tag:blogger.com,1999:blog-6529366099081946602024-02-20T23:23:18.583-08:00 وحدة العناية الملطفة في زحلة والبقاع - لبنان<br> UNITE DES SOINS PALLIATIFS
<br> Zahle et Bekaa. LIBAN
<br> PALLIATIVE CARE UNIT
<br> Zahle and Bekaa. LEBANONUnknownnoreply@blogger.comBlogger1823125tag:blogger.com,1999:blog-652936609908194660.post-90992316215069299492016-01-15T07:17:00.003-08:002016-01-15T07:17:29.824-08:00<div class="yiv7830771659node-title" id="yui_3_16_0_1_1452870854309_3286" style="background-color: #cce7f1; color: #343333; font-family: 'Open Sans', Arial, Verdana, sans-serif; padding: 0px !important;">
<b>Douleur et soins palliatifs. Dossiers progressifs et questions isolées corrigés </b></div>
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ROSTAING-RIGATTIERI, Sylvie ; VARIN, Dominique ; TOURNIAIRE, Barbara ; PASSARD, Andréa, </div>
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Elsevier Masson, novembre 2015</div>
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<b>Cet ouvrage permet aux étudiants de se préparer aux épreuves des ECNI en privilégiant des batteries d'entraînements de plusieurs types : cas cliniques progressifs accessibles, également en ligne, questions isolées QCM ou QROC, TCS et LCA. L'ouvrage est constitué de 2 parties : l'une est composée des énoncés des entraînements classés par typologie ; l'autre propose les corrigés assortis de grilles de correction, précisant les items traités et les recommandations existantes, ainsi que des fiches de synthèse qui rappellent les points clés, privilégiant les algorithmes et l'explication de la démarche du raisonnement clinique.</b></div>
Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-652936609908194660.post-81096234613151577012016-01-15T07:13:00.002-08:002016-01-15T07:13:17.189-08:00<br />
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BILLET</h2>
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<b><span style="color: red; font-size: large;">Pour les soins palliatifs et l’accompagnement</span></b><br />2015 a été riche en événements<br />La Sfap a été entendue dans les débats<br />Et a pu témoigner de ce qui va ou pas<br /> </div>
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La nouvelle loi est dans les mains du parlement<br />Et le ministère va débloquer de l’argent<br />Nous avons maintenant à travailler ensemble<br />Sur les justes valeurs de ce que bon nous semble<br /> </div>
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L’accompagnement des personnes en fin de vie<br />Reste préoccupation première et définie<br />Que nous souhaitons poursuivre et encore développer<br />A travers formations et culture diffuser<br /> </div>
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Ces derniers mois plusieurs écrits ont été lus<br />Entraînant confusion profonde et continue<br />Nous n’avons pas besoin d’angoisse anticipée<br />Mais d’énergie soignante et non désespérée<br /> </div>
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Gardons foi au futur et en ce nouvel an<br />Et restons habités par le moment présent<br />Le plan ministériel est à considérer<br />Pour les soins palliatifs comme une belle avancée<br /> </div>
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Bonne et heureuse année à vous tous adhérents<br />En l’espérant ponctuée d’agréables moments <br /><br />Nathalie Favre,<br />Vice-Présidente de la SFAP</div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-39841607869050031282016-01-14T06:18:00.003-08:002016-01-14T06:18:34.522-08:00<header style="background-color: white; border: 0px; clear: both; font-family: Arial, Helvetica, sans-serif; font-size: 12px; font-stretch: inherit; height: auto; line-height: 19.2px; margin: 0px; padding: 0px 0px 30px; position: relative; vertical-align: baseline;"><h1 style="border-image-outset: initial; border-image-repeat: initial; border-image-slice: initial; border-image-source: initial; border-image-width: initial; border: 0px; font-family: BertholdBaskervilleBold; font-size: 30px; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: 32px; margin: 0px 0px 15px; padding: 0px; vertical-align: baseline;">
<span style="color: red;">Digital technology should be better utilised to give those facing terminal illness more control over their care</span></h1>
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08 December 2015</div>
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Health and care staff need digital skills in order to support patients to make the most of digital tools and technology</div>
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Health and care staff need digital skills in order to support patients to make the most of digital tools and technology</div>
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<strong style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">A cross-sector project to help give older people facing the end of life more control over their care is one of a number of proposals put forward today on how to increase digital inclusion across the NHS.</strong></div>
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Earlier this year, Health Secretary Jeremy Hunt tasked Baroness Martha Lane Fox to look into how to increase the take-up of internet enabled services in health and care.</div>
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Today Martha Lane Fox will present her recommendations to the National Information Board leadership summit, and lead a discussion on potential strategies for widening digital participation.</div>
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Those with the most health and social care needs are often the most digitally excluded – which is why one of Martha’s four recommendations is to “reach the furthest first”.</div>
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“I would like to see a massive transformation using internet enabled technologies, focussing on those who are digitally excluded. Older people are a traditionally digitally excluded group and people with life-limiting illness have high health and social care needs,” she explains.</div>
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Martha proposes a cross-sector project, working with older people with life-limiting or terminal illness facing the end of life, to give them “more control over their healthcare destinies.”</div>
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Her organisation Doteveryone is working with NHS England on a prototype which will demonstrate how internet-enabled technology can give older people with life-limiting illnesses greater control in planning and managing their care.</div>
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Development of this self-management tool for patients and carers, which will link up with electronic palliative care coordination systems, will begin in 2016 – with the code being made open and accessible for all.</div>
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Those behind the project hope it will show how, when you reach the furthest first, you can reach everyone, as well as provide a new model to show how to build and scale technological development in health and social care for the benefit of all.</div>
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Other recommendations put forward today include:</h2>
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<ul style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; list-style-image: url("../Images/ico/list_dot.png"); margin: 0px; padding: 0px 0px 15px 18px; vertical-align: baseline;">
<li style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 4px 0px; vertical-align: baseline;">Free Wi-Fi in all NHS buildings to allow hospital patients to self-monitor their conditions using apps and maintain contact with social networks, which can support recovery and help them to stay in contact with family and friends.</li>
<li style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 4px 0px; vertical-align: baseline;">Building the basic digital skills of the NHS workforce so they can make the most of digital tools and technology and feel confident to recommend these to patients.</li>
<li style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 4px 0px; vertical-align: baseline;">At least 10% of registered patients in each GP practice should be using a digital service such as online appointment booking, repeat prescriptions and access to records by 2017.</li>
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Today's recommendations have been welcomed by the Digital Legacy Association, a research and training organisation which supports the end of life and hospice sector in areas relating to digital assets, digital legacy and digital bereavement.</div>
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CEO and founder of the Digital Legacy Association James Norris said: "We are delighted that today’s digital recommendations by Baroness Martha Lane Fox place such a strong emphasis on utilising today’s communication technologies.</div>
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"The recommendations include aiming to drastically improving IT literacy within the NHS workforce, setting figures on patient internet adoption and providing free Wi-Fi in every NHS building. The goals set appear to be both challenging and achievable. </div>
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"The internet has been the biggest catalyst for change since the industrial revolution. It has changed the way in which we communicate with one another and consume information. It can also significantly speed up the amount of time it takes to carry out administrative tasks within healthcare settings.</div>
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"If the recommendations are adopted it may significantly help to improve hospital and hospice care within the UK. Furthermore, areas such as patient satisfaction may also improve."</div>
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Health Secretary Jeremy Hunt said: "Creating an NHS which is digitally fit for purpose in the twenty-first century is a key priority for this government. New investment of £1 billion in health technology announced in the autumn statement will help us to achieve this – making sure that patients and staff can access the services they need, helping to free up time and reduce costs."</div>
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Tim Kelsey, National Information Board Chair and NHS England national director of patients and information, added: "Digital health tools can dramatically improve people’s lives and wellbeing. These bold challenges to the system to ensure that every person in the UK benefits are very welcome, and will galvanise work already underway to put power in the hands of patients, enabling them to take control of their care and improve their health."</div>
</section></div>
</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-71578158689453548092016-01-14T05:52:00.002-08:002016-01-14T05:52:26.816-08:00<header style="background-color: white; border: 0px; clear: both; font-family: Arial, Helvetica, sans-serif; font-size: 12px; font-stretch: inherit; height: auto; line-height: 19.2px; margin: 0px; padding: 0px 0px 30px; position: relative; vertical-align: baseline;"><h1 style="border-image-outset: initial; border-image-repeat: initial; border-image-slice: initial; border-image-source: initial; border-image-width: initial; border: 0px; font-family: BertholdBaskervilleBold; font-size: 30px; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: 32px; margin: 0px 0px 15px; padding: 0px; vertical-align: baseline;">
<span style="color: red;">Hundreds of people in Scotland die while waiting for social care packages</span></h1>
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Author: Tom Moran</div>
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14 January 2016</div>
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<strong style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">A freedom of information request by motor neurone disease campaigner Gordon Aikman has revealed that at least 276 people in Scotland died last year while waiting for their social care packages to be arranged.</strong></div>
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NHS Scotland figures indicate that a large proportion of the people waiting for social care to be provided – around 70% – are over the age of 75. There were 1,294 people waiting in hospital for social care in November 2015.</div>
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Of the 276 who died while on the waiting list, 95 were from the Edinburgh council area, the highest figure from any single council. Services in Glasgow are contracted out to a private company, and therefore not subject to freedom of information legislation; 26 of Scotland’s 32 councils responded to the request.</div>
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Aikman, who has motor neurone disease and receives visits from carers three times a day, said his findings showed "a cruel crisis in care" which he attributed to council budget cuts.</div>
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"Behind these figures are real people with stories of desperation, misery and indignity," <a href="http://www.scotsman.com/news/270-scots-died-waiting-for-social-care-to-start-in-2015-1-3999239" style="border: 0px; color: #396179; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;" target="_blank">he told the Scotsman</a>. "Imagine it was your mum or your son waiting months for the help they need to live their life."</div>
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He added: "Given our parliament now has revenue-raising powers, it need not be this way."</div>
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His sentiments were shared by Richard Meade, head of policy and public affairs in Scotland for Marie Curie.</div>
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"Marie Curie patients have experienced delays in getting social care packages, which can impact on their care and place of care. This is not acceptable, particularly for those living with a terminal illness when time may be short," he said.</div>
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"Social care support is vital in enabling people to be cared for and die at home if that is their choice. The integration of health and social care in Scotland must address this and ensure that people living with a terminal illness and their carers get the care and support they need from the time they need."</div>
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The health secretary, Shona Robison, said that the Scottish government would work with councils to improve care and explained that there would be a £250 million investment in social care in next year’s budget.</div>
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"The Scottish government is joining up health and social care for the first time to ensure that our health boards work seamlessly with local authorities to deliver the best possible care," she said.</div>
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"We are committed to supporting councils, NHS boards and integrated health and social care partnerships to ensure that their social care packages are arranged effectively to meet the needs of local people."</div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-54149260480273931892016-01-14T05:51:00.003-08:002016-01-14T05:51:28.042-08:00<header style="background-color: white; border: 0px; clear: both; font-family: Arial, Helvetica, sans-serif; font-size: 12px; font-stretch: inherit; height: auto; line-height: 19.2px; margin: 0px; padding: 0px 0px 30px; position: relative; vertical-align: baseline;"><h1 style="border-image-outset: initial; border-image-repeat: initial; border-image-slice: initial; border-image-source: initial; border-image-width: initial; border: 0px; font-family: BertholdBaskervilleBold; font-size: 30px; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: 32px; margin: 0px 0px 15px; padding: 0px; vertical-align: baseline;">
<span style="color: red;">Doctors call on government to prioritise end of life care</span></h1>
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Author: Caroline May</div>
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14 January 2016</div>
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<strong style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">Publishing new research which highlights a ‘postcode lottery’ of end of life care in the UK, the British Medical Association (BMA) is calling on the government to prioritise improvements in end of life care.</strong></div>
<aside class="quote" style="background: transparent; border-radius: 8px; border: 0px; color: #083957; float: right; font-family: NewBskvllBTItalic; font-size: 30px; font-stretch: normal; line-height: 1.2em; margin: 10px; padding: 10px; text-align: center; vertical-align: baseline; width: 275px;">"Doctors need the time, support and sufficient training necessary for caring for people at their end of life, and patients must be able to access a high quality of end of life care wherever they live, whatever their medical condition."</aside><div data-role="pagedContent" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">
<section class="page" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px auto; padding: 0px; vertical-align: baseline; width: auto;"><div style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 15px; padding: 0px !important; vertical-align: baseline;">
<a href="http://www.ehospice.com/uk/Default/tabid/10697/ArticleId/13174/" style="border: 0px; color: #396179; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;" target="_blank">Launched in November 2014</a>, the BMA’s latest research project set out to explore a number of practical and ethical issues around end of life care and physician-assisted dying.</div>
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As part of this, member of the public and doctors were invited to take part in a series of 21 discussion events around the UK last year.</div>
<div style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 15px; padding: 0px !important; vertical-align: baseline;">
The <a href="http://www.bma.org.uk/endoflifecare" style="border: 0px; color: #396179; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;" target="_blank">final report on this research</a>, published today, reinforces many of the findings from other recent reports and inquiries – the variability in the quality and availability of end of life care, the need for better communication between doctors and their patients, and the importance of coordination of services in ensuring good outcomes for patients who are dying.</div>
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Noting that the UK has "led the world in developing comprehensive and holistic care for people whose lives are coming to an end," BMA representative body chair Dr Ian Wilson said that the research highlights how "the provision of end of life care remains variable, dependent on a patient’s geographical location, their condition, and their knowledge of local services."</div>
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Adding: "One member of the public who had recently suffered a bereavement described the quality of end of life care as a postcode lottery – a sentiment shared by the public and doctors alike.</div>
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"This is completely unacceptable. What came through loud and clear during the study was that people want to be treated as individuals, with care and compassion, and it is very important to many people that their families are involved in the process, but the current system doesn’t always enable this."</div>
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Communication was also highlighted as a particular area of concern. While doctors recognised that communication between them, patients and their family could be critical in making end of life easier to understand and accept, many doctors felt uncomfortable about the prospect of having to give uncertain answers, particularly on the timescale of life expectancy.</div>
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Very few doctors claimed to have had adequate training in discussing death and the dying process with patients, with many doctors saying that they had to develop these skills ‘on the job’.</div>
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As well as exploring perceptions around the availability, accessibility and quality of end of life care, the research also looked at:</div>
<ul style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; list-style-image: url("../Images/ico/list_dot.png"); margin: 0px; padding: 0px 0px 15px 18px; vertical-align: baseline;">
<li style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 4px 0px; vertical-align: baseline;">views on and experiences of the doctor-patient relationship and whether this changes when a patient has a terminal illness</li>
<li style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 4px 0px; vertical-align: baseline;">patients’ fears and concerns about the impact of serious/terminal illness and facing death</li>
<li style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 4px 0px; vertical-align: baseline;">views about the potential impact of legalised physician-assisted dying on the doctor-patient relationship</li>
<li style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 4px 0px; vertical-align: baseline;">the professional and emotional impact of involvement in assisted dying upon doctors.</li>
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"A top priority for government"</h2>
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The BMA is calling on the government to prioritise improvements in end of life care.</div>
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Dr Wilson explained: "While positive steps forward, such as the new guidelines for the NHS, have been made, it is still essential that care for people who are dying becomes a top priority for governments across the UK.</div>
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"Doctors need the time, support and sufficient training necessary for caring for people at their end of life, and patients must be able to access a high quality of end of life care wherever they live, whatever their medical condition."</div>
<div style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 15px; padding: 0px !important; vertical-align: baseline;">
The National Council for Palliative Care (NCPC) <a href="http://www.ncpc.org.uk/news/national-council-palliative-care-supports-bma%E2%80%99s-call-government-prioritise-end-life-care" style="border: 0px; color: #396179; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;" target="_blank">supports the BMA’s call for the government to prioritise end of life care</a>.</div>
<div style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 15px; padding: 0px !important; vertical-align: baseline;">
Claire Henry, CEO of the NCPC, said: "End of life care has improved in recent years, but much more needs to be done.</div>
<div style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 15px; padding: 0px !important; vertical-align: baseline;">
"At the government’s request, I chaired a wide-ranging review into end of life care that identified a number of urgent areas for further improvement. I know the government received and appreciated the review, but we are still waiting for a detailed response after almost a year.</div>
<div style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 15px; padding: 0px !important; vertical-align: baseline;">
"At the moment, too many people do not receive good quality end of life care, and the system is disjointed and inefficient. The way we care for dying people and their families is an important measure of our values as a society. Improving their quality and experience of care should be an urgent priority for the government."</div>
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Later this year, the BMA will publish a further report, bringing together responses to the research and subsequent discussions with groups of members and experts in the fields and make a number of recommendations.</div>
</section></div>
</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-14349968781681232772015-08-24T03:00:00.000-07:002015-08-24T03:00:49.312-07:00<div class="cit" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.8465em; line-height: 1.45em;">
<span role="menubar"><a abstractlink="yes" alsec="jour" alterm="Cochrane Database Syst Rev." aria-expanded="false" aria-haspopup="true" href="http://www.ncbi.nlm.nih.gov/pubmed/25879099#" role="menuitem" style="border-bottom-width: 0px; color: #660066;" title="The Cochrane database of systematic reviews.">Cochrane Database Syst Rev.</a></span> 2015 Jan 2;1:</div>
<h1 style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 1.231em; line-height: 1.125em; margin: 0.375em 0px;">
<span style="color: red;"><span class="highlight">Palliative</span> pharmacological <span class="highlight">sedation</span> for terminally ill adults.</span></h1>
<div class="auths" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.923em;">
<a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Beller%20EM%5BAuthor%5D&cauthor=true&cauthor_uid=25879099" style="border-bottom-width: 0px; color: #660066;">Beller EM</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">1</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=van%20Driel%20ML%5BAuthor%5D&cauthor=true&cauthor_uid=25879099" style="border-bottom-width: 0px; color: #660066;">van Driel ML</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=McGregor%20L%5BAuthor%5D&cauthor=true&cauthor_uid=25879099" style="border-bottom-width: 0px; color: #660066;">McGregor L</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Truong%20S%5BAuthor%5D&cauthor=true&cauthor_uid=25879099" style="border-bottom-width: 0px; color: #660066;">Truong S</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Mitchell%20G%5BAuthor%5D&cauthor=true&cauthor_uid=25879099" style="border-bottom-width: 0px; color: #660066;">Mitchell G</a>.</div>
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<h3 style="color: #724128; font-size: 1.0769em; line-height: 1.2857; margin: 0.5em 0em; zoom: 1;">
<a aria-disabled="false" aria-expanded="false" class="jig-ncbitoggler ui-widget ui-ncbitoggler" href="http://www.ncbi.nlm.nih.gov/pubmed/25879099#" role="button" style="border-bottom-width: 0px; color: #660066; display: block; font-family: arial, sans-serif !important; font-size: 13.9996995925903px; outline: none; padding-left: 16px; position: relative; text-decoration: none !important;" title="Open/close author information list"><span class="ui-ncbitoggler-master-text">Author information</span><span class="ui-icon ui-icon-triangle-1-e" style="background: url(http://static.pubmed.gov/portal/portal3rc.fcgi/4066669/img/3974597) 0px -21px no-repeat scroll transparent; border-bottom-left-radius: 3px; border-bottom-right-radius: 3px; border: none; display: inline; height: 16px; left: 0px; margin: 0px; overflow: hidden; padding: 0px; position: absolute; right: 0px; text-indent: -99999px; top: 0px; width: 16px;"></span></a></h3>
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<h3 style="color: #985735; display: inline; font-size: 1.0769em; line-height: 1.2857; margin: 0px;">
Abstract</h3>
<div class="">
<h4 style="float: left; font-size: 1em; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
BACKGROUND:</h4>
<div style="font-size: 13px; margin-bottom: 0.5em;">
<abstracttext label="BACKGROUND" nlmcategory="BACKGROUND">Terminally ill people experience a variety of symptoms in the last hours and days of life, including delirium, agitation, anxiety, terminal restlessness, dyspnoea, pain, vomiting, and psychological and physical distress. In the terminal phase of life, these symptoms may become refractory, and unable to be controlled by supportive and <span class="highlight">palliative</span> therapies specifically targeted to these symptoms. <span class="highlight">Palliative</span> <span class="highlight">sedation</span>therapy is one potential solution to providing relief from these refractory symptoms. <span class="highlight">Sedation</span> in terminally ill people is intended to provide relief from refractory symptoms that are not controlled by other methods. Sedative drugs such as benzodiazepines are titrated to achieve the desired level of<span class="highlight">sedation</span>; the level of <span class="highlight">sedation</span> can be easily maintained and the effect is reversible.</abstracttext></div>
<div style="font-size: 13px; margin-bottom: 0.5em;">
<abstracttext label="BACKGROUND" nlmcategory="BACKGROUND"><br /></abstracttext></div>
<h4 style="float: left; font-size: 1em; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
OBJECTIVES:</h4>
<div style="font-size: 13px; margin-bottom: 0.5em;">
<abstracttext label="OBJECTIVES" nlmcategory="OBJECTIVE">To assess the evidence for the benefit of <span class="highlight">palliative</span> pharmacological <span class="highlight">sedation</span> on quality of life, survival, and specific refractory symptoms in terminally ill adults during their last few days of life.</abstracttext></div>
<div style="font-size: 13px; margin-bottom: 0.5em;">
<abstracttext label="OBJECTIVES" nlmcategory="OBJECTIVE"><br /></abstracttext></div>
<h4 style="float: left; font-size: 1em; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
SEARCH METHODS:</h4>
<div style="font-size: 13px; margin-bottom: 0.5em;">
<abstracttext label="SEARCH METHODS" nlmcategory="METHODS">We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 11), MEDLINE (1946 to November 2014), and EMBASE (1974 to December 2014), using search terms representing the sedative drug names and classes, disease stage, and study designs.</abstracttext></div>
<div style="font-size: 13px; margin-bottom: 0.5em;">
<abstracttext label="SEARCH METHODS" nlmcategory="METHODS"><br /></abstracttext></div>
<h4 style="float: left; font-size: 1em; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
SELECTION CRITERIA:</h4>
<div style="font-size: 13px; margin-bottom: 0.5em;">
<abstracttext label="SELECTION CRITERIA" nlmcategory="METHODS">We included randomised controlled trials (RCTs), quasi-RCTs, non-RCTs, and observational studies (e.g. before-and-after, interrupted-time-series) with quantitative outcomes. We excluded studies with only qualitative outcomes or that had no comparison (i.e. no control group or no within-group comparison) (e.g. single arm case series).</abstracttext></div>
<div style="font-size: 13px; margin-bottom: 0.5em;">
<abstracttext label="SELECTION CRITERIA" nlmcategory="METHODS"><br /></abstracttext></div>
<h4 style="float: left; font-size: 1em; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
DATA COLLECTION AND ANALYSIS:</h4>
<div style="font-size: 13px; margin-bottom: 0.5em;">
<abstracttext label="DATA COLLECTION AND ANALYSIS" nlmcategory="METHODS">Two review authors independently screened titles and abstracts of citations, and full text of potentially eligible studies. Two review authors independently carried out data extraction using standard data extraction forms. A third review author acted as arbiter for both stages. We carried out no meta-analyses due to insufficient data for pooling on any outcome; therefore, we reported outcomes narratively.</abstracttext></div>
<div style="font-size: 13px; margin-bottom: 0.5em;">
<abstracttext label="DATA COLLECTION AND ANALYSIS" nlmcategory="METHODS"><br /></abstracttext></div>
<h4 style="float: left; font-size: 1em; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
MAIN RESULTS:</h4>
<div style="font-size: 13px; margin-bottom: 0.5em;">
<abstracttext label="MAIN RESULTS" nlmcategory="RESULTS">The searches resulted in 14 included studies, involving 4167 adults, of whom 1137 received <span class="highlight">palliative</span> <span class="highlight">sedation</span>. More than 95% of people had cancer. No studies were randomised or quasi-randomised. All were consecutive case series, with only three having prospective data collection. Risk of bias was high, due to lack of randomisation. No studies measured quality of life or participant well-being, which was the primary outcome of the review. Five studies measured symptom control, using four different methods, so pooling was not possible. The results demonstrated that despite <span class="highlight">sedation</span>, delirium and dyspnoea were still troublesome symptoms in these people in the last few days of life. Control of other symptoms appeared to be similar in sedated and non-sedated people. Only one study measured unintended adverse effects of sedative drugs and found no major events; however, four of 70 participants appeared to have drug-induced delirium. The study noticed no respiratory suppression. Thirteen of the 14 studies measured survival time from admission or referral to death, and all demonstrated no statistically significant difference between sedated and non-sedated groups.</abstracttext></div>
<div style="font-size: 13px; margin-bottom: 0.5em;">
<abstracttext label="MAIN RESULTS" nlmcategory="RESULTS"><br /></abstracttext></div>
<div style="font-size: 13px; margin-bottom: 0.5em;">
<abstracttext label="MAIN RESULTS" nlmcategory="RESULTS"><br /></abstracttext></div>
<h4 style="float: left; font-size: 1em; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
AUTHORS' CONCLUSIONS:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="AUTHORS' CONCLUSIONS" nlmcategory="CONCLUSIONS"><br /></abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext label="AUTHORS' CONCLUSIONS" nlmcategory="CONCLUSIONS">There was insufficient evidence about the efficacy of <span class="highlight">palliative</span> <span class="highlight">sedation</span> in terms of a person's quality of life or symptom control. </abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext label="AUTHORS' CONCLUSIONS" nlmcategory="CONCLUSIONS">There was evidence that <span class="highlight">palliative</span> <span class="highlight">sedation</span> did not hasten death, which has been a concern of physicians and families in prescribing this treatment. </abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext label="AUTHORS' CONCLUSIONS" nlmcategory="CONCLUSIONS">However, this evidence comes from low quality studies, so should be interpreted with caution. </abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext label="AUTHORS' CONCLUSIONS" nlmcategory="CONCLUSIONS">Further studies that specifically measure the efficacy and quality of life in sedated people, compared with non-sedated people, and quantify adverse effects are required.</abstracttext></div>
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<dt style="display: inline; margin-bottom: 0px; margin-left: 0px !important; margin-right: 0px; margin-top: 0px; padding: 0px; white-space: nowrap;">PMID:</dt>
<dd style="display: inline; margin: 0px; padding: 0px; white-space: nowrap;">25879099</dd> <dd style="display: inline; margin: 0px; padding: 0px; white-space: nowrap;">[PubMed - in process]</dd><span style="font-size: 0.8465em;"><dd style="display: inline; margin: 0px; padding: 0px; white-space: nowrap;"></dd></span></dl>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-29486267228094611432015-08-24T02:58:00.000-07:002015-08-24T02:58:15.999-07:00<div class="cit" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.8465em; line-height: 1.45em;">
<span role="menubar"><a abstractlink="yes" alsec="jour" alterm="J Pain Symptom Manage." aria-expanded="false" aria-haspopup="true" href="http://www.ncbi.nlm.nih.gov/pubmed/19041216#" role="menuitem" style="border-bottom-width: 0px; color: #660066;" title="Journal of pain and symptom management.">J Pain Symptom Manage.</a></span> 2009 May;37(5):771-9Nov 28.</div>
<h1 style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 1.125em; margin: 0.375em 0px;">
<span style="color: red; font-size: large;">Controlled <span class="highlight">sedation</span> for refractory symptoms in dying patients.</span></h1>
<div class="auths" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.923em;">
<a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Mercadante%20S%5BAuthor%5D&cauthor=true&cauthor_uid=19041216" style="border-bottom-width: 0px; color: #660066;">Mercadante S</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">1</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Intravaia%20G%5BAuthor%5D&cauthor=true&cauthor_uid=19041216" style="border-bottom-width: 0px; color: #660066;">Intravaia G</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Villari%20P%5BAuthor%5D&cauthor=true&cauthor_uid=19041216" style="border-bottom-width: 0px; color: #660066;">Villari P</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Ferrera%20P%5BAuthor%5D&cauthor=true&cauthor_uid=19041216" style="border-bottom-width: 0px; color: #660066;">Ferrera P</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=David%20F%5BAuthor%5D&cauthor=true&cauthor_uid=19041216" style="border-bottom-width: 0px; color: #660066;">David F</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Casuccio%20A%5BAuthor%5D&cauthor=true&cauthor_uid=19041216" style="border-bottom-width: 0px; color: #660066;">Casuccio A</a>.</div>
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<h3 style="color: #724128; font-size: 1.0769em; line-height: 1.2857; margin: 0.5em 0em; zoom: 1;">
<a aria-disabled="false" aria-expanded="false" class="jig-ncbitoggler ui-widget ui-ncbitoggler" href="http://www.ncbi.nlm.nih.gov/pubmed/19041216#" role="button" style="border-bottom-width: 0px; color: #660066; display: block; font-family: arial, sans-serif !important; font-size: 13.9996995925903px; outline: none; padding-left: 16px; position: relative; text-decoration: none !important;" title="Open/close author information list"><span class="ui-ncbitoggler-master-text">Author information</span><span class="ui-icon ui-icon-triangle-1-e" style="background: url(http://static.pubmed.gov/portal/portal3rc.fcgi/4066669/img/3974597) 0px -21px no-repeat scroll transparent; border-bottom-left-radius: 3px; border-bottom-right-radius: 3px; border: none; display: inline; height: 16px; left: 0px; margin: 0px; overflow: hidden; padding: 0px; position: absolute; right: 0px; text-indent: -99999px; top: 0px; width: 16px;"></span></a></h3>
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</div>
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<div class="abstr" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 17.9998016357422px; margin: 1em auto auto;">
<h3 style="color: #985735; display: inline; font-size: 1.0769em; line-height: 1.2857; margin: 0px;">
Abstract</h3>
<div class="">
<div style="margin-bottom: 0.5em;">
<abstracttext>Terminally ill cancer patients near the end of life may experience intolerable suffering refractory to <span class="highlight">palliative</span> treatment. Although <span class="highlight">sedation</span> is considered to be an effective treatment when aggressive efforts fail to provide relief in terminally ill patients, it remains controversial. The aim of this study was to assess the need and effectiveness of <span class="highlight">sedation</span> in dying patients with intractable symptoms, and the thoughts of relatives regarding<span class="highlight">sedation</span>. A prospective cohort study was performed on a consecutive sample of dying patients admitted to an acute pain relief and <span class="highlight">palliative</span> care unit within a cancer center. Indications for <span class="highlight">sedation</span>, opioid and midazolam doses, level of delirium and <span class="highlight">sedation</span>, nutrition, hydration, rattle, inability to cough and swallow, pharyngeal aspiration, duration of <span class="highlight">sedation</span> and survival, and use of anticholinergics or other drugs were recorded. Family members were interviewed. Forty-two of 77 dying patients were sedated, and had a longer survival than those who were not sedated (P=0.003). </abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext><br /></abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext>Prevalent indications for <span class="highlight">sedation</span> were dyspnea and/or delirium. Twelve patients began with an intermediate <span class="highlight">sedation</span>, and 38 patients started with definitive <span class="highlight">sedation</span>. The median <span class="highlight">sedation</span> duration was 22 hours. Opioid doses did not change during <span class="highlight">sedation</span>. Agitated delirium significantly decreased with increasing doses of midazolam, whereas the capacity to communicate concomitantly decreased. Interviewed relatives were actively involved in the process of end-of-life care, and the decision to sedate, and the efficacy of <span class="highlight">sedation</span>, were considered appropriate by almost all relatives. </abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext><br /></abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext>Controlled <span class="highlight">sedation</span> is successful in dying patients with untreatable symptoms, did not hasten death, and yielded satisfactory results for relatives. This study also points to the importance of <span class="highlight">palliative</span> care and the experience of professionals skilled in both symptom control and end-of-life care.</abstracttext></div>
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<dt style="display: inline; margin-bottom: 0px; margin-left: 0px !important; margin-right: 0px; margin-top: 0px; padding: 0px; white-space: nowrap;">PMID:</dt>
<dd style="display: inline; margin: 0px; padding: 0px; white-space: nowrap;">19041216</dd> <dd style="display: inline; margin: 0px; padding: 0px; white-space: nowrap;">[PubMed - indexed for MEDLINE]</dd></dl>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-7309173562681571332015-08-24T02:56:00.004-07:002015-08-24T02:56:32.921-07:00<div class="cit" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.8465em; line-height: 1.45em;">
<span role="menubar"><a abstractlink="yes" alsec="jour" alterm="J Clin Oncol." aria-expanded="false" aria-haspopup="true" href="http://www.ncbi.nlm.nih.gov/pubmed/22412129#" role="menuitem" style="border-bottom-width: 0px; color: #660066;" title="Journal of clinical oncology : official journal of the American Society of Clinical Oncology.">J Clin Oncol.</a></span> 2012 Apr 20;30(12):1378-83. </div>
<h1 style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 1.125em; margin: 0.375em 0px;">
<span style="color: red; font-size: large;"><span class="highlight">Palliative</span> <span class="highlight">sedation</span> in end-of-life care and survival: a systematic review.</span></h1>
<div class="auths" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.923em;">
<a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Maltoni%20M%5BAuthor%5D&cauthor=true&cauthor_uid=22412129" style="border-bottom-width: 0px; color: #660066;">Maltoni M</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">1</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Scarpi%20E%5BAuthor%5D&cauthor=true&cauthor_uid=22412129" style="border-bottom-width: 0px; color: #660066;">Scarpi E</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Rosati%20M%5BAuthor%5D&cauthor=true&cauthor_uid=22412129" style="border-bottom-width: 0px; color: #660066;">Rosati M</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Derni%20S%5BAuthor%5D&cauthor=true&cauthor_uid=22412129" style="border-bottom-width: 0px; color: #660066;">Derni S</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Fabbri%20L%5BAuthor%5D&cauthor=true&cauthor_uid=22412129" style="border-bottom-width: 0px; color: #660066;">Fabbri L</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Martini%20F%5BAuthor%5D&cauthor=true&cauthor_uid=22412129" style="border-bottom-width: 0px; color: #660066;">Martini F</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Amadori%20D%5BAuthor%5D&cauthor=true&cauthor_uid=22412129" style="border-bottom-width: 0px; color: #660066;">Amadori D</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Nanni%20O%5BAuthor%5D&cauthor=true&cauthor_uid=22412129" style="border-bottom-width: 0px; color: #660066;">Nanni O</a>.</div>
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Erratum in</h3>
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<li class="comments" style="display: block;">J Clin Oncol. 2012 Sep 20;30(27):3429.</li>
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<h3 style="color: #985735; display: inline; line-height: 1.2857; margin: 0px;">
<span style="font-size: small;">Abstract</span></h3>
<div class="">
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
PURPOSE:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="PURPOSE" nlmcategory="OBJECTIVE"><span class="highlight">Palliative</span> <span class="highlight">sedation</span> is a clinical procedure aimed at relieving refractory symptoms in patients with advanced cancer. It has been suggested that sedative drugs may shorten life, but few studies exist comparing the survival of sedated and nonsedated patients. We present a systematic review of literature on the clinical practice of <span class="highlight">palliative</span> <span class="highlight">sedation</span> to assess the effect, if any, on survival.</abstracttext></div>
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
METHODS:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="METHODS" nlmcategory="METHODS">A systematic review of literature published between January 1980 and December 2010 was performed using MEDLINE and EMBASE databases. Search terms included <span class="highlight">palliative</span> <span class="highlight">sedation</span>, terminal <span class="highlight">sedation</span>, refractory symptoms, cancer, neoplasm, <span class="highlight">palliative</span> care, terminally ill, end-of-life care, and survival. A manual search of the bibliographies of electronically identified articles was also performed.</abstracttext></div>
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
RESULTS:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="RESULTS" nlmcategory="RESULTS">Eleven published articles were identified describing 1,807 consecutive patients in 10 retrospective or prospective nonrandomized studies, 621 (34.4%) of whom were sedated. One case-control study was excluded from prevalence analysis. The most frequent reason for <span class="highlight">sedation</span> was delirium in the terminal stages of illness (median, 57.1%; range, 13.8% to 91.3%). Benzodiazepines were the most common drug category prescribed. Comparing survival of sedated and nonsedated patients, the <span class="highlight">sedation</span> approach was not shown to be associated with worse survival.</abstracttext></div>
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
CONCLUSION:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="CONCLUSION" nlmcategory="CONCLUSIONS">Even if there is no direct evidence from randomized clinical trials, <span class="highlight">palliative</span> <span class="highlight">sedation</span>, when appropriately indicated and correctly used to relieve unbearable suffering, does not seem to have any detrimental effect on survival of patients with terminal cancer. In this setting,<span class="highlight">palliative</span> <span class="highlight">sedation</span> is a medical intervention that must be considered as part of a continuum of <span class="highlight">palliative</span> care.</abstracttext></div>
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<span style="font-size: small;">Comment in</span></h3>
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<li class="comments" style="display: block;"><a href="http://www.ncbi.nlm.nih.gov/pubmed/22412126" ref="ncbi_uid=22412129&link_uid=22412126&commcorr_type=commentin" style="border-bottom-width: 0px; color: #14376c; text-decoration: none;"><span class="highlight">Palliative</span> <span class="highlight">sedation</span>: when and how?</a><span class="source" style="color: #777777; padding-left: 0.3em;"> [J Clin Oncol. 2012]</span></li>
<li class="comments" style="display: block;"><a href="http://www.ncbi.nlm.nih.gov/pubmed/23071241" ref="ncbi_uid=22412129&link_uid=23071241&commcorr_type=commentin" style="border-bottom-width: 0px; color: #14376c; text-decoration: none;"><span class="highlight">Palliative</span> <span class="highlight">sedation</span>: further evidence needs to be accompanied by ethical guidance to ensure professional practice at the end of life.</a><span class="source" style="color: #777777; padding-left: 0.3em;"> [J Clin Oncol. 2012]</span></li>
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<dd style="display: inline; margin: 0px; padding: 0px; white-space: nowrap;">22412129</dd> <dd style="display: inline; margin: 0px; padding: 0px; white-space: nowrap;">[PubMed - indexed for MEDLINE]</dd><span style="font-size: 0.8465em;"><dd style="display: inline; margin: 0px; padding: 0px; white-space: nowrap;"></dd></span></dl>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-74284271450156130572015-08-24T02:55:00.001-07:002015-08-24T02:55:19.657-07:00<div class="cit" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.8465em; line-height: 1.45em;">
<span role="menubar"><a abstractlink="yes" alsec="jour" alterm="BMC Palliat Care." aria-expanded="false" aria-haspopup="true" href="http://www.ncbi.nlm.nih.gov/pubmed/25810691#" role="menuitem" style="border-bottom-width: 0px; color: #660066;" title="BMC palliative care.">BMC Palliat Care.</a></span> 2015 Mar 15;14:5.</div>
<h1 style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 1.231em; line-height: 1.125em; margin: 0.375em 0px;">
<span style="color: red;"><span class="highlight">Palliative</span> <span class="highlight">sedation</span> for terminally ill cancer patients in a tertiary cancer center in Shanghai, China.</span></h1>
<div class="auths" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.923em;">
<a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Gu%20X%5BAuthor%5D&cauthor=true&cauthor_uid=25810691" style="border-bottom-width: 0px; color: #660066;">Gu X</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">1</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Cheng%20W%5BAuthor%5D&cauthor=true&cauthor_uid=25810691" style="border-bottom-width: 0px; color: #660066;">Cheng W</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">1</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Chen%20M%5BAuthor%5D&cauthor=true&cauthor_uid=25810691" style="border-bottom-width: 0px; color: #660066;">Chen M</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">1</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Liu%20M%5BAuthor%5D&cauthor=true&cauthor_uid=25810691" style="border-bottom-width: 0px; color: #660066;">Liu M</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">1</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Zhang%20Z%5BAuthor%5D&cauthor=true&cauthor_uid=25810691" style="border-bottom-width: 0px; color: #660066;">Zhang Z</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">1</span>.</div>
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<h3 style="color: #985735; display: inline; line-height: 1.2857; margin: 0px;">
<span style="font-size: small;">Abstract</span></h3>
<div class="">
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
BACKGROUND:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="BACKGROUND" nlmcategory="BACKGROUND">There are a number of studies dedicated to characteristics of <span class="highlight">sedation</span>, but these studies are mostly bound to western country practices. The aim of this study is to describe the characteristics of patients who suffered from cancer and who had been sedated until their death in Shanghai, China.</abstracttext></div>
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
METHODS:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="METHODS" nlmcategory="METHODS">Retrospective medical data of 244 terminally ill cancer patients including 82 sedated patients were collected. Data collected included demographic characteristics, disease-related characteristics and details of the <span class="highlight">sedation</span>.</abstracttext></div>
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
RESULTS:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="RESULTS" nlmcategory="RESULTS">In sedated cases, patients and/or caregivers gave the consent to start <span class="highlight">palliative</span> <span class="highlight">sedation</span> due to unmanageable symptoms. On average,<span class="highlight">sedation</span> was performed 24.65(±1.78)hours before death. Agitated delirium and dyspnea were the most frequent indications for <span class="highlight">palliative</span> <span class="highlight">sedation</span>. There was no significant difference in survival time from admission till death between sedated and non-sedated patients (p > 0.05).</abstracttext></div>
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
CONCLUSIONS:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="CONCLUSIONS" nlmcategory="CONCLUSIONS"><span class="highlight">Palliative</span> <span class="highlight">sedation</span> is effective for reducing terminally ill cancer patients' suffering without hastening death. Prospective research is needed to determine the optimal conditions for Chinese patients including indications, decision making process, informed consent, cultural and ethical issues, type of <span class="highlight">sedation</span> and drugs.</abstracttext></div>
</div>
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<div class="keywords" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; margin: 1.8em auto auto;">
<h4 style="float: left; margin: 0px 0.35em 0px 0px; text-transform: uppercase;">
KEYWORDS:</h4>
<div style="margin-bottom: 0.5em; margin-top: 0.5em;">
Agitated delirium; End of life; <span class="highlight">Palliative</span> <span class="highlight">sedation</span>; Survival; Symptom management; Terminally ill cancer patients</div>
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<dd style="display: inline; margin: 0px; padding: 0px; white-space: nowrap;">25810691</dd> <dd style="display: inline; margin: 0px; padding: 0px; white-space: nowrap;">[PubMed] </dd><dd style="display: inline; margin: 0px; padding: 0px; white-space: nowrap;"></dd>
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<dd style="display: inline; margin: 0px; padding: 0px; white-space: nowrap;">PMC4373517</dd><dd style="display: inline; margin: 0px; padding: 0px; white-space: nowrap;"></dd> </dl>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-90153815543521899792015-08-24T02:53:00.003-07:002015-08-24T02:53:38.444-07:00<div class="cit" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.8465em; line-height: 1.45em;">
<span role="menubar"><a abstractlink="yes" alsec="jour" alterm="Am J Hosp Palliat Care." aria-expanded="false" aria-haspopup="true" href="http://www.ncbi.nlm.nih.gov/pubmed/26273094#" role="menuitem" style="border-bottom-width: 0px; color: #660066;" title="The American journal of hospice & palliative care.">Am J Hosp Palliat Care.</a></span> 2015 Aug 13. </div>
<div class="cit" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.8465em; line-height: 1.45em;">
<br /></div>
<h1 style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 1.125em; margin: 0.375em 0px;">
<span style="color: red; font-size: large;">A Distress Protocol for Respiratory Emergencies in Terminally Ill Patients With Lung Cancer or Chronic Obstructive Pulmonary Disease.</span></h1>
<div class="auths" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.923em;">
<a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Godbout%20K%5BAuthor%5D&cauthor=true&cauthor_uid=26273094" style="border-bottom-width: 0px; color: #660066;">Godbout K</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">1</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Tremblay%20L%5BAuthor%5D&cauthor=true&cauthor_uid=26273094" style="border-bottom-width: 0px; color: #660066;">Tremblay L</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">1</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Lacasse%20Y%5BAuthor%5D&cauthor=true&cauthor_uid=26273094" style="border-bottom-width: 0px; color: #660066;">Lacasse Y</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">2</span>.</div>
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Abstract</h3>
<div class="">
<div style="margin-bottom: 0.5em;">
<abstracttext><span style="font-size: large;">A combination of opioid, midazolam, and scopolamine (that we call "distress protocol" [DP]) is used to induce transient <span class="highlight">sedation</span> when emergencies occur in <span class="highlight">palliative</span> care.</span></abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext><span style="font-size: large;"><br /></span></abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext><span style="font-size: large;"> We wished to describe the prescription and administration of DP in terminally ill patients with either lung cancer or chronic obstructive pulmonary disease (COPD).</span></abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext><span style="font-size: large;"> In a retrospective study, 96 of 100 patients with cancer and 85 of 100 patients with COPD had a DP prescribed.</span></abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext><span style="font-size: large;"> Thirty patients with cancer and 29 with COPD received at least 1 DP.</span></abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext><span style="font-size: large;"><br /></span></abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext><span style="font-size: large;"> All patients receiving a DP for an appropriate indication were sedated within 30 minutes.</span></abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext><span style="font-size: large;"> There was no difference in survival from DP administration among patients who received it and those who did not.</span></abstracttext></div>
<div style="margin-bottom: 0.5em;">
<span style="font-size: large;">© The Author(s) 2015.</span></div>
</div>
</div>
<div class="keywords" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.923em; margin: 1.8em auto auto;">
<h4 style="float: left; font-size: 1em; margin: 0px 0.35em 0px 0px; text-transform: uppercase;">
KEYWORDS:</h4>
<div style="margin-bottom: 0.5em; margin-top: 0.5em;">
COPD; distress protocol; end-of-life symptoms; lung cancer; <span class="highlight">palliative</span> crises</div>
</div>
<div class="aux" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 1.4em; margin: 1.2em auto auto;">
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<dl class="rprtid" style="display: inline; font-size: 0.8465em; line-height: 1.4em; margin: 0px 15px 0px 0px;">
<dt style="display: inline; margin-bottom: 0px; margin-left: 0px !important; margin-right: 0px; margin-top: 0px; padding: 0px; white-space: nowrap;">PMID:</dt>
<dd style="display: inline; margin: 0px; padding: 0px; white-space: nowrap;">26273094</dd> <dd style="display: inline; margin: 0px; padding: 0px; white-space: nowrap;">[PubMed - as supplied by publisher]</dd></dl>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-498234526720693992015-08-21T08:04:00.003-07:002015-08-21T08:04:17.022-07:00<div class="cit" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.8465em; line-height: 1.45em;">
<span role="menubar"><a abstractlink="yes" alsec="jour" alterm="Am J Hosp Palliat Care." aria-expanded="false" aria-haspopup="true" href="http://www.ncbi.nlm.nih.gov/pubmed/26273094#" role="menuitem" style="border-bottom-width: 0px; color: #660066;" title="The American journal of hospice & palliative care.">Am J Hosp Palliat Care.</a></span> 2015 Aug 13</div>
<h1 style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 1.231em; line-height: 1.125em; margin: 0.375em 0px;">
<span style="color: red;">A Distress Protocol for Respiratory Emergencies in Terminally Ill Patients With Lung Cancer or Chronic Obstructive Pulmonary Disease</span>.</h1>
<div class="auths" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.923em;">
<a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Godbout%20K%5BAuthor%5D&cauthor=true&cauthor_uid=26273094" style="border-bottom-width: 0px; color: #660066;">Godbout K</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">1</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Tremblay%20L%5BAuthor%5D&cauthor=true&cauthor_uid=26273094" style="border-bottom-width: 0px; color: #660066;">Tremblay L</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">1</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Lacasse%20Y%5BAuthor%5D&cauthor=true&cauthor_uid=26273094" style="border-bottom-width: 0px; color: #660066;">Lacasse Y</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">2</span>.</div>
<div class="afflist" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 17.9998016357422px; zoom: 1;">
<h3 style="color: #724128; font-size: 1.0769em; line-height: 1.2857; margin: 0.5em 0em; zoom: 1;">
<a aria-disabled="false" aria-expanded="false" class="jig-ncbitoggler ui-widget ui-ncbitoggler" href="http://www.ncbi.nlm.nih.gov/pubmed/26273094#" role="button" style="border-bottom-width: 0px; color: #660066; display: block; font-family: arial, sans-serif !important; font-size: 13.9996995925903px; outline: none; padding-left: 16px; position: relative; text-decoration: none !important;" title="Open/close author information list"><span class="ui-ncbitoggler-master-text">Author information</span><span class="ui-icon ui-icon-triangle-1-e" style="background: url(http://static.pubmed.gov/portal/portal3rc.fcgi/4066669/img/3974597) 0px -21px no-repeat scroll transparent; border-bottom-left-radius: 3px; border-bottom-right-radius: 3px; border: none; display: inline; height: 16px; left: 0px; margin: 0px; overflow: hidden; padding: 0px; position: absolute; right: 0px; text-indent: -99999px; top: 0px; width: 16px;"></span></a></h3>
<div aria-live="assertive" class="ui-helper-reset" style="border: 0px; line-height: 1.3; list-style: none; margin: 0px; outline: 0px; padding: 0px;">
</div>
</div>
<div class="abstr" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 17.9998016357422px; margin: 1em auto auto;">
<h3 style="color: #985735; display: inline; font-size: 1.0769em; line-height: 1.2857; margin: 0px;">
Abstract</h3>
<div class="">
<div style="margin-bottom: 0.5em;">
<abstracttext><span style="font-size: large;">A combination of opioid, midazolam, and scopolamine (that we call "distress protocol" [DP]) is used to induce</span></abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext><span style="font-size: large;"> transient <span class="highlight">sedation</span> when emergencies occur in <span class="highlight">palliative</span> care.</span></abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext><span style="font-size: large;"><br /></span></abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext><span style="font-size: large;"> We wished to describe the prescription and administration of DP in terminally ill patients with either lung cancer or chronic obstructive pulmonary disease (COPD). </span></abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext><span style="font-size: large;"><br /></span></abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext><span style="font-size: large;">In a retrospective study, 96 of 100 patients with cancer and 85 of 100 patients with COPD had a DP prescribed. Thirty patients with cancer and 29 with COPD received at least 1 DP. </span></abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext><span style="font-size: large;"><br /></span></abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext><span style="font-size: large;">All patients receiving a DP for an appropriate indication were sedated within 30 minutes. There was no difference in survival from DP administration among patients who received it and those who did not.</span></abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext><span style="font-size: large;"><br /></span></abstracttext></div>
<div style="margin-bottom: 0.5em;">
<span style="font-size: large;">© The Author(s) 2015.</span></div>
</div>
</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-32347687604729362972015-07-18T14:39:00.000-07:002015-07-18T14:39:42.244-07:00<span style="color: red; font-family: Arial, Helvetica, sans-serif; font-size: large;"><b>http://congres.sfap.org/sites/default/files/pdf/Lille2013/SP1.pdf</b></span><br />
<b><span style="color: red; font-family: Arial, Helvetica, sans-serif;"><br /></span></b>
<span style="color: red; font-family: Arial, Helvetica, sans-serif; font-size: large;"><a href="http://congres.sfap.org/sites/default/files/pdf/Lille2013/SP1.pdf" target="_blank"><b>http://congres.sfap.org/sites/default/files/pdf/Lille2013/SP1.pdf</b></a></span>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-90082398428316764242015-07-15T10:14:00.000-07:002015-07-15T10:14:04.113-07:00<div class="cit" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.8465em; line-height: 1.45em;">
<span role="menubar"><a abstractlink="yes" alsec="jour" alterm="Dan Med Bull." aria-expanded="false" aria-haspopup="true" href="http://www.ncbi.nlm.nih.gov/pubmed/20816024#" role="menuitem" style="border-bottom-width: 0px; color: #660066;" title="Danish medical bulletin.">Dan Med Bull.</a></span> 2010 Sep;57(9):B4184.</div>
<h1 style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 1.125em; margin: 0.375em 0px;">
<span style="font-weight: normal;"><span style="color: red; font-size: x-large;">Health-related quality of life in early breast <span class="highlight">cancer</span>.</span></span></h1>
<div class="auths" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.923em;">
<a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Groenvold%20M%5BAuthor%5D&cauthor=true&cauthor_uid=20816024" style="border-bottom-width: 0px; color: #660066;">Groenvold M</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">1</span>.</div>
<div class="afflist" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 17.9998016357422px; zoom: 1;">
<h3 style="color: #724128; font-size: 1.0769em; line-height: 1.2857; margin: 0.5em 0em; zoom: 1;">
<a aria-disabled="false" aria-expanded="false" class="jig-ncbitoggler ui-widget ui-ncbitoggler" href="http://www.ncbi.nlm.nih.gov/pubmed/20816024#" role="button" style="border-bottom-width: 0px; color: #660066; display: block; font-family: arial, sans-serif !important; font-size: 13.9996995925903px; outline: none; padding-left: 16px; position: relative; text-decoration: none !important;" title="Open/close author information list"><br /><span class="ui-icon ui-icon-triangle-1-e" style="background: url(http://static.pubmed.gov/portal/portal3rc.fcgi/4066669/img/3974597) 0px -21px no-repeat scroll transparent; border-bottom-left-radius: 3px; border-bottom-right-radius: 3px; border: none; display: inline; height: 16px; left: 0px; margin: 0px; overflow: hidden; padding: 0px; position: absolute; right: 0px; text-indent: -99999px; top: 0px; width: 16px;"></span></a></h3>
<div aria-live="assertive" class="ui-helper-reset" style="border: 0px; line-height: 1.3; list-style: none; margin: 0px; outline: 0px; padding: 0px;">
</div>
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<div class="abstr" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 17.9998016357422px; margin: 1em auto auto;">
<h3 style="color: #985735; display: inline; font-size: 1.0769em; line-height: 1.2857; margin: 0px;">
Abstract</h3>
<div class="">
<div style="margin-bottom: 0.5em;">
<abstracttext>The treatment of primary breast <span class="highlight">cancer</span> usually consists of surgery often followed by adjuvant therapy (radiotherapy, chemotherapy, hormonal treatment, etc.) to reduce the risk of recurrence. The <span class="highlight">cancer</span> diagnosis and the treatments may have significant impact on the patients' quality of life. This thesis deals with scientific aspects and clinical results of a study aimed at assessing the impact of breast <span class="highlight">cancer</span> (and its treatment) on the patients' quality of life. Studies such as this assessing the problems and symptoms experienced by the patients are often referred to as health-related quality of life (HRQL) research. HRQL research deals with subjective experiences and raises challenging, scientific questions. Therefore, much attention was directed towards methodological issues in this clinically motivated project. The study was a prospective, longitudinal, questionnaire-based investigation of women with newly diagnosed breast <span class="highlight">cancer</span> registered in the Danish Breast <span class="highlight">Cancer</span> Co-operative Group's DBCG 89 Program. The patients were sub-divided into low-risk and high-risk patients. High-risk patients were offered randomisation in one of three randomised adjuvant therapy trials involving chemotherapy, ovarian ablation, and endocrine therapy. After a literature study and interviews with breast <span class="highlight">cancer</span> patients, a questionnaire was composed that included two widely used standard questionnaires (EORTC QLQ-C30 and Hospital Anxiety and Depression (HAD) Scale) and a DBCG 89 Questionnaire developed for this study. A total of 1,898 eligible patients were invited by post to participate in the study involving six assessments over a 2-year period, and 1,713 patients (90%) completed the first questionnaire. Furthermore, a questionnaire was sent to 872 women selected at random from the general population; 608 (70%) responded. The multi-item scales of the two standard questionnaires were analysed for so-called differential item functioning (DIF) in order to investigate whether the (summary) scale scores were adequate representations of the information obtained by the individual items. The DIF analyses identified a number of cases of DIF, which, among other things, contributed to detection of possible problems in the HAD Scale. It was concluded that DIF analyses are relevant when important analyses based on multi-item scales are made. A new way to evaluate the validity of questionnaires was developed. The results from questionnaires completed by patients were compared against results from open ended interviews with the same patients rated by observers. The idea was that if results were similar, the patients had then probably understood and completed the questionnaire items as intended. On the other hand, if results from self-assessment and interviews deviated, misunderstandings or other errors might have taken place, and the study would give insight into possible problems. Of 57 breast <span class="highlight">cancer</span> patients, 46 (81%) were successfully interviewed. In general, the agreement between patient-completed questionnaires and interviews was excellent, indicating very good validity. The median weighted kappa for the EORTC QLQ-C30 was 0.85 (range 0.49-1.00); it was 0.79 (range 0.65-0.95) for the HAD Scale, and 0.92 (range 0.51-1.00) for the DBCG 89 Questionnaire. However, the study identified a mechanism called selective reporting, which may affect results from most HRQL questionnaires: in order to provide correct and useful answers some patients do not report symptoms they believe are irrelevant to the study, e.g., symptoms unrelated to <span class="highlight">cancer</span>. This mechanism may lead to bias if results from patients are compared to results from populations reporting their symptoms more completely, e.g., general population samples. In contrast, this mechanism has little importance when results from different sub-groups of <span class="highlight">cancer</span> patients are compared. In this study multiple variables were assessed at multiple points in time and we did not have a priori hypotheses for all these potential comparisons. Therefore, a staff survey involving experienced doctors and nurses was conducted in order to generate hypotheses that could be tested in the data from patients. We contacted 46 health care professionals and 36 (78%) responded. Overall, the staff survey did not prove very useful for the intended purpose. The main reason for this was probably that the health care professionals had limited insight into the patients' HRQL. A different approach to the problem of multiple hypothesis testing proved more useful. Hypotheses generated from the initial literature review were tested in the comparison of patients in chemotherapy against patients not in chemotherapy. The study of women selected at random from the general population showed that these women experienced a considerable degree of "morbidity" according to all three questionnaires. This shows that symptoms and problems reported by <span class="highlight">cancer</span>patients may have causes other than <span class="highlight">cancer</span>, and thus constitutes a good justification for the use of data from general population studies when interpreting data from <span class="highlight">cancer</span> patients. The levels of anxiety and depression of low-risk breast <span class="highlight">cancer</span> patients were found to be lower than those from the general population sample. After careful consideration we concluded that this finding was probably incorrect. The most important explanations were thought to be the wording of some HAD Scale items as well as two mechanisms that are not specific to the HAD Scale, the "selective reporting mechanism" found in the validation study, and the response-shift problem. These findings indicate - in contrast to the conclusion above - that the comparability of HRQL data from <span class="highlight">cancer</span> patients and general population data must be questioned. However, as this is the first study to raise the problem, this issue needs further investigation. Based on the initial literature review and interviews we hypothesised that 30 different HRQL issues would be impaired in patients undergoing CMF chemotherapy compared to patients not in chemotherapy; 23 of these hypotheses were confirmed. In addition, our study and other research suggest that other HRQL aspects may also be affected by chemotherapy. Thus, there is considerable evidence that patients in chemotherapy may experience effects on a wide spectrum of HRQL issues. Most other studies have assessed surprisingly few of the HRQL issues shown in our study to be impaired in patients receiving chemotherapy. Similarly, current review articles on HRQL effects of adjuvant chemotherapy mention only relatively few of these topics. Concerning HRQL after the treatment period, our main finding was that many symptoms and problems had declined or disappeared, but some persisted: anticipatory nausea, weight gain, endocrine effects (e.g., hot flushes/sweats, irregular bleedings/amenorrhea, vaginal dryness), disturbed sleep, and sexual dysfunction. These findings are in agreement with the literature. The staff study showed that experienced physicians and nurses did not expect many of the "scientifically well documented" consequences of chemotherapy. Taken together, our findings suggest that information to patients about chemotherapy should be more comprehensive than that which has been practised in most places. When compared against ovarian ablation, chemotherapy was associated with more impact on HRQL during the treatment period; only hot flushes/sweats were more pronounced in the ovarian ablation group. Thus, from an overall "HRQL perspective" ovarian ablation or suppression may be preferable. However, younger women may preserve their premenopausal status (including fertility) by having chemotherapy, and this may be an argument for chemotherapy or for temporary ovarian ablation via goserelin, rather than permanent ovarian ablation. Furthermore, while ovarian ablation/suppression may be preferable because of less impairment of HRQL, contemporary chemotherapeutic regimens may be more effective. These results indicate that for some patients, the HRQL data and results on treatment efficiency may be in conflict. There is no simple, universally correct solution to this dilemma. More research into patients' views and expectations to the health-care system in cases where medical decision-making involves complex trade-offs between treatment efficiency and HRQL issues is needed. Contrary to expectations, the analyses showed that fatigue and emotional function predicted the risk of recurrence and death independently of biological and clinical prognostic variables. In multivariate Cox regression analyses patients who were more fatigued or had poorer emotional function had a worse prognosis. These results are consistent with one small study, but are inconsistent with five similar studies in patients with primary breast <span class="highlight">cancer</span>, which found no such associations. The reasons for these important differences are currently unknown. In conclusion, this study consisted of methodological and clinical investigations of HRQL in primary breast <span class="highlight">cancer</span> patients. The initial questionnaire development resulted in a combination of questionnaires that was more comprehensive than in other similar studies. The results of the methodological studies generally supported the validity of the questionnaires but also gave important insights into potential scientific problems that are probably not restricted to the present study. These insights helped to prevent misinterpretations of the clinical data. The study provided the most detailed description of HRQL during and after breast <span class="highlight">cancer</span> adjuvant chemotherapy to date, and compared results of chemotherapy against ovarian ablation. It also provided controversial results concerning the prognostic value of HRQL data. The combination of a large empirical study and several methodological sub-studies thus proved useful and gave new results.</abstracttext></div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-91295570825414887132015-07-11T13:13:00.003-07:002015-07-11T13:13:23.124-07:00<a href="http://kcur.org/post/death-and-dying-expanding-palliative-care" target="_blank">http://kcur.org/post/death-and-dying-expanding-palliative-care</a><h1 class="post-title" itemprop="name" style="background-color: rgba(241, 243, 242, 0.4); box-sizing: border-box; font-family: Lato, 'Helvetica Neue', Helvetica, Helvetica, Arial, sans-serif; font-size: 3em; letter-spacing: -0.015em; line-height: 1; margin: 0.4rem 0px; padding: 0px; text-indent: -0.1rem; text-rendering: optimizeLegibility; word-spacing: 0.400000005960465px;">
<span style="color: red;">Death And Dying: Expanding Palliative Care</span></h1>
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<span class="submitted" style="box-sizing: border-box; color: #777777; font-size: 0.75em; line-height: 1.25;"><span content="2015-07-10T12:14:06-05:00" datatype="xsd:dateTime" property="dc:date dc:created" rel="sioc:has_creator" style="box-sizing: border-box;"><span class="submitted-label" style="box-sizing: border-box;">By</span> <span class="name" style="box-sizing: border-box; text-transform: uppercase;">MIKE SHIELDS</span></span></span> <i class="bullet" style="box-sizing: border-box; color: #777777; font-size: 0.5em; line-height: inherit; padding: 0px 0.5em;">•</i> <span class="pub-date" style="box-sizing: border-box; color: #777777; font-size: 0.75em; text-transform: uppercase;">JUL 10, 2015</span></div>
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<span style="box-sizing: border-box; font-weight: 900; line-height: inherit;"><em style="box-sizing: border-box; line-height: inherit;">Editor’s note:</em></span><em style="box-sizing: border-box; line-height: inherit;"> On Wednesday, Medicare, announced that it would reimburse doctors for end-of-life counseling. It’s part of an emerging conversation about end-of-life issues and the policy changes needed to give people more control over what happens to them in their final days. This three-part series of stories by KHI News Service, and a video produced in partnership with Kansas City public television station KCPT, is about that conversation and the role that experts at two regional institutions are playing in it. The <a href="http://kcur.org/post/death-and-dying-emerging-conversation" style="background: transparent; box-sizing: border-box; color: #168dd9; line-height: inherit; text-decoration: none;">first story </a>in the series focuses on efforts to encourage end-of-life discussions and <a href="http://kcur.org/post/death-and-dying-advocates-seek-state-laws" style="background: transparent; box-sizing: border-box; color: #168dd9; line-height: inherit; text-decoration: none;">the third</a>on the push to enact state laws allowing terminally ill patients to receive a doctor’s aid in dying.</em></div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-41902366591912528562015-07-11T13:10:00.003-07:002015-07-11T13:10:28.868-07:00<div class="hst-articletitle articletitle" style="background: url(http://www.timesunion.com/img/utils/rule_dots.gif) 0% 100% repeat-x rgb(255, 255, 255); border: 0px; font-family: Arial, sans-serif; font-size: 12px; line-height: 18px; margin: 0px 0px 10px; padding: 0px 0px 10px; vertical-align: baseline;">
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<span style="color: red;">Palliative care's dying with dignity</span></h1>
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<span class="name" style="border: 0px; font-family: inherit; font-size: 11.039999961853px; font-style: inherit; font-weight: inherit; margin: 0px; padding: 0px; vertical-align: baseline;">By Edward B. Scharfenberger, Commentary</span></h5>
<h5 class="timestamp updated" style="border: 0px; color: #666666; font-size: 0.92em; font-stretch: normal; font-weight: normal; line-height: normal; margin: 0px; padding: 0px; vertical-align: baseline;" title="2015-07-07T18:51:27Z">
Published 6:51 pm, Tuesday, July 7, 2015</h5>
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The recent conference in Colonie promoting assisted suicide points to the progress of the so-called "death with dignity" movement, which would reverse the ancient Hippocratic Oath to "do no harm" in favor of allowing physicians to become active agents in the deaths of patients.</div>
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The proponents of such a change in the law are no doubt motivated by a noble desire to prevent suffering. However, in so doing, they are seeking to sanitize the dying process in a dangerous way. What's more, they have latched on to the offensive argument that there is something inherently undignified about a natural death.</div>
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As a priest of 42 years, I can tell you that nothing can be further from the truth. In my priestly ministry, I have been at the deathbeds of more people than I can count. Usually, these individuals are elderly, but I have had the sad duty of consoling those burying children or young adults as well. No one wants to see a loved one die, but, without exception, the families to whom I have ministered have seen it not only as their duty but as their privilege to care for and see their loved ones through to the point where God called them home. Most of the deaths I have witnessed, including my own father's earlier this year, have been holy and peaceful.</div>
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Science has given us drugs that can be used to poison to death those who are suffering from the fear and depression that often accompanies terminal illness. But it has also given us something much more useful — palliative care, which enables medical personnel to control pain in remarkable ways, while at the same time preparing patients emotionally and spiritually for what is to come.</div>
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I appeal to our state legislators to reject legislation that promotes suicide for those considered as unuseful or a burden to society.</div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-38613860527701880992015-07-02T14:31:00.003-07:002015-07-02T14:31:22.363-07:00<div class="cit" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.8465em; line-height: 1.45em;">
<span role="menubar"><a abstractlink="yes" alsec="jour" alterm="J Am Med Dir Assoc." aria-expanded="false" aria-haspopup="true" href="http://www.ncbi.nlm.nih.gov/pubmed/26123254#" role="menuitem" style="border-bottom-width: 0px; color: #660066;" title="Journal of the American Medical Directors Association.">J Am Med Dir Assoc.</a></span> 2015 Jun 26.[Epub ahead of print]</div>
<h1 style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 1.231em; line-height: 1.125em; margin: 0.375em 0px;">
<span style="color: red;">Physician Treatment Orders in Dutch Nursing Homes.</span></h1>
<div class="auths" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.923em;">
<a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Bouwstra%20H%5BAuthor%5D&cauthor=true&cauthor_uid=26123254" style="border-bottom-width: 0px; color: #660066;">Bouwstra H</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">1</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Smalbrugge%20M%5BAuthor%5D&cauthor=true&cauthor_uid=26123254" style="border-bottom-width: 0px; color: #660066; outline: 0px;">Smalbrugge M</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">2</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Hertogh%20CM%5BAuthor%5D&cauthor=true&cauthor_uid=26123254" style="border-bottom-width: 0px; color: #660066;">Hertogh CM</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">2</span>.</div>
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<h3 style="color: #724128; font-size: 1.0769em; line-height: 1.2857; margin: 0.5em 0em; zoom: 1;">
<a aria-disabled="false" aria-expanded="false" class="jig-ncbitoggler ui-widget ui-ncbitoggler" href="http://www.ncbi.nlm.nih.gov/pubmed/26123254#" role="button" style="border-bottom-width: 0px; color: #660066; display: block; font-family: arial, sans-serif !important; font-size: 13.9996995925903px; outline: none; padding-left: 16px; position: relative; text-decoration: none !important;" title="Open/close author information list"><span class="ui-ncbitoggler-master-text">Author information</span><span class="ui-icon ui-icon-triangle-1-e" style="background: url(http://static.pubmed.gov/portal/portal3rc.fcgi/4066669/img/3974597) 0px -21px no-repeat scroll transparent; border-bottom-left-radius: 3px; border-bottom-right-radius: 3px; border: none; display: inline; height: 16px; left: 0px; margin: 0px; overflow: hidden; padding: 0px; position: absolute; right: 0px; text-indent: -99999px; top: 0px; width: 16px;"></span></a></h3>
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<h3 style="color: #985735; display: inline; line-height: 1.2857; margin: 0px;">
<span style="font-size: small;">Abstract</span></h3>
<div class="">
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
OBJECTIVES:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="OBJECTIVES" nlmcategory="OBJECTIVE">Physician treatment orders (PTOs) prevent burdensome unnecessary medical treatment of frail nursing home patients. The aim was to determine the prevalence of PTOs and time duration between nursing home admittance and PTO completion.</abstracttext></div>
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
DESIGN:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="DESIGN" nlmcategory="METHODS">Population-based, retrospective cohort study.</abstracttext></div>
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
SETTING:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="SETTING" nlmcategory="METHODS">Nursing homes across the Netherlands.</abstracttext></div>
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
DATA COLLECTION:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="DATA COLLECTION" nlmcategory="METHODS">Digital medical records of patients who subsequently were submitted to 14 Dutch nursing homes across The Netherlands were studied between 2010 and 2013. The prevalence's of do-resuscitate, do-not-resuscitate, life-sustaining, and palliative care PTOs and the time intervals between nursing home admittance and documentation of PTOs were measured. Information regarding demographic patient characteristics, type of nursing home ward, and mention of a discussion of PTOs with the patient or caregivers was obtained.</abstracttext></div>
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
RESULTS:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="RESULTS" nlmcategory="RESULTS">Eighty-two percent of the nursing home patients received a PTO regarding resuscitation, life-sustaining, or palliative care treatment. Twenty-four percent of the patients received a do-resuscitation PTO, 55% received a do-not-resuscitate PTO, 44% a life-sustaining PTO, and 16% a palliative care PTO. The median duration between nursing home admittance and documentation of the first PTO was 1 day. Most nursing home patients had PTOs within 1 week after admittance.</abstracttext></div>
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
CONCLUSION:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="CONCLUSION" nlmcategory="CONCLUSIONS">A minority (18%) of Dutch nursing home patients has no documented PTOs during their nursing home stay, which could have negative effects on end-of-life care of nursing home residents.</abstracttext></div>
<div style="margin-bottom: 0.5em;">
Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.</div>
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<div class="keywords" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; margin: 1.8em auto auto;">
<h4 style="float: left; margin: 0px 0.35em 0px 0px; text-transform: uppercase;">
KEYWORDS:</h4>
<div style="margin-bottom: 0.5em; margin-top: 0.5em;">
Physician treatment order; advance care planning; long-term care facility; nursing home; palliative care; resuscitation</div>
</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-29425812566988048122015-07-02T09:31:00.004-07:002015-07-02T09:31:44.626-07:00<div class="cit" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.8465em; line-height: 1.45em;">
<span role="menubar"><a abstractlink="yes" alsec="jour" alterm="Psychooncology." aria-expanded="false" aria-haspopup="true" href="http://www.ncbi.nlm.nih.gov/pubmed/26123474#" role="menuitem" style="border-bottom-width: 0px; color: #660066;" title="Psycho-oncology.">Psychooncology.</a></span> 2015 Jun 29. doi: 10.1002/pon.3887. [Epub ahead of print]</div>
<h1 style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 1.231em; line-height: 1.125em; margin: 0.375em 0px;">
<span style="color: red;">A tsunami of unmet needs: pancreatic and ampullary cancer patients' supportive <span class="highlight">care</span> needs and use of community and allied health services.</span></h1>
<div class="auths" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.923em;">
<a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Beesley%20VL%5BAuthor%5D&cauthor=true&cauthor_uid=26123474" style="border-bottom-width: 0px; color: #660066;">Beesley VL</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">1</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Janda%20M%5BAuthor%5D&cauthor=true&cauthor_uid=26123474" style="border-bottom-width: 0px; color: #660066;">Janda M</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">2</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Goldstein%20D%5BAuthor%5D&cauthor=true&cauthor_uid=26123474" style="border-bottom-width: 0px; color: #660066;">Goldstein D</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">3,</span><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">4</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Gooden%20H%5BAuthor%5D&cauthor=true&cauthor_uid=26123474" style="border-bottom-width: 0px; color: #660066;">Gooden H</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">5</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Merrett%20ND%5BAuthor%5D&cauthor=true&cauthor_uid=26123474" style="border-bottom-width: 0px; color: #660066;">Merrett ND</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">6,</span><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">7</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=O%27Connell%20DL%5BAuthor%5D&cauthor=true&cauthor_uid=26123474" style="border-bottom-width: 0px; color: #660066;">O'Connell DL</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">8</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Rowlands%20IJ%5BAuthor%5D&cauthor=true&cauthor_uid=26123474" style="border-bottom-width: 0px; color: #660066;">Rowlands IJ</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">9</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Wyld%20D%5BAuthor%5D&cauthor=true&cauthor_uid=26123474" style="border-bottom-width: 0px; color: #660066;">Wyld D</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">10,</span><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">11</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Neale%20RE%5BAuthor%5D&cauthor=true&cauthor_uid=26123474" style="border-bottom-width: 0px; color: #660066;">Neale RE</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">12</span>.</div>
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<a aria-disabled="false" aria-expanded="false" class="jig-ncbitoggler ui-widget ui-ncbitoggler" href="http://www.ncbi.nlm.nih.gov/pubmed/26123474#" role="button" style="border-bottom-width: 0px; color: #660066; display: block; font-family: arial, sans-serif !important; font-size: 13.9996995925903px; outline: none; padding-left: 16px; position: relative; text-decoration: none !important;" title="Open/close author information list"><br /><span class="ui-icon ui-icon-triangle-1-e" style="background: url(http://static.pubmed.gov/portal/portal3rc.fcgi/4066669/img/3974597) 0px -21px no-repeat scroll transparent; border-bottom-left-radius: 3px; border-bottom-right-radius: 3px; border: none; display: inline; height: 16px; left: 0px; margin: 0px; overflow: hidden; padding: 0px; position: absolute; right: 0px; text-indent: -99999px; top: 0px; width: 16px;"></span></a></h3>
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<h3 style="color: #985735; display: inline; font-size: 1.0769em; line-height: 1.2857; margin: 0px;">
Abstract</h3>
<div class="">
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
OBJECTIVE:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="OBJECTIVE" nlmcategory="OBJECTIVE">People diagnosed with pancreatic cancer have the worst survival prognosis of any cancer. No previous research has documented the supportive <span class="highlight">care</span> needs of this population. Our objective was to describe people's needs and use of support services and to examine whether these differed according to whether or not patients had undergone surgical resection.</abstracttext></div>
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
METHODS:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="METHODS" nlmcategory="METHODS">Queensland pancreatic or ampullary cancer patients (n = 136, 54% of those eligible) completed a survey, which assessed 34 needs across five domains (Supportive <span class="highlight">Care</span> Needs Survey-Short Form) and use of health services. Differences by resection were compared with Chi-squared tests.</abstracttext></div>
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
RESULTS:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="RESULTS" nlmcategory="RESULTS">Overall, 96% of participants reported having some needs. More than half reported moderate-to-high unmet physical (54%) or psychological (52%) needs, whereas health system/information (32%), patient <span class="highlight">care</span> (21%) and sexuality needs (16%) were described less frequently. The three most frequently reported moderate-to-high needs included 'not being able to do things they used to do' (41%), 'concerns about the worries of those close' (37%) and 'uncertainty about the future' (30%). Patients with non-resectable disease reported greater individual information needs, but their needs were otherwise similar to patients with resectable disease. Self-reported use of support was low; only 35% accessed information, 28%, 18% and 15% consulted a dietician, complementary medicine practitioner or mental health practitioner, respectively. <span class="highlight">Palliative</span> <span class="highlight">care</span> access was greater (59% vs 27%) among those with non-resectable disease.</abstracttext></div>
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
CONCLUSION:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="CONCLUSION" nlmcategory="CONCLUSIONS">Very high levels of needs were reported by people with pancreatic or ampullary cancer. Future work needs to elucidate why uptake of appropriate supportive <span class="highlight">care</span> is low and which services are required. Copyright © 2015 John Wiley & Sons, Ltd.</abstracttext></div>
<div style="margin-bottom: 0.5em;">
Copyright © 2015 John Wiley & Sons, Ltd.</div>
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</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-9209525072739757862015-07-02T09:30:00.003-07:002015-07-02T09:30:22.361-07:00<div class="results_settings one_setting" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 13px; line-height: 17.9998016357422px; overflow: auto; position: relative; width: 863.09375px; zoom: 1;">
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<div class="cit" style="font-size: 0.8465em; line-height: 1.45em;">
<span role="menubar"><a abstractlink="yes" alsec="jour" alterm="Int J Palliat Nurs." aria-expanded="false" aria-haspopup="true" href="http://www.ncbi.nlm.nih.gov/pubmed/25426881#" role="menuitem" style="border-bottom-width: 0px; color: #660066;" title="International journal of palliative nursing.">Int J Palliat Nurs.</a></span> 2014 Nov;20(11):542-8. doi: 10.12968/ijpn.2014.20.11.542.</div>
<h1 style="font-size: 1.231em; line-height: 1.125em; margin: 0.375em 0px;">
P<span style="color: red;">erspectives of an international education initiative in children's </span><span class="highlight"><span style="color: red;">palliativ</span>e</span> <span class="highlight">care</span>.</h1>
<div class="auths" style="font-size: 0.923em;">
<a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Price%20J%5BAuthor%5D&cauthor=true&cauthor_uid=25426881" style="border-bottom-width: 0px; color: #660066;">Price J</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">1</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Janicki%20JS%5BAuthor%5D&cauthor=true&cauthor_uid=25426881" style="border-bottom-width: 0px; color: #660066;">Janicki JS</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=McKee%20H%5BAuthor%5D&cauthor=true&cauthor_uid=25426881" style="border-bottom-width: 0px; color: #660066;">McKee H</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Nurse%20S%5BAuthor%5D&cauthor=true&cauthor_uid=25426881" style="border-bottom-width: 0px; color: #660066;">Nurse S</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Gray%20E%5BAuthor%5D&cauthor=true&cauthor_uid=25426881" style="border-bottom-width: 0px; color: #660066;">Gray E</a>.</div>
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<span style="font-size: small;">Abstract</span></h3>
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<abstracttext>Education is viewed as central to improving future <span class="highlight">palliative</span> <span class="highlight">care</span> for children and families across all countries. International education initiatives will ensure practitioners are aware of global health issues and can provide culturally sensitive <span class="highlight">care</span>. Creative and innovative means of meeting such directives are required to achieve meaningful student learning. </abstracttext></div>
<div style="margin-bottom: 0.5em;">
<abstracttext>This paper focuses on one innovation, a children's <span class="highlight">palliative</span> <span class="highlight">care</span> workshop using case studies as a teaching method, with <span class="highlight">nursing</span> students from the USA and <span class="highlight">nursing</span> and midwifery students from the UK. Key learning points arising from student evaluation were recorded under three main themes, these were: differences across countries, similarities across countries, and making learning fun and memorable. </abstracttext></div>
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<abstracttext><br /></abstracttext></div>
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<abstracttext>Findings indicated that this joint learning activity was viewed positively by all students and has enabled them to learn with and from each other, potentially impacting on their future practice.</abstracttext></div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-39934056897350889302015-07-02T09:29:00.003-07:002015-07-02T09:29:21.454-07:00<div class="cit" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.8465em; line-height: 1.45em;">
<span role="menubar"><a abstractlink="yes" alsec="jour" alterm="Int J Palliat Nurs." aria-expanded="false" aria-haspopup="true" href="http://www.ncbi.nlm.nih.gov/pubmed/26126677#" role="menuitem" style="border-bottom-width: 0px; color: #660066;" title="International journal of palliative nursing.">Int J Palliat Nurs.</a></span> 2015 Jun 2;21(6):287-91. doi: 10.12968/ijpn.2015.21.6.287.</div>
<h1 style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 1.231em; line-height: 1.125em; margin: 0.375em 0px;">
<span style="color: red;">We are not alone: international learning for professionals caring for children requiring <span class="highlight">palliative</span> <span class="highlight">care</span>.</span></h1>
<div class="auths" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.923em;">
<a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Price%20J%5BAuthor%5D&cauthor=true&cauthor_uid=26126677" style="border-bottom-width: 0px; color: #660066;">Price J</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">1</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Quinn%20K%5BAuthor%5D&cauthor=true&cauthor_uid=26126677" style="border-bottom-width: 0px; color: #660066;">Quinn K</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">2</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=McNeilly%20P%5BAuthor%5D&cauthor=true&cauthor_uid=26126677" style="border-bottom-width: 0px; color: #660066; outline: 0px;">McNeilly P</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">3</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Heywood%20M%5BAuthor%5D&cauthor=true&cauthor_uid=26126677" style="border-bottom-width: 0px; color: #660066;">Heywood M</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">4</span>.</div>
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<span style="font-size: small;">Abstract</span></h3>
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BACKGROUND:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="BACKGROUND" nlmcategory="BACKGROUND">Educational opportunities for professionals working with children requiring <span class="highlight">palliative</span> <span class="highlight">care</span> are central to future development within the specialty across countries. International educational initiatives involving a range of professionals are important for learning with and from others working within the field.</abstracttext></div>
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AIM:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="AIM" nlmcategory="OBJECTIVE">To explore the experiences and value to students from participating in an international online discussion forum.</abstracttext></div>
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METHOD:</h4>
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<abstracttext label="METHOD" nlmcategory="METHODS">This article examines one such initiative; the use of an international asynchronous discussion forum with students in Melbourne, Australia and Belfast, UK who work with children and families. The innovation is examined and student perspectives of the forum's value are presented.</abstracttext></div>
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
RESULTS:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="RESULTS" nlmcategory="RESULTS">Students endorsed the value of the forum, identifying three main areas of learning: differences across locations within countries, respecting different views and being open, and need for continued learning within children's <span class="highlight">palliative</span> <span class="highlight">care</span>. The overarching theme 'we are not alone' supported the idea that participation in the international discussion forum enabled students to see a broader perspective. Ideas for future developments of similar forums are also explored.</abstracttext></div>
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KEYWORDS:</h4>
<div style="margin-bottom: 0.5em; margin-top: 0.5em;">
Asynchronous discussion forum; Children's <span class="highlight">palliative</span> <span class="highlight">care</span>; Continuing education; International; Interprofessional</div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-50718811101695108712015-06-24T00:40:00.004-07:002015-06-24T00:40:45.630-07:00http://www.nursingtimes.net/nursing-practice/specialisms/end-of-life-and-palliative-care/palliative-care-in-nursing-homes-linked-to-managers-knowledge/5083564.article<br />
<br />
<span style="color: red; font-family: Arial, Helvetica, sans-serif;"><br /></span>
<a href="http://www.nursingtimes.net/nursing-practice/specialisms/end-of-life-and-palliative-care/palliative-care-in-nursing-homes-linked-to-managers-knowledge/5083564.article" target="_blank"><span style="color: red; font-family: Arial, Helvetica, sans-serif;">http://www.nursingtimes.net/nursing-practice/specialisms/end-of-life-and-palliative-care/palliative-care-in-nursing-homes-linked-to-managers-knowledge/5083564.article</span></a>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-52233683109135686592015-06-18T08:13:00.001-07:002015-06-18T08:13:04.617-07:00<div class="cit" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.8465em; line-height: 1.45em;">
<span role="menubar"><a abstractlink="yes" alsec="jour" alterm="J Pain Symptom Manage." aria-expanded="false" aria-haspopup="true" href="http://www.ncbi.nlm.nih.gov/pubmed/23796586#" role="menuitem" style="border-bottom-width: 0px; color: #660066;" title="Journal of pain and symptom management.">J <span class="highlight">Pain</span> Symptom Manage.</a></span> 2014 Jan;47(1):77-89. </div>
<div class="cit" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.8465em; line-height: 1.45em;">
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<h1 style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 1.231em; line-height: 1.125em; margin: 0.375em 0px;">
<span style="color: red;">Concepts and definitions for "actively dying," "end of life," "terminally ill," "terminal <span class="highlight">care</span>," and "transition of<span class="highlight">care</span>": a systematic review.</span></h1>
<div class="auths" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.923em;">
<a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Hui%20D%5BAuthor%5D&cauthor=true&cauthor_uid=23796586" style="border-bottom-width: 0px; color: #660066;">Hui D</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">1</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Nooruddin%20Z%5BAuthor%5D&cauthor=true&cauthor_uid=23796586" style="border-bottom-width: 0px; color: #660066;">Nooruddin Z</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">2</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Didwaniya%20N%5BAuthor%5D&cauthor=true&cauthor_uid=23796586" style="border-bottom-width: 0px; color: #660066;">Didwaniya N</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">2</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Dev%20R%5BAuthor%5D&cauthor=true&cauthor_uid=23796586" style="border-bottom-width: 0px; color: #660066;">Dev R</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">2</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=De%20La%20Cruz%20M%5BAuthor%5D&cauthor=true&cauthor_uid=23796586" style="border-bottom-width: 0px; color: #660066;">De La Cruz M</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">2</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Kim%20SH%5BAuthor%5D&cauthor=true&cauthor_uid=23796586" style="border-bottom-width: 0px; color: #660066;">Kim SH</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">3</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Kwon%20JH%5BAuthor%5D&cauthor=true&cauthor_uid=23796586" style="border-bottom-width: 0px; color: #660066;">Kwon JH</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">4</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Hutchins%20R%5BAuthor%5D&cauthor=true&cauthor_uid=23796586" style="border-bottom-width: 0px; color: #660066;">Hutchins R</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">5</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Liem%20C%5BAuthor%5D&cauthor=true&cauthor_uid=23796586" style="border-bottom-width: 0px; color: #660066;">Liem C</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">5</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Bruera%20E%5BAuthor%5D&cauthor=true&cauthor_uid=23796586" style="border-bottom-width: 0px; color: #660066;">Bruera E</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">2</span>.</div>
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Abstract</h3>
<div class="">
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
<span style="font-size: 1em;">C</span>ONTEXT:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="CONTEXT" nlmcategory="BACKGROUND">The terms "actively dying," "end of life," "terminally ill," "terminal <span class="highlight">care</span>," and "transition of <span class="highlight">care</span>" are commonly used but rarely and inconsistently defined.</abstracttext></div>
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
OBJECTIVES:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="OBJECTIVES" nlmcategory="OBJECTIVE">We conducted a systematic review to examine the concepts and definitions for these terms.</abstracttext></div>
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
METHODS:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="METHODS" nlmcategory="METHODS">We searched MEDLINE, PsycINFO, Embase, and CINAHL for published peer-reviewed articles from 1948 to 2012 that conceptualized, defined, or examined these terms. Two researchers independently reviewed each citation for inclusion and then extracted the concepts/definitions when available. We also searched 10 dictionaries, four <span class="highlight">palliative care</span> textbooks, and 13 organization Web sites, including the U.S. Federal Code.</abstracttext></div>
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
RESULTS:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="RESULTS" nlmcategory="RESULTS">One of 16, three of 134, three of 44, two of 93, and four of 17 articles defined or conceptualized actively dying, end of life, terminally ill, terminal <span class="highlight">care</span>, and transition of <span class="highlight">care</span>, respectively. Actively dying was defined as "hours or days of survival." We identified two key defining features for end of life, terminally ill, and terminal <span class="highlight">care</span>: life-limiting disease with irreversible decline and expected survival in terms of months or less. Transition of <span class="highlight">care</span> was discussed in relation to changes in 1) place of <span class="highlight">care</span> (e.g., hospital to home), 2) level of professions providing the <span class="highlight">care</span> (e.g., acute <span class="highlight">care</span> to hospice), and 3) goals of <span class="highlight">care</span> (e.g., curative to <span class="highlight">palliative</span>). Definitions for these five terms were rarely found in dictionaries, textbooks, and organizational Web sites. However, when available, the definitions were generally consistent with the concepts discussed previously.</abstracttext></div>
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
CONCLUSION:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="CONCLUSION" nlmcategory="CONCLUSIONS">We identified unifying concepts for five commonly used terms in <span class="highlight">palliative care</span> and developed a preliminary conceptual framework toward building standardized definitions.</abstracttext></div>
<div style="margin-bottom: 0.5em;">
Copyright © 2014 U.S. <span class="highlight">Cancer</span> <span class="highlight">Pain</span> Relief Committee. Published by Elsevier Inc. All rights reserved.</div>
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<div class="keywords" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; margin: 1.8em auto auto;">
<h4 style="float: left; margin: 0px 0.35em 0px 0px; text-transform: uppercase;">
KEYWORDS:</h4>
<div style="margin-bottom: 0.5em; margin-top: 0.5em;">
Actively dying; end of life; systematic review; terminal <span class="highlight">care</span>; terminally ill; terminology; transition of <span class="highlight">care</span></div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-46452785028279821082015-06-18T08:12:00.000-07:002015-06-18T08:12:02.141-07:00<div class="cit" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.8465em; line-height: 1.45em;">
<span role="menubar"><a abstractlink="yes" alsec="jour" alterm="Support Care Cancer." aria-expanded="false" aria-haspopup="true" href="http://www.ncbi.nlm.nih.gov/pubmed/22936493#" role="menuitem" style="border-bottom-width: 0px; color: #660066;" title="Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer.">Support <span class="highlight">Care</span> <span class="highlight">Cancer</span>.</a></span> 2013 Mar;21(3):659-85.</div>
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<span style="color: red;">Concepts and definitions for "supportive <span class="highlight">care</span>," "best supportive <span class="highlight">care</span>," "<span class="highlight">palliative care</span>," and "hospice <span class="highlight">care</span>" in the published literature, dictionaries, and textbooks.</span></h1>
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<a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Hui%20D%5BAuthor%5D&cauthor=true&cauthor_uid=22936493" style="border-bottom-width: 0px; color: #660066;">Hui D</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">1</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=De%20La%20Cruz%20M%5BAuthor%5D&cauthor=true&cauthor_uid=22936493" style="border-bottom-width: 0px; color: #660066;">De La Cruz M</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Mori%20M%5BAuthor%5D&cauthor=true&cauthor_uid=22936493" style="border-bottom-width: 0px; color: #660066; outline: 0px;">Mori M</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Parsons%20HA%5BAuthor%5D&cauthor=true&cauthor_uid=22936493" style="border-bottom-width: 0px; color: #660066;">Parsons HA</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Kwon%20JH%5BAuthor%5D&cauthor=true&cauthor_uid=22936493" style="border-bottom-width: 0px; color: #660066;">Kwon JH</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Torres-Vigil%20I%5BAuthor%5D&cauthor=true&cauthor_uid=22936493" style="border-bottom-width: 0px; color: #660066;">Torres-Vigil I</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Kim%20SH%5BAuthor%5D&cauthor=true&cauthor_uid=22936493" style="border-bottom-width: 0px; color: #660066;">Kim SH</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Dev%20R%5BAuthor%5D&cauthor=true&cauthor_uid=22936493" style="border-bottom-width: 0px; color: #660066;">Dev R</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Hutchins%20R%5BAuthor%5D&cauthor=true&cauthor_uid=22936493" style="border-bottom-width: 0px; color: #660066;">Hutchins R</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Liem%20C%5BAuthor%5D&cauthor=true&cauthor_uid=22936493" style="border-bottom-width: 0px; color: #660066;">Liem C</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Kang%20DH%5BAuthor%5D&cauthor=true&cauthor_uid=22936493" style="border-bottom-width: 0px; color: #660066;">Kang DH</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Bruera%20E%5BAuthor%5D&cauthor=true&cauthor_uid=22936493" style="border-bottom-width: 0px; color: #660066;">Bruera E</a>.</div>
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Abstract</h3>
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PURPOSE:</h4>
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<abstracttext label="PURPOSE" nlmcategory="OBJECTIVE">Commonly used terms such as "supportive <span class="highlight">care</span>," "best supportive <span class="highlight">care</span>," "<span class="highlight">palliative care</span>," and "hospice <span class="highlight">care</span>" were rarely and inconsistently defined in the <span class="highlight">palliative</span> oncology literature. We conducted a systematic review of the literature to further identify concepts and definitions for these terms.</abstracttext></div>
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METHODS:</h4>
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<abstracttext label="METHODS" nlmcategory="METHODS">We searched MEDLINE, PsycInfo, EMBASE, and CINAHL for published peer-reviewed articles from 1948 to 2011 that conceptualized, defined, or examined these terms. Two researchers independently reviewed each citation for inclusion and then extracted the concepts/definitions when available. Dictionaries/textbooks were also searched.</abstracttext></div>
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RESULTS:</h4>
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<abstracttext label="RESULTS" nlmcategory="RESULTS">Nine of 32 "SC/BSC," 25 of 182 "PC," and 12 of 42 "HC" articles focused on providing a conceptual framework/definition. Common concepts for all three terms were symptom control and quality-of-life for patients with life-limiting illness. "SC" focused more on patients on active treatment compared to other categories (9/9 vs. 8/37) and less often involved interdisciplinary <span class="highlight">care</span> (4/9 vs. 31/37). In contrast, "HC" focused more on volunteers (6/12 vs. 6/34), bereavement <span class="highlight">care</span> (9/12 vs. 7/34), and community <span class="highlight">care</span> (9/12 vs. 6/34). Both "PC" and "SC/BSC" were applicable earlier in the disease trajectory (16/34 vs. 0/9). We found 13, 24, and 17 different definitions for "SC/BSC," "PC," and "HC," respectively. "SC/BSC" was the most variably defined, ranging from symptom management during <span class="highlight">cancer</span> therapy to survivorship <span class="highlight">care</span>. Dictionaries/textbooks showed similar findings.</abstracttext></div>
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CONCLUSION:</h4>
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<abstracttext label="CONCLUSION" nlmcategory="CONCLUSIONS">We identified defining concepts for "SC/BSC," "PC," and "HC" and developed a preliminary conceptual framework unifying these terms along the continuum of <span class="highlight">care</span> to help build consensus toward standardized definitions.</abstracttext></div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-11408719906368260852015-06-18T08:10:00.003-07:002015-06-18T08:10:26.873-07:00<div class="cit" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.8465em; line-height: 1.45em;">
<span role="menubar"><a abstractlink="yes" alsec="jour" alterm="Ann Oncol." aria-expanded="false" aria-haspopup="true" href="http://www.ncbi.nlm.nih.gov/pubmed/25922064#" role="menuitem" style="border-bottom-width: 0px; color: #660066;" title="Annals of oncology : official journal of the European Society for Medical Oncology / ESMO.">Ann Oncol.</a></span> 2015 Apr 28. </div>
<h1 style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 1.125em; margin: 0.375em 0px;">
<span style="color: red; font-size: large;">Implementation of supportive <span class="highlight">care</span> and best supportive <span class="highlight">care</span> interventions in clinical trials enrolling patients with <span class="highlight">cancer</span>†.</span></h1>
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<a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Lee%20RT%5BAuthor%5D&cauthor=true&cauthor_uid=25922064" style="border-bottom-width: 0px; color: #660066;">Lee RT</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">1</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Ramchandran%20K%5BAuthor%5D&cauthor=true&cauthor_uid=25922064" style="border-bottom-width: 0px; color: #660066;">Ramchandran K</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">2</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Sanft%20T%5BAuthor%5D&cauthor=true&cauthor_uid=25922064" style="border-bottom-width: 0px; color: #660066;">Sanft T</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">3</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Von%20Roenn%20J%5BAuthor%5D&cauthor=true&cauthor_uid=25922064" style="border-bottom-width: 0px; color: #660066;">Von Roenn J</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">4</span>.</div>
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Abstract</h3>
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BACKGROUND:</h4>
<div style="margin-bottom: 0.5em;">
<abstracttext label="BACKGROUND" nlmcategory="BACKGROUND">With the growing and evolving role of <span class="highlight">palliative care</span> in oncology, we examined how supportive <span class="highlight">care</span> (SC) and best supportive <span class="highlight">care</span>(BSC) are implemented in clinical trials when used as a comparison treatment arm.</abstracttext></div>
<h4 style="float: left; margin: 0px 0.25em 0px 0px; text-transform: uppercase;">
METHODS:</h4>
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<abstracttext label="METHODS" nlmcategory="METHODS">We conducted a systematic review of the literature for clinical trials published between 1980 and 2012 in which systemic anticancer therapy was compared with an SC-only arm and compared SC implementation with World Health Organization (WHO) published guidelines.</abstracttext></div>
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RESULTS:</h4>
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<abstracttext label="RESULTS" nlmcategory="RESULTS">Our search identified 189 articles, 73 of which met our inclusion criteria with the following <span class="highlight">cancer</span> types: 29 lung, 7 colorectal, 6 pancreatic, 5 gastric and 26 others. Fifty-five studies (75%) provided some definition of SC, and 48 studies (66%) used the term BSC. Twenty-one of the 55 studies that provided a definition described the use of <span class="highlight">palliative</span> therapies as being 'at the discretion of the treating physician' without standardization. Only two studies provided SC that incorporated routine physical, psychological and social assessments including rapid referral to SC specialists. SC interventions most commonly included analgesics (47%) and radiotherapy (44%). Trials using the term BSC versus SC were more likely to include blood transfusions (P = 0.002) and antibiotics (P = 0.033), but less likely to include steroids (P = 0.05) and <span class="highlight">palliative</span>specialists (P = 0.047).</abstracttext></div>
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CONCLUSIONS:</h4>
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<abstracttext label="CONCLUSIONS" nlmcategory="CONCLUSIONS">The implementation of SC in clinical trials in this systematic review is highly variable. The vast majority of the studies did not meet the WHO guidelines on SC because <span class="highlight">palliative care</span> therapies were not recommended or integrated into <span class="highlight">care</span>. Future clinical trials utilizing a SC intervention arm should define these interventions in a standardized approach that meets current guidelines such as the WHO recommendations.</abstracttext></div>
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© The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.</div>
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KEYWORDS:</h4>
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best supportive <span class="highlight">care</span>; <span class="highlight">cancer</span> clinical trials; <span class="highlight">palliative care</span>; supportive <span class="highlight">care</span></div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-57906580392739999712015-06-18T08:08:00.005-07:002015-06-18T08:08:49.867-07:00<div class="cit" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.8465em; line-height: 1.45em;">
<span role="menubar"><a abstractlink="yes" alsec="jour" alterm="Br J Cancer." aria-expanded="false" aria-haspopup="true" href="http://www.ncbi.nlm.nih.gov/pubmed/26068397#" role="menuitem" style="border-bottom-width: 0px; color: #660066;" title="British journal of cancer.">Br J <span class="highlight">Cancer</span>.</a></span> 2015 Jun 11. </div>
<h1 style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 1.125em; margin: 0.375em 0px;">
<span style="color: red; font-size: large;">Best supportive <span class="highlight">care</span> in clinical trials: review of the inconsistency in control arm design.</span></h1>
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<a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Nipp%20RD%5BAuthor%5D&cauthor=true&cauthor_uid=26068397" style="border-bottom-width: 0px; color: #660066;">Nipp RD</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">1</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Currow%20DC%5BAuthor%5D&cauthor=true&cauthor_uid=26068397" style="border-bottom-width: 0px; color: #660066;">Currow DC</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">2</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Cherny%20NI%5BAuthor%5D&cauthor=true&cauthor_uid=26068397" style="border-bottom-width: 0px; color: #660066;">Cherny NI</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">3</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Strasser%20F%5BAuthor%5D&cauthor=true&cauthor_uid=26068397" style="border-bottom-width: 0px; color: #660066;">Strasser F</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">4</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Abernethy%20AP%5BAuthor%5D&cauthor=true&cauthor_uid=26068397" style="border-bottom-width: 0px; color: #660066;">Abernethy AP</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">5</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Zafar%20SY%5BAuthor%5D&cauthor=true&cauthor_uid=26068397" style="border-bottom-width: 0px; color: #660066;">Zafar SY</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">5</span>.</div>
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<span style="font-size: small;">Abstract</span></h3>
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BACKGROUND:</h4>
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<abstracttext label="BACKGROUND" nlmcategory="BACKGROUND">Best supportive <span class="highlight">care</span> (BSC) as a control arm in clinical trials is poorly defined. We conducted a review to evaluate clinical trials' concordance with published, consensus-based framework for BSC delivery in trials.</abstracttext></div>
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METHODS:</h4>
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<abstracttext label="METHODS" nlmcategory="METHODS">A consensus-based Delphi panel previously identified four key domains of BSC delivery in trials: multidisciplinary <span class="highlight">care</span>; supportive <span class="highlight">care</span>documentation; symptom assessment; and symptom management. We reviewed trials including BSC control arms from 2002 to 2014 to assess concordance to BSC standards and to selected items from the CONSORT 2010 guidelines.</abstracttext></div>
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RESULTS:</h4>
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<abstracttext label="RESULTS" nlmcategory="RESULTS">Of 408 articles retrieved, we retained 18 after applying exclusion criteria. Overall, trials conformed to the CONSORT guidelines better than the BSC standards (28% vs 16%). One-third of articles offered a detailed description of BSC, 61% reported regular symptom assessment, and 44% reported using validated symptom assessment measures. One-third reported symptom assessment at identical intervals in both arms. None documented evidence-based symptom management. No studies reported educating patients about symptom management or goals of therapy. No studies reported offering access to <span class="highlight">palliative care</span> specialists.</abstracttext></div>
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CONCLUSIONS:</h4>
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<abstracttext label="CONCLUSIONS" nlmcategory="CONCLUSIONS">Reporting of BSC in trials is incomplete, resulting in uncertain internal and external validity. Such studies risk systematically over-estimating the net clinical effect of the comparator arms.British Journal of Canceradvance online publication 11 June 2015; doi:10.1038/bjc.2015.192 www.bjcancer.com.</abstracttext></div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-652936609908194660.post-75584405933719097012015-06-18T08:07:00.004-07:002015-06-18T08:07:34.985-07:00<div class="cit" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: 0.8465em; line-height: 1.45em;">
<span role="menubar"><a abstractlink="yes" alsec="jour" alterm="Eur J Cancer." aria-expanded="false" aria-haspopup="true" href="http://www.ncbi.nlm.nih.gov/pubmed/26074396#" role="menuitem" style="border-bottom-width: 0px; color: #660066;" title="European journal of cancer (Oxford, England : 1990).">Eur J <span class="highlight">Cancer</span>.</a></span> 2015 Jun 11. </div>
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<span style="color: red;">Survival prediction for advanced <span class="highlight">cancer</span> patients in the real world: </span></h1>
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<span style="color: red;">A comparison of the <span class="highlight">Palliative</span> Prognostic Score, Delirium-<span class="highlight">Palliative</span> Prognostic Score, <span class="highlight">Palliative</span> Prognostic Index and modified Prognosis in <span class="highlight">Palliative Care</span>Study predictor model.</span></h1>
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<a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Baba%20M%5BAuthor%5D&cauthor=true&cauthor_uid=26074396" style="border-bottom-width: 0px; color: #660066;">Baba M</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">1</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Maeda%20I%5BAuthor%5D&cauthor=true&cauthor_uid=26074396" style="border-bottom-width: 0px; color: #660066;">Maeda I</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">2</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Morita%20T%5BAuthor%5D&cauthor=true&cauthor_uid=26074396" style="border-bottom-width: 0px; color: #660066;">Morita T</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">3</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Inoue%20S%5BAuthor%5D&cauthor=true&cauthor_uid=26074396" style="border-bottom-width: 0px; color: #660066;">Inoue S</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">4</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Ikenaga%20M%5BAuthor%5D&cauthor=true&cauthor_uid=26074396" style="border-bottom-width: 0px; color: #660066;">Ikenaga M</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">5</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Matsumoto%20Y%5BAuthor%5D&cauthor=true&cauthor_uid=26074396" style="border-bottom-width: 0px; color: #660066;">Matsumoto Y</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">6</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Sekine%20R%5BAuthor%5D&cauthor=true&cauthor_uid=26074396" style="border-bottom-width: 0px; color: #660066;">Sekine R</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">7</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Yamaguchi%20T%5BAuthor%5D&cauthor=true&cauthor_uid=26074396" style="border-bottom-width: 0px; color: #660066;">Yamaguchi T</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">8</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Hirohashi%20T%5BAuthor%5D&cauthor=true&cauthor_uid=26074396" style="border-bottom-width: 0px; color: #660066;">Hirohashi T</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">9</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Tajima%20T%5BAuthor%5D&cauthor=true&cauthor_uid=26074396" style="border-bottom-width: 0px; color: #660066;">Tajima T</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">10</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Tatara%20R%5BAuthor%5D&cauthor=true&cauthor_uid=26074396" style="border-bottom-width: 0px; color: #660066;">Tatara R</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">11</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Watanabe%20H%5BAuthor%5D&cauthor=true&cauthor_uid=26074396" style="border-bottom-width: 0px; color: #660066;">Watanabe H</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">12</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Otani%20H%5BAuthor%5D&cauthor=true&cauthor_uid=26074396" style="border-bottom-width: 0px; color: #660066;">Otani H</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">13</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Takigawa%20C%5BAuthor%5D&cauthor=true&cauthor_uid=26074396" style="border-bottom-width: 0px; color: #660066;">Takigawa C</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">14</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Matsuda%20Y%5BAuthor%5D&cauthor=true&cauthor_uid=26074396" style="border-bottom-width: 0px; color: #660066;">Matsuda Y</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">15</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Nagaoka%20H%5BAuthor%5D&cauthor=true&cauthor_uid=26074396" style="border-bottom-width: 0px; color: #660066;">Nagaoka H</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">16</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Mori%20M%5BAuthor%5D&cauthor=true&cauthor_uid=26074396" style="border-bottom-width: 0px; color: #660066;">Mori M</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">17</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Tei%20Y%5BAuthor%5D&cauthor=true&cauthor_uid=26074396" style="border-bottom-width: 0px; color: #660066;">Tei Y</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">18</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Hiramoto%20S%5BAuthor%5D&cauthor=true&cauthor_uid=26074396" style="border-bottom-width: 0px; color: #660066;">Hiramoto S</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">19</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Suga%20A%5BAuthor%5D&cauthor=true&cauthor_uid=26074396" style="border-bottom-width: 0px; color: #660066;">Suga A</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">20</span>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/?term=Kinoshita%20H%5BAuthor%5D&cauthor=true&cauthor_uid=26074396" style="border-bottom-width: 0px; color: #660066;">Kinoshita H</a><span style="font-size: 0.8461em; line-height: 1.6363em; position: relative; top: -0.5em; vertical-align: baseline;">21</span>.</div>
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Abstract</h3>
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PURPOSE:</h4>
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<abstracttext label="PURPOSE" nlmcategory="OBJECTIVE">The aim of this study was to investigate the feasibility and accuracy of the <span class="highlight">Palliative</span> Prognostic Score (PaP score), Delirium-<span class="highlight">Palliative</span>Prognostic Score (D-PaP score), <span class="highlight">Palliative</span> Prognostic Index (PPI) and modified Prognosis in <span class="highlight">Palliative Care</span> Study predictor model (PiPS model).</abstracttext></div>
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PATIENTS AND METHODS:</h4>
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<abstracttext label="PATIENTS AND METHODS" nlmcategory="METHODS">This multicentre prospective cohort study involved 58 <span class="highlight">palliative care</span> services, including 19 hospital <span class="highlight">palliative care</span>teams, 16 <span class="highlight">palliative care</span> units and 23 home <span class="highlight">palliative care</span> services, in Japan from September 2012 to April 2014. Analyses were performed involving four patient groups: those treated by <span class="highlight">palliative care</span> teams, those in <span class="highlight">palliative care</span> units, those at home and those receiving chemotherapy.</abstracttext></div>
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RESULTS:</h4>
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<abstracttext label="RESULTS" nlmcategory="RESULTS">We recruited 2426 participants, and 2361 patients were finally analysed. Risk groups based on these instruments successfully identified patients with different survival profiles in all groups. The feasibility of PPI and modified PiPS-A was more than 90% in all groups, followed by PaP and D-PaP scores; modified PiPS-B had the lowest feasibility. The accuracy of prognostic scores was ⩾69% in all groups and the difference was within 13%, while c-statistics were significantly lower with the PPI than PaP and D-PaP scores.</abstracttext></div>
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CONCLUSION:</h4>
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<abstracttext label="CONCLUSION" nlmcategory="CONCLUSIONS">The PaP score, D-PaP score, PPI and modified PiPS model provided distinct survival groups for patients in the three <span class="highlight">palliative care</span>settings and those receiving chemotherapy. The PPI seems to be suitable for routine clinical use for situations where rough estimates of prognosis are sufficient and/or patients do not want invasive procedure. If clinicians can address more items, the modified PiPS-A would be a non-invasive alternative. In cases where blood samples are available or those requiring more accurate prediction, the PaP and D-PaP scores and modified PiPS-B would be more appropriate.</abstracttext></div>
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Copyright © 2015 Elsevier Ltd. All rights reserved.</div>
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KEYWORDS:</h4>
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Accuracy; <span class="highlight">Palliative</span> Prognostic Index; <span class="highlight">Palliative</span> Prognostic Score; <span class="highlight">Palliative care</span>; PiPS model; Predication; Prognosis</div>
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