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Annual Report 2006/2007

Palliative Care McGill

June 1, 2007.

Director: Anna Towers, MD


Research Director: Robin Cohen, PhD

Prepared by Gayle A. Shinder, PhD


Palliative Care McGill Annual Report 2006/2007

Director’s Report

Over the last 35 years McGill has been and continues to be a world leader in the young
and growing discipline of palliative care. Palliative Care McGill exists to develop and
sustain excellence in patient care, teaching and research. This is achieved by:

1. Developing and supporting palliative care services in McGill affiliated centres, the
community and beyond;
2. Providing excellence in physical, psychological, social and spiritual care for patients
with a life-threatening illness and their families during the illness and bereavement;
3. Educating patients, families, caregivers and the public;
4. Conducting research to improve the quality of life of patients and families.

To be true to its philosophy, and because of its interdisciplinary and cross-disciplinary


nature, palliative care requires collaboration with many divisions and involvement in
multiple levels of care. Current trends indicate increasing involvement earlier in the
trajectory of chronic illness, with palliative care educators and clinicians having a major
teaching and training role to ensure that patients and families with advanced illness, or
with significant issues earlier in the course of their illness, receive the support that they
require. Recent Ministry of Health policy supports this development, although specific
provincial funding remains to be allocated.

The activities of the Palliative Care Division cut across all oncology tumour sites and
medical and surgical specialties. Its medical practitioners are mostly family physicians,
joined by specialist colleagues from various disciplines such as oncology, anesthesia,
internal medicine and surgery. Its McGill teachers and researchers come from medicine,
psychology, nursing, anthropology and music therapy. Palliative Care McGill has
academic programs in the following hospitals:

1. MUHC adult sites: Director: Dr. Anna Towers


Director of Clinical Programs: Dr. Manuel Borod
2. MUHC- Montreal Children’s Hospital: Director: Dr. Stephen Liben
3. Sir Mortimer B. Davis-Jewish General Hospital: Director: Dr. Bernard Lapointe
4. St. Mary’s Hospital: Director: Dr. Justine Farley
5. Mt Sinai Hospital: Coordinator: Dr. Golda Tradounsky

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Palliative Care McGill Annual Report 2006/2007

In the last few years McGill has seen the development of supportive care programs under
the auspices of, or affiliated with, palliative care (e.g. Cancer Nutrition-Rehabilitation
Program, lymphedema, psycho-oncology, supportive care for those with a non-cancer
diagnosis). This demonstrates that the mandate of this discipline goes beyond end-of-life
care and beyond cancer care. The highlights of the past year’s activities are as follows:

1. The 16th International Congress on the Care of the Terminally Ill, held from
September 25-28, 2006 at the Palais des Congrès, was a great success, attracting
1500 participants from 40 countries. This is the largest as well as oldest international
palliative care congress, bringing together clinicians from all relevant disciplines,
researchers, educators, and volunteers from around the world. Dr. Anna Towers was
the Chair of this Congress and is chairing the next 2008 Congress.
2. The Division is increasingly involved in teaching, clinical and program development
activities within the RUIS, coordinated at the McGill level via the Department of
Oncology and Palliative Care McGill.
3. The Cancer Nutrition-Rehabilitation Program continues to develop with support at
the McGill level, at the MUHC and at the Sir Mortimer B. Davis-Jewish General
Hospital.
4. The Lymphedema Program is increasing its involvement with the Breast Cancer
Tumour Group. There are interdisciplinary projects at the local and national levels.
McGill was involved in setting standards of care at the international level.
5. The Psycho-Oncology Program, for years established and thriving at the Sir
Mortimer B. Davis-Jewish General Hospital, is recently receiving increasing support
at the MUHC, adult sites.
6. Non-Cancer End of Life Care is a developing interdivisional interest at the MUHC,
with interdisciplinary professionals seeking to learn, teach and hopefully eventually
affect policy and practice.
7. In February 2006 Dr. Balfour Mount retired from the Flanders Chair which he had
assumed since it was first endowed in 1994. The Search Committee for a
replacement is continuing its activities. Filling this Chair on a priority basis is critical
to the continuing leadership of McGill on the international palliative care scene.
8. We had a very successful Palliative Care Week (May 6-11, 2007) with a multitude of
activities throughout the McGill network and in the community, including a Hike-
for-Hospice and many invited speakers.

Summary of New and Ongoing Research


Palliative Care McGill researchers are involved in research concerning physical
(lymphoedema; pain; cachexia; anorexia; inflammation), psychological (stress;
depression; anxiety), and existential/spiritual (meaning-making) well-being and aspects

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Palliative Care McGill Annual Report 2006/2007

of care and patient and family caregiver quality of life, prognostication, as well as health
services (types of services received; quality of services; evaluation of new types of
service delivery), social policy (Compassionate Care Benefit), and safety research.
Research is conducted with patients and family caregivers in the community as well as
those who are hospitalized and/or attending outpatient clinics. Our research concerns both
adult and pediatric populations. The bereavement experience of family caregivers is also
studied.

The Division members have published papers in peer-reviewed journals, book chapters,
and other fora. We are members of different editorial boards and have reviewed articles
for a number of scientific journals. We continue to serve on peer-review committees and
act as ad-hoc reviewers for different grant agencies. Importantly, this year we organized
and ran the 16th International Congress on Care of the Terminally Ill, with over 1500
people from 42 different countries attending, which, based on the evaluations by congress
participants was highly successful. We also began organizing the 17th International
Congress and continue to integrate more and more research into the program. This has
now reached the point where the 17th International Congress will no longer have separate
research sessions (with the exception of the Research Fora which have an educational
component on research methods) as many of the presentations on practice and health
services will be research-based. Robin Cohen continues to lead three national research
teams: the CIHR-NCIC Strategic Training Program in Palliative Care Cancer Research;
The NCIC Sociobehavioural Cancer Research Network Palliative Care Team; and the
CIHR New Emerging Team in Family Caregiving in Palliative and End-of-life Care (the
latter as co-PI).

Teaching And Training


Palliative Care McGill is very involved in the teaching and training of students. At the
undergraduate level, academic leadership is provided at the provincial and national levels
through the Réseau Universitaire Québecois des Soins Palliatifs, chaired by Anna
Towers. This network regroups palliative care leaders from the four Quebec medical
schools. In the past three years it has helped develop a Canadian undergraduate
curriculum for Palliative Care which is now in the implementation stage. Palliative Care
McGill physicians are involved in over 20 hours of undergraduate teaching, mostly in
small groups. In addition, many of our Faculty are Osler Fellows and are involved in the
Physician Apprenticeship Course over four years, again in small groups. At the
postgraduate level, rotating residences come from Geriatrics, Family Medicine, Surgical
Oncology as well as elective residents. In addition, we are involved in interdisiplinary
teaching for nursing and psychology (Masters and PhD students), and we also receive
music therapy and pastoral interns. Below is a summary of Palliative Care McGill
teaching and training:

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Palliative Care McGill Annual Report 2006/2007

1. Undergraduate Teaching
ITP ICM WHOLE ICM POM DAY ICM Pain
COHORT Communication Pathophysiology
(PCU Visits)
Skills (JGH)
Students 168 169 169 160 169
Sessions 28 3 9 1 day / 14 3
taught groups
Mount Sinai = 6 (5grps/ Session)
MGH = 11
JGH = 8
St- Mary’s = 3

Total Hours 56 37.5 18 25 6


of teaching
(Lectures = 4 hrs;
Small groups =
21 hrs)

2. Teaching and Training: PhD and Postdoctoral Fellows


Winter 2006, NUR2 705, Palliative Care in Cancer. (Robin Cohen). A required course
for the interdisciplinary Psychosocial Oncology Option in the Faculty of Graduate
Studies and Research.
CIHR-NCIC Strategic Training Program in Palliative Care Cancer Research (Robin
Cohen)
PhD Students
Shuling Chen
Anita Mehta
Marianne Olivier-d’Avignon
Lisa Chan
Réjeanne Dupuis
Postdoctoral Fellows
Melissa Henry, Ph.D.
Mary Rykov, Ph.D.
Dawn Allen, Ph.D.

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3. Students/Residents that completed one-month rotations.

Montreal General Hospital

Program McGill Visiting Number


trainees trainees (Total)

Undergraduate/Elective 3 2 5

Family Medicine 10 10

Geriatrics 2 2

Psychiatry 1 1

Internal Medicine 5 5

Surgical Oncology 2 2

Anesthesiology 1 1 2
Total
24 3 27

4. Education Committee Meetings

Meetings 3
Hours 5
Members involved MGH
JGH
Mount Sinai
St-Mary’s
M.C.H
Residents

5. Journal Club (MGH)


Number of sessions Hours
37 37

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Palliative Care McGill Annual Report 2006/2007

6. Residents (One year palliative medicine program)


2 residents:
* Dr. Andree Iancu
* Dr. Véronique Chaput

7. Palliative Care McGill rounds (at MGH)

Rounds 2005/2006 5
Disciplines involved Palliative Care
Clinical Ethics/Nursing
Geriatrics
Research/Palliative Care
Visiting Professors 1

8. Internal Medicine Residents


• Number of sessions: 6
• Tutors involved: 4 (MGH)
• Hours of teaching: 12

This year also saw some changes in leadership. Dr. Neil MacDonald stepped down as
Director of the McGill Cancer Nutrition-Rehabilitation Program. Dr. Martin Chasen of
the Department of Oncology is the new clinical director of this program and Dr. Thomas
Jagoe has been recruited from the UK to take up the post of Director in September 2007.
Dr. Krista Lawlor stepped down as Palliative Care Program Director and a replacement is
sought.
Heading into the 2007-2008 academic year, new and exciting initiatives are planned.
These include various RUIS-related initiatives such as the development of a RUIS-
targeted continuing education program, the search for a replacement for the Flanders
Chair and the recruitment of two additional clinicians at the MUHC including a clinician
scientist interested in symptom control trials, an area that would be important to develop.

Anna Towers, MD

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Palliative Care McGill Annual Report 2006/2007

Anna Towers
1. Summary of New and Ongoing Research
The research studies in which I am involved are in the area of cancer rehabilitation and
arm morbidity following breast cancer treatment. Although my primary interest is in
lymphedema, our research to date shows that there are functional problems as well as
issues with pain and social problems following breast cancer treatment, all of which need
to be addressed.
The first and largest study is a CIHR funded Canadian-wide study of which McGill is one
of four sites. The PI is at the University of Saskatchewan and I am the McGill
collaborator and co-ordinator. This study investigates arm morbidity following breast
cancer in prospective fashion. At the end of the study, we hope to be able to identify the
frequency of arm morbidity for female survivors of Stage I to III breast cancer treatment,
the course of this impairment, possible triggers of the morbidity, its psychosocial
impacts, and how care and treatment varies from region to region. For this I have a full-
time research assistant and we have so far recruited 260 patients. We are putting in a
renewal grant to CIHR for March 2007 and hope to recruit 400 participants at the McGill
site and 1000 across Canada.
The second study, funded by NCIC, investigates the effectiveness of exercise
interventions for breast cancer related lymphedema. In this study I am co-PI with the
Director of Graduate Studies at the McGill School of Physical and Occupational Therapy.
The patients are being recruited from my clinic and we are in the intervention stage. The
third project, of which I am PI, is funded by Fondation Québecoise du Cancer. We are in
the intervention development phase of this study that looks at educational interventions to
help improve quality of life and prevent arm morbidity following breast cancer treatment.

Summary of research activities 2006-2007


In the last year I have completed a research study on the psychosocial effects of
lymphedema. I supervised a full-time research assistant and continued to recruit for a
Canadian CIHR-funded study on arm morbidity following breast cancer. I attended a co-
investigators meeting in Saskatoon in August 2006 to plan for a grant renewal application
that will be submitted to CIHR in March 2007.
I helped refine the intervention on an NCIC funded study on the effect of exercise
interventions for lymphedema, added another site to this study (Charles Lemoyne
Hospital) and helped train the therapists who will give this intervention. Data gathering
began in January 2007.
I applied for and received new research funding from the Fondation Québecoise du
Cancer to investigate educational interventions to reduce arm morbidity following breast
cancer.
I wrote a chapter on lymphedema for a Palliative Care textbook. This was accepted for
publication in 2007.

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Palliative Care McGill Annual Report 2006/2007

I gave and/or was involved in the preparation of 13 research presentations between June
2005 and December 2006.

2. Research Grants (new and ongoing)


Congress Chair, Support for 16th International Congress on the Care of the Terminally Ill,
CIHR: $15,000; NCIC: $10,000 2006.
Réduire L’incidence de la morbidité du membre supérieur suite aux traitements pour le
cancer du sein: développement et évaluation d’un projet pilote en kinésiologie. Towers
A, Cohen SR, Letellier ME. Fondation québécoise du cancer. Programme de recherche
portant sur la qualité de vie des patients atteints de cancer, $15,000, 2006-2007.
Evaluation of group remedial exercises for chronic breast cancer related lymphedema.
St. Pierre D, Towers A (co-PI), Cohen SR, Collet JP., Canadian Cancer Society
Feasibility Grant no. 016221, $34,380, 2005-2007
Towers A, St. Pierre D, Cohen SR, Collet JP. Evaluation of group remedial exercises for
chronic breast cancer related lymphedema, Ahepa Ladies Senior Auxiliary Penelope
Meandros Chapter 168, $7000, 2005-2006
Charting the course of arm morbidity following breast cancer treatment: a prospective
follow-up s\tudy. Thomas-MacLean R, , Kwan W, Hack T, Miedema B, Tatemichi S
Towers, A. CIHR MOP 68883. $438,336 (My share $75,000 per annum), 2004-2007.
500 out of the 1000 subjects to be recruited for this multisite Canadian study will come
from the McGill University Health Centre and the Jewish General Hospital
IMN 1207 versus casein in the prevention of wasting over six months in colorectal or non
small cell lung cancer: a multicentre randomized double-blind study. Gagnon B,
MacDonald N, Towers A et al. IMMUNOTEC phase II trial 1207-003, 2004-2006.

3. Education and Training


Postgraduate Teaching
McGill Medical Postgraduate Residency Programs, Oncology, Geriatrics, Internal
Medicine Postgraduate Programs, 1993-present

Undergraduate Teaching
Faculty of Medicine, Physician Apprenticeship, 2005 to present
Faculty of Medicine, ICMB-Seminars on Symptom Control Issues and Ethical Issues in
Palliative Care, 1993 to present
Faculty of Medicine, ICMB- Seminars on communication , 2000 to present
Faculty of Medicine, ITP Palliative Care Seminar, 1994 to present

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Palliative Care McGill Annual Report 2006/2007

Clinical Teaching
Oncology, Medicine, Family Medicine, Division of Palliative Medicine, Royal Victoria
Hospital,, Montreal General Hospital, MUHC, Palliative Medicine residents, Rotating
Residents from other Departments, International Trainees, 1993-present

Research Trainees Supervised


2006-2007, Marie-Ève Letellier- A kinesiology intervention for patients treated for breast
cancer, McGill University Kinesiology, PhD qualifying course work

4. Scientific Reviews
International Advisory and Editorial Boards
International Consensus Group on Best Practice Guidelines for the Management of
Lymphoedema , 2006

Scientific Manuscript Reviewer


Canadian Family Physician, 1989 - present
McGill-Queen’s University Press, 1999 to present
Journal of Palliative Care, 1996 – to present
Oxford University Press, 1999 to present
Journal of Lymphedema, 2006 to present

Grant Reviewer
Internal reviewer CIHR 2006

Ad-hoc reviewer:
NCIC (2003-present)
CIHR (2001- present)
Social Sciences and Humanities Research Council (1997- present)
MUHC Research Institute (1999 to present)

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Palliative Care McGill Annual Report 2006/2007

5. Conference organization
Congress organization
I chaired the 16th International Congress on the Care of the Terminally Ill that took place
September 23-26 2006. The Congress attracted 1500 participants from 40 countries and
had a large research component.
Within the last few months we have started to organize the 17th International Congress on
the Care of the Terminally Ill that will be held in September 2008, and of which I am
Chair. We are looking at the evaluations of the September 2006 Congress, which I also
chaired, to guide us in programme development for 2008. The programme will be in
place and preliminary announcements will be sent in September 2007. We will be
reviewing abstracts from February through March 2008. Our next Congress will be more
focussed on international advocacy issues and will involve my travelling to the European
Congress in Budapest in June 2007, to the African Palliative Congress in Nairobi in
September 2007, and to the Latin American Palliative Care Congress in Lima in March
2008. There I will be meeting with colleagues to not only finalize the programme for our
Congress but also to initiate joint collaborations with the aim of enhancing palliative care
development worldwide.

Chair, 17th International Congress for the Care of the Terminally Ill, Montreal, Sept 21-
25, 2008
Chair, 16th International Congress for the Care of the Terminally Ill, Montreal, Sept 25-
29, 2006

6. Invited Presentations and Session Leadership


Towers A. « La gestion du lympoedème relié au cancer : qui s’en occupe? » Le
département de médecine générale du Centre Hospitalier et Centre de Santé et services
sociaux du Suroît. Québec
Kwan W, Thomas-MacLean R, , Tilley A, , Miedema B, Tatemichi S, Hack T, Towers A
“Arm morbidity following breast cancer treatment”, Poster presentation, Annual BC
Cancer Day Nov 23-25 2006
Klove J, Langevin N, Letellier, ME, Towers A. Living with Lymphedema; Prevention,
Treatment and Working Together to Advocate for our Patients, Poster presentation, 16th
Congress on the Care of the Terminally illl, Montreal, (and Abstract), September 2006
Preventing and Managing Lymphedema, Public Lecture Jewish General Hospital Hope and
Cope, June 8, 2006
Le lymphoedème relié aux traitements pour le cancer. Oncology Rounds Centre Hospitalier
Université de Montréal, June 1, 2006

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Palliative Care McGill Annual Report 2006/2007

Lymphedema Risk Factors and Prevention Public Lecture, CanSupport, Montreal April 3,
2006
Oncologic and Palliative Management of Advanced Leukemia (AML) patients, combined
Hematology-oncology and palliative Care rounds- McGill University Health Centre March
29, 2006

7. Abstracts
Winkle Kwan, Roanne Thomas-MacLean, Thomas Hack, Anna Towers, Bo Miedema,
Sue Tatemichi and Andrea Tilley. Charting the Course of Arm Morbidity after Breast
Cancer Treatment: A Prospective, Longitudinal Follow-up Study. British Columbia
Cancer Agency Annual Cancer Conference, November 23-25,2006 Vancouver, BC, pp.
71.
Roanne Thomas-MacLean, Andrea Tilley, Anna Towers, Bo Miedema, Sue Tatemichi,
Winkle Kwan and Thomas Hack, 2006. "Lymphedema After Breast Cancer: Symptoms,
Disability and Access to Treatment." Published abstract, 7th National Lymphedema
Network International Conference, (NLN), November 1-5, Nashville, TN, pp. 9.
Klove J, Towers A, Langevin N, Letellier ME. Living with Lymphedema: Prevention,
Treatment and Working Together to Advocate for Our Patients.”, Journal of Palliative Care
22(3):241, 2006
Thomas-MacLean R, Miedema B, Tatemichi S, Tilley A, Towers A, Hack T and Kwan W,
2006. “Arm Morbidity and Breast Cancer: Mapping New Terrain.” Published Abstract,
Reasons for Hope, 4th Scientific Conference, May 6-8, Montreal, PQ, pp. 248.
Thomas-MacLean R, Hack T, Miedema B, Tatemichi S, Tilley A, Kwan W and Towers A,
2006. “Sociological and Psychological Consequences of Arm Morbidity after Breast
Cancer.” Published Abstract, Psychosocial Risks and Consequences across the Lifespan,
Canadian Association of Psychosocial Oncology (CAPO), May 3-6, Montreal, PQ, pp. 90.

8. Committees
National
Member of the Board, Canadian Association of Palliative Care Physicians, 2006 to
present
Réseau des Soins Palliatifs, Association Québecoise des Soins Palliatifs (organization
regrouping 1900 palliative care professionals and volunteers, Member of the Board,
2005-present

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Palliative Care McGill Annual Report 2006/2007

Provincial
Réseau Universitaire Québecois des Soins Palliatifs (RUQSP) – regrouping palliative
care chiefs from the four Quebec medical schools), Founder and Chairperson, 2001 to
present
Scientific Advisor, Lymphedema Association of Quebec, Scientific Advisor and Member
of the Board, 1999 to present
Clinical Advisory Council, ProCure Alliance, Member, 2003 to present

McGill network commitees


RUIS Table d’Oncologie, Member, 2005- present
Executive Committee, MUHC Department of Family Medicine, Member, 2003-present
Executive Committee, MUHC Non-Cancer End of Life Care Interest Group, Co-Chair,
2005 to present
Scientific and Research Advisory Board, Hope and Cope Wellness Center, JGH,
Member, 2005-present
Executive Committee, Department of Oncology, Member, 1999-present
Women’s Cancer Section, Clinical trials Committee, Department of Oncology, Member,
2005 to present
Council on Palliative Care, Member, 1999- present
Education Committee, Palliative Medicine McGill, 1999-2003 (Chair), 2003 to present
(Member)
Executive Committee MUHC Division of Palliative Care, Chair, 1999- present

9. Other Publications and Media Communications


Other non peer-reviewed publications:
Towers, Anna, "Touch Their Hand Gently" in Selected Journals of Successful Hospice
Palliative Care from the 16th International Congress on Care of the Terminally Ill,
September 26-29, 2006 in Montreal, Canada. Toronto: Legacies Inc., 2006

Media communications
Regarding lymphedema access to treatments:
Since 2003 I have been giving national and provincial television and radio media
interviews several times yearly, in English and in French to advocate for access to
lymphedema treatments under Medicare. I have also participated and facilitated many
provincial, municipal and community newspaper reports on this topic.

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Palliative Care McGill Annual Report 2006/2007

Regarding access to palliative care:


Since 2000 I have been giving regular interviews to advocate for access to treatment in
Canada and in Quebec.

Bruno Gagnon
1. Research Grants (ongoing)
Gagnon, B. Mayo, N., Hanley, J., Goldberg, M. and Deschamps, M. Patterns of care
during the last six months of life of patients dying of cancer. CIHR: Operating Grant.
($411,610) 2004-2008.
The overall aim of this study is to estimate, using administrative data, the extent to which
the patterns of care received during the last 6 months of life by patients dying of cancer
reflect health care services in keeping with a palliative care philosophy (care-oriented
approach), and to determine the clinical, societal and health care system factors
modifying access to this type of care.
Gagnon B. Les différents profiles de soins reçus par les patients mourant du cancer
durant les six derniers mois de vie: une étude basée sur des banques de données
administratives. FRSQ ($30,000) 2004-2007.

S. Robin Cohen
1. Research Grants
Improving Quality of Life and Informing Social Policy in Palliative Care. Infrastructure
Funding to form a National Palliative Care Research Team. Robin Cohen (PI), Co
Investigators: Allard P, Band P, Blood P, Chochinov H, Courneya K, Daneault S,
Deschamps M, Dumont S, Fiset V, Fournier L, Fyles G, Gagnon P, Graham I, Gratton J,
Kristjanson L, Lawlor P, Leis A, Logan J, Marchand R, Neron S, Nikoletti S, Poirier L,
Porock D, Poulson J, Viola R, Wilson K, and others. National Cancer Institute of Canada
- #010281 01/2000–12/2002, $60,000/year Renewed, 01/2003 – 06/2007; $88,000/year;
$88,000/year; $88,000/year
Quality of Life for Palliative Care Patients and Their Family Caregivers Robin Cohen
(PI), Co-investigators: Brown S, Fiset V, Fyles G, Kristjanson L, Leis A, Porterfield P,
Viola R. National Cancer Institute of Canada - #012201 Renewal. 07/2001 – 06/2006
$555,659
Strategic Training Program in Palliative Care Cancer Research. Robin Cohen (PI), Co
Investigators: M Aubin, S Dumont, L Fillion, D Blondeau, P Gagnon, P Allard, F
Fothergill-Bourbonnais, P Hall, P Dobkin, N Mayo, K Wilson. Canadian Institutes of
Health Research/National Cancer Institute of Canada - #STI-63286, 04/2003 – 03/2009,
$1,800,000

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Palliative Care McGill Annual Report 2006/2007

Prognostic value of clinical correlates of cancer cachexia: A prospective multicenter,


population-based study. A Vigano PI, Co-investigators: Baracos, V, S Robin Cohen,
Dalzell MA, Franco E, Macdonald N, Morais J, Thirlwell M, Canadian Institutes of
Health Research - #122338 06/2004 – 05/2007 $200,644
A multidisciplinary cancer pain research network to improve the classification,
assessment, and management of difficult cancer pain problems. P.I.s: N.A. Hagen , R.L.
Fainsinger, P.M. Brasher, Co-investigators: Pereira, JL, Moulin, D Cahill CM, Cohen
SR, Cummings- OLinyk GG, Canadian Institutes of Health Research- # 129697, 2004 –
2009 $1,363,586
GRISIM: Groupe de recherche interuniversitaire en soins infirmiers de Montréal P.I.s:
Celeste Johnston and Nicole Richard, Co-investigator Cohen SR and many others
FRSQ/Newton Foundation/MSSS, 04/2004 – 03/2008, $2,000,000
Evaluation of group remedial exercises for chronic breast cancer related lymphedema.
P.I. Diane St. Pierre, Co-Investigators: Towers A, Cohen SR, Collet JP, Dalzell M
National Cancer Institute of Canada - CCS Feasibility Grant, 2005 – 2006 $34,380
Quality of life in cancer patients admitted to an acute palliative care unit and their
caregivers: a prospective study of self-report and proxy-for-patient ratings P.I.: Jennifer
Jones, Co-Investigators: Cohen SR, Rodin GM, Zimmerman C, McPherson CNational
Cancer Institute of Canada – CCS Research Grant for New Investigators, 2005 – 2006,
$55,371; 2006 – 2007, $56,956; 2007 – 2008, $62,614
Measuring the quality of end-of-life care provided in inpatient health care settings, P.I.
Kelli Stajduhar, Co-investigator Cohen SR, others, Michael Smith Foundation for Health
Research HSPRSN Research Operating Grant, 05/2006 – 04/2008, $99,796
An evaluation of Canada’s compassionate care benefit from a family caregiver’s
perspective, Co- P.I.s: A Williams and V Crooks, Co-investigators Stajduhar K, Allan D,
Cohen SR , Brazil K. Canadian Institutes of Health Research (CIHR) 09/2006 –
08/2009, $169,729
Safety in home care: Perspectives from clients, family members, caregivers, and
providers. P.I: Lang A, Co-investigators: Cohen SR, Easty AC, Lachance JA, Germain
D, Stajduhar KI, Williams AM Canadian Institutes of Health Research 04/2007-
03/2010, $53, 237/year
Family caregiving at the end of life: A women’s health issue, PI Koop P, Co-
investigators: deJong-Berg MA, Cohen SR, Williams A, Stadjuhar K, Allan D, Canadian
Foundation for Women’s Health, 01/06/2006 –31/05/2007, $8,035
Réduire l'incidence de la morbidité du membre supérieur suite aux traitements pour le
cancer du sein : développement et évaluation d'un projet pilote en kinésiologie, PI:
Towers A, Co-investigators: Letellier M, St. Pierre D, Cohen SR, Fondation Québécoise
du Cancer (no grant number), 06/2006 – 06/2007, $15,000
Family caregiving in palliative and end-of-life care: A new emerging team, Robin
Cohen (Co-PI with Kelli I Stajduhar), Co-investigators: Chappell, N, Koop, P,

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Palliative Care McGill Annual Report 2006/2007

Williams, A, Heyland, D. Canadian Institutes of Health Research- #129692, 2004 – 2009,


$1,361,361
T.I.P.S: Tele-homecare in palliation study. Co-investigators: Larry Librach, Co-
applicants: Cohen SR, Abernathy T, GoldSmith, C, Jadad, C, Kirshen, A, Librach L,
Thabane L (P.I.: A. Stern, McMaster) Ontario Ministry of Health Primary Health Care
Transition Fund 04/2004 – 04/2006, $933,900

2. Teaching and Research Training


PhD Students and Postdocs
Shuling Chen Spirituality & Palliative Care in Chinese Canadians, Education (Ph.D.
Thesis Committee Member), Ph.D. in progress Oct. 2002 – present.
Anita Mehta Family caregivers of palliative care patients at home: The pain management
process, Nursing, Ph.D. in progress, Sept. 2003 – present. (Maternity leave July-Dec
2006), -NCIC Studentship
Marianne Olivier- d’Avignon Development of a needs profile for siblings of terminally ill
children, Social Work, U. Laval. Co- supervisor with Serge Dumont, Ph.D., May 2006-
present
Lisa Chan The experience of end-of life-care on an end-stage medical in-patient unit,
Nursing, Ph.D., Sept.2005-present.
Melissa Henry, Ph.D. (Psychology) Meaning Making Intervention for women with newly
diagnosed advanced ovarian cancer, Oncology , Postdoctoral Fellowship, April 2006-
present
Mary Rykov, Ph.D. (Adult Education) The impact of music therapy on patients and
families on palliative care units, Oncology, Postdoctoral Fellowship, July 2006- present,
NCIC Postdoctoral Fellowship.
Réjeanne Dupuis, Psychology,York University Co-supervisor with Paul Ritvo, Ph.D.,
Sept. 2006- present.
Andreea Iancu, M.D. Palliative Medicine Fellow, Cancer Pain Classification System,
Nov.2005-Oct.2006
McGill Courses
Winter 2006 , NUR2 705 A required course for the interdisciplinary Psychosocial
Oncology Option in the Faculty of Graduate Studies and Research, Palliative Care in
Cancer.
April 20, 2006, Oncology Interdisciplinary Journal Club, Staff member responsible for
discussion of student presentation of RCT.

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Palliative Care McGill Annual Report 2006/2007

3. Scientific Reviews: Editorial Boards and Journal Reviews


Editorial Boards
Journal of Palliative Care, 2004- present
American Journal of Hospice and Palliative Care, 2004- present

Ad Hoc Reviews
Journal of Palliative Care, 1996, 97, 98, 99, 2000, 2001, 2002, 2004, 2005, 2006
Palliative Medicine, 1996, 97, 98, 99, 2001, 2006
Journal of Pain and Symptom Management, 2001, 2002, 2006
Quality of Life Research, 2006, 2007

4. Research Advisory Work for National and International Organizations


National Cancer Institute of Canada , Clinical Fellowships Peer Review Committee, July
1-2006-June 30-2007
Ad Hoc Reviewer: Fonds de recherche en santé du Québec 1997, 1998, 2006

Committees
McGill Department of Oncology Clinical Trials Operations, Supportive Care Section,
Member, 1999 –present
Canadian Hospice Palliative Care Association, Research Advisor, March 2003 – present
Wellness Centre, Jewish General Hospital, Research Advisory Board, Member, February
2005- present
VON Canada-University of Ottawa Bereavement Think Tank, Member, April 2005-
present

5. Congress and Workshop Organization


16th International Congress on Care of the Terminally Ill, Montreal,
September 25-28, 2006, Executive and Organizing Committee:
Determining Congress content and schedule
Sole Organizer of Research Program.
Chair of Research Abstract Review Committee.
Chair all Research Fora

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Palliative Care McGill Annual Report 2006/2007

17th International Congress on Care of the Terminally Ill, Montreal,


September 22-26, 2008, Executive and Organizing Committee:
Determining Congress content and schedule
Sole Organizer of Research Program.
Chair of Research Abstract Review Committee.
Chair all Research Fora

6. Invited Presentations and Workshops (National and International) and Peer


Reviewed Abstracts
Williams A, Crooks V, Stadjuhar K, Cohen SR, Allan D. Women's Caregiving Work at
End-Of-Life: An Evaluation of Canada's Compassionate Care Benefit. Ontario Women's
Health Council Conference "Enhancing Women's Health Research", April, 2006, Ottawa,
Ont.
Cohen SR, Brown KS, Fyles G, Lachance J, Leis A, Viola R, Porterfield, P. The Quality
of Life of Family Caregivers of People with Cancer at the End of Life. Canadian
Association of Psychosocial Oncology Annual Conference: Psychosocial Risks and
Consequences Across the Lifespan, Montreal, May 3-6, 2006
Koop PM, deJong-Berg MA, Williams A, Cohen SR, Allan D, Stajduhar K. Defining
Caregiver Respite in End-of-Life Care: A Systematic Literature Review: Canadian
Association of Psychosocial Oncology Annual Conference: Psychosocial Risks and
Consequences Across the Lifespan, Montreal, May 3-6, 2006.
Koop PM, deJong-Berg MA, Williams A, Cohen SR, Allan D, Stajduhar K. Defining
Caregiver Respite in End-of-Life Care: A Systematic Literature Review. UICC World
Cancer Congress, Washington, DC, July 8-12, 2006.
Allan,DE, Heyland DK, Homer S, Gafni A, Frank C, Stajduhar KI, and Cohen SR.
Prognostic awareness, satisfaction with quality of care, and resource utilization at end of
life. Canadian Association for Health Services and Policy Research, Vancouver, BC,
September 17-19, 2006.
Cohen SR, Fyles G, Leis A, Viola R, Porterfield P, Lachance J, Brown KS. Family care
quality of life relationship to carer optimism, sense of self-efficacy, and sense of
preparedness to provide care to terminally ill people with cancer International Psycho-
Oncology Society Conference, Venice, Italy, Oct.18-22, 2006.Psycho-Oncology 2006, 15
(Supp2);S207
*Thibodeau-Jarry N, Cohen SR. Content validity and acceptability of patient and family
caregiver quality of life: Instruments for an end stage medical population 16th
International Congress on the Care of the Terminally Ill, Montreal, Quebec, Sept.26-29,
2006. Journal of Palliative Care 2006, 22; 247.

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Palliative Care McGill Annual Report 2006/2007

*Taylor G, Carpentier S, Cohen SR. Quality of life assessment in palliative care: How do
family caregivers interpret the items? 16th International Congress on the Care of the
Terminally Ill, Montreal, Quebec, Sept.26-29, 2006, Journal of Palliative Care 2006, 22;
240.
*Carpentier S, Taylor G, Cohen SR. Quality of life assessment in palliative care: How
do patients interpret the items? 16th International Congress on the Care of the Terminally
Ill, Montreal, Quebec, Sept.26-29, 2006, Journal of Palliative Care 2006, 22, 237.
Rose PA, Cohen SR, Amsel R. Pressure ulcer (PU) risk assessment in the critically ill.
National Pressure Ulcer Advisory Panel biennial conference, San Antonio, Texas,
February 9-10, 2007.

7. Hospital Activities
Encompassed within responsibilities with McGill.
McGill
Executive Committee, Palliative Care McGill, Member, 1995 – present
Division of Palliative Care, Oncology, Research Director, April 1996 – present
Palliative Care McGill Education Committee, Member, 1998 – present
Oncology, Member, Interdisciplinary Postgraduate Training Committee, Sept. 2002 –
present
Oncology, Member, Psychosocial Oncology Program, Sept. 2002 – present
School of Nursing, Student Standing and Promotions Committee, Member, Dec. 2002 –
April 2004 Sept.2005-present
School of Nursing, Ph.D. Supervisors Committee, Member, January 2001 – present
MUHC Palliative Care Service Divisional Meeting, Member, January 2003 – present
Cancer Nutrition and Rehabilitation Program Steering Committee , Member, June 2005-
present
Eric Flanders Professor in Palliative Care Medicine Selection Advisory Committee,
Member, June 2005-present
Faculty of Medicine Student Research and Summer Research Bursary Committee,
Member, 2006, 2007
Thomas Hutchinson
1. Research Grants
New and Ongoing
Qualitative Study on "Living with end-stage renal disease (ESRD): multiple perspectives
on patients’ suffering and healing." Allied Health Research Grant awarded by the Kidney

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Palliative Care McGill Annual Report 2006/2007

Foundation of Canada, April 2006 ($85,000). On-going. PI: Dr. Tom Hutchinson; Co-
applicants: Dawn Allen, Steve Jordan, Antonia Arnaert, Paul-Eugene Barré, Murray
Vasilevsky, Mark Lipman, Johana Eid - $85,952 (July 2006-June 2008).

2. Education Activities
Hutchinson. Introduction to Clinical Medicine, “Communication Skills”, May 2006.
Hutchinson. One half-day teaching session to pastoral care students, July 2006.
Hutchinson. MUHC Medical residents. Post-graduate Core Competencies. Small groups.
September 12, 2006.
Hutchinson. Lecture to Nursing Students (Dr. Arnaert’s Chronic Illness & Palliative Care
class). “Healing, a Healthcare Revolution: Opportunities at the Bedside.” February 16,
2007.
Hutchinson. Concordia University. Dr. P. O’Rourke’s Religion and Healing course.
“Healing, a Healthcare Revolution: Opportunities at the Bedside.” February 26, 2007.
Integration of material based on “Healing and the Art of Medicine” into Physician
Apprenticeship Program for second year medical students.
Hutchinson, Small group teaching re. palliative care to medical students, ongoing.
Hutchinson, Small group teaching to medical students re. Physician Apprenticeship,
ongoing.
Hutchinson, Small group teaching to medical students re. ICM Communication Skills.
Hutchinson T, Dobkin, P. Design of an 8-week program for health care professionals
based on the Mindfulness Based Stress Reduction Program developed by Jon Kabat-Zinn
and colleagues at the University of Massachusetts. First program offered to physicians
April 20 – June 8, 2007. (Accredited for 20 CME hours)

Curricular Change
Participation with Associate Dean Donald Boudreau in a Faculty of Medicine revision of
curriculum. Design of “Physicianship IV” program for Med 3 students, to commence
August 2007 (Hutchinson and McNamara).

3. Congress Organization
Organization of a full-day seminar: Healing, a Healthcare Revolution: The Challenge, the
Opportunities for Caregivers. (Affiliated with the 16th International Congress on Care of
the Terminally Ill). Attendance: 330.
Organizing Committee: 17th Annual Congress on Care of the Terminally Ill scheduled for
September 2008.

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Palliative Care McGill Annual Report 2006/2007

4. Presentations
Invited Presentations and Workshops (National and International)
Hutchinson T. “Aequanimitas for the 21st Century.” McGill Pain Centre Rounds.
MUHC. May 31, 2006.
Hutchinson T. “Healing and the Practice of Medicine.” McGill Alumni Event, Toronto.
June 9, 2006.
Hutchinson T. “Healing, a Healthcare Revolution: The opportunities at the bedside.”
September 26, 2006.
Hutchinson T. Nephrology Rounds. “Palliative Care in the Dialysis Unit: An overview
for the diehard nephrologist.” MUHC, March 23, 2007.
Hutchinson T. McGill Seminars on Healing. “Longing for Virginia: Satir’s Genius for
Healing.” April 27, 2007.

5. Hospital Activities
Dr. Hutchinson continues to practice as a palliative care physician (50%) with the McGill
University Health Centre.

6. Public Education
McGill Seminars on Healing
May 2, 2006. The Interconnectedness is Already There. Michael Kearney.
September 25, 2006, Soul Pain, Fear and Healing at the End of Life. Michael Kearney.
October 27, 2006, Humour in Medicine. Manuel Borod, MUHC.
November 24, 2006, Whole Health: Making the Connections. Steve Sims, Padua Centre,
Montreal.
December 15, 2006, Healing and the Artistic Process. Garry Beitel, Filmmaker (The Man
Who Learned to Fall).
January 26, 2007. Dr. Neil MacDonald and Dr. Martin Chasen. McGill’s Cancer
Nutrition and Rehabilitation Program.
February 23, 2007. Dr. David Kuhl. Physician Self-Care.
April 27, 2007. Dr. Tom Hutchinson. Longing for Virginia: Satir’s Genius for Healing.
May 25, 2007. Dr. Marc Laporta. Emotions and Empathy: Music as a Vehicle.

Film Series
May 2, 2006: ‘Ram Dass: Fierce Grace’ (Michael Kearney, physician)

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Palliative Care McGill Annual Report 2006/2007

June 6, 2006: ‘How’s Your News?’ (Lisa Walsh, singer)


September 19, 2006: Flight From Death (Bal Mount, physician)
October 17, 2006: Bonjour, Shalom (Garry Beitel, filmmaker)
November 28, 2006: To a Safer Place (Beverly Shaffer, filmmaker)
December 12, 2006: Gap Toothed Women (Garry Beitel and Steve Sims)
January 16, 2007. “Doing Time, Doing Vipassana.” With guest discussants Dr. John
Seely and Dr. George Poland.
February 13, 2007. “Joseph Guinta: A Silent Triumph.” With guest discussants Pepita
Ferrari (filmmaker) and Dr. Howard Chertkow.
March 6, 2007. “This Beggar’s Description.” With guest discussants, Philip and Pierre
Tetrault.
April 17, 2007. “Born Into Brothels.” With guest discussant: Twinkle Rudberg (Leave
Out Violence)
May 15, 2007. “Murderball.”

Other Activities
Organization of a Reflective Practice Seminar for physicians, June 13, 2006. Sharyn
Andrews & Ron Smith.
“Practicing Medicine Mindfully: Cultivating Imperturbability and Equanimity”. A one
day workshop for physicians: An introduction to mindfulness in Medicine. Dr.
Hutchinson & Dr. Dobkin. December 1, 2006. 18 physicians participated.
“Practicing Medicine Mindfully: Cultivating Imperturbability and Equanimity”. A one
day workshop for physicians. Dr. Hutchinson & Dr. Dobkin, March 2, 2007.
Participation with GWISH (George Washington University): GWish Canadian Advisory
Board on Spirituality and Health in Medical Education (Tom Hutchinson).
Attendance at MBSR Research Conference: Integrating Mindfulness-Based Interventions
into Medicine, Health Care, and Society, Worcester, Mass. March 2007. (Tom
Hutchinson & Dawn Allen).
Participation in the MUHC non-cancer palliative care group, Drs. Hutchinson & Allen.

Stephen Liben
1. Summary of New and Ongoing Research
Caregiving Parents of Children with Life-Limiting Illnesses: Beyond Stress & Coping to
Growth.

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Palliative Care McGill Annual Report 2006/2007

2. Research grants
Caregiving Parents of Children with Life-Limiting Illnesses: Beyond Stress & Coping to
Growth. Principal applicant: Susan Cadell. Co-Applicants: S. Liben, H Siden, E Davies,
R Steele, L Straatman, D Hemsworth. CIHR, Year 1 $ 101,318, year 2 $102,618, year 3
$59,510; 2006-2008.

3. Education and Training


Residents: Dr C Phe IACS/Palliative care 2 months; Dr Catherine Audet Heme-
Onc/Palliative care 3 months; Dr. G Rizzo - Anaesthesia/Palliative care Observership
Pediatric Palliative Care –1st year P&OT Students McGill University –1 hr/yr.
Faculty of Medicine Osler Fellow for Class of 2009. Approx 4hrs/month = 36hrs/year
Course Director (27 hours direct instruction/yr): 4th Year Students Medicine &
Society Seminar Course #inds-406) :” The doctor patient relationship” 2000 - present
Introduction to the Patient (ITP) – 1st-2nd year medical students; Decision Making at the
end-of-life for children. 2hours/yr. 2001 - present
Invited discussant: Faculty of Religious Studies. McGill University. Director Dr Norman
Cornett. Oct 2004, 2005, 2006, 2007 3 hrs/yr.
Introduction to Pediatrics Course – 3rd year medical students, Small Group Leader. 14
hours/yr, 2003 - present
Introduction to Pediatrics Course – 3rd year medical students: Yearly Lecturer: 4 hours/yr
Pediatric Fluids and Dehydration. 1997 - present
Communications Plus - Seminar Course – Final year medical students. Small Group
Leader – Talking to Children About Death, 5 hours/year April 1999 – present
Seminar in Palliative Medicine – 3rd and 4th year medical students, Yearly Lecturer:
Pain Management in Children, 4 hours/yr – 1997 - present
Pediatric Clinical Clerks (3rd year students), Bimonthly Lecturer: Approach to the
Critically Ill Child, 1-hour/2 months = 6 hrs/yr – 1997 - present
Pediatric Residents – Protected teaching time workshop – Pediatric Palliative Care 2004
– present 2-4 hrs/yr.

4. Scientific Reviews
Current Ad-Hoc Manuscript Reviews 2006
Pediatrics -2 manuscripts
J of Palliative Care-1 manuscript
J Palliative Medicine-1 manuscript

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Palliative Care McGill Annual Report 2006/2007

Editorial Board Member


The American Journal of Hospice and Palliative Care

5. Conference Organization
International Congress on Care of the Terminally Ill

6. Invited Presentations and Workshops


2006 International Congress on care of the Terminally Ill – One day symposium
Organizer and Chair –
Keynote Speaker: 3rd International Cardiff Conference Paediatric Palliative Care June
2006, Progress in Palliation: Intervention or Interference? Cardiff, United Kingdom

7. Peer-Reviewed Abstracts
Nadeau, L.; Johnson-Lafleur, J.; Liben, S.; MacDonald, ME.; Rousseau, C.;
Polychronakos, C.; Perrault, J.; Lands, L. Treatment-compliance in chronically ill
adolescents from cultural minorities. CACAP 26th Annual Meeting: November 2006,
Toronto

8. Hospital Activities
Ward attending – Medical wards 2-3 months/year, (4-5 medical students & 4-5 residents)
Palliative Care Consultant – full time
Emergency Room Physician – 1 shift per month

Mary-Ellen Macdonald
1. Summary of New and Ongoing Research
I joined the following projects (grants were already awarded when I was asked to join):
Patients’ Perspective on the Physician as Professional and Healer, JD Boudreau, J
Jagosh, ME Macdonald, R Slee, Y Steinert, Montreal General Hospital Foundation,
$110,000, 2005-2007.
The relationship between culture and treatment-compliance in chronically ill adolescents
from cultural minorities, L Nadeau, S Liben, ME Macdonald, Montreal Children’s
Hospital Research Institute and Department of Psychiatry, $13 160, 2005-2007.

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Palliative Care McGill Annual Report 2006/2007

Faculty Development: A Field of Dreams? Y Steinert, M Boillat, P McLeod, S


Meterissian, ME Macdonald, Royal College of Physicians and Surgeons Faculty
Development Grant, $5000, 2005- 2007.
Teaching Medicine in the ER: a Problem Becomes an Opportunity, Peter McLeod, C
Chalk, ME Macdonald, J Wiseman, P Zanell, McGill Teaching and Learning Services:
Teaching Innovations Grant, $4200, 2006-2007.
Transitions in Paediatric Palliative and End of Life Care, H Siden, S Cadell, E Davies, R
Steele, L Straatman, Collaborator: ME Macdonald, CIHR New Emerging Team Grant,
$1,348,575, 2004-2009.

2. Research grants (new and ongoing)


Family Caregiving in Palliative and End-of-Life Care, K Stajduhar, SR Cohen, N
Chappell, D Heyland, P Koop, A Williams, (New Investigator: ME Macdonald, 2006-
2009) CIHR New Emerging Team Grant, $1,363,586, 2004-2009.
An Anthropology of Bereavement: A sociocultural understanding of parental grief and
mourning, ME Macdonald, S Cadell, L Mitchell, P Stephenson, SSHRC, $75,000
(supplemental + in-kind 25,000), 2007 – 2010
Conference Grant: Ensuring Quality in Qualitative Research, ME Macdonald,
Sociobehavioural Cancer Research Network (CPRPE), $900, 2007
Travel Grant: Geneva, International Congress on Pediatric Critical Care, ME
Macdonald, Sociobehavioural Cancer Research Network (CPRPE), $1500, 2007
Promoting Cultural Awareness: A Faculty Development Cultural Competency Training
Program, FA Carnevale, ME Macdonald, Y Steinert, S Razack, Faculty Development
Grant, Royal College of Physicians and Surgeons, $5500, 2006-2007.
Parental and Professional Decision-Making Regarding Benefits and Burdens of
Interventions for Children with Life-Limiting Conditions, H Sidden, M Bennett, R
Adderleym, S Cadell, L D’Agincourt-Canning, ME Macdonald, T Northway, L
Straatman, E Stephanson, British Columbia Child and Youth Health Research Network
Grant, $4815, 2006.
Tuberculosis among Urban Aboriginals in Montreal, P Brassard, ME Macdonald, R
Menzies, K Schwartzman, Partnered with the Native Friendship Centre of Montreal,
CIHR Strategic Initiative: Aboriginal Community-based Research Competition, $213
450, 2005-2008
3. Research Trainees
CIHR-NCIC Strategic Training Program in Palliative Care
Mary Rykov, Postdoctoral Student, McGill University (Oncology)
Mentor, 2006 to present

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Palliative Care McGill Annual Report 2006/2007

Topic: Music therapy and cancer care

Nicolas Vonarx, Postdoctoral Student, Laval University (Ethics and Nursing)


Mentor, 2006 to present
Topic: Les figures du religieux dans les épisodes de maladie marqués par une souffrance
existentielle: pour une meilleure lecture de ces figures dans le cadre des soins palliatifs

Lisa Chan, Doctoral Student, McGill University (School of Nursing)


Mentor, 2006 to present
Topic: Ethnographic Study of End-Stage Illness on an Acute Medical Unit

McGill University
Dawn Allen, Postdoc, Whole Person Care
Postdoctoral Supervision, 2007 (informal mentorship until funding secured)

Lisa Chan, Doctoral Student, School of Nursing


Doctoral Co-Supervisor, 2006 to present
Topic: Ethnographic Study of End-Stage Illness on an Acute Medical Unit

Royal Victoria Hospital


Ebba Oloffson, PhD
Mentorship + RA Supervision, 2007 to present
Supervision in research techniques, protocol writing, analysis

4. Scientific Reviews: Editorial Boards and Journal Reviews


Manuscript Review
2007 to present:
Journal of Aboriginal Health
2006 to present
Pediatrics
Canadian Medical Association Journal

26
Palliative Care McGill Annual Report 2006/2007

Journal of Child Health Care


Journal of Hospice and Palliative Medicine

Protocol Review
2007 to present
Institutional Review Board, Faculty of Medicine, McGill University

Operating Grant Review


2006 to present
Indian and Northern Affairs, Government of Canada
Nursing Scientific Review Committee, Nursing Research Funds for Nurses, McGill
University Health Centre (Chair, Judith Ritchie, PhD)

Scholarship Review
2006-Trainee Selection Committee, CIHR-NCIC Strategic Training Program in Palliative
Care Research

5. Conference Organization
2007, McGill Qualitative Health Research Group Annual Conference: Ensuring Quality
in Qualitative Research. Funded by NCIC-Sociobehavioural Cancer Research Network,
and Palliative Care Program, Montreal Children’s Hosital, April 5, 2007, Conference
Organizer and Chair.

6. Invited Presentations and Workshops


2006, Macdonald, ME, A Clash of Cultures: When Family Culture Meets Professional
Culture in an Intensive Care Unit. 16th International Congress on Care of the Terminally
Ill, Montreal, September 26, 2006.
McGill University, Faculty of Medicine, Centre for Medical Education IMEX Program,
Guest Instructor, May 2007, IMEX scholars (Dalhousie University, McGill University,
Utrecht University, Karolinska Institute) Topic: “Qualitative Research in Medical
Education”
Faculty of Medicine, School of Nursing, Guest Instructor, March 2007, Chronic Illness
and Palliative Care (NUR1 322), Topic: An Anthropology of Bereavement

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Palliative Care McGill Annual Report 2006/2007

McGill University, Faculty of Medicine, Faculty Development Office, Cultural


Competency Workshop: Educating for Cultural Awareness: Avoiding Stereotypes,
Assumptions and Other Traps, 2007, With S Razack, FA Carnevale, Y Steinert
Royal College of Physicians and Surgeons, Caring for a Diverse Diversity: Reconciling
Cultural, Socioeconomic and Sexual Difference in Medical Education, 2006, with S
Razack, FA Carnevale, Y Steinert, PP Tellier

7. Peer-Reviewed Abstracts
Macdonald, ME, Liben, S, Carnevale, FA, Rennick, JE, Cohen, SR. Office or Bedroom?
A Disconnect Between Family Culture and Professional Culture in the PICU, 5th World
Congress on Pediatric Critical Care, June 24-8, 2007, Geneva. To be published in
Pediatric Critical Care Medicine
McLeod, P, Chalk, C, Zanelli, P, Wiseman J, Macdonald, ME, A Problem Becomes an
Opportunity: The Emergency Department Consult Service for Students in Internal
Medicine, Conference of the Canadian Association of Medical Education, Victoria., May
4-9, 2007
Boudreau, JD, Jagosh, J, Slee, R, Macdonald, ME, Steinert, Y, Incorporating the
Patient Perspective in Curricular Renewal, Conference of the Canadian Association of
Medical Education, Victoria., May 4-9, 2007
Razack, S, Macdonald, ME, Steinert Y, Carnevale, FA. Training in Cultural
Competence: What We Want to Learn vs. What We Ought to Learn. Conference of the
Canadian Association of Medical Education, Victoria. May 4-9, 2007
Nadeau, L, Johnson-Lafleur, J, Liben, S, Macdonald, ME, Rousseau, C Polychronakos,
C, Perrault, J, Lands, L. Treatment-compliance in chronically ill adolescents from
cultural minorities. Canadian Academy of Child and Adolescent Psychiatry 26th Annual
Conference, Toronto, 2006 (Nov). Published in conference proceedings.
Razack, S, Steinert Y, Macdonald, ME, Carnevale, FA, Tellier, PP (September, 2006)
Caring for a diverse diversity; Reconciling cultural, socioeconomic, and sexual
difference in medical education. Royal College/Canadian Society for clinical
Investigation, Annual Conference, Ottawa. Clinical and Investigative Medicine 2006
29(4): 221-222
Neil MacDonald
1. Summary of New and Ongoing Research
New Emerging Team Grant (CIHR) – studies on cachexia. McGill PI. A collaboration
with the University of Alberta. Dr Vickie Baracos is the overall PI.
Clinical Trials – PI study on dronabinol – effects on appetite, taste and smell. A
collaboration with the University of Alberta.

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Palliative Care McGill Annual Report 2006/2007

Co-investigator – AVR 118 in the management of cancer anorexia (Dr Chasen PI – study
to start in late May - early June.
Studies on the role of inflammation as reflected by ↑ CRP and a high white count in
patients with NSCLC.

Current studies include:


A continuing analysis of overall prognosis
Relationship of inflammation to chemotherapy response
Impact of CRP on early dropout rate in clinical trials
Relationship of PET intensity to inflammatory markers

Other research activities include:


Shared supervision of a Master’s student (Ms Swinton) and continuing interaction with
physiotherapy colleagues who are studying the role of exercise activities in NSCLC
patients

2. Scientific Reviews
Editorial Boards
Journal of Palliative Care
Journal of Pain and Symptom Management
Quaderni di Cure Palliative
Journal of Supportive Oncology
Palliative and Supportive Care
Oncology Exchange

Reviewer
Canadian Medical Association Journal
Journal of Clinical Oncology
Journal of Palliative Care
Journal of Palliative Medicine
Journal of Supportive Oncology
Journal of Clinical Nutrition

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Palliative Care McGill Annual Report 2006/2007

Journal of Pain and Symptom Management


Cancer
Journal of Applied Physiology, Nutrition and metabolism
Journal of Palliative Care – Book Review
CIHR Grant

3. Advisory Work for National and International Organizations


Chair, WHO IAHPC Joint Program - Developing a List of Essential Medicines for
Palliative and End-of-Life Care. Salzburg, Austria May 2006.

4. Invited Presentations and Workshops (National and International)


“Cancer Cachexia: The Argument for Early Palliative Care Intervention”. The 16th
Annual Ontario Provincial Conference on Palliative and End-of-Life Care. Toronto
Ontario. April 23 and 24, 2006.
“How to Identify and Approach the Malnourished Patient”. Issues in Palliative Care
Conference. Antigonish, Nova Scotia. May 13, 2007.
“Ethics and End-of-Life Care”. Issues in Palliative Care Conference. Antigonish, Nova
Scotia. May 14, 2007.

5. Hospital Activities
Royal Victoria Hospital, Montreal - Attending Staff
Montreal General Hospital, Montreal - Attending Staff
Jewish General Hospital, Montreal – Associate
St Mary’s Hospital, Montreal - Associate

Antonio Vigano
1. Research Grants (ongoing)
Laboratory for correlative and interdisciplinary research on cancer nutrition and
rehabilitation; Amount $ 303,582.00; Agency: Canadian Foundation for Innovation.
(Support period; 11/2004 to 11/2009) McGill Nutrition and Performance Laboratory
recruited first patient on December 11, 2006. Official opening April 2007. Patients
recruited to date (May 18, 2007): 48
Prognostic value of clinical correlates of cancer cachexia: a prospective, multicenter,
population-based study; Amount $ 211,925.00; Agency: Canadian Institutes for Health
Research. (Support period; 06/2004 to 05/2007) Patients accrued: 240 (target: 300)

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Palliative Care McGill Annual Report 2006/2007

2. Invited speaker

Vigano A. McDonald N, Swinton N, Dalzell MA, Falconer W, Gombos M, Chasen


Assessing and Managing Cancer Cachexia: What’s up. M, 16th International Congress
on Care of the Terminally Ill, Montreal, Canada, September, 2006.
A. A. Vigano. Three sessions. a) The science of prognosis: Snapshot – Tools in use: PaP.
b) The science of prognosis: how can it be improved: Symptom distress. c) Have we
discovered anything new? International Workshop on prognosis in palliative care. May
25-27, 2007. Surrey, British Columbia, Canada.

3. Peer-reviewed accepted/published abstracts


Angiotensin-converting enzyme gene polymorphism (ACEGP) and cancer cachexia (CC):
is there a link? A. A. Vigano1, N. Hamel2, J. Morais3, W. Foulkes2, R. Kilgour4, R.
Bond1, B. Trutschnigg1, S. Brar1, J. Theberge5, M. Tremblay5;
Poster presentation/discussion for the American Society of Clinical Oncology at the
43rd ASCO Annual Meeting, in Chicago, Illinois, June 1-5 2007.
Body composition changes in advanced cancer associated with Angiotensin-Converting
Enzyme (ACE) gene polymorphism: preliminary results. Vigano Antonio1, Trutschnigg
Barbara1, Bond Rachel1, Brar Seema1, Hamel Nancy2, Theberge Jean-Francois3, Foulkes
William2, Morais Jose4; Poster presentation for the European Association for Palliative
Care at the 10th EAPC Congress in Budapest, Hungary, June 7-9 2007.
Taxonomy for cancer cachexia: usefulness of blood counts, albumin and C-reactive
protein. A. A. Vigano1, B. Trutschnigg1, R. Bond1, L. Hornby1, J. Morais1,2, R.
Kilgour1,2; Poster presentation for the Multinational Association of Supportive Care in
Cancer at the Supportive Care Cancer Research 20th International Anniversary
Symposium in St. Gallen, Switzerland, 27-30 June 2007.

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Palliative Care McGill Annual Report 2006/2007

Appendix I: Honours Awards and Prizes

Stephen Liben
Service Award – Commander Palliative Care Presentation. Nov 2006 The Military &
Hospitaller Order of St. Lazarus
First Prize - Royal Society of Medicine Book Awards. Oct 2006, Oxford Textbook of
Palliative Care for Children (Goldman, Hain, Liben eds).

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Palliative Care McGill Annual Report 2006/2007

Appendix II: Publications

Articles in peer-reviewed journals


Towers A, Carnevale F, Baker ME The Psychosocial Effects Of Cancer-Related
Lymphedema, submitted to The Journal of Palliative Care. Submitted
*Xu W, Towers A, Li P, Collet JP. Traditional Chinese Medicine in Cancer Care:
Perspectives and Experiences of Patients and Professionals in China ECC-2005-0074,
European Journal of Cancer Care, online 22 May 2006
*Lee V, Cohen SR, Edgar L, Laizner AM, Gagnon A. Meaning-making and
Psychological Adjustment to cancer: development of an intervention and pilot results.
Oncology Nursing Forum, 2006; 33 (2): 291-302.
*Lee V, Cohen SR, Edgar L, Laizner AM, Gagnon AJ. Meaning-making intervention
during breast or colorectal cancer treatment improves self-esteem, optimism, and self-
efficacy. Social Science & Medicine, 2006; 62(12) 3133-3145.
*Macdonald ME, Liben S, Cohen SR. Truth and consequences: Parental perspectives
on autopsy after the death of a child. Pediatric Intensive Care Nursing, 2006; 7(1) 6-15.
Williams A, Crooks VA, Stajduhar KI, Allan D, Cohen SR. Canada’s Compassionate
Care Benefit: Views of family caregivers in chronic illness. International Journal of
Palliative Nursing, 2006; 12 (9) 438-45.
Cohen SR, Leis AM, Kuhl D, Charbonneau C, Ritvo P, Ashbury FD. QOLLTI-F:
measuring family carer quality of life. Palliative Medicine, 2006; 20: 755-767.
Mount BM, Boston P, Cohen SR. Healing connections: on moving from suffering to a
sense of well-being. Journal of Pain and Symptom Management, 2007; 33(4) 372-388.
Suissa S, Hutchinson T, Brophy JM, Kezouh A. ACE-inhibitor use and the long-term
risk of renal failure in diabetes. Kidney International 2006; 69:913-919.
Schneider V, Lévesque LE, Zhang B, Hutchinson T, Brophy JM. The association of
selective and conventional non-steroidal anti-inflammatory drugs with acute renal failure:
a population based nested case-control analysis. American Journal of Epidemiology
2006; 164(9): 881-889.

Gagnon B, Mayo NE Laurin C, Hanley, J.A and MacDonald N Identification in


Administrative Databases of Women Dying of Breast Cancer. Journal of Clinical
Oncology 2006;24(6):838-40.

Swinton N, Chasen M, MacDonald N. Simple Nutritional Screening in Clinical Practice.


Oncology Exchange 2006; 5(4):34-37.

33
Palliative Care McGill Annual Report 2006/2007

DeLima L, MacDonald N, Doyle D. IAHPC List of Essential Medicines for Palliative


Care: summary of process for editors of pain and palliative care journals. Journal of
Palliative Care 2006; 22(4):300-304.

MacDonald N. Cancer Cachexia and Targeting Chronic Inflammation: a unified


approach to cancer treatment and palliative/supportive care. Journal of Supportive
Oncology 2007;5(4):157-162.

MacDonald N. Cancer symptom control trials: how may we advance this field? Current
Oncology. In Press.

De Lima L, Krakauer E, Lorenz K, Praill D, MacDonald N, Doyle D. Ensuring Palliative


Medicine Availability: the development of the IAHPC List of Essential Medicines for
Palliative Care. Journal of Pain and Symptom Management 2007;33(5):521-526.

Books and Book Chapters


Towers A. Lymphoedema, Chapter 92, in Walsh D. ed. Palliative Medicine Elsevier
Philadelphia 2007 (in press)
Lymphoedema Framework: Best Practice for the Management of Lymphoedema.
International Consensus. London MEP Ltd, 2006. ISBN 0-9547669-4-6. I was a member
of the international advisory board that drafted these practice guidelines.
Cohen SR. Quality of life assessment in palliative care. In: Textbook in Palliative
Medicine, E. Bruera, I. Higginson, C. von Gunten, and C. Ripamonti eds. Hodder Arnold
Limited, London, England. Distributed by Oxford University Press, New York, N.Y.
(2006) pp. 349-55.
Liben S. Breathlessness in Children (2006). In :Dyspnoea in advanced disease; a guide
to clinical management. S Booth & D Dudgeon (eds). Oxford University Press.
The Oxford Textbook of Palliative Care for Children – Edited by Goldman A, Liben S,
and Hain R. Oxford University Press, 2006
Alimentation/hydration. Chasen M and MacDonald N. In: ESMO Handbook of
Advanced Cancer Care. Catane R, Cherny NI, Kloke M, Tanneberger S and Schrijvers D
(eds). Oxford: Taylor & Francis 2006: 71-79.
The Development of Palliative Care in Canada. MacDonald N. In: Palliative Medicine.
Bruera E, Higginson I, Ripamonti C and von Gunten C. (eds). London: Hodder Arnold
Publishers. 2006: 22-29.
Quality end-of-Life Care. Singer PA, MacDonald N. Tulsky JA. In: Bioethics for
Clinicians. Cambridge University Press. 2007. Accepted for publication.

34
Palliative Care McGill Annual Report 2006/2007

Conference Proceedings
Liben S. Understanding what families want and what children need; pediatric palliative
care research brings us closer. Chair: Pediatric Day Seminar: 16th International Congress
On Care of the Terminally Ill. Sept 2006 Montreal

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Palliative Care McGill Annual Report 2006/2007

Appendix III: Consulting Activities


None Reported

36

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