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PC-FACS January 3, 2018
Table of Contents (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 10, 2018 Category: Palliative Care Authors: Andie Bernard Source Type: research

Communication Disparity between Bereaved and Others: What Hurts Them and What is Unhelpful? – A Nationwide Study of the Cancer Bereaved
The importance of communication between the cancer bereaved and others has been emphasized, but little is known about the more problematic aspects of this communication such as “unhelpful communication”. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 9, 2018 Category: Palliative Care Authors: EMayumi Ishida, Hideki Onishi, Tatsuya Morita, Yosuke Uchitomi, Megumi Shimizu, Satoru Tsuneto, Yasuo Shima, Mitsunori Miyashita Tags: Original Article Source Type: research

Author ’s Response
We thank the reader for pointing out this important issue in our previous meta-analysis. [1] We wish to clarify that we have included both Michna et al [2] and Iyer et al [3] albeit being the same study because one of the secondary outcomes in the meta-analysis is “change in pain scores” and the data for this outcome was provided only by the latter article. We have not included the data from latter study for assessment of any other outcomes. Similarly, Thomas et al [4] and Chamberlain et al [5] although are the same studies, the data on another secondary outcome, “Time to achieve rescue free bowel movemen...
Source: Journal of Pain and Symptom Management - January 9, 2018 Category: Palliative Care Authors: kannan sridharan Source Type: research

Possible redundant data in the network meta-analysis of pharmacological therapies for opioid-induced constipation
We read with great interest the recent systematic review and network meta-analysis by Sridharan and Sivaramakrishnan, (1) which synthesised data from 23 separate articles reporting randomised controlled trials (RCTs) of pharmacological therapies for opioid-induced constipation (OIC). After pooling and analysing the results from these articles, the authors concluded that subcutaneous methylnaltrexone performed better than other medications for OIC. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 6, 2018 Category: Palliative Care Authors: Nicholas E. Burr, Alexander C. Ford Source Type: research

Nonpharmacologic Interventions for Improving Sleep Disturbances In Patients with Lung Cancer: A Systematic Review and Meta-Analysis
Lung cancer patients suffer from higher levels of sleep disturbances compared to other cancer patients and this leads to greater distress, poorer function and lower quality of life. Nonpharmacologic interventions have demonstrated improvements in the context of breast cancer but their efficacy in the lung cancer population is unclear. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 5, 2018 Category: Palliative Care Authors: Dimitrios Papadopoulos, Apostolos Papadoudis, Maria Kiagia, Konstantinos Syrigos Source Type: research

Implementing Routine Palliative Care Consultation Prior to LVAD Implantation: A Single Center Experience
Left-ventricular assist devices (LVADs) are increasingly used to improve quality of life for end-stage heart failure patients. The Joint Commission now requires pre-implantation palliative care assessment, however many palliative care teams have little experience providing this service. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 4, 2018 Category: Palliative Care Authors: Say Salomon, Hilary Frankel, Elizabeth Chuang, Serife Eti, Peter Selwyn Source Type: research

A Systematic Review of Palliative Care Intervention Outcomes and Outcome Measures in Low Resource Countries
This study was conducted to synthesize the current evidence to guide future programmatic and research efforts. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 2, 2018 Category: Palliative Care Authors: Maryellen Potts, Kathleen B. Cartmell, Lynne Nemeth, Gautam Bhattacharjee, Suparna Qanungo Source Type: research

“I’d recommend ...” How to incorporate your recommendation into shared decision making for patients with serious illness
We describe an expert approach to formulating a recommendation using a shared decision making framework. We offer three steps to formulating a recommendation: (1) evaluate the prognosis and treatment options; (2) understand the range of priorities that are important to your patient given the prognosis; and (3) base your recommendation on the patient ’s priorities most compatible with the likely prognosis and available treatment options. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 2, 2018 Category: Palliative Care Authors: Juliet Jacobsen, Craig Blinderman, Corinne Alexander, Vicki Jackson Tags: Special Article Source Type: research

Factors associated with symptom relief in end-of-life care in residential care homes; a national register-based study
Residential care homes (RCHs) are a common place of death. Previous studies have reported a high prevalence of symptoms such as pain and shortness of breath among residents in the last week of life. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 2, 2018 Category: Palliative Care Authors: Sofia Andersson, Kristofer Årestedt, Olav Lindqvist, Carl-Johan Fürst, Margareta Brännström Source Type: research

The structure of the FACT-Cog v3 in cancer patients, students, and older adults
The FACT-Cog version 3 questionnaire is designed to assess perceived cognitive function and impact on quality of life in cancer patients. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 29, 2017 Category: Palliative Care Authors: Daniel S.J. Costa, Vanessa Loh, Damian P. Birney, Haryana H. Dhillon, Joanna E. Fardell, Danielle Gessler, Janette L. Vardy Source Type: research

Accurate prognostic awareness facilitates, whereas better quality of life and more anxiety symptoms hinder end-of-life care discussions: a longitudinal survey study in terminally ill cancer patients ’ last six months of life
Terminally ill cancer patients do not engage in end-of-life (EOL)-care discussions or do so only when death is imminent, despite guidelines for EOL-care discussions early in their disease trajectory. Most studies on patient-reported EOL-care discussions are cross-sectional without exploring the evolution of EOL-care discussions as death approaches. Cross-sectional studies cannot determine the direction of association between EOL-care discussions and patients ’ prognostic awareness, psychological well-being, and quality of life (QOL). (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 28, 2017 Category: Palliative Care Authors: Siew Tzuh Tang, Chen Hsiu Chen, Fur-Hsing Wen, Jen-Shi Chen, Wen-Cheng Chang, Chia-Hsun Hsieh, Wen-Chi Chou, Ming-Mo Hou Source Type: research

Current Best Practices for Sexual and Gender Minorities in Hospice and Palliative Care Settings
This article provides a brief overview of issues pertaining to SGMs in HPC settings, highlighting gaps in knowledge and research. Current and best practices for SGM individuals and their families in HPC settings are described, as are recommendations for improving the quality of such care. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 27, 2017 Category: Palliative Care Authors: S. Maingi, A. Bagabag, S. O ’Mahony Tags: Review Article Source Type: research

A novel screening method to identify late-stage dementia patients for palliative care research and practice
Investigators need novel methods for timely identification of patients with serious illness to test or implement new palliative care models. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 27, 2017 Category: Palliative Care Authors: Natalie C. Ernecoff, Kathryn L. Wessell, Stacey Gabriel, Timothy S. Carey, Laura C. Hanson Source Type: research

Diuretics combined with compression in resistant limb edema of advanced disease – a case series report
The extremity edema of advanced disease is a common, multifactorial feature, which impairs patient activities and quality of life. The most frequently chosen management is based on combined decongestive physiotherapy or pharmacotherapy (with diuretics or steroids). Subcutaneous lymphatic drainage in refractory edema may decrease the swelling, prevent spontaneous lymphorrhoea but also increase the risk of infection. Safe and effective conservative management in diuretics resistant edemas is lacking. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 27, 2017 Category: Palliative Care Authors: Tomasz Gradalski Source Type: research

Family caregivers ’ reflections on experiences of assisted suicide in Switzerland: a qualitative interview study
Thousands of family members worldwide are annually involved in assisted dying. Family participation in assisted dying has rarely been investigated and families ’ needs typically are not considered in assisted dying legislation and clinical guidelines. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 27, 2017 Category: Palliative Care Authors: C. Gamondi, M. Pott, N. Preston, S. Payne Source Type: research

Distributive Justice: An Ethical Priority in Global Palliative Care
Providing care to cancer patients in resource-poor settings often demands complex trade-offs regarding resource allocation. It is estimated that over 60% of all cancer deaths worldwide occur in low- and middle-income countries (LMICs), where channels to care and appropriate symptom management interventions are overstressed or obsolete. Concepts of distributive justice underlie much of global health policy. As appetites for expanding global palliative care services increase so do questions of fair and culturally appropriate distribution. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 27, 2017 Category: Palliative Care Authors: Rachel A. Hadler, William E. Rosa Source Type: research

Development and Assessment of a Measure of Parent and Child Needs in Pediatric Palliative Care
Pediatric palliative care has no evidence-based needs assessment measure. The Parent and Child Needs Survey (PCNeeds) is a new instrument designed to assess the needs of children in palliative care, including children receiving end-of-life care, and their families. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 27, 2017 Category: Palliative Care Authors: James P. Donnelly, Kim Downing, Jason Cloen, Patricia Fragen, Alyssa W. Gupton, Jen Misasi, Kelly Michelson Source Type: research

Promoting LGBTQ Inclusivity in Palliative Care
When I first published my research on the perspectives of the lesbian and gay community regarding end-of-life care, advance care planning, and disclosure of sexual orientation a decade and a half ago,1,2 there was little awareness of the unique concerns and experiences of this community, or the importance of cultural proficiency in serving these individuals in palliative care settings. With growing interest in addressing the health needs and disparities among diverse cultural and demographic populations, it has been increasingly common for professional articles, conference presentations, and clinical guidelines to consider...
Source: Journal of Pain and Symptom Management - December 23, 2017 Category: Palliative Care Authors: Gary L. Stein Tags: Book Review Source Type: research

In defence of sympathy, in consideration of empathy, and in praise of compassion: A history of the present
“History is the best medicine for a sick mind, for in history you have a record of the infinite variety of human experience plainly set out for all to see, and in that record you can find for yourself and your country both examples and warnings: fine things to take as models, base things rotten th rough and through to avoid”Livy, Roman Historian (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 21, 2017 Category: Palliative Care Authors: Ana Soto-Rubio, Shane Sinclair Source Type: research

Developing a healing environment for broken souls of patients with life-threatening illnesses and their caregivers
What a privilege it is to be able to touch those sacred spaces in the soul of each person that we encounter every day. Patients with life-threatening illnesses can struggle with physical, emotional, and existential and spiritual concerns and the suffering of caregivers. A key goal of our supportive and palliative care teams is to alleviate patient and caregiver suffering. When caring for patients with advanced and terminal illness the spirituality of each member of the palliative care team becomes a single collective spirituality or soul with common goals, values, and belonging, with a main goal of providing the best care ...
Source: Journal of Pain and Symptom Management - December 16, 2017 Category: Palliative Care Authors: Marvin Omar Delgado-Guay Tags: Special Article Source Type: research

Editorial Board
(Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 15, 2017 Category: Palliative Care Source Type: research

Table of Contents
(Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 15, 2017 Category: Palliative Care Source Type: research

Opioids in the treatment of pain. Beliefs, knowledge, and attitudes of the general Spanish population. Identification of subgroups through cluster analysis
A lack of information has been found related to patients ’ perception towards pain management. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 15, 2017 Category: Palliative Care Authors: Helena de Sola, Alejandro Salazar, Mar ía Dueñas, Inmaculada Failde Tags: Original Article Source Type: research

‘When less is more: Optimising care for elderly patients failing to thrive on dialysis.’
As the prevalence of end-stage renal disease (ESRD) has risen significantly over the last ten years, renal replacement therapy (RRT) remains a limited resource. In addition, 25% of new dialysis patients in the United Kingdom are over 75 years of age, and have the greatest increase in uptake of RRT.1 For the majority of patients with ESRD, RRT prolongs life and alleviates symptom burden. However, in those aged ≥75 years when first commencing RRT, the survival advantage may be substantially reduced by comorbidity, in particular, by ischaemic heart disease,2 with probability of survival of 71% at one year and 54% at 2 year...
Source: Journal of Pain and Symptom Management - December 14, 2017 Category: Palliative Care Authors: Julien O. Riordan, Andrew Smyth, Pauline M. Kane, Helen Noble, Sharon Beatty, Eileen Mannion, Camilla Murtagh, Ita Harnett Source Type: research

Comparison of indicators for achievement of pain control with a personalized pain goal in a comprehensive cancer center
The achievement of a personalized pain goal (PPG) is advocated as an individualized pain relief indicator. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 14, 2017 Category: Palliative Care Authors: Yuki Sumazaki Watanabe, Tomofumi Miura, Ayumi Okizaki, Keita Tagami, Yoshihisa Matsumoto, Maiko Fujimori, Tatsuya Morita, Hiroya Kinoshita Source Type: research

Variations in Hospice Utilization and Length of Stay for Medicare Patients with Melanoma
Timely hospice referral is an indicator of high quality end-of-life care for cancer patients. Variations in patient characteristics associated with hospice utilization and length of stay have been demonstrated in studies of other malignancies but not melanoma. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 13, 2017 Category: Palliative Care Authors: Rebecca N. Hutchinson, F.L. Lucas, Mary Becker, Heidi R. Wierman, Kathleen M. Fairfield Source Type: research

Effects of exercise training on restless legs syndrome, depression, sleep quality and fatigue among hemodialysis patients: A systematic review and meta-analysis
Hemodialysis patients experience a heavy symptom burden that leads to a decreased quality of life. Pharmacological treatment is effective but costly and has adverse effects. Exercise is a promising approach for symptom management, but the effect of exercise on restless legs syndrome, depression, sleep quality and fatigue in hemodialysis patients is still uncertain. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 13, 2017 Category: Palliative Care Authors: Yuan-yuan Song, Ru-jun Hu, Yong-shu Diao, Lin Chen, Xiao-lian Jiang Tags: Review Article Source Type: research

Advance care planning in community dwelling patients with dementia
Little is known about advance care planning (ACP) among community-dwelling patients with dementia. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 13, 2017 Category: Palliative Care Authors: Jane L. Givens, Rebecca L. Sudore, Gad A. Marshall, Alyssa B. Dufour, Ilona Kopits, Susan L. Mitchell Source Type: research

Pc-facs
PC-FACS (Fast Article Critical Summaries for Clinicians in Palliative Care) provides hospice and palliative care clinicians with concise summaries of the most important findings from more than 100 medical and scientific journals. If you have colleagues who would benefit from receiving PC-FACS, please encourage them to join the AAHPM at aahpm.org. Comments from readers are welcomed at pc-facs@aahpm.org. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 11, 2017 Category: Palliative Care Authors: Mellar P. Davis Source Type: research

PC-FACS December 1, 2017
Snyder Sulmasy L, Mueller PS. Ethics and the legalization of physician-assisted suicide: an American College of Physicians position paper. Ann Intern Med. 2017;167(8):576-578 (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 11, 2017 Category: Palliative Care Authors: David Newcombe Source Type: research

Chemotherapy use, end-of-life care, and costs of care among patients diagnosed with Stage IV pancreatic cancer
For patients with metastatic cancer and limited life-expectancy, potential benefits of chemotherapy must be balanced against harms to quality-of-life near death and increased out-of-pocket costs of care. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 11, 2017 Category: Palliative Care Authors: Yuhua Bao, Renee C. Maciejewski, Melissa M. Garrido, Manish A. Shah, Paul K. Maciejewski, Holly G. Prigerson Source Type: research

Doctors ’ Attitudes to Palliation and Palliative Care in Patients with Advanced Chronic Obstructive Pulmonary Disease
Patients with severe Chronic obstructive pulmonary disease (COPD) may experience distressing symptoms and reduced quality of life, therefore many international COPD guidelines recommend palliative care and advance care planning (ACP) together with disease-directed care [1, 2]. However, COPD patients rarely discuss ACP and infrequently access any specialist palliative care, with doctors ’ attitudes and poor communication reported as barriers [3-6]. Junior doctors working in tertiary medical care commonly manage, under consultant supervision, COPD patients who are approaching the end of life, and it is therefore essent...
Source: Journal of Pain and Symptom Management - December 8, 2017 Category: Palliative Care Authors: Natasha Smallwood, Nicole Gaffney, Alexandra Gorelik, Louis Irving, Brian Le, Jennifer Philip Source Type: research

Earlier initiation of community-based palliative care is associated with fewer unplanned hospitalisations and emergency department presentations in the final months of life: a population-based study amongst cancer decedents
While community-based palliative care (CPC) is associated with decreased acute care use in the lead up to death, it is unclear how the timing of CPC initiation affects this association. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 8, 2017 Category: Palliative Care Authors: Cameron M. Wright, David Youens, Rachael E. Moorin Source Type: research

Rapid Response Events in Hospitalized Patients: Patient Symptoms and Clinician Communication
Patients triggering Rapid Response Team (RRT) intervention are at high risk for adverse outcomes. Data on symptom burden of these patients does not currently exist and current symptom management and communication practices of RRT clinicians are unknown. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 7, 2017 Category: Palliative Care Authors: Charles A. Austin, Summer Choudhury, Taylor Lincoln, Lydia H. Chang, Christopher E. Cox, Mark A. Weaver, Laura C. Hanson, Judith E. Nelson, Shannon S. Carson Source Type: research

Palliative Care Need and Availability in Four Referral Hospitals in Senegal: Results from a Multi-Component Assessment
With prevalence of non-communicable diseases and life expectancy rising in Senegal, the need for palliative care is likely growing. No national palliative care needs assessments have been carried out. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 6, 2017 Category: Palliative Care Authors: Hana Hamdi, Oumar Ba, Serigne Niang, Christian Ntizimira, Mouhadou Mbengue, Aminata Sophie Coulbary, Rokhaya Niang, Matthew Parsons, Joseph J. Amon, Diederik Lohman Tags: Original Article Source Type: research

A Comparison of the Accuracy of Clinician Prediction of Survival versus the Palliative Prognostic Index
Survival predictions for advanced cancer patients impact many aspects of care, but the accuracy of clinician prediction of survival (CPS) is low. Prognostic tools such as the Palliative Prognostic Index (PPI) have been proposed to improve accuracy of predictions. However, it is not known if PPI is better than CPS at discriminating survival. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 5, 2017 Category: Palliative Care Authors: Paige Farinholt, Minjeong Park, Ying Guo, Eduardo Bruera, David Hui Source Type: research

Gabapentin as an adjuvant therapy for prevention of acute phantom-limb pain in pediatric patients undergoing amputation for malignant bone tumors: a prospective double-blind randomized controlled trial
Gabapentin is reported to have an analgesic effect of reducing phantom-limb pain(PLP) in adult patients. There ’s no study on preoperative use of gabapentin in pediatric population in term of PLP prevention. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 5, 2017 Category: Palliative Care Authors: Xiandi Wang, Ying Yi, Dingbo Tang, Yi Chen, Yanhua Jiang, Jun Peng, Jiwei Xiao Source Type: research

Menopausal-related Symptoms in Women One Year After Breast Cancer Surgery
Approximately 60% to 100% of women with breast cancer experience at least one menopausal-related symptom. Little is known about associations between menopausal status and symptoms in women 12 months after breast cancer surgery. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 5, 2017 Category: Palliative Care Authors: Melissa Mazor, Kathryn Lee, Anand Dhruva, Janine K. Cataldo, Steven M. Paul, Michelle Melisko, Betty J. Smoot, Jon D. Levine, Charles Elboim, Yvette P. Conley, Christine Miaskowksi Tags: Original Article Source Type: research

Characterizing the Role of U.S. Surgeons in the Provision of Palliative Care: A Systematic Review and Mixed-Methods Meta-Synthesis
The provision of palliative care varies appropriately by clinical factors such as patient age and severity of disease, but also varies by provider practice and specialty. Surgical patients are persistently less likely to receive palliative care than their medical counterparts for reasons that aren ’t clear. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 5, 2017 Category: Palliative Care Authors: Pasithorn A. Suwanabol, Arielle E. Kanters, Ari C. Reichstein, Lauren M. Wancata, Lesly A. Dossett, Emily B. Rivet, Maria J. Silveira, Arden M. Morris Source Type: research

Outpatient Pain Medication Use: An Electronic Daily Diary Study in Metastatic Breast Cancer
Understanding cancer patients ’ everyday pain experiences and their concomitant use of pain medication may help identify ways to improve pain management among outpatients. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 5, 2017 Category: Palliative Care Authors: Ellen Stephenson, Anita DeLongis, Brian Bruel, Hoda Badr Source Type: research

Prevailing Ethical Dilemmas Encountered by Physicians in Terminal Cancer Care Changed after the Enactment of the Natural Death Act: Fifteen Years Follow up Survey
Advance directive laws have influences on ethical dilemmas encountered by physicians caring for terminal cancer patients. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 5, 2017 Category: Palliative Care Authors: Hsien-Liang Huang, Chien-An Yao, Wen-Yu Hu, Shao-Yi Cheng, Shinn-Jang Huang, Chih-Dao Chen, Wen-Yuan Lin, Yen -Chun Lin, Tai-Yuan Chiu Source Type: research

Impact of opioid therapy on sleep and respiratory patterns in adults with advanced cancer receiving palliative care
In advanced cancer, abnormal sleep patterns may contribute to poor quality of life but the impact of opioid related sleep disorders has not been explored in detail in these patients. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 2, 2017 Category: Palliative Care Authors: Phillip Good, Ross Pinkerton, Simon Bowler, Justin Craig, Janet Hardy Source Type: research

Pilot Testing of a Brief Couple-Based Mind-Body Intervention for Patients with Metastatic Non-Small Cell Lung Cancer and Their Partners
Given the generally incurable nature of metastatic lung cancer, patients and their spouses/partners are at risk for psychological and spiritual distress. To address this concern, we developed a couple-based mind-body (CBMB) intervention. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 2, 2017 Category: Palliative Care Authors: Kathrin Milbury, Rosalinda Engle, Anne Tsao, Zhongxing Liao, April Owens, Alejandro Chaoul, Eduardo Bruera, Lorenzo Cohen Source Type: research

Moral Distress at the End of a Life: When Family and Clinicians Do Not Agree on Implantable Cardioverter-Defibrillator Deactivation
A 63-year-old man with end-stage ischemic cardiomyopathy presented with incessant ventricular tachycardia. He had been hospitalized multiple times in the past year for severe heart failure. As he approached end of life and was regularly receiving defibrillator shocks, his care team recommended deactivation of his implantable cardioverter-defibrillator. However, his family did not wish to allow deactivation, reporting a religious obligation to prolong his life, regardless of the risk of suffering. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - November 27, 2017 Category: Palliative Care Authors: Jill M. Steiner, Kristen K. Patton, Jordan M. Prutkin, James N. Kirkpatrick Tags: Ethical Issues in Palliative Care Source Type: research

Moral distress at the end of a life: when family and clinicians don ’t agree on implantable cardioverter-defibrillator deactivation
A 63-year-old man with end-stage ischemic cardiomyopathy presented with incessant ventricular tachycardia. He had been hospitalized multiple times in the past year for severe heart failure. As he approached end-of-life and was regularly receiving defibrillator shocks, his care team recommended deactivation of his implantable cardioverter-defibrillator. However, his family did not wish to allow deactivation, reporting a religious obligation to prolong his life, regardless of the risk of suffering. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - November 27, 2017 Category: Palliative Care Authors: Jill M. Steiner, Kristen K. Patton, Jordan M. Prutkin, James N. Kirkpatrick Source Type: research

Early Palliative Care In Patients With Hematological Malignancies: Where Do We Go From Here?
We have read with great interest the paper by Porta-Sales and colleagues (1) reporting encouraging and innovative results of an early palliative care (PC) program in patients with multiple myeloma (MM). Interestingly, the authors noted that symptoms improved quickly, leading to a decrease in the interference of symptoms with daily functioning. We speculate that benefits of early PC could also be extended to other hematologic disorders. Although the benefits of the early PC integration into standard clinical practice for cancer patients have been widely recognized (2, 3), little empirical data exist in this area for patient...
Source: Journal of Pain and Symptom Management - November 27, 2017 Category: Palliative Care Authors: Pasquale Niscola, Andrea Tendas, Fabio Efficace Source Type: research

Changes in the Use of Intensive and Supportive Procedures for Patients with Stroke in Taiwan in the Last Month of Life between 2000 and 2010
Stroke is the second leading cause of death and the primary cause of disability worldwide. It is uncertain what care patients with stroke receive in their end of life care and what trends in care are in recent years. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - November 27, 2017 Category: Palliative Care Authors: Pei-Yi Wang, Yen-Ni Hung, Robert Smith, Chia-Chin Lin Source Type: research

Botulinum toxin for painful torticollis in leptomeningeal disease: case reports
Torticollis is a rare but challenging complication of cancer with leptomeningeal spread (LMD) or intracranial disease. While this has been described in the pediatric literature (1,2,3) with brainstem gliomas and spinal cord tumors, it has not been reported to our knowledge in the adult literature. Cervical dystonia/torticollis in the general population has a myriad number of causes and approaches to treatment but one accepted form of treatment is injection of botulinum toxin (4,5). We had noted a number of patients in our Palliative Care Unit (PCU) who had developed torticollis seemingly related to LMD but who had failed t...
Source: Journal of Pain and Symptom Management - November 27, 2017 Category: Palliative Care Authors: Debbie Selby, Melody Nguyen, Harleen Toor Source Type: research

Editorial Board
(Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - November 24, 2017 Category: Palliative Care Source Type: research

Table of Contents
(Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - November 24, 2017 Category: Palliative Care Source Type: research