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The experiences of primary caregivers providing palliative care to women living with advanced breast cancerChauhan, Jyoti January 2006 (has links)
Magister Psychologiae - MPsych / The aim of this explorative study was to understand the experiences and challenges of primary caregivers providing palliative care to women with advanced breast cancer. This study was conducted within a qualitative research design framework underpinned by phenomenology. The significance of this study was to contribute to the knowledge that would help care professionals understand the experiences and challenges that primary caregivers face whilst providing palliative care to women with advanced breast cancer. / South Africa
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Vers un système d’aide à la décision pour l’allocation des postes à quai dans un terminal à conteneurs / Towards a decision support system for the allocation of berths in container terminalZoubeir, Zeinebou 10 September 2014 (has links)
ALa concurrence féroce entre les terminaux à conteneurs et la nécessité d’optimiser leur utilisation ont conduit les opérateurs de terminaux maritimes à l’élaboration et l’application d’une riche variété de politiques d’ordonnancement de postes à quai. Les exploitants des terminaux à conteneurs cherchent une politique d’ordonnancement de postes à quai qui, permet de réduire le délai de séjour de navires au port, d’augmenter le trafic et la compétitivité portuaires et conduit à une hausse des revenus, tout en maintenant la satisfaction des clients à un niveau optimal. Plusieurs questions se posent lors de la définition des meilleurs politiques d’ordonnancement pour chaque opérateur portuaire et la décision finale dépend de plusieurs facteurs dont : le type de la fonction du port (dédié d’un terminal multiutilisateurs, hub de transbordement, etc...), la taille et l’emplacement du port, la concurrence à proximité, le type d’accords contractuels avec les transporteurs maritimes, etc... Certaines de ces questions ont fait l’objet de recherches académiques, mais ils restent encore plusieurs attributs qui méritent d’être mieux étudiés et compris davantage pour que ces modèles reflètent l’état réel de la pratique de l'exploitationdes terminaux à conteneurs. Dans cette thèse, nous proposons deux modèles d’aide à la décision pour le problème d’allocation des postes à quai dans un terminal à conteneurs, dans les deux cas : statique et dynamique. Ces systèmes ont été modélisés en prenant en considération des contraintes réelles qui se posent pour l’environnement opérationnel d’un terminal à conteneurs. Les formulations et les solutions des modèles mathématiques, présentées ici, cherchent à planifier, de façon optimale, l’accostage des navires entrants dans un terminal à conteneurs. / The fierce competition between container terminals and the need to optimize their use led marine terminal operators in the development and applying a rich variety of scheduling policies stations dockside. The operators of container terminals seeking a scheduling policy berths which reduces the ship free time to port, increase traffic and port competitiveness and led to a rise income while maintaining customer satisfaction at optimal levels. Several questions arise when defining the best scheduling policies for each port operator and the final decision depends on several factors: the type of the port function (of a dedicated multi-user terminal, transhipment hub, etc ...), the size and location of the port, the competition nearby, the type of contractual arrangements with shippers, etc... Some of these issues were the subject of academic research, but they still more attributes that deserve to be better studied and understood more for these models reflect the real state of the practice of exploitation container terminals. In this thesis, we propose two models to assist the decision for the problem allocation of berths at a container terminal in both cases: static and dynamic. These systems were modeled taking into account real constraints that arise for the operational environment a container terminal. The formulations and solutions of mathematical models, presented here, looking to plan optimally, berthing incoming ships in a container terminal.
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Terminal oxidases of micrococcus denitrificansWhite, Fred G. 01 August 1956 (has links)
Purification of the terminal oxidases of the facultative anerobe, M. denitrificans, was undertaken. The bacterium contains both a cytochrome c oxidase and a cyanide-insensitive DPNH oxidase. A procedure for purification of each of these enzymes is given. These procedures involve fractionation with ammonium sulfate, acetone, and calcium phosphate gel. By the use of the procedures given, cytochrome c oxidase can be purified seventeen-fold and the DPNH oxidase ninty-fold over the original cell-free extract. The cytochrome c oxidase was found to be associated with the particulate material of the cell, had an optimum activity at pH 7.0 to 7.4, and was not affected by aluminum, magnesium, or manganous ion. The enzyme was completely inhibited by cyanide and carbon monoxide but only 65% by azide. The cytochrome c oxidase oxidized reduced mammalian cytochrome c directly. Oxidative phosphorylation was demonstrated during oxidation of reduced mammalian cytochrome c by cell-free extracts of the bacteria. The absorption maxima of the reduced spectrum of the partially purified cytochrome c oxidase were at 420, 522, and 554 mμ., and the maxima of the difference spectrum were at 427, 522, and 551 mμ. The DPNH oxidase appears to be a soluble flavoprotein. An active DPNH oxidase preparation which was inactivated by ammonium sulfate fractionation, could be reactivated by addition of flavin mononucleotide; flavin adenine dinucleotide restored only partial activity. The Michaelis constant with respect to DPNH of the partially purified DPNH oxidase was found to be 3.42 x 10^-6 moles/liter. The activation energy of the DPNH oxidase was determined and found to be 14,900 cals/mole. The oxygen uptake of a cell-free extract of M. denitrificans functioning as a cytochrome c oxidase and as a DPNH oxidase, was 7.54 u liters/minute and 3.52 u liters/minute respectively. The cytochrome c oxidase appears to be the primary terminal oxidase, however, the DPNH oxidase does make a significant contribution to the aerobic respiration of the bacterium. The participation of the bacterial cytochrome c oxidase and DPNH oxidase in the aerobic respiration of the bacterium is discussed.
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Rearrangements of the Adenovirus Genome Induced by Embedded Inverted Terminal Repeat Sequences / Rearrangements of Adenovirus GenomeLee, Frank 08 1900 (has links)
The adenovirus genome is a linear double stranded DNA molecule and the current widely accepted model of viral DNA replication proposes linear viral DNA intermediates at all stages of replication. Although the experimental evidence for this mechanism of replication is very strong, circular forms of adenovirus serotype 5 (Ad5) DNA molecules have also been detected in both permissive and non-permissive cell lines. In some experiments the circular structures were detected before the onset of viral DNA replication and thus suggested a possible role for circular forms of Ad5 DNA in the life cycle of the virus after infection. This study was undertaken to better understand the role of circular forms of the adenovirus genome in virus replication. The approach was to subclone the viral junction internally into the linear genome thus creating mutant viruses with embedded terminal sequences and to study the effect of such inserts on DNA structure. A total of five mutant viruses were constructed containing a variety of inserts and viral DNA from infected cells and banded viruses was analyzed by Southern Blot hybridization. The data clearly showed that embedded viral junctions have biological activity in that they generated novel, rear ranged viral DNA molecules, and that embedded single ITR sequences were also biologically active, but to a lesser extent. It was also observed that the copy numbers of the rearranged molecules were variable. It appeared that the embedded viral junction was active in recombination and replication of the viral genome, creating the rearrangements through these two processes. However, the results suggested that circular forms are not obligatory intermediates in DNA replication. The analysis of banded viral DNA in this study suggested that the encapsidation signal from the left end of the linear genome was required in cis for packaging of the viral genome, confirming previous results which identified an encapsidation signal for viral DNA packaging. The banding experiments also showed that truncated viral DNA molecules containing 75% of the viral genome were packaged. / Thesis / Master of Science (MS)
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Vivência de enfermeiros no cuidar de pacientes na terminalidade: um enfoque bioético / Experience of nurses in caring for terminally ill patients: A bioethical approachFelix, Zirleide Carlos 27 February 2014 (has links)
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Previous issue date: 2014-02-27 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / INTRODUCTION: With technological advances, the field of bioethics emerged as reflection to guide professionals in the health care context , in particular the practice of caring for terminally ill patients. OBJECTIVES: This study aimed to investigate the experiences of nurses in caring for patients in terminally; to analyze the experiences of nurses in caring for terminally ill patients highlighted by the principles of bioethics. METHODS: This was an exploratory study, with qualitative approach, developed in the Intensive Care Unit of the Hospital Lauro Wanderley, Federal University of Paraíba located in the city of João Pessoa (PB). The sample consisted of fifteen clinical nurses from the institution selected for the study. The research project was submitted to the Committee in Ethics Research of the hospital, which received approval certificate, with CAAE registration under paragraph 13289213.1.0000.5183. Data collection occurred from March till July 2013 by applying a formulary containing questions relevant to the proposed objectives. The empirical material was analyzed qualitatively using the technique of content analysis, following phases: pre -analysis, material exploration and using the results, inference and interpretation. RESULTS AND DISCUSSION: From the qualitative analysis emerged the following thematic categories: Category I: the experience of nurses in caring for terminally ill patients: coping and care before death; Category II: The practice of nursing care to patients in the terminally ill: bioethical principles. CONCLUSION: The study shows the commitment of nurses participating in the study regarding the care of terminally ill patients, especially with regard to bioethical principles surrounding this practice. Therefore, due the reduced amount of researches focusing on this topic in the national literature, it is expected that this study will contribute to further investigations under the care of the terminally ill patients . / INTRODUÇÃO: Com os avanços tecnológicos, a bioética surge como campo de reflexão para nortear os profissionais da área da saúde no âmbito assistencial, em especial na prática do cuidar de pacientes em fase terminal. OBJETIVOS: Esse estudo teve como fio condutor os seguintes objetivos: Investigar a vivência de enfermeiros no cuidar de pacientes na terminalidade; Analisar a vivência de enfermeiros no cuidar de paciente terminal à luz dos princípios da bioética. METODOLOGIA: Trata-se de um estudo exploratório, de natureza qualitativa, desenvolvido na Unidade de Terapia Intensiva do Hospital Universitário Lauro Wanderley, da Universidade Federal da Paraíba, localizado na cidade de João Pessoa (PB). A amostra foi constituída por quinze enfermeiros assistenciais da instituição selecionada para o estudo. O projeto de pesquisa foi submetido ao Comitê de Ética em Pesquisa do mencionado hospital, do qual recebeu certidão de aprovação, com registro CAAE, sob nº 13289213.1.0000.5183. A coleta de dados ocorreu no período de março a julho de 2013, mediante aplicação de um formulário contendo questões pertinentes aos objetivos propostos. O material empírico foi analisado qualitativamente, por meio da técnica de análise de conteúdo, seguindo as fases: pré-análise, exploração do material e tratamento dos resultados, inferência e interpretação. RESULTADOS E DISCUSSÕES: Da análise qualitativa emergiram as seguintes categorias temáticas: Categoria I: Vivência de enfermeiros no cuidar de pacientes em fase terminal: assistência e enfrentamento diante da morte; Categoria II: A prática do cuidar de enfermagem aos pacientes na terminalidade: princípios bioéticos. CONSIDERAÇÕES FINAIS: O estudo revela o compromisso dos enfermeiros participantes do estudo no que concerne ao cuidar de pacientes em fase terminal, especialmente no que diz respeito aos princípios bioéticos que circundam a referida prática. Ademais, devido ao quântico reduzido de estudos direcionados a essa temática na literatura nacional, espera-se que essa pesquisa possa contribuir para novas investigações no âmbito do cuidar de pacientes na terminalidade.
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Terminallokalisering från varuägarens perspektivBrinnen, Axel, Norrlander, Patrik January 2016 (has links)
Denna studie har använt sig av AHP-modellen för att analysera ett företags val av lokalisering ur ett hållbarhetsperspektiv. AHP-modellen är en modell som underlättar vid beslut. Modellen har använt sig av faktorer som har nämnts i tidigare skriftligt material. Modellen har sedan applicerats på företaget för att undersöka deras val av lokalisering av terminal i Gävle. Syftet med denna studie var att analysera AHP-modellen, ur varuägarens synpunkt, för lokalisering av konsolideringspunkt/terminal ur ett hållbarhetsperspektiv samt att sedan applicera denna modell på ett företag i Gävleregionen. Företaget som används i denna studie är ett stort välkänt svenskt företag. De har lokaliserat en terminal i Gävle där varor samlas ihop och sedan skickas till företagets centralförråd i ort A och ort B. Ledtiden var en viktig faktor vid valet av lokalisering och den måste understiga en dag. Platser som ansågs vara alternativ till Gävle var ort C, ort D och någon mer lokalisering längre söderut i Sverige. Slutsatsen påvisar att Gävle enligt företagets värderingar är den bästa platsen för deras verksamhet. Gävle motsvarar alla företagets förväntningar. Ort C faller bort p.g.a. att ledtiden inte kan hållas under en dag medan ort D inte har en hamn att tillgå. Denna studie har kombinerat modellerna för att få ett hållbart synsätt vid lokaliseringsprocessen. Det finns fortfarande svårigheter med att definiera vad som är långsiktigt hållbart. Fortsatt forskning inom ämnet är att föredra för att kunna utveckla modellen mot ett mer hållbart synsätt. / This paper analyses the usage of the AHP-model to localize a freight consolidation center from a sustainable perspective. The AHP-model is a model that makes decisions easier by weighting various factors against each other according to given priorities. Once analyzed, the AHP-model has been applied to a case company in order to evaluate its effect and eventually see if the case companys localization decision was correct. The case company in this paper is a large swedish company active both on the swedish market and internationally. They have a freight consolidation center located in Gävle, Sweden with the purpose of replenishing stock at company warehouses located in area A and area B. The company requires a transport lead time of less than one day. When the company chose to locate their freight consolidation center to Gävle, there were a few other options, namely area C and area D as well as a thir option located too far south in Sweden. The conclusion of this paper shows that Gävle is the best area for the freight consolidation center out of the available options based on the companies priorities. Area C can not keep the leadtime below one day and area D does not have a port available. It is still hard to define what is sustainable on a long term perspective when it comes to localization. Further research is therefore recommended in order to improve the model in a sustainable manner.
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Can integrated palliative care services enhance the quality of end-of-life cancer care?Law, Chi-ching., 羅志清. January 2009 (has links)
published_or_final_version / Community Medicine / Master / Master of Public Health
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Existential practitioners' experience of feeling competent in death work : an interpretative phenomenological analysisMurphy, Ellen Louise January 2013 (has links)
Competency assessment and evaluation for all psychological therapies are now a common requirement. Recent international research studies have resulted in the development of the phrase ‘death competence’ as “tolerating and managing clients’ problems related to dying, death, and bereavement” with an urging for death work competence to be an ethical imperative (Gamino & Ritter, 2012). A further study of 176 death work professionals using an open ended question and content analysis proposed a model of death work competence that suggests it is dependent on more than knowledge and skills, with the emergence of emotional and existential coping as key elements (Chan & Tin, 2012). This study aims to build on this existing research with an Interpretative Phenomenological Analysis of six existential practitioners` experience of feeling competent in their death work, grounding the research in Heidegger`s notion of being-towards-death. The aim was to get as close as possible to the lived experience of death work competency in a small, purposive sample to investigate the subjective meanings and understandings of their death work competency. Semi structured interviews were conducted with five major themes emerging. These were frameworks for death work competency; existential engagement in competent death work; existential ways of being in death work; the psychological impact of death work on feelings of competency and the elusive essence of death work competency. The significant finding was the primary import placed by all participants on dialogues with personal mortality, suffering and death as providing them with “competency in adversity” and “competency in fragility” that were vital for their competent death work, both personally and professionally. These findings match the identification of existential coping and emotional coping as key elements in death work competency in the previous research. From this research a tentative framework is proposed for death work competency that looks to include these vital elements of an engagement with existential issues and personal mortality, for counselling psychologists and death work practitioners. Further research is suggested with regards to the absence or presence of similar experiences of death work competencies in other fields of death work with wider implications for training in both professional organisations and teaching institutions.
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Nurses' education and their experiences of caring for people who are dying and their familiesMorgan, Naomi Mary Ann January 1997 (has links)
No description available.
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Caring for someone with HIV related illness : the experience of family carersStark, Catherine M. January 1995 (has links)
No description available.
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