Browse Items (339 total)
- Tags: Article
The Impact Of A Sibling's Life-limiting Genetic Condition On Adult Brothers And Sisters
Tags: 2017, Adult, American Journal of Medical Genetics Part A, Article, Brother, Brown E, Coad J, Coping Behavior, Family Attitude, Female, Franklin A, Genetic Disorder, Grief, Human, Male, Parental Attitude, Peer Group, Priority Journal, Psychological Resilience, Qualitative Analysis, September 2017 List, Sibling, Sibling Attitude, Sister, Structured Interview, Trisomy 13, Trisomy 18, Wellbeing
Single-center Experience Providing Palliative Care To Pediatric Patients With End-stage Renal Disease
Tags: 2017, Article, Child, Clinical Article, Consultation, Emotional Stress, End Stage Renal Disease, Female, Human, Interdisciplinary Communication, Journal of Palliative Medicine, Keefer P, Khang E, Lehmann K, Luckritz K, Male, Medical Record Review, October 2017 List, Palliative Therapy, Parent, Saul D, Shanley M, Social Support, Woloszyk T
Analysis Of Death And Palliative Care In A Neonatal Intensive Care Unit
Tags: 2017, Analgesia, Analgesic Agent, Article, Ceccon M E J, Clinical Article, De Barbosa S M M, Descriptive Research, Female, Follow Up, Hospitalization, Human, Male, Marcola L, Neonatal Intensive Care Unit, Newborn, Newborn Death, October 2017 List, Pain Assessment, Palliative Therapy, Polastrini R T V, Prematurity, Resuscitation, Retrospective Study, Revista Paulista de Pediatria, Sedation, Sedative Agent, Zoboli I
Guidance on forgoing life-sustaining medical treatment
Tags: 2017, Apparent Life Threatening Event/th [therapy], Article, Awareness, Boss RD, Caregiver, Carter BS, Child Abuse, Child Care, Christian CW, Clinical Decision Making, Comatose Patient, Consensus, Consultation, Critical Illness/th [therapy], Davies D, Death, Death By Neurologic Criteria, Dell ML, Developmental Disorder/th [therapy], Diekema DS, Disease Burden, Disease Course, Elster N, Ethical Decision Making, Extremely Low Gestational Age, Family Decision Making, Family Stress, Feudtner C, Flaherty EG, Fortson BL, Foster Care, Gavril AR, Gestational Age, Goal Attainment, Guinn-Jones M, Hauer JM, Health Belief, High Risk Population, Human, Humphrey LM, Hurley TP, Hydration, Idzerda SM, Imaizumi S, Imminent Death, Informed Consent, Intensive Care, Interpersonal Communication, Katz AL, Klick J, Klipstein S, Laskey A, Laventhal N, Legal Aspect, Legano LA, Leventhal JM, Life-sustaining Medical Treatment, Linebarger JS, Lord B, MacAuley RC, MacMillan H, Medical Ethics, Medical Expert, Medical Information, Medical Procedures, Medical Specialist, Medically Administered Nutrition And Hydration, Moon MR, Neglect, Neurologic Disease/di [diagnosis], November 2017 List, Nutrition, Okun AL, Opel DJ, Oxygenation, Pain/th [therapy], Palliative Therapy, Parker S, Patient Care Planning, Pediatrician, Pediatrics, Practice Guideline, Priority Journal, Prognosis, Quality Of Life, Resuscitation, Rivera F, shared decision making, Social Support, Spiritual Care, Statter MB, Stedt E, Survival, Teamwork, Terminal Care, Tissue Perfusion, Uncertain Prognosis, Weise KL
Trisomy 18: A survey of opinions, attitudes, and practices of neonatologists
Tags: 2016, Adult, American Journal of Medical Genetics Part A, Article, Attitude Of Health Personnel, Attitude To Abortion, Biggio JR, Caucasian, Christian, Chromosomes Human Pair 18, Clinical Practice, Correlation Analysis, December 2017 List, Demography, Disease Management, Disease Severity, Edwards RK, Family, Female, Fetus Malformation, Health Care Surveys, Human, Humans, Intellectual Impairment, Jacobs AP, Male, Marriage, Medical Decision Making, Medical Society, Neonatologist, Neonatologists/px [psychology], Newborn Care, Normal Human, Outcome Assessment (health Care), Palliative Care, Palliative Therapy, Parental Attitude, Philips JB 3rd, Physician Attitude, Practice Patterns Physicians', Prenatal Diagnosis, Priority Journal, Race Difference, Resuscitation, Robin NH, Subramaniam A, Survival Rate, Tang Y, Trisomy 18, Trisomy/di [diagnosis], United States
[Difficulties in communication with parents of pediatric cancer patients during the transition to palliative care]
Tags: 2017, Article, Attitude Of Health Personnel, Cancer Mortality, Cancer Palliative Therapy, Cancer Patient, Cancer Therapy, Child, Childhood Cancer, Communication Barrier, Communication Barriers, Critical Illness/nu [nursing], Critical Illness/px [psychology], Disease Management, Dying, Empathy, Female, Hauser P, Hegedus K, Human, Humans, Interpersonal Communication, Medical Expert, Nyiro J, Oncologist, Oncology 2017 List, Orvosi Hetilap, Palliative Care/mt [methods], Palliative Care/px [psychology], Parent-child Relations, Parental Attitude, Parents/px [psychology], Pediatrician, Physician-patient Relations, Psychologist, Quality Of Health Care, Self Defense, Structured Interview, Zorgo S
Disparities in the intensity of end-of-life care for children with cancer
Tags: 2017, Adolescent, Adult, Alvarez E, Article, Bhatia S, Cancer Chemotherapy, Caucasian, Chamberlain LJ, Child, Childhood Cancer, Childhood Mortality, Cohort Analysis, Controlled Study, Demography, Female, Health Care Disparity, Hematologic Malignancy, Hemodialysis, Hospital Admission, Hospital Mortality, Human, Infant, Intensive Care Unit, Intubation, Johnston EE, Major Clinical Study, Male, Newborn, Oncology 2017 List, Pediatrics, Population Research, Priority Journal, Resuscitation, Retrospective Study, Sanders L, Saynina O, Terminal Care
Practice patterns of palliative radiation therapy in pediatric oncology patients in an international pediatric research consortium
Tags: 2017, Alcorn SR, Anesthesia, Article, Brain Metastasis, Cancer Patient, Chen MJ, Chen Q, Child, Childhood Cancer/rt [radiotherapy], Cone Beam Computed Tomography, Conformal Radiotherapy, Dieckmann K, Electron Therapy, Ependymoma, Ermoian RP, Ewing Sarcoma, Figueiredo MLS, Ford EC, Health Survey, Histopathology, Human, Intensity Modulated Radiation Therapy, Intestine Obstruction, Kobyzeva D, Ladra MM, Leukemia, Lymphoma, MacDonald SM, Major Clinical Study, Malignant Neoplasm, Medulloblastoma, Metastasis, Nechesnyuk AV, Neuroblastoma, Nilsson K, Oncology 2017 List, Osteosarcoma, Pain, Palliative Therapy, Pediatric Blood and Cancer, Primary Tumor, Priority Journal, Proton Therapy, Radiation Dose Fractionation, Radiosensitivity, Rao AD, Re-irradiation, Respiratory Tract Disease, Rhabdomyosarcoma, Spinal Cord Compression, Stereotactic Body Radiation Therapy, Stomach Distension, Terezakis SA, Villar RC, Winey BA
Use of opioids in palliative care of children with advanced cancer
Tags: 2016, 52-26-6 (morphine), 53663-61-9 (opiate), 57-27-2 (morphine), 8002-76-4 (opiate), 8008-60-4 (opiate), Adjuvant, Advanced Cancer, Analgesia, Article, Child, Childhood Cancer, Cid Barria L, Constipation, Diagnosis, Drug Efficacy, Drug Safety, Female, Fernandez Urtubia B, Human, Major Clinical Study, Male, Medical Record, Morphine, Morphine/dt [drug Therapy], Nonsteroid Antiinflammatory Agent, Nonsteroid Antiinflammatory Agent/dt [drug Therapy], Oncology 2017 List, Opiate/dt [drug Therapy], Pain Intensity, Pain/dt [drug Therapy], Palliative Therapy, Palma Torres C, Retrospective Study, Revista Chilena De Pediatria, Rodriguez Zamora N, School Child, Sedation, Trevigno Bravo A, Visual Analog Scale
Moral distress in PICU and neonatal ICU practitioners: A cross-sectional evaluation
Tags: 2017, Adult, Article, Burnout, Correlation Analysis, Cross-sectional Study, Demography, Distress Syndrome, Dryden-Palmer KD, Female, Gibbons C, health practitioner, Hospital care, Human, Intensive Care, January 2018 List, Larson CP, linear regression analysis, Major Clinical Study, Male, Maslach Burnout Inventory Depersonalization Subscale, Middle Aged, Mishel Parent Perception of Uncertainty Scale, Morality, Neonatal Intensive Care Unit, Nurse, outcome assessment, Parshuram CS, Pediatric Critical Care Medicine, Pediatric Intensive Care Unit, Physician, Priority Journal, Prognosis, Questionnaire, Rating Scale, Revised Moral Distress Scale, Terminal Care, tertiary care center, Uncertainty, Work, Young Adult
Emerging Collaboration Between Palliative Care Specialists and Mechanical Circulatory Support Teams: A Qualitative Study
Tags: 2016, Adult, Advance Care Planning, Article, assisted circulation, Child, Clinical Article, Decision Making, Fahlberg BB, Family, February 2018 List, Heart Failure, Heart-Assist Devices, Hospice Care, Human, Journal of Pain and Symptom Management, Kirkpatrick JN, Medicaid, Medical Specialist, Medicare, O'Connor NR, Palliative Care, Palliative Therapy, Patient Referral, Perception, Pisani BA, Qualitative Research, Sagin A, Self-Help Devices, Semi Structured Interview, Sundlof AL, telephone interview, ventricular assist device
Designing pain research from the patient's perspective: What trial end points are important to patients with chronic pain?
Tags: 2001, Adult, Aged, Article, Asch DA, Backlog, Casarett D, Chronic Pain/dt [Drug Therapy], Clinical Article, Clinical Study, Controlled Study, Demography, Disease Severity, Dose Response, Empiricism, Evaluation, Female, Health Center, Hirschman K, Human, Interview, Journal Article, Karlawish J, Male, Medical Decision Making, Medical Information, Medical Research, Methodology, Opiate/do [Drug Dose], Opiate/dt [drug Therapy], Outcomes Research, Pain Assessment, Pain Clinic, Pain Medicine, Perception, Qualitative Analysis, Rating Scale, Sankar P, Sleep, Urban Area
Neonatal end-of-life care: A single-center NICU experience in Israel over a decade
Tags: 2013, adrenal insufficiency/ep [Epidemiology], anemia/ep [Epidemiology], Article, Bar-Oz B, brain edema/ep [Epidemiology], brain hemorrhage/ep [Epidemiology], Cause Of Death, Child Parent Relation, congenital malformation/ep [Epidemiology], Eventov-Friedman S, Gestational Age, Human, Incidence, Israel, Jerusalem, Kanevsky H, kidney failure/ep [Epidemiology], March 2018 List, Medical Decision Making, Middle East, necrotizing enterocolitis/ep [Epidemiology], Newborn, Newborn Care, Newborn Death, newborn hypoxia/ep [Epidemiology], Newborn Intensive Care, newborn mortality, newborn sepsis/ep [Epidemiology], Pediatrics, Practice Guideline, Prematurity, Priority Journal, Quality Of Life, Religion, respiratory failure/ep [Epidemiology], sepsis/ep [Epidemiology], shock/ep [Epidemiology], treatment duration
Parental perceptions of forgoing artificial nutrition and hydration during end-of-life care
Tags: 2013, Article, Artificial Feeding, Child Care, Child Death, Clinical Practice, Concept Formation, Controlled Study, Decision Making, Female, Human, Hydration, Male, March 2018 List, Newman C, Parental Attitude, Pediatrics, Personal Experience, Priority Journal, Qualitative Research, Quality Of Life, Rapoport A, Religion, Rugg M, Satisfaction, Shaheed J, Steele R, Terminal Care
Facebook Advertisements Recruit Parents of Children With Cancer for an Online Survey of Web-Based Research Preferences
Tags: 2014, Adolescent, advertizing, Akard TF, Article, Backlog, Cancer Nursing, Cancer Palliative Therapy, Cancer Patient, Cancer Recurrence, Cancer Research, Caregiver, Child, Childhood Cancer, click, computer, Diseases, Facebook, Female, Gilmer Mary Jo, Health Survey, Human, Income, Information Processing, Internet, Interpersonal Communication, Journal Article, legal guardian, Major Clinical Study, Male, mobile phone, Neoplasm, Nurse, Oncology, Only Child, Palliative Therapy, Parent, Parental Attitude, participant recruitment, Patient, Population, Priority Journal, Sample Size, School Child, social media, social network, Video Recording, Wray S
Involvement of nurses in end-of-life discussions for severely disabled children
Tags: 2018, April 2018 List, Article, Child, Clinical Article, de Vos MA, Disabled Children, Distress Syndrome, Ewals F, Female, Handicapped Child, Human, Human Experiment, Intellectual Impairment, Journal of Intellectual Disability Research., Male, Morality, Nurse, Only Child, Qualitative Research, Quality Of Life, Retrospective Study, Semi Structured Interview, van Goudoever JB, Willems DI, Zaal-Schuller IH
Parental assessment of comfort in newborns affected by lifelimiting conditions treated by a standardized neonatal comfort care program
Tags: 2018, Adult, April 2018 List, Article, Byrne M, Child Parent Relation, Clinical Article, Daho M, Female, fluid intake, Foe G, Health Care Delivery, Health Care Quality, health program, Health Survey, Human, Infant, Infant Nutrition, Journal Of Perinatology, kangaroo care, Life Expectancy, life limiting disease, Male, Newborn, Newborn Care, Parental Attitude, parental behavior, Parravicini E, Patient Comfort, Peer Review, physical disease, Prospective Study, Self Report, standardization, Steinwurtzel R
Survey on Neonatal End-of-Life Comfort Care Guidelines Across America
Tags: 2018, anxiety, April 2018 List, Article, bodily secretions, Canada, Carter B, Comfort, Compassion Fatigue, Farooqi S, Gastrointestinal Symptom, geographic distribution, Haug S, Hopper A, Human, Infant, Institutional Review, Intensive Care, Journal of Pain and Symptom Management, neonatal nurse practitioner, Neonatologist, Newborn, Oei G, Pain, Palliative Care, Palliative Therapy, Pediatrics, Perinatal Care, Practice Guideline, Satisfaction, Terminal Care, Wilson CG
Parenting in Childhood Life-Threatening Illness: A Mixed-Methods Study
Tags: 2018, April 2018 List, Article, Child, Child Parent Relation, childhood, Controlled Study, Deatrick JA, Decision Making, Female, Feudtner C, Human, Human Experiment, Interview, Journal of Palliative Medicine, Male, Meghani SH, Mooney-Doyle K, Only Child, Palliative Therapy, Perception, Problem Solving, Sibling, Social Work, Ulrich CM
Proxy-Reported Quality of Life and Family Impact for Children Followed Longitudinally by a Pediatric Palliative Care Team
Tags: 2018, Analysis of Variance, April 2018 List, Article, Attention, Bace S, Child, daily life activity, Darnall C, Diagnosis, Female, Human, Journal of Palliative Medicine, Longitudinal Studies, longitudinal study, Macfadyen A, Major Clinical Study, Male, Metronidazole, minimal clinically important difference, Only Child, Palliative Care, Palliative Therapy, physical model, Prospective Study, Quality Of Life, Statistical Significance, Vail C, Weaver M, Wichman C
Bringing social context into the conversation about pediatric long-term ventilation
Tags: 2018, April 2018 List, Article, Artificial Ventilation, Boss RD, Child, decision support system, Family Decision Making, Henderson CM, Home Care, home care services, home environment, Hospital Patient, Hospital Pediatrics, Human, Life Sustaining Treatment, Long Term Care, Long-Term Care, Mechanical, Medical Information, Only Child, Patient-centered Care, Pediatrics, Personal Experience, practice gap, Quality Of Life, Social Environment, Tracheostomy, Ventilators, Wilfond BS
Barriers and facilitators to the implementation of a paediatric palliative care team
Tags: 2018, April 2018 List, Article, Awareness, BMC Palliative Care, Child, concrete, Expectation, Female, Grootenhuis MA, Health Care Personnel, Human, Human Experiment, Kars MC, Major Clinical Study, Male, Only Child, Palliative Care, Palliative Therapy, Patient Satisfaction, Pediatrics, Pilot Projects, Pilot Study, Schepers SA, Schouten-Van Meeteren AYN, tertiary health care, van Delden JJM, Verberne LM
Interventions in the operating room for children near end of life: A multidisciplinary approach
International Children's Palliative Care Network: A Global Action Network for Children With Life-Limiting Conditions
Parents' needs for physician-parent communication in the face of life-threatening illness: Qualitative analysis
Tags: 2017, Adolescent, Article, Child, Child Death, child hospitalization, Childhood Disease, Clinical Article, Female, Health Care System, Hospice, Human, Infant, Interpersonal Communication, Janusz B, June 2018 List, Knowledge, law suit, Life Threatening illness, Male, malpractice, Palliative Medicine in Practice, Parent, Personal Experience, personal needs, physical disease, Physician, Preschool Child, Qualitative Analysis, School Child, Semi Structured Interview, Walkiewicz M
Advance care planning and outcome in pediatric palliative home care
Tags: 2018, Advance Care Planning, Article, Balzer S, Borkhardt A, Child, Controlled Study, Danneberg M, Death, Female, Gagnon G, Hoell JI, Home Care, Hospice, Human, Janßen G, June 2018 List, Kuhlen M, Life Sustaining Treatment, Major Clinical Study, Male, medical order, Oncotarget, Palliative Therapy, Resuscitation, Retrospective Study, Trocan L, Weber HL
Identifying the Types of Support Needed by Interprofessional Teams Providing Pediatric End-of-Life Care: A Thematic Analysis
Tags: 2018, Article, Child, Death, Education, Female, Firn J I, Human, Human Relation, institutional care, Journal of Palliative Medicine, June 2018 List, Keefer P M, Kukora S K, Major Clinical Study, Male, Riotte CO, Staff, Statistics, Terminal Care, Thematic Analysis, United States, work environment
Paediatric palliative care should focus on living as well as dying
Social Media Consequences of Pediatric Death
Making Meaning After the Death of a Child
Fifteen-minute consultation: Developing an advance care plan in partnership with the child and family
End-of-life decisions and practices for very preterm infants in the Wallonia-Brussels Federation of Belgium
Tags: 2018, Article, Aujoulat I, Bmc Pediatrics, Broux I, Brussels Capital Region, Cavatorta E, Charon A, Clinical Practice, Debauche C, Dussart A, Female, Flausch M, Gestational Age, Haumont D, Henrard S, Henrion E, Human, Infant, Johansson AB, Kalenga M, Langhendries JP, Lecart C, Major Clinical Study, Male, Marechal Y, Maton P, Mostaert A, Muller MF, Neonatologist, Neonatology, Newborn, Palliative Therapy, perinatal period, Prematurity, Qualitative Research, Questionnaire, September 2018 List, Sepulchre B, Terminal Care, Uncertainty, Van Herreweghe I, Van Overmeire B, Vanden ES, Verellen G, Vermeylen D, Vlieghe V, Wallonia
Decision-making at the limit of viability: Differing perceptions and opinions between neonatal physicians and nurses
Tags: 2018, Adult, Article, assisted ventilation, Barbara D, Baumann-Hölzle R, Berger TM, Bmc Pediatrics, Brigitte S, Bucher HU, Controlled Study, enteric feeding, Fauchère JC, Female, Gudrun J, Hendriks MJ, hospital policy, Human, Infant Mortality, Jean-Claude F, Kai R, Klein SD, Legal Aspect, Liliane S, Magali C, Male, Mathias N, Matthias R, Medical Decision Making, Medical Practice, Neonatal Intensive Care Unit, Neonatal Nurse, Neonatologist, nurse attitude, October 2018 List, Patient Participation, Philipp M, Physician Attitude, Prematurity, Questionnaire, Religion, Renate I, Riccardo P, Roland N, Ruth D, September 2018 List, Streuli JC, Switzerland, Terminal Care, Ulrike S, work experience
Patterns of paediatric end-of-life care: A chart review across different care settings in Switzerland
Tags: 103-90-2 (paracetamol), 2018, Adolescent, Aebi C, Ansari M, Article, Baer R, Bergstraesser E, Bernet V, Bmc Pediatrics, Brazzola P, Bucher HU, Buder R, Cagnazzo S, Cardiology, Cause Of Death, Child, Child Care, Child Death, Cignacco E, Cohort Analysis, community care, Dinten B, Dorsaz A, Drug Use, Elmer F, Engberg S, Enriquez R, Eskola K, Fahrni-Nater P, Female, Finkbeiner G, Frey B, Frey U, Greiner J, Hassink RI, Health Care Utilization, Home Care, Hospital Admission, Human, Infant, Intensive Care Unit, invasive procedure, Keller S, Kretschmar O, Kroell J, Laubscher B, Leibundgut K, Length Of Stay, Life Sustaining Treatment, Major Clinical Study, Malaer R, Male, Medical Record Review, Meyer A, narcotic analgesic agent, Nelle M, Neonatology, Neuhaus T, Neurology, Newborn, Niggli F, October 2018 List, Oncology, Paracetamol, Perrenoud G, Pfammatter JP, Plecko B, Popovic MB, Ramelet AS, Resuscitation, Retrospective Study, Rupf D, Sennhauser F, September 2018 List, Stade C, Steinlin M, Stoffel L, Stuessi C, Switzerland, Terminal Care, Thomas K, Treatment Withdrawal, Von der Weid N, von Vigier R, Vonarburg C, Wagner B, Wernz B, Wieland J, Zimmermann K
Low prevalence of palliative care and ethics consultations for children with chronic critical illness
Tags: 2018, Acta Paediatrica, International Journal of Paediatrics, Article, Artificial Ventilation, Boss RD, childhood disease th [Therapy], Chronic Disease, Consultation, Critical Illness, Donohue PK, Ethics, Falck A, Goloff N, Hospital Admission, Human, Hutton N, Intensive Care Unit, Length Of Stay, Miles A, November 2018 List, Palliative Therapy, Prevalence, Priority Journal, Shapiro M, Tracheostomy, Weiss EM
Exploring the vagueness of Religion & Spirituality in complex pediatric decision-making: A qualitative study
Tags: 2018, Article, Barfield RC, BMC Palliative Care, Brandon DH, Child, Decision Making, Docherty SL, Father, genetic transcription, Health Care Personnel, Human, Human Tissue, Intensive Care, Interview, Life Sustaining Treatment, Major Clinical Study, Male, Medical Record, Mother, Narrative, Neonatology, November 2018 List, Palliative Therapy, Prognosis, Qualitative Research, Religion, Superdock AK, Thematic Analysis, Treatment Withdrawal
National Impact of the EPEC-Pediatrics Enhanced Train-the-Trainer Model for Delivering Education on Pediatric Palliative Care
Tags: 2018, Advance Care Planning, Article, Bouffet E, Brennenstuhl S, Canada, Cancer Palliative Therapy, Child, Childhood Cancer, Clinical Practice, Friedrichsdorf S, Greenberg M, Health Care Quality, health practitioner, Human, Husain A, Journal of Palliative Medicine, Leyden M, Liben S, Medical Education, November 2018 List, Pediatrics, Pole JD, professional knowledge, Quality Of Life, Rapoport A, Self Care, Siden H, tertiary care center, Total Quality Management, Whitlock JA, Widger K, Wolfe J
Advance care planning for adolescent patients with life-threatening neurological conditions: A survey of Japanese paediatric neurologists
Tags: 2017, Adult, Advance Care Planning, Article, Artificial Ventilation, BMJ Paediatrics Open, Cross-sectional Study, do not resuscitate order, Family, Female, Health Care Survey, hematologist, Human, Japan, Kizawa Y, living will, Male, Middle Aged, Neurologic Disease, neurologist, November 2018 List, Pediatrician, Priority Journal, Prognosis, Shintaku H, Terminal Care, Yotani N
Opinions of Israeli neonatologists about life and death decisions in neonates
Tags: 2018, Adult, Age, Article, Bin-nun A, Demography, disabled person, Disease Severity, Dying, Ethnicity, Family Attitude, Female, Health Care Cost, Human, Israel, Israeli, Journal Of Perinatology, Kasirer MY, Male, Medical Decision Making, Medical Ethics, medicolegal aspect, Middle Aged, Mimouni FB, Neonatal Intensive Care Unit, Neonatologist, Normal Human, November 2018 List, Personal Experience, Physician Attitude, Prospective Study, psychological well being, Questionnaire, Religion, Schimmel MS, sex difference, Simulation, Terminal Care