Current Opinion in Supportive and Palliative Care最新文献_第3页

Improving supportive, palliative and end of life care for teenagers and young adults with cancer in adult haematology services. 在成人血液学服务中改善对青少年和年轻成人癌症患者的支持、姑息和临终关怀。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-04-23 DOI: 10.1097/SPC.0000000000000698

Claire Lewis-Norman, Jennifer Vidrine, Emma Thistlethwayte

{"title":"Improving supportive, palliative and end of life care for teenagers and young adults with cancer in adult haematology services.","authors":"Claire Lewis-Norman, Jennifer Vidrine, Emma Thistlethwayte","doi":"10.1097/SPC.0000000000000698","DOIUrl":"https://doi.org/10.1097/SPC.0000000000000698","url":null,"abstract":"PURPOSE OF REVIEW\u0000Adolescents with haematological malignancies within adult services, in the UK from 16 years old, have unique needs and require developmentally targeted services and approaches to care delivery. High-risk intensive treatments are common for this cohort and a better understanding of what individualised supportive and palliative care means in this context is required.\u0000\u0000\u0000RECENT FINDINGS\u0000Being known and understood as an emerging adult, with particular recognition of developmental stage, is an essential component of quality measures and underpins the adolescent, and caregiver, experience when faced with an uncertain or poor cancer prognosis (UPCP). Healthcare professionals (HCPs) can experience increased emotional labour and feelings of professional inadequacy when caring for adolescents with UPCP. Therapeutic alliance improves HCPs understanding of optimum individualised care by improving communication and supported decision making. Access to training and support for HCPs is required to address the emotional impact of therapeutic alliance with teenage/adolescent and young adults (T/AYAs) with advanced cancer.\u0000\u0000\u0000SUMMARY\u0000Investment in therapeutic alliance, alongside robust support mechanisms and targeted training, can improve the skills, confidence and wellbeing for HCPs, and can also ensure optimum individualised care for T/AYAs with UPCP. Evidence for optimum care for adolescents with advanced cancer is relatively scarce, especially for younger T/AYAs (16-24) in the UK who sit within adult services. Further evaluation of the impact of current UK expertise, services and programs are needed to inform future development.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140670924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Telemedicine in geriatric oncology - lessons learned from the COVID-19 experience. 老年肿瘤远程医疗--从 COVID-19 经验中汲取的教训。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-04-23 DOI: 10.1097/SPC.0000000000000697

Leana Cabrera Chien, C. Uranga, V. Katheria

{"title":"Telemedicine in geriatric oncology - lessons learned from the COVID-19 experience.","authors":"Leana Cabrera Chien, C. Uranga, V. Katheria","doi":"10.1097/SPC.0000000000000697","DOIUrl":"https://doi.org/10.1097/SPC.0000000000000697","url":null,"abstract":"PURPOSE OF REVIEW\u0000Telemedicine quickly became integrated into healthcare caused by the Coronavirus 19 (COVID-19) pandemic. Rapid use of telemedicine into healthcare systems was supported by the World Health Organization and other prominent national organizations to reduce transmission of the virus while continuing to provide access to care. In this review, we explored the effect of this swift change in care and its impact on older adults with cancer.\u0000\u0000\u0000RECENT FINDINGS\u0000Older adults are susceptible to the COVID-19 virus caused by various risk factors, such as comorbidity, frailty, decreased immunity, and cancer increases vulnerability to infection, hospitalization, and mortality. We found three major themes emerged in the literature published in the past 18 months, including access to care, telemedicine modes of communication, and the use of technology by older adults with cancer. These findings have brought insight into issues regarding healthcare disparities.\u0000\u0000\u0000SUMMARY\u0000The utilization of telemedicine by older adults with cancer has potential future benefits with the integration of technology preparation prior to the patient's initial visit and addressing known health disparities. The hybrid model of care provides in-person and or remote access to clinicians which may allow older adults with cancer the flexibility needed to obtain quality cancer care.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140666383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Role of mucositis in predicting gut microbiota composition in people with cancer. 粘膜炎在预测癌症患者肠道微生物群组成中的作用。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-04-23 DOI: 10.1097/SPC.0000000000000700

Jacqui S Scott, Anna Li, Hannah R. Wardill

{"title":"Role of mucositis in predicting gut microbiota composition in people with cancer.","authors":"Jacqui S Scott, Anna Li, Hannah R. Wardill","doi":"10.1097/SPC.0000000000000700","DOIUrl":"https://doi.org/10.1097/SPC.0000000000000700","url":null,"abstract":"PURPOSE OF REVIEW\u0000Disruption of the precious ecosystem of micro-organisms that reside in the gut - the gut microbiota - is rapidly emerging as a key driver of adverse side effects/toxicities caused by numerous anti-cancer agents. Although the contribution of the gut microbiota to these toxicities is understood with ever increasing precision, the cause of microbial disruption (dysbiosis) remains poorly understood. Here, we discuss current evidence on the cause(s) of dysbiosis after cancer therapy, positioning breakdown of the intestinal mucosa (mucositis) as a central cause.\u0000\u0000\u0000RECENT FINDINGS\u0000Dysbiosis in people with cancer has historically been attributed to extensive antibiotic use. However, evidence now suggests that certain antibiotics have minimal impacts on the microbiota. Indeed, recent evidence shows that the type of cancer therapy used predicts microbiota composition independently of antibiotics. Given most anti-cancer drugs have modest effects on microbes directly, this suggests that their impact on the gut microenvironment, in particular the mucosa, which is highly vulnerable to cytotoxicity, is a likely cause of dysbiosis. Here, we outline evidence that support this hypothesis, and discuss the associated clinical implications/opportunities.\u0000\u0000\u0000SUMMARY\u0000The concept that mucositis dictates microbiota compositions provides two important implications for clinical practice. Firstly, it reiterates the importance of prioritising the development of novel mucoprotectants that preserve mucosal integrity, and indirectly support microbial stability. Secondly, it provides an opportunity to identify dysbiotic events and associated consequences using readily accessible, minimally invasive biomarkers of mucositis such as plasma citrulline.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140669022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gastrointestinal mucositis: a sign of a (systemic) inflammatory response. 胃肠道粘膜炎：（全身）炎症反应的一种表现。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-04-23 DOI: 10.1097/SPC.0000000000000701

N. M. Blijlevens, Björn Reijnders, Eva Molendijk

{"title":"Gastrointestinal mucositis: a sign of a (systemic) inflammatory response.","authors":"N. M. Blijlevens, Björn Reijnders, Eva Molendijk","doi":"10.1097/SPC.0000000000000701","DOIUrl":"https://doi.org/10.1097/SPC.0000000000000701","url":null,"abstract":"PURPOSE OF REVIEW\u0000Gastrointestinal mucositis (GIM) is a significant complication of cancer therapy. Whilst inflammation is a central feature of GIM, studies attempting to mitigate mucosal damage via this mechanism are scarce. This review describes the relation between GIM, local and systemic inflammation, and the microbiome and its metabolites, and explores recent research on therapeutics that target this relationship.\u0000\u0000\u0000RECENT FINDINGS\u0000Recent literature underscores the pivotal role of inflammation in GIM, elucidating its bidirectional relation with disturbance of the gut microbiota composition and intestinal permeability. These events cause a heightened risk of bloodstream infections and lead to systemic inflammation. While studies investigating risk prediction models or therapeutics targeting GIM-related inflammation remain scarce, results have shown promise in finding biomarkers and alleviating GIM and its accompanying clinical symptoms.\u0000\u0000\u0000SUMMARY\u0000The findings underscore the important role of inflammation and the microbiome in GIM. Understanding the inflammatory pathways driving GIM is crucial for developing effective treatments. Further research is needed using genomics, epigenomics, and microbiomics to explore better risk prediction models or therapeutic strategies aimed at mitigating GIM-related inflammation.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140670447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bridging research gaps in geriatric oncology: unraveling the potential of pragmatic clinical trials. 缩小老年肿瘤学研究的差距：发掘实用临床试验的潜力。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-03-01 Epub Date: 2023-12-22 DOI: 10.1097/SPC.0000000000000688

Carlos A Carmona-Gonzalez, Mateus T Cunha, Ines B Menjak

{"title":"Bridging research gaps in geriatric oncology: unraveling the potential of pragmatic clinical trials.","authors":"Carlos A Carmona-Gonzalez, Mateus T Cunha, Ines B Menjak","doi":"10.1097/SPC.0000000000000688","DOIUrl":"10.1097/SPC.0000000000000688","url":null,"abstract":"Purpose of review: This review examines the role of pragmatic clinical trials (PCTs) in addressing the underrepresentation of older adults with cancer (OAC) in clinical trials. Focusing on real-world evidence (RWE), it aims to provide a comprehensive overview of PCT utilization, emphasizing their potential to enhance treatment decisions and patient outcomes. Existing knowledge gaps in PCT implementation are also discussed.Recent findings: PCTs are identified as effective tools to include OACs with comorbidities and complex conditions in research, bridging the representation gap. Despite their proven value in healthcare provision, their application in OAC contexts remains limited, hindering comprehensive understanding and inclusivity in clinical trials.Summary: While randomized controlled trials (RCTs) are considered the gold standard in oncology research, OACs have historically been excluded, perpetuating underrepresentation. Furthermore, even in current oncology clinical development trials, this demographic continues to be underrepresented. PCTs offer a valuable avenue for the identification and evaluation of therapies within authentic RW contexts, encompassing various healthcare settings, such as hospitals, clinics, and physician practices. RCTs and PCTs complement one another, and the utilization of PCTs has the potential to inform clinical decision-making across the OACs entire treatment trajectory.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Virtual geriatric and frailty assessment for older adults with cancer. 为患有癌症的老年人提供虚拟老年病学和虚弱评估。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-03-01 Epub Date: 2024-01-26 DOI: 10.1097/SPC.0000000000000696

Isabel Tejero, Eva Amor, Olga Vázquez-Ibar

{"title":"Virtual geriatric and frailty assessment for older adults with cancer.","authors":"Isabel Tejero, Eva Amor, Olga Vázquez-Ibar","doi":"10.1097/SPC.0000000000000696","DOIUrl":"10.1097/SPC.0000000000000696","url":null,"abstract":"Purpose of review: Since SARS-CoV2 pandemic, many specialties have introduced virtual assessments within clinical practice. Conducting an online geriatric assessment, or relying on self-reported questionnaires, may be more challenging than a conventional medical appointment. This review aims to discuss the state of research on virtual assessment and self-reported questionnaires in the general geriatric population and specifically in Oncology.Recent findings: Virtual assessment of older adults has been the focus of two separate position papers. Aside from videoconferences or phone appointments, self-reported questionnaires have emerged in recent years as reliable tools to screen for frailty and triage patients who would benefit from a comprehensive in-person assessment, with adequate correlation with in-person tests, good acceptance by the respondents and being well received by healthcare providers. Although some have been tried in geriatric oncology, many still lack validation, and their widespread use may be limited by digital literacy, cognitive impairment, and social supports.Summary: The development, validation and adoption of self-reported questionnaires and virtual assessment in the care of older adults with cancer may overcome the staffing limitations and time constrains that frequently hampers the widespread evaluation of this population to improve their care.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139567552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mitigating late effects in cancer survivors: harnessing personalised medicine and new models of care. 减轻癌症幸存者的晚期影响：利用个性化医疗和新的护理模式。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-03-01 Epub Date: 2024-01-31 DOI: 10.1097/SPC.0000000000000693

Joanne Bird, Sara Faithfull

引用次数: 0

Supportive and palliative care for older adults with cancer; facilitating person-centred, age friendly care. 为患有癌症的老年人提供支持性和姑息治疗；促进以人为本的老年友好型护理。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-03-01 Epub Date: 2024-01-31 DOI: 10.1097/SPC.0000000000000689

Christopher B Steer, Schroder Sattar, Ines Menjak

引用次数: 0

Age-friendly healthcare: integrating the 4Ms to enable age-friendly cancer care. 老年友好型医疗保健：整合 4Ms 以实现老年友好型癌症护理。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2024-03-01 Epub Date: 2024-01-04 DOI: 10.1097/SPC.0000000000000687

Oliver Hodge, Tshepo Rasekaba, Irene Blackberry, Christopher B Steer

{"title":"Age-friendly healthcare: integrating the 4Ms to enable age-friendly cancer care.","authors":"Oliver Hodge, Tshepo Rasekaba, Irene Blackberry, Christopher B Steer","doi":"10.1097/SPC.0000000000000687","DOIUrl":"10.1097/SPC.0000000000000687","url":null,"abstract":"Purpose of review: There is a growing movement towards person-centred, age-friendly healthcare in the care of older adults, including those with cancer. The Age-Friendly Health Systems (AFHS) initiative uses the 4Ms framework to enable this change. This review documents the utility and implications of 4Ms implementation across different settings, with a particular focus on cancer care.Recent findings: The AFHS initiative 4Ms framework uses a set of core, evidence-based guidelines (focussing on What Matters, Medication, Mentation and Mobility) to improve person-centred care. The successful implementation of the 4Ms has been documented in many different healthcare settings including orthopaedics primary care, and cancer care. Implementation of the 4Ms framework into existing workflows complements the use of geriatric assessment to improve care of older adults with cancer. Models for implementation of the 4Ms within a cancer centre are described. Active engagement and education of healthcare providers is integral to success. Solutions to implementing the What Matters component are addressed.Summary: Cancer centres can successfully implement the 4Ms framework into existing workflows through a complex change management process and development of infrastructure that engages healthcare providers, facilitating cultural change whilst employing quality improvement methodology to gradually adapt the status quo to age-friendly processes.","PeriodicalId":48837,"journal":{"name":"Current Opinion in Supportive and Palliative Care","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Incidence, description, predictors, and consequences of persistent taxane-induced peripheral neuropathy. 持续性紫杉类药物诱发的周围神经病变的发生率、描述、预测因素和后果。

IF 2.1 4区医学

Current Opinion in Supportive and Palliative Care Pub Date : 2023-12-06 DOI: 10.1097/spc.0000000000000684

Daniel L Hertz

引用次数: 0