Palliative care for all? How can Brazil develop a palliative care service founded on principles of equity and access for all?

We describe an existing model of practice in a primary care setting in Rio Grande in Brazil, which could act as a template for redesign of palliative care services. Recent findings Traditional models of palliative care have focussed on the physical, social, psychological and spiritual domains. Abel and Kellehear have proposed a new model, uniting specialist and generalist palliative care with compassionate communities and the civic component encapsulated in the compassionate city charter. This model is more comprehensive, emphasizing both harm reduction and health and well being promotion, and is currently being rolled out within the Family Health Strategy in Rio Grande in Brazil. Summary An existing model of palliative care, which includes the public health approach in Rio Grande be used as a basis for more equitable palliative care in Brazil, to meet a large unmet need.
Source: Current Opinion in Supportive and Palliative Care - Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone and Bridget Johnston Source Type: research

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This work describes a novel application of MR-guided online adaptive radiotherapy (MRgoART) in the management of patients whom urgent palliative care is indicated using statum-adaptive radiotherapy (STAT-ART). The implementation of STAT-ART, as performed at our institution, is presented including a discussion of the advantages and limitations compared to the standard of care for palliative radiotherapy on conventional c-arm linacs. MR-based treatment planning techniques of STAT-ART for density overrides and deformable image registration (DIR) of diagnostic CT to the treatment MR are also addressed.
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
ConclusionIncreasing patient age and caregiver ’s perceived spousal support may both have a positive effect on caregivers’ levels of depression. This can be utilized by clinicians in the process of empowering older patients and their spousal caregivers to confront the challenges of cancer treatment into advanced old age.
Source: Supportive Care in Cancer - Category: Cancer & Oncology Source Type: research
AbstractPurposeThe oldest old, described as those aged 85 and older, is a growing cancer population. There are limited studies evaluating the symptoms of the oldest old cancer patient population. Our study aimed to evaluate symptom frequency and clinical symptom change as assessed by the Edmonton Symptom Assessment System (ESAS) of the oldest old ( ≥ 85) compared to older adult (65–84) and general adult (18–64) outpatient cancer patients on initial consult and follow-up visit.MethodsRetrospective review of a total of 441 patients, 200 randomly sampled patients in the general and older adult group and ...
Source: Supportive Care in Cancer - Category: Cancer & Oncology Source Type: research
AbstractConstipation, one of the adverse effects of opioid therapy with a major impact on quality of life, is still an unmet need for cancer patients, particularly those with an advanced and progressive disease, and for non-cancer patients chronically treated with opioids. The awareness of this condition is poor among healthcare providers, despite the recent publication of guidelines and consensus conferences. An early multidisciplinary approach of opioid-induced bowel dysfunction (OIBD), based on available therapies of proven effectiveness, could support clinicians in managing this condition, thus increasing patients &rsq...
Source: Supportive Care in Cancer - Category: Cancer & Oncology Source Type: research
Conditions:   Cancer;   Palliative Radiotherapy Interventions:   Radiation: Lattice stereotactic body radiation therapy;   Procedure: Peripheral blood Sponsor:   Washington University School of Medicine Not yet recruiting
Source: - Category: Research Source Type: clinical trials
European migrant populations are aging and will increasingly be in need of palliative and end of life care. However, migrant patients are often underrepresented in palliative care research populations. This po...
Source: BMC Palliative Care - Category: Palliative Care Authors: Tags: Research article Source Type: research
ConclusionsThe study illustrates the many ways in which compassion can be shaped by context and highlights the role of teamwork in identifying gaps and lapses in compassion and responding in a way that supports patients, families, and colleagues.
Source: Journal of General Internal Medicine - Category: Internal Medicine Source Type: research
Hey, I recall reading something about a NICU attending letting a resident work on and keep a baby alive overnight... meanwhile the attending knew the patient was going to die. I had something similar happen in the adult world. It's infinitely easier to let go there on a 90 year old. I would have stopped care on this patient in their early 70's and had a palliative discussion. Instead, got re-intubated and then LVEF 5% from the 10% it was... for whatever that's worse. On massive doses of... Letting your fellow/resident work on someone despite probable futility...
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Critical Care Source Type: forums
Cachexia is a complex and multifactorial syndrome defined as severe weight loss and muscle wasting which frequently goes unrecognised in clinical practice [1]. It is a debilitating syndrome, resulting in patients...
Source: BMC Palliative Care - Category: Palliative Care Authors: Tags: Study protocol Source Type: research
ConclusionA new risk score system for patients with first recurrence of stage 4 neuroblastoma aged ≥18 months at diagnosis is proposed.
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: ORIGINAL RESEARCH Source Type: research
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