scholarly journals Associations Between a Targeted Metabolomics Panel of Urinary Flavonoids and Flavonoid Intakes from Fruits and Vegetables Across Dietary Assessment Periods

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 322-322
Author(s):  
Emily Hill ◽  
Anna Pashkova ◽  
Elizabeth Grainger ◽  
Kristen Roberts ◽  
Chureeporn Chitchumroonchokchai ◽  
...  
Keyword(s):  
Fruits And Vegetables ◽  
Dietary Assessment ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Future Research ◽  
Urine Collection ◽  
Targeted Metabolomics ◽  
Diet Records ◽  
Assessment Period ◽  
Dietary Flavonoids

Abstract Objectives Aligning dietary intake and food composition data with biomarkers of exposure is critical for advancing assessment methodology. Flavonoids present in fruits and vegetables (FV) are rapidly metabolized and excreted in urine; therefore they may serve as acute intake biomarkers. Yet, the optimal dietary assessment period has not been determined. The objective of this study was to evaluate associations between a targeted metabolomics panel of six urinary flavonoids and dietary intakes of these flavonoids from FV across varying dietary assessment periods. Methods In this cross-sectional study, three-day diet records from 17 individuals were analyzed via Nutrition Data System for Research to determine FV intakes over one-day, two-day, and three-day assessment periods. Dietary flavonoids from FV were estimated via the Phenol-Explorer database; total intakes of targeted flavonoids (quercetin, kaempferol, isorhamnetin, phloretin, naringenin, hesperetin) were calculated by summing aglycone and glycosylated forms. Twenty-four-hour (24-h) urine was collected on the final day of diet records. Urinary flavonoid aglycones were quantified using HPLC; total urinary flavonoids were calculated by summing targeted flavonoids. Spearman correlations between flavonoid intakes and urinary flavonoids were analyzed by dietary assessment period. Results Mean targeted flavonoid intake from FV was 53.6 mg/day. Ten specific FV provided >95% of dietary flavonoids, with greatest contributions from citrus (orange juice, grapefruit, orange) and onion. Mean urinary flavonoid excretion was 9.5 μmol/24-h. Urinary flavonoids were moderately associated with flavonoid intakes from the one-day assessment period on the day prior to urine collection (rs = 0.485, P = 0.048) and summed intakes from the two-day assessment period (rs = 0.598, P = 0.011), but not from intakes over the three-day assessment period. Conclusions Urinary flavonoids are most strongly associated with dietary flavonoids consumed within two days of 24-h urine collection, indicating two-day diet records aligned with 24-h urine collection is optimal for assessing (poly)phenol exposure from FV in future research. Funding Sources OSU CCTS, Rosita Schiller Award, OSU Comprehensive Cancer Center MCC Program, and OSU CAFFRE.

Predictors of referral to outpatient specialty palliative care (SPC) in gynecologic cancer (GC) patients.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 159-159
Author(s):  
Rachel Ruskin ◽  
Michelle Renee Rowland ◽  
Katherine N Moore ◽  
Katrina Slaughter ◽  
Adam Walter ◽  
...  
Keyword(s):  
Palliative Care ◽  
Sexual Dysfunction ◽  
Gynecologic Oncology ◽  
Gynecologic Cancer ◽  
Routine Care ◽  
Multivariate Model ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Future Research ◽  
Cross Sectional

159 Background: Prior studies in GC patients have described predictors of inpatient palliative care (PC) consultation, but predictors of outpatient SPC consultation have not been elucidated. We sought to identify factors predictive of referral and associated care outcomes. Methods: We performed a cross-sectional study of GC patients seen in the gynecologic oncology clinic at a comprehensive cancer center over a three month period. As a part of routine care, patients completed a symptom questionnaire. Patients previously seen at the outpatient PC clinic were compared to those who had not with respect to demographics, disease characteristics, symptom scores, and provider factors using univariate statistics. A multivariate model was created to identify independent predictors of referral. Results: 913 patients completed the symptom survey. 76 patients (8%) had been seen in the outpatient PC clinic. Disease factors associated with referral included site (p < 0.01), stage (p < 0.01), evidence of disease (p < 0.01), active treatment (p < 0.01), and time point in the disease trajectory (p < 0.01). Women with moderate to severe pain (p < 0.01), sadness (p = 0.03), distress (p < 0.01), fatigue (p < 0.01), neuropathy (p = 0.03), and sexual dysfunction (p < 0.01) were more likely to have seen PC. Marital status, number of symptoms, and patient provider were also predictive of referral (all p < 0.01). In a multivariate model, site, stage, number of symptoms, moderate to severe sexual dysfunction, and provider were independently associated with referral. Compared to women who had not been referred, patients seen in the PC clinic were more likely to have a health care proxy documented in the electronic medical record (p < 0.01). Among patients with related symptoms, patients referred to PC more often had an opioid prescribed for pain (p < 0.01) and medications prescribed for depression (p < 0.01), anxiety (p = 0.04), insomnia (p < 0.01), and fatigue (p < 0.01). Conclusions: Women with depression, anxiety, insomnia, and fatigue were more likely to receive pharmacologic treatment for these symptoms from a SPC provider. Future research should identify referral triggers for those patients most likely to benefit from outpatient SPC consultation.

Assessing caregiver satisfaction with care on an acute palliative care unit.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 51-51
Author(s):  
Ernie Mak ◽  
Patricia Murphy-Kane ◽  
Camilla Zimmermann
Keyword(s):  
Palliative Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Palliative Care Unit ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Future Research ◽  
Joint Decision ◽  
Caregiver Satisfaction ◽  
Patients With Cancer

51 Background: Accreditation Canada has adopted four main values for hospice, palliative, and end-of-life services: dignity and respect; information sharing; partnership and participation; and collaboration . These domains, as well as communication and joint decision-making, are important for satisfaction of caregivers for patients with cancer, and can be measured using the FAMCARE questionnaire. We aimed to assess satisfaction of caregivers for patient admitted to an acute palliative care unit at a comprehensive cancer center in Toronto, Canada. Methods: The FAMCARE questionnaire was administered by a trained volunteer to self-identified caregivers of patients who were admitted for more than five days on the acute palliative care unit. A short, anonymous demographic survey accompanied the FAMCARE questionnaire to gather information on relationship to patient, ethnicity, patient length of stay, and location of residence. The survey package either was completed in the presence of the volunteer, or was left to be completed by the caregiver alone and collected later by the volunteer. Results were reviewed regularly at the quality committee of the palliative care service. Results: From September 2014 to March 2017, 90 caregivers completed the questionnaire. Most caregivers were female (69%), identified as Canadian or Caucasian (57%), and lived in Toronto (63%). In all, 57% were spouses while 31% were children of the patient. Most patients had been admitted between a week and a month (67%). Care was rated as “Satisfied” or “Very satisfied” most of the time on all items (range 81-100%). The availability of nurses and doctors (100% satisfied/very satisfied) and the way tests and treatments were followed-up (99%) were rated highest. Information given about side effects (81%) and referral to specialists (83%) were rated lowest. Conclusions: Despite the nature of the acute palliative care unit, where patients admitted tend to be very ill with complex symptoms and psychosocial issues, caregiver satisfaction was high. Future research will examine whether caregivers of different ethnicities value different aspects of cancer care.

Palliative care referral patterns of adolescent and young adult patients at a comprehensive cancer center.

2019 ◽  
Vol 37 (31_suppl) ◽  
pp. 63-63
Author(s):  
Bethany Lockwood ◽  
Olanipekun Lanny Ntukidem ◽  
Sarah Ehrman ◽  
Maryam B. Lustberg ◽  
Bhavana Bhatnagar ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Diagnosis ◽  
Average Length ◽  
Adolescent And Young Adult ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Future Research ◽  
Inpatient Setting ◽  
Referral Patterns ◽  
Oncology Care

63 Background: Adolescent and young adults (AYA) diagnosed with cancer have distinct physical, developmental and psychosocial needs that are often unmet during oncology treatment. Such needs are further intensified for AYA patients with an advanced cancer diagnosis. Palliative Care (PC), specialized care for patients and families with serious illness, can address these needs throughout the disease trajectory including symptom management, supportive communication, and advance care planning. The incorporation of PC remains suboptimal despite evidence that palliative services can improve quality of life. In an effort to identify strategies to advance access to PC for the AYA population at our institution, the referral pattern to PC was studied. Methods: A retrospective chart review was performed to identify referral patterns to PC in the AYA population (ages 18-39) from July 2017 through June 2019 at a National Cancer Institute designated comprehensive cancer center. Descriptive statistics were utilized to summarize referral patterns and trends. Results: In the past 2 years, 1,894 AYA patients established oncology care at our institution. The most common AYA cancer diagnoses included hematologic 20.8% (n=944), thyroid 10.8% (n=490), brain 9.9% (n=451) and breast 9.1% (n=414). There were 311 (16%) referrals placed to PC, mostly in the inpatient setting (81.4%). Less than half (43%) of the inpatient referrals had a post-discharge follow-up appointment in the PC clinic. Multiple disease-specific service lines were represented including leukemia (40%), colorectal (14.5%), sarcoma (9%) and breast (9%). Quarterly volumetric trends remained static over the 2 years (average number of referrals: 54/quarter). The average age at cancer diagnosis in the AYA population was 30 years and 32.7 years (range 19-39) at time of PC referral. This was consistent with the average length of time from initial diagnosis to PC referral of 2.8 years. Conclusions: Comprehensive oncology care in the AYA population should include PC. Yet, involvement of PC in the AYA population during oncologic treatment was limited. Future research will investigate optimal models of integrative PC to address the unique needs of AYA cancer.

scholarly journals Association Between Acupoint Selection, Target Symptoms, and Traditional Chinese Medicine Diagnosis in Real-Time Clinical Practice in a Comprehensive Cancer Center

2020 ◽  
Vol 19 ◽  
pp. 153473542092849 ◽  
Author(s):  
Wenli Liu ◽  
Aiham Qdaisat ◽  
Gabriel Lopez ◽  
Santhosshi Narayanan ◽  
Susan Underwood ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Symptom Control ◽  
Hot Flashes ◽  
Final Analysis ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Future Research ◽  
Acupuncture Intervention ◽  
Acupuncture Research

Background: Acupuncture intervention in actual practice is rarely reported and may be different from that applied in acupuncture research. Objectives: To review acupuncture practice in an integrative medicine clinic and characterize the association between targeted symptoms, traditional Chinese medicine (TCM) diagnosis, and acupoint selection. Methods: We reviewed outpatient acupuncture records from March 2016 to April 2018. Statistical analyses were applied to characterize referral symptoms and associated TCM diagnosis as well as acupoint selection. Results: The final analysis included 5393 acupuncture records (1264 patients). Twelve TCM diagnosis components were identified in the referral symptoms of pain, neuropathy, xerostomia, and hot flashes. Pain was associated with 78 different TCM diagnoses (combinations of TCM diagnosis components). Total of 217 different acupoints were used in the acupuncture treatments (1739) for neuropathy. The acupoint yintang was used in 73.8% of the visits for neuropathy, yet only in 26.5% ( P < .001) of the treatments when patients had a TCM diagnosis of qi deficiency, qi stagnation, and blood stagnation. Similarly, both consistencies and variations were seen in acupoint selection with each targeted symptom and its associated TCM diagnoses. Conclusions: TCM diagnosis was not homogeneous among acupuncture treatments for a single referral symptom. In contrast to most of the research on acupuncture for symptom control, there were considerable variations in acupoint selection among treatments for the same symptom in a clinical setting. Future research is needed to examine the clinical relevance of a fixed intervention structure in acupuncture research and the value of individualized acupuncture treatment.

Implementation of clinician-facing prostate cancer therapeutic clinical trial decision tool at a comprehensive cancer center.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 19-19
Author(s):  
Hala Borno ◽  
Patricia Li ◽  
Sylvia Zhang ◽  
Dame Idossa ◽  
Arpita Desai ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Characteristics ◽  
Parp Inhibitors ◽  
Internet Technology ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Future Research ◽  
User Engagement ◽  
Decision Tool ◽  
Radium 223

19 Background: The conventional model for clinical trial (CT) recruitment relies on clinicians to identify potential CTs for patients. Internet technology can be leveraged as a decision tool to enhance the CT recruitment process. Methods: An internet-based, clinician-facing decision tool was developed in genitourinary medical oncology clinic at a Comprehensive Cancer Center (CCC). The tool provided access to a real-time, tailored list of treatment CTs actively recruiting patients with PCa at the CCC based on clinical characteristics inputted by user. The clinical data was summarized. All clinicians (n = 9) with access to the decision tool completed a survey to assess effectiveness and satisfaction. Results: During a 9-month pilot period, user engagement increased from a baseline of 36 to 136 cases per month, with a total of 644 cases overall. Among cases, 525 had metastatic disease, 436 of which were metastatic castration resistant PCa (mCRPC). Overall, 145 cases were classified as having oligo-metastatic ( < = 3) PCa, 93 of whom were also mCRPC. Prior treatments received included abiraterone in hormone-sensitive PCa (HSPC 19.3%, CRPC 48.7%); enzalutamide (HSPC 3.7%, CRPC 34.9%) apalutamide (HSPC 1.3%, CRPC 6.9%), taxane (HSPC 17.2%, CRPC 27.8%), radium-223 (6.1%), sipuleucel-T (18.3%), parp inhibitors (4%), or check-point inhibitors (6%). Clinician-inputted genomics of cases included CDK12 (20.9%), MSI-high disease (13.6%), BRCA1/2 (32.7%), ARID1a (7.3%), ATM (21.8%), FANCA (4.5%), or CHEK2 (6.4%) and HDAC2 (0.9%). Among survey respondents, use of tool in clinic was reported sometimes (22%), often/always (78%). Results of decision tool were reported to inform treatment sometimes (22%) or often/always (78%). Respondents confidence in often/always knowing all available CTs increased from a baseline of 0% to 89%, and 89% of users reported very/complete satisfaction with decision tool. Conclusions: An internet-based CT decision tool for provides detailed clinical characteristics of patients for whom CTs are being considered at a CCC. Clinicians using the decision tool report high levels of satisfaction. The tool was effective in increasing confidence in knowledge of current available CTs. Data gathered in the decision tool may inform future CT development. Future research with expanded use of decision tool among referring clinicians will assess its impact in promoting diversity among CT participants.

scholarly journals Youth Enjoy Science Program at the Case Comprehensive Cancer Center: Increasing Engagement and Opportunity for Underrepresented Minority Students

2020 ◽  
Vol 30 (1) ◽  
pp. 15-24
Author(s):  
Kelli Qua ◽  
Klara K. Papp ◽  
Damian J. Junk ◽  
Monica Webb Hooper ◽  
Nathan A. Berger
Keyword(s):  
High School ◽  
High School Students ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Responsible Conduct Of Research ◽  
Future Research ◽  
Full Time ◽  
Underrepresented Minority ◽  
School Students ◽  
Faculty Mentor

The Youth Enjoy Science (YES) Program at the Case Comprehensive Cancer Center is a National Cancer Institute (NCI) R25- funded training grant, designed to increase the pipeline of underrepresented minor­ity (URM) students entering college and pursuing biomedical research and health care careers in the Cleveland Metropolitan and surrounding school districts. The three components of the program include: Learn to Beat Cancer, engaging middle school students and their families; Research to Beat Cancer, designed for high school students and college undergraduates; and Teach to Beat Cancer, focused on enhancing science, technology, engineering, and mathemat­ics (STEM) teaching capacity among high school teachers. This study focuses on Research to Beat Cancer, which, in 2018 enrolled 36 URM students as paid sum­mer scholars. Students were assigned to a faculty mentor, were taught laboratory safety, responsible conduct of research and the scientific method, and then immersed in full-time laboratory cancer research during an eight-week period. Twice each week, students participated in Lunch and Learn Seminars where faculty members provided combined motivational and scientific guidance lectures. In a capstone poster session at the end of the program, students presented their research to peers, medical and graduate students, family members, faculty, community members and leaders. Students’ perceptions of the program were reported using descriptive statistics and qualitative thematic analyses. Twenty-four of the 2018 YES students (67%) and 19 (53%) mentors completed the online post-program survey. Opportunity was a major qualitative theme from student and mentor responses. Future research will investigate the long-term impacts of YES, including college enrollment.Ethn Dis. 2020;30(1):15-24; doi:10.18865/ed.30.1.15

Assessing caregiver satisfaction with care on an acute palliative care unit.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 180-180 ◽  
Author(s):  
Ernie Mak ◽  
Patricia Murphy-Kane ◽  
Camilla Zimmermann
Keyword(s):  
Palliative Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Palliative Care Unit ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Future Research ◽  
Joint Decision ◽  
Caregiver Satisfaction ◽  
Patients With Cancer

180 Background: Accreditation Canada has adopted four main values for hospice, palliative, and end-of-life services: dignity and respect; information sharing; partnership and participation; and collaboration . These domains, as well as communication and joint decision-making, are important for satisfaction of caregivers for patients with cancer, and can be measured using the FAMCARE questionnaire. We aimed to assess satisfaction of caregivers for patient admitted to an acute palliative care unit at a comprehensive cancer center in Toronto, Canada. Methods: The FAMCARE questionnaire was administered by a trained volunteer to self-identified caregivers of patients who were admitted for more than five days on the acute palliative care unit. A short, anonymous demographic survey accompanied the FAMCARE questionnaire to gather information on relationship to patient, ethnicity, patient length of stay, and location of residence. The survey package either was completed in the presence of the volunteer, or was left to be completed by the caregiver alone and collected later by the volunteer. Results were reviewed regularly at the quality committee of the palliative care service. Results: From September 2014 to May 2018, 116 caregivers completed the questionnaire. Most caregivers were female (66%), identified as Canadian or Caucasian (56%), and lived in Toronto (66%). In all, 52% were spouses while 27% were children of the patient. Most patients had been admitted between a week and a month (68%). Care was rated as “Satisfied” or “Very satisfied” most of the time on all items (range 77-99%). The availability of nurses and doctors (99% satisfied/very satisfied) were rated highest. Information given about side effects (77%) and referral to specialists (84%) were rated lowest. Conclusions: Despite the nature of the acute palliative care unit, where patients admitted tend to be very ill with complex symptoms and psychosocial issues, caregiver satisfaction was high. Developing adequate support for the spouses of patients is important. Future research will examine whether caregivers of different ethnicities value different aspects of cancer care.

Telehealth: Reducing or increasing cancer care disparities?

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1582-1582
Author(s):  
Patricia Jewett ◽  
Rachel I. Vogel ◽  
Rahel G. Ghebre ◽  
Arpit Rao ◽  
Jane Yuet Ching Hui ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cancer Care ◽  
Urban Areas ◽  
Underserved Populations ◽  
The United States ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Future Research ◽  
Urban Rural ◽  
Race Ethnicity

1582 Background: During the COVID-19 pandemic, most cancer care in the United States transitioned to telehealth (phone or video visits) to reduce infection risks for patients and providers. Telehealth may simplify care logistics (e.g. reduce travel and waiting times), but it may also unintentionally exacerbate existing disparities in healthcare utilization by race/ethnicity, age, or rural/urban status. As telehealth will likely continue long-term, we examined telehealth use at a comprehensive cancer center during the COVID-19 pandemic across patient populations with established disparities in cancer treatment and outcomes. Methods: We retrospectively reviewed telehealth visits from March until December 2020 among individuals diagnosed with cancer at the University of Minnesota Masonic Cancer Center (MCC). We used Chi-squared tests and GEE logistic regression to compare video vs. phone visits by age, urban/rural status, and race/ethnicity (American Indian / American Native [AIAN], Asian, Non-Hispanic Black/African American [NH Black/AA], Hispanic, Multiple, Native Hawaiian / Pacific Islander [NHPI], NH White). Results: Over the study period, 42,171 telehealth visits were performed with 11,097 patients at the MCC. Patients had a mean age of 62.7±13.9 years; 59.2% were female; 88.7% lived in urban areas; 90.0% of patients were NH White, 4.4% NH Black/AA, 3.0% Asian, 1.5% Hispanic, 0.8% AIAN, 0.3% of multiple races, and 0.1% NHPI. The most common cancer sites were breast (24.1%), hematological (21.0%), gynecologic (10.0%), and lung (8.4%). NH White individuals were more likely (53.9%) to use video than AIAN (39.7%), Black/AA (37.8%), or NHPI individuals (34.9%). Video use was less common among rural (45.3%) than urban (53.7%; p<.0001) residents, and among individuals aged 65 or older (45.2%) vs. younger than 65 (59.5%; p<.0001). In a logistic regression, adjusted for continuous age and urban/rural status, all race/ethnic groups except Multiple were less likely to use video than NH White individuals (vs. phone; Table). Conclusions: Our findings underscore disparities in telehealth use for cancer care across historically underserved populations. Future research should evaluate potential underlying contributors to these disparities such as technology access, internet capability, and fear of discrimination. Additional research is also needed to determine whether video vs. phone visits affect cancer outcomes, therefore indicating true disparity.[Table: see text]

ASCO-GU 2019: Fortgeschrittenes Nierenzellkarzinom

2019 ◽  
Vol 10 (02) ◽  
pp. 75-76
Author(s):  
Ine Schmale
Keyword(s):  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Washington Dc

Das Armamentarium zur Behandlung des Nierenzellkarzinoms (RCC) hat sich um effektive Therapien erweitert, durch die der Therapiealgorithmus komplett umgestellt werden musste. Prof. Michael B. Atkins vom Georgetown-Lombardi Comprehensive Cancer Center, Washington DC/USA, und Prof. Daniel Y. C. Heng vom Tom Baker Cancer Center, Calgary/Kanada, teilten beim ASCO-GU ihre Einschätzung zur optimalen Behandlung des Nierenzellkarzinoms in der Erst- und Zweitlinientherapie für das Jahr 2019.

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