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Primary palliative care

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https://www.readbyqxmd.com/read/29145313/the-importance-of-family-caregiving-to-achieving-palliative-care-at-home-a-case-report-of-end-of-life-breast-cancer-in-an-area-struck-by-the-2011-fukushima-nuclear-crisis-a-case-report
#1
Akihiko Ozaki, Masaharu Tsubokura, Claire Leppold, Toyoaki Sawano, Manabu Tsukada, Tsuyoshi Nemoto, Kazuhiro Kosugi, Yoshitaka Nishikawa, Shigeaki Kato, Hiromichi Ohira
RATIONALE: The primary setting of palliative care has shifted from inpatient care to patients' residences. Family caregiving is essential for patients with life-limiting illnesses to receive palliative care at home, however little information is available regarding potential interventions to achieve palliative homecare for those without sufficient support from family members in various settings, including disasters. PATIENT CONCERNS: In March 2011, Fukushima, Japan experienced an earthquake, tsunami and nuclear disaster...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29144543/primary-thromboprophylaxis-in-individuals-without-cancer-admitted-to-a-geriatric-palliative-care-unit
#2
Adam J Gurau, Anna Berall, Jurgis Karuza, Giulia-Anna Perri
BACKGROUND/OBJECTIVES: The prevalence of individuals with advanced noncancer disease is increasing on palliative care units (PCUs), but there are no current guidelines to direct venous thromboembolism (VTE) prophylaxis decisions in these individuals. The aim of this study was to compare primary VTE prophylaxis in elderly adults with advanced noncancer diagnoses with that of those with advanced cancer on a dedicated geriatric PCU. DESIGN: Single-center retrospective chart review...
November 16, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29143390/chemotherapy-and-healthcare-utilisation-near-the-end-of-life-in-patients-with-cancer
#3
K J G Schulkes, I C van Walree, L J R van Elden, F van den Bos, L van Huis-Tanja, J-W J Lammers, D Ten Bokkel Huinink, M E Hamaker
The quality of medical care delivered to patients with cancer near the end of life is a significant issue. Previous studies have defined several areas suggestive of aggressive cancer treatment as potentially representing poor quality care. The primary objective of current analysis was to examine chemotherapy and healthcare utilisation in the last 3 months of life among patients with cancer that received palliative chemotherapy. Patients were selected from the hospital administration database of the Diakonessenhuis Utrecht, the Netherlands...
November 16, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/29140139/health-related-quality-of-life-in-different-states-of-breast-cancer-comparing-different-instruments
#4
Mervi Rautalin, Niilo Färkkilä, Harri Sintonen, Tiina Saarto, Kimmo Taari, Tiina Jahkola, Risto P Roine
BACKGROUND: The prognosis of breast cancer has improved significantly during the last few decades increasing the interest in health-related quality of life (HRQoL). The aim of this study was to compare the HRQoL scores produced by different instruments and to shed light on their validity in various states of breast cancer by studying the association of cancer-related symptoms with HRQoL. MATERIAL AND METHODS: An observational, cross-sectional study of breast cancer patients treated in the Helsinki and Uusimaa Hospital District from September 2009 to April 2011...
November 15, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/29139565/leukocyte-adhesion-defect-i-rare-primary-immune-deficiency
#5
Nitesh Tewari, Vijay Prakash Mathur, Vikender Singh Yadav, Prabhat Chaudhari
Leukocyte adhesion defect I is a rare disorder (1:1,000,000) caused by diminished expression of CD-18 β2 integrins on leukocytes leading to abnormal adhesion, migration, and chemotaxis. Clinical manifestations include delayed separation of umbilical cord, omphalitis, recurrent severe infections, impaired wound healing, persistent oral ulcers, and severe periodontitis in primary and permanent dentition. A 5-year-old girl, second-born child to parents with consanguinity, presented with pain and mobility of lower teeth...
November 15, 2017: Special Care in Dentistry
https://www.readbyqxmd.com/read/29138955/the-impact-of-palliative-care-training-for-oncologists-and-integrative-palliative-service-in-a-public-funded-hospital-cluster-a-retrospective-cohort-study
#6
Pak-Lun Lam, Tai-Chung Lam, Cheuk-Wai Choi, Anne Wing-Mui Lee, Kwok-Keung Yuen, To-Wai Leung
PURPOSE: Oncological care of advanced cancer patients was provided by multiple departments in Hong Kong. One of these departments, the clinical oncology department (COD), introduced systematic palliative care training for its oncologists since 2002. The COD was recognized as a European Society for Medical Oncology (ESMO) Designated Centre of Integrated Oncology and Palliative Care since 2009. This retrospective cohort study aims to review the impact of integrative training and service on palliative care coverage and outcome...
November 14, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29129740/survey-on-neonatal-end-of-life-comfort-care-guidelines-across-america
#7
Shelly Haug, Sara Farooqi, Christopher G Wilson, Andrew Hopper, Grace Oei, Brian Carter
CONTEXT: Infants of age < 1 year have the highest mortality rate in pediatrics. The American Academy of Pediatrics (AAP) published guidelines for palliative care in 2013, however, significant variation persists among local protocols addressing neonatal comfort care at the end-of-life (EOL). OBJECTIVES: The purpose of this study was to evaluate current neonatal EOL comfort care practices and clinician satisfaction across America METHODS: After Institutional Review Board approval (516005), an anonymous, electronic survey was sent to members of the AAP Section on Neonatal-Perinatal Medicine...
November 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29129177/copd-x-australian-and-new-zealand-guidelines-for-the-diagnosis-and-management-of-chronic-obstructive-pulmonary-disease-2017-update
#8
Ian A Yang, Juliet L Brown, Johnson George, Sue Jenkins, Christine F McDonald, Vanessa M McDonald, Kirsten Phillips, Brian J Smith, Nicholas A Zwar, Eli Dabscheck
Chronic obstructive pulmonary disease (COPD) is characterised by persistent respiratory symptoms and chronic airflow limitation, and is associated with exacerbations and comorbidities. Advances in the management of COPD are updated quarterly in the national COPD guidelines, the COPD-X plan, published by Lung Foundation Australia in conjunction with the Thoracic Society of Australia and New Zealand and available at http://copdx.org.au. Main recommendations: Spirometry detects persistent airflow limitation (post-bronchodilator FEV1/FVC < 0...
November 20, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/29125784/identifying-the-population-with-serious-illness-the-denominator-challenge
#9
Amy S Kelley, Evan Bollens-Lund
BACKGROUND: To ensure seriously ill people and their families receive high-quality primary and specialty palliative care services, rigorous methods are needed to prospectively identify this population. OBJECTIVE: To define and operationalize a definition of serious illness for the purpose of identifying patients and caregivers who need primary or specialty palliative care services. DESIGN/SETTING: Two stages of work included (1) building expert consensus around a conceptual definition of serious illness and (2) using the National Health and Aging Trends Study linked to Medicare claims data to test a range of operational definitions composed of diagnoses, utilization, and markers of care needs...
November 10, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29123348/symptom-prevalence-in-patients-with-advanced-incurable-illness-in-bangladesh
#10
Megan Doherty, Farzana Khan, Fazle Noor Biswas, Marufa Khanom, Rubayat Rahman, Mohammad Munirul Islam Tanvir, Farhana Akter, Mridul Sarker, Nezamuddin Ahmad
Context: There is a significant need for palliative care for patients living in low- and middle-income countries. The presence and intensity of physical symptoms is a major factor influencing the suffering of patients at the end of life. Objectives: The primary aim of this study was to determine the prevalence and characteristics of common physical symptoms experienced by patients with advanced, incurable illness in a developing country. Method: This study used semi-structured interviews in patients with advanced cancer or HIV/AIDS in Bangladesh...
October 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29120683/unavoidable-pressure-ulcers-at-the-end-of-life-and-nurse-understanding
#11
Maria Carlsson, Lena Gunningberg
OBJECTIVES: prevention of pressure ulcers (PUs) in end-of-life care is often problematic because both PUs and interventions to prevent them can cause suffering. The primary aim of this study was to identify and describe the different ways in which nurses understood unavoidable PUs in late palliative care. A second aim was to explore the expediency of the different levels of understanding. METHODS: a qualitative interview study with a phenomenographic approach was carried out...
November 8, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29118265/a-systematic-review-of-health-related-quality-of-life-reporting-in-ovarian-cancer-phase-iii-clinical-trials-room-to-improve
#12
REVIEW
Michelle K Wilson, Michael L Friedlander, Florence Joly, Amit M Oza
BACKGROUND: Epithelial ovarian cancer (OC) remains a significant cause of morbidity and mortality for women worldwide. Patients may experience a multitude of disease- and treatment-related symptoms that can impact quality of life (QOL) and should be measured and reported in clinical trials. This systematic review investigated the adequacy of reporting of QOL in randomized phase III trials in OC in both the first-line and recurrent disease setting. MATERIALS AND METHODS: A systematic review of MEDLINE and EMBASE identified randomized clinical trials of systemic therapy in OC from 1980 to 2014...
November 8, 2017: Oncologist
https://www.readbyqxmd.com/read/29105289/predictors-of-care-for-patients-with-cancer-of-unknown-primary-site-in-three-australian-hospitals
#13
Simon Y S Tan, Siobhan O'Neill, David Goldstein, Robyn L Ward, Benjamin Daniels, Claire M Vajdic
AIM: Cancer of unknown primary site (CUP) is a medically challenging malignancy with a poor prognosis. We describe an incident tertiary CUP patient cohort and identify factors predictive of specific types of health care. METHODS: We reviewed the medical records of 217 patients diagnosed with CUP (2006-2011) in three public hospitals in New South Wales, Australia. We systematically abstracted data and performed multivariable logistic regression to identify factors predictive of tumor biopsy, surgery, chemotherapy, radiotherapy and palliative care...
November 3, 2017: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29100002/palliative-care-utilization-among-patients-admitted-for-gastrointestinal-and-thoracic-cancers
#14
Faiz Gani, Zachary O Enumah, Alison M Conca-Cheng, Joseph K Canner, Fabian M Johnston
BACKGROUND: Although a growing body of literature recommends the early initiation of palliative care (PC), the use of PC remains variable. OBJECTIVE: The current study sought to describe the use of PC and to identify factors associated with the use of inpatient PC. DESIGN: Retrospective, cross-sectional analysis of data from the National Inpatient Sample. SETTING AND SUBJECTS: Patients admitted with a primary diagnosis of gastrointestinal and/or thoracic cancer from 2012 to 2013...
November 3, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29094668/decisional-control-preferences-of-patients-with-advanced-cancer-receiving-palliative-care
#15
Colombe Tricou, Sriram Yennu, Murielle Ruer, Eduardo Bruera, Marilène Filbet
OBJECTIVE: Understanding patients' decisional control preferences (DCPs) is important to improving the quality of care and the satisfaction of patients who have advanced cancer with their care. In addition to passive decisional control (i.e., the patient prefers his/her doctor or family caregiver to make a decision on their behalf) and active decisional control (i.e., the patient decides alone), shared decisional control, where patients and caregivers decide together, could be more appropriate...
November 2, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29094475/a-possibility-for-strengthening-family-life-and-health-family-members-lived-experience-when-a-sick-child-receives-home-care-in-sweden
#16
Charlotte Castor, Kajsa Landgren, Helena Hansson, Inger Kristensson Hallström
Families often prefer home care to hospital care, and home-care services for ill children are increasing worldwide with limited knowledge of families' needs during curative and palliative home care. The aim of this study was to elucidate family members' lived experience when a sick child received home care from county-based primary healthcare services. A descriptive qualitative design was chosen and 12 families including sick children receiving home care and their mothers, fathers and siblings in the south of Sweden were interviewed between December 2015 and January 2017...
November 2, 2017: Health & Social Care in the Community
https://www.readbyqxmd.com/read/29068784/predictors-of-posthospital-transitions-of-care-in-patients-with-advanced-cancer
#17
Daniel E Lage, Ryan D Nipp, Sara M D'Arpino, Samantha M Moran, P Connor Johnson, Risa L Wong, William F Pirl, Ephraim P Hochberg, Lara N Traeger, Vicki A Jackson, Barbara J Cashavelly, Holly S Martinson, Joseph A Greer, David P Ryan, Jennifer S Temel, Areej El-Jawahri
Purpose Patients with advanced cancer experience potentially burdensome transitions of care after hospitalizations. We examined predictors of discharge location and assessed the relationship between discharge location and survival in this population. Methods We conducted a prospective study of 932 patients with advanced cancer who experienced an unplanned hospitalization between September 2014 and March 2016. Upon admission, we assessed patients' physical symptoms (Edmonton Symptom Assessment System) and psychological distress (Patient Health Questionnaire-4)...
October 25, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29050492/prevalence-of-dementia-in-a-geriatric-palliative-care-unit
#18
Amanda T Lo, Jurgis Karuza, Anna Berall, Giulia-Anna Perri
OBJECTIVES: To determine the prevalence of dementia in a palliative care unit (PCU) and to determine whether there is a difference between length of stay (LOS) and Palliative Performance Scale (PPS) score in individuals admitted with a primary diagnosis of dementia compared to individuals admitted with other noncancer and cancer diagnoses. DESIGN: Descriptive retrospective chart review. SETTING: Geriatric PCU in an academic community geriatric hospital...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29033560/proactive-palliative-care-for-patients-with-copd-prolong-a-pragmatic-cluster-controlled-trial
#19
R G Duenk, C Verhagen, E M Bronkhorst, Pjwb van Mierlo, Meac Broeders, S M Collard, Pnr Dekhuijzen, Kcp Vissers, Y Heijdra, Y Engels
BACKGROUND AND AIM: Patients with advanced chronic obstructive pulmonary disease (COPD) have poor quality of life. The aim of this study was to assess the effects of proactive palliative care on the well-being of these patients. TRIAL REGISTRATION: This trial is registered with the Netherlands Trial Register, NTR4037. PATIENTS AND METHODS: A pragmatic cluster controlled trial (quasi-experimental design) was performed with hospitals as cluster (three intervention and three control) and a pretrial assessment was performed...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29031914/bringing-the-medical-home-back-home-in-the-context-of-population-health-home-based-primary-care-and-home-based-palliative-care
#20
Christine S Ritchie, Bruce Leff
With the growth of value-based care, payers and health systems have begun to appreciate the need to provide enhanced services to homebound adults. Recent studies have shown that home-based medical services for this high-cost, high-need population reduce costs and improve outcomes. Home-based medical care services have two flavors that are related to historical context and specialty background-home-based primary care and home-based palliative care. While the type of services provided by home-based primary care and home-based palliative care (together termed "home-based medical care") overlap, home-based primary care tends to encompass longitudinal and preventive care, while home-based palliative care often provides services for shorter durations focused more on distress management and goals of care clarification...
October 11, 2017: Journal of Pain and Symptom Management
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