(Press-News.org) Based on current scientific literature, gastrostomy tube (G-tube) placement or other long-term enteral access devices should be withheld or withdrawn in patients with advanced dementia or other near end-of-life conditions, according to a special report published today in the OnlineFirst version of Nutrition in Clinical Practice (NCP), the official journal of the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.).
Written by the International Clinical Ethics Section of A.S.P.E.N., the report suggests that advanced dementia be seen by health care providers as a terminal illness. And that view and what it means should be communicated to the patient's family and loved ones for patient-centered care decision making.
The report states, "Numerous articles have been published about advanced dementia and use of feeding tubes, yet there remains a high consistency in finding a lack of efficacy in tube feeding in this population. Current scientific evidence suggests that the potential benefits of tube feeding do not outweigh the associated burdens of treatment in persons with advanced dementia. Studies consistently demonstrate a very high mortality rate in older adults with advanced dementia who have feeding tubes."
Based on its findings, the authors conclude that a thorough discussion should take place with the patient, family, significant others, caregivers, and/or surrogate decision makers, touching on the risks, burdens, and benefits, as well as the most updated evidence-based findings. They also stress that the final informed decision should be reached by all members of the healthcare team using a patient-centered approach, which respects the patient's autonomy, self-determination and dignity.
Recognizing the role health care institutions play in end-of-life planning, the authors of the report recommend that hospitals and long-term care facilities develop a process to promote advance directives to provide health care based on the patient's wishes and best interest.
While the report focuses on patients with advanced dementia or near end of life conditions, the authors of the report believe the findings may be applicable to other patients if used in conjunction with scientific information about that defined patient population.
INFORMATION:
Nutrition in Clinical Practice (NCP) is a peer-reviewed, interdisciplinary journal that publishes articles about the scientific basis and clinical application of nutrition and nutrition support. NCP contains comprehensive reviews, clinical research, case observations, and other types of papers written by experts in the field of nutrition and health care practitioners involved in the delivery of specialized nutrition support. NCP is an official journal of the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). All published NCP articles are available online at http://ncp.sagepub.com.
The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) is dedicated to improving patient care by advancing the science and practice of nutrition support therapy and metabolism. Founded in 1976, A.S.P.E.N. is an interdisciplinary organization whose members are involved in the provision of clinical nutrition therapies, including parenteral and enteral nutrition. With more than 6,000 members from around the world, A.S.P.E.N. is a community of dietitians, nurses, nurse practitioners, pharmacists, physicians, scientists, students, and other health professionals from every facet of nutrition support clinical practice, research, and education. For more information about A.S.P.E.N., please visit http://www.nutritioncare.org.
Past research shows physical beauty can be detrimental to women applying for masculine jobs. But belles can put the brakes on discrimination by acknowledging their looks during an interview, according to a new study led by the University of Colorado Boulder.
The paper, published in Organizational Behavior and Human Decision Processes, is the first to provide a method for curtailing such prejudice against attractive women.
In the study, when an attractive woman applied for a job typically filled by men -- a construction job -- and said, "I know I don't look like your ...
This news release is available in German.
Because of the deforestation of tropical rainforests in Brazil, significantly more carbon has been lost than was previously assumed. As scientists of the Hemholtz Centre for Environmental Research (UFZ) write in the scientific journal Nature Communications, the effect of the degradation has been underestimated in fragmented forest areas, since it was hitherto not possible to calculate the loss of the biomass at the forest edges and the higher emission of carbon dioxide. The UFZ scientists have now closed this knowledge gap. ...
If a scientist has a good reputation among his colleagues, other scientists are more likely to cite his publications. According to a study, reputation is crucial for the impact of publications.
Author reputation is key in driving a paper's citation count early in its life cycle, before a tipping point, after which reputation has much less influence compared to the paper's citation count, says Aalto University Professor Santo Fortunato, pointing out that this is a key finding of the study.
Quality – not quantity – of publications build authors' reputation
As ...
The results of a four-year international study of 2060 cardiac arrest cases across 15 hospitals published and available now on ScienceDirect. The study concludes:
The themes relating to the experience of death appear far broader than what has been understood so far, or what has been described as so called near-death experiences.
In some cases of cardiac arrest, memories of visual awareness compatible with so called out-of-body experiences may correspond with actual events.
A higher proportion of people may have vivid death experiences, but do not recall them due ...
A new study suggests that drops of fuel spilled at gas stations — which occur frequently with fill-ups — could cumulatively be causing long-term environmental damage to soil and groundwater in residential areas in close proximity to the stations.
Few studies have considered the potential environmental impact of routine gasoline spills and instead have focused on problems associated with large-scale leaks. Researchers with the Johns Hopkins Bloomberg School of Public Health, publishing online Sept. 19 in the Journal of Contaminant Hydrology, developed a mathematical ...
Washington, DC—A researcher who found that testosterone raised the risk of prostate tumors and exacerbated the effects of carcinogenic chemical exposure in rats is urging caution in prescribing testosterone therapy to men who have not been diagnosed with hypogonadism, according to a new study published in the Endocrine Society's journal Endocrinology.
Testosterone use has soared in the last decade among older men seeking to boost energy and feel younger. One study published in The Journal of Clinical Endocrinology & Metabolism found that the number of American men ...
Until now, if you want to print a greeting card for a loved one, you can use colorful graphics, fancy typefaces or special paper to enhance it. But what if you could integrate paper-thin displays into the cards, which could be printed at home and which would be able to depict self-created symbols or even react to touch? Those only some of the options computer scientists in Saarbrücken can offer.
They developed an approach that in the future will enable laypeople to print displays in any desired shape on various materials and therefore could change everyday life completely.
For ...
In a ground-breaking research project at the University of Gothenburg, seven Swedish women have had embryos reintroduced after receiving wombs from living donors. Now the first transplanted woman has delivered a baby – a healthy and normally developed boy. The world-unique birth was acknowledged in The Lancet on 5 October.
The uterus transplantation research project at the University of Gothenburg started in 1999 and has been evaluated in over 40 scientific articles. The goal of the Gothenburg project is to enable women who were born without a womb or who have lost ...
To explore any possible limits of the two theories, they have been experimentally verified many times already and both have passed all the tests so far. Hence, scientists look for deviations in experiments with increasing precision or under extreme conditions.
For this purpose, Nörtershäuser's team has now accelerated ions to velocities near the speed of light and illuminated them with a laser.
The results, which are presented in two new publications, confirm the time dilation predicted for high velocities in the theory of relativity with an accuracy that ...
Deerfield, Ill. (October 8, 2014) — The annual number of dengue fever cases in India is 282 times higher than officially reported, and the disease inflicts an economic burden on the country of at least US$1.11 billion each year in medical and other expenses, according to a new study published online today in the American Journal of Tropical Medicine & Hygiene.
The study, led by researchers at Brandeis University's Schneider Institute for Health Policy in Waltham, Massachusetts, the INCLEN Trust International in New Delhi, and the Indian Council of Medical Research's ...
