Associations between physicians' personal preferences for end-of-life decisions and their own clinical practice: PROPEL survey study in Europe, North America, and Australia.

Background: Physicians have significant influence on end-of-life decisions. Therefore, it is important to understand the connection between physicians' personal end-of-life care preferences and clinical practice, and whether there is congruence between what they prefer for themselves and for patients.

Aim: Study to what extent physicians believe their personal end-of-life preferences impact their clinical practice and to what extent physicians' personal treatment option preferences differ from what they prefer for their patients.

Continuous palliative sedation until death: a qualitative study of palliative care clinicians' experiences.

Background: The practice of continuous palliative sedation until death is the subject of much medical and ethical debate, which is reflected in the inconsistency that persists in the literature regarding the definition and indications of palliative sedation.

Aim: This study aims to gain a better understanding of palliative care clinicians' experiences with continuous palliative sedation.

Design: We conducted a qualitative study based on focus group discussions.

Accelerated transcranial magnetic stimulation for psychological distress in advanced cancer: A phase 2a feasibility and preliminary efficacy clinical trial.

Background: Psychological and existential suffering affects many people with advanced illness, and current therapeutic options have limited effectiveness. Repetitive transcranial magnetic stimulation (rTMS) is a safe and effective therapy for refractory depression, but no previous study has used rTMS to treat psychological or existential distress in the palliative setting.

Aim: To determine whether a 5-day course of "accelerated" rTMS is feasible and can improve psychological and/or existential distress in a palliative care setting.

Long-term bereavement outcomes in family members of those who died in acute care hospitals before and during the first wave of COVID-19: A cohort study.

Background: Severe grief is highly distressing and prevalent up to 1 year post-death among people bereaved during the first wave of COVID-19, but no study has assessed changes in grief severity beyond this timeframe.

Aim: Understand the trajectory of grief during the pandemic by reassessing grief symptoms in our original cohort 12-18 months post-death.

Design: Prospective matched cohort study.

Comorbidities, symptoms and end-of-life medication use in hospitalised decedents before and during the COVID-19 pandemic: a retrospective regional cohort study in Ottawa, Canada.

Objective: To compare comorbidities, symptoms and end-of-life (EoL) palliative medication (antisecretories, opioids, antipsychotics and sedatives) use among decedents before and during the COVID-19 pandemic.

Design: In a retrospective cohort study, decedent records in three acute care hospitals were abstracted, generating a prepandemic (November 2019-February 2020) group (pre-COVID) and two intrapandemic (March-August 2020, wave 1) groups, one without (COVID-ve) and one with COVID-19 infection (COVID+ve). Control group decedents were matched 2:1 on age, sex and care service (medicine/intensive care unit (ICU)) with COVID+ve decedents.

Bereavement outcomes in family members of those who died in acute care hospitals before and during the first wave of COVID-19: A cohort study.

Background: The COVID-19 pandemic has caused millions of deaths worldwide, leading to symptoms of grief among the bereaved. Neither the burden of severe grief nor its predictors are fully known within the context of the pandemic.

Aim: To determine the prevalence and predictors of severe grief in family members who were bereaved early in the COVID-19 pandemic.

Comparative end-of-life communication and support in hospitalised decedents before and during the COVID-19 pandemic: a retrospective regional cohort study in Ottawa, Canada.

Objective: To compare end-of-life in-person family presence, patient-family communication and healthcare team-family communication encounters in hospitalised decedents before and during the COVID-19 pandemic.

Design: In a regional multicentre retrospective cohort study, electronic health record data were abstracted for a prepandemic group (pre-COVID) and two intrapandemic (March-August 2020, wave 1) groups, one COVID-19 free (COVID-ve) and one with COVID-19 infection (COVID+ve). Pre-COVID and COVID-ve groups were matched 2:1 (age, sex and care service) with the COVID+ve group.

Access to Long-Term Care for Minority Populations: A Systematic Review.

It has been shown that there is disparity in access to long-term care and other services for minority populations. This study assessed long-term care access among older individuals belonging to minority populations including visible, ethnocultural, linguistic, and sexual minorities. Barriers and facilitators influencing admission were identified and evaluated.

Health and social interventions to restore physical function of older adults post-hip fracture: a scoping review.

Objectives: Despite inpatient rehabilitation, many older adults post-hip fracture have difficulty returning to their prefracture levels of function and activity. This scoping review aims to identify interventions for community-dwelling older adults discharged from inpatient rehabilitation and examine the function and activity outcomes associated with these interventions.

Design: This scoping review followed Arksey and O'Malley's five-stage framework.

Stability of Dexmedetomidine in Polyvinyl Chloride Bags Containing 0.9% Sodium Chloride Intended for Subcutaneous Infusions.

Dexmedetomidine is a sedative medication with co-analgesic effects that has been used primarily in critical care and anesthesia as a continuous intravenous infusion. Its utility in the treatment of refractory agitated delirium is being investigated in other settings including palliative care, but continuous intravenous infusions are not always feasible during end-of-life care. Subcutaneous infusions are more commonly used in this setting, but smaller volumes and higher concentrations are typically required.

Diagnostic Testing in Long-Term Care and Resident Emergency Department Visits: A Retrospective Cohort Study.

Objectives: To investigate the association between rapid access to radiographs, blood tests, urine cultures, and intravenous (IV) therapy in a long-term care (LTC) home with resident transfers to the emergency department (ED).

Design: Retrospective cohort study.

Setting And Participants: 21,811 residents living in 162 LTC homes in Ontario, Canada.

Describing Differences Among Recent Immigrants and Long-Standing Residents Waiting for Long-Term Care: A Population-Based Retrospective Cohort Study.

Objectives: Immigrants often face many unique cultural and logistical challenges in their health care that differ from nonimmigrants. We sought to describe and compare characteristics and the time to placement between recent immigrants and long-standing residents waiting for long-term care (LTC).

Design: Population-based retrospective cohort study using linked health administrative data.

Health Outcomes of Immigrants in Nursing Homes: A Population-Based Retrospective Cohort Study in Ontario, Canada.

Objective: Older adults account for a significant portion of Canadian immigrants, yet characteristics and health outcomes of older immigrants in nursing homes have not been studied. We aimed to describe the prevalence of immigrants living in nursing homes, their characteristics, and their hospitalization and mortality rates compared to long-term residents in the first year of entry to nursing homes.

Design: Population-based, retrospective cohort study using linked health administrative databases.

Severe pain at the end of life: a population-level observational study.

Background: Pain is a prevalent symptom at the end of life and negatively impacts quality of life. Despite this, little population level data exist that describe pain frequency and associated factors at the end of life. The purpose of this study was to explore the prevalence of clinically significant pain at the end of life and identify predictors of increased pain.

How Often, Where, and by Which Specialty Do Long-Term Care Home Residents Receive Specialist Physician Care? A Retrospective Cohort Study.

This retrospective cohort study describes the rates, location, and determinants of specialist physician visits among 257,216 long-term care (LTC) residents across 648 LTC homes in Ontario, Canada, between 2007 and 2016. Visit rates in the last year of life were calculated for a sub-cohort of residents who died in LTC between 2013 and 2016. Visits were measured per resident-year using physician billings.

Does inpatient palliative care consultation impact outcomes following hospital discharge? A narrative systematic review.

Background: While most patients desire to die at home or in a community-based hospice, the transition from hospital to community settings often lacks streamlined coordination of care to ensure that adequate support is provided in the preferred care setting. The impact of hospital-based palliative care consultations on post-discharge care and outcomes has not been extensively studied.

Aim: The aim of this study was to appraise available research on the impact of inpatient palliative care consultations on transitions from hospital to community settings.

Implementing Safe Practices in Administering Pro re nata Medications in a Rural Hospital.

Developing and implementing a policy for safe pro re nata medications practices became a priority when 1 nurse questioned a regularly occurring double-range narcotic order. This article describes how double-range medications can compromise patient safety and how a small rural hospital with minimal resources was able to develop an interdisciplinary practice standard to ensure safe medication practices.