Review of Ordering Don't Resuscitate in Iranian Dying Patients.

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Cheraghi, Mohammad Ali; Bahramnezhad, Fatemeh; Mehrdad, Neda

2018-06-01

Making decision on not to resuscitate is a confusing, conflicting and complex issue and depends on each country's culture and customs. Therefore, each country needs to take action in accordance with its cultural, ethical, religious and legal contexts to develop guidelines in this regard. Since the majority of Iran's people are Muslims, and in Islam, the human life is considered sacred, based on the values of the community, an Iranian Islamic agenda needs to be developed not taking measures about resuscitation of dying patients. It is necessary to develop an Iranian Islamic guidelines package in order to don't resuscitate in dying patients.

DIES FOR STRIKING REPUBLICAN AND EARLY IMPERIAL COINS FROM MOESIA AND THRACE: ANCIENT FORGERIES OR SOMETHING ELSE?

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Evgeni I. Paunov

2014-04-01

Full Text Available This paper attempts to trace the distribution of unofficial dies for striking late Republican and early Imperial coins in Moesia and Thrace, discussing eleven dies and one hub (master die. It deals with the key issues concerning these rare numismatic finds , their occurrence in the Balkan provinces of Roman Empire and their interpretation as genuine monetary items or as forgers’ accessories. Such a large concentration of dies is found in a relatively constrained area, but so far understanding does not clearly revealed what their importance is. The problem appears to be essential for the comprehension of Roman political and military activities in the Balkans during the Augustan-Tiberian period, as well as for the general discussion on ancient coin techniques.

On the Moral Acceptability of Physician-Assisted Dying for Non-Autonomous Psychiatric Patients.

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Varelius, Jukka

2016-05-01

Several authors have recently suggested that the suffering caused by mental illness could provide moral grounds for physician-assisted dying. Yet they typically require that psychiatric-assisted dying could come to question in the cases of autonomous, or rational, psychiatric patients only. Given that also non-autonomous psychiatric patients can sometimes suffer unbearably, this limitation appears questionable. In this article, I maintain that restricting psychiatric-assisted dying to autonomous, or rational, psychiatric patients would not be compatible with endorsing certain end-of-life practices commonly accepted in current medical ethics and law, practices often referred to as 'passive euthanasia'. © 2015 John Wiley & Sons Ltd.

Enabling ICU patients to die at home.

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Battle, Emma; Bates, Lucy; Liderth, Emma; Jones, Samantha; Sheen, Sheryl; Ginty, Andrew; Northmore, Melanie

2014-10-07

There is often an overlap between intensive care medicine and palliative medicine. When all curative treatment options have been explored, keeping the patient comfortable and free from pain is the main concern for healthcare practitioners. Patient autonomy in end of life decisions has not been encouraged in the intensive care unit (ICU), until now, because of its specialised and technical nature. Staff at the Royal Bolton Hospital have broken down the barriers to enabling ICU patients to die in their own homes, and have developed a system of collaborative working that can help to fulfil a patient's final wish to go home. This article describes how ICU staff developed a process that enabled two ventilated patients to be transferred home for end of life care.

Long-term results of patients with clinical stage C prostate cancer treated by photontherapy and early orchiectomy

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Wiegel, T. [Univ. Hospital Eppendorf, Hamburg (Germany). Dept. of Radiotherapy]|[Dept. of Radiotherapy, Univ. Hospital Benjamin Franklin, Freie Univ. Berlin (Germany); Tepel, J. [Univ. Hospital Eppendorf, Hamburg (Germany). Dept. of Radiotherapy; Schmidt, R. [Univ. Hospital Eppendorf, Hamburg (Germany). Dept. of Radiotherapy; Klosterhalfen, H. [Univ. Hospital Eppendorf, Hamburg (Germany). Dept. of Urology; Arps, H. [General Hospital Fulda (Germany). Inst. of Pathology; Berger, P. [Univ. Hospital Eppendorf, Hamburg (Germany). Inst. of Medical Statistics; Franke, H.D. [Univ. Hospital Eppendorf, Hamburg (Germany). Dept. of Radiotherapy

1996-11-01

Background: To evaluate the value of radiotherapy and immediate hormonal therapy in the treatment of stage C prostate cancer. Patients and Method: From 1977 to 1986, 169 patients with clinically stage C prostate cancer underwent irradiation with curative intent following early orchiectomy. Sixty-four patients had a transurethral resection, 22 patients a prostatectomy and 83 patients had only a biopsy. In 38 patients a grade Ia/b tumor was found, in 78 patients a grade IIa/b tumor and in 43 patients a grade IIIa/b tumor using the German grade of malignancy. Treatment fields included the prostate, the seminal vesicles and the locoregional lymphatics. Until 1979 the dose was 60 Gy for the tumor encompassing isodose and from then on 65 Gy with a single dose of 2 Gy. Results: With a median follow-up of 98 months, the overall survival rate for 8 and 10 years was 51% and 37% and the cause-specific survival rate was 84% and 77%, respectively. Thirty-two patients (19%) developed distant metastases. Patients with local tumor control (n=148) had a significantly better overall survival rate of 45% for 10 years compared to patients with clinical local progression of disease (n=21) of 22% (p<0.05). Multivariate analysis showed the grade of malignancy and local control as independent factors for overall survival and cause-specific survival (p<0.05). Twenty-three patients (14%) had at least one late side effect for the rectum or the bladder, in almost all cases grade I or II. Five patients (3%) showed severe late side effects RTOG grade III (n=2) or IV (n=3). One patient had a colostomy, in 2 patients a severe haemorrhagic cystitis was seen. Conclusions: Radiotherapy with photons and early orchiectomy for patients with stage C prostate cancer achieves high local control rates and a 30% to 40% 10-year survival rate with a low incidence of late side effects. The value of the radiotherapy of the locoregional lymphatics remains controversial. (orig.) [Deutsch] Zwischen 1977 und 1986

Consensus guidelines on analgesia and sedation in dying intensive care unit patients

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Lemieux-Charles Louise

2002-08-01

Full Text Available Abstract Background Intensivists must provide enough analgesia and sedation to ensure dying patients receive good palliative care. However, if it is perceived that too much is given, they risk prosecution for committing euthanasia. The goal of this study is to develop consensus guidelines on analgesia and sedation in dying intensive care unit patients that help distinguish palliative care from euthanasia. Methods Using the Delphi technique, panelists rated levels of agreement with statements describing how analgesics and sedatives should be given to dying ICU patients and how palliative care should be distinguished from euthanasia. Participants were drawn from 3 panels: 1 Canadian Academic Adult Intensive Care Fellowship program directors and Intensive Care division chiefs (N = 9; 2 Deputy chief provincial coroners (N = 5; 3 Validation panel of Intensivists attending the Canadian Critical Care Trials Group meeting (N = 12. Results After three Delphi rounds, consensus was achieved on 16 statements encompassing the role of palliative care in the intensive care unit, the management of pain and suffering, current areas of controversy, and ways of improving palliative care in the ICU. Conclusion Consensus guidelines were developed to guide the administration of analgesics and sedatives to dying ICU patients and to help distinguish palliative care from euthanasia.

Health care practitioners and dying patients

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Panagiotis Pentaris

2013-06-01

Full Text Available A full understanding of and a competent approach to dying patients may lead to a more qualitative service delivery, an enhanced quality of life paradigms, and the patients’ wellbeing, all of which remain the ultimate goal of health care practice. The modern world has developed in parallel with secularism and religious diversity. This paper aims to illustrate the secularization process in Britain (with indications of generalized meanings and juxtaposes it with a description of the needs of dying patients regarding the meanings of religion and nonreligion. Although this paper draws on and provides a review of selected theoretical literature, it also addresses a significant challenge: the lack of scientifi c research on the subject. Hence, this paper aims to give an overview of the issues, but not synthesise them. The arguments that are elaborated in the paper are also supported by the author’s current research project in the city of London. The approach here is client oriented, and concerns social and health care. Practitioners ought to become competent, and maintain their competence throughout their professional career. Religious competence seems to have not been at the centre of discussions, regardless of the historical pathway that religious discourse has drawn since the beginnings of humanity. The paper concludes with certain suggestions for future research and inclusive approaches regarding religious matters.

Early myeloma-related death in elderly patients: development of a clinical prognostic score and evaluation of response sustainability role.

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Rodríguez-Otero, Paula; Mateos, María Victoria; Martínez-López, Joaquín; Martín-Calvo, Nerea; Hernández, Miguel-Teodoro; Ocio, Enrique M; Rosiñol, Laura; Martínez, Rafael; Teruel, Ana-Isabel; Gutiérrez, Norma C; Bargay, Joan; Bengoechea, Enrique; González, Yolanda; de Oteyza, Jaime Pérez; Gironella, Mercedes; Encinas, Cristina; Martín, Jesús; Cabrera, Carmen; Palomera, Luis; de Arriba, Felipe; Cedena, María Teresa; Paiva, Bruno; Puig, Noemí; Oriol, Albert; Bladé, Joan; Lahuerta, Juan José; San Miguel, Jesús F

2018-02-23

Although survival of elderly myeloma patients has significantly improved there is still a subset of patients who, despite being fit and achieving optimal responses, will die within 2 years of diagnosis due to myeloma progression. The objective of this study was to define a scoring prognostic index to identify this group of patients. We have evaluated the outcome of 490 newly diagnosed elderly myeloma patients included in two Spanish trials (GEM2005-GEM2010). Sixty-eight patients (13.8%) died within 2 years of diagnosis (early deaths) due to myeloma progression. Our study shows that the use of simple scoring model based on 4 widely available markers (elevated LDH, ISS 3, high risk CA or >75 years) can contribute to identify up-front these patients. Moreover, unsustained response (<6 months duration) emerged as one important predictor of early myeloma-related mortality associated with a significant increase in the risk of death related to myeloma progression. The identification of these patients at high risk of early death is relevant for innovative trials aiming to maintain the depth of first response, since many of them will not receive subsequent lines of therapy.

Patients who die during palliative radiotherapy. Status survey

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Berger, B.; Ankele, H.; Bamberg, M.; Zips, D.

2014-01-01

Palliative radiotherapy (RT) is routinely used in end of life care of patients with advanced malignancies; however, unnecessarily burdensome treatment shortly before death should be avoided. There is little knowledge on incidence and causes of intercurrent deaths during palliative RT. In this study death events among inpatients receiving palliative RT between January 2009 and December 2011 at this department were retrospectively analyzed. Among epidemiological factors, treatment schedule and chronology, latency and duration of treatment in relation to the actual survival were identified. In this study 52 patients died during or shortly after palliative RT. Symptomatic bone metastases and brain metastases represented the most common RT indications. The general health status was poor with a median Karnofsky performance score of 50 %, RT was realized with a median single dose of 2.5 Gy to a median total dose of 30.5 Gy and was stopped prematurely in 73 % of patients. On average 53 % of the remaining lifetime was occupied by latency to starting RT. Once RT was begun the treatment duration required a median 64 % of the still remaining lifetime. The majority of patients who died had explicitly adverse pre-existing factors and rarely completed RT as scheduled. Latency to RT and RT duration occupied more than half of the remaining lifetime. (orig.) [de

Cultural beliefs about a patient's right time to die: an exploratory study.

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Perkins, Henry S; Cortez, Josie D; Hazuda, Helen P

2009-11-01

Generalist physicians must often counsel patients or their families about the right time to die, but feel ill-prepared to do so. Patient beliefs may help guide the discussions. Because little prior research addresses such beliefs, we investigated them in this exploratory, hypothesis-generating study. Anticipating culture as a key influence, we interviewed 26 Mexican Americans (MAs), 18 Euro-Americans (EAs), and 14 African Americans (AAs) and content-analyzed their responses. Nearly all subjects regardless of ethnic group or gender said God determines (at least partially) a patient's right time to die, and serious disease signals it. Yet subjects differed by ethnic group over other signals for that time. Patient suffering and dependence on "artificial" life support signaled it for the MAs; patient acceptance of death signaled it for the EAs; and patient suffering and family presence at or before the death signaled it for the AAs. Subjects also differed by gender over other beliefs. In all ethnic groups more men than women said the time of death is unpredictable; but more women than men said the time of death is preset, and family suffering signals it. Furthermore, most MA women--but few others--explicitly declared that family have an important say in determining a patient's right time to die. No confounding occurred by religion. Americans may share some beliefs about the right time to die but differ by ethnic group or gender over other beliefs about that time. Quality end-of-life care requires accommodating such differences whenever reasonable.

From will to live to will to die: oncologists, nurses, and social workers identification of suicidality in cancer patients.

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Granek, Leeat; Nakash, Ora; Ariad, Samuel; Chen, Wendy; Birenstock-Cohen, Shira; Shapira, Shahar; Ben-David, Merav

2017-12-01

The purpose of this research was to examine how oncologists, nurses, and social workers identify suicidality in cancer patients. Sixty-one healthcare professionals (23 oncologists, 18 social workers, and 20 nurses) at two academic cancer centers were interviewed using an in-depth interview guide. This was a qualitative study based on grounded theory methodology. Analysis involved line-by-line coding, with categories and themes emerging from participants' narratives. Suicidality in cancer patients exists on a wide spectrum that ranges from an active will to live to an active will to die. Four phases were identified that included: (A) a strong will to live expressed in themes of active treatments, seeking second opinions, overtreatment, and alternative treatments; (B) a decreasing will to live indicated in themes of mental health distress and physical pain and suffering; (C) a readiness to die expressed in themes of mental health distress, previous mental health diagnoses, physical pain, avoiding more suffering, preserving quality of life in old age, nearing end of life, lack of social support, and maintaining a sense of control; and (D) a will to die indicated in themes of euthanasia and active suicidality. Suicidality in cancer patients exists on a continuum. Cancer patients fluctuate on this spectrum depending on circumstances such as degree of suffering, their personalities and life circumstances, and whether they are nearing the end of life. Results of the study emphasize the need to collect more context specific data on suicidality among cancer patients and the importance of early integration of psychosocial and palliative care in the cancer treatment trajectory.

Oh death, where is thy sting? Reflections on dealing with dying patients.

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Loewy, Erich H

1988-01-01

This paper examines the reactions of physicians and other health professionals when they become involved in decisions about the death of their patients... Four traditional views of death are explored. The problem that physicians have in helping patients die (be it by hastening death through pain control, assisting patients in suicide or by more active means) is analyzed. Physicians, in dealing with such patients, must be mindful of their own, and their patients beliefs as well as mindful of the community in which such dying takes place. They must try to reconcile these often divergent views but can neither paternalistically deny patients their rational will, hide themselves behind an appeal to the law or go against their own deeply held moral views. When such views cannot be reconciled, compassionate transfer to a more compatible physician may be necessary.

The Lived Experiences of Nurses Caring For Dying Pediatric Patients.

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Curcio, Danna L

2017-01-01

Nurses and healthcare professionals may have difficulty adjusting to and comprehending their experiences when a patient’s life ends. This has the potential to interfere with patient care. Reflection on past events and actions enables critical discovery of strategies to benefit both nurses and patients. This qualitative phenomenological study explores the lived experiences of nurses caring for dying pediatric patients. The philosophical underpinning of Merleau-Ponty (2008), in combination with the research method of van Manen (1990), was used for this study. The Roy Adaptation Model (RAM) (Roy, 2009; Roy & Andrews, 1991) was the nursing model that guided the study to help understand that nurses are an adaptive system, using censoring as a compensatory adaptive process to help function for a purposeful cause. Nine female nurse participants with one to four years of experience were interviewed. The context of the experiences told by nurses caring for dying pediatric patents uncovered seven essential themes of empathy, feelings of ambivalence, inevitability, inspiration, relationship, self-preservation, and sorrow, and these themes demonstrated a connection formed between the nurse and the patient.

The best interests of persistently vegetative patients: to die rather that to live?

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Chan, Tak Kwong; Tipoe, George Lim

2014-03-01

Adults without the capacity to make their own medical decisions have their rights protected under the Mental Capacity Act (2005) in the UK. The underlying principle of the court's decisions is the best interests test, and the evaluation of best interests is a welfare appraisal. Although the House of Lords in the well-known case of Bland held that the decision to withhold treatment for patients in a persistent vegetative state should not be based on their best interests, judges in recent cases have still held that the best interests of persistently vegetative patients demand that the right to die with dignity prevails over society's interest to preserve life. The basis of suggesting that it is in the best interests for one who is alive (although vegetative) in peace to die in peace is weak. Even if it may not be in their best interests to live on, it may not be so to die either. The phrase 'the right to dignity/to die with dignity' has been misused as a trump card to justify the speculation that a vegetative patient would necessarily refuse to live on machines. Without disrespect to the court's decision, we argue that the use of the best interests test to authorise withdrawing/withholding treatment from persistently vegetative patients without an advance directive is problematic. We propose that the court could have reached the same decision by considering only the futility of treatment without working through the controversial best interests of the patient.

The absent body: representations of dying early modern women in a selection of seventeenth-century diaries.

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Becker, L

2001-01-01

This article seeks to explore the absence of the body in the depiction of dying women in a selection of seventeenth-century diaries. It considers the cultural forces that made this absence inevitable, and the means by which the physical body was replaced in death by a spiritual presence. The elevation of a dying woman from physical carer to spiritual nurturer in the days before death ensured that gender codes were not broken. The centrality of the body of the dying woman, within a female circle of care and support, was paradoxically juxtaposed with an effacement of the body in descriptions of a good death. In death, a woman might achieve the stillness, silence and compliance so essential to perfect early modern womanhood, and retrospective diary entries can achieve this ideal by replacing the body with images that deflect from the essential physicality of the woman.

Can we make an early 'do not resuscitate' decision in severe burn patients?

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Yüce, Yücel; Acar, Hakan Ahmet; Erkal, Kutlu Hakan; Tuncay, Erhan

2017-03-01

The present study was conducted to examine topic of issuing early do-not-resuscitate (DNR) order at first diagnosis of patients with severe burn injuries in light of current law in Turkey and the medical literature. DNR requires withholding cardiopulmonary resuscitation in event of respiratory or cardiac arrest and allowing natural death to occur. It is frequently enacted for terminal cancer patients and elderly patients with irreversible neurological disorders. Between January 2009 and December 2014, 29 patients (3.44%) with very severe burns were admitted to burn unit. Average total burn surface area (TBSA) was 94.24% (range: 85-100%), and in 10 patients, TBSA was 100%. Additional inhalation burns were present in 26 of the patients (89.65%). All of the patients died, despite every medical intervention. Mean survival was 4.75 days (range: 1-24 days). Total of 17 patients died within 72 hours. Lethal dose 50 (% TBSA at which certain group has 50% chance of survival) rate of our burn center is 62%. Baux indices were used for prognostic evaluation of the patients; mean total Baux score of the patients was 154.13 (range: 117-183). It is well known that numerous problems may be encountered during triage of severely burned patients in Turkey. These patients are referred to burn centers and are frequently transferred via air ambulance between cities, and even countries. They are intubated and mechanical ventilation is initiated at burn center. Many interventions are performed to treat these patients, such as escharotomy, fasciotomy, tangential or fascial excision, central venous catheterization and tracheostomy, or hemodialysis. Yet despite such interventions, these patients die, typically within 48 to 96 hours. Integrity of the body is often lost as result of aggressive intervention with no real benefit, and there are also economic costs to hospital related to use of materials, bed occupancy, and distribution of workforce. For these reasons, as well as patient comfort

Die funksie van die belydenis in die struktuur van die kerk en die ...

African Journals Online (AJOL)

Ter wille van die argument wat in hierdie voordrag na vore gebring word, word vier sodanige konstituerende elemente van die kerklike struktuur onderskei, te wete die belydenis, die teologie, die verkondi- ging (meer bepaald die prediking) en die kerkorde (kerkwet volgens ons terminologie). Ons gaan nou elkeen hiervan ...

Attitudes of elderly Korean patients toward death and dying: an application of Q-methodology.

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Yeun, Eunja

2005-11-01

The aim of this study was to identify the attitudes of elderly Korean patients toward death and dying using Q-methodology to aid in the development of basic strategies for nursing care of elderly Koreans. Thirty participants at a university hospital sorted 40 selected Q-statements on a nine-point scale. Data analysis identified three types of attitudes toward death and dying in elderly patients in Korea: religion-dependent, science-adherent, and sardonic. Religion-dependent elders are highly dependent upon religion as evidenced by their reply that they would like to rely on God and a minister the most. Science-adherent elders have great affection for life and believe in modern medical advancements. The sardonic elders regard death as the dispensation of nature so there is no need to be afraid of death and dying. This study will contribute to the understanding that nurses and other health professionals have of the perceptions of elderly Koreans about death and dying. Also, the findings may provide the basis for the development of more appropriate strategies to improve death and dying education programs of health professionals.

die rol van die unieverdedigingsmag in die onderdrukking van die

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agv regeringsoptrede nie.39. Siotsom. In die geskiedenis van die Unieverdedigings- mag word die gebeure random die 1914-staking oorskadu deur die Rebellie en Suid-Afrika se deelname aan die Eerste Wereldoorlog. Tog was dit 'n belangrike mylpaal in die geskiedenis van die organisasie, omdat dit sy eerste optrede ...

Uncovering the decision-making work of transferring dying patients home from critical care units: An integrative review.

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Lin, Yanxia; Myall, Michelle; Jarrett, Nikki

2017-12-01

To understand how decisions are made to transfer dying patients home from critical care units. Many people prefer a home death, but a high proportion die in critical care units. Transferring dying patients home is recognized to be complex but transfer decision-making itself remains unclear. Integrative review. Seven bibliographic databases (origin-2015), grey literature and reference lists were searched. An integrative review method was used to synthesize data from diverse sources. Papers were selected through title and abstract screening and full-text reviewing, using inclusion and exclusion criteria derived from review questions. Following quality appraisal, data were extracted and synthesized using normalization process theory as a framework. The number of patients transferred home ranged from 1-346, with most papers reporting on the transfer of one or two patients. Four themes regarding transfer decision-making work were generated: divergent views and practice, multiple stakeholders' involvement in decision-making, collective work and limited understanding of individuals' experiences. The practice of transferring patients home to die and its decision-making varies internationally and is usually influenced by the care system, culture or religion. It is less common to transfer patients home to die from critical care units in western societies. A better understanding of the decision-making work was obtained but mainly from the perspective of hospital-based healthcare professionals. Further research is needed to develop decision-making practice guidance to facilitate patients' wishes to die at home. © 2017 John Wiley & Sons Ltd.

Experiences of Family Members of Dying Patients Receiving Palliative Sedation.

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Tursunov, Olga; Cherny, Nathan I; Ganz, Freda DeKeyser

2016-11-01

To describe the experience of family members of patients receiving palliative sedation at the initiation of treatment and after the patient has died and to compare these experiences over time.
. Descriptive comparative study.
. Oncology ward at Shaare Zedek Medical Center in Jerusalem, Israel.
. A convenience sample of 34 family members of dying patients receiving palliative sedation. 
. A modified version of a questionnaire describing experiences of family members with palliative sedation was administered during palliative sedation and one to four months after the patient died. Descriptive statistics were used to describe the results of the questionnaire, and appropriate statistical analyses were conducted for comparisons over time.
. Experiences of family members and time.
. Most relatives were satisfied with the sedation and staff support. Palliative sedation was experienced as an ethical way to relieve suffering. However, one-third felt that it shortened the patient's life. An explanation of the treatment was given less than half of the time and was usually given on the same day treatment was started. This explanation was given by physicians and nurses. Many felt that they were not ready for changes in the patient's condition and wanted increased opportunities to discuss the treatment with oncology care providers. No statistically significant differences in experiences were found over time. 
. Relatives' experiences of palliative sedation were generally positive and stable over time. Important experiences included timing of the initiation of sedation, timing and quality of explanations, and communication.
. Nurses should attempt to initiate discussions of the possible role of sedation in the event of refractory symptoms and follow through with continued discussions. The management of refractory symptoms at the end of life, the role of sedation, and communication skills associated with decision making related to palliative sedation should be a

Death and caring for dying patients: exploring first-year nursing students' descriptive experiences.

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Ek, Kristina; Westin, Lars; Prahl, Charlotte; Osterlind, Jane; Strang, Susann; Bergh, Ingrid; Hammarlund, Kina

2014-10-01

To describe first-year nursing students' experiences of witnessing death and providing end-of-life care. This study is part of a larger longitudinal project. Interviews (n=17) were conducted with nursing students at the end of their first year of education. To analyse the interviews (lived-experience descriptions), a thematic analysis, 'a search for meaning' ( Van Manen, 1997 ) was applied. The results are presented within the framework of four separate themes: (1) The thought of death is more frightening than the actual experience, (2) Daring to approach the dying patient and offering something of oneself, (3) The experience of not sufficing in the face of death and (4) Being confronted with one's own feelings. Nursing students require continuous support and opportunity to reflect and discuss their experiences about caring for dying patients and confronting death throughout the entirety of their education. In addition, teachers and clinical supervisors need to give support using reflective practice to help students to develop confidence in their capacity for caring for dying patients.

Die rol van die blanke werker in die motivering van die swart werker

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G. J. Oosthuizen

1980-11-01

Opsomming Die motivering van die Swart werker kan nie in die huidige situasie in isolasie bestudeer word nie, omdat die Blanke werker steeds in die bestuursposisie is en daarom die motivering van die Swart werker kan beïnvloed. Hierdie ondersoek was daarop gerig om die rol van die Blanke werker in die motivering van die Swart werker nader te ondersoek. Die houding en die leierskapsbenadering van die Blanke werker teenoor die Swart werker is gemeet, asook die behoeftes wat volgens die Blanke werker by die Swart werker bestaan, bevredig is, of nie bestaan nie. Die behoeftes van Swart werkers, soos deur hulleself gesien, is ook ondersoek. Ten opsigte van sekere aspekte is beduidende verskille gevind.

Attitude of Palestinian Nursing Students Toward Caring for Dying Patients: A Call for Change in Health Education Policy.

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Abu-El-Noor, Nasser Ibrahim; Abu-El-Noor, Mysoon Khalikl

2016-06-01

Death is a natural process that occurs each day. Some nursing students may encounter the experience of taking care of a dying patient while others do not. Therefore, their attitude toward death and caring for dying patients may vary. The purpose of this study was to assess Palestinian student nurses' attitudes toward death and caring for dying patients and their families. In a cross-sectional, descriptive study, all fourth-year students at the College of Nursing, Islamic University of Gaza, Palestine, were invited to participate in this study. A total of 141 students completed the Frommelt Attitude Toward Care of the Dying Scale Form B (FATCOD-B). Results revealed that the mean score on the FATCOD-B was (96.96 ± 8.30). Overall, nursing students in the sample demonstrated a relatively low attitude toward caring for dying patients and their families. No statistically significant differences of students' attitudes toward caring for dying patients were found between male and female students nor between students who attended death cases and those who did not. The results suggest that theoretical nursing education should place more emphasis on palliative care to improve the quality of care at the end of life. © The Author(s) 2015.

Music thanatology: prescriptive harp music as palliative care for the dying patient.

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Freeman, Lindsay; Caserta, Michael; Lund, Dale; Rossa, Shirley; Dowdy, Ann; Partenheimer, Andrea

2006-01-01

Music thanatology represents an emerging area in which the raw materials of music, usually harp and/or voice, assist and comfort the dying patient. During prescriptive "music vigils, " the clinician-musician carefully observes physiological changes, cues, and breathing patterns, thereby synchronizing the music to reflect or support the patient's physiology and overall condition. Using data collected from 65 patients, this study was designed to assess the effectiveness of prescriptive harp music on selected palliative care outcomes using a sample of de-identified data forms from past music vigils. Patients were administered a 25- to 95-minute intervention of prescriptive harp music. Data collected included vital signs and observational indicators before (Ti) and after (T2) the vigil. Patients were more likely to experience decreased levels of agitation and wakefulness while also breathing more slowly and deeply with less effort at the conclusion of the music vigil. Results from this study suggest that a prescriptive vigil conducted by a trained music thanatologist could provide an effective form of palliative care for dying patients.

Music therapy with imminently dying hospice patients and their families: facilitating release near the time of death.

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Krout, Robert E

2003-01-01

Hospice care seeks to address the diverse needs of terminally ill patients in a number of physical, psychosocial, and spiritual areas. Family members of the patient often are included in the care and services provided by the hospice team, and hospice clinicians face a special challenge when working with families of patients who are imminently dying. When loved ones are anticipating the patient's impending death, they may find it difficult to express feelings, thoughts, and last wishes. Music therapy is a service modality that can help to facilitate such communication between the family and the patient who is actively dying, while also providing a comforting presence. Music therapy as a way to ease communication and sharing between dying patients and their loved ones is discussed in this article. The ways in which music therapy can facilitate a means of release for both patients and family members in an acute care unit of a large US hospice organization are specifically described. Case descriptions illustrate how music therapy functioned to allow five patients and their families to both come together and let go near the time of death. Elements to consider when providing such services to imminently dying patients and their families are discussed.

The End-of-Life Phase of High-Grade Glioma Patients: Dying With Dignity?

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Sizoo, E.M.; Taphoorn, M.J.B.; Uitdehaag, B.M.J.; Heimans, J.J.; Deliens, L.; Reijneveld, J.C.; Pasman, H.R.W.

2013-01-01

Background. In the end-of-life (EOL) phase, high-grade glioma (HGG) patients have a high symptom burden and often lose independence because of physical and cognitive dysfunction. This might affect the patient's personal dignity. We aimed to (a) assess the proportion of HGG patients dying with

Doing one's utmost: nurses' descriptions of caring for dying patients in an intensive care environment.

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Fridh, Isabell; Forsberg, Anna; Bergbom, Ingegerd

2009-10-01

The aim of this study was to explore nurses' experiences and perceptions of caring for dying patients in an intensive care unit (ICU) with focus on unaccompanied patients, the proximity of family members and environmental aspects. Interviews were conducted with nine experienced ICU nurses. A qualitative descriptive approach was employed. The analysis was performed by means of conventional content analysis [Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res 2005;15:1277-88] following the steps described by e.g. Elo and Kyngas [Elo S, Kyngas H. The qualitative content analysis process. J Adv Nurs 2008;62:107-15]. The analysis resulted in a main category; Doing one's utmost, described by four generic categories and 15 sub-categories, comprising a common vision of the patients' last hours and dying process. This description was dominated by the nurses' endeavour to provide dignified end-of-life care (EOLC) and, when relatives were present, to give them an enduring memory of their loved one's death as a calm and dignified event despite his/her previous suffering and death in a high-technological environment. This study contributes new knowledge about what ICU nurses focus on when providing EOLC to unaccompanied patients but also to those whose relatives were present. Nurses' EOLC was mainly described as their relationship and interaction with the dying patient's relatives, while patients who died alone were considered tragic but left a lesser impression in the nurses' memory.

The end-of-life phase of high-grade glioma patients: dying with dignity?

NARCIS (Netherlands)

Sizoo, Eefje M.; Taphoorn, Martin J. B.; Uitdehaag, Bernard; Heimans, Jan J.; Deliens, Luc; Reijneveld, Jaap C.; Pasman, H. Roeline W.

2013-01-01

In the end-of-life (EOL) phase, high-grade glioma (HGG) patients have a high symptom burden and often lose independence because of physical and cognitive dysfunction. This might affect the patient's personal dignity. We aimed to (a) assess the proportion of HGG patients dying with dignity as

Die Region braucht die Kultur - die Kultur braucht die Region

OpenAIRE

Klemm, Ulrich

1995-01-01

Die Region braucht die Kultur - die Kultur braucht die Region. - In: Region in Aktion - oder: Region im Abseits? - Boxberg-Wölchingen : Eigenständige Regionalentwicklung Baden-Württemberg, 1995. - S. 25 f.

DIE GESKIEDENIS VAN DIE PERSONEELFUNKSIE IN DIE SA ...

African Journals Online (AJOL)

stel (kortdiensstelsel). Met die uitbreek van die oorlog in 1939 het die. Unieverdedigingsmag uit 40% Staandemag en. 60% aktiewe Burgermag bestaan. Op 22 Sept. 1939 is magtiging aan die Aktiewe Burgermag- eenhede verleen om vrywilligers vir die duur van die oorlog te aanvaar. Agv beswaar dat die Verdedigingswet.

Barriers to Quality Care for Dying Patients in Rural Communities

Science.gov (United States)

Van Vorst, Rebecca F.; Crane, Lori A.; Barton, Phoebe Lindsey; Kutner, Jean S.; Kallail, K. James; Westfall, John M.

2006-01-01

Context: Barriers to providing optimal palliative care in rural communities are not well understood. Purpose: To identify health care personnel's perceptions of the care provided to dying patients in rural Kansas and Colorado and to identify barriers to providing optimal care. Methods: An anonymous self-administered survey was sent to health care…

Die posisie van die Helper in die sending

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I. J. van der Walt

1972-05-01

Full Text Available Gedurende die aanvangsjare van die sending het die helper ’n onmisbare funksie vervul. Hulle het die onherbergsame binnelande geken, waardevolle kontakpunte vir die sendelinge geopen en hulle mense geestelik help voorlig en voorberei.

Why is the Liverpool care pathway used for some dying cancer patients and not others? Healthcare professionals’ perspectives

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Freemantle Alison

2012-09-01

Full Text Available Abstract Background Despite evidence suggesting that the Liverpool Care Pathway for the Dying Patient is a structured and proficient means of supporting care delivery in the last hours or days of life, discrepancies in uptake are widespread. This exploratory study sought to understand why patients dying of cancer in oncology wards of one hospital trust were, or were not, supported by the LCP. A purposive qualitative case study design was used; each case represented a patient who had died and their most involved nurse and doctor. In-depth interviews explored both recollections of the ‘case’ and wider experiences of using the Pathway in end-of-life care. Eleven healthcare professionals were interviewed about their involvement in the end-of-life care of six patients. For four of these patients care was supported by the LCP. Findings Although doctors and nurses reported they preferred to use the Pathway to ensure comfortable death, an important factor influencing their decisions was time of death. Access to timely senior review was regarded as an essential preliminary to placing patients on the Pathway but delayed access ‘out of hours’ was commonly experienced and tensions arose from balancing conflicting priorities. Consequently, the needs of dying patients sometimes failed to compete with those receiving curative treatment. Conclusions This study suggests that greater attention should be focused on ‘out of hours’ care in hospitals to ensure regular senior review of all patients at risk of dying and to support front line staff to communicate effectively and make contingency plans focused on patients’ best interests.

die ontstaan en die ontwikkeling van die skoolkadette-stelsel in die rsa

African Journals Online (AJOL)

toe algemene diensplig ingestel is. Die diens- plig het intussen sy volle beslag gekry en in. Weermagkringe het die gedagte posgevat dat skoolkadette. 'n deeglike ondersoek vereis ten einde die skoolgaande seun vir sy komende nasionale diensplig te orienteer. Tydens kadetopleldlng leer die seuns al die fynere kunsles ...

Quality of dying in nursing home residents dying with dementia: does advanced care planning matter? A nationwide postmortem study.

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An Vandervoort

Full Text Available Advance care planning is considered a central component of good quality palliative care and especially relevant for people who lose the capacity to make decisions at the end of life, which is the case for many nursing home residents with dementia. We set out to investigate to what extent (1 advance care planning in the form of written advance patient directives and verbal communication with patient and/or relatives about future care and (2 the existence of written advance general practitioner orders are related to the quality of dying of nursing home residents with dementia.Cross-sectional study of deaths (2010 using random cluster-sampling. Representative sample of nursing homes in Flanders, Belgium. Deaths of residents with dementia in a three-month period were reported; for each the nurse most involved in care, GP and closest relative completed structured questionnaires.We identified 101 deaths of residents with dementia in 69 nursing homes (58% response rate. A written advance patient directive was present for 17.5%, GP-orders for 56.7%. Controlling for socio-demographic/clinical characteristics in multivariate regression analyses, chances of having a higher mean rating of emotional well-being (less fear and anxiety on the Comfort Assessment in Dying with Dementia scale were three times higher with a written advance patient directive and more specifically when having a do-not-resuscitate order (AOR 3.45; CI,1.1-11 than for those without either (AOR 2.99; CI,1.1-8.3. We found no association between verbal communication or having a GP order and quality of dying.For nursing home residents with dementia there is a strong association between having a written advance directive and quality of dying. Where wishes are written, relatives report lower levels of emotional distress at the end of life. These results underpin the importance of advance care planning for people with dementia and beginning this process as early as possible.

Die funksie van die skeppingstradisie in die boek Jeremia

African Journals Online (AJOL)

gedeeites voor wat sterk ooreenkomste toon met die beskrywings van die skep pingsgebeure in die boek Jeremia. • Volgpns Von Rad (1957:144-146) het daar wel 'n groep bestaan wat belange ge- had liet by die oorlewering van die skeppingstradisies. Dit was waarskynlik die. Sadokitiese priesters wat om twee redes aan ...

Die binding van die konfessie

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P. J. Coetzee

1970-05-01

Full Text Available Ons moet waak teen twee uiterstes. Aan die een kant het die dogma as onversoenlike vyand die dogmatisme en aan die ander kant die antidogmatisme — dit hou enersyds die gevaar in van verabsolutering (oorskatting, en ander- syds die gevaar van relativisme (onderskatting.

Intensity of early correction of hyperglycaemia and outcome of critically ill patients with diabetic ketoacidosis.

Science.gov (United States)

Mårtensson, Johan; Bailey, Michael; Venkatesh, Balasubramanian; Pilcher, David; Deane, Adam; Abdelhamid, Yasmine Ali; Crisman, Marco; Verma, Brij; MacIsaac, Christopher; Wigmore, Geoffrey; Shehabi, Yahya; Suzuki, Takafumi; French, Craig; Orford, Neil; Kakho, Nima; Prins, Johannes; Ekinci, Elif I; Bellomo, Rinaldo

2017-09-01

To determine the impact of the intensity of early correction of hyperglycaemia on outcomes in patients with diabetic ketoacidosis (DKA) admitted to the intensive care unit. We studied adult patients with DKA admitted to 171 ICUs in Australia and New Zealand from 2000 to 2013. We used their blood glucose levels (BGLs) in the first 24 hours after ICU admission to determine whether intensive early correction of hyperglycemia to ≤ 180 mg/dL was independently associated with hypoglycaemia, hypokalaemia, hypo-osmolarity or mortality, compared with partial early correction to > 180 mg/dL as recommended by DKA-specific guidelines. Among 8553 patients, intensive early correction of BGL was applied to 605 patients (7.1%). A greater proportion of these patients experienced hypoglycaemia (20.2% v 9.1%; P < 0.001) and/or hypo-osmolarity (29.4% v 22.0%; P < 0.001), but not hypokalaemia (16.7% v 15.6%; P = 0.47). Overall, 11 patients (1.8%) in the intensive correction group and 112 patients (1.4%) in the partial correction group died (P = 0.42). However, after adjustment for illness severity, partial early correction of BGL was independently associated with a lower risk of hypoglycaemia (odds ratio [OR], 0.38; 95% CI, 0.30-0.48; P < 0.001), lower risk of hypo-osmolarity (OR, 0.80; 95% CI, 0.65-0.98; P < 0.03) and lower risk of death (OR, 0.44; 95% CI, 0.22-0.86; P = 0.02). In a large cohort of patients with DKA, partial early correction of BGL according to DKA-specific guidelines, when compared with intensive early correction of BGL, was independently associated with a lower risk of hypoglycaemia, hypo-osmolarity and death.

Die nabyheid van die Koninkryk

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W.J. Snyman

1963-03-01

Full Text Available Vanweë die belangrikheid daarvan volg hier ’n breër bespreking van die proefskrif van dr. Tjaart van der Walt oor die nabyheid van die Koninkryk as wat in ’n gewone resensie kan geskied. Die vraagstuk wat onder oë gesien word is so oud as die kerk en die teologie, soms minder en soms meer op die voorgrond. Tans kan gesê word, staan dit in die middelpunt. Daarby is dit nie maar ’n akademiese vraagstuk nie, maar ’n vraagstuk waarvoor elke nadenkende leser van die Skrif te staan kom.

Nursing care of patients during the dying process: a painful professional and human function.

Science.gov (United States)

Lopera Betancur, Martha Adiela

2015-01-01

This work sought to describe the care functions of nurses with patients during the dying process. This was a qualitative study with ethnographic approach stemming from the analysis of the culture of nurses; it was conducted in the city of Medellín, Colombia. Theoretical saturation was obtained with 23 interviews. Nurses feel the duty to care for patients throughout the vital cycle through functions defined as: serving, helping, accompanying, offering support, advocating, educating, and representing, which they identify as indispensable. They also perceive as their own the social responsibility for some issues related to death and due to this they get involved at the personal level, appropriate care and are affected as persons. Patient care during dying processes transcends the limits of the nurse' professional functions to become a human obligation.

Suffering and euthanasia: a qualitative study of dying cancer patients' perspectives.

Science.gov (United States)

Karlsson, Marit; Milberg, Anna; Strang, Peter

2012-05-01

Although intolerable suffering is a core concept used to justify euthanasia, little is known about dying cancer patients' own interpretations and conclusions of suffering in relation to euthanasia. Sixty-six patients with cancer in a palliative phase were selected through maximum-variation sampling, and in-depth interviews were conducted on suffering and euthanasia. The interviews were analyzed using qualitative content analysis with no predetermined categories. The analysis demonstrated patients' different perspectives on suffering in connection to their attitude to euthanasia. Those advocating euthanasia, though not for themselves at the time of the study, did so due to (1) perceptions of suffering as meaningless, (2) anticipatory fears of losses and multi-dimensional suffering, or (3) doubts over the possibility of receiving help to alleviate suffering. Those opposing euthanasia did so due to (1) perceptions of life, despite suffering, as being meaningful, (2) trust in bodily or psychological adaptation to reduce suffering, a phenomenon personally experienced by informants, and (3) by placing trust in the provision of help and support by healthcare services to reduce future suffering. Dying cancer patients draw varying conclusions from suffering: suffering can, but does not necessarily, lead to advocations of euthanasia. Patients experiencing meaning and trust, and who find strategies to handle suffering, oppose euthanasia. In contrast, patients with anticipatory fears of multi-dimensional meaningless suffering and with lack of belief in the continuing availability of help, advocate euthanasia. This indicates a need for healthcare staff to address issues of trust, meaning, and anticipatory fears.

Transcultural comparison of hospital and hospice as caring environments for dying patients.

Science.gov (United States)

Gates, M F

1991-01-01

Leininger's nursing Theory of Cultural Care Diversity and Universality provided the framework for this comparative study of two environments for persons who are dying; namely a hospital oncology unit and a free-standing hospice unit. Analysis of data from ethnographic and ethnonursing research methods including unstructured interviews, observation-participation, and field journal materials yielded contrasts with two settings. The presence of a caring atmosphere/ambience was apparent in both the hospital and hospice. Universal patterns common to both were: caring beliefs and practices of staff; identification of each setting as "community" or "home"; and multiple symbolic uses of humor and food. Diversities included hierarchical organizational structure and cure orientation in the hospital; interdisciplinary collaboration and care orientation in hospice; more pronounced use of touch as a caring modality; and greater evidence of symbolism and ritual related to death and dying in hospice. Adoption of the cultural care modes of accommodation, repatterning, and maintenance are suggested in promoting a caring atmosphere wherever dying patients are served.

Determinants of care outcomes for patients who die in hospital in Ireland: a retrospective study.

LENUS (Irish Health Repository)

McKeown, Kieran

2015-04-18

More people die in hospital than in any other setting which is why it is important to study the outcomes of hospital care at end of life. This study analyses what influenced outcomes in a sample of patients who died in hospital in Ireland in 2008\\/9. The study was undertaken as part of the Irish Hospice Foundation\\'s Hospice Friendly Hospitals Programme (2007-2012).

["Good dying"--definition and current state of research].

Science.gov (United States)

Hutter, Nico; Stößel, Ulrich; Meffert, Cornelia; Körner, Mirjam; Bozzaro, Claudia; Becker, Gerhild; Baumeister, Harald

2015-08-01

The advances of modern medicine did not only result in prolongation of life expectancy, but also led to a shift from dying at home to dying in public institutions. In western countries most people die at advanced age in medical facilities. Hence, the question regarding the conditions, which should be provided by society and especially medicine, to allow terminally ill people to experience "good dying" is substantial. For this purpose, an examination of patients', family members' and health care providers' understanding of the term " good dying" is required. The present paper aims at shedding light on the term "good dying" and to summarize the current state of research. Therefore, the attributes of "good dying" will be described from the perspectives of patients, family members and health care providers, which are discussed and examined in current medical-sociological research. These attributes can be illustrated on three dimensions: Quality of life at the end of life (e. g. pain relief, mental well-being), quality of dying (e. g. avoiding prolonged dying, autonomy, presence of relatives) and quality of health care at the end of life (e. g. patient-oriented health care, positive communication between health care providers and patients, availability of guidelines). Although the attributes of "good dying" are described in detail in the existing literature, further studies have to clarify the relevance and impact of these attributes as predictors of "good dying". © Georg Thieme Verlag KG Stuttgart · New York.

Factors associated with preference for dying at home among terminally ill patients with cancer

DEFF Research Database (Denmark)

Schou-Andersen, Marianne; Ullersted, Maria P; Jensen, Anders Bonde

2016-01-01

relatives of deceased patients who died of cancer in Denmark in 2006. Bereaved relatives were asked to state patient's preference concerning place of death at the beginning and end of the palliative period. These data were recently combined with updated, extensive demographic and socio-economic data from...

Nursing care of patients during the dying process: a painful professional and human function

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Martha Adiela Lopera Betancur

2015-08-01

Full Text Available Objective. This work sought to describe the care functions of nurses with patients during the dying process. Methodology. This was a qualitative study with ethnographic approach stemming from the analysis of the culture of nurses; it was conducted in the city of Medellín, Colombia. Theoretical saturation was obtained with 23 interviews. Results. Nurses feel the duty to care for patients throughout the vital cycle through functions defined as: serving, helping, accompanying, offering support, advocating, educating, and representing, which they identify as indispensable. They also perceive as their own the social responsibility for some issues related to death and due to this they get involved at the personal level, appropriate care and are affected as persons. Conclusion. Patient care during dying processes transcends the limits of the nurse' professional functions to become a human obligation.

Die histologie en ultrastruktuur van die hepatopankreas van die bloukurper Oreochromis mossambicus

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M. M. Nel

1990-07-01

Full Text Available Die histologie en ultrastruktuur van die hepatopankreas van die bloukurper Oreochromis mossambicus word beskryf. ’n Dun bindweefselkapsel omring die lewer. Die hepatosietrangskikking vertoon as lobules, met die koorde van hepatosiete wat vanaf ’n sentrale vene uitradieer en met mekaar anastomaseer. Indiwiduele lewerlohules vertoon nie duidelike grense nie, maar enkele duidelike triades word wel in die lewer van O. mossambicus aangetref. Die hepatosiete bevat ’n enkele ronde kern met ’n duidelike nukleolus en die growwe endoplasmiese retikula kom in twee of meer rye om die kerne en teen die selgrense van die hepatosiete voor. Die ander sitoplasmiese organelle kom verspreid in die hepatosietsitoplasma voor. Die eksokriene pankreasselle is om die portale venes gesetel. Die kerne van hierdie selle is rond en is hasaal in die kubies- tot silindervormige selle gelee. ’n Goedontwikkelde growwe endoplasmiese retikulum — vesikulêr, tubulêr en sirkulêr in vorm — en sektretoriese granules wat apikaal in die sel gelee is, kom voor.

die impak van metodologie op die verstaan van die nuwe testament

African Journals Online (AJOL)

voorbeeld eers een maal deur die bril van die vorm- en redaksiekritiek na die Evangelies gekyk het, dink jy vir altyd anders oor hulle tot- standkoming. Inderdaad, nuwe metodes lei tot nuwe perspektiewe! Dit is dan ook waar die fokus van hierdie artikel val: die impak van metodologie op die verstaan van die Nuwe ...

Die vrede van Münster / Westfale en die betekenis daarvan vir die ...

African Journals Online (AJOL)

In die Suid-Afrikaanse kerkgeskiedenis egter is die Vrede van Münster as epogmakende gebeure tot dusver nie net in die algemeen verwaarloos nie, maar boonop is die direkte verband tussen hierdie sentrale historiese baken aan die een kant en aan die ander kant die vestiging van die VOC se verversingspos aan die ...

Survival and psychomotor development with early betaine treatment in patients with severe methylenetetrahydrofolate reductase deficiency.

Science.gov (United States)

Diekman, Eugene F; de Koning, Tom J; Verhoeven-Duif, Nanda M; Rovers, Maroeska M; van Hasselt, Peter M

2014-02-01

The impact of betaine treatment on outcome in patients with severe methylenetetrahydrofolate reductase (MTHFR) deficiency is presently unclear. To investigate the effect of betaine treatment on development and survival in patients with severe MTHFR deficiency. MEDLINE, EMBASE, and Cochrane databases between January 1960 and December 2012. Studies that described patients with severe MTHFR deficiency who received betaine treatment. We identified 15 case reports and case series, totaling 36 patients. Data included the following: (1) families with 2 or more patients with severe MTHFR deficiency, of whom at least 1 received betaine, or (2) single patients with severe MTHFR deficiency treated with betaine. To define severe MTHFR deficiency, methionine, homocysteine, MTHFR enzyme activity in fibroblasts, or mutations (in the MTHFR gene) had to be described as well as the effect of treatment (survival and/or psychomotor development). We compared the outcome in treated vs untreated patients and early- vs late-treated patients. Sensitivity analysis was performed to address definition of early treatment. To further assess the impact of treatment on mortality, we performed a subanalysis in families with at least 1 untreated deceased patient. Survival and psychomotor development. Eleven of 36 patients (31%) died. All deaths occurred in patients who did not receive treatment or in patients in whom treatment was delayed. In contrast, all 5 early-treated patients survived. Subgroup analysis of patients with deceased siblings-their genotypically identical controls-revealed that betaine treatment prevented mortality (P = .002). In addition, psychomotor development in surviving patients treated with betaine was normal in all 5 early-treated patients but in none of the 19 surviving patients with delayed treatment (P psychomotor development in patients with severe MTHFR deficiency, highlighting the importance of timely recognition through newborn screening.

Lactate clearance cut off for early mortality prediction in adult sepsis and septic shock patients

Science.gov (United States)

Sinto, R.; Widodo, D.; Pohan, H. T.

2018-03-01

Previous lactate clearance cut off for early mortality prediction in sepsis and septic shock patient was determined by consensus from small sample size-study. We investigated the best lactate clearance cut off and its ability to predict early mortality in sepsis and septic shock patients. This cohort study was conducted in Intensive Care Unit of CiptoMangunkusumo Hospital in 2013. Patients’ lactate clearance and eight other resuscitationendpoints were recorded, and theoutcome was observed during the first 120 hours. The clearance cut off was determined using receiver operating characteristic (ROC) analysis, and its ability was investigated with Cox’s proportional hazard regression analysis using other resuscitation endpoints as confounders. Total of 268 subjects was included, of whom 70 (26.11%) subjects died within the first 120 hours. The area under ROC of lactate clearance to predict early mortality was 0.78 (95% % confidence interval [CI] 0.71-0.84) with best cut off was <7.5% (sensitivity and specificity 88.99% and 81.4% respectively). Compared with group achieving lactate clearance target, group not achieving lactate clearance target had to increase early mortality risk (adjusted hazard ratio 13.42; 95%CI 7.19-25.07). In conclusion, the best lactate clearance cut off as anearly mortality predictor in sepsis and septic shock patients is 7.5%.

die pers as bron oor die geskiedenis van die eerste vrydeidsoorlog

African Journals Online (AJOL)

dood agv wonde wat hy tydens die slag opgedoen het. Dit was vir die Britse volk onaanvaarbaar dat slegs twee Boere gedood is nadat daar tussen. 20 000 en 30 000 rondtes op die Boere afgevuur is. Die pers kon net nie die ware syfers publiseer nie, want dit sou na 'n onwaarheid Iyk. Het die. Britse volk egter die Boere ...

Die partypolitiek en die toekoms van die Afrikaanse volkskultuur

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A.P. Treurnicht

1970-03-01

Full Text Available Reeds in 1853 het die Zuid Afrikaan hom soos volg uitgelaat: „Dis ’n dwaling wat ons reeds meermale bestry het dat ons as Britse onderdane verplig sou wees, om die Britse nasionaliteit ons s’n te maak. Die Kolonis van Hollandse oorsprong kan geen Engelsman word nie, en moet ook geen Nederlander wil wees nie. Wanneer hy weet om sy standpunt te waardeer, dan sal hy as verligte kolonis die grondtrekke van die Engelse volkskarakter met dié van die Nederlandse harmonies leer verenig en daardeur word wat hy as Kapenaar moet word.”

die heidelbergse kategismus en die kategesemateriaal van die ned

African Journals Online (AJOL)

subjek, objek, leerstof en die metodiek van die senior kategese. Bloemfontein: Algemene Jeugkommissie Sondagskoolboekhandel. de rAAd oer ned ger kerken in Zuid AfrikA. 1921. De zevende vergadering: handelinge. 1925. De negende vergadering: handelinge. de villierS, d. W. 1957. Die Kategese in die Ned. Geref.

Physicians' current practices and opportunities for DNA banking of dying patients with cancer.

Science.gov (United States)

Quillin, John M; Bodurtha, Joann N; Siminoff, Laura A; Smith, Thomas J

2011-05-01

The availability of genetic tests for cancer susceptibility is increasing. Current tests, however, have limited clinical sensitivity. Even when clinically valid tests are available, the genetic counseling and informed consent process might not be feasible for dying patients with cancer. DNA banking preserves the opportunity for future research or clinical testing and may provide critical opportunities for surviving relatives. This study explored the current practices and potential for DNA banking for cancer susceptibility among oncologists specializing in palliative care. Palliative care oncologists actively providing clinical care for dying patients with cancer were recruited for an online survey. Descriptive statistics for DNA banking practices, perceived qualification to recommend banking, and potential predictors were assessed. Data were collected from 49 physicians (37% recruitment rate). Eighty percent reported assessing at least some patients for genetic cancer susceptibility in the past 12 months. No participants reported banking DNA for patients in the past 12 months. Only 5% reported feeling at least somewhat qualified to order DNA banking. A Web-based risk assessment tool and genetic counselor on staff were perceived as the most helpful potential resources. Despite its potential, DNA banking is not being used by palliative care oncologists.

Work engagement and attitudes toward caring for dying patients and families among home-visiting nurses in Japan.

Science.gov (United States)

Mahiro, Sakai; Takashi, Naruse; Satoko, Nagata

2014-07-01

Nurses with higher levels of work engagement tend to be highly efficient in their work and more willing to keep working and to provide patient-centred care. However, whether more engaged nurses provide end-of-life care more proactively has not been examined in the home-care setting. This study aimed to examine work engagement among home-visiting nurses in Japan and its relationship with their attitudes toward caring for dying patients and their families. A total of 343 nurses working in 62 agencies across Chiba prefecture, eastern Japan, received an anonymous self-administered questionnaire from July to August 2012. The authors performed multiple regression analysis to explore the relationships between home-visiting nurses' work engagement and attitudes. Data from 184 nurses (53.6%) was analysed. Work engagement was significantly positively related to the nurses' attitudes toward caring for dying patients and their families. As more engaged nurses tend to have more positive attitudes toward caring for dying patients and their families, further research is needed to identify the factors that might help nursing managers to enhance their staff's engagement and perhaps thereby improve their attitudes, with the ultimate aim of achieving better outcomes for patients and families.

Die invloed van die neo-marxistiese kultuuranalise op die Wêreldraad van Kerke en die Gereformeerde Kerke van Nederland

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J. M. Vorster

1979-05-01

Full Text Available Toe die studente dwarsoor die VSA en Europa in die laat sestigerjare ’n plotselinge en radikale verset openbaar het teen die bestaande orde, het hulle die deur geopen vir ’n nuwe mededinger om die hart van die Westerse kultuur. Dit is die nou reeds bekende neo-Marxisme. Sedertdien het hierdie jongeling sy voetspore op vele vlakke van die Westerse kultuur gelaat.

Die regsposisie van die gemolesteerde kind 1

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P.J. Schabort

1991-03-01

Full Text Available Hoe reik die reg uit na die seksueel gemolesteerde kind? As na die reg in wye verband gekyk word, sou dit alie wetgewing en alle gemeneregsbeginsels en alle regsprosedures insluit waardeur die Staat poog om molestering te voorkom en die gemolesteerde kind in beskerming te neem. Dit le baie wyd en sou byvoorbeeld die maatreels insluit van die Kindenvet 33 van 1960; die Wet op Egskeiding 70 van 1979; die Wet op Kindersorg 74 van 1983; die Wet op die Status van Kinders 82 van 1987 en die Wet op Bemiddeling in Sekere Egskeidingsaangeleenthede 24 van 1987. Eersdaags sal dit moontlik ook ’n Manifes vir die Regte van Kinders insluit wat vermoedelik geskoei sal wees op die W O se Konvensie vir die Regte van die Kind (1989 w a arv an die RSA tan s nog nie ’n ondertekenaar is nie.

Die hervertolking van die paradigma in verband met die ...

African Journals Online (AJOL)

Kerkorde van De Mist en die Algemene Reglement van 1816, wat onderskeidelik vir die Kaapse Kerk en die .... Een van die eerstes was Sam Freiherr von Pufendorf (1632-1694) wat in sy werk De habitu religionis ..... Koning was weer aan bewind (vgl Diepenhorst sj:74w; De Visser 1926/1927 lll:202w). 43.1 JD Janssen ...

Die teologiese skool in die P.U.K vir C.H.O.: met die betekenis van die teologiese skool vir die Christelike wetenskap

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F. Postma

1944-03-01

Full Text Available Die Teologiese Skool van die Gereformeerde Kerk gedink op 29 November 1944 sy vyf-en-sewentigjarige bestaan.Die Raad en Senaat van die P.U.K. vir C.H.O. wil ook langs hierdie weg die Teologiese Skool van harte gelukwens en die versekering gee dat daar by die outoriteite van die P.U.K. ’n diepgevoelde dankbaarheid heers dat hierdie inrigting sovele jare deur onse God en Vader gedra en gespaar is.

Are religiousness and death attitudes associated with the wish to die in older people?

Science.gov (United States)

Bonnewyn, Anke; Shah, Ajit; Bruffaerts, Ronny; Demyttenaere, Koen

2016-03-01

A wish to die is common in older persons and is associated with increased mortality. Several risk factors have been identified, but the association between religiousness and a wish to die in older adults has been underexplored, and the association between death attitudes and the presence of a wish to die has not been investigated yet. The aim of this study is to explore the relationship between religiousness and death attitudes on the one hand and wish to die on the other hand, adjusting for clinical factors such as the presence of depression or somatic disorder. The sample comprised 113 older inpatients (from a psychiatric and somatic ward) with a mean age of 74 years. Psychiatric diagnoses were assessed by the Structured Clinical Interview for DSM-IV Disorders, and logistic regression analyses estimated the unique contribution of religiousness and death attitudes to the wish to die, controlling for socio-demographic variables, depressive disorder, and somatic symptoms. Both religiousness and death attitudes were associated with a wish to die in univariate models. Adding these variables in a multivariate logistic hierarchical model, death attitudes remained significant predictors but religiousness did not; 55% of the pseudovariance of the wish to die was explained by these variables, with an effective size of 0.89. Major depressive episode, somatic symptoms, Fear of Death, and Escape Acceptance were the most important predictors of the wish to die. This study suggests that how older adults perceive death partly determines whether they have a wish to die. There may be a clinical, patient-oriented benefit in discussing with older patients about how they perceive death, as this can play a role in the early detection (and prevention) of death or suicide ideation and associated behaviors in older adults.

die sinodale verband van die nederduitse gereformeerde kerk in die

African Journals Online (AJOL)

Liezel

Strauss. Die sinodale verband van die Nederduitse Gereformeerde Kerk. 122 die Vrystaatse Sinode anti-veranderingsgesind of eerder gesond-behoudend of gereformeerd-gematig? Veral as dit .... howe) in moeilike omstandighede gebring is (NG Kerk in die OVS 1865-1912:5). In 'n brief op 8 Augustus 1864 ontken Ds.

Die kerkregtelike posisie van die ouderling en diaken in die ...

African Journals Online (AJOL)

... drie dekades die Kerkreg gevestig as 'n selfstandige vak in die teologiese curriculum, maar ook 'n baie groot rol gespeel daarin dat die beginsels van die kerk like reg beter begryp word. Naas sy wetenskaplike bydrae word met eweveel genoegdoening gedink aan sy bcsondere persoonlikheid, sy werkvermoe, sy humor-.

Die gebruik van parallelplaatreologie vir die bepaling van die intrinsieke viskositeit van poli-etileentereftalaat

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O. C. Vorster

2005-09-01

Full Text Available Die bepaling van die intrinsieke viskositeit van poli-etileentereftalaat word bemoeilik deur die feit dat daar tans slegs twee metodes in gebruik is. In die eerste metode word die bepaling deur middel van oplossingsviskometrie gedoen, maar die toksisiteit van die oplosmiddel, asook die tydperk wat dit neem om die bepaling te doen, is ’n probleem. Die tweede metode word beperk deur die kompleksiteit en beskikbaarheid van die apparatuur in Suid-Afrika. In hierdie studie word ’n alternatiewe metode, gebaseer op parallelplaatreologie, voorgestel wat albei hierdie probleme oorkom en die resultate sodoende verkry, word vergelyk met dié wat met bestaande metodes verkry is.

Die ontwikkeling van die bestuursmotiveringsvraelys (BMV

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A. S. Engelbrecht

1991-06-01

Full Text Available The development of the Managerial Motivation Questionnaire (MMQ: Several criticisms of the psychometric suitability of existing measures of managerial motivation are reported in the literature. This study aimed at developing a new psychometrically sound instrument, the Managerial Motivation Questionnaire (MMQ. This was done on the basis of a comprehensive study of the literature on managerial motivation and the role-motivation theory. The preliminary MMQ was systematically shortened and refined until the final MMQ of 98 items was composed. This was based on social desirability and semantic appraisal, item analysis and factor analysis of the questionnaire. The results indicate that it was possible to develop a final MMQ that was relatively free of social desirability. It further demonstrated satsifactory internal consistencies on two samples (a = 0/90, N = 360; a = 0/91, N = 535, where all subscale items were found to be relatively pure measures of the isolated factors. Although some evidence was found providing support for the reliability of the MMQ, a need for further research on the construct validity of managerial motivation still exists. Opsomming In die literatuur word verskeie punte van kritiek teen die psigometriese geskiktheid van bestaande meetinstrumente van bestuursmotivering gerapporteer. Die doelstelling van hierdie studie was dus om aan die hand van die konseptuele omiyning van bestuursmotivering, en die rolmotiveringsteorie as algemene verwysingsraamwerk, 'n nuwe psigometries aanvaarbare meetinstrument, die Bestuursmotiveringsvraelys (BMV, te ontwikkel. Op grond van sosiale wenslikheids- en semantiese beoordeling, itemontleding en faktorontleding van die voorlopige BMV is die vraelys stelselmatig verkort en verfyn totdat die finale BMV van 98 items saamgestel is. Die resultate dui daarop dat hierdie studie wel daarin geslaag het om 'n finale BMV te ontwikkel wat relatief vry van sosiale wenslikheid is, bevredigende interne

Validation of a Pediatric Early Warning Score in Hospitalized Pediatric Oncology and Hematopoietic Stem Cell Transplant Patients.

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Agulnik, Asya; Forbes, Peter W; Stenquist, Nicole; Rodriguez-Galindo, Carlos; Kleinman, Monica

2016-04-01

To evaluate the correlation of a Pediatric Early Warning Score with unplanned transfer to the PICU in hospitalized oncology and hematopoietic stem cell transplant patients. We performed a retrospective matched case-control study, comparing the highest documented Pediatric Early Warning Score within 24 hours prior to unplanned PICU transfers in hospitalized pediatric oncology and hematopoietic stem cell transplant patients between September 2011 and December 2013. Controls were patients who remained on the inpatient unit and were matched 2:1 using age, condition (oncology vs hematopoietic stem cell transplant), and length of hospital stay. Pediatric Early Warning Scores were documented by nursing staff at least every 4 hours as part of routine care. Need for transfer was determined by a PICU physician called to evaluate the patient. A large tertiary/quaternary free-standing academic children's hospital. One hundred ten hospitalized pediatric oncology patients (42 oncology, 68 hematopoietic stem cell transplant) requiring unplanned PICU transfer and 220 matched controls. None. Using the highest score in the 24 hours prior to transfer for cases and a matched time period for controls, the Pediatric Early Warning Score was highly correlated with the need for PICU transfer overall (area under the receiver operating characteristic = 0.96), and in the oncology and hematopoietic stem cell transplant groups individually (area under the receiver operating characteristic = 0.95 and 0.96, respectively). The difference in Pediatric Early Warning Score results between the cases and controls was noted as early as 24 hours prior to PICU admission. Seventeen patients died (15.4%). Patients with higher Pediatric Early Warning Scores prior to transfer had increased PICU mortality (p = 0.028) and length of stay (p = 0.004). We demonstrate that our institution's Pediatric Early Warning Score is highly correlated with the need for unplanned PICU transfer in hospitalized oncology and

Die uitbouing van die Bybelse kanon in antieke Judaïsme en die ...

African Journals Online (AJOL)

31 Jul 2015 ... die oer-Christelike boodskap tot by sy Ou Testamentiese wortels, die geskrifte van Israel wat cum grano salis die 'Bybel' van die oer-Christendom geword het en die blywende verwysingspunt van die Christelike boodskap is. Erkenning. Hierdie artikel is vertaal na Afrikaans deur Prof. Jan G. van der Watt.

Influence of Training on First-Year Nursing Department Students' Attitudes on Death and Caring for Dying Patients: A Single-Group Pretest-Posttest Experimental Study.

Science.gov (United States)

Cerit, Birgül

2017-01-01

The study examined the influence of training on first-year nursing department students' attitudes on death and caring for dying patients. Utilizing the experimental model, the study sample consisted of 81 first-year students attending the nursing department of a university. Death Attitude Profile-Revised and Frommelt Attitude toward Care of the Dying Scale were used for data collection. Data analysis included means, standard deviation, and t test for related samples. Student attitudes toward death were measured as 146.43 (16.741) and 152.75 (15.132) for pre- and posttraining, respectively. Student attitudes toward caring for dying patients were established to be 103.02 (7.655) during pretraining period and 111.02 (10.359) at posttraining period. The difference between pre- and posttests for mean attitudes toward death and caring for the dying patient was statistically significant. Study results determined that training was effective in forming positive student attitudes toward death and caring for dying patients.

Existential Needs among the Dying

DEFF Research Database (Denmark)

Moestrup, Lene

meaning making. Methods: The key research question is: 1. What kind of existential needs are central to dying cancer patients and their relatives during the terminal phase in Danish hospices? Exploring this highly sensitive and complex research area entails substantial ethical responsibility during data...... based and practice relevant knowledge about the complexity of existential considerations and needs among dying cancer patients and their relatives in a secularized society as Denmark. Existential needs are seen as a multidimensional concept that encompasses religious, spiritual and secular existential...

Would you be surprised if this patient died?: Preliminary exploration of first and second year residents' approach to care decisions in critically ill patients

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Armstrong John D

2003-01-01

Full Text Available Abstract Background How physicians approach decision-making when caring for critically ill patients is poorly understood. This study aims to explore how residents think about prognosis and approach care decisions when caring for seriously ill, hospitalized patients. Methods Qualitative study where we conducted structured discussions with first and second year internal medicine residents (n = 8 caring for critically ill patients during Medical Intensive Care Unit Ethics and Discharge Planning Rounds. Residents were asked to respond to questions beginning with "Would you be surprised if this patient died?" Results An equal number of residents responded that they would (n = 4 or would not (n = 4 be surprised if their patient died. Reasons for being surprised included the rapid onset of an acute illness, reversible disease, improving clinical course and the patient's prior survival under similar circumstances. Residents reported no surprise with worsening clinical course. Based on the realization that their patient might die, residents cited potential changes in management that included clarifying treatment goals, improving communication with families, spending more time with patients and ordering fewer laboratory tests. Perceived or implied barriers to changes in management included limited time, competing clinical priorities, "not knowing" a patient, limited knowledge and experience, presence of diagnostic or prognostic uncertainty and unclear treatment goals. Conclusions These junior-level residents appear to rely on clinical course, among other factors, when assessing prognosis and the possibility for death in severely ill patients. Further investigation is needed to understand how these factors impact decision-making and whether perceived barriers to changes in patient management influence approaches to care.

Die verband tussen die sielkundige kontrak en organisasieverbondenheid

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K. J. Stanz

1999-06-01

Full Text Available The relationship between the psychological contract and organisational commitment. The aim of this study is to design a measuring instrument with acceptable metric characteristics for the strength of the psychological contract within the South African context, and to determine empirically the relation between the strength of the psychological contract and organisational commitment. The Dhammanungune Model served as foundation for the design of the Strength of the Psychological Contract Questionnaire which consists of two scales namely, a needs expectation scale and a needs fulfilment expectation scale. The items of each scale have been formulated in the manner that ensures that the respondent reacts consecutively to two instructions namely, (a the level of the expectation and (b the importance of the expectation. This questionnaire was administered together with the Organisational Commitment Questionnaire to two population groups within the military environment. The Pearson Product Moment Correlation was calculated between the strength of the psychological contract and organisational commitment and the significance of the correlations was evaluated. Opsomming Die doel van die studie is om 'n meetinstrument met aanvaarbare metriese eienskappe vir die sterkte van die sielkundige kontrak vir Suid-Afrikaanse omstandighede te ontwerp en om empirics die verband tussen die sterkte van die sielkundige kontrak en organisasieverbondenheid te bepaal. Die sterkte van die sielkundige kontrak vraelys is op grond van die Dhammanungune-model ontwerp en het uit twee skale naamlik, die behoefteverwagting- en vervullingsverwagtingskale bestaan. Items vir eike skaal is sodanig geformuleer dat die respondent agteropeenvolgens op twee instruksies naamlik (a die vlak van die verwagting en (b die belangrikheid van die verwagting moet reageer. Die vraelys is saam met die organisasieverbondenheidsvraelys op twee populasies uit 'n militere omgewing toegepas. Die Pearson

[Clinical evaluation on causes of death in patients with active pulmonary tuberculosis].

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Kuba, M; Nakasone, K; Miyagi, S; Kyan, K; Shinzato, T; Kohagura, N; Futenma, M; Genka, K

1996-04-01

Seventy one patients with active pulmonary tuberculosis who died during the past 5 years (1989 to 1993) were evaluated on their causes of death. Twenty two patients (31%) died directly of tuberculosis, and among them, 18 patients (81%) of 22 patients who died of tuberculosis) had very advanced tuberculosis. The majority of them (64%) were old age over 70 years and were bedridden due mostly to cerebrovascular injuries. The serum level of albumin was low in all 17 patients in whom it was measured. Establishment of diagnosis of tuberculosis was delayed over one month after the onset of symptoms in 59% of patients who died of severe disease. Sixty one percent (11/18) of patients died within the first month after the initiation of chemotherapy and about 90% (16/18) died within 3 months. Two patients died from massive hemoptysis and other patients died of either respiratory failure or tuberculosis meningitis. From these observations it was found that very advanced tuberculosis was the major cause of death in patients who died of tuberculosis and that the advanced disease was chiefly caused by the delay on the establishment of diagnosis, and it was most important to detect tuberculosis as early as possible, with regular check up of chest X-ray and frequent examination for AFB (acid-fast bacilli) for tuberculosis suspected patients. On the other hand, the majority of patients (49/71) died of complicating medical problem unrelated to tuberculosis. Seventeen patients died from malignancy (seven lung cancer, four lymphoma, two laryngeal cancer, etc). Ten deaths were the result of bacterial superinfection. Other patients died from respiratory failure due to COPD, arteiosclerotic heart disease, or cerebrovascular injuries, etc. Two patients of old age died of hepatic failure possibly caused by adverse reaction of TB chemotherapy. It was found that diseases unrelated to tuberculosis were the cause of death in approximately 70% of patients with active tuberculosis, and it should

DIE ROL VAN DIE TAALWETENSKAP IN DIE ONTWIKKELING VAN ...

African Journals Online (AJOL)

aanslag op die sogenaamde "Intentional Fallacy", heelwat verder. n. Mens sou hier eintlik ook op die invloed van Lacan se toepassing van. De Sacs sure op Freud moet wys, en op Macherey se Theory of Literary. Production. Barthes is naamlik besig om repressie teen te werk, en die teks as produksieproses in stede van ...

Student Nurses' Perception of Death and Dying

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Niederriter, Joan E.

2009-01-01

Student nurses are involved in caring for patients who are actively dying or who have been told they have a terminal illness and are faced with the process of dying. Students encounter these patients in hospitals, nursing homes, at home or in hospice care settings. According to Robinson (2004), "nurses are the healthcare providers that are most…

Die belangrikste kenmerk van die diereproduksie- bedrywe oor die ...

African Journals Online (AJOL)

digdhede teen 1980 uit 'n kudde van 30 rnilj.skape ge- produseer moet word. Tweedens sal die faktore ... die Republiek van Suid-Mrika teen 1980 in totaal 28 milj. sal wees. Indien die produsente dit as 'n ..... Appendix Table 4 in Digestive Physiology and nutrition of ruminants Vol. 3 Ed. and Publ. D.C. Church, Oregon State ...

Maintaining Low Voiding Solder Die Attach for Power Die While Minimizing Die Tilt

Energy Technology Data Exchange (ETDEWEB)

Hamm, Randy; Peterson, Kenneth A.

2015-10-01

This paper addresses work to minimize voiding and die tilt in solder attachment of a large power die, measuring 9.0 mm X 6.5 mm X 0.1 mm (0.354” x 0.256” x 0.004”), to a heat spreader. As demands for larger high power die continue, minimizing voiding and die tilt is of interest for improved die functionality, yield, manufacturability, and reliability. High-power die generate considerable heat, which is important to dissipate effectively through control of voiding under high thermal load areas of the die while maintaining a consistent bondline (minimizing die tilt). Voiding was measured using acoustic imaging and die tilt was measured using two different optical measurement systems. 80Au-20Sn solder reflow was achieved using a batch vacuum solder system with optimized fixturing. Minimizing die tilt proved to be the more difficult of the two product requirements to meet. Process development variables included tooling, weight and solder preform thickness.

Die brein soos beskou deur die Grieke en Romeine

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Francois P. Retief

2015-02-01

Full Text Available In Ou Egipte is mummifikasie met uitgebreide reseksie of uitsnyding van organe geassosieer, maar geen kennis is geneem van die morfologie van die brein nie. Griekse skrywers van die sesde en vyfde eeue v.C. het die brein aanvanklik gesien as die setel van intelligensie, die orgaan van sensoriese waarneming en gedeeltelik die oorsprong van sperma. Pneuma het ’n belangrike rol in breinfunksie gespeel. Hippokrates was die eerste om die brein te beskryf as ’n dubbele orgaan, wat met harsingvlies (meninges bedek, funksioneel van pneuma afhanklik en vertolker van begrip is. Tydgenote soos Plato, Aristoteles en Diokles het tot die beskrywing bygedra, maar laasgenoemde twee het beweer dat die hart die middelpunt van intelligensie is en nie die brein nie. Gedurende die laaste helfte van die vierde eeu v.C. is disseksie van die menslike liggaam tydelik aan die mediese skool van Alexandrië toegelaat en het dit tot merkwaardige vooruitgang in die begrip van die menslike anatomie en fisiologie gelei. Herofilus en Erasistratus het uitstekende beskrywings van die struktuur en funksie van die brein gegee wat eers in die tweede eeu n.C. deur Galenus geëwenaar is.

Die Britse owerheid en die onderwys op Heidelberg gedurende die ...

African Journals Online (AJOL)

The establishment of Christian National Education (CNE) Schools stimulated the concept of mother tongue education. Oor die klaskamerpraktyk en die werklike gehalte van onderrig tydens die kampskooltydperk is daar min bekend. Heidelberg wat na 1902 in 'n belangrike onderwyssentrum in Transvaal ontwikkel het, het ...

Sedimentêre omgewings van die Inhaca-eilandstelsel met spesiale verwysing na die petrografiese en geochemiese eienskappe van die sedimente spesiale verwysing na die petrografiese en geochemiese eienskappe van die sedimente

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Marieke Peché

2011-09-01

Full Text Available Die Inhaca-eilandstelsel is geleë langs die suidooskus van Mosambiek. Die oostekant van die stelsel grens aan die Indiese Oseaan en die westekant aan die Baai van Maputo. Hierdie eilandstelsel bestaan uit Inhaca- en Portugese eiland, asook ’n groep sandbanke wat van die noordlike punt van Inhaca na Portugese eiland strek. Die doel van hierdie studie is om die verskillende moderne en oer-sedimentêre omgewings op die eilandstelsel te identifiseer en te beskryf, die invloed van getye en golfaksie op die moderne sedimentêre omgewing vas te stel en die geochemiese en petrografiese samestelling van die geologiese eenhede te bepaal.

Die Ware Buch und die Philologie

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Bernhard Hurch

2017-10-01

Full Text Available Die im 19. Jahrhundert sich verändernden Produktionsbedingungen für Druckwerke (Buchdruck, Satz, Papier, Bindung wirkten katalysierend auf die Fachkonstitution und Institutionalisierung der Philologien. Hier steht der tatsächliche Buchmarkt im Vordergrund der Darstellung, das Käuferpublikum und die Voraussetzungen des Vertriebs. Dazu gehören auch die Rezension als entstehende Textsorte und die rasch arbeitenden Rezensionsorgane. F.-R. Hausmann wurde in den letzten Jahren unentbehrlicher Mitarbeiter dieses im Rahmen des Grazer Schuchardt-Projekts "Netzwerk des Wissens" angesiedelten Ansatzes.

Differences between terminally ill cancer patients who died after euthanasia had been performed and terminally ill cancer patients who did not request euthanasia.

Science.gov (United States)

Georges, Jean-Jacques; Onwuteaka-Philipsen, Bregje D; van der Wal, Gerrit; van der Heide, Agnes; van der Maas, Paul J

2005-12-01

Palliative care, directed at improving the quality of life of terminally ill patients, is generally not aimed at any form of postponing or hastening death. It is possible that high quality palliative care could prevent requests for euthanasia. However, empirical evidence on this issue is scarce. In a national survey of end-of-life medical decisions in The Netherlands the subject of care at the end of life has been addressed. Data on terminally ill cancer patients who died after their request was granted and euthanasia had been performed were compared with those of terminally ill cancer patients who did not request euthanasia. The results show that the prevalence and severity of symptoms e.g., pain, feeling unwell, nausea, was higher in patients who died after their request was granted and euthanasia had been performed. No differences concerning the treatment of symptoms or the care provided were found between the two groups. The results suggest that the practice of euthanasia is mainly related to the patient's suffering.

How to Deal With Relatives of Patients Dying in the Hospital? Qualitative Content Analysis of Relatives' Experiences.

Science.gov (United States)

Witkamp, Erica; Droger, Mirjam; Janssens, Rien; van Zuylen, Lia; van der Heide, Agnes

2016-08-01

Hospital care and communication tend to be focused on the individual patient, and decision making is typically based on the principle of individual autonomy. It can be questioned whether this approach is adequate when a patient is terminally ill. Our aim was to explore the involvement and experiences of relatives in the hospital during the patient's last phase of life. This study was embedded in a retrospective questionnaire study on the quality of dying of a consecutive sample of patients who died in a general university hospital in The Netherlands. We performed a secondary qualitative analysis of relatives' comments and answers to open questions. Relatives of 951 deceased adult patients were asked to complete a questionnaire; 451 questionnaires were returned and analyzed for this study. Relatives expressed a need for 1) comprehensible, timely, and sensitive information and communication, 2) involvement in decision making, 3) acknowledgment of their position, 4) being able to trust health care staff, and 5) rest and privacy. When relatives felt that their role had sufficiently been acknowledged by health care professionals (HCPs), their experiences were more positive. Relatives emphasized their relation with the patient and their involvement in care of the patient dying in the hospital. An approach of HCPs to care based on the concept of individual autonomy seems inadequate. The role of relatives might be better addressed by the concept of relational autonomy, which provides HCPs with opportunities to create a relationship with relatives in care that optimally addresses the needs of patients. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

No Negative Impact of Palliative Sedation on Relatives' Experience of the Dying Phase and Their Wellbeing after the Patient's Death: An Observational Study.

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Bruinsma, S M; van der Heide, A; van der Lee, M L; Vergouwe, Y; Rietjens, J A C

2016-01-01

Palliative sedation is the widely-used intervention of administering sedating agents to induce a state of unconsciousness to take away a dying patient's perception of otherwise irrelievable symptoms. However, it remains questionable whether this ethically complex intervention is beneficial for patients and whether the associated lack of communication in the last phase of life has a negative impact on relatives' wellbeing. An observational questionnaire study was conducted among relatives of a consecutive sample of patients who died a non-sudden death in the Erasmus MC Cancer Institute or in the hospice 'Laurens Cadenza' (both in Rotterdam) between 2010 and 2013. Relatives filled in questionnaires regarding 151 patients who had been sedated and 90 patients who had not been sedated. The median time since all patients had passed away was 21 (IQR 14-32) months. No significant differences were found in relatives´ assessments of the quality of end-of-life care, patients´ quality of life in the last week before death and their quality of dying, between patients who did and did not receive sedation, or in relatives' satisfaction with their own life, their general health and their mental wellbeing after the patient's death. The use of sedation in these patients appears to have no negative effect on bereaved relatives' evaluation of the patient's dying phase, or on their own wellbeing after the patient's death.

No Negative Impact of Palliative Sedation on Relatives' Experience of the Dying Phase and Their Wellbeing after the Patient's Death: An Observational Study.

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S M Bruinsma

Full Text Available Palliative sedation is the widely-used intervention of administering sedating agents to induce a state of unconsciousness to take away a dying patient's perception of otherwise irrelievable symptoms. However, it remains questionable whether this ethically complex intervention is beneficial for patients and whether the associated lack of communication in the last phase of life has a negative impact on relatives' wellbeing.An observational questionnaire study was conducted among relatives of a consecutive sample of patients who died a non-sudden death in the Erasmus MC Cancer Institute or in the hospice 'Laurens Cadenza' (both in Rotterdam between 2010 and 2013.Relatives filled in questionnaires regarding 151 patients who had been sedated and 90 patients who had not been sedated. The median time since all patients had passed away was 21 (IQR 14-32 months. No significant differences were found in relatives´ assessments of the quality of end-of-life care, patients´ quality of life in the last week before death and their quality of dying, between patients who did and did not receive sedation, or in relatives' satisfaction with their own life, their general health and their mental wellbeing after the patient's death.The use of sedation in these patients appears to have no negative effect on bereaved relatives' evaluation of the patient's dying phase, or on their own wellbeing after the patient's death.

Multi-institutional analysis of early squamous cell carcinoma of the hypopharynx treated with radical radiotherapy

International Nuclear Information System (INIS)

Nakamura, Katsumasa; Shioyama, Yoshiyuki; Kawashima, Mitsuhiko; Saito, Yoshihiro; Nakamura, Naoki; Nakata, Kensei; Hareyama, Masato; Takada, Takahiro; Karasawa, Kumiko; Watanabe, Toshiichi; Yorozu, Atsunori; Tachibana, Hiroyuki; Suzuki, Gen; Hayabuchi, Naofumi; Toba, Takashi; Yamada, Shogo

2006-01-01

Purpose: To analyze the outcomes of patients with early hypopharyngeal cancer treated with radical radiotherapy (RT). Methods and Materials: Ten institutions combined the data from 115 patients with Stage I-II hypopharyngeal squamous cell carcinoma treated with definitive RT between 1990 and 2001. The median patient age was 67 years; 99 patients were men and 16 were women. Of the 115 patients, 39 had Stage I and 76 had Stage II disease. Conventional fractionation was used in 98 patients and twice-daily RT in 17 patients; chemotherapy was combined with RT in 57 patients. The median follow-up period was 47 months. Results: The overall and disease-specific 5-year survival rate for 95 patients without synchronous malignancies was 66.0% and 77.4%, respectively. The 5-year disease-specific survival rate by T stage was 95.8% for patients with T1 disease and 70.1% for patients with T2 disease (p = 0.02). Of the 115 patients, local control with laryngeal voice preservation was achieved in 34 of 39 patients with T1 lesions, including 7 patients successfully salvaged, and in 56 of 76 patients with T2 lesions. Sixty-five patients (56.5%) had synchronous or metachronous cancers. Of the 115 patients, 19 died of hypopharyngeal cancer, 10 died of second primary cancers, and 14 died of other causes during the study and follow-up periods. Conclusions: Patients with early hypopharyngeal cancer tended to have a good prognosis after RT. However, second malignancies had an adverse effect on the overall outcomes of patients with early hypopharyngeal cancer

[Can cancer patient in terminal stage of cancer die with dignity at home? And under what conditions?].

Science.gov (United States)

Slovácek, L; Simková, M; Petera, J; Filip, S

2011-01-01

In their brief communication, the authors are discussing the issue of palliative care for cancer patients in terminal stage of cancer. The authors are also contributing their own experience with the provision of such care to patients who wish to die at home.

Die tug oor ampsdraers tydens die doleansie van 1886

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J. Visser

1986-06-01

Full Text Available In art 29 van die Nederlandse Geloofsbelydenis word bely: “Die merktekens om die ware Kerk te ken is die volgende: As die Kerk die suiwere prediking van die evangelie uitoefen, as dit die suiwer bediening van die sakramente gebruik soos Christus dit ingestel het, as die kerklike tug gebruik word om die sondes te straf.” Dit spreek vanself dat wanneer ampsdraers, aan wie Christus sy kudde toevertrou het (Hand 20 : 28, met leer en /of lewenswandel in sonde volhard en nie daarin met tug gestuit word nie, word die ware kerk nie gebou nie maar afgebreek. 0ns sal later in hierdie artikel aantoon hoedanig die suiwer tug oor ampsdraers, veral leertug, tydens die Doleansie tot skade van die kerk van Christus agterweë gebly het.

Die kritiek van tradisie en die tradisie van kritiek in die Geesteswetenskappe. 'n Rekonstruksie van die debat tussen Habermas en Gadamer

OpenAIRE

Duvenage, Pieter

2013-01-01

In hierdie bydrae word die bekende debat (1967-1971) tussen Jürgen Habermas en Hans-Georg Gadamer gerekonstrueer. Die debat word hier in noue samehang met die kwessie van die geesteswetenskappe gelees. Die bydrae val in vier dele uiteen. In die eerste afdeling word Habermas se opening tot die debat in vyf onderafdelings uiteengesit. Dit gaan hier oor Gadamer se verdediging van tradisie en Habermas se kritiek op die begrip (1.1). In antwoord op Gadamer se begrip van tradisie ontwerp Habermas s...

Die transvaalse ontwerp-ordonnansie oor die onderwys

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J. C. Coetzee

1952-03-01

Full Text Available In ’n Buitengewone Provinsiale Koerant van die Provinsie Transvaal is onder datum 25 Junie 1952 gepubliseer ’n „Ontwerp-Ordonnansie tot samevatting en wysiging van die Wette betreffende die Sentrale Beheer van die Onderwys, die Plaaslike Beheer van Skole, Godsdiensonderrig in Openbare Skole, Taal en die Onderwys, Onderwyspersoneel, Verpligte Onderwys, Toelating van Leerlinge tot Skole, Klasse of Inrigtings, Openbare Onderwys, Private Skole, Onderwys vir Kleurlinge en Asiate en Onderwys vir Naturelle, en om vir sake in verband daarmee voorsiening te maak” .

Dying for security

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Buchan, Bruce

2011-01-01

Full Text Available If political statements and media coverage are any guide, it seems Australians today are dying for security. At no other moment in our history has the spectre of war and terrorism so haunted popular, political and scholarly perceptions of Australia’s colonial past and of its geopolitical future. And yet, debates over colonial war or genocide and contemporary terrorism have been conducted in more or less complete isolation. In this article I argue that our contemporary obsession with ‘security’ is premised on the perennial threat of ‘insecurity’. This is the problem of in/security, and it has played a central role in the development of Western political thought. More importantly, its formulation in Western political thought provided a powerful justification for the violence of the early decades of Australia’s colonisation during which Indigenous Australians could also be said to have been dying for security.

Dying for Security

Directory of Open Access Journals (Sweden)

Bruce Buchan

2011-03-01

Full Text Available If political statements and media coverage are any guide, it seems Australians today are dying for security. At no other moment in our history has the spectre of war and terrorism so haunted popular, political and scholarly perceptions of Australia’s colonial past and of its geopolitical future. And yet, debates over colonial war or genocide and contemporary terrorism have been conducted in more or less complete isolation. In this article I argue that our contemporary obsession with ‘security’ is premised on the perennial threat of ‘insecurity’. This is the problem of in/security, and it has played a central role in the development of Western political thought. More importantly, its formulation in Western political thought provided a powerful justification for the violence of the early decades of Australia’s colonisation during which Indigenous Australians could also be said to have been dying for security.

Dying cancer patients talk about physician and patient roles in DNR decision making.

Science.gov (United States)

Eliott, Jaklin A; Olver, Ian

2011-06-01

Within medical and bioethical discourse, there are many models depicting the relationships between, and roles of, physician and patient in medical decision making. Contestation similarly exists over the roles of physician and patient with regard to the decision not to provide cardiopulmonary resuscitation (CPR) following cardiac arrest [the do-not-resuscitate or do-not-resuscitate (DNR) decision], but there is little analysis of patient perspectives. Analyse what patients with cancer within weeks before dying say about the decision to forego CPR and the roles of patient and physician in this decision. Discursive analysis of qualitative data gathered during semi-structured interviews with 28 adult cancer patients close to death and attending palliative or oncology clinics of an Australian teaching hospital. Participants' descriptions of appropriate patient or physician roles in decisions about CPR appeared related to how they conceptualized the decision: as a personal or a medical issue, with patient and doctor respectively identified as appropriate decision makers; or alternatively, both medical and personal, with various roles assigned embodying different versions of a shared decision-making process. Participants' endorsement of physicians as decision makers rested upon physicians' enactment of the rational, knowledgeable and compassionate expert, which legitimized entrusting them to make the DNR decision. Where this was called into question, physicians were positioned as inappropriate decision makers. When patients' and physicians' understandings of the best decision, or of the preferred role of either party, diverge, conflict may ensue. In order to elicit and negotiate with patient preferences, flexibility is required during clinical interactions about decision making. © 2010 Blackwell Publishing Ltd.

DIE PLEK VAN SANG EN MUSIEK IN DIE PROTESTANTSE ...

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Test

Sy moet hierdie opdrag uitvoer deur mid del van die Prediking d.w.s. deur middel van die Woord-vorm, maar ook deur die bediening van die sakramente, dws. deur middel van die vorm van die Daad. Maar nou wil God nie hê dat die Kerk slegs één maal die Evangelie sal predik en die mense sal doop om hulle daarna.

Thomas Erastus oor die struktuur van die gemeenskap'^

African Journals Online (AJOL)

óók aansprake en regte het, is die opvatting dat sowel die burgerlike gemeenskap as die kerk 'n perfecta societas sibi sufficiens is, nié werklik aanvaar nie. Die Middeleeuse gemeenskap was die corpus christianum,. 'n gemeenskap wat nie deur fisiese of politieke grense beperk was nie. Sy grense het gelê waar die grense ...

Die vestiging van die Kerk in Natal, die Vrystaat en Transvaal na ...

African Journals Online (AJOL)

as eerste predikant van die Voortrekkers laat orden en bevestig. Daama het verskeie kerksake van tyd tot tyd aandag geniet. Met betrekking tot die bevestiging van huwelike stel Retief 'n meer ordelike reëling daar, naamlik dat die gebooie van voomemende egpa- re van nou af drie maal in die kerk afgekondig moes wrord ...

Die historiese betroubaarheid van die aartsvadervertellinge. 'n Beknopte bespreking van die huidige debat na aanleiding van die jongste publikasie

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W. Vosloo

1982-08-01

Full Text Available Die afgelope twintig jaar was daar �n toenemende belangstelling in die aartsvadervertellinge in Genesis. Benewens die talle tydskrifartikels het skrywers soos die volgende ook boeke oor die onderwerp die lig laat sien: A. Parrot (1962, W. M. Clark (1964, R. Kilian (1966, R. E. Clements (1967, N. Lohfink (1967, H. Weidemann (1968, R. Martin-Achard (1969, T. L. Thompson (1974, J. van Seters (1975, J. P. Fokkelman (1975, C. Westermann (1976, R. Rendtorff (1977, J. Bright (1977, W. McKane (1979 en A. R. Millard en D. J. Wiseman (1980.

Prediking aan die hand van die metafoor van fiksieskryf

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HTS 64(3) 2008 siening van die self en waarheid. In die pre-moderne paradigma kan die dominante metafoor verstaan word aan die hand van 'n spieël wat die lig uit 'n transendente oorsprong weerkaats, terwyl die moderne paradigma uitgedruk word met die metafoor van 'n lamp wat 'n eie, oorspronklike lig binne die self.

Cost analysis of medical assistance in dying in Canada.

Science.gov (United States)

Trachtenberg, Aaron J; Manns, Braden

2017-01-23

The legalization of medical assistance in dying will affect health care spending in Canada. Our aim was to determine the potential costs and savings associated with the implementation of medical assistance in dying. Using published data from the Netherlands and Belgium, where medically assisted death is legal, we estimated that medical assistance in dying will account for 1%-4% of all deaths; 80% of patients will have cancer; 50% of patients will be aged 60-80 years; 55% will be men; 60% of patients will have their lives shortened by 1 month; and 40% of patients will have their lives shortened by 1 week. We combined current mortality data for the Canadian population with recent end-of-life cost data to calculate a predicted range of savings associated with the implementation of medical assistance in dying. We also estimated the direct costs associated with offering medically assisted death, including physician consultations and drug costs. Medical assistance in dying could reduce annual health care spending across Canada by between $34.7 million and $138.8 million, exceeding the $1.5-$14.8 million in direct costs associated with its implementation. In sensitivity analyses, we noted that even if the potential savings are overestimated and costs underestimated, the implementation of mdedical assistance in dying will likely remain at least cost neutral. Providing medical assistance in dying in Canada should not result in any excess financial burden to the health care system, and could result in substantial savings. Additional data on patients who choose medical assistance in dying in Canada should be collected to enable more precise estimates of the impact of medically assisted death on health care spending and to enable further economic evaluation. © 2017 Canadian Medical Association or its licensors.

Ontsporing van die regstaatsbegrip en sy konsekwensies vir die afrikanervolk

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N. G.S. Van der Walt

1966-03-01

Full Text Available Die opvatting van die suiwere regstaat bring sy vraagstukke mee wanneer dit in verband gebring word met die leer van die soewereiniteit in eie kring. Laasgenoemde leer wortel in die geloof dat God die mens roep tot diens aan Hom, en dat die mens vry moet wees om ten opsigte van alle lewensaspekte God na die hoogste mate te kan dien. Hierdie verskeidenheid van aspekte is deur dr. A. Kuyper en sy volgelinge gesistemati- seer tot menslike verbande en lewenskringe, elk met ’n be- paalde sfeer waarin ander kringe nie mag inmeng nie. Elkeen is dan soewerein binne sy eie kring. Met verwysing na die staat is dan gespreek van die staatstaak as synde die hand- hawing van die reg, en omdat die staat in toenemende mate hom veral in die latere tyd ook besig gehou het met bedrywig- hede wat nouliks as van juridiese aard beskou kan word, is daar die onderskeid gemaak tussen die primêre en sekundêre taak van die staat. Die sistematiek van die wetsidee, deur prof. Dooyeweerd ontwikkel, waar die staat sy bestemmingsfunksie in die regsaspek vind, het vanselfsprekend geen plek vir so 'n dualistiese staatstaak nie, en die oplossing is deur sommige daarin gesoek om sulke staatsoptrede te vertolk as hebbende wel betrekking op die regsgemeenskap of die regsverkeer. Staatsondernemings soos paaie, spoorweë, spellingreëling, ens. word dan beskou as noodsaaklik vir die instandhouding van die regsgemeenskap en regsverkeer. Tereg wys A. M. Donner1 daarop dat so ’n vertolking eintlik neerkom op ’n oorspanning van die regsbegrip. Hy self sien dan die staatstaak in vrede- of orde-handhawing, wat in die eerste plaas wel regshandha- wing veronderstel. Onder orde word dan alles verstaan wat noodsaaklik is vir die gladde verkeer in die ontwikkelingsgang van die regsgemeenskap. Die wese van die staat het dan vol- gens hom te doen met reg, maar sy taak is meer as suiwere regshandhawing. Wat onrus verwek en die orde versteur, moet uit die openbare lewe verwyder word, en die

Radiation exposure to the patient caused by single-photon transmission measurement for 3D whole-body PET; Die Strahlenexposition des Patienten durch die Einzelphotonen-Transmissionsmessung bei der PET

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Schaefer, A.; Donsch, P.; Kirsch, C.M. [Universitaet des Saarlandes, Homburg/Saar (Germany). Abt. fuer Nuklearmedizin; Seifert, H. [Universitaet des Saarlandes, Homburg/Saar (Germany). Abt. Strahlentherapie der Radiologischen Klinik

2000-11-01

Aim: The aim of the study was the determination of the radiation exposure to the patient caused by single-photon transmission measurement for 3D whole-body PET. Material and method: Single-photon-transmission measurement is performed using two Cs-137 pointsources (E{gamma}=662 keV, A=2*614 MBq) on a 3D PET scanner (ECAT ART). During a simulation of a whole body transmission scan (axial length: 75 cm, 6 contigous bed positions) dose measurements with thermoluminescent dosimeters were carried out using a thorax and an abdomen phantom. Following the guidelines of the ICRU report No. 60 an estimation of the effective dose caused by a single-photon transmission measurement was calculated. Results: For a total acquisition time of 360 min (6 beds with an acquisition time of 60 min per bed) the absorbed doses amounted to: Surface (xyphoid) 189 {mu}Gy, heart 196 {mu}Gy, lungs 234 {mu}Gy, vertebra 240 {mu}Gy, liver 204 {mu}Gy, gonads 205 {mu}Gy, thyroid 249 {mu}Gy and bladder 185 {mu}Gy resulting in a conversion factor of 1.7*10{sup -4} mSv/(h*MBq). The estimation of the effective dose for a patient's transmission (acquisition time of 3.2 min per bed) yields a value of 11 {mu}Sv. An estimation of the ratio of the conversion factors for transmission measurements in single-photon- and in coincidence mode (two Ge-68/Ga-68 rod sources of 40 MBq each), respectively, resulted in a value of 0.18. The comparison of the effective doses caused by single-photon transmission and by emission measurement (injection of 250 MBq of FDG) yields a ratio of 2.3*10{sup -3}. Conclusion: The radiation exposure of the patient caused by the transmission measurement for 3D whole-body-PET can be neglected. In comparison with the coincidence-transmission using uncollimated line sources of low activity the radiation exposure is still reduced using single photon transmission with collimated point sources of high activity. (orig.) [German] Ziel: Ziel war die Bestimmung der Strahlenexposition des

Beyond Pain: Nurses' Assessment of Patient Suffering, Dignity, and Dying in the Intensive Care Unit.

Science.gov (United States)

Su, Amanda; Lief, Lindsay; Berlin, David; Cooper, Zara; Ouyang, Daniel; Holmes, John; Maciejewski, Renee; Maciejewski, Paul K; Prigerson, Holly G

2018-06-01

Deaths in the intensive care unit (ICU) are increasingly common in the U.S., yet little is known about patients' experiences at the end of life in the ICU. The objective of this study was to determine nurse assessment of symptoms experienced, and care received by ICU patients in their final week, and their associations with nurse-perceived suffering and dignity. From September 2015 to March 2017, nurses who cared for 200 ICU patients who died were interviewed about physical and psychosocial dimensions of patients' experiences. Medical chart abstraction was used to document baseline patient characteristics and care. The patient sample was 61% males, 70.2% whites, and on average 66.9 (SD 15.1) years old. Nurses reported that 40.9% of patients suffered severely and 33.1% experienced severe loss of dignity. The most common symptoms perceived to contribute to suffering and loss of dignity included trouble breathing (44.0%), edema (41.9%), and loss of control of limbs (36.1%). Most (n = 9) remained significantly (P dignity (AOR 3.15). Use of feeding tube was associated with severe loss of dignity (AOR 3.12). Dying ICU patients are perceived by nurses to experience extreme indignities and suffer beyond physical pain. Attention to symptoms such as dyspnea and edema may improve the quality of death in the ICU. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Accurate defect die placement and nuisance defect reduction for reticle die-to-die inspections

Science.gov (United States)

Wen, Vincent; Huang, L. R.; Lin, C. J.; Tseng, Y. N.; Huang, W. H.; Tuo, Laurent C.; Wylie, Mark; Chen, Ellison; Wang, Elvik; Glasser, Joshua; Kelkar, Amrish; Wu, David

2015-10-01

Die-to-die reticle inspections are among the simplest and most sensitive reticle inspections because of the use of an identical-design neighboring-die for the reference image. However, this inspection mode can have two key disadvantages: (1) The location of the defect is indeterminate because it is unclear to the inspector whether the test or reference image is defective; and (2) nuisance and false defects from mask manufacturing noise and tool optical variation can limit the usable sensitivity. The use of a new sequencing approach for a die-to-die inspection can resolve these issues without any additional scan time, without sacrifice in sensitivity requirement, and with a manageable increase in computation load. In this paper we explore another approach for die-to-die inspections using a new method of defect processing and sequencing. Utilizing die-to-die double arbitration during defect detection has been proven through extensive testing to generate accurate placement of the defect in the correct die to ensure efficient defect disposition at the AIMS step. The use of this method maintained the required inspection sensitivity for mask quality as verified with programmed-defectmask qualification and then further validated with production masks comparing the current inspection approach to the new method. Furthermore, this approach can significantly reduce the total number of defects that need to be reviewed by essentially eliminating the nuisance and false defects that can result from a die-to-die inspection. This "double-win" will significantly reduce the effort in classifying a die-to-die inspection result and will lead to improved cycle times.

DIE ONTVC'ERP VAN 'N SENDINGBELEID IN DIE HUIDIGE ...

African Journals Online (AJOL)

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DIE ONTVC'ERP VAN 'N SENDINGBELEID IN DIE. HUIDIGE SITUASIE. Sending is 'n deel van die vervulling van die apostoliese opdrag van die kerk. Dit geskied op grond van en in gehoorsaamheid aan Gods. \\C'oord. Teologiese besinning is daarom die eerste en grondliggende vereiste by die ontwerp van 'n ...

Die sestienpersoonlikheidsfaktorvraelys as hulpmiddel by die takseersentrum

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J. C. D. Augustyn

1988-05-01

Full Text Available The 16PF Personality Test as an aid to the assessment centre Assessment centres still remains costly and thime consuming. This study investigates the reduction of time and costs by the use of the 16 PF Personality Test as a method for measuring management dimensions. Promising results were obtained with a relatively small sample for the prediction of initiative and perseverance. Significant multiple correlations were also found for three criteria of management success. Further research may establish the use of the 16 PF as an aid to management assessment and thereby reduce the costs and time involved in assessment centres. Opsomming Takseersentrums se grootste probleem is gelee in die koste en tyd wat dit behels. Hierdie studie ondersoek die moontlikheid om beide te verminder deur die aanwending van die 16 PF Persoonlikheidsvraelys vir die meting van bestuursdimensies. Belowende resultate is met 'n relatiewe klein steekproef bevind ten opsigte van die voorspelling van inisiatiefen deursettingsvermoe. Beduidende meervoudige korrelasies is ook ten opsigte van drie kriteria van bestuursukses bevind. Verdere navorsing kan die gebruik van die 16 PF as hulpmiddel by bestuursevaluering vestig en sodoende die tydsduur en koste van takseersentrums verminder.

Gestalt Therapy with the Dying Patient: Integrative Work Using Clay, Poetry Therapy, and Creative Media.

Science.gov (United States)

Petzold, Hilarion G.

1982-01-01

Reports the use of death therapy with a cancer patient. Gestalt therapy and creative media were used to facilitate an integration of life and a sense of balance with life. Suggests that counseling the dying means walking along a stretch of the path together. (Author)

ELECTROENCEPHALOGRAPHY SHOWING DYING BRAIN IN A PATIENT WITH ACUTE BACLOFEN POISONING

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A. Y. Mikhaylov

2017-01-01

Full Text Available We report a case of acute baclofen poisoning in a 23-year-old female patient, who committed suicide, which led to the development of a deep coma. The electroencephalogram on the first day recorded the phenomenon of “burst suppression”, which was seen as a sign of a dying brain. Subsequent studies have shown positive changes of the electroencephalogram and regression of neurological symptoms. Thus, the phenomenon of “burst suppression” in the depression of consciousness to deep coma and given adequate treatment, can be reversible.

die korrelasie tussen die gemiddelde daaglikse toename van ...

African Journals Online (AJOL)

'n Regressielyn is uit die gegewens bereken deur 'n beswaarde regressieanaliese en die 80 persent-voorspellings- bande is bepaal. Die punte wat ver buite die normale ver- spreidingsband geval hetkon almal met goeie rede as abnor- maal beskou word (sien tabel 1) en is nie ingesluit by die statistiese berekenings nie.

Compassion Fatigue: Exploring Early-Career Oncology Nurses' Experiences
.

Science.gov (United States)

Finley, Brooke A; Sheppard, Kate G

2017-06-01

Oncology nurses have a higher risk and rate of compassion fatigue (CF) compared to professionals in other specialties. CF exhibits tangible negative outcomes, affecting nurses' health and professional practice.
. Early-career oncology nurses' unique CF experiences lack thorough scientific exploration. This secondary analysis seeks to qualitatively augment this paucity and illuminate targeted interventions.
. Open-ended interviews were conducted with five early-career inpatient oncology nurses. Subsequent transcripts were explored for CF themes secondarily using thematic analysis.
. Themes indicate that early-career oncology nurses enjoy connecting with patients and families, but over-relating, long patient stays, and high patient mortality rates trigger CF. Symptoms include internalizing patients' and families' pains and fears, being haunted by specific patient deaths, feeling emotionally depleted, assuming that all patients will die, and experiencing burnout, physical exhaustion, and hypervigilance protecting loved ones.

Symptoms, unbearability and the nature of suffering in terminal cancer patients dying at home: a prospective primary care study

NARCIS (Netherlands)

Ruijs, C.D.M.; Kerkhof, A.J.F.M.; van der Wal, G.; Onwuteaka-Philipsen, B.D.

2013-01-01

Background: Primary care physicians provide palliative home care. In cancer patients dying at home in the Netherlands (45% of all cancer patients) euthanasia in about one out of every seven patients indicates unbearable suffering. Symptom prevalence, relationship between intensity of symptoms and

Evaluation of early and late complications in patients with congenital lobar emphysema: A 12 year experience

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Nazem Masood

2010-01-01

Full Text Available Background: Congenital lobar emphysema (CLE is characterised by over distension of one lobe and pressure on the adjacent lobe and mediastinum. In this study, we review the pathological results of our paediatric patients with CLE, highlighting the early and late complications that occurred in these patients. Patients and Methods: In a prospective study from 1996 to 2008, we evaluated 30 patients with CLE diagnosis. Variables collected included sex, age at the time of diagnosis, radiological diagnostic method, type of treatment, pathological analysis, surgical findings and early postoperative complications. Parents were asked to refer to our clinic for follow-up and evaluation of late complications. Results: Thirty patients and males accounted for majority of the study population (n = 20, 67%. The mean age of male and female patients (at admission was 7.2 ± 2.3 and 4.7 ± 1.2 months respectively (P = not significant. The main diagnostic method was chest x-ray (CXR in all patients. Abnormal bronchial cartilage was found in 71% of patients. The most affected lobe was left upper lobe (50%. Associated anomalies were seen in four patients. Early postoperative periodhadtwo cases of pneumothoraces. At six month follow up, five (25% males and four females (40% had delayed weight gain. Permanent oxygen dependency was seen in two patients. Twenty- six patients underwent thoracotomy. Mortality rate was 13%. Base deficit at the time of admission was greater in those patients who eventually died, (-8.6 ± 1.2 versus -3.1 ± 0.4 (P = 0.0003. There were two deaths in the bilobar involvement group and two in the unilobar involvement group (P = 0.07, near significant. Conclusion: This study confirms that the number of affected lobes and base deficit at the time of admission were associated with significantly increased mortality.

enkele fasette van die problematiek van die akademikus by die skryf

African Journals Online (AJOL)

Om verskeie redes het dit van die allergrootste belong geword dot 'n his- tories korrekte, wetenskaplike weerga- we van bogenoemde gebeure opge- teken moet word. Die sluier, in sommige gevalle am logiese redes toegepas, moes eenvoudig gelig word am gebeure wat die gewone man op stroot in Suid-Afrika dikwels ...

Clinical and Socio-Demographic Predictors of Home Hospice Patients Dying at Home: A Retrospective Analysis of Hospice Care Association's Database in Singapore.

Science.gov (United States)

Lee, Yee Song; Akhileswaran, Ramaswamy; Ong, Eng Hock Marcus; Wah, Win; Hui, David; Ng, Sheryl Hui-Xian; Koh, Gerald

2017-06-01

Hospice care can be delivered in different settings, but many patients choose to receive it at home because of familiar surroundings. Despite their preferences, not every home hospice patient manages to die at home. To examine the independent factors associated with home hospice patient dying at home. Retrospective analysis of Hospice Care Association's database. Hospice Care Association is the largest home hospice provider in Singapore. The study included all patients who were admitted into home hospice service from January 1, 2004 to December 31, 2013. Cox proportional hazards modeling with time as constant was used to study the relationship between independent variables and home death. A total of 19,721 patients were included in the study. Females (adjusted risk ratio [ARR] 1.09, 95% CI 1.04-1.15), older patients (ARR 1.01, 95% CI 1.00-1.01), shorter duration of home hospice stay (ARR 0.88, 95% CI 0.82-0.94), fewer episodes of hospitalization (ARR 0.81, 95% CI 0.75-0.86), living with caregivers (ARR 1.54, 95% CI 1.05-2.26), doctor (ARR 1.05, 95% CI 1.01-1.08) and nurse (ARR 1.06, 95% CI 1.04-1.08) visits were positive predictors of dying-at-home. Diagnosis of cancer (ARR 0.93, 95% CI 0.86-1.00) was a negative predictor of dying-at-home. Female, older age, living with a caregiver, non-cancer diagnosis, more doctor and nurse visits, shorter duration of home hospice stays, and fewer episodes of acute hospitalizations are predictive of dying-at-home for home hospice patients. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Die huwelik as identiteitsmerker in die Ou Testament

African Journals Online (AJOL)

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Gen 2:18). Uit die woorde van Genesis 2:24 dat man en vrou een sal wees, lei die derde formulier af dat dit “getuig dat die huwelik 'n allesinsluitende gemeenskap is ..... die formule gebruik word: “Hier volg die vertelling oor X se nageslag.” (Gen ..... verwys daarna as “intertwining the principal value concepts of tradition”.

amp' van die ouderling in die Nuwe Testament

African Journals Online (AJOL)

Jesus self het geen kerk gestig nie en daarom, veral omdat die Jesus-beweging inter mums ten opsigte van die Joodse godsdiens van sy tyd tot stand gekom het, het ...... Die klem val dus nie op die npoTCTT0fievo<; se rang of outoriteit nie, maar op sy pastorale funksie in die huishouding of huisgemeente (kyk Reicke.

Chronological shifts and changing causes of death after radiotherapy for early-stage oral cancer.

Science.gov (United States)

Fujisawa, Rina; Shibuya, Hitoshi; Harata, Naoki; Yuasa-Nakagawa, Keiko; Toda, Kazuma; Hayashi, Keiji

2014-02-01

Following recent improvements in the curability of oral cancer, chronological shifts and changes in the causes of death after treatment have been observed. We conducted a review of the post-treatment causes of death following radiotherapy for oral cancers. The medical records of 966 patients with early-stage (stage I and II) oral cancer treated at our institute between 1980 and 2001 were reviewed, and the chronological shifts and changes in the causes of death after radiotherapy were assessed. Of the 966 patients enrolled in this study, 365 have died to date. Two hundred and eleven patients died of their primary malignancy; 193 of these deaths occurred within 5 years of treatment for the primary oral cancer. The second most frequent cause of death was second primary cancer (n = 90). Twenty-three patients with head and neck cancers and 18 patients with esophageal cancers died within 10 years of radiotherapy, and six patients with lung cancers died after more than 10 years. Within the first 5 years following treatment, the major cause of death was the primary oral cancer. After 5-10 years, a second primary cancer, such as head and neck cancer or esophageal cancer, became the leading cause of death. Over a 10-year period, the proportion of deaths from a second primary cancer in the lung was significant. We have demonstrated that there are chronological shifts and changes in the causes of death following treatment for early-stage oral cancer.

Trends in the aggressiveness of end-of-life care for Korean pediatric cancer patients who died in 2007-2010.

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June Dong Park

Full Text Available In light of the Korean Supreme Court's 2009 ruling favoring a patient's right to die with dignity, we evaluated trends in aggressive care in a cohort of pediatric cancer patients. Methods We conducted a population-based retrospective study that used administrative data for patients who died in 2007-2010 among the 5,203 pediatric cancer patients registered at the Korean Cancer Central Registry (KCCR during 2007-2009.In the time period covered, 696 patients died. The proportion who had received chemotherapy in the last 30 days of life decreased from 58.1% to 28.9% (P<0.001, those who received new chemotherapy in the same time period decreased from 55.2% to 15.1% (P<0.001, and those who received treatment in the last 2 weeks of life decreased from 51.4% to 21.7% (P<0.001. In the last 30 days of life, the proportion of patients whose hospital admission period was over 14 days increased from 70.5% to 82.5% (P = 0.03, the proportion who received cardiopulmonary resuscitation decreased from 28.6% to 9.6% (P<0.001, and we found no statistically significant trends in the proportion of emergency department visits, intensive care unit admissions, or mechanical ventilation.In this study, in contrast with earlier ones, the aggressiveness of end-of-life care of Korean pediatric cancer patients decreased dramatically.

Organ donation after medical assistance in dying or cessation of life-sustaining treatment requested by conscious patients: the Canadian context.

Science.gov (United States)

Allard, Julie; Fortin, Marie-Chantal

2017-09-01

In June 2016, following the decision of the Supreme Court of Canada to decriminalise assistance in dying, the Canadian government enacted Bill C-14, legalising medical assistance in dying (MAID). In 2014, the province of Quebec had passed end-of-life care legislation making MAID available as of December 2015. The availability of MAID has many implications, including the possibility of combining this practice with organ donation through the controlled donation after cardiac death (cDCD) protocol. cDCD most often occurs in cases where the patient has a severe neurological injury but does not meet all the criteria for brain death. The donation is subsequent to the decision to withdraw life-sustaining treatment (LST). Cases where patients are conscious prior to the withdrawal of LST are unusual, and have raised doubts as to the acceptability of removing organs from individuals who are not neurologically impaired and who have voluntarily chosen to die. These cases can be compared with likely scenarios in which patients will request both MAID and organ donation. In both instances, patients will be conscious and competent. Organ donation in such contexts raises ethical issues regarding respect for autonomy, societal pressure, conscientious objections and the dead-donor rule. In this article, we look at relevant policies in other countries and examine the ethical issues associated with cDCD in conscious patients who choose to die. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Enkele opmerkings oor die intrinsieke waarde van die Latynse teks van Kodeks Bezae as herstelbron vir die Griekse teks van die Nuwe Testament

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G. J.C. Jordaan

1985-05-01

Full Text Available Een van die belangrikste oud-Latynse vertalings word gevind in Kodeks Bezae, ’n vyfde-eeuse manuskrip van die vier Evangelies. Kodeks Bezae bevat ’n Griekse teks (D en ’n Latynse teks (d van die Evangelies langs mekaar, die Latynse teks in ’n lettertipe wat baie aan die Griekse majuskelskrif herinner. Wat hierdie dokument so merkwaardig maak, is die feit dat dit die enigste manuskrip is wat ’n Griekse Evangelie-teks uit die Westerse teksfamilie bevat.

n Oorsig van die huidige stand van navorsing oor die

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7 Jun 2011 ... Die eerste maal wat dit as deel van die teks van 1 Johannes aangehaal word, is in die. 4de eeu in 'n Latynse teks, Liber Apologeticus (hf 4). Eers aan die einde van die 16de eeu is dit in 'n amptelike Katolieke uitgawe van die Vulgaat ingesluit. Die doel van die Johannesbriewe. Waarom is die Briewe ...

Chemoradiation therapy with or without salvage surgery for early squamous cell carcinoma of the hypopharynx

International Nuclear Information System (INIS)

Nakamura, Katsumasa; Shioyama, Yoshiyuki; Sasaki, Tomonari; Ohga, Saiji; Saku, Madoka; Urashima, Yusuke; Yoshitake, Tadamasa; Nakashima, Torahiko; Kuratomi, Yuichiro; Komune, Shizuo; Terashima, Hiromi; Honda, Hiroshi

2005-01-01

Purpose: Early squamous cell carcinoma of the hypopharynx is a rare clinical entity. Our objective was to analyze the outcome of patients with early hypopharyngeal cancer treated with curative radiotherapy or the combination of preoperative radiotherapy with surgery. Methods and Materials: Forty-three patients with Stage I-II hypopharyngeal cancer were initially treated with 30-40 Gy of irradiation with or without chemotherapy. Thirty-two patients (74.4%) who demonstrated a complete response continued to receive further radiotherapy, with a median total dose of 61.2 Gy. Eleven other patients (25.6%) received surgery. Results: Local control with laryngeal voice preservation was achieved in 8 (88.9%) of 9 patients with Stage I disease, and in 23 (67.6%) of 34 patients with Stage II disease. The overall and disease-specific 5-year survival rates for all patients were 70.4% and 89.5%, respectively. The disease-specific survival rates according to the T-category were 100% for patients with T1 disease and 87.2% for patients with T2 disease (p = 0.32). Twenty patients (46.5%) had synchronous or metachronous cancers. Four patients died of hypopharyngeal cancer, and 5 died of second-primary esophageal cancer. Conclusions: A majority of patients with early hypopharyngeal cancer was curable. However, second malignancies influenced the overall outcome of patients with early hypopharyngeal cancer

Die dogmatiese binding van die prediking

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genoemde probleemstelling wat ons homileties na riglyne wil soek, sonder die pretensie dat finale oplossings gevind sal word. Om hierdie probleem te ontleed is dit nodig om eers kortliks 'n begripsbepaling van die begrippe dogma, binding en prediking te maak. Vanuit die begripsbepaling kan ons dan probeer vasstel wat ...

DIE HEDENDAAGSE SIENING VAN DIE NORMERING VAN DUITS ...

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v a k t a a l k w a l i £ i k a s i e s ) neem d i e I n s t i t u t t a l l e take waar ter u i t b r e i d i n g van kennis van die Duitse taal in die buiteland. Sedert 1964 publiseer die. Institut die tydskrif Deutsch als Fremdsprache met die bylae Sprachpraxis, asook 'n handboek met die titel Deutsch - eln Lehrbuch Eur Auslander (Duits.

Die topkwark

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R. Tegen

1998-07-01

Full Text Available ’n Oorsig van die belangrikheid van die onlangs ontdekte topkwark by Fermilab in Chicago word gegee. Daar word aangetnon dat die topkwark belangrik is in fisika van die Oerknal, oftewel "Big Bang", en in die Standaard Model van Elementêredeeltjie-fisika. Toepaslike literatuur vir verdere studie kan van die lys van verwysings in hierdie kort, nietegniese artikel, nagegaan word.

oor die inhoud en boodskap van die heidelbergse kategismus

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Smit. Oor die Inhoud en Boodskap van die Heidelbergse Kategismus. 52. Uiteraard sal dié tema saamhang met die bedoelinge agter die opstel van die Kategismus. Ook die vraag na moontlike bedoelinge of motiewe is egter 'n ingewikkelder vraag as wat miskien gedink mag word. Uiteraard was daar agter elke kategismus ...

Die vangnet van die woord: forensies-linguistiese getuienis in 'n ...

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Een van die redes daarvoor is waarskynlik die gepaardgaande sleurwerk verbonde aan die verwerking van die betrokke taaldata — iets wat egter deur die onlangse meteoriese vooruitgang in tegnologiese tegnieke op die agtergrond geskuif is en nuwe moontlikhede na vore laat kom het. In die lig van die kompleksiteit van ...

Die Voortrekker-Monument

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Gerard Moerdyk

1938-03-01

Full Text Available Die Eeufeesjaar is vir die Afrikaner ’n tydperk van besieling. Nog nooit sedert die ontstaan van ons volk het een enkele gebeurtenis soveel nasietrots gewek as die honderdjarige herdenking van die Groot Trek. Vir die eerste keer in ons geskiedenis voel ons ons nie meer Kapenaars, Vrystaters, Natalers, en Transvalers nie, maar Afrikaners, saamgesnoer deur die tradisies van ’n selfstandige kultuurvolk. Wanneer die klimaks van die Ossewatrek met die hocksteenlegging van die Voortrekker-Monument bereik word, sal die besieling nie uitsterf nie, die krag wat geskep is sal bly voortgroei tot ’n onweerstaanbare mag. Die Afrikaner sal homself vind, en as die Monument na sowat vyf jaar onthul word, sal die saad wat in hierdie jaar gesaai is, tot voile rypheid gekom het. Dan sal die Monument self tot die volk spreek; intussen egter, is dit wenslik, nee noodsaaklik selfs, om die Monument aan die Afrikaners te verklaar, om ‘n uiteensetting te gee van die noodsaaklikheid van so ’n Monument, sowel as om die motief te verduidelik wat as inspirasie gedien het vir die ontwerpdaar van.

e .Kuraioriufn. DIE W ETENSKAPLIKE BETEKENIS VAN DIE W ERK

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ENGELBRECHT ver antwoordelik vir die Ou-Testamentiese vakke en Hebreeus. Die aan stelling van 'n derde professor het noodsaaklik geword, want dit sou. 85 .... De .Spreuken ran 5a/o?no omvat die nuwe vertaling en die ekse gese van die eerste 24 hoofstukke van die Spreukeboek. Die geskoold- heid in die Semitiese ...

[How Can We Cuddle Up to Dying Patients? Attempts of Cancer Philosophy Clinic and Education].

Science.gov (United States)

Yamada, Keisuke

2016-03-01

What is needed to treat problems about how can we cuddle up to dying patients is not scientific thinking but philosophical thinking. Cancer philosophy clinic is a place where both patients and medical staffs think about death and how to live until death. The author tries to manage cancer philosophy clinic with the idea of logotherapy and terminal art. The author also tries to educate medical students and other medical staffs in cancer philosophy.

IL-6 and TNF-α serum levels are associated with early death in community-acquired pneumonia patients

International Nuclear Information System (INIS)

Bacci, M.R.; Leme, R.C.P.; Zing, N.P.C.; Murad, N.; Adami, F.; Hinnig, P.F.; Feder, D.; Chagas, A.C.P.; Fonseca, F.L.A.

2015-01-01

Community-acquired pneumonia (CAP) is amongst the leading causes of death worldwide. As inflammatory markers, cytokines can predict outcomes, if interpreted together with clinical data and scoring systems such as CURB-65, CRB, and Acute Physiology and Chronic Health Evaluation II (APACHE II). The aim of this study was to determine the impact of inflammatory biomarkers on the early mortality of hospitalized CAP patients. Twenty-seven CAP patients needing hospitalization were enrolled for the study and samples of interleukin-1 (IL-1) and interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), C-reactive protein (CRP), and homocystein were collected at the time of admission (day 1) as well as on the seventh day of the treatment. There was a significant reduction in the levels of IL-6 between the first and the second collections. Median IL-6 values decreased from 24 pg/mL (day 1) to 8 pg/mL (day 7) (P=0.016). The median levels of TNF-α were higher in patients: i) with acute kidney injury (AKI) (P=0.045), ii) requiring mechanical ventilation (P=0.040), iii) with short hospital stays (P=0.009), iv) admitted to the intensive care unit (ICU) (P=0.040), v) who died early (P=0.003), and vi) with worse CRB scores (P=0.013). In summary, IL-6 and TNF-α levels were associated with early mortality of CAP patients. Longer admission levels demonstrated greater likelihood of early death and overall mortality, necessity of mechanical ventilation, and AKI

IL-6 and TNF-α serum levels are associated with early death in community-acquired pneumonia patients

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M.R. Bacci

2015-05-01

Full Text Available Community-acquired pneumonia (CAP is amongst the leading causes of death worldwide. As inflammatory markers, cytokines can predict outcomes, if interpreted together with clinical data and scoring systems such as CURB-65, CRB, and Acute Physiology and Chronic Health Evaluation II (APACHE II. The aim of this study was to determine the impact of inflammatory biomarkers on the early mortality of hospitalized CAP patients. Twenty-seven CAP patients needing hospitalization were enrolled for the study and samples of interleukin-1 (IL-1 and interleukin-6 (IL-6, tumor necrosis factor alpha (TNF-α, C-reactive protein (CRP, and homocystein were collected at the time of admission (day 1 as well as on the seventh day of the treatment. There was a significant reduction in the levels of IL-6 between the first and the second collections. Median IL-6 values decreased from 24 pg/mL (day 1 to 8 pg/mL (day 7 (P=0.016. The median levels of TNF-α were higher in patients: i with acute kidney injury (AKI (P=0.045, ii requiring mechanical ventilation (P=0.040, iii with short hospital stays (P=0.009, iv admitted to the intensive care unit (ICU (P=0.040, v who died early (P=0.003, and vi with worse CRB scores (P=0.013. In summary, IL-6 and TNF-α levels were associated with early mortality of CAP patients. Longer admission levels demonstrated greater likelihood of early death and overall mortality, necessity of mechanical ventilation, and AKI.

IL-6 and TNF-α serum levels are associated with early death in community-acquired pneumonia patients.

Science.gov (United States)

Bacci, M R; Leme, R C P; Zing, N P C; Murad, N; Adami, F; Hinnig, P F; Feder, D; Chagas, A C P; Fonseca, F L A

2015-05-01

Community-acquired pneumonia (CAP) is amongst the leading causes of death worldwide. As inflammatory markers, cytokines can predict outcomes, if interpreted together with clinical data and scoring systems such as CURB-65, CRB, and Acute Physiology and Chronic Health Evaluation II (APACHE II). The aim of this study was to determine the impact of inflammatory biomarkers on the early mortality of hospitalized CAP patients. Twenty-seven CAP patients needing hospitalization were enrolled for the study and samples of interleukin-1 (IL-1) and interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), C-reactive protein (CRP), and homocystein were collected at the time of admission (day 1) as well as on the seventh day of the treatment. There was a significant reduction in the levels of IL-6 between the first and the second collections. Median IL-6 values decreased from 24 pg/mL (day 1) to 8 pg/mL (day 7) (P=0.016). The median levels of TNF-α were higher in patients: i) with acute kidney injury (AKI) (P=0.045), ii) requiring mechanical ventilation (P=0.040), iii) with short hospital stays (P=0.009), iv) admitted to the intensive care unit (ICU) (P=0.040), v) who died early (P=0.003), and vi) with worse CRB scores (P=0.013). In summary, IL-6 and TNF-α levels were associated with early mortality of CAP patients. Longer admission levels demonstrated greater likelihood of early death and overall mortality, necessity of mechanical ventilation, and AKI.

IL-6 and TNF-α serum levels are associated with early death in community-acquired pneumonia patients

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Bacci, M.R.; Leme, R.C.P.; Zing, N.P.C. [Departamento de Cliníca Médica, Faculdade de Medicina do ABC, Santo André, SP (Brazil); Murad, N. [Departamento de Cardiologia, Faculdade de Medicina do ABC, Santo André, SP (Brazil); Adami, F.; Hinnig, P.F. [Departamento de Cliníca Médica, Faculdade de Medicina do ABC, Santo André, SP (Brazil); Feder, D. [Departamento de Farmacologia, Faculdade de Medicina do ABC, Santo André, SP (Brazil); Chagas, A.C.P. [Departamento de Cardiologia, Faculdade de Medicina do ABC, Santo André, SP (Brazil); Fonseca, F.L.A. [Departamento de Cliníca Médica, Faculdade de Medicina do ABC, Santo André, SP (Brazil)

2015-02-24

Community-acquired pneumonia (CAP) is amongst the leading causes of death worldwide. As inflammatory markers, cytokines can predict outcomes, if interpreted together with clinical data and scoring systems such as CURB-65, CRB, and Acute Physiology and Chronic Health Evaluation II (APACHE II). The aim of this study was to determine the impact of inflammatory biomarkers on the early mortality of hospitalized CAP patients. Twenty-seven CAP patients needing hospitalization were enrolled for the study and samples of interleukin-1 (IL-1) and interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), C-reactive protein (CRP), and homocystein were collected at the time of admission (day 1) as well as on the seventh day of the treatment. There was a significant reduction in the levels of IL-6 between the first and the second collections. Median IL-6 values decreased from 24 pg/mL (day 1) to 8 pg/mL (day 7) (P=0.016). The median levels of TNF-α were higher in patients: i) with acute kidney injury (AKI) (P=0.045), ii) requiring mechanical ventilation (P=0.040), iii) with short hospital stays (P=0.009), iv) admitted to the intensive care unit (ICU) (P=0.040), v) who died early (P=0.003), and vi) with worse CRB scores (P=0.013). In summary, IL-6 and TNF-α levels were associated with early mortality of CAP patients. Longer admission levels demonstrated greater likelihood of early death and overall mortality, necessity of mechanical ventilation, and AKI.

Die faktore gemeenskaplik aan die selfondersoekvraelys van Holland en die nuwe Suid-Afrikaanse beroepsbelangstellingsvraelys

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C. Swanevelder

1992-06-01

Full Text Available The factors common to the Self Directed Search of Holland (SDS and the new South African Vocational Interest Inventory (SAVII. The new South African Vocational Interest Inventory was locally developed with the purpose to create a single vocational interest inventory for all population groups in the RSA. In this study the common factors underlying the SDS and the SAVII were determined with the aid of interbattery factor analysis. The results indicate that there are six common factors underlying the two instruments for both the standard nine boys and girls, and that these factors agree with the six factors built into the SDS by Holland. Opsomming Die nuwe Suid-Afrikaanse Beroepsbelangstellingsvraelys (SABBV is plaaslik ontwikkel met die doel om 'n enkele beroepsbelangstellingsvraelys vir alle bevolkingsgroepe binne die RSA, daar te stel. In hierdie studie is daar ondersoek ingestel na die gemeenskaplike faktore onderliggend aan die SABBV en die Selfondersoekvraelys (SOV van Holland met behulp van 'n interbatteryfaktorontleding. Daar is bevind dat daar ses gemeenskaplike faktore onderliggend aan die twee instrumente is vir sowel standerd nege seuns as dogters, en dat hierdie faktore ooreenstem met die ses faktore wat deur Holland in die SOV ingebou is.

P. J. N. Smal, Die Universalisme in die Psalms. Academisch ...

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dat die historiese element in Israel se Godsopenbaring en daarmee die insig in sy betekenis te kort gedoen word. Die betekenis van die studie vir die historia revelationis is daardeur gering; as duidelike „tydlose” sistematisering van Outestamentiese gegewens oor die betrokke onder- werpe, soos die laaste hoofstuk, bl.

Die Defects and Die Corrections in Metal Extrusion

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Sayyad Zahid Qamar

2018-05-01

Full Text Available Extrusion is a very popular and multi-faceted manufacturing process. A large number of products for the automotive, aerospace, and construction sectors are produced through aluminum extrusion. Many defects in the extruded products occur because of the conditions of the dies and tooling. The problems in dies can be due to material issues, design and manufacturing, or severe usage. They can be avoided by maintaining the billet quality, by controlling the extrusion process parameters, and through routine maintenance. Die problems that occur on a day-to-day basis are mostly repairable and are rectified through various types of die correction operations. These defects and repair operations have not been reported in detail in the published literature. The current paper presents an in-depth description of repairable die defects and related die correction operations in metal extrusion. All major die defects are defined and classified, and their causes, preventive measures, and die correction operations are described. A brief frequency-based statistical study of die defects is also carried out to identify the most frequent die corrections. This work can be of direct benefit to plant engineers and operators and to researchers and academics in the field of metal extrusion.

Geslagsverskille in die ouditiewe ontlokte potensiaal van die brein

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Anita D Stuart

2006-10-01

Full Text Available Gender differences in the auditory evoked potential of the brain. Based on literature indications of an association between temperament characteristics and the evoked potential of the brain, and indications of gender differences in certain temperament traits, the purpose of this study was to ascertain whether evoked responses also differentiated between the genders. A sample of 81 male and 210 female students was randomly selected. Two auditory evoked potential procedures were applied. The results indicated statistically significant differences in evoked potential responses between the genders. The results are interpreted against the background of sensory and neurological sources of the evoked potential responses and linked to the neurophysiological foundations of temperament. Opsomming: Gegrond op aanduidings in die literatuur van ’n assosiasie tussen temperamentskenmerke en die ontlokte potensiaal van die brein, sowel as aanduidings van geslagsverskille in sekere temperamentstrekke, was die doel van die huidige studie om te bepaal of ontloktepotensiaal-response ook tussen die geslagte onderskei. ’n Steekproef van 81 manlike en 210 vroulike studente is ewekansig geselekteer. Twee ouditiewe ontloktepotensiaal- prosedures is toegepas. Die resultate het op statisties beduidende verskille tussen die geslagte gedui. Die bevindinge word teen die agtergrond van die sensoriese en neurologiese oorsprong van ontloktepotensiaal–response geïnterpreteer en verbind aan die neurofisiologiese verankering van temperament.

die doeltreffendheid van die afrikaanse woordelys en spelreels

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sluiting by die reel vir die verdubbeling van medeklinkers na 'n kort, be- klemtoonde klinker, woorde soos ballet, ballon, terras, terrein, dissipel en dissipline slegs met een konsonant na die eerste vokaal gespel moes word, omdat daardie voorafgaande vokaal onbeklemtoon is. Ook hierdie uit- sondering op die reel word ...

calvyn oor die leiding van die heilige gees in die verklaring van die

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Mittel alters, bis er zur Ruhe kommt bei den kanonischen Schriften der. Urzeit der christlichen Ära (Barth ... (ego tamen dimoveri non possum ab amore compendii, CO 10, 403). Deur die boodskap van die .... Idem ergo spiritus qui per os prophetarum loquutus est, in corda nostra penetret necesse est, ut persuadeat fideliter ...

Die verband tussen lokus van beheer en die werks prestasie van swart bemarkers in die lewensversekeringsbedryf

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E. L. Coetzer

1997-06-01

Full Text Available The relationship between locus of control and the work performance of black marketers in the life assurance industry. The aim of the study was to establish the relationship between locus of control and the work performance of black marketers in the life assurance industry. These constructs were selected by virtue of the lack of empirical research regarding the assumed relationship between them. The Locus of Control Scale of Schepers (1995 was used for measuring locus of control. Work performance was measured by the commission earned per month by the marketer, the number of policies generated by the marketer, as well as the percentage of lapsed policies. The relevant measurements were obtained in respect of a sample of 149 black marketing personnel. The results indicated a modest but statistically significant relationship between external locus of control and the work performance of black marketers. Opsomming Die doel van die studie was om die verband tussen lokus van beheer en die werksprestasie van swart bemarkers in die lewensversekeringsbedryf te bepaal. Hierdie konstrukte is gekies op grond van die gebrek aan empiriese navorsing rakende die veronderstelde verband tussen genoemde konstrukte. Die Lokus van Beheer-vraelys van Schepers (1995 is in die meting van lokus van beheer gebruik. Werksprestasie is aan die hand van kommissie per maand verdien, aantal polisse gegenereer deur 'n bemarker en die persentasie vervalde polisse, gemeet. Die tersaaklike metinge is verkry ten opsigte van 'n steekproef van 149 swart bemarkers. Die resultate toon 'n klein, dog statisties beduidende verband tussen eksterne lokus van beheer en die werksprestasie van swart bemarkers in die lewensversekeringsbedryf.

die doel en wese van opvoedende onderwys en die implikasies

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Oaar moet onderskei word tussen die doelstellings van opvoedende onderwys en die einddoel wat bereik word deur die nastrewing van hierdie doelstellings. Gunter praat van die naderliggende doelstellings (1981, b1.105). \\/at die enddoel van opvoedende onderwys bet ref, gaan die meeste opvoedkundi ges akkoord dat ...

Is die ortodoksie se verstaan van die sondeval belemmerend vir die gesprek tussen teologie en natuurwetenskap?

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Johan Buitendag

2012-11-01

Full Text Available In hierdie artikel is betoog dat die Gereformeerde Ortodoksie se begrip van die sondeval ’n  belemmering  was  vir  die  gesprek  tussen  teologie  en  natuurwetenskap.  Die  rede hiervoor was dat dit ten eerste ’n bepaalde verstaan van liniêre tyd nahou en ten tweede dat dit ’n bonatuurlike ingryp veronderstel het. Albei hierdie aspekte het die debat onnodig problematiseer. Die argument is ontwikkel deur eerstens die probleem te definieer, gevolg deur ’n uiteensetting van die standpunte van Augustinus en Calvyn onderskeidelik oor die sondeval. As ’n heuristiese sleutel is die konsepte van infralapsarisme en supralapsarisme aangewend om die tema te ontleed. Die artikel is afgesluit met die oortuiging dat die imago Dei ’n beliggaamde menslike persoon is wat biologies in die geskiedenis in terme van selfbewussyn en morele verantwoordelikheid ontluik het. Is the Orthodoxy’s notion of the Fall inhibitory for the dialogue between theology and science? In this article it was argued that the Reformed Orthodoxy’s interpretation of the Fall had become an impediment in the dialogue between theology and science. The reason was that it assumed firstly a specific understanding of linear time and secondly a metaphysical intervention. Both events were unnecessarily problematising the debate. The argument was deployed by stating the problem, followed by an exposition of the views of Augustine and Calvin on the Fall. As a heuristic key, the concepts of infralapsarism and supralapsarism were applied respectively to analyse the topic. The article concluded with the conviction that the imago Dei is an embodied human person that had biologically emerged in history as a center of self-awareness, and moral responsibility.

Early Pulomonary Irradiation in Paraquat (Gramoxone) Poisoning

International Nuclear Information System (INIS)

Lee, Chang Geol; Kim, Gwi Eon; Suh, Chang Ok

1995-01-01

Purpose : To evaluate whether the early pulmonary irradiation can prevent or decrease the pulmonary damage and contribute to improve ultimate survival in paraquat lung. Materials and Methods : From Jun. 1987 to Aug. 1993, thirty patients with paraquat poisoning were evaluated. Fourteen of these patients were received pulmonary irradiation(RT). All of the patients ere managed with aggressive supportive treatment such as gastric lavage, forced diuresis, antioxidant agents and antifibrosis agents. Ingested amounts of paraquat were estimated into three groups(A: minimal 50cc). Pulmonary irradiation was started within 24 hours after admission(from day 1 to day 11 after ingestion of paraquat). Both whole lungs were irradiated with AP/PA parallel opposing fields using C0-60 teletherapy machine. A total of 10Gy(2Gy/fr. X 5 days)was delivered without correction of lung density. Results : In group A, all patients were alive regardless of pulmonary irradiation and in group C, all of the patients were died due o multi-organ failure, especially pulmonary fibrosis regardless of pulmonary irradiation. However, in group B, six of 7 patients(86%) with no RT were died due to respiratory failure, but 4 of 8 patients with RT were alive and 4 of 5 patients who received pulmonary irradiation within 4 days after ingestion of paraquat were all alive though radiological pulmonary fibrosis. All 3 patients who were received pulmonary irradiation after 4 days after ingestion were died due to pulmonary fibrosis in spite of recovery from renal and hepatic toxicity. Conclusion : It is difficult to find out the effect of pulmonary irradiation on the course of the paraquat lung because the precise plasma and urine paraquat concentration were not available between control and irradiation groups. But early pulmonary irradiation within 4 days after paraquat poisoning with aggressive supportive treatment appears to decrease pulmonary toxicity and contribute survival in patients with mouthful ingestion

Die opleiding van bedryfsielkundiges aan die universiteit van Fort Hare

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W. Botha

1977-11-01

Full Text Available Die Departement Bedryfsielkunde aan die Universiteit van Fort Hare is 'n relatiewe jong departement en het eers in 1965 tot stand gekom. Voor hierdie datum is Bedryfsielkunde as 'n kort kursus deur die departement van suiwer Sielkunde aangebied en een van die destydse dosente, Dr. W. Backer, het die inisiatief geneem om 'n selfstandige departement van Bedryfsielkunde in die Fakulteit van Ekonomiese Wetenskappe op die been te bring.

The Transformation Process in Nurses Caring for Dying Patients.

Science.gov (United States)

Huang, Ching-Chi; Chen, Jih-Yuan; Chiang, Hsien-Hsien

2016-06-01

Despite the recent increase in attention to end-of-life hospice care, little empirical evidence regarding the process of emotional or mental transformation in caregivers is available. This study explores the transformative process that occurs in nurses because of the spiritual suffering and conflict associated with after caring for dying patients. A phenomenological approach was used to investigate eight nurses (27-40 years old) working in the hospice ward of a medical center in Taipei. Data were collected through open-ended questions using semistructured interviews and were analyzed reflectively. A three-stage transformation in the emotional processes of participants was observed. In the first stage, the participants experienced acute emotional suffering because of facing the death of their patients, potentially exacerbated by their own memories of losing family members. In the second stage, the participants adopted coping strategies to improve self-care. These strategies included attempting to soothe patients, helping patients face or deal with unfulfilled business, and participating in funeral or memorial services. In the third stage, the participants learned to provide better care through emancipatory reflection and a reassertion of responsibilities toward the self, patients, and patient families. After the third stage, the initial emotional impact morphed into a medium for self-strengthening, and participants became more adept at detecting patient needs and at providing care to complete the transformational process fully. Emotional suffering was the primary factor that induced participants to transform their personal and professional selves. Adequate emotional self-management, dialogue with other nurses, and personal reflection are crucial actions that nurses may use to cultivate personal growth, implement ethical practice, interact with other nurses, and engage in personal reflection. Strategies such as caring for patients, implementing reflective nursing

Prognostic index to identify patients who may not benefit from whole brain radiotherapy for multiple brain metastases from lung cancer

International Nuclear Information System (INIS)

Sundaresan, P.; Yeghiaian, R.; Gebski, V.

2010-01-01

Full text: Palliative whole brain radiotherapy (WBRT) is often recommended in the management of multiple brain metastases. Allowing for WBRT waiting time, duration of the WBRT course and time to clinical response, it may take 6 weeks from the point of initial assessment for a benefit from WBRT to manifest. Patients who die within 6 weeks ('early death') may not benefit from WBRT and may instead experience a decline in quality of life. This study aimed to develop a prognostic index (PI) that identifies the subset of patients with lung cancer with multiple brain metastases who may not benefit from WBRT because of'early death'. The medical records of patients with lung cancer who had WBRT recommended for multiple brain metastases over a 10-year period were retrospectively reviewed. Patients were classified as either having died within 6 weeks or having lived beyond 6 weeks. Potential prognostic indicators were evaluated for correlation with 'early death'. A PI was constructed by modelling the survival classification to determine the contribution of these factors towards shortened survival. Of the 275 patients recommended WBRT, 64 (23.22%) died within 6 weeks. The main prognostic factor predicting early death was Eastern Cooperative Oncology Group (ECOG) status >2. Patients with a high PI score (>13) were at higher risk of'early death'. Twenty-three per cent of patients died prior to benefit from WBRT. ECOG status was the most predictive for 'early death'. Other factors may also contribute towards a poor outcome. With further refinement and validation, the PI could be a valuable clinical decision tool.

Filosofiese tendense in die wordinggeskiedenis van ons verstaan van die fisiese natuur

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D. F. M. Strauss

2006-09-01

Full Text Available Die ontstaan van ’n lang tradisie van natuurwetenskaplike denke is in antieke Griekeland te vind – die bakermat van die Westerse beskawing en die bron van geartikuleerde rasionele besinning. Die vroegste fases van die Griekse kultuur het reeds geboorte geskenk aan ’n teoretiese nadenke oor die heelal. Die Pythagoreërs is veral bekend vir hul klem op die verklaringskrag van getalsverhoudinge. In hul tese dat “alles getal is” het hulle egter slegs rasionale getalle (breuke erken en gevolglik uiteindelik vasgeloop in die ontdekking van irrasionale getalle wat tot die geometrisering van die Griekse wiskunde gelei het en tegelyk die bedding gevorm het van waaruit ’n magtige tradisie van ruimte-metafisika gegroei het wat die hele middeleeuse tydperk omspan het. Die vermeende statiese syn is in die mees ekstreme geval – die skool van Parmenides en die argumente van Zeno teen veelheid en beweging – tot in die uiteindelike antinomiese konsekwensies daarvan deurdink. Dit was egter eers die vroeg-moderne tyd – die voorgangers en nakomelinge van Galilei – wat naas getal en ruimte ’n waardering ontwikkel het vir die verklaringskrag van beweging (vergelyk die klassieke meganistiese wêreldbeeld van die heelal as ’n meganisme van stofdeeltjies in beweging. Maar ook hierdie meganistiese reduksie (waardeur alle fisiese verskynsels herlei is tot die beweging van al of niegelade massapunte sou uiteindelik misluk omdat dit nie van die onomkeerbaarheid van fisiese prosesse rekenskap kon gee nie. Gevolglik beliggaam eers die fisika van die 20ste eeu ’n erkenning van die deurslaggewend-stempelende rol van energie-werking (dus van die fisiese aspek in die aard van stoflike dinge en prosesse. Die artikel word afgesluit met ’n vlugtige verduideliking van die implikasies van die voorafgaande argumentasie vir ’n benadering van die misterie van die bestaan van materie.

Dying in the Hospital: Perspectives of family members.

Science.gov (United States)

Dose, Ann Marie; Carey, Elise C; Rhudy, Lori M; Chiu, Yichen; Frimannsdottir, Katrin; Ottenberg, Abigale L; Koenig, Barbara A

2015-01-01

Although most patients express a preference to die at home, many (over 30 percent) still die in hospital. This study's purpose was to explore the experience of hospital death from the perspective of patients' family members. interviews were conducted with family members of patients who had died at hospitals affiliated with a large tertiary referral centre in the United States. Content analysis was used to analyze findings. We interviewed 30 family members by phone. Themes were arranged by time frame: before death, time of death, and after death. Families do not interpret clinical cues leading up to death in the same way healthcare providers do; families need clear and direct explanations from providers. Clinicians should assess patient and family understandings of prognosis and communicate clearly and directly. Family members value being with their loved one at the time of death, and they value spending time with the body after death; this should be facilitated in clinical practice.

N HERSIENING VAN DIE AFRIKAANSE VERTALING VAN DIE ...

African Journals Online (AJOL)

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vergewe. Dit sou in orde gewees het as daar gestaan het, ReMomë- j^onta^is hepta?ds. wat die grieks is vir sewentig maal sewe. Die uitdrukking. heMom&ontabis heptd sien hoogswaarskynlik op Gen. 4 : 24 (LXX) waar. Lameg meedeel dat hy sewe-en-sewentig-maal gewreek sal word. Daar sit die Afr. Vert, die uitdrukking ...

Modeling the Mechanical Performance of Die Casting Dies

Energy Technology Data Exchange (ETDEWEB)

R. Allen Miller

2004-02-27

The following report covers work performed at Ohio State on modeling the mechanical performance of dies. The focus of the project was development and particularly verification of finite element techniques used to model and predict displacements and stresses in die casting dies. The work entails a major case study performed with and industrial partner on a production die and laboratory experiments performed at Ohio State.

Precision die design by the die expansion method

CERN Document Server

Ibhadode, A O Akii

2009-01-01

This book presents a new method for the design of the precision dies used in cold-forging, extrusion and drawing processes. The method is based upon die expansion, and attempts to provide a clear-cut theoretical basis for the selection of critical die dimensions for this group of precision dies when the tolerance on product diameter (or thickness) is specified. It also presents a procedure for selecting the minimum-production-cost die from among a set of design alternatives. The mathematical content of the book is relatively simple and will present no difficulty to those who have taken basic c

n hoofstuk in die (outo)biografie van die predikant (pastor?) 1 ...

African Journals Online (AJOL)

biografie van die dominee (pastor?), spreek om verskeie redes boekdele. Die gebruik van die onbepaalde lidwoord is eerstens 'n bevestiging dat die artikel slegs 'n verdere bydrae (hoofstuk) tot die bestaande en steeds voortgaande gesprek (boek) oor die biografie van die dominee is (Heitink 2001). Tweedens plaas ek ...

DIE ROL VAN DIE SUID-AFRIKAANSE WEERMAG IN NATUUR- EN ...

African Journals Online (AJOL)

sedert die vroeg 1900's deur die Weermag be- heer. In 1967 was dit die eerste militere terrein wat tot privaatnatuurreservaat verklaar is. Vhembe bestaan uit 4 hoofplantgemeenskappe nl. rivieraewerbos, vloedvlaktes, ranteveld en die sandveldplato. Wildsoorte op die terrein sl!Jit rooibokke, bosbokke, waterbokke, koedoes,.

What do Japanese residents learn from treating dying patients? The implications for training in end-of-life care

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Kazuko Arai

2017-11-01

Full Text Available Abstract Background How medical residents’ experiences with care for dying patients affect their emotional well-being, their learning outcomes, and the formation of their professional identities is not fully understood. We examine residents’ emotional states and learning occurring during the provision of care to dying patients and specifically discuss the impact of providing end-of-life (EOL care on professional identity formation. Methods Semi-structured interviews were conducted with 13 residents who had graduated in the last 3 to 5 years. Thematic theoretical analysis was applied, and key themes were developed based on Kolb’s experiential learning cycle. Results Eight key themes emerged from the analysis. The residents experienced dilemmas in confronting the reality of medical uncertainty as well as a disruption of emotional state and self-efficacy. Although the residents felt a sense of helplessness and guilt, they were able to reflect on strategies for handling medical care that focused on patients and that required a truly sincere attitude. They also contemplated the importance of palliative care and communication with patients, patients’ family members and medical staff. Building on these experiences, the residents rebuilt a sense of awareness that allowed them to directly engage with the type of medical care that they are likely to be called upon to perform in the future as the population continues to age. Conclusions This study revealed Japanese residents’ perceptions, emotions and learning processes in caring for dying patients by applying Kolb’s experiential learning theory. The findings of this study may illuminate valuable pieces of knowledge for future education in EOL care.

Die entwicklung, die metamorphose, die entstehung: Die konzepte des organismus von Aristoteles bis Darwin

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Kamerer Eva

2009-01-01

Full Text Available (nemački In diesem Aufsatz versuche ich, die Elemente verschiedener Konzepte des Organismus in der Philosophie und in der Wissenschaft zu analysieren. Die Deutungen des Organismus und der Einheit der Natur bei Aristoteles, Kant und Goethe werden als ein Beispiel der Bewegung von einem finalistischen zum antifinalistischen Bild der Natur verstanden.

die aard van wetgewende diskresies by die suid-afrikaanse ...

African Journals Online (AJOL)

Administrator

In enige moderne demokrasie is daar een of ander vorm van skeiding van magte tussen die wetgewende, uitvoerende en regsprekende gesag. Hierdie skeiding van magte, die sogenaamde trias politica, kan sover teruggevoer word as 1215, met die ondertekening van die Magna Carta deur Koning John van Engeland.

die krag van simbole en rites in die liturgie 1. probleemstelling

African Journals Online (AJOL)

uitroepe vervang met die drie keer Kyrie eleison, die drie maal Christe eleison en die drie keer Kyrie eleison-uitroepe (Albrecht 1989:43). Op die lang duur het die uitroep dus heeltemal losgeraak van die gebede en het dit 'n selfstandige liturgiese element geword (Van Rongen. 1990:35). Die Reformasie met sy nadruk op ...

Early versus delayed hormonal treatment in locally advanced or asymptomatic metastatic prostatic cancer patient dilemma.

Science.gov (United States)

Prezioso, Domenico; Iacono, Fabrizio; Romeo, Giuseppe; Ruffo, Antonio; Russo, Nicola; Illiano, Ester

2014-06-01

The objective of this work is to compare the effectiveness of hormonal treatment (luteinizing hormone-releasing hormone agonists and/or antiandrogens) as an early or as a deferred intervention for patients with locally advanced prostate cancer (LAPC) and/or asymptomatic metastasis. Systematic review of trials published in 1950-2007. Sources included MEDLINE and bibliographies of retrieved articles. Eligible trials included adults with a history of LAPC who are not suitable for curative local treatment of prostate cancer. We retrieved 22 articles for detailed review, of which 8 met inclusion criteria. The Veterans Administration Cooperative Urological Research Group suggested that delaying hormonal therapy did not compromise overall survival and that many of the patients died of causes other than prostate cancer. In European Organisation for Research and Treatment of Cancer (EORTC) 30846 trial, the median survival for delayed endocrine treatment was 6.1 year, and for immediate treatment 7.6 year, the HR for survival on delayed versus immediate treatment was 1.23 (95 % CI 0.88-1.71), indicating a 23 % nonsignificant trend in favour of early treatment. In EORTC 30891, the immediate androgen deprivation resulted in a modest but statistically significant increase in overall survival. The protocol SAKK 08/88 showed the lack of any major advantage of immediate compared with deferred hormonal treatment regarding quality of life or overall survival. The early intervention with hormonal treatment for patients with LAPC provides important reductions in all-cause mortality, prostate cancer-specific mortality, overall progression, and distant progression compared with deferring their use until standard care has failed to halt the disease.

Die vroeë kommunikasieontwikkeling van ’n groep babas met pediatriese MIV/VIGS in sorgsentrums

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Isabel Bam

2003-11-01

Full Text Available The high prevalence and serious sequelae of the pediatric human immunodeficiency virus (HIV/AIDS in South Africa pose great challenges for clinicians involved in early intervention to develop appropriate interdisciplinary programmes for primary prevention of transmission of the virus as well as secondary interventions directed at the early management of the unique combination of serious health problems, neuro-developmental needs and caregiving circumstances of the infants. Opsomming Die hoë prevalensie en ernstige gevolge van die pediatriese menslike immuniteitsgebrek-virus (MIV/VIGS in Suid-Afrika stel groot uitdagings aan klinici betrokke by vroeë intervensie om toepaslike interdissiplinêre programme te ontwikkel vir primêre voorkoming van oordrag van die virus asook sekondêre intervensies gerig op die vroeë hantering van die babas se unieke kombinasie van ernstige Gesondheids-probleme, neuro-ontwikkelingsbehoeftes en versorgingsomstandighede. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

Paradigmas en progressie in die teologie: *n Perspektief op die ...

African Journals Online (AJOL)

Die metodologie as besinningsterrein word egter al belangriker. Gedurende die tweede week van April 1988 het teoloë van dwarsoor Suid-. Afrika by die nuwe gebou van die Raad vir Geesteswetenskaplike Navorsing in. Pretoria byeen gekom vir 'n kongres van amper drie dae met die tema Paradigma.'> 476. ISSN 0259 ...

DIE PERSOON VAN VREDE IN DIE SENDING

African Journals Online (AJOL)

aan dat 'n lewe onder die gesag van God tot volle vrede lei: “In coming under the rule of Yahweh, moreover, life was made whole and safe.” Dit is spesifiek in die tempel waar die volheid van God se vrede ondervind word (1997:662):. The temple is indeed the place where Israel entered into Yahweh's full zone of shalom.

A Retrospective Medical Records Review of Risk Factors for the Development of Respiratory Tract Secretions (Death Rattle) in the Dying Patient.

Science.gov (United States)

Kolb, Hildegard; Snowden, Austyn; Stevens, Elaine; Atherton, Iain

2018-05-09

Identification of risk factors predicting the development of death rattle. Respiratory tract secretions, often called death rattle, are among the most common symptoms in dying patients around the world. It is unknown whether death rattle causes distress in patients, but it has been globally reported that distress levels can be high in family members. Although there is a poor evidence base, treatment with antimuscarinic medication is standard practice worldwide and prompt intervention is recognised as crucial for effectiveness. The identification of risk factors for the development of death rattle would allow for targeted interventions. A case ̶ control study was designed to retrospectively review two hundred consecutive medical records of mainly cancer patients who died in a hospice inpatient setting between 2009 - 2011. Fifteen potential risk factors including the original factors weight, smoking, final opioid dose and final Midazolam dose were investigated. Binary logistic regression to identify risk factors for death rattle development. Univariate analysis showed death rattle was significantly associated with final Midazolam doses and final opioid doses, length of dying phase and anticholinergic drug load in the pre-terminal phase. In the final logistic regression model only Midazolam was statistically significant and only at final doses of 20 mg/24hrs or over (OR 3.81 CI 1.41-10.34). Dying patients with a requirement for a high dose of Midazolam have an increased likelihood of developing death rattle. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Measuring death-related anxiety in advanced cancer: preliminary psychometrics of the Death and Dying Distress Scale.

Science.gov (United States)

Lo, Christopher; Hales, Sarah; Zimmermann, Camilla; Gagliese, Lucia; Rydall, Anne; Rodin, Gary

2011-10-01

The alleviation of distress associated with death and dying is a central goal of palliative care, despite the lack of routine measurement of this outcome. In this study, we introduce the Death and Dying Distress Scale (DADDS), a new, brief measure we have developed to assess death-related anxiety in advanced cancer and other palliative populations. We describe its preliminary psychometrics based on a sample of 33 patients with advanced or metastatic cancer. The DADDS broadly captures distress about the loss of time and opportunity, the process of death and dying, and its impact on others. The initial version of the scale has a one-factor structure and good internal reliability. Dying and death-related distress was positively associated with depression and negatively associated with spiritual, emotional, physical, and functional well-being, providing early evidence of construct validity. This distress was relatively common, with 45% of the sample scoring in the upper reaches of the scale, suggesting that the DADDS may be a relevant outcome for palliative intervention. We conclude by presenting a revised 15-item version of the scale for further study in advanced cancer and other palliative populations.

Various opportunistic infections and neoplasms in patients dying of AIDS in the last 12 years--report based on pathomorphological investigations.

Science.gov (United States)

Kamiński, Z

2001-01-01

The aim of the study was microscopic diagnostics of infections and neoplasms in patients who died of AIDS. Post-mortem analyses were performed in the Hospital for Infectious Diseases in Warsaw. In total, 200 patients with AIDS who were treated and subsequently died were included in the analysis. The study group consisted of 175 men and 25 women. Patients' age ranged between 11 months and 64 years (mean age 43 years). The most frequent infection diagnosed in these subjects was cytomegalovirus, followed by bacterial, mycotic, tuberculotic infections and toxoplasmosis. As far as neoplasms are concerned, patients with AIDS suffered most frequently from malignant lymphoma, Kaposi's sarcoma and finally, from Hodgkin's disease. In most cases, many types of infections coexisted with one another or there was a co-occurrence of the infection and neoplasm. The author suggests that the material presented in this paper is representative for Polish population. Pulmonary changes is the most often cause of the death of the patients with AIDS.

Study of radial die-wall pressure changes during pharmaceutical powder compaction.

Science.gov (United States)

Abdel-Hamid, Sameh; Betz, Gabriele

2011-04-01

In tablet manufacturing, less attention is paid to the measurement of die-wall pressure than to force-displacement diagrams. Therefore, the aim of this study was to investigate radial stress change during pharmaceutical compaction. The Presster(TM), a tablet-press replicator, was used to characterize compaction behavior of microcrystalline cellulose (viscoelastic), calcium hydrogen phosphate dihydrate (brittle), direct compressible mannitol (plastic), pre-gelatinized starch (plastic/elastic), and spray dried lactose monohydrate (plastic/brittle) by measuring radial die-wall pressure; therefore powders were compacted at different (pre) compaction pressures as well as different speeds. Residual die-wall pressure (RDP) and maximum die-wall pressure (MDP) were measured. Various tablet physical properties were correlated to radial die-wall pressure. With increasing compaction pressure, RDP and MDP (P compaction behavior of materials and detecting friction phenomena in the early stage of development.

Etiese perspektiewe op haatspraak in die lig van die derde gebod

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Jakobus M. (Koos Vorster

2014-03-01

Full Text Available Hierdie artikel fokus op die implikasies van die derde gebod met betrekking tot haatspraak in Suid-Afrika (SA vandag. Die artikel gaan uit van die standpunt dat die name van God op sy wese dui. Die name van God soos dit in die bybelse openbaringsgeskiedenis ontwikkel word, druk die gemeenskapskarakter van God se verhouding met mense en die skepping uit. Die betekenis van die name kulmineer in die Nuwe-Testamentiese uitdrukkings Vader en God is liefde. Alle verbale gedrag wat hierdie gemeenskaps- en liefdesverhouding inhibeer, oortree die derde gebod. Die misbruik van die Naam van God vind onder andere plaas wanneer mense, wat na die beeld van God geskep is, gedegradeer word deur haatspraak, omdat sodanige degradering die gemeenskap en liefde tussen God en die mens skend. Ten slotte word sekere gevalle van haatspraak soos dit vandag in Suid-Afrika voorkom, teologies-eties belig teen die agtergrond van die betekenis van die derde gebod. Hierdie vorms sluit religieuse, rassistiese, xenofobiese, seksistiese en homofobiese haatspraak in. This article focuses on the implications of the third commandment for hate speech in modern-day South Africa. The article contends that the names of God are expressions of his Being. The names of God as they are developed in the biblical history of revelation express his creation of covenantal community and restored relations with humankind and creation. The meaning of the names of God culminates in the New Testament expressions Father and God is love. Verbal actions that inhibit the new community created by God or violate love transgress the third commandment. Misuse of the name of God occurs among others when people, created in the image of God, are verbally degraded by hate speech because such degradation violates the community of love between God and humankind. In conclusion, the article indicates forms of hate speech in South Africa that should be dealt with in the light of the third commandment. These are acts

Die era van Suid-Afrika se militere hoogbloei met die ...

African Journals Online (AJOL)

4 Jun 1976 ... Die Toyota 1200 bakkie is geadverteer met die woorde 'Hier kom die pantserbakkie', teen die agtergrond van 'n olifant tenk.32. Daar is ook 'n betrekking deur Thorold en van Wyk geadverteer waar militere opleiding 'n voorvereiste was.33. Daar was ook films wat weermag en polisie gebasseer is wat in die ...

’n Etiek van liefde: Die etiese perspektiewe van die Heidelbergse Kategismus

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Koos Vorster

2013-06-01

Full Text Available Hierdie artikel behandel die etiese perspektiewe van die Heidelbergse Kategismus – een van die prominente belydenisskrifte in die gereformeerde tradisie. Die etiese relevansie is ingebed in die konfessie se verklaring van die tien gebooie. Die artikel verduidelik dat die etiek van die Heidelbergse Kategismus ten diepste ’n karakteretiek is en dat dit gelowiges oproep tot ’n etiek van liefde. Hierdie liefde sluit in liefde vir die verbondsgemeenskap, die bediening van die Woord, die heiligheid van God en die waardigheid van mense, die gemeenskap van die gelowiges, gesag, die lewe, die huwelik, privaatbesit en arbeid asook waarheid en geregtigheid. As gevolg van die sinekdogeekarakter van die wet is hierdie etiek van liefde vandag baie relevant. This article deals with the ethical relevance of one of the prominent confessions in the reformed tradition, namely the Heidelberg Cathechism. The ethical relevance lies in the confession’s elucidation of the ten commandments and its application to moral conduct. The article explains that the ethics of the Heidelberg Catechism is essentially a virtue ethics calling for an ethics of love. This love should include love for the covenantal communion, ministry of the Word, the holiness of God and the dignity of people, the communion of the saints, authority, life, marriage, private property and labour, and truth and justice. Due to the synecdochical character of the ten commandments this ethics of love is highy relevant in the present times.

Die invloed van herbivorie en vuur op die oorlewing van sekere meerjarige kruide langs die Sabierivier, Kruger Nasionale Park

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H. Myburgh

2012-03-01

Full Text Available Die groot vloede wat in die jaar 2000 in die Kruger Nasionale Park plaasgevind het, het dierivieroewerplantegroei versteur. Dit het die geleentheid gebied om heinings op te rig langsdie Sabierivier om herbivore uit sekere gebiede uit te sluit en sodoende die herstel van die rivieroewerekosisteme te monitor.

Chrístologie: Die historiese Jesus en die kerugmatiese Christus by ...

African Journals Online (AJOL)

dige Here van sy kerk. Die Christelike teologie en die kerk het dus nie 'n ander oprsprong as wat die Christologiese belydenis van die oer-Christendom het nie, naamlik die paasgebeure. Schmithals (1972b:77) wil kerk en teologie aanmoedig om hierdie oorsprong in gedagte te hou en om goed te besef dat die Christus-.

Die invloed van gesondheidsopvoeding op die prevalensie van skistosoombesmettings by leerders in ’n skistosoom - endemiese gebied in die Limpopoprovinsie

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Corrie Wolmarans

2008-09-01

Full Text Available In hierdie studie is geselekteerde direkte en indirekte onderrigmetodes geëvalueer ten opsigte vanhulle potensiaal om die prevalensie van skistosoombesmettings by skoolgaande kinders, woonagtigin ’n landelike omgewing in ’n skistosoom-endemiese gebied, te verlaag. Twee direkte (poppekas enblaaibord en drie indirekte (plakkaat, kennisgewingbord en onderrig via ouers of voogdeonderrigmetodes is geëvalueer.Skistosoombesmette leerders is met behulp van parasitologiese metodes geïdentifiseer en aan ’nvraelys in hul moerdertaal onderwerp om onder andere op hoogte van hulle kennis ten opsigte vanskistosomose te kom en te bepaal hoe die infrastruktuur tot hulle beskikking wat water en sanitasiebetref, daar uitsien. Leerders is met behulp van plaaslike gesondheidspersoneel vir die siekte behandelen daarna op verskeie geleenthede in samewerking met plaaslike onderwysers aan die verskillendeonderrigmetodes blootgestel.’n Aansienlike toename in die leerders se kennis aangaande skistosomose is reeds na die tweedeonderrigsessie waargeneem. Ten spyte van die feit dat die leerders in ’n skistosoom-endemiesegebied woonagtig was, het slegs 2% die siekte met ’n natuurlike waterhabitat soos ’n rivier geassosieer.Daar is verder gevind dat relevante amptelike strukture soos klinieke, geneeshere en skole byna geenrol speel in die verskaffing van inligting van wat die siekte behels en hoe dit oorgedra word nie.Betekenisvolle afnames in die kumulatiewe prevalensie van besmetting het by al die groepe, wat aandie onderskeie onderrigmetodes blootgestel was gedurende die ondersoek, voorgekom, wanneer ditmet die kontrolewaarde waar die leerders geen onderrig ontvang het nie, vergelyk is. Statistiesevergelykings tussen die verskillende onderrigmetodes het getoon dat die poppekas, blaaibord enplakkaat die effektiefste was om die prevalensie te verlaag, terwyl die gebruik van ouers of voogdedie minste effektief was. Alhoewel die kumulatiewe prevalensie van

Analyses of patterns-of-failure and prognostic factors according to radiation fields in early-stage Hodgkin lymphoma

Energy Technology Data Exchange (ETDEWEB)

Krebs, Lorraine; Guillerm, Sophie; Menard, Jean; Hennequin, Christophe; Quero, Laurent [Saint Louis Hospital, Radiation Oncology Department, Paris (France); Amorin, Sandy; Brice, Pauline [Saint Louis Hospital, AP-HP, Hematooncology Department, Paris (France)

2017-02-15

Doses and volumes of radiation therapy (RT) for early stages of Hodgkin lymphoma (HL) have been reduced over the last 30 years. Combined modality therapy (CMT) is currently the standard treatment for most patients with early-stage HL. The aim of this study was to analyze the site of relapse after RT according to the extent of radiation fields. Between 1987 and 2011, 427 patients were treated at our institution with RT ± chemotherapy for stage-I/II HL. Among these, 65 patients who experienced a relapse were retrospectively analyzed. Most patients had nodular sclerosis histology (86 %) and stage-II disease (75.9 %). Bulky disease was present in 21 % and 56 % of patients belonged to the unfavorable risk group according to European Organization for Research and Treatment of Cancer (EORTC)/The Lymphoma Study Association (LYSA) definitions. CMT was delivered to 91 % of patients. All patients received RT with doses ranging from 20 to 45 Gy (mean = 34 ± 5.3 Gy). The involved-field RT technique was used in 59 % of patients. The mean time between diagnosis and relapse was 4.2 years (range 0.3-24.5). Out-of-field relapses were suffered by 53 % of patients. Relapses occurred more frequently at out-of-field sites in patients with a favorable disease status, whereas in-field relapses were associated with bulky mediastinal disease. Relapses occurred later for favorable compared with the unfavorable risk group (3.5 vs. 2.9 years, p = 0.5). From multivariate analyses, neither RT dose nor RT field size were predictive for an in-field relapse (p = 0.25 and p = 0.8, respectively), only bulky disease was predictive (p = 0.018). In patients with bulky disease, RT dose and RT field size were not predictive for an in-field relapse. In this subgroup of patients, chemotherapy should be intensified. We confirmed the bad prognosis of early relapses. (orig.) [German] Waehrend der letzten 30 Jahre wurden die Strahlentherapie-(RT-)Dosis und die RT-Volumina fuer die Behandlung der Fruehstadien

The Contribution of Death-Related Experiences to Health Care Providers' Attitudes toward Dying Patients: II. Medical and Nursing Students with No Professional Experience.

Science.gov (United States)

Brent, Sandor B.; And Others

1993-01-01

Compared attitudes toward care of dying patients of beginning medical and nursing students with no professional death-related experience. On five of six attitude measures, female nursing students expressed more positive attitude than either male or female medical students. Hours of death-and-dying coursework and general life experience exerted…

Early supported discharge for patients with exacerbations of chronic obstructive pulmonary disease

DEFF Research Database (Denmark)

Ringbaek, T.J.; Nielsen, L.L.; Admasu, H.

2008-01-01

-29) days. While being cared for at home, one patient died and readmission was necessary in 19 (17.6%) cases. Within three months 51.4% of the patients were readmitted and 14.8% died. The income and costs related to ESD were approximately 120,000 EUR and 75,000 EUR, respectively. CONCLUSION: Almost 20......% of all admissions were eligible for ESD. Compared to British studies on ESD, our patients had more severe COPD. We cannot determine whether this model of care has reduced days in hospital, but costs and income seem to balance Udgivelsesdato: 2008/1/7...... the previous year; 159 (18.2%) admissions in 108 patients were suitable for ESD. Prior to ESD, the mean duration of in-hospital stay was 4.0 days. Patients selected for ESD had severe COPD with FEV1 31.8% (7-89%) of predicted value. They had on average 3.8 (1-11) home visits in a mean period of 10.5 (1...

duele verse sowel as die somtotaal die leser

African Journals Online (AJOL)

27 Jan 2006 ... selfs 'n landkaart afgedruk) terwyl dit ter- selfdertyd ver bo die lokale uitstyg. Die digter is sterk bewus van sy omgewing, geskiedenis en tradisies, maar veral van die algemene menslike kondisie wat binne hierdie referensiekader vergestalt word. Hy gebruik 'n bekende historiese slagveld as bundeltitel (en ...

Paulus as vredemaker. Oor die resepsie van die Brief aan Filemon ...

African Journals Online (AJOL)

7 Jul 2015 ... Inleiding. Die woord 'vrede' kom net een maal in die Filemonbrief voor, en wel in die aanhef van die brief. Kommentatore merk egter gereeld op dat 'n mens nie daaruit moet aflei dat dié begrip onbelangrik vir die verstaan van die brief is nie. Om een voorbeeld te noem: Barth en Blanke. (2002) skryf as volg:.

Early Onset Marfan Syndrome: Atypical Clinical Presentation of Two Cases

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Ozyurt Abdullah

2015-06-01

Full Text Available Early onset Marfan Syndrome (eoMFS is a rare, severe form of Marfan Syndrome (MFS. The disease has a poor prognosis and most patients present with resistance to heart failure treatment during the newborn period. This report presents two cases of eoMFS with similar clinical features diagnosed in the newborn period and who died at an early age due to the complications related to the involvement of the cardiovascular system.

Die wet is evangelie: Die Heidelbergse Kategismus steeds aktueel na 450 jaar

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Piet Strauss

2013-09-01

Full Text Available In die denke van Martin Luther bestaan daar spanning tussen die wet van God en die evangelie. Vir Luther is liefde die eie werk en die wet die vreemde werk van God. Daarteenoor integreer of versoen Johannes Calvyn God se wet met die evangelie. Hy vertolk die openingswoorde van die wet byvoorbeeld as liefdevol en bevrydend en daarom evangelies. Calvyn beskou die wet as die manier waarop ’n Christen sy liefde vir God uitleef en sy dankaarheid teenoor God vir sy verlossing betoon. Calvyn se siening oor die verhouding tussen die wet en die evangelie het ’n betekenisvolle invloed op die Heidelbergse Kategismus se formulering ten opsigte van hierdie saak. Volgens die Kategismus is die wet evangelie, of die vorm wat die evangelie in die lewe van die mens aanneem. In the thought of Martin Luther tension exists between the law of God and the gospel. Luther regards love as the own work of God and the law as something strange to the Lord. John Calvin, however, integrates Gods law and the gospel to the extent that the opening words of the ten commandments are regarded as words of love and redemption and therefore evangelical. To Calvin the law becomes the way in which a converted Christian lives and shows his gratitude to God for his salvation. Calvin’s view on the relationship between law and gospel had a significant influence on the way in which the Heidelberg Cathecism formulates these two concepts. For the Cathecism the law is gospel or the form in which the gospel takes shape in human life.

Male ICU nurses' experiences of taking care of dying patients and their families: a gender analysis.

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Wu, Tammy W; Oliffe, John L; Bungay, Vicky; Johnson, Joy L

2015-01-01

Male intensive care unit (ICU) nurses bring energy and expertise along with an array of beliefs and practices to their workplace. This article investigates the experiences of male ICU nurses in the context of caring for dying patients and their families. Applying a gender analysis, distilled are insights to how masculinities inform and influence the participants' practices and coping strategies. The findings reveal participants draw on masculine ideals of being a protector and rational in their decisive actions toward meeting the comfort needs of dying patients and their families. Somewhat paradoxically, most participants also transgressed masculine norms by outwardly expressing their feelings and talking about emotions related to these experiences. Participants also reported renewed appreciation of their life and their families and many men chronicled recreational activities and social connectedness as strategies for coping with workplace induced stresses. The findings drawn from this study can guide both formal and informal support services for men who are ICU nurses, which in turn might aid retention of this subgroup of workers. © The Author(s) 2014.

Why are some patients with Duchenne muscular dystrophy dying young: An analysis of causes of death in North East England.

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Van Ruiten, H J A; Marini Bettolo, C; Cheetham, T; Eagle, M; Lochmuller, H; Straub, V; Bushby, K; Guglieri, M

2016-11-01

Duchenne muscular dystrophy (DMD) is the most common inherited muscle disease in children. Recent years have seen an increase in age of survival into adulthood following the introduction of proactive standards of care. We reviewed mortality in DMD in our population in order to identify potential underlying risk factors for premature death and improve clinical care. A retrospective case note review of all deaths in the DMD population over the last 10 years in North East England. We identified 2 groups of patients: patients who died from underlying cardiac and/or respiratory failure (group 1) and patients who died unexpectedly in the absence of underlying cardio-respiratory failure (group 2). Detailed information was available on 21 patients. Mean age of death in group 1 (17 patients) was 23.9 (14.4-39.5) years, in group 2 (4 patients) 14 (12.7-14.9) years. Causes of death in group 2 were acute pneumonia, cardiac arrest, acute respiratory distress and multi-organ failure. Across both groups we identified concerns regarding respiratory failure, inadequate nutrition, non-attendance at appointments, suboptimal coordination of care and decreased psychological wellbeing. In group 2, fat embolism, cardiac arrhythmia and adrenal insufficiency were also potential contributing factors. The main cause of death in DMD in our population remains cardio-respiratory failure. Four patients (19%) died in their teenage years in the absence of severe cardiorespiratory failure. A more thorough understanding of the impact of DMD and its treatment on all organs systems is required to minimise the risk of an untimely death. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Die gebruik van die mite in Die werfbobbejaan van Alexander Strachan

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E. M.M. Klopper

1996-05-01

Full Text Available The use of myths in Die werfbobbejaan by Alexander Strachan This article focuses on the rote of Zulu myths in Alexander Strachan’s novel Die werfbobbejaan. It lakes as point of departure sources on mythology like Cuddon (1991, Baldick (1990, Grimal (1969, Levi-Strauss (1979 and Jung (1969. Die werfbobbejaan essentially recounts the story of a man (the adventurer, the academic, the writer, the hunter who also is the central character in Strachan's two preceding novels. Die werfbobbejaan focuses on the completion of an individuation process in the life of the central character, a process already begun in the preceding two novels and which in this novel finally culminates in the confrontation between hunter and baboon. The completion of this process is facilitated by the African milieu of Zululand where people give meaning to their existence by means of myths, and where no distinction is made between the mythic and rational modes of experiencing reality.

Death the great leveller? Towards a transcultural spirituality of dying and bereavement.

Science.gov (United States)

Holloway, Margaret

2006-07-01

This paper aims to provide a critical engagement with the subject of transcultural spirituality and nursing practice in the context of dying and bereavement. There has been considerable interest in the subject of spirituality over the past decade, and a particular association between the study of death and the study of spirituality. The nursing literature has been at the forefront of these developments amongst health and social care professionals. Some of this literature has begun to address the issues raised for culturally competent practice and the significance of patients' belief systems in the diverse cultural contexts with which nurses must engage in contemporary health care. However, the author argues that understanding of the range of contemporary spiritualities and transcultural practice is at an early stage. Transcultural spirituality is explored through a critical review of the literature, including the author's own published research on spiritual and philosophical issues in death, dying and bereavement. The conclusion is drawn that some common themes and approaches can be found which offer a framework to guide nursing practice with the individual patient and family. In the absence of guidance, nurses struggle with implementing spiritual care in the fluid and complex context of contemporary spiritualities and frequently resort to broad categorizations. This paper opens up a way of connecting with the unique spiritual position of each patient.

Finding common ground to achieve a "good death": family physicians working with substitute decision-makers of dying patients. A qualitative grounded theory study.

Science.gov (United States)

Tan, Amy; Manca, Donna

2013-01-22

Substitute decision-makers are integral to the care of dying patients and make many healthcare decisions for patients. Unfortunately, conflict between physicians and surrogate decision-makers is not uncommon in end-of-life care and this could contribute to a "bad death" experience for the patient and family. We aim to describe Canadian family physicians' experiences of conflict with substitute decision-makers of dying patients to identify factors that may facilitate or hinder the end-of-life decision-making process. This insight will help determine how to best manage these complex situations, ultimately improving the overall care of dying patients. Grounded Theory methodology was used with semi-structured interviews of family physicians in Edmonton, Canada, who experienced conflict with substitute decision-makers of dying patients. Purposeful sampling included maximum variation and theoretical sampling strategies. Interviews were audio-taped, and transcribed verbatim. Transcripts, field notes and memos were coded using the constant-comparative method to identify key concepts until saturation was achieved and a theoretical framework emerged. Eleven family physicians with a range of 3 to 40 years in clinical practice participated.The family physicians expressed a desire to achieve a "good death" and described their role in positively influencing the experience of death.Finding Common Ground to Achieve a "Good Death" for the Patient emerged as an important process which includes 1) Building Mutual Trust and Rapport through identifying key players and delivering manageable amounts of information, 2) Understanding One Another through active listening and ultimately, and 3) Making Informed, Shared Decisions. Facilitators and barriers to achieving Common Ground were identified. Barriers were linked to conflict. The inability to resolve an overt conflict may lead to an impasse at any point. A process for Resolving an Impasse is described. A novel framework for developing

N HERSIENING VAN DIE AFRIKAANSE VERTALING VAN DIE ...

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Test

aangetoon het, 'n huis in Kapernaum gehad en hierdie geskiedenis speel in Kapernaum of daar digby af. Jesus en sy dissipele het namelik, volgens 6:35 geland by Gennesaret, net suid van Kapernaum Die gevolgtrekking word ondersteun deur Joh. 6:17 waarvolgens die dissi pele na die spysiging op Kapernaum gevaar ...

Die dinamika van die beperkte drie-deeltjie-probleem in sterrekunde

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Keegan D. Anderson

2011-09-01

Full Text Available Die beperkte drie-deeltjie-probleem is een van die oudste probleme in klassieke fisika en is alvir ongeveer die afgelope honderd jaar bestudeer. Die probleem is nie oplosbaar op ‘n geslote analitiese wyse nie, alhoewel ’n oneindige reeks oplossing bestaan.

Die taak van akademiese geletterdheid/hede binne die konteks van ...

African Journals Online (AJOL)

Opsomming. Die vestiging van Akademiese Geletterdheid by tersiêre instansies in Suid-Afrika het gegroei uit die besef dat 'n goedontwikkelde akademiese taalvermoë essensieel is vir akademiese prestasie. Gepubliseerde literatuur getuig van die belangrike verskuiwings wat oor die afgelope aantal dekades plaasgevind ...

Volumetric parameters on FDG PET can predict early intrahepatic recurrence-free survival in patients with hepatocellular carcinoma after curative surgical resection

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Lee, Jeong Won [Catholic Kwandong University College of Medicine, Department of Nuclear Medicine, Incheon (Korea, Republic of); Hwang, Sang Hyun; Kim, Hyun Jeong; Kim, Dongwoo; Cho, Arthur; Yun, Mijin [Yonsei University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of)

2017-11-15

This study assessed the prognostic values of volumetric parameters on {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in predicting early intrahepatic recurrence-free survival (RFS) after curative resection in patients with hepatocellular carcinoma (HCC). A retrospective analysis was performed on 242 patients with HCC who underwent staging FDG PET and subsequent curative surgical resection. The tumor-to-non-tumorous liver uptake ratio, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the HCC lesions on PET were measured. The prognostic values of clinical factors and PET parameters for predicting overall RFS, overall survival (OS), extrahepatic RFS, and early and late intrahepatic RFS were assessed. The median follow-up period was 54.7 months, during which 110 patients (45.5%) experienced HCC recurrence and 62 (25.6%) died. Patients with extrahepatic and early intrahepatic recurrence showed worse OS than did those with no recurrence or late intrahepatic recurrence (p < 0.001). Serum bilirubin level, MTV, and TLG were independent prognostic factors for overall RFS and OS (p < 0.05). Only MTV and TLG were prognostic for extrahepatic RFS (p < 0.05). Serum alpha-fetoprotein and bilirubin levels, MTV, and TLG were prognostic for early intrahepatic RFS (p < 0.05) and hepatitis C virus (HCV) positivity and serum albumin level were independently prognostic for late intrahepatic RFS (p < 0.05). Intrahepatic recurrence showed different prognoses according to the time interval of recurrence in which early recurrence had as poor survival as extrahepatic recurrence. MTV and TLG on initial staging PET were significant independent factors for predicting early intrahepatic and extrahepatic RFS in patients with HCC after curative resection. Only HCV positivity and serum albumin level were significant for late intrahepatic RFS, which is mainly attributable to the de novo formation of new primary HCC. (orig.)

Die 'postmoderne' stempel in die Nuwe-Testamentiese hermeneutiek

African Journals Online (AJOL)

georiënteerde teorie en kritiek wat volgens Moore opbou tot 'n herhaling binne. Bybelnavorsing. Dit het reeds by Immanuel Kant begin. Sedert Kant is dit proble- maties cm die objek van kennis te beskou as iets wat kennis objektief in sigself bevat. Objektiwisme is prys gegee. Dialektiek het in die plek daarvan gekom. Die.

DIE KONINGSBEDE AS ELEMENT IN DIE KRONINGSRITUEEL. By ...

African Journals Online (AJOL)

Test

Die offerfees te Gibeon was 'n plegtigheid, waaraan geheel Israel deelgeneem het. Die duisend. "brandoffers" wat sowel Kon. as Kron. vermeld, sal wel opgevat moet word as „brandoffers en dankoffers", sodat daar vir die aanwesiges. *n groot feesmaaltyd aangerig is, vgl. I Kon. 3:15. n Sodanige maal- tyd verbind vors en ...

Quantenfische die Stringtheorie und die Suche nach Weltformel

CERN Document Server

Lüst, Dieter

2011-01-01

Lässt sich das Verhalten aller Dinge, von den kleinsten Teilchen bis zum Universum, einheitlich beschreiben? Der heißeste Kandidat für die Entwicklung einer Weltformel, die alle physikalischen Phänomene erklären kann, ist die Stringtheorie. Sollte sie sich als richtig erweisen, so würde das unser Verständnis über den Ursprung der Naturgesetze dramatisch verändern. Denn das von uns beobachtete Universum wäre dann vermutlich eine winzige Blase in einem viel größeren Gebilde, dem Multiversum. Um die Stringtheorie und die Idee des Multiversums plausibel zu machen, greift der international bekannte theoretische Physiker Dieter Lüst auf ein Modell zurück: das Leben von Fischen in einem Teich. Eines Tages gelingt es den Fischen, die kleinsten Teilchen zu identifizieren, aus denen alles im Fischteich besteht - eingeschlossen sie selbst. Sie nennen diese Urbausteine Quantenfische, da ihr Verhalten nahelegt, dass sie auch eine Art von Lebewesen sind. Doch der ersten folgt eine weitere Entdeckung der Fisch...

Dying in Palliative Care Units and in Hospital: A Comparison of the Quality of Life of Terminal Cancer Patients.

Science.gov (United States)

Viney, Linda L.; And Others

1994-01-01

Compared quality of life of terminal cancer patients (n=182) in two palliative care units with that of those in general hospital. Patients in specialized palliative care units were found to differ from those dying in hospital, showing less indirectly expressed anger but more positive feelings. They also reported more anxiety about death but less…

Van die Gasredakteur

African Journals Online (AJOL)

cherish and teach.'1. Die Fakulteit Geneeskunde van die Universiteit van die Oranje-Vrystaat het pragtig gegroei ge- durende die eerste 21 jaar van sy bestaan. Die entoesiasme, doelgerigtheid, harde werk en inisia- tiewe van 'n groot aantal persone was hiervoor verantwoordelik. 'If we see a bit more clearly than they, it is ...

Gebed en die vorming van Christelike identiteit in Openbaring

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31 Jul 2015 ... 111.3 – Johns 2003). Deur die ... David Aune (2006:107) merk tereg op dat ... Stevenson 1995:257–272). ... sien Stevenson (2001:234). 6. ...... McKinnon, J., 1987, Music in early chrisfian worship, Cambridge University Press,.

When LVAD Patients Die: The Caregiver's Mourning.

Science.gov (United States)

Rossi Ferrario, Silvia; Omarini, Pierangela; Cerutti, Paola; Balestroni, Giangluigi; Omarini, Giovanna; Pistono, Massimo

2016-05-01

Left ventricular assist devices (LVADs) have progressively evolved, particularly in the last 10 years, to serve patients affected by severe heart failure as a bridge to transplant or destination therapy. The survival rate and quality of life of pre- and postimplant patients, as well as caregivers' perceptions and distress, are under investigation by the scientific community. But what caregivers think and feel after the loss of their loved one has not so far been examined. We contacted 16 principal caregivers of deceased LVAD patients by telephone. They were asked to evaluate their experience with LVADs and were administered a specific questionnaire about their mourning, the Caregiver Mourning Questionnaire (CMQ), to evaluate their perceptions of the physical, emotional, and social support-related problems that they had experienced during the previous 3 months. Positive aspects reported by the caregivers were the patient's overall subjective well-being and increased survival. Negative aspects were the difficulty to manage infections and the driveline, and the incomplete autonomy of the patient. Half of the caregivers reported not being preadvised about many of the problems they would face. The CMQ revealed that numerous caregivers had health problems, difficulty in sleeping, eating disorders, lack of energy, and loneliness. Use of psychotropic drugs and regrets about how they assisted their loved one also emerged. In conclusion, caregivers of LVAD patients may experience complicated mourning. Our data support in particular the need for an early intervention of palliative care which could prevent or reduce complicated mourning. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Die benutting van vraelyste met die oog op meer effektiewe ...

African Journals Online (AJOL)

UPuser

effektiewe stresbeheer as een van die temas te hanteer. Op grond van die navorsing deur onder andere Lawson (1985) en Taylor (1999) sou ek graag die proses van differensiasie2 ook by genoemde lys voeg as tema vir bespreking tydens huweliksvoorbereiding. 2 Differensiasie kan beskryf word as die losmaakproses ...

Dying with dignity: a concept analysis.

Science.gov (United States)

Hemati, Zeinab; Ashouri, Elaheh; AllahBakhshian, Maryam; Pourfarzad, Zahra; Shirani, Farimah; Safazadeh, Shima; Ziyaei, Marziyeh; Varzeshnejad, Maryam; Hashemi, Maryam; Taleghani, Fariba

2016-05-01

This article is a report of an analysis of the concept of dying with dignity. Dignity is an important component of providing care for dying patients and their families. Nevertheless, given that this concept is poorly defined, concept analysis is one of the best ways to define and clarify the concept of death with dignity with the aim to enhance its application in clinical practice, research and education. A search of multiple nursing and social sciences databases was undertaken, including Academic Search Complete, Science Direct, ProQuest, Scopus, Medline, PubMed, EBSCO, Ovid, Noormage, Cinahl, Magiran, PsycINFO and SID. After an extensive review of the literature from 1998-2014, about 14 related articles were included in the study. Based on these articles, the applications, attributes and experimental results of and references to death with dignity were recorded. Based on this analysis, the most important attributes of this concept included respect for privacy, respect, spiritual peace and hope. The antecedents of this concept included consideration of moral values during caregiving, preservation of human dignity as a patient right and professional ethics, and belief in the dignity of self and others, consideration of culture in providing end-of-life care. The consequences of this concept included a sense of peace in the patient and their family, peaceful death and provision of patient privacy and comfort. The concept of patient dignity has been referred to in many contexts. However, considering the dignity of dying patients commensurate with their culture is the most important component of care provided by nurses to facilitate a peaceful death. Respecting the dignity of the patient results in the reduction of her/his suffering and prepares her/him for a comfortable death. © 2016 John Wiley & Sons Ltd.

Wêreldmededingendheid en die tegnologie

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C. W. I. Pistorius

1996-07-01

Full Text Available Afgesien van die interne uitdagings wat die Heropbou- en Ontwikkelingsprogram (HOP aan Suid-Afrika bied, moet die land ook tred hou met die veranderende globale omgewing, spesifiek die toenemende belangrikheid van ekonomiese sekuriteit as komponent van nasionale sekuriteit. Die konsep van mededingendheid vergestalt die doelwit wat nagestreef moet word ten einde die ontluikende globale ekonomiese stryd aan te durf. As ’n belangrike drywer van ekonomiese welvaart is tegnologie een van die belangrikste sleutels tot internasionale mededingendheid. Tegnologiese innovasie is die proses wat as hefboom hiervoor gebruik moet word. Dit is egter nodig dat tegnologie, en spesifiek die proses van tegnologiese innovasie, formeel en gestruktureerd bestuur moet word, sowel op nasionale as firmavlak. Op nasionale vlak is die voorsiene Nasionale Innovasiestelsel beslis ’n stap in die regte rigting.

Die skrifbeskouing van feministiese teoloë, in die besonder dié van Fiorenza, Brenner en Van Dijk-Hemmes – beoordeel in die lig van die gereformeerde teologie

Directory of Open Access Journals (Sweden)

Alta E. Swart

2013-10-01

Full Text Available Dit wil voorkom asof die feministiese Skrifbeskouing op die beginsel van selektiewe Skrifgesag berus. Dit beteken dat slegs dié dele in die Bybel wat met die feministiese ideologie ooreenstem, as gesaghebbend aanvaar word. Dit is veral die sogenaamde androsentriese taalgebruik wat dit vir aanhangers van hierdie benadering moeilik maak om die hele Skrif as gesaghebbend te erken. Hermeneuties vertoon hierdie benadering groot ooreenkomste met die Postmodernisme, waarin geen vaste reëls bestaan om die betekenis van tekste te bepaal nie. Gesien in die lig van die gereformeerde teologie, soos veranker in die Woord en belydenisskrifte, vertoon die feministiese teologie ernstige leemtes. Die bydraes (Skrifbeskouing van drie prominente feministiese teoloë – Fiorenza, Brenner en Van Dijk-Hemmes – word onder die loep geneem en teologies-krities geëvalueer ten einde hierdie leemtes uit te wys. It appears that the feminist view of Scripture is based on the principle of selective authority of the Scriptures, which means that only the parts of the Bible corresponding with the feminist ideology are accepted as authoritative. The use of androcentric language, in particular, makes it difficult for followers of feminism to accept the whole Bible as authoritative. Hermeneutically, their approach resembles Postmodernism, interpreting without any rules. Viewed from the paradigm of the reformed theology, which is anchored in Scripture and the articles of faith, feminist theology shows serious shortfalls. The contributions of three prominent feminist theologians – Fiorenza, Brenner and Van Dijk-Hemmes – are studied closely and evaluated critically in the light of the reformed theology, to underline these shortfalls.

die kasteel••de goede hoop" (1921.1923): die verhaal van in ...

African Journals Online (AJOL)

3. TWEE. KOMITEE-VERGADERINGS. BESLUITE a. Doel en samestelling van die komitee. Op 12 Desember 1921 stuur die Sekretans yap Verdediging uitnodigings aan sekere amptelike instansies en ander behingstd1endes waarin hy die redes vir die wenslikheid van 'n komitee en die werksaamhede uitecnsit en die ge-.

ontwikkeling van die gemenereg in die lig van artikels 39(2)

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'n Mens kan met reg vra of die ius connubiorum van Brouwer en die Law of. Husband and Wife van ... AD 560 (Geheime Raad) 563. 5 Sien vir besonderhede Hahlo en Kahn SA Legal System and its Background 304. ..... Die Franse chemikus, Antoine Lavoisier, is in 1794 tydens die Franse revolusie tereggestel. Terwyl die ...

Die relevansie van die boek Prediker

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ook in die dogmatiek te bespeur is nie. 'n Vinnige oorsig oor die teksverwysings van. 'n paar wydgelese dogmatiekhandboeke kan dit bevestig. In Karl Barth se omvang- ryke Kirchliche Dogmatik word Prediker slegs vyf en dertig maal aangehaal en slegs sewe maal word teksgedeeltes bespreek. Emil Brunner haal Prediker ...

Die wonders in Johannes 6 verklaar aan die hand van 'n ...

African Journals Online (AJOL)

Maar die Evangelie van Johannes gee self 'n aanduiding van wat die intensie van die geskrif is, te wete Johannes 20: 30-31: Jesus het nog baie ander wondertekens, wat nie in hierdie boek beskrywe is nie, voor sy dissipels gedoen. Maar hierdie wonder tekens is beskrywe sodat julle kan glo dat Jesus die Christus is, die.

Packaged die heater

Science.gov (United States)

Spielberger, Richard; Ohme, Bruce Walker; Jensen, Ronald J.

2011-06-21

A heater for heating packaged die for burn-in and heat testing is described. The heater may be a ceramic-type heater with a metal filament. The heater may be incorporated into the integrated circuit package as an additional ceramic layer of the package, or may be an external heater placed in contact with the package to heat the die. Many different types of integrated circuit packages may be accommodated. The method provides increased energy efficiency for heating the die while reducing temperature stresses on testing equipment. The method allows the use of multiple heaters to heat die to different temperatures. Faulty die may be heated to weaken die attach material to facilitate removal of the die. The heater filament or a separate temperature thermistor located in the package may be used to accurately measure die temperature.

Die teologie in gesprek met die ekonomie

African Journals Online (AJOL)

(1723-1790) sy vertrekpunt neem, ontwikkel, as oorwinnaars uit die Franse Revolu .... Die onmiddellike sukses van Adam Smith se 'Wealth of Nations' was .... alle vorme van sosialisme niks anders as 'kommunisme' (Wassenaar 1977:12) nie.

Finding privacy from a public death: a qualitative exploration of how a dedicated space for end-of-life care in an acute hospital impacts on dying patients and their families.

Science.gov (United States)

Slatyer, Susan; Pienaar, Catherine; Williams, Anne M; Proctor, Karen; Hewitt, Laura

2015-08-01

To explore the experiences and perceptions of hospital staff caring for dying patients in a dedicated patient/family room (named Lotus Room). Dying in hospital is a common outcome for people across the world. However, noise and activity in acute environments present barriers to quality end-of-life care. This is of concern because care provided to dying patients has been shown to affect both the patients and the bereaved families. A qualitative descriptive approach was used. Semi-structured interviews were conducted with 17 multidisciplinary staff and seven families provided information through an investigator-developed instrument. Qualitative data analysis generated three categories describing: Dying in an hospital; The Lotus Room; and the Outcomes for patients and families. The Lotus Room was seen as a large, private and, ultimately, safe space for patients and families within the public hospital environment. Family feedback supported staff perspectives that the Lotus Room facilitated family presence and communication. The privacy afforded by the Lotus Room within this acute hospital provided benefits for the dying patients and grieving families. Improved outcomes included a peaceful death for patients, which may have assisted the family with their bereavement. This study provides evidence of how the physical environment can address well-established barriers to quality end-of-life care in acute hospitals. © 2015 John Wiley & Sons Ltd.

Dying with dignity.

Science.gov (United States)

Madan, T N

1992-08-01

Death is a theme of central importance in all cultures, but the manner in which it is interpreted varies from society to society. Even so, traditional cultures, including Christian, Hindu and Jain religious traditions, exhibited a positive attitude to death and did not look upon it in a dualistic framework of good vs bad, or desirable vs undesirable. Nor was pessimism the dominant mood in their thinking about death itself. A fundamental paradigm shift occurred in the West in the eighteenth century when death was desacralized and transformed into a secular event amenable to human manipulation. From those early beginnings, dying and death have been thoroughly medicalized and brought under the purview of high technology in the twentieth century. Once death is seen as a problem for professional management, the hospital displaces the home, and specialists with different kinds and degrees of expertise take over from the family. Everyday speech and the religious idiom yield place to medical jargon. The subject (an ageing, sick or dying person) becomes the object of this make-believe yet real world. As the object of others' professional control, he or she loses the freedom of self-assessment, expression and choice. Or, he or she may be expected to choose when no longer able to do so. Thus, not only freedom but dignity also is lost, and lawyers join doctors in crisis manipulation and perpetuation. Although the modern medical culture has originated in the West, it has gradually spread to all parts of the world, subjugating other kinds of medical knowledge and other attitudes to dying and death.(ABSTRACT TRUNCATED AT 250 WORDS)

The Importance of Early Brain Injury after Subarachnoid Hemorrhage

Science.gov (United States)

Sehba, Fatima A.; Hou, Jack; Pluta, Ryszard M.; Zhang, John H.

2012-01-01

Aneurysmal subarachnoid hemorrhage (aSAH) is a medical emergency that accounts for 5% of all stroke cases. Individuals affected are typically in the prime of their lives (mean age 50 years). Approximately 12% of patients die before receiving medical attention, 33% within 48 hours and 50% within 30 days of aSAH. Of the survivors 50% suffer from permanent disability with an estimated lifetime cost more than double that of an ischemic stroke. Traditionally, spasm that develops in large cerebral arteries 3-7 days after aneurysm rupture is considered the most important determinant of brain injury and outcome after aSAH. However, recent studies show that prevention of delayed vasospasm does not improve outcome in aSAH patients. This finding has finally brought in focus the influence of early brain injury on outcome of aSAH. A substantial amount of evidence indicates that brain injury begins at the aneurysm rupture, evolves with time and plays an important role in patients’ outcome. In this manuscript we review early brain injury after aSAH. Due to the early nature, most of the information on this injury comes from animals and few only from autopsy of patients who died within days after aSAH. Consequently, we began with a review of animal models of early brain injury, next we review the mechanisms of brain injury according to the sequence of their temporal appearance and finally we discuss the failure of clinical translation of therapies successful in animal models of aSAH. PMID:22414893

Die evaluering van 'n bestuursopleidingskursus met behulp van die posmandjie-tegniek

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W. de Jager

1997-06-01

Full Text Available The evaluation of a management training course by using the in-basket technique. A management training course was evaluated for effectiveness by using two specially compiled in-basket exercises equivalent in complexity. Outcome evaluation was performed so as to determine whether learning transfer took place, ie., whether management skills in the application of planning, organising and control manifest in the work context afterwards. Significant differences were found between the experimental and the control group and were investigated by means of the "Univariate procedure". This management training course could effectively be measured with the behaviour assessment approach using two groups, where only the one group was exposed to a management training course to assess whether management behaviour changed as a result of learning transfer. This study utilises the in-basket technique as an instrument for training course evaluation. Opsomming Die effektiwiteit van 'n bestuursopleidingskursus is geevalueer aan die hand van gedragverandering soos gemeet deur twee posmandjies van dieselfde moeilikheidsgraad. Uitkomsevaluering is gedoen om te bepaal of leeroordrag plaasgevind het, met ander woorde/ of the nuut aangeleerde bestuursvaardighede in die toepassing van die bestuursdimensies beplanning, organisering en beheer wel na die tyd in die konteks van werkgedrag manifesteer. Beduidende verskille tussen die eksperimentele en die kontrole groep is gevind. Dit is ondersoek met behulp van enkelveranderiike-variansie-ontleding. Die bestuursopleidingskursus kon effektief vanuit die gedragbeoordelingsbcnadering gemeet word by twee groepe, waar slegs die een groep aan 'n bestuursopleidingskursus blootgestel word om te kon bepaal of bestuursgedrag verander het. Die studie benut die posmandjie-tegniek as kursusevalueringsinstmment.

Die ontmaskering van die bose: Eksegetiese perspektiewe op ...

African Journals Online (AJOL)

p1243322

2 Yarbro Collins (1983) bied tans nog die beste agtergrond vir 'n besinning oor geweld in ..... John's grammatical howlers are intentionally designed to alert listerners ..... 26 In die Nuwe Testament word Paul se snydende opmerking teenoor die Korintiërs as ..... rnt g0r`m nh8 ldfhrs`}m du sg}u fg}u + n2sh d/m sg>}} e`ql`jdh.

PROF DR FELIX V. lATEGAN: Die Boer se Roer. Die Groot ...

African Journals Online (AJOL)

PROF DR FELIX V. lATEGAN: Die Boer se. Roer. Die Groot Geweerboek van Suid-. Afrika. Tafelberg. Uitgewers. Kaapstad, pp. 209, bibliografie, register. Sonder die Boer en sy roer is die geskiede:lis van ons land feitlik ondenkbc:wr en dit is clan ook vo/kome juis gesien dat die skrywer van hierdie baanbrekerswerk die ...

Sal die ‘ewolusie’ vanaf biologie na lewenswetenskappe ‘uitsterwing’ van die vakgebied voorkom?

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Johanna G. Ferreira

2012-03-01

Full Text Available In hierdie artikel word die wysiging van die skoolvak van ‘biologie’ na ‘lewenswetenskappe’ bespreek, asook die gepaardgaande en verwagte implikasies van die verandering. Die vraag word gestel of die beoogde wysiging wel noemenswaardig is en of dit enigsins ‘n verskil aan die dalende belangstelling in die lewenswetenskappe op tersiêre vlak sal maak. Die wysigings in die nuwe kurrikula verhoog die relevansie van die vakinhoud vir leerders en vir die gemeenskap, maar sekere kwessies kry nie aandag nie. Voorstelle word gemaak om die kurrikulum te wysig en onderrigmetodes aan te pas om die nodige vaardighede by leerders te vestig.

n opinie oor die behaviouristiese siening versus die fenomenologie ...

African Journals Online (AJOL)

verband die eksperimente van Pavlov, Thorndike,. Skinner, Tolmann en Hull.) Fenomenologie. Die fenomenologie is 'n essensie-openbarende denkrigting. Dit impliseer'n denkende soektog na dit wat 'n besondere verskynsel of werklikheid maak juis dit wat dit is en nie iets anders nie. In die fenomenologiese antropologie ...

Die dialogiese prinsipe

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J. J. de Klerk

1981-08-01

Full Text Available Met die dialogiese prinsipe word daardie beginsel bedoel, waarin die tweerigtingverkeer of kommunikasie onder, of met, of deur die mense op 'n heel besondere gesprekmatige wyse gere�l word. Tot die wese van die dialogiese prinsipe behoort "als Grundvoraussetzung das Ernstnehmen des Gesprachspartners und das darin enthaltene zuhoren-konnen. Dialog ist also etwas anderes als Disput oder Diskussion. Er setzt gegenseitiges Vertrauen und Hochachtung voraus."

Die aanspraak op Goddelike steun in 'n konfliksituasie volgens die ...

African Journals Online (AJOL)

laws, and ethical or political principles. A synchronic investigation of relevant Old ... die toneel gebring met die vraag: 'aan wie se kant is God' (vgl bv The road to. Damascus 1979:6)? Volgens .... betrekking tot die Ou Testament: Hoe moet ons vasstel wie se kant God nou regtig kies, of wie veg aan die kant van God en wie ...

Die begrafnisdíens

African Journals Online (AJOL)

Num 20: 1; Jos 24: 30; Hand 5: 5 - 11). Selfs van die ... Gebruike rondom die begrafnis het van geslag tot geslag gewissel. De Vaux ... der geskied deur die hoorders 'te onderrig, te vermaan, te vertroos en te bestraf, soos dit in elke geval ..... gehandhaaf hoef te word, veral in die lig van die feit dat die predikant die kerklike.

Die Ontstaan en Ontwikkeling van die Pan-Afrikanisme en due implikasies daarvan

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A. J.H. van der Walt

1961-03-01

Full Text Available Dit was nie voor 1880 dat tropiese Afrika, dil is die grootste gedeelte van Wes-, Oos- en Midde-Afrika, deur ontdekkingsreisigers,handelaars en sendelinge tot so ’11 mate ontsluit is, dat dit in die vaarwater van die wêreldpolitiek geraak het nie. Lank voor hierdie tyd is natuurlik steunpunte aan die Wes-, Suid- en Ooskusdeur die Portugese en later die Nederlanders en Engelse eset ter wille van óf dieslawehandel en/óf as steunpunte op dielarig handelsweg na die ryke Ooste.

Die toepassing van die K3-model op die televisieteks Colour TV

African Journals Online (AJOL)

“OIL's approach to investigating the coloured market took place in the form of ethnographic research which ... communication strategies” (Botha 2010: 14). ... Op grond van die waarnemings, onderhoude en vraelyste het OIL tot die volgende ..... hold onto your nearest and dearest because this is going to be a kwaai mix bag.

Vanaf die Fermat-punte na die De Villiers-punte van ’n driehoek

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Michael de Villiers

2010-01-01

Full Text Available Hierdie artikel beskryf die ontdekking van die sogenaamde De Villiers-punte van ’n driehoek die bewyse wat betrokke is, en trek die historiese oorsprong terug na die Fermat-punte van ’n driehoek, die swaartepunt van ’n driehoek, en ’n nuttige veralgemening van die Fermat-punte van ’n driehoek.

Die uitbeelding van die vrou in Huisgenoot (1963 en 2013: ’n Multimodale diskoersanalise

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Susann H. Marais

2017-05-01

Full Text Available Die standpunt dat die mens en die media in ’n verhouding van wedersydse beïnvloeding staan, sowel as die studie wat die kulturele konseptualisering van vroulikheid in twee Huisgenoot-uitgawes (1953 en 2003 ondersoek, geld as uitgangspunt vir dié studie. Hierdie studie het ten doel om te bepaal of daar ’n verskil is in die uitbeelding van die vrou in die Huisgenoot uitgawes van onderskeidelik 1963 en 2013. Volgens navorsing werk die visuele beeld en geskrewe teks saam om ’n boodskap oor te dra. Multimodale diskoersanalise (MDA word juis gebruik om beide visuele beeld en geskrewe teks te bestudeer. Sodoende word die metode van intersemiotiese komplementariteit binne MDA in hierdie studie gebruik. Die studie kom tot die gevolgtrekking dat die uitbeelding van die ideale vrou se verantwoordelikhede uitgebrei is, maar dat die vrou se rol tóg tot sekere ruimtes beperk word, soos die sigbaarheid van die moeder-stereotipe weerspieël.

Die Dependenzgrammatik von Tesnière uno die neue slowenische Syntax

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Breda Pogorelec

1994-12-01

Full Text Available In der Enzyklopädie der slowenischen Sprache (Toporišič 1992: 159 wird die Dependenzgrammatik unter besonderem Stichwort erklärt, in dem diese Grammatik zuerst als "eine Grammatik, die vor allem die Dependenzrelationen im Satz untersucht", definiert wird. Dann werden laut Lucien Tesnière im Satz Reza poje drei Elemente dargestellt: Reza, poje + die Verbindung dazwischen und dann werden drei Stufen des Graphs mit dem Verb als "dem Element, das die Ganzheit zusammenhält" erklärt; außerdem wird gesagt, daß die Koordination gemäß dieser Theorie durch die entsprechende Konjunktion ausgedrückt wird (aus dem graphischen Schema ist ersichtlich, daß dabei die Satzteilkoordination gemeint ist: pojeta -Tine -in -Tone. Im Kommentar wird hinzugefügt, daß auch "unsere" (= moderne slowenische Satzanalyse so aussieht, d. i. sie fängt mit dem Prädikat an, dann fragt man nach folgenden drei Hauptsatzteilen (Subjekt, Objekt, adverbiellen Prädikatbestimmungen, dann nach Attributen und deren Bestimmungen. Es wird die Methode des Unterstreichens von Satzteilen dargestellt, außerdem wird auf mehrere Arten der Dependenzgrammatik und auf verschiedene graphische Bezeichnungen der sprachlichen Erscheinungen aufgrund dieser Methode hingewiesen. -Im demselben Werk werden unter dem Stichwort translativ (Toporišič 1992: 331 zwei Bedeutungen gezeigt, von denen die erste auf einen entfernten Zusammenhang mit der Theorie von Tesnière hinweist, obwohl diese nicht erwähnt ist, lediglich bei der Definition selbst, nicht aber bei den Beispielen; translativ ist nach dieser Enzyklopädie "was aus einem Zustand in den anderen übertragen wird". Aber aus den Beispielen kann man sehen, das geht es um die Translation und nicht um Translativ als Instrument dieser Translation.

Early detection of consciousness in patients with acute severe traumatic brain injury.

Science.gov (United States)

Edlow, Brian L; Chatelle, Camille; Spencer, Camille A; Chu, Catherine J; Bodien, Yelena G; O'Connor, Kathryn L; Hirschberg, Ronald E; Hochberg, Leigh R; Giacino, Joseph T; Rosenthal, Eric S; Wu, Ona

2017-09-01

of language function, responses to language and music were more frequently observed than responses to motor imagery (62.5-80% versus 33.3-42.9%). Similarly, in 16 matched healthy subjects, responses to language and music were more frequently observed than responses to motor imagery (87.5-100% versus 68.8-75.0%). Except for one patient who died in the intensive care unit, all patients with cognitive motor dissociation and higher-order cortex motor dissociation recovered beyond a confusional state by 6 months. However, 6-month outcomes were not associated with early functional magnetic resonance imaging and electroencephalography responses for the entire cohort. These observations suggest that functional magnetic resonance imaging and electroencephalography can detect command-following and higher-order cortical function in patients with acute severe traumatic brain injury. Early detection of covert consciousness and cortical responses in the intensive care unit could alter time-sensitive decisions about withholding life-sustaining therapies. © The Author (2017). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Ruimtelike beplanning: die rol van die stads - en streeksbeplanner ...

African Journals Online (AJOL)

Ruimtelike beplanning: die rol van die stads - en streeksbeplanner in die saw. R Erasmus. Abstract. Since 1978 regional and town planners are employed in the SADF on a permanent basis as well as in the capacity of national service men. These men are all academically qualified and as such satisfy a need that developed ...

Where is God in My Dying?

DEFF Research Database (Denmark)

Moestrup, Lene; Hvidt, Niels Christian

2016-01-01

Despite increased focus on the role of spiritual care in palliative care, there is limited knowledge about spirituality / religiosity among dying patients in secularized cultures such as Denmark. This study aims through semi-structured interviews with Danish hospice patients and participant obser......, important faith although it was not something they knew much about, let alone discussed or practiced much....

Bevordering van transformerende leer: Die skryf van ’n reflektiewe joernaal in die Natuurwetenskappe

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Erna R. du Toit

2012-03-01

Full Text Available Die doel van die artikel is om aan te toon hoe die skryf van ’n reflektiewe joernaal in die Natuurwetenskappe die perspektiewe en denke van onderwysstudente kan transformeer en/of leer kan bevorder. Die studie maak voorspraak vir die gebruik van ’n reflektiewe joernaal as ’n instrument vir studente om betekenis te gee aan die leeromgewing vanuit verskillende perspektiewe deur te leer in praktyk. ’n Kwalitatiewe navorsingsmetode is gevolg om die inskrywings in ’n joernaal te analiseer aan die hand van bepaalde indikatore. Die bevindinge toon dat die meeste studente na die praktykervaring positief was en sommiges het tot ander perspektiewe vanweë hul ervaring gekom.

Early esophagogastroduodenoscopy is associated with better Outcomes in upper gastrointestinal bleeding: a nationwide study

Science.gov (United States)

Garg, Sushil K.; Anugwom, Chimaobi; Campbell, James; Wadhwa, Vaibhav; Gupta, Nancy; Lopez, Rocio; Shergill, Sukhman; Sanaka, Madhusudhan R.

2017-01-01

Background and study aims We analyzed NIS (National Inpatient Sample) database from 2007 – 2013 to determine if early esophagogastroduodenoscopy (EGD) (24 hours) for upper gastrointestinal bleeding improved the outcomes in terms of mortality, length of stay and costs. Patients and methods Patients were classified as having upper gastrointestinal hemorrhage by querying all diagnostic codes for the ICD-9-CM codes corresponding to upper gastrointestinal bleeding. For these patients, performance of EGD during admission was determined by querying all procedural codes for the ICD-9-CM codes corresponding to EGD; early EGD was defined as having EGD performed within 24 hours of admission and late EGD was defined as having EGD performed after 24 hours of admission. Results A total of 1,789,532 subjects with UGIH were identified. Subjects who had an early EGD were less likely to have hypovolemia, acute renal failure and acute respiratory failure. On multivariable analysis, we found that subjects without EGD were 3 times more likely to die during the admission than those with early EGD. In addition, those with late EGD had 50 % higher odds of dying than those with an early EGD. Also, after adjusting for all factors in the model, hospital stay was on average 3 and 3.7 days longer for subjects with no or late EGD, respectively, then for subjects with early EGD. Conclusion Early EGD (within 24 hours) is associated with lower in-hospital mortality, morbidity, shorter length of stay and lower total hospital costs. PMID:28512647

Die impak van die verbond op 'n paradigma vir pastoraat: research ...

African Journals Online (AJOL)

Die verbond het 'n meer omvattende impak op pastorale sorg as ander paradigmas. Genoemde stelling word in hierdie artikel beredeneer. Daar word aangetoon dat die inhoud wat aan die gelowige gekommunikeer word, asook die tegnieke wat gebruik word, deur 'n verbondmatige paradigma vir pastorale sorg be?nvloed ...

Die berekening van vloeiing in ’n roterende annulus deur die metode van kunsmatige saamdrukbaarheid

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H. Grobler

1987-03-01

Full Text Available Die vloeiing van ’n onsaamdrukbare, viskeuse vloeier word ondersoek aan die hand van die numeriese oplossing van die gediskretiseerde Navier-Stokes- en kontinuiteitsbeheervergelykings. In die besonder word vloeiing in ’n annulus bestaande uit twee koaksiale silinders wat elk ten opsigte van die ander kan roteer, en met ’n voorgeskrewe drukval oor die lengte van die silinder, beskou. Die oplossings word bereken deur die toepassing van Chorin se metode van kunsmatige saamdrukbaarheid, waarin die tydonafhanklike beheervergelykings getransformeer word na tydafhanklike hulpvergelykings deur die invoering van ’n kunsmatige toestandsvergelyking. Die oplossing van die hulpvergelykings konvergeer na ’n stasionêre oplossing, wat ooreenstem met die oplossing van die oorspronklike tydonafhanklike beheervergelykings. Die gedrag van die vloeier, wanneer ten voile ontwikkelde laminêre vloeiing bereik word, is met sukses bereken. ’n Eenvoudige model vir die bepaling van ontwikkeling van vloeiing langs die annulus vir enige gegewe invloeisnelheidsprofiel word voorgestel. Die berekende resultate stem ooreen met die resultate wat uit die fisika van die probleem verwag word.

Legal physician-assisted dying in Oregon and the Netherlands: evidence concerning the impact on patients in "vulnerable" groups.

Science.gov (United States)

Battin, Margaret P; van der Heide, Agnes; Ganzini, Linda; van der Wal, Gerrit; Onwuteaka-Philipsen, Bregje D

2007-10-01

Debates over legalisation of physician-assisted suicide (PAS) or euthanasia often warn of a "slippery slope", predicting abuse of people in vulnerable groups. To assess this concern, the authors examined data from Oregon and the Netherlands, the two principal jurisdictions in which physician-assisted dying is legal and data have been collected over a substantial period. The data from Oregon (where PAS, now called death under the Oregon Death with Dignity Act, is legal) comprised all annual and cumulative Department of Human Services reports 1998-2006 and three independent studies; the data from the Netherlands (where both PAS and euthanasia are now legal) comprised all four government-commissioned nationwide studies of end-of-life decision making (1990, 1995, 2001 and 2005) and specialised studies. Evidence of any disproportionate impact on 10 groups of potentially vulnerable patients was sought. Rates of assisted dying in Oregon and in the Netherlands showed no evidence of heightened risk for the elderly, women, the uninsured (inapplicable in the Netherlands, where all are insured), people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations. The only group with a heightened risk was people with AIDS. While extralegal cases were not the focus of this study, none have been uncovered in Oregon; among extralegal cases in the Netherlands, there was no evidence of higher rates in vulnerable groups. Where assisted dying is already legal, there is no current evidence for the claim that legalised PAS or euthanasia will have disproportionate impact on patients in vulnerable groups. Those who received physician-assisted dying in the jurisdictions studied appeared to enjoy comparative social, economic, educational, professional and other privileges.

’n Voorgestelde matriks vir die pastorale berading van die verwonde geloofsvervreemde

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Wentzel C. Coetzer

2013-04-01

Full Text Available Hierdie artikel fokus op die rol van pastorale berading aan die emosioneel-verwonde en geloofsvervreemde persoon deur middel van die redding in Christus. Die rol van God Drie-enig en die sentrale posisie van die Skrif word ondersoek. Verder word aspekte wat ’n Skrifgefundeerde mensbeeld onderlê, gekonstrueer. Die verband tussen emosionele trauma en geloofsvervreemding, asook die aspek van reg en geregtigheid, word hierna ondersoek. Die belangrikheid van die heil in Christus in die geestelike genesingsproses word ook bespreek. Ter afsluiting word ’n pastoraal-terapeutiese matriks voorgestel vir ingrype in die huidige lewenskrisis en die bestaande geloofsvervreemding met inagneming van die traumageskiedenis. Praktiese riglyne word verder verskaf as hulpmiddel vir begeleiding in die ondersteuningsproses. A proposed matrix regarding the pastoral counselling of the wounded faith-estranged. This article focuses on the role of the pastoral counselling of the emotionally wounded and faith-estranged person through the mediation of the salvation in Christ. The role of the Triune God and the central position of Scripture in mediating the salvation in Christ are also examined and the Scriptural view of man is constructed. The role of emotional trauma in the estrangement from God as well as the importance of justice and retribution are examined as it relates to the spiritual and emotional healing of the wounded faith-estranged. The article also discusses the prominence of the salvation in Christ in the spiritual healing process. In conclusion, a pastoral-therapeutic matrix of intervention is proposed to help in addressing the present life crisis and current faith-estrangement within the context of the trauma history, with a view to find healing from the woundedness and the faith-estrangement through salvation in Christ. Practical guidelines are offered to guide this supporting process.

Etíese perspektiewe vir die bantering van konflik in die mediese ...

African Journals Online (AJOL)

mits versagtende omstandighede nie aangevoer kan word nie. Die howe oefen dan ook alleen sy regterlike funksie uit oor 'n konkrete geskil wat van daadwerklike belang vir die werklike partye is (Strauss 1982:14). Die hof laat hom lei deur die maatstaf van goeie sedes, die boni mores. Regter Mostert se verduideliking in ...

'n Verkenning van die soorte vennootskappe in die Amerikaanse reg ...

African Journals Online (AJOL)

In die Amerikaanse literatuur word talle verwysings gevind na die vennootskap in mynbou ("mining partnership"), familievennootskap ("family partnership", vennootskap in vaste eiendom ("partnership in real estate") en vennootskap vir boerdery ("farming partnership"). Hierdie onderskeiding is primer gebaseer op die tipe ...

Die identifisering van maatstawwe vir die navorsingsprestasie van akademici

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H. A. Labuschagne

1990-06-01

Full Text Available Identification of criteria for academic research performance. At South African universities, the achievement of objectives is usually measured in terms of so-called "process criteria" (e.g. pass rates, instead of performance criteria which reflect the quality of academic personnel. Stimulated by the need to identify valid indices of research performance, as a component of academic performance, this study investigated the dimensionality of several criteria, identified from empirical and literature studies. It was found that various valid criteria could be represented by six constructs, viz.: the stature of the researcher as scientist; scientific contributions; enhancement of own profession; community development; participation in research projects; and giving advice to persons or institutions outside the university. Opsomming By Suid-Afrikaanse universiteite word doelwitbereiking gewoonlik aan die hand van sogenaamde "prosesmaat-stawwe" (bv. slaagsyfers in plaas van prestasiemaatstawwe wat die gehalte van akademiese personeel weerspieel, gemeet. Na aanleiding van 'n behoefte aan die identifisering van geldige rigtingwysers vir navorsingsprestasie as 'n komponent van akademiese prestasie, is daar ondersoek ingestel na die dimensionaliteit van verskillende maatstawwe wat vooraf deur middel van empiriese- en literatuurstudies geidentifiseer is. Daar is gevind dat verskeie geldige maatstawwe deur ses konstrukte verteenwoordig word, te wete: die statuur van die navorser as wetenskaplike, wetenskaplike bydraes, uitbouing van eie professie, gemeenskapsontwikkeling, deelname aan navorsingsprojekte en advieslewering aan persone of instellings buite die Universiteit.

Riglyne vir ‘n omvattende verrykingsprogram vir die bevordering van die geestesgesondheid

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Antoinette Gmeiner

1997-12-01

Full Text Available In Suid-Afrika, met die snelle veranderinge in die politiek, ekonomie, lewenstyl en tegnologiese vooruitgang, gepaard met die geweld tans in die land, is die lewenskwaliteit van mense so bemvloed dat produktiwiteit en gedrag benadeel is. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

Die effek van intelligensie op die verhouding tussen lokus van kontrole en taakkompleksiteit

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F. G. de Kock

1995-06-01

Full Text Available The effect of intelligence on the relationship between locus of control and task complexity. The aim of the study was to establish the effects of intelligence on the relationship between locus of control and task complexity. These constructs were selected by virtue of their importance in the literature, as well as the lack of empirical research regarding the assumed relationship which exists between them. The Human Sciences Research Council's (HSRC General Scholastic Aptitude Test (ASAT was used for measuring intelligence, Duttweiler's Internal Control Index (ICI was used for determining locus of control and the Raven's Advanced Progressive Matrices (APM was used as a criterion for coping with task complexity. These instruments were administered to 292 subjects to determine whether the relationship between locus of control and task complexity was effected when the effect of intelligence was controlled. The results indicated a significant relationship between locus of control and task complexity, however the relationship was no longer significant after the effect of intelligence was controlled. Opsomming Die doel van die studie was om die effek van intelligensie op die verhouding tussen lokus van kontrole en taak-kompleksiteit te ondersoek. Hierdie konstrukte is gekies na aanleiding van hulle belangrikheid in die literatuur asook die leemte in empiric se navorsing rakende die veronderstelde verband wat tussen hulle bestaan. Die Algemene Skolastiese Aanlegtoets (ASAT van die Raad vir Geesteswetenskaplike Navorsing (RGN is gebruik vir die meting van intelligensie, die Internal Control Index (ICI van Duttweiler is gebruik vir die meting van lokus van kontrole en die Advanced Progressive Matrices (APM van Raven is gebruik as maatstaf vir die bantering van taakkompleksiteit. Die genoemde meetinstrumente is op 292 proefpersone toegepas om te bepaal of die verband tussen lokus van kontrole en taakkompleksiteit geaffekteer word wanneer daar vir die effek

Dying cancer patients' own opinions on euthanasia: an expression of autonomy? A qualitative study.

Science.gov (United States)

Karlsson, Marit; Milberg, Anna; Strang, Peter

2012-01-01

Deliberations on euthanasia are mostly theoretical, and often lack first-hand perspectives of the affected persons. Sixty-six patients suffering from cancer in a palliative phase were interviewed about their perspectives of euthanasia in relation to autonomy. The interviews were transcribed verbatim and analysed using qualitative content analysis with no predetermined categories. The informants expressed different positions on euthanasia, ranging from support to opposition, but the majority were undecided due to the complexity of the problem. The informants' perspectives on euthanasia in relation to autonomy focused on decision making, being affected by (1) power and (2) trust. Legalization of euthanasia was perceived as either (a) increasing patient autonomy by patient empowerment, or (b) decreasing patient autonomy by increasing the medical power of the health care staff, which could be frightening. The informants experienced dependence on others, and expressed various levels of trust in others' intentions, ranging from full trust to complete mistrust. Dying cancer patients perceive that they cannot feel completely independent, which affects true autonomous decision making. Further, when considering legalization of euthanasia, the perspectives of patients fearing the effects of legalization should also be taken into account, not only those of patients opting for it.

'n Ondersoek na die potensiaal-bepaling van werknemers in die landbousektor.

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J. C. D. Augustyn

1989-05-01

Full Text Available An investigation into determining the potential of workers in the agricultural sector. Industrial Psychological principles and concepts are not being applied extensively in the agricultural sector. Against this background an attempt was made to scientifically identify potential and predict job performance amongst farm labourers. Using the PAQ method of job analysis, critical attributes were identified and a satisfactorily valid battery of tests was developed. The results of this study underlines the importance of the identification of the potential of farm labourers as a first step in the personnel management process. It also serves as a source of information that could be used by farmers for counselling purposes. Opsomming Wat die toepassing van Bedryfsielkundige beginsels en konsepte betref bestaan daar in die landboubedryf nog groot leemtes. Teen hierdie agtergrond is 'n poging aangewend om op 'n wetenskaplike wyse die potensiaal van plaasarbeiders te bepaal. Deur middel van die WOV-metode van posontleding is kritieke attribute by workers geidentifiseer en kon 'n toetsbattery met aanvaarbare geldigheid saamgestel word. Die resultate van die studie bevestig dat die identifisering van die potensiaal van plaaswerkers 'n noodsaaklike eerste stap in die personeelbestuursproses is. Dit kan ook met groot vrug as voorligtingshulpmiddel deur boere gebruik word.

Die invloed van ‘n intensiewe opleidingsprogram op die Kardio Stres-indeks

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Tammy Claassen

2012-03-01

Full Text Available Mense ondervind baie stressors in hul alledaagse lewe, wat ‘n groot uitwerking het op daagliksefunksionering. Kardio Stres-indeks (KSI is ‘n nie-indringende mate van die stres wat die hartervaar. KSI (uitgedruk as ‘n persentasie berekeninge word gebaseer op die duur van die QRSkompleks, hart tempo, ritme en standaardafwyking van die RR-interval (RRSD spesifieke parameters.

Verskuiwing in die moraal?

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S.P. van der Walt

1974-03-01

Full Text Available Modewoorde het ons deesdae oorgenoeg in die Christelike sedeleer en hulle kan nogal verwarring stig. U moet my vergun om met u te spreek oor een so ’n modewoord nl „verskuiwing’’ in die moraal. Dis nogal ’n mooi woord, wat so dikwels gebruik word op baie terreine en tog meer wil aandui as maar net ’n veranderde sienswyse, ’n wysiging in opvattinge of nuwe riglyne wat al gangbaar geword het in die praktyk. Die begrip wil eintlik die ewolusionêre gang beklemtoon, want dit is dan eintlik net die ou norme wat effens anders bekyk word of nie meer so nou geneem of dik onderstreep word nie. Die verskuiwing beteken dan dat alles nog dieselfde bly, net die posisie of plek het verander. Verskuiwing beteken tog plekverandering of plekwisseling en dan sekerlik nie in die sin dat die plekke ver uitmekaar lê nie. Verskuiwing beteken net maar vlak langs die vorige te staan kom. As dit dan ’n beter plek is, is dit ewolusie, ontwikkeling, verbetering.

Die bantering van daar-interferensie in die Duits van Afrikaansmoedertaliges

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Emerencia C. Steyn

2013-02-01

Full Text Available A comparison of sentence constructions in the soundtracks (simulcast of some television programmes indicates a general lack of a German equivalent for the multiple use of the A.frikaans daar. This naturally results in interference in the usage of German by A.frikaans speaking students, as they are inclined to construct their German sentences in accordance with the A.frikaans equivalents. This problem is mainly illustrated in either the erroneous use of a da or an inappropriate es gibt. Various exercises are submitted, aimed at obviating such errors of interference which are mainly noticeable in the spoken ·language. Soos blyk uit 'n vergelyking van segslryses in die parallelle klankbane van enkele televisieprogramme, het die veelvuldige gebruik van die Afrikaanse woord daar gewoonlik geen ekwivalensie in Duits nie. Dit lei maklik tot interferensie in die Duits van Afrikaansmoedertalige studente, omdat hulle daartoe neig om hul Duitse sinne soos die in A.frikaans te konstrueer. Hierdie probleem word hoofsaaklik in die foutiewe gebruik van da geopenbaar; soms egter ook in 'n misplaaste es gibt. Verskeie oefeninge word aan die hand gedoen om sulke interferensiefoute, wat vera! in m(mdelinge werk opduik, te bekamp.

Experience with early postoperative feeding after abdominal aortic surgery.

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Ko, Po-Jen; Hsieh, Hung-Chang; Liu, Yun-Hen; Liu, Hui-Ping

2004-03-01

Abdominal aortic surgery is a form of major vascular surgery, which traditionally involves long hospital stays and significant postoperative morbidity. Experiences with transit ileus are often encountered after the aortic surgery. Thus traditional postoperative care involves delayed oral feeding until the patients regain their normal bowel activities. This report examines the feasibility of early postoperative feeding after abdominal aortic aneurysm (AAA) open-repair. From May 2002 through May 2003, 10 consecutive patients with infrarenal AAA who underwent elective surgical open-repair by the same surgeon in our department were reviewed. All of them had been operated upon and cared for according to the early feeding postoperative care protocol, which comprised of adjuvant epidural anesthesia, postoperative patient controlled analgesia, early postoperative feeding and early rehabilitation. The postoperative recovery and length of hospital stay were reviewed and analyzed. All patients were able to sip water within 1 day postoperatively without trouble (Average; 12.4 hours postoperatively). All but one patient was put on regular diet within 3 days postoperatively (Average; 2.2 days postoperatively). The average postoperative length of stay in hospital was 5.8 days. No patient died or had major morbidity. Early postoperative feeding after open repair of abdominal aorta is safe and feasible. The postoperative recovery could be improved and the length of stay reduced by simply using adjuvant epidural anesthesia during surgery, postoperative epidural patient-controlled analgesia, early feeding, early ambulation, and early rehabilitation. The initial success of our postoperative recovery program of aortic repair was demonstrated.

Early changes of parotid density and volume predict modifications at the end of therapy and intensity of acute xerostomia

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Belli, Maria Luisa; Broggi, Sara [Ospedale San Raffaele Scientific Institute, Medical Physics, Milano (Italy); Scalco, Elisa; Rizzo, Giovanna [CNR, Istituto di Bioimmagini e Fisiologia Molecolare, Milano (Italy); Sanguineti, Giuseppe [Regina Elena National Cancer Institute, Department of Radiation Oncology, Rome (Italy); Fiorino, Claudio; Cattaneo, Giovanni Mauro [Ospedale San Raffaele Scientific Institute, Medical Physics, Milano (Italy); CNR, Istituto di Bioimmagini e Fisiologia Molecolare, Milano (Italy); Dinapoli, Nicola; Valentini, Vincenzo [Universita Cattolica del Sacro Cuore, Radiotherapy, Rome (Italy); Ricchetti, Francesco [Ospedale Sacro Cuore, Radiotherapy, Negrar (Italy)

2014-11-15

To quantitatively assess the predictive power of early variations of parotid gland volume and density on final changes at the end of therapy and, possibly, on acute xerostomia during IMRT for head-neck cancer. Data of 92 parotids (46 patients) were available. Kinetics of the changes during treatment were described by the daily rate of density (rΔρ) and volume (rΔvol) variation based on weekly diagnostic kVCT images. Correlation between early and final changes was investigated as well as the correlation with prospective toxicity data (CTCAEv3.0) collected weekly during treatment for 24/46 patients. A higher rΔρ was observed during the first compared to last week of treatment (-0,50 vs -0,05HU, p-value = 0.0001). Based on early variations, a good estimation of the final changes may be obtained (Δρ: AUC = 0.82, p = 0.0001; Δvol: AUC = 0.77, p = 0.0001). Both early rΔρ and rΔvol predict a higher ''mean'' acute xerostomia score (≥ median value, 1.57; p-value = 0.01). Median early density rate changes for patients with mean xerostomia score ≥ / < 1.57 were -0.98 vs -0.22 HU/day respectively (p = 0.05). Early density and volume variations accurately predict final changes of parotid glands. A higher longitudinally assessed score of acute xerostomia is well predicted by higher rΔρ and rΔvol in the first two weeks of treatment: best cut-off values were -0.50 HU/day and -380 mm{sup 3}/day for rΔρ and rΔvol respectively. Further studies are necessary to definitively assess the potential of early density/volume changes in identifying more sensitive patients at higher risk of experiencing xerostomia. (orig.) [German] Ziel der Studie ist die Untersuchung der praediktiven Aussagekraft von fruehen Veraenderungen in Volumen und Dichte der Ohrspeicheldruese in Bezug auf die finale Verformung zum Ende der Therapie sowie das Risiko von Xerostomie waehrend der intesitaetsmodulierten Strahlentherapie (IMRT) bei Kopf und Hals Tumoren. Die Studie

Die faktorstruktuur van Bass se veelfaktor- leierskapsvraelys in die Suid-Afrikaanse konteks

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C .P. Ackermann

2000-06-01

Full Text Available The factor structure of Bass's Multifactor Leadership Questionnaire in the South African context. The aim of the study was to determine whether the factor structure of Bass's Multifactor Leadership Questionnaire (MLQ, as a measure of transformational leadership, could be replicated within the South African context. The MLQ was chosen not only because it promised to be a valid and reliable measuring instrument of the construct in question, but also due to the fact that there was an urgent need for such an instrument in the management of human resources within organisations undergoing transformation. The MLQ was administered to 406 subjects within the military context and was subjected to factor analysis and item analysis. The factor analysis yielded three factors, namely transformational leadership, transactional leadership and avoidance of leadership ("laissez faire" leadership. The reliabilities of the scales were determined by means of Cronbach's coefficient alpha, and yielded coefficients of 0,944, 0,736 and 0,803 respectively. The factor structure as conceptualised by Bass (1985 was largely confirmed in the present study. Opsomming Die doel van die studie was om vas te stel of die faktorstruktuur van die Veelfaktorleierskapsvraelys (MLQ van Bass, as maatstafvan transformasionele leierskap, in die Suid-Afrikaanse konteks gerepliseer kon word. Die MLQ is gekies omdat dit belofte inhou as n geldige en betroubare meetinstrument van die onderhawige konstruk, en ook weens die feit dat daar 'n dringende behoefte bestaan aan so n instrument vir gebruik in die bestuur van menslike hulpbronne in organisasies tydens verandering. Die MLQ is op 406 proefpersone binne militêre konteks toegepas, en aan n faktorontleding en n itemontleding onderwerp. Die faktorontleding het drie faktore opgelewer, te wete transformasionele leierskap, transaksionele leierskap en vermyding van leierskap ("laissez faire"-leierskap. Die betroubaarheid van die skale is bepaal

Ek wil hier graag van die geleentheid gebruik maak am die ...

African Journals Online (AJOL)

die wildlewe am van die jagters nie eers mel- ding te maak nie en in Lucas se werk kan hulle ure van genot deurbring. Wat ons veral in Lucas se publikasie interes- seer is sy deelname aan die agste grensoor~' log (1850-1853), sy aantekeninge in verband met die slag by Berea (20 Oesember 1852) en sy indrukke van ...

Die radio in Afrika

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S. de Villiers

1966-03-01

Full Text Available Omvang van radio-uitsendings in en na Afrika. — Redes vir die versnelde tempo van uitbreiding. — Radio as die geskikste massa-kommunikasiemiddel vir Afrika. — Faktore wat die verspreiding bemoeilik. — Skouspelagtige toename in luistertalle.Toe Plinius, wat in die jaar 79 oorlede is, in sy „Historia Naturalis” verklaar het dat daar altyd iets nuuts uit Afrika afkomstig is, kon hy nouliks voorsien het dat die „iets" negentien eeue later in die lug sou setel wat hierdie reuse-vasteland oorspan — ’n Babelse spraakverwarring en ’n ongekende, verbete woorde-oorlog in die etergolwe, onder meer daarop bereken om die harte en hoofde van derduisendes te verower.

Halfkrone vir die Nagmaal

African Journals Online (AJOL)

Owner

die omgewing van Velddrif en Laaiplek, ook noordwaarts verby Lambertsbaai tot by. Doringbaai en Strandfontein. “Haar seeverhale is Sussie (Kotze) se belangrikste bydrae tot die Afrikaanse letterkunde”, sê Kotzé-Myburgh in die voorwoord van die versamelbundel. Die leser word herinner aan Kotze se debuutroman, ...

Treatment of Die-Punch Fractures with 3D Printing Technology.

Science.gov (United States)

Chen, Chunhui; Cai, Leyi; Zhang, Chuanxu; Wang, Jianshun; Guo, Xiaoshan; Zhou, Yifei

2017-07-19

We evaluated the feasibility, accuracy and effectiveness of applying three-dimensional (3D) printing technology for preoperative planning for die-punch fractures. A total of 107 patients who underwent die-punch fracture surgery were enrolled in the study. They were randomly divided into two groups: 52 cases in the 3D model group and 55 cases in the routine group. A 3D digital model of each die-punch fracture was reconstructed in the 3D group. The 3D digital model was imported to a 3D printer to build the full solid model. The operation time, blood loss volume, and the number of intraoperative fluoroscopy were recorded. Follow-up was performed to evaluate the patients' surgical outcomes. Treatment of die-punch fractures using the 3D printing approach reduced the number of intraoperative fluoroscopy, blood loss volume, and operation time, but did not improve wrist function compared to those in the routine group. The patients wanted the doctor to use the 3D model to introduce the condition and operative plan because it was easier for them to understand. The orthopedic surgeons thought that the 3D model was useful for communicating with their patients, but their satisfaction with the preoperative plan was much lower than the benefit of using the 3D model to communicate with their patients. 3D printing technology produced more accurate morphometric information for orthopedists to provide personalized surgical planning and communicate better with their patients. However, it is difficult to use widely in the department of orthopedics.

Die Leben Einsteins eine Reise durch die Geschichte der Physik

CERN Document Server

Fiami

2005-01-01

Jeder kennt die Namen Einstein, Newton oder Galilei. aber was weiss man über sie? Hier ein Porträt Einsteins anhand von sechs Meilensteinen aus der Geschichte der Physik. Einstein tritt auf als Protagonist in verschiedenen Epochen und bei verschiedenen Entdeckungen, die die Welt verändert haben.

Die Ukraine-Krise und kritische Fragen an die EU-Erweiterungspolitik

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Lippert, Barbara

2014-01-01

Die Ukraine-Krise konfrontiert die EU mit kritischen Fragen zu ihrer Erweiterungs-politik. Muss sie nach der Osterweiterung 2004/07 und dem gerade erst begonnenen Einzug der Westbalkan-Staaten nun mit Osteuropa für die übernächste Erweiterungs-runde rechnen? Sollte sie sich gar alsbald politisch verpflichten, interessierte und beitrittsfähige osteuropäische Länder eines Tages aufzunehmen? Wie jetzt auch viel-fach von EU-Akteuren geäußert, wäre dies voreilig: Denn in der konfliktgeladenen und ...

Die waarde van voorafopleiding deur die ouer vir pedo-oudiometrie by drie- en vierjarige kleuters

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Merisa Lodewyckx

1981-11-01

Full Text Available Die verkryging van akkurate, betroubare inligting aangaande die gehoorvermoë van jong kinders is van besondere belang vir die oudioloog, maar word dikwels bemoeilik aangesien die kleuter nie goeie samewerking bied in die vreemde pedo-oudiometriese situasie nie. Die oplossing hiervoor is grootliks geleë in die opleiding van die kind voor formele  gehoortoetsing en meer spesifiek  opleiding tuis deur die ouer. Die doel van hierdie studie was om 'n voorbereidende program op te stel wat die ouer tuis met die kind kan uitvoer, voordat formele  toetsing plaasvind. Die waarde en effek van hierdie program in die pedo-oudiometriese situasie is geevalueer by 'n groep drie- en vierjarige kleuters. Resultate dui daarop dat laer en meer akkurate drempels, 'n korter toetstydperk, verminderde angs en beter samewerking verkry is by die kleuters wat vooraf  opleiding ontvang het. Die opleidingsprogram kan dus in die kliniese praktyk benut word as voorafopleiding  vir pedo-oudiometrie.

Varswateralge en die ekonomie

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W. E. Scott

1988-03-01

Full Text Available Die artikel bespreek die ekonomiese belong wat varswateralge alreeds het en hul moontlike verdere ontginning in die toekoms. Sowel gewenste as ongewenste aspekte word oorweeg en hoofsaaklik met voorbeelde uit Suid-Afrika geïllustreer. Die oormatige ontwikkeling van ongewenste alge in varswater verlaag die watergehalte dear verskeie chemiese veranderinge, wat kan wissel van smake en geure tot die produksie van verbindings wat gesondheidsgevare vir mens of dier inhou. Verwydering van ongewenste alge dra aansienlik by tot die koste van waterbehandeling. Oormatige alggroei belemmer ontspanningsgebruike en kan eiendomswaardes langs rivier- en damoewers beïnvloed.

Early and midterm outcomes of open stent-graft treatment for distal aortic arch aneurysm

International Nuclear Information System (INIS)

Yamada, Kazunori; Mochizuki, Takaaki; Tsubota, Hideki; Funamoto, Masaki

2008-01-01

The aim of this study was to investigate early and late outcomes for open stent-graft treatment, which was introduced as a less-invasive technique for thoracic aortic aneurysm of the distal arch, and to clarify the validity of and indications for this treatment. We retrospectively investigated 38 patients with thoracic aortic aneurysm of the distal arch who underwent open stent-graft placement at our hospital between June 2000 and September 2006. Five patients died in hospital (hospital mortality 13.2%). Age at the time of surgery and onset of postoperative paraplegia were identified as risk factors. Four patients (10.5%) had postoperative paraplegia, but no significant risk factors were seen. The size of the aneurysm was clearly reduced in 18 of the 25 patients (75.8%), in whom computed tomography was performed after discharge, and late outcomes were good. Mural thrombus thickness on the stent landing zone of <4 mm was a predictor for aneurysm shrinkage. Seven patients died during the late period, and the 5-year survival rate among hospital survivors was 80.1%. Early outcomes for open stent-graft are not necessarily good, and late survival is also not excellent. Open stent-graft thus cannot be regarded as an ideal technique for all patients with distal aortic arch aneurysm. However, after aneurysm shrinkage was confirmed during the early period, late outcomes were good. Absence of thick mural thrombus on the stent landing zone may represent a good indication for open stent-graft surgery. (author)

Killing, letting die and euthanasia.

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Husak, D N

1979-12-01

Medical ethicists debate whether or not the moral assessment of cases of euthanasia should depend on whether the patient is 'killed' or 'allowed to die'. The usual presupposition is that a clear distinction between killing and letting die can be drawn so that this substantive question is not begged. I contend that the categorisation of cases of instances of killing rather than as instances of letting die depends in part on a prior moral assessment of the case. Hence is it trivially rather than substantively true that the distinction has moral significance. But even if a morally neutral (ie non-question begging) distinction could be drawn, its application to the euthanasia controversy is problematic. I illustrate the difficulties of employing this distinction to reach moral conclusions by critically discussing Philippa Foot's recent treatment of euthanasia. I conclude that even if an act of euthanasia is an instance of killing, and there exists a prima facie moral duty not to kill, and no more stringent duty overrides this duty, one still cannot determine such an act to be morally impermissible.

Killing, letting die and euthanasia.

Science.gov (United States)

Husak, D N

1979-01-01

Medical ethicists debate whether or not the moral assessment of cases of euthanasia should depend on whether the patient is 'killed' or 'allowed to die'. The usual presupposition is that a clear distinction between killing and letting die can be drawn so that this substantive question is not begged. I contend that the categorisation of cases of instances of killing rather than as instances of letting die depends in part on a prior moral assessment of the case. Hence is it trivially rather than substantively true that the distinction has moral significance. But even if a morally neutral (ie non-question begging) distinction could be drawn, its application to the euthanasia controversy is problematic. I illustrate the difficulties of employing this distinction to reach moral conclusions by critically discussing Philippa Foot's recent treatment of euthanasia. I conclude that even if an act of euthanasia is an instance of killing, and there exists a prima facie moral duty not to kill, and no more stringent duty overrides this duty, one still cannot determine such an act to be morally impermissible. PMID:541821

The Influence of Race/Ethnicity and Education on Family Ratings of the Quality of Dying in the ICU.

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Lee, Janet J; Long, Ann C; Curtis, J Randall; Engelberg, Ruth A

2016-01-01

Racial and ethnic differences in end-of-life care may be attributable to both patient preferences and health-care disparities. Identifying factors that differentiate preferences from disparities may enhance end-of-life care for critically ill patients and their families. To understand the association of minority race/ethnicity and education with family ratings of the quality of dying and death, taking into consideration possible markers of patient and family preferences for end-of-life care as mediators of this association. Data were obtained from 15 intensive care units participating in a cluster-randomized trial of a palliative care intervention. Family members of decedents completed self-report surveys evaluating quality of dying. We used regression analyses to identify associations between race/ethnicity, education, and quality of dying ratings. We then used path analyses to investigate whether advance directives and life-sustaining treatment acted as mediators between patient characteristics and ratings of quality of dying. Family members returned 1290 surveys for 2850 decedents. Patient and family minority race/ethnicity were both associated with lower ratings of quality of dying. Presence of a living will and dying in the setting of full support mediated the relationship between patient race and family ratings; patient race exerted an indirect, rather than direct, effect on quality of dying. Family minority race had a direct effect on lower ratings of quality of dying. Neither patient nor family education was associated with quality of dying. Minority race/ethnicity was associated with lower family ratings of quality of dying. This association was mediated by factors that may be markers of patient and family preferences (living will, death in the setting of full support); family member minority race/ethnicity was directly associated with lower ratings of quality of dying. Our findings generate hypothesized pathways that require future evaluation. Copyright �

DIE GESKIEDENIS VAN AFDELING LOGISTIEK

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1 Aug 1978 ... dan ook aangebied, Agv die probleem wat ont- staan het met die gebrek aan goedgekeurde poste vir die Afdeling en as gevolg van die ver- wagte vertraging met die ondersoek van die. DOS-span, het die Afdeling Logistiek en Afde- ling Personeel oorleg gepleeg en laasgenoemde het ingestem dat die ...

Surgery Should Complement Endocrine Therapy for Elderly Postmenopausal Women with Hormone Receptor-Positive Early-Stage Breast Cancer

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Olivier Nguyen

2012-01-01

Full Text Available Introduction. Endocrine therapy (ET is an integral part of breast cancer (BC treatment with surgical resection remaining the cornerstone of curative treatment. The objective of this study is to compare the survival of elderly postmenopausal women with hormone receptor-positive early-stage BC treated with ET alone, without radiation or chemotherapy, versus ET plus surgery. Materials and Methods. This is a retrospective study based on a prospective database. The medical records of postmenopausal BC patients referred to the surgical oncology service of two hospitals during an 8-year period were reviewed. All patients were to receive ET for a minimum of four months before undergoing any surgery. Results. Fifty-one patients were included and divided in two groups, ET alone and ET plus surgery. At last follow-up in exclusive ET patients (n=28, 39% had stable disease or complete response, 22% had progressive disease, of which 18% died of breast cancer, and 39% died of other causes. In surgical patients (n=23, 78% were disease-free, 9% died of recurrent breast cancer, and 13% died of other causes. Conclusions. These results suggest that surgical resection is beneficial in this group and should be considered, even for patients previously deemed ineligible for surgery.

Euthanasia, assisted dying and the right to die in Ghana: a socio-legal analysis.

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Owusu-Dapaa, Ernest

2013-12-01

There is unanimity among states to protect the continuation of life of the individual as a safeguard against their collective extinction. The right to life is accordingly guaranteed but its antithesis, the right to die is the subject of an unending debate. The controversy over the right to die is deepened by rapid advances in medicine, creating the capability for prolongation of life beyond the span which one's natural strength can endure. Ghana's supreme law explicitly guarantees the right to life but remains ambiguous on right to die, particularly euthanasia and assisted dying. Thus, some of the other rights, such as the right to dignity and not to be tortured, can creatively be exploited to justify some instances of euthanasia. Ghana's criminal code largely proscribes euthanasia. Notwithstanding, proscription of euthanasia and assisted dying by the law, in Ghana's empirical work undertaken in some of the communities in Ghana, suggests that euthanasia is quietly practisedin health facilities and private homes, especially in the rural areas. Contrary to the popular reasons assigned in the literature of the Western world, with respect to the practice or quest for legalization of euthanasia as being a necessity for providing relief from pain or hopeless quality of life, empirical data from social and anthropological studies conducted in Ghana reveal that poverty is the motivation for informal euthanasia practice in Ghana rather than genuine desire on part of patients to die or their relatives to see to their accelerated death. Apart from poverty, traditional cultural values of African societies consider non-natural death as a taboo and ignominy to the victim and his family. Thus, any move by the government to legalize euthanasia will need to be informed by widely held consultations and a possible referendum; otherwise the law may be just a mere transplant of Western models of legislation on euthanasia without reflecting the ethos of the African people.

Quasi-experimental evaluation of a multifaceted intervention to improve quality of end-of-life care and quality of dying for patients with advanced dementia in long-term care institutions.

Science.gov (United States)

Verreault, René; Arcand, Marcel; Misson, Lucie; Durand, Pierre J; Kroger, Edeltraut; Aubin, Michèle; Savoie, Maryse; Hadjistavropoulos, Thomas; Kaasalainen, Sharon; Bédard, Annick; Grégoire, Annie; Carmichael, Pierre-Hughes

2018-03-01

Improvement in the quality of end-of-life care for advanced dementia is increasingly recognized as a priority in palliative care. To evaluate the impact of a multidimensional intervention to improve quality of care and quality of dying in advanced dementia in long-term care facilities. Quasi-experimental study with the intervention taking place in two long-term care facilities versus usual care in two others over a 1-year period. The intervention had five components: (1) training program to physicians and nursing staff, (2) clinical monitoring of pain using an observational pain scale, (3) implementation of a regular mouth care routine, (4) early and systematic communication with families about end-of-life care issues with provision of an information booklet, and (5) involvement of a nurse facilitator to implement and monitor the intervention. Quality of care was assessed with the Family Perception of Care Scale. The Symptom Management for End-of-Life Care in Dementia and the Comfort Assessment in Dying scales were used to assess the quality of dying. A total of 193 residents with advanced dementia and their close family members were included (97 in the intervention group and 96 in the usual care group). The Family Perception of Care score was significantly higher in the intervention group than in the usual care group (157.3 vs 149.1; p = 0.04). The Comfort Assessment and Symptom Management scores were also significantly higher in the intervention group. Our multidimensional intervention in long-term care facilities for patients with terminal dementia resulted in improved quality of care and quality of dying when compared to usual care.

Die begrafnisdíens

African Journals Online (AJOL)

(De Vaux 1961:108). Was die begrafnis 'n familie of 'n kerklike aangeleentheid? Hierdie vraag word nie in die Bybel beantwoord nie. Abraham het sy vrou begrawe (Gen 23: 19-. 20). Isak en Ismael ..... ver gekom om die begrafnis 'n kerklike aangeleentheid te maak nie. Hierdie stap .... trou aan die sorg van God. * Die kerk ...

het om die Woord van God aan die gemeente te bedien. A. D. P ont ...

African Journals Online (AJOL)

Test

Sizoo vertel met die vlotheid van die ervare skrywer en die ver antwoordelikheid van die wetenskaplike ... Maar in stiptelike trou aan die feitelikheid, verlaat die skrywer hom uitsluitlik op die outentieke bronne om ... de leser; in sy rykdom van gegewens en wetenskaplike betroubaarheid kan dit met vrug gelees word deur die ...

Professionalisme met verwysing na die posisie van bedryfsielkunde en die bedryfsielkundige in Suid-Afrika

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A. van der Merwe

1981-11-01

Bedryfsielkunde, as relatief jong maar snelgroeiende wetenskap, word aan die hand van ses kriteria vir 'n professie evalueer. Resultate in hierdie verband dui in die algemeen daarop dat die vakgebied alreeds vir 'n aantal jare in 'n oorgangsfase tot ‘n volwaardige professie is en dat daar in hierdie proses reeds ver op die professionele kontinuum gevorder is. Verdere onder-soeke ten opsigte van professionele opleiding, die statutêre organisering van Bedryfsielkunde asook 'n professionele kode en vereniging vir die Bedryfsielkunde word bepleit ten einde die professionele posisie van die vakgebied volledig te konsolideer.

Die design and process optimization of die cast V6 engine blocks

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Henry Hu

2005-02-01

Full Text Available The use of aluminum, particularly for engine blocks, has grown considerably in the past ten years, and continues to rise in the automotive industry. In order to enhance the quality and engineering functionality of die cast engine blocks, die design and processes have to be optimized. In this study, a computer simulation software, MAGMAsoft, as an advanced tool for optimizing die design and casting process, was emplooyed to virtually visualize cavity filling and patterns of a V6 engine block. The original die design and process was simulated first to establish a baseline. A reality check was used to verify the predicted results. Then, the die modification with a different unner system was made by using a CAD software, Unigraphics (UG. The simulation on combinations of the modified die design and revised process was performed to examine the effect of die modification and process change on flow filling of V6 engine blocks. The simulated prediction indicateds that the enhancement of cavity filling due to the die and process modification minimizeds the occurrence of defects during casting, and consequently improves the quality of blocks. The results of mechanical testing show a significant increase in fatigue strengths, and a moderately improvement on tensile properties for the blocks die cast with the new die design and prpocess in comparison with those produced by the original ones.

Early Infantile Leigh-like Gene Defects Have a Poor Prognosis: Report and Review

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Majid Alfadhel

2017-10-01

Full Text Available Solute carrier family 19 (thiamine transporter, member 3 ( SCL19A3 gene defect produces an autosomal recessive neurodegenerative disorder associated with different phenotypes and acronyms. One of the common presentations is early infantile lethal Leigh-like syndrome. We report a case of early infantile Leigh-like SLC19A3 gene defects of patients who died at 4 months of age with no response to a high dose of biotin and thiamine. In addition, we report a novel mutation that was not reported previously. Finally, we review the literature regarding early infantile Leigh-like SLC19A3 gene defects and compare the literature with our patient.

die ontstaan van vrouelugverenigings in suid-afrika voor die tweede

African Journals Online (AJOL)

aangestel. Ander eenhede het later gevolg. Drle van die Vrouehulplugmag se lelersflgure staan voor die VHLM se kleure wat gewy Is In Durban op 18 Mei 1940. Die vroue Is vlnr mal (meil E. Percival-Hart, It-kol (mev) D. Dunning en mal (mel) M. Egerton-Bird. 24. Scientia Militaria, South African Journal of Military Studies, ...

Legal physician‐assisted dying in Oregon and the Netherlands: evidence concerning the impact on patients in “vulnerable” groups

Science.gov (United States)

Battin, Margaret P; van der Heide, Agnes; Ganzini, Linda; van der Wal, Gerrit

2007-01-01

Background Debates over legalisation of physician‐assisted suicide (PAS) or euthanasia often warn of a “slippery slope”, predicting abuse of people in vulnerable groups. To assess this concern, the authors examined data from Oregon and the Netherlands, the two principal jurisdictions in which physician‐assisted dying is legal and data have been collected over a substantial period. Methods The data from Oregon (where PAS, now called death under the Oregon Death with Dignity Act, is legal) comprised all annual and cumulative Department of Human Services reports 1998–2006 and three independent studies; the data from the Netherlands (where both PAS and euthanasia are now legal) comprised all four government‐commissioned nationwide studies of end‐of‐life decision making (1990, 1995, 2001 and 2005) and specialised studies. Evidence of any disproportionate impact on 10 groups of potentially vulnerable patients was sought. Results Rates of assisted dying in Oregon and in the Netherlands showed no evidence of heightened risk for the elderly, women, the uninsured (inapplicable in the Netherlands, where all are insured), people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations. The only group with a heightened risk was people with AIDS. While extralegal cases were not the focus of this study, none have been uncovered in Oregon; among extralegal cases in the Netherlands, there was no evidence of higher rates in vulnerable groups. Conclusions Where assisted dying is already legal, there is no current evidence for the claim that legalised PAS or euthanasia will have disproportionate impact on patients in vulnerable groups. Those who received physician‐assisted dying in the jurisdictions studied appeared to enjoy comparative social, economic, educational, professional and other privileges. PMID

’n Oorsig van die bepaling van die vroeë bakterisidiese aktiwiteit van verskeie antituberkulosemiddels

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P. R. Donald

2003-06-01

Full Text Available Die vroeë bakterisidiese aktiwiteit (VBA van ’n antituberkulosemiddel is die daaglikse afname van M tuberculosis in log10 kolonievormende eenhede per ml sputum, tydens die eerste twee dae van behandeling met die middel. Dit weerspieël die vermoë van ’n middel om aktief metaboliserende organismes in tuberkulose-longholtes te dood. Dit is ’n relatief goedkoop metode om in ’n klein groep pasiënte die antituberkulose-aktiwiteit van ’n middel, binne maande, in vivo te evalueer. Hierdie artikel som ons ondervinding op tydens sewe gepubliseerde VBA-studies, en die bronne van variasie in die prosedure word identifiseer. Die pasiënte in hierdie studies was gemiddeld 33 jaar oud, met ’n gemiddelde gewig van 50 kg en 55% het ekstensiewe of massiewe longaantasting gehad. Die hoogste VBA-waardes (0,50-0,66 is gevind in pasiënte wat isoniasied ontvang het, en die laagste waardes (0,05 en 0,09 respektiewelik was gevind in pasiënte wat die aminoglikosiede amikasien en paromomisien, albei in doserings van 15 mg/kg liggaamsgewig, ontvang het. Die algehele variasie in die VBA van 248 pasiënte was 0,0312, en die variasie toegeskryf aan die proses van sputumproduksie en -versameling was 0,0223. Dit blyk dat die verskillende aspekte van sputumproduksie en -versameling, betrokke by die lewering van ’n verteenwoordigende sputummonster, ’n groter bydrae maak tot variasie tydens die prosedure as die laboratoriumaspekte van die tegniek. Die keuring van pasiënte vir insluiting in VBA-studies, en hulle vermoë om saam te werk om ’n verteenwoordigende sputummonster te produseer, is van deurslaggewende belang in die suksesvolle voltooiing van VBA-studies.

Riglyne vir die onderwys.

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J. L. du Plooy

1960-03-01

Full Text Available In die afgelope vyftig jaar sedert die Unie tot stand gekom het, is veel op die gebied van onderwys tot stand gebring. Dit is heel natuurlik dat ’n mens sou vra: Wat van die toekoms?

Die huwelik in die eerste-eeuse Mediterreense wêreld (III): Jesus en ...

African Journals Online (AJOL)

p1243322

30 Jan 2007 ... description of what marriage, betrothal, adultery, divorce and ..... egbreuk teen wie? Wanneer daar in ag geneem word dat 'n man in die eerste- eeuse Mediterreense wêreld nie egbreuk teenoor sy vrou kon pleeg nie (kyk ... volg egbreuk teen die vrou in die huwelik beteken – al het die vrou owerspel.

Die Energiesicherheit Europas in Bezug auf Erdgas und die Auswirkungen einer Kartellbildung im Gassektor

OpenAIRE

Krämer, Luis-Martín

2011-01-01

Die Dissertation untersucht die aktuelle Sicherheit der europaeischen Erdgasversorgung. Sie beruecksichtigt zudem die moeglichen Auswirkungen einer Kartellbildung auf die europaeische Gasversorgungssicherheit. Die Arbeit besteht aus einer detaillierten empirischen Studie und darauf aufbauender Szenarioanalyse. Hierzu wird auf den Interdependenzansatz von Robert O. Keohane und Joseph Nye zurueckgegriffen. Zur Darstellung des komplexen Themenbereichs wird auf die Darstellungspraxis der Dichten ...

Der Einfluss von personeller Einkommensverteilung auf die „Great Depression“ und die „Great Recession“

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Stefan Trappl

2015-12-01

Full Text Available Der Einfluss gestiegener Einkommensungleichheit auf die „Great Depression“ und die „Great Recession“ wurde mehrfach postuliert (Galbraith 1954/2009; Eccles 1951; Rajan 2010; Stiglitz 2012; Piketty 2014. Konkrete empirische Arbeiten zum Zusammenhang zwischen Einkommensverteilung und dem Entstehen von Wirtschaftskrisen gibt es aber bislang wenige. Kumhof/Ranciere (2010 überprüften die von Rajan (2010 aufgestellte Hypothese, die einen entsprechenden Zusammenhang postuliert, mittels Modellrechnung. Bordo/Meissner (2012 und darauf aufbauend Gu/Huang (2014 verwendeten unterschiedliche Regressionsmodelle in Bezug auf einen entsprechenden Zusammenhang, ohne jedoch eindeutige Ergebnisse zu liefern. Die vorliegende Arbeit schließt an diese Arbeiten an, beschränkt die Untersuchung allerdings auf Staaten, für die Daten für die letzten hundert Jahre verfügbar sind, und untersucht zudem explizit die Zeiträume um die beiden größten Krisen der letzten hundert Jahre, die „Great Depression“ und die „Great Recession“. Die Auswertungen zeigen, dass die personelle Einkommensverteilung ein guter Prädiktor für die Kriseneintrittswahrscheinlichkeit ist.

Eksistensialisme in die Franse letterkunde

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A. A. Teurlinckx

1966-03-01

Full Text Available Nooit sou die Franse jeug — en die van Europa en verder — in dié mate deur die eksistensialisme be'invloed gewees het nie, indien hierdie filosofie in wysgerige traktate sou begrawe gelê het. Die eksistensialiste het die koning van die filosofiese verhaal, Voltaire, met sukses op sy Candide- en Zadig-pad gevolg en hulle teorieë in letterkundige werke, ver- hale, romans en ook toneelstukke kwytgeraak, wat baie gelees is en waaruit ook ander literatore kragte en inspirasie geput het. Omrede daarvan is daar inderdaad baie eksistensialisme in die Franse letterkunde, maar ’n eintlike eksistensialistiese letterkunde was daar nie, en ’n Eksistensialistiese Letterkun­ dige skool het nooit bestaan nie. Ook sit hierdie eksistensialiste nie langs dieselfde vuur nie. Die Christelike eksistensialis Gabriel Marcel het op 21 April van hierdie jaar uitgevaar teen die „Sartriane” na aanleiding van die opvoering van Les Paravents, Die W indskerms van Jean Genêt in ’n Paryse staatsondersteunde teater. „Mens mag seker wees”, skryf Marcel in Les Nouvelles Littéraires, „dat die hele sartriaanse parogie sal skreeu: groot meesterwerk”. Voortgaande op sy distansiëring kan die literêre eksistensialiste in drie groepe ingedeel word: 1. Die Sartriane; 2. Die Christelike Eksistensialiste; 3. Die Onafhanklikes.

Die singulation method

Science.gov (United States)

Swiler, Thomas P.; Garcia, Ernest J.; Francis, Kathryn M.

2013-06-11

A method is disclosed for singulating die from a semiconductor substrate (e.g. a semiconductor-on-insulator substrate or a bulk silicon substrate) containing an oxide layer (e.g. silicon dioxide or a silicate glass) and one or more semiconductor layers (e.g. monocrystalline or polycrystalline silicon) located above the oxide layer. The method etches trenches through the substrate and through each semiconductor layer about the die being singulated, with the trenches being offset from each other around at least a part of the die so that the oxide layer between the trenches holds the substrate and die together. The trenches can be anisotropically etched using a Deep Reactive Ion Etching (DRIE) process. After the trenches are etched, the oxide layer between the trenches can be etched away with an HF etchant to singulate the die. A release fixture can be located near one side of the substrate to receive the singulated die.

Die toekoms en ons roeping

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S. du Toit

1954-03-01

Full Text Available Om te weet wat ons roeping in die toekoms sal wees, moet ons eers besef wat in ons eie tyd aan die gang is en langs watter lyne die dinge beweeg. Dit is ons plig om te let op die tekens van die tye in die lig van die profetiese Woord. En dan wil ons dadelik beklemtoon dat ons in Suid-Afrika nie in die waan moet lewe dat ons hier onbekommerd en onaangetas deur die wêreldgebeure ons roeping en bestemming kan uitwerk nie.

Die rol van persoonlikheidstrekke in die weerstand teen stres

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Sonja V. R. van Oudtshoorn

1988-05-01

Full Text Available The role of personality characteristics in resistance to stress: A study was conducted to establish whether certain personality characteristics contribute to resistance to stress. Rescue brigadesmen, performing dangerous rescue operations in the goldmining industry, served as basis for the study. The sample consisted of 63 current, 56 ex- and 50 non-brigadesmen. Results indicate that brigadesmen, on the basis of their personality structure, are better equipped to cope with stress. Scores on the 16PF show that they have a lower level of interpersonal anxiety (Factor Q4 and that they are more practical (Factor I, emotionally stable (Factor C, and conscientious (Factor G. These findings support existing knowledge of the 16PF. Opsomming Ten einde vas te stel ofdaar sekere persoonlikheidstrekke bestaan wat bydra tot weerstand teen stres, is 'n studie uitgevoer met reddingspanlede, wat lewensgevaarlike reddingsdiens in die goudmynbedryf verrig, as ondersoekgroep. Die streekproefhet uit 63 huidige, 56 oud-reddingspanlede en 50 amptenare, wat nog nooit aan die span behoort het nie, bestaan. Dit blyk dat reddingspanlede, op grond van hulle persoonlikheidstruktuur, beter toegerus is om stres te hanteer. Tellings op die 16PF toon dat hulle oor 'n laervlakvan interpersoonlike angs beskik, (Faktor Q4, dat hulle meer prakties (Faktor I, emosioneel stabiel (Faktor C en konsensieus is (Faktor G. Hierdie bevindinge sluit aan by die reeds bestaande kennis oor die 16PF.

Die invloed van grootgroeponderrig op die selfgereguleerde leer van tersiêre wiskundeleerders

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Annalie

2013-04-01

Full Text Available elfregulering is belangrik in die ontwikkeling van lewenslange leerders, veral by voordiensonderwysers wat op hul beurt modelleerders van selfregulering in hul eie klaskamers gaan wees. Onderrig op tersiêre vlak word grootliks gekenmerk deur tradisionele onderrigmetodes vanweë die groot groepe leerders betrokke. In hierdie studie is vasgestel of ’n bepaalde grootgroeponderrigstrategie ’n invloed het op lede van groot klasgroepe se selfregulering, al dan nie. ’n Kwantitatiewe voortoets-natoets-ontwerp is gebruik waarin die studiegewoontesveld van die Studie-Oriëntasievraelys in Wiskunde aan die begin en einde van die semester ingesluit is. In ’n tweede vraelys het leerders hul belewenis van die grootgroeponderrigstrategie volgens ’n vyfpunt-Likertskaal beoordeel en ’n oopeindevraag voltooi wat ingesluit is om moontlike addisionele verklarings te bied vir die resultate wat verkry is uit die geslote vrae van die vraelys oor grootgroeponderrig. Beskrywende statistiek is gebruik om die data te interpreteer. Uit die resultate blyk dit dat daar nie ’n verbetering in leerders se selfregulering was nie. By ontleding van die oopeindevraag het dit aan die lig gekom dat verskeie aspekte van selfregulering by leerders ontbreek, soos tydsbestuur en goeie studiegewoontes, asook die bereidwilligheid om meer as net die voorgeskrewe probleme te doen.The influence of a large group teaching strategy on the self-regulated learning of tertiary mathematics learners. Self-regulation is important in developing lifelong learners, especially in the case of pre-service teachers who will soon be models of self-regulation in their own classrooms. In many instances, teaching at tertiary level is characterised by traditional teaching methods in large classes. In this study a particular large group instructional strategy was examined to determine whether it had an influence on learners’ self-regulation. A quantitative pre-test post-test design was used which

Montessori-skole: die ander kant

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Monica Viljoen

1995-03-01

Full Text Available Na aanleiding van die artikel “Die invloed van die New Age-beweging op die onderwysagenda van die toekoms” deur Lien van Niekerk en Corinne Meier van die Departement Historiese Opvoedkunde van Unisa (vgl. Koers, 59 (1 1994:69-84 wil ek graag ’n ander sy van Montessori-skole onder die aandag van Koers lesers bring.

Tegnologie en die mens

African Journals Online (AJOL)

omgewingsbesoedeling, volgend op industrialisasie en verstedeliking, gee uit- ing tot krete van wanhoop en frustrasie. Die maatskaplike ontwrigting agv outomatisasie het die begrippe van vervreemding en naam- loosheid op die voorgrond van sosiale be- wustheid geplaas. • Die Neutrale Siening. Tegnologie was nag. 34.

Spondylolysis in adolescents: the diagnostic value of MRI; Die Spondylolyse im Stadium der Entstehung: Diagnostischer Beitrag der MRT

Energy Technology Data Exchange (ETDEWEB)

Staebler, A.; Steinborn, M.; Matzko, M.; Reiser, M. [Klinikum Grosshadern, Muenchen (Germany). Inst. fuer Radiologische Diagnostik; Paulus, R.; Bosch, R. [Muenchen Univ. (Germany). Orthopaedische Klinik

2000-01-01

Purpose: To assess the value of MR imaging in demonstrating ongoing spondylolysis in adolescents. Methods: MRI was performed in 9 juvenile patients (3 female, 6 male aged 8-16 years; mean 12.5 y) with pain during hyperextension. In 6 patients a CT scan and in 5 a plain film was available. Results: In all patients bone marrow edema was found in the pars interarticularis and the pedicle, which was bilateral in 4 patients. In 7/9 cases the L5 vertebra was affected, in 2/9 cases spondylolysis was found in L4. In 3 cases the edema reached the middle third of the vertebral body and a tumor was suspected. In all CT scans a bilateral incomplete or complete cleft in the pars interarticularis was found. In 4/6 CT-scans a sclerosis was seen in the area of the bone marrow edema. Only in 1/5 pain films was there a suspicion for a spondylolysis, four examinations were completely normal. Conclusions: To eliminate underlying causal conditions of spondylolysis and to install specific therapy, early diagnosis is mandatory. MR imaging should be the first and only imaging modality in young patients with low back pain during and after exercise and pain with hyperextension. Bone scans and CT scans should be avoided due to irradiation, plain films usually do not reveal pathological findings in developing spondylolysis. (orig.) [German] Ziel: Darstellung der Wertigkeit der MR-Tomographie in der Diagnostik der Spondylolyse im Stadium der Entstehung. Methoden: 9 sportlich, aktive jugendliche Patienten im Alter von 8-16 Jahren (Durchschnitt 12,5 Jahre) mit Rueckenschmerzen bei der Hyperextension wurden MR-tomographisch untersucht. In 6 Faellen lag eine CT, in 5 Faellen Roentgenaufnahmen vor. Ergebnisse: Bei den 9 Jugendlichen wurden Knochenmarkoedeme in der Pars interarticularis und den Bogenwurzeln nachgewiesen, die in 4 Patienten beidseitig vorhanden waren. In 7/9 Faellen war LWK 5 betroffen, in 2/9 LWK 4. In 3 Faellen reichte das Oedem in die Wirbelkoerper, bei 2 Patienten bestand

Pneumonia in immunosuppressed patients; Pneumonien bei immunsupprimierten Patienten

Energy Technology Data Exchange (ETDEWEB)

Solyanik, O.; Gaass, T.; Hellbach, K. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer klinische Radiologie, Muenchen (Germany); Dinkel, J. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer klinische Radiologie, Muenchen (Germany); Comprehensive Pneumology Center Munich (CPC-M), Muenchen (Germany)

2017-01-15

Pulmonary infections are a common complication in immunosuppressed patients with a frequently fatal prognosis despite modern prophylactic therapy. An early and correct diagnosis is important for initiation of the appropriate therapy. Chest radiography is the preferred initial imaging examination but is not accurate enough for the detection of pulmonary infections in immunosuppressed patients. Pneumonia is caused by a broad spectrum of pathogens in immunocompromised patients. In addition to imaging, the clinical history and epidemiology also play an important role in the diagnostics. Using epidemiological and anamnestic information, computed tomography (CT) shows a significantly better sensitivity and specificity particularly for the diagnosis of atypical forms of pneumonia. Due to the exact imaging of the different infiltration patterns CT provides an increased sensitivity with respect to the etiological classification of pulmonary infections. This article reviews in particular the radiological findings of commonly occurring pulmonary infections in immunosuppressed patients. (orig.) [German] Pneumonien bei immunsupprimierten Patienten sind haeufige Komplikationen, die trotzt moderner Prophylaxe toedlich verlaufen koennen. Eine korrekte Diagnose ist daher von entscheidender Bedeutung, um die richtige Therapie einleiten zu koennen. Die Roentgenthoraxaufnahme ist selten spezifisch genug fuer die genaue Einordnung atypischer Pneumonien in Folge einer Immunsuppression. Pneumonien unter Immunsuppression werden durch ein sehr breites Erregerspektrum verursacht. Eine wichtige Rolle bei der Diagnosefindung spielen neben der Bildgebung auch die klinische Anamnese und Epidemiologie. Mithilfe der klinischen Anamnese und Epidemiologie bietet die Computertomographie (CT) bei immunsupprimierten Patienten zum einen eine erhoehte Sensitivitaet bei der Detektion insbesondere atypischer Pneumonien. Zum anderen weist die CT durch die exakte Abbildung unterschiedlicher Infiltratmuster

Early perfusion changes within 1 week of systemic treatment measured by dynamic contrast-enhanced MRI may predict survival in patients with advanced hepatocellular carcinoma

Energy Technology Data Exchange (ETDEWEB)

Chen, Bang-Bin; Yu, Chih-Wei; Liang, Po-Chin [National Taiwan University College of Medicine and Hospital, Department of Medical Imaging and Radiology, Taipei City (China); Hsu, Chao-Yu [National Taiwan University College of Medicine and Hospital, Department of Medical Imaging and Radiology, Taipei City (China); Taipei Hospital, Ministry of Health and Welfare, Department of Radiology, New Taipei City (China); Hsu, Chiun; Hsu, Chih-Hung; Cheng, Ann-Lii [National Taiwan University College of Medicine and Hospital, Department of Oncology, Taipei City (China); Shih, Tiffany Ting-Fang [National Taiwan University College of Medicine and Hospital, Department of Medical Imaging and Radiology, Taipei City (China); Taipei City Hospital, Department of Medical Imaging, Taipei City (China); National Taiwan University Hospital, Department of Medical Imaging, Taipei (China)

2017-07-15

To correlate early changes in the parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) within 1 week of systemic therapy with overall survival (OS) in patients with advanced hepatocellular carcinoma (HCC). Eighty-nine patients with advanced HCC underwent DCE-MRI before and within 1 week following systemic therapy. The relative changes of six DCE-MRI parameters (Peak, Slope, AUC, Ktrans, Kep and Ve) of the tumours were correlated with OS using the Kaplan-Meier model and the double-sided log-rank test. All patients died and the median survival was 174 days. Among the six DCE-MRI parameters, reductions in Peak, AUC, and Ktrans, were significantly correlated with one another. In addition, patients with a high Peak reduction following treatment had longer OS (P = 0.023) compared with those with a low Peak reduction. In multivariate analysis, a high Peak reduction was an independent favourable prognostic factor in all patients [hazard ratio (HR), 0.622; P = 0.038] after controlling for age, sex, treatment methods, tumour size and stage, and Eastern Cooperative Oncology Group performance status. Early perfusion changes within 1 week following systemic therapy measured by DCE-MRI may aid in the prediction of the clinical outcome in patients with advanced HCC. (orig.)

Physician Burnout and the Calling to Care for the Dying: A National Survey.

Science.gov (United States)

Yoon, John D; Hunt, Natalie B; Ravella, Krishna C; Jun, Christine S; Curlin, Farr A

2017-12-01

Physician burnout raises concerns over what sustains physicians' career motivations. We assess whether physicians in end-of-life specialties had higher rates of burnout and/or calling to care for the dying. We also examined whether the patient centeredness of the clinical environment was associated with burnout. In 2010 to 2011, we conducted a national survey of US physicians from multiple specialties. Primary outcomes were a validated single-item measure of burnout or sense of calling to end-of-life care. Primary predictors of burnout (or calling) included clinical specialty, frequency of encounters with dying patients, and patient centeredness of the clinical environments ("My clinical environment prioritizes the need of the patient over maximizing revenue"). Adjusted response rate among eligible respondents was 62% (1156 of 1878). Nearly a quarter of physicians (23%) experienced burnout, and rates were similar across all specialties. Half of the responding physicians (52%) agreed that they felt called to take care of patients who are dying. Burned-out physicians were more likely to report working in profit-centered clinical environments (multivariate odds ratio [OR] of 1.9; confidence interval [CI]: 1.3-2.8) or experiencing emotional exhaustion when caring for the dying (multivariate OR of 2.1; CI: 1.4-3.0). Physicians who identified their work as a calling were more likely to work in end-of-life specialties, to feel emotionally energized when caring for the dying, and to be religious. Physicians from end-of-life specialties not only did not have increased rates of burnout but they were also more likely to report a sense of calling in caring for the dying.

Acceptance of dying: a discourse analysis of palliative care literature.

Science.gov (United States)

Zimmermann, Camilla

2012-07-01

The subject of death denial in the West has been examined extensively in the sociological literature. However, there has not been a similar examination of its "opposite", the acceptance of death. In this study, I use the qualitative method of discourse analysis to examine the use of the term "acceptance" of dying in the palliative care literature from 1970 to 2001. A Medline search was performed by combining the text words "accept or acceptance" with the subject headings "terminal care or palliative care or hospice care", and restricting the search to English language articles in clinical journals discussing acceptance of death in adults. The 40 articles were coded and analysed using a critical discourse analysis method. This paper focuses on the theme of acceptance as integral to palliative care, which had subthemes of acceptance as a goal of care, personal acceptance of healthcare workers, and acceptance as a facilitator of care. For patients and families, death acceptance is a goal that they can be helped to attain; for palliative care staff, acceptance of dying is a personal quality that is a precondition for effective practice. Acceptance not only facilitates the dying process for the patient and family, but also renders care easier. The analysis investigates the intertextuality of these themes with each other and with previous texts. From a Foucauldian perspective, I suggest that the discourse on acceptance of dying represents a productive power, which disciplines patients through apparent psychological and spiritual gratification, and encourages participation in a certain way to die. Copyright © 2012 Elsevier Ltd. All rights reserved.

Understanding the Problems of Death and Dying: A Health Professionals' Attitude Survey.

Science.gov (United States)

Green, Joseph S.; And Others

1978-01-01

Attitudes of health practitioners and others toward death and dying and their emotional reactions to dying patients were surveyed both before and after a Veterans Administration workshop. Some attitude changes were noted, with implications for future workshops. (MF)

Pain-to-hospital times, cardiovascular risk factors, and early intrahospital mortality in patients with acute myocardial infarction

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Brković E

2015-02-01

Full Text Available Eliana Brković,1 Katarina Novak,2,3 Livia Puljak3 1Department of Psychiatry, 2Department of Internal Medicine, Division of Cardiology, 3Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia Background: The aim of the study was to analyze the most recent trends in myocardial infarction (MI care, the number of patients treated for MI and their outcomes, cardiovascular disease risk factors, and pain-to-hospital times in MI patients. Subjects and methods: For 778 patients treated for acute MI at the Coronary Care Unit (CCU of University Hospital Split, Croatia the following data were acquired: outcome during hospitalization (survived, deceased, cardiovascular risk factors (hypertension, diabetes, dyslipidemia, previous MI, smoking, and pain-to-CCU time. Results: Among 778 patients treated for acute MI, there were 291 (37% women and 487 (63% men. Forty-five patients (6% died during hospitalization, mostly due to cardiogenic shock. An association was found between early intrahospital mortality and the following risk factors: age >70 years, female sex, previous MI, and smoking. Median pain-to-call time was 2 hours, and median time from the onset of pain to arrival into the CCU was 4 hours. There were 59 (7.6% patients admitted to the CCU within recommended 90 minutes. Diabetic comorbidity was not associated with early death or with longer time from pain to emergency calls. Conclusion: Some of the risk factors associated with adverse outcomes in MI are modifiable. Prehospital delay of 4 hours observed in patients who suffered an MI is too long, and more effort should be devoted to investments in health care and education of the general public regarding chest pain symptoms. Keywords: prehospital delay, ischemic heart disease

Die rol van die onderwys in die handhawing en uitbouing van ons volkskultuur

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G.J. Jordaan

1970-03-01

Full Text Available Op die oog af lyk dit ’n baie maklike onderwerp, maar hoe meer 'n mens daaroor nadink hoe ingewikkelder en omvangryker word die implikasies wat verband hou. Dit is veral so omdat dit hier voor alles gaan om eerste fundamentele uitgangspunte, dit wil sê, om lewens- en wêreldbeskouing. Dit geld van albei komponente — van onderwys sowel as van kultuur.

DIE SUID-AFRIKAANSE JEUG IN VOORTREKKERTYDPERK

African Journals Online (AJOL)

dien. Die planke en velie moes keer dat die assegaaie die mense tref. Voor die geveg het die vrouens en groter dogters koeels gegiet. Tydens die geveg het die seuns gehelp skiet terwyl die vrouens en dogters die gewere vir die mans gelaai het. Van die dogters soos Nellie. Botha (11 jaar oud) en haar sussie Fya (15 jaar.

IRAN IN DIE INTERNASIONALE MAGSTRYD

African Journals Online (AJOL)

In die verband kan genoem word dat die Russe nog grotendeels gebruik maak van 'n metode waarvolgens water in die oliestratum gepomp word om 'n opwaartse druk van ru-olie te verseker; een nadeel hiervan is dat die water mettertyd deur die oliehoudende laag ontsnap en agv die drukverlies isvoortgesette ontginning.

Die rol van kapitaal in die ekonomiese groei en ontwikkeling van onderontwikkelde gebiede*

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F. J. du Plessis

1961-03-01

Full Text Available In die teorie oor ekonomiese groei speel kapitaal ’n besonder prominente rol. Kapitaal met die daarby behorende tegnologiese ontwikkeling, word beskou as die belangrikste enkele faktor verantwoordelik vir die bereiking en instandhouding van ’n „ten voile ontwikkelde” volkshuishouding.

Artikel 2 van die Nederlandse Geloofsbelydenis as geloofsvooronderstelling in die gesprek tussen wetenskap en geloof

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Jan A. Erasmus

2014-09-01

Full Text Available Artikel 2 van die Nederlandse Geloofsbelydenis bely dat God deur twee middele geken word, te wete deur middel van die skepping, onderhouding en regering van die wêreld (waaronder die wetenskap en deur die heilige en goddelike Woord (die Bybel. Hierdie belydenis is van groot belang vir die gesprek tussen Wetenskap en Teologie. In hierdie artikel word gepoog om die verskille, maar ook die ooreenkomste tussen hierdie twee middele van openbaring uit te lig, elkeen tot sy reg te laat kom, maar hulle ook in balans met mekaar te stel. Die wyse waarop te werk gegaan word, is die volgende: eers word gestel wat vooronderstellings is, asook die plek wat vooronderstellings in die beoefening van wetenskap sowel as geloof inneem. Daarna word nagevors watter perspektiewe artikel 2 van die Nederlandse Geloofsbelydenis as geloofsvooronderstelling vir die wetenskaps- en teologiebeoefening respektiewelik bied. Hieruit word ’n aantal gevolgtrekkings gemaak wat kan help om die problematiek in die wetenskap-geloofsgesprek op te los. Die kernbevinding van hierdie artikel is die volgende: Vanweë die verskil in die aard en die doel tussen Bybelfeite en wetenskaplike navorsingsresultate kan en sal klaarblyklike harmonieprobleme tussen die Skrif en die wetenskap ontstaan. Hierdie is egter slegs klaarblyklike probleme, omdat ’n verrekening van die verskil in die aard en die bedoeling van die wetenskapresultate en die Bybelfeite hierdie probleem sal oplos. Article 2 of the Belgic Confession as faith presupposition in the science-faith debate. Article 2 of the Belgic Confession confesses that God can be known by two means: firstly by studying the creation, preservation and government of the universe (i.e. science and secondly by studying the Word of God (the Bible. This confession is very important for the discussion between science and faith. In this article the similarities, but also the differences between these two means of revelation are researched. The aim is to

Die gebruik van ’n reologiese tegniek in die bepaling van die verhardingsreaksiekinetika van ’n reaktiewe poliësterpoeierdeklaag

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O. C. Vorster

2004-09-01

Full Text Available

Die studie van die verhardingsreaksiekinetika van deklae word bemoeilik deur die aanwesigheid van vlugtige stowwe, pigmente en bypigmente. In hierdie studie word die verhardingsreaksiekinetika van ’n karboksielgetermineerde poliëstertriglisediel-isosianuraat deur middel van parallelplaatspanningsreometrie bepaal. Jeltye is verkry en skaleringseksponente bepaal. ’n Nuwe metode vir die voorspelling van die verloop van die reaksie word voorgestel en vergelyk met resultate verkry deur middel van differensiël skanderingskalorimetrie.

Abstract

The use of a rheological technique in the determination of the curing kinetics of a reactive polyester powder coating

In this article a study of the curing process of carboxyl terminated polyester-triglycidyl isocyanurate systems is reported. A comparison is made between the generally used Differential Scanning Calorimetric methods and rheokinetic methods, using a parallel plate oscillating stress rheometer. Gel times were determined and scaling exponents calculated. A new method for the estimation of the extent of reaction is presented and compared with results obtained by means of differential scanning calorimetry

Patent foramen ovale does not have a negative impact on early outcomes in patients undergoing liver transplantation.

Science.gov (United States)

Alba, Ana Carolina; Verocai Flaman, F; Granton, J; Delgado, D H

2011-01-01

To identify the impact of the presence of patent foramen ovale (PFO) in patients undergoing liver transplantation. Twenty-seven pre-liver transplant patients who had a PFO (PFO group) were identified and compared with 61 patients without PFO (NoPFO group). Patients were matched according to age, gender and cause of liver disease. The diagnosis of PFO was made by transthoracic echocardiography prior to liver transplantation. Patient baseline characteristics and complications during the early post-transplant period were analyzed. The mean age in the PFO group was 47 ± 14 (range 18-68) yr and 50 ± 11 (range 12-65) yr in the NoPFO group. The PFO group had a mean model for end-stage liver disease (MELD) score of 15 ± 10 whereas in the NoPFO group the MELD score was 19 ± 10 (p = 0.08). There were non-significant differences in echocardiographic parameters between groups. Duration of mechanical ventilation and the incidence of neurological complications were similar. Thirty-day mortality rate was similar in both groups; only one patient in the NoPFO group died within the first 30 days post-transplantation. The presence of PFO in patients with end-stage liver disease undergoing liver transplantation does not appear to affect patient outcomes during the peri-operative period. © 2010 John Wiley & Sons A/S.

A mixed method thematic review: the importance of hope to the dying patient.

Science.gov (United States)

Broadhurst, Kathleen; Harrington, Ann

2016-01-01

To review the literature and investigate the meaning of hope to patients receiving palliative care and to examine the themes that foster hope in those patients. Hope is often linked to the future and is a significant factor for patients dealing with adversity, such as a terminal illness. The concept of hope is underreported in the literature. Mixed method thematic review. CINAHL, Scopus, PsychINFO, Informit, PubMed, Science Direct, ProQuest, Web of Science and Google Scholar online databases were searched using keywords and inclusion and exclusion criteria published between 2003-2013. Twelve qualitative articles were thematically analysed using Braun and Clarke's (2006) steps to ascertain major themes and sub-themes. On analysis, the remaining three mixed method studies were found to reflect the themes generated by the qualitative studies. Seven key themes that increased hope were found: disease status; positive personal relationships; positive character traits; quality of life; setting and achieving goals; spirituality/religion; and hope after death. The importance of hope to dying patients was established. Hope is a very complex and personal phenomena requiring hope-enhancing strategies to be individualized. More research is needed with groups whose culture, youth or type of illness may affect their ability to foster and maintain hope. © 2015 John Wiley & Sons Ltd.

Die kliniese kindersielkundige as diagnostikus1

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D. J. W. Strümpfer

1961-03-01

Full Text Available Die benaming „Kliniese Kindersielkunde” is nog onbekend en gevolglik betreklik onbemind. Dit is in 1951 die eerste keer gebruik. Die werk van die Kliniese Kindersielkunde is egter so oud as die werk van die algemene Kliniese Sielkunde, waarvan die geskiedenis gewoonlik teruggevoer word tot die begin van sielkundige toetsing vroeg in die tagtigerjare. Tot ’n aansienlike mate is hierdie vroeë werk op kinders uitgevoer, bv. dié van Galton en later die van Binet en Simon. Witmer het in 1896 die eerste sielkundige kliniek geopen en het ook die term „Kliniese Sielkunde” ingevoer; die meerderheid van sy pasiënte was egter ook kinders. Tot voor die Tweede Wêreldoorlog was klinies-sielkundige werk hoofsaaklik op kinders toegespits. Sedertdien het die kliniese sielkundige tot ’n belangrike mate toegetree tot die gebied van die diagnose en terapie van psigiese afwykings by volwassenes, tot so ’n mate dat in die gedagtes en geskrifte van baie werkers die terrein van die Kliniese Sielkunde byna tot werk met volwassenes beperk word.

‘Op de wijze van Kavafis’: Die voorbeeld van die digter uit Alexandrië

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Phil van Schalkwyk

2014-12-01

Full Text Available Die Griekse digter K.P. Kavafis (1863–1933 word wêreldwyd deur lesers sowel as skrywers besonder hoog geag. Hy het nie net van die grootste twintigste-eeuse skrywers beïnvloed nie,maar is vanweë die buitengewone vertaalbaarheid van sy werk ook betreklik sterk teenwoordig in die letterkunde van meer tale as slegs Grieks en Engels. Vir baie – veral gay lesers, skrywers en kunstenaars – besit Kavafis ’n voorbeeldstatus, ten opsigte van die letterkunde sowel asdie lewe. W.H. Auden het beweer dat dit wat Kavafis onderskei, sy stemtoon is, een wat ’n persoon met ’n unieke perspektief op die wêreld openbaar. Hierdie bydrae, wat deel is van ’nnavorsingsprojek oor idiolektiese skrywersidentiteit, is daarop gerig om die onderskeidende kenmerke van Kavafis se werk, sowel in terme van vorm as inhoud, opnuut te ondersoek. Dit word gedoen binne die raamwerk van die breë kritiese diskoers oor Kavafis en met verwysing na enkele manifestasies/voorbeelde van Nederlandse en Afrikaanse kritiese en kreatieweperspektiewe op sy poësie, met die doel om spesifiek lig te werp op die besondere soortwysheid wat in Kavafis se werk oorgedra word.

Dying or living?: The double bind.

Science.gov (United States)

Longhofer, J

1980-06-01

Describing the behaviors of terminally ill patients, their families and those charged with their care has received considerable attention during the past decade. This study of comprehensive cancer treatment and research facility indicates that the prevailing theory is limited to explanation at the intra-psychic level. In her work with hundreds of terminal cases, Dr. Elizabeth Kubler-Ross found that patients typically progress through five stages: 1) denial, 2) anger, 3) bargaining, 4) depression, and 5) acceptance. She concludes that the majority of her patients die in a stage of acceptance--a state of equanimity. Recently, scholars have claimed that this five stage scheme has limited applicability and may in fact contribute to the formalization of a dying person's behavior. This preliminary report proposes that the stage theory, if it has any descriptive validity, becomes meaningful only when used to describe behaviors occurring among patients, families, and medical practitioners. A plausible explanation of these behaviors is accomplished by examination of communication patterns containing the structure of paradox or double bind. Patients are forced to perceive realities about their physical conditions not as they appear to them, but as they are defined by those in their environment. This paper explores these communication patterns in relation to the structure of social relationships and the specific contents of messages being transmitted and received.

die kerk, maatskappy en vrye verenigings: 'n studie van die kerkorde ...

African Journals Online (AJOL)

Engelhard en Hofman 2001; PKN 2003). Die begrip “moderne gedifferensieerde samelewing”, saamgelees met 'n selfstandigheid in eie bevoegdheid, kom net so van Dooyeweerd af (1957:379; 1963:81). NGK-KO 1962 neem vorm aan in 'n tyd waarin. Dooyeweerd akademies op die kruin van die golf is – gemeet aan sy.

Die sprachnorm und die künstlerische sprache I. Tavčars in seinem werdegang

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Martina Orožen

1975-11-01

Full Text Available In dem ganzen Zeitraum vom 16. his zum 18. Jahrhundert hemühten sich die slovenischen Schriftsteller urn die sprachliche Richtigkeit und stilistische Voll­ kommenheit des Textes. Die praktischen Resultate dieser Bemühungen waren aller­ dings nicht einheitlich, weil auch·die theoretischen Ansichten in Bezug auf die Umständlichkeiten, in denen sich die Schriftsprache entwickelte, nicht einheitlich und so geklärt waren, wie es heutzutage ist. Die wechselseiten Beziehungen dieser Bestrehungen sind in gegenwärtigen Ahhandlungen dargestellt am sprachlichen Material eines einzigen, aher vornehmen Schriftstellers Ivan Tavčar. Die angefiihrte Durchsicht des sprachlichen Materials lässt schliessen, class sich der Schriftsteller Tavčar in seinen Werken nach den Normen der Schriftsprache richtete. Wenn er selhst diese Normen nicht immer heohachtete, so taten es die Redakteure und die Korrektoren der literarischen Zeitschriften. Die Normen hetrachtete er als etwas Verhindliches, doch unterordnete er sich nicht ahsolut allen Vorschriften, welche die Archaisierung der Sprache hezielten. Die slavischen Leihwörter verwendete er, wenn sie dem Sinne funktionell entsprachen. So verstand es, auch die nicht mehr lehendigen Glieder des sprachlichen Systems zu helehen und hildend zu entwickeln. Geschickt verwendete er alle Moglichkeiten des Duhlettierens sowohl in lexikalischer als auch in syntaktischer Hinsicht. Bei der Auswahl des sprachlichen Ausdruckes war für ihn die Funktion massgehend, weshalh in seinen Satzen sowohl die archaischen als auch die zeitgemässen sprachlichen Mittel stilistisch wertvoll erscheinen. Tavčars Werke zeigen von den Anfangen in den Siehzigerjahren his zum Ende des 19. Jahrhunderts eine heneidenswerte sprachliche Entwicklung. Trotz der heengenden Normen der Neunzigerjahre fühlte er sich ungehunden und leistete viel für die Entwicklung der Schriftsprache. In der Zeit, wo die Sprache in ihren Regeln eine höhere Stufe der

„Die kriminelle Frau“ – ein „Anwendungsfall“ für die Anomietheorie?

OpenAIRE

Gabriele Schmölzer

2008-01-01

Die von der Verfasserin vorgenommene Bearbeitung der Anomietheorie des Soziologen Robert K. Merton zielt darauf ab, „relevante Unterschiede zwischen Frauen und Männern zu finden, die den unterschiedlichen Anteil der Geschlechter bei der registrierten Kriminalität erklären können“ (S. 223). Dies gelingt insofern, als sie strukturelle Variablen herausarbeiten kann, die per se die Wahrscheinlichkeit von strafbarem Verhalten erhöhen. Das Geschlecht spielt dabei (nur) insofern eine Rolle, als der ...

Die afrikaner en sy pers*

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G. D. Scholtz

1963-03-01

Full Text Available Die versoek w at van u inrigting tot my gekom het om buitengewone professor in die Persw etenskap te word, was vir my deels vererend, m aar deels het dit my in 'n moeilike posisie gestel. Dit was vir my vererend, om dat dit gekom het van 'n universiteit m et wie se Christelik- Nasionale koers ek my ten voile kan vereenselwig. Dit was dan ook vir my vererend, om dat ek daardeur in staat gestel kan w ord om die volk w aartoe ek behoort, op 'n vir my nuwe terrein te dien. As sodanig is dit vir my im m ers m oontlik om ook ’n beskeie bydrae te lewer tot die geestelike vorm ing van die jeug van ons volk. Dit het my m oeilik geval om, w aar ek reeds die m iddeljarige leeftyd bereik het, nou vir die eerste maal as dosent op te tree, aangesien ek daarvan in die verlede nie die m inste kennis en ervaring opgedoen het nie. As joernalis rig ek my im m ers tot die breë publiek deur middel van die pen. As dosent m oet ek my deur middel van die mond tot die studente rig. Dit lê voor die hand dat die eise w at so aan my gestel word, totaal anders is as dié waar- aan ek oor 'n tydperk van m eer as 'n kw arteeu as joer­ nalis gewoond geraak het.

[Clinical characteristics and renal uric acid excretion in early-onset gout patients].

Science.gov (United States)

Li, Q H; Liang, J J; Chen, L X; Mo, Y Q; Wei, X N; Zheng, D H; Dai, L

2018-03-01

Objective: To investigate clinical characteristics and renal uric acid excretion in early-onset gout patients. Methods: Consecutive inpatients with primary gout were recruited between 2013 and 2017. The patients with gout onset younger than 30 were defined as early-onset group while the others were enrolled as control group. Clinical characteristics and uric acid (UA) indicators were compared between two groups. Results: Among 202 recruited patients, the early-onset group included 36 patients (17.8%). Compared with control group, the early-onset group presented more patients with obesity [13 patients (36.1%) vs. 22 patients (13.3%), Pgout early onset. Conclusion: The gout patients with early-onset younger than 30 present high serum and glomerular load of uric acid which might be due to obesity and relative under-excretion of renal uric acid.

Dimensional control of die castings

Science.gov (United States)

Karve, Aniruddha Ajit

The demand for net shape die castings, which require little or no machining, is steadily increasing. Stringent customer requirements are forcing die casters to deliver high quality castings in increasingly short lead times. Dimensional conformance to customer specifications is an inherent part of die casting quality. The dimensional attributes of a die casting are essentially dependent upon many factors--the quality of the die and the degree of control over the process variables being the two major sources of dimensional error in die castings. This study focused on investigating the nature and the causes of dimensional error in die castings. The two major components of dimensional error i.e., dimensional variability and die allowance were studied. The major effort of this study was to qualitatively and quantitatively study the effects of casting geometry and process variables on die casting dimensional variability and die allowance. This was accomplished by detailed dimensional data collection at production die casting sites. Robust feature characterization schemes were developed to describe complex casting geometry in quantitative terms. Empirical modeling was utilized to quantify the effects of the casting variables on dimensional variability and die allowance for die casting features. A number of casting geometry and process variables were found to affect dimensional variability in die castings. The dimensional variability was evaluated by comparisons with current published dimensional tolerance standards. The casting geometry was found to play a significant role in influencing the die allowance of the features measured. The predictive models developed for dimensional variability and die allowance were evaluated to test their effectiveness. Finally, the relative impact of all the components of dimensional error in die castings was put into perspective, and general guidelines for effective dimensional control in the die casting plant were laid out. The results of

Die reg van die homoseksuele ouer om beheer en toesig oor 'n kind ...

African Journals Online (AJOL)

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regtens seëvier sodat die grondwetlike verbod op onbillike diskriminasie teen mense op grond van hul seksuele georiënteerdheid so .... gerig teen die homoseksueel self en die homoseksuele daad wat hy/sy beoefen, maar dat daar ook gediskrimineer ..... Die Uniform Marriage and Divorce Act,. 60 aangeneem in verskeie ...

Mid-dose rate intracavitary therapy for uterine cervix cancer with a Selectron; An early experience of Osaka University

Energy Technology Data Exchange (ETDEWEB)

Teshima, Teruki; Inoue, Takehiro; Sasaki, Shigeru; Ohtani, Masatoshi; Kozuka, Takahiro; Inoue, Toshihiko; Ikeda, Hiroshi; Yamazaki, Hideya (Osaka Univ. (Japan). Faculty of Medicine); Murayama, Shigeyuki

1993-05-01

From May 1991 through September 1992, a total of 17 previously untreated patients with invasive uterine cervix cancer and with intact uterus were treated with mid-dose rate intracavitary therapy administered with a Selectron. Early primary tumor responses for all patients were complete. No acute or subacute radiation injury was observed except one patient with aplastic anemia who developed rectal ulcer. Two patients of Stage IIIb died from tumor because of local, paraaortic lymph node and distant metastases. Our early experience concluded that Selectron MDR can be used for cervix cancer patients as safely and effectively as our previously used high-dose rate machine. (author).

Die verband tussen waargenome leierskap en die vlak van outonomie binne spanverband

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A. Van der Heyde

2003-10-01

Full Text Available The relationship between perceived leadership and the level of outonomy in a team context remains a contemporary theme in the work environment and seemingly has a substantial influence on organisational success. This study attempted to ascertain the relationship between leadership and the level of outonomy in a team context. Two hundred and thirty (N=230 individuals, grouped into 56 teams from four South African companies participated in the study. The superordinate’s leadership style as well as the level of outonomy in the specific group was measured. Apart from the useful information obtained in comparison with international research, especially in terms of leadership data, the study did conclusively point out a significant correlation between leadership style and autonomy in team context. Opsomming Leierskap en selfgerigte spanfunksionering bly kontemporêre temas in die bedryfsmilieu, wat oënskynlik organisasiesukses wesenlik kan beïnvloed. Die doel van hierdie studie was om die waargenome verband tussen leierskap en die vlak van outonomie binne spanverband te bepaal. Tweehondered-en-dertig (N=230 individue, gegroepeer in 56 spanne vanuit vier Suid-Afrikaanse maatksappye het aan die studie deelgeneem. ‘n Meting van sowel die bogeskikte se leierskapstyl en die vlak van outonomie binne spanverband is verkry. Afgesien van bruikbare inligting rondom veral die leierskapdata in vergelyking met internasionale navorsing, het die studie ‘n beduidende verband tussen leierskapstyl en outonomie binne spanverband uitgewys.

Versoening tussen leerders: Is parallelmediumskole die antwoord op die rassismeprobleem?

OpenAIRE

Du Plessis, Elize; Marais, Petro

2017-01-01

Die Suid-Afrikaanse Grondwet stel dit duidelik dat enige vorm van diskriminasie nie toegelaat mag word nie. In ons skole beteken dit dat elke leerder ʼn reg het op goeie opvoeding en ʼn veilige skoolomgewing. Die fokus van hierdie navorsing is gerig op bestaande parallelmediumskole. Die uiteindelike vraagstuk is dus hoe multikulturele onderwys bevorder word en hoe rassisme aangespreek kan word? As teoretiese raamwerk is Kohlsberg se kognitiewe ontwikkelingsbenadering en Whitehouse se univerele ...

GODSBEELDE IN DIE LITURGIE

African Journals Online (AJOL)

15 Mei 2010 ... Biezeveld, de Boer, Brümmer, Muis. 2001; Brown 2006; Durand 2007). ... Wanneer sal hy weer in God se teenwoordigheid verskyn (vers 3)? Dié vraag is vol onsekerheid. (Schuman 2004:8). Sy onsekerheid ... God se volk en die enkeling in die geskiedenis het al die trou van God ervaar waarop die digter ...

Die metafoor by Breyten Breytenbach

African Journals Online (AJOL)

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23 Jun 2009 ... metafories, of spesifiek verwysend, te werk gegaan is. Tyd sou mens die hoofmotief van die bundel noem, tyd en geheue wat verbygaan: 1 en 2; en die einde van die storie wat gekom het: “fluit-fluit my storie is uit”. (Die tema van verbygaan word weer opgeneem in 8 en 9: die stories wat nooit meer gehoor ...

Attitudes and views of physicians and nurses towards cancer patients dying at home.

Science.gov (United States)

Porta, M; Busquet, X; Jariod, M

1997-03-01

The objective was to study attitudes and views of primary care professionals towards terminally ill cancer patients who die at home, using a cross-sectional study based in the health district of Manresa (province of Barcelona, Catalonia, Spain) of the Catalan Health Service, involving 151 primary health care professionals (87 physicians and 64 nurses). By using a self-responded anonymous questionnaire (response rate 89%) it was found that despite excellent motivation, primary care professionals reported widespread frustration and a poor opinion of the quality of care provided to terminally ill cancer patients. Attitudes and views clearly differ by age, sex and geographic setting. In the study area, most professional are reluctant to disclose the diagnosis of cancer, and this attitude is associated with a more favourable assessment of the support provided to the family. The idea that the most appropriate place of death is at home is strongly linked to the belief that patients ought to be informed of their illness, to feelings of frustration and to youth. These findings further substantiate the need and the potential for ample changes in terminal cancer care in Spain.

Die teologiese debat: Die waarde of betekenis daarvan

African Journals Online (AJOL)

Ego vero hoc libro non contuli sed asservi et assero, ac penes nullum vo- lo esse iudicium, sed omnibus suadeo, ut praestent obsequium. (M Luther, De servo arbitrio, 1525). 1. INLEIDING. In ons dae is dit hoe mode om oor alles debat te voer. Een van die towerwoorde van ons tyd, veral op die politiek-staatkundige terrein, ...

Cognitive Development in Infantile-Onset Pompe Disease Under Very Early Enzyme Replacement Therapy.

Science.gov (United States)

Lai, Chih-Jou; Hsu, Ting-Rong; Yang, Chia-Feng; Chen, Shyi-Jou; Chuang, Ya-Chin; Niu, Dau-Ming

2016-12-01

Most patients with infantile-onset Pompe disease die in early infancy before beginning enzyme replacement therapy, which has made it difficult to evaluate the impact of Pompe disease on cognitive development. Patients with infantile-onset Pompe disease can survive with enzyme replacement therapy, and physicians can evaluate cognitive development in these patients. We established an effective newborn screening program with quick clinical diagnostic criteria. Cognitive and motor development were evaluated using the Bayley Scales of Infant and Toddler Development-Third Edition at 6, 12, and 24 months of age. The patients who were treated very early demonstrate normal cognitive development with no significant change in cognition during this period (P = .18 > .05). The cognitive development was positively correlated with motor development (r = 0.533, P = .011). The results indicated that very early enzyme replacement therapy could protect cognitive development in patients with infantile-onset Pompe disease up to 24 months of age. © The Author(s) 2016.

Modelle in die onderrig van fisika

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J. J. A. Smit

1998-07-01

Full Text Available Die rol van modelle in die onderrig van fisika is sedert die vroeë tagtigerjare erken. In die onderrig word die absent op die kwantitaiewe aspekte van die vak geplaas, terwyl die kwatitatiewe aspekte min aandag kry.

Effectiveness of early adalimumab therapy in psoriatic arthritis patients from Reuma.pt - EARLY PsA.

Science.gov (United States)

Santos, Helena; Eusébio, Mónica; Borges, Joana; Gonçalves, Diana; Ávila-Ribeiro, Pedro; Faria, Daniela Santos; Lopes, Carina; Rovisco, João; Águeda, Ana; Nero, Patrícia; Valente, Paula; Cravo, Ana Rita; Santos, Maria José

2017-01-01

Objective To compare outcomes in psoriatic arthritis (PsA) patients initiating adalimumab (ADA), with short- and long-term disease duration and to evaluate the potential effect of concomitant conventional synthetic disease-modifying antirheumatic drugs (csDMARD) or glucocorticoids. Methods Analyses included adult PsA patients registered in the Rheumatic Diseases Portuguese Register (Reuma.pt) between June 2008-June 2016 who received ADA for ≥3 months. Psoriatic Arthritis Response Criteria (PsARC) response, tender and swollen joint count, inflammatory parameters, patient (PtGA) and physician global assessment (PhGA), Disease Activity Score-28 joints (DAS28), and Health Assessment Questionnaire Disability Index (HAQ-DI) were compared between patients with PsA) and those with ≥5 years of disease duration (late PsA). Time to achieving PsARC response was estimated using the Kaplan-Meier method. Results Of 135 PsA patients treated with ADA, 126 had information on disease duration (earlyPsA, n=41). PsARC response was achieved by 72.9% of the patients (88.0% early PsA vs 62.2% late PsA; P=0.022) after 3 months and by 85.4% after 24 months (100% early PsA vs 75.9% late PsA; P=0.044). Early PsA patients achieved significantly less painful joints (2.7 vs 6.7, p=0.006), lower mean C-reactive protein (0.5 mg/dL vs 1.3 mg/dL; P=0.011), and PhGA (18.3 vs 28.1; P=0.020) at 3 months. In the long term, early PsA patients also had fewer swollen joints (0.3 vs 1.7; P=0.030) and lower PhGA (6.3 vs 21.9; PPsA, respectively. Early PsA patients obtained PsARC response more rapidly than late PsA (3.8 and 7.4 months, respectively; P=0.008). Concomitant csDMARDs showed clinical benefit (2-year PsARC response, 88.3% vs 60.0%; P=0.044). Concomitant glucocorticoids had no effect on PsARC response over 2 years of follow-up. Persistence on ADA was similar in both groups. Conclusion Early PsA patients had a greater chance of improvement after ADA therapy and better functional outcome, and

Die huwelik in die eerste-eeuse Mediterreense wêreld (II): Huwelik ...

African Journals Online (AJOL)

p1243322

ingebed was, die vrou altyd in die eer van die man ingebed was, en .... contracted between families (segments of the same family) for a male and a female. ... marriage is on offspring ... this being the sole valid motivating factor in sexual encounters. ...... role in some measure only when she became the mother of a son.38.

DART-bid: dose-differentiated accelerated radiation therapy, 1.8 Gy twice daily. High local control in early stage (I/II) non-small-cell lung cancer

Energy Technology Data Exchange (ETDEWEB)

Zehentmayr, Franz; Wurstbauer, Karl; Deutschmann, Heinz; Sedlmayer, Felix [Landeskrankenhaus Salzburg, Univ.-Klinik fuer Radiotherapie und Radio-Onkologie, Univ.-Klinikum der Paracelsus Medizinischen Privatuniversitaet, Salzburg (Austria); Paracelsus Medizinische Privatuniversitaet, Institute for Research and Development of Advanced Radiation Technologies (radART), Salzburg (Austria); Fussl, Christoph; Kopp, Peter; Dagn, Karin; Fastner, Gerd [Landeskrankenhaus Salzburg, Univ.-Klinik fuer Radiotherapie und Radio-Onkologie, Univ.-Klinikum der Paracelsus Medizinischen Privatuniversitaet, Salzburg (Austria); Porsch, Peter; Studnicka, Michael [Landeskrankenhaus Salzburg, Univ.-Klinik fuer Pneumologie, Univ.-Klinikum der Paracelsus Medizinischen Privatuniversitaet, Salzburg (Austria)

2014-09-23

While surgery is considered standard of care for early stage (I/II), non-small-cell lung cancer (NSCLC), radiotherapy is a widely accepted alternative for medically unfit patients or those who refuse surgery. International guidelines recommend several treatment options, comprising stereotactic body radiation therapy (SBRT) for small tumors, conventional radiotherapy ≥ 60 Gy for larger sized especially centrally located lesions or continuous hyperfractionated accelerated RT (CHART). This study presents clinical outcome and toxicity for patients treated with a dose-differentiated accelerated schedule using 1.8 Gy bid (DART-bid). Between April 2002 and December 2010, 54 patients (median age 71 years, median Karnofsky performance score 70 %) were treated for early stage NSCLC. Total doses were applied according to tumor diameter: 73.8 Gy for < 2.5 cm, 79.2 Gy for 2.5-4.5 cm, 84.6 Gy for 4.5-6 cm, 90 Gy for > 6 cm. The median follow-up was 28.5 months (range 2-108 months); actuarial local control (LC) at 2 and 3 years was 88 %, while regional control was 100 %. There were 10 patients (19 %) who died of the tumor, and 18 patients (33 %) died due to cardiovascular or pulmonary causes. A total of 11 patients (20 %) died intercurrently without evidence of progression or treatment-related toxicity at the last follow-up, while 15 patients (28 %) are alive. Acute esophagitis ≤ grade 2 occurred in 7 cases, 2 patients developed grade 2 chronic pulmonary fibrosis. DART-bid yields high LC without significant toxicity. For centrally located and/or large (> 5 cm) early stage tumors, where SBRT is not feasible, this method might serve as radiotherapeutic alternative to present treatment recommendations, with the need of confirmation in larger cohorts. (orig.) [German] Die Standardbehandlung fuer nichtkleinzellige Bronchialkarzinome (NSCLC) im Stadium I/II ist die Operation, wobei Radiotherapie fuer Patienten, die nicht operabel sind oder die Operation ablehnen, als Alternative

Thrombocytosis portends adverse prognostic significance in patients with stage II colorectal carcinoma

DEFF Research Database (Denmark)

Guo, Tianhua; Krzystanek, Marcin; Szallasi, Zoltan Imre

2014-01-01

of the 78 patients (6.4%) with stage II cancer showed thrombocytosis, and four of these patients showed early recurrence and/or metastatic disease, resulting in shortened survival (they died within one year after surgery). The incidence of thrombocytosis increased to 12.2% and 20.6%, respectively...

Die postpolitische Stadt

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Erik Swyngedouw

2013-12-01

Full Text Available Die Polis ist tot, es lebe die kreative Stadt! Während die Stadt, zumindest in Teilen des städtischen Raums, blüht und gedeiht, scheint die Polis im idealisierten griechischen Sinn dem Untergang geweiht; in diesem Verständnis ist sie der Ort der öffentlichen politischen Auseinandersetzung und demokratischen Unterhandlung und somit eine Stätte (oft radikaler Abweichung und Unstimmigkeit, an der die politische Subjektivierung buchstäblich ihren Platz hat. Diese Figur einer entpolitisierten (oder postpolitischen und postdemokratischen Stadt im Spätkapitalismus bildet das Leitmotiv des vorliegenden Beitrags. Ich lehne mich dabei an Jacques Rancière, Slavoj Žižek, Chantal Mouffe, Mustafa Dikeç, Alain Badiou und andere Kritiker jenes zynischen Radikalismus an, der dafür gesorgt hat, dass eine kritische Theorie und eine radikale politische Praxis ohnmächtig und unfruchtbar vor jenen entpolitisierenden Gesten stehen, die in der polizeilichen Ordnung des zeitgenössischen neoliberalen Spätkapitalismus als Stadtentwicklungspolitik [urban policy] und städtische Politik [urban politics] gelten. Ziel meiner Intervention ist es, das Politische wieder in den Mittelpunkt der zeitgenössischen Debatten über das Urbane zu stellen. [...

Irradiation of the tumor bed alone after lumpectomy in selected patients with early stage breast cancer treated with breast conserving therapy

International Nuclear Information System (INIS)

Vicini, F.; Chen, P; Benitez, P.; Johnson, P.; Gustafson, G.; Horwitz, E.; McCarthy, K.; Lacerna, M.; Goldstein, Neil; Martinez, A.

1997-01-01

Purpose: We present the initial findings of our in-house protocol treating the tumor bed alone after lumpectomy with low dose rate (LDR) interstitial brachytherapy in selected patients with early stage breast cancer treated with breast conserving therapy (BCT). Materials and Methods: Since 1/1/93, 50 women with early stage breast cancer were entered into a protocol of tumor bed irradiation alone using an interstitial LDR implant. Patients were eligible if their tumor was an infiltrating ductal carcinoma ≤ 3 cm in maximum diameter, pathologic margins were clear by at least 2 mm, the tumor did not contain an extensive intraductal component, the axilla was surgically staged with ≤ 3 nodes involved with cancer, and a postoperative mammogram was performed. Implants were positioned using a template guide delivering 50 Gy over 96 hours to the lumpectomy bed plus a 1-2 cm margin. Local control, cosmetic outcome, and complications were assessed. Results: Patients ranged in age from 40 to 84 years (median 65). The median tumor size was 10 mm (range, 1-25). Seventeen patients (34%) had well differentiated tumors, 22 (4%) had moderately differentiated tumors, and in 11 (22%) the tumor was poorly differentiated. Forty-five patients (90%) were node negative while 5 (10%) had 1-3 positive nodes. A total of 23 (46%) patients were placed on tamoxifen and 3 (6%) received adjuvant systemic chemotherapy. No patient was lost to follow-up. The median follow-up is 40 months (range 29-50). No patient has experienced a local, regional, or distant failure. One patient died from colorectal carcinoma with no evidence of recurrent breast cancer. Good-to-excellent cosmetic results have been observed in all 50 patients (median cosmetic follow-up 36 months). No patient has experienced significant sequelae related to their implant. Conclusions: Early results with treatment of the tumor bed alone with a LDR interstitial implant appear promising. Long-term follow-up of these patients will be

De-tabooing dying control - a grounded theory study

Science.gov (United States)

2013-01-01

Background Dying is inescapable yet remains a neglected issue in modern health care. The research question in this study was “what is going on in the field of dying today?” What emerged was to eventually present a grounded theory of control of dying focusing specifically on how people react in relation to issues about euthanasia and physician-assisted suicide (PAS). Methods Classic grounded theory was used to analyze interviews with 55 laypersons and health care professionals in North America and Europe, surveys on attitudes to PAS among physicians and the Swedish general public, and scientific literature, North American discussion forum websites, and news sites. Results Open awareness of the nature and timing of a patient’s death became common in health care during the 1960s in the Western world. Open dying awareness contexts can be seen as the start of a weakening of a taboo towards controlled dying called de-tabooing. The growth of the hospice movement and palliative care, but also the legalization of euthanasia and PAS in the Benelux countries, and PAS in Montana, Oregon and Washington further represents de-tabooing dying control. An attitude positioning between the taboo of dying control and a growing taboo against questioning patient autonomy and self-determination called de-paternalizing is another aspect of de-tabooing. When confronted with a taboo, people first react emotionally based on “gut feelings” - emotional positioning. This is followed by reasoning and label wrestling using euphemisms and dysphemisms - reflective positioning. Rarely is de-tabooing unconditional but enabled by stipulated positioning as in soft laws (palliative care guidelines) and hard laws (euthanasia/PAS legislation). From a global perspective three shapes of dying control emerge. First, suboptimal palliative care in closed awareness contexts seen in Asian, Islamic and Latin cultures, called closed dying. Second, palliative care and sedation therapy, but not euthanasia

Numerical optimization of die geometry in open die forging

DEFF Research Database (Denmark)

Christiansen, Peter; Hattel, Jesper Henri; Bay, Niels

2013-01-01

This paper deals with numerical optimization of open die forging of large metallic ingots made by casting implying risk of defects, e.g. central pores. Different material hardening properties and die geometries are combined in order to investigate, which geometry gives rise to maximum closure...

Die adversatiewe stelsel van bewyslewering en die beste belang ...

African Journals Online (AJOL)

MJM Venter

weeg. Hierdie vraag word teen die agtergrond daarvan beoordeel dat veral dispute ..... restructuring family into the highly polarized positions of court-based dispute resolution.16. Talle alternatiewe om tekortkominge in die adversatiewe proses te ..... De Jong M "Mediation and Other Appropriate Forms of Alternative Dispute.

Early and 1-year outcomes of aortic root surgery in patients with Marfan syndrome: a prospective, multicenter, comparative study.

Science.gov (United States)

Coselli, Joseph S; Volguina, Irina V; LeMaire, Scott A; Sundt, Thoralf M; Connolly, Heidi M; Stephens, Elizabeth H; Schaff, Hartzell V; Milewicz, Dianna M; Vricella, Luca A; Dietz, Harry C; Minard, Charles G; Miller, D Craig

2014-06-01

To compare the 1-year results after aortic valve-sparing (AVS) or valve-replacing (AVR) aortic root replacement from a prospective, international registry of 316 patients with Marfan syndrome (MFS). Patients underwent AVS (n = 239, 76%) or AVR (n = 77, 24%) aortic root replacement at 19 participating centers from 2005 to 2010. One-year follow-up data were complete for 312 patients (99%), with imaging findings available for 293 (94%). The time-to-events were compared between groups using Kaplan-Meier curves and Cox proportional hazards models. Two patients (0.6%)--1 in each group--died within 30 days. No significant differences were found in early major adverse valve-related events (MAVRE; P = .6). Two AVS patients required early reoperation for coronary artery complications. The 1-year survival rates were similar in the AVR (97%) and AVS (98%) groups; the procedure type was not significantly associated with any valve-related events. At 1 year and beyond, aortic regurgitation of at least moderate severity (≥2+) was present in 16 patients in the AVS group (7%) but in no patients in the AVR group (P = .02). One AVS patient required late AVR. AVS aortic root replacement was not associated with greater 30-day mortality or morbidity rates than AVR root replacement. At 1 year, no differences were found in survival, valve-related morbidity, or MAVRE between the AVS and AVR groups. Of concern, 7% of AVS patients developed grade ≥2+ aortic regurgitation, emphasizing the importance of 5 to 10 years of follow-up to learn the long-term durability of AVS versus AVR root replacement in patients with MFS. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Die «ASEAN-Wirtschaftsgemeinschaft»

DEFF Research Database (Denmark)

Juego, Bonn

2014-01-01

Seit dem Ende der 1990er-Jahre verfolgt die ASEAN die Vision einer politischen, wirtschaftlichen und sozialen Gemeinschaft. Doch wie realistisch ist die Umsetzung eines solch ambitionierten Vorhabens vor dem Hintergrund der enormen Heterogenität der Region? ASEAN vereint Staaten auf...... Entwicklungsstufen, wie sie unterschiedlicher kaum sein können. Der Autor, Bonn Juego, nimmt die ASEAN Vision 2020 sowie die Debatten, die diesbezüglich in den einzelnen Ländern geführt werden, unter die Lupe. Er geht dem Potenzial des ASEANAnsatzes zu sozialer Teilhabe und wirtschaftlicher Verteilungsgerechtigkeit...

Exchange Transfusion and Leukapheresis in Pediatric Patients with AML With High Risk of Early Death by Bleeding and Leukostasis.

Science.gov (United States)

Creutzig, Ursula; Rössig, Claudia; Dworzak, Michael; Stary, Jan; von Stackelberg, Arend; Wössmann, Wilhelm; Zimmermann, Martin; Reinhardt, Dirk

2016-04-01

The risk of early death (ED) by bleeding/leukostasis is high in patients with AML with hyperleukocytosis (>100,000/μl). Within the pediatric AML-BFM (Berlin-Frankfurt-Münster) 98/04 studies, emergency strategies for these children included exchange transfusion (ET) or leukapheresis (LPh). Risk factors for ED and interventions performed were analyzed. Two hundred thirty-eight of 1,251 (19%) patients with AML presented with hyperleukocytosis; 23 of 1,251 (1.8%) patients died of bleeding/leukostasis. ED due to bleeding/leukostasis was highest at white blood cell (WBC) count >200,000/μl (14.3%). ED rates were even higher (20%) in patients with FAB (French-American-British) M4/M5 and hyperleukocytosis >200,000/μl. Patients with WBC >200,000/μl did slightly better with ET/LPh compared to those without ET/LPh (ED rate 7.5% vs. 21.2%, P = 0.055). Multivariate WBC >200,000/μl was of strongest prognostic significance for ED (P(χ(2) ) rate due to bleeding/leukostasis and is recommended at WBC >200,000/μl, and in FAB M4/M5 even at lower WBC. © 2015 Wiley Periodicals, Inc.

Relatives' Perspective on the Terminally Ill Patients Who Died after Euthanasia or Physician-Assisted Suicide: A Retrospective Cross-Sectional Interview Study in the Netherlands

Science.gov (United States)

Georges, Jean-Jacques; Onwuteaka-Philipsen, Bregje D.; Muller, Martien T.; van der Wal, Gerrit; van der Heide, Agnes; van der Maas, Paul J.

2007-01-01

This study used retrospective interviews with 87 relatives to describe the experiences of patients who died by euthanasia or physician-assisted suicide (EAS) in the Netherlands. Most of the patients suffered from cancer (85%). The relatives were most often a partner (63%) or a child (28%) of the patient. Before explicitly requesting EAS most…

Die hermeneutiek van gereformeerde kerkreg

Directory of Open Access Journals (Sweden)

Andries le Roux du Plooy

2012-10-01

Full Text Available Die artikel het op die belangrikheid en noodsaaklikheid van ‘n hermeneutiek vir die gereformeerde kerkreg gefokus. Die kerkregtelike dokument wat besonderlik ter sake was, is die kerkorde van die Gereformeerde kerke in Suid-Afrika, met sy besondere band met die Dordtse kerkorde van 1618 en 1619. Agtereenvolgens is aandag gegee aan die volgende aspekte soos (1 die eiesoortige aard van ‘n kerkorde as ‘n teologiese dokument en teks, in onderskeiding van regsdokumente; (2 die aard van die hermeneutiek van kerkreg; (3 enkele teorieë oor die interpretasie of uitleg van tekste, veral regstekste en (4 normatiewe vooronderstellings en reëls vir die interpretasie en verstaan van die teks en artikels van die kerkorde asook besluite van kerklike vergaderinge. Die gevolgtrekking was dat weinig indringende navorsing gedoen is oor die saak van hermeneutiek vir kerkreg, hoewel dit noodsaaklik is. Duidelike hermeneutiese reëls is gesuggereer en verduidelik, wat sou kon meehelp dat kerke en kerklike vergaderinge die artikels van die kerkorde asook besluite en reglemente wat daarop berus het, kan interpreteer en toepas. The hermeneutics of reformed church polity. The article focused on the importance and urgency of a design for reformed hermeneutics on church polity. The Church Order referred to in the article is the Church Order of the Reformed Churches in South Africa, which are closely related to the Church Order of Dordt of 1618 and 1619. The following aspects received attention namely (1  the unique character of a Church Order, in comparison to and distinguished from legal documents and statutes; (2 the character and nature of hermeneutics of church polity; (3 theories of interpretation in the common law tradition and their relevance to church polity and (4 normative presuppositions and marks for the interpretation and understanding of the text and articles of the Church Order, as well as the resolutions of church assemblies. It was found that

Die sterwende kindjie

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J.T. De Jongh van Arkel

1983-09-01

Full Text Available The thought of a child dying appears as an antithesis and thus the feelings evoked by the dying child are stronger than when older persons are dying. Around the child’s death bed there is no place for detached spectators and all become involved in caring for and supporting him. Caregivers also have a supporting responsibility towards the members of the child’s family.

Die invloed van drie kruisbestuiwers op die saadinhoud van Minneola tangelo (Citrus parodist x C reticulata

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H. J. Esterhuizen

1991-07-01

Full Text Available Die invloed van verskillende kruisbestuiwers (Clementine, Empress en Valencia op die gemiddelde saadinhoud van Minneo­la tangelo is ondersoek. Clementine en Empress as kruisbestuiwers het die grootste invloed op die gemiddelde saadinhoud van die vrugte gehad, terwyl dié van Valencia nie noemenswaardig was nie. Die gemiddelde saadinhoud van die vrugte het afgeneem met toename in afstand vanaf die kruisbestuiwer. Indien ’n beperking op die afstand tussen kultivar en kruisbestuiwer geplaas word, sal ’n groter persentasie vrugte aan uitvoerstandaarde ten opsigte van saadinhoud voldoen.

„Die kriminelle Frau“ – ein „Anwendungsfall“ für die Anomietheorie?

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Gabriele Schmölzer

2008-07-01

Full Text Available Die von der Verfasserin vorgenommene Bearbeitung der Anomietheorie des Soziologen Robert K. Merton zielt darauf ab, „relevante Unterschiede zwischen Frauen und Männern zu finden, die den unterschiedlichen Anteil der Geschlechter bei der registrierten Kriminalität erklären können“ (S. 223. Dies gelingt insofern, als sie strukturelle Variablen herausarbeiten kann, die per se die Wahrscheinlichkeit von strafbarem Verhalten erhöhen. Das Geschlecht spielt dabei (nur insofern eine Rolle, als der Frauenanteil in der besonders kriminalitätsgefährdeten Personengruppe geringer ist.

Die koninkryk van God as ’n kontekstueel-paradigmatiese sleutel vir Skrifberoep in die etiek

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De Wet Saaiman

2014-11-01

Full Text Available In die lig van die Christelike etiek is ’n beroep op die Skrif ’n sine qua non waar standpunte oor etiese vraagstukke ingeneem word. Deur ’n beroep op die Skrif te doen, is die probleem ongelukkig nie sonder meer opgelos nie. Hierdie artikel toon aan dat die begrip koninkryk van God as tema as ’n hermeneutiese vertrekpunt kan dien in die soeke na antwoorde op etiese vraagstukke. Daar word aangedui dat die koninkryk van God ’n noodsaaklike tema is omdat sekere wetsbepalings en kontekstueel bepaalde beginsels en norme in die voortsetting van die gedagte van die koninkryk van God in die Ou en Nuwe Testament ingebed is. Daar is egter ook sekere voorskrifte binne die teokratiese bestel wat vir die volk Israel in hulle spesifieke konteks gegee is wat nie noodwendig direk in die hedendaagse samelewingskonteks kan en mag toegepas word nie. Die boodskap van die Skrif moet dus op ’n verantwoordelike en geldige wyse gekonstateer word en effektief aan die moderne samelewing oorgedra word. The kingdom of God as a contextual paradigmatic key for using Scripture in ethics. The use of Scripture is, in light of Christian ethics, a sine qua non when positions with regard to ethical problems are assumed. A simple interpretation of Scripture does not necessarily settle the problem. This article shows that the concept kingdom of God as a theme can serve as a hermeneutical point of departure in the search for answers to ethical questions. It is shown that the kingdom of God is a necessary theme due to the fact that certain legal stipulations and contextual based principles and norms are embedded in the idea of the kingdom of God in the Old and New Testament. There are also certain prescriptions within the theocratic system of Israel in its specific context that may not and cannot be directly applied to the modern day societal context. The message of the Bible must thus be established in a responsible and valid way, and communicated effectively to modern

Cerebral oxygen metabolism in patients with early Parkinson's disease

DEFF Research Database (Denmark)

Borghammer, Per; Cumming, Paul; Østergaard, Karen

2012-01-01

) and cerebral blood flow (CBF) PET scans from PD patients and healthy controls. MATERIALS AND METHODS: Nine early-stage PD patients and 15 healthy age-matched controls underwent PET scans for quantitative mapping of CMRO(2) and CBF. Between-group differences were evaluated for absolute data and intensity...... in spatially contiguous cortical regions in early PD, and support the hypothesis that ETC dysfunction could be a primary pathogenic mechanism in early PD....

Personeelbestuur as toepassingsgebied van die bedryfsielkunde met verwysing na die implikasies wat dit inhou vir die arbeidsituasie in Siud-Afrika

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W. S. De Villiers

1976-11-01

Full Text Available Industrial Psycho logy is a relatively young discipline. In recent years, however, it has been characterised by accelerated development and today covers various areas of application. The most rapid progress in this respect was perhaps experienced in the field of personnel management. Personnel management can be defined as the planning, organising, directing and controlling of the procurement, development, compensation, integration and maintenance of people for the purpose of contributing to organisational goals. In the past some personnel departments rendered merely screening services which included little more than preliminary interviews of applicants, wage and salary administration and other routine administrative work. Personnel management has, however, undergone drastic changes in which the trend has been clearly towards broader and more important assignments. From narrowly prescribed chores, its responsibilities have grown wider and deeper. The personnel manager of the modern organisation is undisputably a participant in top management, where he provides leadership in developing policies and programmes for manpower management. Opsomming Wetenskaplike personeelbestuur kan gedefinieer word as die beplanning, organisasie, rigtinggewing en kontrole van die voorsiening, ontwikkeling, vergoeding, integrasie en instandhouding van personeel om sodoende 'n bydrae tot organisasiedoelbereiking te lewer. Waar die vroegste "personeeldepartemente" hul hoofsaaklik bemoei het met aktiwiteite soos rekrutering en keuring van werkers, loon- en salarisadministrasie en ander roetine en administratiewe take, het daar in die laaste aantal jare drastiese veranderinge na vore gekom. Die personeeldepartement het tans heelwat meer komplekse take van 'n bestuurs- en uitvoerende aard. Die senior personeelamptenaar is dan ook tans deel van die topbestuur van die onderneming waar hy leiding gee in die ontwikkeling van beleid en programme vir doeltreffende

Determination of spent nuclear fuel assembly multiplication with the differential die-away self-interrogation instrument

Energy Technology Data Exchange (ETDEWEB)

Kaplan, Alexis C. [Los Alamos National Laboratory, Los Alamos, NM 87544 (United States); Department of Nuclear Engineering and Radiological Sciences, University of Michigan, Ann Arbor, MI 48109 (United States); Henzl, Vladimir; Menlove, Howard O.; Swinhoe, Martyn T.; Belian, Anthony P. [Los Alamos National Laboratory, Los Alamos, NM 87544 (United States); Flaska, Marek; Pozzi, Sara A. [Department of Nuclear Engineering and Radiological Sciences, University of Michigan, Ann Arbor, MI 48109 (United States)

2014-09-01

We present a novel method for determining the multiplication of a spent nuclear fuel assembly with a Differential Die-Away Self-Interrogation (DDSI) instrument. The signal, which is primarily created by thermal neutrons, is measured with four {sup 3}He detector banks surrounding a spent fuel assembly. The Rossi-alpha distribution (RAD) at early times reflects coincident events from single fissions as well as fission chains. Because of this fact, the early time domain contains information about both the fissile material and spontaneous fission material in the assembly being measured. A single exponential function fit to the early time domain of the RAD has a die-away time proportional to the spent fuel assembly (SFA) multiplication. This correlation was tested by simulating assay of 44 different SFAs with the DDSI instrument. The SFA multiplication was determined with a variance of 0.7%.

Die Formatestadt

OpenAIRE

Günter Trojan

2013-01-01

Zu Zeiten von DV oder VHS (wer kennt das eigentlich noch?) war die Welt noch in Ordnung: Da hatte man eine Kassette in der Hand und wenn das passende Gerät gefunden wurde konnte man das Video auch abspielen. Günter Trojan diskutiert die Geschichte und Gegenwart unterschiedlicher Videoformate ...

Die pastorale sielkundige as diakonale pastor

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A. J. Smuts

1985-08-01

Full Text Available In die bedieningspatroon van die Ned. Geref. Kerk het die pastorale sielkundige die afgelope aantal jare steeds meer op die voorgrond begin tree. Hy is egter 'n problematiese figuur, wie se identiteit van meer as een kant onder bespreking is. In ander lande, selfs in die VSA waar die kerk veel gebruik maak van die sielkunde, is dit moeilik om 'n presiese parallel vir hom te vind. Sowel binne as buite die kerk word hy deur sommige bevraagteken. Daarom is dit noodsaaklik om vanuit die teologie te kyk na die werk wat hy doen.

DIE SAGD - SY ONTSTAAN EN ONTWIKKELING

African Journals Online (AJOL)

31 Okt 1977 ... stelling van 'n higiene afdeling het in 'n belang- rike behoefte voorsien. Die pligte van die SAGO het dus op hierdie stadium die ondersoek van soldate, die sanita- sie van kampe, die verpleging van pasiente in militere hospitale en die opleiding van lede be- hels. 'n Hoogtepunt was die opening van die.

Uitdagings in die onderrig van evolusie in die lewenswetenskappeklaskamer

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Josef J. de Beer

2013-02-01

Full Text Available In hierdie artikel skryf die outeurs oor navorsing wat hulle gedoen het oor onderwysers se siening van die onderrig van evolusie, wat in 2008 as ’n tema in lewenswetenskappe in Suid-Afrikaanse skole ingesluit is. Hierdie vernuwing in die kurrikulum is met gemengde reaksies begroet. Terwyl sommige onderwysers dit met entoesiasme onderrig, is baie gekant teen die onderrig van evolusie. Die artikel is gebaseer op ’n navorsingsprojek waarby 255 onderwysers betrek is. Vraelyste is gebruik om kwalitatiewe data, wat vir diskoers ontleed is, in te samel. Die diskoers van die onderwysers het getoon dat ’n groot getal van hulle nie hul onderrigopdrag kan versoen met hul geloof nie en konsepte oor evolusie as ‘feite’ verduidelik, maar seker maak dat evolusie as ’n teorie gediskrediteer word. Dit het verreikende implikasies vir sowel onderwyseropleiding as kurrikulumontwikkeling. Konseptuele veranderingsteorie word as ’n lens gebruik om na hierdie problematiek te kyk. Challenges in the teaching of evolution in the life sciences classroom. In this article the authors report on research that was conducted about teachers’ views on evolution, which was introduced as a theme in the school life sciences curriculum in 2008. This innovation in the curriculum has been met with mixed reactions. Whereas some teachers embrace this new theme, many teachers are opposed to the teaching of evolution. The article reports on an inquiry that was conducted amongst 255 teachers and in which survey questionnaires were used to collect qualitative data, which was analysed for its discourse. The discourse of the teachers shows that many of them cannot reconcile their religious faith with their teaching and that they may teach the ‘facts’ of evolution, but make sure that they discredit evolution as a theory. This raises serious concerns about teacher education and curriculum development. The authors examine these issues through the lens of conceptual change

Au XXIème siècle, qui sont les patients dialysés souffrant d'une hyperparathyroïdie secondaire sévère ? Cohorte prospective, multicentrique de patients dialysés, incidents pour l'hyperparathyroïdie secondaire. EPHEYL (Etude PHarmacoEpidémiologique de l'hYperparathyroïdie secondaire en Lorraine)

OpenAIRE

Thomas-Laurain , Emmanuelle

2013-01-01

Non disponible / Not available; L'hyperparathyroïdie secondaire (HPTS) est une complication fréquente de l'insuffisance rénale chronique. Mais son diagnostic et sa prise en charge sont encore complexes et mal codifiés. Dans notre étude, nous faisons l'hypothèse que la population de patients atteints d'HPTS est hétérogène. L'objectif de notre étude était d'identifier des sous-groupes de patients présentant un profil d'HPTS commun à partir des données cliniques, biologiques et thérapeutiques di...

Die linke und die rechte todesauffassung: Zur kritik einer antitotalitären thanatologie

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Kuljić Todor

2011-01-01

Full Text Available Hier sind die tiefere Schichten in der Todesauffassung bei der Ideologien der Linke und der Rechte untersucht und die Frage nach ihren antitotalitären Glei­chsetzung in punkto Betrachtung gestellt. Zu diesem Zweck werden verschiedene Opfersauffassungen und verschiedene Heilshoffnungen, aber auch verschiedene Ideolosierungen des Todes im Faschismus und Sozialismus gelegt, verglichen und in einen breiteren Kontext gestellt. Daraus folgt der starke Kluft zwischen linken und rechten Auffassung von normalen Lebensumständen. Die Herrschaft (nicht der Gott formiert und auf ideologische Weise nützt Angst vom Tod. Für die kritische Theorie ist die Gegenüberstellung von Leben und Tod ein Teil von emanzipatorische Praxis und Kapitalismuskritik. Die dargelegte Kritik der neoliberalen Thanathologie ist ein Teil von dieser Absicht.

Die konteks vir die keuse van geriefsvoedsel van bepaalde ...

African Journals Online (AJOL)

Seugnet

70. Die konteks vir die keuse van geriefsvoedsel van bepaalde beroepsvroue *. Martha Kok en Priscilla Botha. ABSTRACT. The purpose of this research is to understand and describe the context in which career women choose, purchase and use convenience food (CF). A person is rarely isolated from or unaffected by.

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Directory of Open Access Journals (Sweden)

Günter Trojan

2013-06-01

Full Text Available Zu Zeiten von DV oder VHS (wer kennt das eigentlich noch? war die Welt noch in Ordnung: Da hatte man eine Kassette in der Hand und wenn das passende Gerät gefunden wurde konnte man das Video auch abspielen. Günter Trojan diskutiert die Geschichte und Gegenwart unterschiedlicher Videoformate ...

DIE SPRACHE VON "BAŠĆANSKA PLOČA" (DIE STEINTAFEL VON BAŠKA

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Stjepan Damjanović

1990-01-01

Full Text Available In einer Mehrzahl von Abhandlungen über Bašćanska ploča berücksichtigen die Verfasser auch die Sprache, in der Regel kurz, nur in einem oder zwei Sätzen. Die größten Bemühungen sind auf die Rekonstruirung der unlesbaren Teilen gerichtet, dagegen nicht weinger interessanter lesbarer Teil regte eine Sprachanalyse selten an. Gewöhnlich wird festgestellt, daß die Tafel in der kroatischen Sprache geschrieben ist, während die philologisch gut unterrichtete Forscher vermeiden diesartige Nenunngen, indem sie das Vorhandensein der altslawischen und altkroatischen Sprachelemente entdeckten. Man versuchte noch nicht in einer Analyse sprachliche Grundschichte und darauf geschichtete Sprachelemente zu bestimmen. Nach dem ersten Eindruck wurde bestimmt, ob es sich um "die kroatische Srpache mit den Elementen der alten slawischen liturgischen Sprache" handelt oder um "die altslawische in der manche kroatische Spracheigenschaften hereingekommen sind". Die Analyse mancher Spracheinzelheiten (Halblaute und "Jat" weist auf altslawische Grundschicht hin. Der Verfasser hat sich trotzdem nicht entschieden den Fachausdruck "kroatische Redaktion des altslawischen" zu verwenden, weil er neue Analyse und neue Begriffsbestimmungen als nötig hält, wie z.B. "Redaktion", "Rezension" usw, um mit Sicherkeit sagen zu können, ob es um kroatische Redaktion des altslawischen oder um andere Formen der altslawischen - alt kroatischen Interferenz geht.

Sal die Era van Aquarius met ’n “skrikkelsprong” in die millennium tot sy reg kom

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D. P. Smits

2001-09-01

Full Text Available Waar ons nou die einde van die 2de millennium AD nader, het dit duidelik geword dat daar heelwat verwarring heers oor hoe en waarom ons kalender opgestel is soos dit is. Die lengte van ’n jaar en van die astronomiese eeu word beide gedefinieer aan die hand van die posisie van ’n bepaalde punt aan die hemel, wat bekend staan as die Eerste punt van Aries. Deurdat hierdie punt met betrekking tot die sterre-agtergrond beweeg, skep dit probleme om sterrekundige gebeurtenisse, wat die seisoene bepaal, aan ’n vaste datum in ons kalender te koppel. Die Katolieke Kerk se wens om Paasfees op ’n datum te vier wat deur spesifieke astronomiese gebeurtenis se bepaal word, het in die 16de eeu gelei tot die implementering van die kalender wat nou internasionaal in gebruik is.

Author: T Bekker DIE MOONTLIKE REGSHERVORMING VAN DIE ...

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RV

So ver terug as die vroeë twintigste eeu het die Appèlhof in Cassiem v Standard. Bank of SA Ltd,1 .... 838; Capital Building Society v De Jager 1963 3 SA 381 (T); Smit v Walles 1985 2 SA 189 (T). 196-198. 18 ...... moeilik kon regverdig.97. Ons howe het tot op hede gehuiwer om 'n algemene plig van goeie trou ten aansien.

Professional tears: developing emotional intelligence around death and dying in emergency work.

Science.gov (United States)

Bailey, Cara; Murphy, Roger; Porock, Davina

2011-12-01

This paper explores how emergency nurses manage the emotional impact of death and dying in emergency work and presents a model for developing expertise in end-of-life care delivery. Care of the dying, the deceased and the bereaved is largely conducted by nurses and nowhere is this more demanding than at the front door of the hospital, the Emergency Department. Whilst some nurses find end-of-life care a rewarding aspect of their role, others avoid opportunities to develop a relationship with the dying and bereaved because of the intense and exhausting nature of the associated emotional labour. Qualitative study using unstructured observations of practice and semistructured interviews. Observation was conducted in a large Emergency Department over 12 months. We also conducted 28 in-depth interviews with emergency staff, patients with terminal illnesses and their relatives. Emergency nurses develop expertise in end-of-life care giving by progressing through three stages of development: (1) investment of the self in the nurse-patient relationship, (2) management of emotional labour and (3) development of emotional intelligence. Barriers that prevent the transition to expertise contribute to occupational stress and can lead to burnout and withdrawal from practice. Despite the emotional impact of emergency deaths, nurses who invest their therapeutic self into the nurse-patient relationship are able to manage the emotional labour of caring for the dying and their relatives through the development of emotional intelligence. They find reward in end-of-life care that ultimately creates a more positive experience for patients and their relatives. The emergency nurse caring for the dying patient is placed in a unique and privileged position to make a considerable impact on the care of the patient and the experience for their family. This model can build awareness in managing the emotive aspects involved in care delivery and develop fundamental skills of nursing patients near

'n Kwalitatiewe ondersoek na die invloed van aspekte van die ...

African Journals Online (AJOL)

S Blignaut

ISSN 0378-5254 Journal of Family Ecology and Consumer Sciences, Vol 26: No1, 1998. 15 ...... van byvoorbeeld die televisie en gedrukte media 'n invloed op die .... fashion promotion and advertising. New York. ... Consumer behaviour to-.

Young infants with severe tetralogy of Fallot: Early primary surgery versus transcatheter palliation.

Science.gov (United States)

Wilder, Travis J; Van Arsdell, Glen S; Benson, Lee; Pham-Hung, Eric; Gritti, Michael; Page, Alexandra; Caldarone, Christopher A; Hickey, Edward J

2017-11-01

Infants with severe tetralogy of Fallot may undergo (1) early primary surgical repair (EARLY) or (2) early transcatheter palliation (CATH) before delayed surgical repair. We compared these strategies with (3) elective single-stage tetralogy of Fallot repair (IDEAL). From 2000 to 2012, 453 children underwent tetralogy of Fallot repair (excluding systemic-pulmonary shunts), including 383 in the IDEAL (75%), 42 in the EARLY (9%), and 28 in the CATH (6%) groups. IDEAL repair at The Hospital for Sick Children occurs after 3 months. Risk-adjusted hazard analysis compared freedom from surgical or catheter reintervention. Somatic size, branch pulmonary artery size, and right ventricle systolic pressure were modeled using 2780 echocardiogram reports via mixed-model regression. CATH involved right ventricular outflow tract stent in 18 patients, right ventricular outflow tract balloon in 9 patients, and ductal-stent in 1 patient. Three patients died (1 per group). Risk-adjusted freedom from surgical reoperation was 89% ± 4%, 88% ± 5%, and 85% ± 6% for the IDEAL, EARLY, and CATH groups, respectively, at 10 years. Patients in the EARLY and CATH groups had similar reoperation rates, except for neonates (tetralogy of Fallot. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

DART-bid: dose-differentiated accelerated radiation therapy, 1.8 Gy twice daily. High local control in early stage (I/II) non-small-cell lung cancer

International Nuclear Information System (INIS)

Zehentmayr, Franz; Wurstbauer, Karl; Deutschmann, Heinz; Sedlmayer, Felix; Fussl, Christoph; Kopp, Peter; Dagn, Karin; Fastner, Gerd; Porsch, Peter; Studnicka, Michael

2015-01-01

While surgery is considered standard of care for early stage (I/II), non-small-cell lung cancer (NSCLC), radiotherapy is a widely accepted alternative for medically unfit patients or those who refuse surgery. International guidelines recommend several treatment options, comprising stereotactic body radiation therapy (SBRT) for small tumors, conventional radiotherapy ≥ 60 Gy for larger sized especially centrally located lesions or continuous hyperfractionated accelerated RT (CHART). This study presents clinical outcome and toxicity for patients treated with a dose-differentiated accelerated schedule using 1.8 Gy bid (DART-bid). Between April 2002 and December 2010, 54 patients (median age 71 years, median Karnofsky performance score 70 %) were treated for early stage NSCLC. Total doses were applied according to tumor diameter: 73.8 Gy for 6 cm. The median follow-up was 28.5 months (range 2-108 months); actuarial local control (LC) at 2 and 3 years was 88 %, while regional control was 100 %. There were 10 patients (19 %) who died of the tumor, and 18 patients (33 %) died due to cardiovascular or pulmonary causes. A total of 11 patients (20 %) died intercurrently without evidence of progression or treatment-related toxicity at the last follow-up, while 15 patients (28 %) are alive. Acute esophagitis ≤ grade 2 occurred in 7 cases, 2 patients developed grade 2 chronic pulmonary fibrosis. DART-bid yields high LC without significant toxicity. For centrally located and/or large (> 5 cm) early stage tumors, where SBRT is not feasible, this method might serve as radiotherapeutic alternative to present treatment recommendations, with the need of confirmation in larger cohorts. (orig.) [de

Metodes in die Christelike etiek

African Journals Online (AJOL)

The basic question in Christian ethics is not primarily. 'What should I do?' The basic question is rather ' ... should therefore be accepted as being part of the method used in Christian ethics. 1. INLEIDEND ..... aan die kant van die onderdrukte' verkondig word, word die Christen opgeroep om horn te skaar aan die kant van die ...

DIE EKSISTENSIEFILOSOFIE VAN KARL JASPERS. ENKELE ...

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Test

Kierkegaard en Nietzsche, Max Weber en Dilthey, om maar enkeles te noem, en 5.) Jaspers se persoonlike beskouing oor die roe ping en die taak van die Filosofie, sy aanvoeling van die filosofiese problematiek en sy grondhouding teenoor die eksistensiële verbonden- hede. Die woord van Fichte, naamlik dat die Filosofie ...

Pentateugtradisies in die boek Hosea

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om te bepaal of die verwysing na 'n gebeure te doen het met die verre verlede of met die .... Hosea 2:1-2 JHWH se trou aan sy beloftes. ... dat huile na Egipte sal terugkeer. Die presiese bedoeiing van die woorde 'huile sal terugkeer na Egipte' is omstre- de. Kommentatore soos Rudolph meen dat dit verstaan moet word as ...