August end of life current awareness by Musgrove Park Hospital Library

Library Services Musgrove Park and Somerset Partnership

Current Awareness End of Life This monthly Current Awareness Bulletin is produced by the Library, Musgrove Park Academy to provide staff with a range of resources focussing on end of life care. It includes recently published guidelines and research articles, news and policy items.

This guide provides a selection of resources relevant to the subject area and is not intended to be a comprehensive list. All websites have been evaluated and details are correct at the time of publications. Details correct at time of going to print. Please note that resources are continuously updated. For further help or guidance, please contact a member of library staff.

This guide has been compiled by: Jess Pawley Senior Library Assistant Musgrove Park Hospital Library Service jessica.pawley@tst.nhs.uk Issue 7 August 2016

Contents Click on a section title to navigate contents Page Results of Library Current Awareness Survey

Colleague App

Recent journal articles

Books

Guidelines

UpToDate

Reports, publications and resources

Topic Alerts and Updates

Twitter

Training & Networking Opportunities, Conferences, Events

Literature search service

Training and Athens

Library contact details: Library Musgrove Park Academy Musgrove Park Hospital Taunton Somerset TA1 5DA Tel: 01823 34 (2433)

Email: library@tst.nhs.uk Blog: http://librarymph.wordpress.com @musgrovesompar

RESULTS OF LIBRARY CURRENT AWARENESS SURVEY BACK TO TOP

During 2015-6 the library team introduced a number of new current awareness bulletins as a result of feedback from staff. Along with the fortnightly Library Alert monthly updates were produced for: Dementia Stroke End of life Sign up to safety

Mentorship Cancer ITU

While we had some feedback that these bulletins were useful, we felt due to the cost in library staff time, it would be better to have more detailed evidence. We circulated the survey via email to the various email lists, added a link on the Library webpage and also put reminders in the Library Alert and Staff Bulletin. During the month when we received 211 replies on all bulletins covering both Taunton and Somerset and Somerset Partnership staff. The final report can be found here

COLLEAGUE APP BACK TO TOP The MPH Staff App has specifically been produced and designed to offer both current and future employees relevant information related to their work. Whether seeking information about policies and procedures, following us on Twitter or even taking advantage of special offers, all can be found here.

Library monthly current awareness bulletins are also available. To download, please follow this link Please note- The app has not been created by the library. If you have any problems downloading or accessing the app then you will need to contact the IT department.

RECENT JOURNAL ARTICLES BACK TO TOP This is a list of journal articles on the topic of end of life. Some articles are available in the library or on-line via an OpenAthens password by following the full-text link. If you would like an article which is not available as full-text then please contact library staff. Please note that abstracts are not always available for all articles.

Title: Ethical Decisions in Palliative Care. Author(s): Hernรกndez-Marrero, Pablo; Pereira, Sandra Martins; Carvalho, Ana Sofia Source: American Journal of Hospice & Palliative Medicine; Sep 2016; vol. 33 (no. 8); p. 723-732

Title: What Are the Components of Interventions Focused on Quality-of-Life Assessment in Palliative Care Practice? A Systematic Review Author(s): Catania, Gianluca; Beccaro, Monica; Costantini, Massimo; Timmins, Fiona; Zanini, Milko; Aleo, Giuseppe; Bagnasco, Annamaria; Sasso, Loredana Source: Journal of Hospice and Palliative Nursing; Aug 2016; vol. 18 (no. 4); p. 310-316 Abstract: Quality-of-life assessment is a central concept in palliative care. Clinical interventions focused on assessing quality of life are complex interventions. Current research is insufficient to determine how to implement interventions focused on quality-of-life assessment in palliative care. To explore the different components of interventions focused on quality-of-life assessment in palliative care, a systematic review and 5 databases were searched. Publications included were analyzed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) Framework Programme 7 practical guidance on using patient-reported outcome measurements in palliative care and the Quality of Life Assessment Principles in Palliative Care. Interventions and their components were identified and discussed. Identifying problems and monitoring change or response to treatment, screening for hidden problems, and facilitating communication were the 3 different types of intervention identified. None of the interventions fulfilled all the 11 Quality of Life Assessment Principles in Palliative Care. Overall, 6 characteristics of the components were identified: the qualityof-life measure, educational training, completing the measure (patients or proxy), collecting quality-oflife data (baseline and further assessment), identifying a coordinator, and presenting quality-of-life data. Because of heterogeneity of interventions, it is not possible to recommend 1 preferred intervention. References

Title: Symptom clusters in patients with cancer in the hospice/palliative care setting Author(s): Stapleton S.J.; Holden J.; Epstein J.; Wilkie D.J. Source: Supportive Care in Cancer; Sep 2016; vol. 24 (no. 9); p. 3863-3871 Abstract: Purpose: We determined commonly experienced symptoms reported by adult patients with cancer admitted to urban, ethnically diverse hospice settings and identified symptom clusters. Methods: We used hierarchical cluster analysis of 150 patients (41 % male, 20-92 years [M = 59, SD = 13.3], 51 % African American, 37 % Caucasian, 12 % other). Using pen-tablet computers, participants completed the Symptom Distress Scale (SDS), a sleep quality item, and listed analgesics consumed in the previous 24 h. Results: Four symptom clusters were identified: cluster 1 (PainFatigue) consisted of pain frequency, fatigue, and pain intensity; cluster 2 (Ingestion-Elimination)

consisted of appetite and bowel problems; cluster 3 (General Well-Being) consisted of insomnia, appearance, and outlook; and cluster 4 (Respiratory-Nausea-Concentration) consisting of breathing, cough, nausea frequency, nausea intensity, and concentration. There were no significant differences between Caucasians and African Americans on total SDS scores, analgesic consumption, sleep quality, or most cluster scores. Conclusion: This is the first symptom cluster analysis in a US sample with a sizeable proportion of minority hospice/palliative care patients with cancer. Further research to determine the stability of identified symptom clusters over time and discovery of the biological interactions of symptoms within the cluster may lead to symptom management therapies designed for the alleviation of all clustered symptoms.

Title: Improving palliative care in selected settings in England using quality indicators: A realist evaluation Author(s): Iliffe S.; Davies N.; Crome P.; Manthorpe J.; Ahmedzai S.H.; Vernooij-Dassen M.; Engels Y. Source: BMC Palliative Care; Aug 2016; vol. 15 (no. 1) Abstract: Background: There is a gap between readily available evidence of best practice and its use in everyday palliative care. The IMPACT study evaluated the potential of facilitated use of Quality Indicators as tools to improve palliative care in different settings in England. Methods: 1) Modelling palliative care services and selecting a set of Quality Indicators to form the core of an intervention, 2) Case studies of intervention using the Quality Indicator set supported by an expert in service change in selected settings (general practice, community palliative care teams, care homes, hospital wards, in-patient hospices) with a before-and-after evaluation, and 3) realist evaluation of processes and outcomes across settings. Participants in each setting were supported to identify no more than three Quality Indicators to work on over an eight-month period in 2013/2014. Results: General practices could not be recruited to the study. Care homes were recruited but not retained. Hospital wards were recruited and retained, and using the Quality Indicator (QI) set achieved some of their desired changes. Hospices and community palliative care teams were able to use the QI set to achieve almost all their desired changes, and develop plans for quality improvements. Improvements included: increasing the utility of electronic medical records, writing a manual for end of life care, establishing working relationships with a hospice; standardising information transfer between settings, holding regular multi-disciplinary team meetings, exploration of family carers' views and experiences; developing referral criteria, and improvement of information transfer at patient discharge to home or to hospital. Realist evaluation suggested that: 1) uptake and use of QIs are determined by organisational orientation towards continuous improvement; 2) the perceived value of a QI package was not powerful enough for GPs and care homes to commit to or sustain involvement; 3) the QI set may have been to narrow in focus, or more specialist than generalist; and 4) the greater the settings''topdown' engagement with this change project, the more problematic was its implementation. Conclusions: Whilst use of QIs may facilitate improvements in specialist palliative care services, different QI sets may be needed for generalist care settings.

Title: Systematic versus on-demand early palliative care: results from a multicentre, randomised clinical trial Author(s): Frassineti G.L.; Ruscelli S.; Faedi M.; Sansoni E.; Ragazzini A.; Zagonel V.; Crivellari G.; Galiano A.; Rodriquenz M.G.; Biasini C.; Porzio R.; Pittureri C.; Amaducci E.; Ferrari D.; Codeca C.; Crepaldi F.; Broglia C.M.; Pedrazzoli P.; Bramanti A.; Buonadonna A.; Garetto F.; Comandone A.; Giordano M.; Luchena G.; Luzzani M.; Cifatte C.; Pino M.S.; Zoccali S.; Cattaneo M.T.; Dalu D.; Sozzi P.; Gauna R.; Alquati S.; Costantini M.; Quadrini S.; Narducci F.; Mastromauro C.; Scognamiglio R.; Degiovanni D.; Negri F.; Caraceni A.; Montanari L.; Maltoni M.; Scarpi E.; Dall'Agata M.; Nanni O.; Berte R.; Bortolussi R.; Trentin L.; Valgiusti M.; Pini S.; Farolfi A.; Casadei Gardini A.; Amadori D. Source: European Journal of Cancer; Sep 2016; vol. 65 ; p. 61-68

Abstract: Background Early palliative care (EPC) in oncology has been shown to have a positive impact on clinical outcome, quality-of-care outcomes, and costs. However, the optimal way for activating EPC has yet to be defined. Methods This prospective, multicentre, randomised study was conducted on 207 outpatients with metastatic or locally advanced inoperable pancreatic cancer. Patients were randomised to receive 'standard cancer care plus on-demand EPC' (n = 100) or 'standard cancer care plus systematic EPC' (n = 107). Primary outcome was change in quality of life (QoL) evaluated through the Functional Assessment of Cancer Therapy - Hepatobiliary questionnaire between baseline (T0) and after 12 weeks (T1), in particular the integration of physical, functional, and Hepatic Cancer Subscale (HCS) combined in the Trial Outcome Index (TOI). Patient mood, survival, relatives' satisfaction with care, and indicators of aggressiveness of care were also evaluated. Findings The mean changes in TOI score and HCS score between T0 and T1 were -4.47 and -0.63, with a difference between groups of 3.83 (95% confidence interval [CI] 0.10-7.57) (p = 0.041), and -2.23 and 0.28 (difference between groups of 2.51, 95% CI 0.40-4.61, p = 0.013), in favour of interventional group. QoL scores at T1 of TOI scale and HCS were 84.4 versus 78.1 (p = 0.022) and 52.0 versus 48.2 (p = 0.008), respectively, for interventional and standard arm. Until February 2016, 143 (76.9%) of the 186 evaluable patients had died. There was no difference in overall survival between treatment arms. Interpretations Systematic EPC in advanced pancreatic cancer patients significantly improved QoL with respect to on-demand EPC.

Title: Palliative care specialists' beliefs about spiritual care. Author(s): Best, Megan; Butow, Phyllis; Olver, Ian Source: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer; Aug 2016; vol. 24 (no. 8); p. 3295-3306 Abstract: A previous survey of the Multinational Association of Supportive Care in Cancer (MASCC) members found low frequency of spiritual care provision. We hypothesized that physicians with special training in palliative medicine would demonstrate an increased sense of responsibility for and higher self-reported adequacy to provide spiritual care to patients than health professionals with general training. We surveyed members of the Australian and New Zealand Palliative Medicine Society (ANZSPM) to ascertain their spiritual care practices. We sent 445 e-mails on four occasions, inviting members to complete the online survey. Tabulated results were analyzed to describe the results. One hundred and fifty-eight members (35.5 %) responded. Physicians working primarily in palliative care comprised the majority (95 %) of the sample. Significantly more of the ANZSPM than MASCC respondents had previously received training in spiritual care and had pursued training in the previous 2 years. There was a significant difference between the two groups with regard to interest in and self-reported ability to provide spiritual care. Those who believed it was their responsibility to provide spiritual care were more likely to have had training, feel they could adequately provide spiritual care, and were more likely to refer patients if they could not provide spiritual care themselves. Training in spiritual care was more common in healthcare workers who had received training in palliative care. ANZSPM members gave higher scores for both the importance of spiritual care and

Title: Reasons doctors provide futile treatment at the end of life: a qualitative study. Source: Journal of medical ethics; Aug 2016; vol. 42 (no. 8); p. 496-503 Author(s): Willmott, Lindy; White, Benjamin; Gallois, Cindy; Parker, Malcolm; Graves, Nicholas; Winch, Sarah; Callaway, Leonie Kaye; Shepherd, Nicole; Close, Eliana Abstract: Futile treatment, which by definition cannot benefit a patient, is undesirable. This research investigated why doctors believe that treatment that they consider to be futile is sometimes provided at the end of a patient's life. Semistructured in-depth interviews. Three large tertiary public hospitals in Brisbane, Australia. 96 doctors from emergency, intensive care, palliative care, oncology, renal

medicine, internal medicine, respiratory medicine, surgery, cardiology, geriatric medicine and medical administration departments. Participants were recruited using purposive maximum variation sampling. Doctors attributed the provision of futile treatment to a wide range of inter-related factors. One was the characteristics of treating doctors, including their orientation towards curative treatment, discomfort or inexperience with death and dying, concerns about legal risk and poor communication skills. Second, the attributes of the patient and family, including their requests or demands for further treatment, prognostic uncertainty and lack of information about patient wishes. Third, there were hospital factors including a high degree of specialisation, the availability of routine tests and interventions, and organisational barriers to diverting a patient from a curative to a palliative pathway. Doctors nominated family or patient request and doctors being locked into a curative role as the main reasons for futile care. Doctors believe that a range of factors contribute to the provision of futile treatment. A combination of strategies is necessary to reduce futile treatment, including better training for doctors who treat patients at the end of life, educating the community about the limits of medicine and the need to plan for death and dying, and structural reform at the hospital level. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Title: Quality of End-of-Life Care Provided to Patients With Different Serious Illnesses. Author(s): Wachterman, Melissa W; Pilver, Corey; Smith, Dawn; Ersek, Mary; Lipsitz, Stuart R; Keating, Nancy L Source: JAMA internal medicine; Aug 2016; vol. 176 (no. 8); p. 1095-1102 Abstract: Efforts to improve end-of-life care have focused primarily on patients with cancer. Highquality end-of-life care is also critical for patients with other illnesses. To compare patterns of end-oflife care and family-rated quality of care for patients dying with different serious illnesses. A retrospective cross-sectional study was conducted in all 146 inpatient facilities within the Veteran Affairs health system among patients who died in inpatient facilities between October 1, 2009, and September 30, 2012, with clinical diagnoses categorized as end-stage renal disease (ESRD), cancer, cardiopulmonary failure (congestive heart failure or chronic obstructive pulmonary disease), dementia, frailty, or other conditions. Data analysis was conducted from April 1, 2014, to February 10, 2016. Palliative care consultations, do-not-resuscitate orders, death in inpatient hospices, death in the intensive care unit, and family-reported quality of end-of-life care. Among 57 753 decedents, approximately half of the patients with ESRD, cardiopulmonary failure, or frailty received palliative care consultations (adjusted proportions, 50.4%, 46.7%, and 43.7%, respectively) vs 73.5% of patients with cancer and 61.4% of patients with dementia (P < .001). Approximately one-third of patients with ESRD, cardiopulmonary failure, or frailty (adjusted proportions, 32.3%, 34.1%, and 35.2%, respectively) died in the intensive care unit, more than double the rates among patients with cancer and those with dementia (13.4% and 8.9%, respectively) (P < .001). Rates of excellent quality of end-of-life care reported by 34 005 decedents' families were similar for patients with cancer and those with dementia (adjusted proportions, 59.2% and 59.3%; P = .61), but lower for patients with ESRD, cardiopulmonary failure, or frailty (54.8%, 54.8%, and 53.7%, respectively; all P ≤ .02 vs patients with cancer). This quality advantage was mediated by palliative care consultation, setting of death, and a code status of do-not-resuscitate; adjustment for these variables rendered the association between diagnosis and overall end-of-life care quality nonsignificant. Family-reported quality of end-of-life care was significantly better for patients with cancer and those with dementia than for patients with ESRD, cardiopulmonary failure, or frailty, largely owing to higher rates of palliative care consultation and do-not-resuscitate orders and fewer deaths in the intensive care unit among patients with cancer and those with dementia. Increasing access to palliative care and goals of care discussions that address code status and preferred setting of death, particularly for patients with end-organ failure and frailty, may improve the overall quality of end-of-life care for Americans dying of these illnesses.

Title: Care of Patients at the End of Life: Management of Nonpain Symptoms. Author(s): Baralatei, Florence T; Ackermann, Richard J Source: FP essentials; Aug 2016; vol. 447 ; p. 18-24 Abstract: Management of nonpain symptoms can improve quality of life for patients at the end of life and their family members. Constipation is the most common nonpain symptom. It can be related to opioid therapy and/or medical conditions. After abdominal examination to detect masses or evidence of bowel obstruction and rectal examination to exclude fecal impaction, constipation should be managed with a stimulant laxative (eg, senna) or an osmotic laxative (eg, sorbitol). Dyspnea also is common, and often improves with use of a fan to blow air into the face, as well with breathing and relaxation exercises. However, many patients require titrated doses of opioids to address respiratory depression, and anxiolytics such as haloperidol may be needed to manage dyspnea-related anxiety. Oxygen typically is not effective in dyspnea management in nonhypoxemic patients at the end of life. Cough is managed with antitussives. Nausea and vomiting occur in 70% of patients in palliative care units. If no reversible etiology can be identified, dopamine antagonists and motility-enhancing drugs can be used. There are no clearly effective treatments to manage noisy respiratory secretions, but position change, decrease in fluid intake, and drugs such as scopolamine or glycopyrrolate may be effective. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

Title: Palliative Care in the Emergency Department. Author(s): McEwan, Alyssia; Silverberg, Joshua Z Source: Emergency medicine clinics of North America; Aug 2016; vol. 34 (no. 3); p. 667-685 Abstract: As the geriatric population increases in the United States, there is an increase in number of visits to emergency departments for end-of-life and palliative care. This provides the emergency physician with a unique opportunity to alleviate and prevent further suffering in this vulnerable population. Competency in communication strategies that support shared decision making and familiarity with medicolegal terminology increase physician confidence about addressing complaints at the end of life. Familiarity with evidence-based recommendations for symptom management of pain at the end of life aids the emergency physician in creating a positive experience for the patient and their loved ones. Copyright ÂŠ 2016 Elsevier Inc. All rights reserved.

BOOKS BACK TO TOP If you are unable to find a book, or require a book that is not on this list, please ask library staff who will be able to locate the book for you using interlibrary loan. Please note that some books detailed below may not be available in your local library and would need to be ordered for you.

Advanced practice palliative nursing Dahlin, C et al 2016

Care at the end of life Round, J 2016

From the back of the book: Advanced Practice Palliative Nursing is the first text devoted to advanced practice nursing care of the seriously ill and dying. This comprehensive work addresses all aspects of palliative care including physical, psychological, social, and spiritual needs. Chapters include: symptoms common in serious illness, pediatric palliative care, spiritual and existential issues, issues around the role and function of the advanced practice nurse (APN), reimbursement, and nursing leadership on palliative care teams. Each chapter contains case examples and a strong evidence base to support the highest quality of care. The text is written by leaders in the field and includes authors who have pioneered the role of the advanced practice nurse in palliative care. This volume offers advanced practice content and practical resources for clinical practice across all settings of care and encompassing all ages, from pediatrics to geriatrics.

From the back of the book: This work carefully guides the reader through the methodological, policy and ethical challenges facing health economists conducting research in palliative care. It has collected the opinions of many cutting-edge researchers. Those who design and conduct economic evaluations or economics-related research in end of life populations will find this book thought provoking, instructive and informative. The provision of care to individuals with disorders associated with advancing age, such as cancer and dementia, is an increasing concern amongst policy makers and providers of health and social care. Accordingly, the burden on state and private funders in providing care to patients with these complex illnesses is of growing importance to health economists. However, answering the questions raised by the research community on end of life and palliative care health economics has received little attention. The authors shed light on many questions including: Are economic evaluation methods fit for purpose in patients at the end of life? What is the best way to measure and value health outcomes in this population? What are the appropriate societal rules to govern resource allocation for people at the end of life? Are these people more or less deserving of resources than other patients? Does age matter? How can we define a good death for the purposes of resource allocation decision making? What ethics govern research in end of life patients?

Taunton and SomPar NHS staff - Have you visited the Proquest Ebook Central catalogue? Follow the links below and login via OpenAthens to read online books free for 5-10 minutes each day, send requests for eBook loans or purchase suggestions eBook catalogue About OpenAthens

GUIDELINES BACK TO TOP NICE Guidelines Current Guideline NG31- Care of dying adults in the last days of life- December 2015

Updated Guideline CG140- Palliative care for adults: strong opioids for pain relief- updated August 2016

UPTODATE BACK TO TOP Whatâ&#x20AC;&#x2122;s new from our clinical decision-making tool on the topic of end of life care. UpToDate (Access for Musgrove Park Staff only) Please contact library staff for details on how to access these resources; you will need an Athens password.

REPORTS, PUBLICATIONS AND RESOURCES BACK TO TOP SCIE (Social Care Institute for Excellence) End of Life Care National Council for Palliative Care

European Association for Palliative Care European Association for Palliative Care th

14 World Congress of the European Association for Palliative Care- information from the 14 World Congress of the European Association for Palliative Care, held in May 2015 Royal College of Physicians Palliative and end of life care toolkit

National Institute for Health Research Themed review- Better Endings: Right care, right place, right time NHS England Transforming end of life care in hospitals: the route to success ‘how to’ guide e-Learning for Healthcare End of life care: e-learning modules to support NICE Guideline NG31 Care of Dying Adults in the Last Days of Life

Ambitions for Palliative and End of Life Care: A national framework for local action 2015-2020 New ambitions raise the bar for end of life care. National framework for action urges local leadership to be at forefront of improvement in end of life care. The National Palliative and End of Life Care Partnership, made up of statutory bodies including NHS England, the Association of Adult Social Services, charities and groups representing patients and professionals has developed a framework for action in making palliative and end of life care a priority at local level. Each community is prepared to help- Guidance on Ambition 6 of the national framework New guidance has been published which includes practical advice aimed at strengthening the capacity of communities to care for dying people and their families. The guidance – entitled Each Community is Prepared to Help - has been produced by the National Council for Palliative Care (NCPC), Public Health Palliative Care UK and Hospice UK. It contains a range of practical ideas for working with hospices, hospitals, Health & Wellbeing Boards, Clinical Commissioning Groups and other relevant organisations in rolling out community development in end of life care. NEW National Council for Palliative Care report The National Council for Palliative Care (NCPC) have published a new report Staff prepared to care? Capacity and competence in the end of life care workforce. CQC Review A different ending: End of life care review This review of end of life care found that people from certain groups in society sometimes experience poorer quality care because providers do not always understand or fully consider their needs. In light of this, the report argues that some commissioners and providers might not be fulfilling their duties under the Equality Act 2010 as all public bodies have a legal duty to consider the needs of a range of equality groups when carrying out their day-to-day work. The review identified examples of good practice, but found that action is needed to make sure everyone has the same access to high quality, personalised care at the end of their lives, regardless of their diagnosis, age, ethnic background, sexual orientation, gender identity, disability or social circumstances. NHS Employers End-of-life care information and training End-of-life care is an important subject. It gives more choice to patients on how and where they die, and ensures that they receive high quality care as they approach the end of their lives. We are working with Health Education England on a new programme of work which aims to support and encourage NHS organisations to invest in the education and training of staff to deliver high quality, end-of-life care.

End-of-life care webinar In this end-of-life care webinar we hear from guest speakers who share their knowledge and experience in this important area of healthcare, including:   

information around the roles of NHS Employers and Health Education England in supporting the end-of-life care agenda good practice from Hampshire Hospitals NHS Foundation Trust about how it is improving end-of-life care for patients through the education and training of staff guidance on starting conversations with patients at the end of life.

Tailored end-of-life care training This case study outlines how the palliative care and end-of-life care specialists at Leeds Teaching Hospitals offered bespoke departmental teaching and focused interventions to improve care within specific clinical areas. Staff at the trust reported an improvement in their skills and confidence in symptom management; facilitating endof-life care at home; recognising end of life; and knowledge of community services. The success of this approach has led to the training being rolled out to other clinical areas across the trust.

TOPIC ALERTS AND UPDATES BACK TO TOP ABSTRACTS AVAILABLE VIA LINKS BELOW- FOR FULL-TEXT PLEASE ASK LIBRARY STAFF

Anxiety as A Predictor for Cognitive Decline and Dementia: A Systematic Review and Meta-Analysis Am J Geriatr Psychiatry. Published online July 4, 2016. A Phase II Study of Fornix Deep Brain Stimulation in Mild Alzheimer’s Disease Journal of Alzheimer's Disease, vol. Preprint, no. Preprint, pp. 1-11, 2016 FREE FULL TEXT Evaluation of Tau Imaging in Staging Alzheimer Disease and Revealing Interactions Between βAmyloid and Tauopathy JAMA Neurol. Published online July 25, 2016 Cognitive interventions in Alzheimer's and Parkinson's diseases: emerging mechanisms and role of imaging Curr Opin Neurol. 2016;29(4):405-411 FREE FULL TEXT Calcium supplementation and risk of dementia in women with cerebrovascular disease Neurology, Published online before print August 17, 2016 Negative Aging Stereotypes Impair Performance on Brief Cognitive Tests Used to Screen for Predementia J Gerontol B Psychol Sci Soc Sci (2016) First published online: July 27, 2016

TWITTER BACK TO TOP The latest from popular Twitter pages dedicated to end of life care: PLEASE NOTE LINKS WORK BETTER IN CHROME BROWSER End of Life Studies @EndofLifeStudy Public Health Palliative Care @PHPalCare European Association for Palliative Care @EAPCOnlus Cicely Saunders Institute @CSI_KCL Palliative Medicine Journal @PalliativeMedJ

TRAINING & NETWORKING OPPORTUNITIES, CONFERENCES, EVENTS BACK TO TOP

Ongoing training: events throughout the yearhttp://www.endoflifecareintelligence.org.uk/events/

15 World Congress of the European Association for Palliative Care- 11 -13 May 2017, Madrid th

5 International Public Health and Palliative Care Conference- 18 - 20 September 2017, Ottawa, Ontario, Canada- Includes links to past conferences and presentations

LITERATURE SEARCH SERVICE BACK TO TOP Looking for the latest evidence-based research but havenâ&#x20AC;&#x2122;t got time to trawl the databases? Do you need a literature search carried out? Do you need to find evidence to support an improvement? Do you want to know how something has been done elsewhere and whether it worked?

Library staff provide a literature search service for busy clinicians who are pressed for time.

To request a search please complete and return the appropriate form, providing as much information as possible. Alternatively if you would like an assisted search training session, where we will sit down with you and go through the steps of a literature search, then please contact the library. Musgrove staff click here to access literature search form Somerset Partnership staff click here to access literature search form

TRAINING AND ATHENS BACK TO TOP Most electronic resources are available via an Athens password. You can register for this via the Library intranet page, or from home at www.swice.nhs.uk and following the link for Athens selfregistration. Please note that registering from home will take longer as it will need to be verified that you are NHS staff/student on placement. The library offers training on how to access and use Athens resources, as well as an introductory course on critical appraisal. You can book a course through the Learning and Development intranet page, or by contacting the library directly.