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Advanced care plans

Maria Alice Dias da Silva Lima, Ana Maria Müller de Magalhães, Nelly Donszelmann Oelke, Giselda Quintana Marques, Elisiane Lorenzini, Luciana Andressa Feil Weber, Iris Fan
OBJECTIVE: To identify and analyze available literature on care transition strategies in Latin American countries. METHODS: Integrative literature review that included studies indexed in PubMed, LILACS, Web of Science Core Collection, CINAHL, SCOPUS databases, and the Scientific Electronic Library Online (SciELO), published in Portuguese, Spanish or English, between 2010 and 2017. RESULTS: Eleven articles were selected and the strategies were grouped into components of care transition: discharge planning, advanced care planning, patient education and promotion of self-management, medication safety, complete communication of information, and outpatient follow-up...
November 29, 2018: Revista Gaúcha de Enfermagem
Victoria L Tang, Ellis C Dillon, Yan Yang, Ming Tai-Seale, John Boscardin, Anna Kata, Rebecca L Sudore
No abstract text is available yet for this article.
December 5, 2018: JAMA Surgery
Joanne C Langan, Roberta Proffitt Lavin, Anne Reid Griffin, Tener Goodwin Veenema, Aram Dobalian
Professional health care societies play a critical role in promoting excellence in patient care, educating and certifying their members on evidence-based practices, and pursuing relevant research agendas to advance the science in the field. Disaster nursing is a subspecialty of professional nursing characterized by a unique knowledge base and set of skills and abilities not used in normal daily health care activities. A disaster or large-scale public health emergency creates a sudden, unanticipated surge of patients with health care needs that far exceeds the capacity of the health care system...
January 2019: Nursing Administration Quarterly
J A Fox, D Langbecker, J Rosenberg, S Ekberg
BACKGROUND: Recent advances in advanced melanoma therapies are associated with improved survival for some patients. How patients with diagnoses of advanced disease and their carers experience this expanding treatment paradigm, however, is not well understood. OBJECTIVES: We explored bereaved carers' accounts of the trajectory of advanced melanoma involving treatment by immune or targeted therapies to build an understanding of their experiences of care relating to diagnosis and prognosis...
December 4, 2018: British Journal of Dermatology
Edward Meinert, Michelle Van Velthoven, David Brindley, Abrar Alturkistani, Kimberley Foley, Sian Rees, Glenn Wells, Nick de Pennington
BACKGROUND: Demands on health services across are increasing because of the combined challenges of an expanding and aging population, alongside complex comorbidities that transcend the classical boundaries of modern health care. Continuing to provide and coordinate care in the current manner is not a viable route to sustain the improvements in health outcomes observed in recent history. To ensure that there continues to be improvement in patient care, prevention of disease, and reduced burden on health systems, it is essential that we adapt our models of delivery...
December 4, 2018: JMIR Research Protocols
Claire Bamford, Richard Lee, Emma McLellan, Marie Poole, Karen Harrison-Dening, Julian Hughes, Louise Robinson, Catherine Exley
BACKGROUND: People with advanced dementia often experience suboptimal end of life care (EoLC) with inadequate pain control, increased hospitalisation, and fewer palliative care interventions compared to those with cancer. Existing policy, guidance and recommendations are based largely on expert opinion because of a shortage of high quality, empirical research. Previous studies have tended to consider the views and experience of particular groups. Whilst providing important evidence, they do not take into account the diversity of perspectives of different stakeholders...
December 4, 2018: BMC Geriatrics
Deb Rawlings, Lauren Miller-Lewis, Jennifer Tieman
Few previous studies have formally examined people's wishes regarding what they want to do before they die. This study aimed to describe responses to an activity within a Massive Open Online Course (MOOC) where people considered what was important when faced with their own mortality. We asked participants to complete the following: "Before I Die, I want to…". The content of participants' responses ( n = 633) was analysed qualitatively with a coding schema developed and then applied. All authors independently coded the first 100 "Before I Die" statements, followed by a second round of coding where themes were verified and confirmed...
November 30, 2018: Behavioral Sciences
Marjorie A Bowman, Kaitlyn Steffensmeier, Marisa Smith, Adrienne Stolfi
OBJECTIVES: Advance care planning (ACP) involvement could be substantially different by physician specialty or sex group, with implications for training and methods to increase ACP activities. The objective of this article is to compare primary care physicians (PCPs) and other specialty physicians and female compared with male physicians' views and interactions surrounding ACP. METHODS: This was a secondary analysis of an online anonymous survey distributed through a survey link to healthcare providers in hospital, ambulatory, and hospice settings in the greater Dayton, Ohio area in preparation for a community-wide advance care planning multitiered intervention...
December 2018: Southern Medical Journal
Daniel David, Ryan D McMahan, Rebecca L Sudore
No abstract text is available yet for this article.
December 3, 2018: Journal of the American Geriatrics Society
Russet R Rogers, John A Owen, Donna M Lake, Carol Fowler Durham, Tina G Latham, Gwen Sherwood, Christopher S Golding
INTRODUCTION: North Carolina AHEC (NC AHEC) leadership recognized that continuing interprofessional education (CIPE) is vital for improving patient care and outcomes. Rather than train and educate in professional silos, interprofessional education presented an opportunity to reframe continuing education (CE) to improve the integration of care delivery and outcomes. METHODS: In April 2014, two regional AHECs collaborated to design a statewide initiative for AHEC CE leaders, CE professionals, and CE faculty to learn about integrating interprofessional education into CE planning and implementation...
October 2018: Journal of Continuing Education in the Health Professions
Nancy A Warren, Harriette L Spiegel
Registered nurses are choosing to further their educational careers by seeking a bachelor's of science degree online (RN-to-BSN). The impetus for choosing the online delivery method is related to the ability to sign into a Learning Management System during times that are advantageous to their hospital work schedules, family, and daily living activities. The RN-to-BSN online option degree requires a Critical Care/Advanced Health Care Course as part of their curriculum plan; therefore, the article presents an overall view of the critical care course, the theoretical underpinnings for progression to the online delivery method, and examples of a module required by the critical care course...
January 2019: Critical Care Nursing Quarterly
Konstantin S German, Ankur Kalra
PURPOSE OF REVIEW: Highlight the difficulties patients, physicians, and the global economy face in relation to treatment of structural heart diseases. It is easy to be carried away by the excitement of medical advancement; however, it is difficult to demonstrate restraint. Transcatheter aortic valve replacement (TAVR) is a modern marvel that can help many patients when utilized appropriately. This article highlights the work that has been done to facilitate decision-making in this challenging patient population...
December 4, 2018: Current Opinion in Supportive and Palliative Care
Seiko Goto, Xuting Shen, Minkai Sun, Yutaka Hamano, Karl Herrup
Dementia is highly prevalent among the worldwide elderly population. Only a small number of the currently marketed drugs are effective in controlling its symptoms, and none has any effect on its progression. Further, as the condition advances, even these pharmaceuticals lose their efficiency, and new research into interventions that might improve the life quality of patients at the end stage of dementia and their families is increasingly rare. In our previous studies, we explored the benefits of exposure to nature, in the form of Japanese garden, for persons with advanced dementia...
November 28, 2018: Journal of Alzheimer's Disease: JAD
Giovanni Battista Levi Sandri, Michel Rayar, Xingshun Qi, Pierleone Lucatelli
Hepatocellular carcinoma (HCC) is one of the most indication to Liver Transplantation (LT). Milan criteria are worldwide accepted as the gold standard for LT indication for HCC. Nevertheless, expanded criteria are often used to transplant patient outside Milan. We described the most important proposed criteria outside Milan criteria. From the University of California San Francisco, to the Toronto criteria. From East to Western, and for living donor liver transplantation. In order to achieve similar results the downstaging strategy is more frequently used and for patients with locally advanced HCC...
2018: Translational Gastroenterology and Hepatology
Seth J Rotz, Eric Kodish
Recent genomic discoveries have improved our understanding of many hematologic diseases and led to novel therapeutic options for many patients. The rapid decrease in the cost of genomic testing has enabled widespread use of clinical genomic testing. However, these advances are accompanied by concomitant challenging ethical concerns. In pediatrics, issues of informed consent for genomic testing, assent, and permission vary significantly by patient age and comprehension. Broader testing strategies, such as whole-exome or whole-genome sequencing, are more likely to yield incidental findings unrelated to the reason for the initial test, and plans to deal with these results when they occur are increasingly important...
November 30, 2018: Hematology—the Education Program of the American Society of Hematology
Matt Hall
In 2018, it is unusual for women with chronic kidney disease (CKD) to be told that pregnancy is not an option. Maternal and foetal outcomes have steadily improved over the last 50 years and a successful pregnancy, resulting in a healthy infant without detrimental to maternal health, is commonplace. Nevertheless, the incidence of adverse outcomes including pre-eclampsia, preterm birth and small-for-gestational age infants is higher for women with CKD than the general population, requiring enhanced monitoring...
October 30, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
Christina Small, Grant Harmon, John Weaver, Vince Vivirito, Ramon Durazo-Arvizu, William Small, Matthew M Harkenrider
PURPOSE: Concurrent chemoradiotherapy and brachytherapy is the standard of care for locally advanced cervical cancer. Brachytherapy is an integral part of treatment and has improved overall survival. Research is needed to ascertain the planning modalities and schedules to best use resources and optimize treatment time course. We hypothesized that MRI-based brachytherapy when delivered with the described regimen would not prolong, and potentially shorten, overall treatment time as compared with CT-based brachytherapy...
November 26, 2018: Brachytherapy
Halim Yammine, Charles S Briggs, Gregory A Stanley, Jocelyn K Ballast, Frank R Arko Iii
The complex aortic anatomy of patients who present with juxtarenal and pararenal abdominal aortic aneurysms requires advanced techniques to ensure adequate coverage and complete exclusion of the aneurysm. Parallel stent grafting is one option for endovascular repair of complex aneurysms. Using chimneys, periscopes, or snorkels, it is possible to extend the length of the proximal seal zone and maintain perfusion to branch vessels. Because readily available stent grafts and covered stents are used, this technique is highly adaptable to each patient's unique anatomical challenges...
September 2018: Techniques in Vascular and Interventional Radiology
Neal Nettesheim, Doug Powell, William Vasios, Jennifer Mbuthia, Konrad Davis, Dan Yourk, Kirk Waibel, Daniel Kral, Francis McVeigh, Jeremy C Pamplin
Introduction: U.S. military forces have engaged in combat in mature areas of operations (AOs) in Iraq and Afghanistan that allow for casualty evacuation to definitive surgical care within "The Golden Hour." Future combat casualty care will be complex and challenging. Facing the medical demand of the Multi-Domain Battlefield remains an uncertain problem set. What can be anticipated is that a near peer adversary will not allow freedom of movement, air superiority, or uninterrupted communications...
November 1, 2018: Military Medicine
Anne B Wichmann, Hanna van Dam, Bregje Thoonsen, Theo A Boer, Yvonne Engels, A Stef Groenewoud
BACKGROUND: Although it is often recommended that general practitioners (GPs) initiate advance care planning (ACP), little is known about their experiences with ACP. This study aimed to identify GP experiences when conducting ACP conversations with palliative patients, and what factors influence these experiences. METHODS: Dutch GPs (N = 17) who had participated in a training on timely ACP were interviewed. Data from these interviews were analysed using direct content analysis...
November 28, 2018: BMC Family Practice
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