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End if life

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https://www.readbyqxmd.com/read/28717713/breaking-cancer-bad-news-to-patients-with-cancer-a-comprehensive-perspective-of-patients-their-relatives-and-the-public-example-from-a-middle-eastern-country
#1
Jamal Zekri, Syed Mustafa Karim
PURPOSE: Empowering patients with cancer requires that they be continuously informed about their condition. In some Eastern cultures, this concept is often opposed by caregivers. We aim to compare the extent of disclosure desired by actual and presumed patients with cancer and their relatives in our practice. METHODS: Nine questions reflecting possible bad news communication to patients from diagnosis to the end of life were designed to investigate the extent of desired disclosure and were answered by 100 patients (cohort I) and 103 accompanying relatives (cohort II) in an outpatient setting...
October 2016: Journal of Global Oncology
https://www.readbyqxmd.com/read/28713086/intensifying-approach-to-the-therapy-of-patients-with-constellation-of-the-diseases-chronic-obstructive-pulmonary-disease-and-osteoarthritis
#2
Vyacheslav N Zhdan, Maksim М Potyazhenko, Galina S Khaymenova, Nadezhda N Lyulka, Tatyana V Dubrovinskaya, Igor V Ivanitsky
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is one of 21st century. About 210 million people all over the world are suffering with COPD, and annually 3 million people die of it. Under the influence of different factors, such as smoking, air prolusion, evaporation of chemicals, poisoning effect of chemical firings, inflammation processes take place in lungs, and if it is prolonged and take place simultaneously with morphological changes in the lungs, it it provide the de4velopment of the systemic inflammation process...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28712524/the-unexpected-death-of-a-child-and-the-experience-of-emergency-service-personnel
#3
Julie Lindsay, Diane Heliker
INTRODUCTION: In 2013, 55,000 infants and children, aged 0 to 14, died in the United States. Nearly 7,000 of those deaths were attributed to traumatic causes. A child's death significantly affects emergency service personnel (ESP) caring for children and families. This study explores the lived experience of ESP involved in unsuccessful pediatric resuscitation efforts and how this experience affects them professionally and personally. METHODS: A phenomenologic approach guided this study...
July 13, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28711069/preterm-birth-and-its-impact-on-renal-health
#4
Valerie A Luyckx
Preterm birth occurs in approximately 10% of all births worldwide. Preterm infants have reduced nephron numbers at birth in proportion to gestational age, and are at increased risk of neonatal acute kidney injury as well as higher blood pressure, proteinuria, and chronic kidney disease later in life. Rapid catch-up growth in preterm infants, especially if resulting in obesity, is a risk factor for end-stage kidney disease among children with proteinuric renal disease. Preterm birth, however, is a risk factor not only for the infant because mothers who deliver preterm have an increased risk of having subsequent preterm deliveries as well as hypertension, cardiovascular disease, and renal disease later in life...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28708343/-knowing-where-the-patients-would-like-to-die
#5
Karine Vantieghem, Françoise Laurent
The majority of the population wishes to die at home. However, most patients die in hospitals or nursing homes. What do health care professionals know about the choices of their patients in this matter? This study concerns persons who died from natural causes during the 1st semester of 2013 in 2 districts of the canton of Vaud. 241 of their health care professionals answered a questionnaire. Only 35.6 % knew their patient's wishes pertaining to where their death should take place. Despite the opportunity to speak about it with one's GP, the issue is not usually raised...
February 1, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28707698/cost-effectiveness-of-intraoperative-nerve-monitoring-in-avoidance-of-bilateral-recurrent-laryngeal-nerve-injury-in-patients-undergoing-total-thyroidectomy
#6
Z Al-Qurayshi, E Kandil, G W Randolph
BACKGROUND: Intraoperative nerve monitoring (IONM) provides dynamic neural information and is recommended for high-risk thyroid surgery. In this analysis, the cost-effectiveness of IONM in preventing bilateral recurrent laryngeal nerve (RLN) injury was investigated. METHODS: A Markov chain model was constructed based on IONM use. The base-case patient was defined as a 40-year-old woman presenting with a 4·1-cm left-sided papillary thyroid cancer who developed RLN injury with loss of monitoring signal during planned bilateral thyroidectomy...
July 14, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28704064/nucleic-acid-extraction-from-synthetic-mars-analog-soils-for-in-situ-life-detection
#7
Angel Mojarro, Gary Ruvkun, Maria T Zuber, Christopher E Carr
Biological informational polymers such as nucleic acids have the potential to provide unambiguous evidence of life beyond Earth. To this end, we are developing an automated in situ life-detection instrument that integrates nucleic acid extraction and nanopore sequencing: the Search for Extra-Terrestrial Genomes (SETG) instrument. Our goal is to isolate and determine the sequence of nucleic acids from extant or preserved life on Mars, if, for example, there is common ancestry to life on Mars and Earth. As is true of metagenomic analysis of terrestrial environmental samples, the SETG instrument must isolate nucleic acids from crude samples and then determine the DNA sequence of the unknown nucleic acids...
July 13, 2017: Astrobiology
https://www.readbyqxmd.com/read/28684551/transitions-in-prognostic-awareness-among-terminally-ill-cancer-patients-in-their-last-6-months-of-life-examined-by-multi-state-markov-modeling
#8
Chen Hsiu Chen, Fur-Hsing Wen, Ming-Mo Hou, Chia-Hsun Hsieh, Wen-Chi Chou, Jen-Shi Chen, Wen-Cheng Chang, Siew Tzuh Tang
BACKGROUND: Developing accurate prognostic awareness, a cornerstone of preference-based end-of-life (EOL) care decision-making, is a dynamic process involving more prognostic-awareness states than knowing or not knowing. Understanding the transition probabilities and time spent in each prognostic-awareness state can help clinicians identify trigger points for facilitating transitions toward accurate prognostic awareness. We examined transition probabilities in distinct prognostic-awareness states between consecutive time points in 247 cancer patients' last 6 months and estimated the time spent in each state...
July 6, 2017: Oncologist
https://www.readbyqxmd.com/read/28681596/high-intensity-interval-training-combined-with-resistance-training-improves-physiological-capacities-strength-and-quality-of-life-in-multiple-sclerosis-patients-a-pilot-study
#9
Pierre Zaenker, Fabrice Favret, Evelyne Lonsdorfer, Guillaume Muff, Jérôme DE Seze, Marie-Eve Isner-Horobeti
BACKGROUND: Numerous studies have shown that mild-to-moderate intensity or resistance exercise training improves physical capacities such as, peak oxygen consumption, maximal tolerated power and strength in multiple sclerosis patients. However, few studies have evaluated the effects of high intensity interval training associated to with resistance training. Only few studies have analysed difference between men and women before and after combined training. Moreover, the evaluation of exercise between ambulatory multiple sclerosis patients without disability (EDSS 0- 3) and patients with disabilities (EDSS 3...
July 5, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28679819/high-cost-dual-eligibles-service-use-demonstrates-the-need-for-supportive-and-palliative-models-of-care
#10
Julie P W Bynum, Andrea Austin, Donald Carmichael, Ellen Meara
Health care spending is generally highest among people who need both complex medical care and long-term services and supports, such as adults dually eligible for Medicare and Medicaid. Understanding how different types of complex patients use services over time can inform policies that target this population. High combined Medicare and Medicaid spending are found in two distinct groups of high-cost dual eligibles: older beneficiaries who are nearing the end of life, and younger beneficiaries with sustained need for functional supports...
July 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28678849/community-health-promotion-and-medical-provision-for-neonatal-health-champion-cluster-randomised-trial-in-nagarkurnool-district-telangana-formerly-andhra-pradesh-india
#11
RANDOMIZED CONTROLLED TRIAL
Peter Boone, Alex Eble, Diana Elbourne, Chris Frost, Chitra Jayanty, Rashmi Lakshminarayana, Vera Mann, Rohini Mukherjee, Gilda Piaggio, Padmanabh Reddy
BACKGROUND: In the mid-2000s, neonatal mortality accounted for almost 40% of deaths of children under 5 years worldwide, and constituted 65% of infant deaths in India. The neonatal mortality rate in Andhra Pradesh was 44 per 1,000 live births, and was higher in the rural areas and tribal regions, such as the Nagarkurnool division of Mahabubnagar district (which became Nagarkurnool district in Telangana in 2014). The aim of the CHAMPION trial was to investigate whether a package of interventions comprising community health promotion and provision of health services (including outreach and facility-based care) could lead to a reduction of the order of 25% in neonatal mortality...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28677921/expertise-in-action-insights-into-the-dynamic-nature-of-expertise-in-community-based-nursing
#12
Caroline A W Dickson, Chris McVittie, Anuj Kapilashrami
AIM: To gain insight into community nurses' experiences and how they make sense of the expertise they offer in their role BACKGROUND: Globally, the spotlight is currently on community nursing expertise because of the movement of hospital-based to community- based care. Caring for people at home is no longer solely concerned with prevention, but delivering complex care to patients who are acutely unwell or at the end of their life. Little is known about the distinct expertise of community nurses, or their contribution to patient outcomes...
July 5, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28676498/health-and-death-literacy-and-cultural-diversity-insights-from-hospital-employed-interpreters
#13
Barbara Hayes, Anne Marie Fabri, Maria Coperchini, Rafatullah Parkar, Zoe Austin-Crowe
OBJECTIVES: 001225The aim of this qualitative study is to better understand, through the experiences and insights of hospital interpreters, how people from culturally and linguistic diverse (CALD) communities might respond to advance care planning (ACP) and end-of-life discussions. METHODS: Hospital interpreters from five Melbourne metropolitan health services were recruited for in-depth semi-structured interviews that explored the question, 'What can be learnt from hospital interpreters about cultural issues related to ACP and end-of-life decision-making?' Thirty-nine interpreters, representing 22 language groups, were interviewed...
July 4, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28676293/attitudes-toward-advance-directives-among-patients-and-their-family-members-in-china
#14
Lin Kang, Xiao-Hong Liu, Jing Zhang, Pei-Yan Shan, Jie-Ping Wang, Ping Zhong, Xiao-Hong Du, Yu-Feng Du, Bao-Cheng Yu, Nan Wei, Hui-Ling Lou, Ou Bian, Huai-Hong Chen, Fan Lin, Hong-Lian Zhou, Wen He, Huai-Cong Long, Lu-Rong Hong, Hui Su, Jun-Nan Yang, Yong-Liang Jiang, Ye Shi, Jing Ning, Fang Liang, Zhong Wang, Ting Gong, Ming-Lei Zhu, Xiao-Hong Ning, Zhi-Jun Chen, Liang-Kung Chen
OBJECTIVES: Chinese people are generally unfamiliar with the concept of advance care planning or advance directives (ACP/ADs), which raises dilemmas in life-support choice and can even affect clinical decision making. To understand and address the issues involved better, we investigated the awareness of ACP/ADs in China, as well as people's attitudes toward medical autonomy and end-of-life care. DESIGN: A multicenter cross-sectional survey, conducted from August 1 to December 31, 2016...
July 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28673216/does-anyone-ever-expect-to-die
#15
Mhr Anstey, N Watts, N Orford, I M Seppelt, I Mitchell
Patients who come to the intensive care unit are amongst the sickest patients in our hospitals. Patients can be admitted to the intensive care unit unexpectedly (following accidents or sudden onset of illness) or as unplanned but not necessarily truly 'unexpected' admissions. These patients often have significant underlying chronic health issues, including metastatic cancer, advanced cardiac, respiratory, renal, or hepatic failure, or frailty, with a high likelihood of death in the ensuing months. Using the Australian and New Zealand Intensive Care Society Clinical Trials Group Point Prevalence Program, a prospective single-day observational study across 46 Australian hospitals in 2014 and 2015, we found that less than 9% of intensive care unit patients (51/577) had an advance directive available...
July 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28672087/interventions-for-chronic-kidney-disease-in-people-with-sickle-cell-disease
#16
REVIEW
Noemi Ba Roy, Patricia M Fortin, Katherine R Bull, Carolyn Doree, Marialena Trivella, Sally Hopewell, Lise J Estcourt
BACKGROUND: Sickle cell disease (SCD) is one of the commonest severe monogenic disorders in the world, due to the inheritance of two abnormal haemoglobin (beta-globin) genes. SCD can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Kidney disease is a frequent and potentially severe complication in people with SCD.Chronic kidney disease is defined as abnormalities of kidney structure or function, present for more than three months. Sickle cell nephropathy refers to the spectrum of kidney complications in SCD...
July 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28668645/herbal-medicinal-products-evidence-and-tradition-from-a-historical-perspective
#17
Robert Jütte, Michael Heinrich, Axel Helmstädter, Jost Langhorst, Günter Meng, Wilhelm Niebling, Tanja Pommerening, Hans J Trampisch
BACKGROUND: Aside from the fully licensed herbal medicines there are products on the European pharmaceutical market which are registered by virtue of their longstanding traditional use. The normal registration procedure does not apply to them because presently they do not meet the legal requirements for a full license as set out in the relevant European Union Directive. One of these requirements, "proof of tradition", has so far been dealt with in different ways and fails to meet the criteria of good practice...
June 29, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28668608/babesia-bovis-bov57-a-theileria-parva-p67-homolog-is-an-invasion-related-neutralization-sensitive-antigen
#18
Takahiro Ishizaki, Thillaiampalam Sivakumar, Kyoko Hayashida, Hitoshi Takemae, Bumduuren Tuvshintulga, Tserendorj Munkhjargal, Azirwan Guswanto, Ikuo Igarashi, Naoaki Yokoyama
Babesia bovis BOV57, which is a homolog of the Theileria parva vaccine candidate antigen P67, is expressed in both the tick and blood stages of the life cycle of this parasite. However, the vaccine potential of BOV57 remained to be investigated. In the present study, we generated recombinant BOV57 (rBOV57) and prepared polyclonal antibodies against rBOV57 in mice and rabbits. Indirect immunofluorescence assays conducted with the mouse anti-rBOV57 antibody demonstrated that BOV57 localized at the apical end of paired merozoites in infected bovine red blood cells, whereas the antigen was found in the parasite membrane around the apical end of intraerythrocytic single and extracellular merozoites...
June 28, 2017: Infection, Genetics and Evolution
https://www.readbyqxmd.com/read/28666922/controversies-in-treatment-selection-for-patients-with-equivocal-er-and-her2-results
#19
Giuseppe Viale
Formally, the term "equivocal" should not be used when reporting results of the assessment of ER status, but controversies exist about the prognostic and predictive value of a low ER expression (i.e. 1-9% positive cells) in breast cancer (so called ER-poor tumors). Because of the rarity of these cases, prospective clinical trials have not been conducted (and are unlikely to be conducted in the future) to define the optimal treatment strategy for the small subset of patients with ER-poor breast cancer. Therefore, the only available data stem from retrospective subgroup analyses of randomized clinical trials or from clinical datasets of individual Institutions...
June 27, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28665744/if-we-don-t-ask-our-patients-might-never-tell-the-impact-of-the-routine-use-of-a-patient-values-assessment
#20
J Russell Hoverman, Cynthia Taniguchi, Kathryn Eagye, Sabrina Mikan, Angela Kalisiak, Susan Ash-Lee, Rhonda Henschel
PURPOSE: Good communication can be associated with better end-of-life outcomes. The US Oncology Network developed and tested a Values Assessment (VA) for facilitating advance care planning (ACP). The results of the first 1,268 patients are reported. METHODS: The VA consists of 10 questions of the format "How valuable is it to me to…" (eg, "...know that I am not a burden to my family, friends, or helpers?"). Responses were on a four-point scale from unsure to very valuable...
June 30, 2017: Journal of Oncology Practice
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