International Association for Hospice and Palliative Care
Subject: IAHPC Newsroom 2005; Volume 6, No 10, October
William Farr, PhD, MD
International Association of Hospice and Palliative Care (IAHPC)
The September issue of the IAHPC newsletter is now on our website at URL:
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Please click on the title of any article to view the full article.
Kathleen M. Foley, MD (USA)
1. Both nominee and nominator must be active members of the IAHPC
Each member can only nominate one candidate. Deadline for nominations is October 30th, 2005. To submit a nomination, please send a copy of the CV of the candidate, plus a brief paragraph describing how the candidate meets the criteria via e-mail to the office of the Executive Director at email@example.com The new Directors will be announced in early December and their terms will begin in January 2006.
We encourage members to recommend candidates from countries around the world and from various disciplines. Candidates and nominators both need to be active IAHPC members. If you are not a current member, we invite you to join IAHPC and participate in this important process. To join IAHPC, click here
We are happy to announce that we are also now accepting nominations for the IAHPC Awards in three categories:
1. Individual - Vittorio Ventafridda Award for Individuals who have demonstrated leadership in palliative care and have had a significant impact in the provision of palliative care in their communities and regions.
2. Institutional Award: For institutions (hospitals, clinics, hospices) that have implemented a successful and comprehensive palliative care program to meet the needs of the patients in the relevant community
3. University Award: For academic hospitals, teaching institutions and universities that have implemented formal palliative care programs as part of the undergraduate or graduate levels in either nursing or medicine.
To apply, please go to www.hospicecare.com and click on IAHPC Programs, then select Recognition Awards Program. You will see the guidelines for application.
Each category has a prize of US $2,000. Deadline for applications is December 31st, 2005. Winners will be announced early February 2006.
We look forward to receiving your applications.
The World Hospice and Palliative Care Day - October 8th - is approaching. One of the objectives of celebrating this Day is to bring palliative care to the attention of governments and policy makers around the world. We invite you to sign the petition found in http://www.worldday.org/petition.asp and become involved in activities in your country to celebrate this important event. IAHPC has provided grants to programs in Colombia, Mexico, Guatemala, Philippines, Argentina, Moldova, India, Brazil, Uruguay and Venezuela to support concerts, symposiums, conferences, art exhibitions, choirs and many others. We look forward to receiving their reports and photos of these events to include in our next Newsletter.
We are very grateful to the individuals and organizations who have donated throughout this year and thus enabled us to help many around the world. Since this organization started, we have been able to support more than 400 programs and individuals with our grants and donations. Please consider donating to IAHPC, joining or renewing your membership to IAHPC - it will help us continue helping patients, families and health care providers around the world.
Until next month,
Kathleen Foley, MD
Liliana De Lima, MHA
Carla Ripamonti, MD
Low dose diamorphine reduces breathlessness without causing a fall in oxygen saturation in elderly patients with end-stage idiopathic pulmonary fibrosis
Author(s): Allen S, Raut S, Woollard J, Vassallo M.
Idiopathic pulmonary fibrosis (IPF), also known as cryptogenic fibrosis alveolitis, is a non-malignant pulmonary disease, the incidence of which increases with age. The patients with IPF have a poor prognosis (mean survival of 2 years from the time of diagnosis in patients over 75). There are no specific effective therapies except for heart-lung transplantation. There is present a relatively high respiratory drive and patients suffer from severe dyspnea and anxiety in the end-stage of the disease.
To evaluate the efficacy and tolerability of diamorphine in the treatment of dyspnea, the authors carried out an open observational study in 11 elderly, opioid naïve, distressed patients (mean age 86 years, range 78-92, there were eight females and 3 males). The patients had no significant cognitive impairment and experienced severe dyspnea at rest due to the end-stage IPF and most of them had intermittent cough and disturbed sleep.
Among the opioids, diamorphine via the subcutaneous route was chosen because it was habitually used in the hospital and because of its absorption characteristics and its predictable peak effects within 30 minutes.
The patients were not receiving steroids or other drugs able to modify their pattern of ventilation. They received supplemental oxygen therapy to attempt to have at least a 94% oxygen saturation before start ing the study. All patients had a low performance status: they required hoist transfers or nurse-assisted transfers; the mean Activities of Daily Living (ADL) index was 5/20 (range 1-8); and the mean time from the initial diagnosis of IPF was 4.6 years (range 3.1-11).
The following parameters were assessed just before and 15 and 30 minutes after the first subcutaneous injection of 2.5 mg diamorphine (10 patients), or 5 mg (1 patient with a body weight over 60 Kg):
The intensity of dyspnea decreased from a VAS of 83 mm at baseline to 36 at 15 (p<0.0001) and at 30 minutes after diamorphine administration; the heart rate decreased from 99 beats/min to 87 at 15 (p= 0.007) and 86 at 30 minutes after opioid administration. Anxiety and agitation were reduced in all patients. A small non-significant reduction was also observed in oxygen saturation (the largest individual fall in PaO2 was 3%), systolic blood pressure decreased from 115 to 109 mmHg and respiratory rate from 22 to 20 breaths/min.
After the reduction of symptoms was observed due to diamorphine, all patients were treated with controlled release oral morphine and the therapy was then tailored according to the patients’ needs. Some of them were switched to short release oral morphine at doses of 20 to maximum of 60 mg/day. Some patients required diamorphine via continuous subcutaneous infusion later in the illness.
No patient had respiratory depression. Seven patients survived an additional 5 weeks and four patients were discharged to nursing homes.
Why I Chose this article
There is very little data available in the literature about the efficacy and safety of opioids in the management of dyspnea in an elderly population with advanced and terminal cancer and with non-malignant end-stage pulmonary diseases. Moreover, there is again (still) the fear of opioid induced respiratory depression and a reluctance to use opioids for the treatment of dyspnea in the context of elderly patients with non-oncological diseases such as in idiopathic pulmonary fibrosis (IPF). This observational study may be considered a pilot study on the efficacy and tolerability of diamorphine and oral morphine in a population of very frail elderly patients with dyspnea, anxiety, and agitation due to end-stage a “non-malignant” condition such as IPF. The authors state that further research is necessary on a larger sample of patients treated over a longer period of time.
Carla Ripamonti, MD
Please visit the following link to read past Articles Of The Month:
A PHYSICIAN’S GUIDE TO PAIN AND SYMPTOM MANAGEMENT IN CANCER PATIENTS. 2 nd Edition
Janet L. Abrahm
This book is about comprehensive psychosocial as well as physical care for patients with cancer, regardless of where they are in the course of their disease.
The first section—Hidden Concerns, Unasked Questions—covers the unique issues that must be addressed if we are to provide optimal care, and demonstrates tremendous insight into patient-focused care. Particularly useful is the liberal use of clinical vignettes and snippets from conversations to illustrate the principles of better patient management.
The second part of the book is a detailed manual of pain and symptom control, including the management of terminal illness and bereavement. The use of numerous tables and summaries of important clinical practice points is a definite plus.
This book contains a wealth of information and wisdom and definitely deserves a place on the library shelf on any Oncology or Palliative Care ward.
As with the first edition, this book is a valuable resource providing a wealth of information about the use of syringe drivers and CSCIs in palliative care and should be readily available wherever syringe drivers are used.
THE HUSBAND’S GUIDE TO CANCER SURVIVAL
Mark Elliott Miller
WORLD HOSPICE AND PALLIATIVE CARE DAY –
8th OCTOBER, 2005
“There are just a few days left before the first unified day of action to celebrate and support hospice and palliative care around the world but its not too late to take part. Here is the latest news.”
The National Consensus Project for Quality Palliative Care
Clinical Practice Guidelines for Quality Palliative Care
There is useful information in the above document that can be modified in order to apply in locations outside the US. In the conclusion section of this document it states, “ These guidelines for quality palliative care programs represent a consensus opinion of the major palliative care organizations and leaders in the United States, and are based both on the available scientific evidence and expert professional opinion.”
For further information, the Guidelines are available in the internet at http://www.nationalconsensusproject.org/Guideline.pdf
From the Hospice and Palliative Nurse Association (HPNA)
“The National Consensus Project for Quality Palliative Care (NCP).
In 2001, a group of palliative and hospice care leaders from the USA met to discuss how palliative practice could best be standardized. The group formed the NCP Steering Committee, whose goals were to (1) define a process by which a national consensus on palliative care could be reached; (2) develop guidelines by studying model organizations and consulting experts; and then (3) disseminate those guidelines so that all stakeholders might benefit from the consensus of the field.
The entire report may be viewed in pdf format at the following URL
Helping hands following Hurricane Katrina
From the Hospice Foundation of America
“Hospice Foundation of America Establishes Hospice Patient Locater Message Board at www.hospicefoundation.org in Response to Hurricane Katrina
Our thoughts at Hospice Foundation of America go to those who have suffered catastrophic loss in the Gulf States . This special edition of our e-newsletter is being sent to inform you of a resource that may be of assistance; please watch for our regular September e-newsletter next week.
Hospice Foundation of America (HFA) has established an Internet-based bulletin board to help reconnect families to hospice patients in the areas affected by Hurricane Katrina. "Since the flooding began in the Gulf region, we have received numerous calls from families and friends of hospice patients who cannot locate their loved ones," said Jack Gordon, HFA chairman. "They are obviously distressed."
Family members will be able to post messages on the site, accessible at www.hospicefoundation.org, and hospice employees and others with knowledge of transfer arrangements will be able to contact those who have posted messages. Hospice care is delivered in a variety of places, including homes, nursing homes and assisted living facilities, inpatient and residential hospices.
If you are visiting our website, please consider visiting our donation page and designating a donation toward the Hurricane Katrina relief effort. All funds will be used to assist hospices in the Gulf States area, and HFA donations will first go to hospices in need of assistance as a result of the hurricane and flooding. Hospice Foundation of America will match donations received that are designated for this effort.
Caring for the dying is difficult under normal circumstances; hospices face especially daunting challenges during natural disasters. HFA hopes that the Hospice Patient Locater will provide some needed support for families and hospice professionals.
From The American Society of Clinical Oncology (ASCO)
“The American Society of Clinical Oncology (ASCO) continues to help coordinate treatment services for cancer patients displaced by Hurricane Katrina. For patients in need of acute care, it is important that their cancer treatment not be interrupted.
The following resources can be found at www.asco.org/katrina
Treatment Coordination Message Board: ASCO's Hurricane Katrina Message Board, searchable by keyword, is a physician/patient locator and communications tool. Messages are welcome from dislocated patients or from health care providers treating hurricane victims who need to consult with those patients' cancer doctors.
NCI Assistance: Because many displaced patients do not have internet access, ASCO and The National Cancer Institute (NCI) are collaborating to help connect patients with alternate cancer care providers, using NCI's toll-free operators who are aided by ASCO's online resources. Live assistance is available at 1-800-4CANCER between 9:00 a.m. and 4:30 p.m.-based on the callers' local time-Monday through Friday. NCI and ASCO are sharing updated information on a regular basis.
List of Oncology Practices Accepting Displaced Patients: ASCO is maintaining a continuously updated list of oncology practices in Louisiana, Mississippi, and Texas-as well as in several other states-that have indicated their ability to care for patients in need of urgent treatment during this time. Patients can call the listed doctors' offices or cancer centers to learn more about receiving treatment while they are unable to access their primary cancer care facilities.”
An evaluation of a morphine public health programme for cancer and AIDS pain relief in Sub-Saharan Africa
By Dorothy E. Logie and Richard Harding
Read at URL:
International Observatory on End of Life Care
The Observatory has recently posted the second of six Middle East country reports. For more information, click on the link below to view our new Jordan pages.
Additionally, the Observatory is pleased to announce the addition of the Cyprus country report, details of which are available at the following URL:
International Observatory on End of Life Care
End of Life/Palliative Education Resource Center’s E-News
There is a great deal of very good information regarding End of Life Care / Palliative care in the above website. Also you can sign up for the free E-news. This is a website worth visiting on a regular basis.
14th International Conference on AIDS and Sexually Transmitted Infections in Africa
Sponsored by the Society for AIDS in Africa (SAA)
December 4-9, 2005
For information, registration and submission of abstracts for plenaries, roundtables and special sessions, please contact:
Dr. Uzodinma A. Adirieje
Plot 823 Ralph Shodeinde Street , the same compound with NACA, by
Federal Ministry of Finance Headquarters
Annual Assembly of the American Academy of Hospice and Palliative Medicine and Hospice and Palliative Nurses Association
“Glenview, IL – The American Academy of Hospice and Palliative Medicine (AAHPM), in collaboration with the Hospice and Palliative Nurses Association, will host its Annual Assembly February 8-11, 2006, at the Renaissance Nashville Hotel in Nashville , TN. The conference is a platform for the dissemination of the evidence base, knowledge, skills, and philosophy to all disciplines that provide hospice and palliative care. Physicians, nurses, social workers, pharmacists and others who provide palliative care to the terminally-ill and dying are invited to attend. The event is expected to draw over 1,200 attendees.
Attendees will be able to participate in a full program of 60 concurrent sessions, 40 paper presentations, and three plenary sessions. Pre-conference workshops include: Communication Skills for Palliative Care Consultation, Providing Optimal Hospice Inpatient Care under the Medicare Hospice Benefit, Issues in Advanced Pain Management, Pediatric Diseases and What to Expect, and Appropriate Selection of Medications in Palliative Care.
AAHPM’s membership includes nearly 2,300 physicians and other medical professionals dedicated to excellence in palliative medicine and the prevention and relief of patient and family suffering. Since 1988, AAHPM has supported hospice and palliative medicine through advancement of clinical practice standards, fostering research, providing education, and through public policy advocacy. For more information about the 2006 Annual Assembly or membership in the Academy, contact AAHPM at 847/375-4712 or visit the web site at www.aahpm.org”
XVI International AIDS Conference
Sponsored by the International AIDS Society
For information and registration:
Third Annual Conference of the American Psychosocial Oncology Society (APOS)
16 – 19 February 2006
APOS is committed to advancing the science and practice of psychosocial care for people with cancer while s triving to ensure that all people with cancer have access to psychosocial services as a part of quality cancer care.
About the Conference
With the theme: The Synthesizing Research, Advocacy, and Program Development to Optimize the Quality of Care, the Conference includes seven concurrent half and full day preconference workshops, followed by two days of plenary and concurrent sessions, and yet a final half-day dedicated to advocacy organizations commitment to quality of life for survivors of cancer and the National Action Plan for the future.
For registration and information please contact APOS Headquarters:
8th World Congress on Psycho-Oncology
International Psycho-Oncology Society (IPOS)
16 – 21 October 2006
IPOS is the international, multidisciplinary organization dedicated to fostering the science of psychosocial and behavioral oncology and improving the care of cancer patients and their families throughout the world. The vision of IPOS is that all cancer patients and their families throughout the world receive optimal psychosocial care at all stages of disease and survivorship.
About the Congress
PSYCHOSOCIAL ACADEMY (Preconference training)
One and two-day workshops will address specific psycho-oncology topics. The leading worldwide experts will conduct the workshops for limited groups of participants.
Three days of plenary and concurrent sessions follow the two days of Academy trainings . The Conference theme, Multidisciplinary Psychosocial Oncology: Dialogue and Interaction , underlines the need for scientific societies, health care agencies and academic institutions, to work together, share and integrate their knowledge towards a common language and accepted standards in the comprehensive care of cancer patients, their families and caregivers.
For registration and information, please contact the Organizing Secretariat:
The Temmy Latner Centre for Palliative Care is pleased to announce the:
Golda Fine Memorial Academic Award
The family of the late Golda Fine has established an annual award based at the Temmy Latner Centre for Palliative Care (TLCPC) at Mount Sinai Hospital in Toronto.
The award will honour local, provincial, national or international inter- disciplinary health care providers or academics who are working in the field of palliative/end-of-life care.
The award will allow the recipient to spend 2-3 months at the Temmy Latner Centre to learn and to teach.
AWARD AMOUNT: Two awards for $18,000.00 each
APPLICATION DEADLINE: October 31, 2005
For more information on Requirements, Selection Process and an Application Form please contact:
Ellison Institute for World Health at Harvard University
A new global institution, the Ellison Institute for World Health at Harvard University, is currently seeking distinguished candidates for the Global Fellows Program.
The mission of this groundbreaking new Institute is to improve population health and the efficiency of health-system resource use through the regular reporting of inputs, outputs, and impacts of the world’s health systems and major health funders. Fostering accountability for the achievements of health systems and major health actors requires global reporting of benchmarked measurement of spending, coverage of key services and interventions (preventive and curative), efficiency, and, most importantly, the impact of current policies and practices on population health. The work of the Ellison Institute for World Health at Harvard University is designed to provide key information that will help governments, bilateral donor agencies, multilateral institutions, foundations, nongovernmental organizations, and the private sector to improve their own performance.
The Global Fellows Program is currently accepting applications for a two-year fellowship to work at the Ellison Institute for World Health at Harvard University in Cambridge, MA. Global Fellows will apply their core research skills in the areas of economics, public health, health policy, demography, and related fields with the expectation that they will make important research contributions for future international health policy.
Global Fellows will have abundant opportunities to collaborate with many faculty mentors within the Ellison Institute for World Health on a number of research areas, including: national health accounts, health intervention delivery, cost-effectiveness, mortality, burden of disease/comparative risk assessment, population health, health forecasts, financial risk protection, and efficiency of resource use. Fellows are expected to produce research deliverables related to the content priorities of the Institute, including: working papers, journal articles, and presentations for international conferences during their tenure at the Ellison Institute for World Health. In addition to receiving an annual salary, Fellows will have access to a full range of university resources, including health benefits.
Applicant Eligibility Requirements:
An MD and/or a PhD in health economics, health services research, statistics, epidemiology, public health, or related field or equivalent experience is required. Applications will be accepted on a rolling basis. This fellowship has a flexible start date of January 1, 2006 and a minimum starting salary of $45,000.
Interested applicants should forward an electronic copy of the following:
Please send these documents via email to: firstname.lastname@example.org and include “Ellison Global Fellows Program” in the subject line of your email.
If you are unable to send us your materials via email, you may send them to us at the following address:
Ellison Institute for World Health at Harvard University
The Grief Resources Catalog
“The Grief Resources Catalog offers over 50 different titles - several of them are very inexpensive, quick-read booklets... Many bereavement professionals have found that the materials on our site provide comfort to family, friends and loved ones of the deceased, but many more could benefit from this resource if they just knew about it.
American Psychosocial Oncology Society (APOS)
APOS Institute for Research and Education (AIRE) Offers Online Education and Handbook
The Multidisciplinary Training in Psycho-Oncology includes fifteen webcasts in the five following tracks.
ICAN: Distress Management Training for Oncology Nurses includes four webcasts toeducate oncology nurses on the recognition and management of distress among cancer patients and their caregivers.
Cancer 101 for Mental Health Professionals includes four webcasts to educate mental health professionals about cancer, its treatment, and common symptoms and side-effects. Continuing education credits are available for psychologists, social workers and marriage & family therapists.
Psychosocial Aspects of Cancer Survivorship (u nder development) will include four webcasts to teach oncologists and nurses in primary oncology clinics how to rapidly identify the survivors who are distressed and to treat their distress or refer them to appropriate counseling resources.
Essentials in Psychosocial Oncology (under development), a pocket-sized handbook and downloadable PDA-format e-book, will include chapters on physical symptom management, communication issues, site specific issues and more.
To view webcasts and learn more about APOS programs, please contact APOS Headquarters:
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Did You Know?
The Australian $5, $10, $20, $50 and $100 notes are made out of plastic.
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Until next month!
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© 2005 IAHPC Press