Steroids in spinal cord compression 85.36 KB

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Case Discussion

Use of steroids in spinal cord compression.

Submitted by: Balu Natarajan, M.D.
Chief Medical Officer, Seasons Hospice & Palliative Care. USA

Total Parenteral Nutrition 118.46 KB

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Case Discussion

Is it ever appropriate to give Total Parenteral Nutrition to a dying patient?

Submitted by: Balu Natarajan, M.D.
Chief Medical Officer, Seasons Hospice & Palliative Care. USA

Prison Hospice Backgrounder May 2018 297.02 KB

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Following is a representative sample of articles, reports, etc., on hospice and palliative care in the prison environment noted over the past five years (2013-2018) in the weekly report Media Watch.

1 Although a universal public health issue, it is in the United States that most
interest and attention has been afforded the aging and the terminal ill prison population. This backgrounder begins with twenty-plus articles by way of a broad overview of the issue, followed by additional articles, etc., (in descending order of publication) that offer a national and state-bystate overview. This is followed by a short list of articles, etc., on end-of-life care in the prison systems in Canada, the U.K., France, Poland and Australia. Added is a list of additional, selected resources.

Media Watch 572 544.41 KB

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Attached is the current issue (#572).

Of particular interest in this week's issue:

The hospice and palliative care advanced practice registered nurse workforce: Results of a national survey [in the U.S.]

JOURNAL OF HOSPICE & PALLIATIVE NURSING, 2018;20(4):349-357. One barrier to continued growth of palliative care (PC) is the shortage of qualified hospice and PC clinicians. Advanced practice registered nurses are an important part of the interdisciplinary PC team, and strengthening this workforce can help alleviate the shortage of clinicians and improve access to quality PC. However, there is a dearth of information about this workforce. The authors distributed an online survey between October 2016 and January 2017 and received 556 responses. Sixty-three percent had more than 20 years of experience as a registered nurse yet were newer to practice as a hospice and PC advanced practice nurse, with 53.8% having 0 to 5 years of experience in this role. Forty-one percent indicated that their traditional graduate educational preparation was insufficient in preparing them for their specialty role. Most indicated that they did not experience barriers to practice in their current position, but 7.3% identified significant issues. These results can inform future professional, educational, and regulatory efforts to support and develop the PC advanced practice registered nurse workforce.

How do experienced professors teach palliative medicine in European universities? A cross-case analysis of eight undergraduate educational programs

JOURNAL OF PALLIATIVE MEDICINE | Online – 9 July 2018 – In Europe in recent decades, university teaching of palliative medicine (PM) has evolved. In some countries it has been introduced as a compulsory subject in all medical schools, but in a majority of countries it remains an isolated subject at few universities. An intentional sample of eight university professors from Spain, France, U.K., Italy, Hungary, Sweden, Germany, and Poland was chosen. The introduction of PM in the universities depends on the existence of a favorable social and political context in relation to palliative care and the initiative of pioneers, trusted by students, to push this education forward. A PM curriculum frequently starts as an optional subject and becomes mandatory in a short period. In the reported universities, PM uses a wide variety of teaching methods, such as lectures, workshops, role-plays, and discussions. PM assessment included tests, discussions, reflections, portfolios, and research works. According to respondents' opinions, lack of recognition, funding, and accredited teachers, along with competition from other curricula, are the main barriers for PM teaching development at universities. The described cases may shed light on other medical schools to develop PM curricula.

Content validity of a conceptual model of a palliative approach

JOURNAL OF PALLIATIVE MEDICINE | Online – 9 July 2018 – The term “palliative approach” has emerged to connote healthcare activities provided consistent with the philosophy of palliative care (PC), but not limited to specialized care providers or settings. A rigorous understanding of the palliative approach requires a conceptual model, which links the philosophy of PC to specific actions of practitioners, and is applicable to patients with any life-threatening illness, at any point on the disease trajectory, and provided by any care provider in any setting. The authors propose a conceptual model asserting that a palliative approach exists when care simultaneously addresses whole-person needs, enhances quality of life, and acknowledges mortality. Nineteen definitions are identified [in a literature search]. The three domains were represented in the majority: 1) Whole-person care (17/19); 2) Quality-of-life focus (17/19); and, 3) Mortality acknowledgement (15/19). Published definitions also included other concepts, but only one of these (family within the unit of care) appeared in more than a few definitions. The proposed conceptual model bridges philosophical definitions and clinician behavior and has potential to inform broad implementation of a palliative approach, at both clinic and system levels.

Media Watch 571 529.20 KB

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Attached is the current issue of Media Watch (#571).

Of particular interest in this week's issue:

• The “lived experience” of palliative care patients in one acute hospital setting: A qualitative study
• How might organisational institutionalism support the challenges of the modern hospice?
• Responding to urgency of need: Initial qualitative stage in the development of a triage tool for use in palliative care services

Media Watch 570 466.11 KB

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Attached is the current issue of Media Watch (#570).

Of particular interest in this week's issue:

• Adequate, questionable, and inadequate drug prescribing for older adults at the end of life: A European expert consensus
• Using simulation modelling to test the impact of future demand for end-of-life care
• Re-framing global palliative care advocacy for the sustainable development goal era: A qualitative study of the views of international palliative care experts

Media Watch 569 499.76 KB

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Attached is the current issue of Media Watch (#569).

Of particular interest in this week's issue:

End-stage renal disease and hospice care in the U.S.: Are dialysis patients welcome?

Do medical students expect palliative care will be satisfying?

Advance decisions to refuse treatment: What GPs need to know

Media Watch 568 543.83 KB

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Attached is the current issue of Media Watch (#568)

Of particular interest in this week's issue:

When religion and medicine clash: Non-beneficial treatments and hope for a miracle

Palliative care: Who is responsible?

Media Watch 567 441.85 KB

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Attached is the current issue of Media Watch (#567).

Leadership in palliative medicine: Moral, ethical and educational

False hope with the Right to Try Act

Media Watch 566 548.72 KB

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Attached is the current issue of Media Watch (#566).

Of particular interest in this week's issue:

Palliative curriculum re-imagined: A critical evaluation of the U.K. Palliative Medicine syllabus

End-of-life decision making by family caregivers of persons with advanced dementia: A literature review of decision aids

We spend generously to extend lives of people with terminal illnesses – against the public’s wishes

Media Watch 565 421.06 KB

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Attached is the current issue of Media Watch (#565).

Of particular interest in this week's issue:

Centenarians’ end‐of‐life thoughts and plans: Is their social network on the same page?
Language used by health care professionals to describe dying at an acute care hospital
The colours and contours of compassion: A systematic review of the perspectives of compassion among ethnically diverse patients and healthcare providers

Media Watch 560 712.41 KB

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Attached is the current issue of Media Watch (#560).
Of particular interest in this week's issue:

Increasing information dissemination in cancer communication: Effects of using “palliative,” “supportive,” or “hospice” care terminology

Medical assistance in dying: A paediatric perspective

The involvement of cancer patients in the four stages of decision-making preceding continuous sedation until death: A qualitative study

Media Watch 555 501.64 KB

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Attached is the current issue of Media Watch (#555).

Of particular interest in this week's issue:

Can the ethical best practice of shared decision-making lead to moral distress?

Media Watch 556 469.68 KB

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Attached is the current issue of Media Watch (#556).

Of particular interest in this week's issue:

Evaluating palliative care resources available to the public using the Internet and social media

Media Watch 557 506.60 KB

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Attached is the current issue of Media Watch (#557).

Of particular interest in this week's issue

Value-impregnated factual claims may undermine medical decision-making