scholarly journals Current collaboration between palliative care and neurology: a survey of clinicians in Europe

2020 ◽  
pp. bmjspcare-2020-002322
Author(s):  
David Oliver ◽  
Gian Domenico Borasio ◽  
Simone Veronese ◽  
Raymond Voltz ◽  
Stefan Lorenzl ◽  
...  
Keyword(s):  
Palliative Care ◽  
Online Survey ◽  
Ethical Issues ◽  
Neurological Diseases ◽  
Physical Symptom ◽  
European Academy ◽  
Complex Decision Making ◽  
Complex Decision ◽  
Lateral Sclerosis

IntroductionThe collaboration between palliative care and neurology has developed over the last 25 years and this study aimed to ascertain the collaboration between the specialties across Europe.MethodsThis online survey aimed to look at collaboration across Europe, using the links of the European Association for Palliative Care and the European Academy of Neurology.Results298 people completed the survey—178 from palliative care and 120 from neurology from over 20 countries across Europe. They reported that there was good collaboration in the care for people with amyotrophic lateral sclerosis and cerebral tumours but less for other progressive neurological diseases. The collaboration included joint meetings and clinics and telephone contacts. All felt that the collaboration was helpful, particularly for maintaining quality of life, physical symptom management, psychological support and complex decision making, including ethical issues.DiscussionThe study shows evidence for collaboration between palliative care and neurology, but with the need to develop this for all neurological illness, and there is a need for increased education of both areas.

scholarly journals Upside down solutions: palliative care and COVID-19

2020 ◽  
pp. bmjspcare-2020-002385 ◽  
Author(s):  
Daniel Knights ◽  
Felicity Knights ◽  
Iain Lawrie
Keyword(s):  
Palliative Care ◽  
Symptom Control ◽  
Well Being ◽  
Models Of Care ◽  
Resource Limited ◽  
Relief Of Suffering ◽  
Complex Decision Making ◽  
Complex Decision ◽  
Effective Use

The current COVID-19 pandemic is unprecedented and requires innovation beyond existing approaches to contribute to global health and well-being. This is essential to support the care of people at the end of their lives or who are critically ill from COVID-19 or other life-limiting illnesses. Palliative care (PC) is centred on effective symptom control, promotion of quality of life, complex decision-making, and holistic care of physical, psychological, social and spiritual health. It is ideally placed to both provide and contribute to care for patients, families, communities and colleagues during the pandemic. Where recovery is uncertain, emphasis should be on care and relief of suffering, as well as survival. Where healthcare resources and facilities come under intense pressure, lessons can be learnt from models of care in other settings around the world. This article explores how the field can contribute by ensuring that PC principles and practices are woven into everyday healthcare practice. We explore alternative ways of providing care under such pressure and discuss three areas of learning from resource-limited settings: (1) integration of palliative medicine into everyday practice, (2) simplification of biomedical management plus multidisciplinary teamwork and (3) effective use of volunteers.

Designing Palliative Care Facilities to Better Support Patient and Family Care: A Staff Perspective

2022 ◽  
pp. 193758672110590
Author(s):  
Rebecca McLaughlan ◽  
Kieran Richards ◽  
Ruby Lipson-Smith ◽  
Anna Collins ◽  
Jennifer Philip
Keyword(s):  
Palliative Care ◽  
Online Survey ◽  
Family Care ◽  
Well Being ◽  
Care Staff ◽  
Research Attention ◽  
Lengths Of Stay ◽  
Care Facilities ◽  
Philosophy Of Palliative Care

Objective: To contribute staff perspectives on the design of palliative care facilities to better align with the philosophy of palliative care, in support of patient, family, and staff well-being. Background: The receipt of palliative care differs from other inpatient experiences owing to its distinct philosophy of care, longer lengths of stay, a greater presence of family members, and more frequent end-of-life events. While research regarding the optimal design of palliative care environments recognizes these differences, this knowledge has been slow to exert change on the guidelines and procurement processes that determine the design solutions possible within these settings. Sustained research attention is required. Methods: An online survey, comprising a series of open-ended questions, elicited the perceptions of palliative care staff regarding the relationship between the physical environment and the distinct philosophy of palliative care. Results: Responses from 89 Australian-based palliative care professionals confirmed the high value that staff place on environments that offer privacy, homeliness, safety, and access to gardens to assist the delivery of optimum care. Conclusions: Our findings illustrate that the implications of privacy and homeliness extend far beyond the patient room and that homeliness is about more than an aesthetic of comfort. This highlights a broader capacity for design to better support the philosophy of palliative care. Importantly, the data reveal a key relationship between staff well-being and the environments in which they work; environments that are unable to match the quality of care that staff aspire to deliver can engender frustration and distress.

Palliative Care in End-Stage Neurological Disease

2018 ◽  
Author(s):  
Tobias Walbert ◽  
Joel Phillips
Keyword(s):  
Parkinson’S Disease ◽  
Palliative Care ◽  
Parkinson's Disease ◽  
Symptom Management ◽  
Neurological Diseases ◽  
The United States ◽  
Pain Syndromes ◽  
End Stage ◽  
Chronic Course

Neurological disorders are among the leading causes of morbidity and death worldwide. Although stroke is the third leading cause of death, after heart disease and cancer, in the United States, other neurological diseases have a more chronic course that leads to protracted disability, morbidity, and death. Unfortunately, for many of these disorders, such as Parkinson’s disease, amyotrophic lateral sclerosis (ALS), and multiple sclerosis (MS), no cure is currently available. Patients suffer from dysarthria, dysphagia, muscle spasm, bladder and bowel difficulties, pain syndromes, and fatigue. Adequate symptom management and palliative care have the potential to maintain good quality of life for patients for as long as possible and ease the burden on both caregivers and patients. This chapter outlines the principles of clinical symptom management for some of the most important neurological diseases, specifically ALS, stroke, MS, and Parkinson’s disease.

Requested withdrawal of gastrostomy feeding in motor neurone disease

2020 ◽  
pp. bmjspcare-2020-002428
Author(s):  
Donna Wakefield ◽  
Sarah Rhiannon Hanson
Keyword(s):  
Healthcare Professionals ◽  
Consensus Guidelines ◽  
Early Referral ◽  
Prognostic Group ◽  
Complex Decision Making ◽  
Life Sustaining Treatment ◽  
Advance Care ◽  
Complex Decision ◽  
Additional Support

NICE (National Institute for Health & Care Excellence) guidance recommends that healthcare professionals with expertise in palliative care should be an integral part of the multidisciplinary team in managing patients with motor neuron disease (MND). Those in the poorest prognostic group may benefit from early referral to help manage rapidly progressive symptoms, psychological distress and offer additional support with complex decision-making and early robust advance care planning. Patients frequently develop dysphagia and gastrostomy feeding can be used to prolong survival and improve quality of life. As the disease progresses patients may request withdrawal of life-sustaining treatment such as gastrostomy feeding; however, a literature search found no evidence or guidance on how best to facilitate this. We present the case of a patient with MND admitted to the hospice inpatient unit requesting withdrawal of gastrostomy feeding, outline the challenges and need for further consensus guidelines to inform practice.

scholarly journals (P1-36) Mass Casualty Incident Awareness of Remote Location Staff in Western Australia

2011 ◽  
Vol 26 (S1) ◽  
pp. s110-s110
Author(s):  
R. Goswami
Keyword(s):  
Western Australia ◽  
Medical Staff ◽  
Online Survey ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Population Spread ◽  
Complex Decision Making ◽  
Complex Decision ◽  
Remote Health ◽  
Better Than

IntroductionThe state of Western Australia has a remote population spread throughout an immense area. Remote health and retrieval is strained on a day-to-day basis, let alone in mass casualty incidents (MCIs). Anecdotally, remote medical staff has minimal training in MCI response. There is no research into how aware these staff is on principles of MCI response.MethodologyAn online survey was devised to ascertain the awareness and knowledge of medical staff most likely to be involved in a disaster. Demographic as well as questions in scenario format were disseminated to rural general practitioners (GPs), nurses and paramedics. Data was collected over a 4-month period.Results117 surveys were completed online. Analysis revealed an astute awareness of resources and environment in a potential MCI but triaging was poor and complex decision-making results were equivocal. Trained respondents handled scenarios better than experienced (MCI involvement or planning) respondents.ConclusionsIn general, remote medical staff is aware of only certain MCI principles. Further training is warranted. Voluntary feedback from these staff also strongly corroborated this view.

scholarly journals DEVELOPMENT OF A VIRTUAL 3D-SIMULATOR OF THE FEED PELLETING TECHNOLOGICAL PROCESS

2017 ◽  
Vol 9 (2) ◽  
Author(s):  
N. Shcherbakov ◽  
F. Trishyn
Keyword(s):  
Educational Institutions ◽  
High Tech ◽  
Practical Skills ◽  
Technological Processes ◽  
Emergency Situations ◽  
Training Stage ◽  
Complex Decision Making ◽  
Complex Decision ◽  
Computer Simulators

The process of developing a virtual 3D simulator of the process of granulation of mixed fodders is considered. The consequences of errors in the operation of press granulator operators are considered. The difficulties associated with the training of high-tech and expensive equipment operators are described. The necessity and described difficulties of acquiring practical skills of working with such equipment at the training stage are substantiated. It is argued the need to introduce computer simulators in educational institutions in order to improve the quality of the acquired knowledge, form a complex decision-making skill for future operators of technological processes. The results of a survey on improving the efficiency of management of technological processes after the introduction of simulators at enterprises are considered. The data of the simulator market and its forecasts for 2017 by regions and types of the interface used are presented. The conclusion is drawn about the growing popularity of simulators based on the 3D interface. The advantage of using the 3D interface with respect to the 2D interface is substantiated. The types of immersion in the learning environment in various simulator interfaces are considered. The vulnerabilities of the 3D simulator are noted. The goal is to develop a 3D simulator for a press granulator operator. A solution of a set of tasks is proposed to achieve this goal. The plan for creating a simulator was developed. A detailed consideration of the development stages of the simulator is given. The possibilities of using the simulator being developed are considered. The possibility of developing a simulator of emergency situations is described. The relevance of this development is justified.

scholarly journals Role of automatic, conscious, and unconscious thought processes in complex decision making

1970 ◽  
Vol 14 (1) ◽  
pp. 33-52
Author(s):  
Draženka Levačić ◽  
Mario Pandžić ◽  
Dragan Glavaš
Keyword(s):  
Decision Making ◽  
Careful Examination ◽  
Automatic Processes ◽  
Thought Processes ◽  
Unconscious Thought ◽  
Conscious Thought ◽  
Complex Decision Making ◽  
Complex Decision

A complex decision is any decision which includes choosing among options with numerous describing attributes. Certain decisions are fast, often guided with automatic processes of thought, while other decisions are made much slower with careful examination of all the factors. These processes can have a significant impact on the quality of decision making. The aim of this research was to investigate the effect of automatic, conscious and unconscious thought processes in the context of decision making. Participants were psychology students aged between 19 to 28 years. First experiment investigated the role of three different thought processes on choosing a subjectively best option, as well as TTB heuristic option. The second experiment investigated metacognitive aspects of decision making, precisely, to determine the differences in feeling of rightness (FOR) as well as the tendency to change the decision, depending on the activated thought processes. Different thought processes determined the choice of the subjectively best option. In the conscious thought condition, participants chose the subjectively best option more often than in the automatic or unconscious thought condition. However, there was no difference between conditions in choosing the TTB heuristic option. The feeling of rightness was significantly higher in conscious thought condition than in automatic or unconscious thought condition, but the two latter conditions did not differ in the judgment of feeling of rightness nor did they differ in the tendency to change the decision.

scholarly journals A Hybrid Tool for Visual Pollution Assessment in Urban Environments

2019 ◽  
Vol 11 (8) ◽  
pp. 2211 ◽  
Author(s):  
Khydija Wakil ◽  
Malik Asghar Naeem ◽  
Ghulam Abbas Anjum ◽  
Abdul Waheed ◽  
Muhammad Jamaluddin Thaheem ◽  
...  
Keyword(s):  
Pollution Assessment ◽  
Observation Point ◽  
Urban Environments ◽  
Policy Makers ◽  
Complex Decision Making ◽  
Complex Decision ◽  
Developed World ◽  
The Impact ◽  
Reliable Methods

With increasing focus on more nuanced aspects of quality of life, the phenomenon of urban visual pollution has been progressively gaining attention from researchers and policy makers, especially in the developed world. However, the subjectivity and complexity of assessing visual pollution in urban settings remain a challenge, especially given the lack of robust and reliable methods for quantification of visual pollution. This paper presents a novel systematic approach for the development of a robust Visual Pollution Assessment (VPA) tool. A key feature of our methodology is explicit and systematic incorporation of expert and public opinion for listing and ranking Visual Pollution Objects (VPOs). Moreover, our methodology deploys established empirical complex decision-making techniques to address the challenge of subjectivity in weighting the impact of individual VPOs. The resultant VPA tool uses close-ended options to capture the presence and characteristics of various VPOs on a given node. Based on these inputs, it calculates a point based visual pollution scorecard for the observation point. The performance of the VPA tool has been extensively tested and verified at various locations in Pakistan. To the best of our knowledge, this is the first such tool, both in terms of quantitative robustness and broad coverage of VPOs. Our VPA tool will help regulators in assessing and charting visual pollution in a consistent and objective manner. It will also help policy makers by providing an empirical basis for gathering evidence; hence facilitating evidence-based and evidence-driven policy strategies, which are likely to have significant impact, especially in the developing countries.

A Mashup Application to Support Complex Decision Making for Retail Consumers

2012 ◽  
pp. 277-294 ◽  
Author(s):  
Steven Walczak ◽  
Deborah L. Kellogg ◽  
Dawn G. Gregg
Keyword(s):  
Decision Making ◽  
Information Overload ◽  
Decision Quality ◽  
Online Tools ◽  
Decision Making Processes ◽  
Complex Decision Making ◽  
Complex Decision ◽  
Time Required ◽  
Decision Complexity

Purchase processes often require complex decision making and consumers frequently use Web information sources to support these decisions. However, increasing amounts of information can make finding appropriate information problematic. This information overload, coupled with decision complexity, can increase time required to make a decision and reduce decision quality. This creates a need for tools that support these decision-making processes. Online tools that bring together data and partial solutions are one option to improve decision making in complex, multi-criteria environments. An experiment using a prototype mashup application indicates that these types of applications may significantly decrease time spent and improve overall quality of complex retail decisions.

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