PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Program to improve palliative care falls short of hopes

2010-09-10
(Press-News.org) There may be no simple one-size-fits-all approach to improving end-of-life care in ICU settings, according to a recent study from some of the world's leading researchers in palliative care.

The study, which will be published online ahead of the print edition of the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine, showed that an intervention designed to improve doctor-patient communication and overall satisfaction of families whose loved ones died in critical care settings failed to improve family satisfaction after the death of their loved one, or to better communication between doctors, nurses and families.

"We were surprised that it was a negative study," said J. Randall Curtis, M.D., M.P.H, immediate past president of the ATS and lead author of the study. "It is very difficult to change busy critical care clinicians' – including both nurses and physicians – behavior patterns, because they have a lot of pressures on them. While we designed the intervention with that in mind, it was more difficult than we anticipated."

Twelve Seattle/Tacoma-area hospitals took part in the study and were randomized to receive the intervention or to serve as controls. The intervention specifically addressed five components: clinical education, local champions, academic detailing, clinician feedback of quality data, and system supports, and took place over 13-20 months. Outcomes were assessed by comparing family satisfaction with the death of their loved one before and after the intervention, both within single institutions and across all.

Doctors and nurses at each institution that received the intervention underwent training designed to increase their communication skills with one another and with families, and were instructed to discuss end-of-life options openly, as appropriate, with families. The hospitals that were randomized as controls received the intervention after completion of the study.

"Our focus was communication, but that is something difficult to change in general," said Dr. Curtis. "Tasks are easier to convey and more concrete, whereas this communication skill is is more complex and therefore harder to teach and maintain, especially through an externally implemented program."

The primary outcome measured was the family's satisfaction with the ICU experience after the death of their loved one. All families whose loved one had died either in the ICU, or within 30 hours of ICU discharge, were sent validated questionnaires designed to assess their assessment of the "quality of dying and death" and their overall satisfaction with the ICU experience. Of the 1924 patient who had died in the study, 822 family members (43 percent) responded to the questionnaires. However, there was no detectable difference in the satisfaction of families, regardless of whether the institution where their loved on had died had received the intervention.

"I do not think that our results indicate a failure of palliative care," said Dr. Curtis. "I think it is clear that palliative care does good, a fact that has been shown through many studies. However, we did show that the method we used of implementing changes as a package from an external source does not work. We asked whether this intervention could improve families' experience with the death of their loved one in the ICU, and the answer was no."

Dr. Curtis believes that palliative care can be improved in institutions more effectively through an internal commitment to the process and through interventions that are developed and supported at the local level, rather than as a set of changes administered from external sources and delivered to institutions as a package. "When we first did this intervention in our own hospital, we were able to show improvements in communication among nurses and doctors and nurses ratings of end-of-life care, but we were not able to export that to other institutions," he said.

Improving palliative care may be one of the more effective ways to both reduce healthcare costs and improve outcomes. "A significant portion of our healthcare spending is at the very end of life," said Dr. Curtis.

"We have a real challenge in the U.S. in terms of addressing the problems of our healthcare system," he said. "On one hand, we are trying to increase access and quality, but on the other, we are focused on reducing costs. Palliative care is one of the rare instances where all three of these goals can be met through a single intervention. Effectively improving education among doctors and patients, as well as family members, nurses and social workers, can both improve quality of care and patient/family satisfaction and reduce costs. This is an area of care that is especially important in our current time."

INFORMATION:

END



ELSE PRESS RELEASES FROM THIS DATE:

Mount Sinai researchers analyze impact of chemical BPA in dental sealants used in children

2010-09-10
Researchers from Mount Sinai School of Medicine have found that bisphenol A (BPA) released from some plastic resins used in pediatric dentistry is detectable in the saliva after placement in children's mouths. BPA is a widely used synthetic chemical that has been associated with changes in behavior, prostate and urinary tract development, and early onset of puberty. The findings are published in the current issue of Pediatrics. Reins containing BPA are commonly used in preventive and restorative oral care. Children often have their teeth sealed with a dental resin containing ...

World's first transcontinental anesthesia

Worlds first transcontinental anesthesia
2010-09-10
Videoconferences may be known for putting people to sleep, but never like this. Dr. Thomas Hemmerling and his team of McGill's Department of Anesthesia achieved a world first on August 30, 2010, when they treated patients undergoing thyroid gland surgery in Italy remotely from Montreal. The approach is part of new technological advancements, known as 'Teleanesthesia', and it involves a team of engineers, researchers and anesthesiologists who will ultimately apply the drugs intravenously which are then controlled remotely through an automated system. This achievement is ...

IV drips can be left in place

2010-09-10
Small intravenous devices (IVDs) commonly used in the hand or arm do not need to be moved routinely every 3 days. A randomized controlled trial comparing regular relocation with relocation on clinical indication, published in the open access journal BMC Medicine, found that rates of complications were the same for both regimens. Claire Rickard, from Griffith University, Australia, worked with a team of researchers to carry out the study with 362 patients at Launceston General Hospital, Tasmania. She said, "Recommended timelines for routine resite have been extended over ...

Scientists of Helmholtz Zentrum Muenchen and TU Muenchen elucidate structure details of protein Sam68

2010-09-10
The renowned Journal of Biological Chemistry has selected the report of these research findings as one of two "papers of the week" for its September 10, 2010 issue and has chosen the structural model as cover image. Using NMR spectroscopy, Professor Michael Sattler and his team elucidated the spatial structure of the Qua1 region of Sam68, which is responsible for the dimerization of the protein. In collaboration with the research group of Professor Ruth Brack-Werner of the Institute of Virology, the authors showed that this region is essential for the biological function ...

Many roads lead to superconductivity

2010-09-10
Since their discovery in 2008, a new class of superconductors has precipitated a flood of research the world over. Unlike the previously familiar copper ceramics (cuprates), the basic structure of this new class consists of iron compounds. Because the structure of these compounds differs from the cuprates in many fundamental ways, there is hope of gaining new insights into how the phenomenon of superconductivity arises. In cooperation with an international research group, researchers from Helmholtz-Zentrum Berlin (HZB) have now discovered a magnetic signature that occurs ...

NYU researchers identify new neurological deficit behind lazy eye

2010-09-10
Researchers at New York University's Center for Neural Science have identified a new neurological deficit behind amblyopia, or "lazy eye." Their findings, which appear in the most recent issue of the Journal of Neuroscience, shed additional light on how amblyopia results from disrupted links between the brain and normal visual processing. Amblyopia results from developmental problems in the brain. When the parts of the brain concerned with visual processing do not function properly, problems ensue with such visual functions as the perception of movement, depth, and fine ...

Sizing up stockpiles of children's vaccines

2010-09-10
A creative version of a classic engineering technique may improve decisions about building and using supplies of important pediatric vaccines, potentially leading to lower public health costs and healthier children. The United States maintains a six-month supply of common pediatric vaccines to ensure protection from deadly diseases, such as the flu, polio, and diphtheria, despite interruptions in vaccine production. The stockpiles must be replenished as the vaccines are used or expire, and, because the manufacture of vaccines is a laborious and unreliable process, health ...

LiXEdrom: Innovative measuring chamber for X-ray study of liquid jets

2010-09-10
X-rays are the medium of choice for many scientific studies. When you shine them on a sample, they literally shed light on the material's structure, providing loads of information about it. Unfortunately, this mostly applies to solids only, since the sample has to be in a vacuum for the entire time it is being irradiated with soft X-rays. For liquids, that means you have to remove all the water. In the case of biological samples such as proteins, however, this destroys their natural environment. The solution to this problems has always been to measure liquids through membranes. ...

Special focus on glycomics in OMICS: A Journal of Integrative Biology

2010-09-10
New Rochelle, NY, September 10, 2010—The glycome, encompassing all of the complex sugars produced by an organism, is comprised of multiple families of molecules whose function in the human body is often determined by the structure, composition, and placement of the attached sugars, as explored in a comprehensive look at the field of glycomics in a group of key articles in OMICS: A Journal of Integrative Biology, a peer-reviewed journal published by Mary Ann Liebert, Inc. (www.liebertpub.com). The relevant articles are available free online at www.liebertpub.com/omi Guest ...

Drug holds promise to halt debilitating condition of diabetes

2010-09-10
LAWRENCE — A drug developed at the University of Kansas has the potential to stop a debilitating condition of diabetes that often leads to pain in the extremities and even amputations, KU researchers have found. The researchers recently published an article showing that KU-32 can stop and even reverse diabetic peripheral neuropathy, or DPN, in mice. The condition leads to death of nerves in the extremities of individuals with diabetes. "People with DPN can be very sensitive to light touch, which can cause significant pain," said Rick Dobrowsky, professor of pharmacology ...

LAST 30 PRESS RELEASES:

Hot dragonfly summer: species with darker wings have evolved to withstand heat and attract partners

Development of a new electrolyte synthesis method for next-generation fuel cells: a step closer to green hydrogen production

Rage clicks: Study shows how political outrage fuels social media engagement

E-waste experts urge public: Stop trashing electronic products with ordinary garbage (International E-Waste Day)

Hospitals that are understaffed for infection prevention and control have higher rates of infection, study says

Study reveals 85% of women prefer choice between self-sampling and traditional cervical screening

Global advances and future trends in cervical cancer research from 2013 to 2022

Inspired by Spider-Man, a lab recreates web-slinging technology

Applied Microbiology International’s 2024 Honorary Fellowship goes to Dr Chikwe Ihekweazu

Pitt scientists validate new lab test platform for blood biomarkers of Alzheimer's disease

No bolts about it: New technology improves structural strength

Medical professionals must lead the fight against climate misinformation

Should doctors be suspended for unlawful climate activism?

Extreme rainfall linked to heightened risk of death

New research highlights the overlooked dangers of subtle and covert abuse in intimate relationships

Snowflake dance analysis could improve rain forecasts

ASPB welcomes Hong Ma as Society President

Can advanced AI can solve visual puzzles and perform abstract reasoning?

West Health-Gallup poll: Healthcare may be sleeper issue in U.S. presidential campaign

UC Irvine scientists track and analyze lofted embers that cause spot fires

Uncovering pandemic inequities

Microbiome researcher awarded NIH Transformative Research Award to pursue personalized treatment for gut diseases

Teresa Bowman, Ph.D., named Chair of Developmental & Molecular Biology at Albert Einstein College of Medicine

Legal system fails to protect people from malicious copyright cases at the cost of sexual privacy, study warns

Ancient climate analysis reveals unknown global processes

Gene therapy shows long-term benefit for patients with a rare pediatric brain disease

Do people with MS have an increased risk of cancer?

New research on octopus-inspired technology successfully maneuvers underwater objects

Newly discovered Late Cretaceous birds may have carried heavy prey like extant raptors

Bat species richness in San Diego, C.A. decreases as artificial lights, urbanization, and unconserved land increase, with Townsend's big-eared bat especially affected

[Press-News.org] Program to improve palliative care falls short of hopes