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https://www.readbyqxmd.com/read/29142957/identifying-factors-that-influence-physicians-recommendations-for-dialysis-and-conservative-management-in-indonesia
#1
Eric A Finkelstein, Semra Ozdemir, Chetna Malhotra, Tazeen H Jafar, Hui Lin Choong, Johnny Suhardjono
Introduction: For elderly end-stage renal disease (ESRD) patients with multiple comorbidities, dialysis may offer little survival benefit compared to conservative management (CM). Yet, many elderly ESRD patients undergo dialysis, partly due to physicians' recommendations regarding treatment choice. This study aims to elucidate the factors that influence these recommendations. Methods: We surveyed a convenience sample of physicians who attended the 9th Asian Forum of Chronic Kidney Disease Initiative conference...
March 2017: KI Reports
https://www.readbyqxmd.com/read/29112876/factors-influencing-attitudes-toward-advance-directives-in-korean-older-adults
#2
Ji Eun Lee, Dong Wook Shin, Ki Young Son, Hyun Jung Park, Jae-Young Lim, Mi Soon Song, Yeon-Hwan Park, BeLong Cho
AIM: We aimed to determine the factors influencing attitudes toward advance directives in Korean older adults with consideration of an Asian cultural background. METHODS: We recruited community-dwelling older adults aged 60 years or older at a regional senior welfare center in Korea. Demographic factors and mental and physical health status were examined using questionnaires and a physical examination. The questionnaire also assessed perceived necessity of advance directives and related experiences...
October 31, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29095198/surgeons-perceptions-toward-providing-care-for-diverse-patients-the-need-for-cultural-dexterity-training
#3
Navin R Changoor, Nidhi R Udyavar, Megan A Morris, Maya Torain, John T Mullen, Tara S Kent, Douglas S Smink, Alexander Green, Adil H Haider
OBJECTIVE: We sought to understand the experiences of surgical residents and faculty with treating culturally diverse patients, and identify recommendations for establishing and implementing structured cultural competency training. SUMMARY BACKGROUND DATA: Cultural competency training for medical professionals could reduce healthcare disparities, yet is currently not a standard part of surgical residency training. Few studies have explored the perspectives of surgical residents and faculty on the skills needed to provide cross-cultural care...
October 31, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29032021/clinical-characteristics-and-survival-outcomes-of-terminally-ill-patients-undergoing-withdrawal-of-mechanical-ventilation
#4
Yu-Shin Hung, Shu-Hui Lee, Chia-Yen Hung, Chao-Hui Wang, Chen-Yi Kao, Hung-Ming Wang, Wen-Chi Chou
BACKGROUND: Withdrawal of mechanical ventilation is an important, but rarely explored issue in Asia during end-of-life care. This study aimed to describe the clinical characteristics and survival outcomes of terminally ill patients undergoing withdrawal of mechanical ventilation in Taiwan. METHODS: One-hundred-thirty-five terminally ill patients who had mechanical ventilation withdrawn between 2013 and 2016, from a medical center in Taiwan, were enrolled. Patients' clinical characteristics and survival outcomes after withdrawal of mechanical ventilation were analyzed...
October 11, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28969413/the-eternal-enigma-in-prostatic-biopsy-access-route
#5
Andrea Fabiani, Emanuele Principi, Alessandra Filosa, Lucilla Servi
Dear Editors,We read with interest the article by Di Franco and co-workers (1). The introduction of prostatic magnetic resonance and the relative fusion-biopsy have not yet allowed the expected improvements in prostate biopsy. To our knowledge, there are no works that demonstrate the superiority of fusion techniques on the remaining ultrasound guided prostate biopsies that are still the widely used in the diagnosis of prostate cancer. Furthemore, these technologies are expensive exams and they are not yet available in all centers, especially in those minors...
October 3, 2017: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/28961835/mapping-unmet-supportive-care-needs-quality-of-life-perceptions-and-current-symptoms-in-cancer-survivors-across-the-asia-pacific-region-results-from-the-international-step-study
#6
A Molassiotis, P Yates, Q Li, W K W So, K Pongthavornkamol, P Pittayapan, H Komatsu, M Thandar, M-S Li, S Titus Chacko, V Lopez, J Butcon, D Wyld, R J Chan
Background: To assess the supportive care needs, quality of life (QoL) and symptoms of patients with cancer after the end of first-line treatments and into survivorship in Asian countries using Australian data as benchmark. Patients and methods: A cross-sectional survey was carried out in Australia and eight high-income (HICs) and low-/middle-income (LMICs) Asian countries (China, Japan, Hong Kong SAR, South Korea, Myanmar, Thailand, India, Philippines) using validated scales (Cancer Survivors Unmet Needs scale), physical-symptom concerns (Cancer Survivors Survey of Needs subscale) and a single-item measure of global QoL perception...
October 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28933991/let-him-not-be-alone-perspectives-of-older-british-south-asian-minority-ethnic-patients-on-dying-in-acute-hospitals
#7
Munikumar Ramasamy Venkatasalu
AIM: To investigate older British South Asians' views on dying at acute hospitals. BACKGROUND: Older people, including those from ethnic minorities prefer 'home as a haven' for their last days of life; however, they are more likely to die in hospital. METHODS: Constructive grounded theory was used as a methodological approach that informed data collection to data analysis. Open meetings with 11 local South Asian community organisations enabled the researchers to recruit a total of 55 older South Asians in this study...
September 2, 2017: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/28831437/paloma-3-phase-iii-trial-of-fulvestrant-with-or-without-palbociclib-in-premenopausal-and-postmenopausal-women-with-hormone-receptor-positive-human-epidermal-growth-factor-receptor-2-negative-metastatic-breast-cancer-that-progressed-on-prior-endocrine-therapy
#8
Hiroji Iwata, Seock-Ah Im, Norikazu Masuda, Young-Hyuck Im, Kenichi Inoue, Yoshiaki Rai, Rikiya Nakamura, Jee Hyun Kim, Justin T Hoffman, Ke Zhang, Carla Giorgetti, Shrividya Iyer, Patrick T Schnell, Cynthia Huang Bartlett, Jungsil Ro
PURPOSE: To assess efficacy and safety of palbociclib plus fulvestrant in Asians with endocrine therapy-resistant metastatic breast cancer. PATIENTS AND METHODS: The Palbociclib Ongoing Trials in the Management of Breast Cancer 3 (PALOMA-3) trial, a double-blind phase III study, included 521 patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative metastatic breast cancer with disease progression on endocrine therapy. Patient-reported outcomes (PROs) were assessed on study treatment and at the end of treatment...
August 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/28764219/teneligliptin-in-early-diabetic-kidney-disease-an-observation-in-asian-indian-patients-with-type-2-diabetes-mellitus-in-real-life-scenario
#9
Kiran Shah
INTRODUCTION: Teneligliptin is a recently developed Dipeptidyl Peptidase 4 (DPP4) inhibitor. Teneligliptin is suitable for glycaemic control with renal impairment including end stage renal disease. AIM: To assess the efficacy and safety of teneligliptin in Asian Indian patients of Type 2 Diabetes Mellitus (T2DM) with early Diabetic Kidney Disease (DKD). MATERIALS AND METHODS: This was a single centre, retrospective analysis of patients with early DKD, who received teneligliptin 20 mg once daily for 24 weeks...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28748743/community-based-game-intervention-to-improve-south-asian-indian-americans-engagement-with-advanced-care-planning
#10
Kavita Radhakrishnan, Lauren Jodi Van Scoy, Regina Jillapalli, Shubhada Saxena, Miyong T Kim
OBJECTIVE: Advance care planning (ACP) allows individuals to express their preferences for medical treatment in the event that they become incapable of making their own decisions. This study assessed the efficacy of a conversation game intervention for increasing South Asian Indian Americans' (SAIAs') engagement in ACP behaviors as well as the game's acceptability and cultural appropriateness among SAIAs. DESIGN: Eligible community-dwelling SAIAs were recruited at SAIA cultural events held in central Texas during the summer of 2016...
July 27, 2017: Ethnicity & Health
https://www.readbyqxmd.com/read/28716485/fatalism-and-educational-disparities-in-beliefs-about-the-curability-of-advanced-cancer
#11
Paul R Duberstein, Michael Chen, Benjamin P Chapman, Michael Hoerger, Fahad Saeed, Elizabeth Guancial, Jennifer W Mack
OBJECTIVE: Understanding socioeconomic disparities in the care of patients with incurable cancer is a high priority. We hypothesized that patients without a high school education are more likely to believe that they could be cured and we explored the role of fatalism. METHODS: We studied 977 patients with advanced, incurable cancer. Two logistic regression analyses were conducted. Model One examined the effect of education on beliefs about curability. Model Two added fatalism...
July 10, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28689478/beyond-a-western-bioethics-in-asia-and-its-implication-on-autonomy
#12
Mark Tan Kiak Min
Despite flourishing as a multidisciplinary subject, the predominant view in bioethics today is based on Anglo-American thought. This has serious implications for a global bioethics that needs to be contextualized to local cultures and circumstances in order to be relevant. Being the largest continent on the earth, Asia is home to a variety of cultures, religions and countries of different economic statuses. While the practice of medicine in the East and West may be similar, its ethical practices do differ. Thus, the Western understanding of autonomy may not be wholly applicable in the Asian setting, especially in the setting of breaking bad news, giving consent, determining best interests and deciding on end-of-life care...
July 8, 2017: New Bioethics: a Multidisciplinary Journal of Biotechnology and the Body
https://www.readbyqxmd.com/read/28649267/evidence-for-a-postreproductive-phase-in-female-false-killer-whales-pseudorca-crassidens
#13
Theoni Photopoulou, Ines M Ferreira, Peter B Best, Toshio Kasuya, Helene Marsh
BACKGROUND: A substantial period of life after reproduction ends, known as postreproductive lifespan (PRLS), is at odds with classical life history theory and its causes and mechanisms have puzzled evolutionary biologists for decades. Prolonged PRLS has been confirmed in only two non-human mammals, both odontocete cetaceans in the family Delphinidae. We investigate the evidence for PRLS in a third species, the false killer whale, Pseudorca crassidens, using a quantitative measure of PRLS and morphological evidence from reproductive tissues...
2017: Frontiers in Zoology
https://www.readbyqxmd.com/read/28631517/what-factors-influence-emergency-department-visits-by-patients-with-cancer-at-the-end-of-life-analysis-of-a-124-030-patient-cohort
#14
Lesley A Henson, Irene J Higginson, Wei Gao
BACKGROUND: Emergency department visits towards the end of life by patients with cancer are increasing over time. This is despite evidence of an association with poor patient and caregiver outcomes and most patients preferring home-based care. AIM: To identify socio-demographic and clinical factors associated with end-of-life emergency department visits and determine the relationship between patients' prior emergency department use and risk of multiple (⩾2) visits in the last month of life...
June 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28616221/time-timing-talking-and-training-findings-from-an-exploratory-action-research-study-to-improve-quality-of-end-of-life-care-for-minority-ethnic-kidney-patients
#15
Emma Wilkinson, Gurch Randhawa, Edwina Brown, Maria Da Silva Gane, John Stoves, Graham Warwick, Tahira Mir, Regina Magee, Sue Sharman, Ken Farrington
Background. With an ageing and increasingly diverse population at risk from rising levels of obesity, diabetes and cardiovascular disease, including kidney complications, there is a need to provide quality care at all stages in the care pathway including at the end of life and to all patients. Aim. This study purposively explored South Asian patients' experiences of kidney end of life care to understand how services can be delivered in a way that meets diverse patient needs. Methods. Within an action research design 14 focus groups (45 care providers) of kidney care providers discussed the recruitment and analysis of individual interviews with 16 South Asian kidney patients (eight men, eight women)...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28578815/three-years-experience-with-the-first-pediatric-hospice-in-asia
#16
Kohei Ando, Makoto Nabetani, Nobuyuki Yotani, Tatsushi Rin, Hiroyuki Sano
OBJECTIVE: Pediatric hospice has been the adoption of several service provision models in highly developed countries such as UK, Germany, Australia or Canada for a few decades, yet it has seldom been the case in the Asian Continent. This study aimed to evaluate the newest challenge for the children with Life-threatening illness (LTI) and described the characteristic of pediatric palliative care at the first pediatric hospice in Japan. METHODS: A retrospective review of all patients at our pediatric hospice in these three years was conducted...
May 31, 2017: Brain & Development
https://www.readbyqxmd.com/read/28554208/physician-variation-in-lung-cancer-treatment-at-the-end-of-life
#17
Jonas B Green, Martin F Shapiro, Susan L Ettner, Jennifer Malin, Alfonso Ang, Mitchell D Wong
OBJECTIVES: To determine whether a treating oncologist's characteristics are associated with variation in use of chemotherapy for patients with advanced non-small cell lung cancer (aNSCLC) at the end of life. STUDY DESIGN: Retrospective cohort. METHODS: Using the 2009 Surveillance, Epidemiology, and End Results-Medicare database, we studied chemotherapy receipt within 30 days of death among Medicare enrollees who were diagnosed with aNSCLC between 1999 and 2006, received chemotherapy, and died within 3 years of diagnosis...
April 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28436189/medication-appropriateness-for-patients-with-dementia-approaching-the-end-of-their-life
#18
Hsien-Yeh Chuang, Yu-Wen Wen, Liang-Kung Chen, Fei-Yuan Hsiao
AIM: To examine medication use among patients with dementia towards the end of their life and to evaluate the appropriateness of medication use by using a nationwide database. METHODS: Using Taiwan's National Health Insurance Research Database, we identified 6532 people with dementia that died between 2008 and 2012. For each person with dementia, data of medication use in the last month of outpatient setting (vs -12th month [baseline]) and last hospitalization (vs -3rd hospitalization [baseline]) before death were retrieved for study...
April 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28345473/exploring-end-of-life-care-for-south-asian-kidney-patients-interviewer-reflections
#19
Emma Wilkinson, Muhammad Waqar, Balbir Gill, Pina Hoque, Champa Jetha, Kulwinder Kaur Bola, Riffat Mahmood, Sultan Mahmood, Rita Saujani, Gurch Randhawa
The reduction of inequalities in access to quality care has been a central tenet of UK health policy. Ethnic minorities may experience additional inequalities because of language and other cultural barriers. This article reports interviewer reflections of conducting interviews with South Asian kidney patients about their experiences of end-of-life care. It explores themes which emerged from the analysis of a focus group held with eight bilingual research interviewers. The relevance of these themes to understanding inequalities and access to end-of-life care is discussed; together with the potential for the research process to contribute to service improvement...
March 16, 2017: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/28295138/frequency-and-risk-factors-for-live-discharge-from-hospice
#20
David Russell, Eli L Diamond, Bonnie Lauder, Ritchell R Dignam, Dawn W Dowding, Timothy R Peng, Holly G Prigerson, Kathryn H Bowles
OBJECTIVES: To report frequencies and associated risk factors for 4 distinct causes of live discharge from hospice. DESIGN: Retrospective cohort study using electronic medical records of hospice patients who received care from a large urban not-for-profit hospice agency in New York City during a 3-year period between 2013 and 2015 (n = 9,190). RESULTS: Roughly one in five hospice patients were discharged alive (21%; n = 1911). Acute hospitalization was the most frequent reason for live discharge (42% of all live discharges; n = 802)...
August 2017: Journal of the American Geriatrics Society
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