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Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.", "websiteTitle": "", "websiteType": "", "date": "", "publisher": "", "place": "", "DOI": "", "citationKey": "", "url": "http://books.nap.edu/openbook.php?record_id=18748", "accessDate": "2015-03-04T22:04:27Z", "shortTitle": "Dying in America", "language": "", "rights": "", "extra": "", "tags": [], "collections": [ "6F34NUEM" ], "relations": {}, "dateAdded": "2015-03-04T22:04:27Z", "dateModified": "2015-03-04T22:04:27Z" } }, { "key": "W7A37DE6", "version": 22, "library": { "type": "group", "id": 321775, "name": "Pain managment in wwu nursing", 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"DOI": "", "citationKey": "", "url": "http://resources.iom.edu/widgets/endoflife/quiz.html#.VPeBIi7QMnA", "accessDate": "2015-03-04T22:03:30Z", "shortTitle": "", "language": "", "rights": "", "extra": "", "tags": [], "collections": [], "relations": {}, "dateAdded": "2015-03-04T22:03:30Z", "dateModified": "2015-03-04T22:03:30Z" } }, { "key": "IKVEMAEG", "version": 20, "library": { "type": "group", "id": 321775, "name": "Pain managment in wwu nursing", "links": { "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/321775/items/IKVEMAEG", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing/items/IKVEMAEG", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/321775/items/RGMGNI88", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2132293, "username": "bilgs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/bilgs", "type": "text/html" } } } }, "data": { "key": "IKVEMAEG", "version": 20, "parentItem": "RGMGNI88", "itemType": "attachment", "linkMode": "linked_url", "title": "Snapshot", "accessDate": "2015-03-04T22:03:30Z", "url": "http://resources.iom.edu/widgets/endoflife/quiz.html#.VPeBIi7QMnA", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2015-03-04T22:03:30Z", "dateModified": "2015-03-04T22:03:30Z" } }, { "key": "6FDNI3N2", "version": 19, "library": { "type": "group", "id": 321775, "name": "Pain managment in wwu nursing", "links": { "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/321775/items/6FDNI3N2", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing/items/6FDNI3N2", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2132299, "username": "uncleiu", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/uncleiu", "type": "text/html" } } }, "creatorSummary": "Duke et al.", "parsedDate": "2009-12", "numChildren": 0 }, "data": { "key": "6FDNI3N2", "version": 19, "itemType": "journalArticle", "title": "The Patient Self-Determination Act: 20 years revisited", "creators": [ { "creatorType": "author", "firstName": "G", "lastName": "Duke" }, { "creatorType": "author", "firstName": "S", "lastName": "Yarbrough" }, { "creatorType": "author", "firstName": "K", "lastName": "Pang" } ], "abstractNote": "Evidence exists that the goals of the Patient Self-Determination Act (PSDA), which went into effect December 1991, have fallen significantly short of their achievement. The purpose of this paper is to explore the outstanding and controversial issues that continue to impact both health care providers and health care consumers today. A brief history of the PSDA and events that led to its passage are discussed. Further, the complex legal, ethical, and societal issues that have arisen in the almost two decades since its passage are explored for their impact on health care providers, health care consumers, families, surrogate decision makers, the economy, and society as a whole. Recommendations for addressing the barriers that impede PSDA goal achievement are also presented, such as education, policy reform, and effective communications among health care providers, health care consumers and others. Recommendations for future research are also offered.", "publicationTitle": "Journal of Nursing Law", "publisher": "", "place": "", "date": "December 2009", "volume": "13", "issue": "4", "section": "", "partNumber": "", "partTitle": "", "pages": "114-123", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Journal of Nursing Law", "DOI": "10.1891/1073-7472.13.4.114", "citationKey": "", "url": "http://ezproxy.library.wwu.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=2010637113&site=ehost-live", "accessDate": "2015-02-15T19:22:42Z", "PMID": "", "PMCID": "", "ISSN": "1073-7472", "archive": "", "archiveLocation": "", "shortTitle": "The Patient Self-Determination Act", "language": "", "libraryCatalog": "EBSCOhost", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Advance Care Planning -- Legislation and Jurisprudence -- United States", "type": 1 }, { "tag": "Advance Directives -- Legislation and Jurisprudence -- United States", "type": 1 }, { "tag": "Communication", "type": 1 }, { "tag": "Consent", "type": 1 }, { "tag": "Decision Making", "type": 1 }, { "tag": "Decision Making, Clinical", "type": 1 }, { "tag": "Decision Making, Ethical", "type": 1 }, { "tag": "Decision Making, Family", "type": 1 }, { "tag": "Decision Making, Patient", "type": 1 }, { "tag": "Ethics Committees", "type": 1 }, { "tag": "Ethics, Professional", "type": 1 }, { "tag": "Ethnic Groups", "type": 1 }, { "tag": "Euthanasia, Passive", "type": 1 }, { "tag": "Family", "type": 1 }, { "tag": "Health Policy", "type": 1 }, { "tag": "Health Resource Utilization", "type": 1 }, { "tag": "Inpatients", "type": 1 }, { "tag": "Liability, Legal", "type": 1 }, { "tag": "Medical Futility", "type": 1 }, { "tag": "Nurses", "type": 1 }, { "tag": "Outpatients", "type": 1 }, { "tag": "Patient Advocacy", "type": 1 }, { "tag": "Patient Autonomy", "type": 1 }, { "tag": "Patient Education", "type": 1 }, { "tag": "Patient Self Determination Act", "type": 1 }, { "tag": "Patient Self Determination Act -- History", "type": 1 }, { "tag": "Physicians", "type": 1 }, { "tag": "Professional Compliance", "type": 1 }, { "tag": "Professional-Family Relations", "type": 1 }, { "tag": "Professional-Patient Relations", "type": 1 }, { "tag": "Terminal Care", "type": 1 }, { "tag": "Terminal Care -- Economics", "type": 1 }, { "tag": "Terminally Ill Patients", "type": 1 }, { "tag": "United States", "type": 1 } ], "collections": [ "6F34NUEM" ], "relations": {}, "dateAdded": "2015-03-04T21:55:36Z", "dateModified": "2015-03-04T21:55:36Z" } }, { "key": "8I8ZSIUJ", "version": 19, "library": { "type": "group", "id": 321775, "name": "Pain managment in wwu nursing", "links": { "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/321775/items/8I8ZSIUJ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing/items/8I8ZSIUJ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2132299, "username": "uncleiu", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/uncleiu", "type": "text/html" } } }, "creatorSummary": "Daly", "parsedDate": "2000-07", "numChildren": 0 }, "data": { "key": "8I8ZSIUJ", "version": 19, "itemType": "journalArticle", "title": "Ethics and economics", "creators": [ { "creatorType": "author", "firstName": "G", "lastName": "Daly" } ], "abstractNote": "The author suggests that one way to better manage the burgeoning costs in acute care settings and improve patient care is by the earlier use of ethics case consultations and end-of-life support from ethics teams. This study determined that, in several very diverse clinical scenarios, timely facilitation of meaningful communication and decision making between patients, families, and health care providers can result in the more appropriate use of health care resources. While few of the patients in this study had recorded advanced directives in place, and there was initially a lack of family consensus in some cases, compliance with the ethics team recommendations led to a more appropriate clinical unit placement; and improved family support helped manage the costs of care and focus on the patients' quality of life. The decrease in the use of medical interventions and therapies after ethics consultations was consistent in all cases presented here.", "publicationTitle": "Nursing Economic$", "publisher": "", "place": "", "date": "July 2000", "volume": "18", "issue": "4", "section": "", "partNumber": "", "partTitle": "", "pages": "194-201", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Nursing Economic$", "DOI": "", "citationKey": "", "url": "http://ezproxy.library.wwu.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=2000064655&site=ehost-live", "accessDate": "2015-02-14T19:21:46Z", "PMID": "", "PMCID": "", "ISSN": "0746-1739", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "EBSCOhost", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Acute Care -- Economics", "type": 1 }, { "tag": "Adult", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Aged, 80 and Over", "type": 1 }, { "tag": "Case Studies", "type": 1 }, { "tag": "Convenience Sample", "type": 1 }, { "tag": "Cost Savings", "type": 1 }, { "tag": "Costs and Cost Analysis", "type": 1 }, { "tag": "Decision Making, Ethical", "type": 1 }, { "tag": "Decision Making, Family", "type": 1 }, { "tag": "Decision Making, Patient", "type": 1 }, { "tag": "Descriptive Statistics", "type": 1 }, { "tag": "Ethics Committees", "type": 1 }, { "tag": "Fees and Charges", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Health Facility Costs", "type": 1 }, { "tag": "Human", "type": 1 }, { "tag": "Inpatients", "type": 1 }, { "tag": "Length of Stay", "type": 1 }, { "tag": "Life Support Care -- Economics", "type": 1 }, { "tag": "Life Support Care -- Ethical Issues", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Middle Age", "type": 1 }, { "tag": "Record Review", "type": 1 }, { "tag": "Referral and Consultation -- Economics", "type": 1 }, { "tag": "Terminally Ill Patients", "type": 1 } ], "collections": [ "6F34NUEM" ], "relations": {}, "dateAdded": "2015-03-04T21:55:14Z", "dateModified": "2015-03-04T21:55:14Z" } }, { "key": "Q27WC6C4", "version": 19, "library": { "type": "group", "id": 321775, "name": "Pain managment in wwu nursing", "links": { "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/321775/items/Q27WC6C4", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing/items/Q27WC6C4", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2132299, "username": "uncleiu", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/uncleiu", "type": "text/html" } } }, "creatorSummary": "Van Leuven", "parsedDate": "2012-11", "numChildren": 0 }, "data": { "key": "Q27WC6C4", "version": 19, "itemType": "journalArticle", "title": "Advanced care planning in health service users", "creators": [ { "creatorType": "author", "firstName": "Karen A", "lastName": "Van Leuven" } ], "abstractNote": "Aims and objectives. To examine the use of advanced directives (ADs) in patients actively using health services in the USA. Background. Since 1991, USA law (PSDA 1991) has required hospitals, skilled nursing facilities (SNFs) and home health services to inquire, at admission, if patients have in place ADs, to provide patients with a written summary of their rights in regard to health-related decision-making and to provide education to staff and the community about ADs. Design. Via chart review and observation, the AD status of patients residing in three SNFs during a six-week period was ascertained ( n = 272). Those with ADs were further evaluated to examine the timing of the directive in regards to their health status. Methods. Patients residing at SNFs were selected for study because SNF patients are admitted from the hospital; therefore, there are at least two opportunities - at hospital admission and at SNF admission - to inquire and educate about advance directives. Results. Residents ranged in age from 35 to 100 years and included patients admitted for short-term rehabilitation after hospitalisation, as well as residents who were initially admitted after a hospitalisation but required long-term care. A full 90·44% ( n = 246) entered skilled care without an AD, and 69·11% ( n = 188) remained without an AD. The most likely reason for the development of an AD was lengthy decline in health status associated with multiple hospitalisations. Conclusions. Current law appears ineffective. A more appropriate approach is to encourage open dialogue about treatment options and quality of life. Relevance to clinical practice. Given the rapidity with which populations are ageing in countries worldwide, ADs would appear to be a phenomenon that should be embraced. However, experience in the USA has called into question their usefulness.", "publicationTitle": "Journal of Clinical Nursing", "publisher": "", "place": "", "date": "November 2012", "volume": "21", "issue": "21/22", "section": "", "partNumber": "", "partTitle": "", "pages": "3126-3133", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Journal of Clinical Nursing", "DOI": "10.1111/j.1365-2702.2012.04190.x", "citationKey": "", "url": "http://ezproxy.library.wwu.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=2011715789&site=ehost-live", "accessDate": "2015-02-14T19:27:32Z", "PMID": "", "PMCID": "", "ISSN": "0962-1067", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "EBSCOhost", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Aged, 80 and Over", "type": 1 }, { "tag": "California", "type": 1 }, { "tag": "Descriptive Research", "type": 1 }, { "tag": "Descriptive Statistics", "type": 1 }, { "tag": "Health Status -- Evaluation", "type": 1 }, { "tag": "Health Status Indicators", "type": 1 }, { "tag": "Human", "type": 1 }, { "tag": "Inpatients", "type": 1 }, { "tag": "MEDICAL records", "type": 1 }, { "tag": "Middle Age", "type": 1 }, { "tag": "Observational Methods", "type": 1 }, { "tag": "Record Review", "type": 1 }, { "tag": "Retrospective Design", "type": 1 }, { "tag": "Scales", "type": 1 }, { "tag": "Skilled Nursing Facilities", "type": 1 }, { "tag": "advance care planning", "type": 1 } ], "collections": [ "6F34NUEM" ], "relations": {}, "dateAdded": "2015-03-04T21:54:59Z", "dateModified": "2015-03-04T21:54:59Z" } }, { "key": "SKIMG5Z9", "version": 18, "library": { "type": "group", "id": 321775, "name": "Pain managment in wwu nursing", "links": { "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/321775/items/SKIMG5Z9", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing/items/SKIMG5Z9", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/321775/items/6JQBK2X4", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2132293, "username": "bilgs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/bilgs", "type": "text/html" } } } }, "data": { "key": "SKIMG5Z9", "version": 18, "parentItem": "6JQBK2X4", "itemType": "attachment", "linkMode": "linked_url", "title": "EBSCO Full Text", "accessDate": "2015-03-04T03:22:59Z", "url": "http://content.ebscohost.com.ezproxy.library.wwu.edu/ContentServer.asp?T=P&P=AN&K=2010763502&S=R&D=ccm&EbscoContent=dGJyMNLr40SeprE4y9fwOLCmr02eqLBSsKi4SbeWxWXS&ContentCustomer=dGJyMPGusk%2BzprdNuePfgeyxw2DNydIA", "note": "", "contentType": "application/pdf", "charset": "", "tags": [], "relations": {}, "dateAdded": "2015-03-04T03:22:59Z", "dateModified": "2015-03-04T03:22:59Z" } }, { "key": "6JQBK2X4", "version": 18, "library": { "type": "group", "id": 321775, "name": "Pain managment in wwu nursing", "links": { "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/321775/items/6JQBK2X4", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing/items/6JQBK2X4", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2132293, "username": "bilgs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/bilgs", "type": "text/html" } } }, "creatorSummary": "Durbin et al.", "parsedDate": "2010-09", "numChildren": 1 }, "data": { "key": "6JQBK2X4", "version": 18, "itemType": "journalArticle", "title": "Systematic Review of Educational Interventions for Improving Advance Directive Completion", "creators": [ { "creatorType": "author", "firstName": "Cr", "lastName": "Durbin" }, { "creatorType": "author", "firstName": "Af", "lastName": "Fish" }, { "creatorType": "author", "firstName": "Ja", "lastName": "Bachman" }, { "creatorType": "author", "firstName": "Kv", "lastName": "Smith" } ], "abstractNote": "Purpose: To systematically analyze evidence about the outcome and percent of newly completed ADs, focusing on the effectiveness of (a) types of educational interventions versus controls and (b) one educational intervention over another. Design: Systematic review of literature based on Cochrane review criteria. Methods: Twelve randomized and four nonrandomized studies were selected from the nursing, medical, and social work literature that met the following criteria: described educational interventions, provided information to calculate the percent of newly completed ADs as an outcome, and published between 1991 and 2009. The review focused primarily on randomized studies. Reviewers calculated the percent of newly completed ADs by determining the number of subjects per group without an AD at baseline and the percentage of those who then completed one by the end of the studies. Findings: Findings were inconsistent regarding all types of educational interventions studied versus controls. Sufficient evidence exists to conclude that combined written and verbal educational interventions were more effective than single written interventions in increasing the percent of newly completed ADs in adult clinic outpatients and hospitalized elderly. Conclusions: Calculating the percent of newly completed ADs was successful in allowing for study result comparisons. Overall, the evidence base regarding the effectiveness of single or combined educational interventions in increasing AD completion is weak. Randomized studies with diverse samples should be conducted against controls before more studies comparing interventions are undertaken. Clinical Relevance: This article provides nurses with a summary of research related to educational interventions and AD completion and identifies where future study is needed.", "publicationTitle": "Journal of Nursing Scholarship", "publisher": "", "place": "", "date": "September 2010", "volume": "42", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "234-241", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Journal of Nursing Scholarship", "DOI": "10.1111/j.1547-5069.2010.01357.x", "citationKey": "", "url": "http://ezproxy.library.wwu.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=2010763502&site=ehost-live", "accessDate": "2015-03-04T03:22:59Z", "PMID": "", "PMCID": "", "ISSN": "1527-6546", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "EBSCOhost", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Adult", "type": 1 }, { "tag": "Advance Directives -- Education", "type": 1 }, { "tag": "Advance Directives -- Utilization", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Aged, 80 and Over", "type": 1 }, { "tag": "CINAHL Database", "type": 1 }, { "tag": "Canada", "type": 1 }, { "tag": "Clinical Trials", "type": 1 }, { "tag": "Information Resources", "type": 1 }, { "tag": "Medline", "type": 1 }, { "tag": "Middle Age", "type": 1 }, { "tag": "Teaching Methods", "type": 1 }, { "tag": "United States", "type": 1 }, { "tag": "World Wide Web", "type": 1 } ], "collections": [ "6F34NUEM" ], "relations": {}, "dateAdded": "2015-03-04T03:22:59Z", "dateModified": "2015-03-04T03:22:59Z" } }, { "key": "WCDKU6D6", "version": 17, "library": { "type": "group", "id": 321775, "name": "Pain managment in wwu nursing", "links": { "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/321775/items/WCDKU6D6", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing/items/WCDKU6D6", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/321775/items/6UIED59X", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2132293, "username": "bilgs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/bilgs", "type": "text/html" } } } }, "data": { "key": "WCDKU6D6", "version": 17, "parentItem": "6UIED59X", "itemType": "attachment", "linkMode": "linked_url", "title": "EBSCO Full Text", "accessDate": "2015-03-04T03:08:48Z", "url": "http://content.ebscohost.com.ezproxy.library.wwu.edu/ContentServer.asp?T=P&P=AN&K=2011657169&S=R&D=ccm&EbscoContent=dGJyMNLr40SeprE4y9fwOLCmr02eqLBSrqy4Sa6WxWXS&ContentCustomer=dGJyMPGusk%2BzprdNuePfgeyxw2DNydIA", "note": "", "contentType": "application/pdf", "charset": "", "tags": [], "relations": {}, "dateAdded": "2015-03-04T03:08:48Z", "dateModified": "2015-03-04T03:08:48Z" } }, { "key": "6UIED59X", "version": 17, "library": { "type": "group", "id": 321775, "name": "Pain managment in wwu nursing", "links": { "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/321775/items/6UIED59X", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing/items/6UIED59X", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2132293, "username": "bilgs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/bilgs", "type": "text/html" } } }, "creatorSummary": "Clabots", "parsedDate": "2012-07", "numChildren": 1 }, "data": { "key": "6UIED59X", "version": 17, "itemType": "journalArticle", "title": "Strategies to Help Initiate and Maintain the End-of-Life Discussion With Patients and Family Members", "creators": [ { "creatorType": "author", "firstName": "Susan", "lastName": "Clabots" } ], "abstractNote": "Nurses face barriers in the acute care setting regarding the initiation and maintenance of end-of-life discussions. Identification of and strategies to overcome these barriers are discussed.", "publicationTitle": "MEDSURG Nursing", "publisher": "", "place": "", "date": "July 2012", "volume": "21", "issue": "4", "section": "", "partNumber": "", "partTitle": "", "pages": "197-204", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "MEDSURG Nursing", "DOI": "", "citationKey": "", "url": "http://ezproxy.library.wwu.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=2011657169&site=ehost-live", "accessDate": "2015-03-04T03:08:48Z", "PMID": "", "PMCID": "", "ISSN": "1092-0811", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "EBSCOhost", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Advance Directives", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Communication", "type": 1 }, { "tag": "Cultural Values", "type": 1 }, { "tag": "Death", "type": 1 }, { "tag": "Decision Making", "type": 1 }, { "tag": "Decision Making, Family", "type": 1 }, { "tag": "Decision Making, Patient", "type": 1 }, { "tag": "Education, Continuing (Credit)", "type": 1 }, { "tag": "Family", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Grief", "type": 1 }, { "tag": "Inpatients", "type": 1 }, { "tag": "Life Support Care", "type": 1 }, { "tag": "Medical Futility", "type": 1 }, { "tag": "Medical-Surgical Nursing", "type": 1 }, { "tag": "Nurse-Patient Relations", "type": 1 }, { "tag": "Nursing Practice", "type": 1 }, { "tag": "Nursing Role", "type": 1 }, { "tag": "Nursing Units", "type": 1 }, { "tag": "Palliative Care", "type": 1 }, { "tag": "Patient Advocacy", "type": 1 }, { "tag": "Patient Autonomy", "type": 1 }, { "tag": "Professional-Family Relations", "type": 1 }, { "tag": "Stress, Psychological", "type": 1 }, { "tag": "Suffering", "type": 1 }, { "tag": "Support, Psychosocial", "type": 1 }, { "tag": "Terminal Care", "type": 1 }, { "tag": "Terminally Ill Patients", "type": 1 }, { "tag": "Truth Disclosure", "type": 1 } ], "collections": [ "6F34NUEM" ], "relations": {}, "dateAdded": "2015-03-04T03:08:48Z", "dateModified": "2015-03-04T03:08:48Z" } }, { "key": "JZ5Q8K3A", "version": 16, "library": { "type": "group", "id": 321775, "name": "Pain managment in wwu nursing", "links": { "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/321775/items/JZ5Q8K3A", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing/items/JZ5Q8K3A", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2132293, "username": "bilgs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/bilgs", "type": "text/html" } } }, "creatorSummary": "Castillo et al.", "parsedDate": "2011", "numChildren": 1 }, "data": { "key": "JZ5Q8K3A", "version": 16, "itemType": "journalArticle", "title": "Lost in translation: the unintended consequences of advance directive law on clinical care", "creators": [ { "creatorType": "author", "firstName": "Ls", "lastName": "Castillo" }, { "creatorType": "author", "firstName": "Ba", "lastName": "Williams" }, { "creatorType": "author", "firstName": "Sm", "lastName": "Hooper" }, { "creatorType": "author", "firstName": "Cp", "lastName": "Sabatino" }, { "creatorType": "author", "firstName": "La", "lastName": "Weithorn" }, { "creatorType": "author", "firstName": "Rl", "lastName": "Sudore" } ], "abstractNote": "Background: Advance directive law may compromise the clinical effectiveness of advance directives. Purpose: To identify unintended legal consequences of advance directive law that may prevent patients from communicating end-of-life preferences. Data Sources: Advance directive legal statutes for all 50 U.S. states and the District of Columbia and English-language searches of LexisNexis, Westlaw, and MEDLINE from 1966 to August 2010. Study Selection: Two independent reviewers selected 51 advance directive statutes and 20 articles. Three independent legal reviewers selected 105 legal proceedings. Data Extraction: Two reviewers independently assessed data sources and used critical content analysis to determine legal barriers to the clinical effectiveness of advance directives. Disagreements were resolved by consensus. Data Synthesis: Legal and content-related barriers included poor readability (that is, laws in all states were written above a 12th-grade reading level), health care agent or surrogate restrictions (for example, 40 states did not include same-sex or domestic partners as default surrogates), and execution requirements needed to make forms legally valid (for example, 35 states did not allow oral advance directives, and 48 states required witness signatures, a notary public, or both). Vulnerable populations most likely to be affected by these barriers included patients with limited literacy, limited English proficiency, or both who cannot read or execute advance directives; same-sex or domestic partners who may be without legally valid and trusted surrogates; and unbefriended, institutionalized, or homeless patients who may be without witnesses and suitable surrogates. Limitation: Only appellate-level legal cases were available, which may have excluded relevant cases. Conclusion: Unintended negative consequences of advance directive legal restrictions may prevent all patients, and particularly vulnerable patients, from making and communicating their end-of-life wishes and having them honored. These restrictions have rendered advance directives less clinically useful. Recommendations include improving readability, allowing oral advance directives, and eliminating witness or notary requirements. Primary Funding Source: U.S. Department of Veterans Affairs and the Pfizer Foundation.", "publicationTitle": "Annals of Internal Medicine", "publisher": "", "place": "", "date": "2011", "volume": "154", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "121-128", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Annals of Internal Medicine", "DOI": "", "citationKey": "", "url": "http://ezproxy.library.wwu.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=2010911783&site=ehost-live", "accessDate": "2015-03-04T01:39:27Z", "PMID": "", "PMCID": "", "ISSN": "0003-4819", "archive": "", "archiveLocation": "", "shortTitle": "Lost in translation", "language": "", "libraryCatalog": "EBSCOhost", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Advance Directives -- Legislation and Jurisprudence", "type": 1 }, { "tag": "Communication Barriers", "type": 1 }, { "tag": "Homosexuality", "type": 1 }, { "tag": 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"accessDate": "2015-03-04T01:35:33Z", "url": "http://tcn.sagepub.com/content/20/4/405.full.pdf", "note": "", "contentType": "application/pdf", "charset": "", "tags": [], "relations": {}, "dateAdded": "2015-03-04T01:35:33Z", "dateModified": "2015-03-04T01:35:33Z" } }, { "key": "K4X9HVHR", "version": 15, "library": { "type": "group", "id": 321775, "name": "Pain managment in wwu nursing", "links": { "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/321775/items/K4X9HVHR", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing/items/K4X9HVHR", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2132293, "username": "bilgs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/bilgs", "type": "text/html" } } }, "creatorSummary": "Johnstone and Kanitsaki", "parsedDate": "2009-10-01", "numChildren": 3 }, "data": { "key": "K4X9HVHR", "version": 15, "itemType": "journalArticle", "title": "Ethics and Advance Care Planning in a Culturally Diverse Society", "creators": [ { "creatorType": "author", "firstName": "Megan-Jane", "lastName": "Johnstone" }, { "creatorType": "author", "firstName": "Olga", "lastName": "Kanitsaki" } ], "abstractNote": "Emerging international research suggests that in multicultural countries, such as Australia and the United States, there are significant disparities in end-of-life care planning and decision making by people of minority ethnic backgrounds compared with members of mainstream English-speaking background populations. Despite a growing interest in the profound influence of culture and ethnicity on patient choices in end-of-life care, and the limited uptake of advance care plans and advance directives by ethnic minority groups in mainstream health care contexts, there has been curiously little attention given to cross-cultural considerations in advance care planning and end-of-life care. Also overlooked are the possible implications of cross-cultural considerations for nurses, policy makers, and others at the forefront of planning and providing end-of-life care to people of diverse cultural and language backgrounds. An important aim of this article is to redress this oversight.", "publicationTitle": "Journal of Transcultural Nursing", "publisher": "", "place": "", "date": "10/01/2009", "volume": "20", "issue": "4", "section": "", "partNumber": "", "partTitle": "", "pages": "405-416", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "J Transcult Nurs", "DOI": "10.1177/1043659609340803", "citationKey": "", "url": "http://tcn.sagepub.com/content/20/4/405", "accessDate": "2015-03-04T01:35:33Z", "PMID": "", "PMCID": "", "ISSN": "1043-6596, 1552-7832", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "en", "libraryCatalog": "tcn.sagepub.com.ezproxy.library.wwu.edu", "callNumber": "", "rights": "", "extra": "PMID: 19597187", "tags": [ { "tag": "advance care planning", "type": 1 }, { "tag": "cultural diversity", "type": 1 }, { "tag": "ethics", "type": 1 }, { "tag": "ethnic minorities", "type": 1 }, { "tag": "human rights", "type": 1 } ], "collections": [ "6F34NUEM" ], "relations": {}, "dateAdded": "2015-03-04T01:35:33Z", "dateModified": "2015-03-04T01:35:33Z" } }, { "key": "A4B3SIVD", "version": 14, "library": { "type": "group", "id": 321775, "name": "Pain managment in wwu nursing", "links": { "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/321775/items/A4B3SIVD", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing/items/A4B3SIVD", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2132293, "username": "bilgs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/bilgs", "type": "text/html" } } }, "creatorSummary": "Fischer et al.", "parsedDate": "2012-01", "numChildren": 1 }, "data": { "key": "A4B3SIVD", "version": 14, "itemType": "journalArticle", "title": "Advance Directive Discussions: Lost in Translation or Lost Opportunities?", "creators": [ { "creatorType": "author", "firstName": "Stacy M.", "lastName": "Fischer" }, { "creatorType": "author", "firstName": "Angela", "lastName": "Sauaia" }, { "creatorType": "author", "firstName": "Sung-Joon", "lastName": "Min" }, { "creatorType": "author", "firstName": "Jean", "lastName": "Kutner" } ], "abstractNote": "Background: Previous studies have shown that minority populations have low rates of documented advance directives and express preferences for more life-prolonging interventions at the end of life. We sought to determine the impact of Latino ethnicity on patients' self-report of having an advance directive discussion and having a completed advance directive in the medical record at an index hospitalization for serious medical illness. Methods: This was a prospective observational cohort study of 458 adults admitted to the general medical services of a safety net hospital, an academic medical center, and a Veterans' Affairs (VA) hospital. Patients were asked if they had discussed advance directives, and we reviewed medical records for documented advance directives. Results: Overall, 45% of patients reported having had a discussion about advance directives (29% of Latinos compared with 54% of Caucasians, p=0.0002) and 24% of patients had a completed advance directive in their medical record (25% Latinos and 26% of Caucasians, p=not significant [ns]). Using logistic regression modeling and adjusting for socioeconomic status (SES), education level, and language spoken, Latinos (odds ratio [OR] 0.42, confidence interval [CI] 0.24-0.75) were less likely to report having advance directive discussions compared with Caucasians (referent). However, modeling of a completed advance directive in the medical record showed no significant difference between Latinos (OR 1.44, CI 0.73-2.85) and Caucasians (referent). Conclusions: The unexpected discrepancy we found highlights the need for more effective communication in advance care planning that includes education that is culturally sensitive and accessible to persons with low health literacy.", "publicationTitle": "Journal of Palliative Medicine", "publisher": "", "place": "", "date": "January 2012", "volume": "15", "issue": "1", "section": "", "partNumber": "", "partTitle": "", "pages": "86-92", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Journal of Palliative Medicine", "DOI": "10.1089/jpm.2011.0328", "citationKey": "", "url": "http://ezproxy.library.wwu.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=70480256&site=ehost-live", "accessDate": "2015-03-04T00:57:58Z", "PMID": "", "PMCID": "", "ISSN": "10966218", "archive": "", "archiveLocation": "", "shortTitle": "Advance Directive Discussions", "language": "", "libraryCatalog": "EBSCOhost", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "ADVANCE directives (Medical care)", "type": 1 }, { "tag": "CHI-squared test", "type": 1 }, { "tag": "COLORADO", "type": 1 }, { "tag": "CONFIDENCE intervals", "type": 1 }, { "tag": "CROSS-sectional method", "type": 1 }, { "tag": "DATA analysis", "type": 1 }, { "tag": "DATA analysis -- Software", "type": 1 }, { "tag": "DISCUSSION", "type": 1 }, { "tag": "Descriptive Statistics", "type": 1 }, { "tag": "EPIDEMIOLOGY", "type": 1 }, { "tag": "HISPANIC Americans", "type": 1 }, { "tag": "INTERVIEWING", "type": 1 }, { "tag": "LOGISTIC regression analysis", "type": 1 }, { "tag": "LONGITUDINAL method", "type": 1 }, { "tag": "MEDICAL care use", "type": 1 }, { "tag": "MEDICAL records", "type": 1 }, { "tag": "RESEARCH", "type": 1 }, { "tag": "RESEARCH -- Finance", "type": 1 }, { "tag": "SOCIOECONOMIC factors", "type": 1 }, { "tag": "STATISTICS", "type": 1 }, { "tag": "T-test (Statistics)", "type": 1 } ], "collections": [ "6F34NUEM" ], "relations": {}, "dateAdded": "2015-03-04T00:57:58Z", "dateModified": "2015-03-04T00:57:58Z" } }, { "key": "ANU2UW9D", "version": 14, "library": { "type": "group", "id": 321775, "name": "Pain managment in wwu nursing", "links": { "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/321775/items/ANU2UW9D", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing/items/ANU2UW9D", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/321775/items/A4B3SIVD", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2132293, "username": "bilgs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/bilgs", "type": "text/html" } } } }, "data": { "key": "ANU2UW9D", "version": 14, "parentItem": "A4B3SIVD", "itemType": "attachment", "linkMode": "linked_url", "title": "EBSCO Full Text", "accessDate": "2015-03-04T00:57:58Z", "url": "http://content.ebscohost.com.ezproxy.library.wwu.edu/ContentServer.asp?T=P&P=AN&K=70480256&S=R&D=a9h&EbscoContent=dGJyMNLr40SeprE4y9fwOLCmr02ep7dSs624SLOWxWXS&ContentCustomer=dGJyMPGusk%2BzprdNuePfgeyxw2DNydIA", "note": "", "contentType": "application/pdf", "charset": "", "tags": [], "relations": {}, "dateAdded": "2015-03-04T00:57:58Z", "dateModified": "2015-03-04T00:57:58Z" } }, { "key": "BUZ58C6S", "version": 13, "library": { "type": "group", "id": 321775, "name": "Pain managment in wwu nursing", "links": { "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/321775/items/BUZ58C6S", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing/items/BUZ58C6S", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2132293, "username": "bilgs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/bilgs", "type": "text/html" } } }, "numChildren": 1 }, "data": { "key": "BUZ58C6S", "version": 13, "itemType": "webpage", "title": "Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life", "creators": [], "abstractNote": "For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.", "websiteTitle": "", "websiteType": "", "date": "", "publisher": "", "place": "", "DOI": "", "citationKey": "", "url": "http://books.nap.edu/openbook.php?record_id=18748&page=R11", "accessDate": "2015-02-18T08:21:44Z", "shortTitle": "Dying in America", "language": "", "rights": "", "extra": "", "tags": [], "collections": [ "CCMJDQPB" ], "relations": {}, "dateAdded": "2015-02-18T08:21:44Z", "dateModified": "2015-02-18T08:21:44Z" } }, { "key": "77XW2FAT", "version": 13, "library": { "type": "group", "id": 321775, "name": "Pain managment in wwu nursing", "links": { "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/321775/items/77XW2FAT", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing/items/77XW2FAT", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/321775/items/BUZ58C6S", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2132293, "username": "bilgs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/bilgs", "type": "text/html" } } } }, "data": { "key": "77XW2FAT", "version": 13, "parentItem": "BUZ58C6S", "itemType": "attachment", "linkMode": "linked_url", "title": "Snapshot", "accessDate": "2015-02-18T08:21:44Z", "url": "http://books.nap.edu/openbook.php?record_id=18748&page=R11", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2015-02-18T08:21:44Z", "dateModified": "2015-02-18T08:21:44Z" } }, { "key": "DN99S842", "version": 12, "library": { "type": "group", "id": 321775, "name": "Pain managment in wwu nursing", "links": { "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/321775/items/DN99S842", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing/items/DN99S842", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/321775/items/K3D4MK8P", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2132293, "username": "bilgs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/bilgs", "type": "text/html" } } } }, "data": { "key": "DN99S842", "version": 12, "parentItem": "K3D4MK8P", "itemType": "attachment", "linkMode": "linked_url", "title": "Snapshot", "accessDate": "2015-02-18T08:06:14Z", "url": "http://www.pbs.org/wgbh/pages/frontline/facing-death/facts-and-figures/", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2015-02-18T08:06:14Z", "dateModified": "2015-02-18T08:06:14Z" } }, { "key": "K3D4MK8P", "version": 12, "library": { "type": "group", "id": 321775, "name": "Pain managment in wwu nursing", "links": { "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/321775/items/K3D4MK8P", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/pain_managment__in_wwu_nursing/items/K3D4MK8P", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2132293, "username": "bilgs", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/bilgs", "type": "text/html" } } }, "numChildren": 1 }, "data": { "key": "K3D4MK8P", "version": 12, "itemType": "webpage", "title": "Facing Death - Facts & Figures", "creators": [], "abstractNote": "How much do you know about the American way of dying? Here are figures from FRONTLINE's Facing Death, a film that intimately examines today's complicated end-of-life decisions. Included is information on how we die, how much it costs and what really happens in ICUs.", "websiteTitle": "FRONTLINE", "websiteType": "", "date": "", "publisher": "", "place": "", "DOI": "", "citationKey": "", "url": "http://www.pbs.org/wgbh/pages/frontline/facing-death/facts-and-figures/", "accessDate": "2015-02-18T08:06:14Z", "shortTitle": "", "language": "", "rights": "", "extra": "", "tags": [], "collections": [ "CCMJDQPB" ], "relations": {}, "dateAdded": "2015-02-18T08:06:14Z", "dateModified": "2015-02-18T08:06:14Z" } } ]