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Background: Hospice and palliative medicine is important in the education of pediatric residents. Little is known about if and how residents' learnings during a pediatric palliative care elective fulfill core competencies and Pediatrics subcompetencies as set forth by the Accreditation Council for Graduate Medical Education (ACGME) and published subspecialty competencies for residents in pediatric hospice and palliative medicine (pHPM). Objectives: To evaluate what residents are learning on a four-week pediatric palliative care elective rotation at a single institution and how these learnings fulfill ACGME and pHPM competencies. Setting/Subjects: Prompted, written reflections were collected from residents completing a pediatric palliative care rotation at a large, urban academic center in the United States between academic years 2016–2017 and 2020–2021. Measurements: A qualitative, inductive reasoning approach was used to analyze reflections for emergent themes and codes. A deductive approach was used to map resulting codes to ACGME core competencies, Pediatric subcompetencies, and pHPM competencies. Results: Twenty-five resident reflections were collected. Inductive analysis revealed three primary themes and 102 codes. These codes were mapped to all six ACGME core competencies and mapped to most Pediatric subcompetencies with the exception of performing a physical examination, organizing and prioritizing patients, diagnostic evaluation, and community and population health. Codes mapped to most pHPM competencies with the exception of two symptom-based competencies, malignant bowel obstruction and severe fatigue. Conclusions: Residents' written reflections following a pediatric palliative care elective rotation demonstrated robust learnings that fulfill many core, specialty, and subspecialty competencies, particularly those that relate to patient- and family-centered care, communication, professionalism, and systems-based practice. [ABSTRACT FROM AUTHOR]

In the mad dash to complete the plethora of projects that lead up to the public launch of a campaign, it would be easy to start thinking of the kickoff as a goal in itself, but it's merely a mile marker in the marathon of a fundraising campaign that may last five to 10 years. Given that only a fraction of an institution's constituents may attend a kickoff event or receive a case statement, development communicators must devise methods for keeping campaign messages interesting and effective well beyond the starting line of the public launch. When preparing for a lengthy campaign, professionals say that having good stories to tell is essential.

The Clean Air Act (CAA) controls routine emissions at petroleum refineries, by creating limits and penalties for excess emissions. The CAA offers provisions for upset events, air emissions released because of unforeseen or unavoidable circumstances, if companies report the emissions and take corrective action. States enforce upset event rules and many states provide exemptions for a variety of circumstances, which may allow upset emissions to become a substantial, yet mostly unregulated source of emissions. We catalog the quantity and type of emissions generated during upset events at 18 Texas petroleum refineries from 2003 to 2008. We find that upset events occur frequently at these facilities and are collectively large in magnitude, emitting a combined total of 75 million lbs of emissions. In a select number of cases, single upset events exceeded annual emissions reported to the Toxics Release Inventory. Future research should assess the accuracy of upset event reporting and impact of upset events on environmental health. [ABSTRACT FROM AUTHOR]