St. Luke's International University

Infant feeding decisions among women living with HIV (WLHIV) represent a complex intersection of public health guidance, personal values, and lived experiences. Although antiretroviral therapy has reduced vertical transmission risks, these decisions remain fraught with challenges. This qualitative evidence synthesis reviewed 41 studies published up to February 2025, exploring WLHIV's breastfeeding experiences through thematic analysis. Four overarching themes emerged: (a) the contradiction of stigma in breastfeeding and formula feeding, (b) breastfeeding for health benefits versus formula feeding to prevent HIV transmission, (c) breastfeeding for personal beliefs and emotional bonding, and (d) the influence of national infant feeding policies and health care systems. Findings reveal that feeding choices are deeply personal and shaped by sociocultural, structural, and emotional contexts. The review highlights the importance of women-centered care that respects women's autonomy, whereas urging health care providers to deliver consistent, empathetic, and comprehensive support to empower WLHIV in making informed decisions.

Guideline-consistent prophylaxis is more effective in managing chemotherapy-induced nausea and vomiting than non-guideline approaches. However, the extent to which patients undergoing anticancer treatment receive guideline-recommended antiemetic therapy in real-world clinical practice remains unclear. This study evaluated the real-world patterns of antiemetic therapy among patients undergoing high emetic risk chemotherapy (HEC) and carboplatin-based moderate emetic risk chemotherapy (MEC) according to cancer type and treatment regimen and identified factors associated with antiemetic use.

We used health service utilization data linked to hospital-based cancer registries from 601 hospitals in Japan. Data from patients aged ≥ 18 years diagnosed with cancer in 2020 and 2021 and treated with intravenous HEC or carboplatin-based MEC were analyzed. The percentage of patients prescribed antiemetics was calculated. A multilevel mixed-effects logistic regression was performed to identify factors associated with antiemetic therapy.

A total of 157,705 patients were analyzed (HEC: 100,163; MEC: 57, 542). Triple-drug antiemetics (an NK₁ receptor antagonist, a 5-HT₃ receptor antagonist, and dexamethasone) were prescribed to 70.6% and 71.9% of patients undergoing HEC and MEC, respectively. In the HEC group, 8.9% received olanzapine in addition to triple-drug antiemetics. Antiemetic therapy varied by cancer type and regimen. In multilevel analysis, odds of receiving triple-drug antiemetics were the highest in small-cell lung cancer (OR = 3.065) for HEC and in endometrial cancer (OR = 1.324) for MEC.

Antiemetic therapy for patients receiving HEC or carboplatin-based MEC varies by cancer type and treatment regimen. Future research should explore reasons for and barriers to non-adherence to guidelines.

This study aimed to evaluate the association of cancer cachexia with psychosocial impact, nutrition impact symptoms (NIS), and geriatric assessment in older patients newly diagnosed with advanced lung cancer undergoing chemotherapy.

Older patients with advanced lung cancer scheduled to receive first-line chemotherapy between August 2021 and February 2022 were enrolled. Cachexia was diagnosed according to the International Consensus. NIS and psychosocial impacts were assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC QLQ) C30, CAX24, and the Eating-Related Distress Questionnaire (ERD). Non-parametric tests evaluated the association between cachexia and its impacts. Patients with cachexia who consented to be interviewed were asked about their experiences with diet and weight changes. Three authors reviewed the interview data to ensure the analysis's veracity.

Twenty-one of the 31 participants (68%) had cachexia at baseline. The cachexia group showed significantly greater severity of Food Aversion (P ​= ​0.035), Eating and Weight Loss Worry (P ​< ​0.001), and Loss of Control (P ​= ​0.005) compared to the non-cachexia group. There were no significant differences in the ERD and geriatric assessment (all P ​> ​0.05). The interview revealed that patients with cachexia perceived diet and weight changes early on and tried to manage their symptoms by themselves.

Cancer cachexia showed an association with NIS and psychosocial impacts. Older patients with advanced lung cancer scheduled to receive first-line chemotherapy should undergo a comprehensive assessment of cancer cachexia, including its potential physical and psychological impacts.

The trial registration number was UMIN 000053843.