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  1. Abdullah R, Guo P, Harding R
    J Pain Symptom Manage, 2020 12;60(6):1223-1238.e4.
    PMID: 32659320 DOI: 10.1016/j.jpainsymman.2020.06.032
    BACKGROUND: Care for people with progressive illness should be person centered and account for their cultural values and spiritual beliefs. There are an estimated 1.7 billion Muslims worldwide, largely living in low-income and middle-income countries.

    AIMS: This study aimed to identify, appraise, and integrate the evidence for the experiences and preferences of Muslim patients and/or families for end-of-life care in Muslim-majority countries.

    DESIGN: Systematic review.

    DATA SOURCES: PsychINFO, MEDLINE, Embase, Global Health, CINAHL, Cochrane Library and Registry of Clinical Trials, PubMed, Applied Social Sciences Index and Abstracts (ASSIA), Social Services Abstracts, Sociological Abstracts, Social Policy & Practice, and Scopus were searched until December 2018. Handsearching was performed, and gray literature was included. Qualitative studies analyzed using thematic analysis and quantitative component provided triangulation.

    RESULTS: The initial search yielded n = 5098 articles, of which n = 30 met the inclusion criteria. A total of 5342 participants (4345 patients; 81.3%) were included; 97.6% had advanced cancer. Most (n = 22) studies were quantitative. Three themes and subthemes from qualitative studies were identified using thematic analysis: selflessness (burden to others and caregiver responsibilities), ambivalence (hope and hopelessness), and strong beliefs in Islam (beliefs in death and afterlife and closeness to Allah). Qualitative studies reported triangulation; demonstrating conflicts in diagnosis disclosure and total pain burden experienced by both patients and families.

    CONCLUSION: Despite the scarce evidence of relatively low quality, the analysis revealed core themes. To achieve palliative care for all in line with the total pain model, beliefs must be identified and understood in relation to decision-making processes and practices.

  2. Lin CP, Boufkhed S, Kizawa Y, Mori M, Hamzah E, Aggarwal G, et al.
    Am J Hosp Palliat Care, 2021 Jul;38(7):861-868.
    PMID: 33789503 DOI: 10.1177/10499091211002797
    BACKGROUND: Hospice and palliative care services provision for COVID-19 patients is crucial to improve their life quality. There is limited evidence on COVID-19 preparedness of such services in the Asia-Pacific region.

    AIM: To evaluate the preparedness and capacity of hospice and palliative care services in the Asia-Pacific region to respond to the COVID-19 pandemic.

    METHOD: An online cross-sectional survey was developed based on methodology guidance. Asia-Pacific Hospice and Palliative Care Network subscribers (n = 1551) and organizational members (n = 185) were emailed. Descriptive analysis was undertaken.

    RESULTS: Ninety-seven respondents completed the survey. Around half of services were hospital-based (n = 47, 48%), and public-funded (n = 46, 47%). Half of services reported to have confirmed cases (n = 47, 49%) and the majority of the confirmed cases were patients (n = 28, 61%). Staff perceived moderate risk of being infected by COVID-19 (median: 7/10). > 85% of respondents reported they had up-to-date contact list for staff and patients, one-third revealed challenges to keep record of relatives who visited the services (n = 30, 31%), and of patients visited in communities (n = 29, 30%). Majority of services (60%) obtained adequate resources for infection control except face mask. More than half had no guidance on Do Not Resuscitate orders (n = 59, 66%) or on bereavement care for family members (n = 44, 51%).

    CONCLUSION: Recommendations to strengthen the preparedness of palliative care services include: 1) improving the access to face mask; 2) acquiring stress management protocols for staff when unavailable; 3) reinforcing the contact tracing system for relatives and visits in the community and 4) developing guidance on patient and family care during patient's dying trajectory.

  3. Lewison G, Hussain SF, Guo P, Harding R, Mukherji D, Sittah GA, et al.
    Ecancermedicalscience, 2020;14:1094.
    PMID: 33014136 DOI: 10.3332/ecancer.2020.1094
    Background and objectives: The 57 countries of the Organisation of Islamic Cooperation (OIC) are experiencing rapid increases in their burden of cancer. The First Ladies Against Cancer meeting at the 2016 OIC meeting in Istanbul committed to the importance of cancer control and the need for more evidence to support national cancer control planning (NCCP). Strong research systems are a crucial aspect of NCCP, but few data exist to support policy-makers across this political grouping.

    Methodology: We identified all cancer research papers from OIC countries in the Web of Science from 2008 to 2017 with a filter based on journal names and title words, with high precision and recall. We analysed the country outputs, the cancer sites investigated, the types of research, sources of funding and the citations to the papers.

    Results: There were 49,712 cancer research papers over this period. The leading countries in terms of output were Turkey, Iran, Egypt and Malaysia, but the most cited papers were from Qatar, Indonesia and Saudi Arabia. International collaboration was low, except in Qatar and the United Arab Emirates. The site-specific cancers accounting for most research were breast and blood, correlating with their disease burden in the OIC countries, but lung, cervical and oesophageal cancers were relatively under-researched. Most funding from within the OIC countries was from their own university sector.

    Conclusion: Cancer is seriously under-researched in most of the OIC countries. This will undermine the ability of these countries and OIC as a whole to deliver on better cancer control for their populations. New policies, OIC leadership and funding are urgently needed to address this situation.

  4. Baharom S, De Matteo R, Ellery S, Della Gatta P, Bruce CR, Kowalski GM, et al.
    Am J Physiol Endocrinol Metab, 2017 07 01;313(1):E75-E83.
    PMID: 28325734 DOI: 10.1152/ajpendo.00450.2016
    Our aim was to determine the disposition of creatine in ovine pregnancy and whether creatine is transferred across the placenta from mother to fetus. Pregnant ewes received either1) a continuous intravenous infusion of creatine monohydrate or saline from 122 to 131 days gestation, with maternal and fetal arterial blood and amniotic fluid samples collected daily for creatine analysis and fetal tissues collected at necropsy at 133 days for analysis of creatine content, or2) a single systemic bolus injection of [13C]creatine monohydrate at 130 days of gestation, with maternal and fetal arterial blood, uterine vein blood, and amniotic fluid samples collected before and for 4 h after injection and analyzed for creatine, creatine isotopic enrichment, and guanidinoacetic acid (GAA; precursor of creatine) concentrations. Presence of the creatine transporter-1 (SLC6A8) and l-arginine:glycine amidinotransferase (AGAT; the enzyme synthesizing GAA) proteins were determined by Western blots of placental cotyledons. The 10-day creatine infusion increased maternal plasma creatine concentration three- to fourfold (P< 0.05) without significantly changing fetal arterial, amniotic fluid, fetal tissues, or placental creatine content. Maternal arterial13C enrichment was increased (P< 0.05) after bolus [13C]creatine injection without change of fetal arterial13C enrichment. SLC6A8 and AGAT proteins were identified in placental cotyledons, and GAA concentration was significantly higher in uterine vein than maternal artery plasma. Despite the presence of SLC6A8 protein in cotyledons, these results suggest that creatine is not transferred from mother to fetus in near-term sheep and that the ovine utero-placental unit releases GAA into the maternal circulation.
  5. Lazarus JV, Safreed-Harmon K, Kamarulzaman A, Anderson J, Leite RB, Behrens G, et al.
    Nat Commun, 2021 07 16;12(1):4450.
    PMID: 34272399 DOI: 10.1038/s41467-021-24673-w
    Health systems have improved their abilities to identify, diagnose, treat and, increasingly, achieve viral suppression among people living with HIV (PLHIV). Despite these advances, a higher burden of multimorbidity and poorer health-related quality of life are reported by many PLHIV in comparison to people without HIV. Stigma and discrimination further exacerbate these poor outcomes. A global multidisciplinary group of HIV experts developed a consensus statement identifying key issues that health systems must address in order to move beyond the HIV field's longtime emphasis on viral suppression to instead deliver integrated, person-centered healthcare for PLHIV throughout their lives.
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