177,375 research outputs found
The development of a questionnaire to assess the attitudes of older people to end-of-life issues (AEOLI)
No full textObjectives: To develop an end-of-life attitudes questionnaire for use in a large community-based sample of older people. Design: Nominal groups and standardization of questions. Participants: Eighteen older people, ten academics and five specialist palliative care health professionals were involved in nominal groups. Thirty older people took part in initial pilot work and a further 50 were involved in reliability testing. Results: A 27-item attitudes of older people to end-of-life issues (AEOLI) questionnaire. Discussion: In modern times, death and dying predominantly occurs among older people and yet we know very little about older people's attitudes to end-of-life care. The AEOLI questionnaire can be used in large scale surveys to elicit attitudes on end-of life issues considered important by older people and health care professionals
The quality and adequacy of care received at home in the last 3 months of life by people who died following a stroke: a retrospective survey of surviving family and friends using the Views of Informal Carers Evaluation of Services questionnaire
No full textStroke is the third leading cause of death in the UK. Despite this, little is known about the care needs of people who die from or following a stroke. In early 2003, a total of 183 questionnaires were returned from a survey of 493 people who had registered a stroke-related death in four Primary Care Trusts, giving a response rate of 37%. This paper reports on 53 deceased from the survey who had lived at home during their last 3 months and who had been ill for more than 1 month. The data were analysed to explore the role of informal carers and the provision of community-based care in the last 3 months of life. Family and friends helped 82% of deceased with household tasks, 68% with personal care, 66% with taking medication and 54% with night-time care. By contrast, health and social services helped 30% with household tasks, 54% with personal care, 20% with taking medication and 6% with night-time care. Two-fifths (43%) of informants had to give up work or make major life changes to care for the deceased, and 26% of informants found looking after them ‘rewarding’. Half (51%) reported that help and support from health services were excellent or good compared to 38% for social services. Results from the Regional Study of Care for the Dying indicated that people who died from a stroke in 1990 and their informal carers would have benefited from increased levels of community-based care and enhanced communication with care professionals. Our data suggest that informal carers continue to provide the majority of care for those who die from stroke, despite government initiatives to improve care for stroke patients and frail elderly people. Further research is required to explore best practice and service provision in caring for this group.<br/
The Palliative Care Research Society in the UK
No full textOne of the things that distinguished St. Christopher’s Hospice from previous homes for dying patients was Dame Cicely Saunders’ emphasis on research, and on developing a robust evidence base for care of the dying. Good palliative care research is still needed to increase our understanding of the nature and aetiology of the physical, psychological, social and spiritual problems encountered by patients and families, to test the effectiveness of pharmacological and nonpharmacological interventions in addressing these problems, and to evaluate models of service delivery
A national survey of health professionals and volunteers working in voluntary hospices in the UK: II: staff and volunteers’ experiences of working in hospices
No full textIn this paper we report findings of a 1999 nationally representative survey of independent hospices in the UK, focusing on hospice staff and volunteers' experiences of working in hospices. Nineteen of 25 sampled services participated, and these differed little in terms of service provision, size and region from the total sample of 175 services. A response rate of 70% for randomly sampled hospice staff and volunteers was achieved (n = 504). There were significant intergroup differences (doctors, nurses, nursing auxiliaries, other staff and volunteers) in participants' reported experience of working in the hospice with, for example, doctors being more likely than other groups to feel appreciated and to report receiving adequate support from hospice management. Overall, 31% of respondents wanted more support from management. Half had considered leaving the hospice (65% nurses, 60% other staff, 55% nursing auxiliaries, 40% doctors and 37% volunteers). Nurses who had considered leaving were less satisfied than other nurses with, for example, support from hospice management, and less likely to feel valued by the hospice. These results raise questions about the quality of the relationship between hospice trustees, managers and staff, and about the realities of enhancing multiprofessional teamwork in organizations where there are significant differences between staff groups in perception of, and satisfaction with, the working environment. Voluntary hospice trustees and managers face a difficult task in managing and supporting staff whilst also negotiating relationships with the NHS at a time of rapid change, and ensuring hospices' financial viability. Access to high quality leadership programmes may play an important role in ensuring voluntary hospices are characterized by effective, supportive working relationships
Simulation of thermal plant optimization and hydraulic aspects of thermal distribution loops for large campuses
No full textFollowing an introduction, the author describes Texas A&M University and its utilities system. After that, the author presents how to construct simulation models for chilled water and heating hot water distribution systems. The simulation model was used in a $2.3 million Ross Street chilled water pipe replacement project at Texas A&M University. A second project conducted at the University of Texas at San Antonio was used as an example to demonstrate how to identify and design an optimal distribution system by using a simulation model. The author found that the minor losses of these closed loop thermal distribution systems are significantly higher than potable water distribution systems. In the second part of the report, the author presents the latest development of software called the Plant Optimization Program, which can simulate cogeneration plant operation, estimate its operation cost and provide optimized operation suggestions. The author also developed detailed simulation models for a gas turbine and heat recovery steam generator and identified significant potential savings. Finally, the author also used a steam turbine as an example to present a multi-regression method on constructing simulation models by using basic statistics and optimization algorithms. This report presents a survey of the author??s working experience at the Energy Systems Laboratory (ESL) at Texas A&M University during the period of January 2002 through March 2004. The purpose of the above work was to allow the author to become familiar with the practice of engineering. The result is that the author knows how to complete a project from start to finish and understands how both technical and nontechnical aspects of a project need to be considered in order to ensure a quality deliverable and bring a project to successful completion. This report concludes that the objectives of the internship were successfully accomplished and that the requirements for the degree of Degree of Engineering have been satisfied
A national survey of health professionals working in voluntary hospice services in the UK. I. Attitudes to current issues affecting hospices and palliative care.
No full textThis paper reports results from a national survey in 1999 of voluntary hospice services in the UK. It focuses on volunteer and staff views of the purposes of hospice care, and on current debates within palliative care. Twenty-five hospice services, stratified by region, services provided (inpatient care, day care and/or home care) and number of beds were randomly sampled from amongst 175 voluntary hospices in the UK. Nineteen participated. Seventy per cent of a random sample of professional and voluntary staff within these hospices returned a postal questionnaire. Both volunteers and professionals considered care of the whole person, pain and symptom control, quality of life and dying peacefully to be important aspects of hospice care. Most doctors chose care of the whole person as the most important aspect, and they were more likely to choose this option than other staff. Hospice volunteers were less positive than hospice staff (particularly doctors and nurses) in their attitudes to extending hospice care to noncancer patients (where many volunteers held no strong view), to restricting care to patients with specialist palliative care needs, and less negative about euthanasia. These findings illustrate the importance of including hospice volunteers and the general public, as well as hospice staff, in debates about the future of hospice and palliative care in the UK. Further research is needed into lay and professional views of the role of hospices and palliative care services
Intern experience at CH���M Hill, Inc.: an internship report
No full textIncludes author's vita"Submitted to the College of Engineering of Texas A&M University in partial
fulfillment of the requirement for the degree of Doctor of Engineering."Includes bibliographical referencesA review of the author's internship experience with CH���M HILL, Inc.
during the period September 1975 through May 1976 is presented. During this nine month
internship the author worked as an Engineer II in the Industrial Processes discipline of this
large consulting engineering firm... The author's prime responsibility was as one of three
lead design engineers on the design of a large wastewater treatment facility for a pulp mill
in Hoquiam, Washington owned by ITT Rayonier Inc. The work generally consisted of the design
of individual treatment units and associated piping and pumping. The purpose of the project
was to provide wastewater treatment capabilities that would satisfy the effluent limitations
(standards) imposed upon the mill by the State of Washington Department of Ecology and the
U.S. Environmental Protection Agency. The author's assignment also entailed necessary
interaction with the project manager and other CH���M HILL design engineers and support staff
members, the client's representatives, and representatives of two other consulting engineering
firms working on the project. Thus, the internship position at CH���M HILL provided considerable
experience coordinating the author's work with the work of other engineers, guiding the design
and administrative efforts of a support staff, and interacting regularly with the client and
other consulting firms. This broad exposure to a variety of engineering and organizational
problems provided a valuable educational experience
What does a diagnosis of brain stem death mean to family members who are approached about organ donation?
No full textDevelopment proposal Addington Open Integrated Campus: Old Addington Railway Workshops site, Canterbury Saleyards site, Christchurch : Feasibility study
No full textLASC 408 major design. Handwritten notes contained within textThe Committee for the Open Integrated Campus, Addington is seeking advice for siting buildings and determining appropriate characteristics for these buildings. It is seeking a landscape design for siting buildings and determining appropriate characteristics for these buildings. It is also seeking a landscape design for the area.
The design brief sets out the information and issues involved in the Campus design. Creative interpretation and resolution of these issues will provide the Addington Open Integrated Campus with a landscape vision which will take it into the 21st century
Intern experience at the Texas Transportation Institute: an internship report
No full text"Submitted to the College of Engineering of Texas A&M University in partial
fulfillment of the requirements for the degree of Doctor of Engineering."Includes vita (leaf 91)Includes bibliographical references (leaf 57)This report discusses the author's engineering experience at the Texas
Transportation Institute (TTI), Texas A&M University from March 1974 through July 1977. A
report of this experience plus twelve additional hours of academic course work were
substituted for an internship according to requirements established by the College of
Engineering. Although the author could not retroactively establish objectives of the type
associated with a typical internship, the work experience gained could be related to the two
general objectives of an intership: 1. To demonstrate an identifiable contribution to the
organization in which the intern served, and 2. To enable the intern to become aware of the
non-technical aspects of working as an engineer in a non-academic environment. While a member
of the Texas Transportation Institute staff, the author worked on a number of projects in the
areas of highway traffic engineering research and the preparation of continuing education
courses for transportation engineering officials. These assignments were contained within the
Urban Transportation Systems Division of TTI. This report delineates the author's contribution
to four particular projects and discusses the technical as well as non-technical experience
gained from each. Having been exposed to more engineering situations than many of the other
Doctor of Engineering students, the author has already formulated some rather specific
milestones for the future. The Doctor of Engineering program is discussed in conjunction with
its potential for helping the author attain these career goals and objectives. Also, some
thoughts are presented regarding the Doctor of Engineering as a viable alternative to the
Ph.D. in preparing for a career in engineering higher education
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