Background: Addressing questions surrounding the feasibility of embedding exercise service units in clinical oncology settings is imperative for developing a sustainable exercise-oncology clinical pathway. We examined available literature and offered practical recommendations to support evidence-based practice, policymaking, and further investigations. Methods: Four thousand eight hundred sixty-three unique records identified in Embase, CINAHL, MEDLINE, Web of Science Core Collection, and ProQuest (Health and Medicine) were screened for studies that recruited cancer patients, assessed the co-location of exercise service and cancer treatment units, and reported findings on service implementation. Evidence from six studies providing data from over 30 programs was integrated using narrative synthesis. Results: Service implementation was relatively modest across the included studies. Exercise services were delivered by physiotherapists, exercise physiologists, and kinesiologists and funded mainly through grants and private donations, with staff salaries accruing as the major expense. Service penetration, adoption, and acceptability were generally low. However, studies recorded high clinician/patient satisfaction. Major barriers to service integration were limited funding, lack of detailed implementation plan, and low organizational buy-in. Common reasons for non-utilization, missed sessions, and dropouts were lack of interest, unwellness, hospital readmission, disease progression, and adverse skeletal events. Conclusion: Implementing exercise services in clinical oncology settings seems an effective approach for increasing access to exercise-based rehabilitation for individuals on cancer treatment. While this model appears feasible for patients/clinicians, efforts are required to optimize service integration both in the short and long term. Key priorities include seeking [local] actions to address issues relating to funding and organizational buy-in. Important considerations may include developing an implementation plan to guide the implementation process, expanding the patient core management team to include staff from the exercise rehabilitation unit, and exploring the role of patient feedback in increasing clinician participation (e.g., treating oncologists and nurses) in the referral process. Future research should consider effective strategies to promote patients’ sense of self-efficacy and behavioral control and, further, the place of audit and feedback in improving exercise service delivery and overall service implementation.

Objective: Mindfulness‐based interventions (MBIs) are increasingly being encouraged for managing treatment‐related symptoms but much less is known about the extent to which mindfulness is effective in relieving the psychosocial distress experienced by men with prostate cancer. A systematic review was conducted to synthesise the literature on MBIs for psychological wellbeing and quality of life improvement in men with prostate cancer.Methods: Embase, CINAHL, MEDLINE, PsycINFO, PsycArticles and Web of Science were searched up to 7th November 2020. Included studies were assessed for quality using appropriate appraisal tools. Homogeneous study results were pooled in a meta‐analysis while narrative synthesis was used to summarise the findings from heterogeneous results. Effect size was expressed as Cohen's d (95% confidence intervals) and statistical significance (p‐value) was set at 0.05.Results: Four studies comprising three randomised trials and one non‐randomised study met the inclusion criteria. MBIs for men with prostate cancer showed small to moderate effect for improving psychological outcomes. The pooled result of quality of life and post‐traumatic growth in study participants showed moderate (d = −0.29 [−1.29, 0.71], p = 0.57) and large (d = 0.77 [−0.33,1.88], p = 0.000) effects, respectively.Conclusion: MBI is potentially promising for psychological outcomes, quality of life and post‐traumatic growth symptoms improvement in men with prostate cancer but recommendations cannot be made based on current evidence due to limited research and inadequate methodological rigour of published literature. Robust research is needed to draw a reliable conclusion about its sustained effect in men with advanced disease.

Delivering bad news often impacts nurses’ emotional well-being and relationships with patients. However, most practice models do not offer a sufficient solution to the distress and reduced job satisfaction that may thus arise. This paper offers a critique of theoretical frameworks for breaking bad news in clinical settings, with the aim of highlighting the inadequate evidence available to guide nursing practice with regard to managing the emotional burden of breaking bad news. Firstly, the concept of emotional intelligence is introduced, followed by an overview of the impact of delivering bad news on the psychological well-being of healthcare workers. Several models for delivering bad news in clinical practice were then presented to emphasise the lack of evidence regarding ways of mitigating the burden associated with breaking bad news. Key components of emotional intelligence are highlighted to increase awareness of this factor among nurses and enable them to improve their interpersonal skills to mitigate the impact of breaking bad news. Enabling nurses to develop emotional self-awareness before utilising these frameworks will likely lead to increased nurse retention rates and improve reflective practice and communication skills, which could, in turn, strengthen nurse-patient relationships and subsequent care planning.

The burden of ischemic heart disease in Nigeria calls for an evidence-based, innovative, and interdisciplinary approach towards decreasing health inequalities resulting from individual lifestyle and poor socioeconomic status in order to uphold the holistic health of individuals to achieve global sustainability and health equity. The poor diagnosis and management of ischemic heart disease in Nigeria contributes to the inadequate knowledge of its prognosis among individuals, which often results in a decreased ability to seek help and self-care. Hence, current policies aimed at altering lifestyle behaviour to minimize exposure to cardiovascular risk factors may be less suitable for Nigeria’s diverse culture. Mitigating the burden of ischemic heart disease through the equitable access to health services and respect for the autonomy and beliefs of individuals in view of achieving Universal Health Coverage (UHC) requires comprehensive measures to accommodate, as much as possible, every individual, notwithstanding their values and socioeconomic status.

Nitrate (NO₃ˉ) is a metabolic waste produced in humans during the detoxification of nitric oxide (NO). Nitric oxide is responsible for the regulation of blood flow, cell signaling and host defense in a number of mammalian tissues. Shortly after synthesis, nitric oxide is oxidized to nitrate in order to terminate its effect. NO can also be synthesized by an alternative mechanism that relies on the sequential reduction of nitrate to nitrite (NO₂ˉ); thereby making nitrite a storage pool that can be reduced to NO under appropriate condition with a concomitant increase in the methemoglobin (metHb) concentration. The NO and metHb produced can result to adverse health effects if not detoxified. NADH-methemoglobin reductase accounts for most metHb reduction. Nitric oxide dioxygenases (NODs) catalyze the conversion of NO to NO₃ˉ­­­­­ which help to protect cells from NO poisoning. Nitrate and its reduction products are involved in the modification of the body’s physiological functions. We are exposed to nitrate from dietary intake and nitric oxide oxidation. Nitrate metabolism becomes a threat when nitrate is consumed in excess and the body lacks the enzymes that catalyze the detoxification of its byproducts. During such condition, the hemoglobin, nucleic acids, dietary amines and glycoproteins acts as the primary molecule that mediates its effects. Nitrate is a potential therapeutic agent in the prevention of cardiovascular diseases and improving cell viability. This review serves to reevaluate nitrate metabolism in human with the intentions of understanding its role in NO homeostasis and its metabolic effect due to excess intake.