| 1. |
- Yildiz, B, et al.
(author)
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Live well, die well - an international cohort study on experiences, concerns and preferences of patients in the last phase of life: the research protocol of the iLIVE study
- 2022
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In: BMJ OPEN. - : BMJ. - 2044-6055. ; 12:8
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Journal article (other academic/artistic)abstract
- Adequately addressing the needs of patients at the end of life and their relatives is pivotal in preventing unnecessary suffering and optimising their quality of life. The purpose of the iLIVE study is to contribute to high-quality personalised care at the end of life in different countries and cultures, by investigating the experiences, concerns, preferences and use of care of terminally ill patients and their families.Methods and analysisThe iLIVE study is an international cohort study in which patients with an estimated life expectancy of 6 months or less are followed up until they die. In total, 2200 patients will be included in 11 countries, that is, 200 per country. In addition, one relative per patient is invited to participate. All participants will be asked to fill in a questionnaire, at baseline and after 4 weeks. If a patient dies within 6 months of follow-up, the relative will be asked to fill in a post-bereavement questionnaire. Healthcare use in the last week of life will be evaluated as well; healthcare staff who attended the patient will be asked to fill in a brief questionnaire to evaluate the care that was provided. Qualitative interviews will be conducted with patients, relatives and healthcare professionals in all countries to gain more in-depth insights.Ethics and disseminationThe cohort study has been approved by ethics committees and the institutional review boards (IRBs) of participating institutes in all countries. Results will be disseminated through the project website, publications in scientific journals and at conferences. Within the project, there will be a working group focusing on enhancing the engagement of the community at large with the reality of death and dying.Trial registration numberNCT04271085.
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| 2. |
- Raijmakers, Natasja J. H., et al.
(author)
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Issues and needs in end-of-life decision making : An international modified Delphi study
- 2012
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In: Palliative Medicine. - : SAGE Publications. - 0269-2163 .- 1477-030X. ; 26:7, s. 947-953
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Journal article (peer-reviewed)abstract
- Background: end-of-life decision making is an important aspect of end-of-life care that can have a significant impact on the process of dying and patients' comfort in the last days of life. Aim: the aim of our study was to identify issues and considerations in end-of-life decision making, and needs for more evidence among palliative care experts, across countries and professions. Participants: 90 palliative care experts from nine countries participated in a modified Delphi study. Participants were asked to identify important issues and considerations in end-of-life decision making and to rate the need for more evidence. Results: experts mentioned 219 issues in end-of-life decision making related to the medical domain, 122 issues related to the patient wishes and 92 related to relatives' wishes, regardless of profession or country (p > 0.05). In accordance, more than 90% of the experts rated the comfort and wishes of the patient and the potential futility of treatment as important considerations in end-of-life decision making, although some variation was present. When asked about issues that are in need of more evidence, 87% mentioned appropriate indications for using sedatives and effects of artificial hydration at the end of life. A total of 83% mentioned adequate communication approaches. Conclusions: palliative care experts from different professions in different countries encounter similar issues in end-of-life decision making. Adequate communication about these issues is universally experienced as a challenge, which might benefit from increased knowledge. This shared experience enables and emphasizes the need for more international research.
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| 3. |
- Jie, L., et al.
(author)
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Optimizing the fleet size of a personal rapid transit system : A case study in port of Rotterdam
- 2010
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In: 2010 13th International IEEE Conference on Intelligent Transportation Systems (ITSC). - : IEEE. - 9781424476572 ; , s. 301-305
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Conference paper (peer-reviewed)abstract
- Cost issues have been an important concern in the development of Personal Rapid Transit (PRT) since the concept was developed several decades ago. The lightweight, computer-guided electric vehicles operating the PRT system are generally a major part of the capital cost of the system, especially in larger network with high demand. A sufficient number of empty vehicles are needed to be moved to the stations where passengers are waiting or demand is expected. Generally a larger fleet size leads to a reduction in waiting time of passengers and thus a higher level of service given a specific demand, but an increased investment cost including capital cost per vehicle and additional operation and maintenance. So it requires a compromise between user cost (in terms of passenger waiting times) and operator cost (in terms of fleet sizedependent capital cost and operating/maintenance costs). There should be an optimal fleet size so that the sum of these two costs can be minimized while an expected level of service is achieved. This paper presents first the way to obtain the PRT demand, and then a prescription to determine the optimal fleet size using a cost-effectiveness analysis with traffic simulation. This prescription identifies the set of activities that are necessary to perform the optimization task. Each activity is regarded as a component in our general framework and this framework is illustrated by a case study in the Waal/ Eemshaven harbor area in the Port of Rotterdam, The Netherlands.
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