Suchergebnisse

Anti-retroviral drugs (ARVs) are the only medications capable of extending the lives of those with AIDS. How they are distributed is, therefore, an important concern for both normative and positive reasons. The paper tests various potential theories about the distribution of scarce resources and provision of public goods from political science and economics against new data on the distribution of ARVs under the South African national rollout plan. Strong evidence is found in support of theories that predict that voter interests and knowledge drive the distribution of resources in democracies.

Cover -- Series -- Oxford American Handbook of Hospice and Palliative Medicine and Supportive Care -- Copyright -- Contents -- Contributors -- 1 Definitions and Key Elements in Palliative and Supportive Care -- 2 Symptom Assessment -- 3 Clinical Decision-​Making -- 4 Pain Assessment and Management -- 5 Fatigue -- 6 Cachexia -- 7 Dehydration -- 8 Anxiety and Depression -- 9 Sleep Disturbance -- 10 Chronic Nausea and Vomiting -- 11 Constipation and Bowel Obstruction -- 12 Delirium -- 13 Clinical Issues Related to Palliative Sedation -- 14 Breathlessness -- 15 Emergencies in Palliative Care

CONTEXT. The International Association for Hospice and Palliative Care developed a consensus-based definition of palliative care (PC) that focuses on the relief of serious health-related suffering, a concept put forward by the Lancet Commission Global Access to Palliative Care and Pain Relief. OBJECTIVE. The main objective of this article is to present the research behind the new definition. METHODS. The three-phased consensus process involved health care workers from countries in all income levels. In Phase 1, 38 PC experts evaluated the components of the World Health Organization definition and suggested new/revised ones. In Phase 2, 412 International Association for Hospice and Palliative Care members in 88 countries expressed their level of agreement with the suggested components. In Phase 3, using results from Phase 2, the expert panel developed the definition. RESULTS. The consensus-based definition is as follows: Palliative care is the active holistic care of individuals across all ages with serious health-related suffering due to severe illness and especially of those near the end of life. It aims to improve the quality of life of patients, their families and their caregivers. The definition includes a number of bullet points with additional details as well as recommendations for governments to reduce barriers to PC. CONCLUSION. Participants had significantly different perceptions and interpretations of PC. The greatest challenge faced by the core group was trying to find a middle ground between those who think that PC is the relief of all suffering and those who believe that PC describes the care of those with a very limited remaining life span.