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To identify transitional palliative care (TPC) interventions for older adults with non-malignant chronic diseases and complex conditions.

A systematic review of the literature was conducted. CINAHL, Cochrane Library, Embase and Pubmed databases were searched for studies reporting TPC interventions for older adults, published between 2002 and 2019. The Crowe Critical Appraisal Tool was used for quality appraisal.

A total of six studies were included. Outcomes related to TPC interventions were grouped into three categories: healthcare system-related outcomes (rehospitalisation, length of stay [LOS] and emergency department [ED] visits), patient-related outcomes and family/carer important outcomes. Overall, TPC interventions were associated with lower readmission rates and LOS, improved quality of life and better decision-making concerning hospice care among families. Outcomes for ED visits were unclear.

Positive outcomes related to healthcare services (including readmissions and LOS), patients (quality of life) and families (decision-making) were reported. However, the number of studies supporting the evidence were limited.

Studies examining the effectiveness of existing care models to support transitions for those in need of palliative care are limited. This systematic literature review identified and appraised interventions aimed at improving transitions to palliative care in older adults with advanced non-malignant diseases or frailty.

The purpose of this paper is to find out the relationship between the qualities of generic drugs perceived by the physicians and brand equity of the branded generics and to examine the physicians' perceptions of prescribing generic drugs for selective medical conditions in India.

The study was carried out across six major cities in Eastern India with 392 physicians. Here components of perceived quality, i.e. intrinsic cues and extrinsic cues are hypothesized to influence perceived quality of branded generics which in turn influence brand equity. It is also hypothesized that respondents' quality experience is assimilated towards their quality expectations, independent of small variations in objective quality of the drug.

Results showed that perceived quality of branded generics significantly, but indirectly, affected brand equity through the mediating variables, intrinsic cues and extrinsic cues. The results also showed that physicians' quality experience leads to quality expectations, independent of small variations in drug quality on five common yet serious diseases in India.

Current research finds that for prescription‐based branded generic drugs, perceived quality mainly depends on intrinsic cues; therefore, managers should be interested in intrinsic cues that increase brand equity and necessary marketing actions should be implemented accordingly.

No other scholarly article has been developed, so far, analyzing the effect of perceived quality on brand equity in the Indian branded generic drug segment. Besides providing evidence from the Indian pharmaceutical context about the impact of quality cues, the paper also presents evidence on physicians' quality observation of branded generics on five common yet serious diseases in India.

The second in a new series about mental health in old age, this article reviews policies and research evidence on services for people with dementia at the end of their lives, and looks at future commissioning priorities

A study comprising both questionnaire and interview of patients waiting for general surgery revealed that the majority of patients suffer from relatively few clinical conditions, that more than three‐quarters had been on the in‐patient list for over a year and that they suffered significant pain while waiting. Patients added to long lists with initially non‐serious (non‐life‐threatening) conditions may be overlooked, yet their clinical and associated social conditions may deteriorate. Since treatment for these conditions is generally effective, many patients would benefit from more organised queue management and earlier surgery.

The purpose of this paper is to examine the physicians’ attitude toward branded generic drugs in prescribing those drugs in some selective medical conditions and to identify the factors that influence physicians’ behavior toward prescribing branded generic drugs in the said selective medical conditions.

The study was carried out across six major cities in eastern India with 301 physicians. The current study introduced some significant elements into the modified technology acceptance model (TAM) with title the extended tam for product usage (TETPU) to analyze the prescribing factors that influence physicians in five common yet serious medical conditions in India. Out of nine factors considered here, seven were selected from the previous literature studies of different product segments and two were proposed by the authors. Demographic factor was proposed as the confounding variable.

The results indicated that apart from the factors “perceived no need” and “physicians’ perception and need achievement” rest of the factors showed satisfactory to excellent results.

The current study findings may enable the pharmaceutical managers to revise or modify their current marketing communication and other brand-building strategies so as to achieve a superior performance that offers them a competitive advantage.

The paper fulfils a need for advancing the knowledge on the physician’s prescription influencing factors by introducing the newer aspects of the concept and offers a theoretical framework for the academia and practical framework for the managers who desire to implement the strategies to achieve competitive advantage.

This paper gives an overview of the prevalence, symptoms, diagnosis and management of coeliac disease and associated disorders. It also gives some background to gluten testing in foods and developments in identification of gluten‐free foods at consumer level.

The most up‐to‐date literature on various aspects of the disease have been considered and included in the report.

Coeliac disease is now known to affect one in 100 of the population, including both adults and children. As more is understood about the pathophysiology of the disease and antibody screening techniques improve rates of diagnosis are increasing. The biopsy is still required for a firm diagnosis. The range of symptoms that is now recognised is far wider than previously thought, but symptoms are still often missed, or mis‐diagnosed as IBS. The treatment for coeliac disease is the gluten‐free diet, which controls the symptoms and reduces the risk of complications such as osteoporosis and gut cancer. Prescriptions of gluten‐free foods are known to improve adherence to the diet, and with the range of suitable foods in supermarkets increasing rapidly, gluten‐free living is becoming easier.

Information on several aspects of coeliac disease are presented in this paper to give the non‐expert a general, up‐to‐date overview of the disease.

THE patrician families of Imperial Rome had relatively short lives and, compared with the average of that era, very small numbers of children. Historians have usually attributed both these phenomena to moral causes but an alternative theory, and one well supported by scientific evidence, is that they suffered from chronic lead poisoning. In those days the metal was relatively cheap, extensively used in cooking vessels and for water pipes and, as lead salts, in cosmetics, medicines, wine and food. The Romans knew lead poisoning of the acute type, among lead workers for example, but did not recognize it as a slow, chronic disease and this environmental health hazard continued undetected.

The principal focus of clinical governance is intended to be at the level of the statutory organisation such as a Health Authority, Primary Care Trust or NHS Trust. This paper suggests that there are at least three levels (micro, macro and meta) at which clinical governance must operate if the original vision of flourishing excellence is to be fulfilled. These do not, regrettably, fit comfortably into the current organisational arrangements for the NHS in England and some cut across any traditional understanding of accountability relationships. With clinical governance at a relatively early stage of its development in many hospitals, and little better than vestigial in most Primary Care and Ambulance Trusts, it may be premature to take on such complex and challenging issues. However, the types of scenario described are typical of those that might create the next major system failure if they remain beyond the scope of clinical governance.

Literature suggests that integrated palliative care (IPC) increases the quality of care for palliative patients at lower costs. However, knowledge on models encompassing all integration levels for successfully implementing IPC is scarce. The purpose of this paper is to describe the experiences of IPC leaders in seven European countries regarding core elements, facilitators and barriers of IPC implementation and provides recommendations for future policy and practice.

A qualitative interview study was conducted between December 2013 and May 2014. In total, 34 IPC leaders in primary and secondary palliative care or public health in Belgium, Germany, Hungary, Ireland, the Netherlands, Spain and the UK were interviewed. Transcripts were analysed using thematic data analysis.

IPC implementation efforts involved a multidisciplinary team approach and cross-sectional coordination. Informal professional relationships, basic medical education and general awareness were regarded as facilitators of IPC. Identified barriers included lack of knowledge about when to start palliative care, lack of collaboration and financial structures. Recommendations for improvement included access, patient-centeredness, coordination and cooperation, financing and ICT systems.

Although IPC is becoming more common, action has been uneven at different levels. IPC implementation largely remains provisional and informal due to the lack of standardised treatment pathways, legal frameworks and financial incentives to support multilevel integration. In order to make IPC more accessible, palliative care education as well as legal and financial support within national healthcare systems needs to be enhanced.