To evaluate the impact of provision and timing of palliative care (PC) on potentially inappropriate end-of-life care to patients with cancer in a mixed generalist-specialist PC model.
 
  A retrospective population-based observational study using a national administrative health insurance database. All 43 067 adults in the Netherlands, who were diagnosed with or treated for cancer during the year preceding their death in 2017, were included. Main exposure was either generalist or specialist PC initiated >30 days before death (n=16 967). Outcomes were measured over the last 30 days of life, using quality indicators for potentially inappropriate end-of-life care.
 
  In total, 14 504 patients (34%) experienced potentially inappropriate end-of-life care; 2732 were provided with PC >30 days before death (exposure group) and 11 772 received no PC or ≤30 days before death (non-exposure group) (16% vs 45%, p<0.001). Most patients received generalist PC (88%). Patients provided with PC >30 days before death were 5 times less likely to experience potentially inappropriate end-of-life care (adjusted OR (AOR) 0.20; (95% CI 0.15 to 0.26)) than those with no PC or PC in the last 30 days. Both early (>90 days) and late (>30 and≤90 days) PC initiation had lower odds for potentially inappropriate end-of-life care (AOR 0.23 and 0.19, respectively).
 
  Timely access to PC in a mixed generalist-specialist PC model significantly decreases the likelihood of potentially inappropriate end-of-life care for patients with cancer. Generalist PC can play a substantial role.
 Timely access to PC in a mixed generalist-specialist PC model significantly decreases the likelihood of potentially inappropriate end-of-life care for patients with cancer. Generalist PC can play a substantial role.
  Pastoral care in an acute hospital setting necessarily includes some bereavement support for families of patients who die. Termed universal bereavement support, an important component of such support is provision of educational information to assist bereaved people struggling with grief. This project aimed to understand, from the perspective of those attending, the value of providing a memorial service for remembering a loved one and whether the education provided at the service successfully met the requirement of a universal bereavement support strategy.
 
  A qualitative study, comprising a semistructured telephone interview with memorial service attendees was undertaken. Data were audio recorded, transcribed and analysed thematically.
 
  Twenty-nine attendees participated. Three themes provided insights into attendees' perceptions. The first theme encapsulated the value of remembering and celebrating the life of the deceased; the second theme focused on 'finding our way through the grief process' including the value of the educational materials ; and the third theme identified appreciation for the hospital in providing care to those bereaved.
 
  The memorial service provides a valued universal bereavement support strategy and such support strategies are an important part in the process of grieving for many attendees.
 The memorial service provides a valued universal bereavement support strategy and such support strategies are an important part in the process of grieving for many attendees.
  To detect the plexus-specific retinal capillary avascular area in exudative age-related macular degeneration (EAMD) with projection-resolved optical coherence tomography angiography (PR-OCTA).
 
  In this prospective cross-sectional single centre study, eyes with treatment-naïve EAMD underwent macular 3×3 mm OCTA with AngioVue system. OCTA scans were analysed and processed including three-dimensional projection artefact removal, retinal layer semi-automated segmentation and en face angiogram generation. Automated quantification of extrafoveal (excluding the central 1 mm circle) avascular area (EAA) were calculated on projection-resolved superficial vascular complex (SVC), intermediate capillary plexus (ICP) and deep capillary plexus (DCP), respectively.
 
  Nineteen eyes with EAMD and 19 age-matched healthy control eyes were included. There was no significant difference between the EAMD and control eyes in terms of age, sex, axial length and mean ocular perfusion pressure (all p>0.05). Compared with control eyes, EAMD eyes had significantly larger EAA in SVC (median 0.125 vs 0.059 mm
  , p=0.006), ICP (0.016 vs 0.000 mm
  , p=0.004) and DCP (0.033 vs 0.000 mm
  , p＜0.001).
 
  PR-OCTA showed that EAMD is associated with focal avascular area in all the three retinal vascular plexuses.
 PR-OCTA showed that EAMD is associated with focal avascular area in all the three retinal vascular plexuses.
  To assess treatment outcomes after proton beam irradiation (PBI) without surgical localisation of uveal melanomas involving the iris, ciliary body and anterior choroid.
 
  Retrospective chart review of 125 patients evaluated at Massachusetts Eye and Ear and treated with PBI using a light field set-up without localisation surgery between November 1975 and April 2017.  https://www.selleckchem.com/products/cc-930.html  The tumours were characterised as follows iris (n=18, 14.4%), ciliary body (n=12, 9.6%), iridociliary (n=58, 46.4%), ciliochoroidal (n=24, 19.2%) and iridociliochoroidal (n=13, 10.4%). The tumours were measured by transillumination and ultrasonography before treatment. Tumours with posterior margin located less than two disc diameters from the ora serrata were treated using the light field technique. Patient outcomes after PBI were evaluated.
 
  Most patients had good vision at the time of tumour diagnosis (69.6% had baseline visual acuity (VA) of ≥20/40). Median VA at last follow-up (median follow-up 72.1 months) was 20/63. Recurrences occurred iomes after irradiation. Eye preservation and retention of good VA are seen in the majority of cases, and tumour recurrence is low.
  Compared with the current inpatient consultation model, a novel corounding model of care whereby palliative specialists round with oncology teams, increases healthcare collaboration and may improve quality of care for inpatients. Whether this translates to better pain control for patients is unexplored.
 
  To determine whether the corounding model provides better pain control compared with the consultation model for cancer inpatients.
 
  Cancer patients with moderate or severe pain severity during the admission were included in this observational study. Pain severity was determined using electronic records. Improvement to mild or no pain by day 3 of identification of moderate or severe pain was defined as good pain control and proportion of admissions achieving this was compared between models.
 
  A total of 142 and 128 admissions admitted under the consult and corounding model, respectively, had moderate or severe pain. The proportion of patients that achieved good pain control was 77.3% (99/128) and 71.8% (102/142) in the corounding and consult model, respectively.