Core concepts in palliative care

2021 ◽  
pp. 44-54
Author(s):  
Nathan I. Cherny ◽  
Russell K. Portenoy
Keyword(s):  
Palliative Care ◽  
Core Values ◽  
Frame Of Reference ◽  
Good Death ◽  
Clear Understanding ◽  
Life Care ◽  
Basic Principles ◽  
The Core ◽  
Core Concepts ◽  
The Right

Having a clear understanding of why we do what we do in palliative care is one of the factors that mitigates against burnout. This chapter explores some of the core values and central concepts in palliative care. The chapter focuses on underlying basic principles including, care, compassion, and empathy and how they influence the right to effective palliative care. Other less commonly addressed core concepts such as resilience, humility, audacity, and sensitivity to differences are discussed. The chapter then explores the issues around goal-focused care and how it is applied in palliative care and the contentious issues as to what constitutes a good death. It is the hope of the editors that this new contribution will provides a frame of reference that can assist clinicians as we navigate many of the challenges confronted in the delivery of palliative and end of life care.

scholarly journals Outline of Real Physics

2020 ◽  
pp. 9-27
Author(s):  
Zhong-Cheng Liang
Keyword(s):  
Paper Briefly ◽  
Basic Principles ◽  
Natural Processes ◽  
The Core ◽  
Theoretical System ◽  
Motion Modes ◽  
Core Concepts ◽  
Laws Of Motion ◽  
Physical Laws ◽  
Elastic Particles

Real physics is an axiomatic theoretical system based on the model of elastic particles. Unlike point-like and wave-like particles, elastic particles are objects with both mass and volume, which can spin and deform. Electrons, protons, and atoms are elastic particles. Elastic particles have three motion modes of translation, rotation, and vibration. The system of elastic particles follows simple and universal laws of motion. This paper briefly reviews the core concepts, basic principles, main contents, and major achievements of real physics. It shows that the classical physical laws (laws of motion, gravitation, electromagnetism, and thermodynamics) are all conclusions drawn from the statistics of elastic particles, which reveals the irreversibility of natural processes.

The Motivation Elements, Components, and Characteristics of an Outstanding Coach

2019 ◽  
pp. 63-80
Keyword(s):  
Focus Groups ◽  
Mental Effort ◽  
Core Values ◽  
Cultural Norms ◽  
Entry Level ◽  
The Core ◽  
Hiring Process ◽  
Talent Pool ◽  
Values And Beliefs ◽  
The Right

The research discussed throughout this chapter was designed to examine, understand, and explain the key motivational characteristics, elements, and components of outstanding retention and success coaching. The motivational elements of the study are organized using the choice, persistence, and mental effort framework from Clark and Estes (2008) and Eccles and Wigfield (2002). Through interviews and focus groups of elite coaches, the study assessed the motivation of the most successful coaches as well as the core values, beliefs, and sensitivities to background and cultural norms that suggest that an individual can be developed into an excellent coach. The chapter further explains how institutions and organizations can select for these values and beliefs through a careful hiring process that results in the recruitment of the right talent pool for entry-level coaching positions.

scholarly journals 309 The Growing Need for Advance Care Planning Discussion: An Admission to Die for?

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Aoife McFeely ◽  
Cliona Small ◽  
Susan Hyland ◽  
Jonathan O'Keeffe ◽  
Graham Hughes ◽  
...  
Keyword(s):  
Palliative Care ◽  
Older People ◽  
End Of Life ◽  
End Of Life Care ◽  
Care Planning ◽  
Life Care ◽  
Advance Care ◽  
Early Decision ◽  
One Year ◽  
The Right

Abstract Background Older people living in nursing homes (NHs) are among the most frail and vulnerable in our community. Over the last 5 years, a review of our local NH admission database revealed a 7% increase in the number of unscheduled hospital attendances from NHs (1015 in 2012/13 vs 1435 in 2016/17). Additionally we have seen an increase in the number of NH residents experiencing ≥2 unscheduled re-admissions within one year (21.1% in 2012/13 vs 30.45% in 2016/17). Our aim was to examine the proportion of patients from NHs who died within 24 hours of presentation, prompting a review of methods that could prevent inappropriate hospital transfers and promoting dignified and comfortable end of life care. Methods A prospective database was collected between 01/01/2016 - 31/12/2017. This recorded all emergency admissions of older people from NHs recording length of stay, readmission rates and mortality. The data was retrospectively analysed, looking specifically at patients who died in hospital ≤ 24 hours Results Of 1435 ED admissions, 49 patients (3.4%) died in hospital ≤ 24 hours after presentation. Of these, 31 patients (61%) died in palliative care suites. 8 patients (16.3%) died in the ED. Conclusion A small number of NH residents presenting to our hospital died within 24 hours. A large proportion of these patients died in a palliative care suite, suggesting poor prognosis was identified rapidly after presentation. We wonder if some of these hospital transfers were avoidable and could certain patients have experienced less disruptive deaths in their NHs? Advanced Care Planning can be difficult for all involved. However, it plays an essential role in ensuring people receive the right care, at the right time, in the right place, from the right team. We support the collaborative roles of a palliative care CNS or Geriatric ANP, and integration with NH Outreach services, to facilitate early decision-making and promote better end of life care.

scholarly journals The ‘Equality Of Arms’ In Macedonian Criminal Procedure

SEEU Review ◽  
2015 ◽  
Vol 11 (1) ◽  
pp. 123-130
Author(s):  
Olga Kosevaliska
Keyword(s):  
Criminal Justice ◽  
Criminal Justice System ◽  
Case Studies ◽  
Justice System ◽  
Criminal Procedure ◽  
Core Values ◽  
Fair Trial ◽  
Public Hearing ◽  
The Core ◽  
The Right

Abstract The right to a fair trial is implemented in our criminal procedure and is one of the core values of our criminal justice system. This right is absolute and can’t be limited on any legal base. Its essence is fair and public hearing by an independent and impartial court with guaranteeing of all the minimum rights of the defendant. One of those minimum rights is the right of equity of arms between the parties, the prosecutor and the defense. In our Law on Criminal Procedure, it is provided that the defense has the same rights and duties as the prosecutor except those rights that belong to the prosecutor as a state authority. Therefore, the purpose of this article is elaborating the right of ‘equity of arms’ and its misunderstanding in practice. Hence, we intend to show some case studies in which some evidence are not considered by the court just because they are not proposed by the prosecutor and they are crucial for the verdict.

Comparison of Thai older patients’ wishes and nurses’ perceptions regarding end-of-life care

2019 ◽  
Vol 26 (7-8) ◽  
pp. 2006-2015 ◽  
Author(s):  
Manchumad Manjavong ◽  
Varalak Srinonprasert ◽  
Panita Limpawattana ◽  
Jarin Chindaprasirt ◽  
Srivieng Pairojkul ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Older Patients ◽  
Cross Sectional Study ◽  
Self Report ◽  
Good Death ◽  
Life Care ◽  
Cross Sectional ◽  
Adequate Knowledge

Background: Achieving a “good death” is a major goal of palliative care. Nurses play a key role in the end-of-life care of older patients. Understanding the perceptions of both older patients and nurses in this area could help improve care during this period. Objectives: To examine and compare the preferences and perceptions of older patients and nurses with regard to what they feel constitutes a “good death.” Research design: A cross-sectional study. Participants and research context: This study employed a self-report questionnaire that asked about various options for end-of-life care. It was distributed to older patients who attended the outpatient clinic of internal medicine and nurses who worked at two medical schools in Thailand from September 2017 to February 2018. Patients were asked to respond to the questions as if they were terminally ill, and nurses were asked to imagine how older patients would answer the questions. Ethical consideration: Approval from Institutional Review Board was obtained. Findings: A total of 608 patients and 665 nurses responded to the survey. Nurses agreed with concepts of palliative care, but they rated themselves as having poor knowledge. The patient respondents felt that it was most important that they receive the full truth about their illnesses (29.2%). The nurses thought the most important issue was relief of uncomfortable symptoms (25.2%). On seven out of the 13 questions, nurses overestimated the importance of the relevant issue to patients and underestimated the importance on one question (p < 0.05). Discussion: Both nurses and older patients signified concepts of palliative care, but nurses felt that they lacked adequate knowledge. Nurses estimated that patients would have positive attitudes toward autonomy and the closure of life affairs to a significantly greater degree than the patient respondents. Conclusions: We recommend that palliative care education be improved and that steps be taken to allow for more effective nurse–patient communication with regard to the patients’ end-of-life wishes.

scholarly journals Issues of Distribution of Rights to Results of Intellectual Activity within "Megascience" Projects

2020 ◽  
Vol 15 (9) ◽  
pp. 164-173
Author(s):  
T. S. Zaplatina
Keyword(s):  
Intellectual Property ◽  
Intellectual Property Rights ◽  
Intellectual Activity ◽  
Basic Principles ◽  
The Core ◽  
National Norms ◽  
Research Objects ◽  
Project Participants ◽  
Science Framework ◽  
The Right

The concept of intellectual property rights (IP) within the framework of "megascience" projects is based on common international, supranational and national norms in the field of IP. The problem of the distribution of the results of intellectual activity (IA), created within the framework of a "megascience" project, is due to the collective nature of their creation. The IA belongs to both the project participants (team) and the megascience center. Often, the norms of a specific agreement on the creation of intellectual property (IP) solve the issues of distribution of the results of a collective IA. In the case of megascience projects, the norms of the research centers themselves are important, like an agreement between individuals that form the basic principles for the distribution of IA. The form of organization of the research center also affects the distribution of IA results within the framework of megascience projects. Thus, the Institut Laue-Langevin (ILL), which is a national legal entity, makes a distinction in the division of IAs depending on the characteristics of the project and the level of access to research objects, without highlighting the concept of the underlying IP for the ILL. The European Split Source (ESS), an integrated mega-science framework, provides the core IP of the center for research. Such a primary IP can be used under the right of a non-exclusive license by a participant to the project in which the primary IP is used.

Article 22 CFR

2019 ◽  
Author(s):  
Tobias Lock
Keyword(s):  
Cultural Diversity ◽  
Linguistic Diversity ◽  
Religious Diversity ◽  
Core Values ◽  
Cultural And Linguistic Diversity ◽  
The Core ◽  
The Status ◽  
Official Languages ◽  
The Right ◽  
The Eu

Article 22 CFR aims to ensure the diversity of the Union and complements other provisions of the Charter and the Treaties pursuing similar objectives. Cultural and linguistic diversity are among the core values of the EU mentioned in Article 3(3) TEU. Cultural diversity finds further expression in primary law in Article 167(1) and (4) TFEU; and linguistic diversity in the right to address the EU institutions in any one of the EU’s official languages in Article 41(4) CFR as well as in Article 21 CFR, which prohibits discrimination on the basis of language. Moreover, the Union’s commitment to religious diversity is reflected in Article 17 TFEU protecting the status of churches, religious, philosophical, and non-confessional organizations and communities as well as in Article 10 CFR protecting freedom of religion and belief.

Democratic Persuasion and State Subsidy

2012 ◽  
Author(s):  
Corey Brettschneider
Keyword(s):  
Coercive Force ◽  
Core Values ◽  
The State ◽  
Free Expression ◽  
Non Profit ◽  
The Core ◽  
Tax Exempt ◽  
Profit Status ◽  
The Right ◽  
Equal Citizenship

This chapter examines the notion that, while persuasion should not be backed by coercive force, it should be backed by the state's subsidy power. It defines subsidy power as the ability of the state to spend money and, as crucially, to refuse to spend money on certain organizations. The state's subsidy power includes the ability to grant or withdraw tax-exempt, tax-deductible non-profit status. Its use is compatible with the right of free expression. Indeed, the chapter argues that the reasons justifying free expression require the state to withdraw subsidies from groups that oppose the core values of free and equal citizenship.

Principles of Surgical Palliative Care

2019 ◽  
pp. 13-18
Author(s):  
Anne C. Mosenthal
Keyword(s):  
Palliative Care ◽  
Quality Care ◽  
Surgical Care ◽  
Shared Decision ◽  
Life Care ◽  
Patient Centered ◽  
Serious Illness ◽  
The Core ◽  
Relief Of Suffering

The principles of surgical palliative care, an emerging field, represent the integration of surgical care and palliative care and their ethics, drawing on both disciplines to yield a more patient-centered approach to quality care. The core principle focuses on improving quality of life for those patients with serious illness and surgical disease or under the care of surgeons. Surgical palliative care addresses relief of suffering and shared decision-making across the life span, regardless of prognosis, and thus goes beyond end-of-life care and hospice. The chapter defines the principles of surgical palliative care, their ethical foundation, and their application in practice.

Sign in / Sign up

Export Citation Format

Share Document