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End-of-life

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https://www.readbyqxmd.com/read/29792980/language-used-by-health-care-professionals-to-describe-dying-at-an-acute-care-hospital
#1
Kirsten Wentlandt, Philippe Toupin, Natalia Novosedlik, Lisa W Le, Camilla Zimmermann, Ebru Kaya
PURPOSE: To understand the language used to describe the deterioration and death of patients in an acute academic tertiary care centre, and to identify whether patient diagnoses or palliative care(PC) involvement was associated with clearer descriptions of this process. METHODS: We conducted a retrospective chart review of the final admission of 150 patients who died on an inpatient internal medicine unit. Conventional and summative content analysis was performed of the language used to describe, either directly or indirectly, that the patient's death was imminent...
May 21, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29792768/thai-nursing-students-experiences-of-caring-for-patients-at-the-end-of-life-a-phenomenological-study
#2
Yaowarat Matchim, Parinya Raetong
AIM: To describe Thai nursing students' experiences of providing end-of-life care (EoLC). METHODS: Data were collected via in-depth interviews with 21 nursing students and were analysed using Van Manen's method. FINDINGS: Eight themes emerged based on Van Manen's four lived worlds: feeling excited and worried when receiving an assigned case; feeling disappointed with the health-care team's provision of psychosocial support for patients at the end-of-life and their families; being in a time of uncertainty; recognising that EoLC is a time for gaining merit; knowing that a peaceful place and privacy are needed for promoting a peaceful death; knowing that the real-life classroom is around the patient's bedside; feeling lonely and needing help and support; and creating relationships with patients and families as a nurse...
May 2, 2018: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/29791973/a-forbidden-topic-at-the-end-of-life-what-about-you-after-i-m-gone
#3
Michiko Iwasaki, Michael S Di Bianca, Donald R Nicholas
No abstract text is available yet for this article.
May 23, 2018: Psycho-oncology
https://www.readbyqxmd.com/read/29791762/ethical-dilemmas-in-nursing-an-integrative-review
#4
REVIEW
Jennifer Rainer, Joanne Kraenzle Schneider, Rebecca A Lorenz
AIMS: The purpose of this integrative review was to identify themes and gaps in the literature to stimulate researchers to develop strategies to guide decision-making among clinical nurses faced with ethical dilemmas. BACKGROUND: The concept of ethical dilemmas has been well explored in nursing because of the frequency of ethical dilemmas in practice and the toll these dilemmas can take on nurses. Although ethical dilemmas are prevalent in nursing practice, frequently leading to moral distress, there is little guidance in the literature to help nurses resolve them...
May 23, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29790870/genetic-disorders-and-mortality-in-infancy-and-early-childhood-delayed-diagnoses-and-missed-opportunities
#5
Monica H Wojcik, Talia S Schwartz, Inbar Yamin, Heather L Edward, Casie A Genetti, Meghan C Towne, Pankaj B Agrawal
PurposeInfants admitted to a level IV neonatal intensive care unit (NICU) who do not survive early childhood are a population that is probably enriched for rare genetic disease; we therefore characterized their genetic diagnostic evaluation.MethodsThis is a retrospective analysis of infants admitted to our NICU between 1 January 2011 and 31 December 2015 who were deceased at the time of records review, with age at death less than 5 years.ResultsA total of 2,670 infants were admitted; 170 later died. One hundred six of 170 (62%) had an evaluation for a genetic or metabolic disorder...
April 12, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29790421/facilitators-and-barriers-to-oncologists-conduct-of-goals-of-care-conversations
#6
Dena Schulman-Green, Jenny J Lin, Cardinale B Smith, Shelli Feder, Nina A Bickell
INTRODUCTION: Goals of care (GoC) conversations optimally begin early in the course of cancer care, yet most happen near the end of life. We sought to describe oncologist-reported facilitators of and barriers to GoC conversations with patients who have advanced cancer. METHODS AND MATERIALS: We conducted individual, semistructured qualitative interviews with oncologists from 4 academic, community, municipal, and rural hospitals in New York and Connecticut. Interview topics included approach to GoC conversations, facilitators, barriers, and organizational influences...
January 1, 2018: Journal of Palliative Care
https://www.readbyqxmd.com/read/29790153/centenarians-end-of-life-thoughts-and-plans-is-their-social-network-on-the-same-page
#7
Kathrin Boerner, Kyungmin Kim, Yijung Kim, Christoph Rott, Daniela S Jopp
OBJECTIVES: To explore how centenarians think about and plan for the end of life (EOL) and to what extent their primary contacts (proxy informants) are aware of these thoughts. DESIGN: Population-based study with semistructured in-person interviews. SETTING: Defined geographical region approximately 60 km around Heidelberg, Germany. PARTICIPANTS: Subsample drawn from the larger study of centenarians (N = 78) with data on centenarians' EOL thoughts from the centenarian and the proxy informant...
May 22, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29788744/general-practitioners-participation-in-cancer-treatment-in-norway
#8
Knut Holtedahl, Benedicte I Scheel, May-Lill Johansen
INTRODUCTION: General practitioners (GPs) participate in a patient's cancer care to different extents at different times, from prevention and diagnosis to treatment and end-of-life care. Traditionally, the GP has had a minor role in cancer treatment. However, oncological and surgical services frequently delegate limited cancer treatment tasks to GPs, especially in rural areas far from hospitals. The aim of this study was to explore the extent of GPs' participation in cancer treatment in Norway...
May 2018: Rural and Remote Health
https://www.readbyqxmd.com/read/29787408/organ-donation-after-circulatory-death-ethical-issues-and-international-practices
#9
Barbara G Jericho
Donation after circulatory death (DCD) is an increasingly utilized practice that can contribute to reducing the difference between the supply of organs and the demand for organs for transplantation. As the number of transplanted organs from DCD donors continues to increase, there is an essential need to address the ethical aspects of DCD in institutional DCD protocols and clinical practice. Ethical issues of respecting the end-of-life wishes of a potential donor, respecting a recipient's wishes, and addressing potential conflicts of interest are important considerations in developing policies and procedures for DCD programs...
May 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29785938/decision-making-in-end-of-life-care-are-we-really-playing-together-in-the-same-team
#10
M M Lomero-Martínez, M F Jiménez-Herrera, M A Bodí-Saera, M Llauradó-Serra, N Masnou-Burrallo, E Oliver-Juan, A Sandiumenge-Camps
BACKGROUND: Limitation of life-sustaining treatment is increasingly common in critical care units, and controlled donation after circulatory death is starting to be included as an option within patient care plans. Lack of knowledge and misunderstandings can place a barrier between healthcare professionals. OBJECTIVE: To determine the perceptions, knowledge and attitudes of physicians and nurses working in intensive care units regarding Limitation of life-sustaining treatment and controlled donation after circulatory death...
May 18, 2018: Enfermería Intensiva
https://www.readbyqxmd.com/read/29783228/awareness-of-pediatric-palliative-care-among-health-care-workers
#11
Oryna Z Detsyk, Zhanna M Zolotarova, Iryna V Stovban, Roman M Melnyk
OBJECTIVE: Introduction: In order to develop such a relatively new type of medical care in Ukraine, as pediatric palliative care, first of all, qualified medical workers are needed. The aim: to assess the awareness of pediatric palliative care among healthcare workers providing medical services to children. PATIENTS AND METHODS: Materials and methods: It was carried out a survey at health facilities of Ivano-Frankivsk region, which provided medical care for children...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29782631/reflections-on-end-of-life-dialysis
#12
Manuel Carlos Martins Castro
The world population is aging and diseases such as diabetes mellitus and systemic arterial hypertension are increasing the risk of patients developing chronic kidney disease, leading to an increase in the prevalence of patients on dialysis. The expansion of health services has made it possible to offer dialysis treatment to an increasing number of patients. At the same time, dialysis survival has increased considerably in the last two decades. Thus, patients on dialysis are becoming more numerous, older and with greater number of comorbidities...
May 17, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29782212/national-impact-of-the-epec-pediatrics-enhanced-train-the-trainer-model-for-delivering-education-on-pediatric-palliative-care
#13
Kimberley Widger, Joanne Wolfe, Stefan Friedrichsdorf, Jason D Pole, Sarah Brennenstuhl, Stephen Liben, Mark Greenberg, Eric Bouffet, Harold Siden, Amna Husain, James A Whitlock, Myra Leyden, Adam Rapoport
BACKGROUND: Lack of pediatric palliative care (PPC) training impedes successful integration of PPC principles into pediatric oncology. OBJECTIVES: We examined the impact of an enhanced implementation of the Education in Palliative and End-of-Life Care for Pediatrics (EPEC® -Pediatrics) curriculum on the following: (1) knowledge dissemination; (2) health professionals' knowledge; (3) practice change; and (4) quality of PPC. DESIGN: An integrated knowledge translation approach was used with pre-/posttest evaluation of care quality...
May 21, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29781791/the-facilitators-and-challenges-of-dying-at-home-with-dementia-a-narrative-synthesis
#14
Caroline Mogan, Mari Lloyd-Williams, Karen Harrison Dening, Christopher Dowrick
BACKGROUND: It is reported that, given the right support, most people would prefer to die at home, yet a very small minority of people with dementia do so. At present, knowledge gaps remain on how best to support end-of-life care at home for people with dementia. AIM: To identify and understand the challenges and facilitators of providing end-of-life care at home for people with dementia. DESIGN: Narrative synthesis of qualitative and quantitative data...
June 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29781379/innovative-curriculum-integrating-the-bio-behavioral-and-social-science-principles-across-the-lifestages-in-basic-science-years
#15
Anuradha Lele Mookerjee, Bradford D Fischer, Susan Cavanaugh, Vijay Rajput
Behavioral and social science integration in clinical practice improves health outcomes across the life stages. The medical school curriculum requires an integration of the behavioral and social science principles in early medical education. We developed and delivered a four-week course entitled "LifeStages" to the first year medical students. The learning objectives of the bio-behavioral and social science principles along with the cultural, economic, political, and ethical parameters were integrated across the lifespan in the curriculum matrix...
May 20, 2018: Medical Teacher
https://www.readbyqxmd.com/read/29779361/palliative-and-end-of-life-care-for-heart-failure-patients-in-an-aging-society
#16
Takahiro Okumura, Akinori Sawamura, Toyoaki Murohara
The populations of Asian countries are expected to age rapidly in the near future, with a dramatic increase in the number of heart failure (HF) patients also anticipated. The need for palliative and end-of-life care for elderly patients with advanced HF is currently recognized in aging societies. However, palliative care and active treatment for HF are not mutually exclusive, and palliative care should be provided to reduce suffering occurring at any stage of symptomatic HF after the point of diagnosis. HF patients are at high risk of sudden cardiac death from the early stages of the disease onwards...
May 23, 2018: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29778831/black-plastics-linear-and-circular-economies-hazardous-additives-and-marine-pollution
#17
REVIEW
Andrew Turner
Black products constitute about 15% of the domestic plastic waste stream, of which the majority is single-use packaging and trays for food. This material is not, however, readily recycled owing to the low sensitivity of black pigments to near infrared radiation used in conventional plastic sorting facilities. Accordingly, there is mounting evidence that the demand for black plastics in consumer products is partly met by sourcing material from the plastic housings of end-of-life waste electronic and electrical equipment (WEEE)...
May 17, 2018: Environment International
https://www.readbyqxmd.com/read/29778681/portable-x-ray-fluorescence-for-the-detection-of-pop-bfrs-in-waste-plastics
#18
Martin Sharkey, Mohamed Abou-Elwafa Abdallah, Daniel S Drage, Stuart Harrad, Harald Berresheim
The purpose of this study was to establish the efficacy of portable X-ray fluorescence (XRF) instrumentation as a screening tool for a variety of end of life plastics which may contain excess amounts of brominated flame retardants (BFRs), in compliance with European Union (EU) and United Nations Environment Programme (UNEP) legislative limits (low POP concentration limits - LPCLs). 555 samples of waste plastics were collected from eight waste and recycling sites in Ireland, including waste electrical and electronic equipment (WEEE), textiles, polyurethane foams (PUFs), and expanded polystyrene foams...
May 17, 2018: Science of the Total Environment
https://www.readbyqxmd.com/read/29778506/quality-of-life-symptoms-and-care-needs-in-patients-with-persistent-or-recurrent-platinum-resistant-ovarian-cancer-an-nrg-oncology-gynecologic-oncology-group-study
#19
Vivian E von Gruenigen, Helen Q Huang, David Cella, MichaelA Zevon, Jason A LaChance, Joan L Walker, Ritu Salani, Susan C Modesitt, Robert T Morris, William H Bradley, Matthew P Boente, Lari Wenzel
OBJECTIVES: The goals of treating recurrent platinum-resistant ovarian cancer are palliative, aimed at reducing symptoms and improving progression free survival. A prospective trial was conducted to determine the prevalence and severity of symptoms, and associated care needs. METHODS: Eligible women included those with persistent or recurrent platinum-resistant ovarian cancer with an estimated life expectancy of at least 6 months. The Needs at the End-of-Life Screening Tool (NEST), FACIT-Fatigue (FACIT-F), NCCN-FACT Ovarian Symptom Index [NFOSI-18]; Disease Related Symptoms (DRS), Treatment Side Effects (TSE), and Function/Well Being (F/WB) were collected at study entry, 3 and 6 months...
May 17, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29777740/rapid-response-systems
#20
REVIEW
Patrick G Lyons, Dana P Edelson, Matthew M Churpek
INTRODUCTION: Rapid response systems are commonly employed by hospitals to identify and respond to deteriorating patients outside of the intensive care unit. Controversy exists about the benefits of rapid response systems. AIMS: We aimed to review the current state of the rapid response literature, including evolving aspects of afferent (risk detection) and efferent (intervention) arms, outcome measurement, process improvement, and implementation. DATA SOURCES: Articles written in English and published in PubMed...
May 16, 2018: Resuscitation
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