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End of life discussions

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https://www.readbyqxmd.com/read/28932924/when-gis-zooms-in-spatio-genetic-maps-of-multipaternity-in-armadillidium-vulgare
#1
Nicolas Bech, Charlotte Depeux, Sylvine Durand, Catherine Debenest, Alexandra Lafitte, Sophie Beltran-Bech
Geographic information system (GIS) tools are designed to illustrate, analyse and integrate geographic or spatial data, usually on a macroscopic scale. By contrast, genetic tools focus on a microscopic scale. Because in reality, landscapes have no predefined scale, our original study aims to develop a new approach, combining both cartographic and genetic approaches to explore microscopic landscapes. For this, we focused on Armadillidium vulgare, a terrestrial isopod model in which evolutionary pressures imposed by terrestrial life have led to the development of internal fertilisation and, consequently, to associated physiological changes...
September 20, 2017: Genetica
https://www.readbyqxmd.com/read/28925295/characteristics-of-patients-with-existing-advance-directives-evaluating-motivations-around-advance-care-planning
#2
Joanne E Genewick, Dorothy M Lipski, Katherine M Schupack, Angela L H Buffington
INTRODUCTION: Although 80% of patients endorse an advance directive (AD), less than 35% of American adults have a documented AD. Much research has been done on barriers to creating ADs; however, there is a paucity of research addressing motivations for creating ADs. Previous research has identified 4 categories of influence for engaging in advance care planning (ACP). This study aimed to quantify the influence of these 4 motivating categories in creating an AD. METHODS: Participants included 238 adults with documented ADs...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28923833/nephrology-provider-prognostic-perceptions-and-care-delivered-to-older-adults-with-advanced-kidney-disease
#3
Huzaifah Salat, Andrei Javier, Edward D Siew, Rocio Figueroa, Loren Lipworth, Edmond Kabagambe, Aihua Bian, Thomas G Stewart, Maie H El-Sourady, Mohana Karlekar, Cesar Y Cardona, T Alp Ikizler, Khaled Abdel-Kader
BACKGROUND AND OBJECTIVES: Prognostic uncertainty is one barrier that impedes providers in engaging patients with CKD in shared decision making and advance care planning. The surprise question has been shown to identify patients at increased risk of dying. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In our prospective observational study, 488 patients ≥60 years of age with CKD stage 4 or 5 were enrolled. Binary surprise question (i.e., "Would you be surprised if this patient died in the next 12 months?") responses were recorded, and dialysis planning preferences, presence of advance care planning documentation, and care preceding death were abstracted...
September 18, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28921259/epigenetic-effects-of-the-pregnancy-mediterranean-diet-adherence-on-the-offspring-metabolic-syndrome-markers
#4
REVIEW
David Lorite Mingot, Eva Gesteiro, Sara Bastida, Francisco J Sánchez-Muniz
Metabolic syndrome (MS) has a multifactorial and not yet fully clarified origin. Insulin resistance is a key element that connects all the accepted components of MS (obesity, dyslipemia, high blood pressure, and hyperglycemia). There is strong evidence that epigenetic changes during fetal development are key factors in the development of MS. These changes are induced by maternal nutrition, among different factors, affecting the intrauterine environment. The Mediterranean diet has been shown to be a healthy eating pattern that protects against the development of MS in adults...
September 18, 2017: Journal of Physiology and Biochemistry
https://www.readbyqxmd.com/read/28919728/chronic-obstructive-pulmonary-disease-with-mild-airflow-limitation-current-knowledge-and-proposal-for-future-research-a-consensus-document-from-six-scientific-societies
#5
REVIEW
Andrea Rossi, Bojana Butorac-Petanjek, Marco Chilosi, Borja G Cosío, Matjaz Flezar, Nikolaos Koulouris, José Marin, Neven Miculinic, Guido Polese, Miroslav Samaržija, Sabina Skrgat, Theodoros Vassilakopoulos, Andrea Vukić-Dugac, Spyridon Zakynthinos, Marc Miravitlles
Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and morbidity worldwide, with high and growing prevalence. Its underdiagnosis and hence under-treatment is a general feature across all countries. This is particularly true for the mild or early stages of the disease, when symptoms do not yet interfere with daily living activities and both patients and doctors are likely to underestimate the presence of the disease. A diagnosis of COPD requires spirometry in subjects with a history of exposure to known risk factors and symptoms...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28918550/advance-care-planning-challenges-at-the-emergency-department-of-a-cancer-care-center
#6
Maria T Cruz-Carreras, Patrick Chaftari, Jayne Viets-Upchurch
INTRODUCTION: Code status discussions form an important part of advance care planning (ACP) as it enables physicians to respect the patient's wishes for end-of-life care. However, in some cases, code status discussions can be challenging causing the physician to go against the patient's wishes and the code of medical ethics. This is especially true in an emergency setting. In this paper, we will discuss three cases of advanced cancer patients, where code status discussions posed challenges to healthcare providers...
September 16, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28916293/is-there-ever-a-role-for-the-unilateral-do-not-attempt-resuscitation-order-in-pediatric-care
#7
Jonathan M Marron, Emma Jones, Joanne Wolfe
Care for children as they near the end of life is difficult and very complex. More difficult still are the decisions regarding what interventions are and are not indicated during these trying times. Occasionally, families of children who are nearing the end of life disagree with the assessment of the medical team regarding these interventions. In rare cases, the medical team can be moved to enact a do not attempt resuscitation (DNAR) order against the wishes of the patient's parents. This manuscript presents one such illustrative case and discusses the ethical issues relevant to such challenging clinical scenarios...
September 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28915916/effects-of-a-silent-mentor-initiation-ceremony-and-dissection-on-medical-students-humanity-and-learning
#8
Ruei-Jen Chiou, Po-Fang Tsai, Der-Yan Han
OBJECTIVES: Many medical schools in Taiwan have adopted a dignified "silent mentor" initiation ceremony to strengthen student's medical humanity and increase their learning attitudes. This ceremony consists of introductions of the body donor's conduct and deeds, wreath-laying, and a tea party. However, few empirical studies have examined the influences of the ceremony and dissection on medical humanity. This study explored if the initiation ceremony and the course can help students care more about others, develop more positive attitudes toward death, improve learning effectiveness in the course, and decrease negative emotions the first time they see a cadaver...
September 16, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28912674/a-mechanistic-understanding-of-axon-degeneration-in-chemotherapy-induced-peripheral-neuropathy
#9
REVIEW
Yusuke Fukuda, Yihang Li, Rosalind A Segal
Chemotherapeutic agents cause many short and long term toxic side effects to peripheral nervous system (PNS) that drastically alter quality of life. Chemotherapy-induced peripheral neuropathy (CIPN) is a common and enduring disorder caused by several anti-neoplastic agents. CIPN typically presents with neuropathic pain, numbness of distal extremities, and/or oversensitivity to thermal or mechanical stimuli. This adverse side effect often requires a reduction in chemotherapy dosage or even discontinuation of treatment...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28911084/the-critical-mass-survey-of-palliative-care-programme-at-esmo-designated-centres-of-integrated-oncology-and-palliative-care
#10
D Hui, N Cherny, N Latino, F Strasser
Background: The ESMO Designated Centres (ESMO-DCs) of Integrated Oncology and Palliative Care (PC) Incentive Programme has grown steadily. We aimed to characterise the level of PC clinical services, education and research at ESMO-DCs. Methods: We sent all 184 ESMO-DCs an electronic survey consisting of 78 questions examining the DC characteristics, palliative care clinical programme (structure, processes, and outcomes), primary PC delivery by oncologists, education, research and attitudes and beliefs towards the ESMO-DC programme...
September 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28904030/approach-to-advanced-heart-failure-at-the-end-of-life
#11
REVIEW
Leah Steinberg, Meghan White, Jennifer Arvanitis, Amna Husain, Susanna Mak
OBJECTIVE: To outline symptom management in, as well as offer a home-based protocol for, patients with advanced heart failure (HF). SOURCES OF INFORMATION: The terms palliative care and heart failure were searched in PubMed and relevant databases. All articles were reviewed. The specific medical management protocol was developed by the "HeartFull" collaborative team at the Temmy Latner Centre for Palliative Care in Toronto, Ont. MAIN MESSAGE: Educating patients about advanced HF and helping them understand their illness and illness trajectory can foster end-of-life discussions...
September 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28902070/contending-with-preplanned-death-questions-for-clinicians
#12
Joel Yager
BACKGROUND AND OBJECTIVES: The goal of this column is to assist readers in reflecting on their attitudes and responses toward clinical and nonclinical situations involving preplanned deaths by decisionally capable individuals. Such circumstances range from encountering individuals in one's personal and professional lives who desire and intend to end their lives under their own terms, to having such individuals request assistance with predeath and postdeath arrangements. METHODS: Attending to pertinent literature, this essay uses Socratic inquiry to question conventional assumptions and attitudes, push readers' thoughts beyond typical comfort zones, and consider alternative modes of responding to challenges posed by preplanned death...
September 8, 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/28892602/locating-advance-care-planning-facilitators-in-general-practice-increases-consumer-participation
#13
Jill Mann, Stephen D Gill, Lisa Mitchell, Margaret J Rogers, Peter Martin, Frances Quirk, Charlie Corke
BACKGROUND: Advance care planning (ACP) can positively affect end-of-life care experiences. However, uptake of ACP completion is low. The aim of this study was to investigate whether co-locating ACP facilitators in general practice increased participation METHODS: Barwon Health commenced promoting its ACP program in 2008. Trained ACP facilitators assisted consumers, which usually occurred in the program's community-based consulting rooms. From 2012 onwards, ACP facilitators were co-located with 18 general practices, where they assisted consumers at the point of care...
September 2017: Australian Family Physician
https://www.readbyqxmd.com/read/28892432/patient-clinician-communication-american-society-of-clinical-oncology-consensus-guideline
#14
Timothy Gilligan, Nessa Coyle, Richard M Frankel, Donna L Berry, Kari Bohlke, Ronald M Epstein, Esme Finlay, Vicki A Jackson, Christopher S Lathan, Charles L Loprinzi, Lynne H Nguyen, Carole Seigel, Walter F Baile
Purpose To provide guidance to oncology clinicians on how to use effective communication to optimize the patient-clinician relationship, patient and clinician well-being, and family well-being. Methods ASCO convened a multidisciplinary panel of medical oncology, psychiatry, nursing, hospice and palliative medicine, communication skills, health disparities, and advocacy experts to produce recommendations. Guideline development involved a systematic review of the literature and a formal consensus process. The systematic review focused on guidelines, systematic reviews and meta-analyses, and randomized controlled trials published from 2006 through October 1, 2016...
September 11, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28891665/levels-of-and-changes-in-life-satisfaction-predict-mortality-hazards-disentangling-the-role-of-physical-health-perceived-control-and-social-orientation
#15
Gizem Hülür, Jutta Heckhausen, Christiane A Hoppmann, Frank J Infurna, Gert G Wagner, Nilam Ram, Denis Gerstorf
It is well documented that well-being typically evinces precipitous decrements at the end of life. However, research has primarily taken a postdictive approach by knowing the outcome (date of death) and aligning, in retrospect, how well-being has changed for people with documented death events. In the present study, we made use of a predictive approach by examining whether and how levels of and changes in life satisfaction prospectively predict mortality hazards and delineate the role of contributing factors, including health, perceived control, and social orientation...
September 2017: Psychology and Aging
https://www.readbyqxmd.com/read/28888893/face-working-memory-deficits-in-developmental-prosopagnosia-tests-of-encoding-limits-and-updating-processes
#16
Margaret C Jackson, Paul Counter, Jeremy J Tree
Developmental prosopagnosia (DP) is a condition in which individuals experience life-long problems recognising faces. In recent years, unpacking the nature of the impairments of this population has been the focus of numerous studies. One focus has been on the nature of face-based memory impairments for such individuals, with the onus being mainly on long-term memory deficits. Far fewer have considered the nature of face-based working memory (WM) impairments for DP cases, and the current study seeks to address this...
September 6, 2017: Neuropsychologia
https://www.readbyqxmd.com/read/28872031/palliative-care-and-management-of-troublesome-symptoms-for-people-with-chronic-obstructive-pulmonary-disease
#17
REVIEW
Matthew Maddocks, Natasha Lovell, Sara Booth, William D-C Man, Irene J Higginson
People with advanced chronic obstructive pulmonary disease (COPD) have distressing physical and psychological symptoms, often have limited understanding of their disease, and infrequently discuss end-of-life issues in routine clinical care. These are strong indicators for expert multidisciplinary palliative care, which incorporates assessment and management of symptoms and concerns, patient and caregiver education, and sensitive communication to elicit preferences for care towards the end of life. The unpredictable course of COPD and the difficulty of predicting survival are barriers to timely referral and receipt of palliative care...
September 2, 2017: Lancet
https://www.readbyqxmd.com/read/28869697/comfort-supporting-nursing-activities-for-end-of-life-patients-in-an-institutionalized-environment
#18
Helena Kisvetrová, Šárka Vévodová, David Školoudík
PURPOSE: Comfort promotion plays a significant role in end-of-life patient care. The objective of this study was to determine the utilization rate of comfort supporting nursing activities in end-of-life patients in an institutionalized environment in the Czech Republic in relation to the age of the registered nurses (RNs), length of work experience, education level, and type of workplace. DESIGN: A cross-sectional, descriptive study was designed. A questionnaire with Likert scales included 31 activities of dying care and spiritual support interventions...
September 4, 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/28869194/-how-to-manage-a-rectal-cancer-with-synchronous-liver-metastases-a-question-of-strategy
#19
V Vendrely, M Terlizzi, F Huguet, Q Denost, L Chiche, D Smith, J-B Bachet
The prognosis of patients with rectal cancer and synchronous liver metastasis has improved thanks to chemotherapy and rectal and liver surgery progresses. However, there is no consensus about optimal management and practices remain heterogeneous. A curative treatment may be considered for 20 to 30% of patients with complete resection of metastasis and primary tumor after induction chemotherapy. To this end, a primary optimal evaluation by a multidisciplinary board including hepatic and colorectal surgeons is crucial...
August 28, 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/28866315/nursing-home-staff-perspectives-on-adoption-of-an-innovation-in%C3%A2-goals-of-care-communication
#20
Latarsha Chisholm, Sheryl Zimmerman, Cherie Rosemond, Eleanor McConnell, Bryan J Weiner, Feng-Chang Lin, Laura Hanson
Nursing homes (NH) are important settings for end-of-life care, but limited implementation may impede goals of care discussions. The purpose of this study was to understand NH staff perceptions of adoption and sustainability of the Goals of Care video decision aid for families of residents with advanced dementia. Study design was a cross-sectional survey of staff at 11 NHs in North Carolina who participated in the Goals of Care (GOC) cluster randomized clinical trial. Staff perceived the GOC decision aid intervention as a positive innovation; it was perceived as more compatible with current practices by male staff, nurses, and more experienced NH staff...
August 30, 2017: Geriatric Nursing
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