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anticipatory care

John W Wax, Amy W An, Nicole Kosier, Timothy E Quill
Voluntary stopping of eating and drinking (VSED) is a deliberate, self-initiated attempt to hasten death in the setting of suffering refractory to optimal palliative interventions or prolonged dying that a person finds intolerable. Individuals who consider VSED tend to be older, have a serious but not always imminently terminal illness, place a high value on independence, and have significant illness burden. VSED can theoretically be performed independent of clinician assistance and therefore avoids many of the ethical and legal concerns associated with physician-assisted dying or other palliative measures of last resort, However, VSED is an intense process fraught with new sources of somatic and emotional suffering for individuals and their caregivers, so VSED is best supervised by an experienced, well-informed clinician who can provide appropriate pre-intervention assessment, anticipatory guidance, medical treatment of symptoms, and emotional support...
March 2018: Journal of the American Geriatrics Society
Barbara Kimbell, Scott A Murray, Heidi Byrne, Andrea Baird, Peter C Hayes, Alastair MacGilchrist, Anne Finucane, Patricia Brookes Young, Ronan E O'Carroll, Christopher J Weir, Marilyn Kendall, Kirsty Boyd
BACKGROUND: Liver disease is an increasing cause of death worldwide but palliative care is largely absent for these patients. AIM: We conducted a feasibility trial of a complex intervention delivered by a supportive care liver nurse specialist to improve care coordination, anticipatory care planning and quality of life for people with advanced liver disease and their carers. DESIGN: Patients received a 6-month intervention (alongside usual care) from a specially trained liver nurse specialist...
March 1, 2018: Palliative Medicine
Anna E Tschiffely, Ashraful Haque, Francis J Haran, Craig A Cunningham, Melissa L Mehalick, Todd May, Keith Stuessi, Peter B Walker, Jacob N Norris
Objective: The purpose of this study is to utilize a natural history approach to describe and understand symptom recovery in personnel diagnosed with a blast-related mild traumatic brain injury (mTBI) resulting from an improvised explosive device blast. Participants and Design: The population included military personnel who experienced a blast mTBI while mounted (vehicle; n = 176) or dismounted (on foot; n = 37) (N = 213). Patients had no co-morbid psychiatric or muscle-skeletal issues and were treated within 72 h of injury...
March 1, 2018: Military Medicine
R Mezzina
AIM: Italy pioneered deinstitutionalisation over the past 60 years and enforced a famous mental health (MH) reform law in 1978. Deinstitutionalisation has been completed with the very closure of all psychiatric hospitals over two decades. METHODS: After 40 years of implementation, this article presents the main achievements and challenges of the Italian MH reform law, including its long-term effect and impact in Italy and abroad. RESULTS: The Legislation of 1978 was based on the discovery of rights as a key tool in mental healthcare...
March 6, 2018: Epidemiology and Psychiatric Sciences
Graham R Serjeant, Nicki Chin, Monika R Asnani, Beryl E Serjeant, Karlene P Mason, Ian R Hambleton, Jennifer M Knight-Madden
Globally, the majority of persons born with sickle cell disease do not have access to hydroxyurea or more expensive interventions. The objectives were to estimate the survival in homozygous sickle cell disease, unbiased by symptomatic selection and to ascertain the causes of death in a pre-hydroxyurea population. The utility of early life biomarkers and genetically determined phenotypes to predict survival was assessed. A cohort study based on neonatal diagnosis was undertaken at the Sickle Cell Unit, a specialist clinic delivering care to persons with sickle cell disease in Jamaica...
2018: PloS One
Deborah R Liptzin, Steven H Abman, Ann Giesenhagen, D Dunbar Ivy
Liptzin, Deborah R., Steven H. Abman, Ann Giesenhagen, and D. Dunbar Ivy. An approach to children with pulmonary edema at high altitude. High Alt Med Biol. 00:000-000, 2018. INTRODUCTION: Diagnosis of high-altitude illness can be more challenging in children, especially those who are preverbal. Families often travel to high elevations for family vacations, either for skiing, hiking, and/or camping. They may present to their primary care providers looking for anticipatory guidance before travel or may follow-up after developing high-altitude illness...
February 22, 2018: High Altitude Medicine & Biology
Mark S Wainwright
PURPOSE OF REVIEW: All critical care is directed at maintaining brain health, but recognizing neurologic complications of critical illness in children is difficult, and limited data exist to guide practice. This article discusses an approach to the recognition and management of seizures, stroke, and cardiac arrest as complications of other critical illnesses in the pediatric intensive care unit. RECENT FINDINGS: Convulsive and nonconvulsive seizures occur frequently in children after cardiac arrest or traumatic brain injury and during extracorporeal membrane oxygenation...
February 2018: Continuum: Lifelong Learning in Neurology
S Macdonald, J Morrison, C A Melville, M Baltzer, L MacArthur, S A Cooper
BACKGROUND: Adults with intellectual disabilities (IDs) have consistently poorer health outcomes than the general population. There is evidence that routine health checks in primary care may improve outcomes. We conducted a randomised controlled trial of practice nurse led health checks. Here, we report findings from the nested qualitative study. AIM: To explore practice nurse perceptions and experience of delivering an anticipatory health check for adults with IDs...
February 9, 2018: Journal of Intellectual Disability Research: JIDR
Camilla Wasserman, Vita Postuvan, Dana Herta, Miriam Iosue, Peeter Värnik, Vladimir Carli
THE YOUTH AWARE OF MENTAL HEALTH (YAM) EXPERIENCE: Youth stand at the core of much mental health promotion, yet little is written about their experiences of such efforts. We aimed to take this on by interviewing youth after they participated in Youth Aware of Mental Health (YAM), a universal mental health promotion program. YAM has a non-anticipatory methodology that provides youth with a safe space for reflection, role-play, and discussion. Addressing everyday mental health, YAM invites the experiences and issues relevant to the youth present to influence the program in a slightly different direction every time...
2018: PloS One
David J Birnkrant, Katharine Bushby, Carla M Bann, Susan D Apkon, Angela Blackwell, David Brumbaugh, Laura E Case, Paula R Clemens, Stasia Hadjiyannakis, Shree Pandya, Natalie Street, Jean Tomezsko, Kathryn R Wagner, Leanne M Ward, David R Weber
Since the publication of the Duchenne muscular dystrophy (DMD) care considerations in 2010, multidisciplinary care of this severe, progressive neuromuscular disease has evolved. In conjunction with improved patient survival, a shift to more anticipatory diagnostic and therapeutic strategies has occurred, with a renewed focus on patient quality of life. In 2014, a steering committee of experts from a wide range of disciplines was established to update the 2010 DMD care considerations, with the goal of improving patient care...
January 23, 2018: Lancet Neurology
Angela M Feraco, Sarah R Brand, Joshua Gagne, Amy Sullivan, Susan D Block, Joanne Wolfe
BACKGROUND: Families' communication needs during the early cancer treatment period (ECTP) may not be optimally met by current practices. We sought to identify potential communication gaps and to ameliorate these by developing a novel in-depth conversation between families and their pediatric oncologists, the "Day 100 Talk" (D100), during the ECTP. PROCEDURE: We conducted semistructured interviews with parents and patients undergoing childhood cancer treatment for < 7 months...
January 31, 2018: Pediatric Blood & Cancer
Lisa A Miller
Litigation in perinatal nursing represents a disproportionate share of indemnity payouts and results in excessive psychological stress. Testimony at deposition or trial can be challenging for clinicians; little is taught in training or postgraduate education regarding litigation. Nurses, midwives, and physicians can effectively navigate the deposition process and prepare for trial testimony by understanding the plaintiff's goals, recognizing the role of documentation, and becoming familiar with various plaintiff's strategies including reptile theory...
January 2018: Journal of Perinatal & Neonatal Nursing
Tamara C Valovich McLeod, Alyssa J Wagner, Cailee E Welch Bacon
Background: Previous studies have identified the effect of sport-related concussion on health-related quality of life through the use of patient-reported outcome measures. However, there has been little research exploring the underlying mechanisms that influence these perceptions of health-related quality of life among adolescent athletes who have sustained a sport-related concussion. Purpose: To explore the psychosocial aspects of concussion among adolescent athletes...
December 2017: Orthopaedic Journal of Sports Medicine
Anne T Berg, Daniel Tarquinio, Sookyong Koh
Early-life epilepsies are a series of disorders frequently accompanied by a broad range of morbidities that include cognitive, behavioral, neuromuscular, and sleep disturbances; enteric and other forms of autonomic dysfunction; sensory processing difficulties; and other issues. Usually these morbidities cluster together in a single patient. Rather than these being separate conditions, all, including the seizures, are manifestations or coexpressions of developmental brain disorders. Instead of viewing epilepsy as the disease and the other features as comorbidities, approaching early-life epilepsies as part of the spectrum of developmental brain disorders could have implications for multidisciplinary care models, anticipatory guidance, and counseling of parents, as well as the design of randomized trials and targeting important outcomes...
November 2017: Seminars in Pediatric Neurology
Diane J Abatemarco, Ruth S Gubernick, Marianna D LaNoue, Ryan T Pohlig, Sara R Slovin, Jill A Healy, Steven Kairys
BACKGROUND: Child maltreatment is a significant public health issue in the United States. Yet, fewer than half of pediatricians discuss behavioral, developmental, or parenting issues with parents. OBJECTIVE: This paper describes the testing of bundles of tools and processes, part of a larger intervention, Practicing Safety, targeted at changing physician and staff behavior to identify families at risk for child maltreatment, provide anticipatory guidance, refer to community resources, and follow-up and track at-risk families...
December 18, 2017: Primary Health Care Research & Development
Anne-Marie Conn, Moira A Szilagyi, Sandra H Jee, Jody T Manly, Rahil Briggs, Peter G Szilagyi
INTRODUCTION: Pediatricians recognize a need to mitigate the negative impact that adverse childhood experiences (ACEs) can have on health and development. However, ACEs screening and interventions in primary care pediatrics may be inhibited by concerns about parental perceptions. We assessed parent perspectives of screening for ACEs in the pediatric primary care setting, to understand their views on the potential impact of their ACEs on their parenting and to identify opportunities for pediatric anticipatory guidance...
December 7, 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
Anthony A Sochet, Kelsey S Ryan, Jennifer L Bartlett, Thomas A Nakagawa, Ladonna Bingham
OBJECTIVES: To determine if standardization of pediatric interfacility transport handover is associated with the development of a prototypical shared mental model between healthcare providers. DESIGN: A single center, prepost, retrospective cohort study. SETTINGS: A 259-bed, tertiary care, pediatric referral center. PATIENTS: Children 0 to 18 years old transferred to our critical care units or emergency center from October 2016 to February 2017...
February 2018: Pediatric Critical Care Medicine
Alexandra Coelho, Maja de Brito, António Barbosa
PURPOSE OF REVIEW: This review aims to synthesize recent findings on anticipatory grief in caregivers, referring to its phenomenology, assessment and clinical interventions. RECENT FINDINGS: Recent literature illustrates the wide scope of the current use of the term anticipatory grief, reflecting caregivers' experiences in different end-of-life trajectories. The anticipation of death is the distinctive aspect of anticipatory grief in the predeath grief continuum, encompassing several progressive losses, past and future...
March 2018: Current Opinion in Supportive and Palliative Care
Kathryn Shaffer, Beth Ann Swan, Mary Bouchaud
To keep pace with the ever-changing health care delivery system, it is important to transform the way future nurses are educated, both in classroom and in clinical settings, to care for people along the life and care continuum, not only in acute-care settings. The purpose of this article is to describe a new approach to educating baccalaureate nursing students using immersion practicums that expose students to population health, transitions of care, care coordination, and the multiple roles a nurse engages in along the continuum...
December 1, 2017: Nurse Educator
Lisa G Smithers, John Lynch, Joanne Hedges, Lisa M Jamieson
There are marked disparities between indigenous and non-indigenous children's diets and oral health. Both diet and oral health are linked to longer-term health problems. We aimed to investigate whether a culturally appropriate multi-faceted oral health promotion intervention reduced Aboriginal children's intake of sugars from discretionary foods at 2 years of age. We conducted a single-blind, parallel-arm randomised controlled trial involving women who were pregnant or had given birth to an Aboriginal child in the previous 6 weeks...
December 2017: British Journal of Nutrition
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