The role of spirituality in people with amyotrophic lateral sclerosis and their caregivers: Scoping review

BACKGROUND

There are few studies evaluating the role of spirituality and the role of spiritually integrated interventions in people with amyotrophic lateral sclerosis (PALS) and their caregivers.

OBJECTIVES

A scoping review was conducted to examine the nature and breadth of peer-reviewed literature on the role of spirituality, interventions integrating spirituality, and outcomes for PALS and their caregivers.

METHODS

A literature review was performed, following the methods from the Joanna Briggs Institute Reviewers, based on all articles published between January 2006 and April 2022, identified in the CINAHL Complete, MEDLINE Complete, MedicLatina, Psychology and Behavioral Sciences Collection, and SPORTDiscus with full-text databases using key terms. Extracted data included research aims, study design, population and characteristics, theme description, and measures or type of intervention.

RESULTS

A total of 18 articles were included in this study: 14 qualitative, 3 quantitative, and 1 protocol of a quantitative study. Eight studies were based in Europe. The search identified different main themes related to spirituality for caregivers and patients, 2 spiritual measure scales, and one intervention. However, many studies were limited in sample size, generalizability, and transferability and used less sophisticated research designs.

SIGNIFICANCE OF THE RESULTS

This scoping review illustrates the importance given to spirituality by caregivers and PALS and reveals a very heterogeneous response. Thus, experimental studies in the area of spirituality are needed to systematically explore the impact of spiritual interventions, and the results of these studies could advance practice and policy by enhancing the quality of life for PALS and their caregivers.

Characterization and monitoring of nutritional risk and nutritional status in oncological patients admitted to an oncological surgery unit: A longitudinal study

BACKGROUND AND AIMS

malnutrition is a common phenomenon in people with cancer and can occur at all stages of the disease trajectory. Prevention, early identification of patients at risk of malnutrition, nutritional diagnosis, and personalized intervention, monitoring and follow-up are essential measures to minimize the occurrence of malnutrition and its consequences. This study aims to evaluate if current institutional practices regarding nutritional intervention guarantees nutritional/dietary care for cancer patients.

METHODS

adescriptive, analytical and longitudinal study was carried out, lasting five months, in a hospital inpatient surgical oncology unit. All patients admitted to the unit in the period between 1 March and 31 July 2022, who underwent nutritional screening at the time of admission to the service, were included. During hospitalization, they were subjected to periodic assessments of weight, body mass index and nutritional screening every 7 days until discharge.

RESULTS

a total of 659 patients were admitted to the inpatient unit. The highest prevalence of malnutrition was observed in Head and Neck (37.6%), Genitourinary (30.8%) and Digestive (27.7%) cancers. Weight loss was especially significant in digestive, skin and sarcoma cancers, as well as genitourinary cancers, but not in breast cancer patients. During the hospitalization period, 14.0% of the hospitalized patients received nutrition-related nursing intervention, and 21.5% were referred for clinical dietetic intervention (by a registered dietitian).

CONCLUSION

this work reinforces the high prevalence of malnutrition in oncological patients and the need to systematically track cancer patients throughout their disease/treatment trajectory, from admission to the hospital, to the day of admission to inpatient unit, and subsequent follow-up. We also propose expedited referrals to different specialized centres in nutritional support for cancer patients from the first day of hospitalization. Assessment of patients should always be accompanied by active referral capacity to a specialized and duly trained nutritional care team that is quick, proactive, and responsive.

A scoping review of mobile apps for use with palliative patients in the context of home care

CONTEXT

Progress in mobile technology, especially the use of applications for mobile devices, can support the process of monitoring patients in palliative care (therapeutics), controlling symptoms, or providing self-care guidelines for the user, namely patients or caregivers.

OBJECTIVES

To map the available knowledge regarding the use of applications for mobile devices to support adult patients in palliative care at home.

METHODS

Literature review, based on the Joanna Briggs Institute model(s) for Scoping Review. All articles published until October 27, 2022, were identified in the electronic databases MEDLINE®, CINAHL®, Psychology and Behavioral Sciences Collection, Cochrane Library, and Scopus using the respective Boolean logical operators and key terms.

RESULTS

A total of 634 articles were identified, and a final 24 studies were included. Eleven mobile device applications were identified, demonstrating different aspects of design, use, and technological development. These have incorporated the most recent technology in their functionalities.

CONCLUSION

Mobile applications can be considered a viable and effective means of monitoring patients in palliative care. However, these applications must go beyond the academic scenario in which they were developed and move toward widespread use in practice, allowing the evaluation of the impact of this "new" intervention modality to understand their effectiveness and the application of best practices.

DNA methylation as a triage marker for colposcopy referral in HPV-based cervical cancer screening: a systematic review and meta-analysis

BACKGROUND

Screening plays a key role in secondary prevention of cervical cancer. High-risk human papillomavirus (hrHPV) testing, a highly sensitive test but with limited specificity, has become the gold standard frontline for screening programs. Thus, the importance of effective triage strategies, including DNA methylation markers, has been emphasized. Despite the potential reported in individual studies, methylation markers still require validation before being recommended for clinical practice. This systematic review and meta-analysis aimed to evaluate the performance of DNA methylation-based biomarkers for detecting high-grade intraepithelial lesions (HSIL) in hrHPV-positive women.

METHODS

Hence, PubMed, Scopus, and Cochrane databases were searched for studies that assessed methylation in hrHPV-positive women in cervical scrapes. Histologically confirmed HSIL was used as endpoint and QUADAS-2 tool enabled assessment of study quality. A bivariate random-effect model was employed to pool the estimated sensitivity and specificity as well as positive (PPV) and negative (NPV) predictive values.

RESULTS

Twenty-three studies were included in this meta-analysis, from which cohort and referral population-based studies corresponded to nearly 65%. Most of the women analyzed were Dutch, and CADM1, FAM19A4, MAL, and miR124-2 were the most studied genes. Pooled sensitivity and specificity were 0.68 (CI 95% 0.63-0.72) and 0.75 (CI 95% 0.71-0.80) for cervical intraepithelial neoplasia (CIN) 2+ detection, respectively. For CIN3+ detection, pooled sensitivity and specificity were 0.78 (CI 95% 0.74-0.82) and 0.74 (CI 95% 0.69-0.78), respectively. For pooled prevalence, PPV for CIN2+ and CIN3+ detection were 0.514 and 0.392, respectively. Furthermore, NPV for CIN2+ and CIN3+ detection were 0.857 and 0.938, respectively.

CONCLUSIONS

This meta-analysis confirmed the great potential of DNA methylation-based biomarkers as triage tool for hrHPV-positive women in cervical cancer screening. Standardization and improved validation are, however, required. Nevertheless, these markers might represent an excellent alternative to cytology and genotyping for colposcopy referral of hrHPV-positive women, allowing for more cost-effective screening programs.

Neoadjuvant Gastric Cancer Treatment and Associated Nutritional Critical Domains for the Optimization of Care Pathways: A Systematic Review

(1) Background: Gastric cancer patients are known to be at a high risk of malnutrition, sarcopenia, and cachexia, and the latter impairs the patient's nutritional status during their clinical course and also treatment response. A clearer identification of nutrition-related critical points during neoadjuvant treatment for gastric cancer is relevant to managing patient care and predicting clinical outcomes. The aim of this systematic review was to identify and describe nutrition-related critical domains associated with clinical outcomes. (2) Methods: We performed a systematic review (PROSPERO ID:CRD42021266760); (3) Results: This review included 14 studies compiled into three critical domains: patient-related, clinical-related (disease and treatment), and healthcare-related. Body composition changes during neoadjuvant chemotherapy (NAC) accounted for the early termination of chemotherapy and reduced overall survival. Sarcopenia was confirmed to have an independent prognostic value. The role of nutritional interventions during NAC has not been fully explored. (4) Conclusions: Understanding critical domain exposures affecting nutritional status will enable better clinical approaches to optimize care plans. It may also provide an opportunity for the mitigation of poor nutritional status and sarcopenia and their deleterious clinical consequences.

Developing a Card Game for Assessment and Intervention in the Person and the Family in Palliative Care: "Pallium Game"

Communication between the multidisciplinary team, the person, and the family in palliative and end-of-life situations implies, in most situations, a high negative emotional burden. Therefore, innovative strategies are needed to reduce it. The goal of this study is to describe the various stages of development and validation of a collaborative card game for people in palliative care and their families. Phase one is an exploratory study, Phase two is a Delphi study, and Phase three is a multiple case study. Participants for phases 2 and 3 were recruited using a convenience sampling method. The results demonstrate in an organized and structured way the different phases required to build a collaborative card game. The use of the game was found to be useful and effective. Four categories emerged from the content analysis of the open-ended responses: usability, evaluation tool, communication and therapeutic relationship, and meaning when using the game. A collaborative game in palliative care helps to create a space for individuals and families to express feelings and experiences, meeting the myriad of physical, psychosocial, and spiritual needs. The "Pallium game" is a useful and impactful approach to discussing sensitive topics in palliative care.

Impact of Exergames on the Mental Health of Older Adults: A Systematic Review and GRADE Evidence Synthesis

Exergames, which combine digital games and physical exercise, have become a popular alternative to traditional exercise programs and are increasingly used in the health domains. This study aimed to provide a systematic review to synthesize existing studies on the use of exergames for the mental wellbeing of healthy older adults, aggregating the collected data to identify effect size. We performed a Systematic Review and Grading of Recommendations, Assessment, Development, and Assessment (GRADE) evidence synthesis. We performed the search in the following databases: MEDLINE®, CINAHL®, SPORTDiscus, SCOPUS, SciELO, Psychology and Behavioral Sciences Collection, and Cochrane® Central Register of Controlled Trials from the first record until October 2021. Randomized controlled trials using exergames as an intervention were included. A total of 10 articles published between 2009 and 2021 were selected. Most studies used the Nintendo Wii® as the exergame in the intervention program. Interventions ranged from 6 to 12 weeks, with 8-week programs being most frequent. It was possible to observe a positive effect on mood, the reduction of apathy, anxiety and depression, self-esteem, and affection.

Exergames to improve Rehabilitation after Anterior Cruciate Ligament Injury: Systematic review and GRADE evidence synthesis

INTRODUCTION

Exergames are a fun, engaging, and interactive form of exercise that has been used in rehabilitation. This systematic review aimed to evaluate the effectiveness of exergames compared to usual rehabilitation after anterior cruciate ligament reconstruction.

METHOD

We performed a Systematic Review and GRADE evidence synthesis. The PRISMA guidelines for systematic reviews were followed. MEDLINE® (Medical Literature Analysis and Retrieval System Online), CINAHL® (Cumulative Index to Nursing and Allied Health Literature), SPORTDiscus, SCOPUS, SciELO (Scientific Electronic Library Online), Cochrane Central Register of Controlled Trials, and PEDro (Physiotherapy Evidence Database) were searched from their first record to May 2021. Randomised controlled trials using exergames as an intervention were included.

RESULTS

Initial literature searches yielded 794 non-duplicated records. After exclusion based on title, abstract, and full text review, five articles were included for analysis. Compared with the control group, the participants in the exergames group showed differences in proprioception and flexion angle difference.

CONCLUSION

Although there is no conclusive evidence that favours exergames over traditional rehabilitation, they did not aggravate the effects of rehabilitation. Nonetheless, exergames can be safe and motivating.

(Re)'Thinking' family in nursing care in pandemic times

AIM

This study aimed to identify which strategies are being adopted to deal with family restrictions in health units and assess nurses' perceptions of including families in nursing care during the current pandemic.

BACKGROUND

Due to the COVID-19 pandemic, health organisations limited access for visitors.

INTRODUCTION

Family centred care needs to be guaranteed, and alternatives for face-to-face interaction should be fostered. Therefore, there is an urgent need to rethink the family in nursing care during a pandemic.

METHODS

We conducted a descriptive exploratory mixed-method study in Portugal using an electronic questionnaire. The study included 192 nurses recruited using a non-probabilistic convenience sample. The study was reported using the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.

RESULTS

A total of 41.1% of participants (n = 79) reported that visits to their services were not authorised, and 66.7% (n = 128) reported resorting to video calls because of the restrictions imposed. Regarding attitude assessment, the average score of the scale was 77.9 (SD = 10.0), ranging between 26 and 98. When analysing the different dimensions of the 'Families' Importance in Nursing Care - Nurses Attitudes' scale, family data stand out as a burden.

CONCLUSION

Although a large percentage of participants had a positive attitude towards families and tried to find strategies to maintain family centred care, many nurses still considered the family as a burden. The current COVID-19 pandemic may have aggravated this perception. IMPLICATIONS FOR NURSING PRACTICE, NURSING POLICY AND HEALTH POLICY: The continued implementation of family centred nursing practice is essential for child-well-being, including during the current pandemic. Therefore, having intervention policies with alternative forms of care is highly recommended.

The Use of Gamification in Patients Undergoing Hip Arthroplasty: Scoping Review

Objective: The use of gamification can promote health-related behavior. This article is the first attempt to provide a historical overview of the use of games in patients undergoing hip arthroplasty. Materials and Methods: We conducted a scoping review to map and characterize the games used for the person undergoing hip arthroplasty. To perform this review, the respective descriptors were identified using search syntax appropriate to each of the databases: MEDLINE_ (Medical Literature Analysis and Retrieval System Online), CINAHL_ (Cumulative Index to Nursing and Allied Health Literature), SPORTDiscus, in the Psychology and Behavioral Sciences Collection, SCOPUS, SciELO (Scientific Electronic Library Online), and PEDRo (Physiotherapy Evidence Database). Results: An initial 968 articles were identified, of which 7 articles were included. The domains of the games under analysis essentially focus on aspects of rehabilitation (n = 5), or related (n = 2), and mostly exergames (n = 6). However, the instruments, characteristics, and procedures used to evaluate the games in the included studies have little depth and large variability. Conclusion: Few games exist that support people who have undergone hip arthroplasty. Most of the games under review were exergames to support rehabilitation. Consequently, we recommend developing another type of game with a focus on monitoring, counseling, and/or social support for selfmanagement training in persons undergoing hip arthroplasty.

Adaptability and cohesion of families in times of the COVID-19 pandemic

Background & Aim: This Covid-19 pandemic represents a threat and a crisis for families' well-being. According to the Olson Circumplex Model, this study aimed to assess the family functioning through the components of cohesion and adaptability of Portuguese families during this pandemic. Methods & Materials: This is a descriptive, exploratory, and correlational study. A nonprobabilistic and convenience sample consisted of 376 people. Sociodemographic data, the family's characterization, the type of housing, the Vital Duvall cycle phase was collected from the participants, and FACES II was used to assess family cohesion and adaptability. The reliability of this instrument is high. The instruments for data collection were organized and sent through Google® forms, including the Informed Consent Form. The data were analyzed by SPSS-26 software using non-parametric tests were used for inferential analysis. Results: The results showed that 14,6% have a disengaged family cohesion; 7,4% have a very rigid dimension in family adaptability, and about the type of family, 6,1% have an unbalanced dimension. Conclusion: Although on average, the participants have a connected family cohesion and family flexible adaptability, many participants have extreme values, under which it will be necessary to intervene. It is a priority for family nursing to understand the experience of families living in this current social, economic, and health context.  

IGestSaúde a mobile application for the self-management of symptoms associated with chemotherapy treatment: Development protocol

Background & Aim: People undergoing chemotherapy treatment of an oncologic disease refer to the need to promote the process of self-management of the disease and the symptoms associated with treatment. This study aims to describe a mobile application's development protocol to support the self-management of symptoms associated with chemotherapy treatment, the IGestSaúde. Methods & Materials: The research is divided into six stages, using an exploratory/descriptive pilot study conducted over 36 months. The stages include research and fundamentals, development, validation of therapeutic guidelines, field study, technological development, implementation, and mobile application evaluation. Discussion: The project will monitor and improve patients' compliance to chemotherapy, to prevent patients’ complications through preventive indications for self-care, and to improve patients' responses to uncontrolled symptoms or complications. Conclusion: Mobile applications can be considered a viable and effective means for selfmanagement of complications associated with chemotherapy treatment, supported by scientific evidence and these people's specific needs.

Exploring the use of Mobile applications by cancer patients undergoing chemotherapy: A scoping review

PROPOSE

Advancements in mobile technology, primarily through the use of applications, may support the process of monitoring adherence to oral therapies, controlling toxicities, or providing self-care guidelines to patients undergoing chemotherapy treatment. This study aims to assemble the available knowledge regarding the use of mobile applications by cancer patients undergoing chemotherapy treatment.

METHODS

A literature review based on the Joanna Briggs Institute model(s) for Scoping Review was conducted. All articles published until 30 May 2019, were identified in the MEDLINE®, CINAHL®, and PsycINFO® electronic databases using the related Boolean logical operators and key terms. Extracted data included research aims, methodological design, application name, the functionalities of the applications, and major results.

RESULTS

A total of 26 articles were included in this study. The search identified 16 different mobile applications, some of which were addressed in various publications, demonstrating different characteristics in design, use, and development.

CONCLUSION

The use of mobile applications can be seen as an important and effective way to monitor adherence and support in the self-management of complications associated with chemotherapy treatments. Notwithstanding, these applications should be tested outside the academic environment, outreaching this group of people to effectively investigate its applicability, allowing the assessment of the impact of this "new" technological intervention process.

Reusable Photocatalytic Optical Fibers for Underground, Deep-Sea, and Turbid Water Remediation

An approach for underground, deep, and turbid water remediation is presented based on optical fibers with a photocatalytic coating. Thus, photocatalytic TiO2 P25 nanoparticles immobilized in a poly(vinylidene difluoride) (PVDF) matrix are coated on polymeric optical fibers (POFs) and the photocatalytic performance of the system is assessed under artificial sunlight. To the best of our knowledge, poly(methyl methacrylate)-POF coated with TiO2/PVDF and the reusability of any type of POF for photocatalytic applications are not previously reported. The photocatalytic efficiency of the hybrid material in the degradation of ciprofloxacin (CIP) and its reusability are evaluated here. It is shown that 50 w/w% of TiO2 P25 achieves a degradation of 95% after 72 h under artificial sunlight and a reusability of three times leads to a loss of activity inferior to 11%. The efficient removal of ciprofloxacin and the stability of the POF coated with TiO2 P25 successfully demonstrate its suitability in the degradation of pollutants with potential application in regions with low light illumination, as in underground and deep water.

Starch characterization in seven raw, boiled and roasted chestnuts (Castanea sativa Mill.) cultivars from Portugal

Changes occurring in seven chestnut (Castanea sativa sp.) cultivars, caused by boiling and roasting, on starch content, cell and starch granules dimension were evaluated, and morphological changes were characterized by scanning electron microscopy. Three clear patterns of variation were detected after processing, namely: i) decrease of starch content with processing; ii) starch increase with the applied treatments; iii) increase of starch with boiling and decrease with roasting. Starch granules of raw chestnuts presented round, oval or elliptical form, external smooth surface and eccentric hilum, with rather ellipsoid-shaped growth rings. Processing resulted in modifications of the granules, with fusion of individual granules, and gelatinization taking place with the formation of elongated clusters. The present results indicate that boiling and roasting, besides changing the starch content of chestnut, causes important modifications in the starch granules, which can affect the sensory, rheological and chemical characteristics of chestnuts.