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End-of-life issues

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https://www.readbyqxmd.com/read/28534004/integrating-health-and-transportation-in-nashville-tennessee-usa-from-policy-to-projects
#1
Leslie A Meehan, Geoffrey P Whitfield
The Nashville Area Metropolitan Planning Organization (MPO) is among the first MPOs in the United States to recognize the interplay of transportation and public health, particularly regarding physical activity, air pollution, and traffic crashes. The Nashville MPO has taken a multifaceted approach to simultaneously improve the transportation system, quality of life, and health status of the region's population. The purpose of this paper is to describe the multiple programs and projects that the MPO has undertaken to this end, so that other cities might learn from Nashville's example...
March 2017: Journal of Transport & Health
https://www.readbyqxmd.com/read/28533101/personal-attitudes-toward-weight-in-overweight-and-obese-us-hemodialysis-patients
#2
Zeb Saeed, Kevin M Janda, Bryan M Tucker, Lacey Dudley, Patricia Cutter, Allon N Friedman
OBJECTIVE: Overweight and obesity have become increasingly common among end-stage renal disease patients on hemodialysis. Yet, little attention has been given to what hemodialysis patients themselves think of their weight, how they perceive it affects their health, and their attitudes about or desire for weight reduction. We explored these issues using a survey that we designed specifically for the dialysis population. DESIGN AND METHODS: Sixty-six chronic hemodialysis patients from a US urban center with a body mass index ≥25 kg/m(2) and stable weight were recruited to participate in a cross-sectional study...
May 19, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/28526563/live-cell-imaging-and-analysis-of-lipid-droplets-biogenesis-in-hcv-infected-cells
#3
Inbar Nevo-Yassaf, Marcos Lovelle, Yaacov Nahmias, Koret Hirschberg, Ella H Sklan
Lipid droplets (LDs) are regulated neutral lipid storage organelles having a central role in numerous cellular processes as well as in various pathologies such as metabolic disorders, immune responses and during pathogen infection. Several viruses were found to use the interface between the endoplasmic reticulum (ER) and LDs as the site for replication and assembly. Due to the growing significance of LDs, extensive efforts are made to study the mechanism and the dynamics of their formation and life history and how are these diverted or modified by pathogens...
May 16, 2017: Methods: a Companion to Methods in Enzymology
https://www.readbyqxmd.com/read/28507610/improving-patient-safety-in-hospitals-through-usage-of-cloud-supported-video-surveillance
#4
Predrag Dašić, Jovan Dašić, Bojan Crvenković
BACKGROUND: Patient safety in hospitals is of equal importance as providing treatments and urgent healthcare. With the development of Cloud technologies and Big Data analytics, it is possible to employ VSaaS technology virtually anywhere, for any given security purpose. AIM: For the listed benefits, in this paper, we give an overview of the existing cloud surveillance technologies which can be implemented for improving patient safety. MATERIAL AND METHODS: Modern VSaaS systems provide higher elasticity and project scalability in dealing with real-time information processing...
April 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28503041/pediatric-end-of-life-care-barriers-and-facilitators-perception-of-nursing-professionals-in-jordan
#5
Omar Mohammad Khraisat, Nemeh Ahmad Alakour, Teresa M O'Neill
INTRODUCTION: End-of-life care is a critical issue for pediatric population with terminal illness to ensure the best possible quality of care for them and their families. A survey was conducted to identify the barriers and facilitators to provide pediatric end-of-life care. METHODS: A descriptive cross-sectional study was conducted at three tertiary centers providing end-of-life care in Jordan. Two hundred critical care nurses were surveyed (response rate 93%). RESULTS: Nurses reported moderate level of experience in all areas of delivering pediatric end-of-life care...
April 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28501793/ethical-issues-in-death-dying-and-palliation-the-ijme-sixth-national-bioethics-conference
#6
Rakhi Ghoshal, V Deepa, Sunita Simon Kurpad
The IJME Sixth National Bioethics Conference (6th NBC), on the theme "Healing and dying with dignity: ethical issues in palliative care, end-of-life care and euthanasia", was held in Pune, Maharashtra from January 12-15, 2017. Palliative care (PC) and end-of-life care (EOLC) are closely related areas of concern, yet they have been neglected so far. There is an urgent need to discuss these issues in India due to the changing demographics, socioeconomic and work profiles of the population, people's living conditions and health status, and the contexts of the country's population...
May 10, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28499745/distress-in-caregivers-accompanying-patients-to-an-emergency-department-a-scoping-review
#7
Thom Ringer, Daniel Moller, Adam Mutsaers
BACKGROUND: Despite substantial research interest in caregiver distress in the emergency department (ED), no recent review of the literature exists. OBJECTIVE: Our aims were to map primary research on caregiver distress in the ED, synthesize key concepts underpinning the literature, identify gaps, and provide guidance for future work. METHODS: We used a five-stage scoping review with tandem screening and data extraction. RESULTS: Of 2121 records, 29 studies were included...
May 9, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28493926/obesity-and-access-to-kidney-transplantation-in-patients-starting-dialysis-a-prospective-cohort-study
#8
Mathilde Lassalle, Léopold K Fezeu, Cécile Couchoud, Thierry Hannedouche, Ziad A Massy, Sébastien Czernichow
BACKGROUND: Obesity has been linked to poor access to medical care. Although scientific evidence suggest that kidney transplantation improves survival and quality of life in obese patients with end-stage renal disease (ESRD), few data exist on the impact of obesity on access to kidney transplantation in this population. OBJECTIVES: We aimed to characterize the relationships between body mass index (BMI) at the start of dialysis, changes in BMI after the start of dialysis, and either access to kidney transplantation or overall mortality in dialysis or transplantation among ESRD patients...
2017: PloS One
https://www.readbyqxmd.com/read/28486892/cardiopulmonary-resuscitation-from-the-patient-s-perspective
#9
S Wee, Z Y Chang, Y H Lau, Yky Wong, Cym Ong
With increasing emphasis on patient autonomy, patients are encouraged to be more involved in end-of-life issues, including the use of extraordinary efforts to prolong their lives. Being able to make anticipatory decisions is seen to promote autonomy, empower patients and optimise patient care. To facilitate shared decision-making, patients need to have a clear and accurate understanding of cardiopulmonary resuscitation (CPR). This study aims to understand the knowledge and perspectives of the local community regarding resuscitation options and end-of-life decision-making and to explore ways to improve the quality of end-of-life discussions...
May 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28483923/rethinking-priorities-experience-of-an-educational-initiative-to-change-attitudes-behaviours-and-clinical-practice-in-end-of-life-care
#10
Annette Edwards, Viv Barros D'Sa, Fiona Hicks
To implement the National End of Life Care strategy and enable more people to express and achieve their preferences about care at the end of life, senior clinicians outside palliative medicine need to make it a routine part of their practice. However, it is acknowledged that recognising that people are entering the last phase of their illness is not always straightforward, and having conversations about aims of treatment and planning for future care may not be easy. In order to begin to address these challenges, funding was sought from the Yorkshire and the Humber Strategic Health Authority (SHA), and subsequently Health Education England, Yorkshire and the Humber (HEEYH), to pilot a development programme in 2 acute trusts...
May 8, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28483444/critical-care-clinician-perceptions-of-factors-leading-to-medical-emergency-team-review
#11
Judy Currey, Josh Allen, Daryl Jones
BACKGROUND: The introduction of rapid response systems has reduced the incidence of in-hospital cardiac arrest; however, many instances of clinical deterioration are unrecognised. Afferent limb failure is common and may be associated with unplanned intensive care admissions, heightened mortality and prolonged length of stay. Patients reviewed by a Medical Emergency Team are inherently vulnerable with a high in-hospital mortality. OBJECTIVE: To explore perceptions of intensive care unit (ICU) staff who attend deteriorating acute care ward patients regarding current problems, barriers and potential solutions to recognising and responding to clinical deterioration that culminates in a Medical Emergency Team review...
May 5, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28479121/ethical-considerations-and-palliative-care-in-patients-with-amyotrophic-lateral-sclerosis-a-review
#12
REVIEW
V Danel-Brunaud, L Touzet, L Chevalier, C Moreau, D Devos, S Vandolaeghe, L Defebvre
Amyotrophic lateral sclerosis (ALS) is not a curable disease, but it is treatable. By definition, much of the care provided to ALS patients is palliative, even though active life-sustaining strategies are available to prolong survival. Healthcare professionals must develop communication skills that help patients cope with the inexorable progression of the disease and the inevitability of death. Symptomatic treatments as well as respiratory insufficiency and nutritional life-sustaining therapies must be regularly evaluated as the disease progresses, without losing sight of the burden placed on the patient's non-professional caregivers...
May 4, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28478847/the-preoperative-reaction-and-decision-making-process-regarding-colostomy-surgery-among-chinese-rectal-cancer-patients
#13
Jun-E Zhang, Frances Kam Yuet Wong, Mei-Chun Zheng
PURPOSE: Patients with rectal cancer have issues in adjusting to their permanent colostomy after surgery, and support is required to help them resume normal life. However, few studies have explored the experience and factors that affect a patient's decision-making and maladjustment prior to colostomy surgery. The aim of this study was to explore the experience of rectal cancer patients who have to undergo colostomy surgery. METHOD: A descriptive, qualitative design was used...
June 2017: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
https://www.readbyqxmd.com/read/28476218/-bioethics-in-end-of-life-decisions-in-neonatology-unresolved-issues
#14
Juan Arnaez, Juan Carlos Tejedor, Sonia Caserío, María Teresa Montes, María Teresa Moral, Javier González de Dios, Alfredo García-Alix
This document is the result of previous work carried out by different expert groups and submitted to multidisciplinary debate at a Conference about controversial, deficient, or new aspects in the field of neonatal palliative care, such as: 1) the deliberative decision-making process, 2) hospital and domiciliary palliative care, 3) donation after controlled cardiac death, and 4) moral stress in professionals. The most relevant conclusions were: the need to instruct professionals in bioethics and in the deliberative method to facilitate thorough and reasonable decision-making; the lack of development in the field of perinatal palliative care and domiciliary palliative care in hospitals that attend newborns; the need to provide neonatal units with resources that help train professionals in communication skills and in the management of moral distress, as well as delineate operational procedure and guidelines for neonatal organ donation...
May 2, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28469984/do-not-resuscitate-brain-death-and-organ-transplantation-islamic-perspective
#15
REVIEW
Hassan Chamsi-Pasha, Mohammed Ali Albar
Muslim patients and families are often reluctant to discuss and accept fatal diagnoses and prognoses. In many instances, aggressive therapy is requested by a patient's family, prolonging the life of the patient at all costs. Islamic law permits the withdrawal of futile treatment, including life support, from terminally ill patients allowing death to take its natural course. "Do not resuscitate" is permitted in Islamic law in certain situations. Debate continues about the certainty of brain death criteria within Islamic scholars...
April 2017: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/28467581/can-we-make-an-early-do-not-resuscitate-decision-in-severe-burn-patients
#16
Yücel Yüce, Hakan Ahmet Acar, Kutlu Hakan Erkal, Erhan Tuncay
BACKGROUND: The present study was conducted to examine topic of issuing early do-not-resuscitate (DNR) order at first diagnosis of patients with severe burn injuries in light of current law in Turkey and the medical literature. DNR requires withholding cardiopulmonary resuscitation in event of respiratory or cardiac arrest and allowing natural death to occur. It is frequently enacted for terminal cancer patients and elderly patients with irreversible neurological disorders. METHODS: Between January 2009 and December 2014, 29 patients (3...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28461024/care-management-in-amyotrophic-lateral-sclerosis
#17
REVIEW
M-H Soriani, C Desnuelle
Amyotrophic lateral sclerosis (ALS) is a relentlessly progressive and fatal neurodegenerative disease characterized by progressive weakness of voluntary muscles of movement as well as those for swallowing, speech and respiration. In the absence of curative treatment, care can improve quality of life, prolong survival, and support ALS patients and their families, and also help them to anticipate and prepare for the end of life. Multidisciplinary management in tertiary centers is recommended in close collaboration with general practitioners, home carers and a dedicated health network...
April 28, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28460515/life-sustaining-treatment-and-palliative-care-in-patients-with-liver-cirrhosis-legal-ethical-and-practical-issues
#18
Dong Joon Kim, Moon Seok Choi
With the enactment of the 'Act on Decisions on Life-Sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life' (Act No. 14013) in Korea, there is growing concern about the practicality of this law. In this review, we discuss definitions, ethics, and practical issues related to this law.
May 2, 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28445277/cancer-studies-based-on-secondary-data-analysis-of-the-taiwan-s-national-health-insurance-research-database-a-computational-text-analysis-and-visualization-study
#19
Jui-Kun Chiang, Chih-Wen Lin, Chun-Lung Wang, Malcolm Koo, Yee-Hsin Kao
There has been a surge in the academic publication output based on secondary analyses of the data from the Taiwan's National Health Insurance claim records. It has become a challenge to comprehend such a rapid expansion of the literature. Therefore, this study aimed to explore the conceptual content of National Health Insurance Research Database-based cancer research, using the abstract of articles extracted from PubMed between 2002 and 2015. Search terms including "National Health Insurance Research Database (NHIRD) AND Taiwan," "Taiwan AND population-based," and "Taiwan AND nationwide" were used to search in PubMed with the publication date limited to between 1997 and 2015...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28441339/still-searching-a-meta-synthesis-of-a-good-death-from-the-bereaved-family-member-perspective
#20
REVIEW
Kelly E Tenzek, Rachel Depner
The concept of a good death continues to receive attention in end-of-life (EOL) scholarship. We sought to continue this line of inquiry related to a good death by conducting a meta-synthesis of published qualitative research studies that examined a good death from the bereaved family member's perspective. Results of the meta-synthesis included 14 articles with 368 participants. Based on analysis, we present a conceptual model called The Opportunity Model for Presence during the EOL Process. The model is framed in socio-cultural factors, and major themes include EOL process engagement with categories of healthcare participants, communication and practical issues...
April 25, 2017: Behavioral Sciences
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