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https://www.readbyqxmd.com/read/29028421/medical-student-reflections-on-geriatrics-moral-distress-empathy-ethics-and-end-of-life
#1
Mary E Camp, Haekyung Jeon-Slaughter, Anne E Johnson, John Z Sadler
INTRODUCTION: Medical students' early clinical encounters may influence their perceptions of geriatrics. This study examines reflective essays written by 3rd year medical students on required clinical rotations. METHODS: Using content analysis, the authors analyzed the essays' thematic content. The authors then used chi-square analysis to compare themes with geriatric patients (age 60+) to themes with other age groups. RESULTS: 120 out of 802 essays described a geriatric patient...
October 13, 2017: Gerontology & Geriatrics Education
https://www.readbyqxmd.com/read/29027835/identifying-the-types-of-support-needed-by-interprofessional-teams-providing-pediatric-end-of-life-care-a-thematic-analysis
#2
Clare O Riotte, Stephanie K Kukora, Patricia M Keefer, Janice I Firn
BACKGROUND: Despite the number of interprofessional team members caring for children at the end of life, little evidence exists on how institutions can support their staff in providing care in these situations. OBJECTIVE: We sought to evaluate which aspects of the hospital work environment were most helpful for multidisciplinary team members who care for patients at the end of life and identify areas for improvement to better address staff needs. DESIGN: Qualitative thematic analysis was completed of free-text comments from a survey distributed to interprofessional staff members involved in the care of a recently deceased pediatric patient...
October 13, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29025443/perceptions-of-nurses-roles-in-end-of-life-care-and-organ-donation-imposition-or-obligation
#3
Kim Crymble, June Fabian, Harriet Etheredge, Petra Gaylard
South Africa has a rich organ-transplant history, and studies suggest that the SA public supports organ donation. In spite of this, persistently low donor numbers are a significant challenge. This may be due to a lack of contextually appropriate awareness and education, or to barriers to referring patients and families in clinical settings. It may also be due to ad hoc regulations that are not uniformly endorsed or implemented. In this article we present the findings of a study in Johannesburg that explored the attitudes and roles of nurses in end-of-life care and organ donation...
June 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29025439/end-of-life-care-and-organ-donation-in-south-africa-it-s-time-for-national-policy-to-lead-the-way
#4
June Fabian, Kim Crymble
No abstract text is available yet for this article.
June 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29025128/opioid-therapy-for-chronic-pain-overview-of-the-2017%C3%A2-us-department-of-veterans-affairs-and-us-department-of-defense-clinical-practice-guideline
#5
Jack M Rosenberg, Brandon M Bilka, Sara M Wilson, Christopher Spevak
Description: The US Department of Veterans Affairs (VA) and US Department of Defense (DoD) revised the 2010 clinical practice guideline (CPG) for the management of opioid therapy for chronic pain, considering the specific needs of the VA and DoD and new evidence regarding prescribing opioid medication for non-end-of-life-related chronic pain. This paper summarizes the major recommendations and compares them with the US Centers for Disease Control and Prevention (CDC) guideline for prescribing opioids...
September 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29024808/critical-care-nurses-experiences-of-withdrawal-of-treatment-a-systematic-review-of-qualitative-evidence
#6
REVIEW
Brandi Vanderspank-Wright, Nikolaos Efstathiou, Amanda D Vandyk
BACKGROUND: Death and dying is a reality of the clinical context of the intensive care unit. Death often follows a decision to withdraw life-sustaining treatments. Critical care nurses, are the primary care providers to patients and families at the end-of-life in the intensive care unit. OBJECTIVE: To synthesize qualitative evidence on the experiences of critical care nurses who have cared for patients and families throughout the process of withdrawal of life-sustaining treatment...
September 28, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29024611/end-of-life-care-conversations-in-resident-care-conferences-in-nursing-home-settings
#7
Gloria Puurveen, Heather A Cooke, Jennifer Baumbusch
No abstract text is available yet for this article.
October 12, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29023648/improvements-in-hospice-utilization-among-patients-with-advanced-stage-lung-cancer-in-an-integrated-health-care-system
#8
Donald R Sullivan, Linda Ganzini, Jodi A Lapidus, Lissi Hansen, Patricia A Carney, Molly L Osborne, Erik K Fromme, Seiko Izumi, Christopher G Slatore
BACKGROUND: Hospice, a patient-centered care system for those with limited life expectancy, is important for enhancing quality of life and is understudied in integrated health care systems. METHODS: This was a retrospective cohort study of 21,860 decedents with advanced-stage lung cancer diagnosed from January 2007 to June 2013 in the national US Veterans Affairs Health Care System. Trends over time, geographic regional variability, and patient and tumor characteristics associated with hospice use and the timing of enrollment were examined...
October 10, 2017: Cancer
https://www.readbyqxmd.com/read/29022708/dynamic-model-for-the-stocks-and-release-flows-of-engineered-nanomaterials
#9
Runsheng Song, Yuwei Qin, Sangwon Suh, Arturo A Keller
Most existing life-cycle release models for engineered nanomaterials (ENM) are static, ignoring the dynamics of stock and flows of ENMs. Our model, nanoRelease, estimates the annual releases of ENMs from manufacturing, use, and disposal of a product explicitly taking stock and flow dynamics into account. Given the variabilities in key parameters (e.g., service life of products and annual release rate during use) nanoRelease is designed as a stochastic model. We apply nanoRelease to three ENMs (TiO¬2, SiO2 and FeOx) used in paints and coatings through seven product applications, including construction and building, household and furniture, and automotive for the period from 2000 to 2020 using production volume and market projection information...
October 12, 2017: Environmental Science & Technology
https://www.readbyqxmd.com/read/29020864/end-of-life-care-a-qualitative-study-comparing-the-views-of-people-with-dementia-and-family-carers
#10
Marie Poole, Claire Bamford, Emma McLellan, Richard P Lee, Catherine Exley, Julian C Hughes, Karen Harrison-Dening, Louise Robinson
BACKGROUND: In recent years, UK policy has increasingly recognised the importance of end-of-life care in dementia. While professional consensus on optimal palliative care in dementia has been reported, little is known about the perspectives of people with dementia and family carers. AIM: To compare the views of people with dementia and family carers of people with dementia (current and recently bereaved) on optimal end-of-life care. DESIGN: Qualitative interviews (32) and a focus group were conducted...
October 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29020854/shared-decision-making-at-the-end-of-life-a-focus-group-study-exploring-the-perceptions-and-experiences-of-multi-disciplinary-healthcare-professionals-working-in-the-home-setting
#11
Paula Brogan, Felicity Hasson, Sonja McIlfatrick
BACKGROUND: Globally recommended in healthcare policy, Shared Decision-Making is also central to international policy promoting community palliative care. Yet realities of implementation by multi-disciplinary healthcare professionals who provide end-of-life care in the home are unclear. AIM: To explore multi-disciplinary healthcare professionals' perceptions and experiences of Shared Decision-Making at end of life in the home. DESIGN: Qualitative design using focus groups, transcribed verbatim and analysed thematically...
October 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29020845/end-of-life-caregiver-social-support-activation-the-roles-of-hospice-clinicians-and-professionals
#12
Susan A LaValley
Caregivers of those with life-limiting illness face many complicated tasks, including providing direct patient care, communicating with professionals, and managing the logistical demands of daily activities. To assist with caregiving responsibilities, caregivers require social support from social network members at all points in the illness process. This study analyzes themes from interviews with 61 caregivers of patients enrolled in hospice services to identify the types of support caregivers mobilize from new social network members for social support during the end-of-life care process...
October 1, 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/29019327/disclosure-of-adverse-cancer-news-the-public-s-perspective-in-a-middle-eastern-country
#13
Jamal Zekri, Mohamed E El Sayed, Youssef Nauf
OBJECTIVES: The disclosure to patients of unfavorable news related to cancer remains a controversial issue in the Middle East. This study investigated the perspective of the public in Saudi Arabia regarding the disclosure of unfavorable cancer-related news. METHODS: A convenience sample of 103 adult noncancer patients attending a family medicine clinic were asked to respond to 9 closed-ended questions. These questions reflected possible adverse news from the time of diagnosis until the end of life...
September 2017: Gulf Journal of Oncology
https://www.readbyqxmd.com/read/29018521/end-of-life-management-of-leadless-cardiac-pacemaker-therapy
#14
Niek Eg Beurskens, Fleur Vy Tjong, Reinoud E Knops
The clinically available leadless pacemakers for patients with a single-chamber pacing indication have shown to be safe and effective. However, the optimal end-of-life strategy of this novel technique is undefined. Suggested strategies comprise of (a) placing an additional leadless device adjacent to the leadless pacemaker, or (b) retrieving the non-functioning leadless pacemaker and subsequently implanting a new device. Although initial studies demonstrate promising results, early experience of acute and mid-term retrieval feasibility and safety remains mixed...
August 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/29017531/can-the-collection-of-expired-long-lasting-insecticidal-nets-reduce-their-coverage-and-use-sociocultural-aspects-related-to-llin-life-cycle-management-and-use-in-four-districts-in-madagascar
#15
Ambinina Ramanantsoa, Marta Wilson-Barthes, Rindra Rahenintsoa, Sarah Hoibak, Harilala Ranaivoharimina, Martha Delphine Rahelimalala, Avotiana Rakotomanga, Alyssa Finlay, Joan Muela Ribera, Koen Peeters Grietens
BACKGROUND: There is growing awareness of the likely impact increased numbers of LLINs will have on the environment, if not disposed of or recycled appropriately. As part of a World Health Organization (WHO) and United Nations Environment Programme (UNEP) pilot study to assess environmentally-sound and cost-effective LLIN recycling strategies, the USAID-Deliver Project collected 22,559 used bed nets in Madagascar. A social science study was conducted to provide data on socio-cultural factors related to collection and replacement of LLINs, including impact on primary and other net uses...
October 10, 2017: Malaria Journal
https://www.readbyqxmd.com/read/29017018/what-is-the-impact-of-population-ageing-on-the-future-provision-of-end-of-life-care-population-based-projections-of-place-of-death
#16
Anna E Bone, Barbara Gomes, Simon N Etkind, Julia Verne, Fliss Em Murtagh, Catherine J Evans, Irene J Higginson
BACKGROUND: Population ageing represents a global challenge for future end-of-life care. Given new trends in place of death, it is vital to examine where the rising number of deaths will occur in future years and implications for health and social care. AIM: To project where people will die from 2015 to 2040 across all care settings in England and Wales. DESIGN: Population-based trend analysis and projections using simple linear modelling...
October 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28993286/spirit-trial-a-phase-iii-pragmatic-trial-of-an-advance-care-planning-intervention-in-esrd
#17
Mi-Kyung Song, Mark L Unruh, Amita Manatunga, Laura C Plantinga, Janice Lea, Manisha Jhamb, Abhijit V Kshirsagar, Sandra E Ward
Advance care planning (ACP) is a central tenet of dialysis care, but the vast majority of dialysis patients report never engaging in ACP discussions with their care providers. Over the last decade, we have developed and iteratively tested SPIRIT (Sharing Patient's Illness Representation to Increase Trust), a theory-based, patient- and family-centered advance care planning intervention. SPIRIT is a six-step, two-session, face-to-face intervention to promote cognitive and emotional preparation for end-of-life decision making for patients with ESRD and their surrogates...
October 6, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28993227/adverse-glycaemic-effects-of-cancer-therapy-indications-for-a-rational-approach-to-cancer-patients-with-diabetes
#18
REVIEW
Marco Gallo, Giovanna Muscogiuri, Francesco Felicetti, Antongiulio Faggiano, Francesco Trimarchi, Emanuela Arvat, Riccardo Vigneri, Annamaria Colao
Diabetes and cancer are common, chronic, and potentially fatal diseases that frequently co-exist. Observational studies have reported an increased risk of cancer in patients with diabetes. Furthermore, many patients with cancer already have diabetes, or develop hyperglycemia as a consequence of the tumor or of cancer therapies, and coexisting diabetes confers a greater risk of mortality for many malignancies. Managing oncologic patients with diabetes is often complicated, since the co-existence of diabetes and cancer poses several complex clinical questions: what level of glycemic control to achieve, which therapy to use, how to deal with glucocorticoid therapies and artificial nutrition, how diabetes complications can affect cancer management, which drug-drug interactions should be taken into account, or even how to manage diabetes at the end of life...
October 6, 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28993099/recognising-older-frail-patients-near-the-end-of-life-what-next
#19
Magnolia Cardona-Morrell, Ebony Lewis, Sanjay Suman, Cilla Haywood, Marcella Williams, Audrey-Anne Brousseau, Sally Greenaway, Ken Hillman, Elsa Dent
Frailty is a state of vulnerability resulting from cumulative decline in many physiological systems during a lifetime. It is progressive and considered largely irreversible, but its progression may be controlled and can be slowed down and its precursor -pre-frailty- can be treated with multidisciplinary intervention. The aim of this narrative review is to provide an overview of the different ways of measuring frailty in community settings, hospital, emergency, general practice and residential aged care; suggest occupational groups who can assess frailty in various services; discuss the feasibility of comprehensive geriatric assessments; and summarise current evidence of its management guidelines...
October 6, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28992715/-my-future-is-now-a-qualitative-study-of-persons-living-with-advanced-cancer
#20
Ann H Cottingham, Larry D Cripe, Kevin L Rand, Richard M Frankel
OBJECTIVES: Advance care planning (ACP) enables individuals to deliberate about future preferences for care based upon their values and beliefs about what is important in life. For many patients with advanced cancer, however, these critical conversations do not occur. A growing body of literature has examined the end-of-life wishes of seriously ill patients. Few studies have explored what is important to persons as they live with advanced cancer. The aim of the current study was to address this gap and to understand how clinicians can support patients' efforts to live in the present and plan for the future...
January 1, 2017: American Journal of Hospice & Palliative Care
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