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https://www.readbyqxmd.com/read/28749056/on-legalizing-physician-assisted-death-for-dementia
#1
Rebecca Dresser
Last November, soon after Colorado became the latest state to authorize physician-assisted suicide, National Public Radio's The Diane Rehm Show devoted a segment to legalization of "physician assistance in dying," a label that refers to both physician-assisted suicide and voluntary active euthanasia. Although the segment initially focused on PAD in the context of terminal illness in general, it wasn't long before PAD's potential application to dementia patients came up. A caller said that her mother had Alzheimer's disease and was being cared for at great expense...
July 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28748593/the-use-of-life-review-to-enhance-spiritual-wellbeing-in-patients-with-terminal-illnesses-an-integrative-review
#2
REVIEW
Cecilia W M Kwan, Marques S N Ng, Carmen W H Chan
AIMS AND OBJECTIVES: An integrative review of the current literature on using life review as an intervention to address the spiritual need of patients with terminal illnesses. BACKGROUND: Palliative care highlights the holistic approach of care including the spiritual aspect. Life review has been used in palliative nursing intending to enhance patients' emotional and spiritual wellbeing, and quality of life. However, there is a lack of publications that provide a structured overview on life review programs and their effectiveness...
July 26, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28733461/should-heart-failure-be-regarded-as-a-terminal-illness-requiring-palliative-care-a-study-of-heart-failure-patients-carers-and-clinicians-understanding-of-heart-failure-prognosis-and-its-management
#3
Rachel Stocker, Helen Close, Helen Hancock, A Pali S Hungin
OBJECTIVES: Communication and planning for heart failure (HF) care near the end of life is known to be complex. Little is known about how the patient experience of palliative assessment and communication needs change over time, and how this might inform management. Our aim was to explore experiences of giving or receiving a prognosis and advanced palliative care planning (ACP) for those with HF. METHODS: We carried out a longitudinal grounded theory study, employing in-depth interviews with 14 clinicians (primary and secondary care) and observations of clinic and home appointments, followed by a series of interviews with 13 patients with HF and 9 carers...
July 21, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28732314/the-effect-of-low-dose-furosemide-in-critically-ill-patients-with-early-acute-kidney-injury-a-pilot-randomized-blinded-controlled-trial-the-spark-study
#4
Sean M Bagshaw, R T Noel Gibney, Peter Kruger, Imran Hassan, Finlay A McAlister, Rinaldo Bellomo
PURPOSE: Furosemide is commonly prescribed in acute kidney injury (AKI). Prior studies have found conflicting findings on whether furosemide modifies the course and outcome of AKI. METHODS: Pilot multi-center randomized blinded placebo-controlled trial in adult patients with AKI admitted to three intensive care units. Participants were randomly allocated to furosemide bolus and infusion or 0.9% saline placebo. Primary endpoint was worsening AKI, defined by the RIFLE criteria...
July 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28729130/information-needs-about-palliative-care-and-euthanasia-a-survey-of-patients-in-different-phases-of-their-cancer-trajectory
#5
Kim Beernaert, Chloë Haverbeke, Simon Van Belle, Luc Deliens, Joachim Cohen
OBJECTIVE: We assessed information provision and information needs about illness course, treatments, palliative care and euthanasia in cancer patients. METHODS: Cancer patients consulting a university hospital (N=620) filled out a questionnaire. Their cancer related data were collected through the treating oncologist. This study is performed in Belgium, where "palliative care for all" is a patient's right embedded in the law and euthanasia is possible under certain conditions...
July 1, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28727995/physician-perceptions-about-living-organ-donation-in-patients-with-amyotrophic-lateral-sclerosis
#6
S Ansari, M B Bromberg, S B Gibson
OBJECTIVES: Patients with Amyotrophic Lateral Sclerosis (ALS) have expressed desire to become living organ donors but are unable to do so with current organ donation policies. Our objective is to assess ALS patient's interest in organ donation, and perceived concerns of this practice by ALS neurologists. PATIENTS AND METHODS: An electronic survey was administered to ALS neurologists across the United States regarding living organ donation in ALS patients prior to respiratory failure...
July 5, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28726026/euthanasia-global-scenario-and-its-status-in-india
#7
REVIEW
Raghvendra Singh Shekhawat, Tanuj Kanchan, Puneet Setia, Alok Atreya, Kewal Krishan
The legal and moral validity of euthanasia has been questioned in different situations. In India, the status of euthanasia is no different. It was the Aruna Ramachandra Shanbaug case that got significant public attention and led the Supreme Court of India to initiate detailed deliberations on the long ignored issue of euthanasia. Realising the importance of this issue and considering the ongoing and pending litigation before the different courts in this regard, the Ministry of Health and Family Welfare, Government of India issued a public notice on May 2016 that invited opinions from the citizens and the concerned stakeholders on the proposed draft bill entitled The Medical Treatment of Terminally Ill Patients (Protection of Patients and Medical Practitioners) Bill...
July 19, 2017: Science and Engineering Ethics
https://www.readbyqxmd.com/read/28719248/the-efficacy-of-dignity-therapy-on-the-psychological-well-being-in-loved-ones-of-terminally-ill-patients
#8
Miguel Julião
No abstract text is available yet for this article.
July 18, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28717772/care-of-the-terminally-ill-patient-in-india-comments-on-the-proposed-legislation
#9
Aju Mathew, M R Rajagopal
No abstract text is available yet for this article.
June 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/28716617/dignity-therapy-and-life-review-for-palliative-care-patients-a-qualitative-study
#10
Dean Vuksanovic, Heather Green, Shirley Morrissey, Sharelle Smith
CONTEXT: Dignity Therapy (DT) is a psychotherapeutic intervention whose aim is to bolster the sense of purpose, meaning and sense of dignity in patients with terminal disease. OBJECTIVES: The aim of this study was to explore, compare and better understand the content of standard DT, waitlist DT (WDT) and Life Review (LR) that utilised the DT interview protocol but omitted the creation of legacy documents. METHODS: Efficacy of these interventions was previously documented in a sample of 56 participants...
July 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28713149/reframing-medical-appropriateness-a-case-study-concerning-the-use-of-life-sustaining-technologies-for-a-patient-with-profoundly-diminished-quality-of-life
#11
Colleen M Gallagher, Elijah Weber, Nisha Rathi
This case study considers the clinical ethics issues of medical appropriateness and quality of life for patients who are critically ill. The case involves a terminally ill cancer patient with a profoundly diminished quality of life and an extremely poor prognosis; his spouse desires to bring him home, where she will arrange to keep him alive for as long as possible via life-sustaining interventions. The analysis engages with the complicated notion of medical appropriateness, both in general and as it pertains to life-sustaining interventions in a critical care setting, and considers the ethical implications of the various ways in which one might understand this concept...
2017: Narrative Inquiry in Bioethics
https://www.readbyqxmd.com/read/28712987/the-tailored-study-a-randomized-controlled-trial-to-improve-surrogate-decision-making
#12
Daniel P Sulmasy, Mark T Hughes, Gayane Yenokyan, Joan Kub, Peter B Terry, Alan B Astrow, Julie A Johnson, Grace Ho, Marie T Nolan
CONTEXT: Patients with terminal illnesses often require surrogate decision makers. Prior research has demonstrated high surrogate stress, and that despite standards promoting substituted judgment, most patients do not want their surrogates to make pure substituted judgments for them. It is not known how best to help loved ones fulfill the surrogate role. OBJECTIVES: To test the effectiveness of an intervention to help surrogate decision makers. METHODS: 166 patients (41% with ALS and 59% with gastrointestinal cancers) and their surrogates at 2 university medical centers were randomized to an intensive nurse-directed discussion of the end of life Decision Control Preferences of the patient (TAILORED) or a discussion of nutrition (CONTROL); 163 completed baseline interviews and underwent the intervention...
July 13, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28711753/psychometric-properties-of-the-greek-version-of-the-patient-dignity-inventory-in-advanced-cancer-patients
#13
Efi Parpa, Sotiria Kostopoulou, Eleni Tsilika, Antonis Galanos, Stylianos Katsaragakis, Kyriaki Mystakidou
CONTEXT: The Patient Dignity Inventory (PDI) is an instrument to measure dignity distressing aspects at the end of life. OBJECTIVES: The aims of the current study was the translation of the PDI in Greek language as well as to measure its psychometric aspects in a palliative care unit. METHODS: A back-translation method was obtained at the Greek version. 120 advanced cancer patients completed the Greek version of the PDI, the Greek Hospital Anxiety and Depression Scale (Gr-HADS), The Greek Schedule of attitudes towards hastened death (SAHD-Gr) and the Greek SF-12 (Short Form Health Survey: SF-12)...
July 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28710219/comparison-of-propofol-and-dexmedetomidine-infused-overnight-to-treat-hyperactive-and-mixed-icu-delirium-a-protocol-for-the-basel-prodex-clinical-trial
#14
Alexa Hollinger, Katrin Ledergerber, Stefanie von Felten, Raoul Sutter, Stephan Rüegg, Lukas Gantner, Sibylle Zimmermann, Andrea Blum, Luzius A Steiner, Stephan Marsch, Martin Siegemund
BACKGROUND/OBJECTIVES: Delirium is a neurobehavioural disturbance that frequently develops particularly in the intensive care unit (ICU) population. It was first described more than half a century ago, where it was already discovered as a state that might come along with serious complications such as prolonged ICU and hospital stay, reduced quality of life and increased mortality. However, in most cases, there is still lack of proof for causal relationship. Its presence frequently remains unrecognised due to suggested predominance of the hypoactive form...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28706540/the-relationship-between-dignity-status-and-quality-of-life-in-iranian-terminally-ill-patients-with-cancer
#15
Abbas Hosseini, Masoud Rezaei, Masoud Bahrami, Mohammad Abbasi, Hesammodin Hariri
BACKGROUND: Palliative care is an approach that has been used to care for terminally ill patients. The current study was performed to assess the association between the status of patient dignity and quality of life (QOL) in Iranian terminally ill patients with cancer. MATERIALS AND METHODS: This descriptive correlational study was conducted on 210 end-stage cancer patients (102 men and 108 women) who were referred to Seyed Al-Shohada Hospital, Isfahan, Iran, in 2015...
May 2017: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/28705925/management-of-hiccups-in-palliative-care-patients
#16
REVIEW
Yong Suk Jeon, Alison Mary Kearney, Peter Graham Baker
Persistent hiccups are a frustrating experience for palliative care patients, and can have a profound impact on their quality of life. This article provides an evidence-based approach overview of the causes and treatment of this not infrequently debilitating condition for such patients, with a management algorithm. In situations where no readily reversible cause is identified, or where simple physical manoeuvres, such as breath holding have failed, a systematic approach is required. Hiccups can be broadly divided into central and peripheral types...
July 13, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28702728/cd8-t-cell-expansion-in-hiv-hcv-coinfection-is-associated-with-systemic-inflammation
#17
E V Saidakova, K V Shmagel, L B Korolevskaya, N G Shmagel, V A Chereshnev
High prevalence of non-AIDS-defining illnesses in treated HIV-infected patients is associated with increased peripheral CD8(+) T cell counts. Hepatitis C virus (HCV) coinfection is an additional risk factor for the development of non-AIDS events. We found that, in HIV/HCV coinfection, the increased proportion of CD8(+) T lymphocytes is due to the effector memory and terminal effector T cells gain. Moreover, in these patients, the accumulation of highly differentiated forms of CD8(+) T lymphocytes was associated with increased concentrations of inflammatory indices...
May 2017: Doklady Biological Sciences: Proceedings of the Academy of Sciences of the USSR, Biological Sciences Sections
https://www.readbyqxmd.com/read/28700812/disparities-in-location-of-death-of-adolescents-and-young-adults-with-cancer-a-longitudinal-population-study-in-california
#18
Nitya Rajeshuni, Emily E Johnston, Olga Saynina, Lee M Sanders, Lisa J Chamberlain
BACKGROUND: Patients with a terminal illness should have access to their chosen location of death. Cancer is the leading cause of non-accidental death among adolescents and young adults (AYAs; those aged 15-39 years). Although surveys have suggested that a majority of these patients prefer a home death, to the authors' knowledge, little is known regarding their barriers to accessing their preferred location of death. As a first step, the authors sought to determine, across a large population, 20-year trends in the location of death among AYA patients with cancer...
July 12, 2017: Cancer
https://www.readbyqxmd.com/read/28698830/prevalence-and-predictors-of-home-use-of-glucometers-in-diabetic-patients
#19
Syed A Farhan, Ali T Shaikh, Maria Zia, Bilal R Kahara, Ramsha Muneer, Muzna Rehman, Ayesha Mubashir, Hassaan Sadiq, Durr-E-Amna Siddiqui, Syed M Haseeb, Hafsa Tanveer, Khadijah Siddiq, Saib B Mujtaba, Samir A Mirza, Hira Feroz, Kaneez Fatima
BACKGROUND: Self-monitoring of blood glucose (SMBG) is a critical component of diabetes care. However, it has been shown that use of glucometers in developing countries such as Pakistan is limited. The aim of this study was to determine the frequency of glucometer usage in the urban diabetic population of Karachi and to identify variables that influenced the likelihood of practice of SMBG. METHODS: A cross-sectional study was conducted among 567 adult diabetic patients selected at random from the out-patient departments of multiple healthcare institutions in Karachi categorized into two settings; Government and Private...
June 10, 2017: Curēus
https://www.readbyqxmd.com/read/28698344/the-involvement-of-physician-assistants-in-inpatient-care-in-hospitals-in-the-netherlands-a-cost-effectiveness-analysis
#20
Marijke J C Timmermans, Geert T van den Brink, Anneke J A H van Vught, Eddy Adang, Charles L H van Berlo, Kim van Boxtel, Weibel W Braunius, Loes Janssen, Alyssa Venema, Frits J van den Wildenberg, Michel Wensing, Miranda G H Laurant
OBJECTIVE: To investigate the cost-effectiveness of substitution of inpatient care from medical doctors (MDs) to physician assistants (PAs). DESIGN: Cost-effectiveness analysis embedded within a multicentre, matched-controlled study. The traditional model in which only MDs are employed for inpatient care (MD model) was compared with a mixed model in which, besides MDs, PAs are also employed (PA/MD model). SETTING: 34 hospital wards across the Netherlands...
July 10, 2017: BMJ Open
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