Understanding the lived experience of chronic pain: A systematic review and synthesis of qualitative evidence syntheses.

Background: Although multiple measures of the causes and consequences of chronic non-cancer pain (CNCP) are available and can inform pain management, no quantitative summary of these measures can describe the meaning of pain for a patient. The lived experience of pain tends to be a blind spot in pain management. This study aimed to: (1) integrate qualitative research investigating the lived experience of a range of CNCP conditions; (2) establish common qualitative themes in CNCP experience; and (3) evaluate the relevance of our results through a survey questionnaire based on these themes, administered across the United Kingdom.

Diet and Chronic Non-Cancer Pain: The State of the Art and Future Directions.

Nutrition plays an important role in pain management. Healthy eating patterns are associated with reduced systemic inflammation, as well as lower risk and severity of chronic non-cancer pain and associated comorbidities. The role of nutrition in chronic non-cancer pain management is an emerging field with increasing interest from clinicians and patients.

Heart failure-the experience of living with end-stage heart failure and accessing care across settings.

Background: Heart failure is a complex clinical syndrome affecting an increasing number of the ageing population. Patients and carers require increasing input from specialist palliative care services to both manage symptoms and access support in the last year of life. An integrated clinical service between the local cardiology team at Princess Royal University Hospital and the palliative care team at St.

The Effect of a Pilot Dietary Intervention on Pain Outcomes in Patients Attending a Tertiary Pain Service.

The aim of this study was to examine the effect of a six-week 2 × 2 design on pain scores, quality of life, and dietary intake in patients attending an Australian tertiary pain clinic. The two intervention components were (1) personalized dietary consultations or waitlist control, and (2) active or placebo dietary supplement (fruit juice). Sixty participants were randomized into one of four groups at baseline (68% female, mean age 49 ± 15 years) with 42 completing the study (70% retention).

Population Characteristics in a Tertiary Pain Service Cohort Experiencing Chronic Non-Cancer Pain: Weight Status, Comorbidities, and Patient Goals.

We describe the characteristics of patients attending an Australian tertiary multidisciplinary pain service and identify areas for nutrition interventions. This cross-sectional study targets patients experiencing chronic pain who attended the service between June-December 2014. Self-reported data was captured from: (1) an Electronic Persistent Pain Outcomes Collaboration (ePPOC) referral questionnaire, incorporating demographics, pain status, and mental health; (2) a Pain Assessment and Recovery Plan (PARP), which documents patients' perceived problems associated with pain and personal treatment goals.

Using social media to challenge unwarranted clinical variation in the treatment of chronic noncancer pain: the "Brainman" story.

There is a substantial clinical variation in the contemporary treatment of chronic noncancer pain reflecting different explanatory models and treatment emphasis. Hunter Integrated Pain Service and collaborators developed three key messaging videos outlining the foundations of chronic pain treatment, thus challenging unwarranted clinical variation and calling for greater therapeutic consistency. The videos were released on YouTube as a low-cost public health intervention.

Ceasing intrathecal therapy in chronic non-cancer pain: an invitation to shift from biomedical focus to active management.

Objective: To report long term experience (1997-2009) of intrathecal (IT) therapy for chronic non-cancer pain in the context of our team's increasing emphasis on active management.

Design: Descriptive case series.

Setting: Australian tertiary multidisciplinary pain center, Hunter Integrated Pain Service (HIPS).

A whole-person model of care for persistent pain: from conceptual framework to practical application.

Setting:   The study was set in an Australian tertiary public hospital multidisciplinary pain center.

Objectives:   The objectives of the study were to describe the conceptual shift undertaken by a multidisciplinary team in moving from a traditional approach to an emerging paradigm in pain medicine and to describe the practical application of a whole-person model of care and report outcomes over the period 2003-2010.

Design:   The study design was descriptive, including a brief review of current evidence base, consideration of models of service delivery, and analysis of the impact of applying a new, whole-person model of care for persistent pain.

Provision of palliative care for chronic heart failure inpatients: how much do we need?

Background: Clinical guidance recommends early CHF palliative care intervention, but the magnitude of need is unknown and evidence-based referral criteria absent.This study aimed to: 1) Measure point prevalence of inpatients appropriate for palliative care. 2) Identify patient characteristics associated with palliative care appropriateness.

Meeting the communication and information needs of chronic heart failure patients.

There is a lack of evidence on how best to meet policy guidance in fulfilling the information needs of patients with chronic heart failure (CHF) and their families. We aimed to generate guidance for appropriate information provision to CHF patients and their families through a cross-sectional qualitative methodology with constant comparison of emergent themes. Participants were 20 CHF patients (New York Heart Association Functional Classification III, III-IV, and IV); 11 family carers; six palliative care staff; and six cardiology staff.

Modelling services to meet the palliative care needs of chronic heart failure patients and their families: current practice in the UK.

Objective: To describe current provision of specialist palliative care for chronic heart failure (CHF) patients, and explore challenges, referral criteria and recommendations to inform service development.

Method: Semi-structured qualitative telephone survey of key professionals involved in CHF palliative care in the UK.

Results: Twenty telephone interviews were conducted with staff from 17 services comprising three main types: hospital-based (n = 7), community-based (n = 6) and hospice-based (n = 4).

A randomized comparison of the Cryolife O'Brien and Toronto stentless replacement aortic valves.

Objective: A composite stentless valve might be less obstructive than a preparation incorporating the porcine right coronary muscle bar. The aim of this study was to compare early hemodynamic function in a prospective series of 78 patients randomized to receive either a Toronto or Cryolife O'Brien stentless valve.

Methods: Echocardiography was performed early after surgery, between 3 and 6 months, and at 1 year after surgery.

Improving end-of-life care for patients with chronic heart failure: "Let's hope it'll get better, when I know in my heart of hearts it won't".

Background: Although chronic heart failure (CHF) has a high mortality rate and symptom burden, and clinical guidance stipulates palliative care intervention, there is a lack of evidence to guide clinical practice for patients approaching the end of life.

Aims: (1) To formulate guidance and recommendations for improving end-of-life care in CHF; (2) to generate data on patients' and carers' preferences regarding future treatment modalities, and to investigate communication between staff, patients and carers on end-of-life issues.

Design: Semistructured qualitative interviews were conducted with 20 patients with CHF (New York Heart Association functional classification III-IV), 11 family carers, 6 palliative care clinicians and 6 cardiology clinicians.

The subcoronary Toronto stentless versus supra-annular Perimount stented replacement aortic valve: early clinical and hemodynamic results of a randomized comparison in 160 patients.

Background: A stentless valve is expected to be hemodynamically superior to a stented valve. The aim of this study was to compare early postoperative hemodynamic function and clinical events in a randomized, prospective series of 160 stentless and stented biological replacement aortic valves.

Methods: We randomized 160 consecutive patients on 1 surgeon's list to receive either a Toronto stentless porcine valve (St Jude Medical, Inc, St Paul, Minn) or a Perimount stented bovine pericardial valve (Edwards Lifesciences, Irvine, Calif).

Hemodynamic performance on exercise: comparison of a stentless and stented biological aortic valve replacement.

Background And Aim Of The Study: Although stentless valves are expected to be hemodynamically superior to stented valves, the results of comparative trials have been inconsistent. The study aim was to compare hemodynamic function at rest and on exercise in 50 stentless and stented biological replacement aortic valves

Methods: Twenty-one patients with a Toronto stentless porcine valve and 29 with a Perimount stented bovine pericardial valve were exercised using a bicycle ergometer. Echocardiography was performed before, and during exercise testing.