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https://www.readbyqxmd.com/read/28928181/development-of-core-outcome-sets-for-effectiveness-trials-of-interventions-to-prevent-and-or-treat-delirium-del-cors-study-protocol
#1
Louise Rose, Meera Agar, Lisa D Burry, Noll Campbell, Mike Clarke, Jacques Lee, Najma Siddiqi, Valerie J Page
INTRODUCTION: Delirium is a common, serious and potentially preventable condition with devastating impact on the quality of life prompting a proliferation of interventional trials. Core outcome sets aim to standardise outcome reporting by identifying outcomes perceived fundamental for measurement in trials of a specific interest area. Our aim is to develop international consensus on two core outcome sets for trials of interventions to prevent and/or treat delirium, irrespective of study population...
September 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28918428/modification-of-cardiovascular-pharmacotherapy-in-palliative-care-patients-with-cancer-narrative-review
#2
Tomasz Pasierski
Palliative care cancer patients are treated with many drugs especially at the end of life. Limiting of polypharmacy a decreases the risk of associated adverse effects, medical errors and harmful drug interactions The time lag to benefit of many medications used for cardiovascular diseases or risk factors like hypertension, hypercholesterolemia is frequently longer than palliative care cancer patient's life expectancy. It is ethically appropriate to modify, even to discontinue cardiovascular pharmacotherapy when there is no prospect of benefit...
September 13, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28916237/ethics-and-palliative-care-in-the-perinatal-world
#3
REVIEW
Colleen M Marty, Brian S Carter
The perinatal world is unique in its dutiful consideration of two patients along the lines of decision-making and clinical management - the fetus and the pregnant woman. The potentiality of the fetus-newborn is intertwined with the absolute considerations for the woman as autonomous patient. From prenatal diagnostics, which may be quite extensive, to potential interventions prenatally, postnatal resuscitation, and neonatal management, the fetus and newborn may be anticipated to survive with or without special needs and technology, to have a questionable or guarded prognosis, or to live only minutes to hours...
September 13, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28910224/an-ethical-analysis-of-euthanasia-and-physician-assisted-suicide-rejecting-euthanasia-and-accepting-physician-assisted-suicide-with-palliative-care
#4
Benjamin Shibata
No abstract text is available yet for this article.
January 2017: Journal of Legal Medicine
https://www.readbyqxmd.com/read/28905726/compassionate-release-policy-reform-physicians-as-advocates-for-human-dignity
#5
Andreas Mitchell, Brie Williams
A rapidly aging correctional population has led to an increasing number of patients with serious progressive and terminal illnesses in correctional settings. "Compassionate release" describes a range of policies offering early release or parole to incarcerated patients with serious or debilitating illnesses. However, in many states that have compassionate release policies, few patients are actually granted release. We describe how the continued incarceration of patients with serious or debilitating illness can constitute a violation of human dignity if appropriate palliative care is unavailable...
September 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28904010/vitamin-d-supplementation-to-palliative-cancer-patients-protocol-of-a-double-blind-randomised-controlled-trial-palliative-d
#6
Maria Helde-Frankling, Jenny Bergqvist, Caritha Klasson, Marie Nordström, Jonas Höijer, Peter Bergman, Linda Björkhem-Bergman
BACKGROUND: According to a small pilot study on palliative cancer patients at our ward, vitamin D supplementation had beneficial effects on pain (measured as opioid consumption), infections and quality of life (QoL) without having any significant side effects. OBJECTIVE: The primary objective of the 'Palliative-D' study is to test the hypothesis that vitamin D supplementation for 12 weeks reduces opioid consumption. The secondary objectives are to study if reduction of antibiotic consumption and fatigue as well as improvement in QoL assessments can be observed...
September 13, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28859792/how-medicine-has-changed-the-end-of-life-for-patients-with-cardiovascular-disease
#7
REVIEW
Haider J Warraich, Adrian F Hernandez, Larry A Allen
Advances in medicine have changed how patients experience the end of life. With longer life spans, there has also been an increase in years lived with disability. The clustering of illnesses in the last years of life is particularly pronounced in patients with cardiovascular disease. At the end of life, patients with cardiovascular disease are more symptomatic, less likely to die at home, and less likely to receive high-quality palliative care. Social determinants have created widening disparities in end-of-life care...
September 5, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28854050/forensic-nursing-and-the-palliative-approach-to-care-an-empirical-nursing-ethics-analysis
#8
David Kenneth Wright, Brandi Vanderspank-Wright, Dave Holmes, Elise Skinner
BACKGROUND: A movement is underway to promote a palliative approach to care in all contexts where people age and live with life-limiting conditions, including psychiatric settings. Forensic psychiatry nursing-a subfield of mental health nursing- focuses on individuals who are in conflict with the criminal justice system. We know little about the values of nurses working in forensic psychiatry, and how these values might influence a palliative approach to care for frail and aging patients...
August 2, 2017: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/28835736/health-care-professionals-experiences-and-needs-when-delivering-end-of-life-care-to-children-a-qualitative-study
#9
Eva Bergsträsser, Eva Cignacco, Patricia Luck
Pediatric end-of-life care (EOL care) entails challenging tasks for health care professionals (HCPs). Little is known about HCPs' experiences and needs when providing pediatric EOL care in Switzerland. This study aimed to describe the experiences and needs of HCPs in pediatric EOL care in Switzerland and to develop recommendations for the health ministry. The key aspect in EOL care provision was identified as the capacity to establish a relationship with the dying child and the family. Barriers to this interaction were ethical dilemmas, problems in collaboration with the interprofessional team, and structural problems on the level of organizations...
2017: Palliative Care
https://www.readbyqxmd.com/read/28827943/the-philosophical-and-cultural-situatedness-of-spirituality-at-the-end-of-life-in-india
#10
Hamilton Inbadas
The sustained interest in exploring the spiritual domain at end of life in the Indian context reflects the recognition of its significance as an integral part of palliative care. A key aspect of findings from studies so far is the identification of challenges, inadequacies, limitations and ethical dilemmas in relation to spirituality at the end of life. India is known for its rich spiritual heritage and has unique ways of understanding, experiencing and expressing spirituality. The philosophical and cultural frames of reference, with which communities in India make sense of life, death and dying, determine the characteristics of Indian spirituality at the end of life...
July 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28827063/beyond-simple-planning-existential-dimensions-of-conversations-with-patients-at-risk-of-dying-from-heart-failure
#11
Valerie Schulz, Allison Crombeen, Denise Marshall, Joshua Shadd, Kori LaDonna, Lorelei Lingard
INTRODUCTION: Despite the recent promotion of communication guides to improve decision-making with patients nearing the end of their lives, these conversations remain challenging. Deeper and more comprehensive understanding of communication barriers that undermine discussions and decisions with patients at risk of dying from heart failure (HF) are vital for informing communication in healthcare. OBJECTIVES: To explore experiences and perspectives of patients with advanced HF, their caregivers and providers, regarding conversations for patients at risk of dying from HF...
August 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28818633/patient-and-caregiver-reported-assessment-tools-for-palliative-care-summary-of-the-2017-ahrq-technical-brief
#12
Rebecca Aslakson, Sydney M Dy, Renee F Wilson, Julie Waldfogel, Allen Zhang, Sarina R Isenberg, Alex Blair, Joshua Sixon, Karen A Robinson
CONTEXT: Assessment tools are data collection instruments that are completed by or with patients or caregivers and which collect data at the individual patient or caregiver level. OBJECTIVES: To (1) summarize palliative care assessment tools completed by or with patients or caregivers, and (2) identify needs for future tool development and evaluation. METHODS: We completed: (1) a systematic review of systematic reviews; (2) a supplemental search of previous reviews and websites, and/or (3) a targeted search for primary articles when no tools existed in a domain...
August 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28807699/communication-challenges-of-oncologists-and-intensivists-caring-for-pediatric-oncology-patients-a-qualitative-study
#13
Folasade Odeniyi, Pamela G Nathanson, Theodore E Schall, Jennifer K Walter
CONTEXT: The families of oncology patients requiring intensive care often face increasing complexity in communication with their providers, particularly when patients are cared for by providers from different disciplines. OBJECTIVE: To describe experiences and challenges faced by pediatric oncologists and intensivists and how the oncologist-intensivist relationship impacts communication and initiation of goals of care discussions (GCDs). METHODS: We conducted semi-structured interviews with a convenience sample of ten physicians, including pediatric oncology and intensive care attendings and fellows...
August 11, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28793184/survey-highlights-the-need-for-specific-interventions-to-reduce-frequent-conflicts-between-healthcare-professionals-providing-paediatric-end-of-life-care
#14
Marie-Anne Archambault-Grenier, Marie-Hélène Roy-Gagnon, France Gauvin, Hubert Doucet, Nago Humbert, Sanja Stojanovic, Antoine Payot, Sylvie Fortin, Annie Janvier, Michel Duval
AIMS: This study explored how paediatric healthcare professionals experienced and coped with end-of-life conflicts and identified how to improve coping strategies. METHODS: A questionnaire was distributed to all 2,300 professionals at a paediatric university hospital, covering the frequency of end-of-life conflicts, participants, contributing factors, resolution strategies, outcomes and the usefulness of specific institutional coping strategies. RESULTS: Of the 946 professionals (41%) who responded, 466 had witnessed or participated in paediatric end-of-life discussions: 73% said these had led to conflict, more frequently between professionals (58%) than between professionals and parents (33%)...
August 9, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28789928/engaging-patients-in-complex-clinical-decision-making-successes-pitfalls-and-future-directions
#15
REVIEW
Aaron A Laviana, Stephanie C Pannell, Kathy H Y Huen, Jonathan Bergman
BACKGROUND: By 2022, there will be 18 million predicted cancer survivors, which is an estimated 30% more than the number of survivors in 2012. In prostate cancer alone, the most common cancer in American men other than skin cancer, 1 in 7 men will be diagnosed during their lifetime. Nevertheless, only approximately 1 in 39 will actually die of the disease. Although life expectancy is often good, these men have multiple treatment management options to choose from, including active surveillance, surgery, or radiotherapy, each of which carries its own array of long-term adverse effects...
September 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28780728/predictive-model-of-complexity-in-early-palliative-care-a-cohort-of-advanced-cancer-patients-palcom-study
#16
Albert Tuca, Mónica Gómez-Martínez, Aleix Prat
PROPOSAL: Model of early palliative care (PC) integrated in oncology is based on shared care from the diagnosis to the end of life and is mainly focused on patients with greater complexity. However, there is no definition or tools to evaluate PC complexity. The objectives of the study were to identify the factors influencing level determination of complexity, propose predictive models, and build a complexity scale of PC. PATIENTS AND METHOD: We performed a prospective, observational, multicenter study in a cohort of advanced cancer patients with an estimated prognosis ≤ 6 months...
August 6, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28776144/-validation-of-medical-ethical-decisions-at-the-bedside-by-the-autopsy-experience-of-the-ethics-committee-at-the-stuttgart-clinic
#17
REVIEW
A Bosse, C Schupp
BACKGROUND: Ethics consultations in a clinical setting can be challenging, specifically with respect to limiting therapeutic interventions in terminally ill patients. Some decisions will even be controversial. OBJECTIVE: Can a clinical autopsy be used to confirm the recommendations given by the ethics committee, i. e. limitation of therapy to palliative care? MATERIAL AND METHODS: We report an exemplary case of a patient with endocarditis and subsequent septic cerebral infarction...
August 3, 2017: Der Pathologe
https://www.readbyqxmd.com/read/28776066/-management-of-an-elderly-patient-in-the-emergency-room-at-the-end-of-life-a%C3%A2-medical-ethics-challenge
#18
G Michels, R Nies, S Ortmann, R Pfister, F Salomon
A 94-year-old patient with cardiogenic shock due to myocardial infarction was admitted via the emergency room. A coronary angiography and intensive care were requested. The need for care due to dementia was known. After case discussion in the interdisciplinary and multiprofessional treatment team, the decision for a palliative care concept in the form of symptom control was made in the emergency room, taking into account the patient's medical history, the current situation, and the presumed patient consent...
August 3, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28754044/relational-approach-to-ethics-and-quality-improvement-in-institutional-care-for-people-with-dementia
#19
Dana Hradcová
BACKGROUND: Autonomy has become a key organizing principle in the official and expert discourses of the social services focused on strengthening of clients' independence and self-sufficiency. While "caring" has been seen as a threat to the autonomy of an individual, the care dependency and need for palliative care for people with dementia living in residential institutions are growing. METHODS: Participatory action research was realized in 9 homes providing services for people with dementia with the aim to improve the quality of care...
October 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28716797/a-pragmatic-phase-iii-multisite-double-blind-placebo-controlled-parallel-arm-dose-increment-randomised-trial-of-regular-low-dose-extended-release-morphine-for-chronic-breathlessness-breathlessness-exertion-and-morphine-sulfate-beams-study-protocol
#20
David Currow, Gareth John Watts, Miriam Johnson, Christine F McDonald, John O Miners, Andrew A Somogyi, Linda Denehy, Nicola McCaffrey, Danny J Eckert, Philip McCloud, Sandra Louw, Lawrence Lam, Aine Greene, Belinda Fazekas, Katherine C Clark, Kwun Fong, Meera R Agar, Rohit Joshi, Sharon Kilbreath, Diana Ferreira, Magnus Ekström
INTRODUCTION: Chronic breathlessness is highly prevalent and distressing to patients and families. No medication is registered for its symptomatic reduction. The strongest evidence is for regular, low-dose, extended- release (ER) oral morphine. A recent large phase III study suggests the subgroup most likely to benefit have chronic obstructive pulmonary disease (COPD) and modified Medical Research Council breathlessness scores of 3 or 4. This protocol is for an adequately powered, parallel-arm, placebo-controlled, multisite, factorial, block-randomised study evaluating regular ER morphine for chronic breathlessness in people with COPD...
July 17, 2017: BMJ Open
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