Att vara närstående till en person i livets slutskede kan vara en stor påfrestning. Vid palliativ vård är det därför viktigt att inte enbart se patienten utan även de närstående och deras behov av omsorg och delaktighet. Palliativ vård är en helhetsvård som bygger på att lindra och stödja i livets slutskede. Syftet med denna uppsats är att beskriva vad närstående till patienter i den palliativa vården upplever som betydelsefullt i sjuksköterskans bemötande av de närstående.Uppsatsen är en litteraturstudie med kvalitativ innehållsanalys och omfattar vetenskapliga artiklar som har sökts via databaser Pubmed, Cinahl och Medline.Resultatet visar på att de närståendes bedömning av sjuksköterskan bygger på ett tredelat behov.  Behov av kommunikation – att ha en ständig dialog med sjuksköterskan och övrig vårdpersonal oavsett om det hänt något nytt eller ej. Behov av information – att ha en öppen och ärlig information om tillståndet av den vårdade och vad som kan förväntas hända härnäst. Behov av stöd till delaktighet – att bli sedd, hörd och lyssnad på som närstående i de tankar och funderingar som tynger som mest.Av resultatet framgår att sjuksköterskan bemötande karaktäriseras av att ge närstående korrekt information och stöd för att de närstående ska kunna känna delaktighet i omvårdnaden.Sjuksköterskan behöver skapa en öppen kommunikation med närstående för att kunna förstå vilken situation de närstående befinner sig i. Genom att uppmärksamma närståendes behov kan trygghet skapas hos de närstående. Om närståendes upplever trygghet och säkerhet kommer detta även att kunna smitta av sig till patienten vilket kan innebära att hon eller han kan får en bättre sista tid i livet. / Program: Sjuksköterskeutbildning

Os terminais intermodais operam com modos de transporte com diferentes capacidades, e podem constituir pontos de gargalo no sistema de transporte. O objetivo deste trabalho é avaliar a influência que as incertezas nos processos de chegadas causam no desempenho e no dimensionamento do terminal. Na investigação de hipótese adotou-se o método de simular as condições operacionais de um terminal onde existem dados da operação atual. Para isto, coletaram-se dados referentes aos processos de chegadas de barcaças e vagões a um terminal intermodal fluvial localizado na hidrovia Tietê-Paraná. A operação do terminal foi simulada utilizando o software ARENA, representando o período de 150 dias, correspondente a safra de soja. Concluiu-se que a variação estocástica nos processos de chegadas de barcaças e vagões possuem forte influência no desempenho do terminal, e que uma melhoria na gerência operacional desses processos pode representar ganhos consideráveis para os agentes envolvidos. / The difference in the arrival flow of cargo carried in vehicles of different loading capacities usually transform intermodal terminals into bottlenecks of the transportation system. The aim of this study is to evaluate the influence of the uncertainties in the sizing of an intermodal terminal. Data obtained from the observation of arrival process of barges and trains to a grain intermodal terminal located at Tietê-Paraná inland waterway is used in a case study. The operation of the terminal during the 150-day harvest period of oy beans is simulated using the ARENA software. It is concluded that the stochastic variation in the arrival process of bargers and trains have strong influence on the terminal performance, and that better management of these processes would provide considerable gains to all operation in the partners.

Shiga toxin (Stx) is a bacteriophage (phage)-encoded virulence factor of the Enterohaemorrhagic Escherichia coli (EHEC) O157:H7 implicated in the pathogenesis of renal tissue damage and bloody diarrhoea in human. Cattle are the main asymptomatic reservoir for EHEC O157:H7 with the lymphoid-follicle rich areas of the terminal rectum identified as the primary colonisation site. However, the significance of Stx during bovine intestinal colonisation by EHEC O157:H7 remains unclear with mixed findings described in published studies. The objective of this study was to investigate if Stx and the Stx-encoding phage significantly contribute to EHEC O157:H7 colonisation particularly at the bovine terminal rectum. The expression of Stx receptor, Globotrioasylceramide (Gb3) at the bovine terminal rectum was analysed by fluorescence microscopy, revealing a similar pattern of Gb3 detection in the bovine colon with scattered positive detections limited to sub-epithelial, mesenchymal-associated cells. Purified Stx2 treatment of Gb3+ and Gb3- epithelial cell lines for 6 to 18 hours produced no effect on the cell cycle and proliferation. CD3+/CD8+, CD3+/γδ+ and CD21+ cells were significantly different between calves infected with EHEC O157:H7 Strain 9000 (Stx2a+/Stx2c+) and the uninfected calves, but not in calves with Strain 10671 (Stx2c+). Stx did not interfere with IFN-gamma (IFN-γ)-activation of the JAK/STAT1 pathway in epithelial cells. Bovine EHEC O157:H7 strains isolated from Scottish cattle farms in the IPRAVE study (Phage type 21/28 and 32) were used for a series of bacterial phenotypic characterisation assays. Total Stx production, Verocytotoxicity, growth in a competitive environment, epithelial cell adherence and Galleria mellonella virulence assay were performed to compare the IPRAVE EHEC O157:H7 strains (PT21/28 and PT32) and the isogenic Stx-phage mutants. Stx levels produced by the bovine-originated EHEC O157:H7 strains were significantly lower than that of the human isolated strains. The absence of Gb3 on the bovine terminal rectal epithelium, the non-significant changes in the cell cycle along with the uninterrupted IFN-γ activation of the JAK/STAT1 pathway in intestinal epithelial cells and the minute quantities of Stx generated by EHEC O157:H7 bovine strains suggest that the toxin is not involved in colonisation directly, at least at the intestinal epithelial level. Although future work is required to explain the mechanisms underlying the observed EHEC O157:H7 phenotypic changes particularly in the Stx-phage mutant strains, the work done has proven that the Stx-encoding phage indeed has the ability to exert changes in the bacterial cell leading to changes in bacterial phenotypes, which in turn, might affect the colonisation of the bovine intestine.

The thesis deals with the topic of terminal value assessment in DCF models. Examining ten different techniques, the parameters behind, and the possible perils, its aim is to formulate the best practice for terminal value estimation. Afterwards, eleven of real business valuations are analyzed with the previously formulated best practice serving as a benchmark. Where possible, the impact of departures from the best practice on the estimated business value is quantified. The analysis confirms the hypothesis that practical terminal value assessments often diverge substantially from the best practice, which has a material impact on the resulting business value estimate.

Os terminais intermodais operam com modos de transporte com diferentes capacidades, e podem constituir pontos de gargalo no sistema de transporte. O objetivo deste trabalho é avaliar a influência que as incertezas nos processos de chegadas causam no desempenho e no dimensionamento do terminal. Na investigação de hipótese adotou-se o método de simular as condições operacionais de um terminal onde existem dados da operação atual. Para isto, coletaram-se dados referentes aos processos de chegadas de barcaças e vagões a um terminal intermodal fluvial localizado na hidrovia Tietê-Paraná. A operação do terminal foi simulada utilizando o software ARENA, representando o período de 150 dias, correspondente a safra de soja. Concluiu-se que a variação estocástica nos processos de chegadas de barcaças e vagões possuem forte influência no desempenho do terminal, e que uma melhoria na gerência operacional desses processos pode representar ganhos consideráveis para os agentes envolvidos. / The difference in the arrival flow of cargo carried in vehicles of different loading capacities usually transform intermodal terminals into bottlenecks of the transportation system. The aim of this study is to evaluate the influence of the uncertainties in the sizing of an intermodal terminal. Data obtained from the observation of arrival process of barges and trains to a grain intermodal terminal located at Tietê-Paraná inland waterway is used in a case study. The operation of the terminal during the 150-day harvest period of oy beans is simulated using the ARENA software. It is concluded that the stochastic variation in the arrival process of bargers and trains have strong influence on the terminal performance, and that better management of these processes would provide considerable gains to all operation in the partners.

Law, Wai Yan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 83-92). / Abstracts in English and Chinese. / ABSTRACT --- p.I / 論文摘要 --- p.II / TABLE OF CONTENTS --- p.III / Chapter CHAPTER 1 --- INTRODUCTION --- p.1 / Chapter CHAPTER 2 --- LISA SOWLE CAHILL´ةS THEOLOGICAL BACKGROUND --- p.5 / Chapter 2.1 --- Introduction --- p.5 / Chapter 2.2 --- Cahill´ةs theological approach to Christian Ethics --- p.5 / Chapter 2.2.1 --- Catholicism --- p.6 / Chapter 2.2.2 --- Feminism --- p.9 / Chapter 2.2.3 --- Theological Anthropology --- p.16 / Chapter 2.3 --- Moral Methodology --- p.21 / Chapter 2.3.1 --- The Bible --- p.21 / Chapter 2.3.2 --- Tradition --- p.22 / Chapter 2.3.3 --- Normative Accounts of the Human --- p.24 / Chapter 2.3.4 --- Descriptive Accounts of the Human --- p.25 / Chapter 2.4 --- Conclusion --- p.26 / Chapter CHAPTER 3 --- LISA SOWLE CAHILL´ةS PARTICIPATORY THEOLOGICAL BIOETHICS --- p.28 / Chapter 3.1 --- Introduction --- p.28 / Chapter 3.2 --- Cahill´ةs Participatory Theological Bioethics --- p.28 / Chapter 3.2.1 --- Principle of Analysis --- p.29 / Chapter 3.2.1.1 --- Ordinary and Extraordinary means of life support --- p.30 / Chapter 3.2.1.2 --- Principle of double effect --- p.31 / Chapter 3.2.2 --- The common good and bioethics --- p.34 / Chapter 3.2.3 --- Theological bioethics and Social Transformation --- p.38 / Chapter 3.2.4 --- Summary --- p.40 / Chapter 3.3 --- Evaluation and Dialogue with Cahill´ةs Participatory Theological Bioethics --- p.41 / Chapter 3.3.1 --- Catholicism --- p.41 / Chapter 3.3.2 --- Feminism --- p.42 / Chapter 3.3.3 --- Common Good --- p.44 / Chapter 3.4 --- Conclusion --- p.46 / Chapter CHAPTER 4 --- END-OF-LIFE CARE IN HONG KONG --- p.47 / Chapter 4.1 --- Introduction --- p.47 / Chapter 4.2 --- End-of-life care in Hong Kong --- p.48 / Chapter 4.2.1 --- Decline and dying in Hong Kong --- p.48 / Chapter 4.2.2 --- Ethical judgments by the health care professions --- p.50 / Chapter 4.2.3 --- Advance directive --- p.54 / Chapter 4.2.4 --- Patients or family´ةs participation --- p.54 / Chapter 4.2.5 --- Chinese culture and Bioethics --- p.56 / Chapter 4.3 --- Christianity engagement in the end-of-life care in Hong Kong --- p.59 / Chapter 4.3.1 --- Christian communities --- p.59 / Chapter 4.3.2 --- Theology bioethics --- p.60 / Chapter 4.4 --- Conclusion --- p.61 / Chapter CHAPTER 5 --- PARTICIPATORY THEOLOGICAL BIOETHICS IN HONG KONG --- p.63 / Chapter 5.1 --- Introduction --- p.63 / Chapter 5.2 --- The significance and relevance of Participatory Theological Bioethics --- p.63 / Chapter 5.2.1 --- Both individual and social ethics --- p.64 / Chapter 5.2.1.1 --- Who is/are the poor? --- p.64 / Chapter 5.2.1.2 --- Inequalities in access to end-of-life care --- p.66 / Chapter 5.2.1.3 --- Medical paternalism --- p.71 / Chapter 5.2.2 --- Transcendent meanings of life --- p.73 / Chapter 5.3 --- INTERCULTURAL DIALOGUE OF PARTICIPATORY THEOLOGICAL BIOETHICS --- p.74 / Chapter 5.3.1 --- Familial relationship as a starting point --- p.75 / Chapter 5.3.2 --- Interpretation of ´بParticipatory´ة --- p.76 / Chapter 5.4 --- Conclusion --- p.80 / Chapter CHAPTER 6 --- CONCLUSION --- p.81 / BIBLIOGRAPHY --- p.83

Este trabalho apresenta um método para calcular a localização de faltas em linhas de transmissão de alta tensão com três terminais. O método é baseado na utilização dos fasores de tensão e corrente trifásicos a 60 Hz, tomados nos terminais da linha e, faz uso da Transformada Discreta de Fourier (TDF) para flltragem digital das ondas. Subrotinas, como detecção da falta, sincronização dos dados provenientes dos diferentes terminais, extração dos fasores fundamentais e classificação da falta são também abordadas. O método é independente do tipo de falta e insensível às variações da impedância da fonte e a resistência de falta e também despreza a capacitância shunt da linha. A técnica proposta foi testada usando dados obtidos através de simulações do programa Alternative Transients Program (ATP), para uma variedade de condições, aplicando-se diversas localizações, resistências, ângulos de incidência e diferente tipos de faltas, a fim de cobrir as diversas situações comuns a uma linha de transmissão. Os resultados dos testes obtidos são apresentados e demonstraram um alto grau de precisão, destacando-se a confiabilidade e aplicabilidade do algoritmo proposto. / This work presents a method to calculate the fault location in three-terminal high voltage transmission lines. The method is based on the three-phase current and voltage 60 Hz phasors taken at the line terminals and it makes use of Discrete Fourier Transform (DFT) for digital filtering of the waves. Subroutines for fault detection, data synchronisation, extraction the fundamental phasors and fault classification are also described. The method is independent of fault type and insensitive to source impedance variation and fault resistance and totally ignores the lines shunt capacitance. The proposed technique was tested using data obtained through simulations of the Alternative Transients Program (ATP), for a variety of such as different location, fault resistance, inception angles and types of fault. The test results demonstrated a high degree of accuracy, reliability and applicability of the proposed algorithm.

No description available.

Tese de mestrado integrado. Engenharia Electrotécnica e de Computadores (Energia). Faculdade de Engenharia. Universidade do Porto. 2012

El cuidado de enfermería a sido influenciado por la idea de preservación de la vida, hemos respondido a nuestro deber ayudando al individuo a alejarse de la enfermedad, mediante la prevención, tratamiento y recuperación de la salud; Sin embargo no siempre los cuidados de enfermería, ni la atención médica logran restablecerla y la vida no logra mantenerse, siendo para estas situaciones necesario y oportuno ,conocer otros aspectos humanísticos y espirituales que puedan reforzar la actuación de enfermería, fundamental y acertada para brindar a los familiares y al propio paciente la comodidad, tranquilidad e integración familiar, en los momentos finales de su vida. La enfermería no debe de alejarse de la idea de humanismo e integralidad de la persona, y mucho menos en un momento tan espiritual como es la muerte, el apoyo al bien morir, sentir la muerte como una etapa que requiere nuestra atención y no como el final de la vida, el apoyo a la familia en el alivio de las aflicciones, son tareas que debemos de trabajar para el mejoramiento y fortalecimiento de enfermería como una ciencia basada en el humanismo y cientificidad. / -- The Nursing career is influenced by the idea of preservation of life, treatment of diseases and recovery of health, we respond to our duty helping the individual to move away from the disease by means of prevention, treatment and recovery of health; Nevertheless not always the nursing care nor the medical attention manage to restore it and the death is imminent, being for these situations necessary and opportune to know the humanistic and spirituals aspects that can reinforced our performance of nursing fundamental and guessed right to offer to the relatives and to the own patient the comfort, tranquility, and familiar integration in the final moments its life. Nursing does not move away of the idea of humanism and integral principles of the person, and much less in a while as spiritual as the death, giving support to the good to die, to feel the death like a stage that requires our attention and not like the end of the life. The support to the family in the lightening of the afflictions, are tasks that nurses must to work for the improvement and fortification of nursing as a science based on the humanism. / Tesis