FRIDAY LUNCHTIMEIn a room of 100 people, the noisy sounds of lunch hush as the clinician leader, a wiry young oncologist, opens the 70th Schwartz Center Rounds with a topical joke, a brief announcement, and a welcoming smile. He starts in earnest, leaning slightly forward, and introduces a senior Massachusetts General Hospital (MGH) physician and the story he will tell with, "We often ask ourselves, 'what would I do if I got cancer?' " A pediatrician is the colleague who has cancer. He shifts Correspondence: Richard T. Penson, M.R.C.P., M.D.,

OBJECTIVE: To measure the impact of asthma management education on the control of asthma in the community.DESIGN: A cross-sectional study comparing three communities.SETTING: Three rural communities in southern Alberta.PATIENTS AND METHODS: A population sample of patients with asthma attending a pharmacy to fill a prescription for asthma medication were selected from three communities. Patients were asked to complete a questionnaire relating to their asthma management and control.INTERVENTION: Three levels of asthma management education were provided in the three communities with populations of 6000 to 10,000. The levels of education ranged from standard continuing medical education programs relating to the national asthma guidelines and a visiting asthma nurse educator to the establishment of an asthma clinic and a multiple-target, intensive education program for health professionals, town leaders, local media, schools and the public. The survey of the population with asthma was conducted approximately one year after the education program had been completed.RESULTS: A total of 327 completed questionnaires were submitted. Analysis showed that there was no significant difference that could be attributed to the intervention in the management of asthma or in the level of asthma control among the patients from the three communities.RESULTS: A total of 327 completed questionnaires were submitted. Analysis showed that there was no significant difference that could be attributed to the intervention in the management of asthma or in the level of asthma control among the patients from the three communities.

Parents whose children have progressive genetic disorders, such as Tay-Sachs, are confronted with a myriad of painful and compelling issues. This paper describes a long-term, open-ended group set up to allow parents of such children to work together on mutual concerns. The process of collaboration, the evolving structure of the group, and the challenges of working with this special population are explored.ith a growing awareness of the emo-

Carbon 60 has been used in a functionalized form in a bioassay for a common herbicide, atrazine. It was found that the C 60 is a very effective quencher of fluorescence from number of common dyes. C 60 was conjugated to atrazine for use in an immunoassay in which fluorescence from rhodamine was measured. Quenching of the rhodamine emission provided a detection scheme in this assay that yielded very good limit of detection. The C 60 quenching scheme can be used with a wide variety of fluorescent dyes, permitting the potential use of a range of small, cheap excitation sources.

Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital, founded The Kenneth B. Schwartz Center to be housed at Massachusetts General Hospital (MGH). He created this center to advance the hopes, goals, and ideas expressed in his article, "A Patient's Story," published in the July 16, 1995 issue of the Boston Globe Magazine. The Schwartz Center is a non-profit organization dedicated to strengthening the relationship between patients and caregivers and to supporting and advancing "compassionate health care delivery in which caregivers, patients, and their families relate meaningfully to one another in a way that provides hope to the patient, support to caregivers, and sustenance to the healing process." One of the Center's major projects is the sponsoring of the Schwartz Center Rounds, a monthly, multidisciplinary forum in which caregivers discuss a specific cancer patient and the important psychosocial issues faced by the patient, family, and caregivers. The forum allows caregivers to reflect on their experiences with patients and to gain support and insight from fellow staff members.The following case discussion was addressed at the January 1998 Schwartz Center Rounds. In this article, the case will be presented, followed by verbatim dialogue from the Rounds and a subsequent discussion of the relevant issues with emphasis on staff psychosocial issues. J.T. was a 43-year-old man who developed adenocarcinoma of the lung and was treated at MGH. He died while participating in a phase I trial, resulting in marked frustration and distress among his caregivers. Staff questioned whether cancer patients entering phase I trials and their families receive unbiased information about the possible risks and benefits of the trial. They were also concerned about whether or not patients and their families really understand the physical and emotional risks of a trial. Moreover, they addressed whether patients are presented with alternatives to enrolling in a phase I trial, such as palliative care. Despite all these concerns, caregivers are reconciled to the belief that patients do value the opportunity to participate in phase I trials, in that they can contribute hope and meaning to other patients' struggles with cancer. The Oncologist 2002;7(suppl 2):8-15