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End-of-life

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https://www.readbyqxmd.com/read/28214237/knowledge-attitudes-and-preferences-of-advance-decisions-end-of-life-care-and-place-of-care-and-death-in-hong-kong-a%C3%A2-population-based-telephone-survey-of-1067-adults
#1
Roger Yat-Nork Chung, Eliza Lai-Yi Wong, Nicole Kiang, Patsy Yuen-Kwan Chau, Janice Y C Lau, Samuel Yeung-Shan Wong, Eng-Kiong Yeoh, Jean W Woo
OBJECTIVES: According to the 2015 Quality of Death Index published by the Intelligence Unit of the Economist, Hong Kong is ranked 22nd in terms of quality of palliative care in the world, behind many other major developed countries in Asia, including Taiwan, Singapore, Japan, and South Korea. The objectives of the present study were to describe the knowledge, attitude, and preferences of the general Hong Kong adult population across different age groups regarding end-of-life (EOL) care decisions, place of care and death, as well as advance directive (AD)...
February 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28214236/are-hospital-ed-transfers-less-likely-among-nursing-home-residents-with-do-not-hospitalize-orders
#2
Taeko Nakashima, Yuchi Young, Wan-Hsiang Hsu
OBJECTIVES: This study aims to examine whether an advance directive "Do Not Hospitalize" (DNH) would be effective in reducing hospital/emergency department (ED) transfers. Similar effects in residents with dementia were also examined. DESIGN: Cross-sectional study. SETTING/SUBJECTS: New York State (NYS) nursing home residents (n = 43,024). MEASUREMENTS AND ANALYSIS: The Minimum Data Set 2.0 was used to address the study aims...
February 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28212951/priority-to-end-of-life-treatments-views-of-the-public-in-the-netherlands
#3
Sofie Wouters, Job van Exel, Rachel Baker, Werner B F Brouwer
OBJECTIVES: Recent debates in the Netherlands on health care priority setting have focused on the relative value of gains generated by life-extending medicines for people with a terminal illness, mostly new cancer drugs. These treatments are generally expensive, provide relatively small health gains, and therefore usually do not meet common cost per QALY thresholds. Nevertheless, these drugs may be provided under the assumption that there is public support for making a special case for treatments for people with a terminal illness...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28212651/erratum-to-when-parents-face-the-death-of-their-child-a-nationwide-cross-sectional-survey-of-parental-perspectives-on-their-child-s-end-of-life-care
#4
Karin Zimmermann, Eva Bergstraesser, Sandra Engberg, Anne-Sylvie Ramelet, Katrin Marfurt-Russenberger, Nicolas Von der Weid, Chantal Grandjean, Patricia Fahrni-Nater, Eva Cignacco
No abstract text is available yet for this article.
February 17, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28212642/beyond-cultural-stereotyping-views-on-end-of-life-decision-making-among-religious-and-secular-persons-in-the-usa-germany-and-israel
#5
Mark Schweda, Silke Schicktanz, Aviad Raz, Anita Silvers
BACKGROUND: End-of-life decision making constitutes a major challenge for bioethical deliberation and political governance in modern democracies: On the one hand, it touches upon fundamental convictions about life, death, and the human condition. On the other, it is deeply rooted in religious traditions and historical experiences and thus shows great socio-cultural diversity. The bioethical discussion of such cultural issues oscillates between liberal individualism and cultural stereotyping...
February 17, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28211000/the-implementation-and-evaluation-of-a-communication-skills-training-program-for-oncology-nurses
#6
Smita C Banerjee, Ruth Manna, Nessa Coyle, Stacey Penn, Tess E Gallegos, Talia Zaider, Carol A Krueger, Philip A Bialer, Carma L Bylund, Patricia A Parker
Many nurses express difficulty in communicating with their patients, especially in oncology settings where there are numerous challenges and high-stake decisions during the course of diagnosis and treatment. Providing specific training in communication skills is one way to enhance the communication between nurses and their patients. We developed and implemented a communication skills training program for nurses, consisting of three teaching modules: responding empathically to patients; discussing death, dying, and end-of-life goals of care; and responding to challenging interactions with families...
February 16, 2017: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/28210847/ethical-considerations-in-the-long-term-ventricular-assist-device-patient
#7
REVIEW
Amanda Cai, Howard J Eisen
PURPOSE OF REVIEW: As the heart failure population continues to age, the need for definitive therapies such as ventricular assist devices (VADs) to extend life and alleviate suffering from end-stage disease directly increases. The goal of this article is to examine the ethical principles of autonomy, beneficence, non-maleficence, and justice within the context of long-term VAD patients. RECENT FINDINGS: Survival rates in VAD-implanted patients have improved in parallel with modernization of device design and surgical technique, reaching that of cardiac transplantation at 1 year post-procedure...
February 16, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28210521/the-right-to-die-in-chronic-disorders-of-consciousness-can-we-avoid-the-slippery-slope-argument
#8
REVIEW
Rocco Salvatore Calabrò, Antonino Naro, Rosaria De Luca, Margherita Russo, Lory Caccamo, Alfredo Manuli, Alessia Bramanti, Placido Bramanti
Managing individuals with chronic disorders of consciousness raises ethical questions about the appropriateness of maintaining life-sustaining treatments and end-of-life decisions for those who are unable to make decisions for themselves. For many years, the positions fostering the "sanctity" of human life (i.e., life is inviolable in any case) have led to maintaining life-sustaining treatments (including artificial nutrition and hydration) in patients with disorders of consciousness, allowing them to live for as long as possible...
November 2016: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/28209568/experience-based-design-co-design-and-experience-based-co-design-in-palliative-and-end-of-life-care
#9
Erica Borgstrom, Stephen Barclay
Experience-based design, co-design, and experience-based co-design can be used within healthcare to design services that improve the patient, carer and staff experience of the services. As palliative and end-of-life care centrally value person-centred care, we believe that service designers, commissioners and those tasked with making quality improvements will be interested in this growing field. This paper outlines these approaches-with a particular emphasis on experience-based co-design-and describes how they are and can be used within palliative and end-of-life care...
February 16, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28209072/evolving-ethical-and-legal-implications-for-feeding-at-the-end-of-life
#10
Blair Henry
No abstract text is available yet for this article.
January 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28209067/barriers-to-nausea-management-end-of-life-conversations-early-palliative-care-interventions-and-patient-education
#11
Charles B Simone
No abstract text is available yet for this article.
January 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28206736/mechanical-ventilation-withdrawal-at-end-of-life-terminal-extubation-and-terminal-weaning
#12
Alberto Giannini, Guido Miccinesi
No abstract text is available yet for this article.
February 15, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28206733/end-of-life-decisions-in-34-slovene-intensive-care-units-a-nationwide-prospective-clinical-study
#13
Miha Orazem, Urh Groselj, Manca Stojan, Neza Majdic, Gaj Vidmar, Stefan Grosek
BACKGROUND: To determine how end-of-life decisions (EOLD) on limitations of life- sustaining treatment (LST) are made in three different types of intensive care units (ICUs) in Slovenia. METHODS: A national multicenter prospective study among 31 adult and three pediatric/neonatal ICUs (PICUs). The questionnaire form on EOLD was designed to assess the clinical practice. Data were collected between January 1, 2013, and March 31, 2013. For statistical analysis we used IBM® SPSS® Statistics 20 software package...
February 15, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28203146/insulin-like-growth-factor-1-at-the-crossroads-of-brain-development-and-aging
#14
REVIEW
Sarah Wrigley, Donia Arafa, Daniela Tropea
Insulin-like growth factor 1 (IGF1) is a polypeptide hormone structurally similar to insulin. It is central to the somatotropic axis, acting downstream of growth hormone (GH). It activates both the mitogen-activated protein (MAP) kinase and PI3K signaling pathways, acting in almost every tissue in the body to promote tissue growth and maturation through upregulation of anabolic processes. Overall GH and IGF1 signaling falls with age, suggesting that it is this reduced IGF1 activity that leads to age-related changes in organisms...
2017: Frontiers in Cellular Neuroscience
https://www.readbyqxmd.com/read/28203120/international-lessons-in-new-methods-for-grading-and-integrating-cost-effectiveness-evidence-into-clinical-practice-guidelines
#15
REVIEW
Kathryn M Antioch, Michael F Drummond, Louis W Niessen, Hindrik Vondeling
Economic evidence is influential in health technology assessment world-wide. Clinical Practice Guidelines (CPG) can enable economists to include economic information on health care provision. Application of economic evidence in CPGs, and its integration into clinical practice and national decision making is hampered by objections from professions, paucity of economic evidence or lack of policy commitment. The use of state-of-art economic methodologies will improve this. Economic evidence can be graded by 'checklists' to establish the best evidence for decision making given methodological rigor...
2017: Cost Effectiveness and Resource Allocation: C/E
https://www.readbyqxmd.com/read/28199030/lessons-learned-from-the-science-of-caring-extending-the-reach-of-psychosocial-oncology-the-international-psycho-oncology-society-2016-sutherland-award-lecture
#16
Barry D Bultz
In medicine, referral to a medical oncology specialty is based on recent history, physical examination, pathology, surgery reports, imaging, blood work and the patient's vital signs. By contrast, referral to a psychosocial specialist has typically been based on the patients expressed request for psychosocial support or the health care team's observation of the patient's limited adjustment or poor coping with the diagnosis, treatment or end of life distress. These observations are usually based on clinical acumen not on metrics...
February 15, 2017: Psycho-oncology
https://www.readbyqxmd.com/read/28198722/triad-viii-nationwide-multicenter-evaluation-to-determine-whether-patient-video-testimonials-can-safely-help-ensure-appropriate-critical-versus-end-of-life-care
#17
Ferdinando L Mirarchi, Timothy E Cooney, Arvind Venkat, David Wang, Thaddeus M Pope, Abra L Fant, Stanley A Terman, Kevin M Klauer, Monica Williams-Murphy, Michael A Gisondi, Brian Clemency, Ankur A Doshi, Mari Siegel, Mary S Kraemer, Kate Aberger, Stephanie Harman, Neera Ahuja, Jestin N Carlson, Melody L Milliron, Kristopher K Hart, Chelsey D Gilbertson, Jason W Wilson, Larissa Mueller, Lori Brown, Bradley D Gordon
OBJECTIVE: End-of-life interventions should be predicated on consensus understanding of patient wishes. Written documents are not always understood; adding a video testimonial/message (VM) might improve clarity. Goals of this study were to (1) determine baseline rates of consensus in assigning code status and resuscitation decisions in critically ill scenarios and (2) determine whether adding a VM increases consensus. METHODS: We randomly assigned 2 web-based survey links to 1366 faculty and resident physicians at institutions with graduate medical education programs in emergency medicine, family practice, and internal medicine...
February 14, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28198336/managing-tissue-viability-issues-in-patients-with-cancer-approaching-the-end-of-life
#18
Kenneth Robert Ripley, Mark Collier
This article provides an overview of tissue viability issues related to the care of patients with cancer who are approaching the end of life. Altered physiology as a result of various factors, including nutrition, medication and radiotherapy, is identified. The article discusses the presentation and treatment of cutaneous radiation injury, malignant wounds, pressure ulcers and Skin Changes At Life's End (SCALE), an acronym used to describe a set of clinical phenomena associated with skin changes in patients approaching the end of life, and makes recommendations for practice...
February 15, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28198296/online-tool-targets-better-skills-in-end-of-life-care
#19
Stephanie Jones-Berry
A free online resource could help nurses and other healthcare staff to provide palliative and end of life care to people with a terminal illness.
February 15, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28195841/multiple-perspectives-of-symptoms-and-suffering-at-end-of-life-in-the-nicu
#20
Emily L Shultz, Mary Switala, Adrien M Winning, Madelaine C Keim, Amy E Baughcum, Cynthia A Gerhardt, Christine A Fortney
BACKGROUND: Despite technological advances in the neonatal intensive care unit, not all infants survive. Limited research has focused on infants' symptoms and suffering at end of life (EOL) from multiple perspectives. PURPOSE: To compare retrospective parent report and electronic medical record (EMR) documentation of symptoms and to examine associations with parent perceptions of infants suffering at EOL. METHODS/SEARCH STRATEGY: Bereaved parents of 40 infants (40 mothers and 27 fathers) retrospectively reported on their perceptions of infant symptoms and suffering during the last week of life...
February 13, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
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