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"Melanoma is one of the most common types of malignancy in the world, and one known to carry a very poor prognosis until recent years. This review aims to outline the events in the history of the disease and the impact made by the discoveries along the way, as well as the modern-day consensus by referencing the updated literature regarding the present approach and future directions. In the last two decades, several studies and research have brought significant improvement in the diagnosis and clinical management of melanomas. The development of sentinel lymph node biopsy has brought major changes to the surgical approach to the disease, and modern therapies based on recently developed knowledge changed the death sentence this diagnosis once meant to a manageable condition despite its aggressiveness, keeping in mind that early diagnosis and safe margin excision remain the best and most optimistic course of treatment. "

Kennett C, Payne M. Palliative care patients' experiences of healthcare treatmentInt J Soc Welfare 2010: 19: 262–271 © 2009 The Author(s), Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare.This article reports on a thematic analysis of the opinions of 34 palliative care patients about medical and healthcare treatment expressed in comments, narratives and discussions during a series of facilitated group discussions undertaken as part of training events for medical students. Palliative care patients often have long healthcare careers, which enables them to compare different professionals and services, thus offering a more powerful and complex analysis of patient experience than that obtainable from analysis of complaints or satisfaction surveys, and permits some understanding to be obtained of the attitudes that condition evaluations of services. The patients balanced negative views with positive experiences. They appreciated open, listening, equal and friendly relationships with professionals in which careful explanation fostered their confidence in the overall service. They criticised inflexible services that did not consider their broad needs, and in which relationships with professionals were characterised by busy‐ness and professional distance.

Modern medicine is divided into three categories, namely preventive, curative and palliative. Palliative medicine and palliative care focus on people suffering from progressive incurable diseases with an expected fatal outcome, as well as their family members. It is conducted by an interdisciplinary palliative team at all levels of health care. Palliative care is a broader term than palliative medicine, as it encompasses other activities carried out by social welfare institutions as well as civil society organizations, religious institutions and other stakeholders in the community. Although elements of the palliative approach have been encountered throughout history since the beginning of medical treatment, in the last fifty years we have witnessed the rapid development of palliative medicine as a distinct specialization and subspecialisation in many countries around the world. Palliative care is a civilizational step forward and a true example of person-centered medicine. Given the aging population and the growing technological capabilities of modern medicine, we expect a large increase in the need for palliative care which requires the active contribution of all participants involved in creating and implementing social and health policies, both locally, nationally and internationally. This paper presents the historical development and current state of palliative medicine in the world with special emphasis on the situation in Croatia. Key words: palliative medicine, palliative care, palliative team, quality of life, strategic plans, person-centered medicine, total pain, education

Background: Beck Hopelessness Scale (BHS) has been translated and validated in many languages. Aim: The validation of the English version of BHS in advanced cancer patients receiving palliative treatment in Greece. Methods: The final sample was 112 advanced cancer patients. Internal consistency, item-total correlations, and test—retest using four different approaches were calculated for the assessment of the reliability. Construct validity was used by examining correlations between BHS, Hospital Anxiety and Depression Scale (HAD-Depression) and the Schedule of Attitudes toward Hastened Death (SAHD). Known-groups validity was also assessed by detecting group differences according to disease severity as measured by the Eastern Cooperative Oncology Group (ECOG) performance status. Univariate and multivariate analyses were constructed to explore the relationship between hopelessness, depression, hastened death and the patients' demographic and clinical characteristics. Results: One factor solution was yielded accounted for 46.64% of the variance. The test—retest reliability was satisfactory ( p < 0.0005). Validity as performed using known-group analysis showed good results. Most significant correlations were found between BHS, ECOG ( p = 0.018) and gender ( p = 0.08). The strongest predictors were gender ( p = 0.050) and ECOG ( p = 0.045). Conclusions: BHS seemed to be a useful instrument to assess pessimistic attitude and hopelessness in a Greek cancer population, with valid psychometric properties.

The article presents an analysis of the prerequisites for the emergence of palliative care and its functions in modern Russia. The fundamental idea of modern palliative care is the absence of suffering of an incurable patient, first of all, the minimization of physical suffering, while palliative care allows solving a number of problems in the field of comprehensive support for incurable patients. Palliative care in its organizational forms begins its development in European countries and the USA, the hospice movement also emerges in Russia, however, certain prerequisites for caring for incurable patients (and not only oncological patients) were created in our country back in the 19th century. The scientific prerequisites for the formation of hospices as special institutions whose purpose is to care for dying patients are the experience of treating chronic pain, as well as effective psychotropic drugs, dynamically developing anti-cancer chemotherapy and radiation therapy, and achievements of medical psychology. An analysis of the functions of palliative care allows us to come to the conclusion that for palliative medicine and healthcare in Russia in general, the priority goal is to relieve the patient from pain; it is also important to disseminate information about possible means of achieving this effect. Palliative care relieves incurable patients from the humiliation caused by pain, illness, and infirmity. It implements several functions: it forms charitable medicine as a new form of medical and social service for incurable patients, promotes the provision of medical care to patients in the terminal stage, including at home, allows for symptomatic treatment of patients in the terminal stages, and organizes qualified care for them using psychotherapeutic and traditional methods, select and carry out the necessary pain relief therapy, provide psychological and social support to relatives during the period of illness and loss of a loved one.

Objective: To realize the vision of a multidisciplinary team before the child with leukemia in palliative care. Methods: This study is a qualitative approach, outlined by the case study method. The study subjects were 17 health professionals who provided direct assistance to children with leukemia in palliative care. Results: The results showed that, for practitioners, palliative care involves suffering by the family and the professional, arouses many emotions in the team. And that humanized care should be done seeking the host of both the patient and family comfort, relief of pain and symptoms, support and assistance to the family. Conclusion: It is concluded that the health professional creates bond with the child in palliative care, and also with his family, which is beneficial for the treatment of the child.

The National Hospice and Palliative Care Organization (NHPCO) upholds policies prohibiting practices that deliberately hasten death. We find these policies overly restrictive and unreasonable. We argue that under specified circumstances it is both reasonable and morally sound to allow for treatments that may deliberately hasten death; these treatments should be part of the NHPCO guidelines. Broadening such policies would be more consistent with the gold standard of bioethical principles, ie, respecting the autonomy of competent adults.

Background: Currently, palliative care is widely discussed. The aim of this study is to explore different aspects of the ambulatory treatment environment of palliative care patients and its structure in Germany from the viewpoint of caring physicians. Methods: A structured questionnaire was developed and sent to 1,003 office-based physicians in Germany. Topics were the delivery and effort of care, cooperation among health care providers, the subjective assessment of existing health care structures, the reimbursement system, as well as an assessment of future developments. Sub-group analyses were conducted. Results: Three hundred fourteen questionnaires were included in the statistical analyses. Fifty percent of physicians estimate the additional time and effort for palliative care patients compared to non-palliative care patients to be 50% and more. The best cooperation is seen with caregivers; however, cooperation with psycho-social care providers should be improved. Fifty percent describe the outpatient health care situation as (very) insufficient, but improvements are expected in the future. Ninety percent assess German reimbursement structures as (very) insufficient. Conclusions: This study gives an insight into the German outpatient health care setting for palliative care patients. Palliative care patients have higher and more complex needs with respect to health care than other patients. Further studies should focus on the collection of longitudinal patient data for more comprehensive insight.