Search results for " End of life"

Need for Deprescribing in Hospital Elderly Patients Discharged with a Limited Life Expectancy: The REPOSI Study

2019

<b><i>Objective:</i></b> Older people approaching the end of life are at a high risk for adverse drug reactions. Approaching the end of life should change the therapeutic aims, triggering a reduction in the number of drugs.<b><i></i></b>The main aim of this study is to describe the preventive and symptomatic drug treatments prescribed to patients discharged with a limited life expectancy from internal medicine and geriatric wards. The secondary aim was to describe the potentially severe drug-drug interactions (DDI). <b><i>Materials and Methods:</i></b> We analyzed Registry of Polytherapies Societa Italiana di Medicina I…

Palliative Sedation in Patients With Advanced Cancer Followed at Home: A Prospective Study

2014

Abstract Context Home care programs in Italy. Objectives The aim of this study was to assess a protocol for palliative sedation (PS) performed at home. Methods A total of 219 patients were prospectively assessed to evaluate a PS protocol in patients with advanced cancer followed at home by two home care programs with different territorial facilities. The protocol was based on stepwise administration of midazolam. Results A total of 176 of the patients died at home, and PS was performed in 24 of these patients (13.6%). Younger patients received the procedure more frequently than older patients (P = 0.012). The principal reasons to start PS were agitated delirium (n = 20) and dyspnea (n = 4).…

Embedding “substrate” in environmental assessment of green roofs life cycle: evidences from an application to the whole chain in a Mediterranean site

2012

Abstract A classical LCA methodology is here applied to green roofs including in this analysis also the whole life cycle of the substrate, that represented a lack of previous LCA studies on green roofs. This inclusion will allow a complete and proper application of the LCA methodology to achieve an environmental accounting of the “green roof” performance. We have here chosen to approach the problem by analysing a specific substrate, that is used within an actual extensive green roof. Afterwards, we have applied the LCA methodology to the whole actual extensive green roof whose substrate under analysis is part of. In this manner, we achieved an environmental accounting of the “green roof” pe…

Evaluating the Environmental Performance of Green Roofs by a Life Cycle Approach: an Application of the LCA Method on a Case Study in Italy

2011

Unsolved questions and preferred solution about living will

2018

Abstract Background Ethical problems about end-of-life medicine include a variety of issues approached in different ways by physicians and, more recently, special emphasis to this kind of ethical issues and possible answers has done by Italian National Ethical Committee in the issue named “Deep and continuous palliative sedation in the imminence of Death” (January, 2016). The debate is very critical in Intensive Care Units and Cancer Wards, where health care professionals face-off with terminally-ill patients is an outright routine; the Authors investigated their medical knowledge and ethical perception about patient critical and terminal condition to discuss the most relevant conclusions. …

Intricate decision making : ambivalences and barriers when fulfilling an advance directive

2016

Lars Schröder,1 Gerhard Homme,1,2 Stephan Sahm3,4 1Department of Gynecology and Obstetrics, Center of Integrated Oncology, University Hospital Bonn, Bonn, 2Institute of Medical Biometry, Epidemiology and Informatics, Johannes Gutenberg University, Mainz, 3Department of Gastroenterology and Oncology, Ketteler Hospital, Offenbach, 4Institute for Ethics and History of Medicine, Johann Wolfgang Goethe University, Frankfurt, Germany Background: Despite a recent statutory ruling stating the binding nature of advance directives (ADs), only a minority of the population has signed one. Yet, a majority deem it of utmost importance to ensure their wishes are followed through in case they are …

Green Roofs’ End of Life: A Literature Review

2023

Green roofs are increasingly being used in urban settings because of the many benefits they are capable of providing. Because of their widespread use, the issue of how to conduct proper disposal of green roofs once they have reached their end of life is beginning to be raised. The present study is a review of the scientific literature published between 2007 and 2022. Specifically, the contribution of this review study is to clarify whether a waste scenario exists and if so, identify the methodological frameworks and/or criteria used in green roof-related studies to establish the end-of-life scenario of a given green roof, which will then be used to analyze its environmental and economic per…

Palliative care quality indicators in Italy. What do we evaluate?

2012

Purpose In recent years, the number of palliative service providers has increased significantly. This expansion necessitates an evaluation in order to provide the basis for quality improvement of the care. Policymakers, managers of palliative care programs, and others committed to the improvement of end-of-life care need methods and criteria to measure and evaluate the care delivered. As quality measurement is expensive and difficult to undertake, it is fundamental that quality measures evaluate the right things. Quality evaluation in Italy is supported by health authorities who have developed some indicators of palliative care. The aims of this study were to give an overview of these indic…

Gestion de casos en pacientes con cronicidad compleja y con necesidades al final de la vida. Análisis de los resultados

2019

Introduction: Los programas de gestion de casos (GC) surgieron como un nuevo enfoque en la atencion de personas con problemas de salud complejos con el objetivo de mejorar la calidad de vida y de procurar por la eficiencia en el uso de recursos.  Theory/methods: Desde 2010, en el Departament de Salud Valencia-LaFe se desarrolla la GC sobre dos grupos de poblacion: pacientes con cronicidad compleja y con necesidades paliativas (oncologicos y no oncologicos). En ambos casos, la atencion se caracteriza por desarrollar intervenciones de seguimiento programado y continuo,  y por la posibilidad de proporcionar atencion avanzada en domicilio ante la identificacion temprana de necesidades y exacerb…

The anesthesiologist and end-of-life care

2012

Purpose of review Anesthesiologists may face problematic situations when patients are close to death, in which clinical problems, decision-making processes, and ethical issues are often interconnected and dependent on each of them. The aim of this review is to assess the recent literature regarding the anesthesiological role for advanced cancer patients. Recent findings Palliative sedation in the dying patients, end-of-life problems in the ICU, and pain control in advanced cancer patients have been the subject of recent research. All these issues have shown that anesthesiologist would be expert in the field of pain and symptom control at the end of life. End-of-life care problems are common…