scholarly journals The Impact of the Palliative Medicine Rotation On Housestaff Comfort Level With Death (765)

2012 ◽  
Vol 43 (2) ◽  
pp. 459
Author(s):  
Farheen Hasan
Keyword(s):  
Palliative Medicine ◽  
Comfort Level ◽  
The Impact

60. Using a pocket card to improve end-of-life care on clinical teaching units: A controlled trials

2007 ◽  
Vol 30 (4) ◽  
pp. 61
Author(s):  
J. Downar ◽  
J. Mikhael
Keyword(s):  
End Of Life ◽  
Symptom Management ◽  
End Of Life Care ◽  
Palliative Medicine ◽  
Clinical Teaching ◽  
Intervention Group ◽  
Comfort Level ◽  
Control Group ◽  
Life Care ◽  
Comfort Levels

Although palliative and end-of-life is a critical part of in-hospital medical care, residents often have very little formal education in this field. To determine the efficacy of a symptom management pocket card in improving the comfort level and knowledge of residents in delivering end-of-life care on medical clinical teaching units, we performed a controlled trial involving residents on three clinical teaching units. Residents at each site were given a 5-minute questionnaire at the start and at the end of their medicine ward rotation. Measures of self-reported comfort levels were assessed, as were 5 multiple-choice questions reflecting key knowledge areas in end-of-life care. Residents at all three sites were given didactic teaching sessions covering key concepts in palliative and end-of-life care over the course of their medicine ward rotation. Residents at the intervention site were also given a pocket card with information regarding symptom management in end-of-life care. Over 10 months, 137 residents participated on the three clinical teaching units. Comfort levels improved in both control (p < 0.01) and intervention groups (p < 0.01), but the intervention group was significantly more comfortable than the control group at the end of their rotations (z=2.77, p < 0.01). Knowledge was not significantly improved in the control group (p=0.07), but was significantly improved in the intervention group (p < 0.01). The knowledge difference between the two groups approached but did not reach statistical significance at the end of their rotation. In conclusion, our pocket card is a feasible, economical educational intervention that improves resident comfort level and knowledge in delivering end-of-life care on clinical teaching units. Oneschuk D, Moloughney B, Jones-McLean E, Challis A. The Status of Undergraduate Palliative Medicine Education in Canada: a 2001 Survey. Journal Palliative Care 2004; 20:32. Tiernan E, Kearney M, Lynch AM, Holland N, Pyne P. Effectiveness of a teaching programme in pain and symptom management for junior house officers. Support Care Cancer 2001; 9:606-610. Okon TR, Evans JM, Gomez CF, Blackhall LJ. Palliative Educational Outcome with Implementation of PEACE Tool Integrated Clinical Pathway. Journal of Palliative Medicine 2004; 7:279-295.

scholarly journals Investigating Community Pharmacy Take Home Naloxone Dispensing during COVID-19: The Impact of One Public Health Crisis on Another

Pharmacy ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 129
Author(s):  
George Daskalakis ◽  
Ashley Cid ◽  
Kelly Grindrod ◽  
Michael A. Beazely
Keyword(s):  
Public Health ◽  
Community Pharmacy ◽  
Online Survey ◽  
Comfort Level ◽  
Future Research ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Pharmacy Technicians ◽  
The Impact ◽  
Overdose Deaths

A recent report found that the number of opioid-related deaths in Ontario in the first 15 weeks of the COVID-19 pandemic was 38.2% higher than in the 15 weeks before the pandemic. Our study sought to determine if pharmacy professionals self-reported an increase or decrease in naloxone provision due to the pandemic and to identify adjustments made by pharmacy professionals to dispense naloxone during the pandemic. A total of 231 Ontario community pharmacy professionals completed an online survey. Pharmacy professionals’ barriers, facilitators, and comfort level with dispensing naloxone before and during the pandemic were identified. The sample consisted of mostly pharmacists (99.1%). Over half (51.1%) reported no change in naloxone dispensing, while 22.9% of respondents reported an increase and 24.7% a decrease. The most common adjustments made during the pandemic were training patients how to administer naloxone over video or phone, delivering naloxone kits, and pharmacy technicians offering naloxone at prescription intake. Over half (55%) of participants said the top barrier for dispensing was that patients did not request naloxone. Naloxone distribution through pharmacies could be further optimized to address the increased incidence of overdose deaths during the pandemic. Future research should investigate the reasons for changes in naloxone dispensing.

Palliative medicine consultation impacts DNR designation and length of stay for terminal medical MICU patients

2011 ◽  
Vol 9 (4) ◽  
pp. 401-406 ◽  
Author(s):  
Dana Lustbader ◽  
Renee Pekmezaris ◽  
Michael Frankenthaler ◽  
Rajni Walia ◽  
Frederick Smith ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Palliative Medicine ◽  
Intervention Group ◽  
Hospital Length Of Stay ◽  
Rank Test ◽  
Control Group ◽  
Do Not Resuscitate ◽  
Log Rank Test ◽  
The Impact ◽  
Reduced Time

AbstractObjective:The purpose of this study was to assess the impact of a palliative medicine consultation on medical intensive care unit (MICU) and hospital length of stay, Do Not Resuscitate (DNR) designation, and location of death for MICU patients who died during hospitalization.Method:A comparison of two retrospective cohorts in a 17-bed MICU in a tertiary care university-affiliated hospital was conducted. Patients admitted to the MICU between January 1, 2003 and June 30, 2004 (N = 515) were compared to MICU patients who had had a palliative medicine consultation between January 1, 2005 and June 1, 2009 (N = 693). To control for disease severity, only patients in both cohorts who died during their hospitalization were considered for this study.Results:Palliative medicine consultation reduced time until death during the entire hospitalization (log-rank test,p < 0.01). Time from MICU admission until death was also reduced (log-rank test,p < 0.01), further demonstrating the impact of the palliative care consultation on the duration of dying for hospitalized patients. The intervention group contained a significantly higher percentage of patients with a DNR designation at death than did the control group (86% vs. 68%, χ2test,p < 0.0001).Significance of results:Palliative medicine consultation is associated with an increased rate of DNR designation and reduced time until death. Patients in the intervention group were also more likely to die outside the MICU as compared to controls in the usual care group.

149 Use of Risk Model for Assessment of Residents Perception of Complexity of Surgical Steps

Neurosurgery ◽  
2015 ◽  
Vol 62 (CN_suppl_1) ◽  
pp. 214-214
Author(s):  
Ahmed M. Raslan ◽  
Jeffrey Steven Raskin ◽  
Jesse Jia-Xin Liu
Keyword(s):  
High Risk ◽  
Operative Time ◽  
Resident Education ◽  
Comfort Level ◽  
Matrix Analysis ◽  
Published Data ◽  
Dependent Manner ◽  
Risk Matrix ◽  
Danger Zone ◽  
The Impact

Abstract INTRODUCTION: Quality improvement projects have begun to standardize surgical work flow as a component to optimize operative room (OR) efficiency. Removing special cause variability resulting from nonsurgical waste is an obvious target; however, surgical resident education must be maintained even in the setting of process improvement. There are no published data describing the impact on operative time of resident-identified risky or uncomfortable procedural steps during posterior instrumented fusion (PIF). Self-identification of risk or discomfort in surgical steps may allow for shorter OR time and reduced cost, without sacrificing resident education. METHODS: PIF procedure steps were defined. An 8 two-part question survey regarding surgeon comfort level and perceived risk assessment at each step was developed, and completed by junior (17) and senior residents (10), and faculty (6) from orthopedic and neurological surgeons. A risk matrix was constructed defining 2 zones, a “danger zone” where responses were both high risk (3–5) and low comfort (1–3) and a “safe zone” where responses were low risk (1–2) and high comfort (4–5). One-tailed χ2 with Yates correction was performed. RESULTS: Risk matrix analysis showed a statistical difference among danger zone respondents between junior resident and faculty groups for exposure, pedicle screw placement, neural decompression, interbody placement, posterolateral fusion, and hemostasis (Table 2). Radar graph identifies percentage of respondents who fall within the danger zone (Figure 1). CONCLUSION: Resident perception of surgical complexity can be evaluated for procedural steps using a risk matrix survey. For PIF, residents assign more risk and are less comfortable performing steps in a training-dependent manner. Identification of particular high-risk steps, which are uncomfortable, should prompt strict faculty oversight to improve patient safety, monitor resident education, and reduce operative time.

The impact of palliative medicine?

1999 ◽  
Vol 13 (4) ◽  
pp. 273-274 ◽  
Author(s):  
Irene J Higginson ◽  
Alan M McGregor
Keyword(s):  
Palliative Medicine ◽  
The Impact

scholarly journals Thermo-physical characteristics of building integrated phase change materials (PCM) and their applicability to energy efficient homes

2021 ◽  
Author(s):  
Omar Siddiqui
Keyword(s):  
Compressive Strength ◽  
Phase Change ◽  
Phase Change Materials ◽  
Energy Savings ◽  
Physical Characteristics ◽  
Comfort Level ◽  
Thermal Mass ◽  
Lower Phase ◽  
Physical Test ◽  
The Impact

The applicability of utilizing a variety of thermal mass including phase change materials with commonly used building materials is investigated through the use of simulations and physical testing. The thermal performance and occupant comfort potential of a novel solid-solid phase change material, known as Dal HSM, is compared and contrasted to commonly available forms of thermal mass. Detailed experimentation is conducted to successfully integrate Dal HSM with gypsum and concrete. The measurement of physical characteristics such as compressive strength and modulus of rupture is conducted to ensure that the PCM-composite compound retains the structural integrity to be utilized in a typical building. The use of thermal mass in the Toronto Net Zero house was found to contribute to energy savings of 10-15% when different types of thermal mass were used. The comfort level of the indoor occupants was also found to increase. The performance of Dal HSM was found to be comparable to a commercially available PCM known as Micronal in the heating mode. The cooling mode revealed that Dal HSM provided slightly lower energy savings when compared to Micronal due to a lower phase transition temperature and latent heat. The performance of physical test revealed a decrease in the compressive strength as the concentration of Dal HSM was increased in the PCM-gypsum specimens. Tests were also performed to analyze the impact of increasing the PCM concentration on the flexural strength of PCM-gypsum composite.

scholarly journals Case Study on the Impact of Artificial Light on Lighting Performance Quality for Architecture Studios

2021 ◽  
Vol 13 (3) ◽  
Author(s):  
N. A. Adnan ◽  
◽  
N. S. Sujali ◽  
N. D. Md Amin ◽  
◽  
...  
Keyword(s):  
Learning Experience ◽  
Comfort Level ◽  
Learning Space ◽  
Lighting Condition ◽  
Performance Quality ◽  
Engineering Society ◽  
Illuminance Level ◽  
The Impact ◽  
The City

A well-lit learning space is crucial to ensure the comfort of its occupants, especially for an architecture student who spends long hours in a studio to design, sketch, draw and build prototypes. This paper presents the results from a study conducted on the illuminance level of the architecture studios in the city campus of Universiti Tun Hussein Onn Malaysia (UTHM), Malaysia that were once laboratories. Measurements had been done using the Lux meter. Illuminance contours were generated using SigmaPlot and Dialux software for all the five rooms and compared with the requirements stipulated in the Malaysian Standard, Australia/New Zealand Standard and Illumination Engineering Society of North America (IESNA) standard for a room with similar function. A survey was also conducted among undergraduate architecture students who were using the studios daily to gauge their perception on the lighting condition and comfort level. The outcome of this study can be considered for future architecture studio lighting design to improve the students’ learning experience.

scholarly journals Sensitivity Analysis of Occupant Preferences on Energy Usage in Residential Buildings

2021 ◽  
Author(s):  
Kaleb Pattawi ◽  
Prateek Munankarmi ◽  
Michael Blonsky ◽  
Jeff Maguire ◽  
Sivasathya Pradha Balamurugan ◽  
...  
Keyword(s):  
Sensitivity Analysis ◽  
Thermal Comfort ◽  
Residential Buildings ◽  
Electricity Consumption ◽  
Cost Savings ◽  
The United States ◽  
Comfort Level ◽  
Electrical Grid ◽  
Home Energy Management ◽  
The Impact

Abstract Residential buildings, accounting for 37% of the total electricity consumption in the United States, are suitable for demand response (DR) programs to support effective and economical operation of the power system. A home energy management system (HEMS) enables residential buildings to participate in such programs, but it is also important for HEMS to account for occupant preferences to ensure occupant satisfaction. For example, people who prefer a higher thermal comfort level are likely to consume more energy. In this study, we used foresee™, a HEMS developed by the National Renewable Energy Lab (NREL), to perform a sensitivity analysis of occupant preferences with the following objectives: minimize utility cost, minimize carbon footprint, and maximize thermal comfort. To incorporate the preferences into the HEMS, the SMARTER method was used to derive a set of weighting factors for each objective. We performed week-long building energy simulations using a model of a home in Fort Collins, Colorado, where there is mandatory time-of-use electricity rate structure. The foresee™ HEMS was used to control the home with six different sets of occupant preferences. The study shows that occupant preferences can have a significant impact on energy consumption and is important to consider when modeling residential buildings. Results show that the HEMS could achieve energy reduction ranging from 3% to 21%, cost savings ranging from 5% to 24%, and carbon emission reduction ranging from 3% to 21%, while also maintaining a low thermal discomfort level ranging from 0.78 K-hour to 6.47 K-hour in a one-week period during winter. These outcomes quantify the impact of varying occupant preferences and will be useful in controlling the electrical grid and developing HEMS solutions.

scholarly journals Adaptive lighting comfort in the classrooms of educational building and student hostel rooms

2020 ◽  
Vol 170 ◽  
pp. 01012
Author(s):  
Subbarao Yarramsetty ◽  
Nikhil Siva Deka ◽  
MVN Siva Kumar
Keyword(s):  
Classroom Environment ◽  
Indoor Environment ◽  
Critical Role ◽  
Comfort Level ◽  
P Value ◽  
Lighting Intensity ◽  
Institute Of Technology ◽  
Teaching Learning ◽  
Indoor Lighting ◽  
The Impact

The comfort level of occupants inside a building depends on various indoor environment factors like thermal comfort, indoor air quality, and indoor lighting quality. According to studies done on indoor environment quality of buildings, lighting plays a very critical role in determining the occupants comfort level. A proper indoor lighting is very important especially in the classrooms of an educational building as well as in student hostel rooms as it can be said as a vital element, controlling the psychology and comfort of the students and hence a deciding factor in the teaching-learning process. The lighting intensity and its distribution depends on the location of the interior partition as well as the design strategy of the exterior envelop. So, in order to obtain the most occupant friendly results, the impact of various strategies adopted should be evaluated in the early design period itself. This paper adopts a questionnaire-based field surveys which is done in the classrooms of National Institute of Technology Warangal and also in the hostel rooms of 1.8K Ultra Mega hostel of this institute. The main objective of this study includes. 1) To assess the indoor lighting comfort in the classrooms and hostel rooms of National Institute of Technology Warangal through a questionnaire-based lighting comfort study. 2) To identify preferences of subjects in the classroom environment with respect to lighting comfort and 3) To identify the comfort range of lighting intensity inside the classrooms and hostel rooms. SPSS software is used analyse the reliability of survey responses by finding the P value.

Sign in / Sign up

Export Citation Format

Share Document