Testing the feasibility of the Dignity Therapy interview: adaptation for the Danish culture

<p>Abstract</p> <p>Background</p> <p><b>'</b>Dignity Therapy' (DT) is a brief, flexible intervention, which allows patients to complete an interview and create a document regarding their life, identity and what they want to leave in writing for their loved ones. DT is based on the DT Question Protocol. Developed and tested in English speaking settings, DT has proven to be a feasible and effective way to enhance patient dignity, while diminishing suffering and depression. The aim of this study was to test the acceptability and feasibility of the DT Question Protocol among Danish health professionals and cancer patients, and to obtain preliminary estimates of patient uptake for DT. These results will be used to inform a larger evaluation study.</p> <p>Method</p> <p>Ten professionals were interviewed about their perception of DT and the Question Protocol. It was then tested with 20 patients at two palliative care sites and one gynecologic oncology department. Data was analyzed using content analysis techniques to evaluate the protocol for relevance, acceptability and comprehension. The interest and relevance of the intervention was also determined by examining the preliminary participation rate.</p> <p>Results</p> <p>Overall, DT was perceived to be comprehensible and relevant. Professionals highlighted six concerns that might warrant modification. These issues were examined using patient data. Some of their concerns overlapped with those raised by the professionals (e.g. <it>'unacceptable self-praise' </it>and '<it>interference with the lives of others'</it>). Tailoring DT to Danish culture required easily accommodated adjustments to the procedures and the DT Question Protocol. Some concerns expressed by health professionals may have reflected protectiveness toward the patients. While the intervention was relevant and manageable for patients admitted to palliative care, DT was less easily implemented at the gynecologic oncology department.</p> <p>Conclusion</p> <p>Based on patients' and professionals' reaction to the DT Question Protocol, and based on the preliminary proportion of participants accepting DT, the DT question protocol - with minor adaptations - appears to be a manageable, acceptable and relevant intervention for Danish patients admitted to palliative care.</p

Decision Support Systems for Weed Management

Editors: Guillermo R. Chantre, José L. González-Andújar.Weed management Decision Support Systems (DSS) are increasingly important computer-based tools for modern agriculture. Nowadays, extensive agriculture has become highly dependent on external inputs and both economic costs, as well the negative environmental impact of agricultural activities, demands knowledge-based technology for the optimization and protection of non-renewable resources. In this context, weed management strategies should aim to maximize economic profit by preserving and enhancing agricultural systems. Although previous contributions focusing on weed biology and weed management provide valuable insight on many aspects of weed species ecology and practical guides for weed control, no attempts have been made to highlight the forthcoming importance of DSS in weed management. This book is a first attempt to integrate 'concepts and practice' providing a novel guide to the state-of-art of DSS and the future prospects which hopefully would be of interest to higher-level students, academics and professionals in related areas

Synthesis of branched and linear 1,4-linked galactan oligosaccharides

Strategic naphthylidine protection allows for the rapid assembly of linear and branched 1,4-galactans.</p

Hospital-admitted COPD patients treated at home using telemedicine technology in The Virtual Hospital Trial:methods of a randomized effectiveness trial

BACKGROUND: Recent reviews suggest that telemedicine solutions for patients with chronic obstructive pulmonary disease (COPD) may prevent hospital readmissions and emergency room visits and improve health-related quality of life. However, the studies are few and only involve COPD patients who are in a stable phase or in-patients who are ready for discharge. COPD patients hospitalized with an acute exacerbation may also benefit from telemedicine solutions. The overall aim is to investigate a telemedicine-based treatment solution for patients with acute exacerbation of COPD at home as compared to conventional hospital treatment measured according to first treatment failure, which is defined as readmission due to COPD within 30 days after discharge. METHODS: COPD patients with acute exacerbation who fulfilled the eligibility criteria and were from two university hospitals in Denmark were randomized (1:1) by computer-generated tables that allocated treatments in blocks of four to receive either standard treatment at the hospital or the same standard treatment at home using telemedicine technology (that is, a video conference system with a touch screen and webcam and monitoring equipment (spirometer, thermometer, and pulse oximeter)). Patients treated in the telemedicine group were backed up by an organizational setting securing 24/7/365 online access to the hospital, as well as access to oxygen, nebulizer therapy, oral medical therapy and surveillance of vital parameters from home monitoring devices. Patients in both groups were discharged when clinically stable and when fulfilling five pre-specified discharge criteria. Follow-up was performed at 1, 3 and 6 months after discharge. The primary outcome was treatment failure defined as readmission due to exacerbation in COPD within 30 days. Secondary outcomes were death from any cause, prescription of additional antibiotics or steroids, need of intubation or non-invasive ventilation, emergency room visits, visits to the general practitioner, lung function, bed days, health-related quality of life, healthcare costs and user satisfaction. RESULTS: Enrollment of patients started in June 2010 and ended in December 2011. Follow-up ended in May 2012. Results were analyzed in 2013. CONCLUSIONS: The results may have implications on future hospital treatment modalities for patients with severe exacerbations in COPD where telemedicine may be used as an alternative to conventional admission. TRIAL REGISTRATION: Clinical Trials NCT0115585

E. Availability of data on efficacy of reduced doses of herbicides in cereals

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