scholarly journals Limit behaviour of BSDE with jumps and with singular terminal condition

2016 ◽  
Vol 20 ◽  
pp. 480-509 ◽  
Author(s):  
A. Popier
Keyword(s):  
Terminal Condition ◽  
Limit Behaviour

Discordance between the perceptions of clinicians and families about end-of-life trajectories in hospitalized dementia patients

2021 ◽  
pp. 1-8
Author(s):  
Felicity Moon ◽  
David W. Kissane ◽  
Fiona McDermott
Keyword(s):  
End Of Life ◽  
General Medicine ◽  
Terminal Condition ◽  
Life Transitions ◽  
Social Constructionist ◽  
Structured Interviews ◽  
Loved One ◽  
Life Trajectories ◽  
People With Dementia ◽  
Illness Progression

Abstract Background Due to the unpredictable dementia trajectory, it is challenging to recognize illness progression and the appropriateness of a palliative approach. Further confusion occurs during hospitalization where the presence of comorbid conditions complicates prognostication. This research examined clinicians and families' perceptions of dementia as a terminal condition in relation to end-of-life admissions. Context The study was based in the General Medicine units of one Australian public hospital. Medical, nursing, and social work clinicians were recruited to reflect multidisciplinary perspectives. Bereaved caregivers of deceased patients with dementia were interviewed 3 months following death. Methods Qualitative research underpinned by a social constructionist epistemology and framed through complex systems theory. Semi-structured interviews generated data that illuminated perceptions of deterioration observed toward the end of life. Results Although participants anticipated general cognitive and physical deterioration associated with dementia, the emergence of comorbid illness made it difficult to predict the onset of the end of life. During a hospital admission, clinicians attributed the end of life to the advanced outcomes of dementia, whereas families described new medical crises. End-of-life admissions illuminated intersections between dementia and comorbidities rather than illness progression. In contrast with the perception that people with dementia lose awareness at the end of life, families drew attention to evidence that their loved one was present during the dying phase. Significance of results Our findings challenge the dominant understanding of dementia trajectories. Bifurcations between clinicians and families' views demonstrate the difficulties in recognizing end-of-life transitions. Implications for the integration of palliative care are considered.

Support for People with Dementia

2009 ◽  
Vol 2 (4) ◽  
pp. 245-249
Author(s):  
Neil Hunt
Keyword(s):  
Quality Of Life ◽  
Early Intervention ◽  
Support Services ◽  
Daily Life ◽  
Terminal Condition ◽  
People With Dementia ◽  
The Right

Dementia is a progressive and eventually terminal condition, but with early intervention and the right support, people with dementia can continue to enjoy a good quality of life for many years. Living with dementia can be challenging both for those affected and their families as it can affect all aspects of daily life. It is vital that people with dementia and their carers are signposted to the support services that can help them take control of their condition and help them remain active and independent.

Pre-emptive prescription of medications for the management of potential, catastrophic events in patients with a terminal illness: A survey of palliative medicine doctors

2018 ◽  
Vol 33 (2) ◽  
pp. 178-186 ◽  
Author(s):  
Naomi T Katz ◽  
Bronwyn H Sacks ◽  
Brian H Le ◽  
Jenny L Hynson
Keyword(s):  
Palliative Medicine ◽  
Terminal Illness ◽  
Formal Education ◽  
Terminal Condition ◽  
Adult Patients ◽  
Catastrophic Events ◽  
Pharmacological Management ◽  
Available N ◽  
Medication Prescription ◽  
Acute Airway Obstruction

Background: Distressing and potentially life-threatening events, such as significant external bleeding, may occur in patients with a known terminal condition. These events are often referred to as catastrophic or crisis events. Pharmacological management varies and there is little evidence to guide practice. Aim: The aim of this study was to explore Australasian palliative medicine doctors’ approaches to pre-emptive prescription of medications to manage catastrophic events. Design: Anonymous survey data were collected electronically. Setting/Participants: Australian and New Zealand palliative medicine fellows and trainees were surveyed. Results: Surveys were completed by 121 doctors; 108 (89.2%) who care for adult patients only and 13 (10.8%) who care for paediatric patients or paediatric and adult patients. In all, 74 (61.2%) respondents pre-emptively prescribed medications at least five times per year, and most orders were never administered. Significant visible bleeding and severe, acute airway obstruction were almost universally considered catastrophic events. Many respondents expressed concern about the lack of evidence to guide pre-emptive medication prescription in this setting. Clinicians reported adverse events related to pre-emptive medication orders being available ( n = 30, 24.8%), as well as orders not being available ( n = 61, 50.4%). Conclusion: Our study supports the need for guidelines, as well as formal education programmes for medical trainees and nursing staff about this important area of practice.

scholarly journals Exact and approximate limit behaviour of the Yule tree’s cophenetic index

2017 ◽  
Author(s):  
Krzysztof Bartoszek
Keyword(s):  
Limit Distribution ◽  
Heuristic Methods ◽  
Birth Process ◽  
Type Distribution ◽  
Continuous Branch ◽  
Branch Lengths ◽  
Limit Behaviour ◽  
Contraction Type ◽  
Approximate Limit ◽  
Balance Index

AbstractIn this work we study the limit distribution of an appropriately normalized cophenetic index of the pure–birth tree conditioned onncontemporary tips. We show that this normalized phylogenetic balance index is a submartingale that converges almost surely and inL2. We link our work with studies on trees without branch lengths and show that in this case the limit distribution is a contraction–type distribution, similar to the Quicksort limit distribution. In the continuous branch case we suggest approximations to the limit distribution. We propose heuristic methods of simulating from these distributions and it may be observed that these algorithms result in reasonable tails. Therefore, we propose a way based on the quantiles of the derived distributions for hypothesis testing, whether an observed phylogenetic tree is consistent with the pure–birth process. Simulating a sample by the proposed heuristics is rapid, while exact simulation (simulating the tree and then calculating the index) is a time–consuming procedure. We conduct a power study to investigate how well the cophenetic indices detect deviations from the Yule tree and apply the methodology to empirical phylogenies.

scholarly journals Spirituality and/or religious faith: A means for coping with the effects of amyotrophic lateral sclerosis/motor neuron disease?

2015 ◽  
Vol 13 (6) ◽  
pp. 1603-1614 ◽  
Author(s):  
Mary R. O'brien ◽  
David Clark
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Motor Neuron ◽  
Motor Neuron Disease ◽  
Personal Narratives ◽  
Religious Faith ◽  
Terminal Condition ◽  
Spiritual Needs ◽  
Religious Thoughts ◽  
Lateral Sclerosis ◽  
Personal Spirituality

AbstractObjective:The notion of spirituality/religious belief is recognized internationally as a domain within end-of-life care and is important in patients' and carers' quality-of-life. When faced with incurable illness, patients often become more philosophical about their life; many seek comfort in spiritual or religious philosophies. Our intention was to understand how personal spirituality and religious faith might help those living with amyotrophic lateral sclerosis/motor neuron disease (ALS/MND) cope with their impending death.Method:Unsolicited narratives (internet and print-published) written by individuals diagnosed with the terminal condition of ALS/MND were analyzed thematically. Narratives from 161 individuals diagnosed with ALS/MND written over a period of 37 years (from 1968 to 2005) were included.Results:Our findings reveal that religious faith sustains and helps people to avoid despair, and personal spirituality helps them make sense of what is happening to them.Significance of Results:The use of personal narratives by people with ALS/MND has provided a vehicle for sharing their deepest spiritual and religious thoughts with others. The place of spirituality and religious faith within ALS/MND care should not be underestimated. Assessment of religious or spiritual needs should become a routine part of practice and is the responsibility of all members of the multidisciplinary team.

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