Hospice Use Among Individuals With Severe Persistent Mental Illness

BACKGROUND: Severe persistent mental illness (SPMI) currently affects an estimated 11.2 million adults in the United States (National Institute of Mental Health, 2019). Affected individuals are known to experience inequities in care, and on average, they die earlier than individuals without SPMI. Currently, little is known about hospice use among individuals with SPMI, including what factors contribute to the use of hospice services. OBJECTIVE: The aim of this integrated review was to identify factors associated with the use of hospice services by individuals with SPMI. STUDY DESIGN: A review of the available literature on this topic was performed in accordance with PRISMA guidelines. The databases Cumulative Index to Nursing and Allied Health Literature, PubMed, and PsycInfo were searched, and relevant records were identified. Ultimately, eight studies were identified and selected for analysis. RESULTS: Themes illustrating the factors associated with hospice use and, within them, challenges to obtaining hospice care were discovered. The three themes identified within the eight studies were fragmentation of care, inadequate communication, and the need for advance care planning. These patterns indicated that multiple barriers to utilizing hospice care exist for individuals with SPMI when compared with the general population. CONCLUSIONS: By recognizing and addressing factors influencing the use of hospice care, as well as barriers to receiving hospice, improved provision of timely end-of-life care that is consistent with individuals’ preferences may be facilitated.

A Visualization Approach to Analyze Android Smartphone Data

This study aims to design and develop an interactive system that can visualize evidence collected from Android smartphone data. This project is developing to support forensic investigator in investigating the security incidents particularly involving Android smartphone forensic data. The used of smartphone in crime was widely recognized. Several types of personnel information are stored in their smartphones. When the investigator analyses the image data of the smartphone, the investigator can know the behaviour of the smartphone’s owner and his social relationship with other people. The analysis of smartphone forensic data is cover in mobile device forensic. Mobile device forensics is a branch of digital forensics relating to recovery of digital evidence from a mobile device under forensically sound condition. The digital investigation model used in this project is the model proposed by United States National Institute of Justice (NIJ) which consists four phases, which are collection phase, examination phase, analysis phase and presentation phase. This project related with analysis phase and presentation phase only. This paper introduces Visroid, a new tool that provides a suite of visualization for Android smartphone data.

Current controversies in the role of antioestrogens in the treatment of carcinoma of the breast

SynopsisThe development of the triphenylethylene derivatives has been a major advance in the treatment of breast carcinoma, due to their low toxicity. Currently there is controversy not only about their mode of action but in three main areas of clinical practice: (A) adjuvant therapy in premenopausal and oestrogen receptor-negative cases; (B) primary therapy in the elderly; (C) the prevention of breast cancer.The United States' National Institute of Health consensus of 1985 that adjuvant tamoxifen be confined to postmenopausal women with positive nodes and ER positive tumours has been refuted by randomised clinical trials. The evidence that ER negative tumours also respond to tamoxifen has added to laboratory evidence that tamoxifen acts other than purely by oestrogen antagonism at the ER.The use of tamoxifen as sole treatment in primary breast cancer in the elderly is being evaluated in randomised clinical trials. Two that have been reported so far have flaws which make their contradictory conclusions difficult to assess.Recent results from the CRC trial suggest that tamoxifen has more benefit than simply preventing cancer deaths and clarification of the effects of triphenylethylenes on bone metabolism and the cardiovascular system may strengthen the case for a trial of prophylactic tamoxifen in those at risk of developing breast carcinoma.