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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
#1
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/29221765/advances-in-fetal-echocardiography
#2
REVIEW
Helena M Gardiner
The development of fetal echocardiography and success in prenatal cardiac screening programs over the past 30 years has been driven by technical innovation and influenced by the different approaches of the various specialties practicing it. Screening for congenital heart defects no longer focuses on examining a limited number of pregnant women thought to be at increased risk, but instead forms an integrated part of a high-quality anatomical ultrasound performed in the second trimester using the 'five-transverse view' protocol...
December 5, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29219936/end-of-life-care-discussion-for-residents-with-dementia-in-long-term-care-facilities
#3
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/29218304/from-invention-to-innovation-risk-analysis-to-integrate-one-health-technology-in-the-dairy-farm
#4
Andrea Lombardo, Carlo Boselli, Simonetta Amatiste, Simone Ninci, Chiara Frazzoli, Roberto Dragone, Alberto De Rossi, Gerardo Grasso, Alberto Mantovani, Giovanni Brajon
Current Hazard Analysis Critical Control Points (HACCP) approaches mainly fit for food industry, while their application in primary food production is still rudimentary. The European food safety framework calls for science-based support to the primary producers' mandate for legal, scientific, and ethical responsibility in food supply. The multidisciplinary and interdisciplinary project ALERT pivots on the development of the technological invention (BEST platform) and application of its measurable (bio)markers-as well as scientific advances in risk analysis-at strategic points of the milk chain for time and cost-effective early identification of unwanted and/or unexpected events of both microbiological and toxicological nature...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/29217152/advanced-cardiopulmonary-resuscitation-cpr-in-the-catheterization-laboratory-consensus-document-of-the-working-groups-of-1-cardiopulmonary-resuscitation-acute-cardiac-care-and-2-hemodynamic-and-interventional-cardiology-hellenic-cardiological-society
#5
George Latsios, George Mpompotis, Kostas Tsioufis, Kostas Toutouzas, Emmanouil Skalidis, Andreas Synetos, Dimosthenis Avramidis, Dimitris Tousoulis
The incidence of Cardiac (Cardio-Pulmonary) Arrest (CA) in the Catheterization Laboratory is not common. However, not only does it happen occasionally but its frequency tends to increase due to the increase in the overall number and complexity of interventions performed by interventional cardiologists. Therefore, certified knowledge and application of the ALS (Advanced Life Support) protocols by trained Catheterization Laboratory staff is imperative in many countries, by local Hospital standards and also by Law...
December 4, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/29215810/pediatric-deaths-attributed-to-complex-chronic-conditions-over-10-years-in-korea-evidence-for-the-need-to-provide-pediatric-palliative-care
#6
Min Sun Kim, Nam Gu Lim, Hyun Joo Kim, Chohee Kim, Jin Yong Lee
BACKGROUND: Pediatric palliative care (PPC) is the active total care of children suffering from life-threatening illnesses. Palliative care includes symptom management, psychosocial support, and end-of-life care. Despite significant advances in disease diagnosis and treatment, resources for PPC of children with serious illnesses are limited in Korea. This study aimed to investigate the scale, time trends, disease composition, regional distribution, and unmet needs of children dying from complex chronic conditions (CCCs)...
January 1, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29214945/-quality-of-life-and-mental-health-of-patients-with-severe-heart-failure-with-or-without-technical-support-for-the-left-cardiac-ventricle-a-cross-sectional-study
#7
Birte Dahrmann, Jürgen Sindermann, Thomas Geldmacher, Gereon Heuft
Quality of life and mental health of patients with severe heart failure with or without technical support for the left cardiac ventricle - a cross-sectional study Objectives: Chronic heart failure is associated with reduced quality of life (QoL) and poor prognosis. Support via a left ventricular assist device (LVAD) is an alternative to optimised medical management for patients with advanced heart failure. This study evaluated health-related QoL with both therapy options. METHODS: In this consecutive cross-sectional study, patients with LVAD support (n = 50) and patients with optimised medical management (n = 50) were interviewed comprehensively about various domains of QoL, emotional stress, perceived self-efficacy, social support, life satisfaction, and communication...
December 2017: Zeitschrift Für Psychosomatische Medizin und Psychotherapie
https://www.readbyqxmd.com/read/29214123/pay-for-performance-motivation-to-succeed-in-advanced-trauma-life-support-courses-a-question-of-background-or-funding
#8
Roman Klein, Wolfgang Armbruster, Martin Grotz, Bernd Höner, Matthias Münzberg, Paul Alfred Grützner, Christoph Georg Wölfl
Objective: To correlate students' performance with their professional background and motivation to take part in Advanced Trauma Life Support (ATLS) courses. We base our analysis on the self-determination theory that differentiates intrinsic (ambition to perform by individual itself) from extrinsic motivation (incentive by external stimuli). Design: We present a non-blinded, monocentric, non-randomized descriptive study of 376 students taking part in an ATLS course at one course site in Germany. Part of a two-day ATLS course are two written tests; we correlate test scores with background information provided by the students in a questionnaire of 13 items (age, sex, adress, board certification, specialty, subspecialty, position, hospital level of care, hospital operator and hospital participation in trauma network, motivation, funding source, condition of funding)...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
https://www.readbyqxmd.com/read/29212379/provision-of-rehabilitation-services-for-children-with-disabilities-living-in-low-and-middle-income-countries-a-scoping-review
#9
Dawn Magnusson, Frank Sweeney, Michel Landry
BACKGROUND: Childhood disability is a growing global health priority. The purpose of this scoping review was to identify and summarize rehabilitation interventions used to support children with disabilities in low- and middle-income countries. METHODS: This scoping review involved a systematic search of electronic databases using a combination of subject headings and/or keywords related to child disability, rehabilitation, and low- and middle-income countries. Charting involved an iterative process whereby the full text of articles meeting the inclusion criteria were abstracted using a charting form...
December 7, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29210892/physiologically-triggered-digital-cognitive-aid-facilitates-crisis-management-in-a-simulated-operating-room-a-randomized-controlled-study
#10
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/29210621/pathways-to-pleasure-older-adult-women-s-reflections-on-being-sexual-beings
#11
Kate A Morrissey Stahl, Jerry Gale, Denise C Lewis, Doug Kleiber
Older adult women make up a growing part of the population, and yet literature on the sexual activity over their life spans is lacking. This qualitative interview study explored the experience of 16 women aged 57-91 to better understand sexual pleasure over a lifetime. The participants described having to challenge cultural rules to create a supportive environment for sexual expression. Having access to Novel contexts in which to learn, cultivating Intimacy with partners and with oneself, being Creative with sexual activities, and Extending one's sense of sexual possibility into advanced age (NICE) supported sexual pleasure as women aged...
December 6, 2017: Journal of Women & Aging
https://www.readbyqxmd.com/read/29208189/enlightenment-and-lesson-from-the-successful-treatment-of-acute-superior-mesenteric-artery-embolism
#12
Bei Wang, Rongju Sun, Wei Chen, Tanshi Li
 Despite recent advances, treatment of acute superior mesenteric artery embolism (SMAE) in emergency is still very difficult. The comparative rarity, the difficulty of early diagnosis, and the extremely high mortality of SMAE give us the sufficient reasons to report our successful experience in curing a patient with acute SMAE. In the present case, the patient was diagnosed early without evidence of intestinal necrosis. The diagnosis of SMAE was verified by computed tomography angiography (CTA). A comprehensive treatment was immediately employed including a combination of intra-arterial thrombolysis and embolectomy operation with emergent laparotomy...
November 30, 2017: Cellular and Molecular Biology
https://www.readbyqxmd.com/read/29207756/intravenous-fluid-administration-and-the-survival-of-pre-hospital-resuscitated-out-of-hospital-cardiac-arrest-patients-in-thailand
#13
Phichet Nongchang, Wongsa Laohasiri Wong, Somsak Pitaksanurat, Pairoj Boonsirik Amchai
Introduction: Out of Hospital Cardiac Arrest (OHCA) is a leading cause of death worldwide. The Emergency Medical Service (EMS) provides early care to critical OHCA patients. Pre hospital intervention has been improving OHCA survival rate, however it is still unclear for the recommendation of routine infusion of Intravenous (IV) fluids during cardiac arrest resuscitation. Aim: This study aimed to determine whether IV fluid administration was associated with increasing survival of resuscitated OHCA patients and to assess the survival rate of resuscitated OHCA patients...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29206729/extracorporeal-cardiopulmonary-resuscitation-in-the-pediatric-cardiac-population-in-search-of-a-standard-of-care
#14
Javier J Lasa, Parag Jain, Tia T Raymond, Charles G Minard, Alexis Topjian, Vinay Nadkarni, Michael Gaies, Melania Bembea, Paul A Checchia, Lara S Shekerdemian, Ravi Thiagarajan
OBJECTIVES: Although clinical and pharmacologic guidelines exist for the practice of cardiopulmonary resuscitation in children (Pediatric Advanced Life Support), the practice of extracorporeal cardiopulmonary resuscitation in pediatric cardiac patients remains without universally accepted standards. We aim to explore variation in extracorporeal cardiopulmonary resuscitation procedures by surveying clinicians who care for this high-risk patient population. DESIGN: A 28-item cross-sectional survey was distributed via a web-based platform to clinicians focusing on cardiopulmonary resuscitation practices and extracorporeal membrane oxygenation team dynamics immediately prior to extracorporeal membrane oxygenation cannulation...
December 4, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29206553/development-of-imminent-mortality-predictor-for-advanced-cancer-impac-a-tool-to-predict-short-term-mortality-in-hospitalized-patients-with-advanced-cancer
#15
Kerin Adelson, Donald K K Lee, Salimah Velji, Junchao Ma, Susan K Lipka, Joan Rimar, Peter Longley, Teresita Vega, Javier Perez-Irizarry, Edieal Pinker, Rogerio Lilenbaum
PURPOSE: End-of-life care for patients with advanced cancer is aggressive and costly. Oncologists inconsistently estimate life expectancy and address goals of care. Currently available prognostication tools are based on subjective clinical assessment. An objective prognostic tool could help oncologists and patients decide on a realistic plan for end-of-life care. We developed a predictive model (Imminent Mortality Predictor in Advanced Cancer [IMPAC]) for short-term mortality in hospitalized patients with advanced cancer...
December 5, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29206063/age-discrimination-in-out-of-hospital-cardiac-arrest-care-a-case-control-study
#16
Eric Wiel, Christophe Di Pompéo, Nicolas Segal, Gérald Luc, Jean-Baptiste Marc, Carine Vanderstraeten, Carlos El Khoury, Joséphine Escutnaire, Karim Tazarourte, Pierre-Yves Gueugniaud, Hervé Hubert
BACKGROUND: Although some studies have questioned whether cardiopulmonary resuscitation (CPR) in older people could be futile, age is not considered an essential out-of-hospital cardiac arrest (OHCA) prognostic factor. However, in the daily clinical practice of mobile medical teams (MMTs), age seems to be an important factor affecting OHCA care. AIMS: The purpose of this study was to compare OHCA care and outcomes between young patients (<65 years old) and older patients...
December 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29205339/acne-in-late-adolescence-and-risk-of-prostate-cancer
#17
Henrik Ugge, Ruzan Udumyan, Jessica Carlsson, Ove Andrén, Scott Montgomery, Sabina Davidsson, Katja Fall
Accumulating evidence suggest that Propionibacterium acnes may play a role in prostate carcinogenesis, but data are so far limited and inconclusive. The aim of this population-based cohort study was therefore to test whether presence of acne vulgaris during late adolescence is associated with an increased risk of prostate cancer later in life. We identified a large cohort of young men born in Sweden between 1952 and 1956, who underwent mandatory assessment for military conscription around the age of 18 (n= 243,187)...
December 4, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/29203325/-multiple-sclerosis-loss-of-functionality-and-gender
#18
Félix Bravo-González, Arturo Álvarez-Roldán
OBJECTIVE: To identify the type of support and assistance that patients with multiple sclerosis need in order to cope with the loss of functionality, and to show how gender affects the perception of these needs. METHOD: Interpretative-phenomenological qualitative study. LOCATION: Granada (Spain). Year: 2014. Intentional sample: 30 patients and 20 family caregivers. Data were gathered from 26 interviews and 4 focus groups. The data were coded and analysed with the NVivo programme...
December 1, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/29203284/intermediate-term-survival-and-quality-of-life-outcomes-in-patients-with-advanced-colorectal-liver-metastases-undergoing-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy
#19
Kerollos Nashat Wanis, Victoria Ardiles, Fernando A Alvarez, Mauro Enrique Tun-Abraham, David Linehan, Eduardo de Santibañes, Roberto Hernandez-Alejandro
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is an innovative, 2-staged hepatectomy which has elicited controversy within the international hepatobiliary community. Uptake of ALPPS has been limited due to concerns related to evidence of high morbidity and mortality and scant oncologic and quality of life outcome data and quality of life (Ool). Demonstrating reasonable long-term benefits with a short-term risk is necessary to support more widespread endorsement of ALPPS...
December 1, 2017: Surgery
https://www.readbyqxmd.com/read/29202863/a-novel-family-dignity-intervention-fdi-for-enhancing-and-informing-holistic-palliative-care-in-asia-study-protocol-for-a-randomized-controlled-trial
#20
Andy Hau Yan Ho, Josip Car, Moon-Ho Ringo Ho, Geraldine Tan-Ho, Ping Ying Choo, Paul Victor Patinadan, Poh Heng Chong, Wah Ying Ong, Gilbert Fan, Yee Pin Tan, Robert A Neimeyer, Harvey M Chochinov
BACKGROUND: The lack of a holistic approach to palliative care can lead to a fractured sense of dignity at the end of life, resulting in depression, hopelessness, feelings of being a burden to others, and the loss of the will to live among terminally ill patients. Building on the clinical foundation of Dignity Therapy, together with the empirical understanding of dignity-related concerns of Asian families facing terminal illness, a novel Family Dignity Intervention (FDI) has been developed for Asian palliative care...
December 4, 2017: Trials
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