A phase I pilot study evaluating the beneficial effects of black raspberries in patients with Barrett's esophagus.

Black raspberries inhibit a broad range of cancers in preclinical models which has led to clinical evaluations targeting premalignant lesions of the colon, oral cavity and esophagus. A phase I pilot study was conducted in twenty Barrett's esophagus (BE) patients to investigate the effect of lyophilized black raspberries (LBR) on urinary metabolites and markers of lipid peroxidation, DNA damage and tissue markers of cellular proliferation, detoxification, and inflammation. Surveys, biopsies, blood and urine samples were collected before and after 6 months of LBR treatment (32 or 45 g). LBR significantly reduced urinary excretion of 8-epi-prostaglandin F2α, a marker of lipid peroxidation linked to oxidative stress and free radical damage. Urinary levels of the ellagitannin metabolites, urolithin A-glucuronide, urolithin A-sulfate and dimethylellagic acid glucuronide were significantly increased following 12 and 26 weeks of LBR consumption and may prove useful as indicators of compliance in future clinical studies. Immunohistochemical staining of BE biopsies following LBR treatment showed significant increases in mean GST-pi levels, with 55.6% of subjects responding favorably. In summary, LBR significantly decreased urinary lipid peroxidation levels and significantly increased GST-pi, a marker of detoxification, in BE epithelium. Still, LBR may need to be formulated differently, administered at higher concentrations or multiple times a day to increase efficacy.

Nursing students' perceptions of effective problem-based learning tutors.

Aim To explore baccalaureate nursing students' perceptions of what makes an effective tutor in problem-based learning courses, and the influence of effective teaching on students' learning and experience. Method Students enrolled in all four years of a baccalaureate nursing programme completed online surveys (n=511) and participated in focus groups (n=19). Data were analysed and combined using content analysis. Findings The data were summarised using five themes, the '5 Ps' of effective teaching in problem-based learning. Nursing students perceived effective problem-based learning tutors to be prepared with knowledge and facilitation skills, person-centred, passionate, professional and able to prepare students for success in the nursing programme. Effective tutors adjusted their approaches to students throughout the four years of the nursing programme. Conclusion Effective teaching in problem-based learning is essential and has significant effects on nursing students' learning, motivation and experience. Important attributes, skills and strategies of effective problem-based learning tutors were identified and may be used to enhance teaching and plan professional development initiatives.

Student life - ask us what we think.

Students are in the best position to recognise the qualities of effective nurse educators. With this in mind, we asked students on the Bachelor of Science in Nursing (BScN) course what makes a good teacher in the clinical practice setting.

Student perceptions of effective nurse educators in clinical practice.

AIM: To explore baccalaureate nursing student perceptions of what makes an effective nurse educator in the clinical practice setting and the influence of effective teaching on student experiences. METHOD: Online surveys (n=511) and focus groups (n=7) were completed by nursing students enrolled in all four years of the baccalaureate programme. Data were analysed using content analysis. FINDINGS: Participants indicated that effective teachers foster positive experiences, motivation, meaningful learning and success. They were perceived to be prepared, person-centred, professional, passionate and positive, and to prepare students for success using active strategies. They adjusted to meet individual students' needs at each level of the programme. CONCLUSION: Important characteristics and factors in effective clinical teaching were identified. These may be used to develop effective clinical teaching initiatives.

Transitioning from preclinical to clinical chemopreventive assessments of lyophilized black raspberries: interim results show berries modulate markers of oxidative stress in Barrett's esophagus patients.

Increased fruit and vegetable consumption is associated with decreased risk of a number of cancers of epithelial origin, including esophageal cancer. Dietary administration of lyophilized black raspberries (LBRs) has significantly inhibited chemically induced oral, esophageal, and colon carcinogenesis in animal models. Likewise, berry extracts added to cell cultures significantly inhibited cancer-associated processes. Positive results in preclinical studies have supported further investigation of berries and berry extracts in high-risk human cohorts, including patients with existing premalignancy or patients at risk for cancer recurrence. We are currently conducting a 6-mo chemopreventive pilot study administering 32 or 45 g (female and male, respectively) of LBRs to patients with Barrett's esophagus (BE), a premalignant esophageal condition in which the normal stratified squamous epithelium changes to a metaplastic columnar-lined epithelium. BE's importance lies in the fact that it confers a 30- to 40-fold increased risk for the development of esophageal adenocarcinoma, a rapidly increasing and extremely deadly malignancy. This is a report on interim findings from 10 patients. To date, the results support that daily consumption of LBRs promotes reductions in the urinary excretion of two markers of oxidative stress, 8-epi-prostaglandin F2alpha (8-Iso-PGF2) and, to a lesser more-variable extent, 8-hydroxy-2'-deoxyguanosine (8-OHdG), among patients with BE.