Este trabalho volta-se ao estudo das diretivas antecipadas sobre o fim da vida na relação médica no Brasil. Pretende-se verificar a legitimidade bioética e a legitimidade e possibilidade jurídicas da prática das diretivas antecipadas sobre o fim da vida como objetivo central. Busca-se aferir a adequação, bioética e jurídica, das diretivas antecipadas como veículo próprio de autodeterminação da pessoa diante de suas possibilidades existenciais e da formulação de seu projeto de vida e de morte digna. Ademais, especificamente, procura-se determinar a possibilidade jurídica das diretivas antecipadas no Ordenamento brasileiro: a coerência com as garantias constitucionais e a existência de institutos aptos a tal prática. Propõe-se sustentar a legitimação jurídica das diretivas antecipadas no Brasil, indicando possíveis caminhos às soluções interpretativas no plano jurídico, e os efeitos na relação médica a partir, também, das considerações bioéticas. Com essa finalidade, pretende-se averiguar a compatibilidade entre as normas deontológicas de origem bioética e as normas jurídicas de status constitucional de proteção à pessoa humana. A tese também propõe a análise do contexto em que as diretivas antecipadas são utilizadas para (i) problematizar as ideias de capacidade e competência para a prática desse ato de autonomia pessoal, (ii) problematizar sobre como a perspectiva familiar, a perspectiva técnica dos profissionais da saúde e a perspectiva do Poder Judiciário contingenciam a liberdade desse ato e (iii) aferir a eficácia desses atos no espaço clínico e familiar. Para tanto, será empreendido estudo teórico mediante pesquisa bibliográfica e de referências, que levantará as publicações, nacionais e internacionais, sobre os temas da tese. O levantamento bibliográfico compreenderá, preferencialmente, obras sobre filosofia, ética, bioética e direito, que permitam a análise das questões teóricas envolvidas no estudo. O desenvolvimento do trabalho estrutura-se em três capítulos. O primeiro pretende estabelecer as bases conceituais e os fundamentos legais das diretivas antecipadas. O segundo capítulo apresentará a sistematização entre os valores bioéticos e jurídicos que se relacionam a tal prática. O capítulo três apresentará as questões fundamentais pertinentes à validade e eficácia da prática das diretivas antecipadas no Brasil. A partir das premissas construídas ao longo do desenvolvimento, o desfecho da pesquisa pretende reforçar seu argumento central demonstrando, então, a legitimação bioética e a legitimidade e a possibilidade jurídicas das diretivas antecipadas sobre o fim da vida no atual contexto brasileiro.

Abstract Air and soil temperatures, snow cover, serious snow load damage to coniferous trees, wind, topography and edaphic factors on the fells situated between 67°N and 68°N in Finnish Lapland are described and their influence on the location of the actual timberline and treeline is discussed. In addition the relation between annual climate conditions and pollen deposition in the timberline ecotone is analysed and the results of seedling density monitoring in the same environment are presented. The potential for the actual timberline and treeline to advance to a higher elevation is also discussed. The field studies were carried out on the fells of Aakenustunturi, Yllästunturi and Pyhätunturi. The average altitude of the actual timberline varies from 370 metres to 402 metres a.s.l. The actual timberline is hardly ever composed of a single tree species but featured alternating occurrences of Norway spruce (Picea abies), Scots pine (Pinus sylvestris) and mountain birch (Betula pubescens ssp. czerpanovii). The mean tetratherms on the southern and northern slopes (+10.3°C and +10.1°C, respectively), the mean maximum tetratherm on the southern slope (+15.1°C) and the corresponding measures for the treeline (460 m a.s.l), the minimum tetratherm (+6.3°C), mean July temperature (+12.6°C), biotemperature (+3.3°C) and minimum effective temperature sum (455 d.d.), coincide closest with the results of earlier studies. The maximum altitudes of the actual timberline are dictated by many climatic factors on southern and western slopes with a gentle inclination, and the forest cover gradually becomes thinner, in which case the actual timberline does not form any easily distinguishable line. The lowest altitudes of the actual timberline are the results of an extremely high proportion of block fields, slope steepness and snow patches on the northern and eastern slopes. On the precipitous and rocky slopes trees have difficulties in taking root and in obtaining nutrients and water, while as a consequence of snow patches the growing season may be too short for tree growth at all, and if trees exist there they are suffering from low soil temperature and parasitic snow fungi. Serious snow load damage to trees evidently hampers any advance in the actual timberline, as do avalanches and mires. The location of the treeline is the result of a combination of a great number of unfavourable conditions for tree regeneration, seedling establishment and tree growth, such as inadequate snow protection, extreme soil temperatures, almost total destruction of trees by the snow load, wind pressure, an often inadequate effective temperature sum and length of the growing season, night frost in early summer, and poor, dry soil suffering from excessive evaporation. Actual timberline responses to predicted climate warming will differ greatly from site to site in relation to the local topography, edaphic features and associated ecological limitations. Any advance in the treeline to a higher elevation is likely to be slower and at least less certain than that in the actual timberline. In addition, advances in the actual timberline and treeline may even be prevented by phenomena occurring along with climate change. A potential key factor in this is serious snow load damage to the trees.

The emergence of Grid computing infrastructures enables researchers to share resources and collaborate in more efficient ways than before, despite belonging to different organizations and being distanced geographically. While the Grid computing paradigm offers new opportunities, it also gives rise to new difficulties. One such problem is the selection of resources for user applications. Given the large and disparate set of Grid resources, manual resource selection becomes impractical, even for experienced users. This thesis investigates methods, algorithms and software for a Grid resource broker, i.e., a scheduling agent that automates the resource selection process for the user. The development of such a component is a non-trivial task as Grid resources are heterogeneous in hardware, software, availability, ownership and usage policies. A wide range of algorithmically difficult issues must also be solved, including characterization of jobs, prediction of resource performance, data placement considerations, and, how to provide Quality of Service guarantees. One contribution of this thesis is the development of resource brokering algorithms that enable resource selection based on Grid job performance predictions and use advance reservations to provide Quality of Service guarantees. The thesis also includes an algorithm for coallocation of sets of jobs. This algorithm guarantees a simultaneous start of each subjob, as required e.g., when running larger-than-supercomputer simulations that involve multiple resources. We today have the somewhat paradoxal situation where Grids, originally aimed to overcome interoperability problems between different computing platforms, themselves struggle with interoperability problems caused by the wide range of interfaces, protocols and data formats that are used in different environments. The reasons for this situation are obvious, expected and almost impossible to avoid, as the task of defining appropriate standards, models and best-practices must be preceded by basic research, proof-of-concept implementations and real-world testing. We address the interoperability problem with a generic Grid resource brokering architecture and job submission service. By using (proposed) standard formats and protocols, the service acts as an interoperability-bridge that translates job requests between clients and resources running different Grid middlewares. This concept is demonstrated by the integration of the service with three different Grid middlewares. The service also enables users to both fine-tune the existing resource selection algorithms and plug in custom brokering algorithms tailored to their requirements.

Communication concerning the care one wishes to receive at the end of life (EOL) is central to ensuring that wishes are honored. Many studies have examined doctor-patient or doctor-family EOL communication. However, relatively few studies have focused on the occurrence of EOL care discussions among family members. This is an important topic, as research suggests that advance directives (ADs) are ineffective if patients have not involved surrogate decision-makers, most of whom are family members. This study examined EOL care discussions among family members. It used quantitative and qualitative data from a diverse sample of older adults from West Central Florida collected for the purpose of this examination. The quantitative and qualitative data were analyzed separately and together. This study employed the Transtheoretical Model, which proposes that individuals are in varying behavioral “stages of change” and that bringing about a behavioral change requires understanding their particular stage and adapting interventions appropriately. Statistical analysis of the quantitative data (N=364) using multinomial logistic regression showed that participants were in distinct stages that were associated with several factors, including family involvement with health care decision-making and communications with doctors. Racial and ethnic differences were not found in controlled analysis, though Hispanics were less likely to be in more advanced EOL care discussion stages in unadjusted analyses. Several themes were found in qualitative analysis of focus groups (n=36) drawn from the larger sample. Findings suggested that those who engaged in family EOL care discussions were more careful planners overall, more accepting of death, and able to manage complex family dynamics. They also had greater knowledge of EOL matters, largely related to knowledge of loved ones EOL wishes. The quantitative-qualitative (mixed-methods) study reinforced the role of family relationships in general in whether EOL care discussions occurred. It also highlighted the role of being proactive and having EOL care knowledge. All three studies – the quantitative, qualitative, and mixed methods showed the potential for doctors and other health professionals to help families with EOL care discussions and ACP overall.

Die Arbeit beschäftigt sich mit der im Jahr 2009 in Kraft getretenen Regelung der Patientenverfügung des §1901 a BGB, insbesondere den Anwendungsproblemen der Erstellung einer Verfügung sowie den Schwierigkeiten bei Ihrer Umsetzung. Dabei liegt ein Schwerpunkt bei der Frage, inwieweit Patientenverfügungen in der Notfallsituation aufgrund der spezifischen Besonderheiten beachtet werden können bzw. müssen. Die Ausarbeitung unterbreitet Vorschläge für die Abfassung von Patientenverfügungen und bietet im Anhang eine auf der Musterverfügung des BMJuV basierende überarbeitete Textbausteinversion zur Erstellung einer individuellen Patientenverfügung an. Literatur, Rechtsprechung und Gesetze sind bis zum 01.06.2016 berücksichtigt.

Submitted by Biblioteca Central (biblioteca@unicap.br) on 2018-08-22T18:05:58Z No. of bitstreams: 2 steel_rodrigues_vasconcellos.pdf: 501895 bytes, checksum: ab8f901299698ea52e66c99c7eb16bfc (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-08-22T18:05:58Z (GMT). No. of bitstreams: 2 steel_rodrigues_vasconcellos.pdf: 501895 bytes, checksum: ab8f901299698ea52e66c99c7eb16bfc (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2018-06-25 / El presente estudio de investigación cuya metodología fue revisión de literatura - se enfoca en un profundo estudio acerca de los supuestos de concesión de la tutela provisional - urgencia - satisfectiva: específicamente el periculum in mora y el peligro de irreversibilidad de la tutela; Ambos provenientes del art. 300 del código processual civil. El análisis efectuado partió de la premisa del estudio pragmático acerca del derecho vivo de las liminares que considera la tutela de urgencia extremada (hipertrofia estructural del texto) cuando uno de los presupuestos pesa bastante que compensa la falta del otro presupuesto: probabilidad del derecho. Para el presente estudio fue identificado que en el propio art. 300 del Código de Procedimiento Civil hay por supuesto una antinomia valorativa inapropiada. Lo que imposibilita aplicar criterios classicos de solución en el ordenamiento jurídico. Además, se sostuvo que la fuerza principiológica no es suficiente para resolver la falta de criterio normativo. Se estudiaron también las concepciones argumentativas del Derecho y los fundamentos retóricos; Además de haber abordado la importancia axiológica de los derechos de la personalidad. Así la cláusula de excepción al peligro inverso sostiene que en el procedimiento de cognición sumaria- al considerar la concesión de tutela, cuando haya la colisión entre derechos patrimoniales con los derechos extrapatrimoniales, éstos deben prevalecer. / O presente estudo de pesquisa cuja metodologia foi revisão de literatura – enfoca em um profundo estudo acerca dos pressupostos de concessão da tutela provisória – urgência – satisfativa: especificamente o periculum in mora e o perigo de irreversibilidade da tutela; ambos provenientes do art. 300 do Código de Processo Civil de 2015. A análise feita partiu da premissa do estudo pragmático acerca do direito vivo das liminares que considera o pressuposto do periculun in mora prevalente único prevalente no momento da concessão liminar. Para o presente estudo foi identificado que no próprio art. 300 do Código de Processo Civil há uma antinomia valorativa imprópria. O que impossibilita aplicar critérios clássicos de soluções no ordenamento jurídico. Além do que, sustentou-se que a força principiológica normativa não é o suficiente para resolver a falta de critérios normativos. Estudou-se também as concepções argumentativas do Direito e os fundamentos retóricos; além de ter debruçado a importância axiológica dos direitos da personalidade. Destarte a cláusula de exceção ao perigo inverso defende que no procedimento de cognição sumária – ao considerar a concessão de tutela, quando houver a colisão entre direitos patrimoniais com extrapatrimoniais, estes devem prevalecer.

This thesis deals with the selection of the best funding method of purchasing new punching press TruPunch 5000 for company AZ Klima, s.r.o. This work includes analysis of current leasing and credit options on the Czech market and their evaluation in accordance to given kriteria as well. The goal of the thesis is to select the most appropriate funding method.

The city of Philippi was founded as a Roman military colony in 42 BC, directly following one of the largest battles of antiquity, the civil war battle of Philippi. This study shows that one hundred years later, at the time of writing of Paul’s letter to the Philippians, the identity of the city was still deeply connected to its military history. The apostle Paul found in the historical and sociological ties of the Philippians with the military reasons for drafting his letter in a rhetorical arrangement similar to the historical reports of commander’s speeches to his assembled troops before battle. Not only does the vocabulary of Paul’s ethical commands parallel the general’s harangues, as has been previously pointed out by Biblical scholarship, but in Paul’s letter one also finds correspondences to the three largest motifs of the general’s speeches: the objective of the war, the confidence for victory and the rewards for courage and obedience. The major unified theme of Philippians is the mutual military-partnership for the advance of the gospel in a hostile context (Phil. 1:7-12; 1:20; 2:19-24; 2:25-30; 3:12-15; 4:3; 4:10-19). Paul in his letter to the Philippians uses consistently military imagery – and not once athletic imagery, as typically assumed by exegetical scholars – to demonstrate that the courageous sharing of the faith will always result in victory for the one who proclaims Christ. This victory is guaranteed through the unsurpassable abilities of the supreme general, Jesus Christ, whose death on the cross and whose resurrection is portrayed as a military victory and whose exaltation by God the Father acknowledges Christ as the victorious general in an universal extent (Phil. 2:8-11). The victory of the gospel campaign is further guaranteed by the LORD’s initiation of the war for the spread of the faith and by His presence with those who fight in His behalf for the spread of the good news (Phil. 1:5-7; 2:12-13; 2:14-15; 3:1; 4:4). Victory in the Philippian context means either the reception of the gospel by unbelievers or the death of the messenger on account of rejection of and opposition to the gospel; the suffering of the emissary of the gospel serves to glorify Christ and it is compensated by the superior enjoyment of Christ at the resurrection (Phil. 1:19-25). The reward, which God promises to the messenger of the gospel is several times stated in Philippians to be the exalted experience of fellowship with Christ at the resurrection (Phil. 1:21; 3:8-11; 3:20-21; 4:3). The reading of Philippians in light of the appropriation of military terminology confirms that Paul’s main purpose in writing Philippians is to encourage his partners to continue to take risks, to be unafraid of suffering and to make sacrifices in order to boldly testify about Christ and to continue to financially contribute to the mission of spreading the faith. The book of Philippians challenges the contemporary self-centred prosperity culture of the church to take risks and make sacrifices for the proclamation of Christ to unbelievers, sacrifices, which are supremely compensated by a life for the glory of Christ and the surpassing promise of the enjoyment of the glory of God in His Son Christ Jesus. / Thesis (PhD)--University of Pretoria, 2013. / gm2014 / New Testament Studies / unrestricted

The aim of this diploma work is to search the answer to question: What are the causes for little use of advanced directives in real life from expert's point of view? Text is separated into theoretical part, methodological and analytical. In theoretical part, the autor is conceptualising basic terms from main research question and is leading the revers into the context. Methodological part is revealing the background of the research, which was carried out by qualitative research strategy through half-structured interviews with chosen experts in problems with advanced directives. In analytical part are presented results of research, which the autor is comparing to theoretical roots. Particiapnts of the research are seeing the causes of little use in advanced directives in little information about its existence, in legal format and its rising concerns from possible legal punishment and last but not least it can be caused by ethical and personal background. Keywords Advanced directives, illness, autonomy, causes, practise.

The aim of this diploma work is to search the answer to question: What are the causes for little use of advanced directives in real life from expert's point of view? Text is separated into theoretical part, methodological and analytical. In theoretical part, the autor is conceptualising basic terms from main research question and is leading the revers into the context. Methodological part is revealing the background of the research, which was carried out by qualitative research strategy through half-structured interviews with chosen experts in problems with advanced directives. In analytical part are presented results of research, which the autor is comparing to theoretical roots. Particiapnts of the research are seeing the causes of little use in advanced directives in little information about its existence, in legal format and its rising concerns from possible legal punishment and last but not least it can be caused by ethical and personal background. Keywords Advanced directives, illness, autonomy, causes, practise.