Suchergebnisse

End-of-life Care auf Intensivstationen -- Vorwort -- Zusammenfassung -- Abstract -- Inhaltsverzeichnis -- Abbildungsverzeichnis -- Tabellenverzeichnis -- 1. Einleitung -- 2. Sterbekultur in Deutschland -- 3. Sterben in Institutionen -- 4. Spezialbereich Intensivstation -- 4.1. Geschichtliche Entwicklung -- 4.2. Strukturelle Gegebenheiten -- 4.3. Intensivmedizinischer Behandlungsprozess -- 4.4. Ziele und Ergebnisse intensivmedizinischer Maßnahmen -- 5. Rechtliche Rahmenbedingungen -- 5.1. Gesetze und andere verbindliche Rechtsnormen -- 5.2. Rechtsprechung -- 5.3. Leitlinien und vorsorgliche Erklärungen -- 5.4. Synopse und aktuelle Entwicklungen -- 6. Sterbebegleitung auf Intensivstationen -- 6.1. Ist-Situation der Sterbebegleitung auf Intensivstationen -- 6.2. Bedürfnisse sterbender PatientInnen und ihrer Angehörigen -- 6.3. Bedürfnisse und Belastungsfaktoren begleitender Pflegekräfte -- 6.4. End-of-life Care Konzepte und Maßnahmen -- 7. Methodik -- 7.1. Fragestellung und Ziel der Untersuchung -- 7.2. Instrumente -- 7.3. Untersuchungsablauf -- 7.4. Studienpopulation -- 7.5. Statistische Auswertung -- 8. Ergebnisse -- 8.1. Deskriptiv -- 8.2. Analytisch -- 8.3. Zusammenfassung der wichtigsten Ergebnisse -- 9. Diskussion -- 10. Schlussfolgerungen und Ausblick -- 11. Literaturverzeichnis -- 12. Anhang.

One-stop handbook to support training and continuing professional development in end of life care.

BACKGROUND: Despite aggressive treatment with surgery and chemo-radiation therapy, it is difficult to cure patients with glioblastoma (GBM). The end-of-life (EOL) phase of patients with GBM, and related problems, have not yet been adequately studied. Most cancer patients died in the hospital (84%) in 2017, but the Japanese government has recommended palliative home-care and the number of deaths at home has recently been increasing. This study explores the current situation of EOL care for GBM patients in our hospital. METHODS: We retrospectively examined the clinical course and EOL phase of 166 consecutive patients who were treated in our hospital between 2010 and 2017. RESULT: In total, 107 patients died; 28 (26%) at home, 25 (23%) in hospice care, 9(9%) in nursing homes, 21(20%) in long-term care hospitals (LTCH), 13(12%) in our hospital, and 11(10%) in other neurosurgical hospitals. The median survival time and length of EOL phase for patients who died at home were 596 and 77 days; 469 and 103 days in hospice care; 528 days and 149 days in LTCH; 388 days and 52 days in our hospital; 802 and 91 days in other neurosurgical hospital; and 565 days and 55 days in nursing homes, respectively. The KPS of patients who transferred to LTCH or was started palliative care in other neurological hospital was 60. That of other patients was 50.The patients who died at home entered deep coma in the last 3.5 days (n=24) of life and could not take oral feeds for 7 days (n=26). CONCLUSION: According to cancer patient study, the home-based palliative time of longer prognosis group were 59 days. EOL phase of GBM may be longer than other cancer. We must consider the problems of the EOL phase and improve the quality of EOL care.

A structured discussion of End-of-Life (EOL) issues is a relatively new phenomenon in India. Personal beliefs, cultural and religious influences, peer, family and societal pressures affect EOL decisions. Indian law does not provide sanction to contentious issues such as do-not-resuscitate (DNR) orders, living wills, and euthanasia. Finally, published data on EOL decisions in Indian ICUs is lacking. What is needed is a prospective determination of which patients will benefit from aggressive management and life-support. A consensus regarding the concept of Medical Futility is necessary to give impetus to further discussion on more advanced policies including ideas such as Managed Care to restrict unnecessary health care costs, euthanasia, the principle of withhold and/or withdraw, ethical and moral guidelines that would govern decisions regarding futile treatment, informed consent to EOL decisions and do-not-resuscitate orders. This review examines the above concepts as practiced worldwide and looks at some landmark judgments that have shaped current Indian policy, as well as raising talking points for possible legislative intervention in the field.

AbstractEnvironmental and social awareness are the key elements of the sustainable tire industry. End-of-life tire (ELT) waste flow is an important environmental problem worldwide since it produces severe air, water, and soil pollution issues. Significant advancements have been made in ELT management in the last few years. As a result, ELTs should not only be regarded as waste but also as a source of environmentally friendly materials. Besides, sound ELT management has vital importance for circular economy and sustainable development. Over the last decade, ELT management has attracted many researchers and practitioners. Unfortunately, a comprehensive review of the ELT management area is still missing. This study presents the first critical review of the whole ELT management area. It aims to present an extensive content analysis overview of state-of-the-art research, provide its critical analysis, highlight major gaps, and propose the most significant research directions. A total of 151 peer-reviewed studies published in the journals between 2010–2020 are collected, analyzed, categorized, and critically reviewed. This review study redounds comprehensive insights, a valuable source of references, and major opportunities for researchers and practitioners interested in not only ELT material flow but also the whole waste management area.
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