What "best practice" could be in Palliative Care: an analysis of statements on practice and ethics expressed by the main Health Organizations

<p>Abstract</p> <p>Background</p> <p>In palliative care it would be necessary to refer to a model. Nevertheless it seems that there are no official statements which state and describe that model. We carried out an analysis of the statements on practice and ethics of palliative care expressed by the main health organizations to show which dimensions of end-of-life care are taken into consideration.</p> <p>Methods</p> <p>The official documents by the most representative health organisations committed to the definition of policies and guidelines for palliative and end-of-life care had been considered. The documents were analysed through a framework of the components of end-of-life care derived from literature, which was composed of 4 main "areas" and of 12 "sub-areas".</p> <p>Results</p> <p>Overall, 34 organizations were identified, 7 international organisations, and 27 organisations operating on the national level in four different countries (Australia, Canada, UK and United States). Up to 56 documents were selected and analysed. Most of them (38) are position statements. Relevant quotations from the documents were presented by "areas" and "sub-areas". In general, the "sub-areas" of symptoms control as well as those referring to relational and social issues are more widely covered by the documents than the "sub-areas" related to "preparation" and to "existential condition". Indeed, the consistency of end-of-life choices with the patient's wishes, as well as completion and meaningfulness at the end of life is given only a minor relevance.</p> <p>Conclusions</p> <p>An integrated model of the best palliative care practice is generally lacking in the documents. It might be argued that the lack of a fixed and coherent model is due to the relevance of unavoidable context issues in palliative care, such as specific cultural settings, patient-centred variables, and family specificity. The implication is that palliative care staff have continuously to adapt their model of caring to the specific needs and values of each patient, more than applying a fixed, although maybe comprehensive, care model.</p

Na mira do olhar: um exercício de análise da fotografia nas revistas ilustradas cariocas, na primeira metade do século XX

This article presents a historical approach for the analysis of photographic images, followed by the application of these theoretical and methodological considerations to a series of photographs issued in two popular magazines, published in the city of Rio de Janeiro between 1900 and 1960. Through the analysis of the photographic message, class behaviour codes are related to their social representations.Este artigo traz considerações sobre a análise histórica de imagens fotográficas, aplicando as propostas teórico-metodológicas apresentadas a uma série fotográfica composta pelas imagens de duas revistas ilustradas, Careta e O Cruzeiro, publicadas na cidade do Rio de Janeiro entre 1900 e 1960. Por meio da análise da mensagem fotográfica relaciona-se a elaboração dos códigos de comportamento de classe às suas representações sociais

O caso da destruição das pinturas murais da sede da Fazenda Rialto, Bananal

This article is about the eighteenth century mural paintings at the headquarters of Fazenda Rialto, in Bananal, which were destroyed in 1996. These constituted one of the most important sets of ambient paintings with secular themes produced in the state of São Paulo during the period corresponding to the first cycle of coffee production. Orally attributed to the painter José Maria Villaronga y Panella, all that remains of these paintings are some photographs and dozens of fragments, impossible to reassemble. Studying the fragments of the paintings of Rialto as primary material documents, the main objective of this article is to identify the artistic, technical, and executive characteristics of three sets of murals attributed to a single painter. A methodology which combines laboratory tests and historical research on artistic techniques was adopted for objectively recognizing the artistic and artisan characteristics of the period and discussing the attribution of exclusive authorship to the work. The analytical systems adopted for this purpose were: examination with ultraviolet and infra-red radiation, optical microscopy, Scanning Electron Microscopy (SEM) and Energy Dispersive Spectrometry (EDS) to analyze its chemical elements. Issues related to the limitations on official Brazilian preservation activities for this category of artistic work were also discussed, reflecting on the development and changes in notions of historicity related to the preservation of works from the past and their methodological implications for conservation and restoration.Este artigo trata dos murais artísticos oitocentistas da sede da Fazenda Rialto, em Bananal, destruídos em 1996, que constituíam um dos mais importantes conjuntos de pinturas ambientais de temática profana produzidos no Estado de São Paulo no período correspondente ao primeiro ciclo da cultura do café. Atribuídas oralmente ao pintor José Maria Villaronga y Panella, dessas pinturas restaram apenas algumas fotografias e centenas de fragmentos, de impossível reassemblagem. Estudando-se os fragmentos de pintura da Rialto como documento material primário, o trabalho apresentado tem como principal objetivo a identificação das características artísticas e tecnoexecutivas de três conjuntos de murais tributados a um mesmo pintor. Para reconhecimento objetivo dos fazeres artístico-artesanais do período e discussão da atribuição de autoria exclusiva, adotou-se uma metodologia que combina exames laboratoriais e pesquisa histórica das técnicas artísticas. Os sistemas analíticos adotados para esse fim foram: exame com radiação ultravioleta e infravermelha, microscopia óptica, microscopia eletrônica de varredura (MEV) e espectroscopia de energia dispersiva (EDS) para análise química elementar. Discutem-se também questões relativas aos limites da ação preservacionista oficial brasileira sobre essa categoria de obra artística, refletindo sobre o desenvolvimento e as mudanças das noções de historicidade relativas à preservação dos bens do passado e suas implicações metodológicas nos conceitos de conservação e restauro

Christopher Hitchens' Public dying: Toward a Secular-Humanist Ars Moriendi?

This article explores the public dying of journalist, writer, provocateur, public intellectual, and renowned atheist, Christopher Hitchens. It does so primarily through an analysis of television interviews given by Hitchens following his diagnosis with esophageal cancer in June 2010. Four key themes are identified as emerging from analysis of the interviews: (a) Hitchens’ explicit sense of mission in challenging myths and superstitions surrounding cancer, dying, and death; (b) the personal experience of terminal illness and dying and the particular way (or style of dying) by which it is approached; (c) issues of regret and a life well lived; and (d) questions surrounding religion, the afterlife, and possibility of deathbed conversion. In light of the claim that ours is a culture in search of an ars moriendi, the article examines what we can learn from Hitchens’ auto/pathographic interviews (and writings) and the extent to which this rational-humanist, atheistic, and stoical style of dying provides a useable “template” for others nearing the end of life