Defective Visceral Adipose Tissue Adaptation in Gestational Diabetes Mellitus.

Context: Gestational diabetes mellitus (GDM) is a complex obstetric condition affecting localized glucose metabolism, resulting in systemic metabolic dysfunction.

Objective: This cross-sectional study aimed to explore visceral adipose tissue (VAT) as an integral contributor to GDM, focusing on elucidating the specific contribution of obesity and GDM pathology to maternal outcomes.

Methods: Fifty-six nulliparous pregnant women were recruited, including normal glucose tolerant (NGT) (n = 30) and GDM (n = 26) participants.

Quality outcomes for end-of-life care among people with haematological malignancies at a New Zealand cancer centre.

Background: Little is known about the end-of-life (EOL) experience and specialist palliative care use patterns of patients with haematological malignancies (HMs) in New Zealand.

Aims: This retrospective analysis sought to examine the quality of EOL care received by people with HMs under the care of Auckland District Health Board Cancer Centre's haematology service and compare it to international data where available.

Methods: One hundred consecutive adult patients with HMs who died on or before 31 December 2019 were identified.

Do I care for you more when you really need help? An experimental test of the effect of clinical urgency on compassion in health care.

Objectives: To experimentally investigate whether more urgent patient presentations elicit greater compassion from health care professionals than less urgent, facilitating future research and thinking to address systemic barriers to compassion in health care.

Design: This is a pre-registered online study with an experimental, within-subjects repeated-measure study design. Two clinical vignettes that systematically varied the urgency of patient presentation were utilized.

Working in value-discrepant environments inhibits clinicians' ability to provide compassion and reduces well-being: A cross-sectional study.

Background: The practice of compassion in healthcare leads to better patient and clinician outcomes. However, compassion in healthcare is increasingly lacking, and the rates of professional burnout are high. Most research to date has focused on individual-level predictors of compassion and burnout.

Predictors of Medical Students' Compassion and Related Constructs: A Systematic Review.

Compassion, and related constructs such as empathy, are core values in healthcare, with known benefits for both patients and staff. Yet research on the factors that affect compassion and compassion-related constructs remains scattered. This review systematizes and synthesizes studies investigating the predictors of compassion and related constructs among medical students, allowing for a better understanding of the factors that both positively and negatively contribute to the development of compassionate future physicians.

Predictors of Physician Compassion, Empathy, and Related Constructs: a Systematic Review.

Background: Compassion in healthcare provides measurable benefits to patients, physicians, and healthcare systems. However, data regarding the factors that predict care (and a lack of care) are scattered. This study systematically reviews biomedical literature within the Transactional Model of Physician Compassion and synthesizes evidence regarding the predictors of physician empathy, compassion, and related constructs (ECRC).

Performativity, identity formation and professionalism: Ethnographic research to explore student experiences of clinical simulation training.

Developing professional identity is a vital part of health professionals' education. In Auckland four tertiary institutions have partnered to run an interprofessional simulation training course called Urgent and Immediate Patient Care Week (UIPCW) which is compulsory for Year Five medical, Year Four pharmacy, Year Three paramedicine and Year Three nursing students. We sought to understand student experiences of UIPCW and how those experiences informed student ideas about professional identity and their emergent practice as health professionals within multidisciplinary teams.

Happiness at the End of Life: A Qualitative Study.

Background: Happiness is a core ingredient of health and well-being, yet relatively little is known about what happiness means for individuals near the end of life, and whether perceptions of happiness change as individuals approach the end of their lives.

Aim: The aim of this study was to explore, through interviews, how individuals experiencing hospice care understood and conceptualized happiness.

Design: Qualitative interviews with hospice patients were analyzed thematically.

Factors Associated With Terminally Ill People Who Want to Die.

Context: The decision to request and proceed with euthanasia or physician-assisted dying is complex, and predictors of such decisions are heterogeneous with regard to physical health, psychological, and social factors. Local research is therefore needed.

Objectives: To examine the interplay of demographic, clinical, and psychosocial factors routinely collected by a standardized clinical instrument, the interRAI Resident Assessment Instrument for Palliative Care (interRAI-PC), in people with a prognosis of less than 12 months who wanted to die.

Providing a liminal space: Threshold concepts for learning in palliative medicine.

: Experience in palliative medicine provides a beneficial learning opportunity for doctors-in-training. There is, however, a gap in understanding which aspects of learning are most useful, which are problematic and how learning can best be facilitated. This study addresses that gap using the 'threshold concepts' framework.

Deathbed Confession: When a Dying Patient Confesses to Murder: Clinical, Ethical, and Legal Implications.

During an initial palliative care assessment, a dying man discloses that he had killed several people whilst a young man. The junior doctor, to whom he revealed his story, consulted with senior palliative care colleagues. It was agreed that legal advice would be sought on the issue of breaching the man's confidentiality.

Reigniting compassion in healthcare: Manaakitia Reflective Rounds.

Background: The reported levels of staff stress and burnout at all levels of training and disciplines is significant and recognised to impact on the care of patients and families. We present an initiative to support staff at Auckland City Hospital based on the Schwartz Center Rounds.

Aim: To evaluate the efficacy of monthly case-based, staff support reflective rounds to discuss complex emotional and psychosocial issues that arise in caring for patients and families.

The extent and cost of potentially avoidable admissions in hospital inpatients with palliative care needs: a cross-sectional study.

Objective: More than 90% of people spend time in hospital in the last year of life and, in many developed countries, hospitals are the setting in which most people will die. Previous research indicates that a proportion of these hospital admissions could have been avoided. The objective of this study was to establish the extent and cost of potentially avoidable hospital admissions among patients with palliative care needs.

Can we predict which hospitalised patients are in their last year of life? A prospective cross-sectional study of the Gold Standards Framework Prognostic Indicator Guidance as a screening tool in the acute hospital setting.

Background: Screening to identify hospital inpatients with a short life expectancy may be a way to improve care towards the end of life. The Gold Standards Framework Prognostic Indicator Guidance is a screening tool that has recently been advocated for use in the hospital setting.

Aim: To assess the clinical utility of the Gold Standards Framework Prognostic Indicator Guidance as a screening tool in an acute hospital setting.

Clinical staff perceptions of palliative care-related quality of care, service access, education and training needs and delivery confidence in an acute hospital setting.

Context: Central to appropriate palliative care management in hospital settings is ensuring an adequately trained workforce. In order to achieve optimum palliative care delivery, it is first necessary to create a baseline understanding of the level of palliative care education and support needs among all clinical staff (not just palliative care specialists) within the acute hospital setting.

Objectives: The objectives of the study were to explore clinical staff: perceptions concerning the quality of palliative care delivery and support service accessibility, previous experience and education in palliative care delivery, perceptions of their own need for formal palliative care education, confidence in palliative care delivery and the impact of formal palliative care training on perceived confidence.

Palliative care need and management in the acute hospital setting: a census of one New Zealand Hospital.

Background: Improving palliative care management in acute hospital settings has been identified as a priority internationally. The aim of this study was to establish the proportion of inpatients within one acute hospital in New Zealand who meet prognostic criteria for palliative care need and explore key aspects of their management.

Methods: A prospective survey of adult hospital inpatients (n = 501) was undertaken.

The nature of, and reasons for, 'inappropriate' hospitalisations among patients with palliative care needs: a qualitative exploration of the views of generalist palliative care providers.

Background: Recent studies have concluded that there is significant potential to reduce the extent of 'inappropriate' hospitalisations among patients with palliative care needs. However, the nature of, and reasons for, inappropriate hospitalisations within a palliative care context is under-explored.

Aim: To explore the opinions of 'generalist' palliative care providers regarding the nature of, and reasons for, inappropriate admissions among hospital inpatients with palliative care needs.

Validation of the phase II feasibility study in a palliative care setting: gastrografin in malignant bowel obstruction.

Background: Malignant bowel obstruction (MBO) is common in patients with advanced cancer.

Aim: To perform a phase II study to assess the feasibility of conducting a phase III trial investigating the therapeutic value of gastrografin in MBO.

Methods: Randomized double-blinded placebo-controlled feasibility study.

Intensive communication skills teaching for specialist training in palliative medicine: development and evaluation of an experiential workshop.

Background: The Australasian Chapter of the Palliative Medicine (AChPM) Curriculum Development Group identified communication as a core skill that trainees in palliative medicine need to acquire, and proposed the development of a communication skills workshop that should become a compulsory part of training to achieve accreditation as a palliative medicine specialist in Australia and New Zealand. This paper describes the development and subsequent evaluation of this module.

Methods: A three-day communication workshop was developed in collaboration with expert communication skills facilitators from the United States and Australia.

Emotional congruence in learning and health encounters in medicine: addressing an aspect of the hidden curriculum.

This paper aims to draw attention to and provide insights into an area that is of educational significance for clinical teachers, namely the need to acknowledge and respond appropriately to the emotional context of both learning and health encounters in order to improve the outcomes of both. This need has been highlighted by recent calls for more attention to be paid to the role of emotion within medical education and within health care provision. What is already known about the role of emotion in learner-teacher encounters and in patient-doctor encounters will be used to develop the concept of emotional congruence within these two types of encounter as a challenge to clinical teachers to examine their own practice.

A comparative study of self-perceived public health competencies: practice teachers and qualifying SCPHNs.

There is evidence to suggest that population-focused public health nursing is more rhetoric than reality. This quantitative study compares the self-perceived public health competence of qualifying student specialist community public health nurses (SCPHNs) (n = 35) with those of the practice teachers (PTs) facilitating their practice learning (n = 31). Findings suggest that PTs felt more competent than qualifying students on leadership and management for public health, working with communities, and communication skills.