Actinomycetes: A Source of Anticancer Metabolites.

Microbes in general, actinomycetes in particular, produce a wide range of antibiotics with various biological activities such as anticancer, antimicrobial, anti-inflammatory, antituberculosis and enzyme inhibition. Actinomycetes are filamentous gram-positive bacteria found in both terrestrial and marine environments. Currently, antibiotics such as Rifamycin, Tetracycline, Kanamycin, Neomycin, Streptomycin and Clavulanic acid derived from actinobacteria are highly useful in the medical field.

A conceptual model of the nurse's role as primary palliative care provider in goals of care communication.

Objective: Nurses have opportunities to engage in goals of care conversations that can promote palliative care communication. The purpose of this study was to describe nurses' experiences in goals of care communication as summarized in the literature and to present a conceptual model of communication pathways for nurses.

Methods: An integrative review of the literature (2016-2022) addressing nurses' experiences in goals of care communication was conducted using PubMed, CINAHL, and PsychInfo databases.

Medico-Legal Implications and Regulatory Frameworks of Regenerative Orthopaedics.

Regenerative orthopaedics has revolutionized traditional medicine, which represents a giant leap in science and research. The knowledge of the medico-legal implications and regulatory framework of this branch is vital for clinicians and researchers to go forward smoothly. This systematic review of the literature should shed light on these considerations and provide a comprehensive knowledge of the various implications and laws governing practice and research.

Communication and Competencies Across Undergraduate BSN Programs and Curricula.

Background: An investigation was conducted to assess for and describe health communication instruction in entry-level baccalaureate (BSN) programs.

Method: This cross-sectional descriptive study examined entry-level baccalaureate degree nursing programs in the United States. A three-step process was used: (1) online survey of directors of BSN programs, (2) online survey of simulation directors, and (3) analysis of course titles and descriptions.

COVID 19-transformed nursing education and communication competency: Testing COMFORT educational resources.

Background: The COVID-19 pandemic brought a disruption to nurse education for both nursing faculty and students as all non-clinical nurse education courses worldwide moved to distance or online learning. The sudden shift to online education meant the loss of traditional activities for students to learn communication skills creating a critical demand for open educational resources for students and nursing faculty. Tools to support nursing faculty development for teaching communication are nearly non-existent and pedagogical content knowledge is needed.

Opportunities to improve COVID-19 provider communication resources: A systematic review.

Objective: Communication related to COVID-19 between provider and the patient/family is impacted by isolation requirements, time limitations, and lack of family/partner access. Our goal was to determine the content of provider communication resources and peer-reviewed articles on COVID-19 communication in order to identify opportunities for developing future COVID-19 communication curricula and support tools.

Methods: A systematic review was conducted using the UpToDate clinical decision support resource database, CINAHL, PubMed, PsycInfo, and Web of Science.

Patient reported symptom outcomes during medication titration for adult heart failure management.

Aims And Objectives: This project used the Patient Reported Outcomes Measurement Information System (PROMIS) tools to evaluate heart failure patient's experiences of dyspnea, fatigue, and physical mobility during initiation and up titration of drugs in an outpatient setting.

Background: Investigating patient reported outcome may improve adherence to GDMT. Theoretical support for this study is found in the University of California, Theory of Symptom Management.

The nurse influencer: A concept synthesis and analysis.

Aim: The purpose of this paper is to provide a clear definition of the concept of a nurse influencer.

Background: While the nursing profession is known for caring, advocacy, and trustworthiness, the nurse influencer is an emerging concept in health care. Clarification of this concept is essential to understand the necessary characteristics and potential opportunities for the nurse influencer.

Identifying and Addressing Family Caregiver Anxiety.

Family caregivers are an increasingly diverse group of individuals who provide significant amounts of direct and indirect care for loved ones with long-term chronic illnesses. Caregiver needs are vast, particularly as these relate to the caregiver's quality of life. However, caregivers are often unlikely to address their personal and health-related concerns.

Prevalence, risk factors, and significance of iron deficiency and anemia in nonischemic heart failure patients with reduced ejection fraction from a Himachal Pradesh heart failure registry.

Background: The study aimed to estimate the prevalence, risk determinants, and its clinical significance of iron deficiency and anemia in patients of nonischemic heart failure with reduced ejection fraction (HFrEF).

Methods: Serum ferritin, transferrin saturation, and the hemoglobin (Hb) levels were measured in 226 consecutive patients with HFrEF diagnosed based on the left ventricular ejection fraction ≤ 45% and absence of coronary artery luminal narrowing of more than 50%, in a prospective tertiary care hospital-based heart failure registry. Patients with the New York Heart Association functional class III/IV were classified as patients with advanced heart failure.

Randomized clinical trial of a community navigation intervention to improve well-being in persons living with HIV and other co-morbidities.

Long-term survival of people living with HIV (PLWH) is associated with the development of co-morbid conditions and need for symptom management and other efforts to enhance quality of life. We conducted a longitudinal, randomized trial over 36 months to evaluate the effect of a community-based navigator intervention to provide early palliative care to 179 PLWH and other chronic conditions. Outcomes included quality of life, symptom management, coping ability, social support, self-management, and completion of advance directives.

Clinical Characteristics, Complications, and Treatment Practices in Patients With RHD: 6-Year Results From HP-RHD Registry.

Background: Despite the high prevalence of rheumatic heart disease (RHD) in developing countries such as India, data on characteristics, complications, and treatment practices are lacking. The HP-RHD (Himachal Pradesh Rheumatic Heart Disease) registry aimed at reporting these parameters in patients with RHD from a northern state of India.

Methods: A total of 2,005 consecutive patients of RHD were enrolled over a period of 6 years (2011 to 2016) in the present study.

Palliative care services in pediatric oncology.

Pediatric cancer has experienced significant improvement in overall survival rates over the past several decades. Despite this progress, however, it remains the leading cause of death from disease beyond infancy in children. Among the children and adolescents that survive their cancer diagnosis, significant symptom burden and toxicities of therapy are often experienced.

Knowledge, Beliefs, and Behaviors Related to Palliative Care Delivery Among Pediatric Oncology Health Care Providers.

The care of pediatric patients with cancer and their families is complex and rapidly evolving. Despite significant advances in outcomes, symptoms of the disease and complications of therapy continue to cause suffering that may improve with the involvement of pediatric palliative care (PPC) services. This descriptive study responds to the observation of great variability in PPC utilization within pediatric oncology.

Fatigue Symptom Management in People Living With Human Immunodeficiency Virus.

Fatigue is a subjective, unpleasant, potentially disabling symptom rooted in physiological, psychological, and behavioral causes. People living with HIV are a population highly affected by fatigue due to risk factors associated with HIV-infection, treatment, and psychosocial disease burden. People with HIV are living longer, and are facing the challenge of a longer disease trajectory.

Animal Assisted Interactions to Alleviate Psychological Symptoms in Patients on Mechanical Ventilation.

Mechanical ventilation is a common life support intervention for critically ill patients that can cause stressful psychological symptoms. Animal assisted interactions have been used in variety of inpatient settings to reduce symptom burden and promote overall well-being. Due to the severity of illness associated with critical care, use of highly technological equipment, and heightened concern for infection control and patient safety, animal-assisted interaction has not been widely adopted in the intensive care unit.

Mindful Communication: Being Present.

Objectives: To review how mindfulness can be elicited in and strategically managed through communication, with a goal toward enhancing the patient/family relationship in the experience of cancer care.

Data Sources: Published, peer-reviewed literature, research reports, and Web-based resources.

Conclusion: Mindful communication, an active process whereby the health care provider and patient /family unit are attentive to the timing, nature, and context of the dialogue exchange, helps direct care that is patient-centered, reflective, and relational.

Perceptions of Statin Discontinuation among Patients with Life-Limiting Illness.

Background: Optimal management of chronic medications for patients with life-limiting illness is uncertain. Medication deprescribing may improve outcomes in this population, but patient concerns regarding deprescribing are unclear.

Objective: The aim of this study was to quantify the perceived benefits and concerns of statin discontinuation among patients with life-limiting illness.

Multimorbidity With HIV: Views of Community-Based People Living With HIV and Other Chronic Conditions.

People living with HIV (PLWH) experience an increase in chronic conditions with aging, but little is known about experiences of living with multimorbidity with HIV. Because early palliative care services may improve well-being for individuals with multimorbidity, we planned to test an intervention to provide these services to community-dwelling PLWH with other chronic conditions. To tailor our intervention to the target population, we conducted four focus groups (n = 22) that elicited health-related needs, experiences, and views regarding palliative and other health services.

Upstreaming and Normalizing Advance Care Planning Conversations-A Public Health Approach.

As a society, we simply don't talk about this universal experience called dying and death; in fact, we ignore it until we have to face it. Thus, it is often in a crisis experience when we have to make decisions while we are laden with uncertainty and intense emotions. Sixty percent of people say making sure their family is not burdened by tough decisions is extremely important, yet 56% of them have not held a conversation about its context.

Palliative Care, Hospice, and Advance Care Planning: Views of People Living with HIV and Other Chronic Conditions.

People living with HIV (PLWH) who survive to older adulthood risk developing multiple chronic medical conditions. Health policymakers recognize the role of early palliative care and advance care planning in improving health quality for at-risk populations, but misperceptions about palliative care, hospice, and advance care planning are common. Before testing a program of early palliative care for PLWH and other chronic conditions, we conducted focus groups to elicit perceptions of palliative care, hospice, and advance care planning in our target population.

Safety and benefit of discontinuing statin therapy in the setting of advanced, life-limiting illness: a randomized clinical trial.

Importance: For patients with limited prognosis, some medication risks may outweigh the benefits, particularly when benefits take years to accrue; statins are one example. Data are lacking regarding the risks and benefits of discontinuing statin therapy for patients with limited life expectancy.

Objective: To evaluate the safety, clinical, and cost impact of discontinuing statin medications for patients in the palliative care setting.