The evolution of palliative care and the relevance to residential aged care: Understanding the past to inform the future

Improving the experience of dying in residential aged care units became a significant project of the Australian Government’s National Palliative Care Program in 2004. This initiative resulted in an expectation that residential aged care facilities would adopt the recommended palliative approach to underpin service delivery. Recognising palliative care as a specialist area of health care practice is a recent development which has influenced the expectations of community and government. This paper traces the global history of palliative care and how historical factors influenced its development in Australia. This discussion presents an overview of the positioning of dying and death within society, explaining how with the shifting emphasis on care of the dying accordingly has been the focus on palliative care specialists. Care of the dying in residential aged care units has largely been overlooked in the context of specialist involvement. This paper acknowledges dying and death as occurring in residential aged care facilities, illuminating the advantages of adopting a palliative approach and offers recommendations.     

Characteristics of patients referred for discharge planning from a geriatric ward at a national university hospital in Japan: Implications for improving hospital programs

Abstract The purpose of the present study was to identify the characteristics of patients from a geriatric ward who were referred for discharge planning support, a service provided by the first multidisciplinary department for discharge planning among the national university hospitals in Japan. From October 1997 to May 1999, 335 patients were discharged; 23 patients (6.9%) were referred. The referred patients were older and more frequently diagnosed with malignancy, dementia and respiratory infection. In addition, they had lower activities of daily living (ADL) and instrumental ADL scores. Those characteristics, which may be related to the longer hospital stay and lower rate of returning home of the referred patients, can be assessed early in hospitalization to identify patients at risk for difficult discharge planning. It is important to identify patients who need earlier intervention by formalized discharge planning so that the current situation of overly long hospitalization in Japan will improve.     

Effect of Core Material and Restoration Design on Strength of Endodontically Treated Bovine Teeth: A Laboratory Study

Purpose: The purpose of this study was to evaluate the fracture resistance of bovine teeth restored with one-piece cast core/crowns and no ferrule, compared to teeth restored with amalgam cores and full coverage crowns, with and without a dentine ferrule.
Materials and Method: Thirty bovine incisors were selected and modified to ensure all teeth had axial dentine walls of similar size. The teeth were then randomly allocated to one of the three groups: control group restored with amalgam core and cast crown without ferrule; ferrule group restored with amalgam core and cast crown with a 2-mm dentine ferrule; one-piece group restored with one-piece cast core/crown without ferrule. Each tooth was loaded to the point of fracture.
Results: The mean load resisted by the control group, the ferrule group, and the one-piece group were 1092.5, 1843.5, and 1463.1 N, respectively. The mean load resisted by the ferrule group was significantly greater than the control group ( p < 0.001) and the one-piece cast core/crown group ( p = 0.04). The mean load resisted by the one-piece cast core/crown group was significantly greater than the control group ( p = 0.04).
Conclusions: The maximum load resistance was significantly enhanced by a 2-mm ferrule compared with teeth with no ferrule and teeth restored with one-piece cast core/crowns. Teeth restored with one-piece cast core/crowns were significantly more resistant to loading than teeth restored with amalgam cores and crowns without a ferrule.     

Transitioning from Adolescent to Adult Mental Health Services: An Integrative Literature Review

This article aims to present a review of the peer-reviewed, published literature related to the transition from adolescent mental health services to adult mental health services. Six databases (PubMED, Medline, PsycINFO, CINAHL, EMBASE, and Google Scholar) were searched for peer-reviewed, published literature on the transition from adolescent to adult mental health services. Articles on primary research were included in the review if they were published in English between 2000 and 2018, and if they were explicitly about alignment and/or transition between adolescent and adult mental health services. Fifty articles were included in the final review. The findings are discussed in two overarching streams of research from the literature: evaluations of transition arrangements, and the perspectives of various stakeholders (including consumers, carers, and health professionals). The results emphasise the problematic siloes of adolescent and adult mental health services. While there are still no randomised controlled trials on transition to assess transition pathways, our findings have implications to inform best practice in the sector. Given that transitioning to adult mental health services is seen as a point of vulnerability for young people, this review contributes to understandings about how services can offer better support during transition periods.