Māori: living and dying with cardiovascular disease in Aotearoa New Zealand

This article provides an informed perspective on cardiovascular disease (CVD) and palliative care need among Māori New Zealanders. High Māori CVD risk factors will contribute to a sharp increase in older Māori deaths which has implications for health and palliative care service provision. Recent findings CVD is New Zealand's leading cause of premature deaths and disability among Māori. A projected rise in older Māori deaths within the next 30 years will require increased palliative care. However, accessing palliative care and obtaining and understanding information can be challenging for families who are already often overburdened with high social and economic disadvantages. Meeting the high financial costs associated with end-of-life care make living with CVD challenging. Engaging with the health system's biomedical approach when holistic care is preferable can be a major barrier. Summary Māori families provide the bulk of care at end-of-life, but they can become fatigued with the challenges that accompany long-term progressive illnesses, such as CVD. They are also burdened by the financial costs associated with end-of-life. It is often difficult for Māori to access palliative care and to obtain and understand information about the illness and treatment. Navigating an unfamiliar and complex health system, low health literacy among Māori and poor relationship building and communication skills of health professionals are significant barriers. Cultural safety trai...
Source: Current Opinion in Supportive and Palliative Care - Category: Palliative Care Tags: CARDIAC AND CIRCULATORY PROBLEMS: Edited by James M. Beattie Source Type: research

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by Drew Rosielle (@drosielle)A Series of Observations on Opioids By a Palliative Doc Who Prescribes A Lot of Opioids But Also Has Questions.This is the 3rd post in a series about opioid, with a focus on how my thinking about opioids has changed over the years. See also:Part 1 – Introduction, General Disclaimers, Hand-Wringing, and a Hand-Crafted Graph.Part 2 – We Were Wrong 20 years Ago, Our Current Response to the Opioid Crisis is Wrong, But We Should Still Be Helping Most of our Long-Term Patients Reduce Their Opioid DosesThis is Part 3 – Opioids Have Ceiling Effects, High-Doses are Rarely Therapeutic, ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: opioids pain rosielle The profession Source Type: blogs
by Drew Rosielle (@drosielle)This is the second in a series of several posts about many aspects of my current thinking about opioids.The first post is here:Part 1 – Introduction, General Disclaimers, Hand-Wringing, and a Hand-Crafted Graph.Over-prescribing fueled the current drug overdose epidemic, and many of us who thought we were stamping out needless suffering contributed to the epidemic.A lot of what I read and believed about opioids early on in my career was wrong.I ’m old enough to remember those heady days in which there was a pretty large and ‘successful’ movement in American medicine to gr...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: opioids pain rosielle The profession Source Type: blogs
BACKGROUND Older trauma patients have increased risk of adverse in-hospital outcomes. We previously demonstrated that low preinjury Palliative Performance Scale (PPS) independently predicted poor discharge outcomes. We hypothesized that low PPS would predict long-term outcomes in older trauma patients. METHODS Prospective observational study of trauma patients aged ≥55 years admitted between July 2016 and April 2018. Preinjury PPS was assessed at admission; low PPS was defined as 70 or less. Primary outcomes were mortality and functional outcomes, measured by Extended Glasgow Outcome Scale (GOSE), at discharge and ...
Source: Journal of Trauma and Acute Care Surgery - Category: Surgery Tags: AAST 2018 PODIUM PAPER Source Type: research
Paediatric palliative care and neurodisability are two relatively new, evolving paediatric sub-specialities that have increasing relevance in the current paediatric landscape. For many people palliative care has been synonymous with end of life care, but in paediatrics it encompasses much more and is for all children with life-threatening or life-limiting conditions, from the point of diagnosis. This breadth of focus is demonstrated well through the interface between paediatric palliative care and paediatric neurodisability.
Source: Paediatrics and Child Health - Category: Pediatrics Authors: Tags: Symposium: special needs Source Type: research
Abstract Epilepsy surgery offers the chance of seizure remission for the 30%-40% of patients with focal epilepsy whose seizures continue despite anti-epileptic medications. Epilepsy surgery encompasses curative resective procedures, palliative techniques such as corpus callosotomy and implantation of stimulation devices. Pre-surgical evaluation aims to identify the epileptogenic zone and to prevent post-operative neurological and cognitive deficits. This entails optimal imaging, prolonged video-electroencephalogram (EEG) recordings, and neuropsychological and psychiatric assessments; some patients may then require...
Source: Practical Neurology - Category: Neurology Authors: Tags: Pract Neurol Source Type: research
We report a case of a patient with advanced cervical cancer who presented with uncontrollable pain, MDD, and a suicide attempt. RESULT: A 39-year-old woman diagnosed with cervical cancer stage IVB presented to the Emergency Department after a suicide attempt by hanging. Upon evaluation by the palliative care psychiatrist, she reported intense pain, unresponsive to analgesics, and had a history of persistent suicidal ideation. Antidepressant treatment was started (sertraline 50mg/d) after a single dose of ketamine hydrochloride IV (0.5 mg/kg) was administered. Treatment response was measured using the Brief Edinburgh D...
Source: Palliative and Supportive Care - Category: Palliative Care Authors: Tags: Palliat Support Care Source Type: research
Purpose of review Myofascial pain syndrome is a chronic pain condition characterized by the presence of myofascial trigger point, a hyperirritable painful spot involving a limited number of muscle fibers. The literature suggest that myofascial trigger points should be considered peripheral pain generators and this critical review will summarize recent findings concerning the clinical evaluation and the treatment of myofascial trigger points. Recent findings The clinical features of myofascial trigger points and their contribution to the patient pain and disability have been detailed in several recent studies, which su...
Source: Current Opinion in Supportive and Palliative Care - Category: Palliative Care Tags: MUSCULOSKELETAL PROBLEMS: Edited by Roberto Casale and Piercarlo Sarzi Source Type: research
Authors: Ndetei D, Musyimi C, Tele A, Musau A, Gitonga I, Mutiso V Abstract Studies conducted regarding cancer care have mainly focused on the management of physical conditions, with few studies assessing psychological well-being throughout illness course. This cross-sectional study (n = 389) examined the psychological well-being and social functioning of patients with cancer across cancer stages, among adult patients attending a cancer clinic at a public referral hospital in Kenya. Social and occupational functioning entails the ability to interact optimally with one's environments including work, so...
Source: Journal of Social Work in End-of-Life and Palliative Care - Category: Palliative Care Tags: J Soc Work End Life Palliat Care Source Type: research
CONCLUSION: Realistic and compassionate support of parents living with children with trisomy 13 and 18 is possible. Adversarial interactions that lead to distrust and conflicts can be avoided. Many supportive behaviors that inspire trust can be emulated. PMID: 31280664 [PubMed - as supplied by publisher]
Source: Palliative Medicine - Category: Palliative Care Authors: Tags: Palliat Med Source Type: research
Journal of Palliative Medicine, Ahead of Print.
Source: Journal of Palliative Medicine - Category: Palliative Care Authors: Source Type: research
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