No abstract

www.clinicaltrials.gov (NCT 01287585).

Reproducibility of Oil Stability Index (OSI) values dete~ mined on the Metrohm Rancimat wasmeasured with a single run and between experimental runs. Within a single experiment, a range of 0.13 h and a standard deviation of 0.066 h were determined. For multiple experiments, standard deviations of 0.24 and 0.26 were obtained for soybean and low~erucic rapeseed oil, respectively. The effect of temperature was determined for safflower, soybean, lowerucic rapeseed, corn, peanut and olive oils. A linear relationship was established between log (OSI) and temperature. The linear equation obtained for soybean oil was utilized to calculate variability of the OSI due to temperature differences in the heating block.

Context. Optimal advance care planning allows patients to articulate their values as a touchstone for medical decision making. Ideally, this occurs when patients are clinically stable, and with opportunities for iteration as the clinical situation unfolds. Objectives. Testing feasibility and acceptability in busy outpatient oncology clinics of a novel program of systematic, oncology nurse-led values discussions with all new cancer patients. Methods. Within an institutional initiative integrating primary and specialist palliative care from diagnosis for all cancer patients, oncology nurses were trained to use specific questions and an empathic communication framework to discuss health-related values during outpatient clinic visits. Nurses summarized discussions on a template for patient verification, oncologist review, and electronic medical record documentation. Summaries were reviewed with the patient at least quarterly. Feasibility and acceptability were evaluated in three clinics for patients with hematologic or gastrointestinal malignancies. Results. Oncology nurses conducted 177 total discussions with 67 newly diagnosed cancer patients (17 with hematologic and 50 with gastrointestinal malignancies) over two years. No patient declined participation. Discussions averaged eight minutes, and all patients verified values summaries. Clinic patient volume was maintained. Of 31 patients surveyed, 30 (97%) reported feeling comfortable with the process, considered it helpful, and would recommend it to others. Clinicians strongly endorsed the values discussion process. Conclusion. Nurse-led discussions of patient values soon after diagnosis are feasible and acceptable in busy oncology clinics. Further research will evaluate the impact of this novel approach on additional patient-oriented outcomes after broader dissemination of this initiative throughout our institution.

Concurrent mFOLFOX6 plus ADI-PEG-20 intramuscularly at 36 mg/m weekly shows an acceptable safety profile and favorable efficacy compared to historic controls. Further evaluation of this combination is warranted in advanced HCC patients.