Allisonholman4426

To (a) compare palliative care needs of lung cancer patients on their final admission to community-based and inpatient palliative care services; and (b) explore whether and how these care needs affect their utilisation of different palliative care services in the last days of life.

Descriptive study involving 17,816 lung cancer patients who received the last episode of palliative care from specialist services and died between 1 January 2013 and 31 December 2018.

Both groups of patients admitted to community-based and inpatient palliative care services generally experienced relatively low levels of symptom distress, but high levels of functional impairment and dependency. "Unstable" versus "stable" palliative care phase (Odds ratio=11.66; 95% Confidence Interval 9.55-14.24), poorer functional outcomes and severe levels of distress from many symptoms predicted greater likelihood of use of inpatient versus community-based palliative care.

Most inpatient palliative care admissions are not associated with high levels of symptom severity. To extend the period of home care and rate of home death for people with lung cancer, additional investment is required to improve their access to sufficiently skilled palliative care staff, multi-disciplinary teams and 24-hour home support in community settings.

Most inpatient palliative care admissions are not associated with high levels of symptom severity. To extend the period of home care and rate of home death for people with lung cancer, additional investment is required to improve their access to sufficiently skilled palliative care staff, multi-disciplinary teams and 24-hour home support in community settings.Cancer nanomedicine has evolved in recent years and is only expected to increase due to the ease with which nanomaterials (NMs) may be manipulated to the advantage of the cancer patient. The success of nanomedicine is dependent on the cell death mechanism, which in turn is dependent on the organelle initially targeted. The success of cancer nanomedicine is also dependent on other cellular mechanisms such as the induction of autophagy dysfunction, manipulation of the tumor microenvironment (TME) and secretome or induction of host immune responses. Tetrazolium Red chemical Current cancer phototherapies for example, photothermal- or photodynamic therapies as well as radio enhancement also form a major part of cancer nanomedicine. In general, cancer nanomedicine may be grouped into those NMs exhibiting inherent anti-cancer properties that is, self-therapeutic NMs (Group 1), NMs leading to localization of phototherapies or radio-enhancement (Group 2), and NMs as nanocarriers in the absence or presence of external radiation (Group 3). The recent advances of these three groups, together with their advantages and disadvantages as well as their cellular mechanisms and ultimate outcomes are summarized in this review. By exploiting these different intracellular mechanisms involved in initiating cell death pathways, it is possible to synthesize NMs that may have the desirable characteristics to maximize their efficacy in cancer therapy. Therefore, a summary of these important physicochemical characteristics is also presented that need to be considered for optimal cancer cell targeting and initiation of mechanisms that will lead to cancerous cell death. This article is categorized under Therapeutic Approaches and Drug Discovery > Nanomedicine for Oncologic Disease Toxicology and Regulatory Issues in Nanomedicine > Toxicology of Nanomaterials Toxicology and Regulatory Issues in Nanomedicine > Regulatory and Policy Issues in Nanomedicine.Based on a historical and a contemporary fieldwork at a Danish hospital, this article offers a genealogical and philosophical exploration of the development of nurses' doing and focus within a hospital setting from the 1800 s to the present day. This exploration finds that nurses' doing has changed during history, which is reflected in their focus. Thus, nurses' focus has developed from, what the Danish philosopher Uffe Juul Jensen refers to as a situation-oriented, to a disease-oriented practice, and while new values are established, the conception of care as a core value in nursing seems to have receded. This article also argues that today's nurses are doing what doctors did in the 19th century. The French philosopher Michel Foucault discusses how things repeat themselves in new ways and new contexts. The nursing profession has become 'a career open to the talents' where nurses with the appropriate skills and talents are able to build a career, within which they provide status, position and legitimacy. The conclusion of the article discusses the significance of this development for patients and the nursing profession.The hierarchical structure of bone plays pivotal roles in driving cell behavior and tissue regeneration and must be considered when designing materials for orthopedic applications. Herein, it is aimed to recapitulate the native bone environment by using melt electrowriting to fabricate fibrous microarchitectures which are modified with plate-shaped (pHA) or novel nanoneedle-shaped (nnHA) crystals. Nuclear magnetic resonance spectroscopy, scanning electron microscopy, transmission electron microscopy, and X-ray diffraction demonstrate that these coatings replicate the nanostructure and composition of native bone. Human mesenchymal stem/stromal cell (MSC) mineralization is significantly increased fivefold with pHA scaffolds and 14-fold with nnHA scaffolds. Given the protein stabilizing properties of mineral, these materials are further functionalized with bone morphogenetic protein 2 (BMP2). nnHA treatment facilitates controlled release of BMP2 which further enhance MSC mineral deposition. Finally, the versatility of this nnHA treatment method, which may be used to coat different architectures/materials including fused deposition modeling (FDM) scaffolds and Ti6Al4V titanium, is demonstrated. This study thus outlines a method for fabricating scaffolds with precise fibrous microarchitectures and bone-mimetic nnHA extrafibrillar coatings which significantly enhance MSC osteogenesis and therapeutic protein delivery, and leverages these results to show how this surface treatment method may be applied to a wider field for multiple orthopedic applications.