Background: - Living wills have long been associated with end-of- life care. This study explored the promotion and use of living wills amongst general practitioners and frail care nursing coordinators directly involved in the care of the elderly in Howick, Kwa-Zulu Natal. The study also explored their views regarding the proforma living will disseminated by the Living Will Society. Participants: - Seven general practitioners and three frail care nursing coordinators, making ten in total. Design: - Qualitative in-depth interviews and analysis, using the Framework method. Results:- Both doctors and nursing staff understood the concept of living wills and acknowledged their varied benefits to patient, family and staff. They were concerned about the lack of legal status. They felt that the proforma document from the Living Will Society was simple and clear. Despite identifying the low level of use of living wills, they felt that third party organisations and individuals should promote living wills Conclusion: - GPs and frail care nurse coordinators were knowledgeable of living wills in general and the Living Will Society proforma document in particular. They valued the contribution that living wills can make in the care of the elderly, benefitting patients, their families, health care workers and even the health system. They also valued the proforma living will document from the Living Will Society for its clarity and simplicity. However, both GPs and frail care nursing coordinators viewed the living will process as patient- driven and their main role was as custodians and not advocates of the living will.

Child obesity is a significant health concern and treatment typically involves referral to child weight management services (CWM). Evidence suggests that preadolescent children may benefit from greater involvement in their treatment but the younger child can find it difficult to enter treatment discussions, and being overweight can negatively affect child self-esteem and capacity to communicate. Digital technology has the potential to provide scaffolding for child consultations with dietitians by presenting information in an accessible, engaging and interactive format. This research aimed to develop a theory driven, evidence-based interactive e-resource (Feed-back) and to explore the feasibility and acceptability of using Feed-back to facilitate communication between children aged 7 to 11 years and the dietitian within child weight management appointments.

No description available.

A logística permite desenvolver estratégias para a redução de custos e aumento do nível de serviço ofertado ao cliente. A tomada de decisão sobre a empresa executar internamente as atividades logísticas ou terceirizar essas atividades é uma decisão tão importante que na grande maioria das empresas ela é feita em nível de Diretoria ou Gerência. A tendência empresarial de manter o foco no negócio é uma estratégia que vem sendo adotada cada vez mais pelas empresas. Consequentemente, atividades fora do core business estão sendo terceirizadas. No setor de distribuição de produtos químicos verifica-se a presença tanto de empresas que terceirizam suas atividades logísticas quanto de empresas que verticalizam, não havendo uma unanimidade a respeito no setor. Dado este contexto, o objetivo da pesquisa é o de analisar a adoção da verticalização ou da terceirização das atividades logísticas em empresas distribuidoras de produtos químicos. Assim, a questão de pesquisa é: Por que as empresas adotam a estratégia de verticalização ou de terceirização de suas atividades logísticas? A pesquisa é qualitativa descritiva e aplicou o método de estudo de caso, através da investigação de casos múltiplos realizada em empresas distribuidoras de produtos químicos. A pesquisa utilizou como fontes de evidência entrevistas e análise de documentos, sendo inicialmente feitos dois estudos de caso pilotos e após as devidas correções foram feitos mais dois estudos de casos. Os resultados obtidos permitiram a constatação dos seguintes fatores como sendo motivadores da adoção da verticalização das atividades logísticas: reduzir custos, ter maior controle da operação, aumentar os níveis de serviço logístico e focar em logística (competência central) foram determinantes, enquanto dispor de habilidades e recursos e aumentar a proximidade com o cliente foram considerados importantes. O fator atender todos os requisitos logísticos do negócio não foi levado em consideração na adoção da verticalização das empresas. Em relação à terceirização das atividades logísticas, os seguintes fatores foram identificados como motivadores de sua adoção: reduzir investimentos em ativos, reduzir custos e focar no core business foram determinantes, enquanto os fatores expandir mercados e aumentar a flexibilidade da operação foram considerados importantes. Os fatores: ter acesso a competências externas; melhorar as tecnologias de informação utilizadas e aumentar os níveis de serviço logístico não foram fatores considerados pelas empresas quando optam por terceirizar suas atividades logísticas. Assim, a dissertação buscou trazer contribuições para a área de Logística, pois explorou e analisou um tema sempre considerado atual e estratégico que é o da terceirização ou verticalização das atividades logísticas, em um mesmo contexto. Já para a prática gerencial, a principal contribuição pretendida foi a de fornecer subsídios para ajudar os executivos de logística na tomada de decisão terceirizar x verticalizar. / Logistics allow the company to develop strategies for cost reduction and increase the level of the service offered to the client. For the company to make the decision of executing internally the logistics activities or to outsource these activities is such an important one that in most of the companies this decision is made by the directors or managers. The companies’ trend to keep the focus on the business is a strategy which has been adopted more and more. Consequently, activities out of the core business of the companies are being outsourced. In the sector of distribution of chemicals we can observe the presence of companies that outsource their logistics activities and companies that insource, meaning that there is no unanimity about this in the sector. Given this context, the objective of the research is to analyze the adoption of insourcing or outsourcing of logistics activities in chemicals distribution companies. Thus, the research question is: Why do companies adopt the strategy of insourcing or outsourcing their logistics activities? The qualitative research is descriptive and applied the method of case studies, by investigating multiple cases performed in distributors of chemicals. The research used interviews as sources of evidence and analysis of documents and initially two pilot case studies were made and after corrections two more case studies were made. The results led to the finding of the following factors as drivers of the adoption of the vertical integration of logistics activities: reduce costs, greater control of the operation, increase levels of service and focus on logistics (core competency) were determinants, while having skills and resources and increase customer proximity were important. The factor meet all the requirements of the logistics business was not taken into consideration in the adoption of vertical integration of enterprises. Regarding outsourcing logistics activities, the following factors were identified as motivators of the adoption: reduce asset investment, reduce costs and focus on core business were decisive factors while the factors market expansion and increase the flexibility of the operation were considered important. The factors: have access to external expertise, improve the information technology used and increase levels of logistical service were not considered by companies when they choose to outsource their logistics activities.The dissertation sought to bring contributions to the field of logistics, since it explored and analyzed a theme that is always current and strategic, which is the outsourcing or insourcing of logistics activities, in the same context. For the management practice, the main contribution intended was to provide information that can help the logistics executives in the decision to outsource x insource.

60 leaves, 7 leaves of plates : ill. ; 28 cm Thesis (M.A.)--University of Oregon, 1943 Bibliography: leaves [51]-53

ix, 94 p. : ill. A print copy of this thesis is available through the UO Libraries. Search the library catalog for the location and call number. / This thesis examines the Long-Term Ecological Reflections at H.J. Andrews Experimental Forest, Oregon, a project that promotes creative inquiry at an ecological research station. I analyze how reflective writing contributes to a deeper understanding of ecosystem processes and fosters a closer connection to nature, referred to as "ecological awareness." I argue that the greatest ecological awareness comes from a combination of scientific and artistic ways of knowing as well as physical immersion in nature. I critically analyze the work of four writers: Jane Coffey, Vicki Graham, Freeman House, and Robin Kimmerer. These works create a strong connection to place for the reader and facilitate an understanding of the forest ecosystem through a discussion of scientific facts. They also create a sense of place through vivid and metaphorical language. These reflections will become an increasingly valuable mode of inquiry as the Andrews Forest develops a stronger writer-scientists interaction. / Committee in Charge: Dr. Louise V. Westling, Chair; Dr. Brendan Bohannan; Dr. Scott D. Bridgham

xv, 137 p. : ill., maps. A print copy of this title is available through the UO Libraries under the call number: KNIGHT GB565.O7 H84 2008 / This study examines the role of floods in shaping the geomorphology of the multichannel, gravel-bed upper Umatilla River, northeastern Oregon, USA. Three parts are presented: (1) the development and application of an error-sensitive aerial photo-based planform channel-change detection and measurement methodology, (2) an examination of the occurrence, variability, and landform impacts of channel widening, straightening, and lateral movement during two mid-to-Iate 20th century flood periods, (3) an investigation of the effects of these floods on channel complexity, a proxy of habitat quality and indicator of ecological health in multi-channel rivers. Floods in 1964-5 (17- to 37-year recurrence interval) scoured, widened, and straightened the active channel in conjunction with large lateral movements, bar accretion, and capture of marginal vegetated areas by lateral scour. Following the flood, lateral movements were smaller, the channel narrowed, and bars, scoured areas, and vegetation lapsed from the channel. A similar flood in 1975 also scoured, widened, and straightened the channel; however, lateral channel movement and changes in channellandforrns were less in 1975 due to latent adjustment of the channel to the first flood. Migratory straightening, meander cutoffs, and avulsions dominated lateral movements during flood periods, whereas episodes of migratory (lateral) extension and (downstream) translation of meanders dominated lateral movement between flood periods. Channel changes were spatially variable and generally greater in reaches with wide floodplains. Floods reduced the overall complexity of the river channel, although the magnitude of change was highly variable and some areas increased in complexity in response to flooding. By contrast, channel complexity increased in the period between floods, particularly in laterally confined areas where complexity loss was high during the first flood period. Two key processes appear to most affect channel complexity: (a) lateral scour and avulsions, which capture vegetation into the channel, and (2) migrations of the main channel, which reflect bar accretion and dissection. Results of this study are broadly congruent with theories (and their corollaries) emphasizing adjustment of channel dimensions, increased rates of change, and reduced complexity in response to flood disturbance, but only partially consistent with theories emphasizing large geomorphic changes in structurally confined settings. This dissertation includes both previously published and co-authored material. / Committee in Charge: Dr. Patricia F. McDowell, Chair; Dr. W. Andrew Marcus; Dr. Patrick J. Bartlein; Dr. Joshua J. Roering

xv, 203 p. : ill. (some col.) A print copy of this thesis is available through the UO Libraries. Search the library catalog for the location and call number. / Water and pumice accumulated behind a dam that, upon failure, scoured the c1aydominated floodplain and deposited pumice sands across the Sycan Valley. The pumice originated from the eruption of Mount Mazama (approximately 7660 ybp), and dam failure occurred very shortly afterwards. In response to the flood the lower Sycan River underwent episodes of channel aggradation and degradation. This study presents the history of channel evolution for the lower Sycan River from 11,000 years ago to present, based on floodplain stratigraphy and radiocarbon chronology. Seven primary periods of channel and floodplain development are identified: I. Early Holocene Dynamic Equilibrium; II: Sycan Outburst Flood; III. Initial Channel Formation; IV. Degradation & Widening; V. Aggradation & Lateral Migration; VI. (Secondary) Degradation & Widening; VII. Modern Dynamic Equilibrium. The active floodplain of the modern lower Sycan River is flanked by terraces of the rapidly abandoned Sycan Outburst Flood deposits. / Committee in Charge: Dr. Patricia McDowell, Chair; Dr. Jim E. O'Connor; Dr. Andrew Marcus

xii, 98 p. : ill. (some col.) / The upper-crustal seismic-velocity structure of Newberry volcano, central Oregon, is imaged using P-wave travel time tomography. The inversion combines a densely-spaced seismic line collected in 2008 with two USGS seismic experiments from the 1980s. A high-velocity ring (7 km EW by 5 km NS) beneath the inner caldera faults suggests an intrusive ring complex 200 to 500 m thick. Within this ring shallow low velocities (<2 km depth) are interpreted as caldera fill and a subsided block. High velocities below 2 km depth could be intrusive complexes. There appears to be a low-velocity body at 3-6 km depth beneath the center of the volcano. This region is poorly resolved in the inversion because the ray paths bend around the low-velocity body. The 2008 data also recorded a secondary arrival that may be a delayed P-wave interacting with the low-velocity body. / Committee in charge: Emilie E.E. Hooft, Chairperson; Douglas R. Toomey, Member; Katharine V. Cashman, Member

155 pages / In the stratigraphic record of Camp Creek are episodes of fluvial scour and fill thousands of years old. Radiocarbon dates and the Mazama tephra, which serves as a stratigraphic time line, temporally bracket episodes of vertical aggradation and incision. Before 9000 years B.P. the valley floor was scoured to the Tertiary bedrock. Aggradation dominated since that time. Large cut-and-fill structures indicate that two periods of erosion occurred prior to incision of the modern arroyo. The first occurred before 6800 yr B.P. and the second occurred approximately 3000 years ago. The modern arroyo-channel flows at or near the Tertiary bedrock, is entrenched as much as nine meters in the valley-fill alluvium and is thought to have originated during the late 19th century.