Literature Review

Symptom screening for hospitalized pediatric patients with cancer-A randomized clinical trialJAMA Pediatrics; L. Lee Dupuis, RPh, PhD; Donna L. Johnston, MD; David Dix, MBChB; Sarah McKillop, MD, MSC; Sadie Cook, BA; Nicole Crellin-Parsons, BMSc; Ketan Kulkarni, MD; Serina Patel, MD; Magimairajan lssai Vanan, MD, MPH; Paul Gibson, MD; Dilip Soman, PhD; Susan Kuczynski, HBSc; George A. Tomlinson, PhD; Lillian Sung, MD, PhD; 11/24Pediatric cancer survival outcomes are excellent, but patients often require intensive therapies to achieve a cure. Pediatric patients with cancer experience severely bothersome symptoms during treatment. It was hypothesized that symptom screening and provision of symptom reports to the health care team would reduce symptom burden in pediatric patients with cancer. In this randomized clinical trial, among pediatric patients with cancer admitted to a hospital or seen in a clinic daily for at least 5 days, symptom screening with Symptom Screening in Pediatrics Tool (SSPedi) improved total symptom scores compared to usual care.

[Canada] Feasibility of prospective error reporting in home palliative care: A mixed methods studyPalliative Medicine; Allison M Kurahashi, Grace Kim, Natalie Parry, Vivian Hung, Bhadra Lokuge, Russell Goldman, Mark Bernstein; 10/24 Palliative care patients may be particularly vulnerable to experiencing errors due to the complex communication among interdisciplinary team members (including the patient and their caregivers), the use of high-risk medications such as opioids and benzodiazepines, polypharmacy, patient frailty, and patient cognitive decline. Care in patients’ homes presents additional challenges to patient care that are unique from hospital settings: Decreased communication about roles and responsibilities in care can result from involvement of multiple care teams and different electronic records. The collaborative nature of care in a home-based palliative care context may present unique challenges to translating error reporting to improved patient safety. Physicians are amenable to error reporting activities so long as data is used to improve patient safety.

[UK] Multiple points of system failure underpin continuous subcutaneous infusion safety incidents in palliative care: A mixed methods analysisPalliative Medicine; Amy Brown, Sarah Yardley, Ben Bowers, Sally-Anne Francis, Lucy Bemand-Qureshi, Stuart Hellard, Antony Chuter, Andrew Carson-Stevens; 10/24 About 25% of palliative medication incidents involve continuous subcutaneous infusions. Complex structural and human factor issues make these risk-prone interventions. Primary incidents (most proximal to patient outcomes) leading to inappropriate medication use (including not using medication when it was needed) were underpinned by breakdowns in three major medication processes: monitoring and supply ... administration ... and prescribing ... Recurring contributory factors included discontinuity of care within and between settings, inadequate time, inadequate staffing and unfamiliarity with protocols. Psychological harms for patients and families were identified. System infrastructure is needed to enable timely supply of medication and equipment, effective coordinated use of continuous subcutaneous infusions, communication and continuity of care.

[United Kingdom] After tragedy, NJ doctor finds renewed purpose working — and living — at a hospice My Central Jersey - NorthJersey.com; by Scott Fallon; 11/14/24 Even though she was on hospice care for terminal cancer at a New York hospital, Sandy Cattani’s last days were marred with pain and suffering. At one point, she began flailing so much in her hospital bed that her husband, Dr. Charles Vialotti, and other family members had to help hold her arms and legs down. This is not how any patient should die, Vialotti thought. He ought to know, having helped pioneer hospice care at three New Jersey hospitals. About a year after Sandy's death, Vialotti took the unusual step of moving into the Villa Marie Claire hospice in Saddle River, where he has spent 14 years attending to the terminally ill.

[UK] Large language models for mental health applications: Systematic reviewZhijun Guo, Alvina Lai, Johan H Thygesen, Joseph Farrington, Thomas Keen, Kezhi Li; 10/24The study identifies several issues: the lack of multilingual datasets annotated by experts, concerns regarding the accuracy and reliability of generated content, challenges in interpretability due to the "black box" nature of LLMs [large language models], and ongoing ethical dilemmas. These ethical concerns include the absence of a clear, benchmarked ethical framework; data privacy issues; and the potential for overreliance on LLMs by both physicians and patients, which could compromise traditional medical practices. As a result, LLMs should not be considered substitutes for professional mental health services. However, the rapid development of LLMs underscores their potential as valuable clinical aids, emphasizing the need for continued research and development in this area.

[England] Woman doing race for hospice that helped husband BBC News; Lorna Bailey and Andrew Dawkins; 11/4/24 A woman is taking part in a 120km (75-mile) race over four days through the deserts of Jordan for a hospice that helped care for her husband. Charlotte Rochenard-Taylor, from Warwick, said running became a way for her to cope with grief, after Jamie died from a brain tumour in June last year. She is participating in the Marathon des Sables to raise money for Myton Hospice, which has sites in Coventry, Warwick and Rugby. Ms Rochenard-Taylor said it was "just a way to keep alive, if that makes sense, getting again out of my comfort zone to just feel like fully alive". One of her husband's last wishes was to die at home, stated the runner, who made it her "mission for this to happen". She added: "Thanks to the Myton Hospice, the at-home team... that was made possible." ... "I [found] that running actually became for me a way to cope with the grief, just to get out there and just get the rage out and just... mental wellbeing really." Ms. Rochenard-Taylor, who broke her pelvis a few years ago, said the charity was close to her heart, and the race starting on Tuesday was an ideal way to support it.

Europe funeral products and services market size, share & trends analysis report by type (funeral products, funeral services), by country (UK, Germany, France, Italy, Spain), and segment forecasts, 2025 - 2030 Grand View Research; 10/31/24 ... [There] is a rising demand for biodegradable coffins, urns made from natural materials, and shrouds crafted from organic fabrics. For instance, Ecoffins UK LLP offers eco-friendly coffins made from pandanus, willow, and pine. These products are designed to decompose naturally without leaving harmful residues, aligning with the eco-conscious values of many Europeans. Furthermore, natural burial grounds, which avoid embalming chemicals and concrete grave liners in favor of simple, green burials, are gaining popularity. This has spurred the growth of new services offering eco-friendly plots and personalized, sustainable burial plans. Moreover, the COVID-19 pandemic significantly impacted Europe's market. ...Editor's note: This trend for eco-friendly funerals continues to grow in the U.S. 

[UK] Symptom management for people with advanced dementia who are receiving end of life careCurrent Opinion in Supportive and Palliative Care; Maria Drummond , Bridget Johnston; 10/24Recent studies indicate that people with advanced dementia often experience significant unmet palliative care needs, particularly regarding symptom management. Palliative care for people with advanced dementia is currently inadequate due to a lack of tailored interventions, poor symptom management, and disjointed care systems. Enhancing training for caregivers, fostering interdisciplinary collaboration, and focusing on integrated care approaches across home and institutional settings are crucial to improving quality of life and symptom control for people with advanced dementia.

[Canada] Aerobic physical activity and depression among patients with cancer-A systematic review and meta-analysisJAMA Network Open; Matthew Kulchycki, MD; Henry Ratul Halder, MSc; Nicole Askin, MLIS; Rasheda Rabbani, PhD; Fiona Schulte, PhD; Maya M. Jeyaraman, MD; Lillian Sung, MD, PhD; Deepak Louis, MD; Lisa Lix, PhD; Allan Garland, MD, MA; Alyson L. Mahar, PhD; Ahmed Abou-Setta, PhD; Sapna Oberoi, MD, MSc; 10/24A cancer diagnosis increases the risk of anxiety, depression, and emotional distress among patients. Depression prevalence among patients with cancer ranges from 13% to 27%, which is 2 to 3 times higher than the general population. In this systematic review and meta-analysis, APA [aerobic physical activity]was associated with modest short-term and long-term reductions of depression among adults with cancer. Future studies should discern the effectiveness of APA in combination with other strategies for managing depression across various populations of patients with cancer.

Janey Godley says it's important to 'talk about death' in hospice update STV News; 10/8/24 Janey Godley has said it is important to “talk about death” as she shared an update on her condition from her hospice.The Scottish comedian is currently receiving end-of-life care after receiving the news that her cancer had spread, after initially being diagnosed with ovarian cancer in 2021. She shared the “devastating news” in September after cancelling her upcoming autumn tour, adding that her “chemo ran out of options” and she couldn’t take anymore. In a video from the hospice, Godley thanked everybody as she confirmed she has had some issues with sickness – and said it is “hard” to speak about death but these are conversations we “all have to have.”

[Sweden] Reconciliation in palliative care: A concept analysisPalliative and Supportive Care; Margareta Karlsson, Andrea Uhlman, Benedict Kämper, Britt Hedman Ahlstrom; 9/24Terminal illnesses affect almost all aspects of life and being close to death may lead to a need for reconciliation. The end of life is stressful on an existential level for both patients and relatives. It can therefore be of relevance for palliative care nurses to understand the meaning of reconciliation. We conclude that reconciliation is a concept of importance when caring for patients in end-of-life care. A broader and deeper understanding of the concept facilitates conversations about the meaning of reconciliation in palliative care and can enable patients who strive to achieve reconciliation to be more easily identified and supported.

Dame Judi Dench paints watercolour to aid hospice BBC, United Kingdom; by Joshua Askew; 10/2/24 A watercolour painted by Dame Judi Dench has helped raise funds for a local hospice that is struggling financially. The Oscar-winning actress' painting of a Scottish landscape - titled Early Sunset Wester Ross - was used to create £150 hand-signed prints. The artworks are being sold in aid of the St. Catherine's Hospice in Crawley, which provides end-of-life care in Sussex and Surrey. "I am thrilled," said Dame Judi. "All the money raised from these limited-edition prints will help provide care for local people." ... Dame Judi is a long-term resident of Outwood in Surrey, which sits in the hospice's catchment area.