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Background: Patients with serious respiratory illness and their caregivers suffer considerable burdens, and palliative care is a fundamental right for anyone who needs it. However, the overwhelming majority of patients do not receive timely palliative care before the end of life, despite robust evidence for improved outcomes. Goals: This policy statement by the American Thoracic Society (ATS) and partnering societies advocates for improved integration of high-quality palliative care early in the care continuum for patients with serious respiratory illness and their caregivers and provides clinicians and policymakers with a framework to accomplish this. Methods: An international and interprofessional expert committee, including patients and caregivers, achieved consensus across a diverse working group representing pulmonary–critical care, palliative care, bioethics, health law and policy, geriatrics, nursing, physiotherapy, social work, pharmacy, patient advocacy, psychology, and sociology. Results: The committee developed fundamental values, principles, and policy recommendations for integrating palliative care in serious respiratory illness care across seven domains: 1) delivery models, 2) comprehensive symptom assessment and management, 3) advance care planning and goals of care discussions, 4) caregiver support, 5) health disparities, 6) mass casualty events and emergency preparedness, and 7) research priorities. The recommendations encourage timely integration of palliative care, promote innovative primary and secondary or specialist palliative care delivery models, and advocate for research and policy initiatives to improve the availability and quality of palliative care for patients and their caregivers. Conclusions: This multisociety policy statement establishes a framework for early palliative care in serious respiratory illness and provides guidance for pulmonary–critical care clinicians and policymakers for its proactive integration.

Sudden Infant Death Syndrome (SIDS) is a problem world-wide. Since it was identified; Western nations have implemented extensive SIDS education campaigns to reduce SIDS risk which have resulted in dramatically decreasing SIDS death rates. In contrast, there is little information available about the impact of SIDS in Middle East (ME) countries where high infant mortality is common. STo investigate SIDS incidence rates across various ME countries, ascertain specific SIDS risk factors relevant to ME populations, categorise high risk groups and identify SIDS intervention programs in the ME. A structured literature review was performed. A total of 10,509 study were identified with 11 proving to be most relevant to the research purpose. The SIDS incidence rates data available in ME countries is extremely limited with only five studies addressing SIDS rates in the ME. For a range of reasons, many infant deaths are registered as "cause unknown" with no associated autopsy report or other details. Additionally, limitations in the study designs restrict the ability to accurately estimate incidence rates from the research projects reported. The most significant risk factor for SIDS in ME countries identified in the literature is the high incidence of smoking, resulting from less political restrictions on smoking at home and public settings. Targeted public health SIDS education programs need to be developed and promoted in high risk ME countries with a specific focus on infant care practices, lifestyle and general living conditions.

Hamadneh, S. M., Al-Shdayfat, N., Al-Omari, O., Hamadneh, J. M., Bashtawi, M., Alkhatib, A., ... Wilkinson, A. M. (2016). Sudden infant death syndrome in the Middle East: An exploration of the literature on rates, risk factors, high risk groups and intervention programs. Research Journal of Medical Sciences, 10(4), 199-204. Available here.

Chróinín, D. N., Goldsbury, D. E., Beveridge, A., Davidson, P. M., Girgis, A., Ingham, N., ... & O’Connell, D. L. (2018). Health-services utilisation amongst older persons during the last year of life: a population-based study. BMC geriatrics, 18(1), 317. Available here.

Wilkinson, A.M., Matzo, M. (2015). Nursing education for disaster preparedness and response in Journal of Continuing Education in Nursing, 46(2), 65-73. Available here.

Wilkinson, A.M., Johnson, C.E., Walker, H., Colgan, V., Arnet, H., Rai, T. (2015). Evaluating the Liverpool Care Pathway for care of the terminally ill in rural Australia in Supportive Care in Cancer, 23(11), 3173-3181. Available here.