Disposition pathways and pharmacokinetics of herbal medicines in humans

Pharmacokinetic studies have become an integral part of modern drug development, but these studies are not regulatory needs for herbal remedies. This paper updates our current knowledge on the disposition pathways and pharmacokinetic properties of commonly used herbal medicines in humans. To retrieve relevant data, the authors have searched through computer-based literatures by full text search in Medline (via Pubmed), ScienceDirect, Current Contents Connect (ISI), Cochrance Library, CINAHL (EBSCO), CrossRef Search and Embase (all from inception to May 2010). Many herbal compounds undergo Phase I and/or Phase II metabolism in vivo, with cytochrome P450s (CYPs) and uridine diphosphate glucuronosyltransferases (UGTs) playing a major role. Some herbal ingredients are substrates of P-glycoprotein (P-gp) which is highly expressed in the intestine, liver, brain and kidney. As such, the activities of these drug metabolizing enzymes and drug transporters are determining factors for the in vivo bioavailability, disposition and distribution of herbal remedies. There are increasing pharmacokinetic studies of herbal remedies, but these studies are mainly focused on a small number of herbal remedies including St John's wort, milk thistle, sculcap, curcumin, echinacea, ginseng, ginkgo, and ginger. The pharmacokinetic data of a small number of purified herbal ingredients, including anthocyanins, berberine, catechins, curcumin, lutein and quercetin, are available. For the majority of herbal remedies used in folk medicines, data on their disposition and biological fate in humans are lacking or in paucity. For a herbal medicine, the pharmacological effect is achieved when the bioactive agents or the metabolites reach and sustain proper levels at their sites of action. Both the dose levels and fates of active components in the body govern their target-site concentrations after administration of an herbal remedy. In this regard, a safe and optimal use of herbal medicines requires a full understanding of their pharmacokinetic profiles. To optimize the use of herbal remedies, further clinical studies to explore their biological fate including the disposition pathways and kinetics in the human body are certainly needed.<br />

Observing the behaviour and interactions of adults with congenital deafblindness living in community residences

<b>Backgroundb> Adults with congenital deafblindness (CDB) have received little attention from researchers. In this study we examined the nature of interactions between adults with CDB and the staff who mediate their support, and investigated the reliability of an observation coding system, originally designed for observing adults with severe intellectual disability.<br /><br /><b>Methodb> The behaviours of 9 adults with CDB, including their interactions with support staff from 2 community residences, were recorded and subsequently coded by 2 observers.<br /><br /><b>Results b>Interrater reliability, measured using Cohen's k, was variable across the coding system. Adults with CDB were predominantly observed to be disengaged, with few observations of engagement according to the coding schedule's definition of engagement. Interactions between the residents and support staff were rare.<br /><br /><b>Conclusionb> The introduction of interventions designed for staff to promote resident engagement in social interaction is recommended.<br />

The role of personal values in enhancing student experience and satisfaction among international postgraduate students : an exploratory study

<b>Problem Statement:b> Universities are faced with the challenging task of educating an increasingly diverse and mobile student community. An understanding of the backgrounds of students and their expectations is central to ensure effective delivery of educational and support services to enhance student experience and satisfaction. The study of student personal values is able to provide better understanding of student demands and aspirations and to assist universities to target educational and support services to meet the differential needs of students.<br /><br /><b>Purpose of Study:b> To examine the differences in personal values among Asian international postgraduate students studying in Australian universities and to discuss the strategic implications of these differences in relation to enhancing student experience and satisfaction.<br /><br /><b>Research Methods:b> Data collected from a sample of 371 postgraduate students from China, India, Indonesia and Thailand studying in five universities in Victoria, Australia. Personal values were measured using Kahle’s (1983) List Of Values (LOV). Factor analysis was undertaken to determine the underlying personal value domains and Structural Equation Modelling (SEM) to analyse the relationship of the value constructs to student satisfaction. ANOVA and MANOVA tests employed to examine the differences of personal values between the nationalities, gender and age.<br /><br /><b>Findings:b> Factor Analysis resulted in a two factor solution and labelled as Self-efficacy and Hedonism which explained 73.5 percent of the variance. MANOVA and ANOVA results indicated significant differences (.001) across the values constructs of Self-efficacy and Hedonism and the individual variables between nationalities, gender and age.<br /><br />SEM results indicated a link between student satisfaction and the value domains of Self-efficacy and Hedonism.<br /><br /><b>Conclusions:b> The study highlighed the opportunities for universities to recognise that Asia is a differentiated market place and the development of segmented approach in designing educational programs as part of the strategy to enhance student experience and satisfaction. The inclusion of cultural aspects in educational programs, promotional material that fits in with different cultural backgrounds of students, self-paced learning approaches, promotion of cross cultural understanding among university staff are among the recommended strategies.<br />

The CDM-Net project : the development, implementation and evaluation of a broadband-based network for managing chronic disease

<b>Background.b> In Australia most chronic disease management is funded by Medicare Australia through General Practitioner Management Plans (GPMPs) and Team Care Arrangements (TCAs). Identified barriers may be reduced effectively using a broadband-based network known as the Chronic Disease Management Service (CDMS). <br /><br /><b>Aims.b> To measure the uptake and adherence to CDMS, test CDMS, and assess the adherence of health providers and patients to GPMPs and TCAs generated through CDMS. <br /><br /><b>Methods.b> A single cohort before and after study. <br /><br /><b>Results.b> GPMPs and TCAs increased. There was no change to prescribed medicines or psychological quality of life. Attendance at allied health professionals increased, but decreased at pharmacies. Overall satisfaction with CDMS was high among GPs, allied health professionals, and patients. <br /><br /><b>Conclusion.b> This study demonstrates proof of concept, but replication or continuation of the study is desirable to enable the impact of CDMS on diabetes outcomes to be determined.<br />

A pilot study of a telephone-based parental intervention to increase fruit and vegetable consumption in 3-5 year old children

<b>Objective : b>To examine the potential efficacy of a brief telephone-based parental intervention in increasing fruit and vegetable consumption in children aged 3–5 years and to examine the feasibility of intervention delivery and acceptability to parents.<br /><b><br />Design : b>A pre–post study design with no comparison group. Telephone surveys were conducted approximately 1 week before and following intervention delivery.<br />Setting Participants were recruited through pre-schools in the Hunter region, New South Wales, Australia.<br /><b><br />Subjects : b>Thirty-four parents of 3–5-year-olds received four 30-min interventional telephone calls over 4 weeks administered by trained telephone interviewers. The scripted support calls focused on fruit and vegetable availability and accessibility within the home, parental role modelling of fruit and vegetable consumption and on implementing supportive family eating routines.<br /><b><br />Results : b>Following the intervention, the frequency and variety of fruit and vegetable consumption increased (P = 0·027), as measured by a subscale of the children's dietary questionnaire. The intervention was feasible to be delivered to parents, as all participants who started the intervention completed all four calls, and all aspects of the interventional calls, including the number, length, content, format and relevance, were considered acceptable by more than 90 % of parents.<br /><b><br />Conclusions : b>A brief telephone-based parental intervention to encourage fruit and vegetable consumption in pre-school-aged children may be effective, feasible and acceptable. Further investigation is warranted in a randomised controlled trial.<br />

Associations between fruit and vegetable intake, leisure-time physical activity, sitting time and self-rated health among older adults : cross-sectional data from the WELL study

<b>Backgroundb><br />Lifestyle behaviours, such as healthy diet, physical activity and sedentary behaviour, are key elements of healthy ageing and important modifiable risk factors in the prevention of chronic diseases. Little is known about the relationship between these behaviours in older adults. The purpose of this study was to explore the relationship between fruit and vegetable (F&V) intake, leisure-time physical activity (LTPA) and sitting time (ST), and their association with self-rated health in older adults.<br /><br /><b>Methodsb><br />This cross-sectional study comprised 3,644 older adults (48% men) aged 55-65 years, who participated in the Wellbeing, Eating and Exercise for a Long Life ("WELL") study. Respondents completed a postal survey about their health and their eating and physical activity behaviours in 2010 (38% response rate). Spearman's coefficient (rho) was used to evaluate the relationship between F&V intake, LTPA and ST. Their individual and shared associations with self-rated health were examined using ordinal logistic regression models, stratified by sex and adjusted for confounders (BMI, smoking, long-term illness and socio-demographic characteristics).<br /><br /><b>Resultsb><br />The correlations between F&V intake, LTPA and ST were low. F&V intake and LTPA were positively associated with self-rated health. Each additional serving of F&V or MET-hour of LTPA were associated with approximately 10% higher likelihood of reporting health as good or better among women and men. The association between ST and self-rated health was not significant in the multivariate analysis. A significant interaction was found (ST*F&V intake). The effect of F&V intake on self-rated health increased with increasing ST in women, whereas the effect decreased with increasing ST in men.<br /><br /><b>Conclusionb><br />This study contributes to the scarce literature related to lifestyle behaviours and their association with health indicators among older adults. The findings suggest that a modest increase in F&V intake, or LTPA could have a marked effect on the health of older adults. Further research is needed to fully understand the correlates and determinants of lifestyle behaviours, particularly sitting time, in this age group.

Physics practicals for distance education in an undergraduate engineering course

BACKGROUND : Providing engineering practicals to undergraduates by means of distance education is a significant challenge. The past 30 years have seen the rapid development of the distance education. For many years, Deakin University has offered a full Bachelor of Engineering degree programme via distance education. All first-year students study a unit in physics. This unit includes practicals. Providing practical experiences to students is distance education’s greatest challenge.<br /><br />PURPOSE : The purpose of this work was to develop the means for off-campus students to complete practical exercises in first-year engineering physics. The solution to the problem also had to comply with accreditation requirements set by Engineers Australia.<br /><br />METHOD : The long-term solution to the problem was running on-campus lab classes either on weekends or as part of the annual first-year residential school for engineering professional practice. Students work was assessed by means of standard laboratory reports. On-campus marks and off-campus lab marks have been collected and compared over the past 12 years.<br /><br />RESULTS : The results indicate that the off-campus lab experience is similar to the on-campus experience. Marks for the two cohorts were comparable. Those few students who completed their pracs at home faced and overcame significant challenges.<br /><br />CONCLUSIONS : We found that performance in their lab reports for off-campus students was similar to that of the on-campus students. Accreditation requirements has shifted the focus from developing activities that students could perform at home to offering timely and efficient on-campus lab classes for off-campus students. Future work will focus on on-campus lab classes in accordance with accreditation requirements and perhaps on-line broadcasts of prac classes for those students who cannot attend lab on-campus.