Does a palliative medicine service reduce hospital length of stay and costs in adults with a life-limiting illness?-a difference-in-differences evaluation of service expansion in Ireland.

Background: People approaching end of life account disproportionately for health care costs, and the majority of these costs accrue in hospitals. The economic evidence base to improve value of care to this population is thin. Natural experiment methods may be helpful in bridging evidence gaps with credible causal estimates from routine data, but these methods have seldom been applied in this field.

Oxaliplatin-related dysphagia: Mixed-methods study.

Objectives: To evaluate participant-reported atypical dysphagia symptoms and their association with oxaliplatin treatment.

Methods: This observational study recruited 73 adults with solid tumours outside the head, neck or upper gastrointestinal tract. All had dysphagia, were in hospital or hospice and were treated by Medical Oncology, Radiation Oncology or Palliative Care.

Blended Conjugated Host and Unconjugated Dopant Polymers Towards N-type All-Polymer Conductors and High-ZT Thermoelectrics.

N-Type thermoelectrics typically consist of small molecule dopant+polymer host. Only a few polymer dopant+polymer host systems have been reported, and these have lower thermoelectric parameters. N-type polymers with high crystallinity and order are generally used for high-conductivity ( ) organic conductors.

Palliative care patient emergency department visits at tertiary university-based emergency department in Ireland.

Introduction: Palliative care patients often present to the emergency department (ED) for various reasons e.g., acute illness, pain, altered mental status, and complications of therapy.

Dysphagia in Solid Tumors Outside the Head, Neck or Upper GI Tract: Clinical Characteristics.

Context: Dysphagia is common in cancer, but underlying pathophysiology and manifestations within patients are unknown.

Objectives: To examine dysphagia characteristics in those with solid malignancies outside the head, neck and upper gastrointestinal tract.

Methods: Seventy-three individuals with dysphagia (46 male, 27 female, aged 37-91) were recruited from a parent trial conducted in two acute hospitals and one hospice.

A New Polystyrene-Poly(vinylpyridinium) Ionic Copolymer Dopant for n-Type All-Polymer Thermoelectrics with High and Stable Conductivity Relative to the Seebeck Coefficient giving High Power Factor.

A novel n-type copolymer dopant polystyrene-poly(4-vinyl-N-hexylpyridinium fluoride) (PSpF) with fluoride anions is designed and synthesized by reversible addition-fragmentation chain transfer (RAFT) polymerization. This is thought to be the first polymeric fluoride dopant. Electrical conductivity of 4.

Hybridization from Guest-Host Interactions Reduces the Thermal Conductivity of Metal-Organic Frameworks.

We experimentally and theoretically investigate the thermal conductivity and mechanical properties of polycrystalline HKUST-1 metal-organic frameworks (MOFs) infiltrated with three guest molecules: tetracyanoquinodimethane (TCNQ), 2,3,5,6-tetrafluoro-7,7,8,8-tetracyanoquinodimethane (F-TCNQ), and (cyclohexane-1,4-diylidene)dimalononitrile (H-TCNQ). This allows for modification of the interaction strength between the guest and host, presenting an opportunity to study the fundamental atomic scale mechanisms of how guest molecules impact the thermal conductivity of large unit cell porous crystals. The thermal conductivities of the guest@MOF systems decrease significantly, by on average a factor of 4, for all infiltrated samples as compared to the uninfiltrated, pristine HKUST-1.

Community frailty response service: the ED at your front door.

We describe the expansion and adaptation of a frailty response team to assess older people in their usual place of residence. The team had commenced a weekend service to a limited area in February 2020. As a consequence of demand related to the COVID-19 pandemic, we expanded it and adapted the model of care to provide a 7-day service to our entire catchment area.

Dysphagia Prevalence and Predictors in Cancers Outside the Head, Neck, and Upper Gastrointestinal Tract.

Context: Dysphagia is usually associated with malignancies of the head, neck, and upper gastrointestinal tract but also occurs in those with tumors outside anatomic swallow regions. It can lead to aspiration pneumonia, malnutrition, reduced quality of life, and psychosocial distress. No studies have yet reliably described dysphagia prevalence in those with malignancies outside anatomic swallow regions.

Phalangeal fracture leading to digital amputation, sustained during manipulation for Dupuytren's disease as part of clostridial collagenase treatment.

Collagenase injection was approved in Europe for use in the treatment of Dupuytren's disease in 2011. Reported adverse effects include skin tears, swelling, pain and complex regional pain syndrome. Here, we present a case of a rare complication of phalangeal fracture following treatment with collagenase clostridium and the resultant digital amputation.

Clinical utility of portable electrophysiology to measure fatigue in treatment-naïve non-small cell lung cancer.

Purpose: Cancer-related fatigue (CRF) biology remains poorly understood. Responsible mechanisms may be central or peripheral and originate anywhere from the brain to muscle fiber. Objective measurement is complex and previously limited to specialized laboratories.

Telementoring Primary Care Clinicians to Improve Geriatric Mental Health Care.

Health care delivery and payment systems are moving rapidly toward value-based care. To be successful in this new environment, providers must consistently deliver high-quality, evidence-based, and coordinated care to patients. This study assesses whether Project ECHO (Extension for Community Healthcare Outcomes) GEMH (geriatric mental health)-a remote learning and mentoring program-is an effective strategy to address geriatric mental health challenges in rural and underserved communities.

Referral patterns of nonmalignant patients to an Irish specialist palliative medicine service: a retrospective review.

Background: Our perception is that the proportion of referrals made to the specialist palliative medicine service (SPMS) in our institution for patients with a primary diagnosis of nonmalignant disease is high and that these patients are often referred late in their illness. We aimed to review the symptom burden and referral patterns of patients with a noncancer diagnosis to the SPMS in our centre.

Methods: All new non-malignant referrals to the SPMS in 2009 were included.

Air-freshener burns: a new paradigm in burns etiology?

Objectives: We report a rare case of burns following the use of automated air-fresheners.

Methods: We present a case report with a brief overview of the literature relating to burns associated with air-fresheners. The mechanism and treatment of these types of injuries are also described.

Management of split skin graft donor sites-results of a national survey.

The authors wished to obtain a 'snapshot' of the range of practice in the management of split skin graft donor sites in the British Isles. Material/Methods Questionnaires were sent to all British consultants and locum consultant plastic surgeons on July 1, 2006. Of the 357 questionnaires, 279 were returned (a response rate of 78%).

Validation of the Demoralization Scale in an Irish advanced cancer sample.

Objective: This article presents a validation study of the Demoralization Scale, a 24-item, 5-point response questionnaire developed by Kissane et al. in 2004 to assess demoralization in advanced cancer patients.

Method: One hundred Irish inpatients with advanced palliative cancer completed the Demoralization Scale and measures of depression, hopelessness, quality of life, and personal hopefulness.

A comparative study of the palliative care needs of heart failure and cancer patients.

Aims: Studies suggest that patients with advanced heart failure (HF) have unmet palliative care (PC) needs. However, many of these studies have been retrospective or based on patients receiving poorly coordinated ad hoc care. We aimed to demonstrate whether the PC needs of patients with advanced HF receiving specialist multidisciplinary coordinated care are similar to cancer patients deemed to have specialist PC needs; thereby justifying the extension of specialist PC services to HF patients.

Management of split skin graft donor sites--results of a national survey.

Unlabelled: The authors wished to obtain a 'snapshot' of the range of practice in the management of split skin graft donor sites in the British Isles.

Material/methods: Questionnaires were sent to all British consultants and locum consultant plastic surgeons on 1 July 2006. Of the 357 questionnaires, 279 were returned (a response rate of 78%).

Prospective validation of the palliative prognostic index in patients with cancer.

The Palliative Prognostic Index (PPI) was devised and validated in patients with cancer in a hospice inpatient unit in Japan. The aim of this study was to test its accuracy in a different population, in a range of care settings and in those receiving palliative chemotherapy and radiotherapy. The information required to calculate the PPI was recorded for patients referred to a hospital-based consultancy palliative care service, a hospice home care service, and a hospice inpatient unit.