Quality palliative care for cancer and dementia in five European countries: some common challenges.

OBJECTIVES: There is a growing consensus worldwide that palliative care needs to be both more inclusive of conditions other than cancer and to improve. This paper explores some common challenges currently faced by professionals providing palliative care for patients with either cancer or dementia across five countries. METHOD: One focus group (n=7) and 67 interviews were conducted in 2012 across five countries: England, Germany, Italy, the Netherlands and Norway, with professionals from dementia, cancer and palliative care settings. RESULTS: The interviews revealed five common challenges faced across the five countries: communication difficulties (between services; and between professionals, and patients and their families); the variable extent of structural/functional integration of services; the difficulties in funding of palliative care services; problematic processes of care (boundaries, definitions, knowledge, skills and inclusiveness) and, finally, time constraints. CONCLUSION: These are not problems distinct to palliative care, but they may have different origins and explanations compared to other areas of health care. This paper explored deeper themes hidden behind a discourse about barriers and facilitators to improving care.

Áreas corticales elocuentes: estudio con RMF bases fisiológicas, procedimiento y aplicaciones clínicas / Eloquent cortical areas: RMF study physiological bases, procedures and clinical applications

El conocimiento de la anatomía funcional del cerebro es útil para correlacionar síntomas específicos con la localización de lesiones en áreas específicas. La RM funcional es una herramienta diagnóstica no invasiva que permite estudiar funciones cerebrales en base a una técnica denominada BOLD (blood oxygenation level dependent). Si bien la principal indicación de la RMf corresponde a la evaluación prequirúrgica de tumores cerebrales, esta metodología diagnóstica también es útil, entre otras aplicaciones, para el estudio de la lateralización del lenguaje, de la memoria y de la neuroplasticidad como mecanismo compensador de daño cerebral de origen traumático o vascular.

The knowledge of the brain functional anatomy is useful to link specific symptoms with the lesion´s location in specific areas. Functional MRI is a non-invasive diagnostic tool able to visualize brain function with a technique named BOLD(blood oxygenation level dependent). The most important indication of fMRI is for presurgical planning in patients with brain tumors, moreover this technique can use to study language lateralization, memoryand neuroplasticity, among other functions.

Areas corticales elocuentes: estudio con RMF bases fisiológicas, procedimiento y aplicaciones clínicas / Eloquent cortical areas: RMF study physiological bases, procedures and clinical applications

El conocimiento de la anatomía funcional del cerebro es útil para correlacionar síntomas específicos con la localización de lesiones en áreas específicas. La RM funcional es una herramienta diagnóstica no invasiva que permite estudiar funciones cerebrales en base a una técnica denominada BOLD (blood oxygenation level dependent). Si bien la principal indicación de la RMf corresponde a la evaluación prequirúrgica de tumores cerebrales, esta metodología diagnóstica también es útil, entre otras aplicaciones, para el estudio de la lateralización del lenguaje, de la memoria y de la neuroplasticidad como mecanismo compensador de daño cerebral de origen traumático o vascular.(AU)

The knowledge of the brain functional anatomy is useful to link specific symptoms with the lesion´s location in specific areas. Functional MRI is a non-invasive diagnostic tool able to visualize brain function with a technique named BOLD(blood oxygenation level dependent). The most important indication of fMRI is for presurgical planning in patients with brain tumors, moreover this technique can use to study language lateralization, memoryand neuroplasticity, among other functions.(AU)