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https://www.readbyqxmd.com/read/29353499/-who-should-decide-at-the-end-of-life-international-practice-of-advance-care-planning-and-possibilities-for-adaptation-in-hungary
#1
Csilla Busa, Judit Zeller, Ágnes Csikós
At the advanced stage of serious illness, end-of-life decisions need to be made. Advance care planning offers patients the right to decide on their own future care when independent decision-making is no longer possible. The most complex and effective advance care plans include patients' preferred or refused medical treatments, care-related wishes, and individual values as well. Advance care planning can improve end-of-life care and contribute to higher satisfaction. It can also reduce distress in relatives and the costs of care...
January 2018: Orvosi Hetilap
https://www.readbyqxmd.com/read/29343186/association-between-palliative-care-and-life-sustaining-treatments-for-patients-with-dementia-a-nationwide-5-year-cohort-study
#2
Ping-Jen Chen, Fu-Wen Liang, Chung-Han Ho, Shao-Yi Cheng, Yi-Chen Chen, Yu-Han Chen, Yueh-Chun Chen
BACKGROUND: The association between palliative care and life-sustaining treatments for patients with dementia is unclear in Asian countries. AIM: To analyse the use of palliative care and its association with aggressive treatments based on Taiwanese national data. DESIGN: A matched cohort study was conducted. The association between intervention and outcome was evaluated using conditional logistic regression analyses. SETTING/PARTICIPANTS: The source population comprised 239,633 patients with dementia diagnosed between 2002 and 2013...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29341988/utilizing-advance-care-planning-codes
#3
Jill Olmstead
No abstract text is available yet for this article.
February 16, 2018: Nurse Practitioner
https://www.readbyqxmd.com/read/29341162/impact-of-genomics-on-the-surgical-management-of-melanoma
#4
REVIEW
P M Ferguson, G V Long, R A Scolyer, J F Thompson
BACKGROUND: Although surgery for early-stage melanoma offers the best chance of cure, recent advances in molecular medicine have revolutionized the management of late-stage melanoma, leading to significant improvements in clinical outcomes. Research into the genomic drivers of disease and cancer immunology has not only ushered in a new era of targeted and immune-based therapies for patients with metastatic melanoma, but has also provided new tools for monitoring disease recurrence and selecting therapeutic strategies...
January 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29340565/using-chaplains-to-facilitate-advance-care-planning-in-medical-practice
#5
Aoife C Lee, Catherine E McGinness, Stacie Levine, Sean O'Mahony, George Fitchett
No abstract text is available yet for this article.
January 16, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29336907/a-palliative-approach-to-falls-in-advanced-dementia
#6
REVIEW
Andrea Iaboni, Karen Van Ooteghem, Meghan N Marcil, Amy Cockburn, Alastair J Flint, Daphna Grossman, Ron Keren
Falls are viewed as a preventable cause of injury, functional loss, and death in older adults with dementia, and have been used as a marker of quality of care in long-term care facilities. Despite intensive intervention around fall prevention in these settings, falls and injury remain frequent, particularly among residents in the advanced stages of dementia. In this clinical review, we consider the common challenges and pitfalls in both the management of falls and the provision of palliative care in advanced dementia...
December 11, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/29335033/should-capacity-assessments-be-performed-routinely-prior-to-discussing-advance-care-planning-with-older-people
#7
Oleg Kiriaev, Emme Chacko, J D Jurgens, Meagan Ramages, Phillipa Malpas, Gary Cheung
BACKGROUND: People with dementia receive worse end of life care compared to those with cancer. Barriers to undertaking advanced care planning (ACP) in people with dementia include the uncertainty about their capacity to engage in such discussions. The primary aim of this study was to compare the Advance Care Planning-Capacity Assessment Vignette tool (ACP-CAV) with a semi-structured interview adapted from the MacArthur Competence Assessment Tool-Treatment (MacCAT-T). The secondary aim was to identify demographic and cognitive functioning variables that may predict whether a person has capacity to discuss ACP...
January 16, 2018: International Psychogeriatrics
https://www.readbyqxmd.com/read/29334495/the-ethics-of-interventional-procedures-for-patients-too-ill-for-surgery
#8
Caroline G Kan, Michael Nurok
PURPOSE OF REVIEW: Minimally invasive interventional procedures are increasingly popular options for patients who are high-risk candidates for open surgical procedures. It is unclear how to proceed in the rare circumstance of a complication during an interventional procedure, where addressing the complication would require exposing the patient to the full risk that was being avoided with the minimally invasive technique. This review provides recommendations on how to approach this paradoxical scenario...
January 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29328905/diagnosis-and-care-of-patients-with-mild-haemophilia-practical-recommendations-for-clinical-management
#9
REVIEW
Gary Benson, Günter Auerswald, Gerry Dolan, Anne Duffy, Cedric Hermans, Rolf Ljung, Massimo Morfini, Silva Zupančić Šalek
Mild haemophilia is defined by factor levels between 0.05 and 0.40 IU/mL and is characterised by traumatic bleeds. Major issues associated with mild haemophilia are that it may not present for many years after birth, and that awareness, even within families, may be low. Methodological problems exist in diagnosis, such as inconsistencies in results obtained from different assays used to measure factor levels in mild haemophilia. Advances in genetic testing provide insight into diagnosis as well as the likelihood of inhibitor development, which is not uncommon in patients with mild or moderate haemophilia and can increase morbidity...
November 14, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/29328354/end-of-life-conversations-as-a-legacy
#10
Jeanne M Sorrell
Advance directives such as living wills and health care powers of attorney are important documents that offer patients ways to avoid unwanted care when they are unable to express their wishes. Although health care professionals have increased focus on advance care planning in recent years, approximately two thirds of American adults do not have advance medical directives. In addition, 90% of individuals believe that talking to loved ones about end-of-life wishes is important, but only 27% have done so. It is important for nurses to understand the complex factors that influence how individuals make health care decisions and identify ways to encourage conversations with family, friends, and health care providers to help clarify patients' wishes for endof-life care...
January 1, 2018: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/29325441/five-year-experience-of-an-inpatient-palliative-care-unit-at-an-academic-referral-center
#11
Myrick C Shinall, Sara F Martin, Jill Nelson, Richard S Miller, Matthew W Semler, Eli E Zimmerman, Christy C Noblit, E Wesley Ely, Mohana Karlekar
BACKGROUND: Palliative care units (PCUs) staffed by specialty-trained physicians and nurses have been established in a number of medical centers. The purpose of this study is to review the 5-year experience of a PCU at a large, urban academic referral center. METHODS: We retrospectively reviewed a prospectively collected database of all admissions to the PCU at Vanderbilt University Medical Center in the first 5 years of its existence, from 2012 through 2017. RESULTS: Over these 5 years, there were 3321 admissions to the PCU...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29323416/citizenship-and-community-mental-health-care
#12
Allison N Ponce, Michael Rowe
Citizenship is an approach to supporting the social inclusion and participation in society of people with mental illnesses. It is receiving greater attention in community mental health discourse and literature in parallel with increased awareness of social determinants of health and concern over the continued marginalization of persons with mental illness in the United States. In this article, we review the definition and principles of our citizenship framework with attention to social participation and access to resources as well as rights and responsibilities that society confers on its members...
January 11, 2018: American Journal of Community Psychology
https://www.readbyqxmd.com/read/29320792/-advanced-care-planning-and-its-relevance-for-emergency-and-intensive-care-medicine
#13
Friedemann Nauck, Georg Marckmann, Jürgen In der Schmitten
Like in other countries, advance care planning (ACP) is currently being implemented in Germany as a new concept to realise valid and effective advance directives. This concept comprises processes to explore and document individual preferences for future treatment, and to honour them at a time when the person is incapacitated. ACP aims to ensure that patients will be treated according to their preferences when they are no longer capable due to acute health crises or chronic diseases. This paper gives an overview of the concept of ACP with a focus on relevant issues for emergency and intensive care medicine...
January 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29319389/top-10-tips-palliative-care-clinicians-should-know-when-caring-for-patients-with-ovarian-cancer
#14
Brittany A Davidson, Haley A Moss, Arif H Kamal
The vast majority of women diagnosed with ovarian cancer present with advanced-stage disease with a five-year survival rate less than 50%. Studies have shown that in the past, gynecologic oncologists were not routinely collaborating with palliative care physicians resulting in goals of care planning often not occurring until the last 30 days before death. In recent years, professional societies have been increasingly more vocal about the importance of incorporating palliative care early in a patient's disease course...
January 10, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29314264/a-practical-guide-for-the-care-of-patients-with-end-stage-renal-disease-near-the-end-of-life
#15
Amar D Bansal, Jane O Schell
Most patients who rely on dialysis for treatment of end-stage renal disease (ESRD) never receive a kidney transplant. Therefore, it is important for nephrology providers to feel comfortable discussing the role of dialysis near the end of life (EOL). Advance care planning (ACP) is an ongoing process of learning patient values and goals in an effort to outline preferences for current and future care. This review presents a framework for how to incorporate ACP in the care of dialysis patients throughout the kidney disease course and at the EOL...
January 3, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29313756/data-needs-for-a-serious-illness-care-accountability-system-a-framework-and-recommendations
#16
Tom Valuck, Russ Montgomery
BACKGROUND: Successful implementation of a comprehensive accountability system for community-based serious illness care will require a robust data infrastructure. Data will be needed to support care delivery, quality measurement, value-based payment, and evaluation and monitoring. OBJECTIVE: The specific data needs in these areas need to be identified and understood, so that gaps in currently available data may be addressed. DESIGN: We developed a framework that includes the needed data and data infrastructure to support the features and characteristics of a serious illness care accountability system...
March 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29313129/characteristics-and-care-pathways-of-advanced-cancer-patients-in-a-palliative-supportive-care-unit-and-an-oncological-ward
#17
Sebastiano Mercadante, Paolo Marchetti, Claudio Adile, Amanda Caruselli, Patrizia Ferrera, Andrea Costanzi, Alessandra Casuccio
BACKGROUND: A supportive palliative care unit (SPCU) may have a positive impact on patients' care. The aim of this study was to compare the pattern of patients admitted to a specialized SPCU and to a traditional oncologic ward (OW) in a consecutive sample of advanced cancer patients. METHODS: Data on patients demographics, reasons for and kind of admission, care-giver, anticancer treatments, being on/off treatment or uncertain, origin setting, who proposed hospital admission, the use of opioids, and hospitalization were gathered...
January 8, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29309686/congress-of-neurological-surgeons-systematic-review-and-evidence-based-guidelines-on-the-role-of-imaging-in-the-diagnosis-and-management-of-patients-with-vestibular-schwannomas
#18
Ian F Dunn, Wenya Linda Bi, Srinivasan Mukundan, Bradley N Delman, John Parish, Tyler Atkins, Anthony L Asher, Jeffrey J Olson
QUESTION 1: What sequences should be obtained on magnetic resonance imaging (MRI) to evaluate vestibular schwannomas before and after surgery? TARGET POPULATION: Adults with vestibular schwannomas. RECOMMENDATIONS: Initial Preoperative Evaluation Level 3: Imaging used to detect vestibular schwannomas should use high-resolution T2-weighted and contrast-enhanced T1-weighted MRI. Level 3: Standard T1, T2, fluid attenuated inversion recovery, and diffusion weighted imaging MR sequences obtained in axial, coronal, and sagittal plane may be used for detection of vestibular schwannomas...
December 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29307849/implementing-routine-palliative-care-consultation-prior-to-lvad-implantation-a-single-center-experience
#19
Say Salomon, Hilary Frankel, Elizabeth Chuang, Serife Eti, Peter Selwyn
CONTEXT: Left-ventricular assist devices (LVADs) are increasingly used to improve quality of life for end-stage heart failure patients. The Joint Commission now requires pre-implantation palliative care assessment, however many palliative care teams have little experience providing this service. OBJECTIVE: To describe the integration of palliative services at one Center of Excellence for Heart and Vascular Care. METHODS: This is a retrospective chart review of all patients receiving LVADs at a single urban academic medical center from 1/2015 to 9/2016...
January 4, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29307208/implementation-issues-relevant-to-outpatient-neurology-palliative-care
#20
Benzi M Kluger, Michael J Persenaire, Samantha K Holden, Laura T Palmer, Hannah Redwine, Julie Berk, C Alan Anderson, Christopher M Filley, Jean Kutner, Janis Miyasaki, Julie Carter
BACKGROUND: There is growing interest in the application of palliative care principles to improve care for patients and families affected by neurologic diseases. We developed an interdisciplinary outpatient clinic for patients and families affected by neurologic disorders to better address the problems faced by our highest need patients. We have developed and improved this program over the past three years and share several of our most important lessons as well as ongoing challenges and areas where we see our clinic evolving in the future...
November 29, 2017: Annals of Palliative Medicine
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