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End of life issues

Manal Zafar, Ariyana Bozzorg, Madeleine E Hackney
PURPOSE: Our aims were to determine (1) the impact of aging versus combined aging and disease on participation and (2) participation before and after a 12-week, Adapted Tango dance intervention (AT) in older adults with and without Parkinson's disease (PD). METHODS: Participant responses to open and closed-ended questions on the Impact on Participation and Autonomy questionnaire (IPA) were recorded before, one-week-after, and three-months after 20 lessons of AT...
October 21, 2016: Disability and Rehabilitation
H Olschewski, J Behr, H Bremer, M Claussen, P Douschan, M Halank, M Held, M M Hoeper, S Holt, H Klose, S Krüger, T J Lange, F Reichenberger, D Skowasch, S Ulrich, H Wilkens, W Seeger
The 2015 European Guidelines on Pulmonary Hypertension did not cover only pulmonary arterial hypertension (PAH) but also some aspects of pulmonary hypertension (PH) associated with chronic lung disease. The European Guidelines point out that the drugs currently used to treat patients with PAH (prostanoids, endothelin receptor antagonists, phosphodiesterase-5 inhibitors, sGC stimulators) have not been sufficiently investigated in other forms of PH. Therefore, the European Guidelines do not recommend the use of these drugs in patients with chronic lung disease and PH...
October 2016: Deutsche Medizinische Wochenschrift
Massimo Del Fabbro, Stefano Corbella, Patrick Sequeira-Byron, Igor Tsesis, Eyal Rosen, Alessandra Lolato, Silvio Taschieri
BACKGROUND: When primary root canal therapy fails, periapical lesions can be retreated with or without surgery. Root canal retreatment is a non-surgical procedure that involves removal of root canal filling materials from the tooth, followed by cleaning, shaping and obturating of the canals. Root-end resection is a surgical procedure that involves exposure of the periapical lesion through an osteotomy, surgical removal of the lesion, removal of part of the root-end tip, disinfection and, commonly, retrograde sealing or filling of the apical portion of the remaining root canal...
October 19, 2016: Cochrane Database of Systematic Reviews
Edward J Wing
With the wider availability of antiretrovirals, the world's HIV population is aging. More than 10% of the 34.5 million HIV+ individuals worldwide are over the age of 50 and the average age continues to increase. In the US more than 50% of the 1.3 million people with HIV are over 50 and by the year 2030 it is estimated that 70% will be over the age of 50. Although the life expectancy of HIV+ people has increased dramatically, it still lags behind HIV- individuals. There is controversy about whether HIV itself accelerates the aging process...
October 15, 2016: International Journal of Infectious Diseases: IJID
Tan Ying Peh, Grace Meijuan Yang, Lalit Kumar Radha Krishna, Alethea Chung Peng Yee
BACKGROUND: Doctors report inadequate training and lack confidence in providing palliative care. Although palliative care training improves self-assessed competence, it is not known whether the duration of a palliative medicine (PM) posting affects the extent of improvement in confidence. OBJECTIVE: The aim of this study was to determine whether the duration of a PM posting affects the extent of improvement in doctors' confidence in various aspects of palliative care...
October 17, 2016: Journal of Palliative Medicine
Tarek Assi, Elie El Rassy, Tony Ibrahim, Tania Moussa, Aline Tohme, Fadi El Karak, Fadi Farhat, Salma Faddoul, Marwan Ghosn, Joseph Kattan
INTRODUCTION: One major health care issue encountered in elderly cancer patients is the alteration of the quality of life. The purpose of our study is to evaluate the administration of chemotherapy in the last month of life (CLML) and to evaluate the impact of the palliative care consult (PCC) in the elderly patients. METHODS: We conducted a retrospective observational study that included elderly patients diagnosed with an end-stage cancer and who were deceased between the 1st of January 2012 and the 31st of December 2015...
October 13, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Jason P Stopyra, William P Bozeman, David W Callaway, James Winslow, Henderson D McGinnis, Justin Sempsrott, Lisa Evans-Taylor, Roy L Alson
There is some controversy about whether ballistic protective equipment (body armor) is required for medical responders who may be called to respond to active shooter mass casualty incidents. In this article, we describe the ongoing evolution of recommendations to optimize medical care to injured victims at such an incident. We propose that body armor is not mandatory for medical responders participating in a rapid-response capacity, in keeping with the Hartford Consensus and Arlington Rescue Task Force models...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
R Thuret, M O Timsit, F Kleinclauss
OBJECTIVES: To report epidemiology and characteristics of end-stage renal disease (ESRD) patients and renal transplant candidates, and to evaluate access to waiting list and results of renal transplantation. MATERIAL AND METHODS: An exhaustive systematic review of the scientific literature was performed in the Medline database ( and Embase ( using different associations of the following keywords: "chronic kidney disease, epidemiology, kidney transplantation, cost, survival, graft, brain death, cardiac arrest, access, allocation"...
October 7, 2016: Progrès en Urologie
Massimo Delogu, Francesco Del Pero, Lorenzo Berzi, Marco Pierini, Davide Bonaffini
The railway system represents one of the most resource-efficient answer to our ever-growing demand for transport service and the development trends for the following years forecast a substantial increase in this sector. Considering the European Union, rolling stock realizes a significant share of both goods and passengers carriage while it is responsible for a derisory quota of environmental impact and energy consumption involved by transportation. Contrary to the low environmental impact, the amount of End-of-Life (EoL) waste generated by rolling stocks in relation to the number of vehicles is notable, much greater than in the case of road vehicles...
October 7, 2016: Waste Management
Lisa M Wintner, Monika Sztankay, Neil Aaronson, Andrew Bottomley, Johannes M Giesinger, Mogens Groenvold, Morten Aa Petersen, Lonneke van de Poll-Franse, Galina Velikova, Irma Verdonck-de Leeuw, Bernhard Holzner
Cancer has increasingly become a chronic condition and the routine collection of patient-reported outcomes (PROs) like quality of life is widely recommended for clinical practice. Nonetheless, the successful implementation of PROs is still a major challenge, although common barriers to and facilitators of their beneficial use are well known. To support health care professionals and other stakeholders in the implementation of the EORTC PRO measures, the EORTC Quality of Life Group provides guidance on issues considered important for their use in daily clinical practice...
October 6, 2016: European Journal of Cancer
Katie Hatt, Nicholas C Kinback, Anoop Shah, Ernesto Cruz, Eric L Altschuler
Since the late 1980s, lung transplant has become an option for some individuals (in 2014 4000 lung transplants were performed) with end-stage lung disease aimed to help these individuals restore function and improve survival and quality of life. Individuals living with end-stage lung disease are already deconditioned with poor endurance and limited exercise capacity. There are additional post-transplant factors which can contribute to poor endurance and decreased exercise capacity. While pulmonary rehabilitation in the pre-transplant phase is a crucial component for positive functional outcomes following lung transplant, the incidence of post-transplant complications, coupled with the need for immunosuppression often warrants close monitoring by medical professionals...
October 6, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Silvia Villa, Friederike Kendel, Lionne Venderbos, Tiziana Rancati, Chris Bangma, Peter Carroll, Louis Denis, Laurence Klotz, Ida J Korfage, Athene J Lane, Tiziana Magnani, Ken Mastris, Antti Rannikko, Monique Roobol, Bruce Trock, Roderick Van den Bergh, Hendrik Van Poppel, Riccardo Valdagni, Lara Bellardita
BACKGROUND: Literature on the health-related quality of life (HRQoL) for men with localized prostate cancer (PCa) on active surveillance (AS) shows a need for methodological guidance regarding HRQoL issues and how to address them. OBJECTIVE: The European School of Oncology Task Force (ESO TF) aimed to identify a core set of research questions and related measures to include in AS HRQoL studies. DESIGN, SETTING, AND PARTICIPANTS: A modified Delphi study was used to reach consensus on AS HRQoL research topics and tools between 2014 and 2015...
October 6, 2016: European Urology
F Phillips, C H S Ruxton
This paper presents a report of a nutrition conference held at EXPO 2015 in Milan. Over the course of a day, seven speakers from four continents discussed the evidence and scientific processes that underpin the development of dietary guidelines, highlighting issues and challenges at each stage. These include the quality of studies associating disease outcomes with diet, specifically a reliance on observational studies, short duration of intervention trials, low statistical power and lack of follow-up. Concerns were raised over the oversimplification of dietary messages which promote carbohydrates in general without evidence of benefit, while restricting fats when meta-analyses suggests that different fatty acids have different effects on disease risk...
October 6, 2016: Public Health
Yaming Li, Jianhui Li
Death with dignity is a significant issue in modern bioethics. In modern healthcare, the wide use of new technologies at the end of life has caused heated debate on how to protect human dignity. The key point of contention lies in the different understandings of human dignity and the dignity of death. Human dignity has never been a clear concept in Western ethical explorations, and the dignity of death has given rise to more confusions. Although there is no such term as "dignity" in Confucian ethics, there are discussions of a number of ideas related to human dignity and the dignity of death...
October 5, 2016: Theoretical Medicine and Bioethics
Myles Nickolich, Areej El-Jawahri, Thomas W LeBlanc
A growing literature demonstrates that MDS is associated with significant impairments in overall quality of life. Given the poor prognosis for many patients with MDS, and the considerable morbidities associated with this disease, there is a critical need to address palliative and end-of-life care needs in this population. However, palliative and end-of-life care issues are under-represented in the MDS literature. In this article, we highlight a growing body of literature that demonstrates unmet palliative and end-of-life care needs in hematologic malignancies, including MDS, and highlight opportunities for further research and quality improvement initiatives to address unmet needs in MDS care...
October 4, 2016: Current Hematologic Malignancy Reports
Nils-Torge Telle, Jörn Moock, Sandra Heuchert, Vivian Schulte, Wulf Rössler, Wolfram Kawohl
Sickness absence from work due to experienced distress and mental health issues has continuously increased over the past years in Germany. To investigate how this alarming development can be counteracted, we conducted a randomized controlled trial evaluating a job coaching intervention to maintain the working capacity of members of staff and ultimately prevent sickness absence. Our sample included N = 99 employees who reported mental distress due to work-related problems. The intervention group (n = 58) received between 8 and 12 individual job coaching sessions in which they worked with a professional job coach to reduce their mental distress...
2016: Frontiers in Public Health
Philip G Richardson, Jaimi Greenslade, Jonathon Isoardi, Michael Davey, Mark Gillett, Alicia Tucker, Sharon Klim, Anne-Maree Kelly, Ibrahim Abdelmahmoud
OBJECTIVE: We investigated and compared the importance of the considerations and discussions when withdrawing and withholding life-sustaining healthcare between emergency physicians (EP) and emergency registrars (ER). METHODS: This was a sub-study of a prospective cross-sectional questionnaire-based case series conducted in six EDs. Primary outcomes were, which of the discussion and considerations, were rated most important by EP and ER in the decision-making process...
October 4, 2016: Emergency Medicine Australasia: EMA
Bernhard Elsner, Joachim Kugler, Marcus Pohl, Jan Mehrholz
INTRODUCTION: Idiopathic Parkinson's disease (IPD) is a neurodegenerative disorder. The severity of disability usually increases with disease duration and affects patients' impairment, disability and health-related quality of life. A possible adjunct to improve outcomes in patients with IPD might be transcranial direct current stimulation (tDCS) to modulate cortical excitability and hence improving outcomes in people with IPD. EVIDENCE ACQUISITION: Until February 2016 we searched the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL; the Cochrane Library; 2016, Issue 2), MEDLINE, EMBASE, CINAHL, AMED, Science Citation Index, the Physiotherapy Evidence Database (PEDro), Rehabdata, and Inspec and handsearched conference proceedings, and contacted authors and equipment manufacturers...
October 4, 2016: European Journal of Physical and Rehabilitation Medicine
Lisa Brice, Nicole Gilroy, Gemma Dyer, Masura Kabir, Matt Greenwood, Stephen Larsen, John Moore, John Kwan, Mark Hertzberg, Louisa Brown, Megan Hogg, Gillian Huang, Jeff Tan, Christopher Ward, David Gottlieb, Ian Kerridge
PURPOSE: The aim of this qualitative study was to gain a rich understanding of the impact that haematopoietic stem cell transplantation (HSCT) has on long-term survivor's quality of life (QoL). METHOD: Participants included 441 survivors who had undergone HSCT for a malignant or non-malignant disease. Data were obtained by a questionnaire positing a single open-ended question asking respondents to list the three issues of greatest importance to their QoL in survivorship...
October 3, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Peter V Coveney, Edward R Dougherty, Roger R Highfield
The current interest in big data, machine learning and data analytics has generated the widespread impression that such methods are capable of solving most problems without the need for conventional scientific methods of inquiry. Interest in these methods is intensifying, accelerated by the ease with which digitized data can be acquired in virtually all fields of endeavour, from science, healthcare and cybersecurity to economics, social sciences and the humanities. In multiscale modelling, machine learning appears to provide a shortcut to reveal correlations of arbitrary complexity between processes at the atomic, molecular, meso- and macroscales...
November 13, 2016: Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences
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