Browse Items · Pediatric Palliative Care Library

The effect of continuity of care on emergency department use

OBJECTIVE: To examine whether continuity of care with an individual health care provider is associated with the number of hospital emergency department (ED) visits in a statewide Medicaid population. DESIGN: A cross-sectional study based on a 100%…

Rethinking the role of tube feeding in patients with advanced dementia

Integrating palliative and curative approaches in the care of children with life-threatening illnesses

Dr. Ann Goldman, a palliative care specialist and pediatric oncologist at Great Ormond Street Hospital for Children in London, England, describes the pediatric palliative care program she initiated there 14 years ago. Fully integrated within the…

Tags: 2000, Backlog, Child, Goldman A, Heller KS, Journal Article, Journal of Palliative Medicine, Life Support Care, Palliative Care, Palliative Treatment, Terminal Care

End-of-life in the pediatric intensive care unit: seeking the family's decision of when and how, not if

2000

Tags: 2000, Backlog, Child, Critical Care Medicine, Death and Euthanasia, Decision Making, Family, Goldstein B, Humans, ICU Decision Making, Intensive Care Units, Journal Article, Merkens M, Pediatric, Terminal Care

Pediatric acute pain management

The past decade has brought about an explosion of knowledge about the physiology of nociception and many new techniques for pain relief, new analgesic drugs, and new applications of old analgesic drugs. These techniques include methods of opioid…

Clinical problems with the performance of euthanasia and physician-assisted suicide in The Netherlands

BACKGROUND AND METHODS: The characteristics and frequency of clinical problems with the performance of euthanasia and physician-assisted suicide are uncertain. We analyzed data from two studies of euthanasia and physician-assisted suicide in The…

Preventive services in a health maintenance organization: how well do pediatricians screen and educate adolescent patients?

OBJECTIVE: To determine whether pediatricians in managed care settings adhere to national guidelines concerning the provision of clinical preventive services. DESIGN: Surveys were mailed between September 1996 and April 1997 to all pediatricians…

Essential fatty acids in the nutrition of severely neurologically disabled children

Essential fatty acids (EFA) are important for the normal development and functioning of the brain, retina and immune competent cells. Severely neurologically handicapped children often have feeding difficulties, and the composition of the diet may be…

Sleep alterations in juvenile neuronal ceroid-lipofuscinosis

In juvenile neuronal ceroid-lipofuscinosis (JNCL), sleep disorders are common. The purpose of this study was to investigate the sleep structure of 28 patients with JNCL compared with healthy controls subjects and to clarify the pathophysiology…

Crisis intervention strategies when caring for families of children with cancer

A diagnosis of childhood cancer is an unexpected life event that often precipitates a situational crisis for all family members. Required cancer treatments and other ongoing stressors for both child and family will significantly disrupt the family's…

Tags: 2000, Adult, Backlog, Child, Crisis Intervention/methods, Family/psychology, Hendricks-Ferguson VL, Humans, Intervention, Interventions, Journal Article, Journal Of Pediatric Oncology Nursing, Neoplasms/nursing/psychology, Nursing Assessment/methods, Parent caregivers, Patient Care Planning, Professional-family Relations

Place of care in advanced cancer: a qualitative systematic literature review of patient preferences

BACKGROUND: It is commonly written that more patients wish to die at home than currently achieve this. However, the evidence for preferences for place of terminal care and death has not been systematically reviewed. AIM: To carry out a systematic…

Tags: 2000, Backlog, Higginson IJ, Journal Article, Journal of Palliative Medicine, Location Of Death, Sen-Gupta GJ

An evaluation of the Faces Pain Scale with young children

The psychometric characteristics of the Faces Pain Scale (FPS) were evaluated in three groups of preschool and school-aged children (3. 5-4.5; 4.5-5.5 and 5.5-6.5 years, respectively). The FPS was adequately comprehended by even young children. It…

Tags: 2000, Backlog, Cassey J, Child, Facial Expression, Female, Hennessy R, Humans, Hunter M, Journal Article, Journal of Pain and Symptom Management, Male, McDowell L, Non-U.S. Gov't, Pain Measurement/methods/psychology, Preschool, Reproducibility of Results, Research Support

Effect of severity of disability on survival in north east England cerebral palsy cohort

AIMS: To investigate the effect of motor and cognitive disabilities on the survival of people on the North of England Collaborative Cerebral Palsy Survey, and compare this with other published results. METHODS: The cerebral palsy cohort consists of…

Measuring the Quality of Care in Palliative Care Services: An Interview with Irene Higginson, PhD

2000

Tags: 2000, Backlog, Innovations in End-of-Life Care, Journal Article, Longitudinal Studies

Variability of analgesic practices for hospitalized children on different pediatric specialty units

This study examined the differences in the prescription and administration of analgesics in eight pediatric specialty units. Medical records of patients (n = 153) who were reported by nurses to be having pain were reviewed. Results showed that there…

Tags: 2000, Analgesics/administration & dosage/therapeutic use, Backlog, Child, Female, Hospital Units, Humans, Jacob E, Journal Article, Journal of Pain and Symptom Management, Male, Non-U.S. Gov't, P.H.S., Pain/drug Therapy, Pediatrics, Preschool, Puntillo KA, Research Support, U.S. Gov't

Melatonin for the treatment of handicapped children with severe sleep disorders

Sleep disorders are common in children with mental retardation and neurologic disorders. Melatonin, a recently developed natural compound, has been used successfully in sleep disorders. I report my experience with melatonin in an open, prospective…

Novel opioid peptides endomorphin-1 and endomorphin-2 are present in mammalian immune tissues

Endomorphin (EM)-1 and EM-2 are opioid tetrapeptides, reported within the central nervous system, which have very high specificity and affinity for the mu-opioid receptor. We have used newly developed and well-characterised radioimmunoassays (RIAs)…

Reviewing audit: barriers and facilitating factors for effective clinical audit

OBJECTIVE: To review the literature on the benefits and disadvantages of clinical and medical audit, and to assess the main facilitators and barriers to conducting the audit process. DESIGN: A comprehensive literature review was undertaken through a…

Adult education program in palliative care for nursing facility physicians: design and pilot test

Nursing facilities (NF) are important sites for the care of dying patients. Curricula likely to improve end-of-life care are needed for NF physicians. To this end, a model medical school palliative care curriculum was modified for experienced NF…

Attitudes toward limitation of support in a pediatric intensive care unit

OBJECTIVE: To prospectively determine opinions of members of a pediatric intensive care unit (PICU) team regarding the appropriateness of aggressive care. The types of support that caregivers sought to limit and their reasons for wanting these limits…

Stories of life transition: subjective well-being and ego development in parents of children with down syndrome

Eighty-seven parents of children with Down Syndrome (DS; 63 women, 24 men) wrote narratives about finding out that their child had DS and completed questionnaire measures of subjective well-being (SWB) and stress-related growth and completed the…

Tags: 2000, Backlog, Down Syndrome, Growth, Journal Article, Journal Of Research In Personality, King LA, Narrative, Parent caregiving, Ramsey C, Scollon CK, Subjective Well-Being, Transition, Well Being, Williams T

Cachexia

Cachexia represents the clinical consequence of a chronic, systemic inflammatory response, and its manifestations differ considerably from those of starvation. Although cachexia is classically associated with chronic infections and malignant…

Tags: 2000, Acute-Phase Reaction/metabolism, Annals Of Internal Medicine, Backlog, Body Composition, Cachexia/etiology/metabolism/physiopathology/therapy, Cytokines/physiology, Energy Metabolism, Humans, Journal Article, Kotler DP, Nutrition Disorders/diagnosis, Starvation/physiopathology

Intravenous morphine for emergency treatment of cancer pain

Despite the wide use of the World Health Organization (WHO) analgesic ladder for the relief of cancer pain, it is not uncommon to find patients presenting with severe pain to palliative care centres. This is more so in the developing world, where…

Oropharyngeal dysphagia and aspiration in patients with ataxia-telangiectasia

Objectives: To determine whether patients with ataxia-telangiectasia exhibit oropharyngeal dysphagia with concomitant aspiration and to examine the relationships among swallowing function, age, and nutritional status. Study design: Seventy patients…

Tags: 2000, ataxia telangectasia, characteristics, Children, Crawford T O, dysphagia aspiration, feeding difficulties, Journal of Pediatrics, Koerner C B, Lederman H M, Lefton-Greif M A, Loughlin G M, low weight, Pediatrics, Trajectory, Winkelstein J A, Zaburak M

Pain variations during cancer treatment in children: a descriptive survey

Structural interviews were conducted with 66 children and their families to investigate how the experience of pain varied during cancer treatment. At diagnosis, 49% experienced cancer-related pain. Intense pain was more common at the beginning of…

The importance of 'knowing the patient': community nurses' constructions of quality in providing palliative care

This paper reports findings from a study conducted in one community health care trust where 62 members of the district nursing team (grades B-H) were interviewed. An adaptation of the critical incident technique was used to determine factors which…

Tags: 2000, Austin L, Backlog, Caress A, Community Health Nursing, Death and Euthanasia, Empirical Approach, England, Hallett CE, Health Care Reform, Humans, Journal Article, Journal Of Advanced Nursing, Luker KA, Nurse-patient Relations, Palliative Care/standards, Quality Of Health Care, Questionnaires

Learning to care for people with chronic illness facing the end of life

2000

Tags: 2000, Backlog, Death and Euthanasia, Health Services Accessibility, Health Services Research, JAMA, Journal Article, Lynn J, Palliative Care/economics/standards/trends, Policy Making, Professional Patient Relationship, Quality Of Health Care, RDF Project, Terminal Care/economics/standards/trends, United States

Pain control by immune-derived opioids

1. The nervous and immune systems communicate with each other by use of cytokines and neuropeptides. 2. Interactions between immune cell-derived opioid peptides and opioid receptors located in peripheral inflamed tissue lead to endogenous analgesia.…

Tags: 2000, Analgesics, Backlog, Biomarkers of Pain, Clinical And Experimental Pharmacology & Physiology, Humans, Journal Article, Machelska H, Neuropeptides/therapeutic use, Opioid/drug effects/immunology, Opioid/therapeutic use, Pain/drug therapy/immunology, Peripheral Nervous System/drug effects, Receptors, Stein C

Opioid switch to oral methadone in cancer pain

The occurrence of undesirable side effects due to opioids (delirium, confusion, myoclonus, nausea, emesis) is one of the major complications in the management of pain, especially in chronic cancer pain states. Methadone, as an alternative to…

Using bisphosphonates to control the pain of bone metastases: evidence-based guidelines for palliative care

This work was undertaken by the Science Committee of the Association for Palliative Medicine of Great Britain and Ireland (APM) as a demonstration project in developing clinical guidelines relevant to palliative care from a pragmatic approach to…

Systemic lidocaine for neuropathic pain relief

The effectiveness of systemic lidocaine in relieving acute and chronic pain has been recognized for over 35 years. In particular, systemic lidocaine has been utilized both as a diagnostic and therapeutic tool for intractable neuropathic pain during…

Tags: 2000, Administration, Analgesics/administration & dosage/diagnostic use/therapeutic use, Animals, Backlog, Chen LL, Humans, Journal Article, Lidocaine/administration & dosage/diagnostic use/therapeutic use, Mao J, Mexiletine/therapeutic use, Neuralgia/drug therapy/metabolism, Oral, P.H.S., Pain, Research Support, Sodium Channel Blockers, U.S. Gov't

How children die in hospital.

A retrospective analysis was performed to describe the course of terminal care provided to dying hospitalized children in terms of symptom assessment and management, and communication and decision-making, at the end of life. Seventy-seven of 236…

End-of-life decision-making and satisfaction with care: parental perspectives.

OBJECTIVES: To evaluate parents' perceptions of the process by which decisions are made to limit or withdraw life support from critically ill children, and to evaluate parents' perceptions of their child's death in the pediatric intensive care unit…

Tags: 2000, Backlog, ICU Decision Making, Journal Article, Longitudinal Studies, Meert KL, Pediatric Critical Care Medicine, Sarnaik AP, Thurston CS

Experiencing transitions: an emerging middle-range theory

Changes in health and illness of individuals create a process of transition, and clients in transition tend to be more vulnerable to risks that may in turn affect their health. Uncovering these risks may be enhanced by understanding the transition…

The determinants of health care seeking behaviour of adolescents attending STD clinics in South Africa

The study investigated the determinants of delay behaviour in health care seeking in a sample of 292 adolescent patients (20 years and younger) with STD symptoms. Fifty six percent (56%) of the adolescents sought health care within the first 6 days…

Air swallowing in Rett syndrome

The possible causes of excessive swallowing of air leading to bloating, which is common in Rett syndrome (RS), were investigated during feeding and at rest. Seven individuals with RS aged between 4 and 33 years (three with air bloat) underwent…

Searching for the meaning of meaning: Grief therapy and the process of reconstruction

A comprehensive quantitative review of published randomized controlled outcome studies of grief counseling and therapy suggests that such interventions are typically ineffective, and perhaps even deleterious, at least for persons experiences a normal…

Tags: 2000, Backlog, Bereavement, Counseling, Death, Death studies, Grief, Journal Article, Knowledge, Meaning, Neimeyer RA, Time

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