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palliative care, evidence-based medicine

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https://www.readbyqxmd.com/read/28920517/bleeding-control-in-palliative-care-patients-with-the-help-of-tranexamic-acid
#1
Marcus J P Geist, Jens Kessler, Susanne Frankenhauser, Hubert J Bardenheuer
BACKGROUND: Persistent bleeding is a common reason for admitting patients with advanced cancer to a palliative care unit. Several reports show a successful therapeutic use of the antifibrinolytic agent tranexamic acid in palliative care patients having hemorrhages. However, it is not administered routinely in severe bleeding situations in palliative care, and general dosing recommendations are unclear. CASE PRESENTATION: We report on 3 patients who were treated with tranexamic acid due to symptomatic hemorrhage complicating different malignant processes...
January 1, 2017: Journal of Palliative Care
https://www.readbyqxmd.com/read/28843457/development-and-validation-of-a-family-meeting-assessment-tool-fmat
#2
Yuya Hagiwara, Jennifer Healy, Shuko Lee, Jeanette Ross, Dixie Fischer, Sandra Sanchez-Reilly
CONTEXT: A cornerstone procedure in Palliative Medicine is to perform family meetings. Learning how to lead a family meeting is an important skill for physicians and others who care for patients with serious illnesses and their families. There is limited evidence on how to assess best practice behaviors during end of life family meetings. OBJECTIVES: Our aim was to develop and validate an observational tool to assess trainees' ability to lead a simulated end-of-life family meeting...
August 23, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28807643/-use-of-subcutaneous-route-for-comfort-care%C3%A2-in-neonatal-palliative-population-systematic-review-and-survey-of-practices-in-france
#3
N Pouvreau, J Tandonnet, O Tandonnet, L Renesme
INTRODUCTION: Subcutaneous hydration (hypodermoclysis) and drug administration is a widely used method of analgesic therapy in adult palliative care medicine. Very little is known about its use in neonatal medicine. Evidence-based guidelines do not exist due to a lack of data. In this study, the advantages of subcutaneous analgesic therapy in terms of comfort in neonatal palliative care situations were investigated. METHODS: This report details the results of a systematic review associated with a survey in neonatal intensive care units (NICUs) and pediatric palliative care departments (PPCTs) in France...
August 11, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28793905/the-liverpool-care-pathway-a-systematic-review-discarded-in-cancer-patients-but-good-enough-for-dying-nursing-home-patients
#4
Bettina S Husebø, Elisabeth Flo, Knut Engedal
BACKGROUND: The Liverpool Care Pathway (LCP) is an interdisciplinary protocol, aiming to ensure that dying patients receive dignified and individualized treatment and care at the end-of-life. LCP was originally developed in 1997 in the United Kingdom from a model of cancer care successfully established in hospices. It has since been introduced in many countries, including Norway. The method was withdrawn in the UK in 2013. This review investigates whether LCP has been adapted and validated for use in nursing homes and for dying people with dementia...
August 9, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28792780/an-update-nih-research-funding-for-palliative-medicine-2011-2015
#5
Elizabeth Brown, R Sean Morrison, Laura P Gelfman
BACKGROUND: The evidence base to support palliative care clinical practice is inadequate and opportunities to improve the palliative care evidence base remain despite the field's rapid growth. OBJECTIVE: To examine current NIH funding of palliative medicine research, changes since our 2013 report, and trends since our 2008 report. DESIGN: We sought to identify NIH funding of palliative medicine from 2011 to 2015 in two stages: (I) we searched the NIH grants database "RePorter" for grants with key words "palliative care," "end-of-life care," "hospice," and "end of life" and (II) we identified palliative care researchers likely to have secured NIH funding using three strategies...
August 9, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28746664/what-do-cochrane-systematic-reviews-say-about-non-pharmacological-interventions-for-treating-cognitive-decline-and-dementia
#6
Vitória Carvalho Vilela, Rafael Leite Pacheco, Carolina Oliveira Cruz Latorraca, Daniela Vianna Pachito, Rachel Riera
BACKGROUND: Dementia is a highly prevalent condition worldwide. Its chronic and progressive presentation has an impact on physical and psychosocial characteristics and on public healthcare. Our aim was to summarize evidence from Cochrane reviews on non-pharmacological treatments for cognitive disorders and dementia. DESIGN AND SETTING: Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo...
May 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28687558/seizure-management-in-children-requiring-palliative-care-a-review-of-current-practice
#7
Nicola Harris, Megumi Baba, Charlotte Mellor, Rebekah Rogers, Kirsty Taylor, Antonia Beringer, Peta Sharples
OBJECTIVES: Controlling seizures in children approaching death can be difficult, and there is a limited evidence base to guide best practice. We compared current practice against the guidance for seizure management produced by the Association of Paediatric Palliative Medicine (APPM). METHODS: Retrospective case note review of episodes of challenging seizure management in children receiving end-of-life care over a 10-year period (2006-2015) in the south-west region of England...
July 7, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28426520/nursing-practice-research-and-education-in-the-west-the-best-is-yet-to-come
#8
Heather M Young, Susan Bakewell-Sachs, Linda Sarna
PURPOSE: This paper celebrates the 60th anniversary of the Western Institute of Nursing, the nursing organization representing 13 states in the Western United States, and envisions a preferred future for nursing practice, research, and education. BACKGROUND: Three landmark calls to action contribute to transforming nursing and healthcare: the Patient Protection and Affordable Care Act of 2010; the Institute of Medicine report Future of Nursing: Leading Change, Advancing Health; and the report Advancing Healthcare Transformation: A New Era for Academic Nursing...
May 2017: Nursing Research
https://www.readbyqxmd.com/read/28327170/critical-attitudes-and-beliefs-towards-guidelines-amongst-palliative-care-professionals-results-from-a-national-survey
#9
Helen Kalies, Rieke Schöttmer, Steffen T Simon, Raymond Voltz, Alexander Crispin, Claudia Bausewein
BACKGROUND: Little is known about palliative care professionals' attitudes towards guidelines. In 2015, the German Association for Palliative Medicine (DGP) published an evidence based guideline for palliative care in adults with incurable cancer. Before publication we conducted a national survey among members of the DGP to detect possible barriers and facilitators for its implementation. The aim of the present publication was to evaluate critical attitudes and beliefs which could hinder the effective implementation of the new guideline and to evaluate differences within professional groups and medical specialisations...
March 21, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28265046/expanding-medicines-for-neurologic-disorders-on-the-who-model-list
#10
Kathryn Rimmer, Hiral Shah, Kiran Thakur
The WHO Model List of Essential Medicines is a recommended formulary for high-priority diseases based on public health trends and epidemiology patterns. The biennial publication serves as a guide for countries, particularly low- and lower-middle-income countries, to develop their own national essential medicines list (EML), and many nongovernmental organizations base their medication supplies on the WHO EML. Over the last 40 years, WHO has expanded the EML in response to treatment gaps for infectious diseases, pediatrics, palliative care, and cancer...
March 7, 2017: Neurology
https://www.readbyqxmd.com/read/28156598/disparities-in-access-to-palliative-care-services-among-cancer-patients-in-south-texas
#11
Susanne Schmidt, Ifeoma Aduba, Jessica Jones, Laura LaNiel Tenner
130 Background: Palliative medicine is dedicated to improving quality of life for patients throughout their disease course. The integration of palliative medicine in oncology practice has increased due to growing evidence of benefits for patient. While the collaboration of palliative and oncology care is beneficial, access to palliative services remains an issue for cancer patients. The aim of this project is to evaluate how insurance status impacts palliative care access for cancer patients in South Texas...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156434/earlier-access-to-palliative-medicine-an-experience-of-integration-into-a-community-oncology-practice
#12
Jacqueline Matthews
92 Background: A growing body of evidence supports the integration of palliative care as a standard for comprehensive cancer care. Through our experience as an inpatient palliative care provider, with 50% of our population having advanced cancer, we recognized the value proposition to provide continuity in the outpatient setting. Innovative Care Solutions developed a partnership with a large, community oncology program late 2015 for a palliative care multidisciplinary team to be embedded into one location of their practice...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28122560/clinical-trials-in-palliative-care-a-systematic-review-of-their-methodological-characteristics-and-of-the-quality-of-their-reporting
#13
REVIEW
Raquel Bouça-Machado, Madalena Rosário, Joana Alarcão, Leonor Correia-Guedes, Daisy Abreu, Joaquim J Ferreira
BACKGROUND: Over the past decades there has been a significant increase in the number of published clinical trials in palliative care. However, empirical evidence suggests that there are methodological problems in the design and conduct of studies, which raises questions about the validity and generalisability of the results and of the strength of the available evidence. We sought to evaluate the methodological characteristics and assess the quality of reporting of clinical trials in palliative care...
January 25, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/27955816/-reappraisal-role-of-locoregional-radiation-therapy-in-metastatic-cancers
#14
REVIEW
Chloé Rancoule, Cécile Pacaut-Vassal, Alexis Vallard, Benoite Mery, Jane-Chloé Trone, Anis El Meddeb Hamrouni, Nicolas Magné
Recent innovations in oncology area helped to improve the prognosis of certain cancers including metastatic ones with a decrease in mortality. Recommendations describe the treatment of metastatic cancer as systemic therapy or complementary care and the role of locoregional treatment in the treatment plan only occurs in a palliative context. Currently, in the clinical practice, out of "the evidence based medicine", an early locoregional therapy (surgery or radiation therapy) can be proposed in several cases of metastatic cancers...
January 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/27876636/concordance-between-veterans-self-report-and-documentation-of-surrogate-decision-makers-implications-for-quality-measurement
#15
Kimberly K Garner, Patricia Dubbert, Shelly Lensing, Dennis H Sullivan
CONTEXT: The Measuring What Matters initiative of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association identified documentation of a surrogate decision maker as one of the top 10 quality indicators in the acute hospital and hospice settings. OBJECTIVES: To better understand the potential implementation of this Measuring What Matters quality measure #8, Documentation of Surrogate in outpatient primary care settings by describing primary care patients' self-reported identification and documentation of a surrogate decision maker...
January 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/27756146/cancer-associated-thrombosis-and-palliative-care-an-interview-with-simon-noble
#16
Simon Noble
Simon Noble speaks to Sebastian Dennis-Beron, Commissioning Editor: Simon Noble is Clinical Professor in Palliative Medicine at Cardiff University and honorary consultant at the Royal Gwent Hospital in Newport. His main research interests are in the management of venous thromboembolism in advanced cancer, quality of life effects of venous thromboembolism and their therapies, clinical decision-making in venous thromboembolism management and the patient journey. He is involved at a national level in the delivery of evidence-based thromboprophylaxis for hospitalized patients through the All Party Thrombosis Group and sits on the NICE Guideline development group for thromboprophylaxis...
January 2017: Future Oncology
https://www.readbyqxmd.com/read/27739059/palliative-medicines-for-children-a-new-frontier-in-paediatric-research
#17
REVIEW
Liz Jamieson, Ian C K Wong, Finella Craig, Nanna Christiansen, Karen Brombley, Catherine Tuleu, Emily Harrop
OBJECTIVES: This paper seeks to highlight from a UK perspective the current lack of a research evidence base in paediatric palliative care that has resulted in a paucity of available medicines with appropriate formulations (strength and dosage form) to provide symptom management for children with life-limiting illnesses and to raise awareness of this group of 'therapeutic orphans'. Currently, clinicians have limited, often unsuitable medication choices for their paediatric palliative care patients, with little hope of moving away from the status quo...
April 2017: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/27670417/-the-horse-has-bolted-i-suspect-a-qualitative-study-of-clinicians-attitudes-and-perceptions-regarding-palliative-rehabilitation
#18
Fiona Runacres, Heidi Gregory, Anna Ugalde
BACKGROUND: Palliative care patients have numerous rehabilitation needs that increase with disease progression. Palliative rehabilitation practices and perceptions of palliative medicine physicians towards the role of rehabilitation are largely unstudied. AIM: To explore palliative medicine physicians' attitudes and perceptions towards rehabilitation delivered within inpatient palliative care units. DESIGN: Qualitative study utilizing semi-structured interviews...
July 2017: Palliative Medicine
https://www.readbyqxmd.com/read/27521369/guidelines-for-parenteral-fluid-management-for-terminal-cancer-patients
#19
Takashi Higashiguchi, Junichi Ikegaki, Kazuya Sobue, Yoichiro Tamura, Nobuhisa Nakajima, Akihiko Futamura, Mitsunori Miyashita, Naoharu Mori, Akio Inui, Keiichiro Ohta, Toyoshi Hosokawa
BACKGROUND: Japan's first guidelines for parenteral fluid management for terminal cancer patients were issued in 2006. These guidelines focused on the fluid levels to administer to patients with a remaining life expectancy of 1-2 months. However, recent refinement of the concept of cachexia is prompting caregivers worldwide to rethink parenteral fluid management for terminal cancer patients. OBJECTIVE: Our objective was to develop guidelines for parenteral fluid management for terminal cancer patients with a remaining life expectancy of 1 month, a point when cachexia generally begins to severely adversely affect the body...
August 12, 2016: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/26832803/palliative-care-reimagined-a-needed-shift
#20
Julian Abel, Allan Kellehear
Palliative care, since its inception over 60 years ago, has set the standard of how to care for people who are dying. Key features among these standards have been the professional development of clinical specialisms such as palliative medicine and palliative nursing; the essential addition of the multidisciplinary team to these two new specialisms that included social, spiritual and allied health workers-an outgrowth of the recognition that routine work with the dying, their carers, and the bereaved required more than solely clinical skills; and the unique partnership with communities that yielded the volunteer movement within palliative care...
March 2016: BMJ Supportive & Palliative Care
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