The doctor's presence created a safe space - a mixed methods study of students' learning outcomes from an elective course in palliative medicine.

Background: Competence in palliative medicine is required in clinical practice. Based on a literature review, we developed a two-week elective course in palliative medicine for 5th and 6th year medical students. We wanted to study learning outcomes from the course, especially related to knowledge, confidence, and reflections on the doctor's role in palliative care.

The short-term impact of methylprednisolone on patient-reported sleep in patients with advanced cancer in a randomized, placebo-controlled, double-blind trial.

Purpose: Although corticosteroids are frequently used in patients with advanced cancer, few studies have examined the impact of these drugs on patient-reported sleep. We aimed to examine the short-term impact of methylprednisolone on patient-reported sleep in patients with advanced cancer.

Methods: Patient-reported sleep was a predefined secondary outcome in a prospective, randomized, placebo-controlled, double-blind trial that evaluated the analgesic efficacy of corticosteroids in advanced cancer patients (18+), using opioids, and having pain ≥ 4 past 24 h (NRS 0-10).

Expected deaths at home - a qualitative study of collaboration.

Background: It is a goal of health policy that more patients with serious illness should be able to die at home. This study elucidates the collaboration between healthcare personnel and undertakers immediately after the death, the dignity of the deceased patient and the bereaved relatives is challenged.

Material And Method: The study is primarily based on five focus group interviews with undertakers, GPs, nurses and healthcare workers in homecare nursing, a total of 23 participants in an urban municipality.

Cryoneurolysis for cervicogenic headache - a double blinded randomized controlled study.

Background and aims Cervicogenic headache (CEH) is a debilitating condition and analgesics have limited effect. Percutaneous cryoneurolysis is thus still in use although the clinical evidence is lacking. We present a randomized, controlled study to assess the clinical efficacy of cryoneurolysis compared with a corticosteroid combined with a local anaesthetic.

Experiences and challenges of home care nurses and general practitioners in home-based palliative care - a qualitative study.

Background: Norway has one of the lowest home death rates in Europe. However, it is the health authorities´ ambition to increase this by facilitating palliative care at home. The aim of this study was to achieve more insight, through home care nurses and general practitioners, of conditions that facilitate or hamper more time at home and more home deaths for patients with terminal disease and short life expectancy.

CT guided neurolytic blockade of the coeliac plexus in patients with advanced and intractably painful pancreatic cancer.

Background And Aims: Pain caused by infiltrating pancreatic cancer is complex in nature and may therefore be difficult to treat. In addition to conventional analgesics, neurolytic blockade of the coeliac plexus is often recommended. However, different techniques are advocated, and procedures vary, and the results may therefore be difficult to compare.

Adverse events and in-hospital mortality: an analysis of all deaths in a Norwegian health trust during 2011.

Background: The estimated number of in-hospitals deaths due to adverse events is often different when using data from deceased patients compared with that of a population experiencing adverse events.

Methods: The study was conducted at three hospitals in the Bergen Hospital Trust, including a 950-bed university hospital. The objective was to study the reported deaths and investigate the probable number of deaths caused by adverse events.

A European multicenter study on systematic ethics work in nursing homes.

Background: There are many existing ethical challenges in nursing homes. Although different methods and approaches to discussing the ethical challenges have been established, systematic ethics work is not yet a standard in all nursing homes. The aim of the present study was to explore ethical challenges and approaches to implementing systematic ethics work in nursing homes.

They know!-Do they? A qualitative study of residents and relatives views on advance care planning, end-of-life care, and decision-making in nursing homes.

Background: Residents living in long-term care facilities are a vulnerable population. For many residents, a nursing home is their place of death. Palliative care and end-of-life decisions are important components of their care provision.

Ethical challenges in nursing homes--staff's opinions and experiences with systematic ethics meetings with participation of residents' relatives.

Background: Many ethical problems exist in nursing homes. These include, for example, decision-making in end-of-life care, use of restraints and a lack of resources.

Aims: The aim of the present study was to investigate nursing home staffs' opinions and experiences with ethical challenges and to find out which types of ethical challenges and dilemmas occur and are being discussed in nursing homes.

Nothing to complain about? Residents' and relatives' views on a "good life" and ethical challenges in nursing homes.

Background: Nursing home residents are a vulnerable population. Most of them suffer from multi-morbidity, while many have cognitive impairment or dementia and need care around the clock. Several ethical challenges in nursing homes have been described in the scientific literature.

The pendulum time of life: the experience of time, when living with severe incurable disease--a phenomenological and philosophical study.

The aim of this study was to gain a deeper understanding of the experience of time when living with severe incurable disease. A phenomenological and philosophical approach of description and deciphering were used. In our modern health care system there is an on-going focus on utilizing and recording the use of time, but less focus on the patient's experience of time, which highlights the need to explore the patients' experiences, particularly when life is vulnerable and time is limited.

Efficacy of methylprednisolone on pain, fatigue, and appetite loss in patients with advanced cancer using opioids: a randomized, placebo-controlled, double-blind trial.

Purpose: Corticosteroids are frequently used in cancer pain management despite limited evidence. This study compares the analgesic efficacy of corticosteroid therapy with placebo.

Patients And Methods: Adult patients with cancer receiving opioids with average pain intensity ≥ 4 (numeric rating scale [NRS], 0 to 10) in the last 24 hours were eligible.

The European Association for Palliative Care basic dataset to describe a palliative care cancer population: Results from an international Delphi process.

Background: One of the barriers identified in palliative care research is the lack of common criteria to describe the population.

Aim: The aim of this Delphi process was to obtain consensus on a basic set of core variables to describe or classify a palliative care cancer population.

Design And Setting: This was a five-step international Delphi exercise.

Being in transit and in transition: the experience of time at the place, when living with severe incurable disease--a phenomenological study.

The aim of this study is to describe the experience of time as it presents itself at the place being situated when living with severe incurable disease and receiving palliative care. The empirical data consist of 26 open-ended interviews with 23 patients receiving palliative care at home, at a palliative day care, in a palliative bed unit in hospital or in a nursing home in Norway. A common meaning of a shifting space for living emerged from the analysis and was revealed through three different aspects: (i) Transition from a predictable to an unpredictable time: To live with severe incurable disease marks a transition to a changed life involving an ongoing weakened and altered body with bothersome symptoms making experience of time different and unpredictable.

Entering a world with no future: a phenomenological study describing the embodied experience of time when living with severe incurable disease.

This article presents findings from a phenomenological study exploring experience of time by patients living close to death. The empirical data consist of 26 open-ended interviews from 23 patients living with severe incurable disease receiving palliative care in Norway. Three aspects of experience of time were revealed as prominent: (i) Entering a world with no future; living close to death alters perception of and relationship to time.

Serum concentrations of opioids when comparing two switching strategies to methadone for cancer pain.

Purpose: Our aim was to compare pharmacological aspects of two switching strategies from morphine/oxycodone to methadone; the stop and go (SAG) strategy in which methadone is started directly after the initial opioid has been stopped, and the 3-days switch (3DS), in which morphine/oxycodone is gradually changed to methadone by cross-tapering over 3 days.

Methods: Forty-two cancer patients with pain and/or opioid side effects were assessed in this randomised trial. Trough serum concentrations of methadone, morphine, morphine-6-glucuronide (M6G), and oxycodone were measured on days 1, 2, 3, 4, 7, and 14.

The clinical value of routine whole-body magnetic resonance imaging (MRI) in palliative care.

Background: Whole-body MRI (WBMRI) has become an accessible method for detecting different types of pathologies both in the skeleton and the viscera, which may explain painful conditions, for example tumors and inflammation.

Purpose: To assess a possible value of using WBMRI in order to improve palliative care.

Material And Methods: Twenty patients (all eligible patients) admitted to the Department for Palliative Care were consecutively included in this study.

Labour analgesia: a randomised, controlled trial comparing intravenous remifentanil and epidural analgesia with ropivacaine and fentanyl.

Background And Objective: To compare the analgesic efficacy and side-effects of remifentanil intravenous patient-controlled analgesia (IVPCA) with walking epidural analgesia (EDA) during labour.

Methods: Thirty-nine parturient patients of mixed parity, with normal singleton pregnancies, were randomised to receive either remifentanil IVPCA (RA group) or EDA (EA group). The epidural solution contained ropivacaine 1 mg ml⁻¹ and fentanyl 2 μg ml⁻¹, and the initial dose was 10 ml h⁻¹.

A pan-European survey of research in end-of-life cancer care.

Background: To date, there is no coordinated strategy for end-of-life (EOL) cancer care research in Europe. The PRISMA (Reflecting the Positive Diversities of European Priorities for Research and Measurement in End-of-life Care) project is aiming to develop a programme integrating research and measurement in EOL care. This survey aimed to map and describe present EOL cancer care research in Europe and to identify priorities and barriers.

[Emergency admissions from nursing homes to hospital at the end of life].

Background: Admissions from nursing homes to hospital at the end of life have not been previously studied in Norway. The goal of this project was to document acute admissions to a Norwegian hospital for patients who died within 48 hours after hospitalization.

Material And Methods: This study is based on information recorded in patient charts for admissions to Haraldsplass Deaconess Hospital, Bergen in the period 1.

Living with advanced cancer and short life expectancy: patients' experiences with managing medication.

Our aim is to explore patients' experiences of using medicines when they are living with far-advanced cancer and short life expectancy; our method is a qualitative interview study. At a daycare centre at a palliative clinic in Norway, we interviewed 15 patients with advanced incurable cancer with multiple metastases who had a short life expectancy. We found that in taking their medications, they feared losing control, becoming addicted, or suffering harmful effects.

A randomized, open, parallel group, multicenter trial to investigate analgesic efficacy and safety of a new transdermal fentanyl patch compared to standard opioid treatment in cancer pain.

A new 72-hour transdermal fentanyl matrix patch has been designed, which has a 35%-50% reduction of the absolute fentanyl content compared with other currently available transdermal fentanyl patches that are using the matrix technology. The new patch has previously been shown to be pharmacokinetically bioequivalent to the marketed fentanyl patch. To determine noninferiority in efficacy in cancer patients and to compare safety, a clinical trial comparing the new fentanyl patch with standard oral or transdermal opioid treatment was planned.