Comparing the physical, psychological, social, and spiritual needs of patients with non-cancer and cancer diagnoses in a tertiary palliative care setting.

OBJECTIVE: The purpose was to describe the physical, psychological, social, and spiritual needs of patients with non-cancer serious illness diagnoses compared to those of patients with cancer. METHOD: We conducted a retrospective chart review of all patients with a non-cancer diagnosis admitted to a tertiary palliative care unit between January 2008 and December 2017 and compared their needs to those of a matched cohort of patients with cancer diagnoses. The prevalence of needs within the following four main concerns was recorded and the data analyzed using descriptive statistics and content analysis: •Physical: pain, dyspnea, fatigue, anorexia, edema, and delirium•Psychological: depression, anxiety, prognosis, and dignity•Social: caregiver burden, isolation, and financial•Spiritual: spiritual distress. RESULTS: The prevalence of the four main concerns was similar among patients with non-cancer and cancer diagnoses. Pain, nausea/vomiting, fatigue, and anorexia were more prevalent among patients with cancer. Dyspnea was more commonly the primary concern in patients with non-cancer diagnoses (39%), who also had a higher prevalence of anxiety and concerns about dignity. Spirituality was addressed more often in patients with cancer. SIGNIFICANCE OF RESULTS: The majority of patients admitted to tertiary palliative care settings have historically been those with cancer. The tertiary palliative care needs of patients with non-cancer diagnoses have not been well described, despite the increasing prevalence of this population. Our description of the palliative care needs of patients with non-cancer diagnoses will help guide future palliative care for the increasing population of patients with non-cancer serious illness diagnoses.

MedTalks: developing teaching abilities and experience in undergraduate medical students.

OBJECTIVES: According to the CanMEDS' Scholar competency, physicians are expected to facilitate the learning of colleagues, patients and other health professionals. However, most medical students are not provided with formal opportunities to gain teaching experience with objective feedback. METHODS: To address this, the University's Medical Education Interest Group (MEIG) created a pilot teaching program in January 2015 entitled 'MedTalks'. Four 3-hour sessions were held at the University Faculty of Medicine, where first and second year medical students taught clinically oriented topics to undergraduate university students. Each extracurricular session included three 30-minute content lectures, and a 90-minute small group session on physical examination skills. Each medical student-teacher received formal feedback from undergraduate students and from faculty educators regarding teaching style, communication abilities, and professionalism. In addition, medical student-teachers self-evaluated their own teaching experience. RESULTS: Over 50 medical students from the University participated as medical student-teachers. Based on quantitative and qualitative evaluation surveys, 100% of medical students agreed that MedTalks was a useful way to develop teaching skills and 92% gained a greater confidence in individual teaching capabilities, based largely on the opportunity to gain experience (with feedback) in teaching roles. CONCLUSIONS: A program designed to give medical students multi-source teaching experience (lecture- and small group-based) and feedback on their teaching (from learners and Faculty observers, in addition to their own self-reflection) can improve medical student confidence and enthusiasm towards teaching. Future studies will clarify if medical student self-perceived enhancements in teaching ability can be corroborated by independent (Faculty, learner) observations of future teaching activity.

Bronchopulmonary dysplasia - trends over three decades.

OBJECTIVES: To describe the characteristics of bronchopulmonary dysplasia (BPD) and respiratory distress syndrome subjects, along with the trends in severity and mortality associated with BPD over the past three decades. METHODS: Retrospective study of BPD and respiratory distress syndrome subjects born between 1980 and 2008, and admitted to Montreal Children's Hospital (Montreal, Quebec). Data were abstracted from hospital records. RESULTS: Gestational age and birth weight were correlated with the occurrence of BPD with each additional week of gestation and 100 g in birth weight being associated with an OR of developing BPD of 0.77 and 0.89, respectively. BPD severity was associated with male sex, Apgar score and the occurrence of neonatal pneumonia. Significant trends were observed for lower mortality despite lower gestational age and birth weight, greater maternal age and multiple gestations. CONCLUSION: Mortality from BPD has improved over the past three decades despite significant trends toward more pronounced prematurity and lower birth weights.

OBJECTIF: Décrire les caractéristiques des sujets atteints de la dysplasie bronchopulmonaire (DBP) et du syndrome de détresse respiratoire, de même que les tendances quant à la gravité de la DBP et à la mortalité s'y rapportant depuis 30 ans. MÉTHODOLOGIE: Les chercheurs ont mené une étude rétrospective des sujets atteints de la DBP et du syndrome de détresse respiratoire nés entre 1980 et 2008 et hospitalisés à L'Hôpital de Montréal pour enfants, au Québec. Ils ont tiré les données des dossiers hospitaliers. RÉSULTATS: Les chercheurs ont corrélé l'âge gestationnel et le poids de naissance avec l'occurrence de DBP, chaque nouvelle semaine de grossesse et nouvelle tranche de 100 g de poids de naissance s'associant à un RRR de DBP de 0,77 et de 0,89, respectivement. La gravité de la DBP s'associait au sexe masculin, à l'indice d'Apgar et à l'occurrence d'une pneumonie néonatale. Les chercheurs ont observé des tendances importantes de diminution de la mortalité malgré un âge gestationnel et un poids de naissance moins élevés, l'âge plus avancé des mères et des gestations multiples. CONCLUSION: La mortalité liée à la DBP a diminué depuis 30 ans, malgré des tendances importantes vers une prématurité plus prononcée et un plus petit poids à la naissance.