bluuebunny/crossref_metadata_2025 huggingface dataset:
The Power of Narratives and Storytelling
Authors: Wallace Cara L.
Published: March 2022

Our culture has a rich history of storytelling, though often stories are greatly shaped through dominant culture and power. Narrative interventions allow individuals to reclaim power and find meaning through the examination of their stories using a variety of techniques and practices. Storytelling is also deeply connected to the core values of social work practice and the rich tradition in understanding the world through an ecological framework and finding dignity and worth in all people. This chapter explores the use of stories and narratives in palliative and end-of-life care, a growing practice, offering social workers a basic understanding of various methodologies and techniques, existing evidence for interventions, and suggestions for moving forward in research and practice.
Single-Session and Solution-Focused Brief Therapy
Authors: Sinha Kasey
Published: March 2022

Palliative social workers often work with patients and families for limited amounts of time, including single sessions, and solution-focused brief therapy (SFBT) can be an effective intervention with patients experiencing serious illness. SFBT centers on a person’s strengths and coping strategies, and social workers can join with patients and families in eliciting solutions to meet goals. This chapter reviews the history of SFBT, identifies its core principles and tools, and provides direction for incorporating SFBT into palliative social work practice with examples of implementation. Social workers can use their discretion and clinical judgment to modify SFBT for patients with serious illness and their families. An overview of the research is presented with a call for further research on the role of SFBT in palliative care, specifically with persons of color and marginalized communities. SFBT is an adaptable intervention that can be utilized by social workers to create positive therapeutic change in a brief period of time.
Using Schema Therapy to Meet Needs in Palliative Care
Authors: Parsonnet Lissa
Published: March 2022

Palliative care focuses on the reduction of suffering based upon the needs of the patient, rather than the stage of illness or status of treatment. Schema therapy is an integrative psychotherapeutic model focused on helping patients to meet unmet core emotional needs in an effective, healthy way. The failure to get these needs met in childhood may lead to the development of early maladaptive schemas which involve emotional and cognitive patterns that develop as a child attempts to make sense of their world, and the needs they experience which are not appropriately met. These schemas lead to maladaptive and self-defeating behaviors which fail to meet the needs and thus reinforce the distorted perceptions of the schema. Serious illness and the need for care can trigger schema activation that may interfere with treatment and coping. Schema therapy provides clinicians with a perspective and tools for addressing these responses.
Ethical Considerations in Palliative Care
Authors: Walters Wendy B.
Published: March 2022

As modern technology advances, more options are available to patients to prolong their lives, which can create ethical dilemmas when principles of autonomy, beneficence, nonmaleficence, and justice conflict in a myriad of ways. While technology can be seen as miraculous, it can also be a barrier when patients harbor potentially false illusions about its benefits. Social workers have more training in communication styles, family systems, and coping strategies than other members of the interdisciplinary team, positioning them as experts in facilitating difficult conversations. There will always be ethical dilemmas and moral distress in patient care; it is inevitable in a volatile world where the stakes may be enormously high—literally life and death. The palliative social worker is in a unique position to identify, mitigate, and perhaps prevent escalating dilemmas while respecting autonomy and cultural and spiritual values. This opening chapter provides a broad sweep of the most salient ethical issues encountered in palliative care.
Pediatric Palliative Care Ethics and Decision-Making
Authors: Purol Nicholas , Jonas Danielle
Published: March 2022

Pediatric palliative care is interdisciplinary care that focuses on optimizing quality of life for children living with serious and life-threatening illnesses and their families. While concise on the surface, this definition is beset by a number of assumptions about how patients, families, clinicians, and ethicists define terms such as “quality of life,” “suffering,” or “comfort.” This chapter will not proclaim to provide answers for every ethically complex pediatric scenario, however, but will provide an overview of the unique challenges, frameworks, and opportunities to be found when exploring the ethics of decision-making in pediatric palliative care. This exploration is meant to help center and ground clinicians in what can be highly overwhelming situations so as to provide more optimal, compassionate, and intentional care.
Technology and Ethics
Authors: Bach Christina
Published: March 2022

Communication is the hallmark of the relationship between the patient and clinician. In healthcare settings, technology is being used more frequently to facilitate communication. There are benefits and challenges to the use of technology in healthcare settings. Digital interactions act as a new form of medical narrative, giving voice for some who may not have had such privilege or access previously. But location (where), time (when), authority (who), and best practices (what) for the use of digital interactions remain nebulous across healthcare professions. Other challenges include confidentiality, privacy, informed consent, digital accessibility, self-disclosure, and dual relationships in the virtual space. Digital interactions between patients and clinicians require flexibility, fluidity, caution, and perhaps, above all, digital humility. Social workers have enormous potential to mentor and model for other professions in their use of digital encounters in relationships as we take ownership and responsibility for online content, digital relationships, and our digital identity.
Supervision and Mentoring for Social Workers in Palliative and End-of-Life Care
Authors: Berkman Cathy , Genereux Carolyn , Front Anne
Published: March 2022

Supervision and mentoring in palliative social work are critical for guiding, teaching, supporting, and inspiring palliative social workers at all career stages. Supervision and mentoring are mutually beneficial to the individuals in the relationship, as well as to organizations. Best practices in supervision and mentoring are important for meeting the goals set by the participants. There are many similarities between supervision and mentoring but also important differences. The multiple models and modalities used in supervision and mentoring provide flexibility to tailor these relationships to meet the preferences and needs of the individuals involved, as well as institutional requirements and feasibility considerations. Supervision and mentoring facilitate the goal of all palliative social workers to be lifelong learners.
Professionalism
Authors: Csikai Ellen L. , Jones Barbara L. , Koch Kendra D.
Published: March 2022

Professionalism is multifaceted and requires continual attention in an ever-changing field of palliative care. Competent and effective palliative social work practice is based on a foundation of connections with professional peers, educational enhancement, and leadership. Advocacy is not optional; it is one of our profession’s ethical obligations and a cornerstone of social work practice, particularly as it can directly influence social justice, equity in healthcare, and the quality of life of seriously ill individuals and those closest to them. Palliative social workers can and must be leaders in advocacy based on these foundations of connection, competence, knowledge and skills and embrace the opportunity to serve as role models in professional development.
Pain Assessment in Palliative Care
Authors: Uritsky Tanya J.
Published: March 2022

At the core of pain management in palliative care is a good pain assessment. Even without formal scans, this will give insight into the patient’s pain experience and possible underlying etiologies. When performed correctly, evaluating the six key elements of symptom assessment can lead to a therapeutic intervention that incorporates the patient’s expertise in their pain experience and pairs it with the clinician’s expertise in evaluation and treatment. A good assessment can be done using one of several scales or tools and, when combined with physical exam and appropriate imaging or testing, can yield a complete pain assessment that can be used to guide therapy. The focus of the assessment should be to not only better understand the pain, but also how the patient’s function and quality of life is impacted.
Cultural Competence in Pain and Palliative Care
Authors: Cooperstein Noah
Published: March 2022

Patients belonging to a minority group, or patients who are recent immigrants or refugees, may be skeptical of the US medical system. This skepticism and mistrust can be especially heightened when discussing end of life care. Given that every patient combines a unique mix of cultural and personal experiences, there is no one-size-fits-all approach to addressing culture in medicine. This chapter posits a patient-centered approach to culturally competent care that avoids reinforcing cultural stereotypes and the pit falls of applying categorical knowledge to something as dynamic as culture. Unfortunately, hospice and palliative care are failing to reach minority and ethnically diverse patients in a representative manner. Community outreach by palliative care clinicians to culturally and ethnically diverse populations in the local area is a good first step to bolstering mutual understanding and building trust.
Ketamine as an Analgesic Adjuvant in Palliative Care
Authors: Sacks Sandra , Mehta Ambereen K.
Published: March 2022

Ketamine is an analgesic and anesthetic that inhibits N-methyl-D-aspartate (NMDA) receptors and can be used for cancer-related pain, especially neuropathic pain, and depression. It can be delivered in oral, intranasal, topical, and intravenous forms, and the latter is the most well-studied and most effective. Practitioners should be aware of side effects, especially tachycardia, hypertension, increased intracranial pressure, hallucinations, and delirium. It can help with decreasing the amount of opioids necessary for pain control, and a one-time bolus may help with depression symptoms for weeks after. There are consensus guidelines to guide safe use, dosing, and monitoring.
Cannabis for Pain Management in Palliative Care
Authors: Herndon Christopher M. , Cruz Tim
Published: March 2022

Much controversy surrounds the use of cannabis in palliative care. Data from well designed prospective studies supporting its use in the treatment of pain and other symptoms is largely lacking. The endocannabinoid system is comprised of two presynaptic inhibitory cannabinoid receptors and a complex postsynaptic neurotransmitter pathway. Various phytocannabinoids are contained in cannabis, with tetrahydrocannabinol (THC) and cannabidiol (CBD) being the most well described. Patients are able to obtain cannabis in multiple dosage forms, allowing for numerous administration options (vaporization, oral ingestion, sublingual, transdermal, topical, and smoking of the flower). Cannabinoid concentrations, ratios, and delivery technique can all impact efficacy, adverse effects, and possible drug-drug interactions. Cannabis may demonstrate an effective alternative for treating pain and symptoms at the end of life; however, further research warranted.
Opioid Conversion Calculations
Authors: McPherson Mary Lynn
Published: March 2022

More often than not, patients living with a serious or advanced illness will require one or more changes of their opioid to achieve the necessary levels of pain relief. This may entail changing the opioid itself, the route of administration, or the dosage formulation. These switches require careful consideration of the patient’s pain, their current use of opioids, a keen understanding of equianalgesia, and how to implement and monitor the new opioid regimen. In this chapter participants will learn about a five-step process for opioid conversion calculations and how to switch specifically to methadone.
Overview of Seizures and Epilepsy
Authors: Misulis Karl E.
Published: March 2022

In this opening chapter, electroencephalography (EEG) is introduced along with an overview of seizures and epilepsy and a classification of the concepts that are covered in the text. This chapter presents an essential framework on which the remainder of the text is built.
Role of EEG in Diagnosis and Management
Authors: Misulis Karl E. , Sonmezturk Hasan
Published: March 2022

The role of the electroencephalogram (EEG) in diagnosis and management is discussed in depth, including detailed discussion of available modalities. These include routine EEG as well as video-EEG, long-term recordings, and special studies using extracranial and intracranial techniques. Indications are discussed, including when different techniques are appropriate.
Abnormal Nonepileptiform EEG
Authors: Abou-Khalil Bassel
Published: March 2022

Abnormalities on the electroencephalogram (EEG) are identified as epileptiform or nonepileptiform. This chapter presents many of the nonepileptiform abnormalities, findings which do not directly suggest seizures but rather other pathology.
Management of Pediatric Seizures
Authors: Ess Kevin C.
Published: March 2022

Management of seizures in children, compared to adults, is complicated by differences in seizure types and medication response between adults and children, differences in dosing due to difference in size and metabolism, and differences in the safety profile of medications between adults and children. This chapter discusses medical and nonmedical management of seizures in the pediatric population, as well as comorbidities and prognosis with pediatric epilepsies.
Nonmedical Treatment
Authors: Sonmezturk Hasan H.
Published: March 2022

While medications are the cornerstone of seizure and epilepsy management, nonmedical treatments are used for select patients, especially when first- and second-line therapies have not been successful. These techniques are used often along with medications in an attempt to optimize care.
Quality of Care Standards and Counseling
Authors: Abou-Khalil Bassel
Published: March 2022

As part of care for patients with epilepsy, clinicians need ensure that patients are counseled on a variety of topics for their own physical and emotional health and for safety of the community. This includes following American Academy of Neurology Quality standards regarding counseling for a host of issues as well as a discussion of driving safety, a discussion of epilepsy inheritance expectations, and psychological counseling for emotional support. This chapter discusses these issues.
Caring at the Culture and Spirituality Interface
Authors: Powell Richard A. , Lin Cheng-Pei , Guo Ping , Namisango Eve
Published: March 2022

Palliative care is premised on the keystone principle that “total pain” involves suffering in the potentially reciprocally impacting physical, psychological, social, and spiritual domains. It is, therefore, underpinned by a multidimensional, biopsychosocial-spiritual model of care provision. Palliative care providers should not simply assess and manage these multiple domains of patient suffering holistically—including end-of-life spiritual concerns—but do so with a cognisance of, and sensitivity to, prevailing cultural practices and expectations within which the patient, their family and community, exist. This chapter explores palliative care provision at the interface between culture and spirituality, using four brief case studies from China, Taiwan, New Zealand, and sub-Saharan Africa. Insufficient research exists on culturally safe approaches to palliative care, especially among indigenous populations, as determinants of expectations and experiences of service users, and how services are organized and delivered. Similarly, more research is needed regarding the models of spiritual care provision, how death and the dying process are understood, how people find meaning in illness, and the preferred communication and rituals surrounding and planning for death. The chapter therefore proposes the need for research into the culture–spirituality–palliative care nexus. It concludes that by being sensitive to patients’ spiritual and cultural needs and wants, palliative care practitioners acquire the insights and understanding necessary to provide holistic care for the whole person, to address their suffering in its totality, in accord with the biopsychosocial-spiritual model of care provision, as well as helping ensure that their dignity, right to self-determination, and autonomy are respected.
Holistic Care of the Cancer Patient, United States
Authors: Whitehead Phyllis , Gamaluddin Shereen , DeWitt Sarah , Stewart Christi , Kim Kye Y.
Published: March 2022

Palliative care is a type of medical care given to patients with a serious or life-threatening illness, such as cancer. Palliative medicine addresses the needs of the entire patient: mind, body, and spirit. Palliative medicine intends to alleviate suffering, including physical, psychosocial, spiritual, and existential symptoms for those whose illness impacts their daily lives. Total pain is defined here as well nonpharmacological interventions that may be helpful in addressing the care of these patients. To comprehensively address these holistic domains, an interprofessional approach to care is crucial. This chapter discusses the unique emotional, spiritual, and cultural challenges of the cancer patient.
The Challenge of Truth-Telling in Cancer Care, United States
Authors: Hinshaw Daniel B.
Published: March 2022

Not disclosing or lying about diagnostic and prognostic information to cancer patients has been and continues to be a common practice in many cultural settings. Such practices have been defended on the basis of compassion or local cultural tradition and have often been initiated by medical professionals in collusion with or at the request of patients and their families. This chapter examines the cross-cultural, historical, and religious aspects of this phenomenon, as well as the ethical and therapeutic dilemmas posed by intentional deception of cancer patients regarding their diagnosis and prognosis. Various approaches from the medical literature relating to honoring patient autonomy while respecting differing cultural practices regarding communication are reviewed. But lying to cancer patients is unethical, has no place in their compassionate care, and, most importantly, is unnecessary. Deceit cannot be the foundation for an effective therapeutic relationship that depends on trust. Neither should patients be unnecessarily traumatized by the blunt delivery of painful information, especially when they indicate they are not yet ready to hear such information. Drawing from extensive experience in multiple cultural, educational, and clinical settings, a process for communicating sensitive diagnostic and prognostic information to cancer patients is offered based on the concepts of informed consent and shared decision making, fully respecting their autonomy while building trust.
Nurses Providing Emotional Support and Spiritual Care to Patients and Families, Spain & Turkey
Authors: Fernández-Ortega Paz , Kav Sultan , Arimón-Pagès Esther
Published: March 2022

Nurses working in palliative care units take a holistic approach to caring for patients’ body, mind, and soul, and their work always involves emotions. Nurses play a major role in the delivery of palliative care ser vices—whether in hospital, hospice, or community setting—from the time of diagnosis to even after the individual’s death, focusing on emotional and spiritual support for seriously ill patients and their families. Their role is of special relevance to helping patients deal with pain of the soul—the pain that involves the fear, sadness, loneliness, and dejection people feel when they are facing mortality. When asked, many palliative patients often stress that one of the most important skills they expect from a health professional should be empathy. This chapter discusses methods for coping with grief, including setting up grief support and bereavement groups and employing art and music therapy to help both adults and children to express their emotional pain. This chapter also critically examines the literature on spiritual care and emotional labor, analyzing how nurses manage emotions—those of others as well as their own.
The Landscape of Loneliness
Authors: Baider Lea , Goldzweig Gil
Published: March 2022

Human beings are intrinsically social creatures. We grow increasingly vulnerable to loneliness as we age and increasingly susceptible to the physical and emotional symptomology of loneliness. Older people often feel socially isolated and threatened by loss, shattered emotional bonds, uncertainty, and constraint—that is, by a slackening of the pivotal forces that have sustained them and given meaning to their lives. Loneliness in the elderly is thus a state of profound distress, and older people who perceive themselves to be alone are at distinct risk of depression and withdrawal from all social support. Loneliness in older people has distinct features: researchers have linked higher levels of depression among elderly people diagnosed with cancer to higher levels of subjective loneliness and lower levels of perceived social support. This chapter explores the mechanisms that underlie the relationships between depression, age, perceived social support, and loneliness and addresses the question of whether a sense of loneliness is subjective and an integral part of the aging process. Whether the sense of loneliness is expressed through a lessening of perceived social support and higher levels of depression; or whether it is the reverse—depression linked with advanced age, results from feelings of loneliness, and a reduction in perceived social support. Actually, social support in older patients does not correlate with depression, whereas age does. These findings should, however, be considered as no more than a preliminary step toward understanding the complex interplay between depression, loneliness and social support.
Mindfulness and Compassion Practices for Cancer Patients
Authors: Cheli Simone , Petrocchi Nicola
Published: March 2022

The diagnosis of cancer often prompts people to reconsider their existential meaning and their life history. The multicultural and multifaith complexity of our societies often hinders this process and requires the development of interventions that are as sensitive and unbiased as possible. This chapter advocates the usefulness of compassion-focused therapy in supporting the patient diagnosed with cancer. The specific focus is on the transcultural and transreligious relevance of targeting the evolved strategy of compassion, as a way to deal with demoralization, hopelessness, and social disconnection. Also discussed are the evolutionary foundation of compassion-focused therapy and its clinical application in a case of a breast cancer patient of foreign origin.
The Role of Faith in Coping with Cancer among Palliative Care Patients in Turkey, Turkey
Authors: Akcakaya Adem , Can Gulbeyaz
Published: March 2022

When faced with life-threatening events such as illness and death, people display different attitudes and behaviors that have evolved from their historical and cultural backgrounds. Life-threatening disease and death play a major role in people’s orientation toward spirituality. One of the most important coping strategies for palliative care patients in Turkey is positive religious coping. The beliefs of the patient, the spiritual condition of the health professional, and the education they received in this field are important in meeting the spiritual care demand. Islam is the predominant religion of the Turkish population and is an important factor that determines the way people view death and the treatment modalities of diseases. Similar to Western countries, in Turkey there are deficiencies in understanding patients’ spiritual sensitivities concerning the safe journey of death and beyond, understanding the patients’ perception of religion, and communicating with patients about these issues.
Sociocultural Influences on Cancer Care in Sub-Saharan Africa
Authors: Mwaka Amos Deogratius
Published: March 2022

Cultural beliefs impact people’s perceptions regarding health, illness and their ability to understand and respond to health care providers’ instructions, thereby affecting compliance and treatment outcomes. In sub-Saharan Africa (SSA), there is limited data on the extent to which sociocultural beliefs, including the use of traditional and complementary medicine (T&CM) and religion and spirituality influence (1) help-seeking behavior when one is faced with probable cancer symptoms, (2) cancer stage at diagnosis and (3) cancer outcomes. This chapter focuses on the correlations between culture and T&CM, as both a concept and a practice. Culture and religion underlie most human conduct and may determine the uptake of preventive measures, attributions of causes of illnesses, responses to illnesses, coping strategies, and choices of treatments. Beliefs and cultures are, therefore, important determinants of health and illness. However, there are still gaps in our knowledge of how sociocultural factors, including the use of traditional and complementary medicines, and religion contribute to and determine cancer treatment outcomes in SSA, as well as the prevalence of T&CM use, reasons for using T&CM, the safety and risks profiles of the various T&CMs, predictors of use among adult cancer patients, and the benefits of T&CM treatment, including survival rates. There is limited data on T&CM’s mechanism of actions for cancer patients in SSA. Similarly, little is known about health care professionals’ perspectives regarding why cancer patients use T&CMs but prefer not to disclose this use to their health care teams. There is need for appropriately designed research to improve our understanding of how sociocultural beliefs underpin the use of T&CMs for health interventions in sub-Saharan Africa.
Barriers to Addressing Emotional and Psycho-Social Needs in Cancer Care, Turkey
Authors: Şenel Gülçin
Published: March 2022

This chapter discusses the challenges of meeting the emotional and psychosocial requirements that are integral parts of holistic cancer care and that start with the cancer diagnosis and continues throughout the whole treatment process, during the transition from curative treatments to noncurative therapies, palliative care, end of life, death, and bereavement in order to achieve a better quality of life. It reviews factors such as disparities in cultural myths, taboos, and perception/awareness of disease in the psychosocial support requests of patients, families, and caregivers in various populations. It examines awareness, skills and attitudes, beliefs, lack of education, notification, communication, cultural competence, and potential problems causing stress to health care professionals providing cancer care. It also reviews differently structured health system organizations, human resources, and financial and social support mechanisms in each country, which limit access to psychosocial support.
Impact of Culture and Beliefs in Brain Tumor Patients’ Care in Indonesia, Indonesia
Authors: Aninditha Tiara , Agiananda Feranindhya , Sofyan Henry Riyanto
Published: March 2022

A brain tumor is a group of neoplasms affecting the central nervous system, and it has its own unique characteristics of disease, prognosis, and treatment. In Indonesia, there are many challenges to providing comprehensive brain tumor management due to many factors—patient-related factors such as lack of knowledge, cancer beliefs and treatment beliefs; patient/health care provider relationship factors such as paternalistic communication style and unmet need for information; treatment- related factors such as emotional and financial burden and severe side effects of treatment; and socioeconomic and health care system-related factors. These factors are strongly determined by the culture and beliefs of Indonesian people which can have both a positive and negative impact on brain tumor care. Indonesian culture can negatively impact the management of brain tumor patients by delaying the outreach for medical help and discouraging their adherence to treatment. Indonesian brain tumor patients often seek medical assistance in the later stages, which leads to poor treatment outcome. In contrast, a strong support system from family has a positive emotional impact on the patient, making it easier to overcome such stressful conditions.
Ugandan Culture
Authors: Luyirika Emmanuel B. K.
Published: March 2022

The cultural aspects of a society incorporate customary beliefs, language, religion, cuisine, social habits and norms, music, arts, and spirituality. Spirituality relates to that which affects the human spirit or soul, as opposed to material or physical components or matters relating to religion or religious beliefs. All these dimensions can be intertwined and influenced by financial and other resources. Uganda is a religiously diverse nation with over 84% of the population Christian (Protestants, Roman Catholics, and others) and about 14% Muslim; the remainder follow traditional African religions or do not ascribe to any particular faith. The Uganda Cancer Institute, a public medical care facility that provides modern cancer treatment modalities, is one of the oldest specialist cancer care programs on the African continent. It was established in 1967 with most treatment modalities and is now opening regional centers within the country. Cancer care should include the following: understanding the religious and spiritual dimensions; level of education of the population; health literacy packages about specific cancers; addressing barriers to accessing services and beliefs about traditional medicines. In improving cancer care outcomes, patients’ diverse spiritual and cultural beliefs must be recognized, and available methods must be utilized in order to improve access and adherence to treatment modalities and regimens.
Cultural-Spiritual Guidance in Caring for Cancer Patients in the Dominican Republic, Dominican Republic
Authors: Gómez García Wendy C. , Torres Núñez Marleni R.
Published: March 2022

The Dominican Republic is a melting pot of races and cultures. Its people perceive the diagnosis of cancer largely as a catastrophic event, not only from a scientific perspective but also from a magical/religious syncretism. Historically, the Dominican Republic has been influenced by dictatorial regimens (as have other Latin American countries), furthering the doctrine of medical paternalism to current generations. Its medical system strives daily to improve clinical protocols that would offer adequate psychosocial support for patients and their families. Still, many believe that a cure is contingent upon religious deities, and they are always hoping for some miracle or supernatural occurrence to intervene, regardless of their actual condition or stage of disease. Physicians in the Dominican Republic analyze all the clinical elements and sociocultural beliefs of their patients in an effort to offer appropriate interventions and search for better prognoses. National cancer care programs are encouraged to coordinate with the existing reality of the country, respecting family customs, faith, and beliefs which, far from being rejected, must be integrated into the psychoemotional vision of treatment, utilizing them as holistic supplements that contribute to the patient’s and their family’s strength and emotional support throughout the disease process.
Indian Cultural-Spiritual Guidance in Caring for Cancer Patients, India
Authors: Satija Aanchal , Bhatnagar Sushma
Published: March 2022

Life-threatening diseases such as cancer trigger spiritual distress in patients. Spirituality affects patients’ quality of life and helps them find peace, hope, meaning, and purpose in life, and to cope with the disease. There has been growing attention toward addressing patients’ spiritual needs at both a global and national level. Although India is a land rich in cultural and spiritual heritage, empirical studies on spirituality have not gained adequate consideration. This chapter provides an understanding of spirituality in an Indian context and makes recommendations for delivering spiritual care to cancer patients in India. In the absence of national protocols or guidelines, a two-tiered approach for spiritual history-taking is suggested. It is crucial to educate and train health care professionals for sensitive communications on matters related to spirituality and for integration of spiritual care into oncological care to provide holistic patient care.
Neurochemical and metabolic imaging in bipolar disorder
Authors: Baytunca Muharrem Burak , Lyoo In Kyoon , Renshaw Perry F.
Published: March 2022

Bipolar disorder is a chronic psychiatric disorder characterized by alternating mood states of mania, hypomania, and depression, accompanied by changes in behavior, energy, activity levels, and the ability to function. Although there is converging evidence supporting the notion that bipolar disorder has neurobiological underpinnings, the underlying pathophysiology still remains unknown. Magnetic resonance spectroscopy studies in the field of bipolar disorder have produced data that suggests that cellular bioenergetics might be impaired in those with bipolar disorder. Consistent with this, the concentrations of certain metabolites representing mitochondrial function, neural metabolism, and intracellular energy cycles were found to be altered in specific brain regions. Decreased levels of N-acetyl aspartate and phosphocreatine and increased Glx (the combination of glutamate and glutamine) and lactate seem to be the most replicated findings in the literature. Prefrontal and anterior cingulate cortices are the regions where the neurochemical abnormalities have most consistently been reported. This chapter aims to review and interpret the results of magnetic resonance spectroscopy findings in bipolar disorder.
Cerebral blood flow in bipolar disorder
Authors: Mio Megan , Dimick Mikaela K. , Toma Simina , MacIntosh Bradley J. , Goldstein Benjamin I.
Published: March 2022

Brain function is highly reliant on cerebral blood flow (CBF). Despite the availability of multiple methods of evaluating CBF, this approach is currently underutilized in bipolar disorder research. While CBF offers its own unique advantages, it is also relevant to other functional and structural imaging modalities. Measures of CBF may offer important insights into the etiopathology of bipolar disorder given its connection to cerebral metabolism, cardiovascular risk, and microvascular function, all domains relevant to bipolar disorder. This chapter outlines how CBF is measured and summarizes literature to date regarding CBF difference across mood states, CBF in relation to other psychiatric populations, and the association of CBF with psychiatric treatments and treatment response. Finally, we propose an integrative supply-demand model outlining why anomalous perfusion may be observed in bipolar disorder and the possibility of engaging CBF as a novel treatment target. Future, prospective studies are needed to examine CBF as it relates to course of illness, vascular pathology, and treatment in bipolar disorder across the lifespan.
Batteries for wearables
Authors: Wang Lie , Zhang Ye , Bruce Peter G
Published: March 2022

This perspective article highlights the recent advances and future challenges of battery technologies for wearables.
Screening Large Population Health Databases for Potential Coronavirus Disease 2019 Therapeutics: A Pharmacopeia-Wide Association Study of Commonly Prescribed Medications
Authors: MacFadden Derek R , Brown Kevin , Buchan Sarah A , Chung Hannah , Kozak Rob , Kwong Jeffrey C , Manuel Doug , Mubareka Samira , Daneman Nick
Published: March 2022

Background

For both the current and future pandemics, there is a need for high-throughput drug screening methods to identify existing drugs with potential preventive and/or therapeutic activity. Epidemiologic studies could complement laboratory-focused efforts to identify possible therapeutic agents.

Methods

We performed a pharmacopeia-wide association study (PWAS) to identify commonly prescribed medications and medication classes that are associated with the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in older individuals (≥65 years) in long-term care homes (LTCHs) and the community, between 15 January 2020 and 31 December 2020, across the province of Ontario, Canada.

Results

A total of 26 121 cases and 2 369 020 controls from LTCHs and the community were included in this analysis. Many of the drugs and drug classes evaluated did not yield significant associations with SARS-CoV-2 detection. However, some drugs and drug classes appeared to be significantly associated with reduced SARS-CoV-2 detection, including cardioprotective drug classes such as statins (weighted odds ratio [OR], 0.91; standard P < .01, adjusted P < .01) and β-blockers (weighted OR, 0.87; standard P < .01, adjusted P = .01), along with individual agents ranging from levetiracetam (weighted OR, 0.70; standard P < .01, adjusted P < .01) to fluoxetine (weighted OR, 0.86; standard P = .013, adjusted P = .198) to digoxin (weighted OR, 0.89; standard P < .01, adjusted P = .02).

Conclusions

Using this epidemiologic approach, which can be applied to current and future pandemics, we have identified a variety of target drugs and drug classes that could offer therapeutic benefit in coronavirus disease 2019 (COVID-19) and may warrant further validation. Some of these agents (eg, fluoxetine) have already been identified for their therapeutic potential.
Pregnancy outcomes of a joint obstetric and rheumatology clinic in a tertiary centre: a 2-year retrospective study of 98 pregnancies
Authors: Hum Ryan Malcolm , David Trixy , Lau Yen June , Iftikhar Hajira , Thornber Sue , Simcox Louise , Bruce Ian , Tower Clare , Ho Pauline
Published: March 2022

Objectives

The purpose of this study was to describe the maternal and fetal outcomes in patients with inflammatory rheumatic diseases attending a joint rheumatology and obstetric clinic in the UK.

Methods

Electronic records of 98 patients attending the joint rheumatology and obstetric clinic between January 2018 and January 2020 were analysed. Data on patient demographics, characteristics (including age, ethnicity, diagnosis, and medications taken during pregnancy), pregnancy outcomes (miscarriage, stillbirth or live birth), maternal complications [infection, post-partum haemorrhage (PPH) or pre-eclampsia] and fetal complications (sepsis, congenital heart block, prematurity and low birth weight) were tabulated. Subgroups of patients based on maternal diagnosis, medications and Ro/La antibody status were described in a similar manner.

Results

The cohort was found to be predominantly Caucasian women >30 years of age, diagnosed with a CTD. Of 98 pregnancies, 97% (n = 95) resulted in a live birth, with only 2% resulting in miscarriage (n = 2) and 1% in stillbirth (n = 1). The median duration of gestation was 38 (interquartile range 37–39) weeks, and the majority of patients had a normal vaginal delivery (35%, n = 34), whereas 30% had emergency Caesarean sections (n = 29). The median birth weight was 3120 (interquartile range 2690–3410) g. The most common maternal complications were PPH (56%, n = 54) and infection (22%, n = 21). The most common fetal complications were prematurity (23%, n = 22) and low birth weight (17%, n = 16).

Conclusion

We report favourable outcomes from this service model, including a high live birth rate, a low miscarriage rate and a high median birth weight. With limited reported data of pregnancy outcomes from joint obstetric/rheumatology clinics, this service model might be beneficial in other centres.
Intrathecal Injection of Mesenchymal Stromal Cell Cultured on 3D Fiber Ameliorates Multiple Organ Damage in Murine Lupus
Authors: Saito Yuki , Miyajima Maki , Yamamoto Sena , Miura Norihiro , Sato Tsukasa , Kita Arisa , Ijima Shogo , Fujimiya Mineko , Chikenji Takako S
Published: March 2022

Up to 60% of patients with systemic lupus erythematosus (SLE) experience autonomic symptom. Sympathetic nervous system damage can cause dysfunction of the bone marrow that activates inflammatory cells, potentially causing multiple organ damage. We hypothesized that sympathetic nervous system damage would induce bone marrow dysfunction with multiple organ damage in SLE, and that multiple organ damage could be improved by therapy targeting the nervous system. Here, we showed that damage to autonomic nerves and Schwann cells occurred in the bone marrow and central nervous system of SLE model mice. A neurotoxic drug increased mortality and induced severe neuropathy and multiple organ damage, while a neuroprotective drug prevented multiple organ damage. The administration of bone marrow-derived mesenchymal stromal cells (BMSCs) cultured on a 3-dimensional fiber scaffold improved bone marrow neuropathy, skin lesions, kidney function, and mortality. Our results reveal that bone marrow neuropathy influence multiple organ damage associated with SLE, and improvement of bone marrow neuropathy by intrathecal injection of BMSC may be a target for SLE multiple-organ damage.
Imaging Review of Connective Tissue Diseases
Authors: Cledera Thurl Hugh C. , Flores Dyan V.
Published: March 2022

Connective tissue diseases (CTDs) form a group of chronic inflammatory disorders characterized by disturbance in immune mechanisms and defective clearance of apoptotic and immune complexes. Virtually all cells and tissues containing collagen or elastin are affected, resulting in multisystemic derangements and significant morbidity and mortality. Clinical manifestations are nonspecific and may not occur simultaneously, predisposing to a delayed or missed diagnosis. Imaging aids in supporting the diagnosis when diagnostic criteria are not met, determining extent and severity of disease, and monitoring treatment response and complications.
Vitamin C
Authors: Berdanier Carolyn D.
Published: March 2022

Vitamin C or ascorbic acid is a required nutrient for humans. Should this vitamin be lacking in the human diet, the disease, scurvy, will develop. Scurvy has been described since ancient times, and its cure through the provision of ascorbic acid has had a torturous path. Vitamin C is an important contributor to the overall regulation of the redox state of the body due to its easy interconversion from an oxidized form to a reduced form and vice versa. It is important for collagen synthesis and serves as an essential coenzyme to a wide variety of enzymes. Not all animals require dietary intakes of the vitamin, but humans, some primates, guinea pigs, fruit bats, and some fish species do. The recommended daily intakes for this nutrient are well established.
Complications and Quality of Life following Gynecomastia Correction in Adolescents and Young Men
Authors: McNamara Catherine T. , Nuzzi Laura C. , Firriolo Joseph M. , Walsh Landis R. , Massey Gabrielle G. , Malloy Shannon M. , Young Danielle C. , Koup Lauren M. , DiVasta Amy D. , Labow Brian I.
Published: March 2022

Background:

Persistent adolescent gynecomastia negatively affects health-related quality of life. Surgery results in psychosocial improvements, but the effects of postoperative complications on health-related quality of life are unknown. The authors examined whether complications following adolescent gynecomastia surgery impact postoperative health-related quality of life.

Methods:

Patients aged 12 to 21 years who underwent surgical correction of unilateral/bilateral gynecomastia between 2007 and 2019 were enrolled (n = 145). Relevant demographic and clinical data were obtained from medical records. Fifty-one patients completed the following surveys preoperatively, and at 6 months and 1, 3, 5, 7, 9, and 11 years postoperatively: 36-Item Short-Form Health Survey (Version 2), Rosenberg Self-Esteem Scale, and the 26-item Eating Attitudes Test.

Results:

Within a median period of 8.6 months, 36 percent of breasts experienced at least one complication. The most common were residual tissue (12.6 percent), contour irregularities (9.2 percent), and hematomas (7.8 percent). Patients reported significant postoperative improvements in self-esteem and in seven health-related quality-of-life domains (Physical Functioning, Role-Physical, Bodily Pain, Vitality, Social Functioning, Role-Emotional, and Mental Health) at a median of 33.3 months. Postoperative survey scores did not vary by grade or procedure, or largely by body mass index category or complication status. However, patients aged younger than 17 years at surgery scored significantly higher than older patients in the Short-Form Health Survey Vitality and Mental Health domains postoperatively.

Conclusions:

Health-related quality-of-life improvements are achievable in adolescents through surgical correction of persistent gynecomastia. Postoperatively, patients largely experienced similar health-related quality-of-life gains irrespective of complication status, grade, surgical technique, or body mass index category. Minor postcorrection complications are but do not appear to limit postoperative health-related quality-of-life benefits.
Korean endemic species no more: on the occurrence of Pelophylax chosenicus in China
Authors: Borzée Amaël , Shin Yucheol , Bae Yoonhyuk , Othman Siti N.
Published: March 2022

Understanding species distribution is the first requirement to work on their behaviour, conservation, and phylogeography. Over the last decades, the number of species described on the Korean peninsula has significantly increased, but areas around the boundaries of the Korean peninsula still have to be surveyed for the presence of these species, especially where the environment is similar and connected. Here, we conducted surveys in the continuous landscapes of the Republic of Korea, the Democratic People’s Republic of Korea and the People’s Republic of China to determine the range of the Gold-spotted pond frog, Pelophylax chosenicus. The surveys were conducted between 2016 and 2020 through visual and call encounters. We also used molecular tools to confirm the species identity of the northernmost population, in China, sequencing the mitochondrial DNA 16S gene fragment. We then determined the importance of landscape types for the species, and especially rice paddies, and used landscape models to define suitable habitats across the region. We found the species to be widespread in low elevation wetlands along the coast of the Yellow Sea, with two isolated populations on the south-east of the Korean Peninsula, and the northernmost population in the vicinity of Dandong in PR China. As this species is listed as threatened in the Republic of Korea, knowing its exact distribution will be important for conservation practices, and this first record for PR China provides a baseline for further surveys.