Functional polynorbornenes (PNBEs) containing pyrrolidine moiety and bis(trifluoromethyl)biphenyl side group were synthesized via ring‐opening metathesis polymerization (ROMP), and the microstructure of polymer chain was characterized by NMR spectroscopy. Poly(N‐3,5‐bis(trifluoromethyl)biphenyl‐norbornene‐pyrrolidine) (PTNP) and poly(N‐phenyl‐norbornene‐pyrrolidine) (PPNP) are supposed to have practically trans double bonds and adopt isotactic syn conformation, whereas poly(N‐3,5‐bis(trifluoromethyl)biphenyl‐norbornene‐dicarboximide) (PTNDI) has both trans and cis double bonds and atactic microstructure. PTNP, PTNDI, and PPNP have much different dielectric constants of 20, 7, and 3, respectively, which is attributed to both the polar 3,5‐bis(trifluoromethyl)biphenyl group and the stereoregular chain structure. The existence of rigid pyrrolidine moiety has a positive contribution to form the tactic polymer chain during ROMP. Polymers are highly thermal stable up to ∼300 °C. Having good dielectric properties and thermal stability, these functional PNBEs are expected as the potential dielectric material in thin film capacitors. © 2012 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem, 2013
Rationale: The aim of this study was to evaluate whether advanced care planning (ACP) is standard practice in CF. We surveyed 11 adult CF centers that are part of a QI consortium sponsored by the CF Foundation, allowing us to examine ACP practices at different adult CF centers. Additionally, we assessed such practices in our center. Methods: Each of the 11 adult CF centers was asked to provide information regarding their five most recent CF deaths. We examined our own center's practices by conducting semi-structured interviews with 5 CF adults. Trigger questions included, "Would you prefer to be approached at a clinic visit or separate meeting? Do you wish to have family present? Would you find visual aides demonstrating your declining lung function helpful?" We then surveyed health care workers directly involved in CF care in our institution. Results: Data from 11 centers revealed much variability. For example: 100% of deaths occurred in ICU at some centers and only 33% in ICU at others; 6 out of 10 centers did not have any patients listed for transplant, while another center had 66% of its patients listed; one center reported that 100% of their patients had DNR orders, two others reported that 80% and 83% of their patients had no DNR orders. Of 69 deaths, 14.5% occurred at home, 2.9% in hospice, 15.9% in hospital ward, and 60.9% in the ICU. Only 45% had DNR orders, and 16% had advanced directives. Review of our center's practices showed no structured approach to ACP. Semi-structured interviews demonstrated common themes such as: wishing to be initially approached by patient's physician during clinic visit, and discussing ACP options in further detail at a separate meeting with the option of having family present. Patients wish to be advised on disability, oxygen requirements, and lung transplant as their lung function declines, but before such conversations become imperative. The healthcare worker survey revealed lack of agreement that pain at end of life is effectively managed; whether sufficient bereavement services are available for families, and whether the transition to dying is clear. Discussion: No standard process exists for ACP. Much variability exists in ACP delivery among adult CF centers. Patients agree that ACP is essential and should occur early paralleling active treatment. Efforts to understand variability between centers and to standardize the delivery of ACP are required. This abstract is funded by: none Am J Respir Crit Care Med 185;2012:A5137 Internet address: www.atsjournals.org Online Abstracts Issue
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