How integrated are neurology and palliative care services? Results of a multicentre mapping exercise

Background: Patients affected by progressive long-term neurological conditions might benefit from specialist palliative care involvement. However, little is known on how neurology and specialist palliative care services interact. This study aimed to map the current level of connections and integration between these services. Methods: The mapping exercise was conducted in eight centres with neurology and palliative care services in the United Kingdom. The data were provided by the respective neurology and specialist palliative care teams. Questions focused on: i) catchment and population served; ii) service provision and staffing; iii) integration and relationships. Results: Centres varied in size of catchment areas (39-5,840 square miles) and population served (142,000-3,500,000). Neurology and specialist palliative care were often not co-terminus. Service provisions for neurology and specialist palliative care were also varied. For example, neurology services varied in the number and type of provided clinics and palliative care services in the settings they work in. Integration was most developed in Motor Neuron Disease (MND), e.g., joint meetings were often held, followed by Parkinsonism (made up of Parkinson’s Disease (PD), Multiple-System Atrophy (MSA) and Progressive Supranuclear Palsy (PSP), with integration being more developed for MSA and PSP) and least in Multiple Sclerosis (MS), e.g., most sites had no formal links. The number of neurology patients per annum receiving specialist palliative care reflected these differences in integration (range: 9–88 MND, 3–25 Parkinsonism, and 0–5 MS). Conclusions: This mapping exercise showed heterogeneity in service provision and integration between neurology and specialist palliative care services, which varied not only between sites but also between diseases. This highlights the need and opportunities for improved models of integration, which should be rigorously tested for effectiveness

Endometriosis and its influence on woman's life

This work is about gynecological disease, whose incidence is evergrowing, end metriosis. Endometriosis is in itself a very controversial disease, which is sign ificant intervening into life of a woman. Endometriosis is a common gynecological di sorder affecting fertile female population. It is the disease, that is presented by functional endometrial glandules and stroma outside their usuallocality within uterus (womb). General symptoms are pain and infertility. The diagnostic key is the cyclic character of symptom s and laparoscopy - histology testification presence of lesions. Tbe surgical treatment of endometriosis is considered as a golden standard of the therapy. My aim of this work is to have look up to aH sections of the disease. At the same time my work covers survey. I detected prospective abnormalities with theoretic knowledges via fonns distributed to patients with endometriosis. The fonn appraised frequen y oť symptoms in patiens. It presents the most frequent age group of disabled women as well. Fonns a1so outline dilernma of arguments about character of creation and it observes problems of indisposed women and possibility oftheir naturally gravidity. It also deals of possibilities of available therapy and its use in patients. ln no little importance my work adverts to next facts des rving next..

Additional file 2: of How integrated are neurology and palliative care services? Results of a multicentre mapping exercise

Catchment areas, population served and patients seen for neurology and palliative care services. This file contains in-depth information about the catchment areas, population served and patients seen for neurology and palliative care services, for the sites involved in the mapping exercise. (DOCX 22 kb