Fifty subjects were interviewed to determine the items or issues which they considered as reflecting quality of life and how important these items were in the event of a serious illness. Peace of mind, spiritual satisfaction and social satisfaction were considered to be very important by nearly all of the subjects. Individual.s functioning and level of physical and psychological health were given much less significance. Level of satisfaction was valued much higher than the level of functioning.

This is the second in a series of highlights drawn from the www.palliativedrugs.com website. The website provides free access to the Palliative Care Formulary, a monthly newsletter and a bulletin board for advice to be given and received. With almost 10,000 professional members it is the largest palliative care resource of its kind.

Background: Many patients with malignant pleural effusions and ascites require repeated hospital visits for paracentesis. Materials and Methods: Patients and caregivers were taught to drain malignant effusions at home, using an indwelling catheter inserted into the pleural/ peritoneal cavity. The catheter, (ARROW 14 wire gauge with three additional side holes made to prevent blockage) was inserted using the Seldenger technique for central venous cannulation and secured with a stitch. A three way stopcock was used to regulate fluid drainage. The caregiver was taught to do biweekly dressings with antiseptic ointment. Results: The catheter has been used in 200 patients over a period of five years. Two patients developed infections in the pleural cavity, which were managed with antibiotics. Two patients needed catheter change because of blockage. Other patients retained the catheter till last follow up or death. The procedure can be carried out as a day case. This article describes practical guidelines for inserting and maintaining the catheter.

Aim: To determine the extent to which nurses are able to correctly identify drugs as narcotics and to ascertain their perception of the addiction potential of opiates when used for pain management. Methods: A questionnaire was administered to 86 nurses who attended palliative care workshops in India. Findings: Only morphine (95%), heroin (71%) and codeine (75%) were correctly identified as narcotics by the majority of participants. Imipramine (34%), diazepam (20%) and phenobarbitone (39%) were wrongly classified as narcotics by many nurses. Dextropropoxyphene (11%), pentazocine (21%), buprenorphine (15%) were correctly classified as narcotics by fewer than half the participants. Only 14% knew that that the frequency of psychological dependence due to use of morphine for cancer pain was less than 1%.