Bioelectrical Impedance Analysis (BIA) for the Assessment of Body Composition in Oncology: A Scoping Review.

Bioelectrical Impedance Analysis (BIA) is a reliable, non-invasive, objective, and cost-effective body composition assessment method, with high reproducibility. This scoping review aims to evaluate the current scientific and clinical evidence on BIA for body composition assessment in oncology patients, under active treatment. Literature search was conducted through MEDLINE, CINAHL, Scopus and Web of Science databases, following PRISMA-ScR Guidelines. Inclusion criteria comprised studies reporting the use of BIA for body composition evaluation in adults with cancer diagnosis. Studies including non-cancer pathology or only assessing nutritional status were excluded. This scoping review comprised a total of 36 studies: 25 were original studies including 18 prospective studies, six cross-sectional studies and one retrospective study and 11 were systematic reviews. Population size for the included original articles ranged from 18 to 1217 participants, comprising a total of 3015 patients with cancer with a mean baseline Body Mass Index (BMI) ranging from 20.3 to 30.0 kg/m2 and mean age ranging between 47 and 70 years. Review articles included a total of 273 studies, with a total of 78,350 participants. The current review considered studies reporting patients with head and neck cancer (HNC) (n = 8), breast cancer (BC) (n = 4), esophageal cancer (EC) (n = 2), liver cancer (n = 2), pancreatic cancer (PC) (n = 3), gastric cancer (GC) (n = 3), colorectal cancer (CRC) (n = 8), lung cancer (LC) (n = 1), skin cancer (SK) (n = 1) and multiple cancer types (n = 6). BIA is a suitable and valid method for the assessment of body composition in oncology. BIA-derived measures have shown good potential and relevant clinical value in preoperative risk evaluation, in the reduction of postoperative complications and hospital stay and as an important prognostic indicator in persons with cancer. Future research on the diagnostic value and clinical applications of BIA and BIA-derived phase angle (PhA) should be conducted in order to predict its impact on patient survival and other clinical outcomes.

Rethinking palliative care in a public health context: addressing the needs of persons with non-communicable chronic diseases.

Non-communicable chronic diseases (NCCDs) are the main cause of morbidity and mortality globally. Demographic aging has resulted in older populations with more complex healthcare needs. This necessitates a multilevel rethinking of healthcare policies, health education and community support systems with digitalization of technologies playing a central role. The European Innovation Partnership on Active and Healthy Aging (A3) working group focuses on well-being for older adults, with an emphasis on quality of life and healthy aging. A subgroup of A3, including multidisciplinary stakeholders in health care across Europe, focuses on the palliative care (PC) model as a paradigm to be modified to meet the needs of older persons with NCCDs. This development paper delineates the key parameters we identified as critical in creating a public health model of PC directed to the needs of persons with NCCDs. This paradigm shift should affect horizontal components of public health models. Furthermore, our model includes vertical components often neglected, such as nutrition, resilience, well-being and leisure activities. The main enablers identified are information and communication technologies, education and training programs, communities of compassion, twinning activities, promoting research and increasing awareness amongst policymakers. We also identified key 'bottlenecks': inequity of access, insufficient research, inadequate development of advance care planning and a lack of co-creation of relevant technologies and shared decision-making. Rethinking PC within a public health context must focus on developing policies, training and technologies to enhance person-centered quality life for those with NCCD, while ensuring that they and those important to them experience death with dignity.

Clinical Validation of the Portuguese Version of "Substance Addiction Consequences" Derived from the Nursing Outcomes Classification.

Our aim was to contribute to the clinical validation of "Substance Addiction Consequences" (SAC) derived from the nursing outcomes classification (NOC), and to analyse psychometric properties. To that purpose, we applied a methodological design. The study's outcome comprises 16 nursing-sensitive indicators, within four different consequence factors: psychological and family; physical and cognitive ability; self-care; economic and work. The psychometric properties were considered good. We concluded that the scale can be used as a valid tool to measure the consequences of substance addiction and to assess the health status as a nursing sensitive outcome. The scale is considered valid to monitor nursing interventions in the clinical setting; being a comprehensive tool it allows the nurse to understand better this complex health problem.

Avaliação cognitiva de pacientes em cuidados paliativos: estudo piloto / Cognitive Assessment for Patients in Palliative Care: Pilot Study / Evaluación cognitiva de los pacientes en cuidados paliativos: un estudio piloto

Objetivo: evaluar el estado cognitivo de pacientes con necesidades paliativas, admitidos en una unidad de convalecencia, utilizando la Escala de Pfeiffer. Material y métodos: estudio descriptivo, observacional y transversal realizado en 23 pacientes ingresados en una unidad de convalecencia en Portugal, entre el 18 de febrero y el 5 de marzo de 2014. Se realizó la evaluación cognitiva utilizando la Escala Pfeiffer versión portuguesa. El análisis estadístico se realizó con metodología descriptiva y analítica. Resultados: más del 50% de los participantes erró en las preguntas que solicitaban el número de teléfono y domicilio (82,6%), la operación de sustracción (60,9%) y el nombre del anterior presidente de la República (56,5%). La mediana de edad de los pacientes con alteraciones cognitivas era de 83 (66-87 años). Conclusiones: este estudio sugiere que el uso de la Escala de Pfeiffer constituye una herramienta apropiada para evaluar el estado cognitivo de los pacientes con necesidades paliativas.

Objetivo: avaliar o estado cognitivo dos pacientes com necessidades paliativas, internados numa unidade de convalescença, através da utilização do instrumento, Escala de Pfeiffer. Material e métodos: estudo descritivo, observacional e transversal, realizado em 23 pacientes internados numa unidade de convalescença, em Portugal, no período 18 de fevereiro e 5 de março de 2014. A avaliação cognitiva foi efetuada com recurso à Escala de Pfeiffer-Versão Portuguesa. A análise estatística foi realizada com metodologia descritiva e analítica. Resultados: mais de 50% dos inquiridos erraram as questões que solicitavam o número de telefone e morada (82,6%), conta de subtração (60,9%) e o nome do anterior Presidente da República (56,5%). Pacientes com alterações cognitivas têm uma mediana de 83 (66-87 anos). Conclusão: o estudo sugere que o uso da Escala de Pfeiffer constitui-se um instrumento adequado para a avaliação do estado cognitivo, dos pacientes com necessidades paliativas. Palavras-chave: cuidados paliativos, determinação de necessidades de cuidados de saúde, cognição, pacientes internados, cuidados de enfermagem.

Aim: To assess cognitive status of patients with palliative needs, admitted to a convalescent unit, using the instrument, Pfeiffer Scale. Material and Methods: It is a descriptive, observational and cross-sectional study conducted in 23 patients admitted to a convalescent unit in Portugal, between February 18 and March 5, 2014. The cognitive assessment was performed using the Scale Pfeiffer-Portuguese version. Statistical analysis was performed with descriptive and analytical methodology. Results: Over 50% of respondents missed questions requesting the phone number and address (82.6%), subtraction account (60.9%) and the name of the former President of the Republic (56.5%). Patients with cognitive impairments have a median of83 (66-87anos). Conclusion: The study suggests that use of Pfeiffer Scale constitutes an appropriate tool for assessing the cognitive state of patients with palliative needs.