End-of-life care for homeless people study wins Palliative Medicine Paper of the Year award at #EAPC2019 in Berlin

Professor Catherine Walshe, Editor-in-Chief, Palliative Medicine, announces the journal’s award-winning ‘Paper of the Year’ in the closing ceremony of the 16th EAPC World Congress in Berlin.

On behalf of Palliative Medicine, the research journal of the EAPC, we are delighted to have awarded our ‘Paper of the Year’ award at the EAPC World Congress in Berlin. The paper of the year award is judged by members of the journal’s Editorial Advisory Board and myself, as editor-in-chief. This year, we are grateful to Jane Phillips, Jeroen Hasselaar and Gail Eva who carefully appraised every paper published in our 2018 print edition before deciding on our worthy winner. The process created much debate and discussion amongst our judges, given the high standard of papers published in the journal.

‘Palliative Medicine’ Paper of the Year award presented at the 16th EAPC World Congress, Berlin, to Dr Caroline Shulman and Dr Briony Hudson. Left to right: Dr Briony Hudson, Prof Catherine Walshe, Dr Caroline Shulman and Prof Christoph Ostgathe. (Photograph by Stefan Zeitz).














We are delighted to announce that this year, our paper of the year is ‘End-of-life care for homeless people: A qualitative analysis exploring the challenges to access and provision of palliative care’. Palliative Medicine, 32(1), 36–45 (https://journals.sagepub.com/doi/10.1177/0269216317717101) Written by Caroline Shulman, Briony Hudson, Joseph Low, Nigel Hewitt, Julian Daley, Peter Kennedy, Sarah Davis, Niamh Brophy, Diane Howard, Bella Vivat and Patrick Stone, this paper was commended for its focus on an important but under-researched population, rigorous methods and robust reporting.

The prize is a one-year subscription to the journal, and we made the award of this prize, along with a commemorative plaque, during the closing ceremony of the EAPC World Congress in Berlin on 25 May 2019. You can read the paper here – it is open access, so freely available to all.

Prof Catherine Walshe announcing at the winning paper.

Details of the previous winners of the award can be seen on the EAPC website. Each award is judged independently, and on its own merit, but it is pleasing to see the strength and depth of palliative care research represented here with designs including qualitative studies, trials, systematic reviews and cohort studies. Previous winning papers are internationally recognised – last year’s winning paper by Shane Sinclair was our most downloaded paper in 2018, and the review by Samantha Smith that won in 2015 also continues to attract a high number of downloads. Whilst we do not use such metrics in our judging, to avoid a temporal effect, Caroline Shulman’s winning paper from this year was our eighth most downloaded paper of the year and has an Altmetric score of 166, our 12th highest paper, and in the top five per cent of all papers scored by Altmetric.

Palliative Medicine continues to be the journal in the field with the highest impact factor, and supports active dissemination of its research through Twitter, Facebook and Instagram (@palliativemedj), as well as through this blog. To be in with a chance of winning one of our next paper of the year awards, submit your high-quality research here.

Top tips for a winning paper?

We are looking for carefully designed studies, contributing novel knowledge to our field, clearly and robustly reported. We look forward to reading your winning papers of the future.


  • Download your free copy of ‘End-of-life care for homeless people: A qualitative analysis exploring the challenges to access and provision of palliative care’. Palliative Medicine, 32(1), 36–45.
  • View the training video, ‘Homelessness and End-of-life Care’, made by Briony Hudson and Caroline Shulman on the Pathway website (Healthcare for homeless people).
  • Find out more about submitting your high-quality research to Palliative Medicine here.
  • View previous winners of the Palliative Medicine Paper of the Year award here.
  • Read Palliative Medicine Editor’s Choice posts on the EAPC blog.
  • Read more posts relating to the 16th EAPC World Congress here.
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Building a palliative care research career across borders: An interview with Dr Geana Paula Kurita, winner of the 2019 EAPC Post-doctoral Award


Highlights of every EAPC Congress are the EAPC Researcher Awards, which recognise and support the work of scientists and clinicians who make an outstanding contribution to palliative care research. 

We talk to Dr Geana Paula Kurita PhD, winner of the 2019 EAPC Post-doctoral Award, about her work as senior researcher at Rigshospitalet Copenhagen University Hospital, Denmark, and the research that has led to her award.

Dr Geana Paula Kurita delivers her plenary lecture at the 16th EAPC World Congress in Berlin.

Who, or what, inspired you to follow a career in palliative care?

Geana Paula Kurita: As a child, I always knew I would be a researcher and my mother encouraged me to follow my dream. Later, as I observed and treated cancer patients in the Pain League during the nursing undergraduate course, University of Sao Paulo, I realized that I wanted to pursue research in this area.

Three highly respected mentors inspired and helped me to build a research career. The first, Prof. Paulo Antonio de Carvalho Fortes (1951-2015, Faculty of Public Health, University of Sao Paulo, Brazil), assisted me in obtaining my first research scholarship, taught me the elementary steps in research methods, and together we wrote my first article. The second, Prof. Cibele A de Mattos Pimenta (School of Nursing University of Sao Paulo), introduced me to a vast, emerging area – chronic pain, cancer and palliative care – and provided me with the research basis and skills to develop my Master’s and PhD theses, and a post-doc study in chronic pain. The third, Prof. Per Sjøgren (Rigshospitalet, Denmark), kindly accepted me as a research fellow/post-doc in his department and had faith in me so I could develop new skills and embark on a successful research career in palliative care. I am grateful to all of them.

Can you tell us briefly about the research that has led to your winning this award and some of the main findings?

GPK: I have worked mainly in three lines of research: 1) Cognitive dysfunction and other opioid-related adverse effects, 2) epidemiologic profile of chronic pain and opioid use in the Danish population, and 3) research methodology about validation of neuropsychological assessment tools and elaboration of systematic reviews regarding opioid effects and interventional analgesic treatments. The studies are based on cancer and non-cancer pain patients who are treated with opioids and have given us the opportunity to understand the long-term consequences of opioids in two distinct populations. Long-term consequences of opioid treatment have become very relevant, because currently patients with cancer survive or live longer with the disease than previously, and they are often treated with opioids for much longer periods of time. Also, opioid prescriptions to treat chronic non-cancer pain have risen dramatically, but the effects of long-term opioid therapy and the benefits to treat chronic non-cancer pain are unclear.

You come from a nursing background, how can we encourage more nurses to undertake research in palliative care?

GPK: Nurses are at the frontline of patient care. They have a unique and strategic position because of their broad education and 24-hour presence in all health services. A well-educated nurse has a panoramic viewpoint about health (disease prevention, disease process; eg falling ill and living with the disease, treatment and rehabilitation) – a plus not only in clinical settings but also in research. Our profession has developed widely, including research. Nurses can develop research roles in leadership, management, data collection and student tutoring, among others. I believe that current changes in the undergraduate nursing curriculum to include palliative care and educational research activities supported by health professional associations in many countries) are helping to better prepare professionals and awakening an interest in palliative care research.

We are becoming more aware of the gaps in clinical practice and more frequently look for new ideas and strategies to enhance health care. The key to encouraging nurses to undertake research in palliative care is to promote the idea that evidence-based care is the bridge between research and practice, aiming to find out what is the best for the patient.

Nurses have the opportunity and skills to explore many research areas, including symptom control, patient and family education, service management, healthcare models and health policies. Equally, they have much to offer to multidisciplinary research collaboration that embraces comprehensive and patient-centred care, and their participation should be encouraged.

Nurses should see research as a career option and be aware that they can integrate both clinical care and research into a more challenging and satisfying profession.

Dr Geana Paula Kurita receives her award from Prof Sheila Payne (left) and Prof Lieve Van den Block. (Photographs by Stefan Zeitz).

As Vice-chair of the EAPC Research Network (EAPC RN), how do you think the RN can help to foster young researchers? And where would you like the RN to be in 20 years’ time?

GPK: The EAPC RN is committed to helping junior/young researchers to create a network, where they can learn, share experiences, develop skills, and collaborate in palliative care research. Our Research Network Junior Forum (JF), provides a platform for education, communication and collaboration among junior/young researchers. We are currently restructuring the JF by creating more interactive activities at conferences and a dedicated JF space on the EAPC RN website to help young researchers build networks with each other and more established researchers. Hopefully, the RN will become a stronger, more inclusive, group of researchers who are developing research projects around the world and helping to improve palliative care research. 

How do you see your role (and palliative care researchers in general) linked to that of clinicians? 

GPK: Clinicians and researchers are essential components to providing optimal care and evidence-based care, the bridge between research and practice. Therefore, we are collaborators/partners with a higher margin of success if we work closely together. Good collaboration/integration allows exchange of experiences, which increases knowledge on both sides.

How do you see your career opportunities in palliative care in your country?

GPK: Despite the economic and cultural differences between Brazil and Denmark, I think that research opportunities in the public and private sectors exist in both countries but may be more limited in Brazil. Working with other researchers, we have developed a research plan that aims to provide more information regarding the consequences of long-term opioid treatment and developing more precise and targeted therapies for patients with cancer and chronic non-cancer pain. This plan includes analysis of various health-related outcomes, prevalence of opioid addiction and its risk factors including genetic variation, and immunologic and endocrine consequences. I have a lot to work on, and hopefully I can obtain a professorship in the future.

Your personal journey to build your research career in palliative care led you from Brazil to Europe. Tell us about the transition, and any tips for other young researchers who are coming to Europe. 

GPK: My transition to Denmark was very positive. From a professional point of view, colleagues welcomed me and it has been fantastic to be in an environment that provides access to national databases and heavy resource investment to make research feasible. From a personal point of view, there are several differences between Brazil and Denmark besides the weather. A new culture, a new language, new currency, and no family or friends may be very challenging. When moving to a different environment, we should consider the behaviour and culture of the local society and respect and learn how to adapt to it. It is important to observe and understand how the society works to make your life easier in and outside of work.

Read about the country you are moving to and sign up for group activities, eg language course, fitness, etc. This will help you to meet people with similar interests and situations and to develop new friendships. Learning the local language makes it easierto integrate. Many courses also focus on national socio-cultural aspects, which help you to understand your new country.

Outside of palliative care, what do you enjoy doing to relax?

GPK: I have a passion for travelling and watching films. I also like to exercise, which facilitates a good night’s sleep and re-energises me for the next day.


Look out for more interviews on the EAPC blog with Dr Maria Heckel, winner of the 2019 EAPC Palliative Medicine Early Researcher Award, and Dr Mark Taubert, winner of the EAPC Clinical Impact Award. 

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New edition of EAPC Atlas of Palliative Care in Europe launches at 16th EAPC World Congress in Berlin


Reporting live from the 16th EAPC World Congress in Berlin, Eduardo Garralda, Research Assistant at the ATLANTES Research Programme at the University of Navarra, Spain, explains the background to this updated advocacy tool that launches today at the congress.

Eduardo Garralda

The ATLANTES Palliative Care Research Group of the Institute for Culture and Society at the University of Navarra, Spain, has directed and coordinated the production of the new European Atlas, the essential tool for the appropriate planning of the development of palliative care for Europe.  The work has been conducted in close collaboration with local, regional, and international experts and institutions.

EAPC Atlas of Palliative Care in Europe

The EAPC Atlas of Palliative Care in Europe is an initiative of the European Association for Palliative Care (EAPC), commissioned by the EAPC Task Force on Palliative Care Development in Europe and implemented by the ATLANTES Research Group. Scientific advice was provided by the International Association for Hospice & Palliative Care (IAHPC) and the World Health Organization regional office in Europe (WHO-Europe).

The project institution was composed of expert members of the EAPC Development Task Force: Julie Ling, Jeroen Hasselaar, Daniela Mosoiu, David Clark and Carlos Centeno, while the technical advisory group of the research team comprised Liliana De Lima (IAHPC), Marie-Charlotte Bouesseau (WHO) and Marilys Corbex (WHO-Europe).

Part of the ATLANTES Palliative Care Research Group at the Institute for Culture and Society in Spain. Left to right: Carlos Centeno, Eduardo Garralda, Natalia Arias-Casais, Juan José Pons and Jesús López-Fidalgo.

The research team comprised Natalia Arias-Casais, Eduardo Garralda, Juan José Pons, and Carlos Centeno (ATLANTES); John Rhee (Icahn School of Medicine at Mount Sinai, New York); and Liliana De Lima (IAHPC). Based in Pamplona (Spain), the researchers have pursued the objective of producing a study to inform and promote palliative care development and integration across the European region.

As in other editions, the Atlas assesses the progress made in terms of implementation of palliative care specialised services, the development of health policies, the expansion of the use of medicines or the incorporation of palliative care into mainstream health professionals’ education in the region.

But for the first time, the Atlas explores the degree to which palliative care has been integrated into different levels of care, diseases and disciplines. A careful selection of indicators and close collaboration with other EAPC task forces leaders have allowed an accurate view regarding the integration of palliative care into paediatrics, long-term care facilities, primary care, volunteering, public health, oncology and cardiology.

It provides a comparative picture in simple and clear graphics, texts, tables, figures and maps that highlight the information given by national palliative care leaders in the region.

The EAPC Atlas is published at a time in which there has been palliative care growth and integration in European countries but, at the same time, this progress has been largely heterogeneous, insufficient and with unclear development trends. The new information is essential for the appropriate planning of the development of palliative care for Europe.

Brief Manual on Health Indicators Monitoring Global Palliative Care Development.

Over the following months, the co-authors will focus on the dissemination of the data to key experts in Europe, so that the Atlas can be used as an advocacy tool in national governments and Ministries of Health. We would like to thank all those that have donated time and effort to bring this work to completion: in-country key experts, the international committee of experts on indicators, and others that have supported the EAPC Atlas of Palliative Care in Europe.

Join us at the EAPC World Congress

The EAPC Atlas will be launched at the EAPC World Congress this afternoon, 24 May, in Room C4 of the congress venue from 16.00 to 16.45. Come to the EAPC stand today to view the Atlas and get a link to the free online copy!

But if you are unable to attend the congress, please download a PDF copy from the links below and watch the Explanatory video of main findings of the EAPC Atlas (in Spanish, sub-titled in English).

Find out more . . .


La nueva edición del Atlas EAPC de Cuidados Paliativos en Europa se presenta en del XVI Congreso Mundial de la EAPC en Berlín

Informando en vivo desde el XVI Congreso Mundial de la EAPC en Berlín, Eduardo Garralda, técnico del Grupo de Investigación ATLANTES de la Universidad de Navarra, España, explica el contexto de esta herramienta clave para la defensa y promoción de cuidados paliativos, que será presentada en el congreso.

Eduardo Garralda

El equipo de Investigación ATLANTES del Instituto Cultura y Sociedad, Universidad de Navarra, ha dirigido y coordinado la producción del nuevo Atlas europeo en estrecha colaboración con instituciones locales, regionales e internacionales.

EAPC Atlas of Palliative Care in Europe

El Atlas EAPC de Cuidados Paliativos en Europa es una iniciativa comisionada por la Asociación Europea de Cuidados Paliativos (EAPC), encargada al Grupo de Trabajo de Desarrollo de Cuidados Paliativos e implementada por el equipo de investigación ATLANTES. La asesoría científica ha corrido a cargo de la Asociación Internacional de Hospice y Cuidados Paliativos y la Oficina Regional Europea de la Organización Mundial de la Salud (WHO-Europa).

El equipo institucional lo han compuesto expertos del Grupo de Trabajo sobre Desarrollo: Julie Ling, Jeroen Hasselaar, Daniela Mosoiu, David Clark y Carlos Centeno, mientras que el grupo técnico asesor del equipo de investigación lo han conformado Liliana De Lima (IAHPC), Marie-Charlotte Bouesseau (WHO) y Marilys Corbex (WHO-Europa).

El equipo de investigación ha estado compuesto por Natalia Arias-Casais, Eduardo Garralda, Juan José Pons, y Carlos Centeno (ATLANTES); John Rhee (Icahn School of Medicine at Mount Sinai, New York); y Liliana De Lima (IAHPC). Con base en Pamplona (España), los investigadores han perseguido el objetivo de producir un estudio para informar y promover el desarrollo y la integración de cuidados paliativos en la región europea.

Parte del equipo de investigación ATLANTES en el Instituto de Cultura y Sociedad en España. De izquierda a derecha: Carlos Centeno, Eduardo Garralda, Natalia Arias-Casais, Juan José Pons y Jesús López-Fidalgo.

Como en otras ediciones, el Atlas evalúa el progreso realizado en Europa en materia de implementación de servicios especializados de Cuidados Paliativos, de desarrollo de políticas sanitarias, de la expansión del uso de medicinas para el dolor, o de la incorporación de la medicina paliativa como asignatura en la educación de pregrado para los profesionales sanitarios.

Pero también en esta edición, y por primera vez, el Atlas también explora el grado de integración de cuidados paliativos en distintos niveles asistenciales, en enfermedades distintas del cáncer, y en otras disciplinas. Una selección muy cuidadosa de los indicadores, y una colaboración estrecha con líderes de otros grupos de trabajo de la EAPC, han permitido conseguir una panorámica bastante precisa de la situación de los cuidados paliativos pediátricos, de la provisión de paliativos en residencias de mayores, de la integración en atención primaria, en los servicios de oncología y cardiología, etcétera.  Todo ello en un modo comparativo, a través de gráficos, textos, tablas y mapas claros y sencillos, que subrayan la información provista por los líderes regionales de cuidados paliativos.

El Atlas EAPC se publica en un momento de crecimiento y expansión de los cuidados paliativos Europa, pero que al mismo tiempo, lo hace de forma desigual y heterogénea. Esta información actualizada es esencial para una planificación adecuada para el desarrollo de cuidados paliativos en Europa.

Brief Manual on Health Indicators Monitoring Global Palliative Care Development.

En los próximos meses, los coautores se centrarán en la difusión de los datos a los expertos clave en Europa, para que este Atlas EAPC pueda utilizarse como herramienta de defensa y promoción de cuidados paliativos en los gobiernos nacionales y Ministerios de Salud. Nos gustaría agradecer a todos aquellos que han dedicado tiempo y esfuerzo para hacer este proyecto realidad: expertos locales, comité internacional de expertos en indicadores, y otros que han apoyado de algún modo el Atlas EAPC de Cuidados Paliativos en Europa.

Únete a nosotros en el Congreso Mundial de la EAPC

El Atlas EAPC se presentará en el Congreso Mundial de la EAPC esta tarde, 24 de mayo, en la sala C4, del palacio de congresos, desde las 16.00 hasta las 16.45. Habrá copias gratuitas disponibles para los colaboradores, co-autores y asociaciones profesionales en el stand de la EAPC. Si no pudieras asistir al congreso, descárgate gratis tu pdf online del enlace de abajo. 

Para saber más…








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New textbook on palliative care launches at EAPC World Congress in Berlin – #wearepalliativecare: A time to harvest, a time to grow


Prof. Roderick MacLeod, Consultant and Honorary Professor in Palliative Care in Australia and New Zealand, and Prof. Lieve Van den Block, Professor of Aging and Palliative Care in Brussels, Belgium, are co-editors of Springer Nature’s very first textbook on palliative care, which will be launched tomorrow in Berlin.

Prof Roderick McLeod and Prof Lieve Van den Block

Palliative care should be a truly interdisciplinary enterprise. We hope that this has been illustrated by the online release of one of Springer Nature’s Major Reference works, the ‘Textbook of Palliative Care’. And indeed, it was the major reason why we collaborated as intensively as we did over the past few years. Our vision was very clear from the start: to provide a comprehensive, clinically relevant and state-of-the-art book, aimed at advancing palliative care, as a science, a clinical practice andas an art. This implied working with a wide range of experienced and internationally recognised Section Editors and Authors from various regions of the world, various backgrounds, disciplines and professions, and this to produce a helpful and up-to-date resource for practitioners, clinicians, researchers, and policy- and decision-makers worldwide. We are deeply indebted to all of them.

A time to harvest

The Textbook intentionally integrates a wide range of topics of relevance in our field. It includes sections addressing clinical symptom management, care provision and organisational aspects of care in different settings, care in specific disease groups, palliative care emergencies, but also ethics, research, financial and public health approaches and perspectives in palliative care. Many of the authors have provided new insights in the field and challenge the reader’s current conceptions and practices. As palliative care as a discipline and science has been evolving rapidly over the past decades, this Textbook is a timely resource summarising where we are now. It was time to harvest.

A time to grow

Neither the science nor the art of palliative care stands still so we aim to keep this Textbook updated as new evidence and approaches to care arise. The Reference Work is intended as a ’Living Reference‘ with chapters and sections updatable any time. This is only possible via the necessary input from the entire field of palliative care, users and developers, researchers and observers.

A lot of work still needs to be undertaken to help our field grow: we should grow in depth to improve our own knowledge and grow in width to increase our impact in other disciplines and the wider community.

So, what are our priorities for the short term and long term in palliative care and palliative care research? What knowledge is urgently needed? Which discussions are we not having but should have? Please share your thoughts on twitter with us #wearepalliativecare. Each and every one of us can contribute to broadening the horizons of our field.

Please join us at the launch of ‘The Textbook of Palliative Care’

‘The Textbook of Palliative Care’ edited byRoderick D MacLeod and Lieve Van den Block, will be launched at the 16thEAPC World Congress in Berlin. We’re delighted that EAPC President, Professor Phil Larkin, will speak at the launch, which takes place on the EAPC stand at 08:40-08:55 on Friday 24 May. So, if you’re attending the congress, please do join us.


Follow all the EAPC World Congress activity @EAPCvzw #EAPC2019

Read more posts relating to the 16thEAPC World Congress here.


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What motivates a therapy dog to volunteer in palliative care?


Bailey and his ‘buddy’, Dr Rohan McLachlan (a surgical registrar at St George’s hospital, are volunteers with the Pet Therapy Programme at Calvary Health Care Sydney (a public hospital in New South Wales, Australia, that provides specialist palliative care and rehabilitation services). Like countless volunteers in Australia and across the world, volunteers in palliative care make a difference to patients and families near the end of life.

Volunteer Bailey gives us a ‘dog’s eye view’ of why he does the job.

Therapy dog Bailey. Photograph with kind permission of Calvary Health Care Sydney.

Hi there,my name is Bailey.

I acquired a buddy when I was about six months old. He calls himself Rohan but I call him ‘Groof’. He’s ok – he feeds me and picks up my poop like a good provider does.

Life has been pretty good so far. I go to the park most days and hang out with my friends Rocky and Alfie. But l was looking for something more in life…

Then I started working at Calvary Hospital in Kogarah. I drag my buddy Rohan with me too. We go around and visit patients in the palliative care wards and say hi to the staff along the way. I really enjoy it, mostly because I can see how happy I make the patients and their families.

Some patients are really interactive. Their faces light up when they see me coming. I trot up to them and ask for a pat. I can usually tell if they are not feeling like themselves and I seem to distract them from that, which works great for me because I love being petted. I make them feel like they are back home because a lot of them have animals too. Rohan told me that a lot of them have been in hospital for a while, so it’s nice to help them forget that for a short moment.

Often, I’ll walk into a patient’s room that is filled with family members. Usually, they are quiet and solemn. But when I walk in everyone brightens up. I get plenty of smiles and pats. The families always tell me how nice it is to see me. Then they will share provider stories with Rohan and show him photos of the animals they provide for. I wish Rohan would stop trying to steal their attention from me.

Bailey on duty visiting a patient. Photograph with kind permission of Calvary Health Care Sydney.

Some of the patients are really sick. I can always tell. If that’s the case, I will quietly sit next to them and keep them company – just being there makes them at ease. The sickest patients can’t get out of bed and so I’ll stand up with my paws on the bed next to them so they can see me and pat me. Despite them being very unwell, they always smile at me, even if it’s just with their eyes.

It’s not easy being a dog. It’s not easy being a human either and the humans I visit at Calvary are doing it tough, or struggling. I’m grateful that something as simple as just being with them and their families can make such a significant difference to their stay at Calvary. The smiles and stories they share make that obvious to me, and unlimited pats for a few hours’ work make it all worthwhile!


Read more posts on the EAPC blog about Volunteering and Palliative Care and Animals.

Join us in Berlin at the 16TH EAPC World Congress…
In addition to many sessions and posters on volunteering at the congress, there is an International Symposium on Saturday 25 May 2019, 10:00 to 17:00, Volunteers at the Heart of Hospice and Palliative Care – Opportunities and Challenges 2030. View the programme here. Register for the International Symposium here.

View the full EAPC scientific programme here.  Register for the EAPC World Congress here.

Posted in Palliative Care & Animals, VOLUNTEERING IN PALLIATIVE CARE | Tagged | Leave a comment

‘Journal of Palliative Medicine’ Best European Paper of the Year Award at #EAPC2019


Today, Dr Charles von Gunten, Editor-in-Chief, Journal of Palliative Medicine, introduces the EAPC’s newest ‘official journal’ and welcomes you to the plenary session on Friday 24 May in Berlin when the winner of the journal’s ‘Best European Paper’ will be announced.

Charles F. von Gunten.

Journal of Palliative Medicine is now an official journal of the European Association for Palliative Care (EAPC). I couldn’t be more pleased because I have always looked to the EAPC annual meeting for innovations in clinical care.

Journal of Palliative Medicine (JPM) is in its 22nd year of publication. I have been Editor-in-Chief for the last 11 of those years. Our managing editor, Lisa Pelzek-Braun, has served the journal for all of those 22 years. When people ask me about my goals, I say ‘World Domination’. Although that response is designed to elicit a laugh, I am serious.1

Cicely Saunders built St Christopher’s Hospice to simultaneously demonstrate and research her hypotheses about better medical care for those dying of cancer and motor neurone disease. The subsequent 50 years have seen her principles disseminated and implemented around the globe. Research has shown palliative care works in a range of advanced diseases, not just cancer. It works in hospitals, hospices, and at home. Better quality at lower cost has been widely demonstrated. Even more importantly, palliative medicine has been shown to improve healthcare outcomes the earlier during serious illness it is introduced.

I think it is analogous to penicillin. It was initially administered to those dying of pneumonia. It was then discovered to work better when you started it before the person was dying. It then was demonstrated to work for other infections. It also prevents infections. Finally, the host of antimicrobials that followed has changed the face of health care globally. I see the same path for palliative care.

Alleviating the Access Abyss in Palliative Care and Pain Relief – The Lancet Commission Report catalogues the gaps.2  In my mind, the road ahead is clear – World Domination.

Each issue of Journal of Palliative Medicine is shaped to meet the needs of clinicians. Physicians, nurses, social workers, chaplains, pharmacists and other disciplines engaged in direct patient care frequently feel isolated and overwhelmed. When such a person opens Journal of Palliative Medicine, I want them to say, ‘This is relevant to what I do. Here is my tribe. I feel strengthened for the work I do.’ In my observation, one of the barriers to World Domination is lack of confidence. To feel part of a global community is a powerful tonic.

Last May, we announced a prize for the Best European Paper published in Journal of Palliative Medicine in 2018. The paper was selected from all European papers published in Journal of Palliative Medicine during calendar year 2018. Twenty-three papers from ten European countries were eligible. Authors came from Demark, Finland, France, Germany, Italy, the Netherlands, Spain, Sweden, Switzerland, and the United Kingdom. Criteria for ‘best’ included contribution to the current literature, clinical relevance, originality, scientific rigour and the number of downloads from the web. Selection was made by both JPM and the EAPC. The winning paper will be announced at the 16th EAPC World Congress in Berlin at the 24 May plenary session. We hope you will join us to celebrate the occasion.

The EAPC joins other professional associations that have established a formal relationship with JPM. They include: Australia & New Zealand Society of Palliative Medicine (ANZSPM), Asia Pacific Hospice and Palliative Care Association, Canadian Society of Palliative Care Physicians (CSPCP), Center to Advance Palliative Care (CAPC), Hospice & Palliative Nurses Association (HPNA), and the Japanese Society for Palliative Medicine (JSPM).


  1. von Gunten CF, World Domination. J Palliat Med 2017; 2-3
  2. Alleviating the access abyss in palliative care and pain relief – an imperative of universal health coverage. FM Knaul, PE Farmer, EL Krakauer, L De Lima, A Bhadelia, XJ Kwete, H Arreola-Ornelas, O Gómez-Dantés, NM Rodriguez, GAO Alleyne, SR Connor, DJ Hunter, D Lohman, L Radbruch, M del Rocío Sáenz Madrigal, R Atun, KM Foley, J Frenk, DT Jamison, M R Rajagopal, on behalf of the Lancet Commission on Palliative Care and Pain Relief Study Group; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32513-8/fulltext. (Accessed 19.5.2019).

Join us in Berlin at #EAPC2019 for Journal of Palliative Medicine’s European Paper of the Year Award
If you’re attending the 16thEAPC World Congress in Berlin (23-25 May 2019), please come along to the award presentation on Friday 24 May, at 10:20 in Convention Hall II. View and download the final congress programme here. Or, use the interactive programme tool. Start perusing and planning now! Register for the congress here.

Read more posts relating to the 16th EAPC World Congress here.

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Picturing palliative sedation: A new European investigation

Left to right:Jerome Hasselaar, Sheila Payne and Julie Ling.

A new European project will investigate current clinical practice, review guidelines and include a prospective clinical study about palliative sedation. Jeroen Hasselaar (Radboud University Medical Center), Sheila Payne (International Observatory on End of Life Care at Lancaster University) and Julie Ling (European Association for Palliative Care – EAPC) explain more.

Project main partners: Ágnes Csikós (Pécs), Lukas Radbruch (Bonn), Daniela Mosoiu (Boekarest/Brasov), Carlos Centeno (Pamplona), Johan Menten (Leuven), Sebastiano Mercadante (Palermo), Kris Vissers (Nijmegen), Sheila Payne (Lancaster), Julie Ling (Dublin), Jeroen Hasselaar (Nijmegen). 

Mr. A. has advanced metastasized lung cancer. He is bedbound, suffers from severe and ongoing breathlessness and is anxious that he may choke. Regular treatment doesn’t seem to be effective anymore. The family is deeply concerned seeing their loved one gasping for breath. During a family meeting with the clinical team, it has been discussed that the patient’s life expectancy is limited, a matter of days, and that palliative sedation may offer relief.

Palliative sedation involves the lowering of consciousness in patients in the last phase of life. The term palliative connects this practice to palliative care, but major debate exists about the appropriate application of palliative sedation and the settings where this takes place. Despite national and regional guidelines, regulations, and the EAPC framework, practices are still poorly investigated, and many questions remain.

What constitutes the symptom(s) that may necessitate palliative sedation? How are such symptoms assessed as ‘refractory’ and what is the role of a multidisciplinary (palliative care) team? How is palliative sedation performed and in which context? Should decisions regarding palliative sedation be limited to palliative care specialists, or do we also need to acknowledge and support its broader use in primary care for patients who wish to die at home? And although palliative sedation is largely a medical decision, nurses have a significant role in administering drugs and monitoring the patient’s care and condition. Importantly, how can the patient’s voice, or the views of family caregivers, be heard and incorporated in this field where medical and ethical values seem intertwined?

Members of the Palliative Sedation project team at the kick-off meeting in Amsterdam.

On 7 and 8 March 2019, the kick-off meeting of a new European project about palliative sedation took place in Amsterdam. The project is financed by the European Union (Horizon 2020) and brings together partners from England, Germany, the Netherlands, Belgium, Spain, Italy, Hungary and Romania. The five-year project (2019-2023) called ‘Palliative Sedation’ – The use of proportional palliative sedation for the relief of refractory symptoms is coordinated by Radboudumc Nijmegen, the Netherlands.

The project will investigate current clinical practice, review guidelines, and will contain a prospective clinical study about palliative sedation. Furthermore, the project focuses on the similarities and differences in both the clinical and ethical aspects of practice across Europe and will formulate recommendations for an updated European framework for palliative sedation. An online learning programme is planned, together with a policy workshop for the further development and implementation of guidelines, in close connection with the EAPC.


Join us in Berlin at #EAPC2019…
If you’re attending the 16th EAPC World Congress in Berlin, please come along to an Open Meeting, ‘New EU-funded Palliative Care Research: an Overview of all Projects Launching 2019’ on Friday 24 May at 10:30 to 11:15 in Room 5, second floor. You will hear more about ‘Palliation Sedation’, as well as several other new EU-funded research projects. Download the final scientific programme for the EAPC World Congress here – also available with interactive programme tool. Start perusing and planning now! Register here.

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