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Moreover, caloric restriction may reduce the carcinogenic and metastatic potential of cancer stem cells, which are generally considered responsible of tumor formation and relapse. Here, we reviewed in vitro and in vivo studies describing the effects of fasting, caloric restriction and some caloric restriction mimetics on immunosurveillance, gut microbiota, metabolism, and cancer stem cell growth, highlighting the molecular and cellular mechanisms underlying these effects. Additionally, studies on caloric restriction interventions in cancer patients or cancer risk subjects are discussed. Considering the promising effects associated with caloric restriction and caloric restriction mimetics, we think that controlled-randomized large clinical trials are warranted to evaluate the inclusion of these non-pharmacological approaches in clinical practice.Polyploid somatic cells have 'programmed' roles in normal development and stress responses. Transient polyploidy states have been observed in several tumor types at early stages of tumorigenesis. They can give rise to the aneuploidy state which is a common feature of human cancer cells. Similarly, to cancer development, cancer treatment can lead to transient polyploidy. Polyploid giant cells (PGCCs) in cancer are often associated with poor prognosis and disease relapse. Cancer cell senescence- a proliferation arrest accompanied by a set of characteristic markers- induced by therapy is also associated with transient polyploidy formation and cancer relapse. The question is whether therapy-induced senescence (TIS) and therapy induced polyploidy (TIP) are mechanistically or coincidentally connected. This problem needs to be solved rather urgently, because TIS appears to be more common phenomena than originally believed. Another arising question concerns reversibility of cancer cell senescence as a consequence of atypical divisions of polyploid cells. In our review we will try to answer this fundamental question by referring to published literature and to our own studies.

The high risk of mechanical ventilation with COVID hospitalizations requires health-care systems to rapidly innovate advance care planning (ACP) delivery for hospitalized patients to promote goal-concordant care.

Assess the impact of a social work and care management intervention on the proportion of admitted patients each week with a Medical Durable Power of Attorney (MDPOA).

Social workers were consulted to assist with identification of a surrogate decision maker and completion of MDPOA forms for hospitalized patients. This intervention utilized change management strategies and was implemented between April and June2020.

From a baseline average of 30.1%, the weekly percentage of admitted patients with MDPOA forms rose to 42.8% with correlating evidence of nonrandom special cause variation.

Use of change management strategies resulted in rapid implementation of an effective ACP initiative. buy Lirafugratinib Ongoing needs include focusing on intervention sustainability and education of interprofessional providers about ACP processes.

Use of change management strategies resulted in rapid implementation of an effective ACP initiative. Ongoing needs include focusing on intervention sustainability and education of interprofessional providers about ACP processes.

In response to the COVID-19 pandemic, NHS England prohibited people visiting acute hospital trusts. An end-of-life companion scheme was introduced to support the delivery of care for seriously unwell and dying patients during this time.

This study aims to capture the companions' experience and activities, including qualitative feedback, as well as outline recommendations for this role in future services and training.

The companions' service comprised Allied Healthcare Professionals working for the trust who volunteered for the role following a reduction in their normal workload due to COVID-19. They worked in shifts covering a 12-hour period every day of the week with patients identified by the palliative care team. Companions completed questionnaires containing a 4 domains mixture of Likert scale and free text responses before and after their experience. Details of the visits were recorded in daily spreadsheets.

The majority of companions were from the physiotherapy team with a range of experience working in the NHS. In total, 64 patients were seen over 382 visits. The companions often carried out more than one activity per visit including communication with the patient and next of kin, personal care, literature, and spirituality. Data showed a statistically significant association between experience as a companion and reduced anxiety around spending time with dying people.

This study highlights an interesting approach to changing job roles for health-care professionals during the COVID-19 pandemic as well as recognizing the importance of allied health professionals in the multidisciplinary approach to palliative and end-of-life care.

This study highlights an interesting approach to changing job roles for health-care professionals during the COVID-19 pandemic as well as recognizing the importance of allied health professionals in the multidisciplinary approach to palliative and end-of-life care.

To date, no studies have characterized the impacts of urinary incontinence (UI) at the end of life in the home hospice (HH) setting. UI is highly prevalent at the end of life and adversely affects quality of life.

To characterize HH nurses' perspectives on UI in HH patients.

We conducted a qualitative descriptive study of interviews between HH nurses and the study investigator. Thirty-two interviews with HH nurses were transcribed and analyzed. Nurses were mostly female, college-educated, and had several years of experience in HH nursing.

We identified findings in four major themes 1) HH nurses' definition and identification of UI, 2) the absence of formal guidelines for diagnosing UI in HH patients, 3) UI's adverse effect on HH patients and their families, and 4) the lack of standardized guidelines for the management of UI in the HH setting. We found that there was a general lack of clarity on the subtypes of UI and no standardized guidelines for management of UI in the HH setting. Nurses reported that UI was bothersome to HH patients and their caregivers, citing patient discomfort, loss of dignity, and additional labor burden as reasons for this.