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<title>American Journal of Hospice and Palliative Medicine current issue</title>
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<prism:coverDisplayDate>June/July 2009</prism:coverDisplayDate>
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<title>American Journal of Hospice and Palliative Medicine</title>
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<link>http://ajh.sagepub.com</link>
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<item rdf:about="http://ajh.sagepub.com/cgi/reprint/26/3/157?rss=1">
<title><![CDATA[An Overview of Constipation and Newer Therapies]]></title>
<link>http://ajh.sagepub.com/cgi/reprint/26/3/157?rss=1</link>
<description><![CDATA[]]></description>
<dc:creator><![CDATA[Enck, R. E.]]></dc:creator>
<dc:date>2009-06-16</dc:date>
<dc:identifier>info:doi/10.1177/1049909109337298</dc:identifier>
<dc:title><![CDATA[An Overview of Constipation and Newer Therapies]]></dc:title>
<prism:number>3</prism:number>
<prism:volume>26</prism:volume>
<prism:endingPage>158</prism:endingPage>
<prism:publicationDate>2009-06-01</prism:publicationDate>
<prism:startingPage>157</prism:startingPage>
<prism:section>Article</prism:section>
</item>

<item rdf:about="http://ajh.sagepub.com/cgi/content/abstract/26/3/159?rss=1">
<title><![CDATA[Respiratory Support in Oncology Ward Setting: A Prospective Descriptive Study]]></title>
<link>http://ajh.sagepub.com/cgi/content/abstract/26/3/159?rss=1</link>
<description><![CDATA[<p>Background. Mechanical ventilation in cancer patients is a critical issue The present prospective descriptive study was designed (1) to assess the patient population needing respirator support in ward setting at a premier state-run oncology institute in India, (2) to observe and analyze the course of their disease while on respirator, and (3) to coordinate better quality of life measures in cancer patients at the institute based on the present study's outcomes.</p><p>Methods. Beginning from March 2005 to March 2006, all cancer patients who were connected to respirator in the wards were enrolled in the current study. Our anesthesiology department at the cancer institute also has primary responsibility for airway management and mechanical ventilation in high dependency units of oncology wards. Preventilation variables in cancer patients were assessed to judge the futility of mechanical ventilation in ward setting. Subsequently, patients were observed for disease course while on respirator. Final outcome with its etio-pathogenesis was correlated with predicted futility of mechanical ventilation.</p><p>Results. Over a period of 1 year, 132 (46 men and 86 women) cancer patients with median age 40 years (range 1-75 years) were connected to respirator in oncology wards. Based on the preventilation variables and indications for respirator support, right prediction of medical futility and hospital discharge was made in 77% of patients. Underestimation and overestimation of survival to hospital discharge was made in 10% cases and 13% cases, respectively.</p><p>Conclusion. Based on preventilation variables, prediction of outcome in cancer patients needing respirator support can be made in 77% cases. This high probability of prediction can be used to educate patients, and their families and primary physicians, for well-informed and documented advance directives, formulated and regularly revised DNAR policies, and judicious use of respirator support for better quality-of-life outcomes.</p>]]></description>
<dc:creator><![CDATA[Mishra, S., Bhatnagar, S., Gupta, D., Gaurav Nirvani Goyal,  , Agrawal, R., Jain, R., Chauhan, H.]]></dc:creator>
<dc:date>2009-06-16</dc:date>
<dc:identifier>info:doi/10.1177/1049909108330032</dc:identifier>
<dc:title><![CDATA[Respiratory Support in Oncology Ward Setting: A Prospective Descriptive Study]]></dc:title>
<prism:number>3</prism:number>
<prism:volume>26</prism:volume>
<prism:endingPage>164</prism:endingPage>
<prism:publicationDate>2009-06-01</prism:publicationDate>
<prism:startingPage>159</prism:startingPage>
<prism:section>Article</prism:section>
</item>

<item rdf:about="http://ajh.sagepub.com/cgi/content/abstract/26/3/165?rss=1">
<title><![CDATA[Does Caregiver Knowledge Matter for Hospice Enrollment and Beyond? Pilot Study of Minority Hospice Patients]]></title>
<link>http://ajh.sagepub.com/cgi/content/abstract/26/3/165?rss=1</link>
<description><![CDATA[<p>We examined the level of hospice knowledge of caregivers of minority elderly hospice patients and determined how it influences the hospice enrollment decision and the decision on the use of hospice services after enrollment. Based on qualitative analysis of medical records and interviews with caregivers of minority elderly hospice patients who received personal care from paid caregivers (eg, other than family caregivers), we found that hospice knowledge increased access to hospice among minority patients who otherwise would not opt for hospice or enroll too late for comprehensive hospice care services. Furthermore, the highest level of knowledge&mdash;acquired through caregivers' health care occupations&mdash;appears to influence hospice care after hospice enrollment. Caregivers with that level of knowledge made requests for changes in site of care and/or additional services that may enhance the quality of hospice care that their loved ones receive.</p>]]></description>
<dc:creator><![CDATA[Chung, K., Essex, E. L., Samson, L.]]></dc:creator>
<dc:date>2009-06-16</dc:date>
<dc:identifier>info:doi/10.1177/1049909109331883</dc:identifier>
<dc:title><![CDATA[Does Caregiver Knowledge Matter for Hospice Enrollment and Beyond? Pilot Study of Minority Hospice Patients]]></dc:title>
<prism:number>3</prism:number>
<prism:volume>26</prism:volume>
<prism:endingPage>171</prism:endingPage>
<prism:publicationDate>2009-06-01</prism:publicationDate>
<prism:startingPage>165</prism:startingPage>
<prism:section>Article</prism:section>
</item>

<item rdf:about="http://ajh.sagepub.com/cgi/content/abstract/26/3/172?rss=1">
<title><![CDATA[Prospective Evaluation of Transition to Specialized Home Palliative Care in Japan]]></title>
<link>http://ajh.sagepub.com/cgi/content/abstract/26/3/172?rss=1</link>
<description><![CDATA[<p>The aim of this study was to clarify patients' characteristics and the level of symptom management in the transition to specialized home palliative care, and to examine prospectively real-time evaluation of both terminal cancer patients and their families. This study was conducted at one of the largest institutions offering specialized home palliative care in Japan. We asked both the patient's and the family's health status at the initial assessment and 2 weeks later. One hundred sets of patients and their families were included in this study. Regarding patient characteristics at the time of referral to the specialized home palliative care service, patients referred from outpatient settings had more severe physical symptoms than patients referred from inpatient settings. The specialized home palliative care service could contribute to patients' symptom and families' psychosocial status.</p>]]></description>
<dc:creator><![CDATA[Kusajima, E., Kawa, M., Miyashita, M., Kazuma, K., Okabe, T.]]></dc:creator>
<dc:date>2009-06-16</dc:date>
<dc:identifier>info:doi/10.1177/1049909108330029</dc:identifier>
<dc:title><![CDATA[Prospective Evaluation of Transition to Specialized Home Palliative Care in Japan]]></dc:title>
<prism:number>3</prism:number>
<prism:volume>26</prism:volume>
<prism:endingPage>179</prism:endingPage>
<prism:publicationDate>2009-06-01</prism:publicationDate>
<prism:startingPage>172</prism:startingPage>
<prism:section>Article</prism:section>
</item>

<item rdf:about="http://ajh.sagepub.com/cgi/content/abstract/26/3/180?rss=1">
<title><![CDATA[Bioelectrical Impedance Phase Angle Changes During Hydration and Prognosis in Advanced Cancer]]></title>
<link>http://ajh.sagepub.com/cgi/content/abstract/26/3/180?rss=1</link>
<description><![CDATA[<p>Introduction. We wished to determine bioelectrical impedance (BIA) correlates before hydration or changes during hydration and determine if these changes were prognostically important.</p><p>Methods and Materials. Fifty eligible patients underwent BIA measurements 3 consecutive days. Laboratory studies (electrolytes, creatinine, and hemoglobin) on day 1; weights and vital signs were recorded. Kaplan-Meier survival estimates were made at 30 and 60 days. Hazard ratios (HRs) based on Cox proportional hazards model were calculated.</p><p>Results. Weight loss was associated with shorter survival. A higher phase angle (PA) on day 1 predicted longer survival. Increased PA during hydration predicted shorter survival: increased weight during hydration predicted longer survival.</p><p>Discussion. Higher phase angle before hydration predicts poorer survival and, paradoxically, an increase in phase angle during hydration predicted poorer survival and preexisting intracellular dehydration, cachexia, or poor membrane function. Conclusions. Phase angle and weight during hydration predict survival in cancer.</p>]]></description>
<dc:creator><![CDATA[Davis, M. P., Yavuzsen, T., Khoshknabi, D., Kirkova, J., Walsh, D., Lasheen, W., Lagman, R., Karafa, M. T.]]></dc:creator>
<dc:date>2009-06-16</dc:date>
<dc:identifier>info:doi/10.1177/1049909108330028</dc:identifier>
<dc:title><![CDATA[Bioelectrical Impedance Phase Angle Changes During Hydration and Prognosis in Advanced Cancer]]></dc:title>
<prism:number>3</prism:number>
<prism:volume>26</prism:volume>
<prism:endingPage>187</prism:endingPage>
<prism:publicationDate>2009-06-01</prism:publicationDate>
<prism:startingPage>180</prism:startingPage>
<prism:section>Article</prism:section>
</item>

<item rdf:about="http://ajh.sagepub.com/cgi/content/abstract/26/3/188?rss=1">
<title><![CDATA[Motivations of Hospice Volunteers]]></title>
<link>http://ajh.sagepub.com/cgi/content/abstract/26/3/188?rss=1</link>
<description><![CDATA[<p>To recruit and retain volunteers, coordinators need to understand volunteers' motivations. In this study, 351 volunteers from 32 hospices in the western United States answered questions on a mailed survey about their motivations. The motivations reported were, in order of overall importance: to help others and learn, foster social relationships, feel better, and pursue career goals. Younger volunteers reported stronger career motivations, and retired and unemployed volunteers reported stronger social motivations. Volunteer coordinators should consider these motivations in communicating with potential and current volunteers, with special emphasis on compassion for those in need and the importance of helping, on fostering hospice volunteering as a learning experience, and in accessing and building social networks around hospice volunteering.</p>]]></description>
<dc:creator><![CDATA[Planalp, S., Trost, M.]]></dc:creator>
<dc:date>2009-06-16</dc:date>
<dc:identifier>info:doi/10.1177/1049909108330030</dc:identifier>
<dc:title><![CDATA[Motivations of Hospice Volunteers]]></dc:title>
<prism:number>3</prism:number>
<prism:volume>26</prism:volume>
<prism:endingPage>192</prism:endingPage>
<prism:publicationDate>2009-06-01</prism:publicationDate>
<prism:startingPage>188</prism:startingPage>
<prism:section>Article</prism:section>
</item>

<item rdf:about="http://ajh.sagepub.com/cgi/content/abstract/26/3/193?rss=1">
<title><![CDATA[Medication Reconciliation in Hospice: A Pilot Study]]></title>
<link>http://ajh.sagepub.com/cgi/content/abstract/26/3/193?rss=1</link>
<description><![CDATA[<p>Background: The Joint Commission required implementation of medication reconciliation processes by January 2006. Medication reconciliation is the practice of acquiring an accurate medication history at each transitional point of care. Potential for errors increases with inaccurate medication histories. This study determined the extent of medication reconciliation errors in hospice.</p><p>Methods: Patients were enrolled from 2 hospices in Maryland (January 2007). An initial medication history was completed by the nurse on hospice admission. The pharmacist did another medication history within 5 days of admission and compared the medication histories. All differences were reported as medication discrepancies.</p><p>Results: There were 504 medication discrepancies. Medication omissions occurred most commonly. All patients had at least 1 medication discrepancy (average 8.7 per patient). Overall, 190 drug interactions were identified; most were moderately severe. Conclusion: Terminal patients often use numerous medications increasing the risk of medication errors. Accurate medication histories reduce errors and potential for harm.</p>]]></description>
<dc:creator><![CDATA[Kemp, L. O., Narula, P., McPherson, M. L., Zuckerman, I.]]></dc:creator>
<dc:date>2009-06-16</dc:date>
<dc:identifier>info:doi/10.1177/1049909108328698</dc:identifier>
<dc:title><![CDATA[Medication Reconciliation in Hospice: A Pilot Study]]></dc:title>
<prism:number>3</prism:number>
<prism:volume>26</prism:volume>
<prism:endingPage>199</prism:endingPage>
<prism:publicationDate>2009-06-01</prism:publicationDate>
<prism:startingPage>193</prism:startingPage>
<prism:section>Article</prism:section>
</item>

<item rdf:about="http://ajh.sagepub.com/cgi/content/abstract/26/3/200?rss=1">
<title><![CDATA[Beyond Polarization, Public Preferences Suggest Policy Opportunities to Address Aging, Dying, and Family Caregiving]]></title>
<link>http://ajh.sagepub.com/cgi/content/abstract/26/3/200?rss=1</link>
<description><![CDATA[<p>Despite well-documented deficiencies and widespread suffering experienced by millions of elderly or ill Americans and their families, politicians rarely address end-of-life issues. Citizen Forums in New Hampshire surveyed 463 people regarding aging, serious illness, and caregiving. More than 80% indicated it was very or extremely important to have their dignity respected, preferences honored, pain controlled, and to not leave family with debt. Less than half strongly endorsed being kept alive as long as possible, prayed with or for, or having assisted-suicide available. Over 80% strongly endorsed palliative care requirements clinical licensure and reimbursement, expansion of family caregiver leave, respite care, and bereavement support. By avoiding actions which elicit strong divergence of opinion and focusing on actions on which consensus exists, public officials and candidates can respond to problems and improve care and experience for frail elders, dying Americans, and their families.</p>]]></description>
<dc:creator><![CDATA[Byock, I. R., Corbeil, Y. J., Goodrich, M. E.]]></dc:creator>
<dc:date>2009-06-16</dc:date>
<dc:identifier>info:doi/10.1177/1049909108328700</dc:identifier>
<dc:title><![CDATA[Beyond Polarization, Public Preferences Suggest Policy Opportunities to Address Aging, Dying, and Family Caregiving]]></dc:title>
<prism:number>3</prism:number>
<prism:volume>26</prism:volume>
<prism:endingPage>208</prism:endingPage>
<prism:publicationDate>2009-06-01</prism:publicationDate>
<prism:startingPage>200</prism:startingPage>
<prism:section>Article</prism:section>
</item>

<item rdf:about="http://ajh.sagepub.com/cgi/content/abstract/26/3/209?rss=1">
<title><![CDATA[An Educational Program in a Pediatric Hospice Setting]]></title>
<link>http://ajh.sagepub.com/cgi/content/abstract/26/3/209?rss=1</link>
<description><![CDATA[<p>Canuck Place Children's Hospice, a family-centered pediatric hospice in Vancouver, Canada, provides family support and respite, pain and symptom management, and end-of-life care. One of the goals of pediatric hospice palliative care is to create an environment that supports a normal way of life and enhances quality of life. At Canuck Place, a unique school program for children with progressive life-threatening illnesses has been set up to meet this goal. This article describes the Canuck Place educational program, gives insights into the importance and challenges of providing a complete school experience, and discusses the expanded role of the teacher in the pediatric hospice setting.</p>]]></description>
<dc:creator><![CDATA[Wood, I.]]></dc:creator>
<dc:date>2009-06-16</dc:date>
<dc:identifier>info:doi/10.1177/1049909108328608</dc:identifier>
<dc:title><![CDATA[An Educational Program in a Pediatric Hospice Setting]]></dc:title>
<prism:number>3</prism:number>
<prism:volume>26</prism:volume>
<prism:endingPage>212</prism:endingPage>
<prism:publicationDate>2009-06-01</prism:publicationDate>
<prism:startingPage>209</prism:startingPage>
<prism:section>Article</prism:section>
</item>

<item rdf:about="http://ajh.sagepub.com/cgi/reprint/26/3/213?rss=1">
<title><![CDATA[Every Little Thing Is Gonna Be Alright]]></title>
<link>http://ajh.sagepub.com/cgi/reprint/26/3/213?rss=1</link>
<description><![CDATA[]]></description>
<dc:creator><![CDATA[Pies, R.]]></dc:creator>
<dc:date>2009-06-16</dc:date>
<dc:identifier>info:doi/10.1177/1049909109331889</dc:identifier>
<dc:title><![CDATA[Every Little Thing Is Gonna Be Alright]]></dc:title>
<prism:number>3</prism:number>
<prism:volume>26</prism:volume>
<prism:endingPage>213</prism:endingPage>
<prism:publicationDate>2009-06-01</prism:publicationDate>
<prism:startingPage>213</prism:startingPage>
<prism:section>Article</prism:section>
</item>

<item rdf:about="http://ajh.sagepub.com/cgi/reprint/26/3/214?rss=1">
<title><![CDATA[Diversion of Opioid Pain Medications at End-of-Life]]></title>
<link>http://ajh.sagepub.com/cgi/reprint/26/3/214?rss=1</link>
<description><![CDATA[]]></description>
<dc:creator><![CDATA[Baumrucker, S. J., Carter, G. T., VandeKieft, G., Stolick, M., Harrington, D., Sheldon, J. E., Morris, G. M.]]></dc:creator>
<dc:date>2009-06-16</dc:date>
<dc:identifier>info:doi/10.1177/1049909109336005</dc:identifier>
<dc:title><![CDATA[Diversion of Opioid Pain Medications at End-of-Life]]></dc:title>
<prism:number>3</prism:number>
<prism:volume>26</prism:volume>
<prism:endingPage>218</prism:endingPage>
<prism:publicationDate>2009-06-01</prism:publicationDate>
<prism:startingPage>214</prism:startingPage>
<prism:section>Article</prism:section>
</item>

<item rdf:about="http://ajh.sagepub.com/cgi/content/abstract/26/3/219?rss=1">
<title><![CDATA[Review Article: Gynecological Disorders in Geriatric Emergency Medicine]]></title>
<link>http://ajh.sagepub.com/cgi/content/abstract/26/3/219?rss=1</link>
<description><![CDATA[<p>Emergency physicians must be competent in caring for elderly women because they constitute the fastest growing segment of the population in the United States. Familiarity with acute geriatric gynecologic issues is crucial to providing satisfactory health care for these patients with complaints relating to incontinence, pelvic floor dysfunction, and other gynecologic conditions. Vigilant suspicion for malignancy should be maintained in facilities that service patients without primary health care or insurance. This article provides a systematic approach to emergency department management of common geriatric gynecological conditions. Anatomical and physiological changes are discussed, as well as the geriatric pelvic examination, malignancy, urinary tract infection, incontinence, pelvic organ prolapse, and vulvovaginitis.</p>]]></description>
<dc:creator><![CDATA[Lewiss, R. E., Saul, T., Teng, J.]]></dc:creator>
<dc:date>2009-06-16</dc:date>
<dc:identifier>info:doi/10.1177/1049909109331884</dc:identifier>
<dc:title><![CDATA[Review Article: Gynecological Disorders in Geriatric Emergency Medicine]]></dc:title>
<prism:number>3</prism:number>
<prism:volume>26</prism:volume>
<prism:endingPage>227</prism:endingPage>
<prism:publicationDate>2009-06-01</prism:publicationDate>
<prism:startingPage>219</prism:startingPage>
<prism:section>Article</prism:section>
</item>

<item rdf:about="http://ajh.sagepub.com/cgi/reprint/26/3/228?rss=1">
<title><![CDATA[Letters to the Editor]]></title>
<link>http://ajh.sagepub.com/cgi/reprint/26/3/228?rss=1</link>
<description><![CDATA[]]></description>
<dc:creator><![CDATA[Frank, G., Wolch, G.]]></dc:creator>
<dc:date>2009-06-16</dc:date>
<dc:identifier>info:doi/10.1177/1049909109331888</dc:identifier>
<dc:title><![CDATA[Letters to the Editor]]></dc:title>
<prism:number>3</prism:number>
<prism:volume>26</prism:volume>
<prism:endingPage>229</prism:endingPage>
<prism:publicationDate>2009-06-01</prism:publicationDate>
<prism:startingPage>228</prism:startingPage>
<prism:section>Article</prism:section>
</item>

<item rdf:about="http://ajh.sagepub.com/cgi/reprint/26/3/230?rss=1">
<title><![CDATA[The Challenges of Caring for an Incarcerated Patient]]></title>
<link>http://ajh.sagepub.com/cgi/reprint/26/3/230?rss=1</link>
<description><![CDATA[]]></description>
<dc:creator><![CDATA[Zelaya, E.]]></dc:creator>
<dc:date>2009-06-16</dc:date>
<dc:identifier>info:doi/10.1177/1049909109333931</dc:identifier>
<dc:title><![CDATA[The Challenges of Caring for an Incarcerated Patient]]></dc:title>
<prism:number>3</prism:number>
<prism:volume>26</prism:volume>
<prism:endingPage>231</prism:endingPage>
<prism:publicationDate>2009-06-01</prism:publicationDate>
<prism:startingPage>230</prism:startingPage>
<prism:section>Article</prism:section>
</item>

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