Mise en contexte : Les chémoréflexes laryngés (CRI) sont déclenchés suite au contact entre un liquide et la muqueuse laryngée. Chez un organisme mature, ces CRL sont responsables de mécanismes de protection des voies aériennes inférieures (VAI) tels que déglutitions, toux et réaction d'éveil afin d'éviter l'aspiration. Par contre, chez un organisme immature comme c'est le cas chez les nouveau-nés, ces CRL associent apnée, bradycardie, laryngospasme, hypertension et redistribution du débit sanguin. En période néonatale, ces CRL, déclenchés en réponse à un reflux gastro-oesophagien acide, sont tenus responsables d'apnées du prématuré, de malaises graves du nourrisson (ALTE) et probablement de quelques cas de mort subite du nourrisson (MSN). Malgré leur pertinence clinique évidente, la revue de la littérature permet de constater que de nombreuses questions persistent concernant les CRL, principalement parce que les conditions expérimentales des études antérieures ne reflètent pas ce qui est vu en clinique. Ainsi, les CRL ont été étudiés le plus souvent en utilisant des modèles anesthésiés, en utilisant l'eau distillée, en se servant d'une trachéotomie pour l'injection des solutions et finalement en ne prenant pas en compte les stades de conscience. Une meilleure compréhension des CRL, en particulier déclenchés par des solutions acides, est donc nécessaire. But du projet : Le but de ce travail est d'étudier les CRL chez l'agneau nouveau-né sans sédation en réponse à l'acide, en comparaison à l'eau distillée et au salin durant le sommeil calme.

The crime of Dangerous threatening under s. 353 Criminal Code Abstract This thesis is focused on the crime of Dangerous threatening under s. 353 Criminal Code (Act no. 40/2009 Coll.) and firstly aims to analyze and interpret its elements in the light of the relevant case law. Further, this thesis aims to find corresponding crimes in the U.S. legal system, namely under the common law, the Model Penal Code and under the Florida Statutes, then this thesis aims to compare such American crimes with Dangerous threatening, to point out main differences between the jurisdictions, to evaluate Czech Dangerous threatening and finally to propose recommendations de lege ferenda. Firstly, this thesis analyzes the classification of Dangerous threatening within the Czech criminal law and focuses on the history and evolution of the crime of Dangerous threatening on the territory of the Czech Republic starting with the Austrian Criminal Code from 1852. Further, this thesis analyzes the crime of Dangerous threatening and interprets its elements in the light of the relevant case law, whereas a particular attention is paid to the actus reus, in particular to the interpretation of threatening to cause other serious harm and the ability of a threat to raise reasonable fear. Subsequently, this thesis focuses on the punishing the...

It has been suggested that mental health professionals are insufficiently trained to assess and manage suicide risk (U.S. Department of Veterans Affairs and Defense [USDVA/DOD], 2013; Goldsmith, Pellmar, Kleinman, & Burney, 2002; Jobes, Rudd, Overholser, & Joiner, 2008; Mirick, McCauley, Bridger, & Berkowitz, 2015; Silverman & Berman, 2014) and this problem may originate during graduate training (Feldman & Freedenthal, 2006; Mackelprang, Karle, Reighl, & Cash, 2014; Rudd, Cukrowicz, & Bryan, 2008; Schmitz et al., 2012). Unfortunately, however, this area has been inadequately studied (Battista, 2007; Cramer, Johnson, McLaughlin, Rausch, & Conroy, 2013; Department of Health and Human Services, 2012; Stuber & Quinnett, 2013), precluding a full understanding of this problem. The present study surveyed clinical psychology doctoral students’ behavioral competency in responding to suicidal clients, attitudes toward suicide prevention, perceived ability to engage in appropriate practices, subjective norms surrounding SRA behaviors, intentions to engage in these behaviors, and the relationship of amount of graduate training in suicide risk assessment (SRA) core competencies to the aforementioned constructs. It was hypothesized that amount of training in SRA competencies would be significantly related to participants’ attitudes, perceived behavioral control, and subjective norms related to SRA behaviors. Further, it was hypothesized that the aforementioned variables would be significantly related to participant intentions to engage in these behaviors. Finally, it was hypothesized that intentions to engage in SRA behaviors would be positively related to participants’ behavioral competency in SRA. Study participants were 167 students from 46 clinical psychology doctoral programs. Hypotheses were tested using path analysis. Results provided partial support for significant relationships between attitudes, PBC, subjective norms, and intentions (Hypothesis 1a). Implications of this research include advancing the training practices of clinical psychology doctoral programs so as to help increase the number of mental health practitioners competent in suicide risk assessment and management practices.

Incidence of incurable disease and disability has been increasing in the Western world in recent years. Parallel to this increase, survival rates for adolescents and young adults with life threatening illness, specifically cancer, have not improved relative to younger and older age groups. Palliative care is a total care for patients, regardless the type and status of the illness, and aims to improve quality of life by controlling symptoms and alleviating physical social, psychological and spiritual suffering. The varying level of physical, emotional and psychological maturity makes palliative and supportive care needs of adolescents distinct and challenging.  In this systematic review, the aim was to describe the experiences of palliative and supportive care for adolescents with life threatening illness, from the perspectives of adolescents, family and nurses as providers of palliative and supportive care.  A systematic review of descriptive meta-synthesis was the appropriate method of choice concerning the aims focus on subjective experiences of palliative and supportive care for adolescents. PubMed and CINAHL were the two databases used for data sources of qualitative published articles between the years of 2006-2016.  A total of 1066 qualitative published articles were identified, but only 16 articles have met the inclusion criteria. Nine articles were focusing on adolescents’ experiences, whereas five articles were focusing on families’ experiences and the remaining two were on the nurses’ experiences in providing palliative and supportive care to adolescents. A total of eleven themes have emerged. Four themes were from adolescent’s perspective: preserving self or identity, social support, acceptance and feeling positive and care setting. Another four themes were on family’s perspective: social support, information and decision making, care setting and perception of self-image. Whereas the remaining three themes were on nurse’s perspective: importance of family dynamics, reaching out to adolescents, balancing professional and personal involvement.  In conclusion this systematic review meta-synthesis showed that social support, specifically peer’s support had an impact in enhancing coping with the altered body image and ordinary daily social activities of adolescents due to life threatening illnesses and their treatment. Nurses have a key professional role in facilitating the social network of social support to promote quality of life by maintaining the need for normality.

Spiritual health is one of the essential components of health, where patients search for meaning and purpose in life. Patients with life threatening illnesses experience distress, both physically and spiritually. There are studies which found that nurses did not regularly integrate spiritual care into their daily routine, due to lack of time and lack of education. It is important to discover existing evidences of spiritual interventions which help the nurses promote spiritual health as regards to patients’ need in hospital settings. The aim of this study was to describe nursing interventions applied in promoting spiritual health for patients with life threatening illnesses in hospital settings. A literature review of sixteen articles was carried out. Articles were retrieved from CINAHL and MEDLINE databases to answer the study’s objective. Eleven articles were retrieved from the databases and five articles were found using an ancestry search. A process of re-reading and finding the similar categories from articles was being used to develop themes in analyzing the data. Results were categorized into three themes: person-centred communication, adapting a team approach, and modifying the physical environment. It was found that the nurses conducted a deeper level of communication which covered topics about patients’ wishes and hopes, and being there for patients as major interventions. The nurses also assessed patients’ spiritual needs prior to interventions, and were promoting patients and family belief and value in a respectful way. Family and referrals were also included in the intervention given by the palliative care team, moreover the nurses were providing privacy with regards to supporting a healing environment. In conclusion acknowledgement of dying is essential in providing appropriate care. It is essential for the nurses to be prepared adequately through education, to conduct spiritual care interventions within a person-centred care approach. The information from this study may improve the quality of delivering spiritual care in hospital settings for patients with life threatening illnesses. Further recommendation for future research is to explore deeper about various spiritual nursing interventions from various cultures.

No description available.

Threatening behavior is a cause for concern on college campuses. Even though solutions presented cannot completely prevent crime and violence, steps must be taken towards continuous improvement of violence prevention efforts. The purpose of this case study was to examine resident advisors' attitudes and beliefs about the process of identifying and choosing to report threatening behaviors. Thirteen participants from Residence Life at a major Land Grant University served as the case study group. A qualitative approach guided the inquiry of the study and was represented through observations, document analysis, and participant interviews. Analysis of the research questions supported the study's findings. Overall, students' exposure to violence prevention on campus is often through educational programs and resources, while Resident Advisors are also instrumental resources in sharing information with students. They suggest making more efforts in sharing violence prevention education with students. Because a wide range of issues face today's college students, they seek assistance from Resident Advisors, as well as peers, friends, and family. Building community through the residence halls provides a proactive approach in efforts to develop and provide students opportunities for growth, responsibility, and accountability to their communities. Finally, despite reporting systems in place and resources available, barriers still remain for students. The inconsistency between the views and perceptions of violence prevention education and barriers to reporting between Resident Advisors and administration in Residence Life indicates need for further engagement between students and Institutions of Higher Education based upon policies, educational efforts, and reporting structures. Institutions have an obligation to engage students in the prevention of violence through sustained community-building measures and working with targeted peer groups, such as Resident Advisors. Conclusions from this study were explained through the individual, information, and social background factors of The Reasoned Action Approach and guided the recommendations for practice and further research. Addressing the disconnect between the administration and Resident Advisors' perceptions is crucial in reducing barriers to reporting. A need remains for further engagement with peers, friends, family, RAs, and other influential groups to help shape students' understanding, awareness, and continued involvement in the identification and reporting of threatening behaviors. / Ph. D.

I institutionella samtal såsom närståendesamtal mellan en logoped, en närstående till en person med afasi och personen med afasi råder en asymmetri gällande maktförhållandet. Asymmetrin som uppstår i det institutionella samtalet kan innebära att samtalsdeltagaren med minst makt upplever ansiktshot. I samtal ses förståelse som en dynamisk process och när förståelsen innebär ett problem i konversationen störs den pågående aktiviteten. Mottagaren kan lösa problemet som uppstått genom att ge talaren en candidate understanding. Hur kommunikativa strategier används i närståendesamtal är ett relativt obeforskat område och ett viktigt område då närståendesamtal är en vanligt förekommande för logopeder. Syftet med föreliggande studie var därför att undersöka ett antal kommunikativa strategier för att få en gemensam förståelse och minska ansiktshot  vid delgivning av testresultat och rådgivning i närståendesamtal. Tre närståendesamtal mellan logopeder, närstående och i två fall personer med afasi spelades in, transkriberades och analyserades enligt samtalsanalytiska principer (CA). Två logopeder, tre närstående och två personer med afasi medverkade i studien. Totalt omfattade det inspelade materialet en timma och 37 minuter. Deltagande logopeder fick även fylla i ett frågeformulär. Strategier för avdramatisering och förståelse identifierades. Strategierna delades in i två kategorier; avdramatisering av råd och förmedling av testresultat och candidate understandings för att uppnå förståelse. I studien framkom det att candidate understandings ofta initierades av den närstående. Det framkom även att de positiva testresultaten som förmedlades inte avdramatiserades samt att dessa istället ofta framhävdes och att face threatenings acts vid delgivning av negativa testresultat ofta avdramatiserades med hedging. / In institutional interactions such as conversations between a speech and language therapist, a person closely related to a person with aphasia and the individual with aphasia there is an asymmetry considering the power. The asymmetry arising in institutional interactions may mean that the participant with the least power will experience a face threatening act. Understanding is seen as a dynamic process and when understanding is a problem in the conversation the ongoing activity is disturbed. The receiver can solve the problem by giving the speaker a candidate understanding. How these strategies are used in conversations between a speech and language therapist with a person closely related to a person with aphasia is a relatively unexplored field and an important area which is a common for speech therapists. The aim of the present study was to investigate a number of communication strategies in the conversation with a person closely related to a person with aphasia; how understanding was reached and how face threatening acts were reduced when the speech therapists delivered test results and gave counseling. Three conversations between speech and language therapists, persons closely related to a person with aphasia and in two of the recordings the person with aphasia were recorded, transcribed and analyzed according to principles of Conversation Analysis (CA). Two speech and language therapists, three persons closely related to a person with aphasia and two persons with aphasia participated in the study. In total, the recorded material is one hour and 37 minutes. Participating speech and language therapists also filled in a questionnaire. Strategies for mitigation and understanding were identified. The strategies were divided into two categories; strategies to mitigate FTA:s when delivering the test results and counseling, the other categorie was the use of candidate understandings for gaining an mutual understanding. The study revealed that candidate understandings were often initiated by the person closely related to a person with aphasia. The study also revealed that the test results with positive outcome where not mitigated and often emphasized and test results that could be perceived as negative were mitigated with hedging.

Bakgrund: Palliativ vård syftar till att lindra symtom och öka livskvalitén i livets slutskede hos den som har en livshotande sjukdom. Att stödja närstående är en viktig del inom palliativ vård. Närstående definieras som en person med nära relation till den enskilde. Individer upptill 18 år definieras som barn och har lagstadgade rättigheter, bland annat inom vården. Barn som är närstående till en förälder med livshotande sjukdom är sårbara och påverkas både fysiskt och psykiskt. Forskning visar att sjuksköterskor saknar tillräckliga kunskaper för att bemöta och stödja barn som närstående. Syfte: Att utforska barns erfarenheter av att leva med en förälder som har en livshotande sjukdom. Metod: En litteraturöversikt med induktiv ansats bestående av 13 vetenskapliga kvalitativa och kvantitativa artiklar som publicerades mellan år 2004–2023. Resultat: I resultatet framkom fyra stycken teman. Information om sjukdom och vård, Barns känslomässiga reaktioner relaterat till förälderns livshotande sjukdom, Barns upplevelser av hemsituationen” och Barns behov av stöd och strategier för att hantera vardagen. Barnen önskade kontinuerlig information om förälderns sjukdomsförlopp från vårdpersonalen och föräldrarna. Barnen påverkades psykiskt och fysiskt vid brist på information. Förälderns sjukdom fick barnen att uppskatta tiden tillsammans med familjen och ledde till ökad mognad och nya perspektiv på livet. Slutsats: Barn som närstående till föräldrar som har en livshotande sjukdom önskar vara mer delaktiga för att hantera situationen lättare. Sjuksköterskorna önskade utökade insatser såsom utbildning för att främja kommunikationen mellan familjemedlemmarna. Att involvera barnen och delge information om sjukdomsförloppet skapar goda förutsättningar och anses vara till nytta för barnets mående på lång sikt. / Background: Palliative care aims to relieve symptoms and increase the quality of life in the final stages of life for those who have a life-threatening illness. Supporting relatives is an important part of palliative care. A relative is defined as a person with a close relationship to the individual. Individuals up to the age of 18 are defined as children and have statutory rights, including in healthcare. Children who are close to a parent with a life-threatening illness are vulnerable and are affected both physically and psychologically. Research shows that nurses lack sufficient knowledge to respond to and support children as relatives. Aim: To explore children's experiences of living with a parent who has a life-threatening illness. Method: A literature review with an inductive approach consisting of 13 scientific qualitative and quantitative articles that were published between the years 2004–2023. Results: The results revealed four themes. Information about illness and care, Children's emotional reactions related to the parent's life-threatening illness, Children's experiences of the home situation" and Children's need for support and strategies to manage everyday life. The children wanted continuous information about the course of the parent's illness from the care staff and the parents. The children were affected psychologically and physically when there was a lack of information. The parent's illness made the children appreciate the time together with the family and led to increased maturity and new perspectives on life. Conclusion: Children who are relatives to parents who have a life-threatening illness wish to be more involved in order to handle the situation more easily. Nurses wanted increased stakes such as education to promote communication between family members. Involving the children and sharing information about the course of the illness creates good conditions and is considered beneficial for the child's well-being in the long term.

Bakgrund: Palliativ vård syftar till att lindra symtom och öka livskvalitén i livets slutskede hos den som har en livshotande sjukdom. Att stödja närstående är en viktig del inom palliativ vård. Närstående definieras som en person med nära relation till den enskilde. Individer upptill 18 år definieras som barn och har lagstadgade rättigheter, bland annat inom vården. Barn som är närstående till en förälder med livshotande sjukdom är sårbara och påverkas både fysiskt och psykiskt. Forskning visar att sjuksköterskor saknar tillräckliga kunskaper för att bemöta och stödja barn som närstående. Syfte: Att utforska barns erfarenheter av att leva med en förälder som har en livshotande sjukdom. Metod: En litteraturöversikt med induktiv ansats bestående av 13 vetenskapliga kvalitativa och kvantitativa artiklar som publicerades mellan år 2004–2023. Resultat: I resultatet framkom fyra stycken teman. Information om sjukdom och vård, Barns känslomässiga reaktioner relaterat till förälderns livshotande sjukdom, Barns upplevelser av hemsituationen” och Barns behov av stöd och strategier för att hantera vardagen. Barnen önskade kontinuerlig information om förälderns sjukdomsförlopp från vårdpersonalen och föräldrarna. Barnen påverkades psykiskt och fysiskt vid brist på information. Förälderns sjukdom fick barnen att uppskatta tiden tillsammans med familjen och ledde till ökad mognad och nya perspektiv på livet. Slutsats: Barn som närstående till föräldrar som har en livshotande sjukdom önskar vara mer delaktiga för att hantera situationen lättare. Sjuksköterskorna önskade utökade insatser såsom utbildning för att främja kommunikationen mellan familjemedlemmarna. Att involvera barnen och delge information om sjukdomsförloppet skapar goda förutsättningar och anses vara till nytta för barnets mående på lång sikt / Background: Palliative care aims to relieve symptoms and increase the quality of life in the final stages of life for those who have a life-threatening illness. Supporting relatives is an important part of palliative care. A relative is defined as a person with a close relationship to the individual. Individuals up to the age of 18 are defined as children and have statutory rights, including in healthcare. Children who are close to a parent with a life-threatening illness are vulnerable and are affected both physically and psychologically. Research shows that nurses lack sufficient knowledge to respond to and support children as relatives. Aim: To explore children's experiences of living with a parent who has a life-threatening illness. Method: A literature review with an inductive approach consisting of 13 scientific qualitative and quantitative articles that were published between the years 2004–2023. Results: The results revealed four themes. Information about illness and care, Children's emotional reactions related to the parent's life-threatening illness, Children's experiences of the home situation" and Children's need for support and strategies to manage everyday life. The children wanted continuous information about the course of the parent's illness from the care staff and the parents. The children were affected psychologically and physically when there was a lack of information. The parent's illness made the children appreciate the time together with the family and led to increased maturity and new perspectives on life. Conclusion: Children who are relatives to parents who have a life-threatening illness wish to be more involved in order to handle the situation more easily. Nurses wanted increased stakes such as education to promote communication between family members. Involving the children and sharing information about the course of the illness creates good conditions and is considered beneficial for the child's well-being in the long term