Non-Pharmacological Management of Nausea and Vomiting in Cancer: A Scoping Review

Prevention and management of nausea and vomiting are important in cancer treatment. Effective management requires both pharmacological and non-pharmacological interventions. Patients and family members have important contributions to achieve effective control of nausea and vomiting through self-management. The objective of this review is to explore and synthesize the scientific literature about self-management strategies as a type of non-pharmacological intervention for managing nausea and vomiting in cancer patients. The articles were searched in PubMed, Science Direct and ClinicalKey databases using keyword combinations of "cancer", “non-pharmacological”, "intervention", "management", "nausea" and "vomiting". The inclusion criteria were articles that were free; full text; published in the last five years; provided information about non-pharmacological strategies in managing nausea and vomiting in cancer; and were written in English. Out of a total of 232 papers identified, 21 were selected. The results show that non-pharmacological management of nausea and vomiting ranged from simple self-management techniques to integrative therapies and palliative interventions. Self-management emphasizes patient autonomy in their own care and encourages patients and families to assume the responsibility of managing relevant aspects of their condition. The strategies include dietary modifications, environmental modifications, psychological strategies, exercise and taking of medication as prescribed. The interventions discussed in this article can be applied by patients as directed or instructed by healthcare teams. Nurses play an important role in educating patients on non-pharmacological interventions and encouraging them to achieve self-efficacy. Further research of other such interventions with larger sample sizes is needed to provide more accurate results.   Abstrak Manajemen Nonfarmakologis Mual dan Muntah pada Kanker: Scoping Review. Pencegahan dan pengelolaan mual dan muntah penting dalam pengobatan kanker, yang efektif dengan intervensi farmakologis dan nonfarmakologis. Pasien dan anggota keluarga pun mempunyai kontribusi penting untuk mencapai pengendalian mual dan muntah yang efektif melalui manajemen diri pasien. Tujuan dari tinjauan ini adalah untuk mengeksplorasi dan menyintesis literatur ilmiah tentang strategi manajemen diri sebagai jenis intervensi nonfarmakologis untuk mengelola mual dan muntah pada pasien kanker. Artikel-artikel tersebut dicari di basis data PubMed, Science Direct, dan ClinicalKey menggunakan kombinasi kata kunci "kanker", "non-farmakologis", "intervensi", "manajemen", "mual", dan "muntah" dengan kriteria inklusi seperti: artikel tidak berbayar; teks lengkap; diterbitkan dalam lima tahun terakhir; memberikan informasi tentang strategi non farmakologis dalam manajemen mual muntah pada pasien kanker; dan ditulis dalam Bahasa Inggris. Dari total 232 makalah yang diidentifikasi, 21 dipilih untuk penelitian ini. Hasil telaah menunjukkan bahwa manajemen nonfarmakologis mual dan muntah meliputi teknik manajemen diri yang sederhana hingga terapi integratif dan intervensi paliatif. Manajemen diri menekankan otonomi pasien dalam perawatan mandiri dengan mendorong pasien dan keluarga untuk bertanggung jawab mengelola aspek yang relevan dari kondisi mereka. Strategi tersebut meliputi modifikasi pola makan, modifikasi lingkungan, strategi psikologis, olahraga, dan minum obat sesuai resep. Intervensi yang dibahas dalam artikel ini dapat diterapkan oleh pasien seperti yang diarahkan atau diinstruksikan oleh tim kesehatan. Perawat memainkan peran penting dalam mendidik pasien tentang intervensi nonfarmakologis dan mendorong mereka untuk mencapai efikasi diri. Penelitian lebih lanjut dari intervensi serupa lainnya dengan ukuran sampel yang lebih besar diperlukan untuk memberikan hasil yang lebih akurat. Kata Kunci: intervensi, kanker, manajemen, mual, muntah, nonfarmakologi

Going beyond (electronic) patient-reported outcomes: harnessing the benefits of smart technology and ecological momentary assessment in cancer survivorship research

Rapid developments in digital mobile and sensor technology have facilitated the active and passive collection of detailed, personalized data in increasingly affordable ways. Researchers may be familiar with the daily diary, portable computers, or the pedometer for the collection of patientreported outcomes (PRO) in cancer survivorship research. Such methods, termed ecological momentary assessment (EMA), have evolved with technological advances, e.g., collecting data or providing interventions (ecological momentary intervention, EMI) via apps or devices such as smartphones. These smart technology-adapted sEMA/ sEMI methods are more widely used in affective disorders or addictive behavior research but are currently still under-utilized in cancer survivorship research. A recent scoping review on the use of active EMA among cancer survivors identified twelve articles published between 1993 and 2018. Most of the included studies in that review used portable computers. This commentary will discuss the utility of sEMA/sEMI in cancer survivorship research and call for action to advance this area of science

Exercise counselling and referral in cancer care: An international scoping survey of health care practitioners’ knowledge, practices, barriers, and facilitators

Purpose: Evidence supports the role of prescribed exercise for cancer survivors, yet few are advised to exercise by a healthcare practitioner (HCP). We sought to investigate the gap between HCPs’ knowledge and practice from an international perspective. Methods: An online questionnaire was administered to HCPs working in cancer care between February 2020 and February 2021. The questionnaire assessed knowledge, beliefs, and practices regarding exercise counselling and referral of cancer survivors to exercise programs. Results: The questionnaire was completed by 375 participants classified as medical practitioners (42 %), nurses (28 %), exercise specialists (14 %), and non-exercise allied health practitioners (16 %). Between 35 and 50 % of participants self-reported poor knowledge of when, how, and which cancer survivors to refer to exercise programs or professionals, and how to counsel based on exercise guidelines. Commonly reported barriers to exercise counselling were safety concerns, time constraints, cancer survivors being told to rest by friends and family, and not knowing how to screen people for suitability to exercise (40 – 48 %). Multivariable logistic regression models including age, gender, practitioner group, leisure-time physical activity, and recall of guidelines found significant effects for providing specific exercise advice (χ2(7) = 117.31, p \u3c .001), discussing the role of exercise in symptom management (χ2(7) = 65.13, p \u3c .001) and cancer outcomes (χ2(7) = 58.69, p \u3c .001), and referring cancer survivors to an exercise program or specialist (χ2(7) = 72.76, p \u3c .001). Conclusion: Additional education and practical support are needed to equip HCPs to provide cancer survivors with exercise guidelines, resources, and referrals to exercise specialists

Exercise counselling and referral in cancer care: an international scoping survey of health care practitioners' knowledge, practices, barriers, and facilitators

Purpose Evidence supports the role of prescribed exercise for cancer survivors, yet few are advised to exercise by a healthcare practitioner (HCP). We sought to investigate the gap between HCPs' knowledge and practice from an international perspective. Methods An online questionnaire was administered to HCPs working in cancer care between February 2020 and February 2021. The questionnaire assessed knowledge, beliefs, and practices regarding exercise counselling and referral of cancer survivors to exercise programs. Results The questionnaire was completed by 375 participants classified as medical practitioners (42%), nurses (28%), exercise specialists (14%), and non-exercise allied health practitioners (16%). Between 35 and 50% of participants self-reported poor knowledge of when, how, and which cancer survivors to refer to exercise programs or professionals, and how to counsel based on exercise guidelines. Commonly reported barriers to exercise counselling were safety concerns, time constraints, cancer survivors being told to rest by friends and family, and not knowing how to screen people for suitability to exercise (40-48%). Multivariable logistic regression models including age, gender, practitioner group, leisure-time physical activity, and recall of guidelines found significant effects for providing specific exercise advice (chi(2)(7) = 117.31, p Conclusion Additional education and practical support are needed to equip HCPs to provide cancer survivors with exercise guidelines, resources, and referrals to exercise specialists.</p

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Bilateral renal agenesis/hypoplasia/dysplasia (BRAHD):postmortem analysis of 45 cases with breakpoint mapping of two de novo translocations

Bilateral renal agenesis/hypoplasia/dysplasia (BRAHD) is a relatively common, lethal malformation in humans. Established clinical risk factors include maternal insulin dependent diabetes mellitus and male sex of the fetus. In the majority of cases, no specific etiology can be established, although teratogenic, syndromal and single gene causes can be assigned to some cases.45 unrelated fetuses, stillbirths or infants with lethal BRAHD were ascertained through a single regional paediatric pathology service (male:female 34:11 or 3.1:1). The previously reported phenotypic overlaps with VACTERL, caudal dysgenesis, hemifacial microsomia and Müllerian defects were confirmed. A new finding is that 16/45 (35.6%; m:f 13:3 or 4.3:1) BRAHD cases had one or more extrarenal malformations indicative of a disoder of laterality determination including; incomplete lobulation of right lung (seven cases), malrotation of the gut (seven cases) and persistence of the left superior vena cava (five cases). One such case with multiple laterality defects and sirelomelia was found to have a de novo apparently balanced reciprocal translocation 46,XY,t(2;6)(p22.3;q12). Translocation breakpoint mapping was performed by interphase fluorescent in-situ hybridization (FISH) using nuclei extracted from archival tissue sections in both this case and an isolated bilateral renal agenesis case associated with a de novo 46,XY,t(1;2)(q41;p25.3). Both t(2;6) breakpoints mapped to gene-free regions with no strong evidence of cis-regulatory potential. Ten genes localized within 500 kb of the t(1;2) breakpoints. Wholemount in-situ expression analyses of the mouse orthologs of these genes in embryonic mouse kidneys showed strong expression of Esrrg, encoding a nuclear steroid hormone receptor. Immunohistochemical analysis showed that Esrrg was restricted to proximal ductal tissue within the embryonic kidney.The previously unreported association of BRAHD with laterality defects suggests that renal agenesis may share a common etiology with heterotaxy in some cases. Translocation breakpoint mapping identified ESRRG as a plausible candidate gene for BRAHD

Introduction to the process of research: A focus on oncology nursing research

Nurses are expected to be involved with research, as part of their daily practice. Many, however, have not had the opportunity to learn about research or the research process. This article is an introduction to research for nurses working in oncology who have not had the opportunity to learn about the research process formally. Oncology nursing research examples are used to illustrate teh research process. The intent of the article is to offer a user-friendly vehicle for oncology nurses to gain comfort with some of the terminology and concepts used in research. The content was organized on the basis of questions staff nurses have posed about research methods in oncology nursing

Supportive care needs of patients with advanced disease undergoing radiotherapy for symptom control

Many patients with advanced cancer have numerous medical complications and multiple sites involving metastases that cause distressing symptoms. Radiotherapy is often used for the palliative treatment of these patients, especially those with bone metastases. There is a lack of information about the types of supportive care needs these patients experience, the services that are available for them, and whether people want help with their needs. The main purpose of this cross-sectional, descriptive study was to identify the supportive care needs (physical, emotional, social, spiritual, psychological, and practical) of patients with advanced cancer who attended the Palliative Radiation Therapy Rapid Response Clinic (PRTRRC) at a comprehensive, ambulatory cancer centre. A second purpose was to determine if patients wanted assistance in meeting those needs. A total of 69 patients participated in this study by completing a self-report questionnaire. The data provided a clear indication that a range of supportive care needs remained unmet for this patient group. Lack of energy, pain, and concerns about the worries of those close to them were the most frequently reported needs. Additionally, patients expressed a range of difficulty managing needs and many of these patients desired help to manage the identified needs. However, despite this reality, significant numbers of patients indicated they did not wish to have assistance with some needs. Suggestions for practice and future research are offered to assist oncology nurses in providing supportive care to these patients