Search Results for: Linee guida pratiche sulle cure palliative

‘Oltre 25 miliardi per cure non garantite, non è fuga da Ssn’

To the Editor A recent randomized clinical trial of palliative care initiated in the emergency department (ED) is commendable in its scale, effort, and intent. Even though its findings were null, and the authors discussed future research, the most obvious conclusion was not addressed.

In Reply We thank Dr Wong for his thoughtful review of our palliative care trial. We agree that the complexities around caring for persons with serious illness who present to the ED cannot be overstated. Also, safe ED discharge requires a team approach, including close coordination and communication between primary care clinicians, specialists, and other members of the interdisciplinary team. Two points require clarification when considering whether the ED is “the place” to integrate palliative care.

An important aspect of caring for patients with complex chronic illness, especially older adults with cancer, is understanding how treatment is tolerated. Yet barriers to seeking this information are many, including the debilitation caused by not only illness but also the adverse effects of treatment itself, which can effectively silence patients. In “Treatment Tolerability,” poetry becomes a vehicle for addressing these challenges, and imagining what patients may experience when receiving treatment (in this case, multiple transfusions). Immediately noticeable is the lack of capitalization and punctuation throughout the poem, which suggests the subordination of patients to the imperatives of urgent treatment in the quest for a cure. Adverse effects, such as confusion and weakness, are then conveyed by the haphazard rhyming in the poem; breathlessness, perhaps, is felt in the short, enjambed lines. Even the vague nursery rhyme feel of the poem seems a caution against how clinicians might infantilize and speak down to patients when attempting to assess treatment tolerability. That the poem’s speaker is not the patient but an observer seems to underscore the risk, even with the best of intentions, of supplanting the patient’s voice with our own. Finally, the speaker’s recognition of the inescapability of these concerns, and the frustration, shared by clinicians, that often accompanies them, are deftly expressed in the searching lines, “blindfolded in a fog of pain/covering everything/with a god-like fabric/because no mercy/is bright enough to pass/this fatigue onto another.”

Inaugurata struttura per cure alto livello a italiani e locali

“Tutta la famiglia della Segafredo vicina a lui, Forza Achi”

Pubblicate su Annals of Rheumatic Diseases nuove raccomandazioni

Nasce rivista ‘la miglior vita possibile’ per promuovere nuovi hospice e lo sviluppo di reti assistenziali domiciliari

Per la prima volta in oltre cinquant’anni, i Centers for Disease Control and Prevention (Cdc) si ritrovano con un nuovo comitato consultivo sulle pratiche vaccinali (Acip) composto da otto membri,…

Gruppo di lavoro per garantire uniformità e solidità scientifica

Introduction
Epilepsy is a prevalent chronic neurological disorder, with approximately one-third of patients experiencing intractable epilepsy, often necessitating surgical intervention. Deep brain stimulation (DBS) of the thalamus has been introduced as a palliative surgical option for seizure control; however, its precise mechanisms remain largely unclear. The thalamus plays a crucial role in coordinating neural networks, both in normal brain function and the propagation of epileptic activity. This study aims to investigate the involvement of the thalamus in epilepsy networks using stereoelectroencephalography (SEEG) to monitor thalamic activity during epileptic seizures in patients with drug-resistant epilepsy.

Methods and analysis
This single-arm, non-randomised, prospective, exploratory study will be conducted at Nagoya University Hospital, involving 10 patients undergoing SEEG for presurgical evaluation of drug-resistant epilepsy. Participants must be 18 years or older, have normal cognitive function and provide informed consent. Between 7 and 14 SEEG electrodes, including 2 in the bilateral thalamus, will be implanted in key thalamic nuclei (anterior, dorsomedial, centromedian and pulvinar) using a robotic system. The primary outcome focuses on electroencephalographic findings from the thalamus, emphasising waveform and frequency changes around seizures. Secondary outcomes include postoperative seizure frequency, changes in cognitive function and neuroimaging results. SEEG data will be recorded continuously for 1–2 weeks to capture both ictal and interictal activity. Data analysis will employ t-tests to compare ictal and interictal periods, with p values

‘Impatto sulla salute degli operatori e sulla qualità delle cure’

Background
People experiencing homelessness (PEH) often die at a younger age than the general population. Advanced ill-health often occurs late in its trajectory (if at all), leaving many PEH to die without adequate support from hospital-based, hospice-based or community-based palliative care services. Despite the high rate of bereavement and exposure to death among PEH, there are rarely opportunities for them to reflect on their experiences, thoughts and preferences around death or receive bereavement support. Death cafés are a global social franchise, providing a space for people to participate in an open group discussion about death, dying and bereavement. They are free to attend and unstructured but facilitated.

Objectives
To explore the perspectives of PEH and the professionals that support them with regards to the potential acceptability, benefits and challenges of death cafes.

Methods
A qualitative study comprising of interviews with nine homelessness and/or palliative care professionals with experience of running death cafés for, or supporting PEH in other ways, and two focus groups with nine people with lived experience of homelessness. The research was co-produced with a lived experience co-researcher forming a core part of the research team. Reflexive thematic analysis was utilised to develop themes.

Results
Five themes were developed to highlight the perspectives and experiences of death cafés for PEH: choice; expertise in facilitation: recognising risk and the unstructured nature; promoting safety against potential risk; potential benefits and potential practical considerations. Themes highlight the need for a trauma-informed approach. Death cafés could be impactful, where done well, but they are not without risk.

Conclusions
Death cafés for PEH pose risks that require comprehensive consideration and trauma-informed, expert facilitation. However, this research highlighted that a low-pressure space to explore thoughts around death, dying and bereavement is currently an unmet need within this population.

Objective
This study explored the burdens and motivations of family caregivers (FCs) for patients with end-stage liver disease (ESLD) in a tertiary hospital in Ghana.

Design
A qualitative exploratory, descriptive approach with a purposive sampling technique was adopted. Data were collected through face-to-face semi-structured interviews. The interviews were audio-recorded, transcribed verbatim and analysed using content analysis.

Setting
Participants were recruited from a tertiary hospital in the Northern Region of Ghana.

Participants
15 FCs aged between 18 and 50 years caring for patients with ESLD were recruited.

Results
The study’s findings revealed that FCs of individuals with ESLD encountered considerable challenges, including sleep deprivation, physical exhaustion, family conflicts, financial difficulties and social restrictions. These difficulties contributed to a sense of being overwhelmed as caregivers strived to fulfil their duties. Family bonds, reciprocal relationships and religious obligations were the motivation/driving force for FCs caring for relatives with ESLD.

Conclusion
Integrating palliative care services in tertiary health facilities will reduce the burdens FCs of patients with ESLD face. Relevant stakeholders in the health sector need to develop culturally sensitive interventions to support FCs caring for patients with ESLD in Ghana.