No description available.

No description available.

Diss.--Psychologie--Saarbrücken, 1980. / Bibliogr. p. 117-122.

Objective: The Patient Self-Determination Act of 1990 (PSDA) protects a patient’s right to predetermine the level of life-supporting care they are willing to receive (U.S. Department of Health and Human Services, 1993). In Arizona, the advance directive (AD) complies with the PSDA and is used to guide care in the event of cardiopulmonary failure. The AD may indicate “do not resuscitate” (DNR), which prohibits cardiopulmonary resuscitation in the event of cardiac arrest. In the institution used for this project, a palliative care team assists with identifying goals of care and helps guide interventions consistent with the AD. The purpose of this Doctor of Nursing Practice (DNP) project was to complete a retrospective chart review and identify patients admitted to the medical intensive care unit (ICU) with a DNR as indicated by a copy of the AD in the electronic health record (EHR) and determine if they received a palliative care consultation. This information could support a quality improvement project led by the DNP-prepared AGACNP focused on ensuring a palliative care consultation within 48 hours of admission for patients admitted to the ICU with a DNR. Methods: A search of the EHR identified patients admitted to the medical ICU over a 12-month period. The EHR of patients admitted with a DNR were reviewed to determine if they received a palliative care consultation during the ICU stay and the patient’s final disposition. Findings: A total of 38 patients had an AD indicating DNR status on admission to the medical ICU. Of those patients, 26 (68.4%) received a palliative care consultation. Twelve patients (31.6%) with a DNR status on admission did not receive a palliative care consultation. Additionally, five patients with a DNR (13.16%) died in the ICU without receiving a palliative care consultation. Conclusion: Twelve patients with an AD indicating a DNR did not receive a palliative care consultation, and five of those patients died in the ICU. The findings from this project support a quality improvement project to implement palliative care consults to review goals of care for patients with a pre-existing AD indicating a DNR code status.

Water protection proves to be a difficult task, whether it is dealt with through legislation or the implementation of a process to reduce further pollution. This study considers how the issue of water pollution from nitrates in agricultural practices has become better understood through the reforms of the common agriculture policy (CAP) and the enactment of various regulations and directives by EU. The implementation of the EC Nitrate Directive is a main focus of this study because it was a major movement towards protecting water against pollution from agriculture, and an important step in implementing the Water Framework Directive. The implementation process is analyzed from both a formal and practical perspective, along with a discussion of the difficulties that arose in the implementation phase. There is a focus on the implementation of the Nitrate Directive in UK, with an emphasis on England as a case study. The study finds that if the distribution of responsibilities (planning, regulating, implementing, and reporting) is shared between national, regional and local bodies, the compliance with political regulations becomes easier. It is also concluded that rearrangements of the existing institutions are necessary to reduce costs, exchange new ideas that could translate to regulative ideas, and create an atmosphere of trust between regulators and implementers. It can be concluded from this study that, despite the traditional centralization of governments, England has taken several steps towards integrating institutions and has tried to be open and responsive to the local communities. Finally, there are several lessons that can be learned from the UK’s approach to control nitrate pollution, which are discussed and outlined in the conclusion of this study. / Water protection proves to be a difficult task, whether it is dealt with through legislation or the implementation of a process to reduce further pollution. This study considers how the issue of water pollution from nitrates in agricultural practices has become better understood through the reforms of the common agriculture policy (CAP) and the enactment of various regulations and directives by EU. The implementation of the EC Nitrate Directive is a main focus of this study because it was a major movement towards protecting water against pollution from agriculture, and an important step in implementing the Water Framework Directive. The implementation process is analyzed from both a formal and practical perspective, along with a discussion of the difficulties that arose in the implementation phase. There is a focus on the implementation of the Nitrate Directive in UK, with an emphasis on England as a case study. The study finds that if the distribution of responsibilities (planning, regulating, implementing, and reporting) is shared between national, regional and local bodies, the compliance with political regulations becomes easier. It is also concluded that rearrangements of the existing institutions are necessary to reduce costs, exchange new ideas that could translate to regulative ideas, and create an atmosphere of trust between regulators and implementers. It can be concluded from this study that, despite the traditional centralization of governments, England has taken several steps towards integrating institutions and has tried to be open and responsive to the local communities. Finally, there are several lessons that can be learned from the UK’s approach to control nitrate pollution, which are discussed and outlined in the conclusion of this study. / kungsmarksv'gen 105 371 44 karlskrona sweden

No description available.

The main object of this thesis is to summarize legal regulation about package tour in czech legal order, define and describe subject of this contractual relationship, define contracting parties and individual rights and duties that are being established at the beginning or during this contractual relationship. Basic concepts linked to the package tour contract as well as the role of travel agency in the whole process are being analysed in this thesis. I also focused on the most important changes connected with passing of the New Civil Code when individual provisions are examined and their significance is explained. Similarly as a legal ground of this contractual type the directive 90/314 EEC is also being examined. Finally, this thesis evaluates whether implementation of this directive to czech legal order has been done correctly and whether czech laws comply with the basic rules this directive is based on. The thesis is composed of nine chapters, each of them dedicated to individual issue. In the introduction I define basic objective of this thesis. The following chapter focuses on the basic definiton, purpose, basic concepts and character of this contractual relationship. In the third most comprehensive chapter I analyse concrete requirements of package tour contract, individual rights and duties...

No description available.

OMISSION OF EU's MEMBER STATES LEADING TO THE LIABILITY FOR DAMAGE RESUMÉ This thesis deals with the responsibility of the member states of EU for damages caused by failure of member states. Both problems are solved in this work, as general requirements for liability relationship, as description of these failures modes with numerous references to case law of the European Court of Justice. Indeed, case law represented a huge range of sources for this thesis. To sum up the work into several points, we can start by making a breakthrough in the issue of liability in the European Union which Francovich case meant. This case established the rule that it is the responsability of member states to implement EU law properly and in time and provide protection to the rights that follow these standards. This rule was followed by other cases which are called "the first generation of cases liability" by many authors. Typical liability sentence: unlawful act (caused by the EU's institution), the damage suffered by the other party and the causal nexus, was subsequently supplemented by the Schöppenstedt criterion, which established the rule that during the process of adopting EU's legislation must be sufficiently serious breach of the law standards, which serves to protect the individual. The last unification of the...

The Water Framework Directive (WFD, 2000/60/EC) was introduced in 2000. In implementing the WFD in Sweden expert knowledge in areas relating to the WFD was much needed resulting in establishment of national water management authorities, as the five water authorities, boarded in appointed county administrative boards across the country. As much noted in literature, uncertainties appear when implementing the WFD. Previous literature,with the exception of e.g. Raadgever et al (2011), Brugnach et al (2008) and Sigel et al (2007 and2010), has not put much focus on the types of uncertainty experienced by water management officials working with the implementation of the WFD on a daily basis. There are also few studies in Sweden, such as Gipperth & Elmgren (2010), Hammer et al (2011) and Entson & Gipperth(2010), touching upon the subject although not entirely focusing on practical experiences of uncertainty. Therefore, the aim of this study is to reveal the types of uncertainties experienced by water management officials from: SMHI, the county administrative board in Östergötland and Bothnia Bay, the water authority in the Southern Baltic Sea district, the Northern Baltic Sea and the North Sea, as well as the SEPA. In analysing the empirical data, six types of uncertainties emerged. They showed that water management officials experienced uncertainties in interpreting the WFD e.g. recommendation and manuals from supervisory authorities, measurement techniques, the typology of water bodies, what methods to use in e.g. assessments, knowing the effects of action programmes and lack of data ordata deficiency. In combating these uncertainties, the water management officials used communication as an strategy. Furthermore, responsibility in pointing out uncertainties and ways of reducing uncertainties was also seen as ways of handling uncertainties.