#opcp

[nursingwriter]

Bridge/Prehospice Program: Do Hospice Bridge Programs Increase Quality of Life for Terminal Patients by Encouraging Earlier Access to Palliative Resources? The work of Levy, Bemski, and Kutner (2008) entitled "Are Hospices Establishing Pre-Hospice/Palliative Care Programs?" reports that outpatient palliative care programs (OPCPs), sometimes known as prehospice or 'bridge programs' allow for patients to receive comfort care in their home, nursing home, or assisted living facility even if they are not eligible for or are not ready to choose to enroll in hospice care." (p.1)It is reported that the OPCPs in terms of their "prevalence and sustainability…remains uncertain because these programs are, in general, not supported by health care insurance in the United States." (Levy, Bemski, and Kutner, 2008) Reported by Levy, Bemski, and Kutner (2008) is a survey that was comprised by an 18-question Web-based survey "created based on input from a team of palliative care/hospice clinical and researcher physicians and nurses affiliated with PoPCRN." (Levy, Bemski, and Kutner, 2008, p.1) The hospital programs were asked if an OPCP existed within their hospice and if it did what the characteristics of the OPCP were. Then the hospice characteristics were obtained "via 2005 hospice claims data obtained from the Centers for Medicare & Medicaid Services and hospices without OPCPs were compared to those with OPCPs. The report states that 42 of 177 hospice agencies contacted responded to the survey with a response rate of 24%. Findings include the following: 24 or 57% had an OPCP; Agencies with an OPCP had a significantly higher mean number of patients annually and total days of care annually and care for a higher percentage of patients with noncancer diagnoses that did not have an OPCP; 50% were in the process of developing one; 67% indicated that their OPCP is not profitable; 58% stated that they continued providing OPCP services because the program is "an important service to the community." 85% of hospice agencies reported that fewer than 25% of patients remained in the OPCP until death.( Levy, Bemski, and Kutner, 2008, p.1) Other findings include that 50% of the patients enrolled in their OPCP eventually enrolled in a hospice program." (Levy, Bemski, and Kutner, 2008, p.1) In addition, 86% did not report an increase in an overall length of hospice service for patients who were referred to the hospice program from the OPCP compared to non-OPCP patients." (Levy, Bemski, and Kutner, 2008; p.1) It is also reported that 35% of hospice agencies stated that "overall length of hospice services was longer after starting the OPCP." (Levy, Bemski, and Kutner, 2008; p.1) This study is reported to create more questions than it actually answers and that more research is needed in relation to OPCPs. The work of Carlson, et al. (2010) entitled "Impact of Hospital Disenrollment on Healthcare Use and Medical Expenditures for Patients with Cancer" reports a study through use of "Surveillance, Epidemiology, and End-Results Medicare data for hospice users who died as a result of cancer between 1998 and 2002 to compare rates of hospitalization, emergency department, and intensive care unit admission and hospital death for hospital disenrollees and those who remained with hospice until death." (Carlson, et al., 2010, p.1) The study additionally reports comparing "per-day and total Medicare expenditures across the two groups." (Carlson, et al., 2010) Results of the study state that patients with cancer who disenrolled from hospice "were more likely to be hospitalized, more likely to be admitted to the emergency department or intensive care unit, and more likely to die in the hospital." (Carlson, et al., 2010, p.1) Patients who disenrolled from hospice died a median of 24 days following disenrollment, suggest that the reason for hospice disenrollment was not improved health." (Carlson, et al., 2010, p.1) It is reported that the "distribution of Medicare expenditures for individuals with a primary diagnosis of cancer who enrolled with hospice was substantially skewed to the right. The 5% of individuals with the highest Medicare expenditures accounted for 40$ of total Medicare expenditures during the study period. The mean total Medicare expenditure per individual with $9,196, the median expenditure was $3,508 and the 95th percentile expenditure was $35,479." (Carlson, et al., 2010, p.1) The study concludes that oncologists "should view hospice disenrollment by their patients as a marker for patient complexity and be aware of the increased probability that such patients will be hospitalized, perhaps multiple times, and often in their last few weeks of life." (Carlson, et al., 2010, p.1) Recommended are strategies for supporting patients who have disenrolled from hospice. A more targeted approach to decreasing Medicare expenditures for hospice users may be to better understand the processes of care and patient and family decision making related to hospice disenrollment and to develop strategies to better manage the patient's care and support the family following hospice disenrollment." (Carlson, et al., 2010, p.1) The work of Casarett and Quill (2010) reports that hospice programs "provide a unique set of benefits for dying patients and their families." Examples include that hospice patients receive medications related to their hospice diagnosis, durable medical equipment, home health aide services and care from an interdisciplinary team." (Casarett and Quill, 2010, p.1) In addition, families receive emotional and spiritual support and bereavement counseling for at least a yare after the patient's death." (Casarett and Quill, 2010, p.1) While hospice provides high quality care and high levels of satisfaction due to "improved pain assessment and management, improved bereavement outcomes, better overall satisfaction nd lower mortality rates among family members who received hospice care" hospice is noted to make provision of care for "only one-third of all dying patients in this country and patients who enroll generally only do so very late in the course of illness." (Casarett and Quill, 2010, p.1) Casarett and Abrahm (2001) report in the work entitled "Patients with Cancer Referred to Hospice vs. A Bridge Program: Patient Characteristics, Needs for Care and Survival" a study that compared the characteristics and needs of patients with advanced cancer who were referred to hospice with those referred to a prehospice 'bridge' program that is staffed by hospice nurses. Data is reported to have been from a retrospective review of computerized clinical records using precoded data field of 284 patients with cancer enrolled in a bridge program and 1,000 who enrolled in a hospice program. The report states that bridge patients were found to be individuals who were "less likely to have Medicare or Medicaid, were younger, more likely to be married, and more likely to be in the highest income category." (Casarett and Abrahm, 2001, p.1) Bridge patients were stated to have "at least as many needs for care as did patients in hospice." (Casarett and Abrahm, 2001, p.1) Additionally reported is that bridge patients lived significantly longer." (Casarett and Abrahm, 2001, p.1) The study concludes that patients who were referred to the bridge program "had prognoses that are significantly better than those of patients who enter hospice, but they have needs for supportive care that are at least as great." (Casarett and Abrahm, 2001, p.1) The study recommends that the importance of initiatives to extend benefits of hospice care to a wider population of patients should be examined and that similar programs with the ability to meet these types of needs should be analyzed. References Levy, C., Bemski, J., and Kutner, JS (2008) Are Hospices Establishing Pre-Hospice/Palliative Care Programs? Journal of Palliative Medicine. Vol. 11 Issue 3, March 25, 2008. Retrieved from: http://www.liebertonline.com/doi/abs/10.1089/jpm.2007.0274 Carlson, M. (2010). Impact of hospice disenrollment on health care user and Medicare expenditures for patients with cancer. Journal of Clinical Oncology, 28(28), Casarett, D. (2007). I'm not ready for hospice": strategies for timely and effective hospice discussions. Annals of Internal Medicine, 146(6), Casarett, D. (2001). Patients with cancer referred to hospice vs. A bridge program: patient characteristics, needs for care, and survival. Journal of Clinical Oncology, 19(7), Read the full article

[pacosemnoticias]

Faltam médicos, enfermeiros, psicólogos e assistentes sociais nos cuidado paliativos

Os serviços de cuidados paliativos apresentam “insuficiências significativas”, revela um relatório divulgado, segundo qual em 2022 estavam em falta 39 médicos, 246 enfermeiros, 19 psicólogos e 18 assistentes sociais.

O Observatório Português dos Cuidados Paliativos (OPCP) refere, no relatório de Outono 2023, que cerca de 85% dos médicos nestas unidades são de medicina geral e familiar e de medicina interna: “Apenas 37,7% têm competência em Medicina Paliativa”.

Entre os enfermeiros, apenas 13,1% possuem especialidade em Enfermagem Médico-Cir��rgica - Área da Pessoa em Situação Paliativa.

“A dedicação exclusiva a cuidados paliativos é baixa, com apenas 36% das equipas possuindo pelo menos um médico a 100% do tempo”, apontam os relatores.

De acordo com a mesma fonte, o tempo de alocação dos profissionais está “consideravelmente abaixo dos padrões internacionais e dos requisitos mínimos exigidos” pelo Plano Estratégico de Desenvolvimento dos Cuidados Paliativos Biénio 2021-2022.

No documento, em que se faz uma avaliação da cobertura e a caracterização das equipas de cuidados paliativos em Portugal, o Observatório defende “uma maior alocação de recursos e especialização dos profissionais”, para garantir a qualidade e acessibilidade destes cuidados a toda a população.

“A evolução no número de recursos de cuidados paliativos é insuficiente para alcançar uma cobertura aceitável e preconizada, tanto a nível nacional quanto internacional, com significativas assimetrias a nível distrital”, lê-se no relatório.

O OPCP recomenda a criação de um registo nacional da atividade assistencial e a caracterização dos profissionais nesta área, gerido pelo Serviço Nacional de Saúde (SNS) e acessível à comunidade científica, uma medida que “permitirá análises mais precisas e tomadas de decisão informadas, sem sobrecarregar as equipas”, advoga.

“Entre o ano de 2018 e 2022, a rede nacional de cuidados paliativos oferece principalmente cuidados generalistas, longe da desejada diferenciação especializada”, revela o estudo.

Para o Observatório, é essencial uma remodelação do planeamento estratégico.

[onpoli]

Last night’s election result is a nightmare for most of us and I’m sure nobody is interested in dwelling on that, but there are a few specific things I wanted to talk about, both good and bad.

Turnout

As it stands, Elections Ontario has the turnout count pegged at 43%. The ridings with the highest turnout are Huron—Bruce with 54%, and then both Niagara West and Parry Sound—Muskoka with 53%. The ridings with the lowest turnout were Kiiwetinoong with 28% (only 92% of results are in), Humber River—Black Creek with 32%, and Windsor West with 33%.

It’s impossible to gauge how many voters were discouraged from voting by polls that consistently showed the PCs with a strong advantage. We also don’t know how many people didn’t vote due to Covid-19 infection or a lack of easy access to a nearby polling station. All parties were handed a major setback yesterday when a tech issue prevented them from downloading lists of which voters had already cast a ballot and which hadn’t yet, so their ability to work strategically yesterday was limited. Regardless, 43% is a pathetic turnout rate.

It’s worth noting that the Green Party campaigned relentlessly in Parry Sound—Muskoka because, with no Liberal candidate running, they had a good chance of winning that seat. A lot of effort was made to engage with voters and win their support, both from the Greens and the incumbent PCs. Niagara West is Sam Oosterhoff’s riding, where he can mobilize a large group of supporters from his church to canvass and help people vote. Running an energetic campaign is a candidate’s job, but for the rest of us, volunteering and helping to get people to a polling station really does help. Persuading friends and family to vote helps. We’re at a disadvantage in a first past the post electoral system, so there’s zero room for apathy.

Andrea Horwath and the NDP

After four elections as leader, Andrea Horwath read the room and stepped down after running a low-energy and uninspiring campaign. In Brampton, deputy party leader Sara Singh lost her seat, as did Gurratan Singh. The PCs secured several union endorsements over the traditionally more labour-friendly NDP. The Liberals will get more attention for their trainwreck of an election, but yesterday was awful for the NDP.

With Horwath quitting, the NDP’s other deputy leader, John Vanthof, may be interested in running for the party leadership. Joel Harden and Marit Stiles are other potential contenders.

Notable losers

New Blue MPP Belinda Karahalios and New Blue leader Jim Karahalios both lost badly in Cambridge and Kitchener—Conestoga respectively. Derek Sloan also lost by a huge margin. The former Toronto Police Chief Mark Saunders lost in Kathleen Wynne’s old riding.

The Liberals took the riding of Kingston and the Islands from the NDP, beating Mary Rita Holland, the former president of Ontario’s NDP. Sandeep Singh, who was controversially chosen as the NDP candidate in Brampton North over the incumbent, Kevin Yarde, also lost.

Steven Del Duca has stepped down after failing to secure party status for the Liberals or win in Vaughan—Woodbridge. After flipping from the PCs to the Liberals in 2020, MPP Amanda Simard lost her seat and two of the most well-known Liberal newbie candidates, nurse Tyler Watt and vaccination advocate Jill Promoli, also lost.

There’s not much for the PCs to be disappointed about, but their candidate in Haldimand—Norfolk lost to an independent. Former seven-term PC MPP Toby Barrett chose not to run in this election, but he endorsed his assistant Bobbi Ann Brady who was running as an independent. 

Notable winners

After narrowly losing in 2018, Chandra Pasma unexpectedly flipped Ottawa West—Nepean to the NDP. With the NDP’s only other flip, Lise Vaugeois won in Thunder Bay—Superior North.

The biggest winners are obviously the PCs. It’s rare to win a comfortable majority and then increase that majority in the next election. Opposition to Doug Ford and the PCs over the last four years has been ineffective, and we need a hard reset in terms of organization. Signing petitions, marching to Queen’s Park, and literally begging Lisa MacLeod for help has made no material difference on PC policy. I hope that the NDP will fix their deep-seated problems and set the party on a better path, but mostly I hope that people who are upset today will feel motivated to help their neighbours who will be hit hardest by four more years of PC cuts and also to join a group organizing for material and achievable wins.

[casvision-blog]

Are you fuckin kidding me.

Doug Ford has launched a news channel that broadcasts non-stop positive stories showering himself with praise – and your family is paying for it.

At a time when Ford’s government is announcing steep cuts to schools, healthcare and assistance for the poor, running a taxpayer-funded propaganda outlet endlessly glorifying Ontario’s Premier might seem like a wrong priority to some.

Continue Reading.

[gildedmuse]

One Piece Trivia: Cultural Curio

Strawhat Vice Captain Pirate Hunter Roronoa Zoro has developed a unique fighting technique known as Santoryu or Three Sword Style. In terms of character design, this allowed the animators to highlight his Complete Extraness despite his often serious and terse outward demeanor as well as his Utter Fucking Pansexuality.

- 100% True Facts from the anime edition of the One Piece: A Companion Piece book.

The footnote included in the illustrated collector edition of OPCP goes on to note "Those who disagree are free to fight the author of this collection of One Piece Trivia nuggets, keeping in mind she tri-weilds like a badass bitch" but I believe that only appears in the limited release copies.

[I'm sure this has been brought up before. I'm choosing to re-highlight it because of course I am.]

[fatservice]

Taking advantage of this short trip to get some pecans!! And ice cream of course Lol 🍦❤️💛 #PriestersPecans https://www.instagram.com/p/B1R-oPcp-Iq/?igshid=cgmxozaxvinq

[chnuru]

【悲報】高城亜樹、写真集を出す為のクラウドファンディングで目標350万に対し二日間で60万しか集まらず

http://awabi.2ch.net/test/read.cgi/akb/1491227214/ 1: (SB-iPhone) 2017/04/03(月) 22:46:54.28 ヲタ離れすぎだろ、応援してあげろよ 10万出せば合コン出来るらしいぞ http://domeschick.jp/html/products/detail.php?product_id=103 2: 47の素敵な(東京都) (ﾜｯﾁｮｲWW 9f53-Nut6) 2017/04/03(月) 22:47:17.65 ID:9mRs1Klv0 全く興味なし。 3: 47の素敵な(庭) (ｱｳｱｳｶｰ Sa13-OpCP) 2017/04/03(月) 22:48:02.36 ID:fG7Jg/++a さんざんヲタ切りしといてよく言うわ 5: (pc?) 2017/04/03(月) 22:49:19.68…

[osanecif]

Distrito de Coimbra não tem nenhuma equipa de cuidados paliativos

FOTO DR

A cobertura universal de cuidados paliativos “está longe” de ser alcançada e revela “profundas assimetrias” no país, com seis distritos sem nenhuma equipa e outros com taxas superiores a 100%, segundo um relatório hoje divulgado.

“Mais uma vez se verificam assimetrias significativas com seis distritos (Aveiro, Braga, Castelo Branco, Coimbra, Leiria e Vila Real) sem nenhuma equipa e outros com taxas superiores a 100%”, nomeadamente Beja e o Açores, revela o “Relatório de Outono 2019”, do Observatório Português dos Cuidados Paliativos (OPCP), que analisou a cobertura da rede, reportando-se a dados vigentes em 31 de dezembro de 2018.

“No términus do primeiro plano estratégico nacional de cuidados paliativos [2017/2018], embora exista evolução no número de recursos desta tipologia de cuidados, continua-se com uma cobertura, estrutural e profissional, nacional e na generalidade dos distritos, muito abaixo do minimamente aceitável a que acrescem profundas assimetrias, a nível distrital”, salienta o estudo, a que a agência Lusa teve acesso.

O observatório alerta que esta assimetria “não garante uma abordagem especializada integrada e articulada entre as diferentes valências/equipas, por ausência de uma ou mais valências, sendo um sério obstáculo à acessibilidade a estes recursos como um direito humano e condição nuclear para uma cobertura universal de saúde”.

Distrito de Coimbra não tem nenhuma equipa de cuidados paliativos

[latestcanadaposts]

SNOBELEN: Next Ontario PC leader must convince voters that we can do better

SNOBELEN: Next Ontario PC leader must convince voters that we can do better

Like other members of the Ontario PC Party, I need to make an important decision over the next few weeks.

A month from now OPCP members will select a new leader. Three months later Ontarians will elect a new government.

The general election will be more than a referendum on a decade of Liberal governments. The vote is already in on that front. Ontario is ready for change.

The leadership question…

[onpoli]

York Centre MPP and lying enthusiast Roman Baber has been removed by Doug Ford from caucus and will not be permitted to run for the PCs in the next provincial election.

His removal comes only a couple hours after he posted his open letter calling for Ford to stop “imprisoning” Ontarians so we can “go back to normal life.”

[traelsnu-blog]

On Friday you can finde us at Frabrikanterne, in Vejle. You can make a bird house or a pillow at our event. Watch our video where Anders makes a bird house: https://www.youtube.com/watch?v=ifqB-opCpEs

[akb48loveantena-blog]

【欅坂46】ひらがな候補の14番ちゃんは辞退なのかー仕方がないとはいえ

16: 名無しって、書けない？(北海道) (ﾜｯﾁｮｲWW 9750-OPcp) 2017/08/15(火) 13:42:58.15 ID:uo+1Rsgd0 辞退したのか ねるが一番ショックなんじゃ 続きを読む Source: 欅坂46まとめ坂

[sunnywantsome]

RT @RJennromao: https://t.co/f6GOtTZAAU… #OpCPS #OpCAS #Quebec #dad #raped daughter had3 #kids by dad! https://t.co/hEXCFe3w6Z…… https://t.co/fdiNxEfSI3

https://t.co/f6GOtTZAAU… #OpCPS #OpCAS #Quebec #dad #raped daughter had3 #kids by dad!https://t.co/hEXCFe3w6Z…#EpicFail 👀@JustinTrudeau 😉 https://t.co/qHSFGGL8Tp

— AnonOntario (@RJennromao) February 28, 2017

from Twitter https://twitter.com/sunny_wantsome

[onpoli]

Twenty-five years ago this month, then Ontario premier Mike Harris slashed social assistance rates by 21.6 per cent.

In response to criticism of the cuts, Harris’s minister in charge of social services, David Tsubouchi, put forward a shopping list — later dubbed the “welfare diet” — to prove that welfare recipients could survive on the new lower rates by adhering to a $90-a-month grocery budget.

Tsubouchi’s list, which included nine servings of pasta but no sauce, and did not include butter, salt or other pantry staples, was widely ridiculed.

“It is totally out of touch with reality and is consistent with the stupidity and the ignorance of this minister,” Liberal MPP Dominic Agostino said in the legislature at the time.

A quarter-century later, social assistance rates still haven’t recovered and continue to lag behind inflation. Meanwhile, the cost of food, particularly good food, has risen sharply.

[onpoli]

Environmental groups are taking the Ontario government to court over its unlawful use of a Ministerial Zoning Order (MZO) to force through development on the provincially significant Duffins Creek wetlands complex.

Ecojustice, on behalf of Environmental Defence and Ontario Nature, filed the legal application to maintain protections on this special area, which the Ministry of Housing and Municipal Affairs has approved as the future site of a warehouse facility.

Provincially Significant Coastal Wetlands, such as the Lower Duffins Creek complex, are of huge importance to local communities, helping to mitigate flooding, store carbon, filter water and provide habitat to wildlife.

MZOs are meant to be an extraordinary measure. In the past, they were rarely used and were reserved for exceptional circumstances.  But in this year alone, the Ontario government has issued over 30 MZOs to fast-track development.

The legal challenge seeks to have the MZO quashed and declared unlawful for failing to comply with provincial law and policy.  The 2020 Provincial Policy Statement under the Planning Act clearly does not permit development on provincially significant wetlands. Yet, the Minister ignored this prohibition and issued the MZO, thereby allowing development to take place in an otherwise protected wetland.

The proposed development at Lower Duffins Creek faces considerable opposition from several  groups, and thousands of citizens. The Williams Treaties First Nations were not consulted and have voiced concerns. The Toronto and Region Conservation Authority has also rejected development in protected wetlands.

In spite of this, the Ontario government continues to push MZOs through and has even proposed amendments to the Conservation Authorities Act to strip conservation authorities of their powers.