Palliative Care and Intensivists' Different Perspectives on Specialist Palliative Care Engagement in Extracorporeal Membrane Oxygenation Care.

There is limited understanding of critical care (CC) and specialist palliative care (SPC) professionals' perceptions regarding the role and utility of SPC for patients on extracorporeal membrane oxygenation (ECMO). An 18-item survey was distributed via convenience sampling and snowballing strategies to CC and SPC attendings working with veno-venous ECMO patients. A total of 75 surveys were completed.

Multisite Randomized Controlled Trial of CareSTEPS: A Supportive Care Intervention for the Family Caregivers of Patients With Advanced Lung Cancer.

Objectives: Patients with advanced lung cancer (LC) face significant physical, psychological, and functional challenges, increasing their reliance on caregivers for practical and emotional support. This study evaluates the efficacy of CareSTEPS (Self-Care, Stress management, Symptom management, Effective communication, Problem-solving, and Social support), a 6-week telephone-delivered intervention designed to improve psychological functioning (depression and anxiety symptoms) and reduce caregiver burden among family caregivers of patients with advanced LC.

Methods: In this multisite, open-label, parallel-group randomized controlled trial, 174 caregivers (74.

Evaluating the persuasiveness of messages promoting mobile mammography among uninsured women.

Mobile mammography units (MMUs) can enhance access to breast cancer screening by providing convenient, cost-effective service, particularly for uninsured and underinsured women. However, prior studies indicate that acceptability concerns about quality and privacy, among other issues, may prevent women from utilizing MMUs. The current study employs a within-participant experimental design exposing participants to messages about different MMU characteristics to determine which characteristics are most effective in persuading them to use an MMU.

Survivorship Care for Women Living With Ovarian Cancer: Protocol for a Randomized Controlled Trial.

Background: Ovarian cancer ranks 12th in cancer incidence among women in the United States and 5th among causes of cancer-related death. The typical treatment of ovarian cancer focuses on disease management, with little attention given to the survivorship needs of the patient. Qualitative work alludes to a gap in survivorship care; yet, evidence is lacking to support the delivery of survivorship care for individuals living with ovarian cancer.

Behavioral and biologic characteristics of cancer-related cognitive impairment biotypes.

Psychiatric diagnosis is moving away from symptom-based classification and towards multi-dimensional, biologically-based characterization, or biotyping. We previously identified three biotypes of chemotherapy-related cognitive impairment based on functional brain connectivity. In this follow-up study of 80 chemotherapy-treated breast cancer survivors and 80 non-cancer controls, we evaluated additional factors to help explain biotype expression: neurofunctional stability, brain age, apolipoprotein (APOE) genotype, and psychoneurologic symptoms.

A comparative cohort study of gastrointestinal oncology patients: Impact of a shift to telehealth on delivery of interprofessional cancer care.

Early studies of oncology visits performed via telehealth demonstrate patient and provider satisfaction; however, understanding of the impact of telehealth on clinic workflows is limited. The incorporation of telehealth visits into an interprofessional model of oncology care was evaluated to assess for changes in care delivery and patient engagement. New patients with a gastrointestinal cancer diagnosis who were actively undergoing treatment and followed for at least three months were divided into two cohorts based on telehealth utilization.

An exploration of financial toxicity among low-income patients with cancer in Central Texas: A mixed methods analysis.

Objective: Financial toxicity is of increasing concern in the United States. The Comprehensive Score for Financial Toxicity (COST) is a validated measure; however, it has not been widely utilized among low-income patients and may not fully capture financial toxicity in this population. Furthermore, the relationships between financial toxicity, quality of life (QOL), and patient well-being are poorly understood.

Epicondylar plate fixation of humeral condylar fractures in immature French bulldogs: 45 cases (2014-2020).

Objectives: The objective of this study was to report outcome and postoperative complications following stabilisation of humeral condylar fractures in skeletally immature French bulldogs with a transcondylar screw combined with locking or hybrid locking plates.

Materials And Methods: Medical records from one referral hospital were reviewed to identify skeletally immature French bulldogs with humeral condylar fractures treated with a transcondylar screw and epicondylar locking or hybrid locking plates crossing the distal humeral physis.

Results: Forty-five fractures in 41 different dogs with a mean age of 4 months (range 3.

Limb-Sparing Surgery in Two Cats Using a Femoral Endoprosthesis with an Integrated Total Knee Replacement Implant.

Objective:  The aim of this study was to describe a novel limb-sparing technique for the management of feline bone neoplasia using a custom-made femoral endoprosthesis in combination with a total knee replacement (TKR) prosthesis.

Methods:  Two cats with distal femoral bone tumours underwent pelvic limb salvage procedures with custom-made implants designed from patient-specific computed tomography images to replace the distal femur and the stifle. In case 1, the first-generation implant was a combination of a cemented femoral endoprosthesis with a uniaxial hinged cemented TKR prosthesis.

Combined internal fixation and transarticular external skeletal fixation to treat traumatic patellar fractures in five dogs.

Case History: Medical records of dogs (n = 5) that had been treated for patellar fracture with transarticular external skeletal fixation (TA-ESF) to augment internal fixation, at a single referral hospital in the United Kingdom between 2015 and 2017, were reviewed.

Clinical Findings And Treatment: At presentation, two dogs had polar patellar fractures, two had comminuted fractures and one dog had a transverse fracture. The median age at the time of the surgery was 21 (min 8, max 132) months and the median body weight was 19.

Patient reported outcomes affecting quality of life in socioeconomically disadvantaged cancer patients.

Purpose: The aim of this study was to identify correlates of quality of life (QOL) for socioeconomically disadvantaged cancer patients receiving care in the "safety net" health system.

Design: This cross-sectional study used linear regressions to determine the effect of patient reported outcome measures (PRO) on QOL.Sample/Methods: Cancer patients ( = 115) receiving drug therapy completed a series of PROs including: Functional Assessment of Cancer Therapy (FACT-G), PROMIS (Anxiety, Depression, Fatigue, Pain Interference, and Physical Function), and the Comprehensive Score for Financial Toxicity.

Comparison of Two Methods for Implementing Comfort Care Order Sets in the Inpatient Setting: a Cluster Randomized Trial.

Background: There is an ongoing need for interventions to improve quality of end-of-life care for patients in inpatient settings.

Objective: To compare two methods for implementing a Comfort Care Education Intervention for Palliative Care Consultation Teams (PCCT) in Veterans Affairs Medical Centers (VAMCs).

Design: Cluster randomized implementation trial conducted March 2015-April 2019.

African American Recruitment in Early Heart Failure Palliative Care Trials: Outcomes and Comparison With the ENABLE CHF-PC Randomized Trial.

Background: Palliative care trial recruitment of African Americans (AAs) is a formidable research challenge.

Objectives: Examine AA clinical trial recruitment and enrollment in a palliative care randomized controlled trial (RCT) for heart failure (HF) patients and compare patient baseline characteristics to other HF palliative care RCTs.

Methods: This is a descriptive analysis the ENABLE CHF-PC (Educate, Nurture, Advise, Before Life Ends: Comprehensive Heartcare for Patients and Caregivers) RCT using bivariate statistics to compare racial and patient characteristics and differences through recruitment stages.

Effect of an Early Palliative Care Telehealth Intervention vs Usual Care on Patients With Heart Failure: The ENABLE CHF-PC Randomized Clinical Trial.

Importance: National guidelines recommend early palliative care for patients with advanced heart failure, which disproportionately affects rural and minority populations.

Objective: To determine the effect of an early palliative care telehealth intervention over 16 weeks on the quality of life, mood, global health, pain, and resource use of patients with advanced heart failure.

Design, Setting, And Participants: A single-blind, intervention vs usual care randomized clinical trial was conducted from October 1, 2015, to May 31, 2019, among 415 patients 50 years or older with New York Heart Association class III or IV heart failure or American College of Cardiology stage C or D heart failure at a large Southeastern US academic tertiary medical center and a Veterans Affairs medical center serving high proportions of rural dwellers and African American individuals.

Effects of a Telehealth Early Palliative Care Intervention for Family Caregivers of Persons With Advanced Heart Failure: The ENABLE CHF-PC Randomized Clinical Trial.

Importance: Family caregivers of persons with advanced heart failure perform numerous daily tasks to assist their relatives and are at high risk for distress and poor quality of life.

Objective: To determine the effect of a nurse-led palliative care telehealth intervention (Educate, Nurture, Advise, Before Life Ends Comprehensive Heart Failure for Patients and Caregivers [ENABLE CHF-PC]) on quality of life and mood of family caregivers of persons with New York Heart Association Class III/IV heart failure over 16 weeks.

Design, Setting, And Participants: This single-blind randomized clinical trial enrolled caregivers aged 18 years and older who self-identified as an unpaid close friend or family member who knew the patient well and who was involved with their day-to-day medical care.

Healthy lifestyle discussions between healthcare providers and older cancer survivors: Data from 12 cancer centers in the Southeastern United States.

Background: Little is known about the prevalence of healthy lifestyle (HLS) discussions between providers and older cancer survivors.

Methods: We utilized cross-sectional data from older cancer survivors (≥65 years) seen at 12 southeastern cancer centers during 2013-2015. Data on demographics, time since diagnosis, weight, height, and healthy behaviors were collected.

Disparities in Hospice Utilization for Older Cancer Patients Living in the Deep South.

Context: Hospice utilization is an end-of-life quality indicator. The Deep South has known disparities in palliative care that may affect hospice utilization.

Objectives: The objective of this study was to evaluate the association among Deep South patient and hospital characteristics and hospice utilization.

Looking Back, Moving Forward: A Retrospective Review of Care Trends in an Academic Palliative and Supportive Care Program from 2004 to 2016.

To examine a rural-serving HBPC program's 12-year experience and historical trends to inform future program direction and expansion. There is limited information about longitudinal trends in mature hospital-based palliative care (HBPC) programs serving racially diverse rural populations. This is a retrospective cross-sectional study of operational and patient-reported outcomes from the University of Alabama at Birmingham (UAB) Center for Palliative and Supportive Care (CPSC) inpatient (n=11,786) and outpatient (n=315) databases from October 2004 to March 2016.

Unmet social support needs among older adults with cancer.

Background: Adequate social support for older adults is necessary to maintain quality of life and reduce mortality and morbidity. However, little is known regarding the social support needs of older adults with cancer. The objective of the current study was to examine social support needs, specifically the unmet needs, among older adults with cancer.

Lay navigation across the cancer continuum for older cancer survivors: Equally beneficial for Black and White survivors?

Objectives: The Patient Care Connect Program (PCCP), through lay navigators' distress assessments and assistance, was shown to lower healthcare utilization and costs in older cancer survivors. PCCP benefits and assistance needs for disadvantaged minorities (e.g.

Choosing Wisely at the End of Life: Use of Shorter Courses of Palliative Radiation Therapy for Bone Metastasis.

Purpose: American Society for Radiation Choosing Wisely guidelines recommend ≤10 fractions of radiation therapy (RT) for bone metastasis, with consideration for 1 fraction in patients with a poor prognosis. The purpose of this analysis was to evaluate characteristic differences in guideline concordance to fractionation regimens in a modern cohort of older patients with a diagnosis of bone metastasis.

Methods And Materials: Medicare beneficiaries aged ≥65 years treated with RT for bone metastasis from 2012 to 2015 were identified.

Educate, Nurture, Advise, Before Life Ends Comprehensive Heartcare for Patients and Caregivers (ENABLE CHF-PC): study protocol for a randomized controlled trial.

Background: Palliative care is specialized medical care for people with serious illness that is focused on providing relief from symptoms and stress and improving the quality of life (QOL) for patients and their families. To help the 6.5 million U.

Lay Patient Navigators' Perspectives of Barriers, Facilitators and Training Needs in Initiating Advance Care Planning Conversations With Older Patients With Cancer.

Context: Respecting Choices is an evidence-based model of facilitating advance care planning (ACP) conversations between health-care professionals and patients. However, the effectiveness of whether lay patient navigators can successfully initiate Respecting Choices ACP conversations is unknown. As part of a large demonstration project (Patient Care Connect [PCC]), a cohort of lay patient navigators underwent Respecting Choices training and were tasked to initiate ACP conversations with Medicare beneficiaries diagnosed with cancer.