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Objectives: In recent years, there has been increasing attention on the cluster approach to symptom management. Two significant challenges in the symptom cluster (SC) approach are identifying and predicting these clusters. This multiphase protocol aims to identify SCs in patients with advanced cancer as the primary objective, with the secondary objective of developing machine learning algorithms to predict SCs identified in the first phase. Methods: The 2-MIXIP study consists of two main phases. The first phase involves identifying SCs, and the second phase focuses on developing predictive algorithms for the identified SCs. The identification of SCs involves a parallel mixed-method design (quantitative and qualitative). Quantitative and qualitative methods are conducted simultaneously and given equal importance. The data are collected and analyzed independently before being integrated. The quantitative part is conducted using a descriptive-analytical method. The qualitative analysis is conducted using a content analysis approach. Then, the identified SCs from both parts are integrated to determine the final clusters and use them in the second phase. In the second phase, we employ a tree-based machine learning method to create predictive algorithms for SCs using key demographic and clinical patient characteristics. Conclusion: The findings of the 2-MIXIP study can help manage cancer patients' symptoms more effectively and enhance clinical decision-making by using SCs prediction. Furthermore, the results of this study can provide guidance for clinical trials aimed at managing symptoms. [ABSTRACT FROM AUTHOR]

Background: The efficacy of various massage doses in palliative cancer care settings is still debated, and no specific protocol is available. Aim: Evaluating response to various massage doses for symptom cluster of pain-fatigue-sleep. Design: A 7-arm randomized-controlled trial with weekly massage for 4 weeks depending on the prescribed dose (15-, 30-, or 60-min; 2× or 3×/week) and a 4-week follow-up. The intensities of pain, fatigue, and sleep disturbance were measured using a 0–10 scale at nine-timepoint; baseline, weekly during the intervention, and the follow-up period. Then, the mean scores of the three symptoms were calculated as the symptom cluster intensity at each timepoint. IRCT.ir IRCT20150302021307N5. Setting/participants: Adults with cancer (n = 273) who reported all three symptoms at three oncology centers in Iran. Results: The odds of clinical improvement (at least 30% reduction in symptom cluster intensity from baseline) increased with dose-escalation significantly [(OR = 17.37; 95% CI = 3.87–77.90 for 60-min doses); (OR = 11.71; 95% CI = 2.60–52.69, for 30-min doses); (OR = 4.36; 95% CI = 0.94–20.32, for 15-min doses)]. The effect durability was significantly shorter at 15-min doses compared to 30- and 60-min doses. The odds of improvement for doses 3×/week was not significant compared to doses 2×/week (OR = 12.27 vs OR = 8.34); however, the effect durability for doses 3×/week was significantly higher. Conclusions: The findings indicated that dose-escalation increases the efficacy of massage for the pain-fatigue-sleep symptom cluster. Although the 60-min doses were found to be more effective, the 30-min doses can be considered more practical because they are less costly and time-consuming. Our findings can be helpful to develop massage guidelines in palliative care settings. Trial registration: Iranian Registry of Clinical Trials, IRCT20150302021307N5. [ABSTRACT FROM AUTHOR]

Objective: This study examines the effect of the addition of IMOD, a novel multi-herbal drug to the highly active antiretroviral therapy (HAART) regimen, on the immunological status of HIV-positive patients. Materials and Methods: A randomized two-parallel-group (HAART group versus HAART+IMOD group), pretest-posttest design was used. Sixty patients with indications for treatment with the HAART regimen participated. One week before and 2 days after the treatments, immunological parameters including total lymphocyte count (TLC) and CD4 cell count were assessed. The intervention group received the HAART regimen plus IMOD every day for 3 months. The control group received only the HAART regimen every day for 3 months. Results: In the intervention group, a significant difference was observed in CD4between before and after drug therapy (CD4 was increased). However, in the control group, the difference in CD4 was not significant before and after drug therapy. The difference in TLC was not significantly different between the two groups before and after therapy. Nevertheless, TLC was higher in the intervention group. Conclusion: IMOD (as a herbal drug) has been successfully added to the HAART regimen to improve the immunological status of HIV-positive patients. [ABSTRACT FROM AUTHOR]

Objectives: Treatment of hematologic malignancies is generally not possible; it is only possible to relieve symptoms, improve the ability of patients and increase their longevity, so that they can keep living at an acceptable level of life quality. Therefore, in recent years the issue of quality of life is considered as the basic criterion in the evaluation of response to therapy. Thus, we decided to do more research with the goal of determining the effect of massage therapy on the quality of life of leukemia patients undergoing chemotherapy. Materials and Methods: in this clinical trial, 60 patients with acute leukemia were divided into two groups of intervention and control. The intervention group received 4 weeks of back tapping massage (three 10-minute sessions a week, every other day). The dimensions of their quality of life were measured before intervention and also one week after the intervention (fifth week), using a short version of 36-question (SF-36) form in both groups. Statistical tests such as independent t-test and paired t-test were used to analyze data. Results: The results show that the mean of quality of life dimensions was significantly improved after intervention, compared to before intervention (p=0.001). Also, there was no significant difference between the means of quality of life of the two groups (p=0.46), while after intervention it was significantly higher in the massage group (p=0.001). Conclusion: Back tapping massage can be used as a safe and easy method to improve the quality of life, which is the main goal in curing patients with hematologic malignancies. Therefore, this kind of massage therapy should be part of oncology clinical team training programs and used for leukemia patients. [ABSTRACT FROM AUTHOR]

Objectives: Patients with leukemia experience pain, fatigue and sleep disorders at the same time, which severely affect their quality of life. Massage therapy can be used as a non-drug therapy to control these problems. However, there is a scarcity of studies on the effects of massage therapy on patients with leukemia. Materials and Methods: In this clinical trial, 60 patients with acute leukemia were divided into two groups of intervention and control. The intervention group received slow-stroke back massage three times a week (10 minutes per session, every other day), for four weeks. The severity of pain, fatigue and sleep disorders was measured using a numerical rating scale. The quality of sleep was also determined by Pittsburgh Sleep Quality Index. Data were analyzed performing t-test, Chi-square and Mann-Whitney tests. Results: The results showed that the intervention group improved significantly in terms of sleep disorder (p= 0.015), pain severity and fatigue (p=0.001) and quality of sleep (p=0.003), as compared to the control group during the process. Conclusion: Slow-stroke back massage can be used as an easy, safe and cost-effective method alongside with the usual nursing care to improve the cluster of symptoms in patients with acute leukemia undergoing chemotherapy. Oncology nurses have to increase their knowledge in the area of evaluation of symptoms and controlling them by the use of slow-stroke back massage in the patients with leukemia. In addition, using massage therapy for patients with leukemia should be included in the nursing education agenda. [ABSTRACT FROM AUTHOR]

Objective: This study examines the effect of the addition of IMOD, a novel multi-herbal drug to the highly active anti-retroviral therapy (HAART) regimen, on the immunological status of HIV-positive patients., Materials and Methods: A randomized two-parallel-group (HAART group versus HAART+IMOD group), pretest-posttest design was used.Sixty patients with indications for treatment with the HAART regimen participated. One week before and 2 days after the treatments, immunological parameters including total lymphocyte count (TLC) and CD4 cell count were assessed.The intervention group received the HAART regimen plus IMOD every day for 3 months. The control group received only the HAART regimen every day for 3 months., Results: In the intervention group, a significant difference was observed in CD4between before and after drug therapy (CD4 was increased). However, in the control group, the difference in CD4 was not significant before and after drug therapy. The difference in TLC was not significantly different between the two groups before and after therapy. Nevertheless, TLC was higher in the intervention group., Conclusion: IMOD (as a herbal drug) has been successfully added to the HAART regimen to improve the immunological status of HIV-positive patients., Competing Interests: No conflict of interest to declare.