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Textbook of Palliative Medicine provides an alternative, truly international approach to this rapidly growing specialty. This textbook fills a niche with its evidence-based, multi-professional approach and global perspective ensured by the international team of editors and contributing authors. In the absence of an international ‘curriculum' for the study of palliative medicine, this textbook provides essential guidance for those both embarking upon a career in palliative medicine or already established in the field, and the structure and content have been constructed very much with this in mind. With an emphasis on providing a service anywhere in the world, including the important issue of palliative care in the developing nations, Textbook of Palliative Medicine offers a genuine alternative to the narrative approach of its competitors, and is an ideal complement to them. It is essential reading for all palliative care physicians in training and in practice, as well as palliative care nurses and other health professionals in the palliative care team. Evidence-based approach to modern palliative care practice focusing on what the palliative physician in training or in practice needs to know Multidisciplinary in approach reflecting the needs of the palliative care team Designed to shape current thinking and future planning of care - establishing an 'unofficial' international curriculum for the study of palliative medicine Presenting a truly global perspective with particular emphasis on practice in continental Europe and North America as well as the UK Also addresses the important issue of palliative care in the less developed nations Exemplary editorial team and renowned list of contributors Table of Contents: PART 1 The development of palliative medicine in: the UK and Ireland Europe Canada the USA Latin America Africa Australia and New Zealand Asia Palliative care versus palliative medicine Palliative care as a public heath issue The future of palliative medicine PART 2 Principles of bioethics Ethics Dignity PART 3 Dying in different cultures Palliative care global initiatives PART 4 Undergraduate Graduate Postgraduate and continuing education Public education PART 5 Challenges of research The patient population Research designs Outcomes Ethics in research Practical tips for successful research Audit and quality improvement PART 6 Standards of care The engineering of organizational change Financial issues in the delivery of palliative care Organization and support of the multiprofessional / interdisciplinary team Needs assessment for patient care The palliative care consult team Models for palliative care delivery Home care Day hospitals Inpatient hospices The palliative care unit Combined care models PART 7 Patient assessment Tools for pain and symptom assessment Quality of life assessment PART 8 The pathophysiology of chronic pain Causes & mechanisms of pain Opioid analgesics The assessment and management of opioid side effects Adjuvant analgesic drugs Alternative routes for systemic opiod delivery Epidural & intrathecal administration Topical administration of analgesics Non-pharmacological and non-invasive management of pain Pain in children Pain in the elderly Neuropathic pain Bone pain Incidental pain Somatization and pain expression Pain in patients with alcohol and drug dependence PART 9 Pathophysiology of anorexia-cachexia Nutritional and phamacological management of cachexia Nausea/vomiting Constipation/diarrhea Ascites Jaundice Bowel obstruction The endoscopic treatment of gastrointestinal symptoms PART 10 The pathophysiology of fatigue Assessment of fatigue The role of physical function on fatigue The treatment of fatigue PART 11 Dyspnea Other respiratory symptoms PART 12 Depression/anxiety Confusion/delirium Sleeping disorders Counseling Hope PART 13 Dehydration and re-hydration Fever and sweating Pruritus Infections Pressure ulcers and wounds Mouth care Fistulas The assessment and management of lymphedema PART 14 Hypercalcemia Hemorrhage Spinal cord compression Superior venacava syndrome Seizures Acute pain syndromes Suicide PART 15 Radiotherapy Chemotherapy Physical medicine and rehabilitation Integrative and alternative medicine AIDS Neurological diseases Congestive heart failure & other causes of terminal heart disease Palliative care in children Chronic obstructive pulmonary disease & other terminal respiratory conditions Other infectious diseases Practical aspects of palliative care delivery in the developing world Prognostic indicators of survival Palliative sedation PART 16 Physiotherapy and occupational therapy Stress & burnout in health care givers Communication in palliative care Spiritual care Family care Advanced directives Bereavement Children of palliative care patients