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Background: Outcome measurement plays an increasing role in improving the quality, effectiveness, efficiency and availability of palliative care. Aim: To provide expert recommendations on outcome measurement in palliative care in clinical practice and research. Methods: Developed by a European Association for Palliative Care Task Force, based on literature searches, international expert workshop, development of outcome measurement guidance and international online survey. A subgroup drafted a first version and circulated it twice to the task force. The preliminary final version was circulated to wider expert panel and 28 international experts across 20 European Association for Palliative Care member associations and the European Association for Palliative Care Board of Directors and revised according to their feedback. The final version was approved by the European Association for Palliative Care Board for adoption as an official European Association for Palliative Care position paper. Results: In all, 12 recommendations are proposed covering key parameters of measures, adequate measures for the task, introduction of outcome measurement into practice, and national and international outcome comparisons and benchmarking. Compared to other recommendations, the White Paper covers similar aspects but focuses more on outcome measurement in clinical care and the wider policy impact of implementing outcome measurement in clinical palliative care. Patient-reported outcome measure feedback improves awareness of unmet need and allows professionals to act to address patients’ needs. However, barriers and facilitators have been identified when implementing outcome measurement in clinical care that should be addressed. Conclusion: The White Paper recommends the introduction of outcome measurement into practice and outcomes that allow for national and international comparisons. Outcome measurement is key to understanding different models of care across countries and, ultimately, patient outcome having controlled for differing patients characteristics. [ABSTRACT FROM AUTHOR]

Most people who experience trauma want to thrive and often find paths to well-being and healthy functioning. This scoping review explores the existing evidence on adversity and resilience in southeastern European countries, focusing on Kosovo. There is a lack of research on trauma and resilience in cultures outside the US and Western Europe. The paper provides a brief cultural and historical overview of this region and the collectivist cultures found there. We draw from a range of interdisciplinary literatures to identify key strengths that have the potential to improve health outcomes for trauma victims in this region. Overall, 42 papers from PsycInfo and PubMed were identified, using keywords such as "resilience" or "health" and "Kosovo," "Balkans," and "Southeastern Europe." Findings from this scoping review show that different cultural values, norms, and societal ecologies impact resilience within these societies. Some strengths, such as social support and sense of purpose, echoed similar research in the US and Western Europe. There was also evidence that factors such as dignity, family solidarity, social activism, and nationwide meaning-making are strengths associated with resilience for these collectivist societies of southeastern Europe. We also consider the implications of the results for other post-conflict societies. Finally, findings from this review call for culturally sensitive strength-based perspectives in promoting health and well-being after the high dosages of trauma common in this region. [ABSTRACT FROM AUTHOR]

The article presents a study that defines the optimal palliative care in dementia. The study provides a brief overview about the disease. The study invited 89 experts from 27 countries to evaluate a two-round online survey with feedback. It also suggests the availability of immediate and full consensus on the eight domains, including the recommendations person-centered care, communication and shared decision-making and optimal treatment of symptoms.

The first European Union Survey on Violence against Women (EU-VAW) released in 2014 revealed the unexpected result indicating that the world's most egalitarian countries have relatively high rates of Intimate Partner Violence Against Women (IPVAW). This phenomenon, referred to as the "Nordic Paradox," revived a heated, intermittently ongoing discussion dating back four decades where several competing hypotheses about the relationship between gender inequality and IPVAW have been proposed, but no consensus has been reached. The main aim of this paper is to revisit the most important of such hypotheses proposed in the last four decades, while proposing a new one that could potentially throw some light on understanding the "Nordic Paradox." Multilevel linear regression models are estimated using data from the EU-VAW survey conducted in 2012, and an alternative operationalization of the Gender Equality Index (GEI) (our measure of gender equality). We did not find any significant effect of gender equality on IPVAW repetition. However, we found that higher country-level status of women and men go together with less IPVAW, with a larger effect of women's status in economic domains compared to the impact of men's economic status, and a larger effect of men's overall status. These findings support the Marxist feminist hypothesis, stating that women's absolute status in the economic and labor domain is critical in lessening IPVAW, as women's real and potential access to resources is key for leaving a violent relationship. At the same time, our results support the "male privilege protection" hypothesis, which states that gains in women's status in certain domains—such as in the economic sphere considering our results for the European Union—would not suppose a threat to men, allowing ameliorative effects. In contrast, if the overall status of men is threatened, backlash effects would be triggered. [ABSTRACT FROM AUTHOR]

Background: The evolution of the provision of palliative care specialised services is important for planning and evaluation. Aim: To examine the development between 2005 and 2012 of three specialised palliative care services across the World Health Organization European Region – home care teams, hospital support teams and inpatient palliative care services. Design and setting: Data were extracted and analysed from two editions of the European Association for Palliative Care Atlas of Palliative Care in Europe. Significant development of each type of services was demonstrated by adjusted residual analysis, ratio of services per population and 2012 coverage (relationship between provision of available services and demand services estimated to meet the palliative care needs of a population). For the measurement of palliative care coverage, we used European Association for Palliative Care White Paper recommendations: one home care team per 100,000 inhabitants, one hospital support team per 200,000 inhabitants and one inpatient palliative care service per 200,000 inhabitants. To estimate evolution at the supranational level, mean comparison between years and European sub-regions is presented. Results: Of 53 countries, 46 (87%) provided data. Europe has developed significant home care team, inpatient palliative care service and hospital support team in 2005–2012. The improvement was statistically significant for Western European countries, but not for Central and Eastern countries. Significant development in at least a type of services was in 21 of 46 (46%) countries. The estimations of 2012 coverage for inpatient palliative care service, home care team and hospital support team are 62%, 52% and 31% for Western European and 20%, 14% and 3% for Central and Eastern, respectively. Conclusion: Although there has been a positive development in overall palliative care coverage in Europe between 2005 and 2012, the services available in most countries are still insufficient to meet the palliative care needs of the population. [ABSTRACT FROM AUTHOR]