Implementing an evidence-based structured education and management program in an inpatient adult oncology setting to improve patients' pain control.

BACKGROUND AND AIMS: Cancer-related pain is prevalent across the cancer trajectory, and is probably one of the most feared of all cancer symptoms for patients and their families. Although there were guidelines and framework regarding the management of cancer pain, pain control among patients remain suboptimal. This best practice implementation project aimed to improve patients' perception on cancer pain management and pain control through implementing structured patient and family education and patient information leaflet (PIL) on managing cancer pain. METHODS: The current implementation project conducted in an adult oncology inpatient unit utilized the JBI Practical Application of Clinical Evidence System and Getting Research into Practice module for promoting evidence-based health care. RESULTS: A comparison between the preimplementation and postimplementation findings showed significant improvements for both audit criteria outcomes. The percentage of patients receiving verbal education rose from 0 to 69%, whereas the percentage of patients receiving PIL increased 0-100%. Patient compliance to analgesic regime increased from 0 to 100%. There was a significant improvement in patients' pain levels ( P  < 0.001), with majority rate having none-mild pain post intervention. CONCLUSION: A structured educational program on cancer-related pain improved patients' knowledge on cancer-related pain management and pain control. Despite the remarkable increase in the compliance rate, further interventions may still be required to achieve 100% compliance. Continuous audits will be held to guide follow-up interventions to ensure compliance and sustention of the project.

Health-related quality of life, psychological distress, and symptom burden in an Asian population of outpatients with atrial fibrillation.

BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia and has debilitating effects on patients' health-related quality of life (HRQoL) and psychological statuses. AIM: To investigate the HRQoL, psychological distress, and symptom burden, and to identify the significant influencing factors of HRQoL among outpatients with AF in Singapore. METHODS: We conducted a cross-sectional descriptive correlational study of a sample of 116 outpatients with AF. Data were collected using 12-item Short Form Health Survey, Atrial Fibrillation Effect on Quality of Life scale, Patient Health Questionnaire-9 (PHQ-9), and University of Toronto Atrial Fibrillation Symptom Severity (AFSS) scale. RESULTS: Symptom burden and psychological distress significantly influenced the AF-specific HRQoL while symptom burden, unemployment and comorbidity of heart failure were significantly associated with poorer general physical health. Psychological distress was the only significant factor influencing the mental health. CONCLUSION: Optimal symptom management is crucial for better HRQoL in patients with atrial fibrillation.

A meta-analysis on Omega-3 supplements in preventing recurrence of atrial fibrillation.

Previous studies had suggested that Omega-3 fatty acids have pleiotropic effects and favourable safety profile, which may potentially increase the efficacy of antiarrhythmic drugs in suppressing atrial arrhythmias through combination therapy. This meta-analysis aimed to determine the effectiveness of using Omega-3 polyunsaturated fatty acids as a sole anti-arrhythmic agent or as an adjunct to existing pharmacological therapies in preventing atrial fibrillation recurrence. Randomized controlled trials published in English, from inception to December 2016, were considered. We searched for published studies in the following electronic databases: Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Medline, Scopus, and Cumulative Index to Nursing and Allied Health Literature. Pooled hazard ratio (HR) and corresponding 95% confidence intervals (CI) for time to first atrial fibrillation recurrence was analysed using a fixed effects model. Four RCTs with 1,268 participants were included in the review. Our results showed that Omega-3 polyunsaturated fatty acid therapy had no effect on preventing atrial fibrillation recurrence compared to control/placebo group (HR: 1.13, 95% CI: 0.96 to 1.33, p = 0.14), with no significant heterogeneity found among those studies (Q value = 0.15, 9 = 0.99, I2 = 0%). Therefore, current evidence does not support treatment benefit of Omega-3 fatty acids in preventing atrial fibrillation recurrence among patients who have not been treated by any conventional reversion treatment, or who have only been treated with pharmacological therapy.

Effects of dietary administration of water hyacinth (Eichhornia crassipes) extracts on the immune responses and disease resistance of giant freshwater prawn, Macrobrachium rosenbergii.

The hot-water extract of Eichhornia crassipes leaves (ECE) was produced and incorporated into the diet of the prawn, Macrobrachium rosenbergii, as an immunostimulant. Survival rates of prawn against Lactococcus garvieae, and its immune parameters including the total haemocyte count (THC), different haemocyte count (DHC), phenoloxidase (PO) activity, respiratory bursts (RBs), superoxide dismutase (SOD) activity, glutathione peroxidase (GPx) activity, transglutaminase (TG) activity, haemolymph coagulation time, and phagocytic activity and clearance efficiency against L. garvieae by M. rosenbergii were determined when prawn (23.0 ± 2.8 g) were fed ECE-containing diets at 0, 1.0, 2.0 and 3.0 g kg(-1). Prawn fed a diet containing ECE at 2.0 and 3.0 g kg(-1) for 12 days showed significantly increased THC, HC, GC, PO activity, RBs, SOD activity, GPx activity, and TG activity, and a significantly decreased coagulation time. The phagocytic activity and clearance efficiency against L. garvieae of prawn fed the ECE-containing diets at 1.0, 2.0, and 3.0 g kg(-1) were significantly higher than those of prawn fed the control diet at 3-12 days. Survival rates of M. rosenbergii fed the diet containing ECE at concentrations of 2 and 3 g kg(-1) were significantly higher than those fed the control diet after challenge with L. garvieae for 48-144 h. The relative percentage survival of prawn fed the 1.0, 2.0, and 3.0 g kg(-1) ECE-containing diets for 12 days were 17.5%, 39.1%, and 52.2%. It was concluded that the ECE can be used as an immunostimulant for prawn through dietary administration to enhance immune responses and resistance of M. rosenbergii against L. garvieae.