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https://www.readbyqxmd.com/read/28716485/fatalism-and-educational-disparities-in-beliefs-about-the-curability-of-advanced-cancer
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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)...
March 13, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28294479/understanding-advance-care-planning-within-the-south-asian-community
#11
Patricia D Biondo, Rashika Kalia, Rooh-Afza Khan, Nadia Asghar, Cyrene Banerjee, Debbie Boulton, Nancy Marlett, Svetlana Shklarov, Jessica E Simon
BACKGROUND: Advance care planning (ACP) is a process of reflection on and communication of a person's future health-care preferences. Evidence suggests visible minorities engage less in ACP. The South Asian ethnic group is the largest visible minority group in Canada, and information is needed to understand how ACP is perceived and how best to approach ACP within this diverse community. OBJECTIVE: To explore perspectives of South Asian community members towards ACP...
March 10, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28196257/association-between-use-of-a-scalp-cooling-device-and-alopecia-after-chemotherapy-for-breast-cancer
#12
MULTICENTER STUDY
Hope S Rugo, Paula Klein, Susan Anitra Melin, Sara A Hurvitz, Michelle E Melisko, Anne Moore, Glen Park, Jules Mitchel, Erika Bågeman, Ralph B D'Agostino, Elizabeth S Ver Hoeve, Laura Esserman, Tessa Cigler
Importance: Chemotherapy-induced alopecia is a common and distressing adverse effect. In previous studies of scalp cooling to prevent chemotherapy-induced alopecia, conclusions have been limited. Objectives: To evaluate whether use of a scalp cooling system is associated with a lower amount of hair loss among women receiving specific chemotherapy regimens for early-stage breast cancer and to assess related changes in quality of life. Design, Setting, and Participants: A prospective cohort study conducted at 5 US medical centers of women with stage I or II breast cancer receiving adjuvant or neoadjuvant chemotherapy regimens excluding sequential or combination anthracycline and taxane (106 patients in the scalp cooling group and 16 in the control group; 14 matched by both age and chemotherapy regimen)...
February 14, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28179192/palliative-care-and-health-care-utilization-for-patients-with%C3%A2-end-stage-liver-disease-at-the-end-of-life
#13
Arpan A Patel, Anne M Walling, Folasade P May, Sammy Saab, Neil Wenger
BACKGROUND & AIMS: There has been increased attention on ways to improve the quality of end-of-life care for patients with end-stage liver disease, however, there have been few reports of care experiences for patients during terminal hospitalizations. We analyzed data from a large national database to increase our understanding of palliative care for and health care utilization by patients with end-stage liver disease. METHODS: We performed a cross-sectional, observational study to examine terminal hospitalizations of adults with decompensated cirrhosis using data from the National Inpatient Sample from 2009 through 2013...
February 4, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28156594/patterns-of-intensity-of-end-of-life-care-for-adolescents-and-young-adults-with-cancer-a-population-based-study
#14
Elysia Marie Alvarez, Olga Saynina, Lee Sanders, Smita Bhatia, Lisa J Chamberlain
132 Background: Cancer is the leading cause of non-accidental death amongst adolescents and young adults (AYA), aged 15-39, in the U.S. It is critical to understand end of life (EOL) care of AYA cancer decedents, including use of medically intense interventions like intubation. Although desired by some, most patients prefer a natural death. We sought to determine rates of medically intense interventions at end of life for AYA cancer decedents and associated factors. METHODS: Using the California Office of Statewide Health Planning and Development private administrative database linked to death certificates, we performed a retrospective population based analysis of patients aged 15-39 with cancer who died between 2000-2010...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156578/piloting-survivorship-care-planning-with-the-metastatic-breast-cancer-patient
#15
Catherine Saiki, Jane Zorzi, Vered Stearns, Antonio C Wolff
146 Background: Emotional distress and poor symptom management are highly prevalent among patients with metastatic breast cancer (MBC). A high disease burden can further negatively impact these patients' quality of life. To address the evolving survivorship needs in their trajectory from initial diagnosis of advanced disease to end-of-life care, patients with MBC require prompt assessment, reevaluation, and specialized support services. Limited survivorship resources are devoted to this patient population and greater attention to their needs is warranted...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28081552/demographic-and-psychological-correlates-of-new-zealanders-support-for-euthanasia
#16
Carol Hj Lee, Isabelle M Duck, Chris G Sibley
AIMS: To explore the distribution of New Zealanders' support towards the legalisation of euthanasia and examine demographic and psychological factors associated with these attitudes. METHODS: 15,822 participants responded to the 2014/15 New Zealand Attitudes and Values Study (NZAVS) survey. This survey included an item on people's attitudes towards euthanasia, and information on their demographic and psychological characteristics. RESULTS: The majority of New Zealanders expressed support for euthanasia, which was assessed by asking "Suppose a person has a painful incurable disease...
January 13, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27833180/justice-and-health-care-when-ordinary-is-extraordinary
#17
James McTavish
In some Asian countries, the poor are often denied access to health care. In the Philippines, we have thousands of Catholic doctors, Catholic nurses, even Catholic administrators, but not a Catholic, understood as "universal," healthcare system available to all. This is a scandal and places heavy emotional and financial burdens on many families who need to pay the healthcare costs of sick loved ones. The Church teaches the principles of ordinary and extraordinary care, with only the former being morally obligatory...
February 2016: Linacre Quarterly
https://www.readbyqxmd.com/read/27753805/ssa-02-4-disparities-in-hypertension-management-of-ckd-in-south-asia
#18
Tazeen Jafar
Chronic kidney disease (CKD) defined as reduced estimated glomerular filtration rate (eGFR) or presence of albuminuria, progresses to end stage renal disease (ESRD), needing dialysis or kidney transplant to sustain life, and is associated with increased risks of premature cardiovascular disease (CVD) and mortality. CKD ranked 18 leading (and most rapidly rising cause of mortality by the Global Burden of Disease Study 2010. The social and economic consequences of CKD are far worse in low and middle income countries (LMICs) including India, Pakistan, Bangladesh, and Sri Lanka...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27642932/ssa-02-4-disparities-in-hypertension-management-of-ckd-in-south-asia
#19
Tazeen Jafar
Chronic kidney disease (CKD) defined as reduced estimated glomerular filtration rate (eGFR) or presence of albuminuria, progresses to end stage renal disease (ESRD), needing dialysis or kidney transplant to sustain life, and is associated with increased risks of premature cardiovascular disease (CVD) and mortality. CKD ranked 18 leading (and most rapidly rising cause of mortality by the Global Burden of Disease Study 2010. The social and economic consequences of CKD are far worse in low and middle income countries (LMICs) including India, Pakistan, Bangladesh, and Sri Lanka...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27626514/end-of-life-care-in-patients-with-metastatic-lung-cancer-harboring-epidermal-growth-factor-receptor-mutations
#20
Jessica R Bauman, Zofia Piotrowska, Alona Muzikansky, Emily Gallagher, Emily Scribner, Brandon Temel, Lecia V Sequist, Rebecca S Heist, Jennifer S Temel
BACKGROUND/OBJECTIVE: Patients with metastatic nonsmall cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations benefit from improved survival and quality of life with EGFR-directed therapy. We sought to explore if these improvements in cancer care impacted the delivery of end-of-life (EOL) care in this population. DESIGN: We retrospectively reviewed medical records of patients cared for at our institution with the diagnosis of metastatic EGFR-mutant NSCLC who died by January 2015...
December 2016: Journal of Palliative Medicine
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