[doi:10.1063/1.3234384]“
“Objective Attachment theory has received much interest lately in relation to how adults cope with stress and severe illness. The aim of this study was using Selleck Ro-3306 the experiences of patients and family members to explore palliative home care as a secure base (a central concept within the theory). Methods Twelve patients and 14 family members were interviewed during ongoing palliative home care. The interviews were analysed with deductive qualitative content analysis. Results

Informants expressed the relevance of sensing security during palliative home care because death and dying were threats that contributed to vulnerability. Palliative home care could foster a feeling of security and provide a secure base. This was facilitated when informants had trust in staff (e.g. due to availability and competence in providing symptom relief), felt recognised as individuals

and welcomed to contact the team in times of needs. Being comfortable, informed and having an everyday life also contributed to a perception of palliative home care as a secure base. Family members stressed the importance of being relieved from responsibilities that were too heavy. The underlying meanings of experiencing palliative home care as a secure base involved gaining VX-809 concentration a sense of control and of inner peace, perceiving that despite a demanding and changed life situation, one could continue partially being oneself and having something to hope for, even if this no longer concerned cure for the ill person. Conclusions Important aspects of palliative home

care as providing a secure base were identified and these have implications for clinical practice. Copyright (c) 2011 John Wiley & Sons, Ltd.”
“Methods: We evaluated ICE intraoperative imaging of left ventricular (LV) function and aortic valvular flow as well as safety of implementation. ICE was used to guide CRT system lead placement, assess impact of pacing modes, and optimization of device programming.

Results: Twenty-three patients underwent ICE imaging. ICE showed global hypokinesis in six patients, regional selleck compound wall motion abnormality only in 10 patients, and both in seven patients. Optimized CRT modes included mean atrioventricular (AV) interval of 170 ms and interventricular timing using simultaneous right ventricular (RV)-LV pacing (five patients), LV pacing only (one patient), and sequential LV to RV stimulation (15 patients) or RV to LV stimulation (two patients). ICE-guided CRT acutely improved mean left ventricular ejection fraction (LVEF) from 24 +/- 9% to 41 +/- 1% (P < 0.00001). During follow-up of 3-24 (mean 11) months, New York Heart Association class improved in all patients from a mean of 3.2 +/- 0.4 at implant to 1.6 +/- 0.7 (P < 0.0001), with improvement of LVEF from 19 +/- 7% to 34 +/- 12% (P = 0.0001). Actuarial survival was 83% at 12 months.