Transcript: Candace, Kira, Krystal A Child Who is Palliative What is Palliative Care? "Palliative care for children begins when an illness is identified and analyzed, and continues during the entire illness trajectory, aiming to alleviate physical, psychological, and social suffering" (Melin-Johansson, Axelsson, Jonson Grundberg & Hallqvist, 2014, p.61). What is Palliative Care? Similarities: Palliative care can be initiated at the beginning of an illness along with treatments aimed to cure Aims to improve quality of life Caregiving teams aid in decision making and establishing care goals Palliative care invloves many different disciplines Pediatric .VS. Adult Palliative Care Pediatric .VS. Adult Palliative Care Differences: Serious illness is not a "normal" condition for most children Medical decisions for young children are often made by their caregivers Pediatric palliative care can include play therapy, child life therapists and child behaviour specialists getpalliativecare.org Benefits of Palliative Care Benefits of Palliative Care Support Communication Comfort -Focuses on the whole child, while understanding how varying forms of treatment can affect the family as a whole -Support every step of the way, not only just a means of controling the childs symptoms, but also helping families understand treatment goals and options -Palliative care also ensures that children are provided with support through the maintinence of symptoms - Palliative care provides family with an overall extra layer of support, during such a difficult time , it is a resource in itself for families -Bereavement support is also an aspect of palliative care after the child has died getpalliativecare.org Childrens ideas regarding Death, What does it mean for them? Childrens ideas regarding Death, What does it mean for them? Varies depening on: Age Developmental Level Age and Developmental Differences in Response ... Children in this stage have limited understanding regarding accidental events, future and past time, not able to make discrepancies between living and nonliving - Outlook is that life is continuous with death, considered alternate states much like sleep and awake Age and Developmental Differences in Response to Death 1-3 Years 3-5 Years Concepts during this stage are crude and irreversible, unable to distinguish between reality and fantasy - Notion that death is reversible, because of child's egocentricity they are often convinced that they caused the death. Often death can be viewed as a personified entity (Bogeyman) 5-10 Years Thinking begins to become organized and logical, leading to some problem solving but child still lacks abstract reasoning - Child can percieve death as permanent and real. Sometimes may be unaccepting that death can happen to them or any of the people they care about, even though they are starting to know that people will die 10-13 Years Formal logic is starting to be incporated into thinking as well as abstract thoughts - Death viewed as real, final and universal. During this stage children may become more interested in the details such as the funeral, special care must be given to this age group as they will need to be provided with reassurance that they are cared for and loved Thinking is more refined and abstract, allowing this age group to vent emotions is very important - Mature and adult concept of death, may start to view death as an enemy at which they plan on fighting against or dealth can be percieved as failing and may present in this age group as giving up. 14-18 Years Hurwitz, C. A., Duncan, J. & Wolfe, J. (2004). Caring for the child with cancer at the close of life: "There are people who make it, and I'm hoping I'm one of them". Journal of the American Medical Association, 292(17), 2141-2149. Children's Subjective Experiences and Daily Struggles Children's Subjective Experiences and Daily Struggles Therapeutic Communication Emotional Support Physical Comfort Diversional Therapy Therapeutic Play Maintain Self Esteem (Adolescents) What Nurses can do for Children? What Nurses can do for Children? Familie's Subjective Experiences and Daily Struggles Familie's Subjective Experiences and Daily Struggles Financial Strain Emotional Strain (Frustration, Guilt) Breakdowns in Family Structure (Siblings, Spousal Roles) Lack of Self Care Loss of Caregiver Role Communication Empowering Normalization Support Encourage Self Care Encourage Respite Support (Resources) What Nurses can do for the Family? What Nurses can do for the Family? Resources Resources Courageous Parents Network Courageous Parents Network Normalize the Grief (Facilitate Positive Coping) Therapeutic Communication Create Memories Cultural and Spirtual Needs Bereavement Support Bereavement Support Gottlieb's 8 Core Values Gottlieb's 8 Core Values
Transcript: Debt Projections Life Insurance Analysis Common Questions/Decisions: Incorporation What if interest rates change? How much is too much? When is each saving vessel appropriate? Debt Saving Vessels Detailed Projections Insurance Summary Scenario Analysis RRSP's TFSA's RESP's RDSP's Corporate Savings "Am I missing anything?" "Could I be doing anything differently?" Debt strategies Insurance Coverage & Cost Buying a house Starting a family Grants Making sure you're eligible: Cash Flow Life Insurance Summary - Helps analyze coverage & needs. Common Questions/Decisions: What sort of payments will be manageable when it's time to repay? Compare to LoC & Mortgage Insurance Grants & Credits Market Comparisons Resident Practicing Mid-Term Cash Flow Analysis Net Worth Market Search Tax Credits -Fed & Provincial shelters -who can use them? -when should you use them? Timely Completion Benefit Other Grants and Government Programs -Rural CFP Forgiveness Program -New practice grants What kind of coverage do I need? How much will it cost? Common Questions/Decisions: Budgeting Debt Grants & Tax Credits Insurance Offerings "When should I incorporate?" "How should I be investing my money?" Tax Strategies Debt strategies Education Funding Insurance Coverage & Cost Investment Strategies / Financial Ind. Why should I incorporate? Is it worth it? Student
Transcript: The Projects Tahlia Hadley Youth Ministry 3514 Carman Road Schenectady, NY 12303 Contact St. Madeleine Sophie contributes $20,000 for the construction materials Who does the work? Partners Low income Elderly Disabled Serving residents within a 30 minute radius Projects Phone interview conducted How are projects selected? They have impacted the community and residents they served St. Madeleine Sophie Church Unfinished projects are completed by SMS Around 400 Youth and Adults- from across the country G.N.O.M.E.S. Visible work needed Evaluation Process: The youth who attend pay to come- this covers: lodging, food, insurance, programming and development Painting (interior and exterior) Limited Construction (porches and Wheelchair ramps) Limited Roofing Weatherization Group Cares contributes $30 per registered participant There is NO cost to the resident Sunday, July 6, 2014 - Saturday, July 12, 2014 Phone: (518)355 3115 email@example.com firstname.lastname@example.org Fax: (518) 280-0071 Who's payin?! Funds for the project Staying in Guilderland High School Resident fits the criteria Who are the residents? St. Madeleine Sophie Appropriate work Youth arrive and complete projects Residents are mailed a letter letting them know their status. 1. St. Madeleine Sophie Church (G.N.O.M.E.S.) 2. Guilderland Central School District 3. Group Mission Trips - Colorado All applications mailed to St. Madeleine Sophie How have they been identified? Work to be done Giving Neighbors Our Meaningful, Enthusiastic Service The lives of the youth who attended have been changed Home Owners Apply BY APRIL 1st Site Surveyors sent out to residents Senior centers Church Bulletins Community Organization Schenectady Building Department Word of mouth Impact Residents Crews are typically 5 youth 1 adult Range of experience Complete 4.5 days of work when, who and where? Funding We have attended 3 Workcamp experiences
Transcript: Career Presentation: Pediatrics What is a pediatrician? What are the common work tasks for a pediatrician? Education, Training and Experience: How to get a certificate and license for your career: How much can you earn? Some important tips: I hope you had a nice time watching! A pediatrician is physician who specializes in the care of minors- anywhere from infants to teenagers. Care for health of infants to teenagers Treat day to day illness like minor injuries, infectious diseases, and immunization Examine infants and children regularly to assess their growth and development Prescribe or administer treatment therapy, medication, vaccination, and other specialized medical care to treat or prevent illness disease, or injury in infants and children Advise patients, parents, or guardians, and community members concerning diet activity hygiene and disease prevention Treat children who have minor illnesses, acute and chronic health problems, and growth and development concerns Plan and execute medical care programs to aid in the mental and physical growth and development of children and adolescent To be licensed a physician must graduate from an accredited medical school, pass a licensing examination and complete 3 to 7 years of graduate medical education (internship, residency, and/or fellowship) Graduates of foreign medical schools generally can qualify for licensure after passing an examination and completing a U.S. residency The median annual salary for a pediatrician is $140,000 The top ten percent earn more than $145,000 and the lowest ten percent earn less than $67,000 People who wish to become physicians must have a desire to serve patients, be self-motivated, and be able to survive the pressures and long hours of medical education and practice Physicians must also have a good bedside manner, emotional stability, and the ability to make decisions in emergencies As you would have to with any career, you must decide if you would enjoy the day to day duties of a pediatrician, this includes working in the hospital and/or working in the clinic, taking care of sick and healthy children, and counseling parents about raising happy and healthy children Don’t like babies or toddlers? Then pediatrics is probably not for you, although you could work with older children and teen Don’t like learning? Then pediatrics is not for you Although you learn a lot in medical school and residency, one of the greatest challenges of being a doctor is to continue learning new things as technology advances and new medicines are discovered Personally I love being a pediatrician and it almost doesn’t seem like ‘work’ when I go to the office each day Another great thing about pediatrics is that you can work part time like me Although pediatrics can be a challenging career, in the end, it is a very rewarding one To become a pediatrician after high school, you have to go to a college for 4 years, or 2 years at a community college and then 2 years at a university Then you have to take the MCAT You MUST pass the MCAT medical exam in order to be accepted to a medical school You will then have to attend 4 years at a medical school (but a few medical schools offer combined undergraduate and medical school programs for 7 years instead of the customary 8 years) After finishing medical school you have to do 1 year internship and 2 years residency for hands on experience Now you can become a general pediatrician, but if you want to do specialization like pediatric surgery, pediatric neurology, etc. then you have to do 2 to 3 more years of training/fellowship
Transcript: Pediatrics: What's it all about? Nurses who specialize in pediatrics: Associates/ Bachelors degree Pharmacists: Doctor of Pharmacy Medical laboratory technicians: Associates degree Physical and speech therapists: Graduate and Masters degree Social workers Palliative care providers: (serious, chronic illnesses) Masters degree Scope of Practice: A day in the life of a pediatrician Thank You! Occupation Presentation: Pediatrics Kendra Burrow The Road to Pediatrics Teamwork Georgia Regents University~Johns Hopkins University~ Army Licensure & Certification: In order to become a pediatrician, I must pass the national exam, and be licensed by the state. Residency: I must complete 3 years of residency after I earn my degree. I will be doing an additional 3 years to gain my sub specialty in special needs. 1. Bachelors in Biology 2. Doctor of Medicine 3. Complete residency (clinical rotations 4. Medical License (state licensing) 5. Board Certification (optional) The following are the primary duties I will be responsible for when I become a pediatrician. I will have to be capable of preforming physical examinations in a prompt and respectful manner Maintaining strong communication skills with patients and coworkers is vital in the role of a pediatrician I should be able to successfully develop and explain a plan of care for patients when needed. Documentation is one of the most important steps in inpatient care in a pediatricians office. Without the "team" it's just work.(Who wants that?) Pediatricians specialize in health and wellness from birth to age 18. Pediatricians provide preventive measures for children and are responsible for treating those who are ill. These physicians are also play a key part in reducing child and infant mortality rate, control diseases, and provide comfort to chronically ill children. 62 ECG bpm
Transcript: rONALD "rONNIE" Kramer Room 401 Senior Major: Electrical Engineering Fun Fact: He is in Air Force ROTC h bRIAN cASTELLON aLEJNDRA gIRALDO rOOM 411 jUNIOR mAJOR: cj & pSYCHOLOGY Fun Fact: she was an intern for the NYPD The End! mYRCINI vENDETTI rOOM 407 sENIOR mAJOR: cj Fun fact: Rock music is her favorite Room 401 Megan Smith Room 407 Senior MAJOR: mARINE bIOLOGY fUN fACT: She likes dolphins nICK cICCONE rOOM 402 sENIOR mAJOR: fORENSIC SCIENCE fUN Fact: He is on the Club volleyball team mATT mORAN rOOM 412 sENIOR mAJOR: cJ fUN fACT: HIS FAVORITE SPORT IS BASEBALL Ashley Hogan Room 410 Senior MAJOR: pSYCHOLOGY fUN fACT: sHE LOVES NETFLIX Colin McFarlane Room 408 Sophomore Major: Economics Fun Fact: He is on the UNH men's soccer Team Last Break Senior Major: Sports Management Fun Fact: He started the Men's club soccer team at UNH Senior Major: Business Management Fun Fact: He is from the UK Nick Graham Room 408 Senior Major: Sports Management Fun Fact: he likes football Alyssa Berthiaume rOOM 410 gRAD sTUDENT/sENIOR mAJOR: ms Molecular & Cellular Bio Fun Fact: SHe is on the rugby team Sierra Stein Room 414 Junior Major: Criminal Justice Fun Fact: She loves soccer Jacklyn Jones Room 410 Senior Major: Psychology Fun Fact: She loves playing rec sports aRMANI mILLER roOM 409 Junior Major: Finance Fun Fact: He is on the UNH track team cHAD mESSAM rOOM 409 sENIOR mAJOR: cYBER sYSTEMS fUN fACT: HE IS ON THE unh TRACK TEAM Celentano 401-414 Isolina Seda's residents for the 2015-2016 year. The dopest of residents! Welcome to Celentano! sTEPHEN sHEPHERD rOOM 402 sENIOR mAJOR: fORENSIC sCIENCE fUN fACT: hE ACTS AND PLAYS INSTRUMENTS gEORGE mURRAY rOOM 409 jUNIOR Major: Mechanical ENgineering Fun FACT: hE STARTED A YOUTH CHURCH CLUB ON CAMPUS Kassandra Luyando Room 407 Senior Major: Forensic Science Fun Fact: She just got into ASK Stacey Meruelo Room 410 Transfer major: Chemical Engineering Fun Fact: She likes to read Room 401 Jason Bielesz Room 412 Senior Major: Mechanical Engineering Fun Fact: He is on teh UNH Track team Erika Kozak Room 407 Senior Major: CJ Fun fact: She likes to cook Ashley Nunez Room 411 Junior Major: Business Fun FACT: sHE NOW COMMUTES TO SCHOOL Alex Wlcek Room 401 Senior Major: Criminal Justice Fun Fact: He could live at the gym Cassandra Washington Room 403 Senior MAJOR: cRIMINAL jUSTICE fUN fACT: she is dating my resident Stephen Shepherd Christian Torres Room 408 Junior Major: Music & Sound Recording Fun FACT: hE LIKES TO PLAY THE gUITAR Frank Acampora Room 413 Senior Major: Marketing Fun Fact: He doesn't have a fun fact Krystopher Maingrette Room 402 Senior Major: Biology Fun Fact: He is works in USGA bRANDON cOULOMBE rOOM 412 sENIOR/gRAD mba bUSINESS aDMINISTRATION fUN fACT: HE GRADUATED EARLY aLYSSA dEARBORN rOOM 403 Sophomore Major: Music Industry Fun Fact: SHe loves feathers HaRRISON lANES rOOM 408 sOPHOMORE mAJOR: Accounting Fun Fact: He is a huge Patriots Fan Javon Rodd Room 413 Senior Major: CJ Fun Fact: He is in my THeatre class Jordan Dunn Room 413 Junior Major: Sports Management Fun Fact: he works at target Break! Lauren Herbert Room 414 Senior Major: Psychology Fun Fact: She is on the Unh women's basketball team Marisa Garcia Room 414 Senior Major: Sports Management Fun Fact: She is on the Women's SOccer team Victoria Johnson Room 403 Senior Major: Psychology Fun Fact: she was an OL over the summer Daniella Molina Room 411 Junior Major: Psychology Fun Fact: She studied abroad in Italy last spring Tyler Condit Room 413 Senior Major: Business Management Fun fact: He was on the UNH football team Danielle Lippold Room 403 sENIOR mAJOR: cOMMUNICATIONS fUN fACT: SHE IS ON THE unh COLORGUARD TEAM Bobby Errichetti Room 412 Senior Major: Chemical ENgineering Fun Fact: He has a brother that goes here Break jONATHAN sMITH rOOM 409 sENIOR mAJOR: eLECTRICAL eNGINEERING fUN FACT: hE LIKES TO HAVE A "GOOD TIME" Josh Guddemi Shannon Enright Room 414 Junior MAJOR: pSYCHOLOGY Fun Fact: SHe is in love with Converse
Transcript: How are Residents Evaluated? Nurses, Case Managers, Therapists or Patients New Salary Scale But what happens to the evaluations we complete? . . . Faculty Evaluation - 5 evaluations resident + fellows (if applicable), de-identified, comments are not edited so don't write things like . . . Rotation Evaluations & Program Evaluations - Resident anonymity, Program Evaluation Committee will review and make changes Duty Hours Evaluations - PHS GME office reviews ACGME Resident Survey - ACGME RRC review, we see the results, will effect our accreditation After Residency Lead your Continuity Clinic Team Work on fellowship / job credentialing process Tie-Up Loose-Ends Call Schedule Duty Hours Join a Committee Get a mentor Get working on research Initiate or Participate in a Community Project Buddy call with New Residents Plan your electives Re-Credentialing Present for Grand Rounds Apply to start looking into jobs or fellowships Alumni Network Residency Verification Paperwork Clinical Didactic Epic (Inpt, Outpt, Consults) HealthStream ACLS Training What do Residents Evaluate? Evaluations PGY2 Procedures Elective, VA, MGH Neuro = No SRH Call Responsibilities At SRH = 60004 PGY3 = fewer overnights, short call PGY4 = even fewer overnights, short call Residents are expected to assist during the winter holidays Don't miss the boat PGY4 Faculty Rotations Program (NI & ACGME) Duty Hours 360s from (12 or 1/month) RO&CAs (12 or 1/month) Monthly Evaluations Shift Cards (52 or 1/week) Annual / Semiannual Evaluations PGY3 There's an App for that "Wears unfashionable ties" - Mean, Irrelevant "I didn't appreciate it when you told me I wasn't typing fast enough in January, you know I'm prone to hand cramps" - Too Specific "Good, but could be better" - Too General a Resident has got to do what a Resident has got to do
Transcript: Fahad Qureshi Pediatrics Presentation Date 1 Posterior Urethral Valves (PUV) Foundation - The urethra collects urine produced by the kidneys and drains it outside of the body - Potentially obstructive leaflets of tissue may narrow the patency of the vessel - These valves may impair proper drainage and cause obstructive complications Visualization Timeline Demographics/Cause Causes - Thought to develop during growth of baby boys in the uterus - 1 in 8,000 boys are affected - Initially thought to be random, but recent studies have shown some genetic links Symptoms - Dysuria - Abdominal/bladder fullness - Weak stream - Urinating often - Growth issues Workup - Abdominal ultrasound - Voiding Cystourethrogram (VCUG) - Endoscopy - Blood test Treatment Treatment - Supportive Care - Antibiotics - IV Fluids - Cather - Endoscopic Ablation - Vesicostomy Complications - 1 in 3 boys with this condition will end up with long-term kidney complications - Early diagnosis and treatment has been proved to decreased the rates of these complications Long-term - Boys with this conditions are monitored throughout their lives - Many are able to achieve normalcy - May develop normal urologic and reproductive function, and normal quality and quantity of life Works Cited Bibliography EL-GHONEIMI, A. L. A. A., et al. "Outcome of posterior urethral valves: to what extent is it improved by prenatal diagnosis?." The Journal of urology 162.3 Part 1 (1999): 849-853. Hodges, Steve J., et al. "Posterior urethral valves." TheScientificWorldJOURNAL 9 (2009): 1119-1126. Krishnan, Anand, et al. "The anatomy and embryology of posterior urethral valves." The Journal of urology 175.4 (2006): 1214-1220. PARKHOUSE, HELEN FITZMAURICE, et al. "Long‐term outcome of boys with posterior urethral valves." British journal of urology 62.1 (1988): 59-62. Peters, Craig A., et al. "The urodynamic consequences of posterior urethral valves." The Journal of urology 144.1 (1990): 122-126. Rittenberg, Michael H., et al. "Protective factors in posterior urethral valves." The Journal of urology 140.5 Part 1 (1988): 993-996. “Stanford Children's Health.” Stanford Children's Health - Lucile Packard Children's Hospital Stanford, https://www.stanfordchildrens.org/en/topic/default?id=posterior-urethral-valves--90-P03110. Yohannes, Paulos, and Moneer Hanna. "Current trends in the management of posterior urethral valves in the pediatric population." Urology 60.6 (2002): 947-953.
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