End-of-Life Management Protocol Offered Within Emergency Room: a Multicentre Study (EMPOWER)

2019 ◽  
Author(s):  
Keyword(s):  
Multicentre Study ◽  
Emergency Room ◽  
End Of Life ◽  
Life Management ◽  
Management Protocol

scholarly journals End-of-life management protocol offered within emergency room (EMPOWER): study protocol for a multicentre study

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e036598 ◽  
Author(s):  
Rakhee Yash Pal ◽  
Win Sen Kuan ◽  
Ling Tiah ◽  
Ranjeev Kumar ◽  
Yoko Kin Yoke Wong ◽  
...  
Keyword(s):  
Time Series ◽  
Multicentre Study ◽  
End Of Life ◽  
Study Protocol ◽  
Quantitative Methods ◽  
Local Context ◽  
Resource Utilisation ◽  
Care Protocol ◽  
Management Protocol ◽  
Eol Care

BackgroundPatients at their end-of-life (EOL) phase frequently visit the emergency department (ED) due to their symptoms, yet the environment and physicians in ED are not traditionally equipped or trained to provide palliative care. This multicentre study aims to measure the current quality of EOL care in ED to identify gaps, formulate improvements and implement the improved EOL care protocol. We shall also evaluate healthcare resource utilisation and its associated costs.Methods and analysisThis study employs a quasiexperimental interrupted time series design using both qualitative and quantitative methods, involving the EDs of three tertiary hospitals in Singapore, over a period of 3 years. There are five phases in this study: (1) retrospective chart reviews of patients who died within 5 days of ED attendance; (2) pilot phase to validate the CODE questionnaire in the local context; (3) preimplementation phase; (4) focus group discussions (FGDs); and (5) postimplementation phase. In the prospective cohort, patients who are actively dying or have high likelihood of mortality this admission, and whose goal of care is palliation, will be eligible for inclusion. At least 140 patients will be recruited for each preimplementation and postimplementation phase. There will be face-to-face interviews with patients’ family members, review of medical records and self-administered staff survey to evaluate existing knowledge and confidence. The FGDs will involve hospital and community healthcare providers. Data obtained from the retrospective cohort, preimplementation phase and FGDs will be used to guide prospective improvement and protocol changes. Patient, family and staff relevant outcomes from these changes will be measured using time series regression.Ethics and disseminationThe study protocol has been reviewed and ethics approval obtained from the National Healthcare Group Domain Specific Review Board, Singapore. The results from this study will be actively disseminated through manuscript publications and conference presentations.Trial registration numberNCT03906747.

scholarly journals Sustainable End-of-Life Management of Wind Turbine Blades: Overview of Current and Coming Solutions

Materials ◽  
2021 ◽  
Vol 14 (5) ◽  
pp. 1124
Author(s):  
Leon Mishnaevsky Mishnaevsky
Keyword(s):  
Wind Turbine ◽  
End Of Life ◽  
Wind Turbines ◽  
Natural Fiber ◽  
Turbine Blades ◽  
Wind Turbine Blades ◽  
Maintenance And Repair ◽  
Life Management ◽  
Large Wind

Various scenarios of end-of-life management of wind turbine blades are reviewed. “Reactive” strategies, designed to deal with already available, ageing turbines, installed in the 2000s, are discussed, among them, maintenance and repair, reuse, refurbishment and recycling. The main results and challenges of “pro-active strategies”, designed to ensure recyclability of new generations of wind turbines, are discussed. Among the main directions, the wind turbine blades with thermoplastic and recyclable thermoset composite matrices, as well as wood, bamboo and natural fiber-based composites were reviewed. It is argued that repair and reuse of wind turbine blades, and extension of the blade life has currently a number of advantages over other approaches. While new recyclable materials have been tested in laboratories, or in some cases on small or medium blades, there are remaining technological challenges for their utilization in large wind turbine blades.

End of Life Management of Automation and IT Devices

2014 ◽  
Vol 47 (3) ◽  
pp. 3503-3508 ◽  
Author(s):  
P. Kopacek ◽  
B. Kopacek
Keyword(s):  
End Of Life ◽  
Life Management

scholarly journals Lifecycle assessment of a stapling machine

2014 ◽  
Vol 4 (1) ◽  
pp. 12 ◽  
Author(s):  
Israel Dunmade
Keyword(s):  
Climate Change ◽  
End Of Life ◽  
Environmental Impacts ◽  
Material Selection ◽  
Product Distribution ◽  
Mechanical Device ◽  
Lifecycle Assessment ◽  
Life Management ◽  
Resource Recycling ◽  
Eutrophication Potential

A stapler is a mechanical device used to join two or more sheets of paper together by driving a thin metal staple through the sheets. They are widely used in schools, offices, business, government and homes. The anticipated large quantity of waste that is disposed of annually present great risk of environmental pollution and opportunities for economically viable resource recycling. This study evaluates potential environmental impacts of a Stapling machine and its end-of-life management opportunities. Environmental lifecycle assessment (LCA) process was used for the evaluation. The assessment was implemented with the aid of SimaPro software version 7.3.3.Results of the analyses revealed that climate change and eutrophication are the significant potential environmental impacts. Each Stapler has 1.265130 kg CO2-eq in Global Warming Potential and 0.113067 max kg O2-eq as its Eutrophication Potential. Further examination also showed that most of the impacts are from material selection, product distribution, and end-of-life management of the stapling machine. This study provides insights on potential environmental impacts of stapling machines and potential opportunities for improvements in their end-of-life management.

Abstract NS6: Neuroscience Healthcare professionals want Training for End of Life Management in Catastrophic Stroke Patients

Stroke ◽  
2019 ◽  
Vol 50 (Suppl_1) ◽  
Author(s):  
Mallory Lightford ◽  
Adeola Olowu ◽  
Saviour Achilike ◽  
Wamda Ahmed ◽  
Alicia Zha ◽  
...  
Keyword(s):  
End Of Life ◽  
Healthcare Professionals ◽  
Stroke Patients ◽  
Life Management
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