Palliative care provision for patients with a haematological malignancy : can we do more?

This editorial depicts the current challenges in palliative care provision for patients with a haematological malignancy and the contribution of cancer nurses. There have been significant advancements in the care of patients with a hematological malignancy over the past three or more decades1. Despite this, there still exists a significant mortality risk in curative treatment and many patients with a hematological malignancy will die from their disease1. A growing body of research indicates patients with a hematological malignancy do not receive best practice palliative and end-of-life care2. Shortfalls in care include poor referral patterns to specialist palliative care services, lack of honest discussions regarding death and dying, inadequate spiritual care for patients and families, patients frequently dying in the acute care setting and high levels of patient and family distress2. There have been a number of efforts in the United Kingdom, United States of America, Sweden, and Australia demonstrating palliative and hematology care can co-exist, exemplified through clinical case studies and innovative models of care2. However, deficits in the provision of palliative care for patients with a hematological malignancy persist as evident in the international literature2. Addressing this issue requires research exploring new aspects of a complex scenario; here we suggest priority areas of research...

Models of survivorship care provision in adult patients with haematological cancer : an integrative literature review

Purpose: Increasing numbers of haematology cancer survivors warrants identification of the most effective model of survivorship care to survivors from a diverse range of haematological cancers with aggressive treatment regimens. This review aimed to identify models of survivorship care to support the needs of haematology cancer survivors. Methods: An integrative literature review method utilised a search of electronic databases (CINAHL, Medline, PsycInfo, PubMed, EMBASE, PsycArticles, Cochrane Library) for eligible articles (up to July 2014). Articles were included if they proposed or reported the use of a model of care for haematology cancer survivors. Results: Fourteen articles were included in this review. Eight articles proposed and described models of care and six reported the use of a range of survivorship models of care in haematology cancer survivors. No randomised controlled trials or literature reviews were found to have been undertaken specifically with this cohort of cancer survivors. There was variation in the models described and who provided the survivorship care. Conclusion: Due to the lack of studies evaluating the effectiveness of models of care, it is difficult to determine the best model of care for haematology cancer survivors. Many different models of care are being put into practice before robust research is conducted. Therefore well-designed high quality pragmatic randomised controlled trials are required to inform clinical practice.

Provision of survivorship care for patients with haematological malignancy at completion of treatment: a cancer nursing practice survey study

Purpose Many haematological cancer survivors report long-term physiological and psychosocial effects, which persist far beyond treatment completion. Cancer services have been required to extend care to the post-treatment phase to implement survivorship care strategies into routine practice. As key members of the multidisciplinary team, cancer nurses’ perspectives are essential to inform future developments in survivorship care provision. Methods This is a pilot survey study, involving 119 nurses caring for patients with haematological malignancy in an Australian tertiary cancer care centre. The participants completed an investigator developed survey designed to assess cancer care nurses’ perspectives on their attitudes, confidence levels, and practice in relation to post-treatment survivorship care for patients with a haematological malignancy. Results Overall, the majority of participants agreed that all of the survivorship interventions included in the survey should be within the scope of the nursing role. Nurses reported being least confident in discussing fertility and employment/financial issues with patients and conducting psychosocial distress screening. The interventions performed least often included, discussing fertility, intimacy and sexuality issues and communicating survivorship care with the patient’s primary health care providers. Nurses identified lack of time, limited educational resources, lack of dedicated end-of-treatment consultation and insufficient skills/knowledge as the key barriers to survivorship care provision. Conclusion Cancer centres should implement an appropriate model of survivorship care and provide improved training and educational resources for nurses to enable them to deliver quality survivorship care and meet the needs of haematological cancer survivors.

Plasma Biochemical and Haematological Changes in Steers of Different Temperament during Feedlotting

Correlations between liveweight gains and temperament during feedlotting (Voisinet et al., 1997) may be an indication that cattle of different temperament suffer different degrees of stress. This paper describes the effect of grouping into feedlot pens, cattle of good, poor and mixed (some good and some poor) temperament on blood parameters that are indicators of stress (Bennett et al., 1989). Animal production for a consuming world : proceedings of 9th Congress of the Asian-Australasian Association of Animal Production Societies [AAAP] and 23rd Biennial Conference of the Australian Society of Animal Production [ASAP] and 17th Annual Symposium of the University of Sydney, Dairy Research Foundation, [DRF]. 2-7 July 2000, Sydney, Australia.

Do the Hydrolysis Products, Methylamine and N,N'-Dimethylurea, Play any Role in the Methyl Isocyanate-Induced Haematological and Biochemical Changes in Rabbits?

The subcutaneous administration of methyl isocyanate (MIC) to female rabbits, resulted in significant increases in haemoglobin concentration, erythrocyte volume fraction and leucocyte number in blood, as well as plasma total proteins, and urea. The present study was designed to investigate whether the hydrolytic products of MIC, methylamine (MA) and N,N'-dimethylurea (DMU) play any role in eliciting these changes. Both MA and DMU administered subcutaneously in an equimolar dose to that of 1.0 LD50 MIC, 2.2 mmol kg-1, had no influence on these parameters, although there was a marginal increase in the plasma urea level shortly after the administration of DMU. This study establishes that the observed haematological and biochemical changes induced by MIC intoxication in rabbits are mostly due to MIC.

The effects of dietary treatment on the morphometrics and haematological characteristics in Clarias gariepinus

Fingerling of Clarias gariepinus have been reported to have an optimal protein requirement of 40%. Not much is known about the effect that varying this protein level has in the haematological characteristics (i.e packed cell volume, red blood cell count, haemoglobin concentration and mean corpuscular haemoglobin concentration) and on some landmarks measured along the fish's body. The haematological parameter are useful in assessing the effect of dietary treatment on leanness or robustness in the fish. The results of these experiment reveals that of the 17 landmarks measured on the bodies of the fish species fed dietary protein levels of no protein 11% (low protein), 29% (sub optimal) and 40% (optimal), only four of the landmarks show significant difference. Also, analysis of the haematological characteristics show significant difference in haematoant (PCV) and erthroycte count (RBC) in all the treatments

Contribution of haematological factors to the distributions and estimation of Eustrongyliides africanus larvae densities in Clarias gariepinus and Clarias anguillaris from Bida floodplain of Nigeria

The contributions of hematological factors to the distribution and estimations of Eustrongylides africanus larvae densities in Clarias gariepinus and C. anguillaris of Bida floodplain of Nigeria were documented for the first time. The hematological factors making the most important contributions to the distributions of E. africanus larvae infections in clarias species are mean corpuscular haemoglobin concentration (MCHC), mean corpuscular haemoglobin (MCH), mean corpuscular volume (MCV) and neutrophils count, in descending order of magnitude; having the manifestations for the months of January, March, September, and December of the year being closely related. Five haematological factors (neutrophils, lymphocytes and eosinophils counts; MCH and MCV) having positive or negative correlation coefficient (r) between 0.50 and 0.85 contributed to the estimated of E.africanus larvae densities in the wild population of Clarias species

Haematological response of Heterobranchus longifilis fed varying dietary protein levels

Hematological effects of feeding varying dietary crude proteins levels to one hundred and fifty (150) H.longifilis fingerlings was examined on biweekly basis. The fingerlings of mean weights 1.26g plus or minus 0.24g were stocked in eight hapa nets (1mx1m) at 15 fingerlings per hapa. Four experimental diets with crude protein; 35%, 40%, 45% and 50% coded diet 1-4 respectively were fed to the fish for 8 weeks. The blood sample was taken and examined for packed cell volume (PCV) total protein (TP) Hemoglobin (Hb), Serum album, Erythrocyte count (RBC), while blood cell (WBC) mean corpuscle volume (MCV) and mean corpuscle hemoglobin, concentration (MCHC). There was an increase in the values of the hematological indices studied with increase in protein inclusion levels. A higher positive correlation with no significant difference (P greater than or equal to 0.05) exists between the treatments RBC, WBC, Hb and TP. The best RBC (2.10x10 super(6) count/l). WBC (7.65x10 super(4) count/l), PCV (35.4%) and Hb (5.79mg/l) were presented in fingerlings fed 40% crude protein followed by 45% crude protein. The dietary crude protein of 40% is recommended for H. longifilis for sound and healthy condition

Haematological and biochemical alterations of Catla catla fingerlings following sublethal exposure to Nuvan

The sublethal exposure (0.24 ppm) of Nuvan on some biochemical compositions such as serum protein, blood glucose, glutamate oxaloacetate transaminase (AST) and glutamate pyruvate transaminase (ALT) and on some hematological parameters such as red blood corpuscles (RBC), white blood corpuscles (WBC), hemoglobin content (Hb), mean corpuscular concentration (MCV), mean corpuscular hemoglobin concentration (MCHC) of Catla catla fingerlings were studied. The hematological and biochemical parameters evoked a significant reduction (excepting MCV, ALT and AST which is significantly increased) with increasing days of Nuvan exposure.

Toxicity of copper sulphate on some haematological parameters of a freshwater teleost Cyprinus carpio var. communis

Haematological changes in a freshwater teleost, Cyprinus carpio var. communis, exposed to acute and sublethal toxicity of copper sulphate were studied. During the acute treatment, erythrocyte and leucocyte count, and haemoglobin content increased, whereas during the sublethal treatment, erythrocyte count and haemoglobin content decreased and leucocyte count increased.

Seasonal and sex related haematological variations of the freshwater spiny eel, Mastacembelus armatus reared in the cemented cisterns

The seasonal and sex related haematological vanatlons in the freshwater spiny eel Mastacembelus armatuswere studied during summer from April to June 2001 and winter from November 2001 to January 2002. In total 60 fish (30 males and 30 females) ranging from 30- 55.6 cm in total length and from 55-95.5 g in weight were collected from the culture stock maintained in the cemented cisterns. It was observed that the values of the total erythrocyte count (TEC), haemoglobin concentration (Hb ), haematocrit values, packed cell volume (PCV) and neutrophil count were significantly higher (P< 0.05) in males than the females during summer (April to June- on-set of breeding season). Females were observed to have remarkably higher values (P< 0.01) of erythrocyte sedimentation rate (ESR), total leucocyte count (TLC) and thrombocyte count during summer. On the other hand, insignificant variations in the various haematological parameters were noticed during winter (November to January) between the two sexes of M. armatus.

Effect of feed quality restriction followed by realimentation on growth, nutrient utilization, biochemical changes and haematological profiles of Indian major carp, rohu (Labeo rohita H.)

To investigate the effect of protein restriction with subsequent re-alimentation on nutrient utilization, hematological and biochemical changes of Indian major carp, Rohu (Labeo rohita H.), 150 acclimatized Rohu fingerlings (average 20.74 ± 0.13 g) divided into five experimental groups (30 fingerlings in each groups with three replications with 10 fingerlings in each) for experimental trial of 90 days using completely randomized design. Control group (T sub(CPR)) was fed with feed having 30% crude protein at 3% of body weight for 90 days trial period. Other experimental groups T sub(1PR) was alternatively 3 days fed with feed having 20% CP and 30% CP at 3% of body weight, T sub(2PR) was alternatively 7 days fed with feed having 20% CP and 30% CP at 3% of body weight, T sub(3PR) was alternatively 15 days fed with feed having 20% CP and 30% CP at 3% of body weight and T sub(4PR) was alternatively 25 days fed with feed having 20% CP and 30% CP at 3% of body weight during 90 days trial period with daily ration in two equal halves at morning and afternoon. It was noticed that retention of different nutrients was almost similar among all treatment groups indicated improvement of digestibility of nutrients might not be the mechanisms for recovery growth in carps. Increased percent feed intake of body weight (hyperphagia) (4.14 ± 0.30 or 4.94 ± 0.46 and 3.33 ± 0.29), improved specific growth rate (1.86 ± 0.09 or 2.26 ± 0.05 and 1.43 ± 0.01), absolute growth rate (1.57 ± 0.08 or 1.84 ± 0.18 and 1.36 ± 0.12), protein efficiency ratio (1.19 ± 0.11 or1.16 ± 0.12 and 1.05 ± 0.09) were the important mechanism showing better performance index (21.60 ± 1.09 or 23.80 ± 0.21 and 19.45 ± 0.37) through which the experimental groups which were protein restricted and re-alimented at 3 or 7 days alternatively during 90 days trial period could able to compensate the growth retardation and to catch up the final body weight of control (128.68 ± 11.53 g/f) but other experimental groups failed to compensate during 90 days trial period. Result of the present study indicated that deprived fish i.e., fish received alternate 3 or 7 days protein restriction and re-alimentation showed recovery growth had still lower values of Hb (10.21 ± 0.02, and 9.88 ± 0.04 g/dl), hematocrit value (30.62 ± 0.05 and 26.64 ± 0.11%), total erythrocytic count (3.40 ± 0.01 and 3.29 ± 0.01 X10super(6) mm³), plasma glucose (126.93 ± 0.20 and 126.67 ± 0.05 mg/dl), total plasma lipid (1.04 ± 0.01 and 1.02 ± 0.01 g/dl) and liver glycogen (290.10 ± 0.80 and 288.99 ± 0.95 mg/kg) in comparison to control (10.56 ± 0.08 g/dl, 31.68 ± 0.24%, 3.52 ± 0.03 X10super(6) mm³, 128.23 ± 0.25 mg/dl, 1.07 ± 0.01g/dl and 292.00 ± 0.23 mg/kg) at the end of 90 days trial but total plasma protein in deprived group was compensated with advancement of trial period. All hematological and biochemical parameters studied were proportionately lowered in the experimental group got higher degree of deprivation. These findings suggested that with the increase of trial length complete compensation of hematological and biochemical profiles of rohu might be achieved. The results indicated that the implementation of alternative 7 days low and high protein diet feeding during aquaculture of carps could make economize the operation through minimizing the feed input cost.