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End-of-life issues

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https://www.readbyqxmd.com/read/29776973/challenges-in-end-of-life-dementia-care
#1
REVIEW
Anne A Fetherston, Grace Rowley, Charlotte L Allan
Dementia is a chronic, progressive disease that is now much more widely recognised and treated. Patients with dementia may require palliative care when they reach the end stage of their illness, or they may have mild-moderate cognitive symptoms comorbid with a life-limiting illness. The variety of presentations necessitates a highly individual approach to care planning, and patients should be encouraged to set their own goals and contribute to advanced care planning where possible. Assessment and management of distressing symptoms at the end of life can be greatly helped by a detailed knowledge of the individuals' prior wishes, interdisciplinary communication and recognition of changes in presentation that may result from new symptoms, for example, onset of pain, nutritional deficits and infection...
May 18, 2018: Evidence-based Mental Health
https://www.readbyqxmd.com/read/29776669/-the-role-of-end-of-life-palliative-sedation-medical-and-ethical-aspects-review
#2
REVIEW
Miriam S Menezes, Maria das Graças Mota da Cruz de Assis Figueiredo
BACKGROUND AND OBJECTIVE: Palliative sedation is a medical procedure that has been used for more than 25 years to relieve refractory symptoms not responsive to any previous treatment in patients with no possibility of cure and near the end of life. Many uncertainties persist on the issue regarding definition, indications, decision making, most appropriate place to perform the procedure, most used drugs, need for monitoring, fluids and nutritional support, and possible ethical dilemmas...
May 15, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29771249/-new-italian-law-about-end-of-life-self-determination-and-shared-care-pathway
#3
Rosagemma Ciliberti, Matteo Gulino, Ilaria Gorini
The Italian Parliament has recently approved the Law n. 219/2017 concerning "Rules on informed consent and advance directives". The manuscript points out the main key points of the new law, in order to clarify the role of the advance directives and to provide clear operational guidelines for healthcare personnel. Taking into consideration the Italian deontological and juridical context, along with the main jurisprudential judgements, the law has been analysed. The Authors discussed the new rules and the bioethical issues also in relation to the provisions stated by the Convention on Human Rights and Biomedicine (Convention of Oviedo)...
May 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29766728/-euthanasia-legal-comparison-in-selected-european-countries
#4
Adam Doležal
This article deals with the subject of euthanasia (all its forms) and other end-of-life decisions, such as assisted suicide, withdrawing and whithholding life-sustaining treatments. Among other things, the article will also deal with the issue of the offense of Homicide by the Victims Request. Based on an empirical historical method, the article compares the various selected legal orders. From this analysis, it draws some conclusions that have an impact on ethical discourse. First of all, the terminology is defined in the article, which is very important in this area...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29764323/swaps-and-chains-and-vouchers-oh-my-evaluating-how-saving-more-lives-impacts-the-equitable-allocation-of-live-donor-kidneys
#5
Evelyn M Tenenbaum
Live kidney donation involves a delicate balance between saving the most lives possible and maintaining a transplant system that is fair to the many thousands of patients on the transplant waiting list. Federal law and regulations require that kidney allocation be equitable, but the pressure to save patients subject to ever-lengthening waiting times for a transplant has been swinging the balance toward optimizing utility at the expense of justice. This article traces the progression of innovations created to make optimum use of a patient's own live donors...
March 2018: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29764178/compassionate-communities-in-canada-it-is-everyone-s-responsibility
#6
Bonnie Tompkins
Prof. Allan Kellehear first developed a contemporary public health approach to palliative and end-of-life care. Countries around the world have since adopted the theory of practice that mobilizes palliative care as a public health issue-particularly the Compassionate Communities (CC) model. In the wake of Canada's Medical Assistance in Dying (MAiD) legislation and its growing senior population, quality palliative care has enjoyed a renewed focus. Pallium Canada is helping communities across the country understand and adopt the CC model, through education, knowledge mobilization, project facilitation, and leadership...
April 2018: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29764174/healthy-end-of-life-project-help-a-progress-report-on-implementing-community-guidance-on-public-health-palliative-care-initiatives-in-australia
#7
Andrea Grindrod, Bruce Rumbold
BACKGROUND: Contemporary end of life care policies propose increasing community capacity by developing sustainable skills, policies, structures, and resources to support members of a community in caring for each other at the end of life. Public health approaches to palliative care provide strategies to bring this about. Practical implementation can however be ineffective, principally due to failures to grasp the systemic nature of public health interventions, or to ensure that programs are managed and owned by community members, not the professionals who may have introduced them...
April 2018: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29763969/hormone-replacement-therapy-for-women-previously-treated-for-endometrial-cancer
#8
REVIEW
Katharine A Edey, Stuart Rundle, Martha Hickey
BACKGROUND: Endometrial cancer is the sixth most common cancer in women worldwide and most commonly occurs after the menopause (75%) (globocan.iarc.fr). About 319,000 new cases were diagnosed worldwide in 2012. Endometrial cancer is commonly considered as a potentially 'curable cancer,' as approximately 75% of cases are diagnosed before disease has spread outside the uterus (FIGO (International Federation of Gynecology and Obstetrics) stage I). The overall five-year survival for all stages is about 86%, and, if the cancer is confined to the uterus, the five-year survival rate may increase to 97%...
May 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29757459/individual-meaning-centered-psychotherapy-for-the-treatment-of-psychological-and-existential-distress-a-randomized-controlled-trial-in-patients-with-advanced-cancer
#9
William Breitbart, Hayley Pessin, Barry Rosenfeld, Allison J Applebaum, Wendy G Lichtenthal, Yuelin Li, Rebecca M Saracino, Allison M Marziliano, Melissa Masterson, Kristen Tobias, Natalie Fenn
BACKGROUND: Patients with advanced cancer have high rates of psychological distress, including depression, anxiety, and spiritual despair. This study examined the effectiveness of individual meaning-centered psychotherapy (IMCP) in comparison with supportive psychotherapy (SP) and enhanced usual care (EUC) in improving spiritual well-being and quality of life and reducing psychological distress in patients with advanced cancer. METHODS: Patients (n = 321) were randomly assigned to IMCP (n = 109), SP (n = 108), or EUC (n = 104)...
May 14, 2018: Cancer
https://www.readbyqxmd.com/read/29757106/a-snapshot-of-australian-social-workers-in-palliative-care-and-their-work-with-estranged-clients
#10
Kylie Agllias
This paper describes a mixed method survey that was administered to a group of Australian palliative care social workers (n = 27). Specifically, it aimed to investigate the ways that social workers understood and worked with clients who were estranged from family at the end of life. Respondents suggested that estrangement potentially impacted clients emotionally, practically, and existentially. They were challenged to make clear assessments, provide emotional support, encourage news ways of thinking about estrangement, to manage practical issues, work with the client's family, and monitor their own professional role...
May 14, 2018: Social Work in Health Care
https://www.readbyqxmd.com/read/29752324/dances-with-denial-have-medical-oncology-outpatients-conveyed-their-end-of-life-wishes-and-do-they-want-to
#11
Amy Waller, Charles Douglas, Rob Sanson-Fisher, Nicholas Zdenkowski, Angela Pearce, Tiffany Evans, Justin Walsh
Objectives: This study surveyed a sample of medical oncology outpatients to determine (1) the proportion who have already discussed and documented their end-of-life (EOL) wishes; (2) when and with whom they would prefer to convey their EOL wishes; (3) the EOL issues they would want to discuss; and (4) the association between perceived cancer status and advance care planning (ACP) participation. Methods: Adult medical oncology outpatients were approached in the waiting room of an Australian tertiary treatment center...
May 2018: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29750461/psycho-oncological-care-of-melanoma-patients-in-certified-skin-cancer-centers
#12
Frank Meiss, Carmen Loquai, Joachim Weis, Jürgen M Giesler, Katrin Reuter, Dorothée Nashan
BACKGROUND: The establishment und certification of skin cancer centers (SCCs) in compliance with requirements issued by the German Cancer Society play a key role for quality-assured treatment of skin cancer patients. These requirements also call for the implementation of a qualified psycho-oncology program. When planning the present study, we assumed site-specific differences in the way such programs were implemented at various SCCs. METHODS: In 2014, we conducted a cross-sectional survey of all SCCs certified at the time (n = 43), in which these institutions were asked to provide information on the structural and process quality of their psycho-oncology programs...
May 2018: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/29746312/calculation-of-the-alma-risk-of-right-ventricular-failure-after-left-ventricular-assist-device-implantation
#13
Antonio Loforte, Andrea Montalto, Francesco Musumeci, Cristiano Amarelli, Carlo Mariani, Vincenzo Polizzi, Paola Lilla Della Monica, Francesco Grigioni, Roberto Di Bartolomeo, Giuseppe Marinelli
Right ventricular failure after continuous-flow left ventricular assist device (LVAD) implantation is still an unsolved issue and remains a life-threatening event for patients. We undertook this study to determine predictors of the patients who are candidates for isolated LVAD therapy as opposed to biventricular support (BVAD). We reviewed demographic, echocardiographic, hemodynamic, and laboratory variables for 258 patients who underwent both isolated LVAD implantation and unplanned BVAD because of early right ventricular failure after LVAD insertion, between 2006 and 2017 (LVAD = 170 and BVAD = 88)...
May 8, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29746283/spiritual-care-in-cancer-patients-a-need-or-an-option
#14
Carla I Ripamonti, Federico Giuntoli, Silvia Gonella, Guido Miccinesi
PURPOSE OF REVIEW: Because of cancer is generally perceived as a life-threatening illness, patients often develop spiritual needs upon the diagnosis. Spirituality impacts patient quality of life (QoL) and provides a context in which to derive hope and meaning to cope with illness. The goal of this review is to give an overview of the most relevant studies with a focus on the relationship between spiritual well being, QoL and hope in patients with cancer, in addition to exploring the importance of spiritual issues both for patients and healthcare professionals...
May 8, 2018: Current Opinion in Oncology
https://www.readbyqxmd.com/read/29742044/end-of-life-decision-making-in-palliative-care-and-recommendations-of-the-council-of-europe-qualitative-secondary-analysis-of-interviews-and-observation-field-notes
#15
Sandra Martins Pereira, Emília Fradique, Pablo Hernández-Marrero
BACKGROUND: End-of-life decisions (ELDs) are embedded in clinical, sociocultural, political, economic, and ethical concerns. In 2014, the Council of Europe (CoE) through its Committee on Bioethics launched the "Guide on the decision-making process regarding medical treatment in end-of-life situations," aiming at improving decision-making processes and empowering professionals in making ELDs. OBJECTIVE: To analyze if end-of-life decision making in palliative care (PC) is consistent with this Guide and to identify if disputed/controversial issues are part of current ELDs...
May 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29740904/falling-through-the-cracks-a-thematic-evaluation-of-unmet-needs-of-adult-survivors-of-childhood-cancers
#16
Jennifer White, Joanne Park, K Brooke Russell, K A Reynolds, A Madani, Linda E Carlson, Janine Giese-Davis
BACKGROUND: The population of adult survivors of childhood cancers (ASCCs) is growing, resulting in unique long-term challenges. This study explored experiences of perceived unmet ASCC survivorship needs. METHODS: We invited ASCCs to complete surveys sent through the cancer registry. Four open-ended questions allowed participants to write in comments. We analyzed responses to these open-ended questions thematically, employing a process of constant comparison. RESULTS: Our sample included 94 ASCCs who completed open-ended questions (61 female; aged 20-78 years, mean age=34...
May 8, 2018: Psycho-oncology
https://www.readbyqxmd.com/read/29740194/opinions-of-israeli-neonatologists-about-life-and-death-decisions-in-neonates
#17
Moshe Y Kasirer, Francis B Mimouni, Alona Bin-Nun, Michael S Schimmel
BACKGROUND: In 2005, the Israeli parliament passed the "law of dying patients" legalizing life and death decisions (do not resuscitate) in patients with life expectancy less than 6 months. OBJECTIVE: To determine whether ethnic and religious backgrounds (both religion and religiosity) influence neonatologists' attitudes in simulated clinical situations and opinions about the new law. DESIGN/METHODS: Prospective design, using standard questionnaire sent to all 155 board-certified practising Israeli Neonatologists...
May 8, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29738927/the-impact-of-shelf-life-on-exposure-as-revealed-from-quality-control-data-associated-with-the-quargel-outbreak
#18
Martin Wagner, Panos Skandamis, Franz Allerberger, Dagmar Schoder, Caroline Lassnig, Mathias Müller, Kathrin Rychli
A cluster of 34 human cases of listeriosis was traced to consumption of contaminated quargel cheese, a sour milk specialty sold in Austria, Germany and Czech Republic. Here, we try to assess how many portions were consumed by the Austrian population at a certain contamination level (CL). In total, 1623 cheese lots were produced during the outbreak period resulting in >3 million portions of cheese delivered to the market. From 650 sets of quality control data provided by the food business operator, we reconstructed the contamination scenario over time and identified 84 lots that were found to be positive...
April 20, 2018: International Journal of Food Microbiology
https://www.readbyqxmd.com/read/29736116/providing-palliative-care-in-rural-nepal-perceptions-of-mid-level-health-workers
#19
Rajesh N Gongal, Shambhu Kumar Upadhyay, Kedar Prasad Baral, Max Watson, George W Kernohan
Introduction: Nepal is beginning to develop palliative care services across the country. Most people live in rural areas, where the Mid-Level Health Workers (MHWs) are the major service providers. Their views on providing palliative care are most important in determining how the service is organized and developed. Aim: This study aims to ascertain the perceptions of MHWs about palliative care in their local community, to inform service development. Methods: A qualitative descriptive design, using focus group discussions, was used to collect data from a rural district of Makwanpur, 1 of the 75 districts of Nepal...
April 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29723398/trends-in-incidence-and-5-year-mortality-in-men-with-newly-diagnosed-metastatic-prostate-cancer-a-population-based-analysis-of-2-national-cohorts
#20
John T Helgstrand, Martin A Røder, Nina Klemann, Birgitte G Toft, Daphne Y Lichtensztajn, James D Brooks, Klaus Brasso, Ben Vainer, Peter Iversen
BACKGROUND: Early detection has increased prostate cancer (PCa) incidence. Randomized trials have demonstrated that early detection reduces the incidence of de novo metastatic PCa. Concurrently, life-prolonging treatments have been introduced for patients with advanced PCa. On a populations-based level, the authors analyzed whether early detection and improved treatments changed the incidence and 5-year mortality of men with de novo metastatic PCa. METHODS: Men diagnosed with PCa during the periods 1980 to 2011 and 1995 to 2011 were identified in the US Surveillance, Epidemiology, and End Results (SEER) program and the Danish Prostate Cancer Registry (DaPCaR), respectively, and stratified according to period of diagnosis...
May 3, 2018: Cancer
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