Wheat Extract Oil (WEO) Attenuates UVB-Induced Photoaging via Collagen Synthesis in Human Keratinocytes and Hairless Mice.

The efficacy of wheat extract oil (WEO), standardized to glucosylceramides, for protecting against ultraviolet B (UVB)-induced damage of skin barrier function was assessed using the SHK-1 hairless mouse model and two human skin cell lines, namely, CCD-986sk and HeCaT. The ability of repeated oral administration of 30, 60, and 120 mg of WEO/kg/day for 12 weeks to prevent skin damage of SKH-1 hairless mice induced by UVB irradiation was evaluated. The results demonstrated that UVB-induced water evaporation (transepidermal water loss, TEWL) was significantly decreased by WEO. Similarly, UVB-induced losses in moisture and skin elasticity were improved by WEO supplementation. WEO attenuated the tissue procollagen type I, hyaluronic acid (HA), and ceramide reductions induced by UVB treatment as well. Collagen concentrations in skin tissue were increased in the WEO-treated mice, while UVB-induced epidermal thickening was reduced. In vitro studies using HeCaT human keratinocytes confirmed increased HA and collagen synthesis in response to WEO treatment. This may occur via WEO suppression of matrix metallopeptidase-1 (MMP-1), since its induction by UVB treatment was diminished in treated CCD-986sk cells. Oral administration of WEO improves skin barrier function in UVB-irradiated mice by attenuating damage typically observed in photoaging. This research further clarifies the clinical benefits previously observed by dietary WEO consumption.

Toxicological studies on the botanical supplement LI12542F6 containing extracts of Sphaeranthus indicus flower heads and Mangifera indica (mango tree) bark.

LI12542F6, a botanical extract composed of Sphaeranthus indicus and Mangifera indica, was evaluated for mutagenicity in bacteria, clastogenicity in mouse bone marrow, acute oral and dermal toxicity in the rat, irritation (dermal, eye) in rabbit, and subacute and subchronic toxicity (28 and 90 days) in the rat. All studies followed standard OECD test protocols, in accordance with the principles of Good Laboratory Practice (GLP). LI12542F6 did not induce mutations in the bacterial assay using Salmonella and Escherichia coli strains, nor did it induce genotoxic effects in erythrocytes from mouse bone marrow. LI12542F6 was found to have oral and dermal LD 50 values greater than the limit dose of 2,000 mg/kg body weight in the rat. In an eye irritation/corrosion test, LI12542F6 caused conjunctival redness, corneal opacity, and chemosis and is classified as Category 2A ("irritating to eyes - reversible eye effect"). Doses in the 28-day and 90-day rat oral toxicity studies were 0, 500, 1,000, and 1,500 and 0, 1,000, 1,500, and 2,000 mg/kg body weight/day, respectively, administered by gavage. Both studies featured a recovery period. Minor effects were random and not treatment related except for local irritation of the forestomach in the 28-day study, evidenced by histopathologic examination, in mid- and high-dose animals. The frequency and severity of these effects were reduced in the recovery group; irritation was not found in the forestomach of rats in the 90-day study. The no observed adverse effect level (NOAEL) was greater than the highest dose tested, that is, >2,000 mg/kg in the 90-day study. This botanical composition will be marketed commercially for muscle health as Myotor™.

Efficacy of a novel herbal formulation for weight loss demonstrated in a 16-week randomized, double-blind, placebo-controlled clinical trial with healthy overweight adults.

AIM: To re-evaluate the weight loss efficacy of LI85008F in healthy overweight adults via a 16-week randomized, double-blind, placebo-controlled clinical study. MATERIALS AND METHODS: One hundred and forty overweight participants (body mass index [BMI] 27-29.9 kg/m2 , 29.3% male; ages 21-50 years) were randomized into placebo (n =70) and LI85008F (n =70) groups. The participants received either 900 mg/d of LI85008F in two divided doses or two identical placebo capsules. In addition, participants were counselled to follow an ~1800 kcal/d diet and to engage in walking for 30 min, 5 d/wk throughout the study. RESULTS: At the end of the trial period, the LI85008F supplemented group showed significant reductions in body weight (5.36 ± 1.769 vs. 0.87 ± 1.381 kg; P < 0.0001) and BMI (2.05 ± 0.693 vs. 0.34 ± 0.559 kg/m2 ; P < 0.0001), compared with placebo. Significant reductions in waist and hip circumferences, and a 2.08-fold reduction of waist/hip ratio, were noted in the LI85008F supplemented group. LI85008F supplementation also resulted in significant improvements in lipid profiles, compared with the placebo; low-density lipoprotein (LDL) cholesterol decreased, while high-density lipoprotein (HDL) cholesterol increased, resulting in a significantly improved LDL/HDL ratio. No major adverse events were reported by the participants during the study. CONCLUSIONS: The unique herbal extract blend LI85008F, combined with modest calorie restriction and physical activity, is well tolerated, safe, and effective for weight management in overweight men and women.

A Placebo-Controlled Double-Blind Study Demonstrates the Clinical Efficacy of a Novel Herbal Formulation for Relieving Joint Discomfort in Human Subjects with Osteoarthritis of Knee.

LI73014F2 is a novel composition prepared from extracts of Terminalia chebula fruit, Curcuma longa rhizome, and Boswellia serrata gum resin with synergistic benefit in 5-Lipoxygenase (5-LOX) inhibition. This herbal composition with strong anti-5-LOX activity exhibited significant pain relief as indicated through improvements in weight-bearing capacity in a monosodium iodoacetate-induced osteoarthritis (OA) model of Sprague-Dawley rats. A 90-day randomized, placebo-controlled double-blind study evaluates the clinical efficacy and tolerability of LI73014F2 in the management of symptoms of OA of the knee (Clinical Trial Registration No. CTRI/2014/01/004338). Subjects, (n = 105), were randomized into three groups: placebo (n = 35), 200 mg/day of LI73014F2 (n = 35), and 400 mg/day of LI73014F2 (n = 35). All study participants were evaluated for pain and physical function by using standard tools, that is, Visual Analog Scale, Lequesne's Functional Index, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at the baseline (day 0) and on day 14 ± 3, 30 ± 3, 60 ± 3, and at the end of the study (day 90 ± 3). In addition, routine examinations on biochemical parameters in serum, urine, and hematological parameters were conducted on each visit to assess the safety of the study material. At the end of the trial period, LI73014F2 conferred significant pain relief, improved physical function, and quality of life in OA patients. In conclusion, preclinical and clinical data together strongly suggest that the herbal formulation LI73014F2 is a safe and effective intervention for management of joint discomfort, demonstrating efficacy as early as 14 days.

Increasing nurse competence in peripheral intravenous therapy.

Infiltration and phlebitis are common complications associated with peripherally inserted vascular (PIV) therapy. This performance improvement plan included a pretest, a competency-based training module, and a posttest to determine whether nursing knowledge of infiltration and phlebitis improved. The postintervention data revealed a 50% reduction in infiltration and phlebitis. Annual education requirements combined with competency skills for assessing PIV catheter sites will provide nursing staff with the knowledge and tools to change current practice.

Testing a Swedish version of the Consumer Emergency Care Satisfaction Scale in an emergency department and 2 observation wards.

The aim was to investigate the construct validity and internal consistency of the Swedish version of the Consumer Emergency Care Satisfaction Scale. The sample comprised 157 persons from an emergency department and an observation ward. The results showed satisfactory reliability, and an explorative factor analysis revealed 3 factors: Caring, Teaching, and Clinical Competence. The Swedish version of the scale seems reliable and may be a useful tool for measuring satisfaction in different acute care settings.

Comparison of job satisfaction between experienced medical-surgical nurses and experienced critical care nurses.

Hospitals continue to experience high nurse turnover rates. Based on the need to retain skilled nurses, differences in job satisfaction of experienced medical-surgical and critical care nurses were examined.

The relationship between spirituality and compliance in patients with heart failure.

A high incidence of noncompliance to prescribed treatment plans results in increased morbidity, hospitalizations, and mortality rates in patients with heart failure. Exploration of new avenues to encourage adherence is needed in nursing research. The purpose of this study was to explore whether a relationship existed between spirituality and compliance in patients with heart failure. The Spiritual Assessment Scale and the Heart Failure Compliance Questionnaire Revised were mailed to a convenience sample with a return response from 95 participants. Although mean scores for the Spiritual Assessment Scale and the Heart Failure Compliance Questionnaire Revised were high, data suggested no correlation existed between levels of spirituality and degree of compliance among the heart failure participants, r=16393; p=0.115. Although insignificant results were found between levels of spirituality and degree of compliance, the data did not rule out the importance of spirituality as a coping tool.

Caregivers' perceptions of dementia patients' functional ability.

Dementia patients' caregivers often provide information about patients' daily functioning, but little is known about factors influencing caregivers' perceptions. Baseline data from an intervention trial were used to compare caregiver estimates of dementia patients' performance with their actual performance of instrumental activities of daily living (IADLs) and to assess relationships between measures of caregiver responses to caregiving, self-perceived sense of self-efficacy, and depression. We also assessed patient cognition, overall function and behavioral disturbance, and caregivers' perceptions of their patients' behavior as manipulative or deliberate. Disparities between these estimates and actual patient performance on structured IADL tasks were unrelated to any caregiver, patient, or relationship factor that we measured

Patients' perspective on choosing the emergency department for nonurgent medical care: a qualitative study exploring one reason for overcrowding.

INTRODUCTION: For decades it has been known that patients use emergency departments for nonurgent care needs. This study was conducted to help determine how the health care community can assist patients achieve consistent health care while meeting the patient's perceived needs. METHOD: A descriptive qualitative study was conducted based on interviews with 31 persons between 22 and 43 years of age following an ED visit for a nonurgent medical need. Exploration of the patient's perception was accomplished through open-ended questions in a structured interview format. Data were analyzed using content analysis. RESULTS: Patients who participated in our study revealed 3 major themes: (1) They were unable to obtain an appointment with a primary care provider (PCP); (2) they were referred by the staff (not the doctor) in PCPs' offices to be evaluated in the emergency department; and (3) it took less of their time to be seen in the emergency department than it did to contact their PCP, only to then be told to go to the emergency department. DISCUSSION: The findings of this study support the need for health care providers to find ways to provide nonurgent care in a timely and efficient manner. Multiple options for providing this care need to be conceived and evaluated.

A randomized, controlled study of an Alzheimer's caregiver skills training program.

This study was an attempt to improve the quality of the relationship between dementia caregivers and their loved ones by decreasing the gap between caregivers' expectations and patients' actual functional abilities and by teaching supportive skills. Although a group of 49 caregiver-patient dyads were recruited, the outcome measures of only those dyads (47) that completed the week seven session were used for analysis. Half of the dyads were randomized to an intervention group and the other half to a waiting list. The intervention group (N = 24) completed a four-session caregiver training program in which caregivers first watched investigators administering to their loved ones the Texas Functional Living Scale and later progressed to helping their loved ones by appropriate cueing to perform the tasks involved. Comparisons were made between baseline scores, scores at seven weeks, and scores at the end of 17 weeks on the congruence between caregiver estimates and patients' actual performance on the Independent Living Scale and measures of cognition, function, preillness quality of relationship, caregiver mood, feeling of self-efficacy, and several other measures. We were not able to increase the congruence between caregiver estimates and patients' actual performance and found no change in any other measure. We didfind the expected relationship between depression and caregiver sense of self-efficacy.

Evaluating instruments for quality: testing convergent validity of the consumer emergency care satisfaction scale.

Having reliable and valid instruments is a necessity for nurses and others measuring concepts such as patient satisfaction. The purpose of this article is to describe the use of convergence to test the construct validity of the Davis Consumer Emergency Care Satisfaction Scale (CECSS). Results indicate convergence of the CECSS with the Risser Patient Satisfaction Scale and 2 single-item visual analogue scales, therefore supporting construct validity. Persons measuring patient satisfaction with nurse behaviors in the emergency department can confidently use the CECSS.

Patient anxiety and patient satisfaction in hospital-based and freestanding ambulatory surgery centers.

The study examined differences in patient anxiety and patient satisfaction between patients who experienced surgery at a hospital-based ambulatory surgery center versus a freestanding ambulatory surgery center. Forty-seven participants completed the State Trait Anxiety Inventory and Press Ganey Ambulatory Surgery Survey. Patients at both types of facilities experienced moderate levels of preoperative anxiety and were highly satisfied with care received. No significant differences were found in preoperative anxiety, overall satisfaction with care, or overall satisfaction with nursing care. The site where the surgery was performed may not be a determining factor in patient anxiety or satisfaction levels.

Patient satisfaction with triage nursing in a rural hospital emergency department.

This study examined what relationships or differences exist between patient and nurse characteristics, satisfaction with triage nurse caring behaviors, general satisfaction with the triage nurse, and intent to return to a rural hospital emergency department (ED). The ED, located at a 401-bed teaching hospital in a small southern city, averages 28,000 visits annually. Samples of ED nurses (N = 11) and ED patients (N = 65) were asked to respond to demographic forms and the Consumer Emergency Care Satisfaction Scale (CECSS) Adapted. Findings indicated that the nurse's acuity rating and the patient's perception of condition had a positive relationship. The patient's perception of condition, patient satisfaction, and caring satisfaction were predictors of intent to return. When patients perceived themselves as seriously ill or injured, they expressed less intent to return to that ED.

Patient satisfaction of emergency nursing care in the United States, Slovenia, and Australia.

Patient satisfaction with nursing care in the emergency department (ED) was measured in 616 patients in California and Kentucky in the United States, Slovenia, and rural and urban Victoria in Australia. Patients were almost equally divided between men and women, primarily white, with a mean age of 44. They responded to the caring and teaching subscales of the Consumer Emergency Care Satisfaction Scale (CECSS). While scores indicated no differences in caring, the US and Slovenian groups reported greater satisfaction with teaching than did the Australian group. The subscale alpha coefficients were .87 for the caring subscale and .92 for the teaching subscale.

Community-based chronic disease management program for African Americans.

Seventy-five predominately African American volunteers were enrolled in a community-based intervention program designed to lower blood pressure and HgbA1C levels in an African American population. Program components consisted of exercise, meal planning, weekly support groups, periodic cooking schools, and service coordination. Significant decreases in initial and 1-year values were seen in both systolic blood pressure (P < .0001) and diastolic blood pressure (P = .000) and HgbA1Cs for those with initial values > 7% (P = .013).

Tamoxifen induces apoptosis in Fas+ tumor cells by upregulating the expression of Fas ligand.

PURPOSE: Tamoxifen (TAM), a nonsteroidal anticancer agent, is used in the treatment of breast cancer. In the current study, we investigated whether TAM induces apoptosis in tumor cells by altering the expression of Fas and Fas ligand (FasL). METHODS: Several tumor cell lines were used to test the ability of TAM to induce apoptosis, which was studied using the TUNEL assay. The effect of TAM on the expression of Fas and FasL was analyzed using a flow cytometer. RESULTS: TAM was found to suppress the growth of an estrogen receptor-positive human mammary tumor cell line (T-47D) by inducing apoptosis. Interestingly, TAM also induced apoptosis in an estrogen receptor-negative murine T cell lymphoma cell line, EL-4. The ability of TAM to induce apoptosis in T-47D and EL-4 tumor cells correlated with the increased expression of FasL but not Fas on the tumor cells. Similar to TAM, a metalloproteinase (MP) inhibitor, which is known to increase the expression of membrane-bound FasL, was found to induce apoptosis in both T-47D and EL-4 tumor cells by increasing the expression of FasL but not Fas. Furthermore, both TAM and the MP inhibitor failed to induce apoptosis in L1210 tumor cell lines that failed to express FasL. CONCLUSIONS: The current study demonstrates that TAM can induce apoptosis in Fas(+) tumor cells by upregulating FasL.

Overexpression of CRIP in transgenic mice alters cytokine patterns and the immune response.

Cysteine-rich intestinal protein (CRIP), which contains a double zinc finger motif, is a member of the Group 2 LIM protein family. Our results showed that the developmental regulation of CRIP in neonates was not influenced by conventional vs. specific pathogen-free housing conditions. Thymic and splenic CRIP expression was not developmentally regulated. A line of transgenic (Tg) mice that overexpress the rat CRIP gene was created. When challenged with lipopolysaccharide, the Tg mice lost more weight, exhibited increased mortality, experienced greater diarrhea incidence, and had less serum interferon-gamma (IFN-gamma) and more interleukin (IL)-6 and IL-10. Similarly, splenocytes from the Tg mice produced less IFN-gamma and IL-2 and more IL-10 and IL-6 upon mitogen stimulation. Delayed-type hypersensitivity response was less in the Tg mice. Influenza virus infection produced greater weight loss in the Tg mice, which also showed delayed viral clearance. The observed responses to overexpression of the CRIP gene are consistent with a role for this LIM protein in a cellular pathway that produces an imbalance in cytokine pattern favoring Th2 cytokines.