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https://www.readbyqxmd.com/read/29240011/fecal-calprotectin-test-performed-at-home-a-prospective-study-of-pediatric-patients-with-inflammatory-bowel-disease
#1
Maija Piekkala, Henrik Alfthan, Laura Merras-Salmio, Anne Puustinen Wikström, Kaarina Heiskanen, Tytti Jaakkola, Paula Klemetti, Martti Färkkilä Md, Kaija-Leena Kolho
OBJECTIVES: Measuring fecal calprotectin (FC) in a laboratory is time-consuming and that is why home tests have been developed. We studied the use of an FC home test in pediatric patients with inflammatory bowel disease (PIBD) in real-life settings. METHODS: The patients were asked to perform the IBDoc® FC home test monthly for six months and to report their clinical disease activity at testing. However, clinical decision-making was guided by routine FC enzyme-linked immunosorbent assay (ELISA) for patients with raised IBDoc® values...
December 12, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29239602/improving-estimates-of-nitrogen-emissions-for-life-cycle-assessment-of-cropping-systems-at-the-scale-of-an-agricultural-territory
#2
Laure Nitschelm, Virginie Parnaudeau, Francoise Vertès, Hayo M G van der Werf, Michael S Corson, Valerie Viaud, Joel Aubin, Christian Walter
In life cycle assessment (LCA), simple models are currently used to estimate cropping system nitrogen (N) emissions on farms. At large spatial scales (e.g., countries), these models are valid. At a smaller spatial scale (e.g., territories), these models may be less accurate, since they completely or partially ignore local conditions such as management practices, soil or climate. The purpose of this study was to consider the variability of those factors when estimating N emissions in LCA at the watershed scale...
December 14, 2017: Environmental Science & Technology
https://www.readbyqxmd.com/read/29230697/knowing-anticipating-even-facilitating-but-still-not-intending-another-challenge-to-double-effect-reasoning
#3
S Duckett
A recent administrative law decision in Victoria, Australia, applied double effect reasoning in a novel way. Double effect reasoning has hitherto been used to legitimate treatments which may shorten life but where the intent of treatment is pain relief. The situation reviewed by the Victorian tribunal went further, supporting actions where a doctor agrees to provide pentobarbitone (Nembutal) to a patient at some time in the future if the patient feels at that time that his pain is unbearable and he wants to end his life...
December 11, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/29221885/-design-of-a-questionnaire-on-the-knowledge-and-attitudes-of-the-population-of-madrid-spain-facing-the-end-of-life
#4
Belén Ortiz-Gonçalves, Andrés Santiago-Sáez, Elena Albarrán Juan, Elena Labajo González, Bernardo Perea-Pérez
OBJECTIVE: To create and validate a questionnaire about knowledge and attitudes of the general population in Madrid (Spain) about life's end stage. METHOD: A descriptive study designed as a structured self-administered questionnaire, validated by seven Madrid Health Service professional experts and assessed through a pilot study. RESULTS: The questionnaire consisted of 42 questions, divided into six modules: 1) decisions and psychological-physical care at life's end; 2) palliative care; 3) euthanasia and assisted suicide; 4) advance directives document; 5) spiritual factors; and 6) socio-demographic data...
December 5, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/29221846/prevailing-ethical-dilemmas-encountered-by-physicians-in-terminal-cancer-care-changed-after-the-enactment-of-the-natural-death-act-fifteen-years-follow-up-survey
#5
Hsien-Liang Huang, Chien-An Yao, Wen-Yu Hu, Shao-Yi Cheng, Shinn-Jang Huang, Chih-Dao Chen, Wen-Yuan Lin, Yen-Chun Lin, Tai-Yuan Chiu
CONTEXT: Advance directive laws have influences on ethical dilemmas encountered by physicians caring for terminal cancer patients. OBJECTIVES: To identify the prevailing ethical dilemmas among terminal care physicians fifteen years after the Natural Death Act was enacted in Taiwan. METHODS: This study is a cross-sectional survey from April 2014 to February 2015 using the clustering sampling method and a well-structured questionnaire. Targeted participants included physicians at oncology and related wards or palliative care units where terminal cancer care may be provided in Taiwan...
December 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29221845/characterizing-the-role-of-u-s-surgeons-in-the-provision-of-palliative-care-a-systematic-review-and-mixed-methods-meta-synthesis
#6
REVIEW
Pasithorn A Suwanabol, Arielle E Kanters, Ari C Reichstein, Lauren M Wancata, Lesly A Dossett, Emily B Rivet, Maria J Silveira, Arden M Morris
CONTEXT: The provision of palliative care varies appropriately by clinical factors such as patient age and severity of disease, but also varies by provider practice and specialty. Surgical patients are persistently less likely to receive palliative care than their medical counterparts for reasons that aren't clear. OBJECTIVES: We sought to characterize surgeon-specific determinants of palliative care in seriously-ill and dying patients. METHODS: We performed a systematic review of the literature focused on surgery and palliative care within PubMed, CINHAL, EMBASE, Scopus, and Ovid Medline databases from January 1, 2000 through December 31, 2016 according to PRISMA guidelines...
December 5, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29219936/end-of-life-care-discussion-for-residents-with-dementia-in-long-term-care-facilities
#7
Hsiu-Li Huang, Li-Chueh Weng, WeWen-Yu Hu, Yea-Ing Lotus Shyu, Wen-Pin Yu, Kang-Hua Chen
BACKGROUND: Healthcare professionals play an important role in end-of-life care decisions. Although the factors affecting end-of-life care in long-term care facilities have been well studied in Western contexts, few studies have examined factors affecting end-of-life care discussions for residents with dementia among multidisciplinary professionals in Asian or Taiwanese contexts. PURPOSE: The aim of this study was to explore the factors related to the end-of-life care discussions of registered nurses, social workers, and physicians with residents with dementia and their families...
December 6, 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/29214963/ideology-and-palliative-care-moral-hazards-at-the-bedside
#8
Rosamond Rhodes, James J Strain
Palliative care has had a long-standing commitment to teaching medical students and other medical professionals about pain management, communication, supporting patients in their decisions, and providing compassionate end-of-life care. Palliative care programs also have a critical role in helping patients understand medical conditions, and in supporting them in dealing with pain, fear of dying, and the experiences of the terminal phase of their lives. We applaud their efforts to provide that critical training and fully support their continued important work in meeting the needs of patients and families...
January 2018: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
https://www.readbyqxmd.com/read/29212490/attitudes-towards-assisted-suicide-and-euthanasia-among-care-dependent-older-adults-50-in-austria-the-role-of-socio-demographics-religiosity-physical-illness-psychological-distress-and-social-isolation
#9
Erwin Stolz, Hannes Mayerl, Peter Gasser-Steiner, Wolfgang Freidl
BACKGROUND: Care-dependency constitutes an important issue with regard to the approval of end-of-life decisions, yet attitudes towards assisted suicide and euthanasia are understudied among care-dependent older adults. We assessed attitudes towards assisted suicide and euthanasia and tested empirical correlates, including socio-demographics, religiosity, physical illness, psychological distress and social isolation. METHODS: A nationwide cross-sectional survey among older care allowance recipients (50+) in private households in Austria was conducted in 2016...
December 7, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/29212487/recognizing-difficult-trade-offs-values-and-treatment-preferences-for-end-of-life-care-in-a-multi-site-survey-of-adult-patients-in-family-practices
#10
Michelle Howard, Nick Bansback, Amy Tan, Doug Klein, Carrie Bernard, Doris Barwich, Peter Dodek, Aman Nijjar, Daren K Heyland
BACKGROUND: Decisions about care options and the use of life-sustaining treatments should be informed by a person's values and treatment preferences. The objective of this study was to examine the consistency of ratings of the importance of the values statements and the association between values statement ratings and the patient's expressed treatment preference. METHODS: We conducted a multi-site survey in 20 family practices. Patients aged 50 and older self-completed a questionnaire assessing the importance of eight values (rated 1 to 10), and indicated their preference for use of life-sustaining treatment (5 options)...
December 6, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29210892/physiologically-triggered-digital-cognitive-aid-facilitates-crisis-management-in-a-simulated-operating-room-a-randomized-controlled-study
#11
Jonathan Lipps, Lori Meyers, Scott Winfield, Michael Durda, Vedat Yildiz, Michael Kushelev
INTRODUCTION: Although the benefits of using cognitive aids in anesthesia care have previously been demonstrated, several challenges remain. It must be presented in a timely manner, and providers must be amenable to using the tool once it is available. We hypothesized that anesthesia residents would perform superiorly when presented with a digital cognitive aid (DCogA) that is automatically triggered by a set vital sign aberration. METHODS: Thirty anesthesia residents were randomized to either control (with access to hard copy of the cognitive aid) or receive a DCogA projected on their anesthesia information management system with the onset of heart block and associated hypotension...
November 28, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29201947/older-adults-more-likely-to-discuss-advance-care-plans-with-an-attorney-than-with-a-physician
#12
Mercedes Bern-Klug, Elizabeth A Byram
Adults are encouraged to discuss their end-of-life health care preferences so that their wishes will be known and hopefully honored. The purpose of this study was to determine with whom older adults had communicated their future health care wishes and the extent to which respondents themselves were serving as a surrogate decision maker. Results from the cross-sectional online survey with 294 persons aged 50 and older reveal that among the married, over 80% had a discussion with their spouse and among those with an adult child, close to two thirds (64%) had...
January 2017: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/29200118/palliative-care-end-of-life-care-and-advance-care-planning-in-neuro-oncology
#13
Tobias Walbert
PURPOSE OF REVIEW: Despite new therapeutic approaches, most patients with high-grade glioma face limited overall survival and have a high symptom burden throughout their disease trajectory, especially in the end-of-life phase. This article provides an overview of the role of palliative care in neuro-oncology. Management recommendations are made for neurologic symptoms in patients with advanced brain tumors, including headaches, nausea, and fatigue. Special attention is given to how and when to involve subspecialty palliative care and hospice services to improve symptom management during active tumor treatment and in the end-of-life phase of patients with brain tumors...
December 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29199905/potentially-inappropriate-medication-in-primary-care-at-the-end-of-life-a-mixed-method-study
#14
Peter Pype, Fien Mertens, Fleur Helewaut, Bert D'Hulster, An De Sutter
CONTEXT: Polypharmacy results in adverse drug interactions, high pill burden, and medication costs. Stopping or diminishing potentially inappropriate medication (PIM), is complex . Data on the use of PIM in a primary care context are scarce and deprescribing barriers for general practitioners (GP) are underexplored. OBJECTIVE: Describing the use of PIM in primary care at the end of life, and exploring the barriers for GPs to deprescribe. METHODS: Retrospective chart review of 210 consecutive patients referred to a palliative home care service and semi-structured interviews with 11 GPs...
December 4, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29197715/end-of-life-care-of-elderly-patients-with-dementia-a-cross-sectional-study-of-family-carer-decision-making
#15
Rafaella I Peixoto, Vera M da Silveira, Rogério D Zimmermann, Adriana de M Gomes
BACKGROUND: Dementia syndromes pose a major worldwide challenge to public health. In terminal stage of dementia, carers are responsible for decision making in end-of-life treatment and there may be multiple factors that contribute to the choice of a palliative or invasive treatment. AIM: To identify possible factors that influence the decision-making of family caregivers on implementing invasive or palliative interventions for people with end stage dementia. DESIGN: A structured interview with family caregivers of elderly patients addressing aspects of the following categories: elderly with dementia, caregiver, medical treatment history...
November 28, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29197697/the-development-of-a-spatial-palliative-care-index-instrument-for-assessing-population-level-need-for-palliative-care-services
#16
Nadine Schuurman, Michael Martin, Valorie A Crooks, Ellen Randall
We developed an index to measure potential need for palliative care services (PCIX). This is an instrument that enables spatial identification of potential population-level need for palliative care services and can be developed using census data. Four indicators of potential need for palliative care services -age, sex, living arrangement, socio-economic status (SES)-were used to produce composite potential need scores for DAs. Scores were graphically mapped, producing a spatial delineation of relative need for end-of-life services...
November 30, 2017: Health & Place
https://www.readbyqxmd.com/read/29194440/attacking-the-mosquito-on-multiple-fronts-insights-from-the-vector-control-optimization-model-vcom-for-malaria-elimination
#17
Samson S Kiware, Nakul Chitnis, Allison Tatarsky, Sean Wu, Héctor Manuel Sánchez Castellanos, Roly Gosling, David Smith, John M Marshall
BACKGROUND: Despite great achievements by insecticide-treated nets (ITNs) and indoor residual spraying (IRS) in reducing malaria transmission, it is unlikely these tools will be sufficient to eliminate malaria transmission on their own in many settings today. Fortunately, field experiments indicate that there are many promising vector control interventions that can be used to complement ITNs and/or IRS by targeting a wide range of biological and environmental mosquito resources. The majority of these experiments were performed to test a single vector control intervention in isolation; however, there is growing evidence and consensus that effective vector control with the goal of malaria elimination will require a combination of interventions...
2017: PloS One
https://www.readbyqxmd.com/read/29192394/withholding-and-withdrawing-life-support-difficult-decisions-around-care-at-the-end-of-life
#18
EDITORIAL
Kevin J Solverson, Amanda L Roze des Ordons, Christopher J Doig
No abstract text is available yet for this article.
November 30, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29191724/moral-distress-at-the-end-of-a-life-when-family-and-clinicians-don-t-agree-on-implantable-cardioverter-defibrillator-deactivation
#19
Jill M Steiner, Kristen K Patton, Jordan M Prutkin, James N Kirkpatrick
A 63-year-old man with end-stage ischemic cardiomyopathy presented with incessant ventricular tachycardia. He had been hospitalized multiple times in the past year for severe heart failure. As he approached end-of-life and was regularly receiving defibrillator shocks, his care team recommended deactivation of his implantable cardioverter-defibrillator. However, his family did not wish to allow deactivation, reporting a religious obligation to prolong his life, regardless of the risk of suffering. The patient was unable to adequately participate in the decision-making process...
November 27, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29191185/compassionate-collaborative-care-an-integrative-review-of-quality-indicators-in-end-of-life-care
#20
Kathryn Pfaff, Adelais Markaki
BACKGROUND: Compassion and collaborative practice are individually associated with high quality healthcare. When combined in a compassionate collaborative care (CCC) practice framework, they are reported to improve health, strengthen care provision, and control health costs. Little is known about how to integrate and measure CCC, yet it is fundamentally applied in palliative and end-of-life care settings. This study aimed to identify quality indicators of CCC by systematically reviewing and synthesizing the current state of the palliative and end-of-life care literature...
December 1, 2017: BMC Palliative Care
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