Literature Review

Heatwaves and neurodegenerative diseaseJAMA Neurology; Indu Subramanian, MD; Ali Saad, MD; 12/24In 2012, the Global Climate and Health Alliance drafted the Doha Declaration, a call to prioritize global policies that protect health from the effects of climate change. The number of people affected by heat waves increased by around 125 million between 2000 and 2016, and global ambient temperature is expected to increase 0.9 °F (0.5 °C) per year over the next 30 years. Heat stress is an underappreciated mechanism by which climate change impacts the health of people with neurodegenerative diseases. Given the high risk of heat-related complications in people living with neurodegenerative disease, it is critical to strengthen our evidence base to understand these risks and develop targeted solutions. 

Palliative care, mental health services underutilized in pancreatic cancer Healio; by Jennifer Byrne; 12/19/24 Individuals with pancreatic cancer underutilized palliative care and mental health services, according to a retrospective analysis. ... Researchers from Saint Louis University used electronic health record data from Optum’s Integrated Claims-Clinical Data set to identify 4,029 patients with newly diagnosed pancreatic cancer. The investigators then used ICD-9/10 codes to identify subsequent diagnoses of anxiety and depression, as well as palliative care consultations. ... Results showed higher prevalence of anxiety (33.9% vs. 22.8%) and depression (36.2% vs. 23.2%) among patients who had palliative care consultations than those who did not have documented consultations. ... Healio: Did any of your findings surprise you? Divya S. Subramaniam, PhD, MPH: It was unexpected to see that palliative care consultations, despite identifying higher levels of anxiety and depression, did not increase treatment rates for these mental health conditions. This suggests mental health might not yet be a central focus in palliative consultations, which often concentrate on managing physical symptoms.

Palliative care may improve quality of life for stroke survivors and their family members American Heart Association - Stroke News & Brain Health; by Newsroom; 12/16/24 Palliative care ... can help improve quality of life for stroke survivors as well as their family members, according to “Palliative and End-of-Life Care in Stroke,” a new scientific statement published today in the Association’s peer-reviewed scientific journal Stroke. ... The new statement complements the Association’s 2014 Scientific Statement on Palliative and End-of-Life Care in Stroke, which covered core palliative care competencies and skills for health care professionals who treat stroke patients. The statement includes strategies to improve communication about prognosis and goals-of-care, address psychosocial needs such as coping with loss, navigate complex health care systems and prepare for death with end-of-life care when necessary. It also highlights the substantial inequities that exist in palliative care after stroke across sociodemographic and regional characteristics and the need to reduce those disparities.

Allostatic load, educational attainment, and risk of cancer mortality among US menJAMA Network Open; Cynthia Li, BS, MD; Sydney P. Howard, DrPH, MS; Charles R. Rogers, PhD, MPH, MS, MCHES; Sydney Andrzejak, MS; Keon L. Gilbert, DrPH; Keith J. Watts, PhD, MSW; Malcolm S. Bevel, PhD, MSPH; Myles D. Moody, PhD, MA; Marvin E. Langston, PhD; Judah V. Doty, MS; Adetunji T. Toriola, MD, PhD, MPH; Darwin Conwell, MD, MSc; Justin X. Moore, PhD, MPH; 12/24Social determinants of health, such as income, occupation, and education, can influence cancer disparities in men. Men with limited access to education and income are more likely to have high allostatic load (AL), a measure of cumulative physiologic stress on the body over time. Chronic stress triggers prolonged neuroendocrine responses, resulting in elevated proinflammatory cytokines, catecholamines, and other proteins. This overactivation can lead to physiologic dysregulation and can promote cancer development. The findings indicate that men with lower educational attainment and high AL face up to a 4-fold increased risk of cancer mortality and nearly 70% increased risk of cancer mortality when accounting possible confounders. 

Trends in hepatocellular carcinoma mortality rates in the US and projections through 2040JAMA Network Open; Sikai Qiu, MM; Jiangying Cai, MM; Zhanpeng Yang, MM; Xinyuan He, MD; Zixuan Xing, MD; Jian Zu, PhD; Enrui Xie, MD; Linda Henry, MD; Custis R. Chong, MD; Esther M. John, MD; Ramsey Cheung, MD; Fanpu Ji, MD, PhD; Mindie H. Nguyen, MD, MAS; 11/24Primary liver cancer imposes a substantial global disease burden, ranking as the sixth most commonly diagnosed cancer worldwide and the third-leading cause of global cancer-related mortality in 2020. In this cross-sectional study of 188,280 HCC [hepatocellular carcinoma]-related deaths, ASMRs [age-standardized mortality rates] increased from 2006 to 2022 and were projected to continue rising until 2040, primarily due to increased deaths from alcohol-associated liver disease (ALD) and metabolic dysfunction–associated steatotic liver disease (MASLD); deaths from viral hepatitis were under control and were projected to decrease. Large disparities were observed in HCC-related ASMRs by age, sex, and race and ethnicity. ...these findings may serve as a reference for public health decision-making and timely identification of groups at high risk of HCC-related death.

Palliative care bypasses Black heart disease patients The St. Louis American; by Alvin A. Reid; 11/30/24 A study by Saint Louis University researchers paints a grim picture for many heart failure patients in America – and the outlook is worse for African Americans. The study, published in the Journal of the American Heart Association, found that only one in eight patients with heart failure nationwide receive palliative care consultations within five years of diagnosis. Alarmingly, Black people were 15% less likely to receive palliative care compared to white patients with similar heart health illness. Other recent respective studies illustrate the higher risk and mortality rates for cardiovascular disease in the Black population – further demonstrating that the missing palliative care options have a greater negative impact on African American health. New statistics from a medical team at EHproject show African American women are at a greater risk for cardiovascular disease than their white counterparts. It found that 47.3% of Black women have heart disease. If they do not have it currently, they are 2.4 times more likely to develop heart disease. ... A March 2023 study published in JAMA Cardiology showed that Black men remain at the highest risk of dying from cardiovascular disease. ... 

[Netherlands] Electronic health in the palliative care pathway for patients with head and neck cancerJAMA Otolaryngology- Head & Neck Surgery; Boyd N. van den Besselaar, MD; Kira S. van Hof, MD; Aniel Sewnaik, PhD; Robert. J. Baatenburg de Jong, PhD; Marinella P. J. Offerman, PhD; 11/24Head and neck cancer (HNC) generally has a poor prognosis, with more than 40% disease-specific mortality, ... with a median survival of 4 to 5 months. Given the unique nature of HNC, with a wide range of specific cancer-related symptoms, special consideration should be given to end-of-life care. In this quality improvement study, patients and next of kin were satisfied with most aspects of the hybrid palliative care pathway, and remote care seemed to be a promising means of delivery. These insights represent the initial steps toward gaining a deeper understanding of patients’ needs during specific moments in a hybrid palliative trajectory. They may support health care professionals in optimizing personalized and value-based palliative care delivery.

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.

Education, telehealth, and access initiatives aim to improve cancer care for veteransOncLive; by Kyle Doherty; 11/26/24 Manali I. Patel, MD, MPH, MS, details several interventions developed to better serve veterans with cancer who are experiencing economic, social, and geographic barriers to care. Despite having the option of cancer care through the Veterans Affairs (VA) health network, veterans with cancer still experience economic, social, and geographic barriers to receiving high-quality care. This has prompted investigators to develop several interventions to better serve these patients. “Veterans have higher rates of lung cancer [compared with] civilian populations; prostate and bladder cancer [rates] are also pronounced [among] veterans, [and we also see] higher rates of melanoma, [all] largely due to exogenous exposure risk,” Manali I. Patel, MD, MPH, MS, said in an interview with Oncology Live. “One of the biggest barriers [to cancer care] for veterans is the lack of system level resources that can ensure veterans understand the diagnosis and treatment options, such that veterans receive care that is concordant with their goals, preferences, and values. Cancer care is quite complex and trying to not only coordinate care but explain the nuances in plain language is challenging. Having resources [available] that proactively assist veterans in their understanding and support them through cancer care is what is most needed to improve patient outcomes.”

Dialysis facility staffing ratios and kidney transplant access among adolescents and young adultsJAMA; Alexandra C. Bicki, MD, MPH; Barbara Grimes, PhD; Charles E. McCulloch, PhD; Timothy P. Copeland, MPP, PhD; Elaine Ku, MD, MAS; 10/24In this study of adolescents and young adults treated at US dialysis facilities, patients at facilities with higher patient to staff ratios had lower incidence of waitlisting and kidney transplant compared with those receiving care at facilities with lower patient to staff ratios. The effect size for the incidence of transplant was similar with respect to both patient to nurse and patient to social worker staffing ratios, but patient to nurse ratio was not statistically significantly associated with the incidence of waitlisting.

[Australia] Components of home-based palliative and supportive care for adults with heart failure: A scoping reviewPalliative Medicine; Madhurangi Perera, Ureni Halahakone, Sameera Senanayake, Sanjeewa Kularatna, William Parsonage, Patsy Yates, Gursharan K. Singh; 10/24Palliative care and supportive care provided in the home for people with heart failure can improve quality of life, caregiver wellbeing and reduce healthcare costs. Ensuring patient and caregiver-centred care supported by a multidisciplinary team is essential to delivering home-based palliative and supportive care for people with heart failure. Further research focussed on the role of digital interventions in home-based palliative and supportive care, the composition of the multidisciplinary team and research which includes individuals across all stages of heart failure is needed.

Walking pneumonia is booming − and targeting the young and the poor USA Today, Arlington, VA; by John Bacon; 11/20/24 Infections of the bacteria that cause walking pneumonia, a lesser evil of the more serious illness of pneumonia, is seeing a dramatic jump after a lengthy decline that came with the start of the COVID-19 pandemic, health officials say. Most alarming is the sharp increase in children infected with the disease. And, as with COVID-19, the impact of the disease can hit low-income Americans the hardest. The Centers for Disease Control and Prevention said infections from the bacteria that can cause walking pneumonia are common: An estimated 2 million infections occur each year in the United States. However, the true number isn't known, in part because so many people get it without seeking medical help and in part because there is no nationwide reporting system. The infections dropped off during the COVID pandemic but are now booming. Hospital emergency department discharge data from April to October showed an increase in infections of the bacteria among all age groups, according to the CDC.

'Art helps me deal with my cancer diagnosis' BBC News, West Midlands, United Kingdom; by Sophie Madden; 11/18/24 After being diagnosed with pancreatic cancer, Wendy Brookfield said she had lots of emotions. But a referral to art therapy through the Severn Hospice, based in Shrewsbury, Shropshire, helped her deal with what she was going through. "There is so much going on in your mind that being able to go along to art therapy, I could just get it out and get it down on paper," she said. "It just such a good outlet for me." Her therapy sessions led to her starting a book of sketches which she regularly filled in, sometimes during her treatment sessions. They inspired the hospice to host its own art exhibition, built around Ms Brookfield's work and with other pieces created by patients.