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BMJ Supportive & Palliative Care

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https://www.readbyqxmd.com/read/28438759/palliative-care-clinicians-knowledge-of-the-law-regarding-the-use-of-the-deprivation-of-liberty-safeguards-dols
#1
Caroline Barry, Anna Spathis, Sarah Treaddell, Sally Carding, Stephen Barclay
OBJECTIVES: To examine palliative care clinicians' level of knowledge of the law regarding the use of the Deprivation of Liberty Safeguards (DoLS). METHODS: Regional postal survey of palliative care clinicians working in hospices in the East of England, undertaken in April 2015. Clinicians' level of knowledge was assessed by their response to 7 factual questions. Data regarding self-reported levels of confidence in applying the Safeguards was collected, alongside information regarding the number of times they had used DoLS in practice...
April 24, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28432089/preparing-future-doctors-for-palliative-care-views-of-course-organisers
#2
Steven Walker, Jane Gibbins, Paul Paes, Stephen Barclay, Astrid Adams, Madawa Chandratilake, Faye Gishen, Philip Lodge, Bee Wee
BACKGROUND: Effective training at medical school is essential to prepare new doctors to safely manage patients with palliative care (PC) and end of life care (EOLC) needs. The contribution of undergraduate PC course organisers is central but their collective views regarding role are unknown. OBJECTIVE: To survey attitudes of PC course organisers regarding their course, organisation, the adequacy of training provided and level of personal satisfaction. METHODS: An anonymised, multifactorial, web-based questionnaire was devised, tested, modified and then sent to lead PC course organisers at all UK medical schools...
April 21, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28432088/gps-and-paediatric-oncology-palliative-care-a-q-methodological-study
#3
Sue Neilson, Faith Gibson, Stephen Jeffares, Sheila M Greenfield
OBJECTIVE: This mixed-methods study set in the West Midlands region of the UK demonstrates the effectiveness of Q methodology in examining general practitioners' (GPs') perception of their role in children's oncology palliative care. METHODS: Using data obtained from the analysis of semistructured interviews with GPs who had cared for a child receiving palliative care at home and bereaved parents, 50 statements were identified as representative of the analysis findings...
April 21, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28432090/international-variations-in-clinical-practice-guidelines-for-palliative-sedation-a-systematic-review
#4
REVIEW
Ebun Abarshi, Judith Rietjens, Lenzo Robijn, Augusto Caraceni, Sheila Payne, Luc Deliens, Lieve Van den Block
OBJECTIVES: Palliative sedation is a highly debated medical practice, particularly regarding its proper use in end-of-life care. Worldwide, guidelines are used to standardise care and regulate this practice. In this review, we identify and compare national/regional clinical practice guidelines on palliative sedation against the European Association for Palliative Care (EAPC) palliative sedation Framework and assess the developmental quality of these guidelines using the Appraisal Guideline Research and Evaluation (AGREE II) instrument...
April 20, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28428173/poor-prognostication-hidden-meanings-in-word-choices
#5
LETTER
Anne M Kelemen, Grace Kearney, Michael Pottash, Hunter Groninger
No abstract text is available yet for this article.
April 20, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28428172/how-are-non-numerical-prognostic-statements-interpreted-and-are-they-subject-to-positive-bias
#6
Anne Moyer, Samantha Siess, Sumeet Bhinder
OBJECTIVES: Frank, clear communication with family members of terminally ill or incapacitated patients has important implications for well-being, satisfaction with care and sound decision-making. However, numerical prognostic statements, particularly more negative ones, have been found to be interpreted in a positively biased manner. Less precise non-numerical statements, preferred by physicians, and particularly statements using threatening terms (dying vs surviving) may be even more subject to such biases...
April 20, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28424197/dreams-of-the-sea
#7
(no author information available yet)
No abstract text is available yet for this article.
April 19, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28424195/thyroid-skeletal-metastasis-pain-management-with-verteblation
#8
Gianluigi Orgera, Miltiadis Krokidis, Alberto Rebonato, Marcello Andrea Tipaldi, Luca Mascagni, Michele Rossi
The combination of percutaneous vertebroplasty with radiofrequency ablation (verteblation) has not shown to be an effective measure of pain management in patients with metastatic lesions of the spine. The use of this novel technique has not been previously described in metastatic disease from thyroid cancer. We would like to report our experience after treating a patient affected by a thyroid carcinoma and an osteolytic spine metastasis. The patient suffered from life-limiting pain and was successfully treated with a combination of vertebroplasty and radiofrequency ablation...
April 19, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28424194/common-care-practices-among-effective-community-based-specialist-palliative-care-teams-a-qualitative-study
#9
Hsien Seow, Daryl Bainbridge, Melissa Brouwers, Deanna Bryant, Sue Tan Toyofuku, Mary Lou Kelley
OBJECTIVE: Evidence has shown that, despite wide variation in models of care, community-based specialist palliative care teams can improve outcomes and reduce acute care use at end of life. The goal of this study was to explore similarities in care practices among effective and diverse specialist teams to inform the development of other community-based teams. METHODS: Interviews with 78 providers and administrators from 11 distinct community-based specialist palliative care teams from Ontario, Canada were conducted...
April 19, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28373171/protection-during-haempoietic-stem-cell-transplantation-a-survey-from-the-quality-of-life-working-party-of-the-rome-transplant-network
#10
LETTER
O Annibali, A Tendas, A Pignatelli, R Mauroni, I Carli, A Chierichini, V Tomarchio, L Cupelli, D Saltarelli, A Inzeo, M Surano, M Piedimonte, F Marchesi, F Sollazzo, E Conte, C Viggiani, F Di Piazza, M C Tirindelli, W Arcese
No abstract text is available yet for this article.
April 3, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28356304/erythromycin-prophylaxis-against-recurrent-small-bowel-obstruction
#11
Emily Rea, Emma Husbands
We describe three cases where erythromycin suspension has been used successfully in preventing recurrence of small bowel obstruction in patients with terminal illness and for whom it proved more effective than standard preparations such as metoclopramide and domperidone. These patients also experienced a longer term benefit over some months. With recent alerts over longer term use of metoclopramide and domperidone, we demonstrate that erythromycin is a viable alternative prokinetic in patients with terminal illness at risk of small bowel obstruction instead of or alongside metoclopramide and domperidone...
March 29, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28347998/opioid-rotation-to-alfentanil-comparative-evaluation-of-conversion-ratios
#12
LETTER
Alison Cran, Saskie Dorman, Stephen Kirkham
No abstract text is available yet for this article.
March 27, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28270396/affording-opportunities-to-discuss-deterioration-in-paediatric-palliative-care-consultations-a-conversation-analytic-study
#13
Stuart Ekberg, Susan Danby, Anthony Herbert, Natalie K Bradford, Patsy Yates
OBJECTIVE: Discussing the potential deterioration of a child who has a life-limiting condition has recognised benefits for future care, but can be challenging in a clinical context where uncertain illness trajectories are common. Existing research is restricted to indirect forms of evidence such as self-report data from clinicians and families. This study directly explores how discussions about deterioration are managed within actual paediatric palliative care consultations. METHODS: 9 consultations were video recorded in an Australian paediatric palliative care service...
March 7, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28270395/leaky-pipeline-gender-bias-self-selection-or-all-three-a-quantitative-analysis-of-gender-balance-at-an-international-palliative-care-research-conference
#14
Katherine E Sleeman, Jonathan Koffman, Irene J Higginson
OBJECTIVES: The 'leaky pipeline' in academia is a clearly described phenomenon, but has not been examined in palliative care. We analysed the gender balance of speakers at the 9th World Research Congress of the European Association of Palliative Care (EAPC) to test the null hypothesis that there is no difference in the proportion of women and men with senior academic visibility in palliative care conference programmes. METHODS: The final programme of the 2016 EAPC World Congress was examined, and the gender of each speaker was recorded...
March 7, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28258162/developing-a-model-for-embedded-palliative-care-in-a-cancer-clinic
#15
Susan DeSanto-Madeya, David McDermott, Jessica A Zerillo, Nancy Weinstein, Mary K Buss
OBJECTIVES: Describe the development and key features of a model for embedded palliative care (PC) for patients with advanced kidney cancer or melanoma seen in a cancer clinic. METHODS: Retrospective chart review of patients following an initial phase and then a prospective review following the implementation of a model for embedded PC. RESULTS: In the initial phase, 18 patients were seen for a total of 53 visits; 78% were seen more than once, with a mean of three visits per patient...
March 3, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28255070/patient-values-informing-medical-treatment-a-pilot-community-and-advance-care-planning-survey
#16
S Milnes, C Corke, N R Orford, M Bailey, J Savulescu, D Wilkinson
Medicine regards the prevention of death as an important priority. Yet patients may have a range of priorities of equal or greater importance. These other priorities are often not discussed or appreciated by treating doctors. OBJECTIVES: We sought to identify priorities of care for patients attending an advance care planning (ACP) clinic and among the general population, and to identify factors associated with priorities other than prolonging life. METHODS: We used a locally developed survey tool 'What Matters Most' to identify values...
March 2, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28255069/sexual-well-being-in-cancer-and-palliative-care-an-assessment-of-healthcare-professionals-current-practice-and-training-needs
#17
Aoife Gleeson, Emily Hazell
: Sexual well-being is often significantly affected by cancer and its treatments. Previous research shows that a patient's sexual well-being is often overlooked in clinical practice. OBJECTIVES: The aims of this study were twofold. First, to determine the current practice of healthcare professionals (HCPs) working with cancer and palliative care patients in primary and secondary care settings in relation to sexual well-being. Second, to determine the education requirements of HCPs regarding the management of sexual well-being concerns of cancer/palliative care patients...
March 2, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28246083/commissioning-of-specialist-palliative-care-services-in-england
#18
Harriet Lancaster, Ilora Finlay, Maxwell Downman, James Dumas
OBJECTIVES: Some failures in end-of-life care have been attributed to inconsistent provision of palliative care across England. We aimed to explore the variation in commissioning of services by Clinical Commissioning Groups (CCGs) using a data collection exercise. METHODS: We sent a Freedom of Information request in the form of an open questionnaire to all 209 CCGs in England to assess their commissioning of palliative and end-of-life care services, mainly focused on the provision of specialist palliative care services...
February 28, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28246082/survivorship-of-severe-medically-unexplained-symptoms-in-palliative-care
#19
Justin Dwyer, Keryn Taylor, Mark Boughey
OBJECTIVES: Patients who articulate their psychological distress primarily through physical symptoms (referred to as medically unexplained symptoms (MUS)) pose a challenge to the skills of most clinicians, including palliative care physicians. The philosophical underpinnings of palliative care with a stated focus on symptom management and care of the person in their psychosociospiritual context lend itself to the care of these patients. The aim of this study was to investigate the characteristics to improve identification of this patient group within palliative care...
February 28, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28232515/home-palliative-care-works-but-how-a-meta-ethnography-of-the-experiences-of-patients-and-family-caregivers
#20
REVIEW
Vera P Sarmento, Marjolein Gysels, Irene J Higginson, Barbara Gomes
OBJECTIVE: To understand patients and family caregivers' experiences with home palliative care services, in order to identify, explore and integrate the key components of care that shape the experiences of service users. METHODS: We performed a meta-ethnography of qualitative evidence following PRISMA recommendations for reporting systematic reviews. The studies were retrieved in 5 electronic databases (MEDLINE, EMBASE, PsycInfo, BNI, CINAHL) using 3 terms and its equivalents ('Palliative', 'Home care', 'Qualitative research') combined with 'AND', complemented with other search strategies...
February 23, 2017: BMJ Supportive & Palliative Care
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