232 research outputs found
Ensuring competency in end-of-life care: controlling symptoms
BACKGROUND: Palliative medicine is assuming an increasingly important role in patient care. The Education for Physicians in End-of-life Care (EPEC) Project is an ambitious program to increase core palliative care skills for all physicians. It is not intended to transmit specialty level competencies in palliative care. METHOD: The EPEC Curriculum was developed to be a comprehensive syllabus including trainer notes, multiple approaches to teaching the material, slides, and videos of clinical encounters to trigger discussion are provided. The content was developed through a combination of expert opinion, participant feedback and selected literature review. Content development was guided by the goal of teaching core competencies not included in the training of generalist and non-palliative medicine specialist physicians. RESULTS: Whole patient assessment forms the basis for good symptom control. Approaches to the medical management of pain, depression, anxiety, breathlessness (dyspnea), nausea/vomiting, constipation, fatigue/weakness and the symptoms common during the last hours of life are described. CONCLUSION: While some physicians will have specialist palliative care services upon which to call, most in the world will need to provide the initial approaches to symptom control at the end-of-life
Análise de agrupamento da variabilidade espacial da produtividade da soja e variáveis agrometeorológicas na região oeste do Paraná
Clinical validation of cutoff target ranges in newborn screening of metabolic disorders by tandem mass spectrometry: a worldwide collaborative project.
Volcanic ash in bare ice south of Sør Rondane Mountains, Antarctica: geochemistry, rock magnetism and nondestructive magnetic detection with SQUID gradiometer
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Criteria for calculating the efficiency of HEPA filters during and after design basis accidents
We have reviewed the literature on the performance of high efficiency particulate air (HEPA) filters under normal and abnormal conditions to establish criteria for calculating the efficiency of HEPA filters in a DOE nonreactor nuclear facility during and after a Design Basis Accident (DBA). The literature review included the performance of new filters and parameters that may cause deterioration in the filter performance such as filter age, radiation, corrosive chemicals, seismic and rough handling, high temperature, moisture, particle clogging, high air flow and pressure pulses. The deterioration of the filter efficiency depends on the exposure parameters; in severe exposure conditions the filter will be structurally damaged and have a residual efficiency of 0%. Despite the many studies on HEPA filter performance under adverse conditions, there are large gaps and limitations in the data that introduce significant error in the estimates of HEPA filter efficiencies under DBA conditions. Because of this limitation, conservative values of filter efficiency were chosen when there was insufficient data
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Criteria for calculating the efficiency of deep-pleated HEPA filters with aluminum separators during and after design basis accidents
The authors have reviewed the literature on the performance of high efficiency particulate air (HEPA) filters under normal and abnormal conditions to establish criteria for calculating the efficiency of HEPA filters in a DOE nonreactor nuclear facility during and after a Design Basis Accident (DBA). This study is only applicable to the standard deep-pleated HEPA filter with aluminum separators as specified in ASME N509. The literature review included the performance of new filters and parameters that may cause deterioration in the filter performance such as filter age, radiation, corrosive chemicals, seismic and rough handling, high temperature, moisture, particle clogging, high air flow and pressure pulses. The deterioration of the filter efficiency depends on the exposure parameters; in severe exposure conditions the filter will be structurally damaged and have a residual efficiency of 0%. Despite the many studies on HEPA filter performance under adverse conditions, there are large gaps and limitations in the data that introduce significant error in the estimates of HEPA filter efficiencies under DBA conditions. Because of this limitation, conservative values of filter efficiency were chosen when there was insufficient data
A Direct Ab Initio Dynamics Study on the Finite Temperature Effects on the Hyperfine Coupling Constant of a Weakly Bonded Complex
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