Phenolic and tannin compounds in subtropical shrubs (Bituminaria bituminosa, Chamaecytisus proliferus, and Adenocarpus foliosus) and the effects on in vitro digestibility.

The objective of this study was to contribute to the characterization of nutritional potentials, with special attention to the total phenol and condensed tannins content and the effects on in vitro digestibility of some browsing shrub legumes traditionally used for ruminant feeding. The varieties selected were Bituminaria bituminosa var. bituminosa (BBB), Bituminaria bituminosa var. albormaginata (BBA), Chamaecytisus proliferus var. palmensis (CPP), Chamaecytisus proliferus var. canariae (CPC), and Adenocarpus foliosus (AF). Chemical composition, in vitro digestibility, and net energy for lactation (NE) were analyzed and compared among varieties; the effects of total phenol (TP) and condensed tannins (CT) compounds on digestibility were estimated. Condensed tannins ranged from 1 to 5 g/kg DM of tannins, while total phenols ranged from 9 to 32 g/kg DM of tannins. In vitro organic matter digestibility (OMD) ranged from 0.52 to 0.71, and estimated net energy for lactation (NE) ranged from 4.2 to 5.8 MJ/kg DM, with significant differences among all the varieties. This Chamaecytisus varieties (CPC, CPP) have higher feeding values, following CPC > CPP > AF > BBB > BBA in order. Although there were condensed tannins and total phenols in all the shrubs analyzed, total phenol contents differed significantly between the shrubs. The effect of the content of the total phenols and of the tannins condensed in the OMD of the varieties of shrubs analyzed, shows that the higher amounts of total phenols in some of the varieties of shrubs analyzed, increased the in vitro digestibility (OMD) of the shrubs but high amounts of CT decreased OMD.

Potential value of tedera (B. bituminosa) as high protein resource for poultry feed.

Bituminaria bituminosa (C.H. Stirt.) is a drought tolerant legume that grows spontaneously in subtropical areas: Canary Islands (Spain) and in North African and Mediterranean regions, traditionally used as forage for ruminants. The aim of this research was to investigate the potential of B. bituminosa as a high protein resource for poultry feed by means of feed intake, growth, feed conversion rate (FCR), protein efficiency ratio (PER), and the influence of B. bituminosa feed form (fresh green and dried) on the preference by chicks. B. bituminosa showed higher crude protein content (CP), neutral detergent fiber (NDF), and gross energy than commercial feed. Average daily feed intake (ADFI) for the commercial feed group (control group) was higher than ADFI of the B. bituminosa group (experimental group). However, both groups had no significant differences in total crude protein intake, total NDF intake, average daily gain (ADG), FCR, and PER. The poultry's preference for fresh green B. bituminosa was higher than for dry B. bituminosa. Our results suggest that B. bituminosa (tedera) could be an alternative feedstuff in tropical countries or where protein sources are scarce and costly.

Effects of replacing rye-grass (Lolium spp.) hay by banana (Musa acuminata L.) by-products on feed intake, growth, and feed conversion rate of Canary hair sheep breed (Pelibuey) lambs.

The objective of this study was to evaluate the effects of replacing rye-grass (Lolium spp.) hay with banana (Musa acuminata L.) by-products on feed intake, average daily gain (ADG), and feed conversion rate (FCR) in Pelibuey (hair sheep breed) lambs. The lambs (n = 22; initial BW = 14.8 ± 2.5 kg) were individually housed and fed on two different types of diet for 58 days: the first group (experimental diet) received as forage a mixture of fresh banana by-products composed of leaves and pseudostem. The second group received commercial rye-grass hay (conventional diet) as a fiber source. Both groups received a supplementary commercial concentrate food. The total daily forage intake and FCR were lower (P < 0.001) in animals fed on the conventional diet (rye-grass hay) than animals fed on the experimental diet (banana by-products). However, there were no significant differences in total dry matter intake, total digestible energy intake, total body weight gain, and ADG between the two groups. The results obtained in this study suggest that banana by-products could be used as alternative forage for Pelibuey lambs raised in subtropical conditions.

Polyphenols journey through blood-brain barrier towards neuronal protection.

Age-related complications such as neurodegenerative disorders are increasing and remain cureless. The possibility of altering the progression or the development of these multifactorial diseases through diet is an emerging and attractive approach with increasing experimental support. We examined the potential of known bioavailable phenolic sulfates, arising from colonic metabolism of berries, to influence hallmarks of neurodegenerative processes. In silico predictions and in vitro transport studies across blood-brain barrier (BBB) endothelial cells, at circulating concentrations, provided evidence for differential transport, likely related to chemical structure. Moreover, endothelial metabolism of these phenolic sulfates produced a plethora of novel chemical entities with further potential bioactivies. Pre-conditioning with phenolic sulfates improved cellular responses to oxidative, excitotoxicity and inflammatory injuries and this attenuation of neuroinflammation was achieved via modulation of NF-κB pathway. Our results support the hypothesis that these small molecules, derived from dietary (poly)phenols may cross the BBB, reach brain cells, modulate microglia-mediated inflammation and exert neuroprotective effects, with potential for alleviation of neurodegenerative diseases.

Improvement of the stereoselectivity of the glycosylation reaction with 2-azido-2-deoxy-1-thioglucoside donors.

2-Azido-2-deoxy-1-thioglucoside donors with an electron withdrawing group at position 6 were employed to study the stereoselectivity of the glycosylation reaction with several acceptors, ranging from unhindered small primary alcohols to other sugars and steroids, using NIS/TfOH as promoter. p-Tolyl 2-azido-3,4-di-O-benzyl-6-O-chloroacetyl-2-deoxy-1-thio-α/ß-D-glucopyranoside afforded the higher α-selectivity, showing that a stronger electron withdrawing ester at O-6 influenced the anomeric selectivity towards the 1,2-cis glucosides. The anomeric stereoselectivity was highly dependent on the acceptor.

The effect of diethylamine on Stille alkylations with tetraalkylstannanes.

The addition of diethylamine to Stille alkylation reactions using stannanes improves yields by reducing beta-hydride elimination and reduction reactions, it also serves as a substitute for other additives such as Cu(I)I.

The first synthesis of (-)-asperpentyn and efficient syntheses of (+)-harveynone, (+)-epiepoformin and (-)-theobroxide.

A generally applicable strategy for the synthesis of a range of polyoxygenated cyclohexane natural products has been developed. The enantioselective syntheses of (-)-theobroxide, a polyoxygenated cyclohexane natural compound with potent growth inducing properties in potato microtubers has been achieved via a 1,2 O-silyl migration between trans-hydroxyl groups and a remote hydroxyl directed epoxidation of an enone derived from quinic acid. A thus derived alpha-iodoenone was subjected to Stille coupling with tetramethylstannane to afford the first title compound. A similar strategy enabled a route to the complete asymmetric synthesis of the acetylenic phytotoxin (+)-harveynone. By selective reduction of (-)-theobroxide, (+)-epiepoformin was also prepared in enantiopure form and similarly, stereoselective reduction of (+)-harveynone completed the first enantioselective synthesis of (-)-asperpentyn, another natural compound with antimicrobial activity.

Cost analysis of a nursing center for the homeless.

Single women and children now make up a third of the vulnerable U.S. homeless population who tend to seek health care only when their symptoms can no longer be ignored. The school of nursing at SUNY was one of the programs funded by HHS Division of Nursing to develop and implement a nursing center that would provide primary health services to the homeless. The cost of providing nursing services to homeless clients in nurse-managed centers was compared to costs for alternatives in the community including emergency department visits or care at the county supported nurse-run outpatient clinics. The four sites that served the homeless donated space for the SUNY project nurses to see patients. This enhanced accessibility, earlier intervention in health care problems, and decreased client cost (and time) for transportation to other service providers. The potential for earlier and less costly interventions confirmed the value of this humanistic nurse-run service for the homeless.

Efficacy and safety of acarbose in the treatment of Type 1 diabetes mellitus: a placebo-controlled, double-blind, multicentre study.

AIMS: The aim of the study was to evaluate the efficacy and safety of acarbose in patients with Type 1 diabetes mellitus (DM). METHODS: A multicentre double-blind, randomized, placebo-controlled study was performed. After a 6-week run-in, 121 patients were randomized to acarbose or placebo and to high- or low-fibre diet for 24 weeks. Acarbose dose was 50 mg t.d.s. for the first 2 weeks and 100 mg t.d.s. for the subsequent weeks. RESULTS: At the end of 24 weeks of treatment the intention to treat analysis showed that acarbose compared with placebo decreased 2 h postprandial plasma glucose levels (12.23 +/- 0.83 vs. 14.93 +/- 0.87 mmol/l; F = 6.1, P < 0.02) (least square means +/- SEM). No significant effect of acarbose was recorded on HbA1c or on the number of hypoglycaemic episodes. The effect of acarbose on blood glucose control was not influenced by the amount of carbohydrate and/or fibre intake. The incidence of adverse events were 75% and 39% in acarbose and placebo groups, respectively; they were mild and confined to the gastrointestinal tract. CONCLUSIONS: The use of acarbose in combination with insulin reduces postprandial plasma glucose levels in Type 1 diabetic patients who are not satisfactorily controlled with insulin alone but without significant effect on HbA1c.

The development and testing of the patient record pain management assessment tool.

The article reports a study whose purpose was to develop and test the Patient Record Pain Management Assessment Tool, an instrument to evaluate compliance with the American Pain Society's quality assurance standards on acute pain and cancer pain in chart documentation. Content validity, overall validity, and interrater reliability were all found to be acceptable. The instrument is therefore a useful tool for documenting the level of pain management practice in institutional settings.

Factors limiting evaluation of health care programs for the homeless.

The problem of homelessness and the need for health care by homeless people does not seem to be subsiding. All indications are that current legislation to implement dramatic welfare reform will eventually increase the number of homeless persons. Evaluation to guide, monitor, and select the most effective approaches in the provision of health care will remain a key element in health care delivery. Although barriers regarding evaluation of homeless health care have been reported by previous researchers as similar, the results in this study document findings elicited from administrators in the field. The administrators have the expertise to address some of the more common barriers and reduce them. Ways to approach this endeavor and to support staff in participating in and successfully integrating evaluation activities into health care provision will require attention of funding agencies, program administrators, and inclusion of staff and clients in planning. As the era of managed care becomes the focus of how health care is delivered, evaluation of existing programs will be essential to their survival. The descriptive information obtained in this exploratory study provides useful instruction for considering issues that need to be addressed in planning and implementing evaluation of health care to homeless persons.

Lessons learned in implementing a staff education program in pain management in the acute care setting.

With the release of Acute Pain and Cancer Pain Guidelines from the federal government, many healthcare agencies will be instituting programs to improve pain management. The authors describe a pilot project in acute pain management that did not yield desired results. On the basis of this experience and through a review of the literature, information is provided to staff development educators about problems and issues in planning and executing a program in pain management using structure, process, and outcome as a framework.

Focus groups: nursing staff's experiences using restraints.

A phenomenological approach was used to examine nursing staff's experiences using physical restraints. A total of 12 nurses from a tertiary hospital participated in one of three focus groups. Exploring the attitudes of nurses can contribute to a better understanding of how decisions are made concerning restraints. An analysis of the focus group data resulted in a description of the lived experiences of nurses using restraints. Seven themes emerged from the data, one of which reflected that the nurses felt ambiguous about restraints, yet they made judgments and justified their decisions after assessing patient characteristics, environmental safety, and unit traditions. Nurse clinicians could use the focus group method to sensitize themselves to the staff's needs and to allow staff the opportunity to share ideas and to dispel misconceptions about restraints.

Readiness of nurses for electronic networking for quality assessment and improvement.

Quality assessment and improvement (QAI) is a rapidly evolving component of health care. Its operationalization in clinical practice can be greatly enhanced by information sharing, best practice networking, and communication of experiences and resources. Nurses play a key role in both QAI and information sharing in this endeavor. Electronic communication supports the rapid sharing of QAI-related information across agencies to link nurses with a common interest in continuously improving the quality of health care delivery. It offers the opportunity to diminish the barrier of distance, which is especially relevant for nurses in rural areas. Before electronic communication was established as an information-sharing mechanism, however, the readiness of nurses in both rural and urban/suburban settings was assessed. A convenience sample of nurses in western New York, who were surveyed via written questionnaire regarding electronic communication, most often described their comfort in using this medium as uncertain. This finding supports the need for preliminary preparation focusing upon the skills and experience needed to utilize the computer as a communication medium.