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https://www.readbyqxmd.com/read/29776973/challenges-in-end-of-life-dementia-care
#1
REVIEW
Anne A Fetherston, Grace Rowley, Charlotte L Allan
Dementia is a chronic, progressive disease that is now much more widely recognised and treated. Patients with dementia may require palliative care when they reach the end stage of their illness, or they may have mild-moderate cognitive symptoms comorbid with a life-limiting illness. The variety of presentations necessitates a highly individual approach to care planning, and patients should be encouraged to set their own goals and contribute to advanced care planning where possible. Assessment and management of distressing symptoms at the end of life can be greatly helped by a detailed knowledge of the individuals' prior wishes, interdisciplinary communication and recognition of changes in presentation that may result from new symptoms, for example, onset of pain, nutritional deficits and infection...
May 18, 2018: Evidence-based Mental Health
https://www.readbyqxmd.com/read/29776669/-the-role-of-end-of-life-palliative-sedation-medical-and-ethical-aspects-review
#2
REVIEW
Miriam S Menezes, Maria das Graças Mota da Cruz de Assis Figueiredo
BACKGROUND AND OBJECTIVE: Palliative sedation is a medical procedure that has been used for more than 25 years to relieve refractory symptoms not responsive to any previous treatment in patients with no possibility of cure and near the end of life. Many uncertainties persist on the issue regarding definition, indications, decision making, most appropriate place to perform the procedure, most used drugs, need for monitoring, fluids and nutritional support, and possible ethical dilemmas...
May 15, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29756648/direct-percutaneous-endoscopic-jejunostomy-procedural-and-nutrition-outcomes-in-a-large-patient-cohort
#3
Priya K Simoes, Kaitlin M Woo, Moshe Shike, Robin B Mendelsohn, Hans Gerdes, Arnold J Markowitz, Emmy Ludwig, Pari M Shah, Mark A Schattner
BACKGROUND: Direct percutaneous endoscopic jejunostomy (DPEJ) is used for enteral nutrition (EN) in patients with postoperative anastomotic leaks after esophagectomy/gastrectomy and at high risk for aspiration. We characterized the indications, technical success, procedural/nutrition outcomes, and adverse events in a large cohort of patients undergoing DPEJ insertion. METHODS: Patients undergoing DPEJ insertion between January 2009 and March 2015 were identified from an institutional endoscopy database...
December 27, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29750984/liquid-nitrogen-spray-cryotherapy-for-dysphagia-palliation-in-patients-with-inoperable-esophageal-cancer
#4
Toufic Kachaamy, Ravi Prakash, Madappa Kundranda, Raman Batish, Jeffrey Weber, Scott Hendrickson, Leon Yoder, Hannah Do, Theresa Magat, Rajeev Nayar, Digant Gupta, Trisha DaSilva, Ashish Sangal, Shivangi Kothari, Vivek Kaul, Pankaj Vashi
BACKGROUND AND AIMS: Dysphagia is a debilitating symptom in patients with inoperable esophageal cancer contributing to poor quality of life and worsening nutritional status. The 2 most commonly used palliative modalities for dysphagia are radiation therapy (RT) and esophageal stent placement. However, RT is limited by adverse events (AEs) and total dose, and stent placement has a high rate of AEs including reflux, migration, and chest pain. A relatively new modality of liquid nitrogen endoscopic spray cryotherapy has been described as salvage when other options have been exhausted and when patients are no longer receiving systemic therapy...
May 8, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29741571/struggling-with-nutrition-in-patients-with-advanced-cancer-nutrition-and-nourishment-focusing-on-metabolism-and-supportive-care
#5
J Arends
Patients with advanced cancer are at high risk of losing vital body resources resulting in malnutrition, immunodeficiency, impaired quality of life and worse clinical outcome. Prominent among the diverse factors contributing to this complex condition are metabolic derangements characterized by systemic inflammation, catabolism and accumulating changes in body composition. Because cure in advanced cancer still remains elusive, optimal supportive and integrated palliative care are required to allow patients to tolerate aggressive or long-term anticancer treatments, to maintain an adequate quality of life or to stay the course of advancing disease...
February 1, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29735478/development-and-validation-of-a-multidisciplinary-mobile-care-system-for-patients-with-advanced-gastrointestinal-cancer-interventional-observation-study
#6
Ji Yeong Soh, Won Chul Cha, Dong Kyung Chang, Ji Hye Hwang, Kihyung Kim, Miyong Rha, Hee Kwon
BACKGROUND: Mobile health apps have emerged as supportive tools in the management of advanced cancers. However, only a few apps have self-monitoring features, and they are not standardized and validated. OBJECTIVE: This study aimed to develop and validate a multidisciplinary mobile care system with self-monitoring features that can be useful for patients with advanced gastrointestinal cancer. METHODS: The development of the multidisciplinary mobile health management system was divided into 3 steps...
May 7, 2018: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29727261/virtual-telemedicine-visits-in-pediatric-home-parenteral-nutrition-patients-a-quality-improvement-initiative
#7
Bram P Raphael, Caitlin Schumann, Sara Garrity-Gentille, Jennifer McClelland, Carolyn Rosa, Christina Tascione, Mary Gallotto, Melissa Takvorian-Bené, Alexandra N Carey, Patrick McCarthy, Christopher Duggan, Al Ozonoff
BACKGROUND: Despite being less costly than prolonged hospitalization, home parenteral nutrition (HPN) is associated with high rates of post-discharge complications, including frequent readmissions and central line-associated bloodstream infections (CLABSIs). Telemedicine has been associated with improved outcomes and reduced healthcare utilization in other high-risk populations, but no studies to date have supported effectiveness of telemedicine in pediatric HPN. METHODS: We prospectively collected data on pediatric patients managed at a single HPN program who participated in postdischarge telemedicine visits from March 1, 2014 to March 30, 2016...
May 4, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29724207/next-of-kin-involvement-in-improving-hospital-cancer-care-quality-and-safety-a-qualitative-cross-case-study-as-basis-for-theory-development
#8
Inger Johanne Bergerød, Bjørnar Gilje, Geir S Braut, Siri Wiig
BACKGROUND: Next-of-kin are an extension of healthcare professionals in all stages of cancer care. They offer care activities such as interpretations of symptoms, and reporting of negative or adverse effects of treatment, without any professional knowledge or skills. Their participation is often expected from healthcare professionals, managers, or the patient. However, there is limited knowledge of next-of-kin's role in and contribution to quality and safety improvement in hospital cancer care...
May 3, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29713623/nutrition-intervention-through-interdisciplinary-medical-treatment-in-hospice-patients-from-admission-to-death
#9
Hyelim Kang, Yu Jin Yang, Juyeon Park, Gyu Jin Heo, Jeong-Im Hong, Hye-Jin Kim
The demand for hospice services as well as for 'well-dying' of terminal patients is increasing as patient financial burden is decreasing due to National Health Insurance coverage for hospice care. Hospice institutions utilize interdisciplinary teams comprising doctors, nurses, dietitians, and other health staffs to provide comprehensive patient management. This report examined the nutritional status of a hospice patient from admission to death as well as the nutrition management of this patient in the hospice ward through nutrition interventions performed by a dietitian in the interdisciplinary team...
April 2018: Clinical Nutrition Research
https://www.readbyqxmd.com/read/29710016/-evaluation-of-a-two-day-hospital-on-site-training-program-for-community-pharmacists-approach-to-facilitate-collaboration-among-community-healthcare-professionals
#10
Masaki Sumi, Chiaki Hasegawa, Hiroaki Morii, Nobuo Hoshino, Yumi Okunuki, Kashie Kanemoto, Miya Horie, Haruka Okamoto, Naoki Yabuta, Masashi Matsuda, Takaki Kamiya, Masatomo Sudo, Kyouko Masuda, Yuri Iwashita, Kaori Matsuda, Yoshiko Motooka, Daiki Hira, Shin-Ya Morita, Tomohiro Terada
 The importance of community-based care systems has increased due to the highly aging population and diversity of disease. To enhance the cooperation among healthcare professionals in community-based care systems, a two-day on-site training program for community pharmacists based on a multidisciplinary team approach was conducted at the Medical Science Hospital of Shiga University from April 2015 to March 2017. There were two professional courses in this training program: the palliative care course and nutrition support course...
2018: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/29675111/a-survival-model-in-locally-advanced-and-metastatic-pancreatic-ductal-adenocarcinoma
#11
Yi Wang, Xiuying Xiao, Tianyi Wang, Lin Li, Yue Zhu, Haiyan Xu, Yuening Chu, Feng Jiao, Jiujie Cui, Liwei Wang
The prognostic role of serum LDH, CA19-9, CRP and ALB in PDAC patients are controversial. In contrast to single factor, there is much less information about the prognostic value of the combination of the four factors in locally advanced and metastatic PDAC patients. It's essential to set up a survival model with the combination of tumor metabolism, tumor biomarker, systemic inflammation and nutritional status to eliminate the prognostic inaccuracy in single biomarker. 94 advanced PDAC patients who received palliative chemotherapy from 2009 to 2017 were recruited for this study...
2018: Journal of Cancer
https://www.readbyqxmd.com/read/29656713/symptom-management-nutrition-and-hydration-at-end-of-life-a-qualitative-exploration-of-patients-carers-and-health-professionals-experiences-and-further-research-questions
#12
Jessica Baillie, Despina Anagnostou, Stephanie Sivell, Jordan Van Godwin, Anthony Byrne, Annmarie Nelson
BACKGROUND: Symptom management is an essential aspect of palliative and end-of-life care, but evidence suggests that patients' symptoms may not always be relieved, causing significant harm to patients and magnifying their relatives' distress. A growing body of evidence focuses on symptom management at the end-of-life, but research funding for palliative care remains disproportionately low. It is therefore crucial that research funding is targeted at areas of importance to patients and relatives...
April 16, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29625409/relationship-of-nutritional-status-and-inflammation-with-survival-in-patients-with-advanced-cancer-in-palliative-care
#13
Marcela Souza Cunha, Emanuelly Varea Maria Wiegert, Larissa Calixto-Lima, Livia Costa Oliveira
OBJECTIVE: This study aimed to evaluate the prognostic value of nutritional and inflammatory status in patients with advanced cancer receiving palliative care. METHODS: The systemic inflammatory response was assessed using the modified Glasgow Prognostic Score (mGPS), and nutritional status was evaluated according to the Patient-Generated Subjective Global Assessment (PG-SGA) in 172 patients evaluated on their first visit in the Palliative Care Unit at the National Cancer Institute in Brazil...
February 8, 2018: Nutrition
https://www.readbyqxmd.com/read/29603317/innovative-discharge-process-for-families-with-pediatric-short-bowel-syndrome-a-prospective-nonrandomized-trial
#14
Bram P Raphael, Maria Jorina, Mary Gallotto, Glendalis Grullon, Meghan Dalton, Melissa Takvorian-Bené, Christina Tascione, Carolyn Rosa, Jennifer McClelland, Megan Gray, Alexis K Potemkin, Courtney Glavin, Kathleen M Gura, Margaret K Murphy, Kierrah Leger, Judith Mahoney, Jessica Kerr, Al Ozonoff, Christopher P Duggan
BACKGROUND: Home parenteral nutrition (HPN) is a life-sustaining therapy for short bowel syndrome (SBS) and other severe digestive diseases, but complications are common. We evaluated a predischarge HPN hands-on training course to reduce complications in children with SBS, including hospital readmissions. METHODS: We conducted a prospective, nonrandomized controlled research study between April 1, 2014, and April 30, 2017. Eligible participants were children aged <18 years old with SBS and anticipated HPN dependence duration ≥6 months...
March 30, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29591838/getting-comfortable-with-comfort-feeding-an-exploration-of-legal-and-ethical-aspects-of-the-australian-speech-language-pathologist-s-role-in-palliative-dysphagia-care
#15
Katherine Kelly, Steven Cumming, Belinda Kenny, Jennifer Smith-Merry, Hans Bogaardt
PURPOSE: With an ageing population, speech-language pathologists (SLPs) can expect to encounter legal and ethical challenges associated with palliative and end-of-life care more frequently. An awareness of the medico-legal and ethical framework for palliative dysphagia management will better equip SLPs to work effectively in this area. METHOD: This narrative review examines a range of legislation, legal, ethical and SLP literature that is currently available to orient SLPs to legal and ethical palliative dysphagia management in the Australian context...
March 28, 2018: International Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/29571609/assessment-of-parenteral-nutrition-prescription-in-canadian-acute-care-settings
#16
Daniela Adjemian, Bianca M Arendt, Johane P Allard
BACKGROUND: Parenteral nutrition (PN) prescription can be challenging in patients with complex conditions and has potential complications. OBJECTIVE: To assess PN prescription, monitoring, and PN-related complications in a Canadian acute care setting. METHODS: This was a prospective cohort study in which patients receiving PN were assessed by an auditor for nutritional status, PN-related prescription, monitoring, and complications. In addition, length of stay and mortality were recorded...
May 2018: Nutrition
https://www.readbyqxmd.com/read/29548891/pressure-injury-progression-and-factors-associated-with-different-end-points-in-a-home-palliative-care-setting-a-retrospective-chart-review-study
#17
Marco Artico, Daniela D'Angelo, Michela Piredda, Tommasangelo Petitti, Luciano Lamarca, Maria Grazia De Marinis, Angelo Dante, Maura Lusignani, Maria Matarese
CONTEXT: Patients with advanced illnesses show the highest prevalence for pressure injuries. In the palliative care setting, the ultimate goal is injury healing, but equally important is wound maintenance, wound palliation (wound-related pain and symptom management), and primary and secondary wound prevention. OBJECTIVES: To describe the course of healing for pressure injuries in a home palliative care setting according to different end-points, and to explore patient and caregiver characteristics and specific care activities associated with their achievement...
March 13, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29532465/voluntary-stopping-eating-and-drinking
#18
John W Wax, Amy W An, Nicole Kosier, Timothy E Quill
Voluntary stopping of eating and drinking (VSED) is a deliberate, self-initiated attempt to hasten death in the setting of suffering refractory to optimal palliative interventions or prolonged dying that a person finds intolerable. Individuals who consider VSED tend to be older, have a serious but not always imminently terminal illness, place a high value on independence, and have significant illness burden. VSED can theoretically be performed independent of clinician assistance and therefore avoids many of the ethical and legal concerns associated with physician-assisted dying or other palliative measures of last resort, However, VSED is an intense process fraught with new sources of somatic and emotional suffering for individuals and their caregivers, so VSED is best supervised by an experienced, well-informed clinician who can provide appropriate pre-intervention assessment, anticipatory guidance, medical treatment of symptoms, and emotional support...
March 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29508138/perception-of-need-for-nutritional-support-in-advanced-cancer-patients-with-cachexia-a-survey-in-palliative-care-settings
#19
Koji Amano, Tatsuya Morita, Jiro Miyamoto, Teruaki Uno, Hirofumi Katayama, Ryohei Tatara
PURPOSE: Few studies have investigated the need for nutritional support in advanced cancer patients in palliative care settings. Therefore, we conducted a questionnaire to examine the relationship between the perception of need for nutritional support and cancer cachexia and the prevalence of specific needs, perceptions, and beliefs in nutritional support. METHODS: We conducted a questionnaire in palliative care settings. Patients were classified into two groups: (1) non-cachexia/pre-cachexia and (2) cachexia/refractory cachexia...
March 5, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29485752/development-of-consensus-on-models-of-care-in-adults-with-intestinal-failure-using-a-modified-delphi-approach
#20
Sharon Carey, Michelle Kalachov, Lynn Jones, Cherry Koh
BACKGROUND AND AIM: The aims of this study were to establish consensus on service delivery models for management of Type III intestinal failure (IF) and home parenteral nutrition (HPN) within the Australian health-care system and to identify barriers and enablers in moving towards this ideal model. METHODS: A modified Delphi methodology was utilized to survey experts working in Type III IF HPN. The panel comprised physicians, dietitians, nurses, and pharmacists from 18 of the 20 adult Type III IF HPN centres across Australia...
February 27, 2018: Journal of Gastroenterology and Hepatology
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