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Massimiliano Orri, Jordan Sibeoni, Guilhem Bousquet, Mathilde Labey, Juliette Gueguen, Cyril Laporte, Sabine Winterman, Camille Picard, Clara Nascimbeni, Laurence Verneuil, Anne Revah-Levy
PURPOSE: Patients, family members, and physicians participate in cancer care, but their perspectives about what is helpful during cancer treatment have rarely been compared. The aim of this study was to compare these three perspectives. METHODS: Multicenter qualitative study (with previously published protocol) based on 90 semi-structured interviews. Participants (purposively selected until data saturation) came from three different subsamples: (i) patients with cancer (n=30), (ii) their relatives (n=30), and (iii) their referring physicians (n=10, interviewed more than once)...
October 19, 2016: Oncotarget
Olga Tursunov, Nathan I Cherny, Freda DeKeyser Ganz
PURPOSE/OBJECTIVES: To describe the experience of family members of patients receiving palliative sedation at the initiation of treatment and after the patient has died and to compare these experiences over time.
. DESIGN: Descriptive comparative study.
. SETTING: Oncology ward at Shaare Zedek Medical Center in Jerusalem, Israel.
. SAMPLE: A convenience sample of 34 family members of dying patients receiving palliative sedation...
November 1, 2016: Oncology Nursing Forum
Giuseppe Bonifazi, Roberta Palmieri, Silvia Serranti
An innovative strategy, based on micro X-ray fluorescence and HyperSpectralImaging in the short wave infrared range (1000-2500nm), was developed in order to characterize drill core samples collected from End-of-Life concrete. Micro X-ray fluorescence maps were realized to check the drill cores chemical composition, to develop the best approach for HSI analyses and to verify the correctness of the obtained HSI results. HSI analysis was carried out in order to recognize and classify aggregates and mortar paste in concrete...
October 17, 2016: Waste Management
Magnolia Cardona-Morrell, Gustavo Benfatti-Olivato, Jesse Jansen, Robin M Turner, Diana Fajardo-Pulido, Ken Hillman
OBJECTIVE: To describe the range of decision aids (DAs) available to enable informed choice for older patients at the end of life and assess their effectiveness or acceptability. METHODS: Search strategy covered PubMed, Scopus, Ovid MEDLINE, EMBASE, EBM Reviews, CINAHL and PsycInfo between 1995 and 2015. The quality criteria framework endorsed by the International Patient Decision Aids Standards (IPDAS) was used to assess usefulness. RESULTS: Seventeen DA interventions for patients, their surrogates or health professionals were included...
October 11, 2016: Patient Education and Counseling
Chloe Fletcher, Ingrid Flight, Janine Chapman, Kate Fennell, Carlene Wilson
OBJECTIVE: To provide an updated synthesis of the literature that investigates the self-reported information needs of people diagnosed with cancer across the cancer continuum. METHODS: We conducted a scoping review of the literature published from August 2003 to June 2015 and expanded an existing typology summarizing the information needs of people diagnosed with cancer. RESULTS: The majority of the included studies (n=104) focused on questions relevant to the diagnosis/active treatment phase of the cancer continuum (52...
October 12, 2016: Patient Education and Counseling
Anna Lloyd, Marilyn Kendall, John M Starr, Scott A Murray
BACKGROUND: The experiences of people with cancer and organ disease have been described across different dimensions of need as they approach death. Such information is lacking for frail older people approaching death, but could highlight how a palliative approach might be relevant for this population. METHODS: Cognitively intact, community dwelling adults considered to be moderately or severely frail were recruited from a medical day hospital. Those recruited nominated an informal carer and case-linked professional...
October 20, 2016: BMC Geriatrics
Patrick J Dillon, Ambar Basu
Over the past decade, scholars and practitioners have called for efforts to reduce disparities in the cost and quality of end-of-life care; a key contributor to these disparities is the underuse of hospice care by African American patients. While previous studies have often relied on interviewing minority individuals who may or may not have been terminally ill, among them only few who were using hospice care services, this essay reports the findings of a grounded theory analysis of interviews with 26 African American hospice patients (n = 10) and lay caregivers (n = 16)...
2016: Journal of Health Care for the Poor and Underserved
Mark Corbett
Conceivably, in an ideal world, all patients with a life-limiting illness would receive optimal hospice and palliative care so that no one would ever wish to hasten their own death. The reality, however, is that despite provision of optimal hospice and palliative care, individuals with terminal illness experience suffering, loss of meaning, or deterioration in quality of life to the extent where they express the desire to expedite the dying process. While there has been extensive discussion surrounding physician-assisted death (PAD), there has been less attention paid to the practice of voluntary stopping eating and drinking (VSED) near the end of life...
2016: Narrative Inquiry in Bioethics
(no author information available yet)
At The Christie NHS Foundation Trust, Manchester, concerns that end of life care discussions were occurring too late in breast cancer cases led to earlier introduction of palliative care. Benefits include reduced hospital admissions during end of life and improved symptom management. The authors encourage nurses to support an integrated approach to enhance care provision for patients.
October 12, 2016: Nursing Standard
Nicola Vargas, Loredana Tibullo, Emanuela Landi, Giovanni Carifi, Alfonso Pirone, Antonio Pippo, Immacolata Alviggi, Renato Tizzano, Elisa Salsano, Francesco Di Grezia, Maria Vargas
Despite technological advances, the mortality rate for critically ill oldest old patients remains high. The intensive caring should be able to combine technology and a deep humanity considering that the patients are living the last part of their lives. In addition to the traditional goals of ICU of reducing morbidity and mortality, of maintaining organ functions and restoring health, caring for seriously oldest old patients should take into account their end-of-life preferences, the advance or proxy directives if available, the prognosis, the communication, their life expectancy and the impact of multimorbidity...
October 19, 2016: Aging Clinical and Experimental Research
Amber Mills, Anne Walker, Michele Levinson, Alison M Hutchinson, Gemma Stephenson, Anthea Gellie, George Heriot, Harvey Newnham, Megan Robertson
OBJECTIVE: To determine the prevalence of resuscitation orders and Advance Care Plans, and the relationship with Medical Emergency Team (MET) calls. METHOD: A point prevalence review of patient records at five Victorian hospital services. RESULTS: One thousand nine hundred and thirty-four patient records were reviewed, and 230 resuscitation orders and 15 Advance Care Plans found. Significantly, more resuscitation orders were found at public hospitals...
October 19, 2016: Australasian Journal on Ageing
Shannon M Dunlay, Jacob J Strand, Sara E Wordingham, John M Stulak, Angela J Luckhardt, Keith M Swetz
BACKGROUND: Despite the ability of left ventricular assist device as destination therapy (DT-LVAD) to prolong survival for many patients with advanced heart failure, little is known about the eventual end-of-life care that patients with DT-LVAD receive. METHODS AND RESULTS: All patients undergoing DT-LVAD at the Mayo Clinic in Rochester, Minnesota, from January 1, 2007, to September 30, 2014, who subsequently died before July 1, 2015, were included. Information about end-of-life care was obtained from documentation in the electronic medical record...
October 2016: Circulation. Heart Failure
Edward J Wing
With the wider availability of antiretrovirals, the world's HIV population is aging. More than 10% of the 34.5 million HIV+ individuals worldwide are over the age of 50 and the average age continues to increase. In the US more than 50% of the 1.3 million people with HIV are over 50 and by the year 2030 it is estimated that 70% will be over the age of 50. Although the life expectancy of HIV+ people has increased dramatically, it still lags behind HIV- individuals. There is controversy about whether HIV itself accelerates the aging process...
October 15, 2016: International Journal of Infectious Diseases: IJID
Pauline Siew Mei Lai, Salinah Mohd Mudri, Karuthan Chinna, Sajaratulnisah Othman
BACKGROUND: Advance care planning is a voluntary process whereby individual preferences, values and beliefs are used to aid a person in planning for end-of-life care. Currently, there is no local instrument to assess an individual's awareness and attitude towards advance care planning. This study aimed to develop an Advance Care Planning Questionnaire and to determine its validity and reliability among older people in Malaysia. METHODS: The Advance Care Planning Questionnaire was developed based on literature review...
October 18, 2016: BMC Medical Ethics
Arno Maetens, Robrecht De Schreye, Kristof Faes, Dirk Houttekier, Luc Deliens, Birgit Gielen, Cindy De Gendt, Patrick Lusyne, Lieven Annemans, Joachim Cohen
BACKGROUND: The use of full-population databases is under-explored to study the use, quality and costs of end-of-life care. Using the case of Belgium, we explored: (1) which full-population databases provide valid information about end-of-life care, (2) what procedures are there to use these databases, and (3) what is needed to integrate separate databases. METHODS: Technical and privacy-related aspects of linking and accessing Belgian administrative databases and disease registries were assessed in cooperation with the database administrators and privacy commission bodies...
October 18, 2016: BMC Palliative Care
Evelyn Robinson, Fayron Epps
Being knowledgeable about end-of-life care can help nurses overcome barriers to managing chronicity in terminally ill patients. The purpose of this causal-comparative research study was to examine the influence of a palliative care elective course on 74 senior nursing students' knowledge and attitudes toward providing end-of-life care. This study compared the differences between 2 groups of students, with 1 group receiving end-of-life care instruction based on the principles of the End-of-Life Nursing Education Consortium as an elective course...
October 17, 2016: Nurse Educator
Sara Gianella, Jeff Taylor, Timothy R Brown, Andy Kaytes, Cristian L Achim, David J Moore, Susan J Little, Ron J Ellis, Davey M Smith
Despite extensive investigations, we still do not fully understand the dynamics of the total body HIV reservoir and how sub-reservoirs in various compartments relate to one another. Studies using macaque models are enlightening but eradication strategies will still need to be tested in humans. To take the next steps in understanding and eradicating HIV reservoirs throughout the body, we propose to develop a "peri-mortem translational research model" of HIV-infected individuals (called 'The Last Gift'), which is similar to existing models in cancer research...
October 14, 2016: AIDS
Michael J Murray, Heidi DeBlock, Brian Erstad, Anthony Gray, Judi Jacobi, Che Jordan, William McGee, Claire McManus, Maureen Meade, Sean Nix, Andrew Patterson, M Karen Sands, Richard Pino, Ann Tescher, Richard Arbour, Bram Rochwerg, Catherine Friederich Murray, Sangeeta Mehta
OBJECTIVE: To update the 2002 version of "Clinical practice guidelines for sustained neuromuscular blockade in the adult critically ill patient." DESIGN: A Task Force comprising 17 members of the Society of Critical Medicine with particular expertise in the use of neuromuscular-blocking agents; a Grading of Recommendations Assessment, Development, and Evaluation expert; and a medical writer met via teleconference and three face-to-face meetings and communicated via e-mail to examine the evidence and develop these practice guidelines...
November 2016: Critical Care Medicine
Debbie Selby, Dori Seccaraccia, Jim Huth, Kristin Kurrpa, Margaret Fitch
OBJECTIVE: The goal of this study was to explore healthcare professionals' (HCPs') perception of their role in provision of spiritual care, in addition to attempting to identify a simple question(s) to help identify spiritual distress. BACKGROUND: Spirituality is well recognized as important to whole-person care, particularly in those with terminal illnesses. Understanding the role of front-line providers in the identification and management of spiritual distress, however, remains challenging...
October 18, 2016: Journal of Palliative Medicine
Irina A Tikhonova, Martin W Hoyle, Tristan M Snowsill, Chris Cooper, Joanna L Varley-Campbell, Claudius E Rudin, Ruben E Mujica Mota
The National Institute for Health and Care Excellence (NICE) invited the manufacturer of azacitidine (Celgene) to submit evidence for the clinical and cost effectiveness of this drug for the treatment of acute myeloid leukaemia with more than 30 % bone marrow blasts in adults who are not eligible for haematopoietic stem cell transplantation, as part of the NICE's Single Technology Appraisal process. The Peninsula Technology Assessment Group was commissioned to act as the Evidence Review Group (ERG). The ERG produced a critical review of the evidence contained within the company's submission to NICE...
October 17, 2016: PharmacoEconomics
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