bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic tests and principal investigations
Authors: Werner Yuki B. 
Published: May 2023

Abstract
This chapter provides an overview of the different methods to evaluate a disease including invasive, non-invasive, and functional tests. It is divided into ten sections and explains the principles of each test for use in clinical routine based on the current literature. It contains not only memorable but also useful image examples and exemplifies practical classifications. Technological progress and subtle test protocols expand the value of the established methods. Newer functional tests, such as high-resolution manometry and the endoluminal functional lumen imaging probe (EndoFLIP), extend the diagnostic spectrum for symptomatic patients. Functional imaging technologies enable clinicians to identify and differentiate the causes of dysphagia and the severity grades of motility disorders. The use of diagnostic tests will improve the ability to indicate necessary interventions and to predict the therapeutic response. Nevertheless, the introduction of new diagnostic methods into the clinical routine should be based on validated data from controlled clinical trials.
Benign diseases of the stomach
Authors: Aridome Kuniaki 
Published: May 2023

Abstract
Most benign diseases of the stomach are attributed to functional dyspepsia and acid-related disorders such as peptic ulcer disease. Dyspepsia is also the main manifestation of these acid-related conditions of the stomach. Functional dyspepsia comprises three subtypes: postprandial distress syndrome, epigastric pain syndrome, and a subtype with overlapping postprandial distress syndrome and epigastric pain syndrome features. Peptic ulcer disease is characterized by a non-malignant lesion in the gastrointestinal mucosa that may be acute, subacute, or chronic. Proton pump inhibitors significantly improve the management options available for patients with functional dyspepsia or peptic ulcer disease. Reduction of inappropriate prescribing of proton pump inhibitors in inpatient and outpatient settings can minimize the potential for adverse events.
Oesophageal cancer
Authors: van Boxel Gijsbert , van der Sluis Pieter C. , Grimminger Peter P. , van Hillegersberg Richard 
Published: May 2023

Abstract
Surgical resection of the oesophagus and its surrounding lymph nodes in an en bloc manner remains the mainstay treatment in the curative management of oesophageal cancer, with or without neoadjuvant oncological treatment. Evidence in favour of the minimally invasive approach for oesophagectomy is increasing, including that for the use of robotic surgery. The past two decades have seen an increasing uptake in minimally invasive Ivor Lewis oesophagectomy (MIO)—laparoscopic mobilization of the stomach with abdominal lymph node dissection and formation of the gastric conduit, followed by the thoracoscopic resection of the oesophagus and its surrounding lymph nodes and formation of an intrathoracic anastomosis. Several multicentre randomized controlled trials and large-scale meta-analyses have shown a reduction in cardiopulmonary complications with equivalent long-term disease-free and overall survival when comparing MIO to open oesophagectomy. Robot-assisted minimally invasive oesophagectomy (RAMIO) is fast becoming a preferred approach to oesophagectomy. Its principles are similar to MIO, although the evidence available suggests that the increased dexterity, magnification, tremor reduction, and three-dimensional vision permitted by the robotic platform allows for greater lymph node yields and reduced cardiopulmonary complications. This chapter reviews the history and variety of operative approaches to the surgical resection of the oesophagus and the rationale for each approach. The steps involved and the current available evidence for both MIO and RAMIO are described.
Oesophageal cancer
Authors: Goetze Thorsten Oliver , Al-Batran Salah-Eddin 
Published: May 2023

Abstract
Gastric and oesophageal carcinomas, including adenocarcinomas of the oesophagogastric junction, were responsible for more than 1 million deaths worldwide in 2018. Surgery remains the primary curative treatment method for these carcinomas. The overall prognosis for this condition treated with surgery alone, however, is unsatisfactory. Consequently, perioperative multimodal concepts are standard to improve the overall survival according to the FLOT4 and CROSS trials. However, more than 50% of patients continue to die from the disease in a curative setting. Several ongoing clinical trials are investigating the further optimization of perioperative therapies. In the palliation of gastric and oesophagogastric junction adenocarcinomas, there have been some innovations and changes in the conventional treatment, as well as in immunotherapy.
Gastric cancer
Authors: Bang Chang Seok 
Published: May 2023

Abstract
Gastric cancer remains a health-related burden worldwide and is the third leading cause of cancer-related mortality. Endoscopic submucosal dissection is indicated for superficial gastrointestinal neoplasms with negligible risk of lymph node metastasis. This procedure has an advantage of achieving en bloc resection of tumours irrespective of the size and location of the lesions, and the stomach can be preserved. It has evolved through an improvement in endoscopic skills, expertise, and equipment, reaching a better understanding of the indications, short-term and long-term outcomes, and management of adverse events. In this chapter, the indications, procedure, therapeutic outcomes, management of adverse events, and post-endoscopic submucosal dissection surveillance strategy are discussed.
Gastric cancer
Authors: Biebl Matthias , Kröll Dino , Chopra Sascha , Pratschke Johann 
Published: May 2023

Abstract
This chapter summarizes surgical treatment options for adenocarcinomas of the stomach (gastric cancer) as well as the oesophagogastric junction (AOG tumours). Anatomically, the cardia is the anatomical transition zone of the two-layered oesophageal musculature into the three-layered stomach defined by the end of the longitudinal gastric folds. The sharp transition of the oesophageal squamous epithelium into the cylindric gastric mucosa (the Z-line) is a well-defined landmark. It is, however, variable in height and, due to its potential for oral translocation in patients with acid reflux, not suitable for exact anatomical determination of the AOG junction. Siewert coined a classification regarding this junction, of the transitional zone between the oesophagus and stomach extending from 5 cm proximal to the histological cardia to 5 cm of the proximal stomach. Tumours arising within the distal 5 cm of the oesophagus (formally distal oesophageal adenocarcinomas) are defined as AOG I tumours, tumours arising within 2 cm cranial to and less than 2 cm below the anatomical cardia are defined as AOG II tumours. Tumours below 2 cm and within 5 cm distal to the cardia (formally subcardial gastric cancer) are defined as AOG III tumours. However, according to the current classification of the ‘Union international Contre le Cancer’ (UICC), there is no specified classification for AOG tumours, and AOG tumours are classified as oesophageal tumours. This has been criticized by several authors, who attribute to AOG II and III tumours a biological behaviour and lymphatic spread pattern similar to gastric cancers. Tumours distal to the 5 cm line from the cardia are defined according to their position in the stomach as upper-third gastric cancers (proximal tumours), mid-third gastric cancers (corpus carcinomas), and tumours of the distal third of the stomach (antral tumours).
Gastric cancer
Authors: Hikage Makoto , Terashima Masanori 
Published: May 2023

Abstract
Minimally invasive gastrectomy is becoming the mainstay surgical treatment for gastric cancer. Large-scale clinical studies have confirmed the safety and oncological feasibility of laparoscopic gastrectomy. Moreover, robotic systems, which have been introduced to overcome the disadvantages of laparoscopic surgery, are expected to further improve surgical outcomes, even in complicated procedures or highly advanced cases. This chapter provides a histological outline and describes the development of these minimally invasive surgeries with existing evidence. In addition, it comments on the future prospects of these techniques and concludes that that endoscopic surgery will play a leading role in gastric cancer therapy in the near future.
Fundamental Skills and Education for the Generalist and Specialist Palliative APRN
Authors: Wholihan Dorothy , Tilley Charles , Rudden Adrienne 
Published: May 2023

Abstract
Advanced practice registered nurses (APRN) have played a pivotal role in palliative care over the past 15 years and will continue to shape the future of hospice and palliative care. Broadly defined and practice-focused, advanced practice nursing includes interventions that influence healthcare outcomes, including the direct care of individual patients, management of care for individuals and populations, administration of nursing and healthcare organizations, and the development and implementation of health policy. There are specific requirements for education delineated by the American Association of Colleges of Nursing (AACN) and the National Council of State Boards of Nursing (NCSBN) Consensus Model as per Licensure, Accreditation, Certification, and Education (LACE) standards. Palliative nursing is a necessary aspect of all specialty tracks. This chapter reviews graduate requirements for APRNs and both primary and specialty palliative care content in graduate curricula.
The Palliative APRN in Policy and Payment Models
Authors: Grant Marian 
Published: May 2023

Abstract
Palliative care achieves all the key objectives of health reform and health policy revisions, and recent federal legislation and regulation is improving access to palliative care services. In addition, healthcare payment is shifting toward paying for outcomes and value, and palliative care can contribute to achieving those goals. Health policy and payment policy affect patient care and access to care, what palliative advanced practice registered nurses (APRNs) can do clinically, and what they can be reimbursed for. Palliative care is attractive to policymakers because it improves care for serious illness while also controlling costs. This chapter reviews how palliative care meets policy goals, recent developments in federal legislation and regulation for serious illness, new payment models for that population, and how palliative APRNs can play a role in policy development and implementation.
The Palliative APRN in Research and Evidence-Based Practice
Authors: Linton Janice , Carpenter Joan G. 
Published: May 2023

Abstract
Advanced practice palliative nursing is grounded in research and guided by evidence-based practice (EBP). Research is a systematic approach aimed at developing new knowledge through science. EBP is a structured mechanism for solving health-related issues based on the triad of best research (external evidence), clinical expertise (internal evidence), and patient preferences and values to support clinical decision-making for best outcomes. This chapter defines the advanced practice registered nurse (APRN)’s role in conducting research and translating evidence into clinical practice. Case studies are integrated throughout to demonstrate the stepwise approach for conducting high-quality research and applying EBP processes. Supportive statements from leading organizations in the palliative care industry add credence to the APRN’s role in research and EBP. The future of high-quality care for persons living with a serious or life-threatening illness lies in delivering expert palliative care grounded in research and EBP.
The Palliative APRN in the Palliative Care Clinic
Authors: Smith Brooke , Stephens Lisa A. 
Published: May 2023

Abstract
This chapter discusses the role of the advanced practice registered nurse (APRN) in providing symptom management, psychosocial support, and collaborative decision-making support across the disease trajectory. It describes communication, assessment, and management of symptoms; psychosocial and spiritual support; and coordination of care as integral skills that the nurse brings to the care of palliative care patients in the clinic. It details outpatient palliative care clinic models and the APRN role within each model, its financing and scheduling, and the roles of other team members. It also reviews the evidence for the nurse’s role in enhancing patient satisfaction and reducing healthcare utilization. It describes the longitudinal support of the palliative APRN in fostering resilience in patients, family members, and other members of the healthcare team. Finally, it describes the necessity of care coordination to promote quality care.
The Palliative APRN in Primary Care
Authors: Gorman Rosemary , Wholihan Dorothy , Bender Sarah 
Published: May 2023

Abstract
Primary care is defined by the National Academy of Medicine (previously the Institute of Medicine) as “the provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community.” A patient will see his or her primary care provider for routine physicals, preventive care, care of stable chronic illness, and common health-related issues. Advanced practice registered nurses (APRNs), most commonly nurse practitioners, frequently act in the role of primary care providers. The APRN who assumes this role acts as the initial contact point for patients who have a health-related problem. The primary care provider directs and coordinates specialist care as needed. Primary care providers aim for continuity of care that leads to the development of long-standing relationships. Since primary care takes a long-term, life span approach, the implementation of palliative care may be appropriate intermittently in a patient’s health trajectory. It is imperative that the APRN in primary care have primary palliative care skills.
LGBTQ+ Inclusive Palliative Care
Authors: Nymeyer Jessica 
Published: May 2023

Abstract
The palliative advanced practice registered nurse (APRN) cares for individuals who represent the spectrum of gender and sexual identities. Clinicians must be aware of the unique issues facing the LGBTQ+ population, including a history of discrimination in society at large and in healthcare institutions as well. In order to provide patient centered care and meet each patient’s medical and psychosocial needs, the palliative APRN should be familiar with the concerns, issues, and policies that affect the care of LGBTQ+ individuals. Moreover, there are unique concerns at end of life that must be addressed.
The Pediatric Palliative APRN in the Acute Care Setting
Authors: Kinnear Faith , Santucci Gina 
Published: May 2023

Abstract
The role of the pediatric palliative advanced practice registered nurse (PP APRN) in the acute care or inpatient setting encompasses a wide breadth including providing initial consults, managing acute pain and distressing symptoms, assisting families with complex medical decision-making, providing longitudinal support across multiple admission, ensuring goals are communicated among specialty team members, and providing expert care at the end of life. The APRN needs to be aware of the barriers that still exist to providing good pediatric palliative care and how providing primary palliative care education to colleagues can help overcome these barriers. This chapter highlights some of the nuances of inpatient pediatric palliative care and evidenced-based symptom management by utilizing case examples.
The Pediatric Palliative APRN in the Community
Authors: Chrastek Joan “Jody” , Hensel Jaime 
Published: May 2023

Abstract
This chapter provides an overview of pediatric palliative care in the community setting, where care can be complex and multilayered. The chapter describes the role of the pediatric palliative advanced practice registered nurse (PP APRN) in this setting. This includes the transition of care for a child with serious illness from hospital discharge, to care at home, to managing a home death. At times, community palliative care can be intimidating for families, caregivers, and professionals. However, with education and support, families are empowered as experts about their children and can provide the care their children need in a community setting. The PP APRN, along with the team, guides and helps the family care for their child in the place they feel most comfortable. Additional resources and checklists throughout the chapter are provided for more information.
Advance Care Planning
Authors: Farfour Hannah N. 
Published: May 2023

Abstract
Advance care planning (ACP) is a process that supports individuals at any stage of health in understanding and sharing their personal values, life goals, and preferences regarding future medical care. The goal is to help ensure that people receive medical care that is consistent with their beliefs during serious and chronic illness. Advanced practice registered nurses (APRNs) are in a unique position to initiate, facilitate, and support patients and their families with the advance care planning process. They also ensure that these preferences are documented in accessible formats. This chapter discusses such topics as healthcare decision-making, advance directives, living wills, durable powers of attorney, and surrogate decision-making, as well as the important role the APRN plays in this process.
Ensuring Quality Spiritual Care
Authors: Ferrell Betty 
Published: May 2023

Abstract
The National Consensus Project for Quality Palliative Care identifies spiritual, religious, and existential care as one of the eight essential domains of quality care. Spiritual care becomes especially important when patients are facing serious illness or end of life. While all palliative care nurses should be trained in the provision of spiritual care, advanced practices registered nurses (APRNs) need advanced spiritual care training so that they are equipped to perform spiritual assessments, assist patients as they conduct life reviews, coordinate care, and work collaboratively with chaplains to address patients’ complex spiritual needs that may arise at the end of life. APRNs have an important role to play in modeling spiritual care skills, developing policies and procedures, and creating structures and processes of spiritual care as interprofessional palliative care teams assume the important work of spiritual care.
Fatigue
Authors: Pandey Shila 
Published: May 2023

Abstract
Fatigue is a common symptom in patients with cancer as well as in patients with other chronic diseases. Palliative advanced practice registered nurses (APRNs) have the specialized training to synthesize data so they can provide care that is centered on patients’ goals in the areas of health, quality of life, and function. Subjective in nature, fatigue requires that the advance practice nurse assess how much it interferes with the patient’s functional status and quality of life. Assessment should include underlying etiologies as well as contributing factors. The palliative APRN’s role includes educating patients about self-management of fatigue. Palliative APRNs work collaboratively with the interdisciplinary team to provide pharmacologic and nonpharmacologic interventions.
Nausea and Vomiting
Authors: DeMarco Katherine E. 
Published: May 2023

Abstract
This chapter provides an overview of the assessment and management of nausea and vomiting and data on their prevalence for the adult population. The chapter reviews comprehensive symptom assessment that focuses on describing the patient’s experience and an understanding of the physiological pathways of nausea and vomiting, and their common etiologies, including bowel obstruction. It concludes with a review of the evidence base for management strategies, including patient education, lifestyle changes, selected integrative therapies, and a review of the mechanisms of action of antiemetics. This chapter can guide general pediatric palliative advanced practice registered nurse (APRN) practice considerations but it is not inclusive of specialty pediatric antiemetic care plans.
Cognitive Impairment
Authors: Brody Abraham A. , McCabe Donna E. 
Published: May 2023

Abstract
Cognitive impairment in its many forms can bring about devastating symptoms for the person living with the condition as well as for their family. This chapter provides the advanced practice palliative care nurse with an overview of the common conditions that cause cognitive impairment, with a focus on dementia. Assessment and management strategies are described in the context of understanding unmet needs and ameliorating symptoms while optimizing quality of life and preventing functional decline. A systematic assessment tool for identifying the underlying causes of behavioral and psychological symptoms of dementia (BPSD) is included to assist the palliative care advanced practice nurse utilize effective nonpharmacological, patient-centered interventions and, where needed, evidence-based pharmacologic interventions.
Serious Mental Illness
Authors: Pellecchia Kristyn , Murphy Ryan 
Published: May 2023

Abstract
Serious mental illness (SMI) is a chronic, often life-limiting illness that is inherently accompanied by significant psychosocial and spiritual distress. Since SMI is prevalent, it is not uncommon that individuals are concurrently diagnosed with other life-limiting illnesses, for example, cancer. This specialty population presents with unique needs, challenges, and difficulties when trying to navigate the healthcare system. By reviewing SMI diagnoses and treatments, this chapter aims to educate the palliative advanced practice registered nurse (APRN) to better serve patients with both SMI and other palliative diagnoses. The content includes introductions to trauma-informed care, harm reduction, and palliative psychiatry.
Patients with Substance Use Disorders and Dual Diagnoses
Authors: Brant Jeannine M. , Edwards Tonya 
Published: May 2023

Abstract
Substance use disorders (SUDs) are a growing concern in the United States. Often, a mental health concern co-occurs in many patients, creating a dual diagnosis. Palliative care advanced practitioners often manage patients with a SUD or dual diagnosis in the midst of trying to diligently manage pain and other deleterious symptoms that accompany serious illness. This chapter provides an overview of some of the challenges when working with patients with SUDs and a dual diagnosis and provides guidelines for best practice to optimally manage these patients. The use of universal precautions can serve as a guide for assessing patients and managing care in this population. Guidance is provided for a comprehensive assessment, including the use of the prescription drug monitoring program and urine drug testing. Management considerations including risk stratification of patients, pain management for patients with SUDs, the use of opioid treatment agreements, and novel interdisciplinary models of care are described and provide the advanced practice registered nurse (APRN) with a foundation to provide safe and compassionate care.
Anxiety
Authors: Stalhandske Kira 
Published: May 2023

Abstract
Anxiety is common for persons with advanced, serious, and/or life-limiting illness. Anxiety impacts psychoemotional and physical aspects of life. Anxiety is more common for people with higher physical symptom burden. Anxiety is specifically identified in the National Consensus Project for Quality Palliative Care Clinical Practice Guidelines Domain 3 under Psychological and Psychiatric Aspects of Care. The interdisciplinary team assesses and addresses psychological and psychiatric aspects of care based on the best available evidence to maximize patient and family coping and quality of life. The palliative advanced practice registered nurse (APRN) must identify and understand etiologies for anxiety across populations and disease states. Both pharmacological and nonpharmacological strategies can be implemented to improve quality of life.