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No description available.

published_or_final_version / Dentistry / Master / Master of Philosophy

The best interest test is the legal mechanism which governs decision making on behalf of adults who lack the capacity to make their own health care treatment decisions. The test has attracted considerable criticism from health professionals, academics, judges and lawyers for being ill-defined and non-specific. The question of what is meant by 'best interests' remains largely unanswered. As a consequence, the test gives medical and legal decision makers considerable discretion to apply their personal value judgements within supposedly value-free philosophical frameworks - unreasoned and opaque decision making processes are the inevitable result. Because of the dominance of supposedly value-free philosophical frameworks, the place of values in decision making is not always fully understood. Reasoning is not possible without values, which stem from our emotions and passions, our upbringing, our religion, our cultures, our processes of socialisation and from our life experiences. Values help us make sense of our daily lives. I argue that law - like any other social institution - is essentially a human, values based construct. I put forward a theory of values-based law which argues for the recognition that laws, rules and conventions are based on, and contain, individual values. Currently, medical and legal decision makers justify grave decisions on behalf of society's most vulnerable citizens without revealing, or even acknowledging the values which drive and inform their decisions. Any opportunities to scrutinise or debate the values driving decisions are lost. Ultimately, values-based law argues that values underlying best interest determinations must be exposed to facilitate honest, transparent and fulsome decision making on behalf of adults who lack capacity. By applying the theory of values-based law, supposedly value-free decision making processes are exposed as insufficient to facilitate fulsome, honest and transparent legal reasoning.

Thesis (doctoral)--Universität Erlangen.

Thesis (M. Sc.)--McGill University, 1997. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Freiburg i. Br., Univ., Diss., 1993.

Thesis (M. Sc.)--McGill University, 1997. / Includes bibliographical references.

Made available in DSpace on 2014-06-11T19:32:55Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-02-26Bitstream added on 2014-06-13T19:43:47Z : No. of bitstreams: 1 pereira_cr_dr_botfm.pdf: 962736 bytes, checksum: 6a3b10b7b3b5b70dd57a328288829c00 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Métodos de comunicação tem se mostrado úteispara minimizar o estresse do profissional de saúde e facilitar o processo de informar más notícias em saúde para os pacientes. Este trabalho tem por objetivo descrever um protocolo de comunicação (protocolo PACIENTE) e avaliar sua aceitação. Foram realizados treinamentos sobre comunicação de más notícias, onde o método PACIENTE foi apresentado. Após obtenção consentimento livre e esclarecido, distribui-se um questionário com 12 perguntas de múltipla escolha sobre a experiência pregressa em comunicação e sobre as impressões acerca de protocolo apresentado. Houve 200 participantes, sendo 100 médicos e 100 enfermeiros. Os temas considerados mais dificeis no processo de comunicação foram: falar sobre a morte (39,5%)... / Methods of communicationg bad news has been proven effective to minimize heath professionals' stress and easier the bad news disclosure to the patients. The objective of this research is to describe a communication protocol (PACIENTE) and evaluate its acceptance. The protocol PACIENTE was presented during trainings about bad news disclosure. After informed consent, a questionnaire of multiple choice responses was given to the participants concerning previous experiences in communication and about their impressions on the presented protocol. There were 200 participants, 100 doctors and 100 nurses. The most difficult points on the communicating bad news were: discuss death (39,5%), and... (Complete abstract click electronic access below)

Ruminants have a unique ability to acquire protein from non-protein nitrogen (NPN) sources, and to recycle nitrogen back into the rumen, instead of excreting all of it via the urine, faeces and milk. However, a high concentration of blood urea nitrogen (BUN) has a negative influence on conception. Additionally, a high dietary nitrogen intake poses a challenge to the environment in the form of ammonia emissions, eutrophication and bad odours. This calls for strategies to reduce the environmental impact of livestock production. Variation exists in the ability of cattle to recirculate nitrogen between as well as within cattle breeds. The purpose of this study was to investigate the effects of BUN concentration on reproductive performance in beef heifers under different management systems in South Africa. Serum samples from 369 Bonsmara heifers were taken in November and December 2010 to determine the BUN concentrations prior to the onset of the breeding season. Heifers were from five herds with different levels of protein supplementation during the weeks before the commencement of the breeding season. Body mass, age, body condition score (BCS) and reproductive tract score (RTS) were recorded at the same time as BUN concentration. Trans-rectal ultrasound and/or-palpation was performed four to eight weeks after the three-month breeding season to detect and estimate the stage of pregnancy. Days to pregnancy (DTP) was defined as the number of days from the start of the breeding season until a heifer was successfully mated. Logistic regression and Cox proportional hazards survival analysis were performed to estimate the effect of BUN concentration on subsequent pregnancy and DTP respectively, while stratifying by herd and adjusting for potential confounders. The correlations between BUN concentration, BCS and RTS were estimated using Spearman’s rho. Pearson correlations were used for the normally distributed variables of age and body mass. BUN concentration was not a significant predictor of pregnancy status but was a significant (P = 0.007) and independent predictor of DTP in heavily and some moderately supplemented herds. As BUN concentration increased, DTP also increased [hazard ratio (HR) = 0.827; 95% CI: 0.721 – 0.949; P = 0.007], while the chance of becoming pregnant decreased, although this was not statistically significant [odds ratio (OR) = 0.882; 95% CI: 0.772 – 1.007; P = 0.063]. Bonsmara heifers with higher BUN concentration, which suggests a better ability to recirculate nitrogen, might be at a disadvantage when the production system includes high levels of RDP supplementation because of this negative impact on reproductive performance. It is proposed that production systems be adapted to avoid selection against animals with an improved ability to recirculate nitrogen. / Dissertation (MMedVet)--University of Pretoria, 2013. / gm2014 / Production Animal Studies / Unrestricted