Cognitive Changes Associated with Cancer and Cancer Treatment: State of the Science

Background: Cognitive impairment is a distressing, disruptive, and potentially debilitating symptom that can occur as a direct result of cancer or its treatment. National organizations have identified cognitive impairment as a challenge many survivors face and call for research to address this problem. Despite the priority, research is still relatively limited and questions remain unanswered about prevalence and impact on survivors, as well as coping strategies and effective treatment options available to address this potentially debilitating problem. Objectives: The purpose of this article is to (a) analyze the prevalence and types of cognitive impairment that commonly affect survivors; (b) delineate the impact that cognitive impairment after cancer and cancer treatment has on self-esteem, social relationships, work ability, and overall quality of life among survivors; and (c) synthesize and appraise commonly used coping strategies used by survivors to address cognitive impairment and evidence-based interventions that may be incorporated into clinical practice. Methods: A comprehensive review and synthesis of the literature was conducted. Findings: Evidence-based interventions to address cognitive changes after cancer and cancer treatment are limited. However, emerging research has demonstrated that nonpharmacologic treatments, such as cognitive training, are likely to be effective

Evaluation of the passage of Lactobacillus gasseri K7 and bifidobacteria from the stomach to intestines using a single reactor model

<p>Abstract</p> <p>Background</p> <p>Probiotic bacteria are thought to play an important role in the digestive system and therefore have to survive the passage from stomach to intestines. Recently, a novel approach to simulate the passage from stomach to intestines in a single bioreactor was developed. The advantage of this automated one reactor system was the ability to test the influence of acid, bile salts and pancreatin.</p> <p><it>Lactobacillus gasseri </it>K7 is a strain isolated from infant faeces with properties making the strain interesting for cheese production. In this study, a single reactor system was used to evaluate the survival of <it>L. gasseri </it>K7 and selected bifidobacteria from our collection through the stomach-intestine passage.</p> <p>Results</p> <p>Initial screening for acid resistance in acidified culture media showed a low tolerance of <it>Bifidobacterium dentium </it>for this condition indicating low survival in the passage. Similar results were achieved with <it>B. longum </it>subsp. <it>infantis </it>whereas <it>B. animalis </it>subsp. <it>lactis </it>had a high survival.</p> <p>These initial results were confirmed in the bioreactor model of the stomach-intestine passage. <it>B. animalis </it>subsp. <it>lactis </it>had the highest survival rate (10%) attaining approximately 5 × 10⁶cfu ml^-1compared to the other tested bifidobacteria strains which were reduced by a factor of up to 10⁶. <it>Lactobacillus gasseri </it>K7 was less resistant than <it>B. animalis </it>subsp. <it>lactis </it>but survived at cell concentrations approximately 1000 times higher than other bifidobacteria.</p> <p>Conclusion</p> <p>In this study, we were able to show that <it>L. gasseri </it>K7 had a high survival rate in the stomach-intestine passage. By comparing the results with a previous study in piglets we could confirm the reliability of our simulation. Of the tested bifidobacteria strains, only <it>B. animalis </it>subsp. <it>lactis </it>showed acceptable survival for a successful passage in the simulation system.</p

Isothermal micro calorimetry – a new method for MIC determinations: results for 12 antibiotics and reference strains of E. coli and S. aureus

Antimicrobial susceptibility testing of microorganisms is performed by either disc diffusion or broth dilution tests. In clinical use, the tests are often still performed manually although automated systems exist. Most systems, however, are based on turbidometric methods which have well-known drawbacks

Organizational Intellectual Capital and the Role of the Nurse Manager. A Proposed Conceptual Model

Background Nurse managers must leverage both the human capital and social capital of the teams they lead in order to produce quality outcomes. Little is known about the relationship between human capital and social capital and how these concepts may work together to produce organizational outcomes through leadership of nurses. Purpose The purpose of this article was to explore the concepts of human capital and social capital as they relate to nursing leadership in health care organizations. Specific aims included (a) to synthesize the literature related to human capital and social capital in leadership, (b) to refine the conceptual definitions of human capital and social capital with associated conceptual antecedents and consequences, and (c) to propose a synthesized conceptual model guiding further empirical research of social capital and human capital in nursing leadership. Methods A systematic integrative review of leadership literature using criteria informed by Whittemore and Knafl (2005) was completed. CINAHL Plus with Full Text, Academic Search Premier, Business Source Premier, Health Business FullTEXT, MEDLINE, and PsychINFO databases were searched for the years 1995 to 2016 using terms “human capital,” “social capital,” and “management.” Discussion Analysis of conceptual definitions, theoretical and conceptual models, antecedents and consequences, propositions or hypotheses, and empirical support for 37 articles fitting review criteria resulted in the synthesis of the proposed Gilbert Conceptual Model of Organizational Intellectual Capital. Conclusion The Gilbert Conceptual Model of Organizational Intellectual Capital advances the propositions of human capital theory and social capital theory and is the first model to conceptualize the direct and moderating effects that nurse leaders have on the human capital and social capital of the teams they lead. This model provides a framework for further empirical study and may have implications for practice, organizational policy, and education related to nursing leadership

The Caregiver’s Role Across the Bone Marrow Transplantation Trajectory

Background: Approximately 50 000 people undergo bone marrow transplants (BMTs) each year worldwide. With the move to more outpatient and home care, family caregivers are playing an ever-increasing role. However, there is little information regarding the needs and well-being of caregivers of individuals undergoing BMT. Objective: The study purpose was to gain a better understanding of the BMT experience across the trajectory from the perspective of the family caregiver. Methods: Qualitative interviews were conducted with 15 family caregivers during and 4 months after BMT. Interviews were recorded, transcribed verbatim, and analyzed using a content analysis approach. Results: Uncertainty and need for more information were 2 major underlying themes noted across the early BMT trajectory. Caregivers reported feeling overwhelmed and juggling multiple roles, including (a) ‘‘interpreter,’’ which included obtaining and translating medical information to their partner, family, and social network; (b) ‘‘organizer,’’ which included arranging and coordinating medical appointments (pre- and post-BMT) for the patient, but also juggling the needs of immediate and extended family members; and (c) ‘‘clinician,’’ which included assessing and identifying changes in their significant other, with many reporting that they had to be ‘‘vigilant’’ about or ‘‘on top of’’ any changes. Caregivers also reported the most challenging aspects of their role were to ‘‘be strong for everyone’’ and ‘‘finding balance.’’ Conclusions: Our results underscore the unique needs of family caregivers as a consequence of BMT. Implications for Practice: A greater understanding of the adaptation of caregivers will lead to the development of effective interventions for families going through BMT

The Symptom Experience of Patients With Advanced Pancreatic Cancer: An Integrative Review

Background: Pancreatic cancer is a devastating disease with limited treatment options. More than 80% of pancreatic cancers are diagnosed in advanced stages and often have debilitating symptoms, making symptom management paramount, yet the symptom experience of patients with advanced pancreatic cancer (APC) is not well understood. Objective: The purpose of this integrative review is to synthesize the current evidence regarding the symptom experience of patients with APC. Method: An integrative literature review was conducted to identify the patient symptom experience in studies published from 2005 to 2015. Results: Sixteen studies met the inclusion criteria. All studies used a quantitative approach; 44% were quasi-experimental, 31% were descriptive, and 25% were correlational. Physical symptoms, especially pain, were the primary focus in most studies. Fatigue, loss of appetite, and impaired sense of well-being were prevalent and reported by patients to be of high intensity. Few studies examined psychological symptoms in patients with APC, although anxiety and depression were noted. Conclusion: Findings suggest that physical and psychological symptoms are prevalent, some with high intensity. Preselection of symptom inventories limits our ability to fully understand the symptom experience of patients with APC. Future qualitative work is needed to provide a more in-depth understanding of symptoms, especially symptom quality and distress level, from patients' perspectives. More studies are needed to explore psychological symptoms and the interaction of physical and psychological symptoms. Implications for Practice: Findings help healthcare givers to better understand the symptom experience of their APC patients

Lactic Acid Bacteria as Markers for the Authentication of Swiss Cheeses

The manufacture of traditional Swiss-type cheeses adheres to strict rules, so as to guarantee quality and purity of the end product. This raises production costs and means consumers pay more. It also opens the door to cut-rate forgeries claiming to be made to the stringent standards and causing considerable economic losses to the entire dairy sector. In order to combat product counterfeiting, Agroscope has developed proof-of-origin cultures that allow the identification of copycats. Carefully selected lactic acid bacteria, having uniquely located insertion sequence elements, are proliferated by fermentation and subsequently dried by lyophilization. The proof-of-origin culture is added during the cheese production process and sustains maturation. These so-called 'biological markers' can be traced using polymerase chain reaction (PCR) methods, which allow authentication even if the cheese is cut into pieces or grated. They do not lead to any alteration of the cheese's taste or texture, and are compatible with the strict 'protected designation of origin' (PDO) specifications. The proof-of-origin cultures are used for the protection of several traditional Swiss-cheese varieties, such as Emmental PDO, Tête de Moine PDO, and Appenzeller®. A market survey of Emmental PDO showed that the system is effective in revealing fraud and has the power to enforce corrective measures

Potassium Lactate as a Strategy for Sodium Content Reduction without Compromising Salt-Associated Antimicrobial Activity in Salami

Reformulating recipes of ready-to-eat meat products such as salami to reduce salt content can mitigate the negative health impacts of a high salt diet. We evaluated the potential of potassium lactate (KL) as a sodium chloride (NaCl) replacer during salami production. NaCl and KL stress tolerance comparisons showed that four food-derived Listeria innocua isolates were suitable as biologically safe Listeria monocytogenes surrogates. Effects of the high salt (4% NaCl) concentration applied in standard salami recipes and a low salt (2.8% NaCl) plus KL (1.6%) combination on product characteristics and growth of contaminating Listeria and starter culture were compared. Simulated salami-ripening conditions applied in meat simulation broth and beef showed that the low salt plus KL combination retained similar to superior anti-Listeria activity compared to the high salt concentration treatment. Salami challenge tests showed that the low NaCl plus KL combination had comparable anti-Listeria activity as the high NaCl concentration during ripening and storage. No significant differences were detected in starter culture growth profiles and product characteristics between the high NaCl and low NaCl plus KL combination treated salami. In conclusion, KL replacement enabled a 30% NaCl reduction without compromising the product quality and antimicrobial benefits of high NaCl concentration inclusion

PAIN AND ANXIETY AND QUALITY OF LIFE IN BREAST CANCER SURVIVORS

poster abstractBACKGROUND: Pain and anxiety are symptoms that frequently occur as co-related groups termed “clusters.” While it is known that pain may be associated with decreased quality of life (QOL), less is understood about the effects of anxiety on breast cancer survivors (BCS). PURPOSE: The purpose of this study was to: 1) determine levels of pain and anxiety in breast cancer survivors and 2) examine the relationship between anxiety and pain on quality of life in breast cancer survivors (BCS) controlling for age and time post-treatment. THEORETICAL FRAMEWORK: Ferrell’s Quality of Life Model guided this study. METHODS: A cross-sectional, descriptive design was used. BCS enrolled in a longitudinal cognitive behavioral study completed self-report questionnaires including the Medical Outcome Scale-Short Form, Pain Subscale, Spielberger State-Trait Anxiety Instrument (STAI) State Subscale to measure anxiety, and Ferrell’s QOL Instrument which measures Physical, Psychological, Social and Spiritual Well-being (higher scores indicating higher quality of life). Covariates of age and time post-treatment were controlled for. All data were collected at a baseline assessment before randomization in the cognitive intervention study. Data were evaluated using descriptive statistics and general linear regression. RESULTS: 88 female BCS averaging 57 years old (range 40-74; SD=8.54), primarily Caucasian (88.6%), college-educated (88%), approximately 5.3 (SD=4.0) years post-treatment participated. Cancer-related pain (4 lymphedema, 4 neuropathy) was specified by 8 participants. BCS reported low-moderate pain (x= 66.0114; sd = 22.348) and moderate anxiety (x̅=35.0227; sd= 8.7749). Clinically significant levels of anxiety (≥ 39 on the STAI-S where higher scores indicated higher anxiety) were reported in 24% of BCS. Age, anxiety, and pain significantly accounted for 45% of the total variance on QOL in the regression model (R = 0.45, F = 18.61; p = <0.000), controlling for age and time post-treatment. CONCLUSIONS: This study provides support for the fact that both pain and anxiety are negatively associated with QOL. Anxiety is a significant long-term symptom for a sub-set of BCS which negatively impacts all dimensions of BCS quality of life. Findings indicate the need for comprehensive assessment of symptoms of anxiety in long-term BCS and the development of evidenced-based interventions to alleviate anxiety and improve QOL

Neuroimaging, cancer, and cognition: state of the knowledge

OBJECTIVES: To review neuroimaging research concerning cancer- and cancer treatment-related changes in brain structure and function, clinical perspectives, and future directions. DATA SOURCES: Peer-reviewed literature. CONCLUSION: Cancer and chemotherapy are associated with cerebral structural and functional alterations in breast cancer patients that may persist for years; many of these changes are correlated with cognitive complaints or performance. In other cancers there is some evidence that metabolism is altered by cancer, but more research is needed. IMPLICATIONS FOR NURSING PRACTICE: Understanding the role of neuroimaging is important to identify the basis of cognitive changes associated with cancer and cancer treatment