Comment: A long and winding road
Eduardo Bruera
pp 225-225
Over the years there has been impressive growth in the number of healthcare professionals involved in palliative care and in the number of professional associations. There are a number of peer-reviewed journals, such as this one, dedicated to palliative care, and palliative medicine is now a recognised specialty in the UK and many other countries, including this year in the USA.
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‘The pelvic syndrome’: tumours involving the pelvis
Alvaro Sanz and Maria Luisa del Valle
pp 226-229
Syndrome is an elusive medical term and often defines a concept that might be described as intuitive rather than explicit. Essentially, the presence of a syndrome requires the coexistence of signs whereby patients exhibit similar symptoms in similar circumstances. History shows that complex and exhaustive methodology was not required to prove the existence of most syndromes. Often in medicine, the discovery of an anatomical or biomolecular explanation for the cluster of symptoms is not made until years – sometimes even centuries – after the syndrome has been recognised.
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The use of botulinum toxin A to treat drooling in children
Lalita Jindal and Torsten Hildebrandt
pp 230-234
Effective symptom control remains one of the most important aspects in paediatric palliative care. Paediatricians face the challenge, often for many years, of achieving the best quality of life for their patients as well as the families caring for children with life-limiting disease. Drooling is a common symptom in the paediatric population needing palliative care. It can persist for prolonged periods and can significantly impair the life of a child at home and in school. Conventional methods of treatment are sometimes not effective or not acceptable due to various side-effects.
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Case study masterclass 35: Dealing with spinal cord compression as an emergency in a palliative day care patient
Jacqueline S Nicol and Isabel Dosser
pp 235-236
It is Friday morning. You are the nurse in charge at a community palliative day care unit and are expecting ten patients to attend. The unit opens Monday to Friday. The consultant in palliative medicine, who covers from the local hospice, is on annual leave, so there will be no medical cover. Betty*, a 68-year-old with advanced lung cancer and bone metastases, arrives as usual at 10am accompanied by her volunteer driver.
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Case study masterclass 34 answers: Referring a patient with terminal breast cancer for genetic testing
Miriam Colleran, Aileen Butler and Liam O’Síoráin
pp 237-237
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Raising standards for elderly people dying in care homes
Frances Badger, Keri Thomas and Collette Clifford
pp 238-241
In the UK, dying is increasingly experienced in old age and almost 85% of deaths occur in those aged over 65. Most older people die from non-cancerous illnesses, and multiple morbidity is the norm. However, palliative care in most of Europe has focused on those dying from cancer, and there has only been a slow recognition that age related illnesses such as dementia have implications for end-of-life care.
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How vignettes can aid social research in palliative care
Rhidian Hughes
pp 242-244
Vignettes are stimuli that selectively portray elements of reality to which research participants are invited to respond. They have a role across the qualitative and quantitative spectrum of social research and have value in palliative care research, especially given the potentially sensitive nature of the research area.
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Hospital ethics committees: a historical perspective and a modern Turkish exampleHospital ethics committees: a historical perspective and a modern Turkish example
Cagatay Ustun and Inci Hot
pp 247-251
The idea of establishing pharmaceutical research committees and well-organised professional hospital ethics committees emerged during the second half of the 20th century as a result of technological advances in the medical field and new approaches to patients’ rights. They were seen as a way of solving ethical dilemmas that were being encountered.
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Sharing knowledge on the web: the Spanish experience
Javier Rocafort, Alvaro Sanz and Ana de Santiago
pp 252-255
The internet, and particularly the world wide web and email, have been the most important advances in communication during the past decades. As their inventors recognise, ‘The internet has revolutionised the computer and communications world like nothing before’.
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An update on paediatric palliative care in Romania
Delia Birtar
pp 256-259
The Casa Sperantei Hospice in the Romanian city of Brasov was a pioneer of palliative care for adults in the country. It is now working to extend its services for children through a three-year project, the Beacon of Hope, which began in 2005.
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Ireland attempts to change culture for care of the dying
Max Watson, Doiminic Ó Brannagáin and Orla Keegan
pp 260-263
Ireland’s Hospice Friendly Hospitals programme is an ambitious national five-year development initiative to improve the consistent management of death, dying and bereavement across the acute and community hospitals of the country by encouraging increased application of the palliative care approach.
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A ‘taster week’ in palliative care
Emily Kaye
pp 264-265
‘Taster weeks’ were introduced as part of study leave so that doctors in their first year post-registration could gain an insight into specialties not yet experienced but being considered as career choices. This option was introduced partly because doctors in Britain now apply for specialty training posts two years after qualification from medical school. I took advantage of my newly acquired study leave in my FP2 (foundation programme two) year by spending a week in palliative care. I have an interest in it and hope to include it in my career choice. Also, it is an area that is poorly understood by many doctors.
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