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End of life discussions

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https://www.readbyqxmd.com/read/27917548/nurses-comfort-level-with-spiritual-assessment-a-study-among-nurses-working-in-diverse-healthcare-settings
#1
Pamela H Cone, Tove Giske
AIMS: To gain knowledge about nurses' comfort level in assessing spiritual matters and to learn what questions nurses use in practice related to spiritual assessment. BACKGROUND: Spirituality is important in holistic nursing care; however, nurses report feeling uncomfortable and ill-prepared to address this domain with patients. Education is reported to impact nurses' ability to engage in spiritual care. DESIGN: This cross-sectional exploratory survey reports on a mixed-method study examining how comfortable nurses are with spiritual assessment...
December 5, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27916344/advance-care-discussions-with-young-people-affected-by-life-limiting-neuromuscular-diseases-a-systematic-literature-review-and-narrative-synthesis
#2
Andy Hiscock, Isla Kuhn, Stephen Barclay
End of life care policy in the UK advocates open discussions between health professionals and patients as the end of life approaches. Despite well documented understanding of the progression of life-limiting neuromuscular diseases, the majority of patients affected by such conditions die without a formal end of life plan in place. We performed a systematic review to investigate conversations regarding end of life care between healthcare professionals and younger adult patients with life-limiting neuromuscular diseases...
November 21, 2016: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/27912108/encouraging-early-discussion-of-life-expectancy-and-end-of-life-care-a-randomised-controlled-trial-of-a-nurse-led-communication-support-program-for-patients-and-caregivers
#3
Adam Walczak, Phyllis N Butow, Martin H N Tattersall, Patricia M Davidson, Jane Young, Ronald M Epstein, Daniel S J Costa, Josephine M Clayton
BACKGROUND: Patients are often not given the information needed to understand their prognosis and make informed treatment choices, with many consequently experiencing less than optimal care and quality-of-life at end-of-life. OBJECTIVES: To evaluate the efficacy of a nurse-facilitated communication support program for patients with advanced, incurable cancer to assist them in discussing prognosis and end-of-life care. DESIGN: A parallel-group randomised controlled trial design was used...
October 21, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27911718/attacking-hiv-1-rna-versus-dna-by-sequence-specific-approaches-rnai-versus-crispr-cas
#4
REVIEW
Elena Herrera-Carrillo, Ben Berkhout
Human immunodeficiency virus type 1 (HIV-1) infection can be effectively controlled by potent antiviral drugs, but this never results in a cure. The patient should therefore take these drugs for the rest of his/her life, which can cause drug-resistance and adverse effects. Therefore, more durable therapeutic strategies should be considered, such as a stable gene therapy to protect the target T cells against HIV-1 infection. The development of potent therapeutic regimens based on the RNA interference (RNAi) and clustered regularly interspaced short palindromic repeats (CRISPR-Cas) mechanisms will be described, which can be delivered by lentiviral vectors...
October 15, 2016: Biochemical Society Transactions
https://www.readbyqxmd.com/read/27911489/palliative-care-interventions-in-advanced-dementia
#5
REVIEW
Edel Murphy, Katherine Froggatt, Sheelah Connolly, Eamon O'Shea, Elizabeth L Sampson, Dympna Casey, Declan Devane
BACKGROUND: Dementia is a chronic, progressive and ultimately fatal neurodegenerative disease. Advanced dementia is characterised by profound cognitive impairment, inability to communicate verbally and complete functional dependence. Usual care of people with advanced dementia is not underpinned universally by a palliative approach. Palliative care has focused traditionally on care of people with cancer but for more than a decade, there have been increased calls worldwide to extend palliative care services to include all people with life-limiting illnesses in need of specialist care, including people with dementia...
December 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27911019/the-impact-and-measurement-of-social-dysfunction-in-late-life-depression-an-evaluation-of-current-methods-with-a-focus-on-wearable-technology
#6
REVIEW
Sophie Hodgetts, Peter Gallagher, Daniel Stow, I Nicol Ferrier, John T O'Brien
OBJECTIVE: Depression is known to negatively impact social functioning, with patients commonly reporting difficulties maintaining social relationships. Moreover, a large body of evidence suggests poor social functioning is not only present in depression but that social functioning is an important factor in illness course and outcome. In addition, good social relationships can play a protective role against the onset of depressive symptoms, particularly in late-life depression. However, the majority of research in this area has employed self-report measures of social function...
December 2, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27909034/advance-care-planning-in-patients-with-incurable-cancer-study-protocol-for-a-randomised-controlled-trial
#7
Stephanie Johnson, Josephine Clayton, Phyllis N Butow, William Silvester, Karen Detering, Jane Hall, Belinda E Kiely, Jonathon Cebon, Stephen Clarke, Melanie L Bell, Martin Stockler, Phillip Beale, Martin H N Tattersall
INTRODUCTION: There is limited evidence documenting the effectiveness of Advance Care Planning (ACP) in cancer care. The present randomised trial is designed to evaluate whether the administration of formal ACP improves compliance with patients' end-of-life (EOL) wishes and patient and family satisfaction with care. METHODS AND ANALYSIS: A randomised control trial in eight oncology centres across New South Wales and Victoria, Australia, is designed to assess the efficacy of a formal ACP intervention for patients with cancer...
December 1, 2016: BMJ Open
https://www.readbyqxmd.com/read/27908978/potential-of-laboratory-execution-systems-less-to-simplify-the-application-of-business-process-management-systems-bpmss-in-laboratory-automation
#8
Sebastian Neubert, Bernd Göde, Xiangyu Gu, Norbert Stoll, Kerstin Thurow
Modern business process management (BPM) is increasingly interesting for laboratory automation. End-to-end workflow automation and improved top-level systems integration for information technology (IT) and automation systems are especially prominent objectives. With the ISO Standard Business Process Model and Notation (BPMN) 2.X, a system-independent and interdisciplinary accepted graphical process control notation is provided, allowing process analysis, while also being executable. The transfer of BPM solutions to structured laboratory automation places novel demands, for example, concerning the real-time-critical process and systems integration...
December 1, 2016: Journal of Laboratory Automation
https://www.readbyqxmd.com/read/27908943/planning-for-deactivation-of-implantable-cardioverter-defibrillators-at-the-end-of-life-in-patients-with-heart-failure
#9
Destiny R Brady
Implantable cardioverter defibrillators (ICDs) may be burdensome in end-stage heart failure. At the end of life, as many as one-fifth to one-third of patients experience an ICD shock. Critical care nurses should be aware of the potential burden of these shocks at the end of life as well as the ethics and organizational policies surrounding ICD deactivation. This literature review examines the issues surrounding ICD therapy at the end of life. Based on this author's findings, recommendations for discussing and implementing ICD deactivation are offered...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27908501/prospective-evaluation-of-surgical-palliative-care-immersion-training-for-general-surgery-residents
#10
Mustafa Raoof, Lisa O'Neill, Leigh Neumayer, Mindy Fain, Robert Krouse
BACKGROUND: Palliative care competencies in surgical training are recognized to improve the care of surgical patients with advanced or life-threatening illnesses. Formal programs to teach these competencies are lacking. The study aims to assess the feasibility and utility of a unique surgical palliative care immersion training program. STUDY DESIGN: A half-day Surgical Palliative Care Immersion Training (SPCIT) was developed using the American College of Surgeon's manual titled "Surgical Palliative Care: A Resident's Guide" as a framework...
November 27, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27906720/decisions-regarding-forgoing-life-sustaining-treatments
#11
Gail A Van Norman
PURPOSE OF REVIEW: Decisions to forego life-sustaining treatments are complex, and disagreements between physicians and patients occur. This review discusses recent findings regarding what factors influence physicians and patients or their surrogates in these decisions and considers whether futility arguments regarding life-sustaining treatments should be abandoned. RECENT FINDINGS: Cardiopulmonary resuscitation is one paradigm in the literature for studying end-of-life decision-making...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27899160/physiopathology-of-vesico-ureteral-reflux
#12
REVIEW
Salvatore Arena, Roberta Iacona, Pietro Impellizzeri, Tiziana Russo, Lucia Marseglia, Eloisa Gitto, Carmelo Romeo
Vescico-Ureteral Reflux (VUR) is a common condition in childhood, caused by a congenital anomaly at the Vescico-Ureteral Junction (VUJ) level. It seems that the main cause could be an abnormal embryological development occurred during the early stage of fetal life.Refluxing ureteral endings show structural and functional anomalies: previous studies have shown a significant decrease in alfa actin, miosin and desmin contents as well as an high rate of atrophy and muscular degeneration with disorganized muscular fibres...
November 29, 2016: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/27898281/goals-of-care-or-goals-of-trust-how-family-members-perceive-goals-for-dying-nursing-home-residents
#13
Cherie Rosemond, Laura C Hanson, Sheryl Zimmerman
PURPOSE OF STUDY: Dementia affects more than 5 million Americans, and is a leading cause of death. Family members of nursing home (NH) residents with advanced dementia report difficulty making decisions about care toward the end of life. As part of a randomized trial testing an intervention to improve decision making, this qualitative study aimed to understand how family decision makers experienced goal-based decision making in advance of the death of their relative. DESIGN AND METHODS: This qualitative study was conducted as part of the goals of care clinical trial...
November 29, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27896388/-dying-and-death-in-societal-transformation
#14
Andreas Heller, Klaus Wegleitner
Dying and death in modern societies are subject to profound social, professional and cultural-religious changes. Secularization and a stronger differentiation of societies have led to a change in the way humans handle the dying process. Normatively ritualized collective behaviour has been replaced by an individual, subjectivized approach. In late modern societies there are many different views of what "successful" or "good" dying means.In the article this change is described by the following seven theses: 1...
November 28, 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/27895907/succinct-guide-to-liver-transplantation-for-medical-students
#15
REVIEW
Cheng-Maw Ho, Po-Huang Lee, Wing Tung Cheng, Rey-Heng Hu, Yao-Ming Wu, Ming-Chih Ho
Literature on liver transplantation for use in medical education is limited and as yet unsatisfactory. The aim of this article is to help medical students gain enough insight into the reality of being a liver transplant recipient. This is crucial so in the future they can feel confident in approaching these patients with adequate knowledge and confidence. The knowledge-tree based learning core topics are designed for a 2-h class including indication/contraindication in the real-world setting, model for end stage liver disease scoring and organ allocation policy, liver transplantation for hepatic malignancy, transplantation surgery, immunosuppression strategy in practical consideration, and management of viral hepatitis...
December 2016: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/27893884/effect-of-the-goals-of-care-intervention-for-advanced-dementia-a-randomized-clinical-trial
#16
Laura C Hanson, Sheryl Zimmerman, Mi-Kyung Song, Feng-Chang Lin, Cherie Rosemond, Timothy S Carey, Susan L Mitchell
Importance: In advanced dementia, goals of care decisions are challenging and medical care is often more intensive than desired. Objective: To test a goals of care (GOC) decision aid intervention to improve quality of communication and palliative care for nursing home residents with advanced dementia. Design, Setting, and Participants: A single-blind cluster randomized clinical trial, including 302 residents with advanced dementia and their family decision makers in 22 nursing homes...
November 28, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27893221/substance-use-and-psychological-distress-is-related-with-accommodation-status-among-homeless-immigrants
#17
Miguel Angel Navarro-Lashayas, Francisco Jose Eiroa-Orosa
Immigrant homelessness constitutes a cruel expression of social exclusion. We analyzed the relation of sociodemographic characteristics with stressful life events, substance use and psychological distress, giving a special importance to the influence of the time spent on the streets and the accommodation status of 107 homeless immigrants. To this end, both quantitative and qualitative methodologies were combined. Discussion groups with care resources practitioners and service users, were followed by in depth interviews combined with psychometric questionnaires...
November 28, 2016: American Journal of Orthopsychiatry
https://www.readbyqxmd.com/read/27892716/life-and-cancer-without-telomerase-alt-and-other-strategies-for-making-sure-ends-don-t-meet
#18
Manasi S Apte, Julia Promisel Cooper
While most cancer cells rely on telomerase expression/re-activation for linear chromosome maintenance and sustained proliferation, a significant population of cancers (10-15%) employs telomerase-independent strategies, collectively dubbed Alternative Lengthening of Telomeres (ALT). Most ALT cells relax the usual role of telomeres as inhibitors of local homologous recombination while maintaining the ability of telomeres to prohibit local non-homologous end joining reactions. Here we review current concepts surrounding how ALT telomeres achieve this new balance via alterations in chromatin landscape, DNA damage repair processes and handling of telomeric transcription...
November 28, 2016: Critical Reviews in Biochemistry and Molecular Biology
https://www.readbyqxmd.com/read/27887679/-mindfulness-based-interventions-in-obsessive-compulsive-disorder-mechanisms-of-action-and-presentation-of-a-pilot-study
#19
M Gasnier, A Pelissolo, G Bondolfi, S Pelissolo, M Tomba, L Mallet, K N'diaye
Obsessive-compulsive disorder (OCD) is a frequent and severe disease, potentially inducing a major impairment for the patient and burden for their family. Recent research in psychiatry and neuroscience have led to better comprehension of the disease's mechanisms and helped to improve its treatment. However, a large proportion of patients have refractory symptoms, including for traditional cognitive and behavioral therapy by exposure and response prevention (ERP), leading clinicians to look for new treatments...
November 22, 2016: L'Encéphale
https://www.readbyqxmd.com/read/27884867/narrative-medicine-and-death-in-the-icu-word-clouds-as-a-visual-legacy
#20
Meredith Vanstone, Feli Toledo, France Clarke, Anne Boyle, Mita Giacomini, Marilyn Swinton, Lois Saunders, Melissa Shears, Nicole Zytaruk, Anne Woods, Trudy Rose, Tracey Hand-Breckenridge, Diane Heels-Ansdell, Shelley Anderson-White, Robert Sheppard, Deborah Cook
OBJECTIVE: The Word Cloud is a frequent wish in the 3 Wishes Project developed to nurture peace and ease the grieving process for dying critically ill patients. The objective was to examine whether Word Clouds can act as a heuristic approach to encourage a narrative orientation to medicine. Narrative medicine is an approach which can strengthen relationships, compassion and resilience. DESIGN: Word Clouds were created for 42 dying patients, and we interviewed 37 family members and 73 clinicians about their impact...
November 24, 2016: BMJ Supportive & Palliative Care
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