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Lawson McLean AC, Lawson McLean A, Ernst T, Forster MT, Freyschlag C, Gempt J, Goldbrunner R, Grau S, Jungk C, van Oorschot B, Rosahl SK, Wedding U, Senft C, Kamp MA. Benchmarking palliative care practices in neurooncology: a german perspective. J Neurooncol 2024; 168:333-343. [PMID: 38696050 PMCID: PMC11147867 DOI: 10.1007/s11060-024-04674-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 04/04/2024] [Indexed: 06/04/2024]
Abstract
PURPOSE To benchmark palliative care practices in neurooncology centers across Germany, evaluating the variability in palliative care integration, timing, and involvement in tumor board discussions. This study aims to identify gaps in care and contribute to the discourse on optimal palliative care strategies. METHODS A survey targeting both German Cancer Society-certified and non-certified university neurooncology centers was conducted to explore palliative care frameworks and practices for neurooncological patients. The survey included questions on palliative care department availability, involvement in tumor boards, timing of palliative care integration, and use of standardized screening tools for assessing palliative burden and psycho-oncological distress. RESULTS Of 57 centers contacted, 46 responded (81% response rate). Results indicate a dedicated palliative care department in 76.1% of centers, with palliative specialists participating in tumor board discussions at 34.8% of centers. Variability was noted in the initiation of palliative care, with early integration at the diagnosis stage in only 30.4% of centers. The survey highlighted a significant lack of standardized spiritual care assessments and minimal use of advanced care planning. Discrepancies were observed in the documentation and treatment of palliative care symptoms and social complaints, underscoring the need for comprehensive care approaches. CONCLUSION The study highlights a diverse landscape of palliative care provision within German neurooncology centers, underscoring the need for more standardized practices and early integration of palliative care. It suggests the necessity for standardized protocols and guidelines to enhance palliative care's quality and uniformity, ultimately improving patient-centered care in neurooncology.
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Affiliation(s)
- Anna Cecilia Lawson McLean
- Department of Neurosurgery, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG), Jena/Leipzig, Germany
| | - Aaron Lawson McLean
- Department of Neurosurgery, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany.
- Comprehensive Cancer Center Central Germany (CCCG), Jena/Leipzig, Germany.
| | - Thomas Ernst
- University Tumor Center (UTC), Jena University Hospital, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG), Jena/Leipzig, Germany
| | | | | | - Jens Gempt
- Department of Neurosurgery, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | | | - Stefan Grau
- Department of Neurosurgery, Klinikum Fulda, Fulda, Germany
| | - Christine Jungk
- Department of Neurosurgery, Medical Faculty, Heidelberg University, Heidelberg, Germany
| | | | - Steffen K Rosahl
- Department of Neurosurgery, Helios Klinikum and Health Medical University Erfurt, Erfurt, Germany
| | - Ulrich Wedding
- Department of Palliative Care, Jena University Hospital, Jena, Germany
- Comprehensive Cancer Center Central Germany (CCCG), Jena/Leipzig, Germany
| | - Christian Senft
- Department of Neurosurgery, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany
| | - Marcel A Kamp
- Department of Palliative Care and Neuro-Palliative Care, Brandenburg Medical School Theodor Fontane, Immanuel Klinik Rüdersdorf, Neuruppin, Germany
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Selvam D, Crawford GB, Rizvi F, Bellingham K, Philip J. CarePlus: A Model to Address Barriers to Early Palliative Care in Cancer. J Pain Symptom Manage 2024; 67:e495-e497. [PMID: 38278188 DOI: 10.1016/j.jpainsymman.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 01/03/2024] [Indexed: 01/28/2024]
Affiliation(s)
- Dalini Selvam
- University of Melbourne (D.S., F.R., K.B., J.P.), Victoria, Australia; University of Adelaide (G.B.C.), South Australia, Australia; Northern Adelaide Local Health Network (G.B.C.), South Australia, Australia; St. Vincent's Hospital (F.R., K.B., J.P.), Victoria, Australia.
| | - Gregory B Crawford
- University of Melbourne (D.S., F.R., K.B., J.P.), Victoria, Australia; University of Adelaide (G.B.C.), South Australia, Australia; Northern Adelaide Local Health Network (G.B.C.), South Australia, Australia; St. Vincent's Hospital (F.R., K.B., J.P.), Victoria, Australia
| | - Farwa Rizvi
- University of Melbourne (D.S., F.R., K.B., J.P.), Victoria, Australia; University of Adelaide (G.B.C.), South Australia, Australia; Northern Adelaide Local Health Network (G.B.C.), South Australia, Australia; St. Vincent's Hospital (F.R., K.B., J.P.), Victoria, Australia
| | - Kylee Bellingham
- University of Melbourne (D.S., F.R., K.B., J.P.), Victoria, Australia; University of Adelaide (G.B.C.), South Australia, Australia; Northern Adelaide Local Health Network (G.B.C.), South Australia, Australia; St. Vincent's Hospital (F.R., K.B., J.P.), Victoria, Australia
| | - Jennifer Philip
- University of Melbourne (D.S., F.R., K.B., J.P.), Victoria, Australia; University of Adelaide (G.B.C.), South Australia, Australia; Northern Adelaide Local Health Network (G.B.C.), South Australia, Australia; St. Vincent's Hospital (F.R., K.B., J.P.), Victoria, Australia
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Baishya A, Metri K. Effects of yoga on hypothyroidism: A systematic review. J Ayurveda Integr Med 2024; 15:100891. [PMID: 38507967 PMCID: PMC10966165 DOI: 10.1016/j.jaim.2024.100891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/31/2023] [Accepted: 01/18/2024] [Indexed: 03/22/2024] Open
Abstract
Evidence from clinical trials has shown positive effects of yoga on hypothyroidism. To date, there is no review of these studies. This systematic review evaluates the efficacy of yoga as a therapeutic intervention for hypothyroidism. PubMed, Medline, PsycINFO, and Science Direct databases were searched to identify relevant literature. The review included clinical studies that evaluated the effects of yoga on hypothyroidism. Studies that were not conducted inenglish, unavailable, non-experimental, or those that were reviews, case studies, case reports, not based on yoga, involved yoga as a intervention, or included a mixed population were excluded. Eleven studies (n = 516) met the eligibility criteria. Of these, four studies were RCTs, two non-RCTs and five were pretest-posttest studies. The duration of the yoga intervention varied from 1 to 6 months. Most of these studies adopted a combination of suryanamaskar, asana, pranayama and meditation. On quality assessment, one study had a low risk of bias (1 RCT), six studies had a moderate risk of bias (3 RCTs, one non-RCT and two pretest-posttest studies), and four studies had a high risk of bias (1 non-RCT and three pretest-posttest studies). The outcome measures assessed were TSH, T3, T4, and thyroid medication usage, lipid indices, BMI, heart rate variability, pulmonary measures, blood glucose, anxiety, depression, self-esteem, quality of life and sleep. The majority of the studies reported significant improvements in these outcomes following yoga intervention. This systematic review reports evidence for effects of yoga on various outcome measures in hypothyroidism, suggesting its possible role in the management of hypothyroidism. However, there is a need for adequately powered, high-quality RCT studies in the future to draw a definitive conclusion.
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Tanzi S, Peruselli C, Moroni M. Palliative care is a complex care. BMJ Support Palliat Care 2023:spcare-2023-004553. [PMID: 37770101 DOI: 10.1136/spcare-2023-004553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 09/05/2023] [Indexed: 10/03/2023]
Affiliation(s)
- Silvia Tanzi
- Palliative Care Unit, Azienda USL-IRCCS, Reggio Emilia, Italy
- Trieste University Integrated Health Authority, Trieste, Friuli-Venezia Giulia, Italy
| | - Carlo Peruselli
- Former President of SICP, Italian Society of Palliative Care, Biella, Italy
| | - Matteo Moroni
- Trieste University Integrated Health Authority, Trieste, Friuli-Venezia Giulia, Italy
- Palliative Care Unit, ASL Ravenna, Ravenna Medical Center, Ravenna, Emilia-Romagna, Italy
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