The potential impact of a vegetarian diet on glaucoma.

Treatment of primary open-angle glaucoma has centered on the lowering of intraocular pressure that damages the optic nerve; however, this strategy is not uniformly successful, especially in normal tension glaucoma, and there is interest in antioxidant, anti-inflammatory, and other neuroprotective strategies. Vegetarian diets are known to be rich in antioxidant and anti-inflammatory components and have a number of established health benefits. Thus, it would be reasonable to assume that vegetarian diets would be beneficial in glaucoma, but this approach has not been well studied. We examine the possible role of vegetarian diets and their components in the incidence and progression of glaucoma.

Effectiveness of an analogy-containing video project to reinforce pharmacy students' learning of kidney physiology.

BACKGROUND AND PURPOSE: Kidney physiology is one of the most difficult topics covered in health professions education. This study examined the effectiveness of an analogy-containing video project to reinforce pharmacy students' knowledge of kidney physiology. EDUCATIONAL ACTIVITY AND SETTING: Students were assigned in groups to create a video that used analogy to explain kidney physiology processes. Survey responses, a rubric, and an objective test were used to assess the project's effectiveness. FINDINGS: Students generated various analogies, such as making tea or coffee, cars and roads, and the college application process to explain kidney physiology. Most of the submitted videos successfully met all criteria in the rubric. All students believed that the project was effective, to varying degrees, in reinforcing their knowledge. Weak to moderate positive correlations were found between time spent on the project and perceived effectiveness of use of analogy to accomplish most of the learning objectives investigated. Students reported that the project engaged both lower- and higher-order cognitive skills. Quiz score analysis showed higher average scores of students on physiology-related questions compared to non-physiology items. Notably, this improvement was most marked for bottom-performing students. About 60% of students recommended the use of videos as a class assignment, but only 50% believed that they should be used as an alternative to quizzes. SUMMARY: An analogy-containing video project effectively reinforced student learning of kidney physiology. Further studies are needed to verify the effectiveness of this technique compared to other didactic and learning approaches.

Pharmacy Students' Perception of an Elective Course on Evidence-based Learning Strategies.

Objective. To examine pharmacy students' perceptions of an elective course on evidence-based learning strategies.Methods. Pre- and post-course survey questionnaires were administered to students who enrolled in an elective course, to determine the learning strategies they used prior to course attendance, track their use of evidence-based learning strategies and observance of healthy lifestyle habits, and assess their perception of the course. A written assignment was given that required students to reflect on the learning outcomes that resulted from their application of evidence-based learning strategies. Mean scores on the pre- and post-course survey were analyzed using a general linear model repeated measures test.Results. The 59 students in this study predominantly used less-effective strategies (eg, re-reading and re-writing of notes) prior to taking the course. They reported increased use of evidence-based learning strategies, particularly retrieval practice and elaboration, and practice of healthy lifestyle habits (ie, enough sleep, exercise, good nutrition) after course completion. Students believed that using the above learning strategies improved their learning and memory and performance on graded assessments, among other benefits. Students had a positive perception of the course.Conclusion. The elective course was associated with increased use of effective learning strategies, adoption of healthy lifestyle practices that aid learning, and increased appreciation for evidence-based learning strategies by the students. Future studies are needed to examine actual learning outcomes and barriers to implementation of evidence-based learning techniques.

Biologically-Based Complementary and Alternative Medicine (CAM) Use in Cancer Patients: The Good, the Bad, the Misunderstood.

As complementary and alternative medicine (CAM) becomes more popular, it is being used in cancer patients to aid in recovery or to treat symptoms associated with the current chemotherapy. Numerous papers exist that discuss patients using CAM with cancer chemotherapy and their outcomes-both positive and negative. However, in the case of the negative outcomes, the reason for the dangers or interactions with drugs are not made clear. Indeed, many chemotherapy regimens are rendered less effective by the well-meaning but uninformed patient or their family members and friends. Similarly, reports of positive outcomes with CAM and chemotherapy provide a strong basis for further research, but do not identify specific mechanisms of action. These small clinical studies and in vitro studies identify a necessary area for further research and provide a much needed, although often rejected, alternative look at whole treatment plans. Careful review of the available information and evaluation of the nature of the CAM effects are necessary to combat the misunderstanding and sometimes unwarranted claims over CAM use. This mini review will explore some of the commonly used CAM agents and their mechanisms of interactions with other treatments. Suggestions as to which agents can be safe and when to use them will be an integral part of this review.

Reasons to Use and Disclose Use of Complementary Medicine Use - An Insight from Cancer Patients.

Studies have shown a high prevalence (40-83%) of complementary and alternative medicine (CAM) use among cancer patients in the U.S.A cross-sectional, mixed-methods pilot study was completed. This paper focuses on the quantitative analysis conducted on demographic predictors of complementary medicine (CM) use, reasons to use CM, and disclosure to healthcare provider data. Surveys were interview-administered at the Loma Linda University Medical Center Cancer Center. Participants, 18 years or older, were selected from a convenient sample. Eighty-seven percent (87.9%) of participants reported to have used CM as a cancer treatment and most reported to have used it "to help fight the cancer." Women were eight-times more likely to use prayer. All non-Caucasian and Hispanic participants reported to use CM as a cancer therapy and none reported to use a CM provider. More women (72%) disclosed their CM use than men (53.3%). Different prevalences and predictors exist when differentiating CM modalities, reasons to use CM vary by gender, and disclosure proportions vary by gender.

Practices, attitudes, and beliefs associated with complementary and alternative medicine (CAM) use among cancer patients.

INTRODUCTION: The high prevalence of complementary and alternative medicine (CAM) use among cancer patients (40%-83%) receiving conventional treatment and the complex relationship between the psychosocial factors that may contribute to or result from CAM use requires further understanding. The authors conducted a descriptive mixed-methods pilot study to understand CAM practices, attitudes, and beliefs among cancer patients at the Loma Linda University Medical Center. METHODS: This was the qualitative phase of the study, and no hypotheses were set. A total of 23 face-to-face interviews were conducted, and thematic coding was used to analyze 22 interview transcriptions. There were 14 CAM users (64%) and 8 nonusers (36%). FINDINGS: The themes present among those who used CAM were the following: physicians viewed as one aspect of health care options, a holistic view on well-being, satisfaction with CAM use, and 3 key coping methods (confrontive, supportive, and optimistic) to confront cancer. Themes were not independent of each other. Two themes were present among nonusers; nonusers trusted their physician and were more likely to express evasive coping methods. DISCUSSION: Perceptions and behavioral patterns are complex predictors of CAM use. A better understanding of CAM, medical pluralism, and the perceptions of patients would help health care providers deliver a better quality of care. The promotion of integrative care may help health care providers better identify medical pluralism and would shift focus to patient-centered care.

Effects of extracts of lupine seed on blood glucose levels in glucose resistant mice: antihyperglycemic effects of Lupinus albus (white lupine, Egypt) and Lupinus caudatus (tailcup lupine, Mesa Verde National Park).

Lupine is a medicinal food plant with potential value in the management of diabetes. In white mice, extracts of seeds of the white lupine [Lupinus albus (L. termis L.)] were associated with increased tolerance to an oral glucose bolus. Antihyperglycemic activity was present in extracts of the whole seed but not extracts of the seed coat, and was not detected when glucose was administered intraperitoneally rather than orally. However, in contrast to results seen with the prescription drug, acarbose, lupine extract did not appear to increase the bulk or carbohydrate content of the feces. Antihyperglycemic activity was also seen in extracts of the tailcup lupine (L. caudatus) found in the Four Corners Region of the United States.

The role of gut-derived bacterial toxins and free radicals in alcohol-induced liver injury.

Previous research from this laboratory using a continuous enteral ethanol (EtOH) administration model demonstrated that Kupffer cells are pivotal in the development of EtOH-induced liver injury. When Kupffer cells were destroyed using gadolinium chloride (GdCl3 ) or the gut was sterilized with polymyxin B and neomycin, early inflammation due to EtOH was blocked. Anti-tumour necrosis factor (TNF)-α antibody markedly decreased EtOH-induced liver injury and increased TNF-mRNA. These findings led to the hypothesis that EtOH-induced liver injury involves increases in circulating endotoxin leading to activation of Kupffer cells. Pimonidazole, a nitro-imidazole marker, was used to detect hypoxia in downstream pericentral regions of the lobule. Following one large dose of EtOH or chronic enteral EtOH for 1 month, pimonidazole binding was increased significantly in pericentral regions of the liver lobule, which was diminished with GdCl3 . Enteral EtOH increased free radical generation detected with electron spin resonance (ESR). These radical species had coupling constants matching α-hydroxyethyl radical and were shown conclusively to arise from EtOH based on a doubling of the ESR lines when 13 C-EtOH was given. α-Hydroxyethyl radical production was also blocked by the destruction of Kupffer cells with GdCl3 . It is known that females develop more severe EtOH-induced liver injury more rapidly and with less EtOH than males. Female rats on the enteral protocol exhibited more rapid injury and more widespread fatty changes over a larger portion of the liver lobule than males. Plasma endotoxin, ICAM-1, free radical adducts, infiltrating neutrophils and transcription factor NFκB were approximately two-fold greater in livers from females than males after 4 weeks of enteral EtOH treatment. Furthermore, oestrogen treatment increased the sensitivity of Kupffer cells to endotoxin. These data are consistent with the hypothesis that Kupffer cells participate in important gender differences in liver injury caused by ethanol.