MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Palliative Medicine' source. Mon, 06 Feb 2012 21:53:45 +0100 http://www.medworm.com/index.php?rid=5620175&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22258367%26dopt%3DAbstract CONCLUSIONS: Following trends in the USA and Canada, dying is also shifting to people's homes in Britain. Home deaths increased for the first time since 1974 amongst people aged 85 years and over. There is an urgent need across nations for comparative evidence on the outcomes and the costs of dying at home. PMID: 22258367 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5620175 Wed, 18 Jan 2012 05:00:00 +0100 5620175 http://www.medworm.com/index.php?rid=5620177&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22249925%26dopt%3DAbstract CONCLUSIONS: Patients who have IDs do not easily process verbal information in a clinical setting. The new model for breaking bad news to people with IDs needs to be tested in practice using robust outcome measures. The model's relevance to wider patient groups should also be evaluated. PMID: 22249925 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5620177 Mon, 16 Jan 2012 05:00:00 +0100 5620177 http://www.medworm.com/index.php?rid=5620176&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22249926%26dopt%3DAbstract CONCLUSION: While higher than expenditures previously reported for a cancer-only population in an urban Ontario setting, the costs were still within the parameters of the US Medicare Hospice Benefits, on a par with the per diem funding assigned for long-term care homes and lower than both average alternate level of care and hospital costs within the Province of Ontario. The study results may assist service planners in the appropriate allocation of resources and service packaging to meet the complex needs of palliative care populations. PMID: 22249926 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5620176 Mon, 16 Jan 2012 05:00:00 +0100 5620176 http://www.medworm.com/index.php?rid=5577858&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22218096%26dopt%3DAbstract We present the case of a 30-year-old patient with pontine glioblastoma multiforme, World Health Organisation grade IV (WHO IV). This case is of particular interest in terms of the patient's use of social media as a medium of expression. This popular form of communication raises important clinical, ethical and social issues relating to confidentiality and the nature of the physician-patient relationship in a unique context. PMID: 22218096 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5577858 Wed, 04 Jan 2012 05:00:00 +0100 5577858 http://www.medworm.com/index.php?rid=5577857&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22218097%26dopt%3DAbstract CONCLUSIONS: The studies provided limited evidence on improved outcomes following the implementation of these interventions. Further research is needed, both within the UK and internationally, that measures the process and impact of implementing these initiatives. PMID: 22218097 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5577857 Wed, 04 Jan 2012 05:00:00 +0100 5577857 http://www.medworm.com/index.php?rid=5548420&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22190614%26dopt%3DAbstract Authors: Burt J PMID: 22190614 [PubMed - in process] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5548420 Thu, 29 Dec 2011 05:30:22 +0100 5548420 http://www.medworm.com/index.php?rid=5548419&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22190615%26dopt%3DAbstract CONCLUSIONS: UK doctors appear to oppose the introduction of AVE and PAS, even when one considers the methodological limitations of included studies. Attempts to minimise bias in included studies varied. Further studies are necessary to establish if subgroup variables other than degree of religiosity influence attitudes, and to thoroughly explore the qualitative themes that appeared. PMID: 22190615 [PubMed - in process] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5548419 Thu, 29 Dec 2011 05:30:12 +0100 5548419 http://www.medworm.com/index.php?rid=5548421&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22190605%26dopt%3DAbstract CONCLUSIONS: Findings highlight lack of evidence to support practice, and identify the complexity and emotional labour involved in prognostication by hospital specialist palliative care team members, and are used to discuss recommendations for further research and practice. PMID: 22190605 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5548421 Wed, 21 Dec 2011 05:00:00 +0100 5548421 http://www.medworm.com/index.php?rid=5532922&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22179595%26dopt%3DAbstract CONCLUSION: Qualitative observational data collection methods can contribute to theoretical and conceptual development and the explanation of social processes in palliative care. In particular this contribution to understanding care structures and processes should improve understanding of patients' experiences of their care journey and thus impact on care outcomes. PMID: 22179595 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5532922 Fri, 16 Dec 2011 05:00:00 +0100 5532922 http://www.medworm.com/index.php?rid=5532921&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22179596%26dopt%3DAbstract Authors: Slocum-Gori S, Hemsworth D, Chan WW, Carson A, Kazanjian A Abstract BACKGROUND: Despite the increasingly crucial role of the healthcare workforce and volunteers working in hospice and palliative care (HPC), very little is known about factors that promote or limit the positive outcomes associated with practicing compassion. AIM: The purpose of this study was to: 1) understand the complex relationships among Compassion Satisfaction, Compassion Fatigue and Burnout within the hospice and palliative care workforce and 2) explore how key practice characteristics - practice status, professional affiliation, and principal institution - interact with the measured constructs of Compassion Satisfaction, Compassion Fatigue and Burnout. DESIGN: Self-reported measures of Compassion Sati... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5532921 Fri, 16 Dec 2011 05:00:00 +0100 5532921 http://www.medworm.com/index.php?rid=5532920&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22179597%26dopt%3DAbstract CONCLUSIONS: The PHR can be helpful in facilitating communication, understanding medical conditions and treatments, and facilitating end-of-life care discussion; however, for wide-spread implementation, resolving the obstacles related to both patients and health-care professionals is required. PMID: 22179597 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5532920 Fri, 16 Dec 2011 05:00:00 +0100 5532920 http://www.medworm.com/index.php?rid=5512332&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22143040%26dopt%3DAbstract CONCLUSIONS: Various sociocultural factors influence the provision of EoL care in Belgium. This country provides a unique opportunity to witness how euthanasia is put into practice when legalized, in a context where palliative care is also highly developed and where many health care institutions have Catholic affiliation, providing an important example to others. Attention to how the sociocultural context affects EoL care adds to the current evidence base of service provision, which is essential in the further development of EoL care. PMID: 22143040 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5512332 Mon, 05 Dec 2011 05:00:00 +0100 5512332 http://www.medworm.com/index.php?rid=5512331&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22143041%26dopt%3DAbstract CONCLUSION: Our findings demonstrate the importance of patients' awareness of disease status to HRQOL. PMID: 22143041 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5512331 Mon, 05 Dec 2011 05:00:00 +0100 5512331 http://www.medworm.com/index.php?rid=5474192&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22127208%26dopt%3DAbstract Authors: Grande G, Preston N PMID: 22127208 [PubMed - in process] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5474192 Thu, 01 Dec 2011 05:00:00 +0100 5474192 http://www.medworm.com/index.php?rid=5474191&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22127209%26dopt%3DAbstract Authors: Payne S PMID: 22127209 [PubMed - in process] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5474191 Thu, 01 Dec 2011 05:00:00 +0100 5474191 http://www.medworm.com/index.php?rid=5474196&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22126843%26dopt%3DAbstract CONCLUSIONS: The evidence from the available clinical trials is of limited amount and quality, but it weakly supports the proposal that the addition of an NSAIDs to WHO Step III opioids can improve analgesia or reduce opioid dose requirement. There is insufficient evidence to support the use of paracetamol in combination with Step III opioids. Data on the toxicity of NSAIDs in this indication are insufficient owing to the small number of patients and the short duration of treatment reported in the studies. PMID: 22126843 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5474196 Tue, 29 Nov 2011 05:00:00 +0100 5474196 http://www.medworm.com/index.php?rid=5474195&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22126844%26dopt%3DAbstract CONCLUSIONS: Our study indicates that totally implantable port systems yield a higher risk of complications in terminally ill patients. Further investigation should be carefully conducted to compare outcomes of various central venous access devices in patients with advanced cancer and to develop preventive strategies against catheter failure. PMID: 22126844 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5474195 Tue, 29 Nov 2011 05:00:00 +0100 5474195 http://www.medworm.com/index.php?rid=5474194&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22126845%26dopt%3DAbstract CONCLUSIONS: Classroom-based education and training is useful for enhancing professionals' skills and perceived preparedness for delivering end-of-life care but should be reinforced by actual practice experience. PMID: 22126845 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5474194 Tue, 29 Nov 2011 05:00:00 +0100 5474194 http://www.medworm.com/index.php?rid=5474193&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22126846%26dopt%3DAbstract CONCLUSIONS: The reported out-of-hours availability of GPs for terminally ill patients is still high. GPs' perception of their duty of care might change in the next generations, and the increasing number of salaried GPs, living far from their practice, might threaten out-of-hours availability for terminally ill patients. GPs' perception of their duty of care might change in the next generations, and the increasing number of salaried GPs living far from their practice might threaten out-of-hours availability for terminally ill patients. PMID: 22126846 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5474193 Tue, 29 Nov 2011 05:00:00 +0100 5474193 http://www.medworm.com/index.php?rid=5418738&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22084491%26dopt%3DAbstract CONCLUSIONS: Recommendations can be made for the frequency of syringe driver site changes based on which drugs are in use. Incidental findings from the study have been used to change practice at the hospice study site, with regard to choice of parenteral cannulae. PMID: 22084491 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5418738 Mon, 14 Nov 2011 05:00:00 +0100 5418738 http://www.medworm.com/index.php?rid=5418740&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22075163%26dopt%3DAbstract CONCLUSIONS: Challenges exist in therapy with difficult families. Therapy in the home brings special issues. Therapists can apply most of the interventions prescribed by the FFGT model. PMID: 22075163 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5418740 Thu, 10 Nov 2011 05:00:00 +0100 5418740 http://www.medworm.com/index.php?rid=5418739&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22075164%26dopt%3DAbstract CONCLUSIONS: The study findings provide much needed depth to the field's understanding of problem-solving interventions for informal hospice caregivers and can be used to enhance existing support services. PMID: 22075164 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5418739 Thu, 10 Nov 2011 05:00:00 +0100 5418739 http://www.medworm.com/index.php?rid=5418741&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22064045%26dopt%3DAbstract CONCLUSIONS: A targeted education program for health professionals improved understanding about end-of-life care for people with MND. Health care providers also reported having made improvements in the care provided to patients and carers, particularly communication, psychosocial care and symptom management. PMID: 22064045 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5418741 Mon, 07 Nov 2011 05:00:00 +0100 5418741 http://www.medworm.com/index.php?rid=5379166&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22045725%26dopt%3DAbstract CONCLUSIONS: A minority of studies reported the use of observational scales to monitor the effect of palliative sedation. Future studies should be focused on establishing proper instruments, most adequate frequency and timing of assessment, and interdisciplinary evaluation of sedation depth and symptom control for palliative sedation. PMID: 22045725 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5379166 Tue, 01 Nov 2011 04:00:00 +0100 5379166 http://www.medworm.com/index.php?rid=5379165&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22045726%26dopt%3DAbstract CONCLUSIONS: ECHO-D is the first instrument specifically to assess 'quality of care for the dying', focussing on the last days of life, and has direct links with the use of the LCP Programme. PMID: 22045726 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5379165 Tue, 01 Nov 2011 04:00:00 +0100 5379165 http://www.medworm.com/index.php?rid=5379164&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22045727%26dopt%3DAbstract CONCLUSIONS: Rigorously applied MRSA protocols impose significant burdens at the end of life. Research on clinical outcomes including quality of life may identify interventions of questionable benefit. The issue of handling MRSA should be studied as a model for the management of other highly complex conditions and special needs such as patient isolation. PMID: 22045727 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5379164 Tue, 01 Nov 2011 04:00:00 +0100 5379164 http://www.medworm.com/index.php?rid=5379168&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22042225%26dopt%3DAbstract CONCLUSIONS: Findings from a qualitative study suggest that the CALM intervention provides substantial benefits for patients with advanced cancer prior to the end of life. Findings informed the development of a randomized controlled trial to evaluate the effectiveness of this intervention. PMID: 22042225 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5379168 Mon, 31 Oct 2011 04:00:00 +0100 5379168 http://www.medworm.com/index.php?rid=5379167&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22042226%26dopt%3DAbstract CONCLUSIONS: EDSS is insufficient for usage as the sole instrument for measuring severe affectedness as it does not take into account other potential reasons. Complex patient needs necessitate multi-professional care as offered by palliative medicine. PMID: 22042226 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5379167 Mon, 31 Oct 2011 04:00:00 +0100 5379167 http://www.medworm.com/index.php?rid=5344223&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22005106%26dopt%3DAbstract CONCLUSIONS: These findings will aid continuing development and evaluation of palliative care teams, in the domains of effectiveness as well as patient experience. PMID: 22005106 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5344223 Mon, 17 Oct 2011 04:00:00 +0100 5344223 http://www.medworm.com/index.php?rid=5344228&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21993804%26dopt%3DAbstract CONCLUSION: the concept of risk acknowledges the factors that shape and constrain end-of-life choices. Recognition of perceived risks as a central factor in decision making would be of value in acknowledging and supporting meaningful decision making processes for patients with palliative care needs and their families. PMID: 21993804 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5344228 Wed, 12 Oct 2011 04:00:00 +0100 5344228 http://www.medworm.com/index.php?rid=5344227&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21993805%26dopt%3DAbstract CONCLUSION: the Thai PPS Adult Suandok translated tool has good inter- and intra-rater reliability and can be used regularly for clinical care. PMID: 21993805 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5344227 Wed, 12 Oct 2011 04:00:00 +0100 5344227 http://www.medworm.com/index.php?rid=5344226&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21993806%26dopt%3DAbstract CONCLUSION: The fast-track trial has been used successfully in palliative care among patients severely affected by multiple sclerosis, chronic obstructive pulmonary disease and cancer. It is best suited to evaluations of palliative care services among patients who have longer prognoses, for example of several months or more although it has been used in people with prognoses of weeks. PMID: 21993806 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5344226 Wed, 12 Oct 2011 04:00:00 +0100 5344226 http://www.medworm.com/index.php?rid=5344225&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21993807%26dopt%3DAbstract CONCLUSION: the provision of palliative care for the increasing prison population remains under-researched globally, with a notable lack of evidence from the United Kingdom. PMID: 21993807 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5344225 Wed, 12 Oct 2011 04:00:00 +0100 5344225 http://www.medworm.com/index.php?rid=5344224&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21993808%26dopt%3DAbstract CONCLUSIONS: These recommendations (Grade D) include simple linctus, therapeutic trial of sodium cromoglycate and then prescription of an opioid or opioid derivative (dextromethorphan, morphine or codeine). Further research is clearly and urgently required in this area for more effective approaches to managing cough, tested in trials that have sufficient size, power and validity. PMID: 21993808 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5344224 Wed, 12 Oct 2011 04:00:00 +0100 5344224 http://www.medworm.com/index.php?rid=5296177&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21969309%26dopt%3DAbstract CONCLUSIONS: palliative care experts from different professions in different countries encounter similar issues in end-of-life decision making. Adequate communication about these issues is universally experienced as a challenge, which might benefit from increased knowledge. This shared experience enables and emphasizes the need for more international research. PMID: 21969309 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5296177 Mon, 03 Oct 2011 04:00:00 +0100 5296177 http://www.medworm.com/index.php?rid=5296176&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21969310%26dopt%3DAbstract Authors: Ryan T, Gardiner C, Bellamy G, Gott M, Ingleton C Abstract BACKGROUND: The global prevalence of dementia is set to rise to almost 65 million people by 2030, providing policy makers and practitioners with significant challenges, not least within the realms of end-of-life care. The international literature would suggest that people with dementia may benefit from palliative forms of care, but evidence indicates that many fail to access such provision at the end of life. The role of the health care team is pivotal if people with dementia are to benefit from the transition to palliative care. AIM: This paper reports on qualitative research conducted in the UK that sought to explore the experiences of health care practitioners working in palliative care and sought to esta... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5296176 Mon, 03 Oct 2011 04:00:00 +0100 5296176 http://www.medworm.com/index.php?rid=5259525&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21937568%26dopt%3DAbstract CONCLUSIONS: OXN PR provides superior bowel function in cancer pain patients, compared with OxyPR, without compromising analgesic efficacy or safety. This study confirms that OXN PR is well tolerated and efficacious in cancer pain patients and results are in line with those seen in non-malignant pain patients. PMID: 21937568 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5259525 Wed, 21 Sep 2011 04:00:00 +0100 5259525 http://www.medworm.com/index.php?rid=5259527&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21930646%26dopt%3DAbstract CONCLUSIONS: There were objective measures of improved support within the intervention group over time for caregivers through the active engagement of the community network facilitator. This pilot supports the case for an adequately powered study. PMID: 21930646 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5259527 Mon, 19 Sep 2011 04:00:00 +0100 5259527 http://www.medworm.com/index.php?rid=5259526&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21930647%26dopt%3DAbstract CONCLUSION: Timely and appropriate surgical intervention reliably alleviates pain and improves quality of life and can be undertaken with few complications in most patients. Although most procedures can be undertaken by non-specialists, consultation with other members of the multidisciplinary team is mandatory, and in complex cases, referral to a specialist orthopaedic oncology centre can be helpful. PMID: 21930647 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5259526 Mon, 19 Sep 2011 04:00:00 +0100 5259526 http://www.medworm.com/index.php?rid=5228433&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21920987%26dopt%3DAbstract CONCLUSIONS: A consensus syllabus of palliative medicine for undergraduate medical education was developed using a clear and innovative methodology. The final consensus syllabus will be made available for further dissemination of palliative care education throughout the country. PMID: 21920987 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5228433 Thu, 15 Sep 2011 04:00:00 +0100 5228433 http://www.medworm.com/index.php?rid=5228432&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21920988%26dopt%3DAbstract CONCLUSION: This model of volunteering is clearly having an impact on the volunteers, both personally and also in terms of how they are treated in their communities. Further research to explore the long-term personal benefits of being a palliative care volunteer is recommended. PMID: 21920988 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5228432 Thu, 15 Sep 2011 04:00:00 +0100 5228432 http://www.medworm.com/index.php?rid=5218299&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21908520%26dopt%3DAbstract CONCLUSIONS: As a result of this study it is anticipated that the Preparedness for Caregiving Scale, Caregiver Competence Scale and Rewards of Caregiving Scale could provide a basis for collaborative research between different countries and make international studies more comparable and generalizable despite differences in language and culture. PMID: 21908520 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5218299 Fri, 09 Sep 2011 04:00:00 +0100 5218299 http://www.medworm.com/index.php?rid=5218298&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21908521%26dopt%3DAbstract CONCLUSIONS: Written information needs for this patient group vary greatly, sometimes in ways which can be predicted. Using a patient-centred approach to elicit information around an individual's coping strategies, desire for knowledge and empowerment may be helpful. The data supports a proactive approach to making available (to those who want them) clear, concise and attractive leaflets. PMID: 21908521 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5218298 Fri, 09 Sep 2011 04:00:00 +0100 5218298 http://www.medworm.com/index.php?rid=5218297&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21908522%26dopt%3DAbstract This study aimed to explore nurses' assessment and management of delirium when caring for people with cancer, the elderly or older people requiring psychiatric care in the inpatient setting. METHODS: Participants in this qualitative study were nurses working in Australian public hospital inpatient dedicated units in palliative care, aged care (geriatrics), aged care (geriatric) psychiatry and oncology. Semi-structured interviews were used to explore nurses' views about specific areas of delirium assessment and management. Purposive sampling was used and interviews conducted until thematic saturation reached. A thematic content analysis was performed from a grounded theory perspective. RESULTS: A total of 40 participants were included in the study. The analysis revealed four broad analytica... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5218297 Fri, 09 Sep 2011 04:00:00 +0100 5218297 http://www.medworm.com/index.php?rid=5218296&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21908523%26dopt%3DAbstract CONCLUSIONS: The profile of children with progressive neuromuscular conditions who were referred for palliative care has changed over the last 20 years, with a different spectrum of underlying diagnoses and a greater number from a South Asian background. The higher than expected proportion of children living in areas of high deprivation has been consistent over time. PMID: 21908523 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5218296 Fri, 09 Sep 2011 04:00:00 +0100 5218296 http://www.medworm.com/index.php?rid=5218295&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21908524%26dopt%3DAbstract CONCLUSIONS: Despite positive staff attitudes towards corneal donation, many barriers to discussing donation were identified, which may reduce donation rates. This could be improved by local policies encompassing further education, prompts in documentation and availability of leaflets. PMID: 21908524 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5218295 Fri, 09 Sep 2011 04:00:00 +0100 5218295 http://www.medworm.com/index.php?rid=5174930&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21852312%26dopt%3DAbstract Authors: Cleary JF PMID: 21852312 [PubMed - in process] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5174930 Tue, 30 Aug 2011 07:32:50 +0100 5174930 http://www.medworm.com/index.php?rid=5174929&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21852313%26dopt%3DAbstract Authors: Kitamura C, Ng D, Chung A, Bezjak A, Garraway C, McLean M, Nyhof-Young J, Wong R Abstract The aim of our study was to design and evaluate the impact on informational satisfaction of a combined story and fact-based educational booklet designed for patients with multiple brain metastases. Phase A evaluated the preference of participants for combined, fact, or story-based writing style. Based on these results, a resource was developed using a combined story and fact-based approach. Patients with newly diagnosed brain metastases and their caregivers read the booklet. Satisfaction was evaluated using the Information Satisfaction Questionnaire and Client Satisfaction Questionnaire. Anxiety was evaluated before and after reading using the State Trait Anxiety Inventory. Ninety-one... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5174929 Tue, 30 Aug 2011 07:32:44 +0100 5174929 http://www.medworm.com/index.php?rid=5174928&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21852314%26dopt%3DAbstract Authors: Siu SW, Liu RK, Cheung K, Choy Ts, Leung T, Au GKh PMID: 21852314 [PubMed - in process] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5174928 Tue, 30 Aug 2011 07:32:40 +0100 5174928 http://www.medworm.com/index.php?rid=5174926&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21865293%26dopt%3DAbstract CONCLUSIONS: Decision making in prehospital end-of-life care is a challenge for all paramedics. The present investigation demonstrates that a dialogue bridging emergency medical and palliative care issues is necessary. The paramedics indicated that improved guidelines on end-of-life decisions and the termination of cardiopulmonary resuscitation in palliative care patients may be essential. Participants do not feel adequately trained in end-of-life care and the content of advance directives. Other recent studies have also demonstrated that there is a need for training curricula in end-of-life care for paramedics. PMID: 21865293 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5174926 Tue, 23 Aug 2011 23:00:00 +0100 5174926 http://www.medworm.com/index.php?rid=5174925&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21865294%26dopt%3DAbstract CONCLUSIONS: Case study research strategies have great potential in evaluating complex interventions in palliative care settings. Three key features need to be exploited to develop this field: case selection, longitudinal designs, and the use of rival hypotheses. In particular, case study should be used in situations where there is interplay and interdependency between the intervention and its context, such that it is difficult to define or find relevant comparisons. PMID: 21865294 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5174925 Tue, 23 Aug 2011 23:00:00 +0100 5174925 http://www.medworm.com/index.php?rid=5174924&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21865295%26dopt%3DAbstract CONCLUSION: There is not enough evidence to support a net benefit of n-3-FA in cachexia in advanced cancer. On the other hand, adverse effects were infrequent, with no severe adverse effects. The results from the review led to a weak negative GRADE recommendation. PMID: 21865295 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5174924 Tue, 23 Aug 2011 23:00:00 +0100 5174924 http://www.medworm.com/index.php?rid=5174923&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21865296%26dopt%3DAbstract CONCLUSIONS: The composition of symptom clusters varied depending on if patients with non-zero scores were excluded at baseline and on the statistical method employed. Identifying valid clusters may prove useful for bettering symptom diagnosis and management for cancer patients. PMID: 21865296 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5174923 Tue, 23 Aug 2011 23:00:00 +0100 5174923 http://www.medworm.com/index.php?rid=5174922&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21865297%26dopt%3DAbstract CONCLUSIONS: Evaluation processes are integral to action research approaches. The specific evaluative methods adopted will reflect the nature and focus of the evaluation being undertaken. PMID: 21865297 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5174922 Tue, 23 Aug 2011 23:00:00 +0100 5174922 http://www.medworm.com/index.php?rid=5174927&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21859743%26dopt%3DAbstract CONCLUSIONS: Although Dignity Therapy took longer to deliver than expected, this intervention may be a way of enhancing the end-of-life experiences of residents. PMID: 21859743 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5174927 Sun, 21 Aug 2011 23:00:00 +0100 5174927 http://www.medworm.com/index.php?rid=5141058&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21844136%26dopt%3DAbstract CONCLUSIONS: Dyspnea and fatigue are prevalent and increased in the presence of COPD and anemia. No association between β-blocker use and dyspnea or fatigue scores was observed. This may be attributable to inadequate dosing or to retrospective bias. PMID: 21844136 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5141058 Sun, 14 Aug 2011 23:00:00 +0100 5141058 http://www.medworm.com/index.php?rid=5141057&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21844137%26dopt%3DAbstract CONCLUSIONS: These studies illustrate the value of qualitative research, particularly during the earlier phases of the research continuum. Such research may generate hypotheses, strengthen the development and implementation of interventions and enhance their evaluation: all of which are essential to evidence-based medicine. PMID: 21844137 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5141057 Sun, 14 Aug 2011 23:00:00 +0100 5141057 http://www.medworm.com/index.php?rid=5141056&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21844138%26dopt%3DAbstract Authors: Shelby-James TM, Hardy J, Agar M, Yates P, Mitchell G, Sanderson C, Luckett T, Abernethy AP, Currow DC Abstract Rigorous clinical research in palliative care is challenging but achievable. Trial participants are likely to have deteriorating performance status, co-morbidities and progressive disease. It is difficult to recruit patients, and attrition unrelated to the intervention being trialled is high. The aim of this paper is to highlight practical considerations from a forum held to discuss these issues by active palliative care clinical researchers. To date, the Australian Palliative Care Clinical Studies Collaborative (PaCCSC) has randomized more than 500 participants across 12 sites in 8 Phase III studies. Insights from the 2010 clinical research forum of the PaCCSC a... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5141056 Sun, 14 Aug 2011 23:00:00 +0100 5141056 http://www.medworm.com/index.php?rid=5141061&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21831915%26dopt%3DAbstract CONCLUSIONS: The four palliative care regional 'systems' examined using our model were found to be in different stages of development. This research further informs health system planners on important features to incorporate into evolving palliative care systems. PMID: 21831915 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5141061 Tue, 09 Aug 2011 23:00:00 +0100 5141061 http://www.medworm.com/index.php?rid=5141060&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21831916%26dopt%3DAbstract CONCLUSIONS: This analysis confirms the high risk of selection and information bias inherent the uncontrolled before-after study design. The high internal correlation strongly suggests that clustering should be taken into account in this kind of study. PMID: 21831916 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5141060 Tue, 09 Aug 2011 23:00:00 +0100 5141060 http://www.medworm.com/index.php?rid=5141059&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21831917%26dopt%3DAbstract CONCLUSIONS: F1 posts in palliative medicine in the UK have positive influences on perceived generic skills development and practice. These findings might encourage the development of more rotations incorporating palliative medicine in the future. PMID: 21831917 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5141059 Tue, 09 Aug 2011 23:00:00 +0100 5141059 http://www.medworm.com/index.php?rid=5097515&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21807749%26dopt%3DAbstract CONCLUSIONS: the development and evaluation of complex interventions in palliative care benefit from the application of mixed methods. Mixed methods enable better understanding of whether and how an intervention works (or does not work) and inform the design of subsequent studies. However, they can be challenging: mixed method studies in palliative care will benefit from working with agreed protocols, multidisciplinary teams and engaging staff with appropriate skill sets. PMID: 21807749 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5097515 Sun, 31 Jul 2011 23:00:00 +0100 5097515 http://www.medworm.com/index.php?rid=5097493&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21807750%26dopt%3DAbstract CONCLUSION: The findings suggest that a brief guided self-help intervention based on concreteness training can be effective in addressing anxiety in palliative care. PMID: 21807750 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5097493 Sun, 31 Jul 2011 23:00:00 +0100 5097493 http://www.medworm.com/index.php?rid=5097476&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21807751%26dopt%3DAbstract In conclusion, the diagnostic work-up and therapeutic plan for patients with cancer-related fatigue should include an evaluation of laboratory parameters, pain severity, and physical performance. PMID: 21807751 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5097476 Sun, 31 Jul 2011 23:00:00 +0100 5097476 http://www.medworm.com/index.php?rid=5051427&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21775408%26dopt%3DAbstract CONCLUSIONS: Current approaches to assessing constipation in palliative care are very different to those recommended by gastroenterology guidelines. However, modified approaches may be tolerable to palliative care patients and offer the chance of developing targeted palliation. PMID: 21775408 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5051427 Tue, 19 Jul 2011 23:00:00 +0100 5051427 http://www.medworm.com/index.php?rid=5051426&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21775409%26dopt%3DAbstract CONCLUSIONS: The study provided a basis for more research into the role palliative care services has in supporting MND carers before and after the death of their spouse and in particular the provision of more tailored respite and bereavement support. PMID: 21775409 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5051426 Tue, 19 Jul 2011 23:00:00 +0100 5051426 http://www.medworm.com/index.php?rid=5051425&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21775410%26dopt%3DAbstract CONCLUSION: depending on others for help with basic tasks appears to contribute to the burden of depression among men with terminal illness. This gender-specific association may explain why the usual gender differences in depression prevalence are not observed in palliative care. PMID: 21775410 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5051425 Tue, 19 Jul 2011 23:00:00 +0100 5051425 http://www.medworm.com/index.php?rid=5051424&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21775411%26dopt%3DAbstract CONCLUSIONS: We conclude that countries debating legislation must realise that the rules and procedures for euthanasia they would agree upon and the way they are codified or not into law may influence the practice that develops once the legislation is effected or what part of that practice is reported.. PMID: 21775411 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5051424 Tue, 19 Jul 2011 23:00:00 +0100 5051424 http://www.medworm.com/index.php?rid=5051431&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21737479%26dopt%3DAbstract CONCLUSION: Most relevant drug interactions can be expected with: (i) drugs (inter-) acting via histamine, acetylcholine or dopamine receptors; and (ii) Non-steroidal anti-inflammatory drugs. Even in last hours of life the combination of substances (e.g. anticholinergics) may produce relevant drug interactions (e.g. delirium). Perspective: Data on the potential for drug-drug interactions in palliative case is extremely scarce, but drug interactions can be limited if a few facts are considered. A synopsis of the findings of these studies is presented as concise recommendation to minimize drug interactions. PMID: 21737479 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5051431 Wed, 06 Jul 2011 23:00:00 +0100 5051431 http://www.medworm.com/index.php?rid=5051430&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21737480%26dopt%3DAbstract CONCLUSIONS: We have shown that it is feasible to establish a national quality register in end-of-life care and collect data through a web-based system. Ongoing data analyses will show in what way this initiative can lead to improved quality of life for patients and their families. There is an ongoing process internationally to define relevant outcome measures for quality of care at the end-of-life in different care settings; the registry has a potentially important role in this development. PMID: 21737480 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5051430 Wed, 06 Jul 2011 23:00:00 +0100 5051430 http://www.medworm.com/index.php?rid=5051429&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21737481%26dopt%3DAbstract CONCLUSIONS: The evidence suggests a rapid increase in the number of robust intervention studies. However, the range of models remains narrow in relation to caregivers' needs and preferences. PMID: 21737481 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5051429 Wed, 06 Jul 2011 23:00:00 +0100 5051429 http://www.medworm.com/index.php?rid=5051428&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21737482%26dopt%3DAbstract CONCLUSIONS: Both tools are useful. However, the pain tool also picks up distress, which is not caused by pain. It could potentially lead to false ascriptions of pain. The distress tool picks up a broader array of signs, which may be useful both in practice and in research. PMID: 21737482 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5051428 Wed, 06 Jul 2011 23:00:00 +0100 5051428 http://www.medworm.com/index.php?rid=5000902&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21708843%26dopt%3DAbstract Authors: Caraceni A PMID: 21708843 [PubMed - in process] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000902 Thu, 30 Jun 2011 23:00:00 +0100 5000902 http://www.medworm.com/index.php?rid=5000901&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21708844%26dopt%3DAbstract Authors: Reid C, Hanks G PMID: 21708844 [PubMed - in process] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000901 Thu, 30 Jun 2011 23:00:00 +0100 5000901 http://www.medworm.com/index.php?rid=5000900&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21708845%26dopt%3DAbstract Authors: Kaasa S, Haugen DF PMID: 21708845 [PubMed - in process] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000900 Thu, 30 Jun 2011 23:00:00 +0100 5000900 http://www.medworm.com/index.php?rid=5000899&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21708846%26dopt%3DAbstract Authors: McQuay H Evidence-based medicine (EBM) has, over the past 20 years, made us all more critical in our thinking about the efficacy and safety of interventions. This is evident in the higher standards of our spoken and written work, formal and informal, and in our approach to the subject. The downside has been the coincidence of the squeeze on healthcare funding with the emergence of the EBM ideas - it has been all too easy to misuse the tools of EBM to deny patients access to treatment, and this, together with the off-putting political correctness of the EBM approach in some quarters, has made clinicians uneasy. Clinicians have to make decisions about therapy for the individual patient. Ideally this is guided by the best available evidence and their experience. EBM can guide one... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000899 Thu, 30 Jun 2011 23:00:00 +0100 5000899 http://www.medworm.com/index.php?rid=5000898&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21708847%26dopt%3DAbstract Authors: Foley KM There are currently two indicators, Morphine Consumption Data and the Pain Management Index, that have been widely used to assess the efficacy of cancer pain treatment. Both are based on the World Health Organization guidelines for cancer pain and both have limitations in their ability to assess the quality of pain care for cancer patients. The published studies that have used these methods all report that cancer pain is generally undertreated in a wide range of clinical settings and care models. PMID: 21708847 [PubMed - in process] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000898 Thu, 30 Jun 2011 23:00:00 +0100 5000898 http://www.medworm.com/index.php?rid=5000897&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21708848%26dopt%3DAbstract Authors: Caraceni A, Pigni A, Brunelli C The aim of this systematic review was to evaluate the evidence that oral morphine can be recommended as the first choice opioid in the treatment of moderate to severe cancer pain in updating the European Association for Palliative Care opioid recommendations. A systematic literature review was performed to update the 2007 Cochrane review 'Oral morphine for cancer pain'. The literature search was conducted on MedLine, EMBASE and Cochrane Central Register of Controlled Trials databases. The search strategy, limited in time (from 1 July 2006 to 31 October 2009), was aimed to be as extensive as possible using both text words and MeSH/EMTREE terms; a hand search of the reference lists of identified papers was also performed. Randomized clinical trial... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000897 Thu, 30 Jun 2011 23:00:00 +0100 5000897 http://www.medworm.com/index.php?rid=5000896&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21708849%26dopt%3DAbstract Authors: Tassinari D, Drudi F, Rosati M, Tombesi P, Sartori S, Maltoni M To analyse the evidence supporting the widespread use of modified analgesic ladders or oral tramadol as alternatives to codeine/paracetamol for mild to moderate cancer pain. PMID: 21708849 [PubMed - in process] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000896 Thu, 30 Jun 2011 23:00:00 +0100 5000896 http://www.medworm.com/index.php?rid=5000895&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21708850%26dopt%3DAbstract Authors: Klepstad P, Kaasa S, Borchgrevink PC The European Association for Palliative Care recommendation for starting morphine for cancer pain is dose titration with immediate release (IR) oral morphine given every 4 h with additionally doses for breakthrough pain. As part of a EU 6th framework programme to revise the guidelines we review the evidence regarding starting treatment and dose titration of opioids in adult patients with moderate to severe cancer pain. Relevant papers were identified though a systematic search in Medline for papers published until the end of 2009. We identified 15 relevant papers. Thirteen papers were descriptive papers reporting the results from starting treatment with oral morphine (six studies), starting treatment with intravenous morphine (two studies... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000895 Thu, 30 Jun 2011 23:00:00 +0100 5000895 http://www.medworm.com/index.php?rid=5000894&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21708851%26dopt%3DAbstract The objectives were to review the existing literature on management of opioid-induced nausea and vomiting in cancer patients and summarize the findings into evidence-based recommendations. Systematic searches of MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were performed, using free text and MeSH/EMTREE search terms. The searches were limited to articles published in English from each database set-up date to 31 July 2009. Reference lists and relevant international conference proceedings were hand-searched. Fifty-five studies were identified, providing data on 5741 patients. The studies were classified into: (A) studies in which treatment of nausea/vomiting was the primary outcome (a total of 18 studies, of which eight studies specifically addressed opioid-induced ... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000894 Thu, 30 Jun 2011 23:00:00 +0100 5000894 http://www.medworm.com/index.php?rid=5000893&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21708852%26dopt%3DAbstract Authors: King SJ, Reid C, Forbes K, Hanks G Oxycodone is often used as an opioid analgesic for moderate to severe cancer-related pain, but its use varies across Europe. This systematic literature review forms the basis of guidelines for oxycodone use within the European Palliative Care Research Collaborative opioid guidelines project conducted on behalf of the European Association for Palliative Care. PMID: 21708852 [PubMed - in process] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000893 Thu, 30 Jun 2011 23:00:00 +0100 5000893 http://www.medworm.com/index.php?rid=5000892&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21708853%26dopt%3DAbstract In conclusion there is evidence to support the efficacy and tolerability of hydromorphone for moderate to severe cancer pain as an alternative to morphine and oxycodone, while there is no evidence to demonstrate its superiority or inferiority in comparison with morphine as the first choice opioid for the same indication. PMID: 21708853 [PubMed - in process] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000892 Thu, 30 Jun 2011 23:00:00 +0100 5000892 http://www.medworm.com/index.php?rid=5000891&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21708854%26dopt%3DAbstract Authors: Tassinari D, Drudi F, Rosati M, Maltoni M To assess the role of transdermal opioids as a front-line approach to moderate to severe cancer pain. PMID: 21708854 [PubMed - in process] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000891 Thu, 30 Jun 2011 23:00:00 +0100 5000891 http://www.medworm.com/index.php?rid=5000890&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21708855%26dopt%3DAbstract Authors: Cherny N To address the question: is oral methadone better than placebo, or other oral/transdermal opioids in the management of cancer pain? PMID: 21708855 [PubMed - in process] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000890 Thu, 30 Jun 2011 23:00:00 +0100 5000890 http://www.medworm.com/index.php?rid=5000889&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21708856%26dopt%3DAbstract Authors: Dale O, Moksnes K, Kaasa S According to a Cochrane review on opioid switching, sound evidence on the practice of substituting one strong opioid with another to improve pain control and reduce adverse effects was lacking in 2004. A systematic search strategy was developed to include studies after 2004, with adult cancer patients switching between strong opioids and reporting estimates of effect on pain and adverse effects. The search retrieved 288 publications (71 duplicates); 187 abstracts and 19 full papers were excluded. Eleven papers met the inclusion criteria; none were randomized controlled trials/meta-analyses. Studies comprised 280 patients (group size 10-32). A variety of opioids and switching strategies were studied. Pain intensity was significantly reduced in the maj... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000889 Thu, 30 Jun 2011 23:00:00 +0100 5000889 http://www.medworm.com/index.php?rid=5000888&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21708857%26dopt%3DAbstract Authors: Mercadante S, Caraceni A In this paper we describe the results of a systematic search of the literature on conversion ratios during opioid switching. This is part of a project of the European Palliative Care Research Collaboration to update the European Association for Palliative Care recommendations for the use of opioid analgesics in the treatment of cancer pain. Studies were eligible for inclusion if they involved adult patients with chronic cancer pain, contained data on opioid conversion ratios, were prospective and were written in English. Thirty-one studies were identified and included. The majority of the studies had methodological flaws and were not designed to explore or demonstrate equianalgesic dose data. However, the data allow some recommendations to be made that... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000888 Thu, 30 Jun 2011 23:00:00 +0100 5000888 http://www.medworm.com/index.php?rid=5000887&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21708858%26dopt%3DAbstract Authors: Zeppetella G The usual management of cancer related breakthrough pain is with supplemental doses of analgesics (commonly opioids) at a dose proportional to the total around-the-clock opioid dose. The aim of this review, undertaken as part of a European Palliative Care Research Collaborative (EPCRC) project, to update the EAPC guidelines on opioid analgesics in cancer pain was to determine the evidence for the utility of opioids in the management of breakthrough pain in patients with cancer. Randomized controlled trials of opioids used as rescue medication were identified using electronic search strategies. Outcome measures sought were reduction in pain intensity measured by an appropriate scale, adverse effects, attrition, and patient satisfaction. The date of the final search... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000887 Thu, 30 Jun 2011 23:00:00 +0100 5000887 http://www.medworm.com/index.php?rid=5000886&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21708859%26dopt%3DAbstract Authors: King S, Forbes K, Hanks G, Ferro C, Chambers E Opioid use in patients with renal impairment can lead to increased adverse effects. Opioids differ in their effect in renal impairment in both efficacy and tolerability. This systematic literature review forms the basis of guidelines for opioid use in renal impairment and cancer pain as part of the European Palliative Care Research Collaborative's opioid guidelines project. PMID: 21708859 [PubMed - in process] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000886 Thu, 30 Jun 2011 23:00:00 +0100 5000886 http://www.medworm.com/index.php?rid=5000885&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21708860%26dopt%3DAbstract Authors: Kurita GP, Kaasa S, Sjøgren P A systematic review, undertaken according to an initiative to revise European Association for Palliative Care guidelines on the use of opioids for cancer pain, which aimed to analyse analgesic efficacy and side effects of spinal opioids in adult cancer patients previously treated with systemic opioids. PMID: 21708860 [PubMed - in process] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000885 Thu, 30 Jun 2011 23:00:00 +0100 5000885 http://www.medworm.com/index.php?rid=5000884&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21708861%26dopt%3DAbstract In conclusion, the systematic review found good evidence that subcutaneous administration of morphine or other opioids is an effective alternative for cancer patients if oral treatment is not possible. However, for a number of patients intravenous, rectal or transdermal therapy will offer a good alternative to the subcutaneous route. The review found no significant differences in efficacy or side effects between the alternative application routes. PMID: 21708861 [PubMed - in process] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000884 Thu, 30 Jun 2011 23:00:00 +0100 5000884 http://www.medworm.com/index.php?rid=5000883&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21708862%26dopt%3DAbstract Authors: Fallon MT, Laird BJ The use of combinations of opioids is a common clinical practice; however, this is not advocated by the World Health Organization (WHO) analgesic ladder. As opioid combination therapy becomes used increasingly, a review of the evidence on this practice was conducted. PMID: 21708862 [PubMed - in process] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000883 Thu, 30 Jun 2011 23:00:00 +0100 5000883 http://www.medworm.com/index.php?rid=5000882&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21708863%26dopt%3DAbstract Authors: Hanna M PMID: 21708863 [PubMed - in process] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000882 Thu, 30 Jun 2011 23:00:00 +0100 5000882 http://www.medworm.com/index.php?rid=5000881&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21712334%26dopt%3DAbstract CONCLUSION: this study has identified a number of issues people with MND and their carers face in the final stages of the illness, indicating some ways in which health, social and palliative care services could be improved or co-operate more effectively in order to better meet their needs. PMID: 21712334 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000881 Mon, 27 Jun 2011 23:00:00 +0100 5000881 http://www.medworm.com/index.php?rid=5000909&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21697261%26dopt%3DAbstract CONCLUSIONS: Core to the older person's ability to discuss end-of-life care is their acceptance of being in a care home, the involvement of family members in making decisions and the extent to which they believed they could influence decision making within their everyday lives. Advance care plans should document ongoing dialogue. These findings can inform how primary health and palliative care services introduce, discuss and tailor existing frameworks and programmes of end-of-life care. PMID: 21697261 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000909 Tue, 21 Jun 2011 23:00:00 +0100 5000909 http://www.medworm.com/index.php?rid=5000908&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21697262%26dopt%3DAbstract CONCLUSIONS: This study in palliative care is the first of which we are aware to explore factors associated with non-remission of depression. Depressed patients identified with low social support on referral to palliative care services might particularly benefit from additional psychosocial care in the treatment of their depression. This study provides evidence that effective physical symptom management in palliative care may be a valuable intervention for depressive symptoms. PMID: 21697262 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000908 Tue, 21 Jun 2011 23:00:00 +0100 5000908 http://www.medworm.com/index.php?rid=5000907&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21697263%26dopt%3DAbstract We report a retrospective study of 48 patients with congenital heart disease who died while admitted to our hospital (mean age at death 37 ± 14 years). We describe circumstances of death, end-of-life discussions, and the provision of end-of-life care. The majority of patients had complex congenital heart disease and were considered to be in the end stage of their disease. Despite this, only a minority of patients had documented end-of-life discussions prior to their terminal admission and most received continuing aggressive medical treatment up to their demise. Advanced palliative and end-of-life care strategies should be developed for and provided to this group of patients, with the dual aims of reduction of unwarranted therapies and enhancement of the quality of death and dying. PMI... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000907 Tue, 21 Jun 2011 23:00:00 +0100 5000907 http://www.medworm.com/index.php?rid=5000906&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21697264%26dopt%3DAbstract CONCLUSIONS: Age, economics, diagnosis, ethnicity, marital status, and whether one enters a hospice service for (at least in part) respite were all associated to a certain extent with where one dies. These findings contribute to the growing evidence linking various factors, especially ethnic groups, with place of death. PMID: 21697264 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000906 Tue, 21 Jun 2011 23:00:00 +0100 5000906 http://www.medworm.com/index.php?rid=5000905&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21697265%26dopt%3DAbstract CONCLUSION: To improve future research on palliative care in long-term care facilities, agreement on what can be considered as palliative care in long-term care facilities and, the availability of well-developed and tested measurement instruments is needed to provide more evidence, and to make future research more comparable. PMID: 21697265 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000905 Tue, 21 Jun 2011 23:00:00 +0100 5000905 http://www.medworm.com/index.php?rid=5000904&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21697266%26dopt%3DAbstract Authors: Fredheim OM, Moksnes K, Borchgrevink PC, Skurtveit S BACKGROUND: Opioid switching to methadone is reported frequently to improve pain control in patients with an unacceptable balance between pain control and side effects during treatment with first line opioids, but carries a risk of drug accumulation and respiratory depression. To justify this risk it is required that less risky treatments are tried beforehand and that a sufficiently large proportion of patients experience a long-lasting improvement in pain control. Research questions: How large was the proportion of patients remaining on long term methadone treatment after a switch from a strong opioid to methadone? How long had the patients been treated with opioids before the switch to methadone? METHODS: Longitudinal phar... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000904 Tue, 21 Jun 2011 23:00:00 +0100 5000904 http://www.medworm.com/index.php?rid=5000903&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21697267%26dopt%3DAbstract CONCLUSION: Overall these respondents shared similar views and experiences, and both were influenced by similar factors. Multidisciplinary outcome measurement education and training is feasible and required. Multidimensional and brief PROMs that include physical and psychological domains need to be prioritized, and access to freely available, validated and translated tools is needed to ensure cross-national comparisons and coordination of international research. PMID: 21697267 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=5000903 Tue, 21 Jun 2011 23:00:00 +0100 5000903 http://www.medworm.com/index.php?rid=4955456&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21680749%26dopt%3DAbstract CONCLUSIONS: The most appropriate time to ask a patient about end-of-life care is subjective and patient specific and therefore does not lend itself to an inflexible single indicator. Focusing on one isolated question simplifies and distracts from a multi-faceted and complex issue and may lead to patient harm. PMID: 21680749 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4955456 Wed, 15 Jun 2011 23:00:00 +0100 4955456 http://www.medworm.com/index.php?rid=4955455&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21680750%26dopt%3DAbstract Authors: Cohen J, Wilson DM, Thurston A, Macleod R, Deliens L Access to palliative care (PC) is a major need worldwide. Using hospital charts of all patients who died over one year (April 2008-March 2009) in two mid-sized hospitals of a large Canadian city, similar in size and function and operated by the same administrative group, this study examined which patients who could benefit from PC services actually received these services and which ones did not, and compared their care characteristics. A significantly lower proportion (29%) of patients dying in hospital 2 (without a PC unit and reliant on a visiting PC team) was referred to PC services as compared to in hospital 1 (with a PC unit; 68%). This lower referral likelihood was found for all patient groups, even among cancer patien... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4955455 Wed, 15 Jun 2011 23:00:00 +0100 4955455 http://www.medworm.com/index.php?rid=4955454&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21680751%26dopt%3DAbstract CONCLUSIONS: Our findings can be used to develop targeted educational interventions towards providers and families. Understanding the factors that are driving the low uptake in palliative care is the first step in advancing pediatric palliative care overall. PMID: 21680751 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4955454 Wed, 15 Jun 2011 23:00:00 +0100 4955454 http://www.medworm.com/index.php?rid=4955457&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21677020%26dopt%3DAbstract CONCLUSIONS: these data indicate that, within England and New Zealand, the policy rhetoric of universal palliative care provision is not being straightforwardly translated into service delivery and individual clinical practice. Further research is required to explore and evaluate different models of organization and service provision that empower 'generalists' to provide palliative care, without resulting in deskilling. Finally, definitional clarity at an academic/policy level is also needed. PMID: 21677020 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4955457 Tue, 14 Jun 2011 23:00:00 +0100 4955457 http://www.medworm.com/index.php?rid=4905999&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21610113%26dopt%3DAbstract Authors: Murray S, Boyd K PMID: 21610113 [PubMed - in process] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4905999 Tue, 31 May 2011 23:00:00 +0100 4905999 http://www.medworm.com/index.php?rid=4905998&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21610114%26dopt%3DAbstract Authors: Schildmann J, Hoetzel J, Mueller-Busch C, Vollmann J PMID: 21610114 [PubMed - in process] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4905998 Tue, 31 May 2011 23:00:00 +0100 4905998 http://www.medworm.com/index.php?rid=4855923&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21606126%26dopt%3DAbstract CONCLUSIONS: alcohol use disorders in this cohort of patients were not associated with a higher symptom burden, and the prevalence was lower than the general United Kingdom population. PMID: 21606126 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4855923 Sun, 22 May 2011 23:00:00 +0100 4855923 http://www.medworm.com/index.php?rid=4855922&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21606127%26dopt%3DAbstract CONCLUSIONS: We have new evidence that although engaging in follow-back surveys can evoke distress, many participants report it to be a positive experience. We therefore believe that this approach is acceptable when conducted sensitively. PMID: 21606127 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4855922 Sun, 22 May 2011 23:00:00 +0100 4855922 http://www.medworm.com/index.php?rid=4855921&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21606128%26dopt%3DAbstract CONCLUSION: Elderly Taiwanese cancer patients at EOL received less chemotherapy, less aggressive management of health crises associated with the dying process, and fewer life-extending treatments, but they were more likely to receive hospice care in their last year and to achieve the culturally highly valued goal of dying at home. PMID: 21606128 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4855921 Sun, 22 May 2011 23:00:00 +0100 4855921 http://www.medworm.com/index.php?rid=4855920&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21606129%26dopt%3DAbstract This study examined whether there are racial disparities for length of stay in hospice for patients with non-small cell lung cancer (NSCLC).We studied 53,626 deceased patients aged ≥66 years diagnosed with American Joint Committee on Cancer stages I-IV NSCLC identified from the Surveillance, Epidemiology, and End Results-Medicare linked data who used hospice services in the last six months before death, and died between 1 January 1991 and 31 December 2005. Median time (days) and percent length of stay in hospice, and multivariate incidence rate ratios (IRRs) with 95% confidence intervals (CIs) using zero-truncated negative binomial regression described relationships. In 2000-2005, most patients (64.1%) had <30 days, including those (30.2%) with <7 days length of stay in hospice car... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4855920 Sun, 22 May 2011 23:00:00 +0100 4855920 http://www.medworm.com/index.php?rid=4855924&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21586618%26dopt%3DAbstract CONCLUSIONS: Family members monitor and recognize changes in their relative with PD, MND and MS and in themselves. Thus, drawing on the expertise of family members may be a useful tool for prognostication. PMID: 21586618 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4855924 Mon, 16 May 2011 23:00:00 +0100 4855924 http://www.medworm.com/index.php?rid=4855926&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21562030%26dopt%3DAbstract In conclusion, researchers can enhance the methodological knowledge base by presenting more detailed accounts of the participant recruitment and data collection processes. Future researchers should strive to develop more flexible methods of assessing distress among patients with advanced disease. PMID: 21562030 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4855926 Tue, 10 May 2011 23:00:00 +0100 4855926 http://www.medworm.com/index.php?rid=4855925&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21562031%26dopt%3DAbstract CONCLUSION: in Korea, patient autonomy is not a universally accepted value from the perspectives of terminal cancer patients, nor is patient involvement in decision making always conducive to high quality of life or quality of death. The level of information and the pace at which it is provided should be tailored to each individual's ability, preference, need, and culture. PMID: 21562031 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4855925 Tue, 10 May 2011 23:00:00 +0100 4855925 http://www.medworm.com/index.php?rid=4804052&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21543525%26dopt%3DAbstract CONCLUSION: Adding professionals' perspective to that of patients is essential to gain a holistic view on patients' unmet needs and to further optimize their care. The perspective of palliative care might contribute to meet unmet needs of severely affected MS patients. PMID: 21543525 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4804052 Tue, 03 May 2011 23:00:00 +0100 4804052 http://www.medworm.com/index.php?rid=4804051&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21543526%26dopt%3DAbstract CONCLUSIONS: Dying cancer patients perceive that they cannot feel completely independent, which affects true autonomous decision making. Further, when considering legalization of euthanasia, the perspectives of patients fearing the effects of legalization should also be taken into account, not only those of patients opting for it. PMID: 21543526 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4804051 Tue, 03 May 2011 23:00:00 +0100 4804051 http://www.medworm.com/index.php?rid=4804054&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21490116%26dopt%3DAbstract CONCLUSIONS: Fatigue, lack of appetite, feeling sad, and shortness of breath could be predictive factors for survival time of hospitalized patients with far advanced cancer. The more severe these symptoms are, the shorter will be survival time. PMID: 21490116 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4804054 Tue, 12 Apr 2011 23:00:00 +0100 4804054 http://www.medworm.com/index.php?rid=4804053&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21490117%26dopt%3DAbstract CONCLUSION: Anticipatory prescribing of crisis medication rarely benefits the patient and may unintentionally detract from nursing care. Guidelines on the management of terminal haemorrhage should reconsider the emphasis on crisis medication and focus on non-pharmacological approaches to this invariably fatal event. PMID: 21490117 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4804053 Tue, 12 Apr 2011 23:00:00 +0100 4804053 http://www.medworm.com/index.php?rid=4697450&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21474620%26dopt%3DAbstract This study aimed to evaluate the support provided to lung cancer patients post palliative radiotherapy using a computerized assessment tool and to determine the clinical acceptability of the tool in a palliative care setting. However, of the 17 clinicians identified as managing patients who met the initial eligibility criteria for the study, only one clinician gave approval for their patient to be contacted regarding participation, therefore the benefits of this novel technology could not be assessed. Thirteen key clinicians from the centres involved in the study were subsequently interviewed. They acknowledged potential benefits of incorporating computerized patient assessment from both a patient and practice perspective, but emphasized the importance of clinical intuition over standardiz... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4697450 Wed, 06 Apr 2011 23:00:00 +0100 4697450 http://www.medworm.com/index.php?rid=4697449&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21474621%26dopt%3DAbstract Authors: Swallow V, Forrester T, Macfadyen A Few opportunities exist outside the home for children and teenagers with life-limiting conditions to have a break in a setting specifically designed and adequately staffed and resourced to meet their complex clinical, practical and emotional needs; until recently provision focused primarily on providing respite for parents/carers. Based on policy recommendations, a short-break service was established with the aim of working in partnership with families and voluntary and statutory agencies to provide a fun break for children and teenagers with life-limiting conditions and complement the range of services available. This qualitative study used interviews and focus groups to determine teenagers' and parents' views of the service. Three themes e... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4697449 Wed, 06 Apr 2011 23:00:00 +0100 4697449 http://www.medworm.com/index.php?rid=4697448&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21474622%26dopt%3DAbstract CONCLUSION: Asian patients' perceived barriers to managing cancer pain were significantly higher than those for Western patients (especially for concerns about disease progression, tolerance, and fatalism). Asian cancer patients need to be assessed and carefully treated for perceived barriers to optimize cancer pain management. PMID: 21474622 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4697448 Wed, 06 Apr 2011 23:00:00 +0100 4697448 http://www.medworm.com/index.php?rid=4697455&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21464118%26dopt%3DAbstract Authors: Loiselle CG, Sterling MM In providing palliative and end-of-life care, professional and lay hospice workers alike attend to patient and family needs to encourage a dignified death. However, there are few comparative inquiries documenting how differential workplace preparation affects the processes and outcomes related to being confronted to death and dying. This qualitative study explores and compares these experiences among a diverse sample of health workers (N = 25) in a grassroots cancer care hospice in Bangalore, India. Our findings underscore how personal views, socio-economic status, beliefs and values, occupational experience, and workplace interventions interact to shape 'worldviews' about death and dying. Whereas health workers report conflicting feelings of relief an... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4697455 Sun, 03 Apr 2011 23:00:00 +0100 4697455 http://www.medworm.com/index.php?rid=4697454&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21464119%26dopt%3DAbstract Authors: Bausewein C, Le Grice C, Simon ST, Higginson IJ The Palliative Care Outcome Scale (POS) and the Support Team Assessment Schedule (STAS) are outcome measures assessing quality of care in palliative care patients. This review aims to appraise their use in clinical care and research. Five electronic databases were searched (February 2010) for original papers describing the validation or use of POS and/or STAS. Of the 83 papers included, 43 studies were on POS, 39 on STAS and one study using both. Eight STAS studies validated the original version, four an adaptation; 20 studies applied the STAS in another culture and 19 in other languages. POS papers reported included: 14 adapted POS versions, 12 translations of the POS and 15 studies of use in different cultures. Both measures ha... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4697454 Sun, 03 Apr 2011 23:00:00 +0100 4697454 http://www.medworm.com/index.php?rid=4697453&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21464120%26dopt%3DAbstract This article explores the challenges of end-of-life care services to homeless illicit drug users based on data collected during a national study on end-of-life care services delivery to homeless persons in Canada. The authors conducted qualitative interviews with 50 health and social services professionals involved in health services delivery to homeless persons in five cities. Interviews were transcribed verbatim and analysed thematically. Themes were organised into two domains. First, barriers preventing homeless illicit drug users from accessing end-of-life care services, such as competing priorities (e.g. withdrawal management), lack of trust in healthcare providers and discrimination. Second, challenges to end-of-life care services delivery to this population in health and social care... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4697453 Sun, 03 Apr 2011 23:00:00 +0100 4697453 http://www.medworm.com/index.php?rid=4697452&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21464121%26dopt%3DAbstract Authors: Dando N, d'Avray L, Colman J, Hoy A, Todd J This paper reports on undergraduate students' evaluation of a new hospice-based interprofessional practice placement (IPP) that took place in the voluntary sector from 2008 to 2009. Ward-based interprofessional training has been successfully demonstrated in a range of clinical environments. However, the multidisciplinary setting within a hospice in-patient unit offered a new opportunity for interprofessional learning. The development and delivery of the IPP initiative is described, whereby multidisciplinary groups of 12 students provided hands-on care for a selected group of patients, under the supervision of trained health care professionals. The placement was positively evaluated and students reported an increased understanding of ... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4697452 Sun, 03 Apr 2011 23:00:00 +0100 4697452 http://www.medworm.com/index.php?rid=4697451&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21464122%26dopt%3DAbstract Authors: Smith J, Adcock L Clinical experience suggests that screening for delirium on admission to a hospice is often omitted but early recognition and detection can improve outcome for these patients. In a series of audits we have evidenced low use of the recommended screening tool provided within the admission proforma of two hospices. In some circumstances this omission is appropriate to the clinical situation, however the results show this is not always the case. These results have highlighted implications for future work exploring the barriers to routine cognitive screening on admission to an inpatient unit. PMID: 21464122 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4697451 Sun, 03 Apr 2011 23:00:00 +0100 4697451 http://www.medworm.com/index.php?rid=4638042&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21402659%26dopt%3DAbstract Authors: Jack BA, Kirton J, Birakurataki J, Merriman A In Africa, the need for palliative care provision is escalating with an increasing number of people living with HIV/AIDS, coupled with rising cancer and AIDS-related cancer diagnoses. In Uganda there is a shortage of doctors, particularly in rural areas. To address this Hospice Africa Uganda developed a Community Volunteer Programme to train volunteers to help by providing support to patients in their own homes. The aim of this qualitative study was to evaluate the impact of the Community Volunteer Programme. Sixty-four interviews, with patients (21), community volunteer workers (CVWs) (32), and the hospice clinical teams (11) were conducted, using semi-structured digitally recorded individual, group and focus group interviews, at ... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4638042 Mon, 14 Mar 2011 00:00:00 +0100 4638042 http://www.medworm.com/index.php?rid=4638044&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21398345%26dopt%3DAbstract Authors: Zacharias H, Raw J, Nunn A, Parsons S, Johnson M Patients with advanced chronic heart failure (CHF) can experience 'revolving door' admissions, often for parenteral diuretics, when time at home is precious. Home intravenous diuretic services are patchy. This retrospective review describes 43 consecutive episodes of continuous subcutaneous infusion of furosemide (CSCI-F) in 32 advanced CHF patients; 28 episodes aiming to correct fluid balance and prevent hospital admission and 15 aiming to prevent symptoms in the dying. Overall, 26/28 (93%) avoided hospital admission. Weight loss occurred in 20/28 (70%): a median loss of 5.6 kg [interquartile range (IQR) 0.1-8.9]). The daily dose of furosemide ranged from 40 to 250 mg. The median number of days on CSCI-F was 10.5 (range 2-48; I... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4638044 Fri, 11 Mar 2011 00:00:00 +0100 4638044 http://www.medworm.com/index.php?rid=4638043&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21398346%26dopt%3DAbstract Authors: Madden P, Coupland VH, Møller H, Davies EA London has a high proportion of hospital deaths, which health policy seeks to reduce. We explore variation and trends in place of death from cancer within London between 2002 and 2007. Mortality data based on death certificates were used to define deaths from cancer at home, hospice, hospital and nursing home and examine trends over time for London. Proportions of deaths in each place were presented in maps for 31 London primary care trusts (PCTs). Funnel plots were used to identify consistent performance outside the control limits of three standard deviations. There was little overall change in place of death for London, but consistent variation between PCTs. Outer London PCTs had higher proportions of home deaths and inner London P... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4638043 Fri, 11 Mar 2011 00:00:00 +0100 4638043 http://www.medworm.com/index.php?rid=4578768&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21393352%26dopt%3DAbstract CONCLUSIONS: UK doctors appear to oppose the introduction of AVE and PAS, even when one considers the methodological limitations of included studies. Attempts to minimise bias in included studies varied. Further studies are necessary to establish if subgroup variables other than degree of religiosity influence attitudes, and to thoroughly explore the qualitative themes that appeared. PMID: 21393352 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4578768 Thu, 10 Mar 2011 00:00:00 +0100 4578768 http://www.medworm.com/index.php?rid=4578767&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21393353%26dopt%3DAbstract Authors: McCartney A, Butler C, Acreman S Primary brain tumours account for less than 2% of cancer diagnoses in the UK but more people under 40 die from a brain tumour than from any other cancer. Despite developments in some treatment options, survival remains poor and patients suffer with considerable functional and cognitive deficits. Rehabilitation for patients with primary brain tumours produces statistically and clinically significant improvements in function. When compared, similar functional gains are made following rehabilitation for brain tumour patients and for those following stroke and traumatic brain injury. There have been very few studies looking at access to rehabilitation for this group of patients as a primary objective. However, existing studies and clinical experien... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4578767 Thu, 10 Mar 2011 00:00:00 +0100 4578767 http://www.medworm.com/index.php?rid=4578770&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21383059%26dopt%3DAbstract Authors: O'Brien MR, Whitehead B, Murphy PN, Mitchell JD, Jack BA Many patients with the terminal condition motor neurone disease/amyotrophic lateral sclerosis (MND/ALS) do not access social service homecare, which may have implications for the location of end-of-life care. We aimed to identify factors related to uptake of such care in MND/ALS. A case note review of patients at a UK MND/ALS clinic (N = 97) provided data concerning disease onset and severity, demographic variables and care received. Narrative interviews with people with MND/ALS (N = 24) and family carers (N = 18) explored their perspectives on social services homecare. Quantitative analyses highlighted the role of increasing disease severity and age for social services homecare uptake. However, qualitative findings reve... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4578770 Mon, 07 Mar 2011 00:00:00 +0100 4578770 http://www.medworm.com/index.php?rid=4578769&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21383060%26dopt%3DAbstract This study examined MND patients' bereaved relatives' experiences of using the PPC document and their perceptions about its impact on end-of-life care using qualitative methods. Key findings adding to existing literature were that the PPC document was felt to have little impact on end-of-life care amongst this patient group and that there was a perceived lack of awareness of the document amongst health care professionals (HCPs), in particular hospital staff. This was felt to limit the effectiveness of the document. This has obvious implications for practice, looking at awareness amongst HCPs and ways to improve this situation, particularly in light of the current pressures to meet patient preferences at the end of life. PMID: 21383060 [PubMed - as supplied by publisher] (Source: Pallia... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4578769 Mon, 07 Mar 2011 00:00:00 +0100 4578769 http://www.medworm.com/index.php?rid=4578772&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21378066%26dopt%3DAbstract CONCLUSION: OMEQ reflects clinical dosing better than DDD, and can give additional insight into opioid consumption when combined with DDD. Using OMEQ can also lead to different conclusions in opioid consumption studies compared with using DDD alone. PMID: 21378066 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4578772 Fri, 04 Mar 2011 00:00:00 +0100 4578772 http://www.medworm.com/index.php?rid=4578771&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21378067%26dopt%3DAbstract Authors: Johnston B, Kidd L, Wengstrom Y, Kearney N There is a lack of evidence-based research in the use of Telehealth within palliative care in the UK, particularly in Scotland. The aim of this project was to evaluate the current use of Telehealth applications within palliative care across Scotland, and how these and future applications are perceived by patients, carers and professionals. This paper reports on the qualitative findings from focus groups with patients and carers in three geographical areas in Scotland, and individual interviews with key stakeholders from across Scotland, who currently work within areas of high and low Telehealth activity. The key findings indicated that Telehealth initiatives are welcomed by patients and carers but that these should be an adjunct to cl... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4578771 Fri, 04 Mar 2011 00:00:00 +0100 4578771 http://www.medworm.com/index.php?rid=4525328&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21349993%26dopt%3DAbstract Authors: Birks T, Krikos D, McGowan C, Stone P There is an increasing demand for hospital specialist palliative care services to be made more accessible outside of normal working hours. However, it has been argued that extended service provision could be misused and that specialist telephone advisory services are an adequate response to this demand. A 'routine' Saturday face-to-face visiting service was introduced into a hospital palliative care team and the service was evaluated to determine whether it was being utilised appropriately. A retrospective notes review of out-of-hours assessments was undertaken. Anonymised data relating to the nature of the interaction with the palliative care team and the outcome of the consultation were entered into an electronic database. A random sampl... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4525328 Thu, 24 Feb 2011 00:00:00 +0100 4525328 http://www.medworm.com/index.php?rid=4470702&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21310773%26dopt%3DAbstract Authors: Gillon S, Noble S, Ward J, Lodge KM, Nunn A, Koon S, Johnson MJ Primary thromboprophylaxis (PTP) is a Department of Health priority in England. The NICE guidelines agree that PTP is inappropriate in the dying patient, but should be considered for those with reversible pathology. In the light of continued variation and uncertainty in UK hospice practice, we assessed PTP prescribing in three hospices. Case notes were reviewed from consecutive patients admitted before (300 patients) and after (350 patients) implementation of the Pan Birmingham Cancer Network (PBCN) venous thromboembolism prophylaxis (VTE) prevention guidelines. Just under half (43%; 40%) of patients had a contraindication to anticoagulation and PTP. Whilst just under a tenth (8.6%; 8.7%) in each group had a tempo... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4470702 Thu, 10 Feb 2011 00:00:00 +0100 4470702 http://www.medworm.com/index.php?rid=4470703&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21282349%26dopt%3DAbstract Authors: Seymour JE, Kumar A, Froggatt K Nursing homes are a common site of death, but older residents receive variable quality of end-of-life care. We used a mixed methods design to identify external influences on the quality of end-of-life care in nursing homes. Two qualitative case studies were conducted and a postal survey of 180 nursing homes surrounding the case study sites. In the case studies, qualitative interviews were held with seven members of nursing home staff and 10 external staff. Problems in accessing support for end-of-life care reported in the survey included variable support by general practitioners (GPs), reluctance among GPs to prescribe appropriate medication, lack of support from other agencies, lack of out of hours support, cost of syringe drivers and lack of a... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4470703 Mon, 31 Jan 2011 00:00:00 +0100 4470703 http://www.medworm.com/index.php?rid=4470705&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21273220%26dopt%3DAbstract Authors: Belanger E, Rodriguez C, Groleau D The aim of this study is to synthesize knowledge about the process of shared decision-making (SDM) in palliative care. Medline, EMBASE, CINAHL, PsychInfo, Web of Science were searched with core concepts: shared decisions, patient participation in decision-making, and palliative care. Titles and abstracts were screened according to inclusion criteria (original research, adult patients, Western contexts, decision-making, palliative treatment or setting), yielding 37 articles for analysis. A narrative synthesis was created using the methods of thematic analysis, conceptual mapping, and critical reflection on the synthesis process. Results demonstrate that while a majority of patients want to participate in treatment decisions to some extent, mos... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4470705 Thu, 27 Jan 2011 00:00:00 +0100 4470705 http://www.medworm.com/index.php?rid=4470704&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21273221%26dopt%3DAbstract Authors: Slort W, Schweitzer B, Blankenstein A, Abarshi E, Riphagen I, Echteld M, Aaronson N, Van der Horst H, Deliens L While effective general practitioner (GP)-patient communication is required for the provision of good palliative care, barriers and facilitators for this communication are largely unknown. We aimed to identify barriers and facilitators for GP-patient communication in palliative care. In a systematic review seven computerized databases were searched to find empirical studies on GP-patient communication in palliative care. Fifteen qualitative studies and seven quantitative questionnaire studies were included. The main perceived barriers were GPs' lack of availability, and patients' and GPs' ambivalence to discuss 'bad prognosis'. Main perceived facilitators were GPs be... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4470704 Thu, 27 Jan 2011 00:00:00 +0100 4470704 http://www.medworm.com/index.php?rid=4400248&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21248178%26dopt%3DAbstract Authors: Clinch A, Le B Once it has been determined that aggressive medical treatment can no longer meet the goals of care for a ventilated patient, the process of withdrawing mechanical ventilation begins. This is a challenging clinical situation, drawing on the treating physician's skills including clinical decision making with consideration of the ethical and legal domains of practice, high level communication skills, intensive symptom control for the dying patient, and support for families throughout the episode, including bereavement. Central to the success of this process is recognition and respect for the needs and wishes of the patient and family. This case reports on the withdrawal of mechanical ventilation from a conscious patient in their own home, leading to death, followin... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4400248 Wed, 19 Jan 2011 00:00:00 +0100 4400248 http://www.medworm.com/index.php?rid=4400247&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21248179%26dopt%3DAbstract Authors: Bergh I, Kvalem IL, Aass N, Hjermstad MJ The Edmonton Symptom Assessment System (ESAS) is a well-known self-reporting tool for symptom assessment in palliative care. Research has shown that patients experience difficulties in the scoring and interpretation, which may lead to suboptimal treatment. The aims were to examine how palliative care cancer patients interpreted and responded to the ESAS. Eleven patients (3 F/8 M), median age 65 (34-95) with mixed diagnoses were interviewed by means of cognitive interviewing, immediately after having completed the ESAS. The highest mean scores were found with tiredness (6.3) and oral dryness (5.7). The results showed that sources of error were related to interpretation of symptoms and differences in the understanding and use of the respo... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4400247 Wed, 19 Jan 2011 00:00:00 +0100 4400247 http://www.medworm.com/index.php?rid=4400246&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21248180%26dopt%3DAbstract Authors: Coupland VH, Madden P, Jack RH, Møller H, Davies EA There is growing evidence that the palliative care needs of certain people, such as those from minority ethnic groups, are not being met. The aim of this study was to investigate whether place of death from cancer differs between ethnic groups. A total of 101,516 patients resident in South East England and who died from lung, colorectal, breast or prostate cancer between 1998 and 2006 were extracted from the Thames Cancer Registry database. Ethnicity data were available for 68,804 patients (68%). The odds ratios (ORs) of death from cancer in a hospice, at home or in hospital were calculated. The results were adjusted for age at death, deprivation, cancer network of residence and time between diagnosis and death. Following ad... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4400246 Wed, 19 Jan 2011 00:00:00 +0100 4400246 http://www.medworm.com/index.php?rid=4400245&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21248181%26dopt%3DAbstract Authors: Hardy J, O'Shea A, Gilbert C, Norris R Levomepromazine (methotrimeprazine) is an anti-psychotic used at low dose for the control of nausea and vomiting. When levomepromazine hydrochloride as Nozinan® is diluted with 0.9% sodium chloride at concentrations ranging from 0.13 to 6.25 mg/ml, and stored in polypropylene syringes, the drug is stable for at least 14 days. PMID: 21248181 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4400245 Wed, 19 Jan 2011 00:00:00 +0100 4400245 http://www.medworm.com/index.php?rid=4400244&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21248182%26dopt%3DAbstract Authors: Vassal P, Le Coz P, Hervé C, Matillon Y, Chapuis F Although most of the people in good health questioned about the subject said they would like to die at home, in the western world between 60 and 80% of deaths occur in hospital. Most authors consider that the indispensable conditions for a return home are the patient's desire and presence of the family and caregivers with the appropriate skills. The assessment of other factors predictive of a return home is inadequate. The aim of this study is to clarify how the return home is influenced by the vulnerability of the patient at the end of life, and by that of the family and caregivers. We carried out a multicentric, observational, prospective, exhaustive and longitudinal epidemiological study (three months follow-up), including... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4400244 Wed, 19 Jan 2011 00:00:00 +0100 4400244 http://www.medworm.com/index.php?rid=4400252&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21239466%26dopt%3DAbstract This study is aimed at exploring the expectations about and the impact on healthcare staff of the Liverpool Care Pathway for the dying patient (LCP) in an Italian hospital. Qualitative information was derived from four focus group (FG) meetings that were carried out separately by profession and scheduled before the beginning and after the end of the implementation process of the Italian version of LCP for hospitals (LCP-I). Interview topics concerned end-of-life care related problems and expectations about the impact of the LCP-I programme. Tape recordings of the FGs were transcribed verbatim, and transcripts analysed independently by two research psychologists using thematic analysis. Five major topics were identified: managing pain and discontinuing inappropriate treatments, communicatin... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4400252 Fri, 14 Jan 2011 00:00:00 +0100 4400252 http://www.medworm.com/index.php?rid=4400251&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21239467%26dopt%3DAbstract This study aimed to evaluate health professionals' views about palliative care provision in prisons in the counties of Cumbria and Lancashire in the North West of England. Seventeen prison healthcare staff and nine specialist palliative care staff participated in semi-structured interviews and 16 prison healthcare staff completed a questionnaire designed to measure knowledge, skills and confidence in relation to palliative care. The findings highlighted tensions between the philosophies of care and custody, and the many challenges in providing palliative care in a custodial setting. This paper presents two illustrative case study examples, and suggests ways in which some of these challenges can be overcome in practice. PMID: 21239467 [PubMed - as supplied by publisher] (Source: Palliat... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4400251 Fri, 14 Jan 2011 00:00:00 +0100 4400251 http://www.medworm.com/index.php?rid=4400264&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21228087%26dopt%3DAbstract Authors: Sampson EL, Jones L, Thuné-Boyle IC, Kukkastenvehmas R, King M, Leurent B, Tookman A, Blanchard MR Patients with advanced dementia often receive poor end-of-life care. We aimed to design and pilot a palliative care and advance care plan (ACP) intervention. Patients had undergone emergency hospital admission and had severe dementia. The intervention consisted of a palliative care patient assessment which informed an ACP discussion with the carer, who was offered the opportunity to write an ACP for the person with dementia. Carer-patient dyads were randomized to 'usual care' or the intervention. Carer-related outcome measures included the Kessler Distress Scale, Decision Satisfaction Inventory, Client Satisfaction Questionnaire and the Euroqol-5D, measured at baseline, six week... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4400264 Wed, 12 Jan 2011 00:00:00 +0100 4400264 http://www.medworm.com/index.php?rid=4400263&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21228088%26dopt%3DAbstract Authors: Malcolm C, Forbat L, Anderson G, Gibson F, Hain R This paper reports on data from the initial phase of a UK-wide study exploring life-limiting conditions (LLCs) in children where, because of their rarity, little is understood regarding the significant symptom challenges of families and care professionals who support them. In this initial phase, care professionals (n = 43) and families (n = 16) completed a survey to identify which rare LLCs present symptom challenges and which individual symptoms prove difficult to manage. Findings led to the prioritization of mucopolysaccharidoses, Batten Disease and leukodystrophy. Care professionals' rationales for selecting these conditions included the presence of symptoms that are very difficult to manage, a requirement for additional cli... Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4400263 Wed, 12 Jan 2011 00:00:00 +0100 4400263 http://www.medworm.com/index.php?rid=4400262&cid=s_36859_78_f&fid=36859&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D21228089%26dopt%3DAbstract CONCLUSION: People who identify that additional spiritual support would have been helpful have specific demographic characteristics. There is also a strong association with the likelihood of identifying that a number of other additional supports would have been helpful. Clinically, the need for additional spiritual support should open a conversation about other areas where the need for further support may be identified. PMID: 21228089 [PubMed - as supplied by publisher] (Source: Palliative Medicine) Palliative Medicine journals http://www.medworm.com/rss/comments.php?id=4400262 Wed, 12 Jan 2011 00:00:00 +0100 4400262