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Patienters upplevelse av palliativ vård : En litteraturstudie / Patients' experience of palliative care : A literature studyGrahn, Madelene, Sjöberg, Ann-Christine January 2022 (has links)
Abstract Bakgrund: Den palliativa vården omfattar alla åldrar och en mängd olika sjukdomar och tillstånd som slutligen leder till döden. Syftet med palliativ vård är att minska lidande och värna om patientens värdighet och livskvalitet. Det finns få studier som beskriver patienters upplevelser av palliativ vård. Syfte: att beskriva patienters upplevelse av palliativ vård. Metod: En litteraturstudie med kvalitativ induktiv ansats genomfördes. Litteratursökningen utfördes systematiskt där 10 artiklar inkluderades utifrån syftet. Kvalitativ innehållsanalys med manifest ansats enligt Graneheim och Lundmans metod användes för att analysera patienters upplevelse av palliativ vård. Resultat: Analysen resulterade i fyra kategorier som beskriver patienters upplevelse av palliativ vård. Bli sedd som en person med värdighet; Uppleva trygghet vid val av behandling och lindring av symtom; Behöva vänta på vården du är beroende av; Känslan av förlorad kontroll vid brist på information och kontinuitet. Slutsats: Patienter upplevde behov av att bli bemött med vänlighet och empati. Den palliativa diagnosen medför att tid får en annan betydelse. Det fanns ett behov av samordning av vården för att inte slösa på tid. Information och delaktighet minskade oro och ångest. Fundamentals of Care kan stödja sjuksköterskan vid personcentrerat förhållningssätt för att främja patienters delaktighet i vården.
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Hur patientens omvårdnadsbehov uppmärksammas i patientjournalen på en akutmottagning. Journalgranskning med stöd av CAT-CH-ING©Grönberg Sandin, Fanni, Wengström Nymark, Helena January 2022 (has links)
Inledning: Omvårdnaden är kulturellt lågprioriterad inom akutsjukvården vilket bland annat framkommer i patientens negativa upplevelse av akutmottagningsbesök. Bakgrund: Konsekvenserna av bristfälligt utförd omvårdnad är att patientens oro för sitt hälsotillstånd kvarstår efter ett akutmottagningsbesök. Därutöver relaterar utebliven omvårdnad till ökad förekomst av patientrelaterade skador liksom dödlighet. För att på ett strukturerat sätt identifiera patientens omvårdnadsbehov tillämpar sjuksköterskan metodologi enligt omvårdnadsprocessen. Detta sker såväl i det kliniska arbetet som i dokumentationen. Få studier kring hur patientens omvårdnadsbehov uppmärksammas på en akutmottagning har baserats på innehåll från patientjournaler. Syfte: Syftet var att granska hur patientens omvårdnadsbehov uppmärksammades i omvårdnadsdokumentationen på en akutmottagning. Metod: Studien använde en retrospektiv design för journalgranskning med stöd av Cat-ch-Ing©. Resultat: De kvantitativa aspekterna av sjuksköterskans dokumentation fick över lag högre medelpoäng (M17 av max 30) jämfört med de kvalitativa (M =12 av max 29). Högst fokus lades på beskrivning av patientens anamnes, såväl kvantitativt som kvalitativt (M 2,32 respektive M 2,22 av max 3). Däremot var den kvalitativa dokumentationen för omvårdnadsdiagnos, vilken är grunden för mål med omvårdnaden, torftig (M 0,90). För patienter >64 år var dokumentationen av signifikant högre kvalitet (M 12,67 av max 29) än för patienter 18 - 64 år (M 11,06). Det var också i gruppen >64 år som vårdtiden var signifikant längre. Diskussion: Journalgranskningen visade hur sjuksköterskan vid initiala bedömningssituationer i hög grad beskrev patientens såväl oberoende som beroende omvårdnadsproblem. Däremot uteblev omvårdnadsdiagnostiska analyser varpå fokus vad gällde patientens vårdbehov hamnade på den medicinskt beroende omvårdnaden. Patientrelaterade faktorer som ålder likaväl som vårdtid kan ha betydelse för kvaliteten på omvårdnadsdokumentationen. Sjuksköterskans kunskap om omvårdnadsdiagnostisering kan vara bristfällig, men journalstruktur med låg anpassning till omvårdnadsbedömning för kortare vårdtider på akutmottagningar begränsar möjligheterna att förtydliga patientens omvårdnadsbehov. Slutsats: Omvårdnadsjournalens struktur har sannolikt omfattande betydelse för hur patientens integrerade omvårdnadsbehov uppmärksammas under vårdtiden på en akutmottagning. Journaluppbyggnad med kvantitativ inriktning bidrar till att främsta fokus vad avser omvårdnadsdokumentation hamnar på patientens medicinska beroende omvårdnadsbehov.
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Fundamentals of care och sepsis : en litteraturöversikt om omvårdnadsåtgärder vid sepsis / Fundamentals of care and sepsis : a literature review on nursing interventions in sepsisSvanteson, Elin, Söderkvist, Helene January 2024 (has links)
Sepsis är ett globalt folkhälsoproblem som varje år skördar fler liv än cancer, närmare 11 miljoner. Vem som helst kan drabbas av sepsis men yngre och äldre personer löper en ökad risk. Inom loppet av några timmar kan en tidigare fullt frisk person insjukna och dö. Patienter med sepsis kräver många gånger avancerad sjukvård och långa vårdtider. Författarna till denna litteraturöversikt är intresserade av att undersöka vilka initiala omvårdnadsåtgärder patienter med sepsis får. Litteraturen tyder på att tillståndet är tidskritiskt och att patienten behöver träffa en erfaren sjuksköterska med goda kunskaper om sepsis för att få adekvat behandling så tidigt som möjligt. Syftet med litteraturöversikten var att beskriva initiala omvårdnadsåtgärder utifrån Fundamentals of Care hos patienter med sepsis. Metoden som användes var en litteraturöversikt med en systematisk ansats för att skapa en överblick över det aktuella kunskapsläget inom området. Totalt inkluderades 16 artiklar med kvalitativ och kvantitativ design från databaserna CINAHL och PubMed som kvalitetsgranskades utifrån Sophiahemmet Högskolas modifierade bedömningsunderlag. Resultatet delades in i tre kategorier; vårdrelationen, patientens grundläggande behov samt vårdkontexten och visade att patienter som träffar en sjuksköterska med kunskap och erfarenhet av sepsis får adekvat behandling i ett tidigare skede. Sjuksköterskans arbete underlättas av screeningverktyg och tydliga rutiner. Kommunikationen i teamet är avgörande för att rätt vård ska kunna ges, vilket i sin tur minskar risken för komplikationer och ökar patientens möjligheter att överleva. Slutsatsen är att patienten som drabbas av sepsis är i behov av omfattande omvårdnad. Patienten behöver skapa en vårdrelation med ett multiprofessionellt team som arbetar tillsammans med hjälp av screeningverktyg och tydliga rutiner för att förbättra chansen att överleva. / Sepsis is a global public health problem that claims more lives every year than cancer, nearly 11 million. Anyone can get sepsis, but younger and older people are at increased risk. Within a few hours, a previously perfectly healthy person can fall ill and die. The patient with sepsis often requires advanced medical care and long periods of care. The authors of the literature review are interested in investigating which initial nursing measures patients with sepsis receive. The literature indicates that the condition is time-critical and that the patient needs to see an experienced nurse with good knowledge of sepsis and receive adequate treatment as early as possible. The purpose of the literature review was to describe initial nursing measures based on the Fundamentals of Care in patients with sepsis. The method used was a literature review with a systematic approach to create an overview of the current state of knowledge in the field. A total of 16 articles with a qualitative and quantitative design from the CINAHL and PubMed databases were included, which were quality reviewed based on Sophiahemmet University's modified assessment documents. The results were divided into three categories; the care relationship, the patient's basic needs and the care context and showed that patients who see a nurse with knowledge and experience of sepsis receive adequate treatment at an earlier stage. The nurse's work is facilitated by screening tools and clear routines. Communication in the team is crucial for the right care to be provided, which in turn reduces the risk of complications and increases the patient's chances of survival. The conclusion is that the patient suffering from sepsis is in need of extensive nursing care. The patient needs to create a care relationship with a multiprofessional team that works together using screening tools and clear procedures to improve the chance of survival.
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Fundamentals in NatureQuam, Andrea 07 May 2008 (has links)
This project explores innovative methodologies for design education. It is an investigation of teaching design fundamentals in an outdoor classroom.
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Predikce realitních cyklů : případová studie trhu kancelářských prostor v České republice / Forecasting models of office capitalization rate in the Czech RepublicZelenka, Radek January 2011 (has links)
The presented study describes commercial real estate markets with focus on office sector. We identify the capitalization rate (investment yield) as one of the fundamental elements in the commercial property valuation. Based on historical office investment yield observations and various econometric models we predict the office capitalization rate development in the Czech Republic. We use data of the United Kingdom, Ireland and Sweden to identify common yield trend especially with respect to their real estate crises in 1990s that embody features similar to the real estate crisis in 2008-2010. As explanatory variables for the econometric models (ARIMA, OLS, VAR) we use financial and macroeconomic variables. We use the OLS models to identify the optimal set of explanatory variables, to be applied in VAR models. On dataset of the comparable countries we compare the goodness of fit of the VAR and ARIMA models. The best variants are then used for the prediction of the Czech office yield. Lastly, we improve our results by implementing exogenous forecasts of macroeconomic variables used in the models. Majority of our predictions forecast a slow decrease of the capitalization rate in next two years (2010-2012) in the magnitude of 0.25% - 1% (to 6.25%-6%).
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Fundamentos da exploração de petróleo e gás natural e análise geoeconômica da matriz energética brasileira atual e projeções futuras / Fundamentals of oil and natural gas exploration, geo-economic analysis of the current Brasilian energy matrix and future projectionsSirlei Aparecida de Oliveira 28 February 2011 (has links)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A análise da matriz energética mundial, assim como a brasileira, nos mostra que o gás natural representará em breve um importante insumo energético favorecendo a balança de pagamentos nacional, visto que o gás poderá ser usado tanto para consumo interno, quanto para exportação. O aumento das reservas nacionais de hidrocarbonetos se deve ao desenvolvimento de tecnologias, que favoreceram o conhecimento das bacias brasileiras quanto ao seu potencial produtor de combustíveis fósseis, permitindo a descoberta de novas jazidas. O amadurecimento do mercado nacional quanto ao consumo de gás natural passa pela construção de uma infraestrutura robusta, eficiente e que possibilite a captação, o armazenamento e distribuição do mesmo. O Brasil tem todos os requisitos necessários para adentrar ao seleto grupo de países exportadores de hidrocarbonetos, a descoberta do Pré-sal tende a incrementar a importância do gás natural para o país. Ao final do trabalho são descritos cenários futuros (quanto o consumo de energéticos), onde se vê que o consumo de energia para os próximos anos crescerá a taxas superiores as das duas últimas décadas. Análise destes cenários permite antecipar o interesse de futuros investimentos no desenvolvimento do conhecimento geológico para áreas promissoras. / The analysis of global energy matrix, as well as Brazilian, shows that natural gas will soon represent an important source of energy promoting the national balance of payments, since the gas would be used for domestic consumption and export. The increase in national reserves of oil due to the development of technologies that promote knowledge of the brazilian basins as the potential producer of fossil fuels, allowing the discovery of new deposits. The maturing of the domestic market as the consumption of natural gas involves the construction of a robust infrastructure, efficient and enabling the capture, storage and distribution of the product. Brazil has all the necessary requirements to enter the select group of oil exporting countries, the discovery of pre-salt tends to increase the importance of natural gas to the country. At the end of the paper described future scenarios (about the consumption of energy), where we can see that the energy consumption for the coming years will increase faster than the last two decades. Analysis of these scenarios let anticipate the interest of future investments in the development of geological knowledge to promising areas.
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Dinâmica da taxa de câmbio no Brasil de 2004 a 2012: efeitos da crise econômico-financeira internacional de 2008 / Brazilian foreign exchange rate dynamics from 2004 to 2012: effects of the international economic and financial crisis of 2008Oliveira, Jayane Pereira de 15 April 2014 (has links)
O presente trabalho teve por objetivo investigar se há evidências de que o regime de política cambial brasileiro teria se alterado no pós-crise econômico-financeira internacional de 2008, além de captar insights acerca da eficácia dos instrumentos de intervenção recentemente aplicados sobre o mercado de moedas e acerca do poder explicativo dos fundamentos da taxa de câmbio. Três fatos estilizados do mercado de câmbio brasileiro incitam essa investigação. O primeiro deles encontra-se no histórico de mudanças de regime cambial do Brasil e das demais economias emergentes, as quais geralmente têm ocorrido em momentos de crises internacionais por impossibilidade dos governos em sustentar o regime vigente. O segundo assenta-se na dinâmica recente do real cuja variação tem se descolado da dinâmica das demais moedas commodities currencies. Por fim, o terceiro ponto está nas inovações recentes em política de intervenção das autoridades monetárias e fiscais visando à gestão da cotação da moeda com medidas tais como as modificações das alíquotas do IOF sobre operações cambiais. Para o alcance dos objetivos foi utilizado o modelo Markov Switching desenvolvido por Hamilton (1989) aplicado ao modelo estrutural de curto prazo para taxa de câmbio, no qual foram consideradas como variáveis explicativas os fundamentos e as intervenções na taxa de câmbio descritas na literatura atual. O modelo foi estimado com ambas as variáveis sujeitas a estados não observáveis, cujas probabilidades de ocorrência são geradas por um processo markoviano. Como resultado foi identificado que não há evidências representativas de modificação na dinâmica da taxa de câmbio no pós-crise que conduzam a interpretação de alteração no regime de política cambial adotado pelo Brasil. Verificou-se também que as intervenções das autoridades monetárias e fiscais não obtiveram eficácia em gerir ou direcionar a variação ou nível da moeda. Ademais, a aplicação do modelo de mudança de regime na série da taxa de câmbio permitiu compreender a sua dinâmica no período recente e o modo como os fundamentos e intervenção perdem e ganham influência na determinação da cotação ao longo dos ciclos da moeda. / This study seeks evidences of changes in the Brazilian foreign exchange rate regime after the international economic and financial crisis of 2008. Furthermore, captures insights on the effectiveness of the intervention measures recently applied on the currency market and the explanatory power of the fundamentals of exchange rates. Three particular facts of the Brazilian foreign exchange market stimulated this research. First, the historical changes of foreign exchange rate regimes in Brazil and other emerging economies. Generally, it has occurred in times of international crises due to the failure of governments to sustain the regime. Second, recent deviation of the Real, which has been detached from the dynamics of other commodities currencies. Finally, the third fact is the recent innovations on monetary and fiscal intervention policies by authorities in order to manage currency value, such as adjustments of IOF on foreign exchange transactions. This investigation uses Markov switching model, developed by Hamilton (1989), applied to the structural model for short-term exchange rate, considering the fundamentals and interventions on the exchange rate described in the current literature as explanatory variables. The model was estimated with both variables subjected to unobservable states, whose probabilities of occurrence are generated by a Markov process. As result, there is no significant evidence of changes in the dynamic of exchange rate in the post-crisis that explains changes in foreign exchange rate regimes adopted by Brazil. The intervention by monetary authorities was not efficient in managing or guiding the dynamic of foreign exchange rate. In addition, the application of the Markov switching model in the foreign exchange rate series allowed understanding the dynamics in recent periods and how fundamentals and interventions loses and gain influence in determining prices throughout the currency cycles.
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Fundamentals of Theatrical Design: A Guide to the Basics of Scenic, Costume, and Lighting DesignBrewster, Karen, Shafer, Melissa 01 January 2011 (has links)
Script analysis for designers -- The objectives of theatrical design -- Researching the design -- Collaboration -- Design elements -- Design principles and visual composition -- Scenic design -- Costume design -- Lighting design -- Building a career in theater design.
With clear and concise examples and hands-on exercises, Fundamentals of Theatrical Design illustrates the way in which the three major areas of theatrical design--scenery, costumes, and lighting--are intrinsically linked. Veteran theater designers Karen Brewster and Melissa Shafer have consulted with a broad range of seasoned theater industry professionals--playwrights, actors, directors, producers, stage managers--to provide an exhaustive guide full of sound advice and insightful approaches to design. Form beginning designers just starting out to experienced directors looking to gain exposure and advance their careers, anyone with an interest in theatrical design is sure to appreciate this book's unique approach. / https://dc.etsu.edu/etsu_books/1005/thumbnail.jpg
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Les contrats et les droits fondamentaux : perspective franco-québécoise / Contracts and fundamental rightsTorres-Ceyte, Jérémie 31 March 2016 (has links)
La rencontre entre les contrats et les droits fondamentaux est au centre de très nombreux débats juridiques contemporains : qu’il s’agisse notamment de la place du fait religieux dans la société, de la marchandisation du corps humain, ou encore du respect de la dignité de la personne. Cette rencontre stimule la réflexion de nombreux juristes, le sens de l’étude est de contribuer modestement à celle-ci dans la perspective d’une comparaison entre les droits français et québécois.On peut alors observer que l’exigence de respect des droits fondamentaux dans les contrats progresse dans les deux systèmes. En premier lieu, parce que nos droits font une place de plus en plus grande aux instruments de protection des droits fondamentaux, leur autorité s’impose en matière contractuelle. Ensuite, il faut remarquer que l’autorité des droits fondamentaux n’épuise pas leurs effets dans ce domaine. Ils rayonnent dans les contrats, car de relecture en réécriture les droits français et québécois des contrats sont de plus en plus imprégnés par l’exigence de respect des droits fondamentaux. Toutefois, en France et au Québec, à cette progression répond la nécessité de permettre l’inscription sociale des droits fondamentaux. On voit alors que le pouvoir sur les droits fondamentaux dans les contrats s’affirme, et que de contrat médical en contrat de travail, il devient incontournable pour permettre leur exercice. Toutefois, la dangerosité inhérente du pouvoir sur les droits fondamentaux justifie une réflexion sur les limites qui peuvent lui être assigné, à la fois en considération du respect de la dignité de la personne, mais également en considération de sa légitimité / The meeting of contract law with fundamental rights is at the center of numerous contemporary legal debates, notably with regard to the place of the religious in society, the commodification of the body, or respect for human dignity. This encounter has prodded a reflection from numerous jurists. The aim of this study is to bring a modest contribution to the discussion, through a comparison of French and Québec law. The exigencies of respect for fundamental rights is evolving in the two legal systems. Because fundamental rights instruments play a larger role in our laws, their authority in contractual matters is becoming ineludible. Indeed, it should be noted that fundamental rights have not reached their full extent in this field. They emerge within contracts, because from revisiting to re-writing, Québec and French contract law are increasingly influenced by the obligation to comply with fundamental rights.However, this evolution in France and in Quebec is accompanied by a requirement that fundamental rights be allowed social admission. From that point on, we can see power over fundamental rights being asserted within contacts, that power evolving from medical contracts to work contracts towards becoming inescapable for their enforcement. Yet, the danger inherent in such power over fundamental rights calls for serious deliberations on the limits that must be set upon it, both with regard to the dignity of the human person, and in relation to its legitimacy
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Exploring the relationship between market values and accounting numbers of firms listed in an emerging market.Suwardi, Eko January 2004 (has links)
Studies of the relationship between market values and accounting numbers have long been a part of an established theme in capital markets research (CMR). These studies have taken various forms, most being conducted on a cross sectional basis, tied closely with the assumptions of equilibrium behaviour and efficient markets. Explanatory variables for market value have been dominated by firm-specific variables without incorporating macroeconomic variables. Recently, however, some studies have employed macroeconomic variables and dynamic specification in assessing the relationship between market values and accounting numbers (e.g. Bilson et al. 2001, Nissim and Penman, 2003, and Willett, 2003). The objective of this thesis is to investigate the nature of the relationship between share prices and accounting numbers on the Jakarta Stock Exchange for the period 1992-2002, using dynamic modelling principles in addition to the more usual cross sectional analysis. The approach to regression modelling (general-to-specific strategy)incorporated in this thesis relies less heavily than most CMR on prior economic theories of equilibrium behaviour. Apart from these novel aspects of approach and method, the study also provides valuable information about the emerging financial markets of Indonesia. The results of this thesis show that cointegration and the accompanying equilibrium correction relationship between market and book values for firms listed on the Jakarta Stock Exchange (JSX) can often be identified using accounting and macroeconomic regressors. The models are typically more informative, plausible and consistent than cross sectional models and are useful in interpreting the context in which the market to book relationship exists in Indonesia. A possibly surprising result is that in Indonesia, compared to similar models estimated using US data, the book value of net assets seems to have a stronger relationship with market value. This may be a function of the relative importance of financial statements as a source of information on the JSX.
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