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End-of-life issues

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https://www.readbyqxmd.com/read/28429459/nitric-oxide-donors-nitrates-l-arginine-or-nitric-oxide-synthase-inhibitors-for-acute-stroke
#1
REVIEW
Philip Mw Bath, Kailash Krishnan, Jason P Appleton
BACKGROUND: Nitric oxide (NO) has multiple effects that may be beneficial in acute stroke, including lowering blood pressure, and promoting reperfusion and cytoprotection. Some forms of nitric oxide synthase inhibition (NOS-I) may also be beneficial. However, high concentrations of NO are likely to be toxic to brain tissue. This is an update of a Cochrane review first published in 1998, and last updated in 2002. OBJECTIVES: To assess the safety and efficacy of NO donors, L-arginine, and NOS-I in people with acute stroke...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28427472/optimising-conservative-management-of-chronic-low-back-pain-study-protocol-for-a-randomised-controlled-trial
#2
Katherine J Simson, Clint T Miller, Jon Ford, Andrew Hahne, Luana Main, Timo Rantalainen, Wei-Peng Teo, Megan Teychenne, David Connell, Guy Trudel, Guoyan Zheng, Gary Thickbroom, Daniel L Belavy
BACKGROUND: Lower back pain is a global health issue affecting approximately 80% of people at some stage in their life. The current literature suggests that any exercise is beneficial for reducing back pain. However, as pain is a subjective evaluation and physical deficits are evident in low back pain, using it as the sole outcome measure to evaluate superiority of an exercise protocol for low back pain treatment is insufficient. The overarching goal of the current clinical trial is to implement two common, conservative intervention approaches and examine their impact on deficits in chronic low back pain...
April 20, 2017: Trials
https://www.readbyqxmd.com/read/28426520/nursing-practice-research-and-education-in-the-west-the-best-is-yet-to-come
#3
Heather M Young, Susan Bakewell-Sachs, Linda Sarna
PURPOSE: This paper celebrates the 60th anniversary of the Western Institute of Nursing, the nursing organization representing 13 states in the Western United States, and envisions a preferred future for nursing practice, research, and education. BACKGROUND: Three landmark calls to action contribute to transforming nursing and healthcare: the Patient Protection and Affordable Care Act of 2010; the Institute of Medicine report Future of Nursing: Leading Change, Advancing Health; and the report Advancing Healthcare Transformation: A New Era for Academic Nursing...
April 20, 2017: Nursing Research
https://www.readbyqxmd.com/read/28426217/phosphorus-depletion-as-a-green-alternative-to-biocides-for-controlling-biodegradation-of-metalworking-fluids
#4
Yaldah Azimi, Ian P Thompson
Metalworking fluids (MWFs) are used as lubricants and coolants in the manufacturing operations. Their biodeterioration, whilst in-operation, is a widespread problem leading to poor performance and worker health issues. Adding biocides, though effective in reducing microbial growth, leads to the production of more recalcitrant wastewaters that are difficult to dispose or recycle on-site. Increasing environmental concerns have led to robust legislation for reducing/eliminating the use of toxic biocides in MWFs, stimulating a growing interest in the development/application of alternative biological preservation strategies...
April 20, 2017: Environmental Science & Technology
https://www.readbyqxmd.com/read/28420178/how-older-adults-and-their-families-perceive-family-talk-about-aging-related-eol-issues-a-dialectical-analysis
#5
Nichole Egbert, Jeffrey T Child, Mei-Chen Lin, Carol Savery, Tammy Bosley
For older adults, approaching end-of-life (EOL) brings unique transitions related to family relationships. Unfortunately, most families greatly underestimate the need to discuss these difficult issues. For example, parents approaching EOL issues often struggle with receiving assistance from others, avoiding family conflict, and maintaining their sense of personhood. In addition, discussions of EOL issues force family members to face their parents' mortality, which can be particularly difficult for adult children to process emotionally...
April 17, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/28410172/adolescent-and-young-adult-cancer-survivorship-educational-programming-a-qualitative-evaluation
#6
Deborah Vollmer Dahlke, Kayla Fair, Yan Alicia Hong, Debra Kellstedt, Marcia G Ory
BACKGROUND: This program evaluation considers the need for increased professional and patient education for adolescent and young adult (AYA) cancer survivorship. Due to the high incidence of late effects of cancer treatment among AYA cancer survivors, knowledge sharing and communications are needed throughout the transition from cancer care into community care. AYA survivors are likely to need developmentally appropriate psychosocial care as well as extensive follow-on surveillance by physicians who are educated and aware of the likely chronic conditions and late effects that may occur in these patients...
February 10, 2017: JMIR Cancer
https://www.readbyqxmd.com/read/28404134/effect-of-psychological-therapy-on-disease-activity-psychological-comorbidity-and-quality-of-life-in-inflammatory-bowel-disease-a-systematic-review-and-meta-analysis
#7
David J Gracie, Andrew J Irvine, Ruchit Sood, Antonina Mikocka-Walus, P John Hamlin, Alexander C Ford
BACKGROUND: Inflammatory bowel disease is associated with psychological comorbidity and impaired quality of life. Psychological comorbidity could affect the natural history of inflammatory bowel disease. Psychological therapies might therefore have beneficial effects on disease activity, mood, and quality of life in patients with inflammatory bowel disease. We did a systematic review and meta-analysis examining these issues. METHODS: In this systematic review and meta-analysis, we searched MEDLINE, Embase, Embase Classic, PsychINFO, and the Cochrane Central Register of Controlled Trials for articles published between 1947 and Sept 22, 2016...
March 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28403036/commercial-probiotic-products-a-call-for-improved-quality-control-a-position-paper-by-the-espghan-working-group-for-probiotics-and-prebiotics
#8
Sanja Kolaček, Iva Hojsak, Roberto Berni Canani, Alfredo Guarino, Flavia Indrio, Rok Orel, Bruno Pot, Raanan Shamir, Hania Szajewska, Yvan Vandenplas, Johannes van Goudoever, Zvi Weizman
: Probiotics have been proposed for a number of indications ranging from the hypothetical long term immunomodulatory effects to proven benefits in the management of different clinical conditions.An increasing number of commercial products containing probiotics are available. In those products, irrespective if it is food, food supplement, medical food or drug, the probiotic microorganisms have to be present in a sufficient number by the end of the shelf-life, to pass through the gastrointestinal tract resisting acid and bile, to colonize the gut, and to retain functional properties required to obtain the suggested beneficial effect...
April 11, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28399031/the-advance-care-planning-readiness-scale-development-and-validation-of-a-measure-of-willingness-to-discuss-and-acceptance-of-end-of-life-care-in-gynecologic-cancer-patients
#9
Alaina J Brown, Megan Johnson Shen, Diana Urbauer, Jolyn Taylor, Patricia A Parker, Cindy Carmack, Lauren Prescott, Carly Rosemore, Elizabeth Kolawole, Charlotte Sun, Lois Ramondetta, Diane C Bodurka
OBJECTIVE: The objective of this article was to develop and validate a scale that assesses the readiness of gynecologic oncology patients to engage in advance care planning. METHODS: The Advance Care Planning Readiness Scale (ACPRS) was validated across 3 independent samples of gynecologic oncology patients. In step I, patients underwent cognitive interviewing to determine if the scale items were comprehensible and applicable to patients. Based on this, modifications to the scale (addition, removal, and merger of items) were completed...
April 8, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28398367/-implantable-cardioverter-defibrillator-deactivation-at-the-end-of-life-ethical-clinical-and-communication-issues
#10
Massimo Romanò, Maria Antonella Piga, Roberta Bertona, Roberto Negro, Chiara Ruggeri, Federica Zorzoli, Rosvaldo Villani
The number of cardioverter-defibrillator implants is increasing worldwide, with the main indication being primary prevention of sudden cardiac death. During the follow-up, patients may die from progression of their underlying heart disease or from nonarrhythmic causes, such as malignancies, dementia and lung disease, without receiving appropriate shocks until the last few days or weeks of their life. These events occur roughly in 30% of patients, mainly in the last 24 hours before death. In this case, inappropriate and even appropriate shock deliveries can no longer prolong life and may simply lead to pain and reduced quality of life...
February 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28398131/declarations-on-euthanasia-and-assisted-dying
#11
Hamilton Inbadas, Shahaduz Zaman, Sandy Whitelaw, David Clark
Declarations on end of life issues are advocacy interventions that seek to influence policy, raise awareness and call others to action. Despite increasing prominence, they have attracted little attention from researchers. Our study tracks the emergence, content and purpose of declarations concerned with assisted dying and euthanasia, in the global context. We identified 62 assisted dying/euthanasia declarations covering 1974-2016, and analysed them for: originating organization, geographic scope, format, and stated viewpoint on assisted dying/euthanasia...
April 11, 2017: Death Studies
https://www.readbyqxmd.com/read/28394249/cognitive-behavioural-therapy-and-short-term-psychoanalytic-psychotherapy-versus-brief-psychosocial-intervention-in-adolescents-with-unipolar-major-depression-impact-a-multicentre-pragmatic-observer-blind-randomised-controlled-trial
#12
Ian M Goodyer, Shirley Reynolds, Barbara Barrett, Sarah Byford, Bernadka Dubicka, Jonathan Hill, Fiona Holland, Raphael Kelvin, Nick Midgley, Chris Roberts, Rob Senior, Mary Target, Barry Widmer, Paul Wilkinson, Peter Fonagy
BACKGROUND: Although there are effective psychological treatments for unipolar major depression in adolescents, whether or not one or more of the available therapies maintain reduced depressive symptoms 1 year after the end of treatment is not known. This is a non-trivial issue because maintaining lowered depressive symptoms below a clinical threshold level reduces the risk for diagnostic relapse into the adult years. OBJECTIVE: To determine whether or not either of two specialist psychological treatments, cognitive-behavioural therapy (CBT) or short-term psychoanalytic psychotherapy (STPP), is more effective than a reference brief psychosocial intervention (BPI) in maintaining reduction of depression symptoms in the year after treatment...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28393995/-euthanasia-in-chile
#13
Víctor Hugo Carrasco M, Francisca Crispi
Euthanasia is a complex medical procedure. Even though end of life decisions are common situations in health practice, there is a lack of consensus about their terminology. In this manuscript, the main concepts about this issue are defined and delimited; including active and passive euthanasia and limitation of therapeutic effort. Then, a revision is made about the international experience on euthanasia, to then go through the Chile’s history in euthanasia and the population’s opinion. In Chile, euthanasia is an act that has been removed from the social dialogue and legislation...
December 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28393347/-an-experience-of-providing-palliative-care-in-a-long-term-care-facility-let-good-death-in-place-become-a-feasible-reality
#14
Ming-Mei Chen, Chun-Chen Chou, Kuei-Ying Hsu, Yung-Feng Yen, Ya-Ting Yang, Hsiu-Li Huang
As the number of elderly in long-term care facilities (LTCFs) continues to increase, the number of resident deaths in these facilities is expected to increase. Thus, LTCFs may become a main focus for end-of-life (EoL) care in the future. Therefore, promoting quality EoL care in LTCFs should be a priority issue. Currently, the four types of hospice services include hospice wards and hospice-share-services in hospitals and home hospice care and community hospice care in patient homes. However, to date, there has been limited discussion regarding promoting palliative care in LTCFs...
April 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28387818/ethics-and-the-cardiac-pacemaker-more-than-just-end-of-life-issues
#15
Katrina Hutchison, Robert Sparrow
For many years, ethical debate about pacemakers has focused on whether and under what circumstances they may be turned off in end of life care. Several other important ethical issues have been neglected, perhaps because the dilemmas they pose for cardiologists are not so immediate. These include: potential conflicts of interest, particularly those arising from the role of industry employed allied professionals (IEAPs) in pacemaker care; unanticipated impacts of commercial competition and the device improvement cycle; risks associated with remotely accessible software; equity in access to healthcare; and questions about reuse of explanted pacemakers in low and middle income countries...
April 6, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28384309/-if-i-had-stayed-back-home-i-would-not-be-alive-any-more%C3%A2-exploring-end-of-life-preferences-in-patients-with-migration-background
#16
Piret Paal, Johannes Bükki
BACKGROUND: In patients with life-limiting conditions and a history of migration, a higher risk of not dying at home and limited access to palliative care services has been reported. AIM: To explore the views and end-of-life preferences of patients with a migration history in Germany and to identify migration specific themes. DESIGN: Two-armed study using Kaufmann's 'understanding interview' ('focused interview') method and grounded theory approach...
2017: PloS One
https://www.readbyqxmd.com/read/28374104/understanding-patient-needs-without-understanding-the-patient-the-need-for-complementary-use-of-professional-interpreters-in-end-of-life-care
#17
Demi Krystallidou, Ignaas Devisch, Dominique Van de Velde, Peter Pype
High-quality doctor-patient communication in end-of-life care results in better quality of life for patients. In linguistically and culturally diverse societies, language discordant consultations become daily practice, leading to difficulties in eliciting patient preferences toward end-of-life care. Although family members invariably act as informal interpreters, this may cause some ethical dilemmas. We present a case of a palliative patient whose son acted as an interpreter. This case generated a triple- layered ethical dilemma: (i) how to safeguard patient autonomy against paternalistic interventions by family members, (ii) how to respect the relational context in which patient autonomy can be realized, and (iii) how to respect the ethno-cultural values of the patient and his family...
April 3, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28367463/fourth-year-medical-students-reflective-writing-on-death-of-ivan-ilych-a-qualitative-study
#18
Mahshid Zohouri, Mitra Amini, Mohammad Mehdi Sagheb
INTRODUCTION: Medical students should be familiar with the end of life ethical issues and its considerations. For teaching end of life care to medical students, literature is a source of excellent narratives of patients with experiences of terminally ill condition in their journey through suffering and one of the most favourite bioethics literature readings has been the death of Ivan Ilych by Tolstoy. We used this novel to show medical students end of life events and suffering and asked them to write a reflective essay on it...
April 2017: Journal of Advances in Medical Education & Professionalism
https://www.readbyqxmd.com/read/28361632/advance-care-planning-for-people-with-dementia
#19
(no author information available yet)
UK policy and guidance state that people should have their preferences and priorities for end of life care recorded in the form of an advance care plan. However, for people with dementia and their families, issues of reduced capacity, difficulties with discussing end of life preferences and staff understanding can make this process challenges. This research focus summarises two studies that explore these issues.
March 31, 2017: Nursing Older People
https://www.readbyqxmd.com/read/28361048/screening-for-hypertension-in-children-and-adolescents-methodology-and-current-practice-recommendations
#20
REVIEW
Michaela N Lewis, Ibrahim F Shatat, Shannon M Phillips
Hypertension (HTN) requires urgent, uniform, and consistent attention across all frontiers of pediatric health care not only because of established links between the onset of HTN during one's youth and its sustenance throughout adulthood but also because of the sequelae associated with the disease's trajectory, such as cardiovascular disease, end organ damage, and decreased quality of life. Although national guidelines for the diagnosis and management of pediatric HTN have been available for nearly 40 years, knowledge and recognition of the problem by clinicians remain poor due to a host of influencing factors...
2017: Frontiers in Pediatrics
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