United Kingdom were among the first o experiment, employing mostly nurses to address the overall disease with a somewhat passive approach. Today the u.K. claims as many phy icians taking an active part in palliative care as in family medicine. Canada and Australia soon followed Britain's lead, encouraging specialists to take a more active approach by tending to patient' individual symp- toms. In Carolina's program, physicians from oncology, geriatrics and pain serv- ice, as well as social workers and even music therapists, will work to help atients suffering from cancer (though not necessarily end-stage cancer), degen- erative diseases such as AJzheimer's, and advanced cardiac or pulmonary disease. During the coming year, the program is expected to expand to include patients een in Carolina's many primary care practices. Hanson says the goal is to meet the needs ofpatients with life-limiting ill- nesses regardless of whether they con- tinue pursuing curative therapies."We will offer it to any patient in the UNC health system whose physician believes they have an illness that will ultimately cause their death," she said. "This escapes the usual terminal diagnosis 'six months to live' notion and makes compassionate and helpful symp- tom management available to patients who have diseases that are incurable and progressive, that eventually will cause them to die. "Many people think palliative care is care you receive when the doctor has give up on curative care. With this pro- gram we're trying to meet the needs of patients with life-limiting diseases regardless of whether they continue to pursue curative therapies or not." The program also will offer a com- munity-based educational outreach serv-
ice to teach patients and their families
about new treatment approaches, to
offer support for emotional distress, and
to aid in advanced planning for end-of-
life decisions. Referrals can come from
other physician as well as nurses and
The Pain and Symptom Care
Program is the inaugural project of the
University's Center for Health Ethics
and Policy, which Hanson co-directs
with Dr. Larry Churchill, professor of
The program will focus on three
main areas: physical symptoms, such as
pain, shortness of breath , nausea and
mobility problems; advanced directives,
which refers to the terminally ill
patient's future plans; and the perception
of access to medical care and the ability
to have one's needs m.et.
This last area interests Bernard most
of all. "Palliative care," he said, "serves to
restore a balance in medicine to the care
of the person in contrast to the increasingly technological approach that
medical management has taken in tbe
- J essie Tucker
Weight and early puberty: Being overweight is closely associated with ear-lier-than-average puberty in white girls but much less so in African-American
girls, according to the first large study of the subject done by researchers at
UNC and the Virginia Commonwealth University School of Medicine. The discovery was a surprise in an area that has many more questions than answers.
The new study, which did not prove that excessive weight causes early
puberty but established a connection, involved analyzina body mass index
data in an original sample of more than 17,000 girls in the United States.
Genetic or environmental factors may have a stronger effect on when
puberty starts for black girls.
'Small' money: UNC's nanoscience team received a $1 million gift from the
W.M. Keck Foundation that will help the team to buy new instruments that
provide clear, three-dimensional images of microscopic particles. Nanotechnology is the science behind building increaSingly fast devices in dramatically
smaller packages and affects everything from computer chips to medical
PS-l41 graduates: A UNC study of an experimental cancer drug showed
promising results in a small number of patients, and now the drug will be
tested on a larger scale at other cancer centers across the country. In laboratory cell culture and animal studies at UNC and elsewhere, inhibitors such as
the drug, called PS- 34 I, killed cancer cells more readily than normal cells,
enabling it to benefit several patients who were not helped by standard
chemotherapy. The drug will be tested on patients with myeloma and non-Hodgkin's lymphoma.
Embryo survival: A gene discovered by scientists at Carolina appears to be
crucial for female embryo survival,A study by UNC researchet':; furthers the
understanding of a fundamental biological process in mammals and contributes important new knowledge to gene regulation in the developing
embryo. It also has implications for problems such as fetal loss, tumor development, birth defects and mental retardation.