Bakgrund: Beslutet om artificiell nutrition och hydrering (ANH) i det terminala skedet har länge varit ett högaktuellt ämne världen över. Sjuksköterskan är den i vårdteamet som står närmast patienten, identifierar dess behov och initierar en behandling med ANH. Därför var det av intresse att undersöka sjuksköterskans medverkan vid beslutsprocessen. Syfte: Syftet med studien var att beskriva sjuksköterskans medverkan vid bedömning av behovet av artificiell nutrition och hydrering i det terminala skedet. Metod: En allmän litteraturstudie med induktiv ansats. Elva vetenskapliga artiklar användes i resultatet. Resultat: Resultatet av litteraturstudien delades upp i tre teman: Faktorer som påverkar sjuksköterskan, Relationer som påverkar beslutet och Beslutsprocessen. Resultatet visade att de sjuksköterskor som arbetade på en vårdavdelning som hanterade ANH-beslut och de sjuksköterskor som hade lång erfarenhet medverkade i beslutsprocessen i större utsträckning. Det framkom också att relationen mellan sjuksköterskan och ansvarig läkare hade betydelse för sjuksköterskans delaktighet i beslutet. Konklusion: För att sjuksköterskan ska känna sig trygg i att medverka i beslutsprocessen krävs utbildning inom ämnet, tydliga riktlinjer och ett arbetsklimat präglat av goda relationer kollegorna emellan. / Introduction: The decision making process regarding artificial nutrition and hydration (ANH) at the terminal stage of life has been a highly topical subject worldwide. The nurse is the member of the team who’s closest to the patient, the one who identifies the patients’ needs and initiates the ANH treatment. Because of this, examining the nurses’ participation in the decision-making process was of interest. Aim: The aim of the study was to describe the nurses participation regarding the decision-making process surrounding ANH at the terminal stage of life. Method: A general literature review with an inductive approach. Eleven articles were used in the result. Results: The results of the study were divided into three themes. Factors influencing the nurse, Relations that influence the decision, The decision-making process. The result shows that the nurses working in wards often managing ANH treatment decisions and the nurses with more experience participated in the decision making process to a greater extent. The results also showed that the character of the relationship the nurse had with the doctor was important and made a difference regarding the nurses participation in the decision. Conclusion: In order for the nurses to feel comfortable and safe to participate in the decision making process they need education, guidelines and good relations with colleagues.

The aim of this diploma thesis is refer to the supplier evaluation and selection process in business sphere. On the business sphere is putted emphasis because securing of company sources are more and more important parts of strategic decision making. In this paper is analyzed supplier selection problem and are analyzed most common methods to determine the best supplier. The goal of this paper is proposal of own program solution of evaluation and supplier selection build on evolution methods, specifically evolution algorithms. The part of this thesis is map of theoretical possibilities of evolution algorithms and implementation of program for solving supplier selection problem.

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

No description available.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.

No description available.

This thesis deals with the development of new reaction methodology as well as stereochemical investigations. The first part concerns the investigation of 1,2- and merged 1,2- and 1,3- asymmetric induction in Mukaiyama aldol additions to α-heteroatom and α,β- heteroatom substituted aldehydes respectively. In particular, the unexpected 1,2-syn selectivity obtained in the addition of sterically hindered nucleophiles to α-chloroaldehydes is examined, and an explanation for the observed stereochemical trends is proposed. The second part describes the development of a novel entry to α-amino-β- hydroxy esters by a 1,3-dipolar cycloaddition reaction of aldehydes and azomethine ylides, generated by thermolysis of aziridines. The third part deals with our efforts to develop a novel entry to vicinal all- carbon quaternary centers, based on an intramolecular domino Heck- carbonylation reaction using tetrasubstituted olefins. / QC 20120611