Explorations In Collections Care: Martin And Osa Johnson Glass Negatives In The Permanent Collection At The George Eastman House

This paper discusses a professional practical project that dealt with the collections care undertaken for one instance of found-in-collections material. Consisting of 336 four-by-five and five-by-seven gelatin glass plate negatives by American travel and wildlife filmmakers Martin and Osa Johnson, the material had been cared for in the vaults of the permanent collection at the George Eastman House International Museum of Photography and Film for many years without the establishment of official acquisition or public accessibility. The project discussed in this paper involved the trajectory of care required to make the Johnson material available, including provenance research, official acquisition, registration documentation, cataloguing, and housing improvements. The paper discusses this process, analyzing decisions made from issues of arrangement to culturally-sensitive description in associated cataloguing records. Finally, this paper suggests avenues for potential use of the Johnson material, arguing for the possibilities afforded by accessibility.

Explorations In Collections Care: Martin And Osa Johnson Glass Negatives In The Permanent Collection At The George Eastman House

This paper discusses a professional practical project that dealt with the collections care undertaken for one instance of found-in-collections material. Consisting of 336 four-by-five and five-by-seven gelatin glass plate negatives by American travel and wildlife filmmakers Martin and Osa Johnson, the material had been cared for in the vaults of the permanent collection at the George Eastman House International Museum of Photography and Film for many years without the establishment of official acquisition or public accessibility. The project discussed in this paper involved the trajectory of care required to make the Johnson material available, including provenance research, official acquisition, registration documentation, cataloguing, and housing improvements. The paper discusses this process, analyzing decisions made from issues of arrangement to culturally-sensitive description in associated cataloguing records. Finally, this paper suggests avenues for potential use of the Johnson material, arguing for the possibilities afforded by accessibility.

First referral to an Integrated Onco-Palliative Care program: a retrospective analysis of its timing

Background: Palliative care (PC) referral is recommended early in the course of advanced cancer. This study aims to describe, in an integrated onco-palliative care program (IOPC), patient’s profile when first referred to this program, timing of this referral and its impact on the trajectory of care at end-of-life. Patients and Methods: The IOPC combined the weekly onco-palliative meeting (OPM) dedicated to patients with incurable cancer, and/or the clinical evaluation by the PC team. Oncologists can refer to the multidisciplinary board of the OPM the patients for whom goals and organization of care need to be discussed. We analyzed all patients first referred at OPM in 2011-2013. We defined the index of precocity (IP), as the ratio of the time from first referral to death by the time from diagnosis of incurability to death, ranging from 0 (late referral) to 1 (early referral). Results: Of the 416 patients included, 57% presented with lung, urothelial cancers, or sarcoma. At first referral to IOPC, 76% were receiving antitumoral treatment, 63% were outpatients, 56% had a performance status ≤2 and 46% had a serum albumin level >35g/l. The median [1st-3rd quartile] IP was 0.39 [0.16-0.72], ranging between 0.53 [0.20-0.79] (earliest referral, i.e. close to diagnosis of incurability, for lung cancer) to 0.16 [0.07-0.56] (latest referral, i.e. close to death relatively to length of metastatic disease, for prostate cancer). Among 367 decedents, 42 (13%) received antitumoral treatment within 14 days before death, and 157 (43%) died in PC units.Conclusions: The IOPC is an effective organization to enable early integration of PC and decrease aggressiveness of care near the end-of life. The IP is a useful tool to model the timing of referral to IOPC, while taking into account each cancer types and therapeutic advances.

First referral to an Integrated Onco-Palliative Care program: a retrospective analysis of its timing

Background: Palliative care (PC) referral is recommended early in the course of advanced cancer. This study aims to describe, in an integrated onco-palliative care program (IOPC), patient’s profile when first referred to this program, timing of this referral and its impact on the trajectory of care at end-of-life. Patients and Methods: The IOPC combined the weekly onco-palliative meeting (OPM) dedicated to patients with incurable cancer, and/or the clinical evaluation by the PC team. Oncologists can refer to the multidisciplinary board of the OPM the patients for whom goals and organization of care need to be discussed. We analyzed all patients first referred at OPM in 2011-2013. We defined the index of precocity (IP), as the ratio of the time from first referral to death by the time from diagnosis of incurability to death, ranging from 0 (late referral) to 1 (early referral). Results: Of the 416 patients included, 57% presented with lung, urothelial cancers, or sarcoma. At first referral to IOPC, 76% were receiving antitumoral treatment, 63% were outpatients, 56% had a performance status ≤2 and 46% had a serum albumin level >35g/l. The median [1st-3rd quartile] IP was 0.39 [0.16-0.72], ranging between 0.53 [0.20-0.79] (earliest referral, i.e. close to diagnosis of incurability, for lung cancer) to 0.16 [0.07-0.56] (latest referral, i.e. close to death relatively to length of metastatic disease, for prostate cancer). Among 367 decedents, 42 (13%) received antitumoral treatment within 14 days before death, and 157 (43%) died in PC units.Conclusions: The IOPC is an effective organization to enable early integration of PC and decrease aggressiveness of care near the end-of life. The IP is a useful tool to model the timing of referral to IOPC, while taking into account each cancer types and therapeutic advances.

First referral to an Integrated Onco-Palliative Care program: a retrospective analysis of its timing

Background: Palliative care (PC) referral is recommended early in the course of advanced cancer. This study aims to describe, in an integrated onco-palliative care program (IOPC), patient’s profile when first referred to this program, timing of this referral and its impact on the trajectory of care at end-of-life.Patients and Methods: The IOPC combined the weekly onco-palliative meeting (OPM) dedicated to patients with incurable cancer, and/or the clinical evaluation by the PC team. Oncologists can refer to the multidisciplinary board of the OPM the patients for whom goals and organization of care need to be discussed. We analyzed all patients first referred at OPM in 2011-2013. We defined the index of precocity (IP), as the ratio of the time from first referral to death by the time from diagnosis of incurability to death, ranging from 0 (late referral) to 1 (early referral).Results: Of the 416 patients included, 57% presented with lung, urothelial cancers, or sarcoma. At first referral to IOPC, 76% were receiving antitumoral treatment, 63% were outpatients, 56% had a performance status ≤2 and 46% had a serum albumin level >35g/l. The median [1st-3rd quartile] IP was 0.39 [0.16-0.72], ranging between 0.53 [0.20-0.79] (earliest, for lung cancer) to 0.16 [0.07-0.56] (latest relatively to length of metastatic disease, for prostate cancer). Among 367 decedents, 42 (13%) received antitumoral treatment within 14 days before death, and 157 (43%) died in PC units.Conclusions: The IOPC is an effective organization to enable early integration of PC and decrease aggressiveness of care near the end-of life. The IP is a useful tool to model the timing of referral to IOPC, while taking into account each cancer types and therapeutic advances.

First referral to an Integrated Onco-Palliative Care program: a retrospective analysis of its timing

Background : Palliative care (PC) referral is recommended early in the course of advanced cancer. This study aims to describe, in an integrated onco-palliative care program (IOPC), patient’s profile when first referred to this program, timing of this referral and its impact on the trajectory of care at end-of-life. Patients and Methods : The IOPC combined the weekly onco-palliative meeting (OPM) dedicated to patients with incurable cancer, and/or the clinical evaluation by the PC team. Oncologists can refer to the multidisciplinary board of the OPM the patients for whom goals and organization of care need to be discussed. We analyzed all patients first referred at OPM in 2011-2013. We defined the index of precocity (IP), as the ratio of the time from first referral to death by the time from diagnosis of incurability to death, ranging from 0 (late referral) to 1 (early referral). Results: Of the 416 patients included, 57% presented with lung, urothelial cancers, or sarcoma. At first referral to IOPC, 76% were receiving antitumoral treatment, 63% were outpatients, 56% had a performance status ≤2 and 46% had a serum albumin level >35g/l. The median [1 st -3 rd quartile] IP was 0.39 [0.16-0.72], ranging between 0.53 [0.20-0.79] (earliest, for lung cancer) to 0.16 [0.07-0.56] (latest, for prostate cancer). Among 367 decedents, 42 (13%) received antitumoral treatment within 14 days before death, and 157 (43%) died in PC units. Conclusions : The IOPC is an effective organization to enable early integration of PC and decrease aggressiveness of care near the end-of life. The IP is a useful tool to model the trajectory of care while taking into account each cancer types and therapeutic advances.

First referral to an Integrated Onco-Palliative Care program: a retrospective analysis of its timing

Background Palliative care (PC) referral is recommended early in the course of advanced cancer. This study aims to describe, in an integrated onco-palliative care program (IOPC), patient’s profile when first referred to this program, timing of this referral and its impact on end-of-life care. Patients and Methods The IOPC combined the weekly onco-palliative meeting (OPM) dedicated to patients for whom goals and organization of care need to be discussed, and/or the clinical evaluation by the PC team. We analyzed all patients first referred at OPM in 2011-2013. We defined the index of precocity (IP), as the ratio of the time from first referral to death by the time from diagnosis of incurability to death, ranging from 0 (late referral) to 1 (early referral). Results Of the 416 patients included, 57% presented with lung, urothelial cancers, or sarcoma. At first referral to IOPC, 76% were receiving antitumoral treatment, 63% were outpatients, 56% had a PS ≤2 and 46% had a serum albumin level >35g/l. The median [1st-3rd quartile] IP was 0.39 [0.16-0.72], ranging between 0.53 [0.20-0.79] (earliest, for lung cancer) to 0.16 [0.07-0.56] (latest, for prostate cancer). Among 367 decedents, 42 (13%) received antitumoral treatment within 14 days before death, and 157 (43%) died in PC units. Conclusions The IOPC is an effective organization to enable early integration of PC and decrease aggressiveness of care near the end-of life. The IP is a useful tool to model the trajectory of care while taking into account each cancer types and therapeutic advances.

Disorders of Consciousness in Clinical Practice

“Disorders of Consciousness in Clinical Practice” considers the ethical, legal, and policy considerations of working with patients and families with severe brain injury. Topics include professional obligations to patients with disorders of consciousness and the ethical implications of coma, brain death and the vegetative and minimally conscious state as well as their diagnostic classification based on behavioral and neuroimaging assessment. The normative challenge of covert consciousness is considered. Clinical, ethical and communication strategies for working with patients with impaired decision-making capacity and their families and surrogates are presented along a typical trajectory of care from initial presentation, intensive care, and discharge to rehabilitation and/or long-term care. End-of-life care, neuropalliation, and bereavement are also discussed as are ancillary care obligations to this marginalized and vulnerable population. Broader policy needs such as access to care is discussed in the context of civil and disability rights.

Responding to Children When Their Parents are Incarcerated: Exploring the Responses in Victoria and New South Wales, Australia

There is considerable research conducted over the past 50 years which describes the impact on children of parental incarceration. Research has also focused on describing the care arrangements of such children. Yet there has been no specific examination of the trajectory of care for these children, the processes surrounding this care, or its resultant quality. This article reports the findings of an ARC funded study examining care planning processes in Victoria and New South Wales for these children. We concentrate in this paper on a subset of data from 124 professional stakeholders, who commented on their experiences of responding to children, in the context of their organisational remit, processes and expectations. Findings indicate that children of prisoners are largely invisible in adult organisations and that there are typically poor or poorly understood interagency protocols to respond to these children. Respondents report relying on informal information, networks and resources and working outside of their role to meet the needs of children. Clear suggestions are made for improvements, including developing child-sensitive services; a child-focused approach and clearer protocols and guidelines for working with others.