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https://www.readbyqxmd.com/read/29785662/the-timing-and-circumstances-of-the-implementation-of-pediatric-palliative-care-in-hungarian-pediatric-oncology
#1
Judit Nyirő, Szilvia Zörgő, Földesi Enikő, Katalin Hegedűs, Péter Hauser
Despite the continuous improvement of pediatric palliative care, medical professionals still face various barriers regarding its implementation; our aim was to investigate this question in Hungarian pediatric oncology practice. Structured interviews were carried out in person with physicians from the Hungarian Pediatric Oncology Group (n = 22). Codes were generated inductively with the aid of Atlas.ti 6.0 software. Most physicians placed the palliative care discussion at the end of curative treatment (n = 21) and preferred to conduct it in a team setting (n = 18), mainly in the presence of a psychologist...
May 21, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29784742/nccn-frameworks-for-resource-stratification-of-nccn-guidelines-adult-cancer-pain-and-palliative-care
#2
Robert A Swarm, Maria Dans
The NCCN Framework aims to provide adapted guidelines for low- and middle-resource countries to improve the experience of patients with cancer. In particular, the NCCN Frameworks for Adult Cancer Pain and Palliative Care and were designed to help expand access to pain management and palliative care for patients in low-resource countries. The NCCN Framework is one of several tools that can improve cancer care in the developing world. The NCCN Harmonized Guidelines for Sub-Saharan Africa, a collaborative effort between NCCN, American Cancer Society, Clinton Health Access Initiative, and African Cancer Coalition, was developed to harmonize NCCN recommendations with local guidelines across Africa and to make best use of available services and resources...
May 2018: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29783852/usefulness-of-the-surprise-question-on-an-inpatient-oncology-service
#3
Sarguni Singh, Adrian Rodriguez, Darrell Lee, Sung-Joon Min, Stacy Fischer
BACKGROUND: Prognostication of survival in patients with advanced cancer has been challenging and contributes to poor illness understanding. Prognostic disagreement occurs even among providers and is a less studied phenomenon. OBJECTIVE: We introduced the surprise question (SQ), "Would I be surprised if this patient died in the next 1 year, 6 months, and 1 month?," at multidisciplinary rounds to increase palliative care referrals through the introduction of this prognostic prompt...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29783851/the-death-debate-penumbra-conundrum
#4
Robert F Johnson
Determination and declaration of death by neurologic criteria, brain death, is an established and legally accepted clinical practice with profound implications. Concerns regarding the accuracy of this diagnosis raise important clinical, ethical, and legal issues. A recent magazine article highlights these concerns by describing a poignant example of a patient meeting accepted clinical and ancillary testing criteria for brain death in the setting of post cardiac arrest hypoxic ischemic encephalopathy (CA-HIE)...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29783228/awareness-of-pediatric-palliative-care-among-health-care-workers
#5
Oryna Z Detsyk, Zhanna M Zolotarova, Iryna V Stovban, Roman M Melnyk
OBJECTIVE: Introduction: In order to develop such a relatively new type of medical care in Ukraine, as pediatric palliative care, first of all, qualified medical workers are needed. The aim: to assess the awareness of pediatric palliative care among healthcare workers providing medical services to children. PATIENTS AND METHODS: Materials and methods: It was carried out a survey at health facilities of Ivano-Frankivsk region, which provided medical care for children...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29783004/-the-thing-that-really-gets-me-is-the-future-symptomatology-in-older-homeless-adults-in-the-hope-home-study
#6
Adam Bazari, Maria Patanwala, Lauren M Kaplan, Colette L Auerswald, Margot B Kushel
CONTEXT: The homeless population is aging. Older homeless adults experience premature development of age-related conditions and an elevated symptom burden. Little is known about symptom experience among older homeless adults. OBJECTIVES: To characterize the experience, understanding, and management of physical, psychological, social (e.g. loneliness), and existential (e.g. regret, loss of dignity) symptoms among older homeless adults. METHODS: We conducted semi-structured interviews from June 2016 through March 2017 with a purposive sample of participants from the HOPE HOME cohort, a longitudinal study of homeless adults ages 50 and older...
May 18, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29782212/national-impact-of-the-epec-pediatrics-enhanced-train-the-trainer-model-for-delivering-education-on-pediatric-palliative-care
#7
Kimberley Widger, Joanne Wolfe, Stefan Friedrichsdorf, Jason D Pole, Sarah Brennenstuhl, Stephen Liben, Mark Greenberg, Eric Bouffet, Harold Siden, Amna Husain, James A Whitlock, Myra Leyden, Adam Rapoport
BACKGROUND: Lack of pediatric palliative care (PPC) training impedes successful integration of PPC principles into pediatric oncology. OBJECTIVES: We examined the impact of an enhanced implementation of the Education in Palliative and End-of-Life Care for Pediatrics (EPEC® -Pediatrics) curriculum on the following: (1) knowledge dissemination; (2) health professionals' knowledge; (3) practice change; and (4) quality of PPC. DESIGN: An integrated knowledge translation approach was used with pre-/posttest evaluation of care quality...
May 21, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29781791/the-facilitators-and-challenges-of-dying-at-home-with-dementia-a-narrative-synthesis
#8
Caroline Mogan, Mari Lloyd-Williams, Karen Harrison Dening, Christopher Dowrick
BACKGROUND: It is reported that, given the right support, most people would prefer to die at home, yet a very small minority of people with dementia do so. At present, knowledge gaps remain on how best to support end-of-life care at home for people with dementia. AIM: To identify and understand the challenges and facilitators of providing end-of-life care at home for people with dementia. DESIGN: Narrative synthesis of qualitative and quantitative data...
June 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29779882/antithrombotic-therapy-strategy-for-cancer-associated-ischemic-stroke-a-case-series-of-26-patients
#9
Hiroyuki Naito, Tomohisa Nezu, Naohisa Hosomi, Shiro Aoki, Hiroki Ueno, Kazuhide Ochi, Hirofumi Maruyama
BACKGROUND: The risk of complications from thromboembolism is increased for patients with malignancy. Cancer-associated stroke is also a serious issue with regard to the management of patients with cancer because stroke incidence often causes disabilities that affect daily life and cancer treatment strategy. METHODS: Between March 2011 and September 2017, 328 patients with acute ischemic stroke were registered to our hospital. RESULTS: Of these patients, 26 (7...
May 17, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29779802/feasibility-of-initiating-early-enteral-nutrition-after-congenital-heart-surgery-in-neonates-and-infants
#10
Rajat Kalra, Rohit Vohra, Malti Negi, Reena Joshi, Neeraj Aggarwal, Mridul Aggarwal, Raja Joshi
OBJECTIVE: To assess the feasibility of initiating enteral nutrition support with first 24 h of congenital heart repairs in neonates and Infants and its impact on outcomes following surgery. DESIGN: It is a prospective randomized control single blind study. SETTING: It is a single centre prospective study carried out in a tertiary care centre at Pediatric cardiac intensive care unit. PATIENTS: All patients with the cyanotic congenital heart disease with increase pulmonary blood flow, weighing less than 5 kg and undergoing congenital heart repair during the study period were included in the study...
June 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29779361/palliative-and-end-of-life-care-for-heart-failure-patients-in-an-aging-society
#11
Takahiro Okumura, Akinori Sawamura, Toyoaki Murohara
The populations of Asian countries are expected to age rapidly in the near future, with a dramatic increase in the number of heart failure (HF) patients also anticipated. The need for palliative and end-of-life care for elderly patients with advanced HF is currently recognized in aging societies. However, palliative care and active treatment for HF are not mutually exclusive, and palliative care should be provided to reduce suffering occurring at any stage of symptomatic HF after the point of diagnosis. HF patients are at high risk of sudden cardiac death from the early stages of the disease onwards...
May 23, 2018: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29779057/using-patient-reported-outcome-measures-to-deliver-enhanced-supportive-care-to-people-with-lung-cancer-feasibility-and-acceptability-of-a-nurse-led-consultation-model
#12
Grigorios Kotronoulas, Constantina Papadopoulou, Mhairi F Simpson, John McPhelim, Lynn Mack, Roma Maguire
PURPOSE: Developing new supportive/palliative care services for lung cancer should encompass effective ways to promptly identify and address patients' healthcare needs. We examined whether an in-clinic, nurse-led consultation model, which was driven by use of a patient-reported outcomes (PRO) measure, was feasible and acceptable in the identification of unmet needs in patients with lung cancer. METHODS: A two-part, repeated-measures, mixed-methods study was conducted...
May 19, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29778506/quality-of-life-symptoms-and-care-needs-in-patients-with-persistent-or-recurrent-platinum-resistant-ovarian-cancer-an-nrg-oncology-gynecologic-oncology-group-study
#13
Vivian E von Gruenigen, Helen Q Huang, David Cella, MichaelA Zevon, Jason A LaChance, Joan L Walker, Ritu Salani, Susan C Modesitt, Robert T Morris, William H Bradley, Matthew P Boente, Lari Wenzel
OBJECTIVES: The goals of treating recurrent platinum-resistant ovarian cancer are palliative, aimed at reducing symptoms and improving progression free survival. A prospective trial was conducted to determine the prevalence and severity of symptoms, and associated care needs. METHODS: Eligible women included those with persistent or recurrent platinum-resistant ovarian cancer with an estimated life expectancy of at least 6 months. The Needs at the End-of-Life Screening Tool (NEST), FACIT-Fatigue (FACIT-F), NCCN-FACT Ovarian Symptom Index [NFOSI-18]; Disease Related Symptoms (DRS), Treatment Side Effects (TSE), and Function/Well Being (F/WB) were collected at study entry, 3 and 6 months...
May 17, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29776973/challenges-in-end-of-life-dementia-care
#14
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/29775603/genetic-and-extracardiac-anomalies-are-associated-with-inferior-single-ventricle-palliation-outcomes
#15
Bahaaldin Alsoufi, Courtney McCracken, Matthew Oster, Subhadra Shashidharan, Kirk Kanter
BACKGROUND: We aim to examine the effect of genetic syndromes and extracardiac anomalies (GS/EC) on single ventricle (SV) palliation with focus on hospital death, interstage mortality, and progression towards subsequent palliation stages. METHODS: 530 neonates with SV underwent first-stage palliation: Norwood (n=284,53%), shunt (n=173,33%), band (n=73,14%). Outcomes were compared between those with GS/EC (n=121,23%) and without GS/EC (n=409,77%). Regression analyses were adjusted for other risk factors (age, gender, prematurity, weight, SV anomaly, first-stage palliation surgery)...
May 15, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29774777/current-research-status-of-palliative-care-in-mainland-china
#16
Tao Wang, Alex Molassiotis, Betty Pui Man Chung, Jing-Yu Tan
OBJECTIVES: This study aimed to obtain an overview of the current research status of palliative care in Mainland China and identify research directions for future studies by characterizing palliative care studies conducted among patients with any life-limiting illness in Mainland China and published in a peer-reviewed journal before November 2016. METHODS: A review guide with 7 categories was initially developed based on existing international palliative care definitions and guidelines through content analysis...
January 1, 2018: Journal of Palliative Care
https://www.readbyqxmd.com/read/29774394/longitudinal-health-care-cost-in-hypoplastic-left-heart-syndrome-palliation
#17
Jesse E Hansen, Nicolas L Madsen, Laurie Bishop, David L S Morales, Jeffrey B Anderson
Management of hypoplastic left heart syndrome (HLHS) is resource intensive. Heath care systems are pressured to provide value to patients by improving outcomes while decreasing costs. A single-center retrospective cohort of infants with HLHS who underwent Norwood procedure or hybrid Norwood from 2004 to 2014 and survived to first outpatient follow up were studied. The primary outcome was total cost through 12 months with a sub-analysis of patients with 60 months of data. Costs were calculated using internal cost accounting system and reported by cost center...
May 17, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29772922/behavioral-pain-intervention-for-hospice-and-palliative-care-patients-an-integrative-review
#18
Masako Mayahara, JoEllen Wilbur, Louis Fogg, Susan M Breitenstein
Despite the advances in pain management, achieving optimal pain control in hospice and palliative care is challenging. Patient/caregiver's lack of pain management knowledge, poor pain reporting, and poor adherence to pain management regimens are all associated with inadequate pain control. The purpose of this integrated review is to examine behavioral interventions designed for patients and caregivers to improve pain control in hospice and palliative care settings. Ten studies were identified through a database search...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29772281/geriatric-oncology-spirituality-and-palliative-care
#19
Lodovico Balducci
Cancer is a major cause of morbidity and mortality for older individuals. Palliative care is essential to improve the outcome of cancer treatment in terms of quality of life and treatment satisfaction. This review examines the influence of spirituality on aging in general and on the management of older cancer patients. A spiritual perspective has been associated with successful aging, and with better tolerance of physical and emotional stress, including the ability to cope with serious diseases and with isolation...
May 14, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29772280/an-analysis-of-palliative-care-development-in-africa-a-ranking-based-on-region-specific-macro-indicators
#20
John Y Rhee, Eduardo Garralda, Eve Namisango, Emmanuel Luyirika, Liliana de Lima, Richard A Powell, Jesús López-Fidalgo, Carlos Centeno
CONTEXT: To date, there is no study comparing palliative care (PC) development among African countries. OBJECTIVE: To analyze comparatively PC development in African countries based on region-specific indicators. METHODS: Data were obtained from the APCA Atlas of PC in Africa and a comparative analysis conducted. Nineteen indicators were developed and defined through qualitative interviews with African PC experts and a two-round modified Delphi consensus process with international experts on global PC indicators...
May 14, 2018: Journal of Pain and Symptom Management
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