Introduction: In the general ageing population, 40% of deaths occur following a prolonged trajectory of "progressive dwindling," characterised by chronic accumulation of disability and frailty, and associated with increased dependency and reduced reserves. Those who progressively dwindle are poorly catered for by current healthcare systems and would benefit from a coordinated approach to their medical and social care, known as formative care. People with multiple sclerosis (pwMS) may be more likely to progressively dwindle, and may be appropriate targets for formative care pathways.
Objectives: To determine the proportion of pwMS who follow a progressive dwindling trajectory prior to death. To relate trajectory to place of death, and examine what factors predict the progressively dwindling trajectory.
Methods: A retrospective observational study of 582 deceased pwMS enrolled in the UK MS Tissue Bank, including death certificates and extensive clinical summaries.
Results: 73.7% of pwMS had a "progressively dwindling" trajectory of dying. This was predicted by those who reach MS disease milestones earlier. 72.5% of pwMS died an MS-related death, which was predicted by an aggressive disease course from onset. Those who progressively dwindled were equally likely to die in hospital as those with other trajectories to death.
Conclusions: The progressively dwindling trajectory of dying is very common in pwMS, and can be predicted by earlier disease milestones. Pathways could target pwMS in these years prior to death, to improve care.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4956073 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0159210 | PLOS |
Publication Analysis
Top Keywords
Similar Publications
Leprosy.
Nat Rev Dis Primers
November 2024
Leiden University Center of Infectious Diseases (LUCID), Leiden University Medical Center, Leiden, The Netherlands.
Leprosy, a neglected tropical disease, causes significant morbidity in marginalized communities. Before the COVID-19 pandemic, annual new case detection plateaued for over a decade at ~200,000 new cases. The clinical phenotypes of leprosy strongly parallel host immunity to its causative agents Mycobacterium leprae and Mycobacterium lepromatosis.
View Article and Find Full Text PDFApplication research and progress of microalgae as a novel protein resource in the future.
Crit Rev Food Sci Nutr
November 2024
Technical Innovation Center for Utilization of Marine Biological Resources, Third Institute of Oceanography, Ministry of Natural Resources, Xiamen, China.
Economic growth and health awareness spotlight opportunities and challenges in the food industry, particularly with decreasing arable land, climate change, dwindling freshwater resources, and pollution affecting traditional protein sources. Microalgae have emerged as a promising alternative, with higher protein content, better nutritional quality, and greater environmental resilience compared to conventional crops. They offer a protein balance comparable to meat, making them a sustainable protein source with health benefits like antioxidants, cardiovascular support, and anti-inflammatory properties.
View Article and Find Full Text PDFInferring the regional distribution of Visceral Leishmaniasis incidence from data at different spatial scales.
Commun Med (Lond)
November 2024
Department of Population Health Sciences, University of Leicester, Leicester, UK.
Article Synopsis
- The study analyzes the effectiveness of monitoring visceral leishmaniasis (VL) on a village level in Bihar, India, highlighting challenges with resource-intensive surveillance as cases decline.
- The researchers tested a statistical method to estimate VL incidence at the village level from block-level data, finding that this approach didn't provide more accurate estimates than assuming uniformity within blocks.
- The findings suggest that while reactive interventions may not be effective for neighboring villages, maintaining surveillance in areas at risk of population movement could help prevent the spread of VL into currently unaffected areas.
Vanishing lung syndrome a rare cause of dwindling of lungs in children with pulmonary tuberculosis.
Indian J Tuberc
October 2024
Department of Respiratory Medicine, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India. Electronic address:
Article Synopsis
- - Vanishing lung syndrome (VLS) is a rare condition marked by large emphysematous bullae that lead to lung compression, causing breathing difficulties and reduced physical capacity, with potential for sudden symptom worsening from pneumothorax.
- - The text discusses three pediatric cases of VLS linked to tuberculosis (TB), highlighting that cases of VLS from TB are scarce in literature and that these cases exhibited faster disease progression and extensive bilateral bullae.
- - Notably, one patient did not receive isoniazid, a drug often associated with VLS, raising questions about the factors contributing to this condition and hinting at potential sex differences, as all three patients were female.
Chronicling the pursuit for full practice authority in Tennessee: Recommendations for a path forward.
Nurs Outlook
October 2024
Vanderbilt University, School of Nursing, Nashville, TN.
Background: The quest for full practice authority (FPA) for Tennessee Advanced Practice Registered Nurses (APRNs) began with promise in the late 1960s. However, progress has stalled in the ensuing time, and prospects for advancing FPA do not look promising.
Purpose: The purpose of this article is to chronicle the pursuit of FPA in Tennessee, offer reflections on what has transpired to date, and suggest a path forward.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!