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"end of life"

Erin L Robinson, Becky Hart, Sara Sanders
Young adults (N = 80) participated in advance care planning (ACP) as part of a death and dying course and submitted reflection papers on their experiences. These papers were analyzed using directed qualitative content analysis methods. Among the findings, participants almost exclusively chose a parent or other family member as a Health Care Agent. Twenty-five percent expressed concern about placing burden on their agent, but felt their advance directives (AD) would ease that burden. For many, previous experiences with death helped shape their wishes...
June 18, 2018: Death Studies
Nobuyuki Yotani, Yoshiyuki Kizawa
CONTEXT: According to the International Observatory on End of Life Care, the level of pediatric palliative care in Japan is Level 2 (capacity building) and the current status of palliative care for children in Japan has not been clarified. OBJECTIVES: To clarify the availability and utilization of specialist palliative care services among children with life-threatening conditions in Japan. METHODS: A questionnaire was administered to assess the availability of specialist palliative care services among children with life-threatening conditions...
June 14, 2018: Journal of Pain and Symptom Management
Katsiaryna Laryionava, Katja Mehlis, Elena Bierwirth, Friederike Mumm, Wolfgang Hiddemann, Pia Heußner, Eva C Winkler
BACKGROUND: Many patients with advanced cancer receive chemotherapy close to death and are referred too late to palliative or hospice care, and therefore die under therapy or in intensive care units. Oncologists still have difficulties in involving patients appropriately in decisions about limiting tumor-specific or life-prolonging treatment. OBJECTIVE: The aim of this Ethics Policy for Advanced Care Planning and Limiting Treatment Study is to develop an ethical guideline for end-of-life decisions and to evaluate the impact of this guideline on clinical practice regarding the following target goals: reduction of decisional conflicts, improvement of documentation transparency and traceability, reduction of distress of the caregiver team, and better knowledge and consideration of patients' preferences...
June 15, 2018: JMIR Research Protocols
Barbara Fischer, Harry Telser, Peter Zweifel
Healthcare expenditure (HCE) spent during an individual's last year of life accounts for a high share of lifetime HCE. This finding is puzzling because an investment in health is unlikely to have a sufficiently long payback period. However, Becker et al. (2007) and Philipson et al. (2010) have advanced a theory designed to explain high willingness to pay (WTP) for an extension of life close to its end. Their testable implications are complemented by the concept of 'pain of risk bearing' introduced by Eeckhoudt and Schlesinger (2006)...
June 7, 2018: Journal of Health Economics
Kristof Faes, Joachim Cohen, Lieven Annemans
CONTEXT: Chronic obstructive pulmonary disease (COPD) patients often have several comorbidities, such as cardiovascular diseases (CVD) or lung cancer (LC), which might influence resource use in the final months of life. However, no previous studies documented resource use in end-of-life COPD patients at a population level, thereby differentiating whether COPD patients die of their COPD, CVD or LC. AIM: To describe end-of-life resource use in people diagnosed with COPD and compare this resource use between those dying of COPD, CVD and LC...
June 11, 2018: Journal of Pain and Symptom Management
Monique Batten, Bella Nguyen, Brandon Burke, Hilman Harryanto, Imogen Mitchell, Alison Davis
AIM: To examine the current patterns of end-of-life care of medical oncology patients dying in an Australian tertiary acute hospital setting in order to determine potential areas for improvement. METHODS: A retrospective observational study was undertaken of 295 consecutive adult medical oncology inpatients dying between 2010 and 2015. Charts were reviewed for evidence of (1) resuscitation plans, (2) acute interventions in the 48-h period prior to death, (3) palliative care involvement and (4) recognition of the dying patient and comfort care plans...
June 13, 2018: Asia-Pacific Journal of Clinical Oncology
Jae Yoon Park, Chi-Yeon Lim, Gloria Puurveen, Do Yeun Kim, Jae Hang Lee, Han Ho Do, Kyung Soo Kim, Kyung Don Yoo, Hyo Jin Kim, Yunmi Kim, Sung Joon Shin
Completing an advance directive offers individuals the opportunity to make informed choices about end-of-life care. However, these decisions could be influenced in different ways depending on how the information is presented. We randomly presented 185 participants with four distinct types of advance directive: neutrally framed (as reference), negatively framed, religiously framed, and a combination. Participants were asked which interventions they would like to receive at the end of life. Between 60% and 70% of participants responded "accept the special interventions" on the reference form...
January 1, 2018: Omega
Lisa Caulley, Muriel R Gillick, Lisa S Lehmann
New England Journal of Medicine, Volume 378, Issue 24, Page 2339-2341, June 2018.
June 14, 2018: New England Journal of Medicine
Michael D Barnett, Itzel A Ruiz
BACKGROUND: Compassion fatigue among health care professionals has negative effects on patient care. Providing end-of-life care, hospice nurses may be particularly at risk for compassion fatigue. OBJECTIVE: The purpose of this study was to investigate self-esteem and affect as mediators between psychological distress and compassion fatigue among hospice nurses (N = 90). DESIGN AND MEASUREMENTS: Hospice nurses working in a health care setting were recruited to complete a survey...
June 13, 2018: Journal of Palliative Medicine
Ren-Li Deng, Jia-Zhong Duan, Jiang-Hui Zhang, Jia-Rui Miao, Liu-Liu Chen, Diana T F Lee
As the aging population, including frail older people, continues to grow in Mainland China, quality of life and end-of-life care for frail older people has attracted much attention. Advance care planning is an effective way to improve end-of-life care for people with advanced diseases, and it is widely used in developed countries; however, it is a new concept in Mainland China. The effects of advance care planning and its acceptability in Mainland China are uncertain because of its culture-sensitive characteristics...
January 1, 2018: Nursing Ethics
Crystal E Brown, Ruth A Engelberg, Rashmi Sharma, Lois Downey, James A Fausto, James Sibley, William Lober, Nita Khandelwal, Elizabeth T Loggers, J Randall Curtis
BACKGROUND: Although racial/ethnic minorities receive more intense, nonbeneficial healthcare at the end of life, the role of race/ethnicity independent of other social determinants of health is not well understood. OBJECTIVES: Examine the association between race/ethnicity, other key social determinants of health, and healthcare intensity in the last 30 days of life for those with chronic, life-limiting illness. SUBJECTS: We identified 22,068 decedents with chronic illness cared for at a single healthcare system in Washington State who died between 2010 and 2015 and linked electronic health records to death certificate data...
June 12, 2018: Journal of Palliative Medicine
Seyed Hossein Mamanpush, Azadeh Tavousi Tabatabaei, Hui Li, Karl Englund
Wind turbine blades that face end-of-life recycled mechanically. The recycled material was first comminuted via a hammer-mill through a range of varying screen sizes, resonated (polymeric Methylene diphenyl isocyanate (pMDI)) and then hand-formed and hot pressed. The hot press temperature and time were set as 138 °C and 5 min accordingly, typical for pMDI composite processing. Mechanical properties (Modulus of rupture (MOR), Module of elasticity (MOE) and Internal bond(IB)) dataset of composites made from recycled wind turbine blades(rWTBs) presented...
August 2018: Data in Brief
Andrew D Ballantyne, Jason P Hallett, D Jason Riley, Nilay Shah, David J Payne
There is a growing need to develop novel processes to recover lead from end-of-life lead-acid batteries, due to increasing energy costs of pyrometallurgical lead recovery, the resulting CO2 emissions and the catastrophic health implications of lead exposure from lead-to-air emissions. To address these issues, we are developing an iono-metallurgical process, aiming to displace the pyrometallurgical process that has dominated lead production for millennia. The proposed process involves the dissolution of Pb salts into the deep eutectic solvent (DES) Ethaline 200, a liquid formed when a 1 : 2 molar ratio of choline chloride and ethylene glycol are mixed together...
May 2018: Royal Society Open Science
Donald Lucas, Sara M Petty, Olya Keen, Bob Luedeka, Martin Schlummer, Roland Weber, Ramin Yazdani, Brian Riise, James Rhodes, Dave Nightingale, Miriam L Diamond, John Vijgen, Avery Lindeman, Arlene Blum, Catherine P Koshland
This is Part II of a review covering the wide range of issues associated with all aspects of the use and responsible disposal of foam and plastic wastes containing toxic or potentially toxic flame retardants. We identify basic and applied research needs in the areas of responsible collection, pretreatment, processing, and management of these wastes. In Part II, we explore alternative technologies for the management of halogenated flame retardant (HFR) containing wastes, including chemical, mechanical, and thermal processes for recycling, treatment, and disposal...
June 1, 2018: Environmental Engineering Science
Donald Lucas, Sara M Petty, Olya Keen, Bob Luedeka, Martin Schlummer, Roland Weber, Morton Barlaz, Ramin Yazdani, Brian Riise, James Rhodes, Dave Nightingale, Miriam L Diamond, John Vijgen, Avery Lindeman, Arlene Blum, Catherine P Koshland
Flame retardants (FRs) are added to foams and plastics to comply with flammability standards and test requirements in products for household and industrial uses. When these regulations were implemented, potential health and environmental impacts of FR use were not fully recognized or understood. Extensive research in the past decades reveal that exposure to halogenated FRs, such as those used widely in furniture foam, is associated with and/or causally related to numerous health effects in animals and humans...
June 1, 2018: Environmental Engineering Science
Lisa Hjelmfors, Anna Strömberg, Maria Friedrichsen, Anna Sandgren, Jan Mårtensson, Tiny Jaarsma
BACKGROUND: The aim of this paper was to describe the development of an intervention that is developed to improve communication about the heart failure (HF) trajectory and end-of-life care. We also present data that provides a first insight in specific areas of feasibility of the intervention. METHODS: Co-design was used and patients, family members and health care professionals were constructive participants in the design process of the intervention. Feasibility of the intervention was tested in two areas; acceptability and limited efficacy...
June 11, 2018: BMC Palliative Care
Fehmi Gorkem Uctug, Adisa Azapagic
Solar water heating (SWH) systems could help reduce environmental impacts from energy use but their performance and impacts depend on the climate. This paper considers how these vary for residential SWH across four different climatic regions in Turkey, ranging from hot to cold climates. Life cycle assessment was used for these purposes. The results suggest that in the hotter regions, the impacts of SWH are 1.5-2 times lower than those of natural gas boilers. A similar trend was observed in the two colder regions except for acidification, which was four times higher than that of the boiler...
May 1, 2018: Science of the Total Environment
Lisa C Lindley, Elspeth M Slayter
CONTEXT: Children in foster care suffer with serious illness at end of life. However, the relationship between prior trauma exposure and serious illness has received little empirical attention. OBJECTIVES: The objectives were to examine the prevalence and type of trauma exposure, and investigate the relationship between prior trauma and serious illness among foster children at end of life. METHODS: We used national longitudinal foster care data...
June 8, 2018: Journal of Pain and Symptom Management
Andrea S Gershon, Laura C Maclagan, Jin Luo, Teresa To, Tetyana Kendzerska, Matthew B Stanbrook, Jean Bourbeau, Jacob Etches, Shawn D Aaron
RATIONALE: The burden of advanced COPD is high globally; however, little is known about how often end of life strategies are used by this population. OBJECTIVES: To describe trends in the use of end of life care strategies by people with advanced COPD in Ontario, Canada. METHODS: A population-based repeated cross-sectional study examining end of life care strategies in individuals with advanced COPD was conducted. Annual proportions of individuals who received formal palliative care, long-term oxygen therapy or opioids from 2004 to 2014 were determined...
June 11, 2018: American Journal of Respiratory and Critical Care Medicine
Barbara A Heise, Debra K Wing, Amy H R Hullinger
AIM: The purpose of this study was to examine, on a national level, nursing students' perceptions after experiencing a patient death. BACKGROUND: Death is a highly stressful experience for nursing students. Debriefing, which routinely occurs with a patient's demise in the simulation setting, typically does not happen in actual death situations. METHOD: A mixed-methods design using quantitative and qualitative questions as part of an anonymous survey was sent to the membership of the National Student Nurses' Association...
June 7, 2018: Nursing Education Perspectives
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