I even expanded my horizons beyond the usual London based suspects to cross the Irish sea, so fully embraced the European collaboration with the All Ireland institute. In all honesty the best thing about these conferences ( bar the location & beer) is the ability to think and forge new collaborations. There are 328 pages of bumph if you want more or you can merely quote Edward Denning “without data you’re just another man with an opinion”. We are still referred to very late on ( 40-50 days before death) and there is ample data now proving the differences we can make – to quality of life, if not to survival. There were incremental improvements in the recognition of “earlier” palliative care links to nursing homes and community geriatrics / DNACPR discussions / planning and all the routine day to day clinical tasks.
The idea that no one wants to take part in research at the end of life has gone, but if you enter into a trial late, then attrition is of course high. For me, there was no definitive practice-changing trial. The reality that came through in the lectures I attended, is that many clinical interventions are still taking an enormous length of time to complete and end up being significantly underpowered. I did look! All jesting aside, the lack of basic science representation was striking. While it was great to see the usual smattering of psychologists, nurses, social scientists and the like, I did not see too many laboratory based ones, or dermatologists or pulmonologists, for that matter. I like the idea of mixing with other disciplines – not just oncologists, but (you heard it here first) other specialities, too. What it does mean -according to the plenary lectures- is more data on services, more trials and yes, more collaboration.
So you may ask what has changed over the course of time and the answer has to be somewhat tangential – plus ca change … However we are now in a position to future-proof ourselves and apparently that does not involve uploading our consciousness to the cloud, like in a Futurama episode. It was as I later found out an anniversary: “20 years of the EAPC Research Network, the 30th anniversary of the EAPC, as well as the commemoration of the 100th birthday of Dame Cicely Saunders.” Lots of decades of fine work there. Like every medical conference worth its salt, there needs to be a tag line – this was the research version of the annual European conference. Being sufficiently cuckoo, I did not need to bring a Kuckucksuhr home, either. As a result I can share some thoughts about what I learned and bought home, aside from the Swiss chocolate and the #EAPC2018 hashtag. The conference side-programme did not, on this occasion, involve a day visit to the Dignitas clinic, which I did point out on my feedback form. I couldn’t get to Bournemouth for this year’s Association for Palliative Medicine conference so went for complete palliation ( soins palliatifs, dude) in Switzerland, instead. Today, in addition to the traditional mechanical cuckoo clocks, electro-mechanical models are also offered with quartz clockwork, electronically generated cuckoo calls, as well as chain hoist and pendulum fakes.By Dr Ollie Minton, Consultant in Palliative Medicine, Brighton, UK In addition, other movable decorative elements can be attached to the outside of the clock, which move (usually only on the hour) (dancers, other birds). Depending on the version, the mechanical cuckoo - traditionally carved from wood and painted, today often made from plastic - is moved or opens its beak to match the cuckoo call. However, some patents manage with just one flute. The “cuckoo call” is traditionally generated by a pair of organ pipes of different heights inside the clock.
In addition, one or more cuckoo calls are heard every full hour depending on the number of hours (full hours are counted), usually together with a gong. A mechanical cuckoo serves as the acoustic time signal, which is movably mounted in the housing behind a door-like flap above the dial and is usually swiveled out every full hour. The real eponymous feature of the cuckoo clock, however, is the striking mechanism.
Since the middle of the 19th century, the basic shape of the housing has mostly been modeled on a trainman's house with a sloping roof and decorated with more or less elaborately carved wooden ornaments. It is often a wall clock whose mechanical pendulum mechanism is equipped with a chain hoist and striking mechanism. The cuckoo clock is traditionally mainly made in the Black Forest and is known worldwide.