Solomon Liao - Academia.edu (original) (raw)
Papers by Solomon Liao
Communications in Statistics Simulation and Computation, 2007
In survival analysis, it is often of interest to test whether or not two survival time distributi... more In survival analysis, it is often of interest to test whether or not two survival time distributions are equal, specifically in the presence of censored data. One very popular test statistic utilized in this testing procedure is the weighted logrank statistic. Much attention has been focused on finding flexible weight functions to use within the weighted logrank statistic, and we
Critical care medicine, 2015
Pantilat/Hospital-Based Palliative Medicine, 2015
Critical Reviews in Physical and Rehabilitation Medicine, 2013
American family physician, Jan 15, 2008
When patients are diagnosed with cancer, primary care physicians often must deliver the bad news,... more When patients are diagnosed with cancer, primary care physicians often must deliver the bad news, discuss the prognosis, and make appropriate referrals. When delivering bad news, it is important to prioritize the key points that the patient should retain. Physicians should assess the patient's emotional state, readiness to engage in the discussion, and level of understanding about the condition. The discussion should be tailored according to these assessments. Often, multiple visits are needed. When discussing prognosis, physicians should be sensitive to variations in how much information patients want to know. The challenge for physicians is to communicate prognosis accurately without giving false hope. All physicians involved in the patient's care should coordinate their key prognosis points to avoid giving the patient mixed messages. As the disease progresses, physicians must reassess treatment effectiveness and discuss the values, goals, and preferences of the patient an...
Clinical Gerontologist, 2008
About 25% of deaths in the United States now occur in nursing homes, and this proportion is incre... more About 25% of deaths in the United States now occur in nursing homes, and this proportion is increasing. Current end-of-life (EOL) care in these facilities faces substantial challenges, including under-management of pain, dyspnea, and other symptoms, a clash of cultures between palliative care/hospice teams and the nursing facility, and reimbursement policy that discourages the use of hospice. For ethnic minorities,
Gynecologic Oncology, 2014
American Journal of Hospice and Palliative Medicine, 2013
Palliative care requires an interdisciplinary team approach to provide the best care for patients... more Palliative care requires an interdisciplinary team approach to provide the best care for patients with life-threatening illnesses. Like palliative medicine, rehabilitation also uses an interdisciplinary approach to treating patients with chronic illnesses. This review article focuses on rehabilitation interventions that can be beneficial in patients with late stage illnesses. Rehabilitation may be useful in improving the quality of life by palliating function, mobility, activities of daily living, pain relief, endurance, and the psyche of a patient while helping to maintain as much independence as possible, leading to a decrease in burden on caregivers and family. Rehabilitative services are underutilized in the palliative care setting, and more research is needed to address how patients may benefit as they approach the end of their lives.
Journal of Pain and Symptom Management, 2015
Successful and sustained integration of palliative care into the intensive care unit (ICU) requir... more Successful and sustained integration of palliative care into the intensive care unit (ICU) requires the active engagement of bedside nurses. To describe the perspectives of ICU bedside nurses on their involvement in palliative care communication. A survey was designed, based on prior work, to assess nurses' perspectives on palliative care communication, including the importance and frequency of their involvement, confidence, and barriers. The 46-item survey was distributed via email in 2013 to bedside nurses working in ICUs across the five academic medical centers of the University of California, USA. The survey was sent to 1791 nurses; 598 (33%) responded. Most participants (88%) reported that their engagement in discussions of prognosis, goals of care, and palliative care was very important to the quality of patient care. A minority reported often discussing palliative care consultations with physicians (31%) or families (33%); 45% reported rarely or never participating in family meeting discussions. Participating nurses most frequently cited the following barriers to their involvement in palliative care communication: need for more training (66%), physicians not asking their perspective (60%), and the emotional toll of discussions (43%). ICU bedside nurses see their involvement in discussions of prognosis, goals of care, and palliative care as a key element of overall quality of patient care. Based on the barriers participants identified regarding their engagement, interventions are needed to ensure that nurses have the education, opportunities, and support to actively participate in these discussions.
PsycEXTRA Dataset, 2000
... Alternate Corresponding Author: Kerry Burnight, PhD, Assistant Clinical Professor of Family M... more ... Alternate Corresponding Author: Kerry Burnight, PhD, Assistant Clinical Professor of Family Medicine, Program in Geriatrics, University of California, Irvine College of Medicine, 101 The City Drive South, Pavilion III, ZC 1150, Orange, 92868. Email:burnight@uci.edu. ...
Journal of the American Medical Directors Association, 2007
ABSTRACT Physical abuse of the elderly has significant consequences not only on patients and fami... more ABSTRACT Physical abuse of the elderly has significant consequences not only on patients and families but also on the health care team. It is not only a social or family problem but a medical problem that is often under-recognized and underreported. The medical director, as the physician leader of a multidisciplinary team, is well positioned to address abuse through proper assessment, reporting to the appropriate authorities, and if necessary, immediate action to protect the patient. The physician should provide education to the staff about abuse, and all health care professional should be aware of the potential markers of abuse.
Journal of the American Geriatrics Society, 2000
Journal of the American Geriatrics Society, 2000
Journal of the American Geriatrics Society, 2010
OBJECTIVE: To investigate characteristics of people with dementia and their caregivers (CGs) that... more OBJECTIVE: To investigate characteristics of people with dementia and their caregivers (CGs) that are associated with mistreatment in order to inform clinicians about screening for mistreatment. DESIGN: A convenience sample of CG-care recipient (CR) dyads were assessed for literature-supported factors associated with mistreatment, and evidence of mistreatment for the prior year was collected. An expert panel considered the evidence and decided on occurrences of psychological abuse, physical abuse, and neglect based on criteria adopted before data collection. SETTING: Participants' homes. PARTICIPANTS: One hundred twenty-nine persons with dementia and their CGs. MEASUREMENTS: CG and CR characteristics (demographic, health, and psychosocial variables), relationship characteristics, and three elder abuse and neglect detection instruments. RESULTS: Mistreatment was detected in 47.3%. Variables associated with different kinds and combinations of mistreatment types included the CG's anxiety, depressive symptoms, social contacts, perceived burden, emotional status, and role limitations due to emotional problems and the CR's psychological aggression and physical assault behaviors. The combination of CR's physical assault and psychological aggression provided the best sensitivity (75.4%) and specificity (70.6%) for elder mistreatment as defined by the expert panel. This finding has potential to be useful as a clinical screen for detecting mistreatment. CONCLUSIONS: The findings suggest important characteristics of older adults with dementia and their CGs that have potential for use in a clinical screening tool for elder mistreatment. Potential screening questions to be asked of CGs of people with dementia are suggested. J Am Geriatr Soc 58:493-500, 2010.
Journal of Palliative Medicine, 2007
Objective: To benchmark the quality of palliative care in academic hospitals. Design: Multicenter... more Objective: To benchmark the quality of palliative care in academic hospitals. Design: Multicenter, cross-sectional, retrospective chart review conducted between October 1, 2002 and September 30, 2003.
Journal of Palliative Medicine, 2008
Methadone is generally believed to be devoid of neuroexcitatory properties, and its use is increa... more Methadone is generally believed to be devoid of neuroexcitatory properties, and its use is increasing. This paper reports two cases of myoclonus with high-dose parenteral methadone in patients with cancer under hospice care. This side effect may be dose related and/or due to the parenteral route of administration. Reduction of the dose and change of route was sufficient to eliminate the myoclonus while maintaining an adequate pain control. Possible mechanisms for methadone causing myoclonus include a redistribution of receptor saturation in the N-methyl-D-aspartate (NMDA) and delta receptors. Ketamine may be an option for patients with intractable pain who develop methadone-induced myoclonus.
Journal of Palliative Medicine, 2007
The majority of deaths in the United States occur in the geriatric population. These older adults... more The majority of deaths in the United States occur in the geriatric population. These older adults often develop multiple chronic medical problems and endure complicated medical courses with a variety of disease trajectories. Palliative care physicians need to be skilled in addressing the needs of these frail elders with life-limiting illness as they approach the end of life. Although geriatrics and palliative medicine share much in common, including an emphasis on optimizing quality of life and function, geriatric palliative care is distinct in its focus on the geriatric syndromes and on the provision of care in a variety of long-term care settings. Expertise in the diagnosis and management of the geriatric syndromes and in the complexities of long-term care settings is essential to providing high-quality palliative care to the elderly patient. This paper is a practical review of common geriatric syndromes, including dementia, delirium, urinary incontinence, and falls, with an emphasis on how they may be encountered in the palliative care setting. It also highlights important issues regarding the provision of palliative care in different long-term care settings.
Communications in Statistics Simulation and Computation, 2007
In survival analysis, it is often of interest to test whether or not two survival time distributi... more In survival analysis, it is often of interest to test whether or not two survival time distributions are equal, specifically in the presence of censored data. One very popular test statistic utilized in this testing procedure is the weighted logrank statistic. Much attention has been focused on finding flexible weight functions to use within the weighted logrank statistic, and we
Critical care medicine, 2015
Pantilat/Hospital-Based Palliative Medicine, 2015
Critical Reviews in Physical and Rehabilitation Medicine, 2013
American family physician, Jan 15, 2008
When patients are diagnosed with cancer, primary care physicians often must deliver the bad news,... more When patients are diagnosed with cancer, primary care physicians often must deliver the bad news, discuss the prognosis, and make appropriate referrals. When delivering bad news, it is important to prioritize the key points that the patient should retain. Physicians should assess the patient's emotional state, readiness to engage in the discussion, and level of understanding about the condition. The discussion should be tailored according to these assessments. Often, multiple visits are needed. When discussing prognosis, physicians should be sensitive to variations in how much information patients want to know. The challenge for physicians is to communicate prognosis accurately without giving false hope. All physicians involved in the patient's care should coordinate their key prognosis points to avoid giving the patient mixed messages. As the disease progresses, physicians must reassess treatment effectiveness and discuss the values, goals, and preferences of the patient an...
Clinical Gerontologist, 2008
About 25% of deaths in the United States now occur in nursing homes, and this proportion is incre... more About 25% of deaths in the United States now occur in nursing homes, and this proportion is increasing. Current end-of-life (EOL) care in these facilities faces substantial challenges, including under-management of pain, dyspnea, and other symptoms, a clash of cultures between palliative care/hospice teams and the nursing facility, and reimbursement policy that discourages the use of hospice. For ethnic minorities,
Gynecologic Oncology, 2014
American Journal of Hospice and Palliative Medicine, 2013
Palliative care requires an interdisciplinary team approach to provide the best care for patients... more Palliative care requires an interdisciplinary team approach to provide the best care for patients with life-threatening illnesses. Like palliative medicine, rehabilitation also uses an interdisciplinary approach to treating patients with chronic illnesses. This review article focuses on rehabilitation interventions that can be beneficial in patients with late stage illnesses. Rehabilitation may be useful in improving the quality of life by palliating function, mobility, activities of daily living, pain relief, endurance, and the psyche of a patient while helping to maintain as much independence as possible, leading to a decrease in burden on caregivers and family. Rehabilitative services are underutilized in the palliative care setting, and more research is needed to address how patients may benefit as they approach the end of their lives.
Journal of Pain and Symptom Management, 2015
Successful and sustained integration of palliative care into the intensive care unit (ICU) requir... more Successful and sustained integration of palliative care into the intensive care unit (ICU) requires the active engagement of bedside nurses. To describe the perspectives of ICU bedside nurses on their involvement in palliative care communication. A survey was designed, based on prior work, to assess nurses' perspectives on palliative care communication, including the importance and frequency of their involvement, confidence, and barriers. The 46-item survey was distributed via email in 2013 to bedside nurses working in ICUs across the five academic medical centers of the University of California, USA. The survey was sent to 1791 nurses; 598 (33%) responded. Most participants (88%) reported that their engagement in discussions of prognosis, goals of care, and palliative care was very important to the quality of patient care. A minority reported often discussing palliative care consultations with physicians (31%) or families (33%); 45% reported rarely or never participating in family meeting discussions. Participating nurses most frequently cited the following barriers to their involvement in palliative care communication: need for more training (66%), physicians not asking their perspective (60%), and the emotional toll of discussions (43%). ICU bedside nurses see their involvement in discussions of prognosis, goals of care, and palliative care as a key element of overall quality of patient care. Based on the barriers participants identified regarding their engagement, interventions are needed to ensure that nurses have the education, opportunities, and support to actively participate in these discussions.
PsycEXTRA Dataset, 2000
... Alternate Corresponding Author: Kerry Burnight, PhD, Assistant Clinical Professor of Family M... more ... Alternate Corresponding Author: Kerry Burnight, PhD, Assistant Clinical Professor of Family Medicine, Program in Geriatrics, University of California, Irvine College of Medicine, 101 The City Drive South, Pavilion III, ZC 1150, Orange, 92868. Email:burnight@uci.edu. ...
Journal of the American Medical Directors Association, 2007
ABSTRACT Physical abuse of the elderly has significant consequences not only on patients and fami... more ABSTRACT Physical abuse of the elderly has significant consequences not only on patients and families but also on the health care team. It is not only a social or family problem but a medical problem that is often under-recognized and underreported. The medical director, as the physician leader of a multidisciplinary team, is well positioned to address abuse through proper assessment, reporting to the appropriate authorities, and if necessary, immediate action to protect the patient. The physician should provide education to the staff about abuse, and all health care professional should be aware of the potential markers of abuse.
Journal of the American Geriatrics Society, 2000
Journal of the American Geriatrics Society, 2000
Journal of the American Geriatrics Society, 2010
OBJECTIVE: To investigate characteristics of people with dementia and their caregivers (CGs) that... more OBJECTIVE: To investigate characteristics of people with dementia and their caregivers (CGs) that are associated with mistreatment in order to inform clinicians about screening for mistreatment. DESIGN: A convenience sample of CG-care recipient (CR) dyads were assessed for literature-supported factors associated with mistreatment, and evidence of mistreatment for the prior year was collected. An expert panel considered the evidence and decided on occurrences of psychological abuse, physical abuse, and neglect based on criteria adopted before data collection. SETTING: Participants' homes. PARTICIPANTS: One hundred twenty-nine persons with dementia and their CGs. MEASUREMENTS: CG and CR characteristics (demographic, health, and psychosocial variables), relationship characteristics, and three elder abuse and neglect detection instruments. RESULTS: Mistreatment was detected in 47.3%. Variables associated with different kinds and combinations of mistreatment types included the CG's anxiety, depressive symptoms, social contacts, perceived burden, emotional status, and role limitations due to emotional problems and the CR's psychological aggression and physical assault behaviors. The combination of CR's physical assault and psychological aggression provided the best sensitivity (75.4%) and specificity (70.6%) for elder mistreatment as defined by the expert panel. This finding has potential to be useful as a clinical screen for detecting mistreatment. CONCLUSIONS: The findings suggest important characteristics of older adults with dementia and their CGs that have potential for use in a clinical screening tool for elder mistreatment. Potential screening questions to be asked of CGs of people with dementia are suggested. J Am Geriatr Soc 58:493-500, 2010.
Journal of Palliative Medicine, 2007
Objective: To benchmark the quality of palliative care in academic hospitals. Design: Multicenter... more Objective: To benchmark the quality of palliative care in academic hospitals. Design: Multicenter, cross-sectional, retrospective chart review conducted between October 1, 2002 and September 30, 2003.
Journal of Palliative Medicine, 2008
Methadone is generally believed to be devoid of neuroexcitatory properties, and its use is increa... more Methadone is generally believed to be devoid of neuroexcitatory properties, and its use is increasing. This paper reports two cases of myoclonus with high-dose parenteral methadone in patients with cancer under hospice care. This side effect may be dose related and/or due to the parenteral route of administration. Reduction of the dose and change of route was sufficient to eliminate the myoclonus while maintaining an adequate pain control. Possible mechanisms for methadone causing myoclonus include a redistribution of receptor saturation in the N-methyl-D-aspartate (NMDA) and delta receptors. Ketamine may be an option for patients with intractable pain who develop methadone-induced myoclonus.
Journal of Palliative Medicine, 2007
The majority of deaths in the United States occur in the geriatric population. These older adults... more The majority of deaths in the United States occur in the geriatric population. These older adults often develop multiple chronic medical problems and endure complicated medical courses with a variety of disease trajectories. Palliative care physicians need to be skilled in addressing the needs of these frail elders with life-limiting illness as they approach the end of life. Although geriatrics and palliative medicine share much in common, including an emphasis on optimizing quality of life and function, geriatric palliative care is distinct in its focus on the geriatric syndromes and on the provision of care in a variety of long-term care settings. Expertise in the diagnosis and management of the geriatric syndromes and in the complexities of long-term care settings is essential to providing high-quality palliative care to the elderly patient. This paper is a practical review of common geriatric syndromes, including dementia, delirium, urinary incontinence, and falls, with an emphasis on how they may be encountered in the palliative care setting. It also highlights important issues regarding the provision of palliative care in different long-term care settings.