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End-of-life

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https://www.readbyqxmd.com/read/29331488/a-potential-utilization-of-end-of-life-tyres-as-recycled-carbon-black-in-epdm-rubber
#1
M Sagar, K Nibedita, N Manohar, K Raj Kumar, S Suchismita, A Pradnyesh, A Babul Reddy, E Rotimi Sadiku, U N Gupta, P Lachit, J Jayaramudu
End-of-life (EOL) tyres and their decomposition present severe environmental concern due to their resistance to moisture, oxygen, natural degradation, etc. Pyrolysis is considered to be the most effective and sustainable process for recycling, due to its eco-friendly process. The current work studied the effect of recycled carbon black (rCB), obtained from the pyrolysis of EOL tyres, on the properties of ethylene propylene diene rubber (EPDM). The rCB was characterized by scanning electron microscopy (SEM), thermogravimetric analysis (TGA) and chemical methods...
January 10, 2018: Waste Management
https://www.readbyqxmd.com/read/29331475/end-of-life-care-for-patients-with-advanced-kidney-disease-in-the-us-veterans-affairs-health-care-system-2000-2011
#2
Susan P Y Wong, Margaret K Yu, Pamela K Green, Chuan-Fen Liu, Paul L Hebert, Ann M O'Hare
BACKGROUND: Little is known about patterns of end-of-life care for patients with advanced kidney disease not treated with maintenance dialysis. STUDY DESIGN: Case series. SETTING & PARTICIPANTS: A sample of 14,071 patients with sustained estimated glomerular filtration rates < 15mL/min/1.73m2 treated in the US Veterans Affairs health care system who died during 2000 to 2011. Before death, 12,756 of these patients had been treated with dialysis, 503 had been discussing and/or preparing for dialysis therapy, and for 812, there had been a decision not to pursue dialysis therapy...
January 10, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29331209/ethical-and-end-of-life-considerations-for-neonates-requiring-ecmo-support
#3
REVIEW
Roxanne Kirsch, David Munson
ECMO has proven to be a life-saving intervention for a variety of disease entities with a high rate of survival in the neonatal population. However, ECMO requires clinical teams to engage in many ethical considerations. Even with ongoing improvements in technology and expertise, some patients will not survive a course of ECMO. An unsuccessful course of ECMO can be difficult to accept and cause a great deal of angst. These questions can result in real conflict both within the care team, and between the care team and the family...
January 10, 2018: Seminars in Perinatology
https://www.readbyqxmd.com/read/29331192/-psychiatry-and-palliative-care-collaboration-for-the-benefit-of-the-patient
#4
REVIEW
Lionel Regard
As palliative care units continue to develop, the provision of end-of-life care for patients with a chronic mental illness needs to be addressed. Aside from the somatic comorbidities to which these patients are particularly exposed and in view of the specificity of psychiatric treatment, the forms of end-of-life support for a patient with schizophrenia are described here, based on the experience of a psychiatric unit in the Var region.
January 2018: Revue de L'infirmière
https://www.readbyqxmd.com/read/29329163/the-importance-of-parental-connectedness-and-relationships-with-healthcare-professionals-in-end-of-life-care-in-the-picu
#5
Jeannette L Falkenburg, Dick Tibboel, Ruard R Ganzevoort, Saskia J Gischler, Monique van Dijk
OBJECTIVES: Support from healthcare professionals in a PICU is highly valuable for parents of dying children. The way they care for the patients and their families affects the parents' initial mourning process. This study explores what interaction with hospital staff is meaningful to parents in existential distress when their child is dying in the PICU. DESIGN: Qualitative interview study. SETTING: Level 3 PICU in the Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, and the Netherlands...
January 11, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29328354/end-of-life-conversations-as-a-legacy
#6
Jeanne M Sorrell
Advance directives such as living wills and health care powers of attorney are important documents that offer patients ways to avoid unwanted care when they are unable to express their wishes. Although health care professionals have increased focus on advance care planning in recent years, approximately two thirds of American adults do not have advance medical directives. In addition, 90% of individuals believe that talking to loved ones about end-of-life wishes is important, but only 27% have done so. It is important for nurses to understand the complex factors that influence how individuals make health care decisions and identify ways to encourage conversations with family, friends, and health care providers to help clarify patients' wishes for endof-life care...
January 1, 2018: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/29327799/what-is-needed-to-prepare-speech-pathologists-to-work-in-adult-palliative-care
#7
Ashleigh Pascoe, Lauren J Breen, Naomi Cocks
BACKGROUND: Speech pathologists have a pivotal role in palliative care, assisting patients with swallowing and communication disorders, yet very little is known about the preparedness of speech pathologists to work in this field. AIMS: To investigate the preparedness of speech pathologists for working in palliative care. The term 'palliative care' was viewed as an encompassing umbrella term incorporating the management/reduction of symptoms and improvement in a person's quality of life at any point of the disease progression...
January 12, 2018: International Journal of Language & Communication Disorders
https://www.readbyqxmd.com/read/29327100/-provision-of-palliative-care-for-people-with-advanced-dementia
#8
REVIEW
J Diehl-Schmid, L Riedl, U Rüsing, J Hartmann, M Bertok, C Levin, J Hamann, M Arcand, S Lorenzl, B Feddersen, R J Jox
As a result of a literature-based expert process, this review provides an overview about the principles of palliative care for people with advanced dementia that are relevant for clinical practice. In particular, the indications, impact and aims of palliative care for advanced dementia are described. Life-prolonging measures and management of symptoms at the end of life are discussed. Furthermore, the overview focuses on the legal basis of decision making.
January 11, 2018: Der Nervenarzt
https://www.readbyqxmd.com/read/29326414/-effect-of-debriefing-based-on-the-clinical-judgment-model-on-simulation-based-learning-outcomes-of-end-of-life-care-for-nursing-students-a-non-randomized-controlled-trial
#9
Kyung In Jeong, Ja Yun Choi
PURPOSE: This study was conducted to identify effects of debriefing based on the clinical judgment model for nursing students on their knowledge, skill performance, clinical judgment, self-confidence and learner satisfaction during simulation based end-of-life care (ELC) education. METHODS: Simulation based ELC education was developed in six steps as follows: selection of learning subjects and objects, development of learning tools, a trial run of simulation-based education, students' skill training, and evaluators' training...
December 2017: Journal of Korean Academy of Nursing
https://www.readbyqxmd.com/read/29325534/increasing-trend-in-hospital-deaths-consistent-among-older-decedents-in-korea-a-population-based-study-using-death-registration-database-2001-2014
#10
Tran Thi Xuan Mai, Eunsook Lee, Hyunsoon Cho, Yoon Jung Chang
BACKGROUND: With improvement in hospice palliative care services and long-term care, Republic of Korea (hereafter South Korea) has recorded significant changes in places of death (e.g., hospital, home), especially among older adults. Over the last few decades, the most common places of death in South Korea were hospitals. However, Koreans, especially older adults, reportedly prefer to receive terminal care and eventually die at home. This study was conducted to investigate trends in places of death among older Korean adults and factors associated therewith...
January 11, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29325440/case-mix-adjustment-of-the-bereaved-family-survey
#11
Ann Kutney-Lee, Joan Carpenter, Dawn Smith, Joshua Thorpe, Alina Tudose, Mary Ersek
Surveys of bereaved family members are increasingly being used to evaluate end-of-life (EOL) care and to measure organizational performance in EOL care quality. The Bereaved Family Survey (BFS) is used to monitor EOL care quality and benchmark performance in the Veterans Affairs (VA) health-care system. The objective of this study was to develop a case-mix adjustment model for the BFS and to examine changes in facility-level scores following adjustment, in order to provide fair comparisons across facilities...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29323766/acupuncture-in-hospice-settings-a-qualitative-exploration-of-patients-experiences
#12
P McPhail, H Sandhu, J Dale, S Stewart-Brown
Whilst acupuncture has the potential to impact on many aspects of health and well-being, including end-of-life care, there is little research regarding patients' experiences of its effects within the context of palliative care in hospice settings. The aim of this study was to address this gap, by exploring patients' experiences of acupuncture within this setting. In-depth, semi-structured interviews were conducted with a sample of eighteen patients who had received acupuncture as part of hospice care. Transcription of data, with thematic analysis, identified two overarching themes: (1) participant perceptions of the effects of acupuncture including pain control, improved physical and emotional health, spiritual well-being and awareness of health as a holistic phenomenon; and (2) factors which participants believed enabled acupuncture to have these effects including the quality of the practitioner relationship, engagement of participants in the process of their treatment and prior expectations that acupuncture could work...
January 11, 2018: European Journal of Cancer Care
https://www.readbyqxmd.com/read/29323618/measuring-attitudes-towards-the-dying-process-a-systematic-review-of-tools
#13
Bernadette Groebe, Julia Strupp, Yvonne Eisenmann, Holger Schmidt, Anna Schlomann, Christian Rietz, Raymond Voltz
BACKGROUND: At the end of life, anxious attitudes concerning the dying process are common in patients in Palliative Care. Measurement tools can identify vulnerabilities, resources and the need for subsequent treatment to relieve suffering and support well-being. AIM: To systematically review available tools measuring attitudes towards dying, their operationalization, the method of measurement and the methodological quality including generalizability to different contexts...
January 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29321079/the-enactment-stage-of-end-of-life-decision-making-for-children
#14
Jane Elizabeth Sullivan, Lynn Heather Gillam, Paul Terence Monagle
OBJECTIVES: Typically pediatric end-of-life decision-making studies have examined the decision-making process, factors, and doctors' and parents' roles. Less attention has focussed on what happens after an end-of-life decision is made; that is, decision enactment and its outcome. This study explored the views and experiences of bereaved parents in end-of-life decision-making for their child. Findings reported relate to parents' experiences of acting on their decision. It is argued that this is one significant stage of the decision-making process...
January 11, 2018: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29315204/moral-distress-model-reconstructed-using-grounded-theory
#15
Hsun-Kuei Ko, Chi-Chun Chin, Min-Tao Hsu
BACKGROUND: The problems of nurse burnout and manpower shortage relate to moral distress. Thus, having a good understanding of moral distress is critical to developing strategies that effectively improve the clinical ethical climate and improve nursing retention in Taiwan. PURPOSE: The aim of this study was to reconstruct the model of moral distress using the grounded theory. METHODS: Twenty-five staff nurses at work units who attend to the needs of adult, pediatric, acute, and critical disease or end-of-life-care patients were recruited as participants using theoretical sampling from three teaching hospitals in Taiwan...
February 2018: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/29314264/a-practical-guide-for-the-care-of-patients-with-end-stage-renal-disease-near-the-end-of-life
#16
Amar D Bansal, Jane O Schell
Most patients who rely on dialysis for treatment of end-stage renal disease (ESRD) never receive a kidney transplant. Therefore, it is important for nephrology providers to feel comfortable discussing the role of dialysis near the end of life (EOL). Advance care planning (ACP) is an ongoing process of learning patient values and goals in an effort to outline preferences for current and future care. This review presents a framework for how to incorporate ACP in the care of dialysis patients throughout the kidney disease course and at the EOL...
January 3, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29313774/communicating-with-pediatric-families-at-end-of-life-is-not-a-fantasy
#17
Connie M Ulrich, Kim Mooney-Doyle, Christine Grady
No abstract text is available yet for this article.
January 2018: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/29313654/lung-cancer-clinical-presentation-and-diagnosis
#18
Kelly M Latimer
In the absence of screening, most patients with lung cancer are not diagnosed until later stages, when the prognosis is poor. The most common symptoms are cough and dyspnea, but the most specific symptom is hemoptysis. Digital clubbing, though rare, is highly predictive of lung cancer. Symptoms can be caused by the local tumor, intrathoracic spread, distant metastases, or paraneoplastic syndromes. Clinicians should suspect lung cancer in symptomatic patients with risk factors. The initial study should be chest x-ray, but if results are negative and suspicion remains, the clinician should obtain a computed tomography scan with contrast...
January 2018: FP Essentials
https://www.readbyqxmd.com/read/29311368/education-research-difficult-conversations-in-neurology-lessons-learned-from-medical-students
#19
Monica E Lemmon, Charlene Gamaldo, Rachel Marie E Salas, Ankita Saxena, Tiana E Cruz, Renee D Boss, Roy E Strowd
OBJECTIVE: To characterize features of medical student exposure to difficult conversations during a neurology core clerkship. METHODS: This was a cross-sectional concurrent nested mixed methods study, and all students rotating through a required neurology clerkship between 2014 and 2015 were enrolled. Data collection included an electronic communication tracker, baseline and end-of-clerkship surveys, and 4 facilitated focus groups. Students were asked to log exposure to patient-clinician conversations about (1) new disability, (2) poor prognosis, (3) prognostic uncertainty (4), terminal diagnosis, and (5) end-of-life care...
January 9, 2018: Neurology
https://www.readbyqxmd.com/read/29310331/eliciting-community-perspectives-on-research-with-older-adults-living-with-hiv-through-focus-groups
#20
Annie L Nguyen, Brandon Brown, Jeff Taylor, Marlene Estevez, Rick Loftus
Approximately half of all people living with HIV in the US are age 50 and older. Existing research highlights the health challenges of these individuals, but little work has focused on gathering input about concerns in participating in HIV and aging research. Prior to designing a prospective cohort study on HIV and aging, we elicited feedback from potential participants on general attitudes toward participation in a prospective HIV cohort study, and perspectives on important research topics relevant to older adults living with HIV...
December 2017: Medicine (Baltimore)
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