The purpose of this article is to synthesize the evidence on advance care planning (ACP), determine what is applicable to the home health (HH) setting, and find where gaps in knowledge may exist. An integrative review methodology was chosen. Although there is ample literature on the topic of ACP, most research has been conducted in the acute care, outpatient, and general community settings. There is limited literature regarding ACP with patients living with chronic cardiovascular and pulmonary illnesses, who comprise the majority of the HH population. Some literature has been published regarding the interprofessional team's role in ACP in the HH setting. A gap in knowledge exists regarding ACP in HH, and recommendations for future research are provided.

The number of individuals aged more than 65 years in the United States and their life expectancy has been increasing in the past decades. In spite of the presence of federal and accreditation policies recommending completion of advance directive documents by patients admitted to health care settings, advance directive completion rates are low in most health care organizations. The purpose of this study was to determine the level of advance directive completion among home health patients. The health belief model provided the theoretical framework that guided this study. A retrospective chart review was carried out in a home health agency with about 51 patients. Demographic details, including age, gender, ethnicity, nature of illness and type of health insurance were collected. Descriptive statistics were used to determine the percentage of home health patients with existing advance directives and those who do not have an advance directive. The study revealed that only 25% of the patients in the home health care agency had a completed advance directive. The finding indicate a disconnect between the recommended and the actual practice with regards to end of life issues. There is a pressing need for more complete documentation of the patient's desires and wishes regarding end of life care at home health care facilities. Documenting the patient's end of life preferences and wishes may potentially ease the decision-making process, making the end of life days less stressful for the patients and their families at the same time promoting the provision of personalized health care at the end of life.

The purpose of this article is to synthesize the evidence on advance care planning (ACP), determine what is applicable to the home health (HH) setting, and find where gaps in knowledge may exist. An integrative review methodology was chosen. Although there is ample literature on the topic of ACP, most research has been conducted in the acute care, outpatient, and general community settings. There is limited literature regarding ACP with patients living with chronic cardiovascular and pulmonary illnesses, who comprise the majority of the HH population. Some literature has been published regarding the interprofessional team's role in ACP in the HH setting. A gap in knowledge exists regarding ACP in HH, and recommendations for future research are provided.

Advance warning signals installed upstream of a high-speed signalized intersection (HSSI) warn motorists of impending signal changes in an effort to reduce the frequency of red-light running (RLR) and crashes. A new advance warning signal design was tested on an approach to an HSSI in Utah to study the effects of the modified design on motorist behavior. The new design utilized an overhead dynamic blank-out sign and flashers. A state-of-the-art digital wave radar evaluation system was installed at the study site to collect continuous data of vehicle speeds and RLR events by a non-intrusive method. Crash data were collected from the jurisdiction responsible for the study site and for an additional control intersection. Data were collected prior to, immediately after, and eight months after installation The blank-out overhead dynamic advance warning signal (BODAWS) system reduced RLR at the site during the time period immediately after installation. Eight months later, the number of RLR violations was slightly higher on one approach than before BODAWS system installation. Crash results showed that six months after BODAWS installation, the number of crashes declined at the study site. The number of crashes proportionately declined at the control intersection as well indicating a need to continue to evaluate and monitor changes. Mean vehicle speeds recorded before the onset of the yellow signal increased on the approaches to the study site immediately after BODAWS installation, and remained higher eight months later. Mean vehicle speeds recorded during the yellow signal, increased eight months after BODAWS installation to speeds higher than before the system was installed. Higher speeds during the yellow signal, combined with an increase in the number of RLR violations eight months after BODAWS installation, suggest that motorists may have begun to use the advance warning to speed up in an attempt to enter the intersection before the signal turned red. It is recommended that the lead flash time between activation of the BODAWS signs and flashers and the onset of the yellow signal should be adjusted so that motorists are not provided with more time than is necessary to safely clear the intersection.

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published_or_final_version / Community Medicine / Master / Master of Public Health

Seventeen glacially sheared stumps in growth position and abundant detrital wood fragments were exposed by stream avulsion at the terminus of the Saskatchewan Glacier in 1999. The stumps lay buried beneath the glacier and over 5 m of glacial sediment until historical recession and stream incision exposed the 225- to 262-year-old stand of subalpine fir, Englemann spruce and whitebark pine trees. Crossdating and construction of two radiocarbon-controlled floating tree-ring chronologies showed that all the subfossil stumps and boles exposed at this location were killed during a Neoglacial advance of the Saskatchewan Glacier 2,910 ± 60 to 2,730 ± 60 ¹⁴C years B.P. These findings support the Peyto Advance as a regional glaciological response to changing mass balance conditions.

The main purpose of this study was to establish how effectively mediation was applied to advance learners‟ fundamental rights in English First Additional Language classrooms. The researcher did a literature study in Chapter Two to do research on the concept mediation. The researcher briefly looked at a variety of approaches to mediation before deciding to base her study on the twelve mediation principles of Feuerstein. The advantages gained by following a mediational approach while teaching learners could not be disputed. In Chapter Three, the researcher investigated which fundamental rights learners have at South African schools. A variety of legislation was studied before determining those Acts and the legislation applicable to learners‟ fundamental rights. The researcher then proceeded with her empirical design in which she discussed the quantitative and qualitative methods of data collection which were triangulated in order to make findings. The researcher ensured that both mediation and fundamental rights were tested in the questionnaires which were answered by educators and learners. Thereafter, three focus group interviews were held with the educators who had completed the questionnaires. Lastly, the researcher conducted six observations during English First Additional Language literature periods. In order to advance learners‟ fundamental rights while applying mediation during literature periods, the researcher developed a teaching and learning programme for poetry in Grade 11 English First Additional Language educators. Through the research it was found that educators neglect the application of mediation. This, unfortunately, results in detrimental effects concerning the advancement of learners‟ fundamental rights. / Thesis (PhD (Education Law))--North-West University, Vaal Triangle Campus, 2013

Title of thesis: Actual problems of criminal liability in medical treatment in connection with advance directives Abstract The main aim of this thesis is to analyze the topic of advance directives, recent institute in Czech legislation, its problems and mainly criminal liability in medical treatment, which is not summarized complexly in Czech professional literature. This thesis is composed of seven chapters, which are divided into sections and subsections. Chapter One is introductory and is dedicated to moral rights of a patient, which provide the basic starting points of this thesis. The chapter is subdivided into two parts. Part One describes evolution of rights of patients and part Two presents right to life, right to self-determination and finally right to protection of human dignity. Chapter Two analyzes advance directives. This chapter is subdivided into five sections. The basic characteristic is processed with respect to legislation, particular types, issues and critical aspects of advance directives. Chapter Three discusses the legal liability in healthcare. Chapter is divided into four sections; each is devoted to one of the civil, labor, administrative and disciplinary liability. Chapter Three is related to the following chapter, which deals with criminal liability and represents, with respect to...