Palliative Care in Africa and the Caribbean

In many of the world's poorest countries, dying is often accompanied by avoidable pain and other distressing symptoms. How can we improve care at the end of life

To fly or not to fly : Factors influencing the flight capacity of carabid beetles (Coleoptera: Carabidae)

This review considers factors affecting the flight capacity of carabid beetles and the implications of flight for carabids. Studies from the Dutch polders in particular show that young populations of carabids consist predominantly of macropterous species and macropterous individuals of wing-dimorphic species. Also populations of wing-dimorphic carabid species at the periphery of their geographical range contain high proportions of macropterous individuals. However, studies from Baltic archipelagos show that older populations of even highly isolated island habitats contain considerable proportions of brachypterous species and individuals. This suggests that macroptery is primarily an adaptation for dispersal and that there exists a mechanism for subsequently reducing the ratio of macropterous to brachypterous species under stable conditions, due to the competitive advantage of brachyptery. Populations in isolated habitats, such as islands and mountains, have high proportions of brachypterous species. Many macropterous species do not possess functional flight muscles. Species of unstable habitats, such as tree canopies and wet habitats, are mostly macropterous. Brachypterous species tend to disappear from disturbed habitats. There is uncertainty regarding the extent to which carabid dispersal is directed and how much passive. Both Den Boer and Lindroth recognized that mostly macropterous individuals of macropterous and wing-dimorphic species disperse and found new populations, after which brachyptery tends to rapidly appear and proliferate in the newly founded population. It is most likely that the allele for brachyptery would arrive via the dispersal of gravid females which had mated with brachypterous males prior to emigration. Whilst many studies consider wing morphology traits of carabid beetles to be species-specific and permanent, a number of studies have shown that the oogenesis flight syndrome, whereby females undertake migration and subsequently lose their flight muscles by histolysis before eventually regenerating them after reproducing, has been reported for a growing number of carabid species. Wing morphology of carabid beetles clearly offers strong potential for the study of population dynamics. This field of study flourished during the 1940's to the late 1980's. Whilst a considerable amount of valuable research has been performed and published, the topic clearly holds considerable potential for future study.Peer reviewe

Redefining palliative care-a new consensus-based definition

Context: The International Association for Hospice and Palliative Care developed a consensus-based definition of palliative care (PC) that focuses on the relief of serious health-related suffering, a concept put forward by the Lancet Commission Global Access to Palliative Care and Pain Relief. Objective: The main objective of this article is to present the research behind the new definition. Methods: The three-phased consensus process involved health care workers from countries in all income levels. In Phase 1, 38 PC experts evaluated the components of the World Health Organization definition and suggested new/revised ones. In Phase 2, 412 International Association for Hospice and Palliative Care members in 88 countries expressed their level of agreement with the suggested components. In Phase 3, using results from Phase 2, the expert panel developed the definition. Results: The consensus-based definition is as follows: Palliative care is the active holistic care of individuals across all ages with serious health-related suffering due to severe illness and especially of those near the end of life. It aims to improve the quality of life of patients, their families and their caregivers. The definition includes a number of bullet points with additional details as well as recommendations for governments to reduce barriers to PC. Conclusion: Participants had significantly different perceptions and interpretations of PC. The greatest challenge faced by the core group was trying to find a middle ground between those who think that PC is the relief of all suffering and those who believe that PC describes the care of those with a very limited remaining life span

Redefining Palliative CaredA New Consensus-Based Definition

Context. The International Association for Hospice and Palliative Care developed a consensus-based definition of palliative care (PC) that focuses on the relief of serious health-related suffering, a concept put forward by the Lancet Commission Global Access to Palliative Care and Pain Relief. Objective. The main objective of this article is to present the research behind the new definition. Methods. The three-phased consensus process involved health care workers from countries in all income levels. In Phase 1, 38 PC experts evaluated the components of the World Health Organization definition and suggested new/revised ones. In Phase 2, 412 International Association for Hospice and Palliative Care members in 88 countries expressed their level of agreement with the suggested components. In Phase 3, using results from Phase 2, the expert panel developed the definition. Results. The consensus-based definition is as follows: Palliative care is the active holistic care of individuals across all ages with serious health-related suffering due to severe illness and especially of those near the end of life. It aims to improve the quality of life of patients, their families and their caregivers. The definition includes a number of bullet points with additional details as well as recommendations for governments to reduce barriers to PC. Conclusion. Participants had significantly different perceptions and interpretations of PC. The greatest challenge faced by the core group was trying to find a middle ground between those who think that PC is the relief of all suffering and those who believe that PC describes the care of those with a very limited remaining life span

Applying Key Lessons from the Hospice and Palliative Care Movement to Inform Psychedelic-Assisted Therapy

BACKGROUND: Psychedelic-assisted therapy (PAT) has re-emerged as a promising intervention for addressing mental health conditions and existential concerns. Despite growing enthusiasm, PAT may be difficult to integrate into mainstream health systems. The rich sacramental traditions of psychedelics, their centering of the human experience, proposed substrates of action, context-dependent outcomes, and highly relational method of therapy all challenge dominant reductionistic approaches of the biomedical model. Hospice and palliative care are well established as holistic evidence-based standards of care, yet they began as a radical grassroots movement. Hospice and palliative care models may offer unique insights to support the growing field of PAT. PURPOSE: The intention of this commentary is to articulate the deep synergies between hospice and palliative care and PAT, with the intention of fostering interdisciplinary dialogue that may aid in implementation of human-centered high-quality PAT. CONCLUSIONS: Various aspects of hospice and palliative care models were identified and explored, which may support the implementation of human-centered high-quality PAT at scale. These include a focus on truly interdisciplinary care, applying a holistic lens to health and illness, bearing witness to suffering and healing, customized care, centering human relationships, decentralized models of care, generalist/specialist competencies, fostering spirituality, organizing as a social moment around shared goals, and growth from grassroots community organizations to mature care systems. Although hospice and palliative care can offer practical lessons for scaling human-centered experiential therapies, PAT, with its radical centering of meaning-making and relationship in the healing process, may also mutually innovate the fields of hospice and palliative care