Advance directives in European long-term care facilities : a cross-sectional survey

Background: End-of-life care practices in long-term care facilities (LTCFs) are the focus of growing attention in Europe, due to rapidly increasing number of older persons living in LTCFs. The knowledge about end-of-life discussions or existence of written advance directives in the European LTCFs is scarce. This study's aim is to investigate the prevalence of written advance directives and their sociodemographic associates, among recently deceased LTCF residents, in six European countries. Methods: Data from the European Union-funded PACE database were collected from 322 LTCFs in six European countries in 2014. The assessments were performed by using two questionnaires designed for LTCF administrative staff and for staff member.LTCFs were selected within each country by using proportional stratified random sampling procedure. Facilities with certain types and sizes were included from each country.Multilevel multivariate analyses were performed to evaluate associations between written advance directives and selected predictors. Results: In total, 32.5 % of the 1384 deceased LTCF residents had a written advance directive with a range from 0% to 77 % between countries. The proportion of the most common advance directive, 'Do not resuscitate in case of cardiac or respiratory arrest (DNR)', varied correspondingly from 0% to 75%.LTCF type (OR 2.86 95% CI 1.59 to 5.23) and capability of expressing at the time of admission (OR 3.26 95% CI 2.26 to 4.71) were the independent predictors for advance directive. Residents living in LTCFs where physician was available were less likely to have advance directive compared with residents from LTCFs where physician was not available. Conclusion: Extensive differences for prevalence of written advance directive exist between countries among older LTCF residents in Europe. Timely and appropriate response to LTCF resident's health needs and preferences efforts advance care planning

Advance directives in European long-term care facilities: a cross-sectional survey

BackgroundEnd-of-life care practices in long-term care facilities (LTCFs) are the focus of growing attention in Europe, due to rapidly increasing number of older persons living in LTCFs. The knowledge about end-of-life discussions or existence of written advance directives in the European LTCFs is scarce. This study's aim is to investigate the prevalence of written advance directives and their sociodemographic associates, among recently deceased LTCF residents, in six European countries.MethodsData from the European Union-funded PACE database were collected from 322 LTCFs in six European countries in 2014. The assessments were performed by using two questionnaires designed for LTCF administrative staff and for staff member.LTCFs were selected within each country by using proportional stratified random sampling procedure. Facilities with certain types and sizes were included from each country.Multilevel multivariate analyses were performed to evaluate associations between written advance directives and selected predictors.ResultsIn total, 32.5 % of the 1384 deceased LTCF residents had a written advance directive with a range from 0% to 77 % between countries. The proportion of the most common advance directive, 'Do not resuscitate in case of cardiac or respiratory arrest (DNR)', varied correspondingly from 0% to 75%.LTCF type (OR 2.86 95% CI 1.59 to 5.23) and capability of expressing at the time of admission (OR 3.26 95% CI 2.26 to 4.71) were the independent predictors for advance directive. Residents living in LTCFs where physician was available were less likely to have advance directive compared with residents from LTCFs where physician was not available.ConclusionExtensive differences for prevalence of written advance directive exist between countries among older LTCF residents in Europe. Timely and appropriate response to LTCF resident's health needs and preferences efforts advance care planning

Denudation and geomorphic change in the Anthropocene; a global overview

The effects of human activity on geomorphic processes, particularly those related to denudation/sedimentation, are investigated by reviewing case studies and global assessments covering the past few centuries. Evidence we have assembled from different parts of the world, as well as from the literature, show that certain geomorphic processes are experiencing an acceleration, especially since the mid-twentieth century. This suggests that a global geomorphic change is taking place, largely caused by anthropogenic landscape changes

Can empathy lead to emotional exhaustion in teachers? The mediating role of emotional labor

Objectives: The present study was designed to examine the links between empathy, emotional labor (both surface and deep acting), and emotional exhaustion as well as determine if emotional labor mediates the relationship between empathy and emotional exhaustion in teachers. It was assumed that emotional labor can take two opposite directions (positive mood induction and negative mood induction). Thus, the additional aim of the study was to analyze the mediating role of mood regulation strategies in the relationship between empathy and emotional exhaustion. Materials and Methods: A sample of 168 teachers from Łódź and its surroundings completed a set of questionnaires: Emotional Labor Scale; Mood Regulation Scales, Maslach Burnout Inventory, and Empathic Sensitivity Scale. Results: The results provided mixed support for the hypotheses indicating that both types of emotional labor, negative mood induction and emotional exhaustion were positively intercorrelated. Moreover, deep acting was a significant mediator in the relationship between empathy and emotional exhaustion. The analyzed link was also mediated by negative mood induction, whereas positive mood induction did not emerge as a significant mediator. Conclusions: The study provided insight into the role of empathy and emotional labor in the development of teacher burnout. It also confirmed that deep acting and negative mood induction mediate the relationship between empathy and emotional exhaustion in teachers

Polyetherols from melamine cyanurate and ethylene carbobate – synthesis and application

The results of the study on the reactions of melamine cyanurate with ethylene carbonate were presented. As a result of the reactions, polyetherols containing thermostabile 1,3,5-triazine and perhyroxo-1,3,5-triazine rings in their structure were obtained. Basic physical properties such as density, viscosity, hydroxyl number, weight changes were measured. The polyetherols were applied as a polyol component to receiving of thermoresistant polyurethane foams. Some of the properties of the obtained foams were investigated. The value of the apparent density is between 51 and 71 kg/m3, compressive strength 222–356 kPa and the content of the open pores between 14–33%. Thermal resistance was also studied by means of the TGA method. It was found that oxygen index of the selected compositions is between 20–22%

Wpływ parametrów wytwarzania hybrydowych, zawierających grafit uniepalniaczy na efektywność ich działania

Syntheses of hybrid flame retardant (HFR) additives were done on a semi-industrial scale. HFRs were obtained by in situ synthesis of melamine cyanurate in the presence of expandable graphite. HFRs have been used to reduce the flammability of selected polymers: polyester, epoxide, polystyrene. Compositions characterized by high oxygen indexes (in the case of the polyester compositions – 39.8 %) and improved horizontal FH-1 and vertical V-0 flammability parameters were obtained. The influence of the production parameters (including methods and parameters of drying), the grain size and expansion of the received HFRs on their effectiveness in the reduced flammability of selected plastics were investigated.Hybrydowe uniepalniacze (HFR) otrzymano na drodze syntezy cyjanuranu melaminy w obecności grafitu ekspandującego (proces w skali ½-technicznej). HFR użyto do zmniejszenia palności poliestru, epoksydu i polistyrenu. Otrzymane kompozycje charakteryzowały się wysokimi wskaźnikami tlenowymi (w przypadku kompozycji poliestrowych – 39.8 %) oraz parametrami palności poziomej FH-1 ipionowej V-0. Zbadano zależności pomiędzy parametrami wytwarzania (w tym metodami i parametrami suszenia), wymiarami ziaren oraz parametrami ekspansji otrzymanych HFR a ich efektywnością w ograniczaniu palności tworzyw polimerowych