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https://www.readbyqxmd.com/read/28230644/expanding-the-donor-pool-through-intensive-care-to-facilitate-organ-donation-results-of-a-spanish-multicenter-study
#1
Beatriz Domínguez-Gil, Elisabeth Coll, José Elizalde, Jaime E Herrero, Teresa Pont, Brígida Quindós, Bella Marcelo, María A Bodí, Adolfo Martínez, Agustín Nebra, Francisco Guerrero, José M Manciño, Juan Galán, Miguel Lebrón, Eduardo Miñambres, Rafael Matesanz
BACKGROUND: Intensive Care to facilitate Organ Donation (ICOD) may help to increase the donor pool. We describe the Spanish experience with ICOD. METHODS: ACCORD-Spain consisted of an audit of the donation pathway from patients dead as a result of a devastating brain injury (possible donors) in 68 hospitals during 11/1/2014-4/30/2015. We focused on possible donors whose family was interviewed to discuss organ donation once intensive care with a therapeutic purpose was deemed futile and brain death (BD) was a likely outcome...
February 23, 2017: Transplantation
https://www.readbyqxmd.com/read/28224879/-palliative-sedation-because-it-s-what-the-patient-wants-pronouncement-of-disciplinary-court-cause-of-great-confusion
#2
A C Hendriks, B Keizer
The Medical Disciplinary Court of The Hague recently imposed an official warning on two physicians who did not yield to the pressure exerted by a 102-year-old patient and her family to start palliative sedation. This decision not only restricts the directing role of physicians with respect to the end-of-life phase, but is also inconsistent with the guideline from the Royal Dutch Medical Association (KNMG) on palliative sedation.
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28224858/meeting-patients-needs-as-they-near-the-end-of-life
#3
Erin Dean
More than four out of ten nurses and healthcare assistants (HCAs) have received no training in end of life care, a survey by Nursing Standard and Marie Curie has found.
February 22, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28224854/excellent-end-of-life-care-requires-time-and-resources
#4
(no author information available yet)
Delivering excellent end of life care is among the biggest challenges faced by nurses today, regardless of their level of experience or place of work. Just about every nurse will be confronted with a dying patient at some stage, so it is essential they have the training and resources to cope.
February 22, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28224845/-i-love-transforming-services
#5
(no author information available yet)
With a background in critical and end of life care, Fiona Murphy has dedicated most of her 30-year nursing career to helping dying patients and their families. In 2002, she became donor liaison sister at Manchester's Royal Bolton Hospital, and her pioneering work in implementing a nurse-led bereavement and donation service saw her named Nursing Standard Nurse of the Year in 2011. She was awarded an MBE last year for services to nursing, bereavement services and organ donation, and is assistant director of nursing at Pennine Acute Hospitals NHS Trust...
February 22, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28224837/survey-reveals-huge-concern-over-end-of-life-care-provision
#6
Erin Dean
Two thirds (67%) of nurses feel they do not have time to provide high quality care to dying patients, a Nursing Standard and Marie Curie survey has revealed.
February 22, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28224693/analysis-of-team-types-based-on-collaborative-relationships-among-doctors-home-visiting-nurses-and-care-managers-for-effective-support-of-patients-in-end-of-life-home-care
#7
Junko Fujita, Sakiko Fukui, Sumie Ikezaki, Chizuru Otoguro, Mayuko Tsujimura
AIM: To define the team types consisting of doctors, home-visiting nurses and care managers for end-of-life care by measuring the collaboration relationship, and to identify the factors related to the team types. METHODS: A questionnaire survey of 43 teams including doctors, home-visiting nurses and care managers was carried out. The team types were classified based on mutual evaluations of the collaborative relationships among the professionals. To clarify the factors between team types with the patient characteristics, team characteristics and collaboration competency, univariate analysis was carried out with the Fisher's exact test or one-way analysis and multiple comparison analysis...
February 21, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28220317/role-of-narrative-based-medicine-in-proper-patient-assessment
#8
Giovanni Rosti
Improving patient-physician communication is an area of medicine that deserves greater attention. Narrative medicine can be considered as one tool that can aid in fostering better communication. Current medical practice is dominated by evidence-based medicine, and dictates what therapies the clinician will offer in a given circumstance, ideally supported by (evidence-based) guidelines. However, when taken alone it tends to decentralize the patient. There are many different approaches that can be used to understand the patient and what he or she is experiencing as a result of their illness...
February 21, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28220315/attachment-figures-when-death-is-approaching-a-study-applying-attachment-theory-to-adult-patients-and-family-members-experiences-during-palliative-home-care
#9
Anna Milberg, Maria Friedrichsen
PURPOSE: Attachment theory is currently receiving much attention in relation to how adults cope with severe illness. The study aims were using the experiences of patients and family members to explore attachment figures (a central concept within the theory) during palliative home care. METHODS: Twelve patients and 14 family members were interviewed during ongoing palliative home care. The interviews were analysed using qualitative content analysis. RESULTS: Four types of attachment figures were identified: (i) family and friends, (ii) health care practitioners, (iii) pets and (iv) God...
February 20, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28220023/early-palliative-care-reduces-end-of-life-intensive-care-unit-icu-use-but-not-icu-course-in-patients-with-advanced-cancer
#10
Andrew M Romano, Kristine E Gade, Gradon Nielsen, Robert Havard, James H Harrison, Josh Barclay, George J Stukenborg, Paul W Read, Leslie J Blackhall, Patrick M Dillon
BACKGROUND: Early palliative care for advanced cancer patients improves quality of life and survival, but less is known about its effect on intensive care unit (ICU) use at the end of life. This analysis assessed the effect of a comprehensive early palliative care program on ICU use and other outcomes among patients with advanced cancer. PATIENTS AND METHODS: A retrospective cohort of patients with advanced cancer enrolled in an early palliative care program (n = 275) was compared with a concurrent control group of patients receiving standard care (n = 195) during the same time period by using multivariable logistic regression analysis...
February 20, 2017: Oncologist
https://www.readbyqxmd.com/read/28216870/palliative-care-social-work-in-india-current-status-and-future-directions
#11
REVIEW
G Ragesh, Lithin Zacharias, Priya Treesa Thomas
Palliative care (PC) involves total care for persons suffering from life-threatening illnesses and their families. Social work as a profession and an academic discipline is gaining momentum in India for the past few decades. A large number of professional social workers are working with individuals, families, and communities to provide PC in India. Authors have presented the current status of PC social work interventions and discussed the future directions in the practice, research, and training in PC and end-of-life care...
January 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28216869/do-not-resuscitate-order-the-experiences-of-iranian-cardiopulmonary-resuscitation-team-members
#12
Abdolghader Assarroudi, Fatemeh Heshmati Nabavi, Abbas Ebadi, Habibollah Esmaily
BACKGROUND: One dilemma in the end-of-life care is making decisions for conducting cardiopulmonary resuscitation (CPR). This dilemma is perceived in different ways due to the influence of culture and religion. This study aimed to understand the experiences of CPR team members about the do-not-resuscitate order. METHODS: CPR team members were interviewed, and data were analyzed using a conventional content analysis method. RESULTS: Three categories and six subcategories emerged: "The dilemma between revival and suffering" with the subcategories of "revival likelihood" and "death as a cause for comfort;" "conflicting situation" with the subcategories of "latent decision" and "ambivalent order;" and "low-quality CPR" with the subcategories of "team member demotivation" and "disrupting CPR performance...
January 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28216866/home-based-palliative-services-under-two-local-self-government-institutions-of-kerala-india-an-assessment-of-compliance-with-policy-and-guidelines-to-local-self-government-institutions
#13
Rajeev Jayalakshmi, Chatterjee Chopra Suhita
BACKGROUND: In contrast to India's poor performance in palliative and end-of-life care, the state of Kerala has gained considerable attention for its palliative care (PC) policy. This study tried to understand the structure, organization, and delivery of the program currently offered to the rural population, and its conformity to the state's PC policy and guidelines for Local Self-government Institutions (LSGIs). MATERIALS AND METHODS: A descriptive research design involving a review of Kerala palliative policy and guidelines for LSGIs was followed by direct field observation and interviews of stakeholders...
January 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28216856/feasibility-and-acceptability-of-implementing-the-integrated-care-plan-for-the-dying-in-the-indian-setting-survey-of-perspectives-of-indian-palliative-care-providers
#14
Naveen Salins, Jeremy Johnson, Stanley Macaden
INTRODUCTION: Capacity to provide end-of-life care in India is scored as 0.6/100, and very few people in India have access to palliative and end-of-life care. Lack of end-of-life care provision in India has led to a significant number of people receiving inappropriate medical treatment at the end of life, with no access to pain and symptom control and high treatment costs. The International Collaborative for the Best Care for the Dying Person is an initiative that offers the opportunity to apply international evidence on the key factors required to provide best care for the dying in the Indian context...
January 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28216806/regional-distribution-and-losses-of-end-of-life-steel-throughout-multiple-product-life-cycles-insights-from-the-global-multiregional-matrace-model
#15
Stefan Pauliuk, Yasushi Kondo, Shinichiro Nakamura, Kenichi Nakajima
Substantial amounts of post-consumer scrap are exported to other regions or lost during recovery and remelting, and both export and losses pose a constraint to desires for having regionally closed material cycles. To quantify the challenges and trade-offs associated with closed-loop metal recycling, we looked at the material cycles from the perspective of a single material unit and trace a unit of material through several product life cycles. Focusing on steel, we used current process parameters, loss rates, and trade patterns of the steel cycle to study how steel that was originally contained in high quality applications such as machinery or vehicles with stringent purity requirements gets subsequently distributed across different regions and product groups such as building and construction with less stringent purity requirements...
January 2017: Resources, Conservation, and Recycling
https://www.readbyqxmd.com/read/28215972/wind-turbine-blade-waste-in-2050
#16
Pu Liu, Claire Y Barlow
Wind energy has developed rapidly over the last two decades to become one of the most promising and economically viable sources of renewable energy. Although wind energy is claimed to provide clean renewable energy without any emissions during operation, but it is only one side of the coin. The blades, one of the most important components in the wind turbines, made with composite, are currently regarded as unrecyclable. With the first wave of early commercial wind turbine installations now approaching their end of life, the problem of blade disposal is just beginning to emerge as a significant factor for the future...
February 16, 2017: Waste Management
https://www.readbyqxmd.com/read/28215750/organizational-capacities-for-residential-care-homes-for-the-elderly-to-provide-culturally-appropriate-end-of-life-care-for-chinese-elders-and-their-families
#17
Sui-Ting Kong, Christine Meng-Sang Fang, Vivian Weiqun Lou
Developing culturally appropriate end-of-life care for Chinese elderly and families is not an endemic challenge for Hong Kong, but that of the Western countries with a noticeable trend of rising Chinese population. The particular development of Hong Kong healthcare system, which is currently the major provider of end-of-life care, makes Hong Kong a fruitful case for understanding the confluence of the West and the East cultures in end-of-life care practices. This study therefore aims at building our best practice to enhance the capacity of residential care homes in providing culturally appropriate end-of-life care...
January 2017: Journal of Aging Studies
https://www.readbyqxmd.com/read/28214237/knowledge-attitudes-and-preferences-of-advance-decisions-end-of-life-care-and-place-of-care-and-death-in-hong-kong-a%C3%A2-population-based-telephone-survey-of-1067-adults
#18
Roger Yat-Nork Chung, Eliza Lai-Yi Wong, Nicole Kiang, Patsy Yuen-Kwan Chau, Janice Y C Lau, Samuel Yeung-Shan Wong, Eng-Kiong Yeoh, Jean W Woo
OBJECTIVES: According to the 2015 Quality of Death Index published by the Intelligence Unit of the Economist, Hong Kong is ranked 22nd in terms of quality of palliative care in the world, behind many other major developed countries in Asia, including Taiwan, Singapore, Japan, and South Korea. The objectives of the present study were to describe the knowledge, attitude, and preferences of the general Hong Kong adult population across different age groups regarding end-of-life (EOL) care decisions, place of care and death, as well as advance directive (AD)...
February 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28214236/are-hospital-ed-transfers-less-likely-among-nursing-home-residents-with-do-not-hospitalize-orders
#19
Taeko Nakashima, Yuchi Young, Wan-Hsiang Hsu
OBJECTIVES: This study aims to examine whether an advance directive "Do Not Hospitalize" (DNH) would be effective in reducing hospital/emergency department (ED) transfers. Similar effects in residents with dementia were also examined. DESIGN: Cross-sectional study. SETTING/SUBJECTS: New York State (NYS) nursing home residents (n = 43,024). MEASUREMENTS AND ANALYSIS: The Minimum Data Set 2.0 was used to address the study aims...
February 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28212951/priority-to-end-of-life-treatments-views-of-the-public-in-the-netherlands
#20
Sofie Wouters, Job van Exel, Rachel Baker, Werner B F Brouwer
OBJECTIVES: Recent debates in the Netherlands on health care priority setting have focused on the relative value of gains generated by life-extending medicines for people with a terminal illness, mostly new cancer drugs. These treatments are generally expensive, provide relatively small health gains, and therefore usually do not meet common cost per QALY thresholds. Nevertheless, these drugs may be provided under the assumption that there is public support for making a special case for treatments for people with a terminal illness...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
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