Defining 'specialist palliative care.
ConclusionsAreas of connection were identified: clinicians from disease-specific specialties should be more involved in leading discussions on futile or burdensome treatment and providing care to people in their last months and days of life, in collaboration with specialists in palliative care when required.What is known about the topic?At present there is no evidence-based definition or agreement about what constitutes specialist palliative care (as opposed to palliative care delivered by non-specialists) in the Australian Capital Territory. An agreed definition is needed to effectively determine the workforce required and its clinical skill mix, and to clarify roles and expectations to mitigate risks in not adequately providing services to patients with life-limiting conditions.What does this paper add?This paper offers, for the first time, an evidence-based definition that distinguishes specialist palliative care from non-specialist palliative care. End of life care and bereavement support are not just the remit of specialist palliative care clinicians. Clinicians from beyond specialist palliative care should lead discussions about futile or burdensome treatment.What are the implications for practitioners?The findings of this study can facilitate implementation of palliative care strategies by enabling practitioners and patients to distinguish who should be delivering what care. PMID: 31248475 [PubMed - as supplied by publisher]
CONCLUSION: In order to optimise general outpatient palliative care, structural, legal and financial framework conditions need to be correspondingly adapted. PMID: 32059833 [PubMed - as supplied by publisher]
This study aimed to measure the quality of palliative care from the perspective of healthcare professionals at a tertiary hospital in Riyadh, Saudi Arabia. A cross-sectional survey was distributed to 80 healthcare professionals working at the palliative care department. The questionnaire assessed the dimensions that measure the quality of palliative care (Structure and Aspects of Care, Cultural Aspects of Care, Care of the Imminently Dying Patient, Ethical Issues), overall quality of care, ethical Processes of Care, Physical Aspects of Care, Psychological/Psychiatric Aspects dilemmas occurring in the practice setting, and ...
Authors: Haber PK, Sia D Abstract Biliary tract cancers (BTC), which include cholangiocarcinoma (both intra- and extrahepatic) and gallbladder, represent a heterogeneous group of malignancies with relatively low-incidence and poor prognosis. Therapeutic options for BTC patients at advanced stage are severely limited and palliative chemotherapy remains the maintreatment option. In the past decade, genome profiling via next-generation sequencing of large international cohorts has paved the way for precision oncology in BTC, identifying unique molecular subtypes, recurrent mutations, and genomic rearrangements. Target...
CONCLUSION: The increases in clinic utilization, total encounters, and interventions observed for the clinical pharmacy specialists suggest the beneficial role of pharmacy administrators' collaboration with clinical pharmacy specialists to improve workload capture and access to quality care, to justify clinical pharmacy services, and to identify opportunities for pharmacy clinical intervention. PMID: 32061094 [PubMed - as supplied by publisher]
Conditions: Care, Palliative; Respiratory Failure Interventions: Device: High Flow Nasal Cannula; Other: Standard respiratory support Sponsors: Hospital do Coracao; Ministry of Health, Brazil; Fisher and Paykel Healthcare Not yet recruiting
ConclusionRecurrent FGFR2 amplification was observed in roughly 4.0% of GC patients. High FGFR2 amplification was significantly associated with poor progression free survival and overall survival in GC patients. Clinical studies of FGFR2-directed therapies are warranted and should consider stratification by FGFR2 CNA.
Transcutaneous electrical nerve stimulation (TENS) is primarily used for pain, but might be useful for various other physical symptoms, including nausea, fatigue, dyspnea, and constipation. However, few studies have used TENS for treating the physical symptoms of patients with advanced cancer. In this crossover trial, we assess the effects of TENS on pain and other physical symptoms in 20 in-patients with advanced cancer receiving palliative care. For 5-day phases between wash out periods of 5 days, patients received TENS or non-TENS. TENS was delivered at four points: the center of the back for mainly nausea and dyspnea, ...
ConclusionThis technique is reliable and reproducible, giving good functional results and avoiding the radial deviation of the wrist in extension observed with traditional techniques.Level of evidenceIV.
Malignant pleural mesothelioma (MPM) is a rare, aggressive tumor originating from mesothelial cells. It is associated with exposure to asbestos, mainly occupational, rarely environmental or domestic. Diagnosis is usually made at an advanced stage because symptoms are non-specific and late. The management of this tumor is challenging and outcome is poor. Therapeutic strategies are mainly based on surgery with curative intent or palliative cytotoxic chemotherapy. Few patients are candidates for surgery which must necessarily take into account numerous factors (i.e.
ConclusionConcurrent radio- and/or chemotherapy in combination with surgery seems to result in improved survival in stage IVA/B ATC, whereas this is not the case in patients with stage IVC tumors. Novel treatment regimens are urgently needed to improve the dismal prognosis of ATC.