“We Are Here for You All the Way”—Patients’ and Relatives’ Experiences of Receiving Advanced Home Care

Background: It is of great importance to understand how patients and their close relatives experience the pros and cons of advanced home care so as to further develop this quickly growing choice of care. Objective: The aim of this study was to explore the experiences of receiving advanced home care among patients affected by life-threatening illness and their close relatives. Design: The study was an interview study conducted with patients in their homes. Some patient interviews were conducted together with a close relative participating. Setting/Participants: Patients registered in advanced home care in 2017 were offered the opportunity to participate in the study. The selection criteria were that the patient was within grade 3 of the Eastern Cooperative Oncology Group’s Performance Status, older than 18 years, able to orient to time and place, and not newly registered. Analysis: The interviews were recorded and transcribed verbatim and analyzed with qualitative content analysis. Results: A total of 11 interviews were conducted: 8 with patients and 1 or 2 close relatives together; and 3 with the patient alone. It resulted in 3 main categories: create a safe environment, see the person, and better to manage care at home. Conclusion: The results of this study show that patients and close relatives perceived that advanced home care was a safe and secure form of caring during advanced as well as end-of-life care

Unidirectional Influx and Net Accumulation of PIB

The compound {N-methyl-[11C]}2-(4’-methylaminophenyl)-6-hydroxybenzothiazole, “PIB”, measured by positron emission tomography, has been demonstrated to image brain β-amyloid deposition in Alzheimer’s disease (AD). In the present study the benefit of measuring the PIB accumulation rate together with the unidirectional influx of PIB into the brain was investigated in healthy control subjects and patients with AD. In a monkey changes in the influx rate constant K1 of PIB closely followed changes in CBF, caused by alteration of PaCO2. In addition, K1 was high both in the monkey and in humans, suggesting that this parameter reflects CBF. Most AD patients studied showed clearly higher accumulation rate for PIB than the controls in cortical brain areas, while a few patients showed as low accumulation as the controls. K1 did not correlate with the accumulation rate, indicating that K1 for PIB provides extra information besides the accumulation rate

Utilização de peptídeos combinados com nanotecnologia e imagem molecular – novos métodos para diagnóstico e tratamento de doenças neuropsiquiátricas

Inst Israelita Ensino & Pesquisa Albert Einstein, Sao Paulo, BrazilUniv Fed Sao Paulo, LiNC, Sao Paulo, BrazilUniv Fed Sao Paulo, LiNC, Sao Paulo, BrazilWeb of Scienc

Masked-Volume-Wise PCA and "reference Logan" illustrate similar regional differences in kinetic behavior in human brain PET study using [11C]-PIB

<p>Abstract</p> <p>Background</p> <p>Kinetic modeling using reference Logan is commonly used to analyze data obtained from dynamic Positron Emission Tomography (PET) studies on patients with Alzheimer's disease (AD) and healthy volunteers (HVs) using amyloid imaging agent <it>N</it>-methyl [¹¹C]2-(4'-methylaminophenyl)-6-hydroxy-benzothiazole, [¹¹C]-PIB. The aim of the present study was to explore whether results obtained using the newly introduced method, Masked Volume Wise Principal Component Analysis, MVW-PCA, were similar to the results obtained using reference Logan.</p> <p>Methods</p> <p>MVW-PCA and reference Logan were performed on dynamic PET images obtained from four Alzheimer's disease (AD) patients on two occasions (baseline and follow-up) and on four healthy volunteers (HVs). Regions of interest (ROIs) of similar sizes were positioned in different parts of the brain in both AD patients and HVs where the difference between AD patients and HVs is largest. Signal-to-noise ratio (SNR) and discrimination power (DP) were calculated for images generated by the different methods and the results were compared both qualitatively and quantitatively.</p> <p>Results</p> <p>MVW-PCA generated images that illustrated similar regional binding patterns compared to reference Logan images and with slightly higher quality, enhanced contrast, improved SNR and DP, without being based on modeling assumptions. MVW-PCA also generated additional MVW-PC images by using the whole dataset, which illustrated regions with different and uncorrelated kinetic behaviors of the administered tracer. This additional information might improve the understanding of kinetic behavior of the administered tracer.</p> <p>Conclusion</p> <p>MVW-PCA is a potential multivariate method that without modeling assumptions generates high quality images, which illustrated similar regional changes compared to modeling methods such as reference Logan. In addition, MVW-PCA could be used as a new technique, applicable not only on dynamic human brain studies but also on dynamic cardiac studies when using PET.</p

To model for learning - young adults, relatives and co-workers develop forms of experience based improvement work in haematological care : An action research project

Bakgrund: Experience based design (EBD) är en modell som används för att göra patienter och närstående delaktiga i vårdens utveckling. När EBD-modellen genomlyses utifrån ett aktionsforskningsperspektiv synliggörs möjligheter att utöka patienternas delaktighet i utformning och tillämpning av modellen.   Syfte: Syftet med förbättringsarbetet är att tillsammans med unga vuxna med allvarlig blodsjukdom*, närstående och medarbetare modellera fram ett arbetssätt, med utgångspunkt från aktionsforskning och EBD, för att ta till vara på upplevelser och erfarenheter för att förbättra vården på Hematologen, Sahlgrenska Universitetssjukhuset. Studien av förbättringsarbetet syftar till att öka kunskapen om framgångsfaktorer och hinder för deltagarnas delaktighet i detta angreppssätt för förbättringsarbete.   *blodcancer och annan allvarlig blodsjukdom   Metod: Modelleringen genomfördes med en aktionsforskningsapproach i PDSA-cykler i förbättringsarbetet och skapade ett kontinuerligt lärande. Upplevelser från 22 unga vuxna och närstående samlades in och förbättringsområden identifierades och prioriterades. Individuella intervjuer genomfördes för att öka kunskapen om unga vuxna, närstående och medarbetares delaktighet i ett förbättringsarbete samt skapa ett lärande om framgångsfaktorer och hinder.   Resultat och slutsatser: Unga vuxna och närstående var positiva till att modellera fram ett arbetssätt så att de kan delge sina upplevelser för att utveckla den hematologiska vården. När aktionsforskning användes tillsammans med EBD skapades möjligheter till en hög delaktighet och ett partnerskap mellan patienter, närstående och medarbetare. Dessa lärdomar om hur unga vuxna och närstående kan involveras för att förbättra vården resulterade i förslag till en modell i fyra steg; Designa tillsammans, Samla in erfarenheter, Analysera gemensamt och Arbeta i förbättringsteam. Arbetet har resulterat i 14 identifierade förbättringsområden där förbättringsarbete nu har påbörjats inom fyra prioriterade områden.Background: Experience based design is a model which is used to make patients and their friends and family involved in the development of care. When the EBD model is analyzed from an action research perspective, it becomes apparent that there is a possibility to extend patients’ participation in the design and implementation of the model.   Aim: The aim of improvement work is to model a working method, on the basis of EBD and action research, together with the young adults with serious blood disease*, their friends and family and hospital employees. The goal is to take advantage of experiences and improve care in the Haematology department at Sahlgrenska University Hospital. The study of the improvement work aims to increase the knowledge of participants´ involvement in the improvement process and create learning about the success factors and obstacles.   *blood cancer and serious blood disease   Method: The modelling was carried out using an action research approach in PDSA cycles during the improvement work’s different steps, which created continuous learning. Experiences were collected from 22 young adults and their friends and family and areas for improvement were identified and prioritised. Individual interviews with young adults, their friends and family and hospital employee were carried out to increase knowledge about the participation and involvement in improvement as well as to create knowledge about success factors and obstacles.   Results and conclusions: Young adults and their friends and family willingly engaged in efforts to model a working method for sharing their experiences in order to develop care. Action research used in conjunction with EBD created a high level of participation and a clear partnership. Lessons learned on how young adults and their friends and family can be involved to improve care resulted in the proposal of a model. As a result of the project, 14 areas for improvement were identified using the method, and four improvement efforts have been initiated as of now