Pub Date : 2018-01-01DOI: 10.4172/2165-7386.1000339
N. Rahm, Audrey Calmant, C. Combescure
Context and objectives: A specific prognostic tool is lacking for end-stage oncological liver diseases. In addition to various factors, bilirubin, which reflects the severity of liver dysfunction, may be associated with mortality in this population. We aimed to assess how bilirubin influence survival in patients admitted in palliative care units with advanced oncologic liver diseases and to develop a prognostic model combining bilirubin with other factors. Methods: Data were collected retrospectively from 652 patients with oncologic liver diseases, accounting for 25% of all admissions in our palliative care units from 2011 to 2016. Age, gender, chronic liver diseases, infections including spontaneous bacterial peritonitis, gastrointestinal bleeding, encephalopathy, Eastern Cooperative Oncology Group score (ECOG), oral intake, jaundice, dyspnea, bilirubin, albumin and urea variables collected within 24 hours before or after admission were analyzed. Univariate and multivariate survival analyses were performed to identify the predictive value of bilirubin and other variables for 7-day survival. Results: Bilirubin value was collected in 398 patients. Univariate analysis showed that male sex, chronic liver diseases, encephalopathy, ECOG, oral intake, jaundice, bilirubin and urea blood levels, were associated with 7-day survival. Multivariate analysis showed that bilirubin>25 μ mol/L, urea>15 mmol/L, ECOG=4 and reduced oral intake, were independently correlated with survival. Accuracy of the model based on these factors to predict 7-day mortality is high (AUC=0.90). Conclusion: Bilirubin is an independent prognostic factor for 7 day-survival among patients with end-stage oncologic liver disease. Combining bilirubin, urea, ECOG and oral intake increases short term prognostication accuracy in this subgroup of patients.
{"title":"Predictors of Seven-Day Mortality in Patients with Advanced Oncologic Liver Disease Admitted to a Palliative Care Unit","authors":"N. Rahm, Audrey Calmant, C. Combescure","doi":"10.4172/2165-7386.1000339","DOIUrl":"https://doi.org/10.4172/2165-7386.1000339","url":null,"abstract":"Context and objectives: A specific prognostic tool is lacking for end-stage oncological liver diseases. In addition to various factors, bilirubin, which reflects the severity of liver dysfunction, may be associated with mortality in this population. We aimed to assess how bilirubin influence survival in patients admitted in palliative care units with advanced oncologic liver diseases and to develop a prognostic model combining bilirubin with other factors. Methods: Data were collected retrospectively from 652 patients with oncologic liver diseases, accounting for 25% of all admissions in our palliative care units from 2011 to 2016. Age, gender, chronic liver diseases, infections including spontaneous bacterial peritonitis, gastrointestinal bleeding, encephalopathy, Eastern Cooperative Oncology Group score (ECOG), oral intake, jaundice, dyspnea, bilirubin, albumin and urea variables collected within 24 hours before or after admission were analyzed. Univariate and multivariate survival analyses were performed to identify the predictive value of bilirubin and other variables for 7-day survival. Results: Bilirubin value was collected in 398 patients. Univariate analysis showed that male sex, chronic liver diseases, encephalopathy, ECOG, oral intake, jaundice, bilirubin and urea blood levels, were associated with 7-day survival. Multivariate analysis showed that bilirubin>25 μ mol/L, urea>15 mmol/L, ECOG=4 and reduced oral intake, were independently correlated with survival. Accuracy of the model based on these factors to predict 7-day mortality is high (AUC=0.90). Conclusion: Bilirubin is an independent prognostic factor for 7 day-survival among patients with end-stage oncologic liver disease. Combining bilirubin, urea, ECOG and oral intake increases short term prognostication accuracy in this subgroup of patients.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"8 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000339","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70684498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2165-7386.1000341
S. Majeed, N. Rodwell
{"title":"Challenging Pain Management in Widespread Metastatic Neuroendocrine Tumour","authors":"S. Majeed, N. Rodwell","doi":"10.4172/2165-7386.1000341","DOIUrl":"https://doi.org/10.4172/2165-7386.1000341","url":null,"abstract":"","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"08 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000341","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70684677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2165-7386.1000340
Chun-Chu Chang, M. Lee, Yu‐Chuan Wen, Tingting Yu, Shih-Hsiang Chen, T. Jaing
‘‘Do-not-resuscitate’’ (DNR) orders constitute a vital part of End-of-Life (EOL) care for patients with terminal cancer. In this retrospective study, we reviewed the medical records of patients treated at a tertiary referral pediatric oncology unit between May 2006 and May 2017. We gathered data about days from signing the DNR to death, age at death, gender, disease and its status, place of death, and survival and performed t-test and χ2 test as appropriate. Of the 225 patients [127 males, 98 females; median age: 10.0 years (range, 0.4-23.4) years] enrolled, 130 (57.8%) provided DNR orders signed by their surrogates. In addition, 29.3%, 44.8%, and 25.8% of deaths occurred in the pediatric oncology ward, the intensive care unit, and at home or another hospital, respectively. We observed an annual increase in the signing rate of DNR orders. The median duration between signing a DNR order and death was 2 (range: 0-88) days. Furthermore, DNR orders tended to be committed by patients with slowly deteriorating disease and those with extended overall survival. This study deduces that an explicit DNR order is now a rule rather than an exception, with more DNR orders being signed for patients aged>10 years hospitalized for EOL cancer care. Hence, the early implementation of a DNR order could be underutilized in younger patients with cancer.
{"title":"“Do-Not-Resuscitate” Orders in Children with Cancer at the End of Life: A Retrospective Review","authors":"Chun-Chu Chang, M. Lee, Yu‐Chuan Wen, Tingting Yu, Shih-Hsiang Chen, T. Jaing","doi":"10.4172/2165-7386.1000340","DOIUrl":"https://doi.org/10.4172/2165-7386.1000340","url":null,"abstract":"‘‘Do-not-resuscitate’’ (DNR) orders constitute a vital part of End-of-Life (EOL) care for patients with terminal cancer. In this retrospective study, we reviewed the medical records of patients treated at a tertiary referral pediatric oncology unit between May 2006 and May 2017. We gathered data about days from signing the DNR to death, age at death, gender, disease and its status, place of death, and survival and performed t-test and χ2 test as appropriate. Of the 225 patients [127 males, 98 females; median age: 10.0 years (range, 0.4-23.4) years] enrolled, 130 (57.8%) provided DNR orders signed by their surrogates. In addition, 29.3%, 44.8%, and 25.8% of deaths occurred in the pediatric oncology ward, the intensive care unit, and at home or another hospital, respectively. We observed an annual increase in the signing rate of DNR orders. The median duration between signing a DNR order and death was 2 (range: 0-88) days. Furthermore, DNR orders tended to be committed by patients with slowly deteriorating disease and those with extended overall survival. This study deduces that an explicit DNR order is now a rule rather than an exception, with more DNR orders being signed for patients aged>10 years hospitalized for EOL cancer care. Hence, the early implementation of a DNR order could be underutilized in younger patients with cancer.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"08 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000340","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70685090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2165-7386.1000328
W. Mutale, F. Goma, L. Gwyther
Introduction: WHO recommends provision of palliative care for all who need it according to needs and context. However, in Sub-Saharan Africa coverage of palliative care services remain low especially children. This study reports experiences of palliative care services for children and their families attending the University Teaching hospital in Lusaka, Zambia. Methodology: The was a cross-sectional qualitative study conducted at University teaching hospital in Lusaka, Zambia. Results: The major challenges faced by families included lack of economic/financial and bereavement support. Most families were referred to the UTH from very far places without any form of support. One major barrier identified to provision of palliative care was poor coordination of services with most patients missing out on services which were already available. While social workers were available, poor funding negatively affected this service. There were very few trained health workers in palliative care. Pain management remained poor with many clinicians still not comfortable to prescribe stronger analgesia such as morphine for severe pain. Conclusion: The study revealed significant gaps for children’s palliative care services in at the University teaching hospital in Zambia. One major barrier identified to provision of palliative care was poor coordination of services. Families reported lack of economic and bereavement support in addition to lack of information.
{"title":"Access to Palliative Care Services: A Qualitative Study of Experiences of Children and Families Attending University Teaching Hospital in Lusaka","authors":"W. Mutale, F. Goma, L. Gwyther","doi":"10.4172/2165-7386.1000328","DOIUrl":"https://doi.org/10.4172/2165-7386.1000328","url":null,"abstract":"Introduction: WHO recommends provision of palliative care for all who need it according to needs and context. However, in Sub-Saharan Africa coverage of palliative care services remain low especially children. This study reports experiences of palliative care services for children and their families attending the University Teaching hospital in Lusaka, Zambia. Methodology: The was a cross-sectional qualitative study conducted at University teaching hospital in Lusaka, Zambia. Results: The major challenges faced by families included lack of economic/financial and bereavement support. Most families were referred to the UTH from very far places without any form of support. One major barrier identified to provision of palliative care was poor coordination of services with most patients missing out on services which were already available. While social workers were available, poor funding negatively affected this service. There were very few trained health workers in palliative care. Pain management remained poor with many clinicians still not comfortable to prescribe stronger analgesia such as morphine for severe pain. Conclusion: The study revealed significant gaps for children’s palliative care services in at the University teaching hospital in Zambia. One major barrier identified to provision of palliative care was poor coordination of services. Families reported lack of economic and bereavement support in addition to lack of information.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"8 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000328","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70684172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2165-7386.1000337
A. Ababneh
Dying process is too often needlessly protracted by these medical technology is consequently marked by incapacitations, intolerable pain, and indignity. Physician assisted suicide defines as knowingly and intentionally providing a person with the knowledge or means or both required to commit suicide, including counseling about lethal doses of drugs, prescribing such lethal doses or supplying the drugs. Therefore, the aim of this paper is to create an argumentative essay to argue the use of physician assisted suicide for terminally ill patients as a last resort to end their suffer and end their life, while taking the legal and ethical points of view of opponents and proponents into consideration.
{"title":"Physician Assisted Suicide for Terminally Ill Patients: An Argumentative Essay","authors":"A. Ababneh","doi":"10.4172/2165-7386.1000337","DOIUrl":"https://doi.org/10.4172/2165-7386.1000337","url":null,"abstract":"Dying process is too often needlessly protracted by these medical technology is consequently marked by incapacitations, intolerable pain, and indignity. Physician assisted suicide defines as knowingly and intentionally providing a person with the knowledge or means or both required to commit suicide, including counseling about lethal doses of drugs, prescribing such lethal doses or supplying the drugs. Therefore, the aim of this paper is to create an argumentative essay to argue the use of physician assisted suicide for terminally ill patients as a last resort to end their suffer and end their life, while taking the legal and ethical points of view of opponents and proponents into consideration.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"8 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000337","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70684352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2165-7386.1000327
Alaa M. Gouda, N. Alrasheed, Alaa Ali, Ahmad Allaf, Najd Almudaiheem, Youssuf Ali, A. Alghabban, Sami Alsalolami
Introduction: Only a few studies from Arab Muslim countries address DNR practice. Our institute has a clear DNR policy. The knowledge of the existing policy and the attitude towards DNR of emergency room (ER) and intensive care unit (ICU) physicians were studied through this survey. Objective: To identify the knowledge of the participants of the local DNR policy and guidelines and to summarize the possible barriers of addressing DNR including religious background. Method: A questionnaire has been distributed to ER and ICU physicians. The answers to the questions were tabulated and analyzed using frequencies and percentage. Results: Total of 112 physicians with majority (97.3%) are from a Muslim religion. Among the participants 108 (96.4%) were aware about the existence of DNR policy in our institute. 107 (95.5%) stated that DNR is not against Islamic rules. Only (13.4%) of the physicians have advance directives and (90.2%) answered they will request to be placed as DNR if they have terminal illness. Lack of patients and families understanding (51.8%) and inadequate training (35.7%) were the 2 most important barriers for effective DNR discussion. Patients and Families level of education (58.0%) and cultural factors (52.7%) were the main obstacles in initiating a DNR order. Only (1.8%) of the participants stated that DNR is against their religious belief. Conclusions: There is a lack of knowledge about DNR policy which make the optimization of DNR process difficult. Most physicians wish DNR for themselves and their patients at end of life but only a few of them have advance directives. The most important barriers for initializing and discussing DNR were lack of patient understanding, level of education, and the culture of patients. Most of the Muslim physicians believe that DNR is not against Islamic rules. We suggest that the DNR concept should be part of any training program.
{"title":"Knowledge and Attitude of ER and ICU Physicians towards DNR in a Tertiary Care Center in Saudi Arabia: A Survey Study","authors":"Alaa M. Gouda, N. Alrasheed, Alaa Ali, Ahmad Allaf, Najd Almudaiheem, Youssuf Ali, A. Alghabban, Sami Alsalolami","doi":"10.4172/2165-7386.1000327","DOIUrl":"https://doi.org/10.4172/2165-7386.1000327","url":null,"abstract":"Introduction: Only a few studies from Arab Muslim countries address DNR practice. Our institute has a clear DNR policy. The knowledge of the existing policy and the attitude towards DNR of emergency room (ER) and intensive care unit (ICU) physicians were studied through this survey. Objective: To identify the knowledge of the participants of the local DNR policy and guidelines and to summarize the possible barriers of addressing DNR including religious background. Method: A questionnaire has been distributed to ER and ICU physicians. The answers to the questions were tabulated and analyzed using frequencies and percentage. Results: Total of 112 physicians with majority (97.3%) are from a Muslim religion. Among the participants 108 (96.4%) were aware about the existence of DNR policy in our institute. 107 (95.5%) stated that DNR is not against Islamic rules. Only (13.4%) of the physicians have advance directives and (90.2%) answered they will request to be placed as DNR if they have terminal illness. Lack of patients and families understanding (51.8%) and inadequate training (35.7%) were the 2 most important barriers for effective DNR discussion. Patients and Families level of education (58.0%) and cultural factors (52.7%) were the main obstacles in initiating a DNR order. Only (1.8%) of the participants stated that DNR is against their religious belief. Conclusions: There is a lack of knowledge about DNR policy which make the optimization of DNR process difficult. Most physicians wish DNR for themselves and their patients at end of life but only a few of them have advance directives. The most important barriers for initializing and discussing DNR were lack of patient understanding, level of education, and the culture of patients. Most of the Muslim physicians believe that DNR is not against Islamic rules. We suggest that the DNR concept should be part of any training program.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"8 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000327","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70684034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2165-7386.1000330
M. Ulrichová
Dying and death is often understood as an ungraspable process, which is connected with a pain perception, fear and people do not like talking about this topic. We also face with this issue in the Czech Republic; often it is a taboo process. Logo therapy and existential analyses offers another point of view at this phenomenon, logo therapy perceives life as the only one that is meaningful, that has its clear boarders. And by allowing this existence of these limits it gives man everyday meaningful content, experience it intensively and to communicate immediately about its end, which is absolutely natural to life and inherently belongs. Only then, when we accept death as something given and unavoidable, we can help our loved ones who are in terminal phases and to allow them a peaceful leaving from their lives. Palliative medicine plays a great role in many dying men, helps men to cope with those situations which are already medical impractical.
{"title":"Existential Analysis and Logo Therapy on a Good Way to Die","authors":"M. Ulrichová","doi":"10.4172/2165-7386.1000330","DOIUrl":"https://doi.org/10.4172/2165-7386.1000330","url":null,"abstract":"Dying and death is often understood as an ungraspable process, which is connected with a pain perception, fear and people do not like talking about this topic. We also face with this issue in the Czech Republic; often it is a taboo process. Logo therapy and existential analyses offers another point of view at this phenomenon, logo therapy perceives life as the only one that is meaningful, that has its clear boarders. And by allowing this existence of these limits it gives man everyday meaningful content, experience it intensively and to communicate immediately about its end, which is absolutely natural to life and inherently belongs. Only then, when we accept death as something given and unavoidable, we can help our loved ones who are in terminal phases and to allow them a peaceful leaving from their lives. Palliative medicine plays a great role in many dying men, helps men to cope with those situations which are already medical impractical.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"8 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000330","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70684232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2165-7386.1000345
M. Sarfraz, Sana Shaikh, S. A. Zaidi, A. Raees, Ahsan Ali Siddiqui, N. Jamil, A. Anwar
{"title":"Blood Pressure Levels and Urinary Frequency in Hypertensive Patients: A Cross-sectional Analysis","authors":"M. Sarfraz, Sana Shaikh, S. A. Zaidi, A. Raees, Ahsan Ali Siddiqui, N. Jamil, A. Anwar","doi":"10.4172/2165-7386.1000345","DOIUrl":"https://doi.org/10.4172/2165-7386.1000345","url":null,"abstract":"","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"08 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000345","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70684770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2165-7386.1000334
M. Silbermann, L. Baider, D. Respini, P. Tralongo, M. Daher, Rana F. Obeidat, N. Gafer, S. Fadhil, M. Rassouli, S. Cheli, A. Eniu, L. Balducci
The unprecedented wave of refugee migration from Africa and the Middle East to Europe presents major challenges to European health professionals and to society at large. A recent workshop which took place in Syracuse, Sicily, brought together physicians, nurses and psychologists and managers of governmental agencies from Italy, Lebanon, Israel, Iraq, Iran, Sudan, Tunisia, Jordan, and the European Society of Medical Oncology, aimed to create a training program to formulate a dialogue between professionals in their regions and refugees in Italy. A major barrier refugees face is a lack of communication (verbal and cultural) which hinders their smooth absorption into society. Cultural mediators who speak Arabic and Italian and understand the refugees’ faith, tradition and beliefs, are paramount to successfully building bridges between such diversities. Predictably, most asylum seekers undergo anxiety, fear, and depression after arriving in Europe. Following intensive deliberations, all workshop participants agreed that applying palliative care methodologies, as practiced in cancer patients, would be therapeutically advantageous in overcoming the psychological suffering that refugees experience during their initial stay in Europe. Accordingly, all agreed to start with training courses, both in refugees’ countries of origin and in Europe, for representatives or mediators (preferably with some clinical background and experience); whereby tremendous efforts would be made to create a working palliative care model that includes bio-psycho-social elements. This model or paradigm will employ a culturally sensitive approach that takes refugees’ spiritual needs into consideration, relying on core ethical principles.
{"title":"Palliative Care is a Useful Means to Overcome Intercultural Barriers Faced by Refugees in their New Host Countries","authors":"M. Silbermann, L. Baider, D. Respini, P. Tralongo, M. Daher, Rana F. Obeidat, N. Gafer, S. Fadhil, M. Rassouli, S. Cheli, A. Eniu, L. Balducci","doi":"10.4172/2165-7386.1000334","DOIUrl":"https://doi.org/10.4172/2165-7386.1000334","url":null,"abstract":"The unprecedented wave of refugee migration from Africa and the Middle East to Europe presents major challenges to European health professionals and to society at large. A recent workshop which took place in Syracuse, Sicily, brought together physicians, nurses and psychologists and managers of governmental agencies from Italy, Lebanon, Israel, Iraq, Iran, Sudan, Tunisia, Jordan, and the European Society of Medical Oncology, aimed to create a training program to formulate a dialogue between professionals in their regions and refugees in Italy. A major barrier refugees face is a lack of communication (verbal and cultural) which hinders their smooth absorption into society. Cultural mediators who speak Arabic and Italian and understand the refugees’ faith, tradition and beliefs, are paramount to successfully building bridges between such diversities. Predictably, most asylum seekers undergo anxiety, fear, and depression after arriving in Europe. Following intensive deliberations, all workshop participants agreed that applying palliative care methodologies, as practiced in cancer patients, would be therapeutically advantageous in overcoming the psychological suffering that refugees experience during their initial stay in Europe. Accordingly, all agreed to start with training courses, both in refugees’ countries of origin and in Europe, for representatives or mediators (preferably with some clinical background and experience); whereby tremendous efforts would be made to create a working palliative care model that includes bio-psycho-social elements. This model or paradigm will employ a culturally sensitive approach that takes refugees’ spiritual needs into consideration, relying on core ethical principles.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"8 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000334","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70684553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2165-7386.1000346
N. Salim, H. Hussain, M. Tuffaha, Raja Kathamuthu, A. Tamimi, Amna Abunawas Al Mehairi
{"title":"An Overview of Breast Cancer Epidemiology, Incidence and Trends from 2008-2016 in Dubai Hospital, Dubai Health Authority, Hospital-Based Cancer Registry 2018","authors":"N. Salim, H. Hussain, M. Tuffaha, Raja Kathamuthu, A. Tamimi, Amna Abunawas Al Mehairi","doi":"10.4172/2165-7386.1000346","DOIUrl":"https://doi.org/10.4172/2165-7386.1000346","url":null,"abstract":"","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"08 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000346","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70684861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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