Introdução: Apesar dos recentes estudos, a sepse ainda é uma das mais importantes causas de hospitalização e morte nas Unidades de Terapia Intensiva (UTI). A equipe de enfermagem tem papel primordial no reconhecimento dos sinais e sintomas iniciais e acredita-se que a aferição dos sinais vitais de forma correta e completa, possa ser uma ferramenta simples, de baixo custo e não invasiva, para avaliar a predisposição a um desfecho de alta ou óbito nos pacientes sépticos em UTI. Objetivo: Avaliar a relação dos sinais vitais aferidos pela equipe enfermagem no momento do diagnóstico de sepse, com o desfecho clínico e com os scores MEWS e qSOFA. Métodos: Trata-se de um estudo com delineamento observacional, analítico que utilizou dados de fontes secundárias e o tratamento dos dados com abordagem metodológica quantitativa. Resultados: A média de idade dos pacientes foi de 56,4 anos e a maioria do sexo masculino, 53,4%. As doenças cardiovasculares ocuparam 43,1% das comorbidades existentes. O tempo médio de internação em UTI foi 8,0 dias e de internação hospitalar total de 29,6 dias e os pacientes sobreviventes permaneceram mais tempo internados tanto hospitalar quanto na UTI. A frequência cardíaca variou entre 38 e 162 bpm e foi observado que os pacientes que foram a óbito apresentavam-se mais taquicárdicos do que os sobreviventes. O desfecho de óbito ocupou mais de 70% dos casos analisados e após a aplicação dos escores qSOFA e MEWS não foi observado associação estatisticamente significativa entre eles e o desfecho (p=0,215). Conclusão: A aferição da frequência cardíaca no momento do diagnóstico de sepse pode ser utilizado como ferramenta efetiva, rápida, não invasiva e de baixo custo, para auxiliar no diagnóstico e predição de maior risco de óbito nos pacientes sépticos em UTI / Introduction: Despite recent studies, sepsis is still one of the most important causes of hospitalization and death in Intensive Care Units (ICUs). The nursing team has a primordial role in the recognition of the initial signs and symptoms and it is believed that the correct and complete measurement of the vital signs can be a simple, low-cost and non-invasive tool to evaluate the predisposition to an outcome discharge or death in septic patients in ICU. Objective: To evaluate the relationship of the vital signs measured by the nursing team at the moment of the diagnosis of sepsis, with the clinical outcome and the MEWS and qSOFA scores. Methods: This is a study with an observational, analytical design that used data from secondary sources and the treatment of the data with a quantitative methodological approach. Results: The mean age of the patients was 56.4 years and the majority of the males, 53.4%. Cardiovascular diseases accounted for 43.1% of the existing comorbidities. The mean ICU length of hospital stay was 8.0 days and total hospital stay was 29.6 days, and the surviving patients remained longer hospitalized both in the hospital and in the ICU. The heart rate varied between 38 and 162 bpm and it was observed that patients who died had more tachycardia than the survivors. The outcome of death was more than 70% of the cases analyzed and after the application of the qSOFA and MEWS scores, no statistically significant association between them and the outcome (p = 0.215) was observed. Conclusion: Heart rate measurement at the time of diagnosis of sepsis can be used as an effective, fast, non-invasive and low cost tool to assist in the diagnosis and prediction of a higher risk of death in septic patients in ICU

Introdução: Apesar dos recentes estudos, a sepse ainda é uma das mais importantes causas de hospitalização e morte nas Unidades de Terapia Intensiva (UTI). A equipe de enfermagem tem papel primordial no reconhecimento dos sinais e sintomas iniciais e acredita-se que a aferição dos sinais vitais de forma correta e completa, possa ser uma ferramenta simples, de baixo custo e não invasiva, para avaliar a predisposição a um desfecho de alta ou óbito nos pacientes sépticos em UTI. Objetivo: Avaliar a relação dos sinais vitais aferidos pela equipe enfermagem no momento do diagnóstico de sepse, com o desfecho clínico e com os scores MEWS e qSOFA. Métodos: Trata-se de um estudo com delineamento observacional, analítico que utilizou dados de fontes secundárias e o tratamento dos dados com abordagem metodológica quantitativa. Resultados: A média de idade dos pacientes foi de 56,4 anos e a maioria do sexo masculino, 53,4%. As doenças cardiovasculares ocuparam 43,1% das comorbidades existentes. O tempo médio de internação em UTI foi 8,0 dias e de internação hospitalar total de 29,6 dias e os pacientes sobreviventes permaneceram mais tempo internados tanto hospitalar quanto na UTI. A frequência cardíaca variou entre 38 e 162 bpm e foi observado que os pacientes que foram a óbito apresentavam-se mais taquicárdicos do que os sobreviventes. O desfecho de óbito ocupou mais de 70% dos casos analisados e após a aplicação dos escores qSOFA e MEWS não foi observado associação estatisticamente significativa entre eles e o desfecho (p=0,215). Conclusão: A aferição da frequência cardíaca no momento do diagnóstico de sepse pode ser utilizado como ferramenta efetiva, rápida, não invasiva e de baixo custo, para auxiliar no diagnóstico e predição de maior risco de óbito nos pacientes sépticos em UTI / Introduction: Despite recent studies, sepsis is still one of the most important causes of hospitalization and death in Intensive Care Units (ICUs). The nursing team has a primordial role in the recognition of the initial signs and symptoms and it is believed that the correct and complete measurement of the vital signs can be a simple, low-cost and non-invasive tool to evaluate the predisposition to an outcome discharge or death in septic patients in ICU. Objective: To evaluate the relationship of the vital signs measured by the nursing team at the moment of the diagnosis of sepsis, with the clinical outcome and the MEWS and qSOFA scores. Methods: This is a study with an observational, analytical design that used data from secondary sources and the treatment of the data with a quantitative methodological approach. Results: The mean age of the patients was 56.4 years and the majority of the males, 53.4%. Cardiovascular diseases accounted for 43.1% of the existing comorbidities. The mean ICU length of hospital stay was 8.0 days and total hospital stay was 29.6 days, and the surviving patients remained longer hospitalized both in the hospital and in the ICU. The heart rate varied between 38 and 162 bpm and it was observed that patients who died had more tachycardia than the survivors. The outcome of death was more than 70% of the cases analyzed and after the application of the qSOFA and MEWS scores, no statistically significant association between them and the outcome (p = 0.215) was observed. Conclusion: Heart rate measurement at the time of diagnosis of sepsis can be used as an effective, fast, non-invasive and low cost tool to assist in the diagnosis and prediction of a higher risk of death in septic patients in ICU

Thesis (M.A. (Industrial Sociology))--North-West University, Potchefstroom Campus, 2006.

Thesis (Ph. D.)--Kent State University, 2008. / Title from PDF t.p. (viewed Jan. 21, 2010). Advisor: Ralph Lorenz. Keywords: jazz, music, theory, George Macdonald, ballet, harmony, tertian, harmonics analysis, dissonance, consonance, orchestra. Includes bibliographical references (p. 130-140).

Project (D. Min.)--New Orleans Baptist Theological Seminary, 2008. / Abstract and vita. Includes final project proposal. Includes bibliographical references (leaves 137-144, 40-47).

Title from title page of PDF (University of Missouri--St. Louis, viewed February 23, 2010). Includes bibliographical references (p. 129-146).

The aim of this study was to describe and understand how individuals in adulthood experienced a childhood with neglect, and how they handled neglect. In order to reach the perspective of the individuals who grew up with neglect, we chose to use autobiographical books as our empirical material. The criteria the autobiographies had to meet in order to fall within the scope of this study was that the biographies had to display the experience of neglect during childhood, and thereto the books had to be written by individuals who themselves experienced neglect. Based on the aim of this study we sought answers to three questions: How do the individuals describe their upbringing with a mentally or socially disabled parent? How have the individuals coped with the neglect they’ve been exposed to? What consequences have the neglect supposedly led to? The findings of this study show that the extent to which the individuals experienced neglect were profound and comprising. Most prominent in the material was physical and mental abuse. For survival the individuals used different strategies to master the different situations they were subjected to. The strategies the individuals described were most often used to provide food, confirmation and to keep emotions in check. Furthermore the individuals described that the neglect and abuse led to various consequences, some that were prominent during childhood others not until the individuals reached adulthood.

South African organizations experienced more conflict in the past ten years because of all the changes in the management of labour relations. Employees at lower, middle and upper management levels within organizations are not well informed about the different types of conflict, the functionality and dysfunctionality of conflict, how conflict takes place within the different job-levels and how to manage and resolve it. Dysfunctional conflict can be destructive and it can affect the productivity of the organization. Because of the lack of knowledge regarding conflict within the steel organization and the necessity for it to be handled correctly, it was decided to seize the opportunity to contribute to the existing knowledge of conflict. Objectives of the study The major objectives of this study are as follows: To determine how literature conceptualizes conflict dynamics by examining theory, industrial sociology, organizational behaviour and general management. To determine the following aspects by means of an empirical study: - What the main reasons are for conflict within the steel organization. - How the handling of conflict differs among the middle and lower job levels within the organization. Research study and methodology The research study is divided into a theoretical and an empirical framework. Chapters 2, 3 and 4 outline the theoretical basis. Various aspects of conflict and handling or managing it are discussed in detail. The study employs the conflict theories of Ralph Dahrendorf and Karl Marx as points of departure, as found in chapter 2, in an attempt to provide a framework for the problem statement and to attempt the attainment of the set of objectives. This chapter discusses conflict and analyzes it as a social interaction characterized by force, strife and animosity. It also offers and analysis of Dahrendorf s and Marx's theories to determine their suitability to the study. Chapter 3 discusses conflict within a business context with reference to functional and dysfunctional conflict. different approaches to conflict. types of conflict, different reactions to conflict as well as its different stages. Chapter 4 addresses the course, handling and management of conflict by analyzing the conflict process while it keeps the theories of Marx and Dahrendorf in mind. Chapter 5 analyzes and describes the data and results found by means of empirical research according to specific statistical methods. The empirical study was conducted among the employees of a steel company. A standardised questionnaire and personal interviews were used. Major findings Chapter 6 consists of analysed information about the assembled data. The major findings of the study support the set of research objectives and prove all of them. Major findings include the following: Cooperation, discipline and communication are problem areas within the steel organization. A large number of employees show dissatisfaction about the nature and extent of their work. Some of the employees misuse their authority and this is a major cause of conflict. A total of 95% of the population show that they would like further training in the dynamics of conflict management. Half of the population show that they are unaware of any policies and procedures of conflict management in the steel company. Conclusion In conclusion as found in chapter 6 the study makes a number of recommendations centring on the training of employees to handle conflict and policy-making about conflict-handling and management. / Thesis (M.A. (Industrial Sociology))--North-West University, Potchefstroom Campus, 2006.

There is a need to determine the real reasons for conflict in the South African context. because it seems that the transformation process brought forth a reduction in work opportunities, workers losing their jobs, an increase in workplace violence, increasing dissatisfaction amongst workers, more strikes occuring, affirmative action, discrimination, recruitment of workers without the appropriate skills, corruption, workers who are too lazy to work, and professionals going overseas, etcetera. Personnel in the companies must be adequately informed about the nature of conflict, the causes of conflict, the types of conflict and the management of conflict, because conflict is increasing and it must be managed correctly otherwise it will be destructive and inhibit the functioning of a company. The objectives of the research study are as follows: a) To determine how conflict dynamics are conceptualised in literature through the application of industrial sociological theories, organizational principles and general management theories. b) To determine the main sources of conflict within the Engineering Company. c) To determine if personnel on the horizontal and vertical levels in the Engineering Company are influenced differently by conflict. d) To determine if there is a significant difference between the personnel in the Engineering Company in the manner in which they handle conflict with their superior and subordinates. The research study consists of a theoretical and an empirical framework. Chapter 1 covers the introduction, problem statement, the method and purpose of the research, and the description of relevant terms. In Chapter 2, the philosophies of Georg Friedrich Hegel and Immanuel Kant, and the theories of Karl Marx and Max Weber are used to serve as a basis on which the study can be built. In Chapter 3, the nature of conflict is discussed in terms of the following types of conflict: interpersonal conflict, intrapersonal conflict, intergroup conflict, and intragroup conflict. The management of the different types of conflict is also discussed. Chapter 3 covers the empirical data of the research, and the empirical research results of the study. The most important results of this study and recommendations are given in Chapter 5. / Thesis (M.A. (Industrial Sociology))--North-West University, Potchefstroom Campus, 2006

Doctor of Philosophy(PhD) / Atherosclerosis manifests a state of increased oxidative stress characterized by comparable lipid and protein oxidation in the affected arterial wall. While oxidative modification of low density lipoprotein (LDL) has been extensively studied, increasing attention has been focused recently on oxidation of high-density lipoproteins (HDL) and its functional consequences in relation to atherosclerosis. Oxidative modification is thought to generate “dysfunctional” HDL that has lost anti-atherosclerotic activities, including the ability to remove cholesterol from lipid-laden cells. Therefore, there has been much interest in the detection of oxidized HDL. Unfortunately, available methods to detect oxidized HDL are limited at present, in part because oxidative modification of HDL is a complex process and ‘oxidized HDL’ is not a chemically defined entity. What is known however is that conversion of methionine (Met) residues of apolipoprotein (apo) A-I to methionine sulfoxide (MetO) is a process that occurs commonly as HDL undergoes oxidative modification. For example, human apoA-I+16 (containing MetO86 or MetO112) and apoA-I+32 (MetO86 plus MetO112) are generated when apoA-I reacts with lipid hydroperoxides formed as a consequence of the lipoprotein being exposed to 1e−oxidants. The formation of MetO in apoA−I induced by 2e−oxidants (i.e., hydrogen peroxide, hypochlorous acid or myeloperoxidase/hydrogen peroxide/chloride system) is associated with an impaired ability of the apolipoprotein to facilitate reactions relevant to reverse cholesterol transport. In addition, a previous study has suggested the plasma content of apoA-I+32 to be increased in certain subjects that have an increased risk to develop cardiovascular disease (CVD). Moreover, the MetO content in circulating, HDL−associated apoA−I is elevated in type 1 diabetes, a disorder commonly associated with increased oxidative stress and a risk factor for atherosclerosis. Therefore, in the present study, an existing HPLC method was applied to HDL samples from the Fletcher−Challenge study, a nested case control study, to test the potential usefulness of MetO-containing apoA-I as a marker of oxidative stress and/or CVD in a general population. Plasma samples whose HDL contained detectable apoA-I+16 and/or apoA-I+32 had significantly elevated levels of F2-isoprostanes, a marker of in vivo lipid oxidation, consistent with MetO-containing apoA-I being a useful marker of in vivo protein oxidation. Despite this however, there was no significant difference between controls and cases in their concentrations of HDL apoA-I+16 and apoA-I+32 or F2-isoprostanes, suggesting that markers of protein and lipid oxidation are not associated with the risk of coronary heart disease (CHD) in this general population. A limitation of the Fletcher−Challenge study was that only 22% of the 534 HDL samples analyzed contained apoA-I+16 and/or apoA-I+32. In addition, the HPLC−based method used is expensive and time−consuming and may lack the sensitivity needed for apolipoproteins to clinical studies. Thus, a mouse monoclonal anti-human apoA-I+32 antibody (MOA−1) was raised using HPLC−purified apoA-I+32 as immunogen. A sensitive ELISA was then developed using a commercial anti-human apoA-I monoclonal antibody as capture and biotinylated MOA−1 as detection antibody, respectively. The assay detected lipid−free HPLC−purified human apoA-I+32 in a concentration-dependent manner and with a significantly lower limit of detection (i.e., 3 ng/mL) than the HPLC method (1 μg/mL). The ELISA also detected lipid-free apoA-I modified by 2e-oxidants (hydrogen peroxide, hypochlorous acid, peroxynitrite), and HDL oxidized by 1e- or 2e-oxidants and present in buffer or human plasma. Moreover, the extent of recognition of MetO by MOA−1 increased with increasing numbers of MetO in apoA−I, as assessed by the experiments with H2O2−oxidized forms of apoA−I mutants, in which one, two or three Met residues were replaced with Leu. Their detection was concentration-dependent, reproducible, and exhibited a linear response over a physiologically plausible range of concentrations of oxidized HDL. In contrast, MOA-I failed to recognize native apoA-I, native apoA-II, apoA-I modified by hydroxyl radicals or metal ions, or LDL modified by 2e-oxidants. Furthermore, MOA−1 did not detect other Met−containing proteins oxidized by either hypochlorous acid or hydrogen peroxide. Taken together, the results showed that recognition of oxidized proteins by MOA−1 is limited to MetO contained in apoA−I. Finally, in a pilot study, plasma samples obtained from subjects with coronary artery disease (CAD) proven by angiography, and samples from CAD patients undergoing percutaneous coronary intervention (PCI) were analyzed by the ELISA. The preliminary data obtained showed elevated levels of MetO-containing apoA-I in plasma samples of CAD patients compared to those of corresponding control subjects. Unexpectedly, levels of MetOcontaining apoA-I decreased PCI compared to before PCI. A possible explanation for these results is that HDL−associated apoA−I become displaced by acute phase proteins, such as serum amyloid A, in response to PCI. In summary, the ELISA developed here specifically detects apoA-I containing MetO in HDL and human plasma. As such it may provide a useful tool for investigating the relationship between oxidized HDL and CAD.