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https://www.readbyqxmd.com/read/28220315/attachment-figures-when-death-is-approaching-a-study-applying-attachment-theory-to-adult-patients-and-family-members-experiences-during-palliative-home-care
#1
Anna Milberg, Maria Friedrichsen
PURPOSE: Attachment theory is currently receiving much attention in relation to how adults cope with severe illness. The study aims were using the experiences of patients and family members to explore attachment figures (a central concept within the theory) during palliative home care. METHODS: Twelve patients and 14 family members were interviewed during ongoing palliative home care. The interviews were analysed using qualitative content analysis. RESULTS: Four types of attachment figures were identified: (i) family and friends, (ii) health care practitioners, (iii) pets and (iv) God...
February 20, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28220023/early-palliative-care-reduces-end-of-life-intensive-care-unit-icu-use-but-not-icu-course-in-patients-with-advanced-cancer
#2
Andrew M Romano, Kristine E Gade, Gradon Nielsen, Robert Havard, James H Harrison, Josh Barclay, George J Stukenborg, Paul W Read, Leslie J Blackhall, Patrick M Dillon
BACKGROUND: Early palliative care for advanced cancer patients improves quality of life and survival, but less is known about its effect on intensive care unit (ICU) use at the end of life. This analysis assessed the effect of a comprehensive early palliative care program on ICU use and other outcomes among patients with advanced cancer. PATIENTS AND METHODS: A retrospective cohort of patients with advanced cancer enrolled in an early palliative care program (n = 275) was compared with a concurrent control group of patients receiving standard care (n = 195) during the same time period by using multivariable logistic regression analysis...
February 20, 2017: Oncologist
https://www.readbyqxmd.com/read/28216870/palliative-care-social-work-in-india-current-status-and-future-directions
#3
REVIEW
G Ragesh, Lithin Zacharias, Priya Treesa Thomas
Palliative care (PC) involves total care for persons suffering from life-threatening illnesses and their families. Social work as a profession and an academic discipline is gaining momentum in India for the past few decades. A large number of professional social workers are working with individuals, families, and communities to provide PC in India. Authors have presented the current status of PC social work interventions and discussed the future directions in the practice, research, and training in PC and end-of-life care...
January 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28216856/feasibility-and-acceptability-of-implementing-the-integrated-care-plan-for-the-dying-in-the-indian-setting-survey-of-perspectives-of-indian-palliative-care-providers
#4
Naveen Salins, Jeremy Johnson, Stanley Macaden
INTRODUCTION: Capacity to provide end-of-life care in India is scored as 0.6/100, and very few people in India have access to palliative and end-of-life care. Lack of end-of-life care provision in India has led to a significant number of people receiving inappropriate medical treatment at the end of life, with no access to pain and symptom control and high treatment costs. The International Collaborative for the Best Care for the Dying Person is an initiative that offers the opportunity to apply international evidence on the key factors required to provide best care for the dying in the Indian context...
January 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28212642/beyond-cultural-stereotyping-views-on-end-of-life-decision-making-among-religious-and-secular-persons-in-the-usa-germany-and-israel
#5
Mark Schweda, Silke Schicktanz, Aviad Raz, Anita Silvers
BACKGROUND: End-of-life decision making constitutes a major challenge for bioethical deliberation and political governance in modern democracies: On the one hand, it touches upon fundamental convictions about life, death, and the human condition. On the other, it is deeply rooted in religious traditions and historical experiences and thus shows great socio-cultural diversity. The bioethical discussion of such cultural issues oscillates between liberal individualism and cultural stereotyping...
February 17, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28211000/the-implementation-and-evaluation-of-a-communication-skills-training-program-for-oncology-nurses
#6
Smita C Banerjee, Ruth Manna, Nessa Coyle, Stacey Penn, Tess E Gallegos, Talia Zaider, Carol A Krueger, Philip A Bialer, Carma L Bylund, Patricia A Parker
Many nurses express difficulty in communicating with their patients, especially in oncology settings where there are numerous challenges and high-stake decisions during the course of diagnosis and treatment. Providing specific training in communication skills is one way to enhance the communication between nurses and their patients. We developed and implemented a communication skills training program for nurses, consisting of three teaching modules: responding empathically to patients; discussing death, dying, and end-of-life goals of care; and responding to challenging interactions with families...
February 16, 2017: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/28209568/experience-based-design-co-design-and-experience-based-co-design-in-palliative-and-end-of-life-care
#7
Erica Borgstrom, Stephen Barclay
Experience-based design, co-design, and experience-based co-design can be used within healthcare to design services that improve the patient, carer and staff experience of the services. As palliative and end-of-life care centrally value person-centred care, we believe that service designers, commissioners and those tasked with making quality improvements will be interested in this growing field. This paper outlines these approaches-with a particular emphasis on experience-based co-design-and describes how they are and can be used within palliative and end-of-life care...
February 16, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28206733/end-of-life-decisions-in-34-slovene-intensive-care-units-a-nationwide-prospective-clinical-study
#8
Miha Orazem, Urh Groselj, Manca Stojan, Neza Majdic, Gaj Vidmar, Stefan Grosek
BACKGROUND: To determine how end-of-life decisions (EOLD) on limitations of life- sustaining treatment (LST) are made in three different types of intensive care units (ICUs) in Slovenia. METHODS: A national multicenter prospective study among 31 adult and three pediatric/neonatal ICUs (PICUs). The questionnaire form on EOLD was designed to assess the clinical practice. Data were collected between January 1, 2013, and March 31, 2013. For statistical analysis we used IBM® SPSS® Statistics 20 software package...
February 15, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28203146/insulin-like-growth-factor-1-at-the-crossroads-of-brain-development-and-aging
#9
REVIEW
Sarah Wrigley, Donia Arafa, Daniela Tropea
Insulin-like growth factor 1 (IGF1) is a polypeptide hormone structurally similar to insulin. It is central to the somatotropic axis, acting downstream of growth hormone (GH). It activates both the mitogen-activated protein (MAP) kinase and PI3K signaling pathways, acting in almost every tissue in the body to promote tissue growth and maturation through upregulation of anabolic processes. Overall GH and IGF1 signaling falls with age, suggesting that it is this reduced IGF1 activity that leads to age-related changes in organisms...
2017: Frontiers in Cellular Neuroscience
https://www.readbyqxmd.com/read/28198336/managing-tissue-viability-issues-in-patients-with-cancer-approaching-the-end-of-life
#10
Kenneth Robert Ripley, Mark Collier
This article provides an overview of tissue viability issues related to the care of patients with cancer who are approaching the end of life. Altered physiology as a result of various factors, including nutrition, medication and radiotherapy, is identified. The article discusses the presentation and treatment of cutaneous radiation injury, malignant wounds, pressure ulcers and Skin Changes At Life's End (SCALE), an acronym used to describe a set of clinical phenomena associated with skin changes in patients approaching the end of life, and makes recommendations for practice...
February 15, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28187812/family-discussions-on-life-sustaining-interventions-in-neurocritical-care
#11
M M Adil, D Larriviere
Approximately 20% of all deaths in the USA occur in the intensive care unit (ICU) and the majority of ICU deaths involves decision of de-escalation of life-sustaining interventions. Life-sustaining interventions may include intubation and mechanical ventilation, artificial nutrition and hydration, antibiotic treatment, brain surgery, or vasoactive support. Decision making about goals of care can be defined as an end-of-life communication and the decision-making process between a clinician and a patient (or a surrogate decision maker if the patient is incapable) in an institutional setting to establish a plan of care...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28186835/preparing-pediatric-healthcare-professionals-for-end-of-life-care-discussions-an-exploratory-study
#12
Amanda Henderson, Jeanine Young, Anthony Herbert, Natalie Bradford, Lee-Anne Pedersen
BACKGROUND: Preparedness to initiate end-of-life (EoL) discussions is a confronting and daunting task for all healthcare professionals. We conducted a group interview to explore healthcare professionals' experiences of preparing for EoL discussions with the patient and their family in a pediatric context. AIM: To identify what pediatric healthcare professionals consider important when preparing for an EoL discussion. METHODS: A qualitative design using a group interview...
February 10, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28185893/united-states-clergy-religious-values-and-relationships-to-end-of-life-discussions-and-care
#13
Michael J Balboni, Adam Sullivan, Andrea C Enzinger, Patrick T Smith, Christine Mitchell, John R Peteet, James Tulsky, Tyler VanderWeele, Tracy A Balboni
CONTEXT: While clergy interact with approximately half of U.S. patients facing end-of-life medical decisions, little is known about clergy-congregant interactions or clergy influence on end-of-life decisions. OBJECTIVE: To conduct a nationally representative survey of clergy beliefs and practices. METHODS: A mailed survey to a nationally representative sample of clergy completed in March 2015 with 1005 of 1665 responding (60% response rate)...
February 6, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28185791/evolution-of-symptom-burden-of-advanced-lung-cancer-over-a-decade
#14
Mike R Sung, Milan V Patel, Sarvar Djalalov, Lisa W Le, Frances A Shepherd, Ronald L Burkes, Ronald Feld, Stephanie Lin, Roxana Tudor, Natasha B Leighl
INTRODUCTION: Lung cancer is associated with higher levels of symptom distress and unmet needs than other cancer types. We assessed changes in symptoms, function, understanding, and preferences of patients with advanced lung cancer over a 10-year period. MATERIALS AND METHODS: A 26-item self-administered questionnaire was used to assess symptom burden, functional impairment, knowledge of disease and treatment, and information preferences. The survey was administered to consecutive outpatients with advanced lung cancer first in 2002 and a second cohort in 2012...
January 5, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28181897/-discontinuation-of-potentially-inappropriate-medications-at-the-end-of-life-perspectives-from-patients-their-relatives-and-physicians
#15
E C T Geijteman, M M A Tempelman, M K Dees, B A A Huisman, R S G M Perez, L van Zuylen, A van der Heide
OBJECTIVE: To obtain insight into the perspectives of patients, relatives and physicians towards potentially inappropriate medications (PIMs) at the end of life. DESIGN: Qualitative interview study. METHOD: An analysis of in-depth interviews with 17 patients who were diagnosed as having a life expectancy of less than three months, 12 patient relatives, and 20 medical specialists and 12 general practitioners who cared for them. For analysis we applied the constant comparative method, which forms part of the grounded theory approach...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28169857/intersection-of-prognosis-and-palliation-in-neurocritical-care
#16
Michael Rubin, Jordan Bonomo, J Claude Hemphill
PURPOSE OF REVIEW: Difficult discussions regarding end-of-life care are common in neurocritical care. Because of a patient's neurological impairment, decisions regarding continuing or limiting aggressive care must often be made by patients' families in conjunction with medical providers. This review provides perspective on three major aspects of this circumstance: prognostication, family-physician discussions, and determination of death (specifically as it impacts on organ donation). RECENT FINDINGS: Numerous studies have now demonstrated that prediction models developed from populations of brain-injured patients may be misleading when applied to individual patients...
February 4, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28168665/the-life-cycle-of-engineered-nanoparticles
#17
David González-Gálvez, Gemma Janer, Gemma Vilar, Alejandro Vílchez, Socorro Vázquez-Campos
The first years in the twenty-first century have meant the inclusion of nanotechnology in most industrial sectors, from very specific sensors to construction materials. The increasing use of nanomaterials in consumer products has raised concerns about their potential risks for workers, consumers and the environment. In a comprehensive risk assessment or life cycle assessment, a life cycle schema is the starting point necessary to build up the exposure scenarios and study the processes and mechanisms driving to safety concerns...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28166844/parasite-life-cycle-studies-a-plea-to-resurrect-an-old-parasitological-tradition
#18
I Blasco-Costa, R Poulin
Many helminth taxa have complex life cycles, involving different life stages infecting different host species in a particular order to complete a single generation. Although the broad outlines of these cycles are known for any higher taxon, the details (morphology and biology of juvenile stages, specific identity of intermediate hosts) are generally unknown for particular species. In this review, we first provide quantitative evidence that although new helminth species are described annually at an increasing rate, the parallel effort to elucidate life cycles has become disproportionately smaller over time...
February 7, 2017: Journal of Helminthology
https://www.readbyqxmd.com/read/28166425/subjective-nearness-to-death-and-end-of-life-anxieties-the-moderating-role-of-ageism
#19
Yoav S Bergman, Ehud Bodner, Amit Shrira
OBJECTIVES: Subjective nearness to death (SNtD), or individuals' subjective evaluation of how close they are to death, has been demonstrated to be an important predictor for different aspects of the individual's aging process across the life cycle. However, the relationship between SNtD and anxieties linked with the aging process has not been examined among individuals who may be in the initial stages of experiencing the first physical and cognitive signs of aging. Thus, this study examined the association between SNtD and aging, dying, and death anxieties...
February 6, 2017: Aging & Mental Health
https://www.readbyqxmd.com/read/28161337/thermal-behavior-of-vehicle-plastic-blends-contained-acrylonitrile-butadiene-styrene-abs-in-pyrolysis-using-tg-ftir
#20
Guicai Liu, Yanfen Liao, Xiaoqian Ma
As important plastic blends in End-of-Life vehicles (ELV), pyrolysis profiles of ABS/PVC, ABS/PA6 and ABS/PC were investigated using thermogravimetric-Fourier transform infrared spectrometer (TG-FTIR). Also, CaCO3 was added as plastic filler to discuss its effects on the pyrolysis of these plastics. The results showed that the interaction between ABS and PVC made PVC pyrolysis earlier and HCl emission slightly accelerated. The mixing of ABS and PA6 made their decomposition temperature closer, and ketones in PA6 pyrolysis products were reduced...
February 1, 2017: Waste Management
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