Serious life-threatening and life-limiting illnesses place an enormous burden on society health systems. Understanding how this will evolve in the future is essential to inform policies that alleviate suffering prevent system weakening. We aimed project global of serious health-related requiring palliative care until 2060 by world regions, age groups, conditions.We projected as defined Lancet Commission Palliative Care Pain Relief, combining WHO mortality projections (2016-60) with estimates...

Background: Palliative care is an important component of health in pandemics, contributing to symptom control, psychological support, and supporting triage complex decision making. Aim: To examine preparedness for, impact of, the COVID-19 pandemic on hospices Italy inform response other countries. Design: Cross-sectional telephone survey, March 2020. Setting: Italian hospices, purposively sampled according regional prevalence categorised as high (>25), medium (15–25) low (<15) cases...

Abstract Introduction Breast cancer is thought to arise in mammary epithelial stem cells. There is, therefore, a large amount of interest identifying these The breast complex tissue consisting two layers (an outer myoepithelial/basal layer and an inner luminal layer) as well non-epithelial component (fibroblasts, endothelial cells, lymphocytes, adipocytes, neurons myocytes). definitive identification cell population critically dependent on its purity. To date, this has been hampered by the...

The role of estrogen in promoting mammary stem cell proliferation remains controversial. It is unclear if receptor (ER)-expressing cells have stem/progenitor activity themselves or they act a paracrine fashion to stimulate proliferation. We used flow cytometry prospectively isolate mouse ER-expressing epithelial and shown, using analysis gene expression patterns type-specific markers, that form distinct luminal subpopulation expresses not only the ER but also progesterone prolactin...

England has one of the highest rates hospital death in dementia Europe. How this changed over time is unknown. This study aimed to analyse temporal trends place a recent ten year period. Population-based linking Office for National Statistics mortality data with regional variables, 2001–2010. Participants were adults aged 60 certificate mention dementia. Multivariable Poisson regression was used determine proportion ratio (PR) care home (1) and home/hospice compared (0). Explanatory...

Specialist palliative care services have a key role in whole system response to COVID-19, disease caused by the SARS-CoV-2 virus. There is need understand service share good practice and prepare for future care. To map specialist innovations changes COVID-19. Online survey of providers (CovPall), disseminated via stakeholders. Data collected on characteristics, Statistical analysis included frequencies, proportions means, free-text comments were analysed using qualitative framework approach....

understanding how best to provide palliative care for frail older people with non-malignant conditions is an international priority. We aimed develop a community-based episodic model of short-term integrated and supportive (SIPS) based on the views service users other key stakeholders in United Kingdom. transparent expert consultations health professionals, voluntary sector carer representatives including consensus survey; focus groups carers were used generate recommendations SIPS model....

What you need to know• Many patients with severe covid-19 experience distressing symptoms, including breathlessness and agitation.Palliation of suffering is an important part care irrespective prognosis • Patients may deteriorate rapidly.It therefore useful have a strategy in place for managing deterioration potential death (for those not suitable escalation intensive care), which runs alongside the acute medical management plan Clear timely communication patient (if they are able) their...

dying in one's preferred place is a quality marker for end-of-life care. Little known about of death, or the factors associated with achieving this, people dementia.to understand preferences death among dementia; to identify these preferences.adults diagnosis dementia who died between December 2015 and March 2017 were registered on Coordinate My Care, an Electronic Palliative Care Coordination System.retrospective cohort study.multivariable logistic regression investigated death.we...

Palliative and end of life care is essential to healthcare systems worldwide, yet a minute proportion research funding spent on palliative research. Routinely collected health social data provide an efficient useful opportunity for evaluating improving patients families. There are excellent examples routine in care, but resources widely underutilised. We held four workshops using routinely care. Researchers presented studies from the UK, USA Europe. The aim was highlight valuable work with...

Background: mortality statistics are a frequently used source of information on deaths in dementia but limited by concerns over accuracy. Objective: to investigate the frequency with which clinically diagnosed is recorded death certificates, including predictive factors. Methods: retrospective cohort study assembled using large mental healthcare database South London, linked Office for National Statistics data. People clinical diagnosis dementia, aged 65 or older, who died between 2006 and...

Background: COVID-19 has directly and indirectly caused high mortality worldwide. Aim: To explore patterns of during the pandemic implications for palliative care, service planning research. Design: Descriptive analysis population-based modelling routine data. Participants setting: All deaths registered in England Wales between 7 March 15 May 2020. We described following categories by age, gender place death: (1) baseline (deaths that would typically occur a given period); (2) (3) additional...

Background: Palliative care improves outcomes for people with cancer, but in many countries access remains poor. Understanding future needs is essential effective health system planning response to global policy. Aim: To project the burden of serious health-related suffering associated death from cancer 2060 by age, gender, type and World Bank income region. Design: Population-based projections study. Global palliative need were derived combining Health Organization mortality (2016–2060)...

Background: Specialist palliative care services play an important role in conducting advance planning during COVID-19. Little is known about the challenges to this context, or changes made adapt. Aim: Describe that UK specialist experienced regarding COVID-19 and support timely conversations. Design: Online survey of palliative/hospice services’ response Closed-ended responses are reported descriptively. Open-ended were analysed using a thematic Framework approach Social Ecological Model...

Understanding patterns of mortality and place death during the COVID-19 pandemic is important to help provide appropriate services resources.To analyse including in United Kingdom (UK) (England, Wales, Scotland Northern Ireland) date.Descriptive analysis UK data between March 2020 2021. Weekly number deaths was described by death, using following definitions: (1) expected deaths: average estimated historical (2015-19); (2) where mentioned on certificate; (3) additional non-COVID-19 above but...

Globally, a rising number of people live into advanced age and die with multimorbidity frailty. Palliative care is advocated as person-centred approach to reduce health-related suffering promote quality life. However, no evidence-based interventions exist deliver community-based palliative for this population.To evaluate the impact short-term integrated supportive intervention older living chronic noncancer conditions frailty on clinical economic outcomes perceptions care.Single-blind trial...

Summary Objective To explore the experiences of, and impact on, staff working in palliative care during COVID-19 pandemic. Design Qualitative multiple case study using semi-structured interviews between November 2020 April 2021 as part of CovPall study. Data were analysed thematic framework analysis. Setting Organisations providing specialist services any setting. Participants Staff care, purposefully sampled by criteria role, setting experience. Main outcome measures Experiences Results...

Background Healthcare organisations have legal and ethical duties to reduce inequalities in access healthcare services related outcomes. However, lesbian, gay, bisexual and/or transgender (LGBT+) people continue experience anticipate discrimination health social care. Skilled communication is vital for quality person-centred care, but there inconsistent provision of evidence-based clinician education on needs experiences LGBT+ support this. This study aimed identify key stakeholders’...

There are marked inequalities in palliative care provision. Research is needed to understand how such can be addressed, so that everyone living with advanced illness receive the they need, when need it. into should guided by Patient and Public Involvement (PPI) includes people from diverse backgrounds, who less likely specialist services. Multi-disciplinary research partnerships, bringing together primary (the main providers of communities) care, have potential work new ways do address...

Background: Little is known about place of death in chronic neurological diseases. Mortality statistics are ideal for examining trends death, but analyses limited by coding rule changes. Aim: To examine the relationship between and underlying cause Parkinson’s disease, multiple sclerosis motor neurone disease impact changes on analysis death. Design: Population-based study. Proportion ratios hospice, home, care home hospital were calculated according to using multivariable Poisson...