With the continuous advancements in tumor immunotherapy, researchers are actively exploring new treatment methods. Peptide therapeutic cancer vaccines have garnered significant attention for their potential in improving patient outcomes. Despite its potential, only a single peptide-based cancer vaccine has been approved by the U.S. Food and Drug Administration (FDA). A comprehensive understanding of the underlying mechanisms and current development status is crucial for advancing these vaccines. This review provides an in-depth analysis of the production principles and therapeutic mechanisms of peptide-based cancer vaccines, highlights the commonly used peptide-based cancer vaccines, and examines the synergistic effects of combining these vaccines with immunotherapy, targeted therapy, radiotherapy, and chemotherapy. While some studies have yielded suboptimal results, the potential of combination therapies remains substantial. Additionally, we addressed the management and adverse events associated with peptide-based cancer vaccines, noting their relatively higher safety profile compared to traditional radiotherapy and chemotherapy. Lastly, we also discussed the roles of adjuvants and targeted delivery systems in enhancing vaccine efficacy. In conclusion, this review comprehensively outlines the current landscape of peptide-based cancer vaccination and underscores its potential as a pivotal immunotherapy approach.

Background and Purpose: According to patient safety literature, workarounds are used when processes are not clear and may not match the intended workflows. There is no available quantitative instrument to measure the type and frequency of workarounds when nurses administer medications. The purpose of this study was to assess the psychometric properties of a newly developed instrument that measured the type and frequency of workarounds when nurses administer medications to patients. Methods: Items for the newly developed instrument were derived based on the concept analysis of workarounds, and the psychometric evaluation included content validity, face validity, item analysis, dimensionality, reliability, and construct validity testing. The instrument was administered to registered nurses in an acute care hospital in Northern Virginia. Results: Psychometric evaluation of the newly developed instrument demonstrated adequate content and face validity. Based on exploratory factor analysis using principal axis factoring of the 18 items, 12 items were retained comprising three subscales: (a) defining characteristics, (b) type of workarounds, and (c) frequency of workarounds. Cronbach\'s alpha ranged from .83 to .92 for the three subscales. As hypothesized, convergent validity was supported by Spearman Rho correlations ranging from .27 to .47 among the Halbesleben, Rathert, and Bennett total and two subscales. Divergent validity was supported with Spearman Rho correlations ranging from -.09 to .15 with two other Halbesleben, Rathert, and Bennett subscales. Conclusions: The findings provided beginning evidence for the reliability and validity of the newly developed Savage Barcode-Assisted Medication Administration Workarounds Tool comprised of three subscales-defining characteristics, types of workarounds, and frequencies of workarounds.

UNASSIGNED: Children and neonates are more susceptible to diseases and are a vulnerable group in medication administration (MA). Nurses interact directly with patients, ensuring safety and preventing unintended outcomes. Health Information Technology (HIT) has transformed health care, aiding nurses in decision-making and treatment responses. Despite its benefits, technology presents challenges that must be overcome to facilitate the nursing practice. Therefore, the present study aimed to explore the barriers to HIT use in the process of MA in children and neonates in a developing country.
UNASSIGNED: Semi-structured face-to-face interviews were conducted with 22 health care professionals across seven pediatric and neonatal settings. Also, observations were made of these settings for 3 weeks. A qualitative analysis was performed using the conventional content analysis method, recommended by Colaizzi\'s seven-step approach.
UNASSIGNED: The results showed that the most significant barriers to adopting technology in MA process could be classified into two main categories: \"inappropriate management approaches\" with two sub-categories (\"Managers\' reluctance to adopt new technology\", \"lack of adequate budget for hardware resources\"), and \"resistance to change\" with two sub-categories (\"A desire to use conventional (traditional) approaches in care\", \"cultural issues and impracticality of providing some specialized technology services\").
UNASSIGNED: The findings revealed MA process complexities, which have been insufficiently examined in the current literature. We have highlighted the need for improved \"effectiveness of HIT systems in administering medication processes, budget for hardware resources, and managers\" interest in using new technology. The present findings can guide the development of more effective and user-friendly HIT systems in pediatric and neonatal care settings.

BACKGROUND: The Family Caregiver Medication Administration Hassles Scale (FCMAHS) was developed to evaluate the hassles and concerns experienced by family caregivers in medication administration.
OBJECTIVE: This study aimed to evaluate the reliability and validity of the Turkish version of the Family Caregiver Medication Administration Hassles Scale (FCMAHS-TR).
METHODS: The FCMAHS-TR was developed after translation, cultural adaptation, and a pilot study. The cross-sectional study was conducted among family caregivers (≥18 years) in community pharmacies. Test-retest reliability analysis, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) were performed. Hypothesis testing was used for the assessment of construct validity.
RESULTS: The majority (68.7%) of the family caregivers were female (n = 470). In the test-retest reliability analysis (n = 30), the ICC value was 0.917 (P < 0.001). In EFA analysis (n = 251), the Kaiser‒Meyer‒Olkin (KMO) measure was 0.799, 62.6% of the total variance was explained by five factors including eighteen items, and Cronbach\'s alpha was 0.836. According to CFA (n = 219), the root mean square error of approximation (RMSEA) was 0.0654, and the comparative fit index (CFI) was 0.918. In construct validity, family caregivers with low reading ability of health-related materials and with high care burden had significantly higher median scores for all the factors of the FCMAHS-TR (P < 0.05 for all).
CONCLUSIONS: The FCMAHS-TR can be used to evaluate the hassle and concerns experienced by family caregivers in medication administration. This scale can be used by healthcare professionals to identify family caregivers who need individualized interventions for medication administration hassles.

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OBJECTIVE: Investigate how assisted living and residential care (AL/RC) and memory care (MC) contexts are associated with the 90-day prevalence of antipsychotic medication use (APU), considered a quality measure in long-term care.
METHODS: All licensed AL/RC settings in Oregon received an annual mailed questionnaire to provide aggregate resident demographics, health acuity, health service use, payment type, and organizational policies. Organizational measures were collected from state websites.
METHODS: Random intercepts regression models were estimated to assess organizational and resident population characteristics associated with 90-day APU prevalence over 3 study waves (2017-2019).
METHODS: We examine 932 observations in 463 AL/RC settings from 2017 to 2019 (137 settings participated in all 3 waves, 195 in 2 waves, and 131 in 1 wave).
RESULTS: The average 90-day APU prevalence in 464 Oregon AL/RC settings is 30.7%, although rates differ by MC endorsement (23.9% in AL/RC and 42.7% in MC). Nonprofit settings were associated with lower rates of APU in both AL/RC [β = -4.4 (percentage points), 95% CI -8.4, -0.4] and MC (β = -12.4, 95% CI -21.2, -3.6). Compared with low-Medicaid settings, settings with very high proportions of Medicaid residents were associated with higher APU prevalence, +8.9 in AL/RC (95% CI 1.7, 16.1) and +11.0 percentage points in MC (95% CI 2.3, 19.8).
CONCLUSIONS: APU prevalence in MC settings and with high-Medicaid populations is considerably higher than non-MC and lower-Medicaid settings. Federal policies guide APU in nursing homes but not AL/RC. No national database of AL/RC exists; thus, state-based studies can inform the discussion of state policy and practice development. Additional study is needed to contextualize the relationships between AL/RC population-level practices and characteristics and the APU prevalence to inform policy and practice development related to this measure as a quality indicator.

BACKGROUND: Learning medication administration is essential for nursing students, but the first time can be stressful and shape their clinical development. Previous research primarily focused on student knowledge and technical aspects.
OBJECTIVE: This phenomenological study helped explore the lived experiences of nursing students and faculty during student\'s first medication administration in the clinical setting to gain a deeper understanding of their thoughts, feelings, and perspectives.
METHODS: Semi-structured interviews were conducted with female student and faculty informants (N = 12). Using a phenomenological study, data were analyzed using van Manen\'s hermeneutic six-step research activity method.
RESULTS: Five overarching themes were found: administrating medication, (un)preparedness for complexities in the clinical environment, transformative experience, overcoming fears, and reaping the rewards.
CONCLUSIONS: First-time medication experiences are greater than an exercise in skill proficiency and may be improved if faculty provides more structured learning experiences and take sufficient time for student preparation in relating medication knowledge to the skill, technology usage, and supporting students\' attitudes toward nurse-patient interactions. These are essential aspects of the medication administration learning process as nursing programs shift toward competency-based education. Clinical faculty also need support in their role as educators and to be facilitated to find this time, considering their multiple responsibilities.

UNASSIGNED: Knowledge of fasting or Nil Per Os (NPO) guidelines is an essential component of nursing care in the preoperative period.
UNASSIGNED: To describe registered nurses\' (RNs) knowledge and management of the preoperative NPO period.
UNASSIGNED: Selected surgical wards in a tertiary hospital in the Western Cape, South Africa.
UNASSIGNED: Quantitative descriptive, cross-sectional study utilising a structured questionnaire. The population consisted of RNs working in selected surgical wards. Convenience sampling was used and adequate knowledge was determined as ≥ 90%.
UNASSIGNED: The response rate was 100%. Of the 68 participants, 48 (70.6%) held a diploma and 20 (29.4%) held a degree as the highest academic qualification achieved. Sixty-one (89.7%) participants knew the correct reason for keeping patients NPO. Sixty-five (95.6%) knew the correct answer for the NPO time for solids while only 27 (39.7%) knew the correct answer for clear fluids. Only 30 (44.1%), 26 (38.2%) and 33 (48.5%) participants, respectively, answered the questions about oral analgesia, oral antibiotics and chronic medication administration during the NPO period correctly. Significantly more degree participants knew the correct answer for the fasting time for non-human milk (p = 0.005) and more diploma participants would administer chronic medication during the NPO period (p = 0.037).
UNASSIGNED: Inadequate knowledge of NPO times for various fluids and unsatisfactory practice of medication administration for oral and chronic medication require attention.
UNASSIGNED: This study highlights the importance that ongoing education is needed to ensure that patients receive the most up-to-date evidence-based care during the NPO period.

The global spread of severe acute respiratory syndrome coronavirus 2 has resulted in a significant number of individuals developing pulmonary fibrosis (PF), an irreversible lung injury. This condition can manifest within a short interval following the onset of pneumonia symptoms, sometimes even within a few days. While lung transplantation is a potentially lifesaving procedure, its limited availability, high costs, intricate surgeries, and risk of immunological rejection present significant drawbacks. The optimal timing of medication administration for coronavirus disease 2019 (COVID-19)-induced PF remains controversial. Despite this, it is crucial to explore pharmacotherapy interventions, involving early and preventative treatment as well as pharmacotherapy options for advanced-stage PF. Additionally, studies have demonstrated disparities in anti-fibrotic treatment based on race and gender factors. Genetic mutations may also impact therapeutic efficacy. Enhancing research efforts on pharmacotherapy interventions, while considering relevant pharmacological factors and optimizing the timing and dosage of medication administration, will lead to enhanced, personalized, and fair treatment for individuals impacted by COVID-19-related PF. These measures are crucial in lessening the burden of the disease on healthcare systems and improving patients\' quality of life.

Patients with pulmonary arterial hypertension (PAH) who are admitted to the hospital pose a challenge to the multidisciplinary healthcare team due to the complexity of the pathophysiology of their disease state and PAH-specific medication considerations. Pulmonary arterial hypertension is a progressive disease that may lead to death as a result of right ventricular (RV) failure. During acute on chronic RV failure it is critical to decrease the pulmonary vascular resistance with the goal of improving RV function and prognosis; therefore, aggressive PAH-treatment based on disease risk stratification is essential. Pulmonary arterial hypertension treatment for acute on chronic RV failure can be impacted by end-organ damage, hemodynamic instability, drug interactions, and PAH medications dosage and delivery. Sotatercept, a first in class activin signaling inhibitor that works on the bone morphogenetic protein/activin pathway is on track for Food and Drug Administration approval for the treatment of PAH based on results of recent trials in where the medication led to clinical and hemodynamic improvements, even when added to traditional PAH-specific therapies. The purpose of this review is to highlight important considerations when starting or continuing sotatercept in patients admitted to the hospital with PAH.