Inflammatory Burden and Immunomodulative Therapeutics of Cardiovascular Diseases

Phenotyping cardiovascular illness and recognising heterogeneities within are pivotal in the contemporary era. Besides traditional risk factors, accumulated evidence suggested that a high inflammatory burden has emerged as a key characteristic modulating both the pathogenesis and progression of cardiovascular diseases, inclusive of atherosclerosis and myocardial infarction. To mechanistically elucidate the correlation, signalling pathways downstream to Toll-like receptors, nucleotide oligomerisation domain-like receptors, interleukins, tumour necrosis factor, and corresponding cytokines were raised as central mechanisms exerting the effect of inflammation. Other remarkable adjuvant factors include oxidative stress and secondary ferroptosis. These molecular discoveries have propelled pharmaceutical advancements. Statin was suggested to confer cardiovascular benefits not only by lowering cholesterol levels but also by attenuating inflammation. Colchicine was repurposed as an immunomodulator co-administered with coronary intervention. Novel interleukin-1β and −6 antagonists exhibited promising cardiac benefits in the recent trials as well. Moreover, manipulation of gut microbiota and associated metabolites was addressed to antagonise inflammation-related cardiovascular pathophysiology. The gut-cardio-renal axis was therein established to explain the mutual interrelationship. As for future perspectives, artificial intelligence in conjunction with machine learning could better elucidate the sequencing of the microbiome and data mining. Comprehensively understanding the interplay between the gut microbiome and its cardiovascular impact will help identify future therapeutic targets, affording holistic care for patients with cardiovascular diseases.

Islamic Menstrual Holistic Care Education Class for Young Women during the Covid 19 Pandemic

Physical and psychological changes that occur in adolescent girls, especially at the beginning of puberty can affect anxiety which leads to the risk of decreased body immunity. The purpose of this service is that young women can prepare for or undergo puberty and puberty safely, comfortably and can reduce the risk of anemia and decreased endurance, especially during the pandemic Covid-19. The location of the service is at the LKSA Orphanage of Nurus Syamsi Muhammadiyah, Bungkal District, Ponorogo Regency, East Java. Service activities in the form of educational classes with conventional methods, discussions. In the education class, 3 (three) different materials were given, namely 1) Puberty and Akil Baligh, 2) Myths About Menstruation, 3) Thaharoh and Practices During Menstruation. In this educational class, young women are also given blood-boosting multivitamins to prevent anemia during menstruation. After this service activity is carried out, it is hoped that there will be awareness in maintaining cleanliness and health during puberty, especially to reduce the risk of anemia in young women in orphanages during the pandemic Covid-19.

全人照護及其教育訓練與評值

<p>目的：全人照護是對病人身體、心理、社會層面及靈性全面照護的態度與行為，需要醫療院所投注多專 業、跨領域且有效率又有品質的整合服務，才能滿足病人「一站式服務、一次購足」的需求。本文之目的在於詮釋全人照護之真諦、內涵、教育訓練與評值。</p> <p>方法：藉由闡釋全人照護的素養與能力，強調推廣全人照護需要多面向的教育訓練加以養成，並發展以能力為基礎的評值方法。</p> <p>結果：醫療人員需要終身持續學習有關全人照護的核心知識與技能、醫療專業照護、同理心與心理支持、就醫行為和家庭照護，以及生命關懷及和臨終照護，並佐以適合及一致性的評值標準，方能系統性的推廣全人照護。</p> <p>結論：本文探討全人照護的真諦、如何推動全人照護及如何實施全人照護之教育訓練與評值，作為醫療院所推動全人照護之參考。</p> <p>&nbsp;</p><p>Objective: Holistic care is an approach that involves consideration of the physical, emotional, social, and spiritual wellbeing of a patient. It involves multidisciplinary, interprofessional integrated teams with members who educate, cooperate with, and respect each other to offer one-stop fulfillment of patient needs. This article explains the core values and intentions of holistic care and the relevant education, training, and assessments.</p> <p>Methods: By explaining the competencies of holistic care, this article argues that the promotion of holistic care necessitates multidimensional education, training, and competency-based assessments.</p> <p>Results: To systematically promote holistic care, accompanied by appropriate and consistent assessment standards, health care providers must continue to learn about the main components of holistic care, including its required knowledge and competencies, professional medical care empathy and psychological support, the praxeology of healthcare seeking, family care, and end-of-life and hospice care.</p> <p>Conclusion: This article discusses the core values of holistic care; how to promote holistic care; and how to implement education, training, and assessments in the field of holistic care and may therefore serve as a reference for holistic care training in medical settings.</p> <p>&nbsp;</p>

Joint Deep-Learning-Enabled Impact of Holistic Care on Line Coagulation in Hemodialysis

In order to investigate the impact of holistic care on line coagulation and safety in hemodialysis and to address limitations of the conventional ultrasound flow vector imaging (VFM) technique, which requires proprietary software to acquire raw Doppler and scatter tracking data, a combined deep-learning-enabled holistic care approach to line coagulation in hemodialysis is proposed. First, velocity along the direction of the sound beam, which is provided by the color Doppler echocardiogram, is obtained as the radial velocity component using a velocity scale. Moreover, the left ventricular wall contour is automatically identified using a U-Net network and the left ventricular wall velocity is calculated as the boundary condition of continuity equation by a retrained PWC-Net model. Likewise, the velocity component of each blood mass in the vertical direction of the sound beam is obtained by solving the continuity equation (i.e. tangential velocity component). Finally, the velocity vector map of cardiac flow field was synthesized and visualized in the flow diagram. For this purpose, sixty patients admitted to receive hemodialysis from February 2019 to June 2020 were randomly divided into two groups of 30 patients where the control group implemented conventional care and the study group implemented all-round care on the basis of conventional care. The nursing effects of both groups were compared. Incidence of pipeline coagulation and complications in the study group were lower than those in the control group and the difference was statistically significant ( P < 0.05 ). The nursing detail score, nursing attitude score, nursing professionalism score, and total satisfaction score in the study group were higher than those in the control group and the difference was statistically significant ( P < 0.05 ). Applying all-round nursing in hemodialysis can effectively reduce the incidence of line coagulation complications and improve the safety of hemodialysis, as well as improve patients’ satisfaction with nursing care.

Holistic Nurse Practitioner Care Including Promotion of Shared Decision-Making

The purpose of this quantitative, descriptive, exploratory study was to gauge the degree to which nurse practitioners (NPs) incorporate holistic nursing values in their care, with a special focus on shared decision-making (SDM), using the Nurse Practitioner Holistic Caring Instrument (NPHCI), an investigator-developed scale. A single open-ended question inviting free-text comment was also included, soliciting participants’ views on the holistic attributes of their care. A convenience sample of NPs ( n = 573) was recruited from a southeastern U.S. state Board of Nursing's (BON) publicly available list of licensed NPs. Results suggest that NPs do indeed perceive their care to be holistic, and that they routinely incorporate elements of SDM in their care. Highest scores were accorded to listening, taking time to talk to patients, knowledge of physical condition, soliciting patient input in care decisions, considering how other areas of a patient's life may affect their medical condition, and attention to “what matters most” to the patient. Age, gender, level of education, practice specialty, and location were also associated with inclusion of holistic care. Free-text responses revealed that NPs value holistic care and desire to practice holistically, but identify “lack of time” to incorporate or practice holistic care as a barrier.

Cystic fibrosis and caseload midwifery

Midwives must provide woman-centred, holistic care for the diverse UK childbearing population. As the NHS moves to adopt the recommendations made in the ‘Better Births’ report, is there an argument to invest in protected caseload midwifery contacts for women with cystic fibrosis? Caseload midwifery refers to a continuity model where a small team of midwives provide care throughout the antenatal, intrapartum and postnatal continuum. Cystic fibrosis affects multiple organ systems and requires specialist medical management during pregnancy. Living with cystic fibrosis has many psychosocial implications and pregnancy presents additional challenges. Health and wellbeing outcomes are improved when individuals are treated holistically in the non-pregnant population; therefore, during pregnancy, birth and postnatally, caseload midwifery may provide a legitimate intervention to improve health outcomes in pregnant women with cystic fibrosis.

A qualitative study exploring the application of psychosocial screening to identify psychological conditions in non-surgical aesthetic patients

This study explores medical aesthetic practitioners' initial and ongoing application of psychosocial screening, to identify existing or emerging psychological disorders or conditions in non-surgical aesthetic patients. The increased demand for non-surgical aesthetic treatments correlates with the rise of patients who present with existing or evolving psychosocial problems or issues. Therefore, patients must be appropriately and adequately assessed, to identify those vulnerable individuals who are not suitable for treatment or whose treatments may exacerbate underlying psychological conditions. Identification can support signposting to trained professionals to ensure appropriate holistic care. Moreover, the study explores which validated screening tools have been adopted into practice, and routes for guiding patients should concerns arise.

65 & Thrive: Improving Patient Length of Stay, Readmission, and Quality of Care by Becoming an Age-Friendly Hospital

Data indicates that older persons will increase in numbers along with having an increase of life expectancy in the United States. Kaiser Permanente Los Angeles Medical Center’s Utilization Department developed “65 & Thrive”—an age-specialized initiative to provide holistic care that preserves independence, quality of life, prevents functional and cognitive decline, and promotes both patients and their families to continue thriving. The initiative’s focus is guided by the 5 M’s model on mobility, medication, mentation, multi-morbidity, and what matters. Case management staff were given age-sensitivity trainings, improved workflows and made assessments that identified, addressed, and secured resources for patients throughout their hospitalization. Silver Angel volunteers were specially trained to prevent physical and mental decline and focused on activities to prevent delirium, depression and falls. The volunteers visited with patients daily for these interactions. The initiative was piloted in April 2020 on a stroke telemetry unit and since then the hospital has seen a significant decrease in the overall annual readmission rates by 3.1% when compared to 2019. The average length of stay for older adult patients; however, increased from 4.05 to 4.83 days unfortunately due to COVID-19. This initiative demonstrates the necessity to expand “65 & Thrive” throughout the hospital and ultimately to other Kaiser Permanente medical centers to best provide holistic care to older adults.

Spirituality and spiritual well-being among nursing students

Aim: A descriptive study was conducted to assess the spirituality and spiritual among nursing students in a selected college of nursing in Ernakulum District, Kerala. Background: Spirituality and spiritual care are of great importance as fundamental principles in health care. With the introduction of important changes in the health care system, nurses use the concept of holism in patient care and the spiritual aspect of health care is steadily gaining importance. The World Health Organization (WHO) announced that the health needs should include spiritual well-being in addition to physical, mental, and social domains .Spirituality is a positive dimension of the human being and care and might help patients reframe their experiences and condition of illness as well as find meaning in life and in that circumstance.Spiritual well being is one of a core human component that provides driving force to give person stability, meaning, and fulfillment in life, faith in self. The purpose of this study is to assess the spirituality, spiritual wellbeing and perception towards spiritual care among nursing students. Methods: A Descriptive analytical study was conducted among 129 BSc Nursing students studying in a Nursing College attached to a Medical College Hospital of South India during the month of December 2020.Convenience sampling technique was adopted for the study. Spirituality assessment scale and spiritual well being assessment scale were used to collect the data.Pilot study was conducted and the study was found to be feasible. Permission from the authorities was obtained and data collection was done. The data analysis was done using descriptive and inferential statistics and R software used for the analysis. Results: The result revealed the mean score of spirituality and spiritual wellbeing as 84.40(SD+_8.45) and 65.81(SD+_6.09) respectively and a statistically significant strong positive correlation was found between spirituality and spiritual wellbeing with correlation coefficient ( r ) 0.806 at p value < 0.0001. Conclusion: Spirituality is a significant concept for the discipline of nursing with profound consequences for caring patients. Spirituality is an important aspect of holistic care This study identified that there is a strong relationship between spirituality and spiritual wellbeing.So this study convey the significance of spirituality and spiritual well being in holistic care.