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Over the past 4 years the author has had opportunity to visit and teach in 12 countries of east Asia. Each has unique aspects of culture, language and background to bring to palliative care, but there are also some common themes of difference from what has become established in Europe or North America. (Quotes from original text)

This study documents the emotional experiences and coping strategies of a group of caregivers as they move from the diagnosis of a close family member with terminal cancer through the stages of caring and post bereavement. Supportive evidence, matching that of previous literature, was gathered regarding the impact of such care, but additional findings counter the notion of “burden” by revealing that strong positive emotions were experienced by these caregivers regarding the opportunity given to them to express their love through care. By contrast and post bereavement, however, intense grief was reported. There appeared to be a complete lack of emotional support throughout from health professionals, particularly in the bereavement phase when need is very apparent.

This article presents results of the second stage of a research project which explored the palliative care needs of 69 residents with a noncancer diagnosis in South Australia. Extensive data were collected prospectively from case notes, and resident and staff interviews over a 10-week period. Residents were suffering multiple conditions and were highly dependent for activities of daily living. Most residents’ care was consistent with a palliative approach, with only three residents in the study referred to a specialist palliative care service. However, for some residents, pain and symptom management were not always adequate, and referral to a specialist palliative care service would have been appropriate. This research indicates that, with additional education, it could be possible to extend the principles and philosophy of palliative care by adopting a palliative care approach within aged care facilities.

Objective: To identify criteria for measuring the eligibility of patients with end-stage noncancer diseases for palliative care services in Australian residential aged care facilities. Methods: No validated set if guidelines were available so five instruments were used: an adaptation of the American National Hospice Association Guidelines; a recent adaptation of the Karnofsky Performance Scale; the Modified Barthel Index; the Abbey Pain Score for assessment of people who are nonverbal and a Verbal Descriptor Scale, also for pain measurement. In addition, nutritional status and the presence of other problematic symptoms and their severity were also sought. Results: The adapted American National Hospice Association Guidelines provided an initial indicative framework and the other instruments were useful in providing confirmatory data for service eligibility and delivery.

Clinical and epidemiological observations on 87 cases of donovanosis seen at Port Moresby General Hospital are presented, with detailed reports of three cases in which the disease was more severe. The circumstances of infection described were consistent with venereal transmission. Chloramphenicol and gentamicin were effective in curing the disease, while streptomycin was found to be ineffective in a number of cases tested. Complement-fixation tests with Donovania antigen revealed the presence of antibodies in all but one of 23 cases tested, and in nine out of fourteen other patients who on clinical grounds were suspected of having donovanosis but were negative by smear test. The complement-fixation test with Klebsiella antigen was found to be highly specific for donovanosis, but less sensitive than the test using Donovania antigen. The intracellular location of Donovania in tissue and the presence of antibodies which are apparently not protective suggest that cell-mediated immunity may be important in defence against Donovania infection.

Historically, physicians have chosen to consider medical ethics rather than patient rights, as well as preferring responsibility for the individuals seeking their help rather than for the health of populations. Protests against planning for war, and discussions about sustainment of global well-being, were received within the medical profession with both encouragement and hostility. Against the mounting threat of nuclear war, International Physicians for Prevention of Nuclear War (IPPNW) was created, bringing up to 70 national affiliates together into a global federation which spoke with a single voice to oppose the grim reality of nuclear war. IPPNW sought to concentrate its concerns on collective issues rather than individual rights, and on changing ways of thinking rather than on saving individual lives. To this end it has enlarged its agenda to the establishment of more equitable distribution of resources, protection of the global environment, and non-military ways of building regional and global security. IPPNW seeks to promote rights through discussion, education, and non-partisan collective advocacy and consensus-building. This paper traces the evolution of medical groups that formed to promote peace and prevent war. /// Historiquement, les médecins ont choisi de privilégier l'éthique médicale plutôt que les droits des patients. Ils ont également souvent préféré se préoccuper des personnes qui sollicitent leur aide plutôt que de la santé de populations entières. Les protestations contre les préparatifs de guerre et les discussions sur le bien-être planétaire ont reçu un accueil mitigé de la part de la communauté médicale, favorable et hostile à la fois. Les craintes engendrées par le risque de guerre nucléaire amena à la création de L'International Physicians for Prevention of Nuclear War (IPPNW). Ses adhérents dans près de 70 pays se sont exprimés d'une seule voix pour s'opposer à l'affreuse réalité de la guerre nucléaire. L'IPPNW a cherché à concentrer son action sur des problèmes collectifs plutôt que sur les droits des individus, anisi que sur le changement des mentalités plutôt que sauvegarde de vies individuelles. Dans ce but, elle a élargi ses objectifs pour inclure l'instauration d'une répartition plus équitable des ressources, la protection de l'environnement, et le développement de moyens non-militaires pour construire la paix au niveau régional et planétaire. L'IPPNW cherche à encourager le respect du droit à travers la négociation, l'éducation, la recherche non-partisane du bien collectif et la création de consensus. Cet article retrace l'évolution des groupes de médecins qui se sont réunis afin de promouvoir la paix et prévenir la guerre. /// Historicamente, los médicos han escogido privilegiar la ética médica sobre los derechos de los pacientes. Lgualmente han preferido asumir responsabilidad por los individuos que solicitan su ayuda en lugar de la salud de las poblaciones. Las protestas contra los preparativos para la guerra, y las discusiones acerca de un bienestar global sostenido, fueron recibidas dentro de la profesión médica tanto con apoyo que con hostilidad. Contra la amenaza creciente de guerra nuclear, se créo la organización International Physicians for the Prevention of Nuclear War (IPPNW, por su siglas en inglés) que reunió cerca de 70 afiliados nacionales en una federación global que habló con una sola voz para al oponerse a la gris realidad de la guerra nuclear. IPPNW buscó concentrar sus esfuerzos en problemas colectivos en lugar de derechos individuales, y en cambiar las formas de pensar en lugar de salvar vidas individuales. Para lograr este fin la asociación ha expandido su enfoque para incluir el establecimiento de una distribución más igualitaria de los recursos, la protección del medio ambiente global, y maneras no militares de construir seguridad regional y global. IPPNW busca promover la realización de los derechos humanos a través de la discusión, la educación, el apoyo colectivo no partidario y la formación de consenso. Este artículo traza la evolución de los grupos médicos que se formaron para promover la paz y prevenir la guerra.