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End-of-life issues

Ali Hassan Sodhro, Arun Kumar Sangaiah, Gul Hassan Sodhro, Sonia Lohano, Sandeep Pirbhulal
Rapid progress and emerging trends in miniaturized medical devices have enabled the un-obtrusive monitoring of physiological signals and daily activities of everyone's life in a prominent and pervasive manner. Due to the power-constrained nature of conventional wearable sensor devices during ubiquitous sensing (US), energy-efficiency has become one of the highly demanding and debatable issues in healthcare. This paper develops a single chip-based wearable wireless electrocardiogram (ECG) monitoring system by adopting analog front end (AFE) chip model ADS1292R from Texas Instruments...
March 20, 2018: Sensors
Franziska A Herbst, Maria Heckel, Johanna M Tiedtke, Thomas Adelhardt, Alexander Sturm, Stephanie Stiel, Christoph Ostgathe
BACKGROUND: There is a lack of research into how hospital staff and institutional stakeholders (i. e. institutional representatives from public health authorities, hospital hygiene, and the departments of microbiology, palliative care, and geriatrics) engage with patients who are carriers of multidrug-resistant organisms and receiving end-of-life care. Knowledge of their experiences, workload, and needs should be considered in dealing with hospitalized carriers of multidrug-resistant organisms as well as staff education...
March 16, 2018: Zeitschrift Für Gerontologie und Geriatrie
K Ganapathy
Until six decades ago, death was considered to be a specific point in time, referring to the moment at which life ends. With the availability of ventilators, even determining when death has occurred is becoming difficult, as cessation of life functions is often not simultaneous across organ systems. With increasing accessibility to intensive care units (ICUs) even in Tier II and Tier III cities, and the government making it mandatory to notify brain death to facilitate cadaveric organ transplants, it behooves the neurosurgeon and neurologist to totally understand the minutiae of brain death...
March 2018: Neurology India
Rieke Schnakenberg, Lukas Radbruch, Christine Kersting, Friederike Frank, Stefan Wilm, Denise Becka, Klaus Weckbecker, Markus Bleckwenn, Johannes M Just, Michael Pentzek, Birgitta Weltermann
BACKGROUND: Although general practitioners (GPs) are among the preferred contact persons for discussing end-of-life issues including advance directives (ADs), there is little data on how GPs manage such consultations. OBJECTIVES: This postal survey asked German GPs about their counselling for end-of-life decisions. METHODS: In 2015, a two-sided questionnaire was mailed to 959 GPs. GPs were asked for details of their consultations on ADs: frequency, duration, template use, and whether they have own ADs...
December 2018: European Journal of General Practice
Tarek Nehad, Tamer Salem, Mohamed Nagy Elmohamady
Background: Convergence Insufficiency (CI) is a common binocular vision disorder characterized by exophoria more at near than at far, a receded Near Point of Convergence (NPC), and decreased Positive Fusional Vergence (PFV) at near. This disorder is often associated with several symptoms that may disturb the person's quality of life. Therefore, diagnosis and treatment of CI is a vital issue. Objectives: To compare therapeutic yield of Office Based Vision Therapy (OBVT) and combined OBVT with Home Therapy System (HTS) in patients with CI...
2018: Open Ophthalmology Journal
Julie L Masters, Paige M Toller, Nancy J Kelley, Lyn M Holley
Death is among the most avoided topics of conversation. Although end-of-life planning may greatly benefit individuals and their survivors, research and practice indicate that family, friends, and even health care providers resist discussing end-of-life plans. Consequences of not planning ahead have created a public health issue. This article describes a community-level intervention that facilitates those necessary conversations among elders who have at least begun to talk with others about their wishes. A free, three-part educational workshop series on end-of-life planning titled "Begin with the End in Mind" was developed at a midwestern university...
March 12, 2018: Gerontology & Geriatrics Education
Aydan Akyüz Özdemir, Cihat Burak Sayın, Rengin Erdal, Cihangir Özcan, Mehmet Haberal
OBJECTIVES: The aim of the study was to evaluate the quality of life of patients with end-stage renal disease through a "gender role perspective." Patients were on hemodialysis treatment and on a wait list for transplant. MATERIALS AND METHODS: This study was conducted at the Başkent University Adana, Ankara, and Istanbul hemodialysis centers. Patients completed Short Form 36 Health Survey questionnaires voluntarily to evaluate quality of life. The questions were answered independently by patients while they were undergoing hemodialysis treatment...
March 2018: Experimental and Clinical Transplantation
Sagrario Pérez-de la Cruz, Amelia Victoria García-Luengo
The purpose of this study was to explore the perceptions and attitudes of students of health sciences faculties (medicine, nursing, and physiotherapy) regarding specific issues related to death and end of life in both professional and personal realms. A descriptive, cross-sectional, and multi-center approach was used. The modified Bugen Scale for facing death was used. The study population (411 students) encompassed three distinct groups: students from the degrees of medicine, nursing, and physiotherapy. In total, 12 items showed significant differences between the three groups...
March 9, 2018: Nursing & Health Sciences
Kristian Pollock, Jane Seymour
This is the second in an occasional series of paired commentaries in Age and Ageing, the Journal of the British Geriatrics Society and the Journal of the American Geriatrics Society (JAGS). The aim is to address issues of current significance and to foster dialogue and increased understanding between academics and clinicians working in comparative international settings. Both commentaries address the urgent need to improve palliative care for older people, with a critique of some stereotypes surrounding palliative care and the 'good death'...
March 6, 2018: Age and Ageing
C L Jay, M M Abecassis
For decades, evidence has been available demonstrating the superiority of kidney transplantation for patients with end-stage renal disease (ESRD) compared with dialysis in terms of improved survival, better quality of life, and long-term cost-effectiveness.(1, 2) Yet, many barriers continue to exist to increasing patient access to kidney transplant through utilization of higher risk deceased donor kidney transplants (DDKT) or blood type (ABO) or immunologically (HLA) incompatible living donor kidney transplants (LDKT)...
March 7, 2018: American Journal of Transplantation
Lauren R Bangerter, Joan M Griffin, Arielle Eagan, Manish Mishra, Angela Lunde, Véronique Roger, Albert Mulley, Jon Lotherington
Objective: In December 2016, 66 health leaders from 14 countries convened at the Salzburg Global Seminar (SGS) to engage in cross-cultural and collaborative discussions centered on 'Rethinking Care Toward the End of Life'. Conversations focused on global perspectives on death and dying, challenges experienced by researchers, physicians, patients and family caregivers. This paper summarizes key findings and recommendations from SGS. Design: Featured sessions focused on critical issues of end of life care led by key stakeholders, physicians, researchers, and other global leaders in palliative care...
March 2, 2018: International Journal for Quality in Health Care
Nicolino Ambrosino, Michele Vitacca
Background: Progress in management has improved hospital mortality of patients admitted to the intensive care units, but also the prevalence of those patients needing weaning from prolonged mechanical ventilation, and of ventilator assisted individuals. The result is a number of difficult clinical and organizational problems for patients, caregivers and health services, as well as high human and financial resources consumption, despite poor long-term outcomes. An effort should be made to improve the management of these patients...
2018: Multidisciplinary Respiratory Medicine
Jane M Ussher, Janette Perz
BACKGROUND: Infertility is a major concern for people with cancer and their partners. There have been calls for further research on the gendered nature of psychosocial, emotional and identity concomitants of fertility post-cancer across women and men. METHOD: The gendered construction and experience of infertility following cancer was examined through a survey of 693 women and 185 men, and in-depth one-to-one interviews with a subsample of survey respondents, 61 women and 17 men, purposively selected across cancer types and age groups...
March 5, 2018: BMC Cancer
Meera Balasubramaniam
Geriatricians are increasingly encountering older adults expressing suicidal wishes in the absence of overt mental illness. This is expected to grow as life expectancy increases. This article describes the case of an older adult who expressed the wish to end his life in the absence of a diagnosable mental illness. Although he had chronic medical illnesses, he was not terminally ill. The complex subject of rational suicide in elderly adults is approached from a clinician's perspective. Issues of ageism, gerontophobia, and changing perspectives on death are highlighted...
March 2, 2018: Journal of the American Geriatrics Society
N Rose Gaston, Jill M Randall, Lisa R Kiesel
Physician-assisted suicide (PAS) is explicitly legal in five states and by court decision in one. Legislative bills have been introduced in other states including Minnesota, Iowa, and Wisconsin. This quantitative study was designed to understand Midwest, hospice and palliative care at end-of-life social workers' attitudes toward PAS, preferred terminology, perception of preparedness for the implementation, and awareness of PAS legislation in their state. Sixty-two social workers from Minnesota, Iowa, and Wisconsin completed an anonymous online survey...
March 1, 2018: Journal of Social Work in End-of-life & Palliative Care
Christiane S Hartog, Konrad Reinhart
PURPOSE OF REVIEW: End-of-life (EOL) care can be stressful for clinicians as well as patients and their relatives. Decisions to withhold or withdraw life-sustaining therapy vary widely depending on culture, beliefs and organizational norms. The following review will describe the current understanding of the problem and give an overview over interventional studies. RECENT FINDINGS: EOL care is a risk factor for clinician burnout; poor work conditions contribute to emotional exhaustion and intent to leave...
April 2018: Current Opinion in Anaesthesiology
Gail Ewing, Lynn Austin, Debra Jones, Gunn Grande
BACKGROUND: Carer factors prevent patients achieving timely and appropriate hospital discharge. There is a lack of research into interventions to support carers at hospital discharge. AIM: To explore whether and how family carers are currently supported during patient discharge at end of life; to assess perceived benefits, acceptability and feasibility of using The Carer Support Needs Assessment Tool (CSNAT) Approach in the hospital setting to support carers. DESIGN: Qualitative...
February 1, 2018: Palliative Medicine
A Ηatzioannou, M Karanikola, E Papathanasoglou, Aik Kaikoushi, M Nystazaki, G Alevizopoulos
Bipolar disorder (BD) encompasses neuro-cognitive disturbances leading to psychological and social consequences affecting the quality of life of those suffering from it. However, the number of studies on the lived experience of people with BD about the treatment provided is relatively scant. The aim of this study is to investigate the lived experience of people with BD, focused on their perceptions and meanings about the treatment provided for their disorder. A qualitative, phenomenological design was applied...
October 2017: Psychiatrikē, Psychiatriki
Wendy Ann Webb, Theresa Mitchell, Brian Nyatanga, Paul Snelling
Homelessness is a complex and multidimensional issue often involving a combination of personal vulnerability, the limitations of social housing, and inadequacies in welfare support. Providing palliative and end-of-life care to people experiencing homelessness is challenging, both to individuals receiving care and nurses aiming to meet their complex needs. This article discusses what is understood by the concept of 'homelessness' and examines the barriers to accessing effective healthcare for people who are homeless and have life-limiting conditions...
February 28, 2018: Nursing Standard
Atsushi Asai, Sakiko Masaki, Taketoshi Okita, Aya Enzo, Yasuhiro Kadooka
BACKGROUND: Destination therapy (DT) is the permanent implantation of a left ventricular assist device (LVAD) in patients with end-stage, severe heart failure who are ineligible for heart transplantation. DT improves both the quality of life and prognosis of patients with end-stage heart failure. However, there are also downsides to DT such as life-threatening complications and the potential for the patient to live beyond their desired length of life following such major complications...
February 27, 2018: BMC Medical Ethics
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