Learning From the Public: Citizens Describe the Need to Improve End-of-Life Care Access, Provision and Recognition Across Europe.
Learning from the public: citizens describe the need to improve end-of-life care access, provision and recognition across Europe.
Eur J Public Health. 2013 Mar 13;
Daveson BA, Alonso JP, Calanzani N, Ramsenthaler C, Gysels M, Antunes B, Moens K, Groeneveld EI, Albers G, Finetti S, Pettentati F, Bausewein C, Higginson IJ, Harding R, Deliens L, Toscani F, Ferreira PL, Ceulemans L, Gomes B,
BACKGROUND: Despite ageing populations and increasing cancer deaths, many European countries lack national policies regarding palliative and end-of-life care. The aim of our research was to determine public views regarding end-of-life care in the face of serious illness. METHODS: Implementation of a pan-European population-based survey with adults in England, Belgium (Flanders), Germany, Italy, the Netherlands, Portugal and Spain. Three stages of analysis were completed on open-ended question data: (i) inductive analysis to determine a category-code framework; (ii) country-level manifest deductive content analysis; and (iii) thematic analysis to identify cross-country prominent themes. RESULTS: Of the 9344 respondents, 1543 (17%) answered the open-ended question. Two prominent themes were revealed: (i) a need for improved quality of end-of-life and palliative care, and access to this care for patients and families and (ii) the recognition of the importance of death and dying, the cessation of treatments to extend life unnecessarily and the need for holistic care to include comfort and support. CONCLUSIONS: Within Europe, the public recognizes the importance of death and dying; they are concerned about the prioritization of quantity of life over quality of life; and they call for improved quality of end-of-life and palliative care for patients, especially for elderly patients, and families. To fulfil the urgent need for a policy response and to advance research and care, we suggest four solutions for European palliative and end-of-life care: institute government-led national strategies; protect regional research funding; consider within- and between-country variance; establish standards for training, education and service delivery. HubMed – rehab
Age- and sex-related differences in force-velocity characteristics of upper and lower limbs of competitive adolescent swimmers.
J Hum Kinet. 2012 May; 32: 87-95
Nikolaidis PT
While there is a direct relationship between maximal anaerobic power (Pmax) and swimming performance, the relationship between upper and lower limbs with regard to Pmax and force-velocity (F-v) characteristics is not clear. The aim of the present study was to examine the effect of age and sex on the ratios of mechanical characteristics between upper and lower extremities of adolescent swimmers. Seventeen girls (aged 14.7±1.8 yr) (mean±standard deviation) and 28 boys (14.6±1.4 yr), all members of competitive swimming clubs, performed a F-v test for both legs and arms. In legs, boys had higher values of Pmax (t43=2.4, p<0.05), Pmax expressed in relative to body mass values (rPmax, t43=3.4, p<0.01) and v0 (t43=4.3, p<0.001), while no differences were found for F0 (t43=1.0, p=0.31) and v0/F0 (t43=0.55, p=0.59). In arms, boys had higher values of Pmax (t43=3.2, p<0.01), rPmax (t43=3.9, p<0.001) and v0 (t43=3.4, p<0.01), while no differences were found for F0 (t43=1.9, p=0.06) and v0/F0 (t43=0.16, p=0.87). However, no sex difference was found with regard to the ratios of Pmax (t43=1.9, p=0.06), F0 (t43=1.2, p=0.23) and v0 (t43=1.3, p=0.20) between upper and lower extremities. There was direct relationship between age and Pmax of legs (r=0.64, p<0.01 in girls; r=0.43, p<0.05 in boys) and arms (r=0.56, p<0.05; r=0.57, p<0.01 respectively), while there was not any significant association between age and the ratios of mechanical characteristics of upper and lower limbs. These findings emphasize the need for separate evaluation of arms' and legs' force-velocity characteristics on a regular basis and the consideration of these measures in training design. HubMed – rehab
Spinal Infarction Related to the Adjuvant Chemotherapy for Surgically Resected Non-small Cell Lung Cancer: Report of a Case.
Jpn J Clin Oncol. 2013 Mar 13;
Matsutani N, Kawamura M
We report the development of spinal infarction during adjuvant chemotherapy with tegafur, gimeracil and oteracil (TS-1) after surgery for lung adenocarcinoma. A 69-year-old female had a left upper lobectomy for pulmonary adenocarcinoma, T2aN0M0. Six weeks after the surgery, tegafur, gimeracil and oteracil were administered orally as adjuvant chemotherapy for 1 year. After 10 months of adjuvant chemotherapy, the patient suddenly showed signs of numbness and weakness in both lower limbs. The patient did not have a previous medical history, and was receiving only tegafur, gimeracil and oteracil with the stomach medication. Neurological findings showed muscle weakness, numbness and a loss of tendon reflex in both lower limbs, as well as bladder and rectal disturbance. Blood tests, brain magnetic resonance imaging and chest computed tomography showed no signs of abnormalities or metastasis. Magnetic resonance imaging of the spine showed a hyperintense lesion between the Th12 and L1 spinal levels by T2-weighted image. A spinal fluid test indicated no abnormalities, and cytological diagnosis was class II. Anti-aquaporin 4, anti-ganglioside and anti-neuronal autoantibodies were all negative. These results indicated that the patient had a spinal infarction, rather than myelitis or paraneoplastic neurological syndrome. The patient was treated with heparin and steroid pulse treatment followed by rehabilitation, and recovered sufficiently to be able to walk using a cane after 2 months. The development of spinal infarction during anti-cancer chemotherapy has not been previously reported. In this case, an association of spinal infarction with the use of adjuvant chemotherapy was strongly indicated due to the lack of abnormalities in coagulability, atherosclerotic lesions and aortic disease. HubMed – rehab