Home Health Aide Exam – Study Guide Online Version #nearest #motel

#hospice home health aide

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Home Health Hospice Aide Competency Exam Study Guide

Order the newest version today! 2016-2018 Home Health Hospice Aide Competency Exam is now available!

The 2014-2016 Home Health Hospice Aide Exam Will Expire August 31, 2016!
Make sure you are testing with a current version of the exam to avoid State Survey Deficiency in this area.

*Please note: You must fill out separate forms for the Study Guide and Competency Exam

Home Health Hospice Aide Exam

The Oregon Association for Home Care developed the online Home Health Hospice Aide Competency exam as a standard for our industry. This examination tests the basic competencies of individuals who have received training in accordance with the Oregon Nurse Practice Act, to work as nursing assistants. The examination format is based on the Oregon Administrative Rules and the federal Medicare Conditions of Participation with nine points of emphasis relating to home care. The areas of emphasis include:

  • Communication Skills;
  • Observation of, reporting of and documentation about the patient and care provided, including basic elements of body functioning and changes in body function that must be reported to the aide’s supervisor;
  • Physical, emotional and developmental needs of, and ways to work with the population served by the home health agency, including the need for respect for the patient, his/her privacy and his/her property;
  • Maintenance of a clean, safe and healthy environment;
  • Basic infection control procedures;
  • Basic nutrition and food preparation techniques as appropriate;
  • Recognizing emergencies and knowledge of emergency procedures;
  • Reading and recording temperature, pulse and respiration;
  • Basic elements of body functioning and changes in body function that must be reported to an aide’s supervisor.

Biennially the OAHC Education Committee revises the examination and the Board of Directors approves the examination. Each test version has a two-year validity for competency of Aides. The committee provides a bibliography of resources which agencies can use to address specific training needs of the Certified Nurses Assistant or Home Health Hospice Aides.

Educational programs or agencies other than licensed agencies may purchase the testing packet for use in competency testing of aides, providing the purchasing entity has an RN available who is qualified to competency test Home Health Hospice Aides and certifies that he/she will follow the OAHC guidelines. These entities will also have use of the materials for the two-year time frame and must purchase a new packet for use beyond the stated expiration date. Licensed and certified agencies should only accept competency testing done by these agencies or programs only if agency policy allows. The entire procedure for test packet request shall be the same for non-licensed agencies as for licensed agencies, with the exception that non-licensed and certified entities will not receive the OAHC Home Health Hospice Aide certificates with their purchase of the test packet.

New Online Process!
Please note that the requesting agency must provide a computer with internet access for aide testing. The proctor must monitor the exam process and maintain the quiet surrounding conductive to testing. Member agencies currently using the RCTCLearn.Net program will be able to access the exam through their online login.

Watch Now for details on the new online system

OAHCMembers:
Exam (includes 5 aide testing tokens). $195.00
5 additional testing tokens. +$55.00
10 or more testing tokens. +$130.00

NonMembers:
Exam (includes 5 aide testing tokens). $440.00
5 additional testing tokens. +$55.00
10 or more testing tokens. +$130.00





Polytech Montpellier #polytech, #polytech #montpellier, #polytechmontpellier, #ecole #d’ingenieur, #école #d’ingénieurs, #école #ingénieurs,

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Le rapport d’activité 2016 est disponible

NOUVELLE PLATEFORME RECRUTEMENT

Polytech en partenariat avec Job Teaser

Le réseau POLYTECH se dote d’une nouvelle plateforme de recrutement à destination de ses 15 000 élèves-ingénieurs. Les étudiants pourront y retrouver toutes les offres de stage ciblées qui correspondent à leur profil et à leurs critères de recherche.

Job Teaser permet d’accéder à des offres de stages, d’alternance, de VIE. Avec le filtre “Polytech”, des offres exclusivement réservées aux élèves ingénieurs Polytech s’affichent.

Conservez cette adresse. Cette adresse sera valable tout au long de votre vie professionnelle et vous permettra de maintenir un lien avec l’école.

Se connecter à Job Teaser

En cas de difficulté, contacter Jérémy Vacquié. responsable des Relations industrielles.

Table ronde sur la fabrication additive © N. Seling

5e soirée des partenaires

Sur le thème de la fabrication additive (3D)

Jeudi 29 juin a eu lieu la cinquième Soirée des partenaires de l’école, organisée par le service des Relations industrielles. L’événement a rassemblé environ quatre-vingt personnes, industriels, représentants du secteur économique régional, universitaires et étudiants.

Une table-ronde, animée par Fabien SOULIÉ, enseignant-chercheur, a abordé le thème de « La fabrication additive dans les applications industrielles, citoyennes, de la recherche et de la formation ».

Stéphane ABED, président de la société Poly shape, Yann LEFEBVRE, président du FabLab « LabSud », André CHRYSOCHOOS, directeur du centre PRO3D et Christian JORGENSEN, professeur au CHU de Montpellier et directeur de l’unité INSERM “Cellules souches, plasticité cellulaire, médecine régénératrice et immunothérapies”, sont intervenus pour partager leurs expériences et échanger sur les applications de ces technologies.

Les diverses interventions des invités ont permis de montrer le spectre très large des champs d’applications de ces nouvelles techniques de mise en œuvre de la matière, allant de l’industrie de pointe à la recherche médicale avancée, sans oublier les applications standardsaccessibles à tous ” précise Fabien Soulié.

Les présentations ont aussi su faire ressortir toutes les étapes de la démarche de conception, de dimensionnement et d’optimisation, préalables à la phase d’impressionproprement dite ” ajoute André Chrysochoos, concluant que “la fabrication additive est apparue aux participants comme une solution complémentaire aux techniques classiques de fabrication, mais possédant ses propres limites “.

Voir les photos de la soirée

A partir du 5 juillet 2017 à 14h

Votre inscription à POLYTECH Montpellier

Les i nscriptions seront ouvertes à partir du lundi 21 aôut 2017 à 14h et les réinscriptions jusqu’au mercredi 19 juillet 2017 et à partir du lundi 21 août 2017 à 14h.

Du 22 juillet au 20 août

Congés d’été

Attention, l’école ferme ses portes du samedi 22 juillet au 20 août. Réouverture prévue lundi 21 août. Bonnes vacances à tous !

Palliative chemotherapy: harms and benefits weighed in new study – Medical News

#palliative chemotherapy

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Palliative chemotherapy: harms and benefits weighed in new study

Palliative chemotherapy is treatment designed for terminal cancer patients to prolong survival and ease symptoms but not cure disease. Now, researchers have found that the therapy comes with certain harms, which they say need to be addressed.

The researchers, from the Weill Cornell Medical College, Dana-Farber Cancer Institute and Harvard Medical School, have published their results in the BMJ.

They say their findings uncover a discrepancy between what type of care cancer patients want and what they actually receive.

Overall, the team found that terminal cancer patients who receive chemotherapy during the last months of their lives are less likely to die where they wish and are more likely to undergo invasive medical procedures – including CPR and mechanical ventilation – than patients who did not receive the therapy.

Dr. Holly Prigerson, of Weill Cornell Medical College, says that the reasons for the link are complicated, but they may originate in misunderstanding of the purpose and consequences of palliative chemotherapy.

For the study, investigators assessed data from 386 patients in a federally funded study, called Coping with Cancer.

This 6-year study followed terminally ill people and their caregivers until the patients died, and the researchers looked at how psychosocial factors influenced patient care.

After asking the caregivers to rate their patient’s care, quality of life and where the patient would have wanted to die, the researchers reviewed patient medical charts to determine the type of care they actually received during their last week.

Chemotherapy patients less likely to die where they want

The researchers found that patients receiving palliative chemotherapy were less likely to talk to their oncologists about the type of care they wanted to receive, to complete Do-Not-Resuscitate orders or to even acknowledge they were terminally ill.

The findings reveal that 68% of patients receiving palliative chemotherapy died where they wanted, compared with 80% of those not receiving the therapy.

In detail, 47% of patients who received the therapy died at home, compared with 66% of patients who did not receive the palliative care. Additionally, 11% of patients receiving the chemotherapy died in an intensive care unit, versus only 2% of patients not receiving the therapy.

Dr. Prigerson says:

“It’s hard to see in these data much of a silver lining to palliative chemotherapy for patients in the terminal stage of their cancer. Until now, there hasn’t been evidence of harmful effects of palliative chemotherapy in the last few months of life.”

“This study is a first step in proving evidence that specifically demonstrates what negative outcomes may result,” she adds.

The team also found that patients receiving palliative chemotherapy were more likely to be referred to hospice care much later than those not receiving the therapy.

Hospice care is a place that provides comfort and emotional support for terminal patients, and 54% of the patients receiving chemotherapy were referred to hospice late, compared with 37% of the patients not receiving the drugs.

‘Potential need for oncology practice changes’

The team notes that 56% of the patients from the study were receiving palliative chemotherapy in their final months, and they say this majority of use emphasizes the potential need for changes in oncology practice at academic medical centers.

Dr. Alexi Wright, assistant professor and medical oncologist at Dana-Farber, says:

“We often wait until patients stop chemotherapy before asking them about where and how they want to die, but this study shows we need to ask patients about their preferences while they are receiving chemotherapy to ensure they receive the kind of care they want near death.”

But Dr. Wright adds that their findings should not be interpreted that patients should be denied or not offered palliative chemotherapy:

“The vast majority of patients in this study wanted palliative chemotherapy if it might increase their survival by as little as a week. This study is a step towards understanding some of the human costs and benefits of palliative chemotherapy.”

“Additional studies are needed to confirm these troubling findings,” concludes Dr. Prigerson.





IMHS Metaphysics Institute – Premier Metaphysical University, Metaphysical Studies, Metaphysics PhD Degrees

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I always knew I wanted my degree, but the traditional setup of college was a drag to me and every semester there was always an additional class that was required or an increase in tuition or both. I feel as if this program is designed for people like me who want to expand their thinking and be challenged without feeling dumb or getting into debt. I am extremely grateful for a degree program that allows me to simply think and to be myself. —Britney Bryant, USA

IMHS is Fresh, Innovative, and Contemporary: [ Read More ]

Metaphysics is about more than just the abstract; it is also about a successful life. The abstract will certainly stimulate your thinking and can lead to great spiritual development, but for spiritual development to be effective and meaningful, it must be activated by practical life-skills; powerful everyday tools that will enable you to have better relationships, better communication skills, better critical thinking skills, and more. IMHS gives you both the spiritual development and the practical life-skills you need for a balanced, successful life!

IMHS is Powerful and Cutting-Edge: [ Read More ]

The IMHS curriculum is based on the Life Leadership Paragon TM. an exclusive and elegant model for success that has changed countless lives for the better. It is only taught at our schools. For more than a decade, this model has been carefully crafted and developed into a powerful, cutting-edge system for personal growth and spiritual enlightenment. The Life Leadership Paragon TM also serves as the foundation for Life Leadership Coaching TM. a blend of life coaching and transpersonal spiritual counseling which is also only taught at our schools. Students specializing in Holistic Life Coaching or Spiritual Counseling will really appreciate this creative and highly effective approach to helping others!

IMHS Gives You the Training and Skills You Need: [ Read More ]

In addition to spiritual development and practical life-skills, IMHS actually gives students the skills they need to be successful in their chosen areas of specialization (major). Many of our students take additional courses in their areas of interest beyond the ones required for graduation because they have come to know that our courses are comprehensive and beneficial to their personal and professional development. IMHS graduates are well-equipped to go out and make a positive difference in the world!

IMHS is Objective and Grounded: [ Read More ]

Rather than obscure, fringy, and highly esoteric concepts, IMHS approaches metaphysics in an objective, grounded, and real-world manner while still keeping the door open to the great mysteries of consciousness and our Universe. As humanity evolves, many people are leaving the confines of old religious and social notions and seeking new paradigms that focus on the value and worth of the individual. This is why IMHS teaches a human-centered spiritual philosophy which does not surrender one’s power to anyone or anything else. It empowers, encourages, and builds people up. It refreshes the mind, spirit, and soul!

Genuine, Bona-Fide, and Legal Degrees: [ Read More ]

Our degrees are absolutely genuine, legal, and “real.” IMHS is not a diploma mill. Our degrees are non-secular (religiously-based) in nature and require effort on the student’s part. Non-secular degrees are neither better nor worse than traditional degrees; they are simply used for different purposes. Therefore, students can rest assured that the degree they earn is completely legal and “real,” and the title of “Doctor” can be used in front of their names. This applies to nearly every country in the free world–especially countries that protect religious freedom.

Metaphysics for the 21st Century: [ Read More ]

With the many demands of life in this day and age, most adults simply do not have the time to spend several years getting a degree. Nevertheless, many busy adults would like a degree to enhance their lives and careers. Therefore, we have simplified and streamlined our Metaphysics PhD program by offering Bachelor’s, Master’s, and Doctoral degrees in an accelerated format that takes less time to complete thus allowing students to begin using their degrees sooner. And the best part is that our degree program provides an excellent learning platform that is concentrated, comprehensive, and affordable. We think you’ll find this 21st Century approach to getting your Metaphysics PhD degree a refreshing change from the past century!

Hungarian Language Lessons – Puzzles, Quizzes, Sound Files #learn #hungarian,magyar,language,lessons,puzzles,quizzes,sounds,grammar #reference, #wav,multiple

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Hungarian Lessons / Magyar leck�k

Hungarian is spoken by 15 million people worldwide. However, it is hard to learn magyar outside of Hungary, since it is almost impossible to find local source, classes or tutors to help. This website offers lessons for those, who really want to learn Hungarian. You also find a growing collection of sound files, self-quizzes, tests and language puzzles here to support these lessons. Please post your question on my message board or send e-mail if you need more help.
Please, SIGN UP today by answering my questions about your Hungarian level and about your expectations.

It is FREE
For helping aids, please look at my recommended
books and softwares.

Disclaimer My material and sound files can not be used outside of this website without my written permission. These can not be part of any collection, and can not be displayed on other websites for any reason. These are copyrighted files for personal use only. Thank you! Please, create links to this site if you plan to use this material.

This site is part of Hungarotips
Please visit for more than a hundred pictures and lots of information about Hungary.
Hungary | Genealogy | Traditions | Links | Travel tips

Get the most from these lessons

In general you can find here:

  • A growing collection of tutorial, puzzle and grammar pages. You can download and use all of the sound files from this site.
  • A living connection with me using e-mail or chatroom.
  • E-mail notification if new pages added.
  • I have some sets of supplementary exercises in Word and I can send them via e-mail. Please, let me know if you are interested.
    Please, answer the survey to help to prepare new pages.

    Subscribe, to receive HUNGARIAN E-LESSONS in your mailbox 3-times a week.
    The focus of each lesson is a single grammar topic or the use of one word, supported with at least 10-15 sample sentences, and detailed explanation. Sentences are related to Hungarian history, culture, tourism or everyday life. See a sample e-mail. One full year of subsciption is $18, ask for detail. You will receive at least 150 lessons in one year. Also, you can ask for a topic or word you would like to learn. Full refund during the first 20 days.

    Lessons are not available this time, they will start again in May 2015.

    Chatroom hours: (check your local time compare to New York, USA.)
    1. Beginners:
    Monday and Saturday 7PM EST

    2. Advanced:
    Thursday 7PM EST Please note, here Hungarian is the primary language.

    Put your question to my FORUM:

  • The Blackford Centre: About us #study #courses #online, #home #study #certification #correspondence

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    Distance Learning Courses

    Our online courses can give you a new career

    At the Blackford Centre you can study for a new career – in fields that are exciting and in demand.

    What’s more, our courses let you study where and when you want.

    There are no exams: we use positive assessment instead.

    And you don’t ever have to show up and be ‘stuck’ in a musty classroom to attend evening classes.

    Since it’s distance education, everything is at your convenience.

    Plus, you get a valuable qualification that reflects your new knowledge.

    Courses like this one can give you a whole new career and way of life. We’ll give you the confidence to start the new career you’ve been dreaming of.

    And we specialize in courses that let you start your own business.

    To find out more, click the subject on the left that captures your interest.

    Learn from the experts

    Each of our separate divisions has its own specialized, expert tutors.

    And we only employ tutors who are actively working in their field and who want to spread their knowledge.

    Like this page?
    Tell your friends

    That way, you don’t get armchair experts or professional academics who lack experience of the real world.

    Plus, we’re more practical than many organizations. So you’ll find our courses contain more detailed information and instructions about how to run your own business.

    Study online

    When you study one of our courses you’ll access all of the materials online. So you won’t have to wait for the course to arrive.

    Once, you’ve enrolled we’ll provide you with login details and the name of your tutor. And as soon as you have these details you can log straight into the system and get started on the course.

    Your tutor

    As we’ve said, you’ll have your own personal tutor. Research shows you’re more likely to succeed in this interactive, customized way, compared with mere self-study or book learning.

    Our courses are fun

    Some organizations make their courses stuffy and tedious. We hate that. Our materials are written in a light-hearted way, so you’ll absorb the serious information while enjoying yourself.

    That means you’re more likely to complete your course, and get the qualification.

    We’re recognized

    As you’ll see from the logos on the top right of this page, we’re accredited by many independent certification organizations. That means your qualification has real worth in the eyes of other people.

    Payment is simple

    You can pay online using our secure SSL server. In fact, we never see your credit card details, because they get passed straight to the bank without us even glancing at them.

    But we know it’s quite a big website (we have lots to talk about). So If you can’t find the online payment page, let us know and we’ll tell you how to locate it.

    Take the next step

    Want to learn more? Simply click on the topics at the top of the page.

    And if you have any questions, please get in touch.

    Bachelor of Teaching (Early Childhood Education) #early #childhood #education, #study #early #childhood

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    Programme overview

    In this field-based, practical programme you will develop the skills to become a competent, informed and reflective early childhood teacher who is committed to young children and their learning and development. We believe people learn through participation and we value the experience and insight you’ll gain from working in early childhood centres. There will be plenty of opportunities to relate these experiences to theory during campus sessions. When you graduate, you will be eligible to become a registered teacher in licensed early childhood education centres.

    • Teacher registration: once you’ve completed this degree, you can apply for teacher registration with the Education Council of Aotearoa New Zealand (NZ Teachers Council)
    • We aim for informed and reflective teaching based on observation and understanding of how people learn
    • A thorough grounding in educational theory and relevant practice of teaching and learning, child development, relevant te reo and tikanga M ā ori and working with children and their families in Aotearoa New Zealand
    • Emphasis on teaching practice: you’ll be working (paid or voluntary) in a licensed early childhood centre for at least 12 hours per week during the programme
    • Experience teaching in a range of centres: each year you will also take part in a practicum, working full-time in an early childhood education centre for 37.5 hours per week
    • A strong emphasis on the New Zealand early childhood curriculum document, Te Wh ā riki. and a bicultural and sociocultural approach to learning
    • Acknowledgment of Te Tiriti o Waitangi, which prepares you to implement te reo M ā ori me ona tikanga in your teaching practice
    • A focus on research: you’ll develop an understanding of research methodologies with a particular emphasis on action research (self-study) in an early childhood setting
    • Part-time study options are available. Like full-time students, part-time students will need to work (paid or voluntary) in a licensed early childhood centre for at least 12 hours per week during the programme but study time will be part-time. Email Lee-Anne Turton (Academic Leader) or Lisa Helmling (Lecturer) for more information on how to apply for the part-time programme.

    TeachNZ Early Childhood Education Schloarships

    • TeachNZ Early Childhood Education Scholarships: If you want to become an Early Childhood Education (ECE) teacher and you’re passionate about Māori or Pasifika cultures, a TeachNZ ECE Scholarship may be just what you’ve been waiting for.

    Career Options

    • Early childhood teacher
    • Head teacher in an early childhood setting
    • Home-based coordinator/educator
    • Manager in an early childhood education centre
    • Hospital play specialist
    • Nanny

    Annual Tuition Fees

    Admission requirements

    For this programme, you will need the following:

    ​1. University Entrance which requires NCEA Level 3 including:

    • 14 credits at NCEA Level 3 in three different approved subjects
    • 10 credits at NCEA Level 2 or higher in English or Maori (5 in reading, 5 in writing)
    • 10 credits at NCEA Level 1 or higher in Mathematics or Pangarau

    2. Be at least 17 years old by the time the programme begins

    3. Be able to work for a minimum of 12 hours per week for the duration of the programme in a licensed early childhood centre

    4. Complete a self-declaration of criminal conviction(s) and medical condition(s) which may prevent full participation in the programme and/or prevent registration with a regulatory authority (if applicable)

    5. Consent to a Safety Check which meets the requirements of the Vulnerable Children Regulations 2015 including:

    • Provide two forms of ID and evidence of any name changes
    • Consent to a police vet check
    • Provide the names of two referees who Unitec or your placement provider can contact
    • If required, participate in an interview
    • If required, provide a chronological summary of your work history for the past 5 years and the name of any professional organisations, licensing authorities and registration authorities that you have been or are a member of

    6. If English is your second language you will need to provide evidence of achieving an overall IELTS (Academic) band score of no less than 7.0 in each band of the test or be able to provide evidence you satisfy our criteria for existing English proficiency.

    Don’t have NCEA? We also accept:

    • A relevant qualification at Level 3 on the NZQF or above or an equivalent qualification; OR
    • Provide sufficient evidence to be eligible for special or discretionary admission.

    For more information download the programme regulations:

    Courses and timetables

    For more details on the courses including timetables, please click on the course names below.

    To demonstrate teaching and professional practices that recognise and respond to the integrated nature of young children s learning on a teaching practicum

    15 credits (0.125 EFTS)

    To further develop Te Reo Maori language skills, advance knowledge of Tikanga Maori, and develop students understandings of Manaaki Whenua and its application in teaching practice.

    15 credits (0.125 EFTS)

    To critically examine the history and current social and political status of early childhood education in Aotearoa/New Zealand and its impact upon centres especially in the Pasifika community.

    15 credits (0.125 EFTS)

    To assist students to extend their knowledge and skills in professional communication and respond to ethical dilemmas in an early childhood setting

    15 credits (0.125 EFTS)

    To assist students to examine and analyse a range of theories and philosophies on the care, learning and development of infants and toddlers

    15 credits (0.125 EFTS)

    To enable students to critically examine theories and practices relating to curriculum content knowledge.

    15 credits (0.125 EFTS)

    To critically assesses the quality of research underpinned by a variety of research methodologies, with a particular focus upon action research.

    15 credits (0.125 EFTS)

    Examine and apply current approaches in Early Childhood Education assessment, planning and evaluation through participation in a work experience setting.

    Title

    Disclaimer

    The ‘Key Information for Students’ below does not reflect any international student information .

    Please take this information as a guideline only. For example, you will often see a difference between these tuition fees and our estimate above. This is because there are a number of variables, such as the specific courses chosen within a programme.

    The national graduate outcomes information is for all tertiary New Zealand providers including Unitec. This information is provided by the New Zealand Government and is derived from a national database that links educational and income information.

    Key Information for Students

    Entry requirements

    Minimum requirements . University Entrance with 14 credits at NCEA Level 3 in a mix of subjects, 10 credits at NCEA Level 1 or higher in Maths and English language requirements or relevant and equivalent qualifications, special and discretionary admission also accepted.

    Detailed requirements: See the above “Admission requirements” section for more information about entry to this progrogramme.

    Duration

    Bachelor of Behavioural Studies (Psychology) to receive APAC accreditation – Open Universities

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    Open Universities Australia – Online Courses

    Student news

    Date published: 18 July 2011

    Open Universities Australia (OUA) is pleased to announce that the Bachelor of Behavioural Studies (Psychology), available for online study with OUA and provided by Swinburne University, has been offered conditional accreditation by the Australian Psychology Accreditation Council (APAC).

    OUA and Swinburne have been working together to secure APAC accreditation for this course, and have recently been granted conditional approval.

    This is an exciting development for students seeking a career as an accredited psychologist in Australia, and adds immense value to the course for OUA’s students.

    To ensure that OUA students working towards the Bachelor of Behavioural Studies (Psychology) are able to graduate with an accredited degree, some changes to the prerequisite conditions for certain units within the course have been introduced. In particular, certain entry-level units will become mandatory prerequisites for higher-level units in the course. The amended course structure can be viewed at the Bachelor of Behavioural Studies (Psychology) course page .

    Any students currently working towards this qualification who have queries about their current study path are welcome to contact the OUA Student Advisors on 1300 363 652, or submit their question via the Online Enquiry Form .

    For students seeking to undertake higher-level units from this course as electives, they may still be eligible to do so without completing the prerequisites through OUA, and are urged to speak to a Student Advisor using the contact details above.

    OUA hopes that the APAC accreditation will open numerous doors for our students, and hope to assist as many people as possible with achieving their goals of a career in psychology.

    Please note that there have been no changes to the Bachelor of Behavioural Studies, also provided by Swinburne University, although students will be required to meet mandatory prerequisite requirements for future units.

    Let’s connect

    De Anza College #de #anza,deanza,de #anza #college,deanza #college,cupertino,silicon #valley,community #college,education, #course #information,

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    De Anza College offers an extensive course list to help you achieve your goals, which may include:

    • Transfer to a four-year college or university
    • Improve your job skills
    • Seek a new career
    • Take classes for personal enrichment.

    Our academic programs provide specialized career/technical areas of study, Associate in Arts and Science degrees, and lower-division major and general education courses required for transfer.

    CERTIFICATES and DEGREES

    See our AA/AS Degree and Certificate Programs list with links to program requirements.

    Certificate Programs are focused on a particular area of study and designed for students who wish to prepare for immediate employment and/or to upgrade their job skills.

    Many certificates have been designed on the ladder concept. For example, courses taken to fulfill the lowest level Certificate of Achievement (18-26 units) may be applied to the next level, the Certificate of Achievement-Advanced (27+ units). Then those units may be applied to an Associate degree.

    Associate in Arts or Science (AA/AS) Degree Programs (minimum of 90 quarter units) include requirements for a major, general education, and there is usually room for electives. Units/courses applied toward Associate degree programs may sometimes also fulfill lower division requirements for transfer.

    The Workforce Education Program Guide may help you determine a career education path that meets your needs.

    TRANSFER COURSES

    Transfer courses provide you with the lower-division major and general education courses that you will need to transfer to a four-year university. Transfer programs range from narrow specialty majors (i.e. Microbiology) to broad general education programs (i.e. Liberal Arts).Visit our Transfer Planning website for more information.

    Degree Certificate Department Websites

    Check out our Workforce Education Program Guide to determine a career education path that meets your interests and needs.

    ORIENTATION to COLLEGE

    You must take COUN 50: Orientation to College to receive all the information that you need to pursue a certificate, degree and/or transfer to a four-year college/university. You will create an education plan in this 1/2-unit class. Your education plan provides the foundation you’ll want before you meet with a counselor or academic advisor.

    LEARNING MODALITIES

    We offer a variety of ways to learn to fit your schedule and needs. Search the online schedule of classes for these program designations, including evening classes:

    Canadian Colleges & Universities Application fee, Waiver #admission #tests, #ielts, #toefl, #gre,

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    Overseas Education Consultants in Delhi Chandigarh Mumbai Jaipur Hyderabad Ahmedabad Vadodara Pune Jalandhar Ludhiana Chennai Kolkata Indore Jodhpur Udaipur Bikaner Sriganganagar for IELTS, Admission & Visa in Canada, USA, UK, Australia, New Zealand, Germany, Europe, Dubai, Singapore, Switzerland

    Study Abroad Canada Colleges Universities Application fee

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    Application Fee for SPP Colleges Universities:

    Application Fee CAD

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    Need help? please give us a call or send us an email with your details requirements we will be happy to assist you.

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    Study Abroad Programs, Internships – Scholarships #study #abroad, #study #abroad #programs, #studying

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    Welcome to CEA

    At CEA, we re committed to increasing accessibility to study abroad and helping your campus internationalize. On-site staff with specialized local knowledge, meaningful cultural engagement, and 24/7 health and wellness support enhance student life abroad, while internships, service learning, and volunteer opportunities build career readiness and global competence. Our QUIP-recognized academic programs are designed to complement your own programming and strengthen internationalization efforts on your campus.

    Founded on a Promise

    Brian Boubek’s undergraduate study program in France changed his life. but he also knew the experience could have been better. That’s why Brian created CEA: to ensure that students enjoy seamless support, from the moment they first consider studying abroad to the day they return home again (and beyond!) Almost 20 years later, Brian’s goals creating a simple pre-departure process, facilitating high-quality academic programs, offering opportunities for meaningful cultural engagement, and preparing students for a global workplace still inform everything we do at CEA.

    Focused on Academics

    Go learn somewhere else.

    CEA commits $2 million each year to our financial and scholarship programs.

    Think you can t afford to study abroad? Think again! CEA scholarships, grants, payment plans, and financial aid support make finding funding easy. Don’t let finances stand in the way of the adventure of a lifetime. Connect with our Student Accounts team today to learn about your options!

    Immerse Into Life Abroad

    Perks like on-site staff to show you the ropes, cultural engagement activities, and 24/7 health and wellness support enhance your life abroad, while internships, service learning, and volunteer opportunities help build your career readiness. You can even keep that study abroad experience alive after your program ends by becoming a CEA Alumni Ambassador and sharing the benefits of international education on your own campus!

    London Center Now Enrolling

    Explore this vibrant metropolis through courses that turn the city into your living classroom. You can gain r sum -boosting experience through our international internship program, and immerse in local culture by volunteering, writing for a student newspaper, or joining on-campus clubs and activities.

    Featured Destination

    Study abroad is our passion.

    Since 1997, CEA has maintained one simple philosophy: To provide high-quality international academic programs and services. That means support at each step of your experience, from the moment you apply to the day you return home. Along the way you’ll learn to communicate across cultures. You’ll earn credits while gaining valuable skills. And you’ll discover more about yourself than you ever thought possible.

    Attention to Detail
    Over the six years that we have worked with CEA on our custom program to Rome, we have been consistently impressed by the quality of collaboration, the attention to details both logistical and academic CEA staff members have been fantastic friendly, efficient, highly professional, and dedicated to the success of our program.

    William L. North. Associate Professor & Chair, Department of History
    Carleton College

    Custom Programs

    Whether you want to offer a course taught by your own faculty or a cohort arrangement in an area of interest, CEA provides the expert support, resources, and flexibility you need to create your own custom program in 17 locations around the globe.

    Hospice certification study guide #first #world #hotel

    #hospice certification study guide

    #

    Certification for Hospice and Palliative Medicine Specialists

    Today, physicians specializing in hospice and palliative medicine have several certifications available to them beyond their primary board certification: ABMS, AOA, and HMDCB.

    Since 2008, member boards of ABMS and AOA have certified physicians in the specialty-level practice of hospice and palliative medicine. There are 6,952 ABMS/AOA CAQ physicians in hospice and palliative medicine.

    In 2012, AAHPM recommended the creation of the Hospice Medical Director Certification Board (HMDCB) to administer a certification that is complimentary to ABMS and AOA certification but specific to the practice of hospice medicine. The HMDCB examination assesses additional expertise in the unique competencies to perform the role of a hospice medical director, such as regulatory, administrative, legal, ethical competencies, and clinical skills appropriate for hospice patients.

    Maintenance

    AAHPM is committed to providing information and support for

    Information for HMDCB’s recertification will be available when it is developed. A number of educational opportunities and resources are offered for both for preparation and continuing education.

    History of Certification

    Certification is widely considered the gold standard of expertise in medicine because of its unique physician-directed approach for assessing qualifications. While medical licensure sets the minimum competency requirements, board certification demonstrates a physician’s expertise in a particular specialty and/or subspecialty of medical practice.

    Although certification is sought and earned by physicians on a voluntary basis, it is recognized by government, healthcare systems, insurers, and patients themselves as an essential tool to judge that a physician has the knowledge, experience, and skills for providing quality health care within a given specialty or subspecialty.

    ABHPM

    AAHPM has supported certification by its members since 1996. The creation of the American Board of Hospice and Palliative Medicine (ABHPM) provided an independent organization charged with certifying physicians practicing hospice and palliative medicine.

    In October 2006, ABHPM offered its last certification exam in Hospice and Palliative Medicine and phased out recertification and support of existing certifications when the field was officially recognized as a subspecialty by the American Board of Medical Specialties (ABMS) in 2006 and the American Osteopathic Association (AOA) in 2007. AAHPM maintains the ABHPM certification database and provides verification (upon request) for diplomates through 2017.

    For more information, email This email address is being protected from spambots. You need JavaScript enabled to view it. or call 847.375.4712.

    AAHPM Elevate

    A collection of supplemental web-based, on-demand programs offered through AAPL at a special rate for AAHPM members.





    Palliative chemotherapy: harms and benefits weighed in new study – Medical News

    #palliative chemotherapy

    #

    Palliative chemotherapy: harms and benefits weighed in new study

    Palliative chemotherapy is treatment designed for terminal cancer patients to prolong survival and ease symptoms but not cure disease. Now, researchers have found that the therapy comes with certain harms, which they say need to be addressed.

    The researchers, from the Weill Cornell Medical College, Dana-Farber Cancer Institute and Harvard Medical School, have published their results in the BMJ.

    They say their findings uncover a discrepancy between what type of care cancer patients want and what they actually receive.

    Overall, the team found that terminal cancer patients who receive chemotherapy during the last months of their lives are less likely to die where they wish and are more likely to undergo invasive medical procedures – including CPR and mechanical ventilation – than patients who did not receive the therapy.

    Dr. Holly Prigerson, of Weill Cornell Medical College, says that the reasons for the link are complicated, but they may originate in misunderstanding of the purpose and consequences of palliative chemotherapy.

    For the study, investigators assessed data from 386 patients in a federally funded study, called Coping with Cancer.

    This 6-year study followed terminally ill people and their caregivers until the patients died, and the researchers looked at how psychosocial factors influenced patient care.

    After asking the caregivers to rate their patient’s care, quality of life and where the patient would have wanted to die, the researchers reviewed patient medical charts to determine the type of care they actually received during their last week.

    Chemotherapy patients less likely to die where they want

    The researchers found that patients receiving palliative chemotherapy were less likely to talk to their oncologists about the type of care they wanted to receive, to complete Do-Not-Resuscitate orders or to even acknowledge they were terminally ill.

    The findings reveal that 68% of patients receiving palliative chemotherapy died where they wanted, compared with 80% of those not receiving the therapy.

    In detail, 47% of patients who received the therapy died at home, compared with 66% of patients who did not receive the palliative care. Additionally, 11% of patients receiving the chemotherapy died in an intensive care unit, versus only 2% of patients not receiving the therapy.

    Dr. Prigerson says:

    “It’s hard to see in these data much of a silver lining to palliative chemotherapy for patients in the terminal stage of their cancer. Until now, there hasn’t been evidence of harmful effects of palliative chemotherapy in the last few months of life.”

    “This study is a first step in proving evidence that specifically demonstrates what negative outcomes may result,” she adds.

    The team also found that patients receiving palliative chemotherapy were more likely to be referred to hospice care much later than those not receiving the therapy.

    Hospice care is a place that provides comfort and emotional support for terminal patients, and 54% of the patients receiving chemotherapy were referred to hospice late, compared with 37% of the patients not receiving the drugs.

    ‘Potential need for oncology practice changes’

    The team notes that 56% of the patients from the study were receiving palliative chemotherapy in their final months, and they say this majority of use emphasizes the potential need for changes in oncology practice at academic medical centers.

    Dr. Alexi Wright, assistant professor and medical oncologist at Dana-Farber, says:

    “We often wait until patients stop chemotherapy before asking them about where and how they want to die, but this study shows we need to ask patients about their preferences while they are receiving chemotherapy to ensure they receive the kind of care they want near death.”

    But Dr. Wright adds that their findings should not be interpreted that patients should be denied or not offered palliative chemotherapy:

    “The vast majority of patients in this study wanted palliative chemotherapy if it might increase their survival by as little as a week. This study is a step towards understanding some of the human costs and benefits of palliative chemotherapy.”

    “Additional studies are needed to confirm these troubling findings,” concludes Dr. Prigerson.





    Canada ranks 10th for retirement security worldwide: study #health #and #retirement #study

    #

    Canada ranks 10th for retirement security worldwide: study

    Canadians worrying about the state of their retirement savings can enjoy some good news this week: Canada has been ranked 10th in the 2016 Global Retirement Index. up from 12th last year. The annual ranking, by Natixis Global Asset Management. compares the state of retirement security in 43 countries around the world. The ranking placed Norway, Switzerland and Iceland in the top three slots, the United States at 14, with Brazil, Greece and India rounding out the bottom of the list.

    The news comes just a few weeks after Canada’s finance ministers agreed to an expansion of the Canada Pension Plan. “When you look at what is driving these results for Canada, we can point to some things that are clearly working, and some things on the horizon that it would be good to address now,” says Ed Farrington, executive vice president for retirement at Natixis. “What we’re hoping is that this ranking will provide policy makers, employers and individuals with information to use moving forward with planning for retirement savings programs.

    Farrington points to Canada’s health care system and “impressively low level” of income inequality as factors that placed it in the top 10. “To have a high per-capita income and low income inequality is worth noting, because it means that a broad section of the population has the ability to put money towards their retirement,” he explains.

    But it’s not all good news: while Canada ranked relatively high for retirement security, Natixis also found that many Canadian investors are underestimating how much they should be saving for retirement. While 72% of Canadians surveyed identified retirement saving as their highest financial priority, many believed they would need to replace only 60% of their income after retirement, short of the 75-85% generally assumed by planning professionals.

    What’s more, while Canadians reported setting aside an average of 10.5% of their annual income for retirement, the international average sits at 12.2%.

    “My sense of the problem is that people aren’t knowledgeable when it comes to the risks involved in retirement savings,” says Farrington. “As investors, they’re used to the risks of the market, or short-term pressures like debt. Those risks are very different than the ones one assumes when they’re in retirement.”

    Farrington says Canadians are underestimating how long they’ll need their savings to last. “If you’re a couple, and you both retire at the age of 65, there is close to a 9 in 10 chance that one of you will be alive in your 90s,” he explains. “I don’t think people fully grasp that.”

    When it comes to possible solutions, Farrington is quick to point to programs that have “strong participation from the government, the employer and the individual.” He lists a worrying statistic—only 55% of Canadians participate in workplace-based savings programs.

    “Taking a look at a country like New Zealand—number four in the ranking—we can see the impact of a program they implemented 10 years ago,” says Farrington. “The KiwiSaver program is a compulsory program which automatically enrolls employees in a workplace savings program, where the employer provides a match to contributions.” Farrington says that a decade after implementing the program, New Zealand has become “an international role model for retirement savings.”

    That being said, Farrington is firm in his belief that if the participation rate in workplace saving plans went up, Canada too could be a role model. However, despite his advocacy of nation-wide programs, Farrington has a simple message for Canadians thinking about their retirement security: “We hope that this ranking can be a rallying cry to employees to be saving as much as possible, as early as possible.”

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    QUT – Study animation – Courses and degrees #study, #animation, #courses, #degrees

    #

    Our virtual production studio provides students with a range of skills they can apply to big-budget movies, games and interactive content.

    Why study animation at QUT?

    • Explore animation in a range of creative fields, including animated filmmaking, visual effects, game development and the visual arts.
    • Develop practical skills in motion graphics, 3D graphics, drawing and real-time modelling for virtual environments.
    • Gain experience and contacts in your industry through professional industry placements and projects.
    • Choose independent study options to design and implement creative work.

    Undergraduate courses

    Bachelor degrees

    Double degrees

    Postgraduate courses

    Graduate certificates

    Honours degrees

    Masters by research

    Doctoral degrees

    Short courses and professional development

    Get hands-on experience

    Throughout your course, you can choose to work on real-world projects or develop your own practice. You’ll be encouraged to experiment with a range of animation styles and techniques, while producing your own animations, graphics and visual effects. You can use our broad range of study areas to tailor your learning to the parts of industry you’re most interested in.

    In your final year, you’ll develop a major creative work that explores whichever aspect or medium of animation you choose. You’ll showcase this work to industry professionals at your end-of-year graduate exhibition.

    Build real-world skills

    As part of your study, you’ll work in a studio setting and respond to creative briefs that help you develop a comprehensive set of skills and knowledge to express your inspired and innovative ideas. Learn the fundamental concepts, practices and history of animation, including animation for:

    • filmmaking
    • game development
    • visual effects
    • motion graphics
    • virtual production.

    Apply your skills and knowledge via practical training to take your concepts and projects from ideas to reality.

    Pathways to postgraduate study

    Turn your creative interests and professional expertise into a postgraduate research degree to master new techniques, skills and research methods. Complete your research as either a thesis or a practical industry-focused creative work, with a written component.

    Career outcomes

    Our graduates are highly regarded in the animation, games and visual effects industries because they are versatile, innovative and career ready. They’re employed as:

    • animators
    • concept artists
    • visual effects artists
    • game artists
    • designers.

    They work in a range of industries, including:

    • animation studios
    • traditional film production houses
    • computer games companies
    • visual effects and post-production companies
    • advertising and design agencies
    • information visualisation and real-time studios.

    Several of our graduates are award-winning storytellers who successfully produce animated short films that screen at international festivals.

    Phd in france #campusfrance, #campus #france, #campus #france, #campusfrance, #campus, #edufrance, #edufrance,

    #

    Atlas program, Short–term post-doctoral fellowship The Fondation Maison des sciences de l’.

  • Scolarship Sustainable Nuclear Engineering – Applications and Management (SNEAM) Joint Degree.

  • Літні курси у Франції Літні курси у Франції

  • Усі курси француької Повний каталог мовних центрів Франції

  • Париж — найкраще у світі студентське місто Місто, де добре навчатись

  • Death and denial on the cancer ward: Refusing to accept reality can

    #care of terminally ill patient

    #

    Death and denial on the cancer ward: Refusing to accept reality can be shattering to family, study finds

    Tom Blackwell
    Friday, Sept. 14, 2012

    Naomi Kogan, a social worker at Montreal’s Jewish General Hospital, speaks with a patient undergoing chemotherapy at the hospital. Terminally ill patients who refuse to acknowledge their prognosis can cause their loved ones anxiety, depression and even rage, Kogan and two co-authors found in a newly published study. Christinne Muschi for National Post

    The single parent had been in hospital for months, suffering from terminal cancer but refusing to accept that death was near.

    Even the person’s two young children were unaware of the dire prognosis, recalls Naomi Kogan, a social worker at Montreal’s Jewish General Hospital who cared for the patient. Finally, last month, a teenage daughter arrived at the hospital to learn that her only parent would not be coming home — minutes before the person died.

    “The impact has been devastating, to have only an hour to say goodbye,” said the social worker. “The child is having major difficulties.”

    Related

    Yet such entrenched denial of terminal disease is a surprisingly common occurrence on the cancer ward, said Ms. Kogan, and a new study she and colleagues have just published suggests it can have a shattering impact on the family members who care for those patients.

    Relatives struggling to play along with the alternate reality sometimes have to turn a blind eye as the patient pretends to ignore dangerous symptoms, and are unable to share their own emotional turmoil over the illness, the researchers found. Sometimes, children are left completely in the dark.

    Ms. Kogan suggests that health-care workers dealing with those people face similar angst.

    It’s been such a difficult element in my work for all these years, so challenging and causing so much frustration

    “These [patients in denial] are people who until the end are carrying this protective mechanism like a tortoise shell,” she said in an interview. “It’s been such a difficult element in my work for all these years, so challenging and causing so much frustration.”

    The patients at the heart of her study, co-authored by Robin Cohen, a McGill University oncology professor, and Michelle Dumas, an Ottawa General Hospital nurse, acknowledge that they have cancer, but tend to minimize the seriousness of the condition that appears destined to kill them.

    Despite what would seem like unequivocal evidence to the contrary, one woman in the study remained convinced she would recover, and married her common-law partner — inside the palliative-care ward.

    Christinne Muschi for National Post Entrenched denial of terminal disease is a surprisingly common occurrence on the cancer ward, says social worker Naomi Kogan, seen talking with a chemotherapy patient at Montreal s Jewish General Hospital.

    When Ms. Kogan started her career 24 years ago, the psychiatry department would be summoned in an effort to help such patients face reality, but health-care workers no longer try to disavow them of their beliefs, now considered a coping mechanism that is useful to the patient, at least.

    A Montreal woman, who asked not to be named, said she and her family have been dealing with such a situation for several weeks. A close relative has stage-four cancer and likely has less than a year to live, yet until recently has cheerfully avoided the grim truth of her prognosis. She even talked from her hospital bed about running a half-marathon next year.

    She would act as though everything was just fine. It was impossible to even acknowledge she was sick. It was very frustrating and isolating

    “She would act as though everything was just fine,” said the relative. “It was impossible to even acknowledge she was sick. It was very frustrating and isolating.”

    For the study published in the journal Palliative and Supportive Care. Ms. Kogan’s team identified dying patients at the Segal Cancer Centre who were in denial, and arranged interviews with family caregivers of 16 of them.

    All said they felt it necessary to maintain their loved ones’ sense of denial, but that keeping up the pretence of normalcy took a toll in terms of anxiety, depression and even “feeling enraged.” Some said they were forbidden to dig up more information about the disease or ask probing questions of medical staff, or felt they could not make arrangements for funerals or future finances.

    More than half the patients went so far as to not get the care they needed, masking symptoms that might have prevented them from receiving more of the chemotherapy they considered life-saving, or that would drive home the dire state of their health, the study said.

    One patient refused to disclose such problems as severe diarrhea that should have prevented him from getting chemotherapy, went ahead with the treatment and almost died, prematurely, as a result. Another actually hid weights in his clothes so he would reach the minimum requirement to continue chemo, as patients who are too emaciated are not eligible, said Ms. Kogan.

    He’s been crying for the past three days. He’s got pain in the neck, pain in the back, and he doesn’t want me to talk about it

    Others would not acknowledge escalating pain, or refused to step up their medication levels in response. “He’s been crying for the past three days. He’s got pain in the neck, pain in the back, and he doesn’t want me to talk about it,” one caregiver told the researchers.

    Ms. Kogan said there is not a lot that health-care and social workers can do in the face of such denial, though sometimes they can counsel the family members about their own anguish over the situation, and try to help make practical arrangements.

    She said she was able to convince the single-parent patient, after much prodding, to prepare a will, without actually saying the person was dying. The will was a crucial tool for the family as the children started a new life with relatives.

    Elizabeth Beddard-Huber, an advance-practice nurse specializing in pain management at the B.C. Cancer Agency, said she also encounters patients in denial, an experience that can be stressful and “hard to watch,” especially when young children are involved. In one case, two teenagers were so troubled by their inability to talk frankly to their fatally ill mother, they began acting out at school, she said.

    Like the Montreal researchers, Ms. Beddard-Huber noted that such patients will hang on desperately to the hope of chemotherapy, decline pain medication and other palliative care, and occasionally look elsewhere when conventional medical treatment reaches a dead end.

    “Sometimes it gets to a point where they have to spend quite a bit of money to seek extra treatment and go to Mexico or to China or to the States for special treatment,” said Ms. Beddard-Huber. “They’re looking for that miracle.”





    Case Study: Ensuring welfare and safety of nurses while conducting home visits

    #weldmar hospice

    #

    Weldmar Hospicecare Trust of Dorset are now able to ensure the welfare and safety of their nurses with Crystal Ball’s Lone Worker Protection

    Challenges

    The Trust’s community nurses regularly conduct home visits on their own, so it is imperative that their welfare is monitored at all times.

    Prior to May 2012, the Trust had a self-developed paper-based process in place to monitor and report on community nurses’ home visits. However, the system was no longer proving to be adequate and a subsequent internal review identified two clear objectives to replace the system.

    Firstly, the existing welfare protection processes required some form of automation.

    Secondly, the internal reporting capabilities needed to be improved in order to meet the Trust’s legal requirements to lone workers.

    The Solution

    Following careful consideration of other lone worker solutions on the market, WeldmarHospice Care Trust made the decision to implement Crystal Ball’s Mobile LWP solution in May 2012.

    It provided a cost-effective remedy to all Weldmar’s key requisites, with additional features such as routine welfare checks and panic alarms appealing to management as a means of ensuring the safety of the community nurses.

    Today, when the nurses visit patients at their homes, they use Mobile LWP to check in and check out of visits, ensuring their whereabouts can be traced if necessary. The lone worker app also sits discretely on the community nurses’ smartphones requiring minimal interaction to operate.

    The Outcomes

    The introduction of the system has enhanced the safety and welfare of the community nurses at Weldmar and addressed health and safety legislations.

    Joanna Higgs is Head of IT for Weldmar:

    “Being able to locate the nurses has been a huge benefit and the nurses feel much safer knowing that if something was to happen somebody would respond.”

    She also comments on how the panic alarm feature has been a useful safety aspect:

    ”The alarms have gone off a couple of times and we have responded and phoned them straight away, this has made the nurses feel a certain sense of security”.

    Weldmar has also found the history and audit trails beneficial on a number of occasions where specific incidents have happened, as it has allowed them to gain a greater understanding of these events. Furthermore, with Crystal Ball’s system
    being completely web-based, Weldmar have access to the system across several sites simultaneously.





    Palliative chemotherapy: harms and benefits weighed in new study – Medical News

    #palliative chemotherapy

    #

    Palliative chemotherapy: harms and benefits weighed in new study

    Palliative chemotherapy is treatment designed for terminal cancer patients to prolong survival and ease symptoms but not cure disease. Now, researchers have found that the therapy comes with certain harms, which they say need to be addressed.

    The researchers, from the Weill Cornell Medical College, Dana-Farber Cancer Institute and Harvard Medical School, have published their results in the BMJ.

    They say their findings uncover a discrepancy between what type of care cancer patients want and what they actually receive.

    Overall, the team found that terminal cancer patients who receive chemotherapy during the last months of their lives are less likely to die where they wish and are more likely to undergo invasive medical procedures – including CPR and mechanical ventilation – than patients who did not receive the therapy.

    Dr. Holly Prigerson, of Weill Cornell Medical College, says that the reasons for the link are complicated, but they may originate in misunderstanding of the purpose and consequences of palliative chemotherapy.

    For the study, investigators assessed data from 386 patients in a federally funded study, called Coping with Cancer.

    This 6-year study followed terminally ill people and their caregivers until the patients died, and the researchers looked at how psychosocial factors influenced patient care.

    After asking the caregivers to rate their patient’s care, quality of life and where the patient would have wanted to die, the researchers reviewed patient medical charts to determine the type of care they actually received during their last week.

    Chemotherapy patients less likely to die where they want

    The researchers found that patients receiving palliative chemotherapy were less likely to talk to their oncologists about the type of care they wanted to receive, to complete Do-Not-Resuscitate orders or to even acknowledge they were terminally ill.

    The findings reveal that 68% of patients receiving palliative chemotherapy died where they wanted, compared with 80% of those not receiving the therapy.

    In detail, 47% of patients who received the therapy died at home, compared with 66% of patients who did not receive the palliative care. Additionally, 11% of patients receiving the chemotherapy died in an intensive care unit, versus only 2% of patients not receiving the therapy.

    Dr. Prigerson says:

    “It’s hard to see in these data much of a silver lining to palliative chemotherapy for patients in the terminal stage of their cancer. Until now, there hasn’t been evidence of harmful effects of palliative chemotherapy in the last few months of life.”

    “This study is a first step in proving evidence that specifically demonstrates what negative outcomes may result,” she adds.

    The team also found that patients receiving palliative chemotherapy were more likely to be referred to hospice care much later than those not receiving the therapy.

    Hospice care is a place that provides comfort and emotional support for terminal patients, and 54% of the patients receiving chemotherapy were referred to hospice late, compared with 37% of the patients not receiving the drugs.

    ‘Potential need for oncology practice changes’

    The team notes that 56% of the patients from the study were receiving palliative chemotherapy in their final months, and they say this majority of use emphasizes the potential need for changes in oncology practice at academic medical centers.

    Dr. Alexi Wright, assistant professor and medical oncologist at Dana-Farber, says:

    “We often wait until patients stop chemotherapy before asking them about where and how they want to die, but this study shows we need to ask patients about their preferences while they are receiving chemotherapy to ensure they receive the kind of care they want near death.”

    But Dr. Wright adds that their findings should not be interpreted that patients should be denied or not offered palliative chemotherapy:

    “The vast majority of patients in this study wanted palliative chemotherapy if it might increase their survival by as little as a week. This study is a step towards understanding some of the human costs and benefits of palliative chemotherapy.”

    “Additional studies are needed to confirm these troubling findings,” concludes Dr. Prigerson.





    Death and denial on the cancer ward: Refusing to accept reality can

    #care of terminally ill patient

    #

    Death and denial on the cancer ward: Refusing to accept reality can be shattering to family, study finds

    Tom Blackwell
    Friday, Sept. 14, 2012

    Naomi Kogan, a social worker at Montreal’s Jewish General Hospital, speaks with a patient undergoing chemotherapy at the hospital. Terminally ill patients who refuse to acknowledge their prognosis can cause their loved ones anxiety, depression and even rage, Kogan and two co-authors found in a newly published study. Christinne Muschi for National Post

    The single parent had been in hospital for months, suffering from terminal cancer but refusing to accept that death was near.

    Even the person’s two young children were unaware of the dire prognosis, recalls Naomi Kogan, a social worker at Montreal’s Jewish General Hospital who cared for the patient. Finally, last month, a teenage daughter arrived at the hospital to learn that her only parent would not be coming home — minutes before the person died.

    “The impact has been devastating, to have only an hour to say goodbye,” said the social worker. “The child is having major difficulties.”

    Related

    Yet such entrenched denial of terminal disease is a surprisingly common occurrence on the cancer ward, said Ms. Kogan, and a new study she and colleagues have just published suggests it can have a shattering impact on the family members who care for those patients.

    Relatives struggling to play along with the alternate reality sometimes have to turn a blind eye as the patient pretends to ignore dangerous symptoms, and are unable to share their own emotional turmoil over the illness, the researchers found. Sometimes, children are left completely in the dark.

    Ms. Kogan suggests that health-care workers dealing with those people face similar angst.

    It’s been such a difficult element in my work for all these years, so challenging and causing so much frustration

    “These [patients in denial] are people who until the end are carrying this protective mechanism like a tortoise shell,” she said in an interview. “It’s been such a difficult element in my work for all these years, so challenging and causing so much frustration.”

    The patients at the heart of her study, co-authored by Robin Cohen, a McGill University oncology professor, and Michelle Dumas, an Ottawa General Hospital nurse, acknowledge that they have cancer, but tend to minimize the seriousness of the condition that appears destined to kill them.

    Despite what would seem like unequivocal evidence to the contrary, one woman in the study remained convinced she would recover, and married her common-law partner — inside the palliative-care ward.

    Christinne Muschi for National Post Entrenched denial of terminal disease is a surprisingly common occurrence on the cancer ward, says social worker Naomi Kogan, seen talking with a chemotherapy patient at Montreal s Jewish General Hospital.

    When Ms. Kogan started her career 24 years ago, the psychiatry department would be summoned in an effort to help such patients face reality, but health-care workers no longer try to disavow them of their beliefs, now considered a coping mechanism that is useful to the patient, at least.

    A Montreal woman, who asked not to be named, said she and her family have been dealing with such a situation for several weeks. A close relative has stage-four cancer and likely has less than a year to live, yet until recently has cheerfully avoided the grim truth of her prognosis. She even talked from her hospital bed about running a half-marathon next year.

    She would act as though everything was just fine. It was impossible to even acknowledge she was sick. It was very frustrating and isolating

    “She would act as though everything was just fine,” said the relative. “It was impossible to even acknowledge she was sick. It was very frustrating and isolating.”

    For the study published in the journal Palliative and Supportive Care. Ms. Kogan’s team identified dying patients at the Segal Cancer Centre who were in denial, and arranged interviews with family caregivers of 16 of them.

    All said they felt it necessary to maintain their loved ones’ sense of denial, but that keeping up the pretence of normalcy took a toll in terms of anxiety, depression and even “feeling enraged.” Some said they were forbidden to dig up more information about the disease or ask probing questions of medical staff, or felt they could not make arrangements for funerals or future finances.

    More than half the patients went so far as to not get the care they needed, masking symptoms that might have prevented them from receiving more of the chemotherapy they considered life-saving, or that would drive home the dire state of their health, the study said.

    One patient refused to disclose such problems as severe diarrhea that should have prevented him from getting chemotherapy, went ahead with the treatment and almost died, prematurely, as a result. Another actually hid weights in his clothes so he would reach the minimum requirement to continue chemo, as patients who are too emaciated are not eligible, said Ms. Kogan.

    He’s been crying for the past three days. He’s got pain in the neck, pain in the back, and he doesn’t want me to talk about it

    Others would not acknowledge escalating pain, or refused to step up their medication levels in response. “He’s been crying for the past three days. He’s got pain in the neck, pain in the back, and he doesn’t want me to talk about it,” one caregiver told the researchers.

    Ms. Kogan said there is not a lot that health-care and social workers can do in the face of such denial, though sometimes they can counsel the family members about their own anguish over the situation, and try to help make practical arrangements.

    She said she was able to convince the single-parent patient, after much prodding, to prepare a will, without actually saying the person was dying. The will was a crucial tool for the family as the children started a new life with relatives.

    Elizabeth Beddard-Huber, an advance-practice nurse specializing in pain management at the B.C. Cancer Agency, said she also encounters patients in denial, an experience that can be stressful and “hard to watch,” especially when young children are involved. In one case, two teenagers were so troubled by their inability to talk frankly to their fatally ill mother, they began acting out at school, she said.

    Like the Montreal researchers, Ms. Beddard-Huber noted that such patients will hang on desperately to the hope of chemotherapy, decline pain medication and other palliative care, and occasionally look elsewhere when conventional medical treatment reaches a dead end.

    “Sometimes it gets to a point where they have to spend quite a bit of money to seek extra treatment and go to Mexico or to China or to the States for special treatment,” said Ms. Beddard-Huber. “They’re looking for that miracle.”





    CHPN Study Guide #the #standard #hotel

    #hospice certification study guide

    #

    Nursing Study Guides

    CHPN Certified Hospice And Palliative Nurse Exam

    National Board for Certification of Hospice and Palliative Nurses (NBCHPN) administers this examination for CHPN nurses. CHPN nurses assist physicians in treating patients that are dealing with end of life issues. Their duties also include helping family of the dying patients.
    The exam is conducted twice a year in the month of March and September. The examination fees ranges from $295 to $395 depending upon the membership of the candidate with HPNA. The certification is valid for the period of 4 years. Post this certification, candidate has to reapply for the certification.

    CHPN Certified Hospice and Palliative Nurse Exam

    National Board for Certification of Hospice and Palliative Nurses (NBCHPN) administers this examination for CHPN nurses. CHPN nurses assist physicians in treating patients that are dealing with end of life issues. Their duties also include helping family of the dying patients.
    The exam is conducted twice a year in the month of March and September. The examination fees ranges from $295 to $395 depending upon the membership of the candidate with HPNA. The certification is valid for the period of 4 years. Post this certification, candidate has to reapply for the certification.

    Eligibility For CHPN Certified Hospice And Palliative Nurse Exam

    In order to apply for CHPN exam, candidate should meet the following eligibility criteria set by NBCHPN:-
    1)Candidate should hold current license as a registered nurse.
    2)Candidate should have minimum 2 years of working experience in handling patients with end of life issues.

    Syllabus Of CHPN Certified Hospice And Palliative Nurse Exam

    Syllabus of the exam constitute following sections:-
    1) Patient care:Life limiting conditions in adult patients 15%
    2) Patient care: Pain management 24%
    3)Patient care: Symptom management- 24%
    4)Care of patient and family 13%
    5)Education and advocacy 9%
    6) Interdisciplinary/Collaborative Practice – 8%
    7) Professional Issues 7%

    Format Of CHPN Certified Hospice And Palliative Nurse Exam

    The CHPN is a 3 hour multiple choice exam. It consist of 150 questions. The questions are based on nursing care of an adult patient and family with emphasis on their physical, emotional, psychological and spiritual needs at the time of life-limiting illness. Hence candidate should have good knowledge in major body systems that are associated towards end of life.

    CHPN Certified Hospice And Palliative Nurse Exam Study Guide

    The CHPN is a rigorous exam in which the candidates are evaluated regarding their skills and knowledge over various issues. To help you in your exam preparation, subject matter experts have prepared CHPN Exam Study Guide to help you with exact exam format and the content covered in the examination. The Study Guide contains in depth knowledge and assessments on various topics related to exam. Get CHPN Exam Study Guide and increase your chances of passing the exam with flying colors. We wish you all the best for your exam preparation.

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    Home Health Aide Exam – Study Guide Online Version #motel #boston

    #hospice home health aide

    #

    Home Health Hospice Aide Competency Exam Study Guide

    Order the newest version today! 2016-2018 Home Health Hospice Aide Competency Exam is now available!

    The 2014-2016 Home Health Hospice Aide Exam Will Expire August 31, 2016!
    Make sure you are testing with a current version of the exam to avoid State Survey Deficiency in this area.

    *Please note: You must fill out separate forms for the Study Guide and Competency Exam

    Home Health Hospice Aide Exam

    The Oregon Association for Home Care developed the online Home Health Hospice Aide Competency exam as a standard for our industry. This examination tests the basic competencies of individuals who have received training in accordance with the Oregon Nurse Practice Act, to work as nursing assistants. The examination format is based on the Oregon Administrative Rules and the federal Medicare Conditions of Participation with nine points of emphasis relating to home care. The areas of emphasis include:

    • Communication Skills;
    • Observation of, reporting of and documentation about the patient and care provided, including basic elements of body functioning and changes in body function that must be reported to the aide’s supervisor;
    • Physical, emotional and developmental needs of, and ways to work with the population served by the home health agency, including the need for respect for the patient, his/her privacy and his/her property;
    • Maintenance of a clean, safe and healthy environment;
    • Basic infection control procedures;
    • Basic nutrition and food preparation techniques as appropriate;
    • Recognizing emergencies and knowledge of emergency procedures;
    • Reading and recording temperature, pulse and respiration;
    • Basic elements of body functioning and changes in body function that must be reported to an aide’s supervisor.

    Biennially the OAHC Education Committee revises the examination and the Board of Directors approves the examination. Each test version has a two-year validity for competency of Aides. The committee provides a bibliography of resources which agencies can use to address specific training needs of the Certified Nurses Assistant or Home Health Hospice Aides.

    Educational programs or agencies other than licensed agencies may purchase the testing packet for use in competency testing of aides, providing the purchasing entity has an RN available who is qualified to competency test Home Health Hospice Aides and certifies that he/she will follow the OAHC guidelines. These entities will also have use of the materials for the two-year time frame and must purchase a new packet for use beyond the stated expiration date. Licensed and certified agencies should only accept competency testing done by these agencies or programs only if agency policy allows. The entire procedure for test packet request shall be the same for non-licensed agencies as for licensed agencies, with the exception that non-licensed and certified entities will not receive the OAHC Home Health Hospice Aide certificates with their purchase of the test packet.

    New Online Process!
    Please note that the requesting agency must provide a computer with internet access for aide testing. The proctor must monitor the exam process and maintain the quiet surrounding conductive to testing. Member agencies currently using the RCTCLearn.Net program will be able to access the exam through their online login.

    Watch Now for details on the new online system

    OAHCMembers:
    Exam (includes 5 aide testing tokens). $195.00
    5 additional testing tokens. +$55.00
    10 or more testing tokens. +$130.00

    NonMembers:
    Exam (includes 5 aide testing tokens). $440.00
    5 additional testing tokens. +$55.00
    10 or more testing tokens. +$130.00





    VITAS: Innovative Hospice Care Solution And Analysis, HBR Case Study Solution –

    #vitas innovative hospice care

    #

    VITAS: Innovative Hospice Care Harvard Case Solution & Analysis

    VITAS: Innovative Hospice Care Case Solution

    Vitas Healthcare has been one of the country’s oldest and largest hospice care providers in the world. It was founded in the year 1978. The company was founded to serve the needs of the patients that cannot be duplicated by other similar service providers. The company has focused on providing quality services to control the financial health of the company. The care and the level of quality offered by Vitas gives all the patients the direct result of patient care, and it also gives the control, professionalism and the level of quality through its business.

    The hospital is aiming to provide an alternative to the regular treatment in the hospital for those patients who are terminally ill and do not have a very long life. Basically hospice was initiated to offer support and help, to those patients who were dying. Hospice offered such patients with palliative care, rather than the traditional curative care. The idea was to ensure that such patients could enjoy their remaining life with dignity and comfort at the maximum level. The services offered by Vitas are offered in 5 states where it has 27 offices.

    Strategic, Tactical, and/or Operational Issues

    The strategic issues presented in the case are the fact that the company Vitas has been looking to make acquisitions within the fragmented hospice industry. Vitas have faced the strategic issue where it does not have a clear and concrete execution plan to actually acquire a firm. Vitas has a vision of becoming a for-profit hospice where it does not have a proper execution plan to actually become a for-profit firm by making a particular acquisition that can ensure and help Vitas.

    The tactical issues at Vitas is that since Vitas Hospice has focused itself as a for-profit organization from a not for-profit organization, it has been facing quite a few issues in its operations. First of all employees tend to believe and in fact perceive that, since the organization has transformed itself into a profit earning organization it will definitely loose the quality of service it would be offering to the patients.

    Employees believed that Vitas will start to work upon their costs and profits rather than caring for humanity. This has been the main tactical issue because it is necessary for the management to deal with the employees and make them realize that although the focus has shifted to for-profit organization but still it is important for the employees.

    However, Vitas has faced the operational issue where it does not have a clear and concrete execution plan to actually acquire a firm. The organization has made a simple mistake where it did not actually anticipate the three hour time difference, for instance the Florida and the California state. For example, when California hospices needs support for patient, family services, account payable or the billing the corporate office for Vitas is closed and the employees have left for the day. This is a serious issue because no one is present to guide and take charge of such operational daily issues.

    The conceptual factors that have been identified in the case which are relevant to the issues that have been identified in the case in terms of strategic issues, tactical issues and the operational issues are as follows:

    As the case states, Vitas has the vision of providing customer with the optimum and ultimate support. The vision of the company included servicing of each patient that had come to hospice in order to find dignity and peace in the remaining time. Although the vision was quite clear and well directed, but the nature of business and the industry norms were not favoring the entire situation. The employees which included in the team were a group of 5 which included a number of different team members for the team.

    External environmental factors

    The external factors that are presented in the case that have actually come up because of the three types of issues which include the strategic issues, the tactical issues and the operational issues are the fact that since the company Vitas is looking to grow and expand, the uncontrollable factor is that it is a fragmented market. This cannot be controlled by Vitas, infact it has to deal with it in an efficient manner. Along with this, the perception of employees has also been changed where they belief being a profit oriented organization will leave the company focusing on sales and revenue, while patient treatment will become a secondary importance for Vitas .

    This is just a sample partial case solution. Please place the order on the website to order your own originally done case solution.

    Vitas, non-profit hospice has grown through acquisitions and start-ups. The Company believes the storage strategy, and Deirdre Lawe must decide whether to make a particular purchase. Hide
    by Roger Hallowell, Tonicia Hampton Source: Harvard Business School 33 pages. Publication Date: October 10, 1999. Prod. #: 800031-PDF-ENG

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