the necessary care in their own homes where the practitioner will have the responsibility for coordinating treatment. This is usually preferred by the patient and his relatives providing that symptoms are adequately controlled and there is assurance of immediate admission to a hospice if this proves medically or socially necessary'. A Working Group for Terminal Care was set up in March 1979 wit...

Care of cancer patients may be a source of considerable stress. As part of a large scale longitudinal study of the interaction of biological, psychological and environmental factors in determining patient outcome, the mental and physical health status of 37 members of the nursing staff of a cancer hospital was examined. The study identifies risk factors for stress, professional ‘burn-out’ and p...

A report of a problem-based learning project on the ethics of terminal care, offered as one of the options available to first year MB ChB students in Edinburgh University Medical School. The project formed part of the 'clinical correlation course' in the new curriculum. Six students took part under the supervision of two clinical tutors and a moral philosopher. The course was case-based and pra...

BACKGROUND Annually, about 400 cases of sudden unexpected death are attributed to cancer in Tokyo, Japan. These individuals may have been undiagnosed, or their medical conditions may not have been carefully evaluated before death. We examined medical consultations, cancer diagnoses, and economic status of all cancer deaths investigated by medical examiners in 2009. METHODS Among cases handled...

BACKGROUND A palliative approach to the care of people with dementia has been advocated, albeit from an emergent evidence base. The person-centred philosophy of palliative care resonates with the often lengthy trajectory and heavy symptom burden of this terminal condition. AIM To explore participants' understanding of the concept of palliative care in the context of dementia. The participant ...

AIMS The aim of this study was to develop and implement guidelines for sedation and analgesia management in the paediatric intensive care unit (PICU) and evaluate the impact, feasibility and acceptability of these as part of a programme of research in this area and as a prelude to future trial work. METHOD This pilot study used a pre-post design using a historical control. SETTING Two PICUs...

BACKGROUND An integrated tiered service delivery model (ITSDM) has been proposed to provide 'full-coverage' of CD4 services throughout South Africa. Five tiers are described, defined by testing volumes and number of referring health-facilities. These include: (1) Tier-1/decentralized point-of-care service (POC) in a single site; Tier-2/POC-hub servicing processing < 30-40 samples from 8-10 heal...

PURPOSE In Korea, most terminal cancer patients have still not been included in end-of-life (EOL) discussions. The purpose of this study was to evaluate the proportion of patients participating in EOL discussions after adopting advance directives. MATERIALS AND METHODS Medical records of 106 hospice patients between July 2012 and February 2013 were reviewed retrospectively. The proportion of ...

BACKGROUND Although the attitude among doctors toward disclosing a cancer diagnosis is becoming more positive, informing patients of their disease has not yet become a common practice in Japan. We examined the psychological process, from hospitalization until death, among uninformed terminal cancer patients in Japan, and developed a psychological model. METHODS Terminal cancer patients hospit...