Communication skill frameworks: applications in radiation oncology.

Communication is an important part of high-quality care at every step. Communication skills can be learned, practiced, and improved. In this review, we outline the basic frameworks for communication skills training, describe their components, and demonstrate their utility in the context of vignettes.

Top 10 Tips Palliative Care Clinicians Should Know About Radiation Oncology.

As palliative care (PC) moves upstream in the course of advanced illness, it is critical that PC providers have a broad understanding of curative and palliative treatments for serious diseases. Possessing a working knowledge of radiation therapy (RT), one of the three pillars of cancer care, is crucial to PC providers given RT's role in both the curative and palliative settings. This article provides PC providers with a primer on the vocabulary of RT; the team of people involved in the planning of RT; and common indications, benefits, and side effects of treatment.

Update of the systematic review of palliative radiation therapy fractionation for bone metastases.

Purpose: Radiation therapy is an effective modality for pain management of symptomatic bone metastases. We update the previous meta-analyses of randomized trials comparing single fraction to multiple fractions of radiation therapy in patients with uncomplicated bone metastases.

Methods: A literature search was conducted in Ovid Medline, Embase, and Cochrane Central Register.

Bleeding in cancer patients and its treatment: a review.

Bleeding is a common problem in cancer patients, related to local tumor invasion, tumor angiogenesis, systemic effects of the cancer, or anti-cancer treatments. Existing bleeds can also be exacerbated by medications such as bevacizumab, nonsteroidal anti-inflammatory drugs (NSAIDs), and anticoagulants. Patients may develop acute catastrophic bleeding, episodic major bleeding, or low-volume oozing.

Palliative radiation therapy for bone metastases: Update of an ASTRO Evidence-Based Guideline.

Purpose: The purpose is to provide an update the Bone Metastases Guideline published in 2011 based on evidence complemented by expert opinion. The update will discuss new high-quality literature for the 8 key questions from the original guideline and implications for practice.

Methods And Materials: A systematic PubMed search from the last date included in the original Guideline yielded 414 relevant articles.

Outcomes of Definitive Radiation Therapy for Primary Vaginal Carcinoma.

Objective(s): The aim of this study was to review treatment and outcomes of patients with primary vaginal cancer treated with definitive radiotherapy.

Materials And Methods: We retrospectively reviewed medical records of 71 patients with primary vaginal adenocarcinoma or squamous cell carcinoma treated with definitive radiotherapy with at least 2 years of follow-up (median follow-up, 6.24 y).

Care-related risk factors for hospital-acquired pressure ulcers in elderly adults with hip fracture.

Objectives: To identify care-related factors associated with hospital-acquired pressure ulcers (HAPUs).

Design: Prospective cohort study.

Setting: Nine hospitals in Baltimore Hip Studies network.

Declining use of radiotherapy in stage I and II Hodgkin's disease and its effect on survival and secondary malignancies.

Purpose: Concerns regarding long-term toxicities have led some to withhold radiotherapy (RT) for the treatment of Stage I and II Hodgkin's disease (HD). The present study was undertaken to assess the use of RT for HD and its effect on overall survival and the development of secondary malignancies.

Methods And Materials: The present study included data from the Surveillance, Epidemiology, and End Results database from patients aged ≥ 20 years who had been diagnosed with Stage I or II HD between 1988 and 2006.

Trends in self-reported health care provider recommendations for colorectal cancer screening by race.

Objective: To examine whether a racial difference exists in self-reported recommendations for colorectal cancer screening from a health care provider, and whether this difference has changed over time.

Method: Secondary analysis of the 2002, 2004, 2006, and 2008 Maryland Cancer Surveys, cross-sectional population-based random-digit-dial surveys on cancer screening. Participants were 11,368 White and 2495 Black Maryland residents age ≥ 50 years.

Pressure-redistributing support surface use and pressure ulcer incidence in elderly hip fracture patients.

Objectives: To evaluate the association between pressure-redistributing support surface (PRSS) use and incident pressure ulcers in older adults with hip fracture.

Design: Secondary analysis of data from prospective cohort with assessments performed as soon as possible after hospital admission and on alternating days for 21 days.

Setting: Nine hospitals in the Baltimore Hip Studies network and 105 postacute facilities to which participants were discharged.

Post-operative radiation improves survival in children younger than 3 years with intracranial ependymoma.

Concerns regarding long-term toxicities have led to the avoidance of post-operative radiation (PORT) in young children with intracranial ependymoma. We investigated the association between post-operative radiation therapy and overall survival (OS) in children younger than 3 years and compared their survival to other age groups. The study sample from the SEER database included 804 patients with intracranial ependymoma, grades 2-3, and diagnosed between 1988 and 2005.

Frequent manual repositioning and incidence of pressure ulcers among bed-bound elderly hip fracture patients.

Frequent manual repositioning is an established part of pressure ulcer prevention, but there is little evidence for its effectiveness. This study examined the association between repositioning and pressure ulcer incidence among bed-bound elderly hip fracture patients, using data from a 2004-2007 cohort study in nine Maryland and Pennsylvania hospitals. Eligible patients (n=269) were age ≥ 65 years, underwent hip fracture surgery, and were bed-bound at index study visits (during the first 5 days of hospitalization).

Improved survival with radiation therapy in high-grade soft tissue sarcomas of the extremities: a SEER analysis.

Purpose: The benefit of radiation therapy in extremity soft tissue sarcomas remains controversial. The purpose of this study was to determine the effect of radiation therapy on overall survival among patients with primary soft tissue sarcomas of the extremity who underwent limb-sparing surgery.

Methods And Materials: A retrospective study from the Surveillance, Epidemiology, and End Results (SEER) database that included data from January 1, 1988, to December 31, 2005.

Use of pressure-redistributing support surfaces among elderly hip fracture patients across the continuum of care: adherence to pressure ulcer prevention guidelines.

Purpose: To estimate the frequency of use of pressure-redistributing support surfaces (PRSS) among hip fracture patients and to determine whether higher pressure ulcer risk is associated with greater PRSS use.

Design And Methods: Patients (n = 658) aged >or=65 years who had surgery for hip fracture were examined by research nurses at baseline and on alternating days for 21 days. Information on PRSS use and pressure ulcer risk factors was recorded at each assessment visit.

Concordance of family and staff member reports about end of life in assisted living and nursing homes.

Purpose: To identify differences in perspectives that may complicate the process of joint decision making at the end of life, this study determined the agreement of family and staff perspectives about end-of-life experiences in nursing homes and residential care/assisted living communities and whether family and staff roles, involvement in care, and interaction are associated with such agreement.

Design And Methods: This cross-sectional study examined agreement in 336 family-staff pairs of postdeath telephone interviews conducted as part of the Collaborative Studies of Long-Term Care. Eligible deaths occurred in or within 3 days of leaving one of a stratified random sample of 113 long-term care facilities in four states and after the resident had lived in the facility (3)15 days of the last month of life.

Pressure ulcers in elderly patients with hip fracture across the continuum of care.

Objectives: To identify care settings associated with greater pressure ulcer risk in elderly patients with hip fracture in the postfracture period.

Design: Prospective cohort study.

Setting: Nine hospitals that participate in the Baltimore Hip Studies network and 105 postacute facilities to which patients from these hospitals were discharged.

Methodological issues in studies of the effectiveness of pressure ulcer prevention interventions.

Purpose: To enhance the wound care practitioner's understanding of the research methods used to obtain information about the effectiveness of pressure ulcer prevention interventions.

Target Audience: This continuing education activity is intended for physicians and nurses with an interest in skin and wound care.

Objectives: After reading this article and taking this test, the reader should be able to: 1.

Pressure ulcer preventive device use among elderly patients early in the hospital stay.

Background: Clinical guidelines for the prevention of pressure ulcers advise that pressure-reducing devices should be used for all patients at risk of or with pressure ulcers and that all pressure ulcers should be documented in the patient record. Adherence to these guidelines among elderly hospital patients early in the hospital stay has not been examined in prior studies.

Objective: The objective of this study was to examine adherence to guidelines by determining the frequency and correlates of use of preventive devices early in the hospital stay of elderly patients and by determining the frequency and correlates of recording pressure ulcers in the patient record.

Discussion as a factor in racial disparity in advance directive completion at nursing home admission.

Studies have consistently shown racial disparities in advance directive completion for nursing home residents but have not examined whether this disparity is due to differences in interactions with healthcare providers. This study had two aims: to determine whether the racial disparity in advance directive completion by nursing home residents is related to differences in discussion of treatment restrictions with healthcare providers and to examine whether there is a racial disparity in perceptions of residents' significant others that additional discussions would be helpful. Participants were 2,171 white or black (16% of sample) residents newly admitted to 59 nursing homes.

Differences in services provided by hospices based on home health agency certification status.

Background: Similar patient populations and favorable regulations have led many home health agencies to become Medicare and/or Medicaid certified as hospice agencies (mixed), but home health and hospice programs differ in focus and scope. Little research has been performed examining the differences between mixed hospices and those agencies only certified as hospices (nonmixed).

Objectives: To describe the differences in agency characteristics between mixed and nonmixed agencies; and to compare frequencies of service provision by mixed and nonmixed agencies.