MedWorm: Palliative Care Research

Problems and hopes perceived by mothers, fathers and physicians of children receiving palliative care

Health Expectations — Tue, 21 May 2013 06:15:49 +0100

ConclusionAsking parents and physicians to talk about problems and hopes may provide a straightforward means to improve the quality of shared decision making for critically ill children. (Source: Health Expectations)

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The Reverend: Waiting for a Miracle

Journal of Palliative Medicine — Mon, 20 May 2013 03:03:24 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

The Dying Lone Wolf

Journal of Palliative Medicine — Sun, 19 May 2013 19:48:28 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Fighting Words

Journal of Palliative Medicine — Sun, 19 May 2013 19:48:25 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

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The attitudes of neonatal professionals towards end-of-life decision-making for dying infants in Taiwan

Journal of Medical Ethics — Sun, 19 May 2013 04:00:00 +0100

The purposes of research were to describe the neonatal clinicians' personal views and attitudes on neonatal ethical decision-making, to identify factors that might affect these attitudes and to compare the attitudes between neonatal physicians and neonatal nurses in Taiwan. Research was a cross-sectional design and a questionnaire was used to reach different research purposes. A convenient sample was used to recruit 24 physicians and 80 neonatal nurses from four neonatal intensive care units in Taiwan. Most participants agreed with suggesting a do not resuscitate (DNR) order to parents for dying neonates (86.5%). However, the majority agreed with talking to patients about DNR orders is difficult (76.9%). Most participants agree that review by the clinical ethics committee is needed before ...

End-of-life decision making in Taiwan: healthcare practice is rooted in local culture and laws that should be adjusted to patients' best interests

Journal of Medical Ethics — Sun, 19 May 2013 04:00:00 +0100

The observed Taiwanese neonatal professionals' more conservative attitudes than their worldwide colleagues towards end-of-life (EOL) decision making may stem from cultural attitudes toward death in children and concerns about medicolegal liability. Healthcare practice is rooted in local culture and laws; however that should be adjusted to patients' best interests. Improving Taiwanese neonatal professionals' knowledge and competence in EOL care may minimize ethical dilemmas, allow appropriate EOL care decision making, avoid infants' suffering, and ease parents' bereavement grief. (Source: Journal of Medical Ethics)

Effectiveness of a Specialized Outpatient Palliative Care Service as Experienced by Patients and Caregivers

Journal of Palliative Medicine — Fri, 17 May 2013 03:04:04 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Core Medicines for Quality Care of the Dying

Journal of Palliative Medicine — Thu, 16 May 2013 13:57:02 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Four Essential Drugs: Differing Opinions or Heresy?

Journal of Palliative Medicine — Thu, 16 May 2013 13:56:53 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

A Nationwide Study Comparing End-of-Life Care for Men and Women Veterans

Journal of Palliative Medicine — Wed, 15 May 2013 13:56:09 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

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Case Report: Long-Term Mood Response To Repeat Dose Intramuscular Ketamine in a Depressed Patient with Advanced Cancer

Journal of Palliative Medicine — Wed, 15 May 2013 13:56:08 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Creating a Climate for Healing: A Visual Model for Goals of Care Discussions

Journal of Palliative Medicine — Wed, 15 May 2013 13:56:07 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Recent LiteratureFeature Editor: Paul C. Rousseau

Journal of Palliative Medicine — Wed, 15 May 2013 13:56:07 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

The Ambiguities of Free-Standing Pediatric Hospices

Journal of Palliative Medicine — Wed, 15 May 2013 13:56:07 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Early Admission to Community-Based Palliative Care Reduces Use of Emergency Departments in the Ninety Days Before Death

Journal of Palliative Medicine — Wed, 15 May 2013 13:56:02 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

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Human Papillomavirus, p16, and Epidermal Growth Factor Receptor Biomarkers and CT Perfusion Values in Head and Neck Squamous Cell Carcinoma [HEAD & NECK]

American Journal of Neuroradiology — Wed, 15 May 2013 04:00:00 +0100

CONCLUSIONS: A significant correlation exists between CTP measures and EGFR overexpression in head and neck squamous cell carcinomas, suggesting an association between certain imaging findings and molecular biomarkers. These results may be related to a tumor cell survival mechanism linking perfusion and biomarker expression. (Source: American Journal of Neuroradiology)

Knockout of the tetraspanin Cd9 in the TRAMP model of de novo prostate cancer increases spontaneous metastases in an organ‐specific manner

International Journal of Cancer — Wed, 15 May 2013 04:00:00 +0100

Prostate cancer is an extremely heterogeneous disease; patients that do progress to late‐stage metastatic prostate cancer have limited treatment options, mostly palliative. Molecules involved in the metastatic cascade may prove beneficial in stratifying patients to assign appropriate treatment modalities and may also prove to be therapeutic antimetastatic targets. The tetraspanin group of molecules are integral membrane proteins that associate with motility‐related proteins such as integrins. Clinical studies have mostly shown that reduced expression levels of the tetraspanin CD9 are correlated with tumour progression in a range of cancers. Furthermore, functional studies have shown CD9 to be involved in cell motility and adhesion and that it may influence metastasis. The effects of en...

Abstract 16: Early Use of Aspirin is Critical for Improving Outcomes Following Systemic to Pulmonary Artery Shunting [Concurrent Session I Session C: Young Investigator Award Finalists Oral Abstract Presentations]

Circulation: Cardiovascular Quality and Outcomes — Wed, 15 May 2013 04:00:00 +0100

Conclusion: Our results demonstrate a critical role for ASA in lowering rates of mortality and complications in the immediate perioperative period after BT shunt surgery. Administration of ASA as early as first postoperative day can reduce the mortality rate for this common congenital heart procedure. (Source: Circulation: Cardiovascular Quality and Outcomes)

Anti-Epileptic Drugs for Pain #271

Journal of Palliative Medicine — Tue, 14 May 2013 13:07:24 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

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From Qualitative Work to Intervention Development in Pediatric Oncology Palliative Care Research

Journal of Pediatric Oncology Nursing — Tue, 14 May 2013 04:00:00 +0100

Qualitative methods can be particularly useful approaches to use with individuals who are experiencing a rare disease and thus who comprise a small sample (such as children with cancer) and are at points in care that few experience (such as end of life). This data-based methods article describes how findings from a qualitative study were used to guide and shape a pediatric oncology palliative care intervention. Qualitative data can lay a strong foundation for subsequent pilot intervention work by facilitating the development of an underlying study conceptualization, providing recruitment feasibility estimates, helping establish clinically meaningful inclusion criteria, establishing staff acceptability of a research intervention, and providing support for face validity of newly developed in...

“Early Palliative Care: How?” From a Conference Report to a Consensus Document, Bentivoglio, May 14, 2012

Journal of Palliative Medicine — Mon, 13 May 2013 15:53:25 +0100

Journal of Palliative Medicine May 2013, Vol. 16, No. 5: 466-470. (Source: Journal of Palliative Medicine)

In this Issue

Journal of Palliative Medicine — Mon, 13 May 2013 15:53:18 +0100

Journal of Palliative Medicine May 2013, Vol. 16, No. 5: 461-461. (Source: Journal of Palliative Medicine)

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Should We Be Asking about Preferred Place for Dying Care?

Journal of Palliative Medicine — Mon, 13 May 2013 15:53:11 +0100

Journal of Palliative Medicine May 2013, Vol. 16, No. 5: 462-462. (Source: Journal of Palliative Medicine)

Being Well (Even When You're Sick): Mindfulness Practices for People with Cancer and Other Serious Illnesses

Journal of Palliative Medicine — Mon, 13 May 2013 15:52:45 +0100

Journal of Palliative Medicine May 2013, Vol. 16, No. 5: 591-591. (Source: Journal of Palliative Medicine)

Palliative Care and Hematological Malignancies: Increased Referrals at a Comprehensive Cancer Centre

Journal of Palliative Medicine — Mon, 13 May 2013 15:52:39 +0100

Journal of Palliative Medicine May 2013, Vol. 16, No. 5: 537-541. (Source: Journal of Palliative Medicine)

Palliative Care and Essential Drug Availability: Thailand National Survey 2012

Journal of Palliative Medicine — Mon, 13 May 2013 15:52:04 +0100

Journal of Palliative Medicine May 2013, Vol. 16, No. 5: 546-550. (Source: Journal of Palliative Medicine)

Hospice Offers More Palliative Care but Costs Less Than Usual Care for Terminal Geriatric Hepatocellular Carcinoma Patients: A Nationwide Study

Journal of Palliative Medicine — Mon, 13 May 2013 15:51:19 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

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The use of analgesia in mountain rescue casualties with moderate or severe pain

Emergency Medicine Journal — Mon, 13 May 2013 04:00:00 +0100

Conclusions Pain should be assessed using a pain score. When possible, intravenous opioid is the gold standard to achieve early and continuing pain control in patients with moderate or severe pain. Entonox and oral analgesics, as sole agents, have limited use in moderate or severe pain. Intranasal opioid and fentanyl lozenge are effective, and appropriate in MR. Research priorities include bioavailability in different environmental conditions and patient's satisfaction with their pain management. (Source: Emergency Medicine Journal)

Asbestosis: Past voices from the Mumbai factory floor

Indian Journal of Occupational and Environmental Medicine — Mon, 13 May 2013 04:00:00 +0100

Conclusion: Apart from the radical step of ban on asbestos, there is a need of community-based sustainable, affordable, and accessible rehabilitation program with a component of palliative care which will consider the different needs of this marginalized group. The need for such a program is intense as the number of asbestisis patients will keep on increasing till 30 to 40 years of asbestos ban. (Source: Indian Journal of Occupational and Environmental Medicine)

The effect of Bosentan on exercise capacity in Fontan patients; rationale and design for the TEMPO study

BMC Cardiovascular Disorders — Sat, 11 May 2013 04:00:00 +0100

DiscussionWe hypothesize that treatment with Bosentan, an endothelin receptor antagonist, can be administered safely and improve exercise capacity in TCPC patients.Trial registrationclinicaltrials.gov NCT01292551 (Source: BMC Cardiovascular Disorders)

Home-based functional walking program for advanced cancer patients receiving palliative care: a case series

BMC Palliative Care - Latest articles — Sat, 11 May 2013 04:00:00 +0100

Conclusions: This case series demonstrates the challenges of a physical activity intervention in patients with advanced cancer receiving palliative care. Further feasibility research is required in this patient population.Trial registration: This study is registered under ClinicalTrials.gov as NCT00438620. (Source: BMC Palliative Care - Latest articles)

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Dose Ratios between High Dose Oral Morphine or Equivalents and Oral Methadone

Journal of Palliative Medicine — Sat, 11 May 2013 03:03:21 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

The Diverse Landscape of Palliative Care Clinics

Journal of Palliative Medicine — Fri, 10 May 2013 13:07:34 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Palliative Medicine: The Short Version

Home Health Care Management — Fri, 10 May 2013 04:00:00 +0100

(Source: Home Health Care Management)

Dysphagia as a predictor of outcome and transition to palliative care among middle cerebral artery ischemic stroke patients

BMC Palliative Care - Latest articles — Fri, 10 May 2013 04:00:00 +0100

Conclusions: The severity of dysphagia influences early transition to palliative level of care in acute stroke patients. Independent predictors of an early transition to palliative level of care among patients with an acute MCA territory stroke and dysphagia included advancing age, a left MCA infarct, a high NIHSS score on admission, administration of intra-arterial tPA and the inability to be assessed on the 1st swallow evaluation. This information may guide discussions with families of patients with MCA territory strokes regarding artificial nutrition and goals of care. (Source: BMC Palliative Care - Latest articles)

Latent Classes of Prognosis Conversations in Palliative Care: A Mixed-Methods Study

Journal of Palliative Medicine — Thu, 09 May 2013 14:00:03 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Staff Perspectives on the Provision of End-of-Life Care in a Community Residence for Older Adults with Developmental Disabilities

Journal of Palliative Medicine — Thu, 09 May 2013 13:59:59 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Parental understanding of dosing instructions for paracetamol and ibuprofen suspension

Archives of Disease in Childhood — Thu, 09 May 2013 04:00:00 +0100

Conclusions This study has shown that although the majority of caregivers understand the dosing instructions included in GSL packs of Paracetamol and Ibuprofen suspension, at least 1 in 8 caregivers are not able to interpret the information provided in order to use these products optimally for their children. This study did not evaluate whether patient information for different brands of analgesics was easier to use but the need for understandable information about simple analgesics is vitally important to ensure these drugs are used safely and effectively in children. (Source: Archives of Disease in Childhood)

Adherence of paediatric nurses to double checking process steps during medication administration in a children's hospital: an observational study

Archives of Disease in Childhood — Thu, 09 May 2013 04:00:00 +0100

Conclusions There was a variation between paediatric nurses adherence to double checking steps during medication administration. Independent double checks were not apparent for all steps in practice. The majority of medication administration errors observed failed to be prevented by the double checking process. (Source: Archives of Disease in Childhood)

Two years experience of the treatment of molybdenum cofactor deficiency

Archives of Disease in Childhood — Thu, 09 May 2013 04:00:00 +0100

Conclusions Until recently the provision of care to children with MOCD has largely been palliative. The experience in these two children suggest that the longer term treatment of the disease is possible and that near normal development can be possible in a disease that was previously fatal. The ongoing use of cPMP in these patients presents some challenges in supply of a product appropriate for use. (Source: Archives of Disease in Childhood)

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Experiences and opinions of non-medical prescribers in a paediatric hospital concerning electronic prescribing

Archives of Disease in Childhood — Thu, 09 May 2013 04:00:00 +0100

Conclusions NMPs currently use a wide range of resources to support their prescribing decisions. There are some difficulties accessing paediatric information for certain specialties (eg, palliative care and renal) and patients' prescribing histories. NMPs can see a range of benefits to moving to electronic prescribing, but there is a lack of optimism about its potential success due to the current technical difficulties experienced in the Trust's IT systems. (Source: Archives of Disease in Childhood)

Characteristics influencing location of death for children with life-limiting illness

Archives of Disease in Childhood — Thu, 09 May 2013 04:00:00 +0100

Conclusions Most children in New Zealand with a life-limiting illness die in hospital with a significant influence resulting from ethnic background, diagnosis and referral to the PPC service. These findings have implications for resourcing PPC services and end-of-life care. (Source: Archives of Disease in Childhood)

Paracetamol to induce ductus arteriosus closure: is it valid?

Archives of Disease in Childhood — Thu, 09 May 2013 04:00:00 +0100

There remains a need for alternative medical treatments for patent ductus arteriosus (PDA) closure in extreme preterm neonates because of therapeutic failure and adverse effects associated with non-selective cyclo-oxygenase inhibitors. Reports of an association between paracetamol exposure and PDA closure in a limited number of extreme preterm neonates have been published. However, causality cannot be taken for granted because a link between the current knowledge of the clinical pharmacology of paracetamol and (patho)physiology of ductal closure is not known. In contrast to non-selective cyclo-oxygenase inhibitors, paracetamol has limited effects at peripheral sites, is a poor antithrombotic and anti-inflammatory drug and exerts its effects primarily within the central nervous system. Alth...

The evaluation of a peer‐led question‐writing task

The Clinical Teacher — Thu, 09 May 2013 04:00:00 +0100

Conclusion: Peer‐led examination question writing could complement the delivery of palliative care teaching for medical students. (Source: The Clinical Teacher)

5% fluorouracil chemowraps in the management of widespread lower leg solar keratoses and squamous cell carcinoma

Australasian Journal of Dermatology — Wed, 08 May 2013 04:00:00 +0100

Abstract Elderly patients with extensive hypertrophic solar keratoses and squamous cell carcinoma on the lower legs can pose significant management challenges. Typically these patients require surgical treatment which is complicated by comorbidities and poor background lower leg skin. 5% fluorouracil chemowraps provides a useful alternative technique for the management of diffuse hypertrophic solar keratoses and as an adjuvant, and in some situations as a palliative treatment, for squamous cell carcinomas on the lower legs. (Source: Australasian Journal of Dermatology)

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Caring for families of the terminally ill in Malaysia from palliative care nurses’ perspectives

Journal of Clinical Nursing — Wed, 08 May 2013 04:00:00 +0100

ConclusionsThis study highlights the importance of engaging and supporting families of the terminally ill as well as providing a guide that may be used by nurses and carers to better respond to families' needs and concerns. Relevance to clinical practiceThe study draws attention to the need for formal palliative care education, inclusive of family care, to enable nurses to provide the terminally ill person and their family effective and appropriate care. (Source: Journal of Clinical Nursing)

Solitary Painful Osseous Metastases: Correlation of Imaging Features with Pain Palliation after Radiofrequency Ablation--A Multicenter American College of Radiology Imaging Network Study [Vascular and Interventional Radiology]

Continuous Publishing articles — Wed, 08 May 2013 04:00:00 +0100

Existing pathologic fracture and smaller tumor size appear to be predictive parameters of success for palliative radiofrequency ablation of painful solitary osseous metastases. (Source: Continuous Publishing articles)

Long‐term outcomes in patients with duodenal adenocarcinoma

ANZ Journal of Surgery — Wed, 08 May 2013 04:00:00 +0100

ConclusionIn the absence of distant metastasis, curative resection enhances the long‐term survival of patients with duodenal adenocarcinoma. Lymph node metastasis is prognostic factor of overall survival. (Source: ANZ Journal of Surgery)

The development of an instrument that can identify children with palliative care needs: the paediatric palliative screening scale (PaPaS Scale): a qualitative study approach

BMC Palliative Care - Latest articles — Wed, 08 May 2013 04:00:00 +0100

Conclusions: This study is a preliminary report of the development of an instrument to facilitate timely introduction of palliative care in the illness trajectory of a severely ill child. The instrument demonstrated early validity and was evaluated as being a valuable approach towards effective paediatric palliative care. (Source: BMC Palliative Care - Latest articles)

Eugen Bleuler and evidence-based psychiatry

Journal of Neurology, Neurosurgery and Psychiatry — Tue, 07 May 2013 04:00:00 +0100

Not so much a pioneer of EVIDENCE BASE MEDICINE as a visionary for evidence-based psychiatry Stam and Vermeulen1 argue persuasively that Eugen Bleuler (1857–1939) is an unrecognised proponent of evidence-based medicine.2 Bleuler saw the self-absorbed, wish-fulfilling, magical thinking they describe as a fundamental symptom of schizophrenia.3 Rather than suggesting doctors were ill, Bleuler was highlighting the dangers of a medical rigidity of thought and perceptions of infallibility. Bleuler was of course correct that many remedies of the day were unproven and likely to be ineffective or even dangerous, and that their apparent benefits could be attributed to the enthusiasm of pioneers, suggestion and spontaneous recovery. It is fascinating to read that he was one of the first doctors...

Promoting Resilience among Parents and Caregivers of Children with Cancer

Journal of Palliative Medicine — Tue, 07 May 2013 03:05:29 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

End of life care for frail older patients in family practice (ELFOP) -- protocol of a longitudinal qualitative study on needs, appropriateness and utilisation of services

BMC Family Practice — Fri, 03 May 2013 04:00:00 +0100

This study will address end-of-life care needs, service utilisation, and experiences of frail elderly patients and their informal caregivers, with regard to family practice. This paper aims to introduce the research protocol. Methods: The study uses a multiple-perspectives qualitative design. The first study part consists of serial six-monthly in-depth interviews with 30 community-dwelling elderly patients (>=70 years) with moderate to severe frailty and their key informal caregivers, over a period of 18 months. Additionally, semi-structured interviews with the patients' family physician will be conducted. The serial interviews will be analysed with grounded theory and narrative approaches. Special attention will be paid to the comparison of distinct views of the patients', informal caregi...

‘Where do I go from here’? A cultural perspective on challenges to the use of hospice services

Health and Social Care in the Community — Fri, 03 May 2013 04:00:00 +0100

Abstract Do hospice services as shaped by a western perspective adequately fulfil the needs of persons from non‐Western cultures? Based on a Western view of palliative care, the vision outlined in the New Zealand Palliative Care Strategy (2001) is to deliver palliative care services, including hospice services, to all patients and their families requiring them in the context of an increasingly pluralistic and multicultural society. It is predicted that over the next two decades the proportion of people identifying as Māori, Pacific and Asian will dramatically increase within New Zealand. Ministry of Health information provided through a GAP analysis identified hospices as facing access‐to‐care pressures for Māori, Pacific and Asian patients. It is therefore critical to identify the...

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End of life care for frail older patients in family practice (ELFOP) ¿ protocol of a longitudinal qualitative study on needs, appropriateness and utilisation of services

BMC Family Practice — Fri, 03 May 2013 04:00:00 +0100

Discussing Goals of Care for a Delirious Advanced Cancer Patient in the Hospice Setting

Journal of Palliative Medicine — Thu, 02 May 2013 03:02:58 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Palliative and End-of-Life Care: Where Are We Now?

AJN — Wed, 01 May 2013 05:00:00 +0100

Despite regional and national efforts to improve access, many eligible patients aren't getting the care they need. (Source: AJN)

Treatment of malignant effusion by oncolytic virotherapy in an experimental subcutaneous xenograft model of lung cancer

BioMed Central — Wed, 01 May 2013 04:00:00 +0100

Conclusions: Here, we demonstrate for the first time that oncolytic virotherapy using tumor-specific Vaccinia virus represents a novel and promising treatment modality for therapy of ME associated with advanced lung cancer. (Source: BioMed Central)

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Survival of Patients With Spinal Muscular Atrophy Type 1

PEDIATRICS — Wed, 01 May 2013 04:00:00 +0100

Survival of children with spinal muscular atrophy type 1 is determined by treatment choice: tracheostomy with mechanical ventilation, noninvasive mechanical ventilation, or a palliative approach. Few data are available on life expectancies with different approaches. The present study provides data comparing therapeutic strategies that affect life expectancy. Clinicians involved in the care of patients with spinal muscular atrophy type 1 should be aware of survival trends while awaiting more definitive therapeutic strategies. (Read the full article) (Source: PEDIATRICS)

Can a Patient Designate His Doctor as His Proxy Decision Maker?

PEDIATRICS — Wed, 01 May 2013 04:00:00 +0100

We present a case in which those issues arose, and sought comments from Sabrina Derrington, a pediatric palliative care physician; Arthur Derse, an emergency department physician and lawyer; and Phil Black, a pulmonologist. (Source: PEDIATRICS)

Ethical Controversies in Organ Donation After Circulatory Death

PEDIATRICS — Wed, 01 May 2013 04:00:00 +0100

The persistent mismatch between the supply of and need for transplantable organs has led to efforts to increase the supply, including controlled donation after circulatory death (DCD). Controlled DCD involves organ recovery after the planned withdrawal of life-sustaining treatment and the declaration of death according to the cardiorespiratory criteria. Two central ethical issues in DCD are when organ recovery can begin and how to manage conflicts of interests. The "dead donor rule" should be maintained, and donors in cases of DCD should only be declared dead after the permanent cessation of circulatory function. Permanence is generally established by a 2- to 5-minute waiting period. Given ongoing controversy over whether the cessation must also be irreversible, physicians should not be re...

The Groningen Protocol for newborn euthanasia; which way did the slippery slope tilt?

Journal of Medical Ethics — Wed, 01 May 2013 04:00:00 +0100

In The Netherlands, neonatal euthanasia has become a legal option and the Groningen Protocol contains an approach to identify situations in which neonatal euthanasia might be appropriate. In the 5 years following the publication of the protocol, neither the prediction that this would be the first step on a slippery slope, nor the prediction of complete transparency and legal control became true. Instead, we experienced a transformation of the healthcare system after antenatal screening policy became a part of antenatal care. This resulted in increased terminations of pregnancy and less euthanasia. (Source: Journal of Medical Ethics)

Infanticide: a reply to Giubilini and Minerva

Journal of Medical Ethics — Wed, 01 May 2013 04:00:00 +0100

This article challenges these criteria, suggesting that these and related ideas are rely on arbitrary and discriminatory notions of human moral status. Our propensity to sleep, fall unconscious, pass out and so on, demonstrates that we often exhibit our status as ‘potential persons’ who are not in the condition of attributing any value to their own existence. Our abilities, age and desirability can and do fluctuate. The equal dignity principle, distinguished in turn from both the excesses of vitalism and consequentialism, is analysed and defended in the context of human rights logic and law. The normalisation of non- and involuntary euthanasia, via such emerging practices as the self-styled Groningen Protocol, is considered. Substituted consent to the euthanasia of babies and o...

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Determinants of place of death: a population-based retrospective cohort study

BMC Palliative Care - Latest articles — Wed, 01 May 2013 04:00:00 +0100

Conclusions: Information on determinants of place of death can inform public health policy regarding care at the end of life and make resource allocation more efficient. (Source: BMC Palliative Care - Latest articles)

Buprenorphine

Journal of Pain and Symptom Management — Wed, 01 May 2013 04:00:00 +0100

Therapeutic Reviews aim to provide essential independent information for health professionals about drugs used in palliative and hospice care. Additional content is available on www.palliativedrugs.com. Country-specific books (Hospice and Palliative Care Formulary USA, and Palliative Care Formulary, British and Canadian editions) are also available and can be ordered from www.palliativedrugs.com. The series editors welcome feedback on the articles (hq@palliativedrugs.com). (Source: Journal of Pain and Symptom Management)

“Safari ni taabu”: Research and Curriculum Development as an Instrument for Greater Understanding of Spirituality and Love in Health Sciences—Humanistic Personal and Professional Notes on a Journey in Africa

Journal of Pain and Symptom Management — Wed, 01 May 2013 04:00:00 +0100

I found here in the West people who were so submerged in the massive trance of modern culture that they appeared virtually unreachable. It became clear that certain topics of discussion, such as spirituality and rituals, were not permitted in intellectual and professional circles. I noticed some people, particularly those who were most enthralled by the game of consumerism, found mention of indigenous wisdom especially irritating and sometimes would lash out at me, just as child entranced by a Nintendo game reacts with a tantrum to any disturbance.—Malidoma Patrice Somé(p. 14) (Source: Journal of Pain and Symptom Management)

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Pc-facs

Journal of Pain and Symptom Management — Wed, 01 May 2013 04:00:00 +0100

PC-FACS (Fast Article Critical Summaries for Clinicians in Palliative Care) provides hospice and palliative care clinicians with concise summaries of the most important findings from more than 100 medical and scientific journals. If you have colleagues who would benefit from receiving PC-FACS, please encourage them to join the AAHPM at aahpm.org. Comments from readers are welcomed at pc-facs@aahpm.org. (Source: Journal of Pain and Symptom Management)

Major Changes in Chemotherapy Regimens Administered to Breast Cancer Patients During 2000–2008 in the Netherlands

The Breast Journal — Wed, 01 May 2013 04:00:00 +0100

In conclusion, major changes have taken place in the chemotherapeutic treatment of patients with early and recurrent breast cancer. These changes reflect the key findings from large clinical trials, as incorporated in the Dutch guidelines. (Source: The Breast Journal)

Twenty‐first century palliative care: a tale of four nations

European Journal of Cancer Care — Wed, 01 May 2013 04:00:00 +0100

Hospice and palliative care development, in terms of availability and services, occur to varying degrees in the developing world. In this paper, the evolution of palliative care practices in four developing nations (Nigeria, Georgia, Ethiopia and Tanzania) is described. By highlighting common problems as well as the unique individual perspectives of each country's practice, this paper aims at increasing global awareness of palliative care in the developing world. While the call for palliative care to become a fundamental human right is sustained, it is also hoped that this article will stimulate a global discussion on the best possible way to encourage the establishment and growth of palliative care services in other developing countries where hitherto it has not been in existence, with po...

[Correspondence] Non-invasive ventilation for end-of-life oncology patients

The Lancet Oncology — Wed, 01 May 2013 03:16:21 +0100

We read with interest the feasibility trial from Stefano Nava and colleagues, in which palliative non-invasive ventilation (NIV) was compared with oxygen therapy in patients with solid tumours, acute respiratory failure, and life expectancy less than 6 months. The authors have provided the only available data for comfort NIV in patients with cancer. Additionally, the findings that dyspnoea fell more rapidly in the NIV group than in the oxygen group, and that the total dose of morphine needed during the first 48 h was lower in the NIV group than in the oxygen group, provide encouraging evidence for the use of NIV to alleviate respiratory distress in these patients. (Source: The Lancet Oncology)

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Access to Outreach Specialist Palliative Care Teams among Cancer Patients in Denmark

Journal of Palliative Medicine — Tue, 30 Apr 2013 15:03:13 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Rotating to Oral Methadone in Advanced Cancer Patients: A Case Series

Journal of Palliative Medicine — Tue, 30 Apr 2013 15:03:12 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

An Innovative Self-Care Module for Palliative Care Medical Learners

Journal of Palliative Medicine — Tue, 30 Apr 2013 15:03:11 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

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Informed Consent in Palliative Care Clinical Trials: Challenging but Possible

Journal of Palliative Medicine — Tue, 30 Apr 2013 15:03:10 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Stage IIIA Non-Small Cell Lung Cancer: Morbidity and Mortality of Three Distinct Multimodality Regimens [ORIGINAL ARTICLES: GENERAL THORACIC]

The Annals of Thoracic Surgery — Tue, 30 Apr 2013 04:00:00 +0100

Conclusions Chemoradiotherapy carries a significant morbidity profile. However, high-dose neoadjuvant radiation is not associated with increased postoperative morbidity or mortality relative to standard-dose radiation in patients selected for anatomic resection. (Source: The Annals of Thoracic Surgery)

A Brief Educational Intervention To Teach Residents Shared Decision Making in the Intensive Care Unit

Journal of Palliative Medicine — Sun, 28 Apr 2013 03:03:13 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

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A Pilot Study To Assess the Feasibility of Measuring the Prevalence of Slow Colon Transit or Evacuation Disorder in Palliative Care

Journal of Palliative Medicine — Sat, 27 Apr 2013 18:19:57 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Emergency Management Of Dyspnea In Dying Patients

Emergency Medicine Practice — Fri, 26 Apr 2013 23:10:36 +0100

This issue of Emergency Medicine Practice reviews the evidence regarding the types of palliative care that can be provided to patients in the emergency department who are suffering significant breathing discomforts at the end of life. (Source: Emergency Medicine Practice)

The role of radiotherapy in the overall treatment of melanoma

Clinics in Dermatology — Fri, 26 Apr 2013 21:17:07 +0100

Abstract: Radiotherapy has become an effective treatment in the management of melanoma patients. It has its place beneath surgical treatment options in a tumor entity that has only limited response to systemic medical therapies. New therapies, such as ipilimumab and vemurafenib, may prolong survival for several months but will cure only a few patients. Radiotherapy will still be required in adjuvant settings to reduce the local recurrence rate and in palliative situations, particularly in brain and bone metastasis. We review several indications for radiotherapy in the management of malignant melanoma with an effect on the guidelines in our clinical practice. (Source: Clinics in Dermatology)

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Patient-Oncologist Alliance, Psychosocial Well-Being, and Treatment Adherence Among Young Adults With Advanced Cancer [Palliative and Supportive Care]

Journal of Clinical Oncology — Fri, 26 Apr 2013 04:00:00 +0100

Conclusion By developing a strong alliance, oncologists may enhance psychosocial well-being and increase treatment adherence in young adult patients with advanced cancer. (Source: Journal of Clinical Oncology)

Don't Ask – Don't Tell

Journal of Palliative Medicine — Thu, 25 Apr 2013 13:14:08 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

24/7 Coverage, Martyrdom, and a Broken Wrist

Journal of Palliative Medicine — Thu, 25 Apr 2013 13:14:07 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

BMC Palliative Care reviewer acknowledgement, 2012

BMC Palliative Care - Latest articles — Thu, 25 Apr 2013 04:00:00 +0100

Contributing reviewersThe editors of BMC Palliative Care would like to thank all our reviewers who have contributed to the journal in Volume 11 (2012). (Source: BMC Palliative Care - Latest articles)

Evidence-based planning and costing palliative care services for children: novel multi-method epidemiological and economic exemplar

BMC Palliative Care - Latest articles — Thu, 25 Apr 2013 04:00:00 +0100

Conclusions: Findings make a significant contribution to population-based needs assessment and commissioning methodology in children's palliative care. Further work is needed to determine with greater precision which children in the total population require access to services and when. (Source: BMC Palliative Care - Latest articles)

Pain, Family, and Idioms: A Poem Triplet

Journal of Palliative Medicine — Thu, 25 Apr 2013 03:04:30 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

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Demoralization Syndrome: A Condition Often Undiagnosed in Terminally Ill Patients

Journal of Palliative Medicine — Wed, 24 Apr 2013 13:19:30 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Recent Literature; Feature Editor: Paul C. Rousseau

Journal of Palliative Medicine — Wed, 24 Apr 2013 13:19:29 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Opioid Poorly Responsive Cancer Pain #215

Journal of Palliative Medicine — Wed, 24 Apr 2013 13:19:29 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

When It Hits Close to Home

Journal of Palliative Medicine — Wed, 24 Apr 2013 13:19:28 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Pain in Sickle Cell Disease #270

Journal of Palliative Medicine — Wed, 24 Apr 2013 13:19:28 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

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Five Years' Time and The Next Five Things for the List of Choosing Wisely

Journal of Palliative Medicine — Wed, 24 Apr 2013 13:19:27 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

The Edmonton Classification System for Cancer Pain: Comparison of Pain Classification Features and Pain Intensity Across Diverse Palliative Care Settings in Eight Countries

Journal of Palliative Medicine — Wed, 24 Apr 2013 13:19:23 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Complete Genomic Landscape of a Recurring Sporadic Parathyroid Carcinoma

The Journal of Pathology — Wed, 24 Apr 2013 04:00:00 +0100

Abstract Parathyroid carcinoma is a rare endocrine malignancy with an estimated incidence of less than 1 per million population. Excessive secretion of parathyroid hormone, extremely high serum calcium level and the deleterious effects of hypercalcemia are the clinical manifestations of the disease. Up to 60% of patients develop multiple disease recurrences and although long‐term survival is possible with palliative surgery, permanent remission is rarely achieved. Molecular drivers of sporadic parathyroid carcinoma have remained largely unknown. Previous studies, mostly based on familial cases of the disease, suggested potential roles for the tumor suppressor MEN1 and proto‐oncogene RET in benign parathyroid tumorigenesis while the tumor suppressor HRPT2 and proto‐oncogene CCND1 may ...

Pushed: Finding Truth in the Words of a Confused, Elderly Woman

Journal of Palliative Medicine — Tue, 23 Apr 2013 15:15:23 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Using Social Media Tools To Build an Active and Effective Social Media Presence about Palliative Care

Journal of Palliative Medicine — Tue, 23 Apr 2013 15:15:23 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Reflection on the Death of San Diego Hospice and the Institute for Palliative Medicine

Journal of Palliative Medicine — Tue, 23 Apr 2013 15:15:23 +0100

Journal of Palliative Medicine , Vol. 0, No. 0. (Source: Journal of Palliative Medicine)

Using aggregated single patient (N-of-1) trials to determine the effectiveness of psychostimulants to reduce fatigue in advanced cancer patients: a rationale and protocol

BMC Palliative Care - Latest articles — Tue, 23 Apr 2013 04:00:00 +0100

This study will provide high-level evidence using a novel methodological approach about the effectiveness of psychostimulants for cancer-related fatigue. If effective, the findings will guide clinical practice in reducing this prevalent condition to improve function and quality of life.Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12609000794202 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12609000794202 (Source: BMC Palliative Care - Latest articles)