When death do us part : nurses on post-mortem care

Nurses' experiences with post-mortem care and death were diverse and represented a confluence of factors. Nurses' personalities, religious beliefs, cultural value systems, customs, life experiences, and the unit's orientation all converged and influenced their attitudes toward death. Culture and the unit's orientation exerted the strongest influence on nurses' attitudes. Exposure to dying was the most influential factor in determining attitudes toward death and dying, with palliative care nurses being most comfortable in dealing with death. Cultural differences also emerged, with Canadian and Israeli nurses entertaining divergent attitudes toward death, spirituality and post-mortem care. Death was conceptualised by some nurses as the end of an organism, and by others as the beginning of another form of existence. Post-mortem care was reported as an emotionally demanding task, yet most Canadian nurses considered the experience rewarding. The wrapping of the body in a plastic shroud and the covering of the face was the aspect nurses disliked the most; they felt it was repugnant, dehumanising and disrespectful

Preventing Suicides in the Toronto Subway System: A Program Evaluation

Despite the wealth of information on suicide prevention issues and the widespread implementation of suicide prevention strategies, program evaluation efforts have been limited. Lack of sound program evaluation remains one of the most significant barriers to identification and implementation of effective intervention and prevention strategies. The purpose of this study was two-fold: to conduct a summative evaluation of the gatekeeper suicide prevention program implemented at the Toronto Transit Commission, and to concomitantly, appraise the efficacy and effectiveness of the Kirkpatrick evaluation model as an analytical framework to guide suicide prevention program evaluations. The study used a two-phase, sequential mixed-method approach of converging quantitative and qualitative methodologies. The quantitative study employed a repeated measures design and examined the immediate and long-term effects of the gatekeeper program on attitudes, knowledge, intervention abilities. The qualitative study consisted of semi-structured interviews and explored participants’ effective and utility reactions to the gatekeeper training program. The results of this study indicated safeTALK and suicideAWARE training programs increased participants’ knowledge of suicide and suicidal behaviour, enhanced positive attitudes toward the suicidal individual, suicide intervention, and improved intervention skills. The empirical findings from this study support the premise that the Kirkpatrick evaluation model could be adapted for use in gatekeeper program evaluations. The model provides a highly relevant, well-rounded, rigorous approach to suicide prevention program evaluations.Ph

Capturing the Risk-Pooling Effect Through Demand Reshape

The risk-pooling effect has been documented to benefit inventory systems by reducing the need for safety stock and consequently lowering costs such as inventory holding and shortage penalty. In this paper, we propose a new approach, called "demand reshape," to take advantage of the risk-pooling effect. It is demonstrated that a company can improve its profit by encouraging some of its customers, who intended to purchase one product to switch to another. The effectiveness of this approach is evaluated in various scenarios and found to be very promising.Demand Reshape, Risk Pooling, Consolidation, Multiproduct, Substitution