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De närståendes resa mot att släppa taget : En litteraturstudie om närståendes upplevelser inom den palliativa vårdenBengtsson, Helena, Hörnqvist, IngaLill January 2009 (has links)
Background: People who is close to patients suffering from incurable diseases experiences both suffering and grief. It is hard to be there for someone and at the same time handle your own grief. This can create feeling of anxiety, stress and guilt. Problem: Near related persons might not accept the further loss of someone near, the hope remains until it is final. They may not know the whole width of the situation, not acknowledge to the patient or himself how it is going to end. Aim: The aim with the literature study was to describe close ones experiences of suffering and grief within the palliative care. Method: The study is a qualitative analysis of autobiographies written by people close to patients in the palliative care. Result: The study shows how close ones can be spared suffering and grief through kind treatment and empathic personnel. The result shows a great individual dissemination when feelings are to be worked trough and grief gets to the surface and is accepted. Conclusion: To be close to someone in the end of his or her life wakes hard and irrational feelings and thoughts in people. To handle your own experiences and feelings is difficult. To support these persons due to their individual needs is a crucial part in reducing there suffering. / Bakgrund: Närstående till patienter med en obotlig sjukdom som leder till döden upplever både lidande och sorg. Att vara till för någon som skall dö samtidigt som man bearbetar sin egen sorg kan skapa känslor av oro, stress och skuldkänslor. Problem: Närstående vill kanske inte acceptera den kommande förlusten av någon som står en nära, hoppet finns kvar in i det sista. De kanske inte kan förstå hela vidden av situationen, inte erkänna för den sjuke eller sig själva hur det kommer att sluta. Syfte: Syftet med litteraturstudien var att beskriva närståendes upplevelser av lidande och sorg inom den palliativa vården. Metod: Studien är en kvalitativ analys av självbiografier författade av närstående inom den palliativa vården. Resultat: Studien visar på hur närstående kan besparas lidande genom gott bemötande och empatisk personal. Resultatet visar på en stor individuell spridning när känslor skall bearbetas och sorg komma upp till ytan och accepteras. Slutsats: Att vara närstående till någon i livets slutskede väcker svåra och irrationella känslor och tankar hos människor. Att hantera sina egna upplevelser och känslor är svårt. Att stödja dessa personer utifrån individuella behov har en avgörande roll för reducering av deras lidande.
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Sportuojančių ir nesportuojančių suaugusiųjų gyvensena ir sveikatos būklė / The life style and the health condition of athletic and non-athletic adultsPetraitytė, Dovilė 18 June 2008 (has links)
Sveikata priklauso nuo gyvensenos veiksnių, gyvenimo būdo, kuris įtakoja mūsų sveikatą. Norėdami džiaugtis gera sveikata, pirmiausia turime patys pradėti analizuoti savo gyvenimo būdą, pradedant nuo mitybos, žalingų įproči�� mažinimo, fizinio pasyvumo keitimą į fizinį aktyvumą, stresinių situacijų vengimo.
Tyrimo objektas: gyvensena.
Tyrimo tikslas: Nustatyti sportuojančių ir nesportuojančių suaugusiųjų gyvensenos ypatumus ir sveikatos būklę.
Tyrimo uždaviniai:
1. Nustatyti nesportuojančių žmonių gyvensenos ypatumus ir subjektyvų sveikatos vertinimą
2. Nustatyti sportuojančių žmonių gyvensenos ypatumus ir subjektyvų sveikatos vertinimą
3. Palyginti sportuojančių ir nesportuojančių žmonių gyvensenos ypatumus ir sveikatos būklę
Tyrimas buvo atliktas 2006 – 2007 metais. Anketinės apklausos metodu buvo tiriamas žmonių požiūris į sveiką gyvenseną. Siekiant išsiaiškinti tiriamųjų požiūrį į fizinį aktyvumą, mitybą, žalingus įpročius, stresą buvo pateikta anketa, kurią sudarė 36 klausimai.Tyrime dalyvavo 273 žmonės, iš jų 100 vyrų, 173 moterys. Tiriamieji buvo suskirstyti į dvi grupes, sportuojančius (n=145), kurie sportavo sporto klube „Fankas“ ir nesportuojančius (n=128). Sportuojantys sportavo nuo 1 iki 3 kartų per savaitę, po daugiau nei valandą laiko.
Iškėlėme hipotezę: manome, kad sportuojantys turės mažiau žalingų įpročių ir mažiau sveikatos sutrikimų lyginant su nesportuojančiais. Todėl iškėlėme tikslą, nustatyti sportuojančių ir nesportuojančių žmonių gyvensenos ypatumus... [toliau žr. visą tekstą] / Health depends upon the factors of lifestyle, the way of lifestyle which influences our health. With the intention to enjoy good health first of all we have ourselves to start to analyze our lifestyle, beginning with our nutrition, reduction of addictions, changing of physical passivity into physical activity, avoidance of stressful situations.
The object of the research: lifestyle
The purpose of the research: to estimate the peculiarities of the lifestyle of athletic and non-athletic adults and their health condition.
The tasks of the research:
1. To estimate the peculiarities of the lifestyle of non-athletic people and also the subjective assessment of their health.
2. To estimate the lifestyle peculiarities of athletic people and also the subjective assessment of their health.
3. To compare the lifestyle peculiarities of athletic and non-athletic people and their health condition.
The research was accomplished during the period starting from the year 2006 to 2007. With an application of the method of a questionnaire was examined the people’s viewpoint regarding the healthy lifestyle. On purpose to ascertain the viewpoint of the inquired persons towards the physical activity, nutrition, addictions, stress was provided the questionnaire containing 36 questions in total. 273 persons were participating during the research, 100 of them were male and 173 female. The inquired persons were divided into two groups: athletic ones (n=145), who were training in the athletic club... [to full text]
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The Relationship between Horace's Sermones and Epistulae Book 1: "Are the Letters of Horace Satires?"Whybrew, Linda Christine January 2006 (has links)
"Are the Letters of Horace Satires?" (Hendrickson 1897: 313). In response to this question, this thesis investigates whether Horace's Sermones and Epistulae 1 all belong to the genre of satura. Ancient and modern evidence from the use of the terms Sermones, Epistulae, and satura, is surveyed, and is found to be inconclusive, but not to preclude Epist. 1 as satura. The nature of specifically Horatian satura is ascertained from the text of Serm. 1, especially Serm. 1.1 and the explicitly literary Serm. 1.4 and 1.10. The redefinition of Lucilian satura, and its political implications are also considered. To confirm Epist. 1 as satura a sequential reading of the three libelli is undertaken, tracing the evolution of the theme of locus: place, both as geographical location, and as status, place in the social hierarchy, in the context of the socio-political environment of the time of composition. Serm. 1.1 as a programmatic poem is shown to establish Epicurean moderation as a prerequisite for a vita beata. In Serm. 1 Horace's status as client-poet of Maecenas and Octavian initially permits this ideal lifestyle in the Urbs. The misperceptions of outsiders lead to a preference for a life of Epicurean quietude in the rus in Serm. 2, although Horace's aequanimitas is disturbed by urban officia, and abuse of libertas dicendi associated particularly with Stoicism. The ideal of rural withdrawal is reinforced in Epist. 1 through an exploration of appropriate behaviour in relationships with potentes amici. Horace's addressees cover the entire range of the social hierarchy, and in his letters he utilizes the arguments of moral philosophy, thus reconciling poetry and philosophy. He achieves a pragmatic compromise whereby he can enjoy libertas in his role as a poet, while acknowledging that personal libertas and true aequanimitas are still to be attained.
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The New Testament meaning of "little ones"Parkhurst, Diana L. January 1987 (has links)
Thesis (M.A.B.S.)--Talbot School of Theology, Biola University, 1987. / Includes bibliographical references (leaves 77-90).
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Att samtala med närstående inom specialiserad palliativ hemsjukvård : sjuksköterskans erfarenheter / Conversations with family caregivers in specialized palliative home care : nurse´s experiencesRosén, Ulf January 2018 (has links)
Bakgrund: Palliativ vård ska tillgodose behoven hos patienter med livshotande (icke botbara) sjukdomar på alla vårdnivåer i Sverige. Studier har visat att närstående till patienter i specialiserad palliativ hemsjukvård inte alltid har bemötts korrekt eller tagits på allvar vilket har resulterat i att de har slitit hårt ofta i skymundan. Att inte få rätt stöd har visat sig kunna leda till både fysiska, psykiska och psykosociala påfrestningar. Det har till exempel rapporterats om nedstämdhet, koncentrationssvårigheter och fatigue. Centralt i arbetet som sjuksköterska i specialiserad palliativ hemsjukvård är stöd till närstående då de ofta är en förutsättning för att patienten ska kunna vistas den sista tiden i livet i hemmet. Stödet bestod till stor del av samtal. Genom att bekräfta och ta närståendes oro och funderingar på allvar ökade deras välbefinnande. Syfte: Att beskriva sjuksköterskornas erfarenheter av att stödja närstående genom samtal inom specialiserad palliativ hemsjukvård. Metod: Designen var en empirisk studie med induktiv beskrivande ansats. Datainsamling skedde genom kvalitativa forskningsintervjuer. Resultat: Efter analysen framträdde svaret på de två frågeställningarna: Hur gjorde sjuksköteskorna för att etablera en god kontakt med närstående? Hur kunde sjuksköterskorna stötta närstående? Det framkom fyra subkategorier till varje fråga. Resultatet visade att samtalet i specialiserad palliativ hemsjukvård var en stor del av det befintliga arbetet men att det inte alltid skedde under strukturerade och medvetna former. Erfarenheter av strukturerade närståendesamtal var uteslutande positiva. Diskussion: Resultatet diskuterades mot valda delar av Watson´s tio karitativa faktorer. Känslighet gentemot självet och andra, Mänsklig omsorgsrelation, Att ge uttryck för positiva och negativa känslor, Kreativ, problemlösande omsorgsprocess. / Background: Palliative care is intended to cater for the needs of patients with life threatening, non-curable, diseases at all levels of medical care in Sweden. Studies have shown that family and loved ones of patients receiving specialized palliative care in the home have not always been taken seriously or otherwise considered appropriately. This has led to them struggling under the pressure, often without acknowledgment. Not receiving the appropriate support has been shown to be a factor causing physical, psychological as well as psychosocial distresses. For example, depression, difficulties to concentrate and fatigue have been reported. Central to the work as a nurse in specialized palliative home care is to provide support to family and loved ones as it is often a necessity enabling the patient to be at home towards the end of life. The support in this case consisted largely of dialogue. By acknowledging and considering the thoughts and worries of the family, their wellbeing was increased. Aim: Describing the experiences of nurses supporting family and loved ones through dialogue within specialized palliative home care. Method: The study was by design inductive and data were collected via qualitative research interviews. Results: Following the analysis, the answer to the two questions emerged: How did nurses do to establish a good relationship with family and loved ones? How could nurses support family and loved ones? There were four subcategories for each question. The result showed that the conversation in specialized palliative home care was a major part of the existing work, but it did not always happen in structured and conscious forms. The experience of structured conversations with relatives was exclusively positive. Discussion: The result was discussed against selected parts of Watson's ten carative factors. Sensitivity to self and others, Human care relationship, To express positive and negative feelings, Creative, problem-solving care process.
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The segmentation problem in radiation therapyEngelbeen, Céline 30 June 2010 (has links)
The segmentation problem arises in the elaboration of a radiation therapy plan. After the cancer has been diagnosed and the radiation therapy sessions have been prescribed, the physician has to locate the tumor as well as the organs situated in the radiation field, called the organs at risk. The physician also has to determine the different dosage he wants to deliver in each of them and has to define a lower bound on the dosage for the tumor (which represents the minimum amount of radiation that is needed to have a sufficient control of the tumor) and an upper bound for each organ at risk (which represents the maximum amount of radiation that an organ can receive without damaging). Designing a radiation therapy plan that respects these different bounds of dosage is a complex optimization problem that is usually tackled in three steps. The segmentation problem is one of them.<p><p>Mathematically, the segmentation problem amounts to decomposing a given nonnegative integer matrix A into a nonnegative integer linear combination of some binary matrices. These matrices have to respect the consecutive ones property. In clinical applications several constraints may arise that reduce the set of binary matrices which respect the consecutive ones property that we can use. We study some of them, as the interleaf distance constraint, the interleaf motion constraint, the tongue-and-groove constraint and the minimum separation constraint.<p><p>We consider here different versions of the segmentation problem with different objective functions. Hence we deal with the beam-on time problem in order to minimize the total time during which the patient is irradiated. We study this problem under the interleaf distance and the interleaf motion constraints. We consider as well this last problem under the tongue-and-groove constraint in the binary case. We also take into account the cardinality and the lex-min problem. Finally, we present some results for the approximation problem. <p><p>/Le problème de segmentation intervient lors de l'élaboration d'un plan de radiothérapie. Après que le médecin ait localisé la tumeur ainsi que les organes se situant à proximité de celle-ci, il doit aussi déterminer les différents dosages qui devront être délivrés. Il détermine alors une borne inférieure sur le dosage que doit recevoir la tumeur afin d'en avoir un contrôle satisfaisant, et des bornes supérieures sur les dosages des différents organes situés dans le champ. Afin de respecter au mieux ces bornes, le plan de radiothérapie doit être préparé de manière minutieuse. Nous nous intéressons à l'une des étapes à réaliser lors de la détermination de ce plan: l'étape de segmentation.<p><p>Mathématiquement, cette étape consiste à décomposer une matrice entière et positive donnée en une combinaison positive entière linéaire de certaines matrices binaires. Ces matrices binaires doivent satisfaire la contrainte des uns consécutifs (cette contrainte impose que les uns de ces matrices soient regroupés en un seul bloc sur chaque ligne). Dans les applications cliniques, certaines contraintes supplémentaires peuvent restreindre l'ensemble des matrices binaires ayant les uns consécutifs (matrices 1C) que l'on peut utiliser. Nous en avons étudié certaines d'entre elles comme celle de la contrainte de chariots, la contrainte d'interdiciton de chevauchements, la contrainte tongue-and-groove et la contrainte de séparation minimum.<p><p>Le premier problème auquel nous nous intéressons est de trouver une décomposition de la matrice donnée qui minimise la somme des coefficients des matrices binaires. Nous avons développé des algorithmes polynomiaux qui résolvent ce problème sous la contrainte de chariots et/ou la contrainte d'interdiction de chevauchements. De plus, nous avons pu déterminer que, si la matrice donnée est une matrice binaire, on peut trouver en temps polynomial une telle décomposition sous la contrainte tongue-and-groove.<p><p>Afin de diminuer le temps de la séance de radiothérapie, il peut être désirable de minimiser le nombre de matrices 1C utilisées dans la décomposition (en ayant pris soin de préalablement minimiser la somme des coefficients ou non). Nous faisons une étude de ce problème dans différents cas particuliers (la matrice donnée n'est constituée que d'une colonne, ou d'une ligne, ou la plus grande entrée de celle-ci est bornée par une constante). Nous présentons de nouvelles bornes inférieures sur le nombre de matrices 1C ainsi que de nouvelles heuristiques.<p><p>Finalement, nous terminons par étudier le cas où l'ensemble des matrices 1C ne nous permet pas de décomposer exactement la matrice donnée. Le but est alors de touver une matrice décomposable qui soit aussi proche que possible de la matrice donnée. Après avoir examiné certains cas polynomiaux nous prouvons que le cas général est difficile à approximer avec une erreur additive de O(mn) où m et n représentent les dimensions de la matrice donnée. / Doctorat en Sciences / info:eu-repo/semantics/nonPublished
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New functionalisation chemistry of 2- and 4-pyridones and related heterocyclesFernandez, Beatriz January 2016 (has links)
New methodology for the synthesis of several 4H-pyrido[1,2-a]pyrimidin-4-ones has been developed from commercially available 2-aminopyridines and β-oxo esters catalysed by Montmorillonite under solvent-free conditions in good yields. This methodology was expanded for the synthesis of 4H-pyrimido[1,2-a]pyrimidin-4-one derivatives from 2-aminopyrimidine and different β-keto esters. The new methodology for the synthesis of N-alkylated 6-methyl 2-pyridones and N-alkylated 2-methyl 4-pyridones, from commercially available starting materials was developed. For the synthesis of N-alkylated 6-methyl 2-pyridones, 2-methoxy-6-methyl pyridine and a number of different alkylating reagents have been employed as starting materials. For the synthesis of N-alkylated 2-methyl 4-pyridones, 4-chloro 2-methyl pyridine was used successfully to make the desired pyridone in 3 steps. Selective mono-metallation at the 6-methyl substituent of N-alkylated 6-methyl 2-pyridones and N-alkylated 2-methyl 4-pyridones with n-BuLi/KHMDS at -78 °C proceeded smoothly, and the reactivity of the lithiated intermediates towards a wide range of electrophile (diketones, aldehydes, alkylating reagents) was studied. A straightforward synthesis of desirable 4H-quinolizin-4-one scaffolds by condensation of N-benzyl 6-methyl 2-pyridones with dicarbonyl compounds, and the formation of the desired quinolizinone after the condensation step was achieved. An unexpected quinolizinone bearing a fused β-lactam ring was isolated and its structure confirmed by single crystal X-ray diffraction analysis.
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Fonctionnalisation énantiosélective des isoxazolidin-5-ones α-substituées dans des conditions de catalyse par transfert de phase : accès aux acides β2,2-aminés / Enantioselective functionalization of α-substituted isoxazolidin-5-ones under phase-transfer catalytisis : an access to β2,2-amino acidsCadart, Timothée 27 October 2017 (has links)
Le principal objectif de cette thèse a été d'exploiter des isoxazolidin-5-ones α-substituées aisément accessibles comme plateformes originales pour la synthèse d'acides β2,2-aminés énantiomériquement enrichis. Pour cela, nous avons montré que la catalyse par transfert de phase, avec l'utilisation de faibles quantités (2-3 mol%) d'un sel d'ammonium quaternaire énantiopur dédié, était l'outil adéquate pour la fonctionnalisation énantiosélective de la position α des isoxazolidin-5-ones et ainsi générer un centre quaternaire stéréogène. Cette stratégie organocatalytique a été appliquée à la création de liaison Carbone-Soufre, Carbone-Carbone et Carbone-Azote avec des excès énantiomériques de bons à excellents. Des réactions d'hydrogénolyse de la liaison N-O ou bien des réactions d'ouvertures via l'attaque de nucléophiles ont conduit à la formation des acides β2,2-aminés correspondants énantiomériquement enrichis. Enfin, de nouveaux sels d'ammonium quaternaires chiraux de type tropos, faciles d'accès, ont été conçus et évalués dans les réactions d'α-sulfanylation et d'addition conjuguée énantiosélectives dans les conditions de catalyse par transfert de phase mises en place. / The main purpose of this thesis was to use readily available α-substituted isoxazolidin-5-ones as original building blocks for the synthesis of enantioenriched β2,2-amino acids. Phase-transfer catalysis approach, with low loading of an appropriate quaternary ammonium salt, was found to be the most efficient tool for the enantioselective functionalization of the α-position of isoxazolidin-5-ones, allowed thereby to generate a stereogenic quaternary center. This organocatalytic strategy was applied to C-S, C-C and C-N bond formation with good to excellent enantiomeric excess. Hydrogenolysis reactions of the N-O bond or ring-opening reactions via nucleophilic addition reaction led to the corresponding enantioenriched β2,2-amino acids formation. Finally, new easily available chiral quaternary tropos-ammonium salts were designed and evaluated for both the enantioselective α-sulfanylation and conjuguated addition reactions.
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A Fitness Function Elimination Theory For Blackbox Optimization And Problem Class LearningAnil, Gautham 01 January 2012 (has links)
The modern view of optimization is that optimization algorithms are not designed in a vacuum, but can make use of information regarding the broad class of objective functions from which a problem instance is drawn. Using this knowledge, we want to design optimization algorithms that execute quickly (efficiency), solve the objective function with minimal samples (performance), and are applicable over a wide range of problems (abstraction). However, we present a new theory for blackbox optimization from which, we conclude that of these three desired characteristics, only two can be maximized by any algorithm. We put forward an alternate view of optimization where we use knowledge about the problem class and samples from the problem instance to identify which problem instances from the class are being solved. From this Elimination of Fitness Functions approach, an idealized optimization algorithm that minimizes sample counts over any problem class, given complete knowledge about the class, is designed. This theory allows us to learn more about the difficulty of various problems, and we are able to use it to develop problem complexity bounds. We present general methods to model this algorithm over a particular problem class and gain efficiency at the cost of specifically targeting that class. This is demonstrated over the Generalized Leading-Ones problem and a generalization called LO∗∗ , and efficient algorithms with optimal performance are derived and analyzed. We also iii tighten existing bounds for LO∗∗∗. Additionally, we present a probabilistic framework based on our Elimination of Fitness Functions approach that clarifies how one can ideally learn about the problem class we face from the objective functions. This problem learning increases the performance of an optimization algorithm at the cost of abstraction. In the context of this theory, we re-examine the blackbox framework as an algorithm design framework and suggest several improvements to existing methods, including incorporating problem learning, not being restricted to blackbox framework and building parametrized algorithms. We feel that this theory and our recommendations will help a practitioner make substantially better use of all that is available in typical practical optimization algorithm design scenarios.
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Synthesis of Polyaryl-substituted Bisquinazolinones with potential photophysical propertiesMmonwa, Mmakwena Modlicious 11 1900 (has links)
3,5-Dibromo-2-aminobenzamide was reacted with 1,3-cyclohexanedione derivatives in the presence of iodine as catalyst in toluene under reflux to afford novel 6,8-dibromo-2-[3-(2´-alkyl-1´,2´,3´,4´-tetrahydro-6´,8´-dibromo-4´-oxoquinazoline-2yl)propyl]quinazolin-4(3H)-ones in high yields. Suzuki-Miyaura cross-coupling of the latter with arylboronic acids in the presence of Pd(PPh3)2Cl2–Xphos catalyst complex and K2CO3 as a base in dioxane-water mixture (3:1, v/v) afforded the corresponding polyaryl-substituted bis-heterocycles in a single step operation. The resultant compounds were characterized using a combination of NMR (1H and 13C) and IR spectroscopic techniques, as well as mass spectrometry. The electronic absorption and emission properties of these polyaryl-substituted bis-heterocycles comprising 2,3-dihydroquinazolin-4(1H)-one and quinazolin-4(3H)-one moieties linked by a flexible carbon chain were measured in dimethylsulfoxide (DMSO) and acetic acid by means of UV-Vis and fluorescence spectroscopic techniques. The absorption spectra of the resultant polyaryl-substituted bis-heterocycles showed blue-shift in acetic acid and red-shift in DMSO, while their emission spectra are blue-shifted in DMSO and red-shifted in acetic acid. The 4-methoxy groups on aryl-substituents caused red shift on π‒π* transition of the aryl-substituents. Moreover, it was also observed that as the propyl linkage becomes more substituted, the absorption and emission intensities decrease. / Chemistry / M. Sc. (Chemistry)
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