Experiences of bereaved family caregivers with shared decision making in palliative cancer treatment: a qualitative interview study

Background Patients with incurable cancer face complex medical decisions. Their family caregivers play a prominent role in shared decision making processes, but we lack insights into their experiences. In this study, we explored how bereaved family caregivers experienced the shared decision making process. Methods We performed a qualitative interview study with in-depth interviews analysed with inductive content analysis. We used a purposive sample of bereaved family caregivers (n = 16) of patients with cancer treated in a tertiary university hospital in the Netherlands. Results Four themes were identified: 1. scenarios of decision making, 2. future death of the patient 3. factors influencing choices when making a treatment decision, and 4. preconditions for the decision making process. Most family caregivers deferred decisions to the patient or physician. Talking about the patient’s future death was not preferred by all family caregivers. All family caregivers reported life prolongation as a significant motivator for treatment, while the quality of life was rarely mentioned. A respectful relationship, close involvement, and open communication with healthcare professionals in the palliative setting were valued by many interviewees. Family caregivers’ experiences and needs seemed to be overlooked during medical encounters. Conclusions Family caregivers of deceased patients with cancer mentioned life prolongation, and not quality of life, as the most important treatment aim. They highly valued interactions with the medical oncologist and being involved in the conversations. We advise medical oncologists to take more effort to involve the family caregiver, and more explicitly address quality of life in the consultations.

Selected freshness indices of skin and wings from organic chicken packaged in modified atmosphere

This study is part of a project aiming to optimize storage conditions for organic chicken meat. Selected indices of skin and wings from organic chicken were evaluated. A total of 24 samples were packaged in MAP-O2 (80% O2/20% CO2), 24 samples in MAP-N2 (70% N2/30% CO2) and 48 samples as a control. The samples were analysed on days 2, 7, 10 and 14 of storage during a 14-day storage period at 2 ± 2 °C. The surface colour of skin (L*a*b*), ammonia content, thiobarbituric acid reactive substances content (TBARS) and antioxidant capacity were assessed. The lightness values (L*) for chicken skin in MAP-O2 were increased on days 7 and 10 of the storage period, and were significantly (P < 0.05) higher than in the samples in MAP-N2 and the control. Significant increases of TBARS were observed in the samples in MAP-O2 from day 7 and these values continued to increase until the end of the storage period. The antioxidant capacities of the samples in MAP-O2 were mostly lower than those of the samples in MAP-N2. Our results indicate that MAP-O2 only had a positive effect on skin colour, whereas MAP-N2 maybe preferable for shelf-life prolongation.

Local complications in patients with cardiac implantable devices

Cardiac implantable electronic devices (CIEDs) such as pacemakers (PMs), implantable cardioverter-defibrillators (ICDs), both with or without cardiac resynchronization therapy (CRT), became one of the fundamental therapies in present-day electrocardiology. The CIED patients population is increasing year by year due to a growing number of CIED implantations annually and a life prolongation among patients with CIEDs through better pharmacology combined with the proper electrotherapy and patient care. Invasive procedures related to CIED such as an implantation, a replacement or an up-grade of any kind electrotherapy device involves the risk of complications. Pocket hematoma or infection, which are local complications, should be recognized rapidly and treat properly in order to avoid more threatening systemic complications.

Uso de películas pós-colheita para a manutenção dos atributos visuais e produção de etileno em mini-abóboras ornamentais

In recent years, consumers have shown interest in the ornamental use of some fruits that were previously used mainly for food purposes. However, the use of ‘mini-pumpkins’ for ornamentation can be limited by post-harvest aspects, such as skin depigmentation, fresh mass losses, ethylene production and respiration, which compromise the visual quality of the product, resulting in the loss of its ornamental value. The objective was to evaluate the effect of films application (control, carnauba wax, cassava starch and corn starch) in post-harvest of ornamental mini-pumpkins, aiming the shelf life prolongation (experiment 1) and reduction of ethylene production and respiration (experiment 2). The results obtained in experiment 1 pointed to lower mass loss and maintenance of the ornamental mini-pumpkins epidermis color with the application of carnauba wax film. In experiment 2, the application of carnauba wax and the ethylene action inhibitor (1-MCP) did not and respiration production of mini-pumpkins, suggesting that ethylene is not involved in the modifications that occur in the product during the time of exposure to the environment.