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Objective: The aim of this study was to explore end-of-life (EOL) experiences of South Dakotans who had experienced the death of a loved one in the last 5 years. Methods: A mail questionnaire generated a return of 893 people interested in sharing their experiences about the death of a loved one in the last 5 years. From those respondents, 35 people were randomly selected for this qualitative study. Unstructured interviews were conducted, tape-recorded, and transcribed. Data were entered into the computer for analysis, and qualitative analysis was used to extract themes from the narratives. Results: Participants spoke of 42 deaths, with equal thirds being positive, negative, or neutral experiences. Participants primarily discussed deaths of loved ones who were older, most typically their father or mother. Of 10 emergent themes, the most frequently cited was the importance of communication among the dying person, his or her loved ones, and health care providers. Themes revealed components of the dying experience that contributed to quality of life at end of life as well as areas for improvement. Discussion: Participant reflections illuminated characteristics of a 'good' death, how the health care system is understood in the face of dying, people's supportive roles in relation to the dying person, and the impact death has on survivors' own actions and preferences for EOL care. Recommendations for future research and application are discussed. [ABSTRACT FROM AUTHOR]

Objective: To develop a baseline understanding of attitudes, advance planning, knowledge, and preferences about end-of-life (EOL) care among community-dwelling South Dakotans. Methods: Surveys were sent to 10,204 randomly selected households in South Dakota in August 2005, resulting in a 24.8% return rate ( N = 2533). Data were entered into the computer for subsequent univariate (frequencies) and bivariate (using [chi]2) analysis. Results: Most respondents said preparation for EOL was very important, yet far fewer had actually taken steps to ensure their EOL wishes would be known or honored. Most people did not want artificial hydration/nutrition at EOL, preferred to die at home, and harbored misconceptions about pain; yet, most had not engaged in conversations with their physician, minister, or lawyer about these issues. While some adults were unfamiliar with hospice care, when provided with a definition, a majority indicated that they would want hospice care if they were dying and preferably in their own homes. Conclusion: Disparities between what South Dakotans want at EOL and what actions they have taken to address those preferences challenge individuals, families, and professionals to engage in conversation to redress this inconsistency. Receptivity to physician-initiated EOL conversations suggests this talk be included with all patients, not just those who are elderly or at EOL. Data from this statewide study of community-dwelling adults provide information to better understand EOL preferences and to inform health policy and practice. [ABSTRACT FROM AUTHOR]

A community survey of Sioux Falls, South Dakota was conducted in 2004 to understand knowledge, attitudes, and preferences about end-of-life (EOL) care and to generate conversations about these topics. Questionnaires were sent to 5,000 randomly selected households, with a return of 1,042 (21%). Most respondents said preparation for EOL is very important, yet far fewer had taken steps to ensure their EOL wishes would be known or met. These disparities are examined, with recommendations for future research and public policy. Bivariate analyses revealed significant differences by age, sex, education, marital status, and religiosity. Community studies are important for baseline understanding, evoking conversation, and setting goals for change. Public education is needed to strengthen understandings of hospice care, and professional education is needed to raise awareness about practitioners' roles in resolving discrepancies between what people want and what they get at end of life. [ABSTRACT FROM AUTHOR]

The serum 25-hydroxyvitamin D [25(OH)D] response to daily supplementation with 20 microg cholecalciferol (D3) during winter in predominantly white premenopausal women living in Maine was measured and the effects of body composition and hormonal contraceptive use on baseline serum 25(OH)D concentrations and the response to supplementation were examined. A total of 112 women (22.2 +/- 3.7 y old) received placebo from March 2005 until September 2005 when they were randomized to receive either placebo or 20 microg/d D3 through February 2006. Eighty-six women completed the study. Actual mean D3 content of the supplements was 22 microg per capsule. In February 2005 the serum 25(OH)D concentration was 62.0 +/- 23.4 nmol/L (mean +/- SD). Serum 25(OH)D concentrations increased by 35.3 +/- 23.2 nmol/L from February 2005 to February 2006 in the treatment group, significantly more than the 10.9 +/- 16.9 nmol/L increase in the placebo group. Treatment group, magnitude of summer increase in 25(OH)D, estrogen dose, and baseline serum 25(OH)D concentrations, but not body fat, were significant predictors of the 1-y change in 25(OH)D concentrations used to assess the magnitude of the response to supplementation. Daily supplementation with 20 microg D3 during winter achieved optimal 25(OH)D concentrations (> or = 75 nmol/L) in 80% of participants, indicating that this dose is adequate to optimize vitamin D status in most young women in Maine. [ABSTRACT FROM AUTHOR]

Studies the effects of age on twenty-four hour intragastric pH telemetry. Intragastric H+ secretion rates in the elderly; Study of 5 young and 5 elderly people; Measurement of intragastric pH; Parameters.