Sunday, December 2, 2012

Almost half of dying patients placed on the controversial Liverpool ...

The new disclosures demonstrate just how routinely hospitals are placing patients on the pathway without informing them that steps which could hasten their death have been taken. The national audit found:

? In 44 per cent of cases when conscious patients were placed on the pathway, there was no record that the decision had been discussed with them.

? For 22 per cent of patients on the pathway, there was no evidence that comfort and safety had been maintained while medication was administered.

? One in three families of the dying never received a leaflet they should have been given to explain the process.

Critics of the pathway ? which can involve the withdrawal of drugs, fluids and food, and the administration of powerful pain relief ? say it is being used to hasten the deaths of the terminally-ill and elderly, in a form of ?back-door euthanasia?.

Other doctors, nurses and charities for the dying have come to the defence of the approach, which they say is intended to help ensure that people can die in dignity and comfort, instead of enduring invasive and painful treatment.

In recent months, there has been mounting concern over cases in which family members said they were not consulted or even told when food and fluids were withheld from their loved ones.

Earlier this month, Mr Hunt pledged to strengthen laws to protect patients, making it illegal to put anyone on the pathway ? which leads to death in an average of 29 hours ? without consulting them or their families.

It comes as the Government prepares to launch a new ?vision for nursing? this week which will attempt to instill compassion in the profession, amid deepening concerns about the quality of care being provided on hospital wards.

Last night Mr Hunt said the evidence would be examined as part of an independent review of the practice, which will report back to him in the New Year.

He told?The Sunday Telegraph: ?It is totally unacceptable for people to be put on the pathway without consent where they are able to give it ? that is why we are looking at what goes on in practice to make sure this doesn?t happen.?

Mr Hunt said he was concerned that families and patients were not being sufficiently informed, but suggested the approach to end-of-life care had been mischaracterised by some of its critics.

?We need to be much better at ensuring we are giving people dignity in their final few hours and the Liverpool Care Pathway has played a really important role in improving the standard of care in hospital, to hospice level,? he said.

Earlier this month, the Department of Health began a three-month consultation on changes to the NHS constitution, which would give patients and their families a legal right to be consulted on all decisions about end-of-life care.

The rights will mean patients and relatives could sue if the requirements are not met, and doctors could be struck off if they fail to consult properly.

In a hard-hitting speech last week Mr Hunt expressed concern about the culture of the NHS, warning that too many patients were forced to experience ?coldness, resentment, indifference? and ?even contempt?.

He warned that in the worst institutions a ?normalisation of cruelty? had been fostered.

The family of Arthur Oszek, 86, say they did not find out he had been put on the Liverpool Care Pathway last year until he was left begging for a drink, having been taken off his drip.

After almost a day of discussion with medical staff, treatment was resumed, but it was too late, and Mr Oszek died within 24 hours last August.

Ann Murdoch, Mr Oszek?s stepdaughter, said: ?We asked the doctors why he was taken off his drip and we were told he was on the Liverpool Care Pathway. We did not even know what it was.?

?There is no way that should have happened without asking us. We kicked up a fuss and demanded he be put back on his medication and eventually they agreed about 20 hours later.?

NHS Ayrshire and Arran said they could not comment on individual cases, but discussed their assessments with patients and families wherever possible. On other occasions, patients placed on the pathway because doctors judged that they were nearing the end of their life went on to recover.

Patricia Greenwood, 82, was put on the pathway in August, after being admitted to Blackpool Victoria Hospital with heart problems, and then suffering a fall.

Doctors told her family that they had taken her off feeding tubes because she was not expected to last more than a couple of days.

After her son, Terry, 57, defied the hospital?s orders and gave her sips of water through a straw, Mrs Greenwood, a former pub landlady, rallied, and doctors agreed to put her back on a drip.

She is now back at home and has made plans for a world cruise. The hospital trust said it had not received a complaint about her care.

A survey of 22,000 recently-bereaved Britons found relatives of those cared for in hospices rated the care far better than those whose loved ones spent their last months of life in hospital.

Less than half of families felt hospital nurses had always treated their relative with respect, compared with 80 per cent of those whose loved ones were treated in hospices.

One in six respondents said decisions were made about care which the patient would not have wanted.

Overall, health services in London were rated worst for quality of care, featuring most regularly in the bottom 20 per cent, as rated by the bereaved, while those in the South West scored most highly.

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Sick children are being discharged from NHS hospitals to die at home or in hospices on controversial ?death pathways?.

Until now, end of life regime the Liverpool Care Pathway was thought to have involved only elderly and terminally-ill adults.

But the Mail can reveal the practice of withdrawing food and fluid by tube is being used on young patients as well as severely disabled newborn babies.

MailOnline - news, sport, celebrity, science and health stories

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One doctor has admitted starving and dehydrating ten babies to death in the neonatal unit of one hospital alone.

Writing in a leading medical journal, the physician revealed the process can take an average of ten days during which a? baby becomes ?smaller and shrunken?.

The LCP ? on which 130,000 elderly and terminally-ill adult patients die each year ? is now the subject of an independent inquiry ordered by ministers.

The investigation, which will include child patients, will look at whether cash payments to hospitals to hit death pathway targets have influenced doctors? decisions.

Medical critics of the LCP insist it is impossible to say when a patient will die and as a result the LCP death becomes a self-fulfilling prophecy. They say it is a form of euthanasia, used to clear hospital beds and save the NHS money.

The use of end of life care methods on disabled newborn babies was revealed in the doctors? bible, the British Medical Journal.

Earlier this month, an un-named doctor wrote of the agony of watching the protracted deaths of babies. The doctor described one case of a baby born with ?a lengthy list of unexpected congenital anomalies?, whose parents agreed to put it on the pathway.

The doctor wrote: ?They wish for their child to die quickly once the feeding and fluids are stopped. They wish for pneumonia. They wish for no suffering. They wish for no visible changes to their precious baby.

?Their wishes, however, are not consistent with my experience. Survival is often much longer than most physicians think; reflecting on my previous patients, the median time from withdrawal of hydration to death was ten days.

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The use of end of life care methods on disabled newborn babies was revealed in the doctors? bible, the British Medical Journal

?Parents and care teams are unprepared for the sometimes severe changes that they will witness in the child?s physical appearance as severe dehydration ensues.

Read more:?http://www.dailymail.co.uk/news/article-2240075/Now-sick-babies-death-pathway-Doctors-haunting-testimony-reveals-children-end-life-plan.html#ixzz2Dupioj6h

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Source: http://johnib.wordpress.com/2012/12/02/almost-half-of-dying-patients-placed-on-the-controversial-liverpool-care-pathway-are-never-told-that-life-saving-treatment-has-been-withdrawn/

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Funeral held for boxer 'Macho' Camacho in NYC

NEW YORK (AP) ? Hundreds mourned Hector Camacho on Saturday in the landmark East Harlem church the fighter attended as a boy, and hundreds more cheered and shouted "Macho" when his coffin was carried out and loaded into a hearse afterward.

"Hector lived the American dream, to come from simple beginnings and to be known by thousands of people," the Rev. Frank Skelly said. "He could lift us up, and he could break our hearts. He could inspire us and at times disappoint us."

Camacho, a native of Puerto Rico who moved to East Harlem as a child, was shot in the face Nov. 20 while sitting in a parked car with a friend outside a bar in Bayamon, his hometown in the U.S. territory. The friend, Adrian Mojica Moreno, died at the scene. The boxer died after doctors removed him from life support.

Police have said they have suspects but have not yet arrested anyone for the shooting.

There was no mention of Camacho's bloody end during the service at St. Cecilia, an imposing brick and terra cotta church that is on the National Register of Historic Places.

Skelly, the church's former pastor, said he remembered Camacho as a child in the 1970s.

"I really didn't see much of Hector after he left our school, so I still see him as a little boy, and I think that's how God sees him," the priest said. "Everything else is not important."

Justin Camacho, one of the fighter's four sons, read a scriptural passage.

The 50-year-old Camacho's coffin was carried into the church draped in a Puerto Rican flag; the flag was replaced by a white cloth adorned with a cross during the service.

Mourners waved flags and hoisted newspapers with Camacho's picture on the front page.

"I still can't believe it happened to him," said Tanya Espana, who met Camacho in the 1990s through a friend and brought a book of snapshots that documented their friendship. "Macho was very caring, very loving."

Known for his flamboyant displays in the ring, Camacho won super lightweight, lightweight and junior welterweight world titles in the 1980s and fought high-profile bouts against Felix Trinidad, Julio Cesar Chavez and Sugar Ray Leonard. He had a career record of 79-6-3.

The church was about half-filled with a few hundred mourners, but hundreds more waited behind police barricades across the street and cheered the coffin. Burial followed at St. Raymond's Cemetery in the Bronx.

The funeral capped two days of mourning in the neighborhood known as Spanish Harlem where the slain former world champion fighter grew up.

On Friday, hundreds of fans turned out for the public wake and watched as a carriage drawn by white horses carried Camacho's body through the streets.

Source: http://news.yahoo.com/funeral-held-boxer-macho-camacho-nyc-162531152--spt.html

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How signal molecules for formation of various cell types are controlled

ScienceDaily (Nov. 30, 2012) ? The regulation of important signal molecules that are critical for the formation of various cell types can be influenced by a chemically produced variant of indirubin, a natural material used in traditional Chinese medicine. This was shown by scientists from Heidelberg University, Kaiserslautern and Jena. The researchers were also able to demonstrate for the first time that these signal molecules in the cell -- regulatory SMAD proteins -- are not only controlled through regulation of their activation but also through the available quantity of signal molecules in the non-activated state. Because cellular differentiation as well as tumour growth are tied to these processes, the studies suggest a new approach for both the preparation of induced pluripotent stem cells and the development of tumour treatments.

The results of the research were published in the journal Chemistry & Biology.

Cellular differentiation decides which functions can be assumed and carried out by cells in the body. Their precise regulation has a decisive influence on embryonic development and later also plays an essential role in maintaining the activity of organs. After toxic damage, among other things, it is important that cells can react appropriately to limit damage and regenerate the tissue. This requires close communication between the cells, which is controlled by numerous signal molecules. "Only when all the parts of a signal path are present, cells can react to the signals from the environment with a coordinated programme. If one of these components is missing, the proper cellular response is inhibited," explains Prof. Dr. Stefan W?lfl from Heidelberg University's Institute of Pharmacy and Molecular Biotechnology.

How cellular differentiation is controlled during embryonic development and in the mature organism significantly depends on the family of TGF?/BMP growth factors. Representatives of these specific signal molecules also participate in the genesis and development of tumour diseases. Through their work, the researchers have demonstrated that the cells themselves influence how sensitively they react to growth factor signals. This occurs through the availability of the complementary signal mediators within the cell adapting to the given situation. The amount of available regulatory SMAD proteins (R-Smad proteins) in the cell is controlled on the level of synthesis, but in particular through the control of their degradation. This is performed by a special control system present in every cell. This ubiquitin proteasome system makes it possible for cellular proteins to be degraded in a controlled manner.

Earlier research already demonstrated that the degradation of activated R-Smad proteins occurs through the ubiquitin proteasome system, resulting in termination of the signals. "Our results now prove that the reservoir of non-activated R-SMAD signal mediators is also strictly controlled. This prevents corresponding external signals from activating an internal programme," says Prof. W?lfl. "For example, if growing tumour cells are dependent on this signal, these cells could be kept from surviving and cell death may even occur if the signal mediators could be deliberately removed." According to Prof. W?lfl, R-Smad proteins are also important mediators in cellular differentiation. "Reducing or removing these signal mediators from stem cells would cause them to no longer react to differentiation signals, so they would retain their stem cell properties as a result."

In their experiments, the researchers worked with a variant of the natural product indirubin that they chemically synthesised. The studies showed that the indirubin derivative led to a degradation of the R-Smad proteins in human cells. Thus, the signals transmitted by the TGF?/BMP growth factors are blocked. In this procedure, the indirubin variant intervenes in various processes that all contribute to depleting the concentration of R-Smad proteins in the cell. In particular, the activity of specific regulating enzymes called ubiquitin proteases is diminished, which protect proteins from degradation in the ubiquitin proteasome system.

The research was funded by the Federal Ministry of Education and Research (BMBF) within a joint research project focussed on medical system biology. The research team at the Institute of Pharmacy and Molecular Biotechnology of Heidelberg University collaborated with scientists from the University of Kaiserslautern and the Jena University Hospital as well as the Heidelberg University Hospital's Institute of Human Genetics.

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The above story is reprinted from materials provided by Heidelberg, Universit?t.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.


Journal Reference:

  1. Xinlai Cheng, Hamed Alborzinia, Karl-Heinz Merz, Herbert Steinbeisser, Ralf Mrowka, Catharina Scholl, Igor Kitanovic, Gerhard Eisenbrand, Stefan W?lfl. Indirubin Derivatives Modulate TGF?/BMP Signaling at Different Levels and Trigger Ubiquitin-Mediated Depletion of Nonactivated R-Smads. Chemistry & Biology, 2012; 19 (11): 1423 DOI: 10.1016/j.chembiol.2012.09.008

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Source: http://feeds.sciencedaily.com/~r/sciencedaily/most_popular/~3/sqeQVMq_zNw/121130110554.htm

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Women Grows Beard To Promote Prostate Cancer Awareness - Q 103

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Movember is not just for dudes I guess. Also is it weird that this chicks beard makes me feel like less of a man?

Growing a mustache during the month of November is a classic tradition people do to help support and raise money in awareness to prostate cancer. It?s a good cause to help fight cancer and an even better cause to help promote the growth of totally Rad mustaches. According to ABCNEWS a woman in England has decided to participate this year and grow out her beard. Apparently she has a pre existing condition that causes her to grow facial hair and it?s totally easy for her to grow one.

Must be nice lady, growing a beard like a man with zero effort. Mean while I sit here with the beard that looks as if I got super sweaty and someone just through a fist full of pubes at my face. I have patches like the pants of a sad clown. I respect what you?re doing lady but I can?t help but to be super jealous as well.

Click To See Her Beard

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Source: http://q103albany.com/women-grows-beard-to-promote-prostate-cancer-awareness-wait-what/

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Thread: Christmas present for grand baby - Family Woodworking

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Source: http://familywoodworking.org/forums/showthread.php?29029-Christmas-present-for-grand-baby

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