Amy P Abernethy

..This study aims to define these predictors of chronic breathlessness at a population level...

..The goal of this study was to evaluate, at a population level, the association between specialized palliative care services (SPCS) and short- and long-term caregiver outcomes...

..The paper then extends this model to the population level, providing a template for health economic analysis of alternate strategies for managing BTP, and delineating steps for accomplishing the analysis...

..Oncologists may respond more empathically to some patients, and patients may perceive different levels of empathy and trust given past documentation of disparities in cancer care...

..This prospective, single-arm, phase 2 pilot study examined the acceptability and feasibility of Pathfinders for women with metastatic breast cancer...

..Quality cancer care requires addressing patients' emotions, which oncologists infrequently do. Multiday courses can teach oncologists skills to handle emotion; however, such workshops are long and costly...

..This study explores the relationship between psychosocial resources invoked through the Pathfinders intervention and outcomes...

..Although the PCM 1.0 is validated, the updated PCM 2.0 has not been validated nor tested in the academic setting...

..Nurses and physician assistants (PAs) may be able to help fill the need for empathic communication. Our study compares the attitudes of oncologists, nurses, and PAs toward communication with patients who demonstrate negative emotions...

..This study was designed to identify the communication factors that influence patient-oncologist concordance about chance of cure...

..To examine the role of friends as caregivers of people with terminal illness...

..5%; p < 0.0001). Similar proportions had died in hospital (60%) and at home (16%-20%). Palliative care service involvement did not reduce institutional deaths, but shifted them from hospital to hospice...

..We studied patients' experiences with oncology providers regarding communication about sexual issues during and after treatment for cancer...

..Its significance is amplified due to its impact on family and caregivers...

..This paper describes demographic characteristics of caregivers, and key characteristics of the deceased irrespective of specialist service utilization...

..Few hospice and palliative care organizations use health information technology (HIT) for data collection and management; the feasibility and utility of a HIT-based approach in this multi-faceted, interdisciplinary context is unclear...

..The aim of this study was to assess whether perceived comfort in the last 2 weeks of life was associated with accessing SPCS...

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..DATA/SETTING: Primary/Duke Breast Cancer Clinic...

..Studies examining head and neck (H&N) melanoma in the pediatric population are scarce...

..These data, obtained from a usual-practice setting, provide benchmarks to improve clinical practice...

..Although research activity in palliative care is rapidly increasing, the composition of published studies--in terms of significant research characteristics--has not yet been well described...

..These three levels of variation limit the ability to generalize study findings...

..Topics include oxygen, opioids, psychotropic drugs, inhaled frusemide, Heliox28, nutrition, psychosocial support, and breathing techniques...

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..Suggested steps in forming data-sharing collaborations and building data collection procedures are shared...

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..This study challenged and developed the research culture within our clinical team and subsequently translated into further research...

..We examined change over time in QOL among long-term survivors of non-Hodgkin lymphoma and identified demographic, clinical, and psychosocial risk factors for poor outcomes...

..Melanoma of the female genitalia has poor overall prognosis...

..End-stage lung disease (ESLD) is a frequent cause of death. What are the differences in the supports needed by caregivers of individuals with ESLD at end of life versus other life-limiting diagnoses?..

..However, this association may be confounded by PET-induced stage migration and selection bias. We examined the association between PET use and overall survival among Medicare beneficiaries with NSCLC...

..Using the rapid learning health care model, data collected in the process of routine care can simultaneously function both as clinical information and as a resource for research on patient-centered experiences and outcomes...

..We developed and tested the feasibility of the Quality Data Collection Tool version 1.0 (QDACTv1.0) for use in community-based palliative care...

..Breathlessness reportedly worsens as death approaches for many people, but the differences in intensity and time course between underlying causes are not well described...

..Dyspnea is frequently encountered in end-stage diseases even when reversible issues are addressed. Which clinical factors best define patient subpopulations that will most predictably benefit from opioids in this clinical setting?..

..Imaging is the fastest growing expense for Medicare but has not been examined among beneficiaries with cancer...

..2 years. AYLL remained stable across three decades. Conclusions: AYLL for MM is greater than 20 years, and has not improved. This burden underscores the need for continued research and access to funding for this disease...

..There is a need for prospective, systematic pharmacovigilance in hospice and palliative care...

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..Availability of resources was cited as a challenge to implementation of best supportive care standards...

..We present an overview of the literature related to patient and physician decision making and quality of life in patients with advanced cancer, and we propose approaches to future decision-making models in cancer treatment...

..We assessed the effectiveness of oxygen compared with room air delivered by nasal cannula for relief of breathlessness in this population of patients...

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..To explore advances in the pharmacological treatment of refractory breathlessness and the physiological evidence for treatments...

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..e., when PaO2 is >/=55 mmHg; also known as palliative oxygen)...

..Have caregivers of patients who have not accessed SPCS had their needs met?..

..Identifying and systematically reducing symptomatic adverse events is limited in hospice and palliative care because these events are mostly attributed to disease progression...

..Topics include oxygen, opioids, psychotropic drugs, inhaled furosemide, Heliox, rehabilitation, nutrition, psychosocial support, breathing techniques, and breathlessness clinics...

..This review summarizes recent developments in the management of gastrointestinal symptoms experienced by cancer patients and provides a framework for education, assessment and monitoring, and treatment...

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..Anecdotal reports suggest that these adjustments may have negatively affected access to chemotherapy for Medicare beneficiaries...

..Palliative care encompasses physical, psychosocial and spiritual care for patients and caregivers. No population data are available on bereaved people who subsequently report that additional spiritual support would have been helpful...

..To determine how prescribing for comorbid illnesses and symptom control changes during the palliative phase of a terminal illness...

..CONCLUSION: Guideline-based cancer pain management leads to improved pain control with modest increases in resource use...

..Guideline efficacy has not been evaluated, and their dissemination into standard care has been poor. A conceptual framework for better implementation of existing guidelines might improve usage and outcomes...

..This review places dyspnea management in palliative care within the new systems approach offered by rapid learning healthcare...

..Oxygen for refractory dyspnea at the end of life is commonly prescribed, even when the criteria for long-term home oxygen therapy are not met. Is palliative oxygen less likely to be prescribed when a person lives alone at the end of life?..

..We make the case for international prioritization of palliative care as a critical strategy for improving outcomes for people with cancer and their caregivers worldwide...

..Health and social services rely heavily on family and friends for caregiving at the end of life...

..The results of this study could suggest stratification rather than unification of breast cancer prevention strategies, risk assessment, and treatment...

..In the final section, we describe important future directions, including strategies for disseminating psychosocial treatments and disparities in pain management...

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..This study seeks to establish the viability of a whole-of-population method to help characterize SPCS access through proxy report...

..Initial results are expected in mid 2005...

..This Special Article reviews the activities of the workshop and sets the stage to move from vision to action...

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..Randomized controlled trials can answer questions of efficacy, but long-term pharmacovigilance studies generate complementary safety data...

..The objective of this study is to investigate how comorbidity, race and age influence stage of CRC diagnosis...

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..Given the prevalence, it is feasible to explore the onset of breathlessness, the underlying etiologies and subsequent health service utilization, and health consequences...

..The e/Tablet electronic system may provide a "safer" environment than paper questionnaires for cancer patients to answer private or highly personal questions on sensitive topics such as sexuality...

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..The psychosocial impact of arthritis can be profound. There is growing interest in psychosocial interventions for managing pain and disability in arthritis patients...

..The framework has five domains: patients and caregivers; health professionals; service issues; health and social policy; and research...

..This paper reviews the current evidence for the pharmacological treatment of refractory symptomatic breathlessness in people with advanced life-limiting illnesses. The paper does not explore changes in function...

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..We studied whether oncologist traits were associated with empathic opportunities and empathic responses...

..CONCLUSIONS: Sustained release, oral morphine at low dosage provides significant symptomatic improvement in refractory dyspnoea in the community setting...

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..Possible explanations included the following: intermittent great vessel obstruction; baroreceptor failure/hypersensitivity; and autonomic dysfunction. His clinical course favored an antibody-negative dysautonomic paraneoplastic syndrome...

..In this report, we describe the study methods and identify challenges to implementation and how these were overcome...

..How frequently does care at our institution conform to established guidelines?..

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..E/Tablets offered a feasible and acceptable method for collecting longitudinal patient-reported symptom and QOL data within an academic, tertiary care, breast cancer clinic...

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..The Centers for Medicare & Medicaid Services limit coverage of cancer drugs for off-label indications to indications listed in specified compendia...

..The research developed and validated palliative care search filters for use in the general biomedical literature...

..Longitudinal tumor-specific studies of cancer pain across the disease trajectory provide insight into the course of pain. Information on pain predictors refines our understanding of patients with greatest distress and need...