%0 Journal Article
%J Hosp Health Netw
%D 2007 Mar
%N 3
%P 68, 70
%T VALUE process helps families cope with end-of-life choices in the intensive care unit
%V 81
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17447309

%0 Journal Article
%J J Support Oncol
%D 2007 Feb
%N 2
%P 58-96
%T Proceedings of the 2006 Chicago Supportive Oncology Conference
%V 5
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17447290

%0 Journal Article
%J J Support Oncol
%D 2007 Feb
%N 2
%P 75-6
%T Updates from the 2006 Multinational Association of Supportive Care in Cancer International Symposium
%V 5
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17348363

%0 Journal Article
%J J Support Oncol
%D 2007 Feb
%N 2
%P 66
%T Chemotherapy as palliation in advanced colon cancer
%V 5
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17348358

%0 Journal Article
%J Rev Med Suisse
%D 2006 Nov
%N 87
%P 2636-8
%T [Criteria of assessing desire for assisted suicide]
%V 2
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17343156

%0 Journal Article
%A Adderley, U
%A Smith, R
%J Cochrane Database Syst Rev
%D 2007 
%N 2
%P CD003948
%T Topical agents and dressings for fungating wounds
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17443534
%X BACKGROUND: Fungating wounds arise from primary, secondary or recurrent malignant disease and are associated with advanced cancer. A small proportion of patients may achieve healing following surgical excision but treatment is usually palliative. Fungating wound management usually aims to slow disease progression and optimise quality of life by alleviating physical symptoms, such as copious exudate, malodour, pain and the risk of haemorrhage, through appropriate dressing and topical agent selection. OBJECTIVES: To conduct a systematic review of the evidence of the effects of dressings and topical agents on quality of life and symptoms that impact on quality of life in people with fungating malignant wounds. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) and the Wounds Group Specialised Register in August 2006. The Cochrane Breast Cancer Group and the Pain and Palliative Care Group were contacted for relevant studies. The Allied and Complementary Medicine (AMED) database was searched in January 2007. There was no restriction on language or date of publication. SELECTION CRITERIA: Randomised controlled trials (RCTs) or, in their absence, controlled clinical trials (CCTs) with a concurrent control group, both published and unpublished, and written in any language, were eligible for inclusion. DATA COLLECTION AND ANALYSIS: Data extraction was undertaken by one author and checked for accuracy by a second author. Two review authors independently assessed trial quality. MAIN RESULTS: Two trials involving 63 people were included. One RCT in women with superficial breast lesions compared 6% miltefosine solution with placebo and found that miltefosine delayed tumour progression. However, this trial had methodological limitations. A second trial compared topical metronidazole with placebo and found that metronidazole reduced malodour. However, this trial also had methodological limitations and was underpowered. AUTHORS' CONCLUSIONS: There is weak evidence from one small trial that 6% miltefosine solution applied topically to people with superficial fungating breast lesions (smaller than 1cm) who have received either previous radiotherapy, surgery, hormonal therapy or chemotherapy for their breast cancer may slow disease progression. There is insufficient evidence in this review to give a clear direction for practice with regard to improving quality of life or managing wound symptoms associated with fungating wounds. More research is needed

%0 Journal Article
%C Peter Gjersoe Hvidovre Hospital, Gastroenheden, Medicinsk Sektion. nicolaballin@hotmail.com
%A Ballin, Nicola Hvidt
%A Gjersoe, Peter
%J Ugeskr Laeger
%D 2007 Mar
%N 13
%P 1205-8
%T ["Do not resuscitate" orders in Danish medical wards. A questionnaire]
%V 169
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17425923
%X INTRODUCTION: Do not resuscitate (DNR) orders should prevent pointless life-prolonging procedures. Practicing DNR orders in Denmark is not described and there are no national guidelines. The purpose of this study is to clarify how DNR orders, patient autonomy, and living wills are handled in a Danish medical ward. MATERIALS AND METHODS: All 193 medical wards in Denmark received questionnaires (Figure 1) addressed to the medical Head of Department. 138 (71.5 %) questionnaires were analysed. RESULTS: 127 (92 %) wards had DNR orders. In 52 (38 %) wards DNR orders could include reduction of other treatment modalities. Competent patients were 'always' asked in 20 (14 %), 'often' in 34 (25 %), 'seldom' in 59 (43 %), and 'never' in 12 (9 %) of the wards prior to DNR decisions. Spouses were asked more often than the patient; 'always' in 31 (22 %), 'often' in 68 (49 %), 'seldom' in 21 (15 %), and 'never' in 4 (3 %) of the wards. The Danish Living Will Registry was contacted 'always' in 2 (1 %), 'often' in 15 (11 %), 'seldom' in 68 (49 %), and 'never' in 37 (27 %) of the wards. 112 (81 %) wards did not have a written guideline on DNR orders. CONCLUSION: Patients should be asked more often prior to DNR decisions. Health workers should contact The Danish Living Will Registry more frequently. As a decision aid and in order to strengthen both health workers' and patients' legal rights, a national guideline on DNR ordering could be established

%0 Journal Article
%C From the *Center for Research on Health Care, University of Pittsburgh, Pittsburgh, Pennsylvania; daggerDartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; double daggerDepartment of Sociology, Dartmouth College, Hanover, New Hampshire;  section signCenter for Survey Research, University of Massachusetts, Boston, Massachusetts;  paragraph signCenter for the Evaluative Clinical Sciences, Dartmouth Medical School, Hanover, New Hampshire; and  parallelVA Outcomes Group, White River Junction, Vermont
%A Barnato, AE
%A Herndon, MB
%A Anthony, DL
%A Gallagher, PM
%A Skinner, JS
%A Bynum, JP
%A Fisher, ES
%J Med Care
%D 2007 May
%N 5
%P 386-393
%T Are Regional Variations in End-of-Life Care Intensity Explained by Patient Preferences?: A Study of the US Medicare Population
%V 45
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17446824
%X OBJECTIVE:: We sought to test whether variations across regions in end-of-life (EOL) treatment intensity are associated with regional differences in patient preferences for EOL care. RESEARCH DESIGN:: Dual-language (English/Spanish) survey conducted March to October 2005, either by mail or computer-assisted telephone questionnaire, among a probability sample of 3480 Medicare part A and/or B eligible beneficiaries in the 20% denominator file, age 65 or older on July 1, 2003. Data collected included demographics, health status, and general preferences for medical care in the event the respondent had a serious illness and less than 1 year to live. EOL concerns and preferences were regressed on hospital referral region EOL spending, a validated measure of treatment intensity. RESULTS:: A total of 2515 Medicare beneficiaries completed the survey (65% response rate). In analyses adjusted for age, sex, race/ethnicity, education, financial strain, and health status, there were no differences by spending in concern about getting too little treatment (39.6% in lowest spending quintile, Q1; 41.2% in highest, Q5; P value for trend, 0.637) or too much treatment (44.2% Q1, 45.1% Q5; P = 0.797) at the end of life, preference for spending their last days in a hospital (8.4% Q1, 8.5% Q5; P = 0.965), for potentially life-prolonging drugs that made them feel worse all the time (14.4% Q1, 16.5% Q5; P = 0.326), for palliative drugs, even if they might be life-shortening (77.7% Q1, 73.4% Q5; P = 0.138), for mechanical ventilation if it would extend their life by 1 month (21% Q1, 21.4% Q5; P = 0.870) or by 1 week (12.1% Q1, 11.7%; P = 0.875). CONCLUSIONS:: Medicare beneficiaries generally prefer treatment focused on palliation rather than life-extension. Differences in preferences are unlikely to explain regional variations in EOL spending

%0 Journal Article
%C Palliative Care Service, Wellmont Health Systems, Adventa Hospice, and Quillen College of Medicine, Rogersville, Tennessee, USA
%A Baumrucker, Steven J
%J Am J Hosp Palliat Care
%D 2006 Oct-Nov
%N 5
%P 417-21
%T A medical error leads to tragedy: how do we inform the patient?
%V 23
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17060311

%0 Journal Article
%C Marie Lannelongue Hospital, Paris-Sud University, Le Plessis-robinson, France. ebelli@ccml.com
%A Belli, Emre
%A Mace, Loic
%A Ly, Mohammed
%A Dervanian, Patrice
%A Pineau, Emmanuelle
%A Roussin, Regine
%A Lebret, Emmanuel
%A Serraf, Alain
%J Eur J Cardiothorac Surg
%D 2007 Feb
%N 2
%P 236-41
%T Surgical management of pulmonary atresia with ventricular septal defect in late adolescence and adulthood
%V 31
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17222560
%X OBJECTIVE: In presence of adequate pulmonary blood flow, patients presenting with unoperated or palliated pulmonary atresia with ventricular septal defect (PA/VSD) can reach adult age. However, they remain symptomatic with a limited life expectancy. METHODS: Since 1993, 27 patients underwent surgery for unrepaired PA/VSD. Median age was 20 (range: 15-43) years. Nineteen patients had 33 previous palliative procedures while eight were unoperated survivors. Major aortopulmonary collateral artery (MAPCA) had been observed in all but 2 and were still patent in 23. All bronchopulmonary segments were connected to the native pulmonary arteries (NPA) in 4 (type A), to both NPA and MAPCA in 18 (type B) and only to MAPCA in 5 (type C). The biventricular repair was performed in 17 patients: 3 type A, 12 type B and 2 type C. Ten patients underwent palliative procedure: eight aortopulmonary shunt, with unifocalisation in two and one right ventricle to NPA restrictive conduit. RESULTS: One (4%) hospital death occurred following the failure of a palliative procedure. No clinical improvement was observed in seven patients including one repaired and six palliated survivors. Two late cardiac death occurred 1 and 7 years after repair. At last visit, 15 of 16 repaired survivors were in NYHA class I or II. Only one patient awaits septation, while eight other with subsequent palliation were considered not repairable. CONCLUSION: The outcome was encouraging in patients who were eligible for completed biventricular repair. Although considered as unique alternative to cardiopulmonary transplantation, the justification for palliative surgery to improve pulmonary blood flow remains to be established

%0 Journal Article
%C Department of Agricultural and Food Economics, University of Reading
%A Bennett, R
%A Willis, K
%J Vet Rec
%D 2007 Feb
%N 8
%P 266-8
%T Public opinions on badger populations and the control of tuberculosis in cattle in the UK
%V 160
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17322359

%0 Journal Article
%C First Division of Anesthesiology and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Central Hospital of Bolzano, Lorenz Bohler Street 5, 39100, Bolzano, Italy
%A Bock, M
%A Ciarrocchi, V
%A Wiedermann, CJ
%J Intensive Care Med
%D 2007 Apr
%T Case involving end-of-life decision issues in Italy
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17435991

%0 Journal Article
%C 1Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
%A Brosig, CL
%A Pierucci, RL
%A Kupst, MJ
%A Leuthner, SR
%J J Perinatol
%D 2007 Apr
%T Infant end-of-life care: the parents' perspective
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17443196
%X Objective:The purpose of this study was to identify factors important to parents in their infant's end-of-life care.Study Design:Participants were parents (n=19 families) whose infant (less than 1 year old) had died. Parents completed the Revised Grief Experience Inventory (RGEI) and a semi-structured interview regarding their infant's end-of-life care. Interviews were rated using the Post-Death Adaptation Scale (PDAS).Results:Parents scored significantly lower than the normative sample on the RGEI, and PDAS scores suggested that these parents were adapting positively. Parent interviews identified the aspects of care that were important to parents: honesty, empowered decision-making, parental care, environment, faith/trust in nursing care, physicians bearing witness and support from other hospital care providers.Conclusions:Results of this study suggest that parents can effectively cope following the death of an infant and the medical staff can do much to improve the end-of-life care for infants and their families.Journal of Perinatology advance online publication, 19 April 2007; doi:10.1038/sj.jp.7211755

%0 Journal Article
%A Bulow, Hans-Henrik
%A Hartling, Ole J
%J Ugeskr Laeger
%D 2007 Mar
%N 13
%P 1199
%T [No resuscitation in heart arrest--a hidden decision?]
%V 169
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17425921

%0 Journal Article
%C Case Western Reserve University, Cleveland, Ohio, USA. alc53@case.edu
%A Carlson, Alison L
%J J Gerontol Nurs
%D 2007 Apr
%N 4
%P 32-41
%T Death in the nursing home: resident, family, and staff perspectives
%V 33
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17436867
%X The actual experience of dying in the United States is far different from the expressed desires of most Americans. Although most Americans express a preference for dying at home, 73% of Americans die in medical institutions, with 23% dying in nursing homes (Teno, 2004). In this article, the author examines end-of-life care in the nursing home. A literature review identified more than 100 published articles relevant to end-of-life care in nursing homes. Of these, the author evaluated empirical research studies from the perspectives of residents, family members, and nursing home staff with findings specific to seriously ill nursing home residents. By identifying problematic issues and contributing factors, nurses can modify their practice to improve end-of-life care and substantially reduce suffering for nursing home residents and their families

%0 Journal Article
%C Fay W. Whitney School of Nursing, University of Wyoming, 82071, USA
%A Conley, Virginia M
%A Kempson, Diane
%J J Palliat Care
%D 2007 Spring
%N 1
%P 51-3
%T Integrating massage into rural caregiving at end-of-life
%V 23
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17444463

%0 Journal Article
%C Department of Radiology, UDIAT-CD, Corporacio Sanitaria Parc Tauli, Parc Tauli s/n 08208 Sabadell, Spain. adarnell@cspt.es
%A Darnell, A
%A Dalmau, E
%A Pericay, C
%A Musulen, E
%A Martin, J
%A Puig, J
%A Malet, A
%A Saigi, E
%A Rey, M
%J Abdom Imaging
%D 2006 Jul-Aug
%N 4
%P 387-99
%T Gastrointestinal stromal tumors
%V 31
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=16465584
%X BACKGROUND: We reviewed radiologic features of gastrointestinal stromal tumors (GISTs) and correlated them with clinical and pathologic findings. METHODS: We investigated a series of 39 c-Kit-positive GISTs. Clinical and radiologic findings and management of these patients were recorded. RESULTS: Twenty women and 19 men (mean age 64 years) had histologically proved GIST. Tumor locations were the small bowel (n = 20), stomach (n = 14), rectum (n = 4), and omentum (n = l). Symptoms at presentation were most frequently gastrointestinal bleeding (n = 14) and abdominal pain (n = l1). Tumors were classified as very low risk (n = 2), low risk (n = 10), intermediate risk (n = 12), and high risk (n = 11). Ultrasonography, computed tomography, magnetic resonance, digital subtraction angiography, and barium series were used in the evaluation of these tumors. Most tumors were seen as well-delineated soft tissue masses with heterogeneous contrast enhancement. Necrosis, calcification, and ulceration were most commonly seen in large tumors that presented a more aggressive behavior. CONCLUSION: GISTs can arise anywhere in the gastrointestinal tract and present a great variety of clinical and radiologic features, depending mostly on size and location

%0 Journal Article
%C Department of Family Health Care Nursing, University of California, San Francisco 94143-0606, USA
%A Davies, Betty
%A Collins, John
%A Steele, Rose
%A Cook, Karen
%A Distler, Vivian
%A Brenner, Amy
%J J Palliat Care
%D 2007 Spring
%N 1
%P 14-23
%T Parents' and children's perspectives of a children's hospice bereavement program
%V 23
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17444458
%X The provision of some form of bereavement services is an integral part of any pediatric hospice program. The Canuck Place hospice program has offered bereavement services since it began in 1995. A mixed-method evaluation of the impact of the Canuck Place program on the families it served during its first two-and-a-half years of operation was conducted. The bereavement services reviewed included follow-up care for families, and bereavement support groups for children and their parents. Eight children were interviewed in the initial phase, and nine completed a survey questionnaire; 28 parents rated their level of satisfaction with various aspects of their experience with the parent support group. Findings indicated that the follow-up component of the program was well-received by family members. When assessing their group experiences, children and parents most appreciated the support and understanding they received, the freedom to express themselves, a diminished sense of isolation, and the normalization of their emotions. Practical considerations when offering bereavement support groups are discussed in this paper

%0 Journal Article
%C Department of Urology, Saint-Louis Hospital, Paris, France. francois.desgrandchamps@sls.ap-hop-paris.fr
%A Desgrandchamps, Francois
%A Leroux, Stephane
%A Ravery, Vincent
%A Bochereau, Ghislain
%A Menut, Philippe
%A Meria, Paul
%A Ballanger, Philippe
%A Teillac, Pierre
%J J Endourol
%D 2007 Feb
%N 2
%P 173-6
%T Subcutaneous pyelovesical bypass as replacement for standard percutaneous nephrostomy for palliative urinary diversion: prospective evaluation of patient's quality of life
%V 21
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17338616
%X PURPOSE: To improve the quality of life of patients with palliative definitive percutaneous nephrostomy, we prospectively evaluated a subcutaneous ureteral bypass using a newly designed ureteral prosthesis. PATIENTS AND METHODS: A series of 19 patients receiving 27 subcutaneous tubes in replacement for percutaneous nephrostomy were evaluated. The ureteral prosthesis (Detour), a silicone tube glued inside a polyester tube, is inserted percutaneously into the renal pelvis to replace an established nephrostomy, tunneled subcutaneously, and introduced into the bladder through a small incision. All patients were followed every 3 months for 18 months or until death from tumor. Quality of life was assessed using the EORTC QLC-30 questionnaire; ultrasonography, intravenous urography, or both were used to assess the position and patency of the tubes. RESULTS: There was no failure of insertion and no operative or immediate complication. The mean follow-up was 7.8 months, 6.6 months for the 15 patients who died from their tumors and 1 year for the 4 patients still alive at the end of the study. Suprapubic parietal infection occurred in three patients with altered bladders (radiation cystitis or tumor progression). There was an improvement of the function scale as a result of the elimination of the external percutaneous tube and a parallel worsening of the symptom scale secondary to the progression of disease. Patient ratings of the global quality of life and satisfaction with the urinary diversion were improved because of the absence of the percutaneous tube. CONCLUSION: The subcutaneous pyelovesical bypass provides a better quality of life than a standard percutaneous nephrostomy tube in terminally ill patients by making them external-tube free

%0 Journal Article
%C District Hospital, Slatina, Romania
%A Dumitrescu, Luminita
%A Van den Heuvel, Wim
%J J Palliat Care
%D 2007 Spring
%N 1
%P 54-8
%T Evaluation of palliative care at home: the families' perspective
%V 23
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17444464

%0 Journal Article
%C Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, USA. sdy@jhsph.edu
%A Dy, Sydney Morss
%J Am J Hosp Palliat Care
%D 2006 Oct-Nov
%N 5
%P 369-77
%T Enteral and parenteral nutrition in terminally ill cancer patients: a review of the literature
%V 23
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17060304
%X Many terminally ill patients who are able to eat appear to be eating less than they should, losing weight, and becoming malnourished, and many others develop difficulties with eating. These symptoms and signs are usually a marker of advanced cancer, rather than the cause of decreasing functional status, and providing supplemental nutrition rarely changes the course of the disease. This article reviews evidence on issues relevant to enteral and parenteral nutrition in patients with advanced cancer, including benefits, risks, and discomforts; how these types of nutrition are used and perceived, and how decisions are made; and how decision-making might be improved

%0 Journal Article
%C Department of Radiation, Shizuoka General Hospital, Shizuoka. tebara@med.gunma-u.ac.jp
%A Ebara, Takeshi
%A Tanio, Noriko
%A Etoh, Takashi
%A Shichi, Izumi
%A Honda, Atsuro
%A Nakajima, Nobuaki
%J Anticancer Res
%D 2007 Jan-Feb
%N 1B
%P 531-4
%T Palliative re-irradiation for in-field recurrence after definitive radiotherapy in patients with primary lung cancer
%V 27
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17348437
%X AIM: To evaluate the efficacy and toxicity of palliative re-irradiation for in-field recurrence of primary lung cancer after radiotherapy. PATIENTS AND METHODS: Forty-four patients with locally recurrent lung cancer after radiotherapy were retreated with external beam radiation therapy. To evaluate palliative effectiveness, 31 symptoms in 25 patients were analyzed, while all patients were analyzed to evaluate pulmonary toxicity. RESULTS: The median time between prior and secondary irradiation was 12.6 months. Prior radiation doses ranged from 50 to 70 Gy and retreatment ranged from 30 to 60 Gy. The median survival after re-irradiation was 6.5 months. After treatment 74% (23 out of 31) of the symptoms had improvement or complete resolution. After re-irradiation, acute Grade 2 and 3 pulmonary toxicity were recognized in 3 patients each. No significant factors were observed regarding pulmonary toxicity. CONCLUSION: Re-irradiation with moderate doses for recurrent lung cancer after definitive radiotherapy is promising in palliating the symptoms and shows acceptable toxicity

%0 Journal Article
%C Outpatient Hemodialysis, Hartford Hospital, Hartford, CT, USA
%A Farlow, Jonathan T
%J Nephrol Nurs J
%D 2007 Jan-Feb
%N 1
%P 80-1
%T The enigma of nephrogenic systemic fibrosis
%V 34
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17345696
%X Nephrogenic systemic fibrosis is a severely physically disabling phenomenon experienced by a specific subset of patients with renal disease. Several of the 200 reported cases worldwide are currently treated within the author's facility. My colleagues and I have witnessed first-hand the life altering effects of NSF on our patients' physical, psychological, and social health, not to mention the unseen effects on family dynamics and changes in the interpretation and function of individual roles. Outside of the ESRD community, NSF is a largely unknown entity, likely due to the infrequency of incidence and relatively cohorted population. Despite the infrequency, we in the nephrology specialty must spread awareness of this condition and share our common knowledge and experiences to help those suffering from NSF to maintain their quality of life. In collaboration with the Centers for Disease Control (CDC), the Yale University International Center for NSF Research has established a website (www.icnfdr.org) for reporting of new cases of NSF/NFD. Until a causative agent is irrefutably identified, it is of the utmost importance that new cases be reported immediately. We expend a great deal of effort and gain valuable experience in helping our patients live their lives as richly as possible. If we as professional nurses share our knowledge and experience in managing the life-altering effects of NSF, our patients as a collective whole will benefit. It is, therefore, our responsibility to collaborate within and outside of the profession to reduce the number of new cases of NSF and help existing patients live their lives with the highest quality standard possible

%0 Journal Article
%C Det medisinsk fakultet, Universitetet i Bergen
%A Fattah, Sabina
%A Johnsen, Kathrine Helvig
%A Norheim, Ole Frithjof
%J Tidsskr Nor Laegeforen
%D 2007 Mar
%N 7
%P 878-81
%T [Life-prolonging treatment--an analysis of two cases]
%V 127
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17435809
%X BACKGROUND: Life-prolonging treatment is associated with many difficult ethical considerations, especially when such treatment is withdrawn. MATERIAL AND METHODS: Two cases are presented where life-prolonging treatment played a key part. The two were analyzed by using a 5-point checklist that the Clinical Ethics Committee at Haukeland University Hospital has developed. We were visiting students at a neonatal department and an intensive care unit, we read relevant literature and consulted experienced doctors. RESULTS AND INTERPRETATIONS: We saw that well-founded decisions were made for each of the two patients studied; this is in accordance with our experience from hospital departments. We believe that continuous technological advances in medicine require doctors to make more decisions involving ethical considerations now than before, but that they are not necessarily better equipped to do so. There is a need to improve integration of medical ethics in the education of medical students, and for doctors to have more knowledge about existing ethics regulations

%0 Journal Article
%C Matria Healthcare, Inc., Marietta, Georgia 30067, USA. don_fetterolf@matria.com
%A Fetterolf, Donald E
%A Terry, Rachel
%J Dis Manag
%D 2007 Feb
%N 1
%P 30-6
%T Oncology disease management
%V 10
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17309362
%X Oncologic conditions are ubiquitous medical illnesses that present a particular challenge for medical management programs designed to address quality and cost issues in patient populations. Disease management strategies represent a reasonable and effective approach for employers and health plans in their arsenal of health management strategies. Multiple reasons exist for the development of specialized disease management programs that deal with cancer patients, some unique to this group of individuals. Health plans and/or employers have solid justification for addressing these issues directly through programs developed specifically to work with cancer patients. Whether developed within a health plan, or "carved out" to an external vendor, proper evaluation of outcomes is essential

%0 Journal Article
%C Department of Respiratory Medicine, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1BP, UK
%A Free, CM
%A Ellis, M
%A Beggs, L
%A Beggs, D
%A Morgan, SA
%A Baldwin, DR
%J Lung Cancer
%D 2007 Apr
%T Lung cancer outcomes at a UK cancer unit between 1998-2001
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17442450
%X There are few data published on lung cancer survival in the UK. Survival rates for lung cancer at a UK Hospital between 1998-2001 are described. METHODS: Analysis of data collected from multidisciplinary team (MDT) meetings, lung cancer registrations and hospital coding. RESULTS: 835 new lung cancers were diagnosed comprising 597 non-small cell lung cancers (NSCLC) (71%), 133 small cell (SCLC) (16%), and 105 clinical diagnoses (13%). Stage at diagnosis; stage I (25%), II (9%), IIIA (8%), IIIB (23%), IV (35%). Surgery was undertaken in 12%, radical radiotherapy (RT) in 4%, palliative RT in 32%, chemotherapy in 8% and best supportive care (BSC) in 36%. The 3-year cumulative survival for NSCLC was: stage I 39%, stage II 30%, stage III 6%, stage IV 0.5%. Only 46% of patients with stage I-IIIA disease received radical treatment. Reasons included poor lung function (32%), unresectable (24%), co-morbidities (17%), performance status (8%), patient choice (8%), unclear (6%), advanced age (5%). CONCLUSIONS: Survival figures are similar to other UK studies but do not compare favourably with US and European data. This may be because a large proportion of patients with early stage disease receive palliative care only

%0 Journal Article
%A Gillon, Suzie
%A Mannix, Kathryn
%A Price, David A
%J BMJ
%D 2007 Mar
%N 7595
%P 652
%T Dying on the acute take can be improved
%V 334
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17395915

%0 Journal Article
%C Department of Paediatric Cardiac Surgery, Diana, Princess of Wales Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, United Kingdom
%A Griselli, Massimo
%A McGuirk, Simon P
%A Ko, Chung-Sen
%A Clarke, Andrew J B
%A Barron, David J
%A Brawn, William J
%J Eur J Cardiothorac Surg
%D 2007 Feb
%N 2
%P 229-35
%T Arterial switch operation in patients with Taussig-Bing anomaly--influence of staged repair and coronary anatomy on outcome
%V 31
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17223568
%X OBJECTIVE: This study evaluated the results of arterial switch operation and closure of ventricular defects (ASO+VSDc) for double outlet right ventricle with sub-pulmonary ventricular septal defect (Taussig-Bing anomaly). METHODS: Between 1988 and 2003, 33 patients (25 male, 76%) with Taussig-Bing anomaly underwent ASO+VSDc (median age 39 days, 1 day-2.1 years). The relationship of the great arteries was antero-posterior (Group I, n=19) or side-by-side (Group II, n=14). Coronary anatomy (Yacoub's classification) was exclusively type A or D in Group I and predominantly type D or E in Group II (64%). Incidence of sub-aortic obstruction and aortic arch obstruction was similar in Group I and II (37% vs 57%, p=0.25 and 84% vs 79%, p=0.98, respectively). Twenty-five patients (76%) had one-stage total correction. Risk factors were analysed using multivariable analysis. Follow-up was complete (median interval of 6.2 years; range, 0.6-15.2 years). RESULTS: There were three early (9%) and one late death. Actuarial survival was 88+/-6% at 1 and 10 years. There were two early and four late re-operations. Freedom from re-operation was 90+/-5% and 75+/-9% at 1 and 10 years. Four patients required cardiological re-interventions. Freedom from re-intervention at 5 and 10 years was 79+/-9%. On multivariable analysis, complex coronary anatomy (type B and C) was a risk for early mortality (p<0.001) but all other anatomical variables and staged strategy did not influence early or actuarial survival. CONCLUSIONS: The ASO+VSDc approach can be applied to Taussig-Bing anomaly with acceptable mortality and morbidity and it is the procedure of choice at our institution. Anatomical variables did not influence outcomes with this strategy. A staged strategy is still appropriate in complex cases

%0 Journal Article
%C University of Central Lancashire
%A Gurbutt, Dawne
%A Gurbutt, Russell
%J Community Pract
%D 2007 Jan
%N 1
%P 24-7
%T Risk reduction and sudden infant death syndrome
%V 80
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17334115
%X This article explores the concepts of 'risk' and 'risk reduction' in relation to sudden infant death syndrome (SIDS) and the implications for practice. Risk reduction is a term utilised in public health, which is usually linked to evidence-based outcomes. The Back to Sleep campaign is a high profile initiative which seeks to raise awareness of risk factors relating to SIDS and is largely credited with contributing to a significant reduction in the incidence of SIDS in the UK. Misunderstandings may occur between the terms 'risk reduction' and 'prevention' of health conditions and parents may feel that one equates to the other. There are also tensions which are inherent in defining risk in the context of SIDS. Certain measures may become 'shorthand' for a range of interventions and contributing factors. The practice of offering additional monitoring as support may reinforce a (mis)understanding about risk reduction and SIDS. There are implications for practice regarding how health professionals approach this issue, explain the guidelines and offer support.A clearer understanding of risk reduction would potentially enable bereaved parents to articulate their experiences without becoming too self critical in questioning their own consistent adherence to the accepted guidelines

%0 Journal Article
%C Public Health and Health Policy, Division of Community Based Sciences, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK. c.l.hart@udcf.gla.ac.uk
%A Hart, Carole L
%A Hole, David J
%A Lawlor, Debbie A
%A Davey Smith, George
%A Lever, Tony F
%J J Epidemiol Community Health
%D 2007 May
%N 5
%P 455-60
%T Effect of conjugal bereavement on mortality of the bereaved spouse in participants of the Renfrew/Paisley Study
%V 61
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17435215
%X OBJECTIVES: To investigate how loss of a spouse affects mortality risk in the bereaved partner. DESIGN AND SETTING: Prospective cohort study in Renfrew and Paisley in Scotland. PARTICIPANTS: 4395 married couples aged 45-64 years when the study was carried out between 1972 and 1976. METHODS: The date of bereavement for the bereaved spouse was the date of death of his or her spouse. Bereavement could occur at any time during the follow-up period, so it was considered as a time-dependent exposure variable and the Cox proportional hazards model for time-dependent variables was used. The relative rate (RR) of mortality was calculated for bereaved versus non-bereaved spouses and adjusted for confounding variables. MAIN OUTCOME MEASURES: Causes of death to 31 March 2004. RESULTS: Bereaved participants were at higher risk than non-bereaved participants of dying from any cause (RR 1.27; 95% CI 1.2 to 1.35). These risks remained but were attenuated after adjustment for confounding variables. There were raised RRs for bereaved participants dying of cardiovascular disease, coronary heart disease, stroke, all cancer, lung cancer, smoking-related cancer, and accidents or violence. After adjustment for confounding variables, RRs remained higher for bereaved participants for all these causes except for mortality from lung cancer. There was no strong statistical evidence that the increased risks of death associated with bereavement changed with time after bereavement. CONCLUSIONS: Conjugal bereavement, in addition to existing risk factors, is related to mortality risk for major causes of death

%0 Journal Article
%A Haug, Charlotte
%J Tidsskr Nor Laegeforen
%D 2007 Mar
%N 7
%P 851
%T [Right to a good death]
%V 127
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17435799

%0 Journal Article
%C Department of General Practice, Division of Clinical Methods & Public Health, Academic Medical Center-University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands. marjokehoekstra@hotmail.com
%A Hoekstra, Johanna
%A Vernooij-Dassen, Myrra J F J
%A de Vos, Rien
%A Bindels, Patrick J E
%J Patient Educ Couns
%D 2007 Feb
%N 2
%P 223-9
%T The added value of assessing the 'most troublesome' symptom among patients with cancer in the palliative phase
%V 65
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=16965886
%X OBJECTIVE: In this study among patients with cancer in the palliative phase, we analysed whether assessing the symptom, which is causing the most trouble in the patient's every day life ('most troublesome' symptom) had added value apart from the presence and severity of symptoms, which are most commonly assessed in clinical practice. METHODS: Patients with cancer (lung, gastro-intestinal, breast cancer) in the palliative phase from two non-academic hospitals were included in the study. Using the Symptom Monitor tool, 10 physical symptoms were assessed with regard to presence and severity. The Symptom Monitor has an extra added item indicating as the 'most troublesome' symptom. This item was monitored to determine whether it had added value apart from the presence of symptoms and 'most severe' symptom. The severity score on the indicated 'most troublesome' symptom was subtracted from the severity score of the 'most severe' symptom. The generated delta score of 0 indicated no added value, whereas a score of one or more indicated that the 'most troublesome' symptom would have been missed if not specifically asked for by the physician, because its severity was lower that the 'most severe' symptom. RESULTS: One hundred and forty-six patients reported 590 symptoms to be present. In total, 227 symptoms were reported as 'most severe' symptom (n = 138 patients). Among these, fatigue (n = 52) and pain (n = 24) were reported most frequently as 'most severe' symptom. In total, 134 patients indicated a symptom as 'most troublesome'. Fatigue (n = 33; 25%) and pain (n = 22; 16%) were also indicated by most of these patients as the 'most troublesome' symptom. One hundred and fifty-two comparisons could be made between the 'most severe' and the 'most troublesome' symptom. In 102 (67%) of the comparisons assessing the 'most troublesome' symptom had no added value: the score for 'most severe' symptom did not differ from the score for the 'most troublesome' symptom revealing a delta score of 0. In 23 times (15%) of the 152 comparisons made, the delta score was 1 and in 27 (18%) of the comparisons the delta score was 2 or more indicating that assessing the 'most troublesome' symptom substantially had added value. CONCLUSION: In patients in the palliative phase of their disease, extra attention for the 'most troublesome' symptom is needed. In our study, in almost 1/3 of the cases, this symptom would have been missed the physicians attention if not specifically asked for. PRACTICE IMPLICATIONS: We recommend not only to assess the presence and severity of symptoms, but furthermore to assess the patient's 'most troublesome' symptom in addition

%0 Journal Article
%C U.S. Department of Health and Human Services, Office of the Actuary, Centers for Medicare and Medicaid Services, Baltimore, Maryland 21244-1850, USA
%A Hoffman, Earl Dirk Jr
%A Klees, Barbara S
%A Curtis, Catherine A
%J Health Care Financ Rev Stat Suppl
%D 2005 
%P 1-281, 283-304
%T Overview of the medicare and medicaid programs
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17373028

%0 Journal Article
%C U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, Office of Research, Development, and Information, Baltimore, Maryland 21244-1850, USA
%A Hoffman, Earl Dirk Jr
%A Klees, Barbara S
%A Curtis, Catherine A
%J Health Care Financ Rev Stat Suppl
%D 2004 
%P 1-380
%T Overview of the Medicare and Medicaid programs
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17366751

%0 Journal Article
%C Brian Hughes, MDiv, BCC, is a staff chaplain at Banner Good Samaritan Medical Center and focuses on ICU patients and families and ICU staff support. Mary Whitmer, RN, APRN-BC, is a palliative care nurse practitioner at Banner Good Samaritan Medical Center. She has worked in end-of-life case in both hospice and palliative medicine for 25 years. Susan Hurst, MSN, RN, CCRN, CNRN, is a clinical nurse specialist in Critical Care Services, at Banner Good Samaritan Medical Center. She works to improve care in the ICUs through the application of the evidence-based approach. She also reviews manuscripts for DCCN
%A Hughes, B
%A Whitmer, M
%A Hurst, S
%J Dimens Crit Care Nurs
%D 2007 May/June
%N 3
%P 91-95
%T Innovative Solutions: A Plurality of Vision: Integrating the Chaplain into the Critical Care Unit
%V 26
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17440290
%X Banner Good Samaritan Medical Center is a 650-bed quarternary care facility located in the Southwestern United States. It contains 12 intensive care units (ICUs) and experience a high patient acuity as a result of being a referral center for Arizona. The palliative care nurse practitioner and ICU clinical nurse specialist collaborated with the chaplain to entrance his visibility in the ICUs and to incorporate the philosophy of spiritual care assessments in the ICU

%0 Journal Article
%A Hyde, Jayne
%J Community Pract
%D 2007 Jan
%N 1
%P 41
%T Bereaved parents' campaign
%V 80
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17334118

%0 Journal Article
%C Ruth Hynes is a staff nurse and discharge coordinator in the neonatal ICU at Children's Hospital Boston. Contact author: ruth.hynes@childrens.hospital.edu. Reflections is coordinated by Veneta Masson: masson@erols.com
%A Hynes, R
%J Am J Nurs
%D 2007 May
%N 5
%P 88
%T Reflections: Finding the Words
%V 107
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17443093
%X When a nurse understands grief

%0 Journal Article
%C Department of Psychology, New York University, 6 Washington Place, New York, NY, 10003, USA, lmk323@nyu.edu
%A Kressel, LM
%A Chapman, GB
%A Leventhal, E
%J J Gen Intern Med
%D 2007 Apr
%T The Influence of Default Options on the Expression of End-of-Life Treatment Preferences in Advance Directives
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17447099
%X BACKGROUND: Advance directives promise to preserve patient autonomy, but research indicates that end-of-life preferences can be influenced by the way in which questions are posed. OBJECTIVE: To determine whether preferences expressed by geriatric patients on advance directives are influenced by the default response inherent in the question. DESIGN: Mailed survey containing 1 of 3 versions of an advance directive. SETTING: General internal medicine outpatient medical practice. PARTICIPANTS: Outpatients aged 65 or older (n = 106, response rate = 27%). INTERVENTIONS: In the "withhold" version of the survey, participants indicated situations where they would want treatments withheld (i.e., the default preference was in favor of treatment). In the "provide" version, participants indicated situations where they would want treatment provided (i.e., the default preference was against treatment). In the forced-choice control version, participants made an explicit decision to withhold or provide treatment for each situation. MAIN OUTCOME MEASURE: Participants' treatment preferences. RESULTS: Preferences differed by condition, F(2, 103) = 3.61, MSE = 0.09, eta (2) = .07, p = .03. Participants tended to express the default preference, and thus, were more likely to favor treatment in the "withhold" condition than in the "provide" condition. Preferences in the forced-choice control condition were intermediate. CONCLUSIONS: The default inherent in a question can impact preferences for medical treatment. This default effect limits the utility of advance directives

%0 Journal Article
%C Center for Biomedical Ethics and Law, Faculty of Medicine, Katholieke Universiteit Leuven, Kapucijnenvoer 35, 3000 Leuven, Belgium
%A Lemiengre, J
%A de, Casterle BD
%A Van, Craen K
%A Schotsmans, P
%A Gastmans, C
%J Health Policy
%D 2007 Apr
%T Institutional ethics policies on medical end-of-life decisions: A literature review
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17433489
%X OBJECTIVES: The responsibility of healthcare administrators for handling ethically sensitive medical practices, such as medical end-of-life decisions (MELDs), within an institutional setting has been receiving more attention. The overall aim of this paper is to thoroughly examine the prevalence, content, communication, and implementation of written institutional ethics policies on MELDs by means of a literature review. METHODS: Major databases (Pubmed, Cinahl, PsycINFO, Cochrane Library, FRANCIS, and Philosopher's Index) and reference lists were systematically searched for all relevant papers. Inclusion criteria for relevance were that the study was empirically based and that it focused on the prevalence, content, communication, or implementation of written institutional ethics policies concerning MELDs. RESULTS: Our search yielded 19 studies of American, Canadian, Dutch and Belgian origin. The majority of studies dealt with do-not-resuscitate (DNR) policies (prevalence: 10-89%). Only Dutch and Belgian studies dealt with policies on pain and symptom control (prevalence: 15-19%) and policies on euthanasia (prevalence: 30-79%). Procedural and technical aspects were a prime focus, while the defining of the specific roles of involved parties was unclear. Little attention was given to exploring ethical principles that question the ethical function of policies. In ethics policies on euthanasia, significant consideration was given to procedures that dealt with conscientious objections of physicians and nurses. Empirical studies about the implementation of ethics policies are scarce. CONCLUSIONS: With regard to providing support for physicians and nurses, DNR and euthanasia policies expressed support by primarily providing technical and procedural guidelines. Further research is needed whether and in which way written institutional ethics policies on MELDs could contribute to better end-of-life care

%0 Journal Article
%C Division of Thoracic and Hyperbaric Surgery, Department of General Surgery, Medical University Graz, Austria. jo.lindenmann@meduni-graz.at
%A Lindenmann, Joerg
%A Matzi, Veronika
%A Maier, Alfred
%A Smolle-Juettner, Freyja-Maria
%J Eur J Cardiothorac Surg
%D 2007 Feb
%N 2
%P 322-4
%T Transthoracic esophagectomy and lobectomy performed in a patient with synchronous lung cancer and combined esophageal cancer and esophageal leiomyosarcoma
%V 31
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17161608
%X We report a pitfall deriving from the assumption of metastatic disease based upon seemingly identical histology in a pulmonary lesion and in the esophagus. In a 60-year-old patient, cT1 esophageal squamous cell carcinoma was found. One of the two pulmonary nodules was histologically diagnosed as metastasis. When esophageal perforation occurred during palliative therapy, esophagectomy became necessary together with the right lower lobectomy for the removal of the remaining pulmonary lesion. Definitive histology showed pT1N0 cancer of the esophagus, primary esophageal sarcoma and pT4N0 bronchogenic carcinoma. The other pulmonary lesion was re-evaluated and defined as intralobar M1 of bronchogenic carcinoma

%0 Journal Article
%C University of Pittsburgh Medical Center, Pennsylvania 15217, USA. leon3087@gmail.com
%A Margolin, Leon
%A Cope, Doris K
%A Bakst-Sisser, Rachel
%A Greenspan, Joshua
%J J Pain Symptom Manage
%D 2007 Feb
%N 2
%P 224-8
%T The steroid withdrawal syndrome: a review of the implications, etiology, and treatments
%V 33
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17280928
%X Steroid therapy is frequently used for chronic pain, particularly inflammatory pain states. Steroid withdrawal syndrome can produce a broad array of signs and symptoms, some of which are not well recognized. High fever is among these. We describe several cases with this clinical scenario and review the syndrome in broader terms

%0 Journal Article
%C Eleanor and Lou Gehrig MDA/ALS Research Center, Neurological Institute, Columbia University, USA
%A Mitsumoto, Hiroshi
%A Howe, Wesley J
%J Rinsho Shinkeigaku
%D 2006 Nov
%N 11
%P 828-31
%T [Management and care for patients with ALS]
%V 46
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17432192
%X For the past decade or so, the research in ALS has dramatically changed, coinciding with the discovery of SOD1 mutations, the generation of SOD1 transgenic rodents, and the introduction of riluzole. The ALS practice guidelines have been published in a number of countries, whereas the National Database has shown the actual reality of patient practice in ALS. Multidisciplinary ALS Clinics, consisting of a team of health care professionals, provide highly specialized quality care for patients and families, and have become the standard of care in many countries. A number of mostly retrospective studies report that non-invasive positive pressure ventilation prolongs survival and improves the quality of life and other functions. Enteral feeding certainly improves quality of life, but it is still uncertain if it prolongs survival. Although end of life issues in ALS care have been difficult more and more ALS clinicians are paying serious attention to it. Clinical trials are imperative to find effective medications for ALS, and many different pharmacological agents, based on a number of different hypotheses in ALS, are being actively tested or are about to be tested in the near future. Undoubtedly, we are in the midst of incredible progress in ALS

%0 Journal Article
%C Universite du Quebec a Montreal, Canada
%A Mongeau, Suzanne
%A Champagne, Manon
%A Liben, Stephen
%J J Palliat Care
%D 2007 Spring
%N 1
%P 5-13
%T Participatory research in pediatric palliative care: benefits and challenges
%V 23
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17444457
%X Participatory research is an approach wherein all parties concerned play an active role throughout the research process, from initial design to the interpretation and dissemination of results. This article reports on two participatory research projects evaluating a new in-home respite program for children requiring pediatric palliative care and their families. Some of the realities, benefits, and challenges resulting from a participatory approach to research in pediatric palliative care are described. The outcomes of these two studies highlight the conclusion that organizations, professionals, volunteers, and family members accompanying the dying benefit from a participatory research method that actively engages their involvement. This approach offers participants the opportunity to voice concerns as well as supports a sense of empowerment. From the researcher's point of view, a participatory process can serve to increase both the social relevancy and impact of the research

%0 Journal Article
%A Munday, Daniel
%A Dale, Jeremy
%J BMJ
%D 2007 Apr
%N 7598
%P 809-10
%T Palliative care in the community
%V 334
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17446576

%0 Journal Article
%C Kansas City University of Medicine and Biosciences, Kansas City, Missouri, USA. nalamachu@sbcglobal.net
%A Nalamachu, Srinivas
%A Crockett, R S
%A Gammaitoni, Arnold R
%A Gould, Errol M
%J MedGenMed
%D 2006 
%N 3
%P 33
%T A comparison of the lidocaine patch 5% vs naproxen 500 mg twice daily for the relief of pain associated with carpal tunnel syndrome: a 6-week, randomized, parallel-group study
%V 8
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17406167
%X OBJECTIVES: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy caused by median nerve compression. This pilot clinical trial was designed to compare the safety and effectiveness of the lidocaine patch 5% to that of naproxen 500 mg twice daily for the treatment of neuropathic pain associated with CTS. METHODS: In this 6-week, randomized, parallel-group, open-label, multicenter study, participants from 2 practice sites, aged 18 to 75 years with clinical/electrodiagnostic evidence of CTS, were randomized to receive up to 3 lidocaine 5% patches every 24 hours or naproxen 500 mg twice daily for 6 weeks. Outcome assessments included mean changes between baseline and Week 6 average pain intensity (Brief Pain Inventory [BPI]: Question 5, Average Pain Intensity [API]), an Investigator Clinical Global Impression of Improvement (CGI-I) over the course of the treatment period and a comparison of patient satisfaction (Clinical Global Assessment of Treatment [CGAT]). RESULTS: One hundred patients were randomized in this study, 52 in the lidocaine patch 5% group and 48 in the naproxen 500 mg twice daily group. Significant reductions in API scores were observed between baseline and Week 6 for both lidocaine patch 5% (P < .0001) and naproxen 500 mg twice daily (P = .0004); however, there were no statistically significant differences between treatments (P = .083). There was a significant (P = .016) difference in the CGI-I for lidocaine patch 5% (51.1%) compared with naproxen 500 mg twice daily (24.3%). Whereas 71.8% of the lidocaine patch 5% patients reported being "satisfied" to "very satisfied" with the treatment, only 63.2% of naproxen 500 mg twice daily patients reported likewise, although the difference was not statistically significant. Both treatments were well tolerated. Two patients reported treatment-related adverse events in the lidocaine patch 5% group and 6 in the naproxen 500 mg twice daily group, all of which were considered mild or moderate in severity. CONCLUSIONS: This study demonstrates that the lidocaine patch 5% is effective in significantly relieving the pain associated with CTS and is well tolerated. The patch may offer patients an effective, nonsystemic, noninvasive treatment for the management of their symptoms. Further controlled studies are warranted

%0 Journal Article
%C *College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin; daggerAcademic Affairs, St. Edward's University, Austin, Texas; double daggerCollege of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin; and  section signCenter for Psycho Oncology and Palliative Care Research, Dana-Farber Cancer Institute, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School
%A Ott, CH
%A Lueger, RJ
%A Kelber, ST
%A Prigerson, HG
%J J Nerv Ment Dis
%D 2007 Apr
%N 4
%P 332-341
%T Spousal Bereavement in Older Adults: Common, Resilient, and Chronic Grief With Defining Characteristics
%V 195
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17435484
%X The purpose of this study was to identify empirically patterns of grief among 141 older bereaved spouses. A longitudinal hierarchical cluster procedure with the Ward agglomeration method was used to identify distinct clusters based on grief scores. Three clusters were identified: common (49%), resilient (34%), and chronic (17%) grief. Members of the common grief cluster experienced elevated levels of grief and depressive symptoms that decreased over time. Members of the resilient cluster experienced the lowest levels of grief and depression and the highest quality of life. The chronic grief cluster experienced the highest levels of grief and depression, more sudden deaths, the lowest self-esteem, and the highest marital dependency. The majority in this chronic cluster also met proposed criteria for a diagnosis of complicated grief. Five out of every six bereaved spouses adjusted well over time, and about a third of these showed considerable resilience without negative consequences. One out of six experienced a chronic grief syndrome. Early identification of this syndrome can lead to referral to newly emergent treatments specific for grief

%0 Journal Article
%C Istituto Oncologico Veneto, Medical Oncology Division, Via Gattamelata 64, 35128 Padova, Italy. laramary@libero.it
%A Pasetto, Lara Maria
%A D'Andrea, Mario Rosario
%A Falci, Cristina
%A Monfardini, Silvio
%J Crit Rev Oncol Hematol
%D 2007 Mar
%N 3
%P 230-42
%T Gemcitabine in advanced biliary tract cancers
%V 61
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17157524
%X The annual incidence of hepatobiliary cancer has been steadily increasing in the USA from 15,000 in 1993 to 22,200 in 2000. Despite this increase, it still continues to be a rare neoplasm. Surgical resection is the treatment of choice, but a high percentage of patients are unsuitable for resection. These patients have a very poor prognosis because of the lack of efficacious therapy options. Thus, overall survival in these patients ranges from 3 to 12 months, depending on the extent of disease and its site of origin. For some time, mitomycin C, doxorubicin and 5-fluorouracil have been considered among the most active chemotherapeutic agents, with a response rate ranging from 10 to 20%. More recently, gemcitabine has become the reference agent for these neoplasias because of the histologically common origin of biliary cancer and exocrine pancreatic cancer. However, its role has yet to be well-defined. Here we examine clinical trials designed for locally advanced and metastatic biliary tract cancer and review the existing data supporting palliative therapy with gemcitabine alone or in association with other drugs

%0 Journal Article
%C Princess Margaret Hospital, University Health Network, University of Toronto, Canada
%A Pierce, Bruce
%A Dougherty, Elizabeth
%A Panzarella, Tony
%A Le, Lisa W
%A Rodin, Gary
%A Zimmermann, Camilla
%J J Palliat Care
%D 2007 Spring
%N 1
%P 32-9
%T Staff stress, work satisfaction, and death attitudes on an oncology palliative care unit, and on a medical and radiation oncology inpatient unit
%V 23
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17444460
%X Professional caregivers for cancer patients are at high risk for work-related stress, but it is not clear how this relates to exposure to death and dying, and to professional satisfaction. This study compares work-related stress and staff satisfaction on an academic acute palliative care unit (PCU) with that on a medical and radiation oncology inpatient unit (OIU) at the same cancer centre. PCU staff tended to report less work stress-particularly related to terminal care-than those on the OIU, and higher work satisfaction and team support. PCU staff were more likely to perceive their work experience as having "positively altered their attitude to death" (p = 0.007). These results show that a supportive team environment can exist on an academic PCU and suggest that support currently offered to PCU staff in terms of caring for terminally ill patients should also be extended to those working in general oncology settings

%0 Journal Article
%C African Palliative Care Association, Kampala, Uganda. tony.powell@apca.co.ug
%A Powell, Richard A
%A Downing, Julia
%A Harding, Richard
%A Mwangi-Powell, Faith
%A Connor, Stephen
%J J Pain Symptom Manage
%D 2007 Feb
%N 2
%P 229-32
%T Development of the APCA African Palliative Outcome Scale
%V 33
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17280929

%0 Journal Article
%C Florence Nightingale School of Nursing and Midwifery, King's College London, London. emma.ream@kcl.ac.uk
%A Ream, Emma
%J Nurs Stand
%D 2007 Mar
%N 28
%P 49-56; quiz 58
%T Fatigue in patients receiving palliative care
%V 21
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17436895
%X This article discusses fatigue in patients receiving palliative care. The article initially considers the prevalence of fatigue in different groups of palliative care patients, then addresses how it manifests before reviewing how it can be assessed and managed. The focus of the article is on palliative care but it draws on, and has relevance for, chronic disease more widely

%0 Journal Article
%C Geriatrics and Extended Care, VA Medical Center, Phoenix, Arizona 85012, USA. palliativedoctor@aol.com
%A Rousseau, Paul
%J Am J Hosp Palliat Care
%D 2006 Oct-Nov
%N 5
%P 422-3
%T Allegations of euthanasia
%V 23
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17060312

%0 Journal Article
%A Rousseau, Paul
%J Am J Hosp Palliat Care
%D 2006 Oct-Nov
%N 5
%P 351-2
%T Introduction to literature and humanities
%V 23
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17060301

%0 Journal Article
%C Nephrologisches Zentrum Gottingen
%A Schulz, E G
%A Wagner, F
%A Fischer, N
%A Wolf, A
%A Korth, U
%A Weber, M H
%J Dtsch Med Wochenschr
%D 2007 Mar
%N 9
%P 423-6
%T [Body weight telemetry in patients with endstage renal failure on hemodialysis: preliminary data]
%V 132
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17315118
%X BACKGROUND AND OBJECTIVE: Non-adherence to fluid intake restrictions is one of the leading problems in hemodialysis patients. The consequences of chronic volume overload and massive hypotensive episodes resulting from enhanced ultrafiltration lead to an increased mortality and incidence of vascular events. Telemetric body weight monitoring (TBWM) suggests itself as a successful way to reduce daily fluid intake PATIENTS AND METHODS: This monocentric, prospective, randomized open study includes 120 patients with end-stage renal failure undergoing chronic hemodialysis (for at least two months) three times a week. The mean interdialytic weight gain (IWG) was more than 1.5 kg/2 days over the four weeks immediately before start of the study. The effect of daily body weight telemonitoring on IWG, blood pressure, haemoglobin variability, hospital stay, vascular events and mortality were observed for three months. All monitored patients (group 1, n = 60) received a weekly report of their weight changes, the number of alarms (automatically sent by email to the study center when daily IWG was greater than 0.75 kg/d) and of the interventions by phone (conducted by the responsible nephrologist when IWG was > 2 kg/day). Hemodynamics (each hemodialysis procedure) and weekly laboratory data were recorded for all patients. RESULTS: Preliminary data of 44 patients showed a significant reduction of daily IWG (weekly average, p = 0.0187) and a smaller number of alarm reports after the whole study period in group 1. Blood pressure monitoring during hemodialysis showed less hyper- and hypotensive episodes in patients with an IWG of less than 1.5 kg/2 days. In the control group there have so far been no changes of the analysed parameters. CONCLUSIONS: TBWM seems to be an effective method for optimizing adherence to fluid intake restrictions in patients on hemodialysis. Hemoglobin variability, mortality rates and the number of vascular events will still have to be analysed in detail for all patients once the entire study period has been completed

%0 Journal Article
%A Severson, Angela R
%J RN
%D 2007 Feb
%N 2
%P 60
%T Matters of the heart
%V 70
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17340955

%0 Journal Article
%C Keck School of Medicine, University of Southern California, Los Angeles, California 90089-9021, USA
%A Swinney, Ryan
%A Yin, Lu
%A Lee, Andrew
%A Rubin, David
%A Anderson, Clarke
%J J Palliat Care
%D 2007 Spring
%N 1
%P 44-50
%T The role of support staff in pediatric palliative care: their perceptions, training, and available resources
%V 23
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17444462
%X Pediatric palliative care requires the orchestrated efforts of a multidisciplinary care team of medical staff, nursing, psychosocial staff, and other healthcare professionals. Augmenting this team are support staff including financial counsellors, volunteers, secretaries, and others not involved in the direct administration of medical services. Prior research in palliative care has studied the perceptions, training, and professional resources of medical staff and social workers, but neglected to investigate such factors in support staff. Our study examined the effect of involvement in end-of-life pediatric care on support staff. We found this community to consist of a heterogeneous population of hospital employees, who develop numerous, substantial, direct interactions with dying children and their families. They indicated that such experiences had caused some adverse outcomes in their lives, and that few felt they had sufficient knowledge or training in palliative care. Our respondents voiced noteworthy opinions on symptom control, cultural issues, and spirituality pertinent to pediatric palliative care. Support staff play a key role in the palliative care team; research and resources need to be directed to educating, training, and supporting them

%0 Journal Article
%C Capital Hospice, 6565 Arlington Boulevard, Falls Church, VA 22042, USA. mtice@capitalhospice.org
%A Tice, Martha A
%J Home Healthc Nurse
%D 2007 Feb
%N 2
%P 79-81
%T Patient safety: honoring advanced directives
%V 25
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17285032
%X Healthcare providers typically think of patient safety in the context of preventing iatrogenic injury. Prevention of falls and medication or treatment errors is the typical focus of adverse event analyses. If healthcare providers are committed to honoring the wishes of patients, then perhaps failures to honor advanced directives should be viewed as reportable medical errors

%0 Journal Article
%C Memorial Sloan-Kettering Cancer Center, USA
%A Tomarken, A
%A Holland, J
%A Schachter, S
%A Vanderwerker, L
%A Zuckerman, E
%A Nelson, C
%A Coups, E
%A Ramirez, PM
%A Prigerson, H
%J Psychooncology
%D 2007 Apr
%T Factors of complicated grief pre-death in caregivers of cancer patients
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17443644
%X Purpose: Over the past decade, Prigerson and her colleagues have shown that symptoms of 'complicated grief'-intense yearning, difficulty accepting the death, excessive bitterness, numbness, emptiness, and feeling uneasy moving on and that the future is bleak-are distinct from depression and anxiety and are independently associated with substantial morbidity. Little is known about complicated grief experienced by family caregivers prior to the death. This study sought to examine differences in caregiver age groups and potential risk factors for complicated grief pre-death.Method: Two hundred and forty eight caregivers from multiple sites nationwide (20-86 years of age) identified themselves as primary caregivers to a terminally ill cancer patient. Each caregiver was interviewed using the following measures: the Pre-Death Inventory of Complicated Grief-Caregiver Version; the Brief Interpersonal Support Evaluation List; the Structured Clinical Interview for the DSM-IV Axis I; the Life Orientation Test-Revised; the SEPRATE Measure of Stressful Life Events; the Covinsky Family Impact Survey; and mental health access questions.Results: The study found that those under 60 years old had higher levels of complicated grief pre-death than caregivers 60 and older (t(246)=2.30, p<0.05). Significant correlations were also found between levels of complicated grief pre-loss and the following psychosocial factors: perceived social support (r=-0.415, p<0.001); history of depression (r=-0.169, p<0.05); current depression (r=-0.158, p<0.05); current annual income (Spearman rho =-0.210, p<0.01); annual income at time of patient's diagnosis (Spearman rho =-0.155, p=0.05); pessimistic thinking (r=0.320, p<0.001); and number of moderate to severe stressful life events (Spearman rho = 0.218, p=0.001). In a multi-variate analysis (R(2)=0.368), pessimistic thinking (Beta = 0.208, p<0.05) and severity of stressful life events (Beta = 0.222, p<0.05) remained as important factors to developing complicated grief pre-death.Conclusions: These results suggest that mental health professionals who work with caregivers should pay particular attention to pessimistic thinking and stressful life events, beyond the stress of the loved one's illness, that caretakers experience. Additionally, although not reaching significance, mental health professionals should also consider younger caregivers at greater risk for complicated grief pre-loss. Copyright (c) 2007 John Wiley & Sons, Ltd

%0 Journal Article
%C Kenneth J. Norris Jr Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
%A Turner, Jeffrey S
%A Cheung, Eric M
%A George, Jaya
%A Quinn, David I
%J BJU Int
%D 2007 May
%N 6
%P 1305-12
%T Pain management, supportive and palliative care in patients with renal cell carcinoma
%V 99
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17441929

%0 Journal Article
%C From the Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota
%A Virnig, Beth A
%J Med Care
%D 2007 May
%N 5
%P 374-6
%T Toward a Better Understanding of the Role of Geography in Intensity of End-of-Life Care: Must We First Come to an Understanding of End-of-Life Care?
%V 45
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17446822

%0 Journal Article
%C Indianapolis Grief & Loss Consulting & Educational Services, Avon, IN 46123, USA. paulette@indygriefloss.com
%A Walker, Paulette
%A Shaffer, Michelle
%J Health Soc Work
%D 2007 Feb
%N 1
%P 67-8
%T Reducing depression among adolescents dealing with grief and loss: a program evaluation report
%V 32
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17432743

%0 Journal Article
%C The Harry R Horvitz Center for Palliative Medicine, The Cleveland Clinic Taussig Cancer Center, Cleveland, Ohio 44195, USA. walsht@ccf.org
%A Walsh, Declan
%A Perin, Mary Lou
%A McIver, Beth
%J Am J Hosp Palliat Care
%D 2006 Oct-Nov
%N 5
%P 353-9
%T Parenteral morphine prescribing patterns among inpatients with pain from advanced cancer: a prospective survey of intravenous and subcutaneous use
%V 23
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17060302
%X Prescribing patterns for parenteral morphine for symptom control in advanced cancer were studied in 50 consecutive hospital admissions (27 men, 23 women, median age, 62 years). Patients were interviewed daily (median time, 9 days) concerning analgesia while they were receiving parenteral morphine. Five major inpatient prescribing patterns were identified: (1) intravenous to oral, (2) intravenous to subcutaneous, (3) intravenous only, (4) subcutaneous only, and (5) mixed. The intravenoustooral group had more stable pain control than the intravenous-to-subcutaneous group. Pain control was good in the mixed group, suggesting that flexibility in the route of administration contributes to better pain control. Patients with neuropathic pain required higher doses of morphine. These patterns of parenteral morphine application reflect the complexity of the challenge presented by the various cancer pain syndromes. Physicians should be knowledgeable about the appropriate and flexible use of different routes of administration for morphine and other opioids

%0 Journal Article
%C Department for Internal Medicine II, Division of Haematology and Medical Oncology, Friedrich Schiller University, Erlanger Allee 101, 07747 Jena, Germany. ulrich.wedding@med.uni-jena.de
%A Wedding, Ulrich
%A Roehrig, Bernd
%A Klippstein, Almuth
%A Steiner, Peggy
%A Schaeffer, Thomas
%A Pientka, Ludger
%A Hoffken, Klaus
%J Crit Rev Oncol Hematol
%D 2007 Mar
%N 3
%P 269-76
%T Comorbidity in patients with cancer: prevalence and severity measured by cumulative illness rating scale
%V 61
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17207632
%X Comorbidity is defined as the presence of one or more diseases in addition to an index disease. In elderly people, the number and severity of comorbidity increase with age. We report the comorbidity data of 536 patients treated as in-patients: 231 elderly cancer patients (ECP), 172 younger cancer patients (YCP) and 133 elderly patients admitted for non-cancer reasons (EMP). Comorbidity was assessed with the cumulative illness rating scale geriatric version (CIRS-G). Data on number of affected organ systems (levels 1-4), number of affected organ systems with severe disease (levels 3-4), and sum score of levels per patient are reported. The number of comorbidities increases with age. A 76% of ECP, 51% of YCP, and 79% of EMP have severe comorbidity. Palliative treatment approach is not associated with higher levels of comorbidity in ECP. Vascular disorders were the most common comorbidity. The difficulty to rate haematological comorbidity in cancer patients is reflected. This is the first report on detailed results of assessment of comorbidity measured by CIRS-G in cancer patients. In addition, we provide a comparison to an elderly group of patients admitted for non-cancer reasons

%0 Journal Article
%C Department of Pain and Palliative Care, Peter MacCallum Cancer Centre, East Melbourne, Australia, Victoria, Australia
%A Wein, Simon
%J J Palliat Care
%D 2007 Spring
%N 1
%P 40-3
%T Is courage the counterpoint of demoralization?
%V 23
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17444461
%X OBJECTIVE: To consider the role courage plays in our ability to cope with threat and adversity, especially the role of courage in understanding demoralization and dignity. METHOD: By exploring standard psychiatric texts and Aristotle's concept of courage and virtue. A review of Medline and PsycINFO provided few relevant documents, reflecting the paucity of research on the concept of courage in psychiatry, palliative care, and psycho-oncology. RESULTS AND CONCLUSIONS: Courage is an important precursor to maintaining morale and therefore may play a critical causative role in demoralization. Courage is also intimately related to the concepts of self-esteem, free will, and personal values in life. The utility of the concept of courage is that it enables a response to a difficult circumstance. The main drawback of courage in a therapeutic sense is that it is often linked with cowardice, which has a pejorative connotation and is notoriously difficult to diagnose

%0 Journal Article
%C Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden. agneta.wennman-larsen@ki.se
%A Wennman-Larsen, Agneta
%A Tishelman, Carol
%A Wengstrom, Yvonne
%A Gustavsson, Petter
%J J Pain Symptom Manage
%D 2007 Feb
%N 2
%P 146-55
%T Factors influencing agreement in symptom ratings by lung cancer patients and their significant others
%V 33
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17280920
%X Comparisons of symptom ratings and health-related quality of life between significant others and patients have been the focus of numerous studies during the past decades. Additional studies are needed to assess the discrepancies identified in this work. In the present cross-sectional exploratory study, focus has been on evaluating the accuracy of significant other proxy ratings and on investigating factors that influence agreement between lung cancer patients and significant others based on dyadic assessments from 52 patients and 54 significant others. Results indicate that the levels of agreement are fair to good, but that significant others consistently rate the patients' symptoms higher and functioning lower than the patients do themselves. Factors found to influence agreement in various dimensions of symptoms and functioning were gender, patient age, and significant others' self-reported lack of family support, health problems, and caregiver esteem

%0 Journal Article
%C Medical University of South Carolina, Charleston, South Carolina, USA
%A Wong, Jeffrey G
%J Acad Med
%D 2007 Mar
%N 3
%P 263
%T Different worlds
%V 82
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17327715

%0 Journal Article
%C Department of Medicine, Division of General Internal Medicine, Dalhousie University, Halifax, Canada. stephen.workman@gmail.com
%A Workman, S
%J QJM
%D 2006 Oct
%N 10
%P 711-5
%T Cardiopulmonary resuscitation: charting a course for the future
%V 99
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=16998211

%0 Journal Article
%C Spitalul Clinic de Urgenta Militar Central
%A Zemba, M
%A Andrei, Sorana
%A Cucu, B
%A Bratulescu, M
%A Stinghe, Alina
%A Bobeico, Veronica
%A Dobrescu, Nadia
%A Zugravu, Viorica
%A Furedi, G
%J Oftalmologia
%D 2006 
%N 4
%P 51-3
%T [Amniotic membrane transplantation in palliative treatment of bullous keratopathy]
%V 50
%W http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=abstract&list_uids=17345804
%X PURPOSE: To assess the efficacy of amniotic membrane transplantation for the improvement of symptoms in bullous keratopathy. MATERIAL AND METHOD: Prospective study. 14 patients were operated between 01.02.2003 - 01.02.2006. the follow-up period: between 6 and 42 months with an average of 18 months. The following parameters were evaluated: corneal re-epithelialisation appearance of epithelial bullae, pain, photophobia. RESULTS: In 11 cases there was an improvement of the symptomatology: complete in 8 cases and partial in 3 cases. CONCLUSIONS: Amniotic membrane transplantation is an efficient palliative treatment for bullous keratopathy