registers and hospital databases. All interviews were tape-recorded, translated if required and transcribed. A framework approach was adopted to analyse the data. All those interviewed were taking conventional anti-epileptic drugs. Most had also sought help from traditional South Asian practitioners, but only two people had tried conventional CAM. Decisions to consult a traditional healer were taken by families rather than by individuals with epilepsy. Those who made the decision to consult a traditional healer were usually older family members and their motivations and perceptions of safety and efficacy often differed from those of the recipients of the treatment. No-one had discussed the use of traditional therapies with their doctor. The patterns observed in the UK mirrored those reported among people with epilepsy in India and Pakistan. The health care-seeking behaviour of study participants, although mainly confined within the ethnomedicine sector, shared much in common with that of people who use global CAM. The appeal of traditional therapies lay in their religious and moral legitimacy within the South Asian community, especially to the older generation who were disproportionately influential in the determination of treatment choices. As a second generation made up of people of Pakistani origin born in the UK reach the age when they are the influential decision makers in their families, resort to traditional therapies may decline. People had long experience of navigating plural systems of health care and avoided potential conflict by maintaining strict separation between different sectors. Health care practitioners need to approach these issues with sensitivity and to regard traditional healers as potential allies, rather than competitors or quacks.

Prostate and breast cancer are the leading causes of cancer-related death in men and women, respectively, and metastasis is the primary factor underlying the high mortality rates.1 Snail transcription factor is an important molecule that drives prostate and breast cancer metastasis through the process of epithelial mesenchymal transition (EMT). Proteolytic enzymes that promote invasion and metastasis such as the lysosomal cysteine protease cathepsin L (Cat L) have been shown to degrade E-cadherin, promoting the epithelial mesenchymal transition (EMT).2 It has also been shown that silencing Cat L can inhibit transforming growth factor-beta (TGF-β)-mediated EMT by suppressing Snail transcription factor.3 Several recent studies have highlighted an additional unexpected localization and site of action for Cat L within the nucleus in breast, colon and prostate cancer.4 Natural products have been shown to be efficacious in prevention and possible treatment of cancer.5 Specifically, we have been studying Muscadine Grape Skin Extract (MSKE) as a possible candidate to inhibit Snail signaling. MSKE has previously been shown to promote prostate cancer apoptosis.6 We hypothesized that Snail promotes nuclear localization of Cat L, which promotes EMT associated with increased migration and invasion, and that antagonizing Snail-Cat L signaling would lead to mesenchymal epithelial transition (MET). We showed for the first time that MSKE promotes apoptosis through induction of endoplasmic reticulum stress response and autophagy. Additionally, MSKE could inhibit Snail-mediated EMT via scavenging reactive oxygen species. Moreover, Snail could promote nuclear localization of Cat L, which then promoted cleavage of CDP/Cux, increased Snail transcription and decreased E-cadherin transcription by direct promoter binding of cleaved CDP/Cux, leading to EMT associated with increased migration and invasion. Interestingly, Z-FY-CHO, a small molecule specific inhibitor of Cat L, as well as MSKE could antagonize this signaling by promoting nuclear to cytoplasmic re-localization of Cat L. Therefore, we have dissected novel mechanisms of action of Snail and how it can be antagonized by MSKE natural product.

Bakgrund: Arton procent av Sveriges befolkning lider av långvarig smärta, men hur stort mörkertalet är vet man inte. Av den äldre befolkningen har 54% kvinnor och 38% män långvarig smärta. Smärtan påverkar flera faktorer, allt från sämre välmående och fysisk trötthet, till påverkan på socialt liv och arbete. Kostnaderna för samhället beräknas varje år kosta 87.5 miljarder kronor i direkta och indirekta kostnader. Komplementär- och alternativmedicin är ett samlingsnamn för behandlingar som inte ingår i den traditionella medicinska behandlingen, bland annat massage, akupunktur, transkutan elektrisk nervstimulering (TENS), kognitiv beteendeterapi (KBT) och meditation/yoga. Syfte: Att beskriva patienters upplevelser och positiva effekter av alternativ- och komplementärmedicin vid långvarig smärta.  Metod: Studien genomfördes i form av en litteraturöversikt och baserades på 14 vetenskapliga artiklar med kvalitativ eller kvantitativ ansats. Sökningarna gjordes i databaserna CINAHL och PubMed.  Resultat: Tre huvudteman framkom i resultatet vilket var ökat välbefinnande, smärtlindring och ökad rörelseförmåga. Studierna visade att patienterna upplevde god smärtlindring och ökad livskvalité både fysiskt och psykiskt vid behandling med komplementär- och alternativmedicin. Patienter som inte uppnått smärtlindring genom den traditionella vården upplever god smärtlindring med hjälp komplementär- och alternativmedicin.  Slutsats: Komplementär- och alternativmedicin kan vara ett alternativ till traditionell behandling och ibland även ett första alternativ av flera anledningar, bland annat för att undvika biverkningar från läkemedel. / Background: Eighteen of Sweden's population suffers from long-term pain. The unmeasured data in the presence is not known. Among the older population, 54% of women and 38% prevalence of men, have long-term pain. The pain affects several factors, everything from inferior well-being and physical fatigue, to the impact on social life and work. The costs for society are estimated to cost SEK 87.5 billion annually in direct and indirect costs. Complementary and alternative medicine is a collective term for treatments that are not part of the traditional medical treatment. Examples of treatments include massage, acupuncture, transcutaneous electrical nerve stimulation (TENS), cognitive behavioral therapy (KBT) and meditation/yoga. Aim: To describe patients' experiences and the positive effect of alternative and complementary medicine of long-term pain. Method: A literature review based on 14 scientific articles with qualitative or quantitative approach. Searches have been conducted in CINAHL and PubMed. Results: Three main themes emerged in the result, which was increased wellbeing, pain relief and increased mobility. The studies indicate that the patients experienced good pain relief and increased quality of life both physically and mentally during treatment with complementary and alternative medicine. Patients who have not achieved pain relief through traditional care, experienced good pain relief with complementary and alternative medicine. Conclusion:  Complementary and alternative medicine can be an alternative to traditional treatment and sometimes even a first alternative for several reasons, among other things to avoid side effects from drugs.

Often neglected in voice study is the understanding that a singer’s instrument lives in his/her body and therefore cannot be packed away like other musical objects. Yoga and mindfulness compliment the belief of a whole body instrument. Data gathered on college campuses report that stress and anxiety are on the rise, thus reinforcing the need for MBSR and yoga as beneficial and proven tools for stress relief. The current state of research in the realm of mental health in colleges merits the study of a cohesive layout of these exercises and their expected outcomes in singing as well as stress management. Therefore, this document will present yoga sequences that align with the core aspects of singing including breath support, fluid vocal production and artistic expression. Exercises founded on principles of mindfulness are provided to bring awareness of mental qualities within a singer. Mental qualities gained from meditation practice include improved self-esteem, lowered anxiety, and increased focus. Yoga sequences will focus on certain areas of the body commonly addressed in voice studies. Collections of yoga asana, or postures, are featured to allow singers to recognize tightness and inefficiencies in their bodies, thus improving vocal function. This guide will combine yoga traditions along with mindfulness research to introduce ancient philosophies to singers and their teachers, resulting in meaningful and productive voice lessons.