Syfte: Litteraturöversiktens syfte var att belysa vilken påverkan parenteral nutrition har på livskvaliteten hos palliativa patienter. Metod: Denna studie har genomförts som en litteraturöversikt. Vetenskapliga artiklar har insamlats från databaserna Cinahl, Medline och Pubmed. Totalt fann författarna 12 vetenskapliga artiklar som svarade mot litteraturstudiens syfte. De utvalda artiklarna var både kvantitativa och kvalitativa. Kvalitetsgranskningen utfördes med hjälp av granskningsmallar och artiklarna som lade grunden till resultatet motsvarade medel till hög kvalitet. Resultat: Resultatet visade på att flertalet patienter kände en trygghet och lättnad när den parenterala nutritionen introducerades. Patienterna ansåg att vetskapen att deras nutritionsbehov blev tillfredsställt gjorde att de inte behövde vara rädda för att svälta ihjäl. De upplevde en ökad livskvalitet då de slapp oroa sig för födointaget och orkade medverka mera aktivt i det sociala familjelivet. Flertalet av patienterna uppgav en förbättrad livskvalitet när möjlighet gavs att få parenteral nutrition i hemmet trots att det innebar inskränkningar i familjelivet. De uppgav även en ökad styrka till att hantera bland annat sjukdomssymtom och behandlingsbiverkningar. Den parenterala nutritionen gav i vissa fall problem med biverkningar, men de flesta patienterna skattade ändå livskvaliteten högre av att få näringsdroppet. Resultatet visade även på att om den parenterala nutritionen sattes in i ett tidigt skede kunde en förbättring av nutritionsstatusen ske och patienterna behöll sin kroppsvikt under en något längre tid. Det resulterade i en ökad skattning av livskvaliteten. De sista veckorna i livet hade näringsdroppet ingen mätbar positiv effekt.

Our ability to understand and predict the fate and transport of contaminants in natural systems is vital if we are to be successful in protecting our water resources. One important aspect of understanding chemical fate and transport in natural systems is identifying key kinetic controls on important redox reactions such as sulfate reduction. Anaerobic microbial activities like sulfate reduction are of particular interest because of the important role they play in the degradation of contaminants in the subsurface. However, current rate estimates for sulfate reduction have a wide range in the literature making it difficult to determine representative rates for a given system. These differences in rate data may be explained by varying kinetic controls on reactions. Push-pull tests were used to evaluate sulfate reduction rates at the wetland-aquifer interface. Anaerobic aquifer water containing abundant sulfate was injected into sulfate-depleted wetland porewater. The injected water was subsequently withdrawn and analyzed for geochemical indicators of sulfate reduction. Complexities in rate data, such as presence of a lag phase, changing rate order and spatial variability, were observed and are hypothesized to be linked to activities of the native microbial population. Subsequent experiments explored the response of native microorganisms to geochemical perturbations using a novel approach to measure directly the effects of a geochemical perturbation on an in situ microbial population and measure rates of resulting reactions. In situ experiments involved colonization of a substrate by microorganisms native to the wetland sediments followed by introductions of native water amended with sulfate and tracer. Experimental results showed that higher sulfate concentrations and warmer seasonal temperatures result in faster sulfate reduction rates and corresponding increases in sulfate reducing bacteria. Findings from this research provide quantitative evidence of how geochemical and microbiological processes are linked in a system not at equilibrium.

To satisfy the transportation service request of clients and to control the associated costs are the main targets of marine container transportation industry. To achieve the transportation service for clients, plenty of participants and procedures are involved in the Marine Supply Chain (MSC), leading to the need of exchanging a huge amount of information. This study is focused on how and what kind of information sharing should be exchanged in these participants and procedures of Maritime Supply Chain. We use UMM (UN/CEFACT Modeling Methodology of ebXML business process) to investigate the business processes between participants in Marine Supply Chain. We also conducted a case study in an important location of maritime supply chain, i.e., Port Container Terminal to discuss about the information sharing content and sharing pattern in MSC processes. The result shows that in the marine cargo delivery process, Port Container Terminal is responsible for Berth Schedule Planning, Berth Planning, Yard Planning and Gate Planning to achieve the container transport service for the clients. Therefore, plenty of participants and procedures have to be involved in the Marine Supply Chain, and plenty of information have to be interchanged. However, beside Customs Clearance procedure, there are no common information technology platform and standard for information interchange in marine container transportation industry. To improve the service quality of domestic marine cargo delivery, we have to establish an information sharing system. Moreover, I personally hope this study can be used as a reference of information system analysis and design. Improving the information sharing standardization and building information sharing pattern can simplify and improve the procedures of marine cargo delivery system.

国立情報学研究所で電子化したコンテンツを使用している。

Empirical models of airflow output and power consumption were developed for series and parallel fan powered variable air volume terminal units at typical design pressure conditions. A testing procedure and experimental setup were developed to test sets of terminal units from three different manufacturers. Each set consisted of two series and two parallel units, each with 8 in. (203 mm) and 12 in. (304 mm) primary air inlets, for a total of four units in each set. Generalized models were developed for the series and parallel units, with coefficients varying by size and manufacturer. Statistical modeling utilized SAS software (2002). Fan power and airflow data were collected at downstream static pressures over a range from 0.1 to 0.5 in. w.g. (25 to 125 Pa) for the parallel terminal units. Downstream static pressure was held constant at 0.25 in. w.g. (62 Pa) for the series units. Upstream static pressures of all variable air volume (VAV) terminal units ranged from 0.1 to 2.0 in. w.g. (25 to 498 Pa). Data were collected at four different primary air damper positions. Data were also collected at four different terminal unit fan speeds, controlled by a silicon controlled rectifier (SCR). The models utilized the RMS voltage entering the terminal unit fan, the 'rake' sensor velocity pressure, and the downstream static pressure. In addition to the terminal unit airflow and power models, a model was developed to quantify air leakage in parallel terminal units, when the unit fan was off. In all but two of the VAV terminal units, the resulting models of airflow and power had R2 values greater than 0.90. In the two exceptions, there appeared to be manufacturing defects: either excessive air leakage or a faulty SCR that limited the effectiveness of the airflow and power models to capture the variation in the data.

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.

<p>Mobila informationssystem ställer höga krav på användarkontext då det kontinuerligt förändrar sig och därmed även styr systemets användarkrav. Dessa krav sätts under ytterligare press då det mobila informationssystemet tillämpas inom mobila verksamheter vars arbetsuppgifter är av kritisk karaktär, till exempel inom kårverksamheter. För att realisera en lyckad tillämpning av mobila informationssystem inom mobila verksamheter vars arbete är av kritisk karaktär är det viktigt att undersöka vilka kritiska faktorer som ska ligga till grund för systemet med avseende på dess användbarhet. En orsak till varför en sådan undersökning är viktig är på grund av att mobila informationssystem ofta designas efter stationära principer och designriktlinjer vilket är olyckligt då användarkraven skiljer sig markant mellan mobila och stationära system. För att ta reda på dessa kritiska användarkrav har en enkätundersökning genomförts inom den kommunala räddningstjänsten i Skövde. En litteraturstudie inom mobila IT tillämpningar har även utförts för att ge stöd åt de resultat som undersökningen visar. Den centrala slutsatsen i arbetet visar att mobila informationssystem/IT tillämpningar saknar kontextmedvetenhet och därmed anpassningsbarhet till en multikontext.</p>

Do dying patients have a moral claim to access experimental drugs when all else has failed? This question has been the focus of an active and evolving debate concerning the rights of terminally ill patients, the nature of the drug development process, and the scope of federal regulation, with supporters arguing that seriously ill patients should be able to decide for themselves whether and when to attempt experimental therapies and opponents arguing that the resulting state of affairs would be disastrous for patient safety and for the integrity of the drug development process. This thesis concerns the ethical considerations surrounding the provision of experimental drugs for treatmentoften termed compassionate use or expanded accessand argues that compelling ethical merits on both sides of the debate complicate the formation of satisfactory public policy. Although patient autonomy is often invoked to support liberal access to experimental drugs, the paucity of known information about investigational compounds as well as the unique vulnerability of the terminally ill patient call into question the wisdom of the unfettered exercise of autonomy in this context. Although equitable distribution of experimental drugs is often felt to be a concern, the meaning of equity in this context has not been clearly defined, and in fact several working concepts of equitable access may not be achievable or desirable. Although the financial burden on drug manufacturers is frequently recognized as a barrier to expanded access, the potential for expanded access programs to constitute a marketing strategy should be recognized, and the mixing of profit motives with altruistic ones brought to light. Parsing these and other ethical nuances points to certain ways in which policies governing expanded access can be refined to allow for access while maximizing patient protection and ensuring the generation of scientific knowledge. Physicians, as frequent mediators of requests for experimental drugs, should be knowledgeable of the ethical issues inherent and should help to ensure the judicious use of experimental therapies. Finally, general misconceptions about the benefits of experimental therapy, pervasive in our culture, heighten the contentiousness of this debate. A workable legislative solution should be accompanied by a thoughtful and deliberate effort to educate patients, their advocates, and broader society about the realistic pace of drug development and the limits of modern medicine. This thesis recognizes that individuals who seek expanded access often have valid moral claims to do so, but advocates a cautious attitude toward the dissemination of experimental drugs for treatment and maintains the importance of government and physician participation in adjudicating access.

Thesis (M. Arch.)--University of Hong Kong, 1998. / Includes special report study entitled: Design methodology of waterfront. Includes bibliographical references.

Thesis (M.A.)--Catholic Theological Union at Chicago, 2003. / Vita. Includes bibliographical references (leaves 51-52).