bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elucidations
Authors: Schenker Heinrich 
Published: November 2023

Abstract
The fundamental chord in nature (Der Klang in der Natur) is a triad: Because of the inherently narrow compass of the human voice, art—a human activity—can avail itself only of the shortened form of the chord of nature, which when sounded successively defines tonal space: The Urlinie measures out the tonal spaces within the chord, and thereby articulates the chord for the first time, bringing it to consciousness.
Miscellanea
Authors: Schenker Heinrich 
Published: November 2023

Abstract
Forgive me, if an unknown person and a mere musical amateur does not wish to deny himself the opportunity to express his most heartfelt thanks to you for your splendid and seminal work toward the understanding of the Ninth. After a long, long epoch of the most shameless barbarism, you have succeeded in enabling those who have been led so contemptibly astray to understand and appreciate again the strict and serious art. And in your thoroughly painstaking and equally valuable work, as destroyer and creator at the same time, you have succeeded magnificently. Even if the consequences and success may not follow immediately but can only take place in the course of time, perhaps as we move into a somewhat nobler age, you will come to enjoy the respect that you deserve as the first to have mightily promoted the sort of renaissance we have hoped for.
The Opening Chorus (First Chorale Fantasy) from Bach’s St. Matthew Passion
Authors: Schenker Heinrich 
Published: November 2023

Abstract
That Bach was guided by the image of a particular musical form, among other things, in composing the opening chorus of the St. Matthew Passion—the graph of the Urlinie is given on p. 128—cannot be doubted. But with respect to this form, which of course is at the same time the content of the piece, alas, every performance is a failure, as, no less, is all the literature (discussed later). The St. Matthew Passion’s opening chorus itself is incontrovertible evidence that the art of our geniuses stands too high to be the collective property of humanity in any serious sense. The common understanding of music is by its nature too feeble to raise itself to such heights, and no illusion, no yearning, will build a bridge to them. And to overstep the limits of nature, to underestimate God’s grace, election, vocation and occupation, gathering and deepening in the highest dedication of an entire life, because one hopes for more blessings, more fruits, from a wider dissemination, from the artificial gathering together of humanity and its compulsory cultivation—this is assuredly not the way that leads to the high art of genius.
Mendelssohn’s Song without Words, Op67, No. 6
Authors: Schenker Heinrich 
Published: November 2023

Abstract
Since 3 is placed directly above the tonic chord, this tonal space is filled in by the descending third-progression of the Urlinie, 3 2 1 (g –f –e). In the breadth of this narrative, 3 turns twice toward 2 before setting out once more and finally continuing to 1. In the language of form, the first two statements of 3 –2, bars 1–12 and bars 13 – 27, signify antecedent and consequent of a first section. We then recognize in the fifth-progression divided at the third, B–(G –)E, the outline of a middle section, bars 1-12– 61, which is followed by the return appearance of 3 at the beginning of the third section.
Schumann’s Scenes of Childhood, Op. 15, No. 1 “Träumerei”
Authors: Schenker Heinrich 
Published: November 2023

Abstract
Fig. 1a shows how the Urlinie rises from 1 to 3, only to fall back again to 1; it climbs there a second time, and indeed all the way to 4, only to sink back again to 1. Finally, it repeats its first motion, ascending a third time to 3 and falling back to 1. Thus the Urlinie also clearly illustrates the form, the small three-part song form, whose middle section is highlighted by 4.
Introduction to Palliative Nursing Care
Authors: Coyle Nessa 
Published: November 2023

Abstract
“I failed to care for him properly because I was ignorant”— these are haunting words, and they are as true today as they were several decades earlier. Clinicians cannot practice what they do not know. However, the opposite is also true: Individuals and their families, struggling to live in the face of progressive, symptomatic, and debilitating disease, can be well cared for and supported throughout this process and find meaning and peace in the face of death. This is the essence of skilled palliative nursing care—to facilitate the “caring” process through a combination of science, presence, openness, compassion, mindful attention to detail, and teamwork. Although we have both the knowledge and the art to control the majority of symptoms that occur during the last months, weeks, and days of life, we still have much to learn about how to alleviate the psychological and spiritual distress that comes with life-threatening illness.
Pain at the End of Life
Authors: Paice Judith A , Fine Perry G 
Published: November 2023

Abstract
Of the many symptoms experienced by those at the end of life, pain is one of the most common and most feared. However, this fear is largely unfounded because the majority of patients with terminal illness can obtain relief. Nurses are critical members of the palliative care team, particularly in providing pain management. The nurse’s role begins with assessment and continues through the development of a plan of care and its implementation. During this process, the nurse provides education and counsel to the patient, family, and other team members. Nurses also are critical for developing institutional policies and monitoring outcomes that ensure good pain management for all patients within their palliative care program. To provide optimal pain control, all health care professionals must understand the frequency of pain at the end of life, the barriers that prevent good management, the assessment of this syndrome, and the treatments used to provide relief.
Dysphagia, Xerostomia, and Hiccups
Authors: Dahlin Constance M , Goldsmith Tessa 
Published: November 2023

Abstract
Dysphagia and dry mouth are disturbing symptoms that occur frequently in progressive terminal illness. Hiccups, while less frequent, can be as distressing, adversely affecting quality of life. These problems impact the essence of pleasurable activities such as food, communication, intimacy, social interaction, as well as nutrition.
Hydration, Thirst, and Nutrition
Authors: Kedziera Pamela , Coyle Nessa 
Published: November 2023

Abstract
There is lack of consensus either in society or among experts as to whether it is physically, psychologically, socially, or ethically appropriate to provide artificial hydration and nutrition to a terminally ill person. Do these therapies improve the way an individual feels physically and emotionally? Do they cause harm? Can an individual die comfortably without these interventions? Decisions are usually made on the basis of whether the intervention will make the patient more comfortable and whether it will honor his or her wishes. These elements are illustrated in the following two case reports.
Skin Disorders: Tumor Necrosis, Fistulas, and Stomas
Authors: Bates-Jensen Barbara M , Seaman, Susie , Early Lynne 
Published: November 2023

Abstract
Tumor necrosis, also known in the literature as fungating tumors, ulcerative malignant wounds, or malignant cutaneous wounds, presents both a physical and an emotional challenge for the patient and even the most experienced clinician. These wounds are frequently associated with pain, odor, bleeding, and an unsightly appearance. They may be a blow to self-esteem and may cause social isolation just when the patient needs more time with loved ones. The goals in the care of patients with tumor necrosis include pain management; control of exudate, odor, and bleeding; and prevention of infection.
Clinical Interventions, Economic Outcomes, and Palliative Care
Authors: Coyne Patrick J , Lyckholm, Laurie , Smith Thomas J 
Published: November 2023

Abstract
Health care spending and health care quality are major problems in the United States, with health care spending reaching $1.6 trillion, a number expected to triple in the next 10 years. In 2002, there was an annual increase of 9.3%. Drug costs and rising hospital expenses fueled much of this spending. The financial costs of cancer are great both for the individual and for society as a whole. The economic burden is likely to increase as the population ages, the absolute number of people treated for cancer increases, and newer technologies and expensive treatments are adopted as standards of care. Already in the year 2004, the National Institutes of Health estimated overall annual costs for cancer to be $189.8 billion, with direct medical costs totaling $69.4 million, and indirect costs from lost productivity to be $16.9 billion due to illness and $103.5 billion due to premature death. Lack of health insurance and other barriers to health care prevent many Americans from receiving optimal medical care. According to the 2003 National Health Interview Survey data, nearly 27% of Americans between the ages of 18 and 24 and 20% of Americans between the ages of 25 and 44 reported not having a regular source of health care.4 Additionally, 17% of Americans under age 65 have no health insurance, and about one third of older individuals only have Medicare coverage. Nearly one third of all Medicare spending is on patients in their last year of life5,6; we are spending a significant amount on high-technology care for the elderly, and those funds cannot be spent on preventive services or chronic disease conditions for the same population. The pressure on health care funds will increase due to heightened demands for care from an educated elderly population, more elderly long-term survivors, new and expensive technologies, new diseases, and demands for cost cutting.
in Palliative Care
Authors: Berenson Susan 
Published: November 2023

Abstract
Mary was a 64-year-old vivacious, beautiful woman with a zest for life, a wonderful sense of humor, and a terrific Welsh accent. She appeared much younger than her stated age. She was born in Wales and immigrated to the United States at the age of 23. She was happily married for 29 years and had a 23-year-old son, whom she adored. Mary was a strong woman who had managed to stay sober in Alcoholics Anonymous one day at a time for 10 years, and who was able to stop smoking after 35 to 40 years of smoking. She had numerous friends and was cherished by many.
Spiritual Assessment
Authors: Taylor Elizabeth Johnston 
Published: November 2023

Abstract
To solve any problem, one must first assess what the problem is. Consequently, the nursing process dictates that the nurse begin care with an assessment of the patient’s health needs. Although palliative nurses are accustomed to assessing patients’ pain experiences, hydration status, and so forth, they less frequently participate in assessing patients’ and family members’ spirituality. Because spirituality is an inherent and integrating, and often extremely valued, dimension for those who receive palliative nursing care, it is essential that palliative care nurses know to some degree how to conduct a spiritual assessment. This chapter reviews models for spiritual assessment, presents general guidelines on how to conduct a spiritual assessment, and discusses what the nurse ought to do with data from a spiritual assessment. These topics are prefaced by arguments supporting the need for spiritual assessments, descriptions of what spirituality “looks like” among the terminally ill, and risk factors for those who are likely to experience spiritual distress. But first, a description of spirituality is in order.
Cultural Considerations in Palliative Care
Authors: Mazanec Polly , Panke Joan T 
Published: November 2023

Abstract
This chapter defines culture and its components as they relates to palliative care. It addresses cultural competence and the importance of recognizing how one’s own values, practices, and beliefs impact care. Finally, selected palliative care issues influenced by culture are discussed. This chapter is not intended to be a “cookbook” approach to describing behaviors and practices of different cultures as they relate to palliative care, but, rather, a guide to raising awareness of the significance of cultural considerations in palliative care.
Patients with Acquired Immunodeficiency Syndrome
Authors: Sherman Deborah Witt 
Published: November 2023

Abstract
In 20 years, acquired immunodeficiency syndrome (AIDS) has escalated from a series of outbreaks in scattered communities in the United States and Europe to a global health crisis. Although the emerging biomedical paradigm of highly active antiretroviral therapy (HAART) has significantly reduced the mortality from human immunodeficiency virus (HIV) in the developed world and has transformed AIDS into a manageable chronic illness, the reality worldwide is that people are not “living with AIDS,” but, rather, “dying from AIDS” due to a lack of access to medications and appropriate health care. Even in developed countries, AIDS remains the leading cause of serious illness and death for young adults, and at this point in time, there is a false dichotomy created between disease-specific, curative therapies and symptom-specific palliative therapies.3 AIDS has stimulated the need to evaluate clinical practice when curative and palliative care interface and raises some interesting and interconnected issues about the care of individuals with life-threatening, progressive illnesses.4 Both the public and health professionals have been troubled by the reality of overtreatment and undertreatment of pain and symptoms in individuals with life-threatening illnesses, particularly at the end of life.5 Such concern extends to the care of patients with HIV and the resultant illness of AIDS because no cure has yet been found. The focus of care must, therefore, be on improving quality of life by providing palliative care for the management of pain and other physical symptoms while addressing the emotional, social, and spiritual needs of patients and their families throughout the illness trajectory. Even though current therapies have increased the life expectancy of people with HIV/AIDS, the chance of their experiencing symptoms related not only to the disease but to the effects of therapies also increases. Furthermore, palliative measures can be beneficial in ensuring tolerance of and adherence to difficult pharmacological regimens.
Caring for the Drug-Addicted Patient at the End of Life
Authors: Kirsh Kenneth L , Compton, Peggy , Passik Steven D 
Published: November 2023

Abstract
touches medically ill patients and can negatively influence how pain is treated. Because of these issues and despite the fact that national guidelines exist for the treatment of pain disorders such as cancer, pain continues to be undertreated, even at the end of life. In cancer, approximately 40% to 50% of patients with metastatic disease and 90% of patients with terminal cancer or other advanced diseases are reported to experience unrelieved pain. Furthermore, inadequate treatment of cancer pain is an even greater possibility if the patient is a member of an ethnic minority, female, elderly, a child, or a substance abuser.8 Thus, for multicultural patients, we sometimes have conflicting multiple biases in pain treatment that can lead to poor management, mutual suspicion and alienation, and suffering unless these biases are adequately addressed.
Improving the Quality of Care Across All Settings
Authors: Bookbinder Marilyn 
Published: November 2023

Abstract
One system for addressing health and end-of-life care is the inclusion of quality methodologies designed to improve education, streamline health care bureaucracies, help measure costs, and even address how people feel about their jobs. Whether or not your organization is accredited by the Joint Commission on Accreditation of Health Care Organizations (JCAHO), mandated to use a quality improvement (QI) methodology, a planned-change approach is needed to achieve positive outcomes and to cultivate an infrastructure that maintains optimal standards of care for those at the end of life.
Long-Term Care
Authors: Wilson Sarah A 
Published: November 2023

Abstract
Quality end-of-life care in nursing homes is becoming more important as the number of older adults increases, and managed care continues to minimize hospital stays. Nursing home residents are sicker today and have different care needs. Although nursing homes were not established as sites for terminal care, they are becoming the place where many people do die. Statistics on the place of death tell us little about the environment where someone lived and died. This chapter addresses nursing homes, the environment of nursing homes, the staff, the care of dying residents, and model programs to support dying residents.
The Intensive Care Unit
Authors: Puntillo Kathleen , Stannard Daphne 
Published: November 2023

Abstract
An intensive care unit (ICU) is, by tradition, the setting in which the most aggressive care is rendered to hospitalized patients. Patients are admitted to an ICU so that health professionals can perform minute-to-minute titration of care. The primary goals of this aggressive care are patient resuscitation, stabilization, and recovery from the acute phase of an illness or injury. However, many patients die in ICUs. It is estimated that 540,000 people die after admission to ICUs in the United States each year. Stated otherwise, almost one in five Americans receives ICU services before death. ICU deaths account for 59% of all hospital deaths and 80% of all terminal inpatient costs. One third of patients with metastatic cancer who die in hospitals do so in ICUs, as do 85% of patients with acute myocardial infarctions. Therefore, it is clear that management of the process of dying is common in ICUs.
The Outpatient Setting
Authors: Pen Anna R Du , Robison Jeanne 
Published: November 2023

Abstract
Dramatic changes over the last two decades have resulted in shorter and shorter hospital stays, longer survival with chronic debilitating disease, and smaller, fractured families—all of which have contributed greatly to increased use of outpatient services. Outpatient care is delivered in private practice offices, free-standing clinics, and hospital-based outpatient settings. Individuals with chronic and terminal illnesses receive care over time in the outpatient clinic or office setting. In these settings, significant long-term relationships develop among providers, patients, and families. As patients move toward the end of life, visits to the clinic provide an excellent opportunity to assess the patient’s and family’s needs, desires, struggles, and fears.
Rehabilitation and Palliative Care
Authors: Michael Kathleen 
Published: November 2023

Abstract
Even when it is not reasonable to expect cure or reversal of disease processes, or to restore a previous level of functioning and independence, a rehabilitative approach to nursing care adds quality to the experience of life’s completion. Grounded in respect for each unique patient, rehabilitation nurses address palliative and end-of life care with concern for preserving hope, human dignity, and autonomy. They involve social, spiritual, and functional support systems. Rehabilitation nursing interventions are designed to help patients and families make the most out of each day in the context of the disease trajectory. The language of rehabilitation nursing is a language shared with those who practice palliative care.
End-of-Life Decision-Making in Pediatric Oncology
Authors: Hinds Pamela S , Oakes, Linda , Furman Wayne L 
Published: November 2023

Abstract
Deciding to end a child’s life, and involving a child in the decision to end his or her life, are startling phrases, but we in pediatric oncology participate in those considerations with parents, patients, and other members of the health care team as a part of providing the highest-quality care for the child or adolescent with incurable cancer. Participating in end-of-life decisions is life altering for the child or adolescent and for the family, but it can also be life altering for the health care provider. Clinical anecdotes suggest that the way in which patients, family members, and health care providers complete end-of-life decision-making can color all of their preceding treatment-related interactions, and may influence how well parents emotionally survive the dying and death of their child. The manner in which end-of-life decision-making processes are completed may also contribute to the survival of health care providers as compassionate and fully competent professionals.
Grief and Bereavement in Pediatric Palliative Caren
Authors: Davies Betty , Jin Juhye 
Published: November 2023

Abstract
Effective and compassionate care for children with life-threatening conditions and their families is an integral and important part of care from diagnosis through death and bereavement.1 This guiding principle, one of seven put forth by the Institute of Medicine report on the status of palliative and end-of-life care for children and their families, emphasizes that care continues for the family following the child’s death. Though medical science has contributed significantly to the treatment of children with life-limiting illnesses or conditions, children still die from cancer, cardiac disease, respiratory conditions, genetic conditions, and more. Moreover, thousands of neonates die each year and thousands more children of all ages, particularly toddlers and adolescents, die as a result of trauma. Approximately 55,000 children die annually in the United States.1 Regardless of the cause of death, the death of a child is a tragedy, an incomparable life event that has an impact on all family members, friends of the family, and the community in which the family lives. A child’s death also affects the physicians, nurses, social workers, and other health care personnel who provide care for the dying child. The purpose of this chapter is to define common words associated with grief; to describe factors that affect the grief of family members, the effects of grief upon them, and the nurse’s role in helping grieving individuals and their families; and to discuss the needs of nurses who work in pediatric palliative care.
Pediatric Pain: Knowing the Child Before You
Authors: Goldstein Mary Layman , Byrnes-Casey, Maura , Collins John J 
Published: November 2023

Abstract
Pain, a source of suffering, is present in many children—those who are facing a potentially life-threatening illness and those who are not. Expert pain management is a necessary part of pediatric palliative care. It is possible for very young children to feel and express pain. A child’s ability to communicate pain is influenced by age and cognitive level. Even a preverbal child can communicate pain. To effectively manage an individual child’s pain, the nurse first must be aware of the possibility of pain, sensitively observe the child, and use developmentally appropriate, objective assessments. Developmental factors (physical, emotional, and cognitive) play an important role in both pediatric pain assessment and pain management. Through knowledge of these factors and an awareness of how they affect an individual child, it is possible for nurses to effect better management of each child’s pain (Table 55–1). Despite a significant increase in interest and in the study of pediatric pain and its control over the last 20 years, there often remains a gap between what is technically possible and what is clinically practiced.