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End-of-Life Learning from the Philosophy of Ninjas
The objectives of the ninjas are: first, to use ninjutsu to infiltrate the enemy’s camp and observe the situation.” (Hatsumi, 1988 p. 111).How it applies to hospice: Everyone involved in a hospice situation, including the patient, their loved ones, and the staff, are observing everyone else.* The patient often can be stuck in a role of observation whether they chose to or not because they may be too tired to interact, or the family will talk in front of them to staff.* The family is often on high alert, watching the patient for symptoms or watching the staff and timing our responses.* The staff members are observing th...
Source: Pallimed: A Hospice and Palliative Medicine Blog - July 30, 2018 Category: Palliative Care Tags: hospice miles ninjutsu perseverance social work social worker spiritual Source Type: blogs

Where Is the Boundary to Augment Life?
Cloning, CRISPR and gene editing, synthetic life forms, and longevity. The latest scientific discoveries are able to offset the natural order of human existence and meddle with sacred questions of life and death. Even so, does gaining insight into the secrets of being mean it should also be put into practice? Are we aware of the consequences? Where are the boundaries to augment life? Life, death and the coin for Charon the Ferryman In Japanese folklore, the Shinigami, gods or spirits of death came to the persons who were destined to die and invited them over the threshold of life and death. In ancient Egypt, Anubis, having...
Source: The Medical Futurist - July 28, 2018 Category: Information Technology Authors: nora Tags: Bioethics Cyborgization artificial intelligence augmentation bioethical cloning CRISPR death future gene editing Health Healthcare life longevity research synthetic life Source Type: blogs

Summer Research 2018
The post Summer Research 2018 appeared first on Johns Hopkins Nursing Magazine.
Source: Nursing Blogs at Johns Hopkins University - July 16, 2018 Category: Nursing Authors: Editor Tags: Cells to Society New Summer 2018 Aging cancer Cardiovascular disparities Elderly faculty gender global hiv Mental Health opioids palliative care research students Violence Source Type: blogs

Fight Aging! Newsletter, July 9th 2018
In this study, senescent cell distribution and quantity in vastus lateralis muscle were examined in young human adults after a single bout of resistance exercise. To determine the effects of dietary protein availability around exercise on senescent cell quantity and macrophage infiltration of skeletal muscle, two isocaloric protein supplements (14% and 44% in calorie) were ingested before and immediately after an acute bout of resistance exercise, in a counter-balanced crossover fashion. An additional parallel trial was conducted to compare the outcome of muscle mass increment under the same dietary conditions after 12 wee...
Source: Fight Aging! - July 8, 2018 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

Book Review: “Everything Happens For A Reason and Other Lies I’ve Loved” by Kate Bowler
by Andrew Garcia (@ndyG83)“We can focus on your comfort always means we’re giving up.” I can’t count how many times I’ve heard this sentiment from both patients and other healthcare providers, and to read it both frustrated and encouraged me at the same time. It’s frustrating because to know that what I do, as a palliative care physician, to help patients and their families during some of their darkest, scariest, heartbreaking and most painful moments, is seen as ' giving up ' when it couldn ’t be any more different. Yet, I also find it encouraging because it reminds me that there is much work left to be done...
Source: Pallimed: A Hospice and Palliative Medicine Blog - July 7, 2018 Category: Palliative Care Tags: book book review cancer garcia patient experience Source Type: blogs

True Confessions On Why I Prescribe Things Without ' Evidence '
by Drew RosielleWe have a ' required reading ' list for our fellowship, which includes a bunch of what I think are landmark or otherwise really important studies. One of them is thisvery well done RCT of continuous ketamine infusions for patients with cancer pain, which showed it to be ineffective (and toxic).We also recently have seen another high-quality study published with negative results for ketamine. This was a Scottish, multi-center, randomized, placebo-controlled, intention-to-treat, and double-blinded study oforal ketamine for neuropathic pain in cancer patients. The study involved 214 patients, 75% of whom were ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - July 6, 2018 Category: Palliative Care Tags: fatigue ketamine methylphenidate neuropathic pain research research issues rosielle The profession Source Type: blogs

Explaining the Differences Between Palliative Care and Hospice
Many people have heard of hospice care but they mistakenly think that it’s just a way to help cancer patients be more comfortable at the end of their lives. Fewer people have heard of palliative care, and they may have no idea what it is. The truth is that hospice and palliative care are related but used for different reasons at different times, and everyone should be well-versed in what they offer. Here, we’ll clarify some points of confusion. View slideshow that explains the differences between hospice care and palliative care: Photo credit iStock Support a caregiver or jump-start discussion in support groups with re...
Source: Minding Our Elders - July 6, 2018 Category: Geriatrics Authors: Carol Bradley Bursack Source Type: blogs

Can the Top-Down Institutional Approach Promote the Right Sort of Research and Development to Treat Aging?
Most scientists who spend their professional lives within large institutions, such as the big universities, the National Institute on Aging (NIA), and so forth, tend to favor institutional solutions. In practice that means slow engineering of change within the established hierarchy, rather than stepping outside it, or where a new need is identified, meeting it with the creation of a new institutional edifice much like those that already exist. This is the top down approach to development: structure and delegation, provide big-picture guidance and leave the details up to lower levels of the hierarchy. It is advocated in a r...
Source: Fight Aging! - July 5, 2018 Category: Research Authors: Reason Tags: Activism, Advocacy and Education Source Type: blogs

Voluntarily Stopping Eating and Drinking is Legal —And Ethical—For Terminally Ill Patients Looking to Hasten Death
he ASCO Post, in partnership with the American Society of Clinical Oncology (ASCO), communicates news of evidence-based multidisciplinary cancer care to a broad audience of 30,000 oncology professionals and ASCO members.  Professor Pope authors a monthly Law and Ethics in Oncology column that explores the legal and ethical issues oncologists must be aware of in this era of precision medicine and changing health-care policy, both to protect patients’ rights and to safeguard against potential legal jeopardy. In the June 25, 2018 issue, Professor Pope tackles VSED. Terminally ill patients with cancer will sometimes...
Source: blog.bioethics.net - July 1, 2018 Category: Medical Ethics Authors: Thaddeus Mason Pope, JD, PhD Tags: Health Care syndicated Source Type: blogs

Let ' s Stop Claiming That Palliative Care Improves Survival
by Drew RosielleHospice and palliative care community, I ' m calling for a moratorium on all blanket, unqualified claims that hospice and palliative care improve survival.Let ' s just stop doing this.There has never been any actual evidence that palliative care (PC) interventions improve survival in patients, but since thelandmark Temel NEJM 2010 RCT of early outpatient palliative care for lung cancer patients showed a clinically and statistically significant improvement in longevity in the PC arm, I have heard and all read all sorts of statements by palliative people and all sorts of others (hospital executives, poli...
Source: Pallimed: A Hospice and Palliative Medicine Blog - June 30, 2018 Category: Palliative Care Tags: lung cancer palliative palliative care quality of life rosielle temel The profession Source Type: blogs

AMA Rejects Recommendation to Reaffirm Opposition to Medical Aid in Dying
The American Medical Association (AMA) House of Delegates today voted 53 to 47 percent to reject a report by its Council on Ethical and Judicial Affairs (CEJA) that recommended the AMA maintain its Code of Medical Ethics’ opposition to medical aid in dying. Instead, the House of Delegates referred the report back to CEJA for further work. The AMA Code of Medical Ethics Opinion 5.7 adopted 25 years ago in 1993 before medical aid in dying was authorized anywhere in the United States says: “...permitting physicians to engage in assisted suicide would ultimately cause more harm than good. Physician-assisted suic...
Source: blog.bioethics.net - June 11, 2018 Category: Medical Ethics Authors: Thaddeus Mason Pope, JD, PhD Tags: Health Care syndicated Source Type: blogs

Prescription monitoring programs: Helpful or harmful?
The crushing toll of the opioid crisis is daily news, including stories about ways to “fix” it. A wide array of initiatives has been brought forward in an attempt to curb this epidemic and the damage it causes. Prescription monitoring programs (PMPs) are one of them. The goal of PMPs is a good one — to identify patients who are being prescribed multiple medications by multiple clinicians. It is a means to introduce some stewardship for preventing overuse and misuse of prescription drugs. How prescription monitoring programs work Prescription monitoring programs are state-based electronic databases that provide a way ...
Source: Harvard Health Blog - June 8, 2018 Category: Consumer Health News Authors: Stephen P. Wood, MS, ACNP-BC Tags: Addiction Drugs and Supplements Health Source Type: blogs