Pub Date : 2018-01-01DOI: 10.4172/2165-7386.1000e141
K. Mehta, Rinal Parikh
Palliation is a term that has emerged in modern medicine over the last century. Derived from the Latin word “palliat”, palliation notably masks a person’s pain. The standard definition of palliative care given by WHO (World Health Organization) is “Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening diseases, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual” [1].
{"title":"Palliative Care and Universal Health Coverage: Don't Leave those Suffering Behind","authors":"K. Mehta, Rinal Parikh","doi":"10.4172/2165-7386.1000e141","DOIUrl":"https://doi.org/10.4172/2165-7386.1000e141","url":null,"abstract":"Palliation is a term that has emerged in modern medicine over the last century. Derived from the Latin word “palliat”, palliation notably masks a person’s pain. The standard definition of palliative care given by WHO (World Health Organization) is “Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening diseases, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual” [1].","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"8 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000e141","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70686387","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: 10.4172/2165-7386.1000325
T. Bharani, Y. Li, I. Helmy, L. Menon, Arachchige Sm, M. Soliman, Y. Wen, K. Silla, Y. Othman, G. Sadek, A. Bashir, H. Eltahir, Saad Jobran Eziada, A. Allam, A. Hassan
With the increase of geriatric population, there is rise in demand for services aimed at improving end-of-life care. Palliative care, through its five-component approach, focuses on improving the quality of life and provide relief from complications of serious illnesses. Although a widely accepted concept in other parts of the world, palliative care is a relatively new concept in the Middle East, having been initiated in Qatar only in 2008. The paper discusses the development of palliative care program in Qatar from its initiation in 2008 to its development until 2016, and aims to delineate a stepwise approach for establishment of a successful palliative care program elsewhere, especially in the Middle East, through the model used in Qatar. Primary research data was obtained through analysis of patient demographics and interviews, and secondary data was attained through literature review using PubMed, CINAHL and Google Scholar respectively. Through its multi-faceted approach, aligning with the national health strategy, meeting the rising demands of Qatar’s population, involving a multi-disciplinary team, focusing on education and research, palliative care in Qatar has established a successful model. It is the first one in the region to get Joint Commission International accreditation, thus aligning in par with the international standards and is striving to meet the emerging needs of Qatar’s population and uphold its title as a successful model.
{"title":"Palliative Care in Qatar, 2008-2016","authors":"T. Bharani, Y. Li, I. Helmy, L. Menon, Arachchige Sm, M. Soliman, Y. Wen, K. Silla, Y. Othman, G. Sadek, A. Bashir, H. Eltahir, Saad Jobran Eziada, A. Allam, A. Hassan","doi":"10.4172/2165-7386.1000325","DOIUrl":"https://doi.org/10.4172/2165-7386.1000325","url":null,"abstract":"With the increase of geriatric population, there is rise in demand for services aimed at improving end-of-life care. Palliative care, through its five-component approach, focuses on improving the quality of life and provide relief from complications of serious illnesses. Although a widely accepted concept in other parts of the world, palliative care is a relatively new concept in the Middle East, having been initiated in Qatar only in 2008. The paper discusses the development of palliative care program in Qatar from its initiation in 2008 to its development until 2016, and aims to delineate a stepwise approach for establishment of a successful palliative care program elsewhere, especially in the Middle East, through the model used in Qatar. Primary research data was obtained through analysis of patient demographics and interviews, and secondary data was attained through literature review using PubMed, CINAHL and Google Scholar respectively. Through its multi-faceted approach, aligning with the national health strategy, meeting the rising demands of Qatar’s population, involving a multi-disciplinary team, focusing on education and research, palliative care in Qatar has established a successful model. It is the first one in the region to get Joint Commission International accreditation, thus aligning in par with the international standards and is striving to meet the emerging needs of Qatar’s population and uphold its title as a successful model.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"8 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000325","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70683955","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: 10.4172/2165-7386.1000338
K. Wonders
Background: Cancer and its associated treatments often result in long-term physical and psychological side effects that negatively impact the cancer survivor's quality of life. In addition, the financial costs of cancer are substantial and are projected to reach $158 billion by the year 2020. Research indicates that endurance exercise training is helpful in attenuating the deleterious effects of cancer treatments by increasing survival, attenuating myocardial lesions and myocyte disarray, increasing levels of antioxidants, decreasing lipid peroxidation induced by oxidative stress and markers of apoptosis, and preserving cardiac function. However, nationally less than 5% of patients are ever referred to a cancer rehabilitation exercise program. Cost is a barrier to these programs, as they often are not reimbursable under most insurance plans. Purpose: Therefore, the purpose of this investigation was to determine if exercise training during cancer treatment helped to minimize side effects and reduce health care costs. Specifically, treatment tolerance, length of hospital stay, hospital readmits, ER visits, and treatment compliance were measured. Methods: This was a retrospective, two-group study which ascertained the protective effect of an exercisetraining program during cancer treatment. All oncology patients who received cancer treatment at Kettering Medical Center in Dayton, Ohio between January-December 2016 were identified by office staff. Their medical records were pulled and patients were placed in one of two groups: those who exercised during treatment, and those who remained sedentary. The medical records were reviewed to determine outcome data for length of hospital stays, hospital readmits, ER visits, treatment compliance, fatigue, and anxiety/depression related to oncology conditions. The age range of the patients was 21-93 years. Patients were excluded if they had pre-existing cardiac, liver, and bone marrow conditions prior to treatment. Individuals in the exercise group (EX, n=672) completed 12 weeks of prescribed, individualized exercise that included cardiovascular, strength training, and flexibility components. The intensity level for the cardiovascular exercise ranged from 30%-45% of the individual’s predicted VO2max. The strength training involved a full body workout, with emphasis on all major muscle groups. Individuals in the sedentary group (SED, n=728) did not participate in an exercise program during treatment. Results: Patients in the EX group had significantly lower reports of fatigue, pain, and cardiac problems (p<0.05), as well as fewer notes of depression and anxiety than their SED group counterparts. In addition, the EX group tolerated their treatment significantly better than the SED group (p<0.05). Finally, the EX group had a significantly lower number of ER visits (EX=2, SED=14, p<0.05), 30-day readmits (EX=2, SED=53, p<0.05) as well as a shorter length of stay (EX=0.75, SED=3 p<0.05). Conclusion: Results from
{"title":"Supervised, Individualized Exercise Programs Help Mitigate Costs during Cancer Treatment","authors":"K. Wonders","doi":"10.4172/2165-7386.1000338","DOIUrl":"https://doi.org/10.4172/2165-7386.1000338","url":null,"abstract":"Background: Cancer and its associated treatments often result in long-term physical and psychological side effects that negatively impact the cancer survivor's quality of life. In addition, the financial costs of cancer are substantial and are projected to reach $158 billion by the year 2020. Research indicates that endurance exercise training is helpful in attenuating the deleterious effects of cancer treatments by increasing survival, attenuating myocardial lesions and myocyte disarray, increasing levels of antioxidants, decreasing lipid peroxidation induced by oxidative stress and markers of apoptosis, and preserving cardiac function. However, nationally less than 5% of patients are ever referred to a cancer rehabilitation exercise program. Cost is a barrier to these programs, as they often are not reimbursable under most insurance plans. Purpose: Therefore, the purpose of this investigation was to determine if exercise training during cancer treatment helped to minimize side effects and reduce health care costs. Specifically, treatment tolerance, length of hospital stay, hospital readmits, ER visits, and treatment compliance were measured. Methods: This was a retrospective, two-group study which ascertained the protective effect of an exercisetraining program during cancer treatment. All oncology patients who received cancer treatment at Kettering Medical Center in Dayton, Ohio between January-December 2016 were identified by office staff. Their medical records were pulled and patients were placed in one of two groups: those who exercised during treatment, and those who remained sedentary. The medical records were reviewed to determine outcome data for length of hospital stays, hospital readmits, ER visits, treatment compliance, fatigue, and anxiety/depression related to oncology conditions. The age range of the patients was 21-93 years. Patients were excluded if they had pre-existing cardiac, liver, and bone marrow conditions prior to treatment. Individuals in the exercise group (EX, n=672) completed 12 weeks of prescribed, individualized exercise that included cardiovascular, strength training, and flexibility components. The intensity level for the cardiovascular exercise ranged from 30%-45% of the individual’s predicted VO2max. The strength training involved a full body workout, with emphasis on all major muscle groups. Individuals in the sedentary group (SED, n=728) did not participate in an exercise program during treatment. Results: Patients in the EX group had significantly lower reports of fatigue, pain, and cardiac problems (p<0.05), as well as fewer notes of depression and anxiety than their SED group counterparts. In addition, the EX group tolerated their treatment significantly better than the SED group (p<0.05). Finally, the EX group had a significantly lower number of ER visits (EX=2, SED=14, p<0.05), 30-day readmits (EX=2, SED=53, p<0.05) as well as a shorter length of stay (EX=0.75, SED=3 p<0.05). Conclusion: Results from","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/10.4172/2165-7386.1000338","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70684389","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 : 2017-12-07DOI: 10.4172/2165-7386-C2-018
Heeok Park
Tau protein accumulation is the most common pathology among degenerative brain diseases, including Alzheimer9s disease (AD), progressive supranuclear palsy (PSP), traumatic brain injury (TBI) and over twenty others. Tau-containing neurofibrillary tangle (NFT) accumulation is the closest correlate with cognitive decline and cell loss, yet the mechanisms mediating tau toxicity are poorly understood. NFT-containing neurons do not die, which suggests secondary mechanisms are driving toxicity. We evaluated gene expression patterns of NFT-containing neurons microdissected from AD patient brains and found they develop an expression profile consistent with cellular senescence described in dividing cells. This complex stress response induces a near permanent cell cycle arrest, adaptations to maintain survival, cellular remodeling, and metabolic dysfunction. Moreover, senescent cells induce chronic degeneration of surrounding tissue through the secretion of pro-inflammatory, pro-apoptotic molecules termed the senescence-associated secretory phenotype (SASP). Using transgenic mouse models of tau-associated pathogenesis we found that NFTs induced a senescence-like phenotype including DNA damage, karyomegaly, mitochondrial dysfunction and SASP. Cdkn2a transcript level, a hallmark measure of senescence, directly correlated with brain atrophy and NFT load. This relationship extended to postmortem brain tissue from humans with PSP to indicate a phenomenon common to tau toxicity. Tau transgenic mice with late stage pathology were treated with senolytics to remove senescent cells. Despite the advanced age and disease progression, senolytic treatment reduced total NFT burden, neuron loss and ventricular enlargement; and normalized cerebral blood flow to that of non-transgenic control mice. Collectively, these findings indicate that NFTs induce cellular senescence in the brain, which contributes to neurodegeneration and brain dysfunction. Moreover, given the prevalence of tau protein deposition among neurodegenerative diseases, these findings have broad implications for understanding, and potentially treating, dozens of brain diseases.
{"title":"The effects of aroma therapy on agitation in patients with dementia: A systematic review and meta-analysis","authors":"Heeok Park","doi":"10.4172/2165-7386-C2-018","DOIUrl":"https://doi.org/10.4172/2165-7386-C2-018","url":null,"abstract":"Tau protein accumulation is the most common pathology among degenerative brain diseases, including Alzheimer9s disease (AD), progressive supranuclear palsy (PSP), traumatic brain injury (TBI) and over twenty others. Tau-containing neurofibrillary tangle (NFT) accumulation is the closest correlate with cognitive decline and cell loss, yet the mechanisms mediating tau toxicity are poorly understood. NFT-containing neurons do not die, which suggests secondary mechanisms are driving toxicity. We evaluated gene expression patterns of NFT-containing neurons microdissected from AD patient brains and found they develop an expression profile consistent with cellular senescence described in dividing cells. This complex stress response induces a near permanent cell cycle arrest, adaptations to maintain survival, cellular remodeling, and metabolic dysfunction. Moreover, senescent cells induce chronic degeneration of surrounding tissue through the secretion of pro-inflammatory, pro-apoptotic molecules termed the senescence-associated secretory phenotype (SASP). Using transgenic mouse models of tau-associated pathogenesis we found that NFTs induced a senescence-like phenotype including DNA damage, karyomegaly, mitochondrial dysfunction and SASP. Cdkn2a transcript level, a hallmark measure of senescence, directly correlated with brain atrophy and NFT load. This relationship extended to postmortem brain tissue from humans with PSP to indicate a phenomenon common to tau toxicity. Tau transgenic mice with late stage pathology were treated with senolytics to remove senescent cells. Despite the advanced age and disease progression, senolytic treatment reduced total NFT burden, neuron loss and ventricular enlargement; and normalized cerebral blood flow to that of non-transgenic control mice. Collectively, these findings indicate that NFTs induce cellular senescence in the brain, which contributes to neurodegeneration and brain dysfunction. Moreover, given the prevalence of tau protein deposition among neurodegenerative diseases, these findings have broad implications for understanding, and potentially treating, dozens of brain diseases.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"08 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70691739","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 : 2017-11-07DOI: 10.4172/2165-7386.1000323
B. Tan, Ying Li Toh, Y. P. Toh, R. Kanesvaran, L. Krishna
A shortage of trained mentors in Palliative Medicine has inspired efforts to employ near peer, peer and group (NPG) mentoring to supplement traditional novice mentoring or mentoring between senior clinicians and junior doctors and or medical students as a means of ensuring that holistic support is available to mentees in a timely, appropriate and personalised manner. Scrutiny of prevailing data on NPG mentoring however, reveals significant gaps in understanding and practice of NPG mentoring that has precipitated conflation with preceptorship, rolemodeling, sponsorship, supervision and counseling. A failure to consider mentoring's evolving, goal-sensitive, context-specific and relational, mentee, mentor and organizational-dependent process nature has further limited available NPG mentoring research. This review seeks to advance a clinically-relevant understanding of NPG mentoring that will help delineate the practice of NPG mentoring and potentially see it blended with novice mentoring. Methods: The literature search on NPG mentoring in internal medicine was performed on publications across Embase, PsycINFO, ERIC, PubMed, Medline and Scopus databases for articles published between January 2000 to December 2015. The BEME guide and STORIES statement were used to develop a narrative. Results: 1456 citations were reviewed, 8 full text of articles were included and 4 themes were identified through thematic analysis including definitions and descriptions, the structure, the benefits and the obstacles to NPG mentoring. Conclusions: These themes allow for the first evidenced based definition of NPG mentoring. In proffering a means to blending NPG mentoring with novice mentoring, the data suggests the need for effective mentor and mentee training and a flexible structure to the mentoring process that will cater for changes in the evolving relationships but allow effective oversight of the process. Key to this blending process is also maintenance of a social and friendly atmosphere underlining the importance of mentoring environments and highlighting areas for future research.
{"title":"Extending Mentoring in Palliative Medicine-Systematic Review on Peer, Near-Peer and Group Mentoring in General Medicine","authors":"B. Tan, Ying Li Toh, Y. P. Toh, R. Kanesvaran, L. Krishna","doi":"10.4172/2165-7386.1000323","DOIUrl":"https://doi.org/10.4172/2165-7386.1000323","url":null,"abstract":"A shortage of trained mentors in Palliative Medicine has inspired efforts to employ near peer, peer and group (NPG) mentoring to supplement traditional novice mentoring or mentoring between senior clinicians and junior doctors and or medical students as a means of ensuring that holistic support is available to mentees in a timely, appropriate and personalised manner. Scrutiny of prevailing data on NPG mentoring however, reveals significant gaps in understanding and practice of NPG mentoring that has precipitated conflation with preceptorship, rolemodeling, sponsorship, supervision and counseling. A failure to consider mentoring's evolving, goal-sensitive, context-specific and relational, mentee, mentor and organizational-dependent process nature has further limited available NPG mentoring research. This review seeks to advance a clinically-relevant understanding of NPG mentoring that will help delineate the practice of NPG mentoring and potentially see it blended with novice mentoring. \u0000Methods: The literature search on NPG mentoring in internal medicine was performed on publications across Embase, PsycINFO, ERIC, PubMed, Medline and Scopus databases for articles published between January 2000 to December 2015. The BEME guide and STORIES statement were used to develop a narrative. \u0000Results: 1456 citations were reviewed, 8 full text of articles were included and 4 themes were identified through thematic analysis including definitions and descriptions, the structure, the benefits and the obstacles to NPG mentoring. \u0000Conclusions: These themes allow for the first evidenced based definition of NPG mentoring. In proffering a means to blending NPG mentoring with novice mentoring, the data suggests the need for effective mentor and mentee training and a flexible structure to the mentoring process that will cater for changes in the evolving relationships but allow effective oversight of the process. Key to this blending process is also maintenance of a social and friendly atmosphere underlining the importance of mentoring environments and highlighting areas for future research.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"7 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2017-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000323","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43959271","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 : 2017-09-29DOI: 10.4172/2165-7386.1000322
Marie Joseph
{"title":"Palliative Care - A Noble and Holistic Specialty","authors":"Marie Joseph","doi":"10.4172/2165-7386.1000322","DOIUrl":"https://doi.org/10.4172/2165-7386.1000322","url":null,"abstract":"","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"07 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41678751","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 : 2017-09-25DOI: 10.4172/2165-7386.1000321
C. Gutierrez
Our published single-center cohort study determined the outcomes of out-of-hospital transfer of cancer patients to the Intensive Care Unit (ICU) at MD Anderson Cancer Center [1]. In this three year study 228 patients were transferred for further care to our ICU from outside hospitals all over the country. Surprisingly, and contrary to what was reported in the literature, we observed that transferring critically ill oncological patients to a specialized center did not lead to worse outcomes or increased resource utilization [1].
{"title":"Out-of-Hospital Transfers: When the Intention is not to Cure","authors":"C. Gutierrez","doi":"10.4172/2165-7386.1000321","DOIUrl":"https://doi.org/10.4172/2165-7386.1000321","url":null,"abstract":"Our published single-center cohort study determined the outcomes of out-of-hospital transfer of cancer patients to the Intensive Care Unit (ICU) at MD Anderson Cancer Center [1]. In this three year study 228 patients were transferred for further care to our ICU from outside hospitals all over the country. Surprisingly, and contrary to what was reported in the literature, we observed that transferring critically ill oncological patients to a specialized center did not lead to worse outcomes or increased resource utilization [1].","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000321","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48330429","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 : 2017-09-16DOI: 10.4172/2165-7386.1000319
P. Genovese, J. Tobias, A. Kundu
Dexmedetomidine, a central and peripheral alpha-2 receptor agonist approved by the FDA for the use in patients 18 years old and older, it has been increasingly used in the pediatric population for sedation and analgesia due to its advantage of minimal respiratory depression and lack of abuse/dependence. This is a case report of a successful use of dexmedetomidine in an infant for 15 weeks achieving; symptom control, reduction in the dose of opioids and benzodiazepines by 50% and a safe transition to oral equivalents.
{"title":"Prolonged Use of Dexmedetomidine Infusion in an Infant for Sedation as Adjuvant Therapy","authors":"P. Genovese, J. Tobias, A. Kundu","doi":"10.4172/2165-7386.1000319","DOIUrl":"https://doi.org/10.4172/2165-7386.1000319","url":null,"abstract":"Dexmedetomidine, a central and peripheral alpha-2 receptor agonist approved by the FDA for the use in patients \u0000 18 years old and older, it has been increasingly used in the pediatric population for sedation and analgesia due to its \u0000 advantage of minimal respiratory depression and lack of abuse/dependence. This is a case report of a successful \u0000 use of dexmedetomidine in an infant for 15 weeks achieving; symptom control, reduction in the dose of opioids and \u0000 benzodiazepines by 50% and a safe transition to oral equivalents.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7386.1000319","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43164941","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 : 2017-09-14DOI: 10.4172/2165-7386-C1-012
R. Gilroy
Background: There have been numerous anecdotal reports from doctors in East Sussex Healthcare Trust (ESHT) about the difficulties in discussing escalation and resuscitation with patients. We feel the wording of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) is negative and detrimental to these discussions. The Gold Standard Framework and the GMC recognise an alternative wording: Allow Natural Death. Our project was looking to change the wording of these forms to Allow Natural Death (Do Not Attempt Cardiopulmonary Resuscitation) in an effort to improve this difficult conversation.
{"title":"FUTURE HOMES: FUSING RESPONSES TO AGEING, SUSTAINABILITY AND DIGITAL INNOVATION IN NEW HOUSING MODELS","authors":"R. Gilroy","doi":"10.4172/2165-7386-C1-012","DOIUrl":"https://doi.org/10.4172/2165-7386-C1-012","url":null,"abstract":"Background: There have been numerous anecdotal reports from doctors in East Sussex Healthcare Trust (ESHT) about the difficulties in discussing escalation and resuscitation with patients. We feel the wording of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) is negative and detrimental to these discussions. The Gold Standard Framework and the GMC recognise an alternative wording: Allow Natural Death. Our project was looking to change the wording of these forms to Allow Natural Death (Do Not Attempt Cardiopulmonary Resuscitation) in an effort to improve this difficult conversation.","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70691496","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 : 2017-09-13DOI: 10.4172/2165-7386-C1-010
M. Rosenkoetter
{"title":"A PSYCHOSOCIAL INSTRUMENT TO ASSESS WELL ELDERLY RESIDING IN PRIVATIZED, RESIDENTIAL RETIREMENT COMMUNITIES","authors":"M. Rosenkoetter","doi":"10.4172/2165-7386-C1-010","DOIUrl":"https://doi.org/10.4172/2165-7386-C1-010","url":null,"abstract":"","PeriodicalId":91127,"journal":{"name":"Journal of palliative care & medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70690897","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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