Using Radar it is possible to measure vital signs through clothing or a mattress from the distance. This allows for a very comfortable way of continuous monitoring in hospitals or home environments. The dataset presented in this article consists of 24 h of synchronised data from a radar and a reference device. The implemented continuous wave radar system is based on the Six-Port technology and operates at 24 GHz in the ISM band. The reference device simultaneously measures electrocardiogram, impedance cardiogram and non-invasive continuous blood pressure. 30 healthy subjects were measured by physicians according to a predefined protocol. The radar was focused on the chest while the subjects were lying on a tilt table wired to the reference monitoring device. In this manner five scenarios were conducted, the majority of them aimed to trigger hemodynamics and the autonomic nervous system of the subjects. Using the database, algorithms for respiratory or cardiovascular analysis can be developed and a better understanding of the characteristics of the radar-recorded vital signs can be gained.
Background: In 2009, the EAPC published recommendations on standards and norms for palliative care in Europe, and a decade later, wished to update them to reflect contemporary practice. Aim: To elicit consensus on standards and norms for palliative care in Europe, taking account of developments since 2009. Design: A Delphi technique used three sequential online survey rounds, and a final expert consultation (EAPC Board). The original 2009 questionnaire with 134 statements was updated with 13 new concepts and practices following a scoping of the literature between 2009 and 2020 (total: 147 statements). Setting/participants: One contact of Boards of 52 national European organisations affiliated to the EAPC were invited to participate, with subsequent rounds sent to respondees. The EAPC Board ( n = 13) approved final recommendations. Results: In Round 1: 30 organisations (14 organisations × two people, 16 organisations × one person, total n = 44) in 27 countries responded (response rate 58% organisations, 82% countries), Round 2 ( n = 40), Round 3 ( n = 38). 119 statements reached consensus in Round 1, 9 in Round 2, 7 in Round 3. In total 135/145 statements in five domains (terminology, philosophy, levels, delivery, services) reached consensus (defined as >75% agreement), (122) were original EAPC recommendations with 13 new recommendations included emerging specialisms: neonatal, geriatric and dementia care, and better care practices. Seven statements failed to reach consensus and four were removed as irrelevant or repetition. Conclusions: Most recommendations on standards and norms for palliative care in Europe remain unchanged since 2009. Evolving concepts in palliative care can be used to support advocacy.
Stroke is a leading cause of death, disability and is a symptom burden worldwide. It impacts patients and their families in various ways, including physical, emotional, social, and spiritual aspects. As stroke is potentially lethal and causes severe symptom burden, a palliative care (PC) approach is indicated in accordance with the definition of PC published by the WHO in 2002. Stroke patients can benefit from a structured approach to palliative care needs (PCN) and the amelioration of symptom burden. Stroke outcome is uncertain and outlook may change rapidly. Regarding these challenges, core competencies of PC include the critical appraisal of various treatment options, and openly and respectfully discussing therapeutic goals with patients, families, and caregivers. Nevertheless, PC in stroke has to date mainly been restricted to short care periods for dying patients after life-limiting complications. There is currently no integrated concept for PC in stroke care addressing the appropriate moment to initiate PC for stroke patients, and the question of how to screen for symptoms remains unanswered. Therefore, PC for stroke patients is often perceived as a stopgap in cases of unfavorable prognosis and very short survival times. In contrast, PC can provide much more for stroke patients and support a holistic approach, improve quality of life and ensure treatment according to the patient's wishes and values. In this short review we identify key aspects of PC in stroke care and current barriers to implementation. Additionally, we provide insights into our approach to PC in stroke care.
Radar systems allow for contactless measurements of vital signs such as heart sounds, the pulse signal, and respiration. This approach is able to tackle crucial disadvantages of state-of-the-art monitoring devices such as the need for permanent wiring and skin contact. Potential applications include the employment in a hospital environment but also in home care or passenger vehicles. This dataset consists of synchronised data which are acquired using a Six-Port-based radar system operating at 24 GHz, a digital stethoscope, an ECG, and a respiration sensor. 11 test subjects were measured in different defined scenarios and at several measurement positions such as at the carotid, the back, and several frontal positions on the thorax. Overall, around 223 minutes of data were acquired at scenarios such as breath-holding, post-exercise measurements, and while speaking. The presented dataset contains reference-labeled ECG signals and can therefore easily be used to either test algorithms for monitoring the heart rate, but also to gain insights about characteristic effects of radar-based vital sign monitoring.
Background: The working group for palliative medicine within the Comprehensive Cancer Center (CCC) network funded by the German Cancer Aid in Germany has developed and published 14 Standard Operating Procedures (SOPs) for palliative care in CCCs. This study analyzed to what extent these SOPs have been implemented in the clinical routine in the CCC network one year after their publication. Methods: An online-based survey on the implementation status, limitations in daily practice and further themes was conducted between April and July 2018. In total, 125 health professionals in specialized palliative care from all 16 CCC locations were invited to participate. The data were analyzed descriptively using SPSS. Results: The response rate was 52.8%. More than half of the respondents (57.6%) knew about the free availability of SOPs on the CCC network website. The extent to which each SOP was being used actively in practice by the survey respondents ranged from a low of 22.7% (for the "Fatigue" SOP) to a highest of 48.5% (for the "Palliative Sedation" and "Respiratory Distress" SOPs). The respondents became aware of the SOP through recommendations from colleagues, team meetings or from the head of the department. The SOPs "Respiratory distress of an adult palliative patient" and "Palliative sedation" were perceived as the most practically oriented and understandable. Barriers to use SOPs were mainly limited time resources and lack of knowledge of existence and availability. Conclusions: In practice, better knowledge about the SOPs and at the same time increased use can be achieved through systematic training or discussion of SOPs in regular team meetings. There is a need to take measures to optimize the implementation in clinical practice.
This SOP for the first time presents disease-specific guidelines for PC integration into comprehensive (lung) cancer therapy by (1) defining "green flags" for early integration of PC and (2) recommending PC parallel to initiation of anticancer therapy. Furthermore, clear definitions are provided to delineate PC assignments. Such disease-specific algorithms should be helpful to further reduce uncertainty about the way PC can be integrated early in the course of the disease.
Bibliografie DOI http://dx.
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