Cancer is responsible for about 25% of deaths in developed countries and for 15% of all deaths worldwide. Cancer is a devastating disease and while there have been great advances in the development of anticancer drugs, off-target toxicity is a major limitation with conventional cancer chemotherapy. The consequence of this form of treatment results in the killing of healthy and rapidly-growing non-cancerous cells including cells in the bone marrow; hair follicles; and cells in the mouth, digestive tract, and reproductive system. In addition to these general effects, certain anticancer drugs can have other associated toxicities. For instance, the anticancer drug doxorubicin (Dox), which my research has focused around, has dose-limiting cardiotoxicity. For these reasons, there has been much research focused on improving the selectivity of anticancer drugs in order to lower their toxicity to normal cells and decrease associated side effects. To circumvent the problem of non-selectivity, many methods have been developed to target cancer cells regionally at the site of the tumor. One such method is photodynamic therapy (PDT) which relies on a photosensitizer that is activated using light directed towards the tumor. Once activated, the photosensitizer creates singlet oxygen, which is cytotoxic to the illuminated tumor cells. PDT has shown profound effects in the treatment of many cancers including head and neck, lung, bladder, prostate, and esophagus. As PDT continues to be streamlined, it has the potential to serve as a standalone modality in the treatment and management of cancer at different stages. However, there are many inadequacies in the use of PDT. The fundamental problem lies in the inability of PDT to treat solid, bulky tumors or deep-seated tumors. This is partly due to the fact that current PS used cannot effectively kill cancer cells because with increasing tissue thickness the number of hypoxic cells increases. We have designed a new light based drug delivery which will allow for drugs to be released on the surface of the tumor, allowing the drug to freely diffuse through the tumor without the need of O2 and also, due to the manner our drug is attached, a more potent form the pre-attached drug is released. In this methodology, drug delivery will only be specific to an area of interest and the potential for side effects emerging from chemotherapy should be limited. Here we have shown, for the first time the generation of highly potent drug in a light dependent manner via a photocaging molecule and the commonly used chemotherapy agent Dox. We designed our photocage to generate a latent reactive form of Dox after illumination with UV light. This intermediate reacts in an intramolecular fashion to generate a highly potent form of the drug compared to its previous unattached form. Because of its high potency we have named the cleaved drug Super-Dox. Once the synthesis of the photocleavable drug conjugate was complete and we confirmed the photorelease of Super-Dox, via photolytic assay, and confirmed our drug conjugate is 80% cleaved from its photocage after 30 minutes of irritation with UV light. Next, we performed cell viability assays using MCF7 breast cancer cells to determine the efficiency of our drug conjugate to induce cell death. Our drug conjugate was able to induce significant cell death in the presence of light when compared to the dark. When compared to Dox, our cleaved drug conjugate is 26 folds more potent with light illumination an when compared to toxicity in the dark our drug conjugate was 374 fold less potent when conjugated to the photocage. However, our drug conjugate was not completely benign in the dark due to cell permeability, evidenced by confocal microscopy, we have worked equip our linker with sulfated cell impermeable group that will lower its background toxicity in the dark and allow us to achieve even higher enhancements in activity with light. This type of innovation creates a new avenue into cancer treatment which can limit adverse side effects and improve overall treatment.

Increased systemic infections and growing resistance of Candida species in immunosuppressed people have prompted research for additional treatment options. The purpose of this quantitative study was to investigate the potential of lemongrass, oregano, and thyme essential oils tested individually, combined, and combined with the antifungal agents fluconazole and caspofungin to kill Candida albicans isolates in a controlled laboratory setting. This study was grounded on the theoretical concepts of the epidemiologic triangle model. The experimental data collected were used to investigate risk factors related to age, gender, race, and comorbidities. Kill rates of lemongrass, oregano, and thyme essential oils individually and combined, kill rates of fluconazole, caspofungin, and the kill rates when the antifungals were each combined with the 3 essential oils were compared using 117 isolates recovered from bloodstream infections between January 2009 through August 1, 2017. The data collected were analyzed using 2-way repeated ANOVAS. According to study results, there were statistically significant increases in kill rates when the isolates were exposed to any of the combinations of essential oils tested. Using binomial and multinomial regression to analyze age, gender, race, and comorbidities resulted in the age group 25-34, kidney failure, and solid organ tumor cancer all being statistically significantly associated with an increased risk for Candida albicans bloodstream infections, and multiple organ failure negatively associated with the risk. Health care practitioners can use the results of this study to reduce the number of patients becoming infected with life-threatening yeast infections, which could reduce the costs associated with infections.

Breast cancer is one of the leading causes of morbidity and mortality among women. A diagnosis of cancer is a stressful event that requires an individual to adapt to new stressors. The purpose of this qualitative study was to better understand the perceptions of mana'olana/hope and living with breast cancer among Native Hawaiian women. The conceptual framework of this phenomenological study was positive psychology. Data collection included in-depth interviews with 5 Native Hawaiian women who had been diagnosed with breast cancer. Data coding and analysis resulted in identification of 8 themes. The themes included: (a) mana'olana /hope is the essence of my being, (b) family strengthens me and gave me mana'olana/hope, (c) my relationship with God and Jesus promoted mana'olana/hope in me, (d) my religious affiliation promoted mana'olana/hope in me, (e) the cancer support group promoted mana'olana/hope in me, (f) the cancer treatment team promoted mana'olana/hope in me, (g) treatment options; Allopathic, Osteopathic, Naturopathic, Alternative medicine, and herbal remedies promoted mana'olana/hope in me, and (h) nature's beauty and the arts promoted mana'olana/hope in me. Results may be used by health psychologists, cancer treatment practitioners, and the field of biobehavioral oncology to support and improve the well-being and health outcomes of women diagnosed with breast cancer.

Objective: From a patient-centered perspective, this study sought to explore cancer patient experiences using integrative health techniques, while undergoing or after having completed conventional cancer therapy. Methods: Recruitment and data collection both occurred within the Supportive Care Medicine Department of a comprehensive cancer center in the southeastern United States. The primary collection method was semi-structured interviews, of which 13 were conducted. Results: Patients using integrative therapies experienced a variety of physical and mental/emotional benefits from their chosen therapy, such as management of lymphedema and nerve damage, increased mobility, and improved self-confidence. Conclusion: Integrative therapies can provide many benefits to patients in mitigating treatment side effects and other cancer related symptoms. CAM practitioners themselves played an important role in post-treatment cancer support; both by acting as a health educator and by administrating the therapy itself.

Background This thesis investigated the efficacy and safety of Bacopa monnieri in improving memory in healthy Australians over the age of 55-years. A review of the literature showed that memory impairment and dementia are increasingly prevalent in the current demographic climate of an ageing population. As well as the pathological cognitive loss of neurodegenerative disease, many older persons are experiencing memory loss as part of the physiological process of ageing. Bacopa monnieri is a herbal medicine used since antiquity in the traditional Ayurvedic medical system of India for its cognitive enhancing effects. A number of pre-clinical and clinical studies support this traditional usage. Laboratory studies have demonstrated antioxidant and cholinergic actions in the brain as well as improved memory and cognitive performance in animal models. Human trials of Bacopa have also demonstrated improved memory performance. Some of these trials are limited by methodological flaws such as lack of blinding, small sample sizes, or use of outcome measurements which are not well validated. However, a small number of well designed human trials provide evidence for efficacy in cognitive and memory performance improvement. The current study was employed to extend on previous findings by assessing the efficacy and safety of Bacopa in the aged population specifically, as it is in this population that memory impairment becomes apparent. Aims 1. To assess the efficacy of Bacopa monnieri in improving memory in healthy Australians over the age of 55-years. 2. To assess whether the use of Bacopa is associated with side-effects Design A 12-week, randomised, double-blind, placebo-controlled, parallel group clinical trial. Participants Participants were self selected from the general population. They were aged 55-years or over at the commencement of the trial. Participants were without dementia, depression or other serious health conditions and did not use psychotropic medications. Intervention Participants were randomised to one of two treatment conditions, either a tableted extract of Bacopa monnieri called Bacomind™ (300mg/day, standardised to contain at least 40% bacosides), or an identical placebo. Participants attended three clinical evaluations: the first an initial screening session, the second a baseline evaluation of neuropsychological function and subjective memory performance at the commencement of the trial and the third, an end-of-trial outcome evaluation at 12-weeks, during which neuropsychological function and subjective memory performance were again assessed along with side-effects and study compliance. Primary Outcome Measures Rey Auditory Verbal Learning Test (AVLT), Rey-Osterrieth Complex Figure Test (CFT), Memory Complaint Questionnaire (MAC-Q), and Trail Making Test (TMT) Results From 136 people who elected to participate, 103 people met study entry criteria and 98 of these commenced the trial. Of these, 81 participants completed the trial and provided evaluable data for the end point analysis. Bacopa monnieri versus placebo significantly improved verbal learning as well as delayed recall as measured by the AVLT (p<.05). Though improvements were noted in the CFT, MAC-Q and TMT, there were no significant differences between placebo and active groups found for these tests. The Bacopa group reported a higher incidence of gastro-intestinal (GIT) side-effects than the placebo group, these predominantly being increased stool frequency, abdominal cramps and nausea. No other significant adverse effects were found. Conclusions A clinical trial was carried out to assess the effects of 12-weeks administration of Bacopa monnieri (300mg/day) on memory performance in people over the age of 55-years. Primary outcome measures were well validated neuropsychological tests that objectively measured verbal and visual memory and a memory complaint questionnaire that measured subjective memory complaints. The results demonstrated that Bacopa significantly improved memory acquisition and retention in older Australians. This concurs with findings from previous human and animal studies, as well as supports traditional Ayurvedic claims and uses. The beneficial effects on memory observed may be due to previously demonstrated antioxidant and cholinergic effects of the herb on the central nervous system. The use of Bacopa was associated with GIT side-effects, particularly increased bowel movements, nausea and abdominal cramping, findings infrequently reported previously. Possible explanations for these side-effects include GIT irritation by the saponin constituents of the herb, or cholinergic stimulation of autonomic and motor responses in the GIT, or a combination of both of these factors. The side-effects observed in the current study provide supportive evidence that Bacopa may increase cholinergic activity in humans. A worthwhile future extension of the current study would be to assess whether the finding of Bacopa’s efficacy for improving memory performance is replicable in populations with either mild cognitive impairment or early dementia.

Advances in healthcare and shifts toward patient and family centered care have allowed healthcare professionals to focus on the entirety of a patient and what affects his/her health. In noting such changes, and in consideration of what affects quality of life, findings in the literature address the physiological and physiological differences between those who are caregivers versus those who are not caregivers. This study investigated the relaxation state of those who were considered informal caregivers of hospice and palliative patients in an acute hospitalized setting. A family centered music therapy session was conducted utilizing a music-­‐ assisted relaxation intervention incorporating a loving-­‐kindness meditation. A total of 29 participants, 15 males and 13 females, took part in the study and 28 participants were included in data analysis. Findings from the study suggest an increase in relaxation scores after taking part in the brief intervention. Participant survey responses indicated participants’ agreement with feeling more relaxed and supported as a caregiver after the intervention. Survey results also indicated participants’ willingness to try some relaxation techniques from the study intervention on their own.

Background This thesis investigated the efficacy and safety of Bacopa monnieri in improving memory in healthy Australians over the age of 55-years. A review of the literature showed that memory impairment and dementia are increasingly prevalent in the current demographic climate of an ageing population. As well as the pathological cognitive loss of neurodegenerative disease, many older persons are experiencing memory loss as part of the physiological process of ageing. Bacopa monnieri is a herbal medicine used since antiquity in the traditional Ayurvedic medical system of India for its cognitive enhancing effects. A number of pre-clinical and clinical studies support this traditional usage. Laboratory studies have demonstrated antioxidant and cholinergic actions in the brain as well as improved memory and cognitive performance in animal models. Human trials of Bacopa have also demonstrated improved memory performance. Some of these trials are limited by methodological flaws such as lack of blinding, small sample sizes, or use of outcome measurements which are not well validated. However, a small number of well designed human trials provide evidence for efficacy in cognitive and memory performance improvement. The current study was employed to extend on previous findings by assessing the efficacy and safety of Bacopa in the aged population specifically, as it is in this population that memory impairment becomes apparent. Aims 1. To assess the efficacy of Bacopa monnieri in improving memory in healthy Australians over the age of 55-years. 2. To assess whether the use of Bacopa is associated with side-effects Design A 12-week, randomised, double-blind, placebo-controlled, parallel group clinical trial. Participants Participants were self selected from the general population. They were aged 55-years or over at the commencement of the trial. Participants were without dementia, depression or other serious health conditions and did not use psychotropic medications. Intervention Participants were randomised to one of two treatment conditions, either a tableted extract of Bacopa monnieri called Bacomind™ (300mg/day, standardised to contain at least 40% bacosides), or an identical placebo. Participants attended three clinical evaluations: the first an initial screening session, the second a baseline evaluation of neuropsychological function and subjective memory performance at the commencement of the trial and the third, an end-of-trial outcome evaluation at 12-weeks, during which neuropsychological function and subjective memory performance were again assessed along with side-effects and study compliance. Primary Outcome Measures Rey Auditory Verbal Learning Test (AVLT), Rey-Osterrieth Complex Figure Test (CFT), Memory Complaint Questionnaire (MAC-Q), and Trail Making Test (TMT) Results From 136 people who elected to participate, 103 people met study entry criteria and 98 of these commenced the trial. Of these, 81 participants completed the trial and provided evaluable data for the end point analysis. Bacopa monnieri versus placebo significantly improved verbal learning as well as delayed recall as measured by the AVLT (p<.05). Though improvements were noted in the CFT, MAC-Q and TMT, there were no significant differences between placebo and active groups found for these tests. The Bacopa group reported a higher incidence of gastro-intestinal (GIT) side-effects than the placebo group, these predominantly being increased stool frequency, abdominal cramps and nausea. No other significant adverse effects were found. Conclusions A clinical trial was carried out to assess the effects of 12-weeks administration of Bacopa monnieri (300mg/day) on memory performance in people over the age of 55-years. Primary outcome measures were well validated neuropsychological tests that objectively measured verbal and visual memory and a memory complaint questionnaire that measured subjective memory complaints. The results demonstrated that Bacopa significantly improved memory acquisition and retention in older Australians. This concurs with findings from previous human and animal studies, as well as supports traditional Ayurvedic claims and uses. The beneficial effects on memory observed may be due to previously demonstrated antioxidant and cholinergic effects of the herb on the central nervous system. The use of Bacopa was associated with GIT side-effects, particularly increased bowel movements, nausea and abdominal cramping, findings infrequently reported previously. Possible explanations for these side-effects include GIT irritation by the saponin constituents of the herb, or cholinergic stimulation of autonomic and motor responses in the GIT, or a combination of both of these factors. The side-effects observed in the current study provide supportive evidence that Bacopa may increase cholinergic activity in humans. A worthwhile future extension of the current study would be to assess whether the finding of Bacopa’s efficacy for improving memory performance is replicable in populations with either mild cognitive impairment or early dementia.

Background This thesis investigated the efficacy and safety of Bacopa monnieri in improving memory in healthy Australians over the age of 55-years. A review of the literature showed that memory impairment and dementia are increasingly prevalent in the current demographic climate of an ageing population. As well as the pathological cognitive loss of neurodegenerative disease, many older persons are experiencing memory loss as part of the physiological process of ageing. Bacopa monnieri is a herbal medicine used since antiquity in the traditional Ayurvedic medical system of India for its cognitive enhancing effects. A number of pre-clinical and clinical studies support this traditional usage. Laboratory studies have demonstrated antioxidant and cholinergic actions in the brain as well as improved memory and cognitive performance in animal models. Human trials of Bacopa have also demonstrated improved memory performance. Some of these trials are limited by methodological flaws such as lack of blinding, small sample sizes, or use of outcome measurements which are not well validated. However, a small number of well designed human trials provide evidence for efficacy in cognitive and memory performance improvement. The current study was employed to extend on previous findings by assessing the efficacy and safety of Bacopa in the aged population specifically, as it is in this population that memory impairment becomes apparent. Aims 1. To assess the efficacy of Bacopa monnieri in improving memory in healthy Australians over the age of 55-years. 2. To assess whether the use of Bacopa is associated with side-effects Design A 12-week, randomised, double-blind, placebo-controlled, parallel group clinical trial. Participants Participants were self selected from the general population. They were aged 55-years or over at the commencement of the trial. Participants were without dementia, depression or other serious health conditions and did not use psychotropic medications. Intervention Participants were randomised to one of two treatment conditions, either a tableted extract of Bacopa monnieri called Bacomind™ (300mg/day, standardised to contain at least 40% bacosides), or an identical placebo. Participants attended three clinical evaluations: the first an initial screening session, the second a baseline evaluation of neuropsychological function and subjective memory performance at the commencement of the trial and the third, an end-of-trial outcome evaluation at 12-weeks, during which neuropsychological function and subjective memory performance were again assessed along with side-effects and study compliance. Primary Outcome Measures Rey Auditory Verbal Learning Test (AVLT), Rey-Osterrieth Complex Figure Test (CFT), Memory Complaint Questionnaire (MAC-Q), and Trail Making Test (TMT) Results From 136 people who elected to participate, 103 people met study entry criteria and 98 of these commenced the trial. Of these, 81 participants completed the trial and provided evaluable data for the end point analysis. Bacopa monnieri versus placebo significantly improved verbal learning as well as delayed recall as measured by the AVLT (p<.05). Though improvements were noted in the CFT, MAC-Q and TMT, there were no significant differences between placebo and active groups found for these tests. The Bacopa group reported a higher incidence of gastro-intestinal (GIT) side-effects than the placebo group, these predominantly being increased stool frequency, abdominal cramps and nausea. No other significant adverse effects were found. Conclusions A clinical trial was carried out to assess the effects of 12-weeks administration of Bacopa monnieri (300mg/day) on memory performance in people over the age of 55-years. Primary outcome measures were well validated neuropsychological tests that objectively measured verbal and visual memory and a memory complaint questionnaire that measured subjective memory complaints. The results demonstrated that Bacopa significantly improved memory acquisition and retention in older Australians. This concurs with findings from previous human and animal studies, as well as supports traditional Ayurvedic claims and uses. The beneficial effects on memory observed may be due to previously demonstrated antioxidant and cholinergic effects of the herb on the central nervous system. The use of Bacopa was associated with GIT side-effects, particularly increased bowel movements, nausea and abdominal cramping, findings infrequently reported previously. Possible explanations for these side-effects include GIT irritation by the saponin constituents of the herb, or cholinergic stimulation of autonomic and motor responses in the GIT, or a combination of both of these factors. The side-effects observed in the current study provide supportive evidence that Bacopa may increase cholinergic activity in humans. A worthwhile future extension of the current study would be to assess whether the finding of Bacopa’s efficacy for improving memory performance is replicable in populations with either mild cognitive impairment or early dementia.

No description available.

Thesis (MA)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Across the globe scientists are taking issue with pseudoscience, as well as the role of the media in promoting it. Articles based on pseudoscience, especially those relating to Complementary and Alternative Medicine (CAM) that fall outside the realms of orthodox medicine, are common in all forms of media, but especially in women’s health and lifestyle magazines. Scientists are quite vociferous in their condemnation of CAM for both ethical and safety reasons, since neither the therapies nor the remedies associated with CAM practices have been proven to be efficacious, or even safe. In fact, some of the therapies and advice offered by CAM practitioners are dangerous and, in some instances, may even be life threatening. Nevertheless, the media continue to promote CAM, and the public continues to support it – despite the warnings and denunciation by scientists. This is an exploratory study to determine the prevalence of pseudoscience, generally, in South African women’s health and lifestyle magazines, and to uncover the reasons the public supports it. The magazine Longevity is used as an example of this type of publication, and a content analysis is used to illustrate the prevalence of pseudoscience articles and adverts in South African media, while field research, in the form of personal interviews, attempts to determine the reasons people support CAM in spite of its denunciation, as well as the media’s role in fostering this support. Both mainstream science and pseudoscience are described, while a literature review reveals the scientific perspective of CAM, provides examples of the more popular forms of CAM and the dangers inherent in them, as well as the ways in which science and pseudoscience in general, are handled by the media. Using the hypodermic needle theory, plus the results of the content analysis and field research, this study shows that media promote pseudoscience because it pays; the public support CAM because they believe it works; and that that belief is primarily the result of public disillusionment with the practice of orthodox medicine, rather than the result of media’s promotion of CAM, as scientists contend. / AFRIKKANSE OPSOMMING: Wetenskaplikes van regoor die wêreld het ’n probleem met pseudowetenskap, sowel as die rol wat die media speel om dit bevorder. Artikels gebaseer op pseudowetenskap, veral dié met betrekking tot Aanvullende en Alternatiewe Medisyne (AAM), wat buite die grense van ortodokse medisyne val, is algemeen in alle vorme van media, maar veral in gesondheid-en lewenstyltydskrifte vir vroue. Wetenskaplikes is baie uitgesproke in hul veroordeling van AAM om beide etiese en veiligheidsredes, omdat nóg die terapie nóg die middels wat verband hou met AAM praktyke bewys is om doeltreffend, of selfs veilig te wees. Trouens, sommige van die terapieë en advies wat aangebied word deur AAM beoefenaars is gevaarlik, en in sommige gevalle selfs lewensgevaarlik. Tog hou die media aan om AAM te bevorder, en die publiek om dit te ondersteun – ten spyte van die waarskuwings en veroordeling deur wetenskaplikes. Hierdie narvorsing is ’n verkennende studie om die voorkoms van pseudowetenskap in Suid-Afrikaanse vroue se gesondheid- en lewenstyltydskrifte te bepaal, en die redes te ontbloot waarom die publiek dit ondersteun. Die tydskrif Longevity word gebruik as ’n voorbeeld van hierdie tipe publikasie, en ’n inhoudsanalise word gebruik om die voorkoms van pseudowetenskaplike artikels en advertensies in die Suid-Afrikaanse media te illustreer, terwyl navorsing in die veld, in die vorm van persoonlike onderhoude, poog om die redes te bepaal waarom mense AAM ondersteun, ten spyte van veroordeling, sowel as die rol wat die media speel in die bevordering van hierdie ondersteuning. Beide hoofstroom wetenskap en pseudowetenskap word beskryf, terwyl ’n literatuuroorsig die wetenskaplike perspektief van AAM ontbloot, voorbeelde van die meer populêre vorme van AAM word verskaf asook van die gevare daaraan verbonde, sowel as die maniere waarop wetenskap en pseudowetenskap in die algemeen, hanteer word deur die media. Met behulp van die spuitnaald teorie, plus die resultate van die inhoudsanalise en navorsing in die veld, bewys hierdie studie dat die media pseudowetenskap bevorder, want dit betaal; die publiek ondersteun AAM omdat hulle glo dit werk; en dat daardie geloof primêr die gevolg is van openbare ontnugtering met die beoefening van ortodokse medisyne, eerder as die gevolg van die media se bevordering van AAM, soos wetenskaplikes beweer.